Vaccine Nationalism

Article from 1919 (mcmxix.org), the new journal of the North American affiliates of the ICT.

Submitted by Internationali… on April 9, 2021

Introduction

At the time this is being written, nearly one year has passed since the first cases of COVID-19 were reported. Often it can feel as if everything has changed since. The initial period of lockdown after the failure to contain the virus cratered the global economy, and while the markets appear to have rebounded, the working class sits upon an eviction time-bomb while lockdowns have made a come-back in the wake of an even larger wave of infections and deaths than the one in March 2020. The system proved resilient to the destruction of the service economy, so long as commodity production continues. Still, there is a foreboding in the United States that the commodities will no longer arrive on doorsteps, that there will be no tenants to receive them, as the impact of joblessness has only been pushed further into the future by eviction moratoriums set to expire. So, while we feel at present that life has been turned upside-down, we may not yet fully understand what that will look like. With a year of continuous gloom met with worldwide protest, many have put their faith in science to end this nightmare. That is, if there is an effective and safe vaccine that can be administered to produce herd immunity (not of the Swedish variety!), then we can begin to resume life “as normal”, in which case we will still need to figure out what to do about 10 months back-rent.

Even in the life-altering period of early lockdown, researchers across the globe began their search for both treatments and for a vaccine. The treatments, as was hoped, would help reduce mortality and morbidity, perhaps shorten the illness duration, while the vaccine was the golden ticket to putting the pandemic behind us and letting capitalism continue untrammeled by such burdens as “public health”. As it had turned out, our current nemesis, SARS-CoV-2, is related to a somewhat deadlier but less infectious SARS-CoV. This earlier virus rose and fell quickly in world consciousness in 2002-4, but ultimately did not become endemic — that is, just another infection people throughout the population contract. Despite the high mortality, the threat of SARS returning, or the danger of it mutating to be more virulent or infectious, vaccine trials that did begin were eventually closed out, with no progress made toward a viable and safe vaccine for humans.(1) The problem, of course, is that a vaccine for a disease no one presently has surely has no profit potential. Even if it did, trials for vaccines benefit from active spread of a virus by making it possible to assess efficacy. Still, this lack of research and investment in SARS 1.0 meant that when it became apparent that COVID-19 would not go away, the fifteen years to prepare were largely wasted.

Capitalism has produced relative abundance of goods, and technological progress that outstrips past social relations. However, cutting edge technology and thousands of the most brilliant minds were hampered by the sort of systemic disordered priorities of a system built for profit. Even in the world’s best funded laboratories, research in vaccines has appeared to languish throughout the 21st century. After witnessing a mad dash to produce a vaccine for a virus actively leaving bodies in its wake, it becomes apparent that such progress was always possible, it just simply was not important — until it was. When crisis befalls our capitalist system, hindsight is always crystal clear. And while it is all-too-likely that the bourgeois states and the world capitalist economy will survive this crisis, especially now that vaccines have been approved and are currently being administered, we would benefit from close examination of the process that got us here, to better understand the ways in which, simply put, this all could have gone a lot more smoothly.

The focus of this examination is the process of a capitalist system in crisis, and the goal is to understand how it responds to crisis generally. We would benefit from an understanding that there are parallels between how nations shore up their economy when they are struck by a financial meltdown, or when they are beset by a student debt time bomb, or when a dangerous particle cloaked in spiky proteins empties city centers. These nations do not operate as singular, self-reliant individuals. They operate in a manner that is conducive to global capitalism. Both the state and private sectors work in tandem to ensure growth of the national capital. In capitalism in the contemporary era, the illusion of national self-interest is dispelled by the reality of a global capitalist-imperialist system. And in this system, nations compete over resources, hoping to find new markets, or to off-load finance capital to bring growth to stagnating economies at home. What this pandemic has done, effectively, is disrupt this orderly process of capitalist expansion. The crisis for the capitalist class is not the fear of getting sick (especially whether you get sick). Far from it. The crisis capitalists witnessed was in accumulation of capital.

As we mentioned in a previous article(2), at the onset of the pandemic, the state would move quickly to do anything in its power to prevent internal market collapse. When crisis strikes, there is always room for state planning and even state production of commodities. The myth that “the private sector does it better” falls away when there is no longer time to debate. In a pandemic of this magnitude, it appeared initially that a public-private partnership emerged in every nation that could afford it. Each of these countries began attempting to either ramp up production of personal protective equipment (PPE), or to find supplies if they could not make their own. National stockpiles were liquidated and a bidding war for materials ensued.(3) In normal capitalist orthodoxy, competition is a lovely thing. In times of great crisis, doctors re-use masks and nurses wear trash bags. At any rate, states taking a more direct role in stockpiling goods in an emergency is nothing new. The scale of these measures illustrated the reality that the market and the state are not opponents. On the contrary, this great competitive battle between nations to get medical supplies provided us with two lessons. First, it is a glimpse at the efforts the state is willing to take when capital is under threat. And second, it reveals that states will be forced to compete and to favor their own national capital over cooperation within the capitalist framework. It is not a coincidence that radical measures were taken after the initial market downturn, only to be ramped up to record proportions once the global markets vaporized.(4)

While the world was shutting down, and industrial production was being re-routed to medical supplies, another major project was underway. Researchers looked at all available information regarding vaccines for viruses similar to COVID-19, and began searching for a vaccine. Nations with the infrastructure and resources to develop vaccines began rapidly funding and mobilizing these efforts. In January, researchers from Wuhan provided the genetic sequence for the virus for testing and research purposes.(5) Talk of a vaccine came in late February, early enough that most of the world was barely paying attention.(6) This news was met with little fan-fare, but it is important to note that this relatively new and untested type of mRNA vaccine was created within only 42 days. And in quick succession, several other vaccine candidates would arrive in Russia, China, the United Kingdom, and France. In this early stage, researchers had free access to data from one another, and any idea of competition was likely not at the forefront of their minds.

There are, of course, many hurdles a brand-new vaccine must overcome to be distributed, mainly testing, approval, and distribution. Those hurdles would exist under virtually any context. However, over the course of the next several months, state and capitalist priorities shifted. In a short time, research went from open-access to highly secretive. Pharmaceutical companies not only wanted to protect their progress from the prying eyes of competitors who could undercut them in the market in the months ahead, but nation states took an active role in pushing the vaccines to market by any means necessary, with the goal of being first. This seemingly humanitarian goal of providing for the public health became distorted by the nature of imperialist capitalism. We have become witness to perhaps three terrible waves of infection and death, while most of the world’s population finds itself wondering if the vaccine is even safe to take, or if the vials of vaccine will meander their way through the market in time for them to receive their dose. At a moment where humanity should be celebrating (at least distantly) one of our greatest triumphs, there is a sense of lingering doubt in a brighter future.

Imperialism in the 21st century

The goal of this assessment of the international response to the pandemic is to use deductive reasoning to help understand why, from the very onset, the mitigation efforts and vaccine development and deployment have been botched. To do this we must examine what makes capitalism of the 21st century operate, and for this to be understood, we must understand imperialism. Bukharin’s analysis of imperialism in the early 20th century paved the way for the modern understanding of capitalism in its imperialist phase.(7) He understood that the nation state becomes a mediator for further capitalist accumulation as total national capital becomes highly developed. As the nation’s prosperity becomes intertwined with the success of its industry reliant on regionally specific resources, expansion into further territories ensures both that resources can be obtained, and that finance capital can be invested in agriculture, mining, and infrastructure. Bukharin argued that the international nature of the capitalist market collides with the national interest, leading to conflict. In an effort to explain the world he lived in, one which was unraveling amid a world war, he collected data on everything from production to defense budgets to illustrate that what was happening was indeed the product of a new capitalist imperialism. We will use a similar method, to prevent taking for granted that imperialism is the order of the current day, just as it was in Bukharin’s lifetime.

The United States (and sometimes all of NATO) is often identified as the imperialist superpower in the present. Certainly, the United States is a superpower, one with great sway internationally. We should not limit the scope of the analysis of imperialism to US action and inaction, however. In this period, all of the nations of the world are integrated into capitalism, and all participate to some degree in the perpetuation of an imperialist system. We should quickly dispel with any notion of an anti-imperialist bloc within the world capitalist system. That being said, some nations are more powerful than others, and this affords them more influence. The US, Great Britain, and Germany are major players in the pharmaceutical industry, and burgeoning world powers such as Russia and China are also producers of pharmaceuticals. The once-national pharmaceutical industrial giants such as Pfizer in the US, GlaxoSmithKline in the UK, or Bayer in Germany are now vast multinational corporations. These corporations remain profitable largely through the development and sale of prescription drugs such as antidepressants. They also produce vaccines, although research and development has been shrinking as the number of pharmaceutical companies that venture into unprofitable vaccine development has decreased.(8) Vaccines are administered usually once, perhaps twice, and profit margins tend to be thin. Governments are the largest purchasers of vaccines, typically as part of vaccination programs. As the profitability of vaccines has declined, so too has innovation.(9) However, depending on the severity of a disease and how endemic it is to a national population, it becomes the interest of the state to ensure vaccination protocols for certain diseases. This unique problem — the lack of profitability of vaccines alongside the state’s interest in procuring certain vaccines — has led to a centralization of the production of vaccines to a handful of the largest pharmaceutical giants. In many cases, such as the earlier mentioned SARS outbreak, the vaccine development stalls the moment the state no longer sees investment as being in the national interest.

Both Bukharin and Lenin(10) observed the decline in competition as indicative of imperialism. As the state moves toward becoming a single buyer, corporations compete for this financial investment, and this leads to the winners becoming ever larger, and eclipsing the total market. The end result in the pharmaceutical sector has been that a few long-standing firms have grown as large as small countries’ gross-domestic product. While it was true that Bayer and Pfizer were founded in Marx’s lifetime, and were already large corporations in the early 20th century, they are now paradoxically global while being maintained in large part by state benefactors in the form of vaccine development. The relationship between the state and the pharmaceutical industry reached its height in 2020 with the COVID-19 pandemic. Funding for a vaccine, despite the need for international doses, was largely nationally-directed, and with the anticipation that the vaccine would be distributed to the country in question first. That is, that Pfizer’s vaccine would be for Americans first, while AstraZeneca’s vaccine would be for Britons before anybody else. Indeed, Donald Trump sought this explicitly.(11) In the United Kingdom, in its desperation to secure the vaccine for internal distribution, the state ordered enough doses for every citizen to receive two.(12) Unsurprising as this may be, it is not the preferred method of distribution if the goal of vaccination was to prevent deaths. Medical advocacy groups have advocated for prioritization of front-line medical workers and vulnerable populations.(13)

In a truly worldwide effort to stop a virus that has no conception of borders, these populations would be prioritized in an effort to curb deaths and permanent debilitation as a result of the virus. Instead, countries are compelled to bid on a competitive vaccine market in order to procure the vaccines.(14) COVAX is a mostly toothless effort to ensure poorer countries will have access to the vaccine. So far vaccine distribution is limited outside of the richest countries. Leading the pack is Canada, with 9 doses of vaccine per citizen, and way behind is the COVAX coalition with significantly less than a dose per person.(15) The estimated shelf life for vaccines under ideal conditions is six months, which leaves open the potential for over-supplied countries to waste doses that are not distributed elsewhere in a timely manner.(16) Irrational hoarding of vaccines appears to be the norm in the wealthiest countries. Why this may be the case is unclear at first. Truly the Canadian government was not anticipating that Canadians will need nine doses of vaccine. One possible explanation becomes apparent when you look at the irrational market behavior that occurs during a crisis. In March of 2020, toilet paper disappeared from the shelves across the United States. The need for home-use toilet paper may have increased for people new to working from home, but this doesn’t explain the panicked reactions and runs on the big box stores. For those who are not simply seeking to gouge others for rolls once the stores run out, the panic arises from the fear of losing out. The thought process is, “If I don’t stock up now, I may not be able to get it in the future.” For vaccines, the rationale is similar, but with some key differences. There were multiple vaccines in development, all of which ran the risk of not working. States purchased vaccine doses long before it was known whether these vaccines were proven to work. Since the pharmaceutical companies would not seek to produce billions of doses of vaccine without the possibility of a return on investment, bidding wars ensued. The seemingly irrational hoarding, it turns out, contains a kernel of rationality. The thought process then becomes, “If we don’t buy one of every possible vaccine, Canadians could fall behind the rest of the world in vaccination.” The primary reason nations want to be first is because this will provide a competitive edge during the recovery period expected to take place at some point approaching herd immunity.

Although China was the location the virus was first discovered, and where the first major outbreak occurred, the state utilized its muscle to crush the spread of the virus. Severe restrictions early on in the pandemic brought the virus largely under control before other countries had even enacted their earliest restrictions. Twenty-six US States have seen more deaths due to COVID than China. This effort appeared to crater the economy at the time, with some analysts predicting doom ahead.(17) Not only did the crisis quickly reverse, but China is now poised to be one of the few nations to manage economic growth in 2020. Noting this apparent success is not to praise China, and it is certainly not intended to muddle their motivations. The goal of such a strict lockdown was simply to set China on a path to economic recovery sooner than the rest of the world. China’s role in the global capitalist economy as one of the primary exporters of commodities for the world market is still in doubt, as global trade has hit barriers.(18) With that said, China’s internal market is thriving, while other nations are confronted with a new wave of lockdowns. Now, as other world powers seek any avenue to remain competitive on the global stage, adequate vaccine deployment appears to be the only surefire way to recovery. For the United States, the best possible outcome is a distant second place.

In spite of an outward expression of international cooperation, there is little sign that global conflicts have been resolved. The assassination of Qasem Soleimani just prior to the pandemic was a major escalation of conflict between the United States and Iran that had the world on edge. Over the course of 2020, continued escalation in the South China Sea has gone largely unnoticed, but has led to continued deterioration of relations between China and the United States. These types of geopolitical chess games are not new, but current tensions and a uniquely bad global economy on the horizon. Just prior to the pandemic, US-China relations were also strained by a trade war, and China was experiencing declines in GDP growth signaling that a crisis was already on its way, virus or not. The level of cooperation forged in light of the pandemic could be understood as a trade war cease fire that could quickly unravel. The Biden administration has expressed a more dovish approach to China(19), but this should not be perceived as a sudden fall-back to sunny relations between the two countries. A great deal of damage has occurred as a result of both the trade war and the pandemic causing reduced Chinese exports. As the US economy fails to recover fully in the next year, the ruling class will be faced with mounting pressure to “take on China”.

Cold war and the culture war

There is no indication of a pending invasion or any other catalyst for an inter-imperialist war, but there are signs that tensions are escalating and are becoming reminiscent of the Cold War between the US and the USSR in the 20th century. And China is not the only nation with an interest in seeing a diminishing United States on the global stage. Both Russia and China have been accused by UK and US intelligence of espionage dealing with vaccine development research.(20) These types of accusations should be viewed critically, as it is never clear whether the NSA, NSCS, or any other intelligence agency is telling the truth. In either case, there are accusations of tampering with vaccine research as part of an intelligence operation. This suggests motivation to undermine progress on a vaccine that is ostensibly being produced to distribute to anyone who may need it, regardless of the political borders that encircle them. The question must be posed, why sabotage research for a vaccine? What motivations would there be to see to it that other nations fail to discover or distribute the vaccine first? Delaying the vaccine for a single day could lead to thousands more dead. Is some vague notion of national pride over being “first” to discover a workable vaccine sufficient to explain this? Alternatively, a simpler explanation is that COVID-19 vaccine development is being perceived as a zero-sum game between powers, where the US must lose so that Russia (or whichever competitive power) may win.

In the end, the return of 20th century-style industrial sabotage may not be all that necessary in preventing the recovery of the United States’ economy. Self-sabotage has so far been the most effective. As early as March, members of both of the two political parties in the United States were not ready to face the reality of how threatening this pandemic would be. While Donald Trump has been boorishly contrarian about the threats of the virus, even liberals like New York City Mayor Bill De Blasio were going to the gym, and encouraging bar hopping in a reluctance to accept the economic turmoil ahead. Since then, the Democrats have taken a cartoonishly arrogant approach to quarantine, distancing, and masks that is out of touch with the reality for the workers who have not been able to stay home or distance if they want to survive. American political discourse has deteriorated as the virus became politicized. It is no longer a matter of established fact that the virus can be spread more easily through close contact by those not wearing masks, that it is dangerous or deadly. Instead, the country is divided down the middle, with one side claiming the mantle of science and medicine, and the other claiming to stand for freedom and jobs.

This culture war is a largely online phenomenon. The working class wears masks because they are required by employers or by the state, and because they have become a necessity to hold off the inevitable outbreak. Essential workers that have witnessed outbreaks in their plants or in their stores, or who have become infected themselves are not living in the world of hypotheticals on these issues. The unemployed, the unoccupied small business tyrant, the locked down retiree, and others like them have been consuming nothing but media for nearly a year, slowly being radicalized into one or the other of this strange new type of culture-based identity army. With everyone about as atomized as humanly possible (all intentionally), real social bonds are deteriorating between families and friends, while new social bonds between alienated sects of conspiracy theorists have replaced them. This year has seen rapid growth of a far-right extremism built on the cult of personality around the president, and fueled by grievance politics. Believing that the virus is a threat is a signal of one’s membership in one or the other faction. Anti-vaccine politics, once perceived as the domain of vaguely left-wing hippies, has been absorbed into far right conspiracy theories about microchips and Bill Gates. With hundreds of thousands of Americans already falling victim to the virus, it simply isn’t clear that a vaccine roll-out will be successful if only one camp in the culture war is even willing to take the vaccine.

Distrust in the state has reached stratospheric heights, and a large part of this distrust stems from mixed messaging around the virus. The president himself appears to be a champion for the vaccine, which is an about face from his previous distrust in vaccines. His supporters certainly seem more resolutely opposed to vaccines than he is. Combine this suspicion of vaccines with the belief that masks either don’t work or are a form of totalitarian control. Further complicating things is the petty bourgeois push to reopen everything, to get customers back into the bars and restaurants. Now, in what could only be understood as an even worse second wave of the virus, the hope of some sort of “return to normal” appears impossible. COVID-19 has a high mortality rate, and spreads via aerosolized droplets from coughs and sneezes, and spreads more easily in crowded indoor settings. The vaccine offers the safest avenue to herd immunity and reduced carnage as a result of the pandemic. All of this remains true separate from the passions of the culture warriors. It is also true that the conditions of capitalism push workers to want to return to work to survive, to distrust a state that has had a checkered past when it comes to vaccination or social control. Scientific distrust should not be understood through the lens of bad ideas spreading uncontrolled, and unmotivated by rationality. Instead, it should be understood as a product of the conditions in which people currently live, where workers were already under assault prior to the pandemic, and now are being asked to sacrifice potentially everything for something they must rely on authorities to understand. This distrust in the institutions is a product of alienation as well. As social cohesion dissolves, people find new communities, and communities that offer some kind of release from the pain of this isolation, such as QAnon, become attractive. As ludicrous as their theories are, they fill a void for those with weakening social bonds. While these movements are spearheaded by elements outside of the working class, many workers have already been drawn in. Those who have a limited collective memory of their own class may see these theories as a grand narrative to explain something they struggle to articulate. In any case, these movements hinder and harm the potential post-pandemic recovery for capitalism.

While it is not the task of communists to rebuild a trust in scientific institutions, this pandemic raises questions about how a communist society would deal with future pandemics or natural disasters. Capitalism in its ascendant phase produced an enthusiasm for the marvels of science and medicine. Now, as capitalism declines, we see trust in institutions evaporate. This undermining of science only weakens the capitalist system further. In the case of the United States, years and years of culture war battles over taking the shot could lead to an endemic COVID-19 that keeps the economy regionally depressed for years to come. Much of this could be avoided if the motivation was simply to save lives, and was not complicated by profit, national competition, and misinformation campaigns.

Conclusion

Vaccines are now being deployed to medical workers, and soon to other vulnerable populations. The vaccine rollout is going wrong in many ways, including vaccines being wasted(21) and many medical workers refusing to accept it.(22) The roll-out plans carried with them assumptions that people would be lining up to demand the vaccine, so that life could more quickly return to normal, but it appears that few are convinced “normal” is achievable or even desirable. The road ahead for competing nations hoping to reach herd immunity will be fraught. Conflicts that have been postponed but not resolved will continue to boil over. While financial markets have been soaring, this will not be sustained if profitability is not restored in the near term. Although the recent Capitol Hill protest forced the Republican party to issue an ultimatum to President Trump, it is unlikely that these politicians will cooperate with the Biden administration, further complicating recovery efforts. The antagonisms brought on by this economic stagnation push the United States, and by extension its allies, into a corner where it may be compelled to act more aggressively on the world stage. The UK, Russia, and China also face unique troubles ahead regarding trade and economic growth. This year will be a test of what nation states are willing to do in order to achieve stability and to avoid further economic tumult. Whichever direction events turn, the working class are mere observers as these states scramble to manage their diminishing capital.

Magnus Zeller
26 January 2021

Notes

(1) Hixenbaugh, M. (2020, March 8). Scientists were close to a coronavirus vaccine years ago. Then the money dried up. NBC News. https://www.nbcnews.com/health/health-care/scientists-were-close-coronavirus-vaccine-years-ago-then-money-dried-n1150091
(2) Intransigence. (2020, April 15). The pandemic and the crisis. https://mcmxix.org/2020/04/15/the-pandemic-and-the-crisis/
(3) Estes, C. (2020, March 28). States are being forced into bidding wars to get medical equipment to combat coronavirus. https://www.forbes.com/sites/claryestes/2020/03/28/states-have-are-being-forced-into-bidding-wars-to-get-medical-equipment-to-combat-coronavirus/?sh=7a0e8f531cde
(4) California declared a state of emergency on March 4th, 2020, a Wednesday. Black Monday I took place on March 9th. Prior to California’s state of emergency, however, the markets had already witnessed a 10% decline in late February. The United States declared a state of emergency on March 13th. Trump, D. J. (2020, March 13). Proclamation on declaring a national emergency concerning the novel Ccoronavirus disease (COVID-19) outbreak. The White House. https://web.archive.org/web/20210119112405/https://www.whitehouse.gov/presidential-actions/proclamation-declaring-national-emergency-concerning-novel-coronavirus-disease-covid-19-outbreak/
(5) World Health Organization (2020 January 21). Novel coronavirus (2019-nCoV) situation report. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200121-sitrep-1-2019-ncov.pdf?sfvrsn=20a99c10_4
(6) Moderna (2020 February 24). Moderna ships mRNA vaccine against novel coronavirus (mRNA-1273) for phase 1 study. https://investors.modernatx.com/news-releases/news-release-details/moderna-ships-mrna-vaccine-against-novel-coronavirus-mrna-1273
(7) Bukharin, N. (1929). Imperialism and world economy. International Publishers. (Original work published 1915) See: https://www.marxists.org/archive/bukharin/works/1917/imperial/
(8) Institute of Medicine (US) Committee on the Evaluation of Vaccine Purchase Financing in the United States. (2003) Financing Vaccines in the 21st Century: Assuring Access and Availability. National Academies Press. https://www.ncbi.nlm.nih.gov/books/NBK221816/
(9) Xue, Q. C. & Ouellette, L. L. (2020). Innovation policy and the market for vaccines. Journal of Law and the Biosciences, Volume 7, Issue 1, January-June 2020. https://academic.oup.com/jlb/article/7/1/lsaa026/5838028
(10) Lenin, V. I. (1963) Imperialism, the highest stage of capitalism. Selected Works. Progress Publishers: Moscow, Volume 1, 667-766. (Original work published in 1916). See: https://www.marxists.org/archive/lenin/works/1916/imp-hsc/
(11) Chalfant, M. (2020 December 7). Trump to order government to vaccinate Americans first. The Hill. https://thehill.com/policy/healthcare/529128-trump-to-order-government-to-vaccinate-americans-first-at-summit
(12) Gallagher, J & Triggle, N. (2020 December 30) Covid-19: Oxford-AstraZeneca vaccine approved for use in the UK. BBC. https://www.bbc.com/news/health-55280671
(13) Subberaman, N. (2020 September 17). Who gets a COVID vaccine first? Access plans are taking shape. Nature. https://www.nature.com/articles/d41586-020-02684-9
(14) Krueger, A. O. (2020, December 28). Poorer countries must not be left behind in a vaccine bidding war. Irish Examiner. https://www.irishexaminer.com/opinion/commentanalysis/arid-40196883.html
(15) Mullard, A. (2020 November 30). How COVID vaccines are being divvied up around the world. Nature. https://www.nature.com/articles/d41586-020-03370-6
(16) Pfizer. (2020 November 20). Covid-19 vaccine U.S. distribution fact sheet. https://www.pfizer.com/news/hot-topics/covid_19_vaccine_u_s_distribution_fact_sheet
(17) MarketWatch. (2020 March 27). China’s economy will suffer a double whammy as its export partners are overrun by the coronavirus. https://www.marketwatch.com/story/chinas-economy-will-suffer-a-double-whammy-as-its-export-partners-are-overrun-by-the-coronavirus-2020-03-27
(18) United Nations Conference on Trade and Development. COVID-19 drives large international trade declines in 2020. https://unctad.org/news/covid-19-drives-large-international-trade-declines-2020
(19) Swanson, A. (2020 November 16). Biden’s China policy? A balancing act for a toxic relationship. New York Times. https://www.nytimes.com/2020/11/16/business/economy/biden-china-trade-policy.html
(20) National Security Agency Central Security Service. (2020 July 16). NSA teams with NCSC, CSE, DHS CISA to expose Russian intelligence services targeting COVID-19 researchers. https://www.nsa.gov/news-features/press-room/Article/2275378/nsa-teams-with-ncsc-cse-dhs-cisa-to-expose-russian-intelligence-services-target/
(21) Goldstein, J. (2021 January 8). Cuomo widens eligibility after vacine goes unused or is even thrown out. New York Times. https://www.nytimes.com/2021/01/08/nyregion/nyc-coronavirus-vaccine-delays.html
(22) Condon, B., Sedensky, M., & Johnson, C. K. (2021 January 8). Vaccine rollout hits snag as health workers balk at shots. Associated Press. https://apnews.com/article/coronavirus-vaccine-health-workers-676e03a99badfd5ce3a6cfafe383f6af

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