Imagine that a historian decides to reflect on the pandemic, asking quite simply, “How did it come to this?” There would be many ways of telling that story. But one way would be to chart a series of off-ramps on the road to disaster. Some of these off-ramps can be located in China, at least one in the World Health Organization, and then several in the United States. Some are structural. Some are tied to specific decisions. Had any one of them been navigated differently, the pandemic would have been easier to handle.