Last October, a young girl with severe and unusual liver failure was admitted to a hospital in Birmingham, Alabama. Her symptoms were typical: skin and eyes yellow with jaundice, markers of liver damage off the charts. But she tested negative for all the usual suspects behind liver disease. Her only positive test was, surprisingly, for adenovirus—a common virus best known for causing mild colds, pink eye, or stomach flu. In rare cases, it’s linked to hepatitis, or inflammation of the liver, in immunocompromised patients. But this girl had been healthy.

Then it happened again. A second kid came in, about the same age, with all the same symptoms, and again positive for adenovirus. “One patient is a fluke; two is a pattern,” says Markus Buchfellner, a pediatric infectious-diseases doctor at the University of Alabama at Birmingham (UAB). Two quickly became three and then four. Alarmed, the hospital’s doctors alerted local health authorities and the CDC, whose investigation ultimately found nine such cases of unusual hepatitis in kids in Alabama. Two needed liver transplants.

Buchfellner originally thought that whatever was happening was local to Alabama. But this spring, investigators in the U.K. began independently puzzling over their own mysterious uptick in hepatitis among kids. They have since identified more than 150 such cases in the U.K. This prompted the CDC to cast a wider net, bringing the number of suspected cases across the U.S. to 109. Fifteen of the kids have needed liver transplants, and five have died. Worldwide, probable cases now total 348 spread across 20 countries.

The early evidence continues to point to a link with adenovirus—an unexpected correlation that is too strong to dismiss and not strong enough to close the case. Seventy percent of the probable cases globally have tested positive for adenovirus, according to the World Health Organization. But although biopsies have been conducted in a small fraction of those cases, they have failed to find adenovirus in the kids’ livers. At the same time, we definitely know that a different virus infected a massive number of kids recently: SARS-CoV-2, of course. Yet the correlation here is even less clear; only 18 percent of the probable cases tested positive for COVID.

Adenovirus and coronavirus aren’t necessarily mutually exclusive explanations. The leading hypotheses now suggest an interaction between adenovirus and the pandemic—either because social distancing changed the patterns of adenovirus immunity, allowing for more severe or simply more adenovirus infections, or because previous infection or co-infection with the coronavirus triggers an unusual response to adenovirus. Alternatively, did the adenovirus itself recently change, evolving to more readily damage the liver?  

Severe liver failure in kids is very rare, says Helena Gutierrez, the medical director for pediatric liver transplants at UAB and Children’s of Alabama. But when it does happen, a significant proportion of cases even in normal times remains entirely mysterious. No identifiable cause is ever found in almost half of kids with liver failure so severe that they might need a transplant. Ultimately, understanding the recent pattern of unexplained liver-failure cases in kids may shed light on previously mysterious cases that were once too infrequent to attract much attention.

[Read: A human liver can be cooled to -4 degrees C and survive]

But why is there an increase right now? The only culprit that can be conclusively ruled out is COVID vaccines, because kids under 5, who make up the bulk of the hepatitis cases, cannot yet be vaccinated. In the weeks ahead, experts will be looking at three key pieces of data to parse the remaining hypotheses.

The first and perhaps most obvious set of data to gather is: Have these kids had COVID before? The overwhelming majority of the kids with hepatitis tested negative for the coronavirus, but investigators are now collecting antibody data to see if any of them had COVID in the past. “I don’t think it’s directly related to the virus itself,” says Buchfellner, but perhaps a COVID infection could have predisposed a kid to liver failure once something else—say, an adenovirus infection—came along. And although multisystem inflammatory syndrome, or MIS-C, following coronavirus infection can affect the liver, the hepatitis patients did not exhibit the other hallmark signs of that condition, such as high inflammatory markers and heart damage.

When the COVID antibody data do come out, a lot of the kids will be positive—simply because a lot of kids in general have had COVID recently. Experts will want to go one step further to determine whether the coronavirus is really playing a role. If so, they’d expect that kids with hepatitis are more likely to have COVID antibodies than a control group of kids who did not have hepatitis.

[Read: COVID-19’s effect on kids is even stranger than we thought]

A second key piece of data is about the adenovirus itself. Adenoviruses are very common, so could all the positive tests simply reflect incidental infections unrelated to liver failure? Here, too, investigators will want to see if kids hospitalized with hepatitis are more likely to test positive for adenovirus than those hospitalized for other reasons. If they are, the link to adenovirus becomes stronger. The U.K. is analyzing these exact data and is expected to have results in the next week.

Exactly how many kids test positive for adenovirus sounds like a simple statistic, but it can be messy early on, when investigators are dealing with mostly retrospective data. Different doctors in different hospitals might think to order different tests. UAB happened to test for adenovirus, but it’s so low on the list of hepatitis culprits that the test is not necessarily routine. And how tests are done can affect whether they come back positive, says Benjamin Lee, a pediatric infectious-diseases doctor at the University of Vermont. “Is the virus able to be detected in the blood at the time the patient presents for care? Are there other sites that need to be tested?” he asks. What about the nose and throat? Or stool? And indeed, U.K. investigators have had to make sense of a mélange of blood, stool, and respiratory samples, with varying positivity rates.  

A third prong of the investigation will focus on the adenoviruses found in these samples. Sequencing their genomes can determine whether the viruses recently acquired new mutations that can explain the link to liver failure. Adenovirus variants have popped up before, and this type of virus is especially apt at reshuffling its genome. Whole genome sequencing is in the works, though scientists in the U.K. originally had trouble getting enough virus out of early samples. And scientists don’t have a big database of old adenovirus samples of this kind to compare with the new ones. “We take that for granted out with SARS-CoV-2,” says James Platts-Mills, an infectious-diseases doctor at the University of Virginia. So the initial progress may be slow.

Partial sequencing of the viral genome, though, has already pinpointed one particular type of adenovirus that predominates in the hepatitis cases: adenovirus 41, also known as 41F. (There are more than 100 types of adenovirus. F refers to the species, the number reflects the order in which the types were discovered.) Adenovirus 41 infects the GI tract. Platts-Mills has studied adenovirus 41 in developing countries, where it is a leading cause of hospitalizations for diarrhea in children. It circulates in wealthy countries, too, but in the U.S. it doesn’t cause enough trouble to justify active surveillance. Potentially, Platts-Mills says, the hepatitis cases are only the “tip of the iceberg” of a large number of undocumented mild adenovirus 41 cases. The invisible surge, if there is one, could be due to either new viral mutations or many young children getting infected at once, with COVID restrictions relaxing.

Still, it’s surprising to see adenovirus 41 specifically as a suspect in these hepatitis cases, adenovirus experts told me. Although adenovirus has been linked to severe liver failure, it’s not been adenovirus 41 but types 1, 2, 3, 5, and 7. Plus, these cases almost always happen in patients with suppressed immune systems. “In those immunocompromised kids, you could see it in the liver. When we made slides, you could see the viral particles,” says Kurt Schaberg, a pathologist at UC Davis who has studied adenovirus hepatitis. The dark centers of the infected liver cells become big and swollen. It’s all quite obvious. Biopsies didn’t find any of these patterns in the livers of the non-immunocompromised kids. If adenovirus plays a role, it is probably more indirect. Perhaps it somehow triggers the immune system to start attacking the liver, either by itself or in combination with another virus, toxin, or environmental factor. And this might continue even after the virus itself is cleared, so tests for adenovirus could turn up negative.

All of this means that figuring out the answer to these hepatitis cases in kids won’t be straightforward. “If we found virus in the liver, we would be done,” says Buchfellner, in Alabama. “The fact we can’t find that means it’s much harder to prove.” Instead of a single direct cause, investigators are probably looking for an indirect one or multiple indirect ones. In the weeks ahead, nailing down three key questions—whether these kids have also been infected with COVID, whether their adenovirus infections are incidental, and whether their viruses have mutated—will at least narrow down the list of plausible hypotheses.

Meanwhile, the nine kids in Alabama are all recovering. Whatever the cause, doctors stressed to me, the risk of severe hepatitis for healthy kids is still very, very small.

The U.S. response to the pandemic has already spawned a range of speedily published books. A few notable examples have come from masters of journalistic narrative, including Michael Lewis and Lawrence Wright; former officials, such as Scott Gottlieb and Andy Slavitt; and newspaper reporters, especially Yasmeen Abutaleb and Damian Paletta. But the most significant entry so far, the book that should be an indispensable resource for future historians, is Silent Invasion by Deborah Birx, the coordinator of the White House Coronavirus Task Force under President Donald Trump.

Birx’s book has received relatively little attention in the two weeks since it was published—it still has not been reviewed by The Washington Post or the Los Angeles Times, for instance, or sparked nearly as much chatter as Mark Esper’s less consequential memoir that was also just released. Much of the attention that has been paid to Birx has focused not on the contents of the book, but on Birx herself, who witnessed and failed to stem fatal mistakes and poor decision making (with the notable exception of vaccine development) during her almost-one-year tenure on the task force. That’s a shame, because the book is the best account we have so far of how Trump’s team botched the pandemic response so badly.

Birx does a very good job of distilling what went wrong. She repeatedly emphasizes what she identifies as the principal fault in the Trump administration’s pandemic response: a failure to recognize the importance of asymptomatic transmission (thus the book’s title). She laments testing problems, including initial refusals to enlist the private sector, mistakes at the CDC, and later failures to ramp up diagnostics. Birx also cites the CDC’s consistent failure to develop good data about the pandemic, and places this at the center of reforms she proposes toward the book’s end.

But what sets Silent Invasion apart is how Birx, with the writing assistance of Gary Brozek, unhesitatingly names names (and dates and places). She does so with much more detail and nuance than we’ve had from anyone else. Birx paints a portrait of an administration in full, made up of people with a mix of talents and motivations. Where other chroniclers describe the White House as if it had just one occupant, Birx gives us the full cast. The book’s first 150 pages, on the period from January through March 2020, are especially riveting. In the early crucial weeks of the crisis, she writes, “some roaming the halls of the West Wing believed that the less we did, the less we would be held accountable for whatever was about to happen.”

Birx has her own list of bad guys. The worst is Scott Atlas, the radiologist whose epidemiology advice Trump came to take. Atlas, she writes, repeatedly responded to group emails from her by hitting “Reply All” and then removing her from the list before sending. Other lead villains include presidential Chief of Staff Mark Meadows (who seems to care only about politics) and vice-presidential Chief of Staff Marc Short (who seems to care only about protecting his boss from his boss). Also: Health and Human Services Secretary Alex Azar, the entrenched and inflexible staff of the CDC, the out-of-its-depth staff of the Council of Economic Advisers, the politically wobbly World Health Organization, Governor Kristi Noem of South Dakota, and Governor Ron DeSantis of Florida, who, Birx indicates, knew better but caved to political pressure. Birx is forthright in calling out numerous examples of her sexist treatment by other White House staffers, especially Meadows and Short.

The forces for good, in her view, include some surprises. She portrays Vice President Mike Pence and presidential son-in-law Jared Kushner as often aiding work that Trump loudly derided. Pence never seemed publicly at variance with Trump, and Kushner has been widely criticized for inept logistical efforts, but Birx offers a few convincing examples of moments when they worked to quietly facilitate some positive actions. Birx also praises her friend Matt Pottinger, who served as a deputy national security adviser, along with governors including Doug Burgum of North Dakota and Doug Ducey of Arizona. In between, alternately bolstering and disappointing her, are her longtime colleagues Anthony Fauci and CDC Director Robert Redfield.

Other pandemic-book writers have been forced to speculate about what happened outside of Trump’s immediate environment. More than a year has passed since the former administration left office, but the inner workings of its response to the pandemic have still remained out of view. Perhaps that’s why so much coverage focused single-mindedly on Trump, the loudest and most shocking voice, while largely neglecting the rest of the team. But Birx was in the building, watching everything unfold, and she can and does shine light on details that others can’t. She later drove around the country and talked with governors and other local leaders, and has a real basis for comparing their performance.

She does not, however, neglect the central character in Washington. A career public-health worker and career Army officer (on active duty from 1980 until 2008), Birx refuses to sum up her views of Trump personally, but she offers more than enough detail for readers, including historians, to reach their own conclusions. She describes her first meeting with Trump, on March 2, 2020, when she tried to explain to him that the virus “is not the flu.” Trump listened for a minute, briefly challenged her, then literally changed the channel on one of the TV screens he had simultaneously been watching.

Birx didn’t stand up to Trump in public while she worked for him. In the book, she laments her most public lapse: When Trump seemed to advocate consuming disinfectant in a live televised briefing, and she feebly and quietly uttered, “Not as a treatment.” She should have been more forceful, she writes, “should have ignored my deeply ingrained, military-honed instinct not to publicly correct a superior.”

Birx’s refusal to publicly oppose Trump during her time in the White House continues to haunt her reputation. Her subsequent interviews—like her book—have been revealing, but they’ve also often been criticized as too little, too late. This criticism has some merit. Some cynics may believe that she has written her book to obscure the record. I’m more inclined to believe that she continues to be motivated by her own sense of duty, and wants the rest of us to see what she saw.

The book makes a compelling case that much of the blame laid at Birx’s door for Trump-era pandemic shortcomings is an oversimplification, or worse. Birx details how, in private, she and other officials sought to counter Trump’s resistance to fighting the pandemic. In August 2020, Birx writes, Trump hung up on her when she refused to back down after he insisted that “the virus is under control.” She is remarkably candid about how she and her colleagues manipulated Trump into the initial 15-day shutdown in March, and then its 30-day extension, which he almost immediately regretted. (Neither Trump nor anyone in his camp seems to have responded to Birx’s book publicly.)

Birx portrays herself as an experienced bureaucratic infighter. For example, when Pence’s chief of staff told her that the stark language in bullet points at the top of a daily report was too politically explosive, she simply inserted almost identical language farther down in the document, where the busy politicos trying to stifle her would fail to see it. She’s the sort of person who still counts it as a win when her initiatives are refuted publicly but actually remain unchanged.

But Birx seems to have been in over her head in the toxic office politics of the Trump White House. For instance, she speculates at length in the book about which of her rivals was trying to undermine her by releasing a memo she wrote warning of the late-2020 surge on the eve of the presidential election. In this instance, it seems likely that Mark Meadows was right: As Birx writes in the book, he told her that the leak was intended to affect the election, not her career.

Birx had been much more comfortable working for President George W. Bush, who, she writes, “created a space where people could succeed, supported us to make the impossible possible. Trump’s White House was the opposite in many ways.” When Birx was feeling particularly exasperated by Trump, Bush convinced her not to resign.

Deborah Birx could not bring order to the chaos of the Trump White House, or reason or compassion to its management of the pandemic. The resulting losses were huge.

But none of that takes away from what Silent Invasion has to offer. Birx has given us an important record of how and why all those losses were suffered. With COVID cases once again on the rise, her reflections can be put to important use, both as yesterday’s history is written and as today’s unfolds.

Up here in the Northern Hemisphere, the spring weather’s just barely warming, but regulators in the United States are already wringing their hands over a tricksy fall brew: the contents of the COVID shot that vaccine makers are prepping for autumn, when all eligible Americans may be asked to dose up yet again (if, that is, Congress coughs up the money to actually buy the vaccines). In a recent advisory meeting convened by the FDA, Peter Marks, the director of the agency’s Center of Biologics Evaluation and Research, acknowledged the “very compressed time frame” in which experts will need to finalize the inoculation’s ingredients—probably, he said, by the end of June.

Which is, for the record, right around the corner. A big choice is looming. And whatever version of the virus that scientists select for America’s next jab is “probably going to be the wrong one,” says Allie Greaney, who studies the push and pull between viruses and the immune system at the University of Washington and the Fred Hutchinson Cancer Center.

Unavoidably, several months will separate the selection of this autumn’s vaccine and the deployment of said shot. That’s eons in coronavirus time. Half a year ago, we were all still living in Delta’s world; now a whole gaggle of Omicrons are running the show. Any decision that scientists make in June will have to involve assumptions about how SARS-CoV-2 will shape-shift in the future, which exactly no one is eager to make. “We keep getting burned,” says Adam Lauring, a virologist at the University of Michigan. Perhaps the virus will stay on its Omicron bender, making an Omicron vaccine—a favorite for the fall’s jab jubilee—sound like a no-brainer. Or perhaps by the time summer’s through, it will have moved on to a Rho, Sigma, or Chi that sproings out from somewhere totally unexpected and undermines that Omicron shot. With so many people around the world harboring some degree of immunity, the virus is being forced to continually reinvent itself, and no one knows what new costumes it might try on next.

[Read: We might not need annual COVID shots]

Our choice of fall shot, then, is inevitably going to be a gamble and a guess. But with the clock ticking down, most of the experts I’ve been talking with think an ingredient swap is wise, and probably inevitable. “We should be updating the vaccines now or yesterday,” said Jonathan Abraham, a physician and immunologist at Harvard Medical School. Modeled on the version of the virus that kick-started the crisis more than two years ago, our current crop of immunizations is still guarding against severe illness and death. But that OG variant has long since fizzled out—leaving our shots, in this one sense, frozen in the past, while the real SARS-CoV-2 continues to race ahead. A 2022 revamp might finally give our vaccines a chance to close some of that gap.

The decision that regulators make in early summer won’t just be about a boost. In the recent advisory meeting, Marks emphasized that any vaccine updates would be expected to be comprehensive, replacing old formulations as both boosters and primary-series doses; after the changeover, people who haven’t gotten their first doses—who number in the tens of millions in the U.S. alone, and would include future generations of kids—might not be able to nab an original-recipe shot. “We would not be going backwards,” Marks told the committee. “It would be too confusing and potentially dangerous to have different regimens.”

The same system shuffles the populace through a new flu-shot formulation year after year, and it usually works just fine. Those viruses have been twining themselves into the human population for centuries; host and pathogen have settled into an uneasy rhythm, with a more or less set flu season playing out in most parts of the world each year. Last year’s successful flu strains tend to give rise to this year’s, which then sire next year’s—a phenomenon scientists call “ladder-like evolution,” because of its soothing stepwise shape. To concoct the forthcoming season’s flu shot, “we do surveillance; we figure out what to be prepared for,” Lauring told me. With SARS-CoV-2, however, “the dynamics are still so wacky.” Waves of infection crest and crash in different countries every few months; the virus is still sloshing out new variants and subvariants at breakneck speed. The emergence of coronavirus iterations has also been less ladder-ish and more radial, like spokes erupting out of the center of a bicycle wheel: Alpha did not beget Delta, which did not birth Omicron.

In recent months, though, the virus appears to have taken a different tack. Since the end of 2021, nearly everything’s been coming up Omicron. From BA.1 (a.k.a. Omicron classic) to BA.2, and now the rising BA.2.12.1, BA.4, and BA.5, the last few viral successions have all occurred within the Omicron clan. So our next move might seem obvious: counter with an Omicron-centric vaccine, a switch some experts have been favoring for months. On that front, Moderna and Pfizer might soon deliver. The two vaccine makers have each been testing, among other options, bespoke BA.1 versions of their shots that they say could be ready within the next few months, just in time for a pre-winter inoculation push. “We plan to have a data readout soon,” Jerica Pitts, a spokesperson for Pfizer, wrote in an email.

[Read: Why can’t we just call BA.2 Omicron?]

By numbers alone, there is a pretty strong likelihood that more BA-whatever subvariants will come down the pike. And as a booster, especially, an Omicron shot could have clear perks, shoring up the defenses laid down by previous doses while also, ideally, pushing a new batch of immune cells to wise up to the variant’s unique and never-before-seen quirks, says Marion Pepper, an immunologist at the University of Washington. The hope is that Pfizer’s and Moderna’s data will back that notion up and show that people boosted with Omicron’s spike are better at duking it out with most of the BA fam than those who are injected with the original recipe again. But there’s also a chance that the evidence won’t bear this out. A smattering of recent studies, some in animals, hint that chasing an original-recipe shot with something Omicron-y might not push the body to develop a ton of Omicron-specific defenses, at least not at first; studied head-to-head, a BA.1 booster and an OG booster performed about the same. Pepper still has faith that a lesson on Omicron’s spike will pay dividends—the effects just might take more time to unspool. Taia Wang, an immunologist at Stanford, agrees. “Boosting with Omicron will almost certainly provide more immunity against currently circulating strains,” she told me. Currently could quickly become previously, though, if another variant elbows in. Although the virus’s evolution might look sort of, kind of, more stepwise right now, “we’ve seen the different lineages pass the baton back and forth,” Siobain Duffy, a virologist at Rutgers University, told me. “There’s absolutely nothing stopping a similar large jump in SARS-CoV-2 evolution from happening again.”

Perhaps the bigger worry is whether BA.1 will end up being a terrible teacher when deployed as an unvaccinated person’s starter shot. The variant’s bizarro-looking spike, so unlike any that came before it, is such an outlier that it may fail to show an unsavvy immune system how to recognize other morphs of SARS-CoV-2. That’s not a problem if the future of the virus stays hooked on Omicron. But should it be booted by another variant more resembling Alpha, Delta, or something else, bodies schooled on BA.1 alone might be ill-prepared. Pfizer, which is testing a triple-Omicron series in a group of previously unjabbed people, could produce data to the contrary. Absent those, a premature pivot to Omicron might bias immune systems toward the wrong track.

[Read: Should we go all in on Omicron vaccines?]

If an Omicron-only vaccine is starting to sound like a possible lose-lose situation, maybe it’s no surprise that the experts I spoke with ran the entire gamut of opinions about it. “If I could get an Omicron booster now, I definitely would,” Wang told me. Harvard’s Abraham said that he’s in the same boat. Meanwhile, John Wherry, an immunologist at the University of Pennsylvania, was one of several scientists who said that option’s a “nope”—safer, they said, to keep something with OG. The most common refrain, though, was, I’m not sure, and I’m glad I’m not the one deciding.

There could still be a quasi-compromise: a dose that includes two spike variations, maybe more, in the same shot. So-called bi- and multivalent vaccines are already in the works; both Moderna and Pfizer are slurrying together spikes from BA.1 and the OG coronavirus variant, a recipe that Moderna executives have repeatedly described as their “lead candidate for fall 2022.” That tactic could simultaneously enhance and focus the body’s defenses, says Lexi Walls, a biochemist and vaccine developer at the University of Washington. Such combo shots are the wary vaccinologist’s hedge: They might offer both a reminder of a version of the virus that most immune systems have already seen, as well as a preview of what might still be to come.

Cramming several spikes together isn’t a perfect solution. A recipe that’s half BA.1 and half OG won’t necessarily yield an immune response that splits the difference. Such a concoction also doesn’t fully solve the problems of an Omicron-only vaccine. The pesky delay between design and deployment always puts the humans behind: BA.1 may no longer be the most relevant form of Omicron to use, because it’s rapidly being ousted by speedier siblings. And a body trained on BA.1 might have some trouble tussling with some of its more irksome kin, which appear to circumvent some of the antibodies their predecessor lays down. The BA subvariants, for now, share the name Omicron, but in reality, some of them are “just as divergent as some of the variants of concern that have their own Greek letter,” says Jemma Geoghegan, a virologist at the University of Otago, in New Zealand.

Several experts, including UW’s Greaney and Michigan’s Lauring, told me that, in an ideal world, they would have liked to see BA.2’s spike slotted into the next shot instead. That’s not necessarily a reason to forgo an upgrade to BA.1, though, because that could still better familiarize bodies with other Omicron offshoots than if they were left none the wiser. Strain-vaccine mismatches happen all the time with flu shots, Geogeghan points out, and even so, those vaccines “are still really good at protecting against severe disease and death.”

Experts won’t know for sure how bivalent vaccines will fare until Moderna and Pfizer publish data from their ongoing trials. Omicron-only shots might outperform them; original-recipe boosters might still trounce them all; none of those data will have clear bearing on the next theoretical variant to rise. Abraham, for one, isn’t quite sold on the idea of a bivalent vaccine. “We don’t know what the second-best antigen would be” after Omicron’s spike, he told me; pick the wrong one, and it may just end up wasting space in shots. He’d prefer to lean into Omicron’s ongoing monopoly, he said, and model the next shot on only that. (Moderna is also trialing a Beta-OG bivalent shot—remember Beta?—that the company says is performing well, even against BA.1.)

Vaccines may not always need to lag variants this much. Geogeghan expects that the pace at which new, antibody-dodging variants sprout off the coronavirus family tree will eventually slow down. And researchers such as Walls, at UW, are working on universal vaccines that may be able to guard against a whole menagerie of coronavirus iterations—perhaps even ones that haven’t yet been detected—so that the game of variant whack-a-mole can end.

Until then, experts are working with limited options, based on limited data—and there is yet another option that may feel like the easiest of all: Do nothing, and stick with the vaccines we have. They are, after all, still performing extraordinarily well, especially when delivered in full rounds of at least three doses; it’s what’s known, and maybe, what feels safe. Among the dozen-plus experts I spoke with for this piece, there wasn’t consensus on what our next vaccine’s main ingredients should be. Still, most agreed on this: The worst thing to do would be to stay stagnant with our shots—to miss an opportunity to move our understanding forward when the virus has already gained so much ground. “We’re always playing catch-up,” says Karthik Gangavarapu, a computational biologist at UCLA. “But if we don’t do anything, we’re for sure not going to be able to win the race.”

Five things you need to know about the coronavirus pandemic this Friday morning.

To avoid drawing unwanted attention, Tommy and the four others dressed as if they were heading out for a leisurely day. It was July 2020, and the weather was perfect for some time on the water. The young men acted as though they knew one another well, and were excited to reconnect. But inside, Tommy felt panicked and desperate. He was about to attempt an escape from Hong Kong, where he faced a near-certain jail sentence for his role in the prodemocracy protests there. He feared that he, or one of these strangers, might have been tailed by police to the docks.

In the scenario that kept replaying in his head, officers closed in on the men as they stood next to their boat, a roughly 20-foot rigid speedboat laden with jugs of extra fuel and fishing equipment. Tommy—who asked to be identified by a nickname—didn’t allow himself to relax until the boat sped away from land, the coastline shrinking behind them and the blue sky stretching out in front.

As the boat’s hull slapped against the rolling swells, the life vests the men carried flew overboard, but they didn’t bother to turn back. One leaned over the edge and peeled identifying numbers off the boat’s bow, hoping for an extra layer of anonymity. They took turns driving—the young men had learned their elementary boating skills from watching videos on YouTube and had practiced a handful of times. No matter who was behind the wheel, they kept the engine throttle wide open and scanned the horizon for trouble. The whipping wind and the din of the motors made communication nearly impossible. The sun set. The lights of fishing boats and enormous shipping vessels bobbed up and down.

Tommy lost track of how long they’d been driving the boat—at least 10 hours. When the GPS unit showed the vessel leaving Hong Kong waters, they finally eased off on the throttle. “We knew we were safe,” Tommy later told me. They passed around snacks and water, then introduced themselves to one another, sharing their real names for the first time and explaining their reasons for undertaking such a perilous journey: All were prodemocracy activists looking for safety on the island of Taiwan. Their bid for freedom, however, would soon draw in the United States.

Hours earlier, one of Tommy’s green Vans sneakers had sailed over the side of the boat and into the water. No one had considered stopping to retrieve it. Now, in spontaneous, rowdy celebration of their nearly completed escape, the group peed on the remaining shoe, then kicked it overboard—a memory that Tommy would laugh about later.

Their plan had been fairly simple: If they made it this far, they would turn off their engines, and call a contact in Taiwan who would alert the coast guard to their presence. When the authorities arrived, they would claim they had run out of fuel on a fishing trip and needed to be towed to shore. Only once on land would they divulge their true stories. Tommy gazed upward as they waited for the coast guard to arrive. The light pollution radiating from Hong Kong normally obscured his view of the stars. But here, in the open water, he could see the whole sky.

When the Taiwanese coast guard appeared, the five men waved flashlights to attract attention. Their plan fell apart almost as soon as the authorities reached their boat. The coast guard had extra fuel on hand, and initially offered to simply transfer it over, then send the wayward boat on its way. As the coast guard crew spoke to the young men, however, they grew suspicious. What were the five doing in the area? Why were they carrying so few supplies and traveling in an unmarked boat? “They knew that we weren’t just out fishing,” Tommy told me.

The young men fessed up, telling the sailors their real intentions. They had been among huge crowds of people who since the spring of 2019 had taken to the streets to call for democracy in Hong Kong. Now they feared for their safety as Beijing not only stamped out the protests, but moved to decimate all dissent in the city. The Taiwanese coast guard brought the group ashore where they were questioned by military officials. The next day, they were moved again by ship. Tommy slept on and off. He wasn’t sure where they were heading.

Eventually, he and the others were deposited in rooms that reminded him of the dorms at his university back in Hong Kong. They had no computers and no internet access. Government officials—Tommy isn’t sure who they were—came and went, asking more questions. Eventually, the five men were allowed to watch TV and read articles from Apple Daily, the now-defunct prodemocracy newspaper. As their confinement stretched into months, Tommy, who had been an arts student before he abandoned his studies, sketched to pass the time.

Some of the young men wanted to stay in Taiwan, but others hoped to resettle elsewhere. They were given English lessons by a tutor. The materials, for reasons none of them understood, covered the history and geography of Boston, and how to navigate the city on public transportation. To mark New Year’s Eve, Tommy shaved off his long hair. He wanted a symbolic new start. Two weeks later—about six months after he’d fled Hong Kong—the journey to freedom that started on a small boat would end on a commercial flight that touched down in the United States.

Hong Kong was long a magnet for people seeking opportunity and running from persecution. Residents of mainland China fleeing the violence and political purges of the Cultural Revolution swam toward the city’s lights—Tommy’s grandmother among them. In the late 1970s, thousands packed into ships, many of which were cramped wooden fishing boats, to escape to Hong Kong from Vietnam as that country’s war ended. After the 1989 Tiananmen Square massacre, student activists from China snuck into Hong Kong.

Now the fleeing has reversed, as Beijing’s crusade to strip Hong Kong of its defining freedoms has created a wave of exiles. “It is still beautiful,” Kwok Ka-ki, a former prodemocracy lawmaker, told me of the city, “but underneath, everything has changed.” Soon after we spoke, he was arrested, and now faces charges under a draconian national-security law imposed in 2020, an effort to extinguish any form of political opposition wholesale.

At Hong Kong’s airport—even as it is crippled by stringent COVID regulations—crowds gather nightly to board flights abroad, aiming to join the tens of thousands who have already left. Among them are parents worried about the city’s more nationalistic curriculum, activists escaping the ever-shrinking space for dissent, and former prodemocracy legislators who have seen their colleagues locked up.

Over the course of several years living in and covering Hong Kong, I have met countless such exiles. Some want nothing more than anonymity in their new countries, hoping to put the movement behind them. Others remain deeply involved in activism from abroad, setting up organizations and creating online initiatives. They share an acute feeling of isolation and sadness, unmoored from a place they once believed they could help save.

Three in particular are fleeing almost certain jail time after joining in prodemocracy demonstrations and agitation, their stories highlighting the gulf between Hong Kong’s promise and its reality today. They either escaped aboard a tiny boat, ultimately crossing a vast distance, or tested U.S. border policy by illegally slipping into America on land. One later spent months walking from New York to Florida on foot to raise awareness of Hong Kong’s plight. “You think this is crazy?” Tommy said to me when I marveled at the riskiness of his trip. “Imagine how I feel.”

The exiles—all of whom, like Tommy, asked to be identified by nicknames to avoid retribution from Beijing and pro-China groups—are each grappling with their newfound freedom in different ways, at times clashing with other members of the Hong Kong diaspora over how best to help their home city, and wrestling with guilt for those left behind. They have put their fate in the hands of the U.S., a country they still see as a beacon in their fight against China.

Almost as soon as Tommy and his fellow travelers were escorted ashore in Taiwan, officials there began working to resolve the geopolitical dilemma the group had inadvertently set off. Beijing had baselessly accused the U.S. and Taiwan of fomenting the Hong Kong protests, so a public announcement about the five could further inflame tensions. Taiwan—which lives under Beijing’s constant threat of forceful reunification with mainland China—sought American help. The State Department worked with a Hong Kong lobbyist in Washington, D.C., to begin planning the group’s transfer to U.S. soil.

In January 2021, the men boarded a flight from Taipei to New York City. Through all those months in limbo in Taiwan, Tommy had been unable to directly contact his family. He had rehearsed cracking a joke to tell them he was fine, but when he landed in the U.S. and finally spoke to them on the phone, he broke down crying.

Adams Carvalho

On the surface, Tommy and Ray have a lot in common. Both have family members who fled mainland China for the relative safety of Hong Kong (albeit decades apart), and both grew up on tales of Chinese Communist Party abuse. And though the men’s paths did not cross in Hong Kong, they were both active participants in the city’s protest movement. Tommy had been among those who broke into the Legislative Council building; Ray was one of the students who occupied a university campus in a days-long siege.

But the two are also very different. Tommy is a wiry, bespectacled 24-year-old, whereas Ray, 20, is stocky and gregarious, a bit of a smartass. Tommy was riven with fear and uncertainty during the months it took him to plan his escape from Hong Kong; Ray seemed to me to be totally unbothered by the risks he had taken.

Ray fled Hong Kong aboard a plane bound for London in August 2020. After arriving and looking up Britain’s asylum-acceptance rates, he turned his sights to the United States. But the Trump administration had banned flights from Europe as part of efforts to curtail the coronavirus pandemic, so after a few months in Britain, and some scheming with an eccentric Chinese activist and immigration lawyer he connected with on Twitter, he boarded another flight, this one bound for Mexico. He would cross into the U.S. on foot.

Ray first attempted the crossing soon after arriving, in January 2021. He walked for hours after being dropped near a crossing point by a smuggler. It was frigid and windy. To avoid detection, he trekked in complete darkness. But no one stopped him, and eventually he arrived at a gas station in Southern California, where a contact met him. He fell asleep during the car ride north and awoke only when the driver announced, “Welcome to L.A.”

From there, he initiated an asylum claim, which likely would have inched through the bureaucracy were it not for Ray’s own impatience. Holed up in an Airbnb east of Los Angeles, he killed time watching cable news. He was particularly infatuated with debates over immigration. On one show, liberal-leaning politicians claimed the American system was so dysfunctional that migrants detained after attempting to enter the U.S. would likely be granted asylum faster than those who arrived without incident. Hearing this, Ray devised a new plan.

In early February, he headed back to the border, walked into Mexico, and then, after a few days, tried crossing into the U.S. again. This time, he hiked across a stretch of hills outside Mexicali and used a flashlight to catch the attention of a group of border guards. When they got ahold of him, he explained his situation in English, hoping to find a compassionate audience. Instead, the oldest-looking of the three turned him around, menacingly warned him not to try crossing again, and watched as Ray trudged into Mexico. Again.

Undeterred, Ray waited a few days and revised his tactics. He took a new route and this time, after flagging down some border guards, pretended not to understand English, speaking to them in Cantonese, the dominant language of Hong Kong. Carrying only his mobile phone and a few other possessions, he feigned ignorance—and had to stifle a laugh—when one of the agents said, “I caught a ninja!” The border guards finally resorted to using a translation app to pepper him with questions.

Authorities took him to a detention center where he was held for eight days with about 20 other men. The Immigration and Customs Enforcement facility in San Diego where he was soon transferred was far better. After interviews with U.S. officials, he walked out of Otay Mesa Detention Center in mid-April 2021. The asylum process typically takes from six months up to several years, according to the National Immigration Forum, an advocacy group. It took Ray just 63 days.

Since the start of the 2019 protests, the U.S. has consistently called for China to preserve Hong Kong’s independent press, judiciary, and rule of law. Time and again, American officials and politicians have criticized Beijing for its crackdown. Congress passed the Hong Kong Human Rights and Democracy Act in 2019, which put the city’s special trading privileges with the U.S. under greater scrutiny, and compelled the U.S. to level sanctions against Hong Kong officials responsible for human-rights abuses. If these measures were designed to curtail China’s actions, however, they failed. Beijing has brushed them off as little more than a nuisance.

Stories such as Tommy’s and Ray’s suggest the U.S. is fulfilling its obligation to Hong Kong’s prodemocracy movement. The means they took to get to the U.S., though, were drastic and almost impossible to replicate. A truer test of American mettle is the countless others like them who remain in limbo, victims of a broken and deeply politicized American immigration system. These people stood up to Beijing’s authoritarian might and, knowing they would likely lose, fought for their freedoms anyway. Yet U.S. lawmakers from both parties who once cheered them seem to have largely moved on.

The Hong Kong Human Rights and Democracy Act passed the House of Representatives by a 417–1 vote in November 2019, but the bipartisanship was fleeting. At the time, few were more eager to bash China than Senator Ted Cruz, who flew to Hong Kong at the height of the protests and dressed in all black out of “solidarity” with the demonstrators. The marches were “inspiring,” Cruz said then. About a year after he proclaimed Hong Kong to be the “new Berlin,” however, he showed the limits of his support. In December 2020, he killed a bill that included provisions for temporary protected status for Hong Kongers and expedited certain refugee and asylum applications. It had previously passed in the House.

A few months before Cruz shot down the bill, saying it was a ploy by Democrats who support “open borders” to make “all immigration legal,” a group of Hong Kongers, among them an American citizen, sought protection in the city’s U.S. Consulate but were turned away. One was arrested by the Hong Kong authorities and sentenced to three years and seven months in jail.

Last August, the Biden administration made a small concession, blocking the enforced removal of many Hong Kong residents from the U.S. for a period of 18 months. The White House said in a memo that “offering safe haven for Hong Kong residents who have been deprived of their guaranteed freedoms in Hong Kong furthers United States interests in the region.” Getting in, however, remains a challenge.

Adams Carvalho

Kenny, a 27-year-old former civil engineer, took the same route as Tommy to flee Hong Kong; he was on the same boat. But while Tommy soon decided that he liked New York, Kenny felt restless.

Kenny had stayed fervently involved in the Hong Kong prodemocracy movement when he was resettled, initially in Arlington, Virginia. He joined protests and tried to spread his message on social media. But he wanted to do more, and staying planted in Arlington while trying to sound the alarm seemed ineffective. So he settled on the most American of pastimes, a road trip—but without that most American of possessions, a car. His first walk was a 10-day trek from the White House to New York City. He hoped that by speaking to ordinary Americans, he could raise awareness of the crackdown under way in his home city. A few months later, Kenny set off on an even more ambitious route, from the Pentagon all the way to Miami. In all, he estimated, he would walk more than 1,000 miles.

Kenny documented his movements on Instagram, posting videos and photos of the people he encountered and the places he passed through. He snapped pictures fit for a tourism ad for rural America: rolling cornfields, Amish families standing near their horse-drawn buggies, red-painted barns. He embarked on his walk with his face completely covered by a reflective sunglass shield that looked like it was borrowed from the prop closet on a cyberpunk film set, and a thin flag pole jutting from his backpack adorned with two black banners that read Liberate Hong Kong, Revolution of Our Times, one in Chinese and another in English.

His unusual appearance attracted attention, not all of it welcoming. In Maryland, someone called the police on him as he knocked on doors looking for bandages. On the eighth day of his walk to Miami, a stranger pulled a gun on him as he tried to hide near the man’s garage during a rainstorm.

As he moved farther south, Kenny found people to be more accommodating, which he’d expected, and more informed about the prodemocracy movement, which he hadn’t. Often, though, he was downbeat, discovering that many Americans had the luxury of not knowing or caring what was happening on the other side of the world.

He felt more optimistic when a worker at a sports bar in Moncure, North Carolina, told him he had followed the news about Hong Kong, and gave Kenny slices of pizza and an orange soda. In Glynn County, in southeastern Georgia, Kenny spent the night with firefighters who let him sleep in the firehouse. In Florida in mid-October, a woman invited him to sleep at her house. He stayed for three days, met her family, and joined them on a trip to a park where he spotted a manatee in the water. He documented the sighting with an Instagram post punctuated by a string of exclamation points. In all, the walk lasted 66 days.

As he navigated America’s roadways, a court case about him in Hong Kong carried on. Kenny had been among a group of demonstrators who, rallying against a government decision to ban face masks at marches, had assaulted a police officer after the officer grabbed a protester. Video of the skirmish, filmed by a passenger on a nearby bus, was picked up by international news outlets. Kenny was arrested but released on bail, which is when he began trying to escape Hong Kong by boat, eventually succeeding on his fifth or sixth try. (Earlier failed efforts cost him a small fortune.)

Days after his outing to the park in Florida, sentences were handed down against two of Kenny’s co-defendants. One was given seven years in jail, the other sent to a rehabilitation center. Kenny told me he had no regrets about fleeing, that he wanted to look forward. “This is why I decided to walk—because I don’t want to think back or live in a constant state of regret,” he said. He later admitted that he did at times feel guilt about leaving, but he tried to bury it, preferring to focus on forward action. “I’m thinking: What can I do on their behalf?” he said. “This is my purpose.”

In some—extremely limited—respects, he has succeeded, telling individual Americans about a fight for freedom half a world away that many of them are unaware of. I spoke with one of the people who met Kenny on his walking tour, Nicholas Kiernan, who said he had initially driven past Kenny in Northern Virginia in late August while on his way to work. Kenny’s peculiar appearance caught Kiernan’s attention. He resembled “a Google mapping device,” Kiernan told me. “He looked wild.” About a half hour later, Kiernan, a land surveyor, was still thinking about the odd character from his morning commute when Kenny stumbled onto Kiernan’s worksite. Intrigued, Kiernan hopped out of his truck to ask Kenny what he was up to.

Kenny showed him photos of the Hong Kong protests, explaining to Kiernan, who knew nothing about what was happening there, about how police had cracked down on demonstrators. “It was thought-provoking stuff,” Kiernan recounted. But perhaps more than anything, Kiernan said he was impressed by Kenny’s courage—sleeping in a tent and carrying a heavy backpack for miles at a time, speaking to total strangers in a foreign language in a new country. “It takes heart to be able to do something like that.”

Additional reporting by Karina Tsui.

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