theatlantic--2020-04-01--Everyone Thinks They’re Right About Masks

The question , then , isn ’ t whether the coronavirus is “ airborne ” in the tediously academic way the word has been defined .
As the journalist Roxanne Khamsi puts it , the virus is “ definitely borne by air.
” The better questions are : How far does the virus move ?
And is it stable and concentrated enough at the end of its journey to harm someone ’ s health ?
Read : The coronavirus ’ s unique threat to the south A handful of studies have offered preliminary answers .
One team of researchers blasted @ @ @ @ @ @ @ create a cloud of aerosols .
They found that the virus remained stable for several hours within that cloud , raising fears about its ability to persist in ambient air .
But as the researchers have noted , the study ’ s experimental setup was artificial .
It doesn ’ t reflect “ what ’ s occurring when you ’ re just walking down the street , ” says Saskia Popescu of George Mason University , who specializes in infection control and who was not involved in the study .
“ It ’ @ @ @ @ @ @ @ like intubation , which run the risk of aerosolizing the virus , and are unique to the health-care setting.
” A second study suggests that the coronavirus can be released into the air in less dramatic ways .
Joshua Santarpia and his colleagues at the University of Nebraska Medical Center found traces of the coronavirus ’ s RNA—its genetic material—in rooms occupied by a total of 13 COVID-19 patients , most of whom had only mild symptoms .
The RNA was on obvious places such as bed rails and toilets , but also @ @ @ @ @ @ @ , window ledges , and the floors beneath the beds .
The RNA even lingered in the air ; using air-samplers , the team detected viral RNA floating more than six feet away from the patients , and even in the hallways just outside the patients ’ rooms .
This isn ’ t necessarily cause for alarm .
Finding viral RNA is like finding a fingerprint at a crime scene—the culprit was once there , but might be long gone .
So far , the Nebraska team has failed to detect live , @ @ @ @ @ @ @ Santarpia told me that further tests are under way , and results will be released soon .
If the Nebraska team does find infectious particles , it would mean that even mildly symptomatic people can expel SARS-CoV-2 into the air , and that the virus can travel at least the length of a hospital room—a claim supported by a few other studies .
Even that , though , would not guarantee danger .
Are those far-spreading virus particles concentrated enough to infect another person in the same room ?
How many virus particles @ @ @ @ @ @ @ infection ?
How far does the virus travel in outdoor spaces , or in other indoor settings ?
Have these airborne movements affected the course of the pandemic ?
These questions have no answers yet .
To get those answers , “ you ’ d have to expose animals to different quantities of airborne viruses , see if they get infected , and relate that to measures of the virus [ in places ] where people are infected , ” says Bill Hanage , an epidemiologist at Harvard .
“ This is the @ @ @ @ @ @ @ for years , but no one is going to find out for the moment .
”

Updated at 7:22 p.m. ET on April 4, 2020.
As the coronavirus pandemic continues, many people are now overthinking things they never used to think about at all. Can you go outside? What if you’re walking downwind of another person? What if you’re stuck waiting at a crosswalk and someone is there? What if you’re going for a run, and another runner is heading toward you, and the sidewalk is narrow? Suddenly, daily mundanities seem to demand strategy.
Much of this confusion stems from the shifting conversation around the pandemic. Thus far, the official line has been that the new coronavirus, SARS-CoV-2, could be transmitted only through close contact with infected people or contaminated surfaces. But recently, news reports have suggested that the coronavirus can spread through the air. After 60 choir members in Washington State rehearsed together, 45 fell sick, even though no one seemed symptomatic at the time. Now people who were already feeling cooped up are worrying about going outside. Many state guidelines are ambiguous, and medical advice can muddy matters further. When the writer Deborah Copaken came down with COVID-19 symptoms, her doctor chided her for riding her bike through New York City a week earlier. Going outside in the city wasn’t safe, the physician implied, with “viral load everywhere.”
Read: Grocery stores are the coronavirus tipping point
To be clear, every expert I spoke with for this piece told me that it’s still mostly safe to spend time outdoors. If anything, they said, such forays should be encouraged for the sake of our mental health. Distance and ventilation matter, and outdoor spaces offer plenty of both. Distance is harder to maintain in bustling cities like New York, but the point remains that any risk lies in the density of people, not in some thick viral miasma suffusing the air.
That’s the good news. The matter of going outside, however, is just the simplest and most easily resolved part of a larger and more vexing set of questions: Does the coronavirus travel through the air? If so, how can we escape it? Should we all be wearing masks? The details of our new uprooted lives hinge on the answers. And the answers are complicated.
Is the new coronavirus airborne?
Confusingly, in public-health circles, the word airborne has a technical meaning that’s not just “carried through the air.” When people are infected with respiratory viruses, they emit viral particles whenever they talk, breathe, cough, or sneeze. These particles are encased in globs of mucus, saliva, and water. Bigger globs fall faster than they evaporate, so they splash down nearby—these are traditionally called “droplets.” Smaller globs evaporate faster than they fall, leaving dried-out viruses that linger in the air and drift farther afield—these are called “aerosols.” When researchers say a virus is “airborne,” like measles or chickenpox, they mean that it moves as aerosols. When the World Health Organization asserts that the new coronavirus is “NOT airborne,” it’s claiming that the virus instead spreads primarily through the close-splashing droplets, which either land directly on people’s faces or are carried to their faces by unwashed, contaminated hands.
Read: Why the coronavirus has been so successful
Such messaging is “really irresponsible,” argues Don Milton, an expert in aerosol transmission at the University of Maryland. The scientific community doesn’t even agree about whether aerosol transmission matters for the flu, so “to say that after three months we know for sure that this [new] virus is not airborne is … expletive deleted,” he says. Milton and other experts who study how viruses move through the air say that the traditional distinction between big, short-range droplets and small, long-range aerosols is based on outdated science. Lydia Bourouiba of MIT, for instance, has shown that exhalations, sneezes, and coughs unleash swirling, fast-moving clouds of both droplets and aerosols, which travel many meters farther than older studies predicted. Both kinds of glob also matter over shorter distances: Someone standing next to a person with COVID-19 is more likely to be splashed by droplets and to inhale aerosols.
The question, then, isn’t whether the coronavirus is “airborne” in the tediously academic way the word has been defined. As the journalist Roxanne Khamsi puts it, the virus is “definitely borne by air.” The better questions are: How far does the virus move? And is it stable and concentrated enough at the end of its journey to harm someone’s health?
Read: The coronavirus’s unique threat to the south
A handful of studies have offered preliminary answers. One team of researchers blasted virus-laden fluids into a rotating cylinder to create a cloud of aerosols. They found that the virus remained stable for several hours within that cloud, raising fears about its ability to persist in ambient air. But as the researchers have noted, the study’s experimental setup was artificial. It doesn’t reflect “what’s occurring when you’re just walking down the street,” says Saskia Popescu of George Mason University, who specializes in infection control and who was not involved in the study. “It’s more akin to medically invasive procedures like intubation, which run the risk of aerosolizing the virus, and are unique to the health-care setting.”
A second study suggests that the coronavirus can be released into the air in less dramatic ways. Joshua Santarpia and his colleagues at the University of Nebraska Medical Center found traces of the coronavirus’s RNA—its genetic material—in rooms occupied by a total of 13 COVID-19 patients, most of whom had only mild symptoms. The RNA was on obvious places such as bed rails and toilets, but also on harder-to-reach spots such as ventilation grates, window ledges, and the floors beneath the beds. The RNA even lingered in the air; using air-samplers, the team detected viral RNA floating more than six feet away from the patients, and even in the hallways just outside the patients’ rooms.
This isn’t necessarily cause for alarm. Finding viral RNA is like finding a fingerprint at a crime scene—the culprit was once there, but might be long gone. So far, the Nebraska team has failed to detect live, infectious virus in its air samples. Santarpia told me that further tests are under way, and results will be released soon.
If the Nebraska team does find infectious particles, it would mean that even mildly symptomatic people can expel SARS-CoV-2 into the air, and that the virus can travel at least the length of a hospital room—a claim supported by a few other studies. Even that, though, would not guarantee danger. Are those far-spreading virus particles concentrated enough to infect another person in the same room? How many virus particles does it even take to launch an infection? How far does the virus travel in outdoor spaces, or in other indoor settings? Have these airborne movements affected the course of the pandemic?
These questions have no answers yet. To get those answers, “you’d have to expose animals to different quantities of airborne viruses, see if they get infected, and relate that to measures of the virus [in places] where people are infected,” says Bill Hanage, an epidemiologist at Harvard. “This is the type of stuff people will work on for years, but no one is going to find out for the moment.”
Is it safe to go outside?
Even if coronavirus particles can move through the air, they would still diffuse over distance. “People envision these clouds of viruses roaming through the streets coming after them, but the risk of [infection] is higher if you’re closer to the source,” says Linsey Marr, who studies airborne disease transmission at Virginia Tech. “The outside is great as long as you’re not in a crowded park.”
In February, scientists in Wuhan, China—where the coronavirus outbreak originated—sampled the air in various public areas, and showed that the virus was either undetectable or found in extremely low concentrations. The only exceptions were two crowded sites, one in front of a department store and another next to a hospital. Even then, each cubic meter of air contained fewer than a dozen virus particles. (No one knows the infectious dose of SARS-CoV-2—that is, the number of particles needed to start an infection—but for the original SARS virus of 2003, one study provided estimates many times higher than the levels detected in the Wuhan spaces.)*
These particles might not even have been infectious. “I think we’ll find that like many other viruses, [SARS-CoV-2] isn’t especially stable under outdoor conditions like sunlight or warm temperatures,” Santarpia said. “Don’t congregate in groups outside, but going for a walk, or sitting on your porch on a sunny day, are still great ideas.”
Read: This is how we can beat the coronavirus
You could tie yourself in knots gaming out the various scenarios that might pose a risk outdoors, but Marr recommends a simple technique. “When I go out now, I imagine that everyone is smoking, and I pick my path to get the least exposure to that smoke,” she told me. If that’s the case, I asked her, is it irrational to hold your breath when another person walks past you and you don’t have enough space to move away? “It’s not irrational; I do that myself,” she said. “I don’t know if it makes a difference, but in theory it could. It’s like when you walk through a cigarette plume.”
Indoors, experts’ opinions start to diverge. Consider, for example, the grocery store—one of the last vestiges of public life. There, Santarpia is far more concerned about touching shared surfaces than breathing shared air, and he makes sure to sanitize his hands before he leaves. Marr said that she tries to go when it’s less crowded, although that’s obviously harder in a big city. Bourouiba’s best advice is to always keep as much distance from other people as possible, and she adds that the onus is on stores to improve their ventilation or limit the number of concurrent customers. Stores must also devise ways of protecting the people at greatest risk: the cashiers and the workers stocking shelves.
Then there are shared spaces like hallways, stairwells, and elevators in apartment buildings. Elevators pose the highest risk, Bourouiba told me, since they’re enclosed boxes with limited airflow. For stairwells and hallways, she advocated a commonsense approach: “If you hear neighbors going out, and there are 10 people in the corridor right now, maybe wait and go later.”
As for interconnected indoor spaces, such as apartments that share ventilation: “I don’t want to freak people out about their ventilation systems [to the point where] they’re covering their vents,” Marr said. “Just open the windows.” Bourouiba agreed. The calculus might change if you’re in a first-floor unit next to a heavily trafficked street, but in general, “I would encourage people to open their windows and create drafts, once or twice a day.”
Read: The dos and don’ts of social distancing
Apartment life “is not zero-risk, but it’s relatively low-risk, and people shouldn’t be on lockdown to the point that they never get fresh air,” Bourouiba said. The biggest risk—touching contaminated surfaces such as doorknobs and keypads—can be addressed with soap or hand sanitizer. As far as the air goes, “the likelihood of an airborne spread situation—where there’s somebody in the apartment next to you, and you walk by their apartment, and you somehow pick up an aerosol and get sick—seems really small to me,” Santarpia said. “If you know you’re in a shared space, follow social-distancing guidelines, clean your hands, and try to avoid touching your face.”
If people have no choice but to be in a riskier space, such as an elevator or a grocery-store line, the last resort might be to wear a mask. But this issue has become the most divisive one of all.
Should I wear a mask?
For health-care workers, the answer is obviously yes. But which masks? The World Health Organization and the Centers for Disease Control and Prevention both state that doctors and nurses can use basic surgical masks when treating COVID-19 patients, switching to the more advanced N95 respirators if they’re carrying out procedures that might create aerosols. But such recommendations assume that the virus isn’t generally airborne. Because it might be, health-care workers should err on the side of precaution by wearing N95s and using even better respirators for more dangerous procedures, argues Lisa Brousseau of the University of Illinois at Chicago. All of this equipment is in short supply, but health-care workers at least deserve to know what the ideal measures are.
For everyone else, the debate is even trickier. For months, the WHO, the CDC, and most public-health professionals advised that people don’t need to wear face masks unless they have COVID-19 or are caring for someone who does. At the same time, these experts have noted that health-care workers are in dire need of masks, which are running out because of strained supply chains and surging patient numbers. On February 29, the U.S. surgeon general, Jerome Adams, tweeted, “Seriously people- STOP BUYING MASKS! They are NOT effective in preventing general public from catching #Coronavirus, but if healthcare providers can’t get them to care for sick patients, it puts them and our communities at risk!”
If masks are limited, conserving them for the people who need them most makes sense. But that message was lost amid the confusing claim that masks somehow protect health-care workers but are useless for everyone else. In recent weeks, that simmering tension has come to a boil. Opinion pieces, news stories, and scientific papers have urged Western countries to use masks widely, emulating the example set by East Asian countries. Masks are mandatory for anyone entering a supermarket in Austria, and anyone leaving their house in the Czech Republic and Slovakia. In the U.S., the CDC changed its guidelines, recommending that Americans wear cloth or fabric face coverings in public. Many public-health experts have pivoted, too. “I went with the public-health message at the beginning: People don’t need masks,” Marr said. “But I’ve changed because of the mounting evidence that it does seem to be spreading through the air.”
Read: America needs plasma from COVID-19 survivors now
If the virus is traveling through the air, then it seems intuitive that masks would block it. But the evidence for this is all over the place, especially for surgical masks, which are more common than N95 respirators, and which don’t form a tight seal with the face. Several past studies have found that face masks could reduce the risk of flu-like infections, slow flu transmission in households, and even reduce the spread of SARS, especially when combined with hand-washing and gloves. Other studies have been more equivocal, finding that masks provide no benefit, small benefits, or benefits only in conjunction with measures like hand-washing. “Airflow follows the path of least resistance, and if it won’t enter through the mesh, it can come in from the side,” Bourouiba said. “There’s no evidence whatsoever to suggest that [surgical masks] are protective against the smallest droplets.”
There’s still a good case for masks, though, even if they can’t stop viruses from getting in: They can stop viruses from getting out. A new study shows that people who are infected with milder human coronaviruses release fewer viral particles when they wear surgical masks. “I’ve been slightly dismissive of masks, but I was looking at them in the wrong way,” Harvard’s Bill Hanage told me. “You’re not wearing them to stop yourself getting infected, but to stop someone else getting infected.” This might be especially important for SARS-CoV-2, which can spread without immediately causing symptoms. If people are infectious before they fall sick, then everyone should wear face masks “when going out in public, in one additional societal effort to slow the spread of the virus down,” says Thomas Inglesby of the John Hopkins Center for Health Security.
Some commentators have argued that countries that have thus far succeeded in curbing their COVID-19 outbreaks have widely used masks. But this relationship isn’t as perfect as it might appear. China advocated mask use early on and still struggled to contain the disease. Japan uses masks widely but is now seeing an uptick in cases. Singapore reserved them for health-care workers but still flattened the curve of infections. Many successful mask-using countries relied on other measures, such as extensive testing and social distancing, and many were ready for the pandemic because of their prior run-in with the 2003 SARS epidemic.
In Asia, masks aren’t just shields. They’re also symbols. They’re an affirmation of civic-mindedness and conscientiousness, and such symbols might be important in other parts of the world too. If widely used, masks could signal that society is taking the pandemic threat seriously. They might reduce the stigma foisted on sick people, who would no longer feel ashamed or singled out for wearing one. They could offer reassurance to people who don’t have the privilege of isolating themselves at home, and must continue to work in public spaces. “My staff have also mentioned that having a mask reminds them not to touch their face or put a pen in their mouth,” Bourouiba noted.
Or masks could have the opposite effect. Whenever Santarpia sees someone wearing a mask in public, that person is constantly touching it, futzing with it, and pulling it down to wipe their mouth. “Masks are really uncomfortable, and no one wears them correctly,” he said. “Rather than being protective, you’ve put something on your face that makes you want to touch your face more, or to touch the outside of the mask, which is infectious. You’ve created a hazard for yourself that’s right on your face.”
Many public-health experts have voiced similar complaints, based on their own personal experience. But it’s hard to find studies showing that novice mask-users touch their face more, or that such behavior increases the risk of infection. Regardless, if people misuse masks, why not train them? Countless videos and memes have been made to show people how to wash their hands properly, and the WHO already has a good instructional video about using masks.
Read: The curve is not flat enough
The debate is somewhat moot right now, because there simply aren’t enough masks for medical professionals, let alone everyone else. No matter their opinions on widespread mask-wearing, everyone I spoke with for this article agreed that health-care workers should get dibs on any existing medical masks. This might well be why public-health officials have been so loath to recommend mask-wearing more broadly: Hoarders have already begun to exhaust the dwindling supplies. Even so, “policy shouldn’t be made to accommodate a lack of the supply,” Bourouiba said. “It should create the impetus to generate that supply.”
In the meantime, citizens (and, unfortunately, many health-care workers) will have to make do with MacGyvering their own alternatives. A few studies suggest that homemade cloth masks are less effective than proper medical ones, but are still better than nothing. In one experiment, a surgical mask filtered 89 percent of viral particles from volunteers’ coughs, a tea towel blocked 72 percent, and a cotton T-shirt blocked 50 percent.** In general, thicker materials are better than thinner ones, Marr said, and a tight fit across the face is important. If people use makeshift masks, they should thoroughly wash them afterward. And most of all, they should remember that homemade masks are not fully protective. They’re a last-ditch measure to be used in situations when social distancing isn’t possible. “It’s not like ‘I’m wearing [a mask] and now I can talk to everyone,’” Bourouiba said.
The mask debate is so intense because both the stakes and the uncertainty levels are so high. “We’re trying to build the plane while we’re flying it,” Hanage said. “We’re having to make decisions with quite massive consequences in the absence of secure data. It’s a nightmare for your average cautious public-health professional.”
The coronavirus pandemic has moved so quickly that years of social change and academic debate have been compressed into a matter of months. Academic squabbles are informing national policy. Long-standing guidelines are shifting. Within days, an experiment that’s done in a hospital room can affect how people feel about the very air around them, and what they choose to wear on their faces. Masks are a symbol, yes, but not just of conscientiousness. They’re also emblematic of a world that is changing so quickly, no one has time to take a breath.
* This article originally misstated the estimated number of viral particles in an infectious dose of SARS.


Juliette Kayyem

Juliette Kayyem , a former assistant secretary for homeland security under President Obama , is the faculty chair of the homeland security program at Harvard ’ s Kennedy School of Government .
She is the author of Security Mom : An Unclassified Guide to Protecting Our Homeland and Your Home .
• Trump Turns the U.S .
Into an Outcast Other countries are judging America by its sickest states and most reckless politicians .
• Trump Turned the Death Count Into a Story About Himself Official figures exclude thousands who have died during the pandemic .
To draw the right @ @ @ @ @ @ @ tally of the victims .
• The U.S. Is Now Resorting to Plan C Americans are not going to wait for sufficient testing .
So what happens next ?
• Life right now feels very odd .
And it will feel odd for months—and even years—to come .
• Canceling Everything Was the Easy Part Shutting entire states down was painful but clearly necessary .
Governors still have many ugly choices ahead of them .
• If Trump Can ’ t Do the Job , Other People Need To The president is more @ @ @ @ @ @ @ and out of government have to plan around him .
• The Crisis Could Last 18 Months .
Be Prepared .
The shutdowns happened remarkably quickly , but the process of resuming our lives will be far more muddled .
• Trump Leaves States to Fend for Themselves The coronavirus is America ’ s first 50-state disaster , and each governor is dependent on outside help that may never come .
• Trump Is Failing to Prepare Americans for a Disturbing New Reality As news about the coronavirus worsens , Americans need good @ @ @ @ @ @ @ .
The president is providing the public with neither .
• The U.S.
Isn ’ t Ready for What ’ s About to Happen Even with a robust government response to the novel coronavirus , many people will be in peril .
And the United States is anything but prepared .
• The Recurring Folly of ‘ If You See Something , Say Something ’ As tensions with Iran worsen , the post-9/11 homeland-security playbook is coming back .
But hypervigilance against vague threats is more useless than ever .
• Terrorism Only @ @ @ @ @ @ @ Ready for It Since 9/11 , national-security officials have made policy on a myth of American invulnerability .
They should have been preparing everyday citizens for the worst in order to make the country stronger .

Juliette Kayyem is a contributing writer at The Atlantic, the faculty chair of the homeland-security program at Harvard’s Kennedy School of Government, and the author of The Devil Never Sleeps: Learning to Live in an Age of Disasters
Brian Snyder / Reuters The Never-Ending Debate Over Who Deserves to Be Rescued The Titan disaster raised a perennial question: How much should the government protect people who put themselves in harm’s way?
Dustin Chambers / Reuters The Threat From Trump’s Supporters Has Evolved Their words are hot, but coordination is lacking.
Collin County Sheriff's Office / AP The Far Right Is Splintering In his trial, the Oath Keepers leader Stewart Rhodes turned against other extremists.
Dennis Van Tine / STAR MAX / AP An Ominous Warning to the E. Jean Carroll Jury A Manhattan judge’s advice to jurors accurately reflects what the former president has done to democratic norms.
David Paul Morris / Bloomberg / Getty Every Emergency Needs to End, Even COVID-19 Conditions have changed, and powers designed for crises are too easily abused.
John Tlumacki / The Boston Globe / Getty The Day ‘Stop the Bleed’ Entered Civilian Life The Boston Marathon bombing changed disaster management.
Matt Stone / Boston Herald / Getty I Oversaw the Massachusetts Air National Guard. I Cannot Fathom How This Happened. The government may classify too much intelligence, but that doesn’t mean a low-level employee should be able to see it.
Carlos Barria / Reuters The Secret Service’s Day of Reckoning Approaches An indictment of former President Donald Trump would offer the agency a chance to restore its tarnished reputation.
Matt Chase / The Atlantic; source: Getty Elon Musk Has Broken Disaster-Response Twitter The social-media platform’s crisis has become a real-world crisis.
U.S. Navy / Interim Archives / Getty The Simple Explanation for All These Flying Objects American air defense has been looking harder and reacting faster.
Larry Mayer / The Billings Gazette / AP Why the U.S. Isn’t Shooting Down the Chinese Spy Balloon Homeland-security threats and national-security threats demand different responses.
Brad Vest / The New York Times / … Why Memphis Is Different Because of the sheer prevalence of police brutality in America, public officials have gotten better at managing the shock.
Mark Peterson / Redux The Prospect of Prison Time Spoils Far-Right Fantasies Making extremist leaders answer for their actions will deter future violence.
Jason Connolly / AFP / Getty Rethinking ‘Run, Hide, Fight’ Our mass-shooting guidance may be woefully out of date.
AP; Joanne Imperio / The Atlantic Trump Endorsed QAnon Because He’s Stuck He’s grasping at straws, not solidifying his political base.
Eva Marie Uzcategui / Bloomberg / Getty Why Trump’s Safe Was Not Safe U.S. national security depends upon our allies’ ability to trust us with intelligence. Mar-a-Lago was no place to keep top-secret documents.
Peter Zay / Anadolu Agency / Getty The Bad and Good News About Trump’s Violent Supporters The FBI search at Mar-a-Lago prompts sincere talk of violence. But some threats remain mere threats.
Drew Angerer / Getty Trump’s Savviest Aides Already Headed for the Exits The hearings give the former president’s followers a new excuse to quietly back away.
Mark Mulville / The Buffalo News / AP A ‘Lone-Wolf’ Shooter Has an Online Pack Even when a shooter acts alone, their ideology is often shared.


Garrett Epps

The senator from California seems like the obvious choice to be Joe Biden ’ s running mate .
So why is she keeping mum about her thinking ?
A few weeks ago , an adviser to Kamala Harris called me to talk through some polling data .
“ We understand that Joe Biden ’ s the nominee , but the party is so much different than a septuagenarian white male , ” the adviser said .
“ Kamala Harris is more symbolic of that changing America—America coming together—than some of the other potential candidates ” for vice president .
The @ @ @ @ @ @ @ because , officially , Harris is pretending that she ’ s not campaigning to be Biden ’ s running mate .
In public , Harris has repeatedly insisted that she ’ s not talking about or thinking about her prospects of being picked .
But judging from my conversations with people around Harris , she and her team use her prospects to book events and television hits that aim to show she ’ s neither overeager nor overambitious .
She and her team are avoiding situations that could create stumbles .
They ’ @ @ @ @ @ @ @ background , and the force of her personality propel her .
They ’ re picking specific moments for her to grab attention on the Senate floor or send a calibrated tweet .
They ’ re tuning out political reporters who are stuck on their couches , looking to drum up content during the pandemic .
They ’ re trying to ease concerns in Biden ’ s orbit that if she ’ s picked and they win , she ’ ll start running for president the morning after the inauguration .
They want her @ @ @ @ @ @ @ be the Democratic nominee in 2024 .

In a culture devoid of moral education, generations are growing up in a morally inarticulate, self-referential world.
This article was featured in One Story to Read Today, a newsletter in which our editors recommend a single must-read from The Atlantic, Monday through Friday. Sign up for it here.
Over the past eight years or so, I’ve been obsessed with two questions. The first is: Why have Americans become so sad? The rising rates of depression have been well publicized, as have the rising deaths of despair from drugs, alcohol, and suicide. But other statistics are similarly troubling. The percentage of people who say they don’t have close friends has increased fourfold since 1990. The share of Americans ages 25 to 54 who weren’t married or living with a romantic partner went up to 38 percent in 2019, from 29 percent in 1990. A record-high 25 percent of 40-year-old Americans have never married. More than half of all Americans say that no one knows them well. The percentage of high-school students who report “persistent feelings of sadness or hopelessness” shot up from 26 percent in 2009 to 44 percent in 2021.


Vishakha Darbha

Vishakha Darbha is a former associate producer at The Atlantic .
• In a new documentary from The Atlantic , coronavirus survivors describe frightening experiences in the intensive-care unit .
• The Art of Comedy in Quarantine As China enters its eighth week in quarantine , citizens turn to TikTok for a comedic reprieve .
• Giraffes may be omnipresent in popular culture , but they ’ re disappearing in real life .
• The Nuclear Family Wasn ’ t Built to Last David Brooks breaks down the enduring myth of the virtuous all-American family .
• Welcome to the @ @ @ @ @ @ @ people have to make a choice : money or babies ?
• All Great Civilizations Fall .
Is America Next ?
The collapse of the Roman Empire was not a bad thing for the world at large .
• Fake Apologies Are on the Rise When did the true sign of power shift from responsibility to impunity ?
• Why Is America So Obsessed With Ivy League Schools ?
The college-admissions process is so fraught with hysteria , many parents attempt to cheat their kids into elite institutions .
• Physical-education programs were @ @ @ @ @ @ @ but they may be counterproductive .
• It Was Easier to Be Skinny in the ’ 80s A number of surprising factors may be contributing to the modern obesity epidemic .
• ‘ We ’ re the Workaholics of the World ’ In the workism economy , jobs have replaced religion , resulting in widespread burnout and anxiety .
• Why do serial murderers maintain such an enduring grip on the American psyche ?
• What Does It Mean to Support ‘ Free College ’ ?
Many Democratic candidates are animated by the @ @ @ @ @ @ @ the particulars of the policy remain vague .
• Hatred against Jews is on the rise around the world , including in the United States .
• Editor in chief Jeffrey Goldberg explains “ Unthinkable , ” an attempt to chronicle the most bizarre—and dangerous—moments of this presidency .

Vishakha Darbha is a former associate producer at The Atlantic.
Medical Research Council/The Atlantic ‘COVID-19 Is a Delirium Factory’ In a new documentary from The Atlantic, coronavirus survivors describe frightening experiences in the intensive-care unit.
The Art of Comedy in Quarantine As China enters its eighth week in quarantine, citizens turn to TikTok for a comedic reprieve.
The Great Giraffe Illusion Giraffes may be omnipresent in popular culture, but they’re disappearing in real life.
The Nuclear Family Wasn’t Built to Last David Brooks breaks down the enduring myth of the virtuous all-American family.
How Cities Became Childless Welcome to the future of urban living, where young people have to make a choice: money or babies?
Mass Tourism Is Destroying the Planet Overtourism is affecting the Earth in unprecedented ways.
All Great Civilizations Fall. Is America Next? The collapse of the Roman Empire was not a bad thing for the world at large.
Fake Apologies Are on the Rise When did the true sign of power shift from responsibility to impunity?
Why Is America So Obsessed With Ivy League Schools? The college-admissions process is so fraught with hysteria, many parents attempt to cheat their kids into elite institutions.
The Hidden Costs of P.E. Physical-education programs were designed to encourage health and fitness, but they may be counterproductive.
It Was Easier to Be Skinny in the ’80s A number of surprising factors may be contributing to the modern obesity epidemic.
‘We’re the Workaholics of the World’ In the workism economy, jobs have replaced religion, resulting in widespread burnout and anxiety.
‘Serial Killers Are a Uniquely American Phenomenon’ Why do serial murderers maintain such an enduring grip on the American psyche?
What Does It Mean to Support ‘Free College’? Many Democratic candidates are animated by the idea of free secondary education, but the particulars of the policy remain vague.
How Should Americans Tackle Anti-Semitism? Hatred against Jews is on the rise around the world, including in the United States.
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The Atlantic Bears Witness to Trump’s Destructive Presidency Editor in chief Jeffrey Goldberg explains “Unthinkable,” an attempt to chronicle the most bizarre—and dangerous—moments of this presidency.
Health Misinformation Is Rampant on Instagram Wellness gurus on the platform often claim authority on nutrition—but science doesn’t back them up.
Americans Should Be ‘Screaming Mad’ About Amazon’s Free Money America has an absurd—and dangerous—obsession with corporate subsidies, such as those given to Jeff Bezos’s trillion-dollar company.


Edward-Isaac Dovere

Edward-Isaac Dovere is a staff writer at The Atlantic .
• The senator from California seems like the obvious choice to be Joe Biden ’ s running mate .
So why is she keeping mum about her thinking ?
• She Wanted to Be a Republican President .
She ’ s Voting for Biden .
The former Republican presidential candidate Carly Fiorina tells The Ticket that she plans to vote for Joe Biden .
• As Americans continue to protest and Trump calls for “ domination , ” the former president felt compelled to intervene .
• In a speech @ @ @ @ @ @ @ week ’ s events as a turning point for America—and as a binary choice in visions for its future .
• The VP Choice Everyone Is Missing Former National Security Adviser Susan Rice has a powerful backer and an array of experiences that complement Biden ’ s .
• Why Americans Might Not Trust the Election Results Many are already worried about the integrity of November ’ s vote .
• It Really Could Be Warren After her swing and miss at the presidency , the Massachusetts senator is making a case for @ @ @ @ @ @ @ president .
• Why This Democrat Won ’ t Go Home Where should a member of Congress be right now ?
• Ron Klain was a chief of staff to two vice presidents before leading the Obama administration ’ s response to Ebola .
Why isn ’ t he a bigger figure in Biden ’ s campaign ?
• How New Jersey ’ s Governor Figured Out Trump Phil Murphy discusses the state ’ s efforts to mitigate its coronavirus infections and lower its death rate , the second-highest in the country .
@ @ @ @ @ @ @ mark on the presidential campaign with his less-than-rosy view of the country ’ s future , and he still thinks it ’ s exactly what Americans need to hear .
• Joe Biden has committed to choosing a woman as his running mate—and Stacey Abrams has a case to make for why she should be his pick .
• The coronavirus has forced the Democrats to change how they talk about policy .
• Rand Paul Has More Than a Cold The senator from Kentucky was worried enough to get tested .
But @ @ @ @ @ @ @ he kept going to work , the gym , and the pool .

Edward-Isaac Dovere is a former staff writer at The Atlantic and the author of Battle for the Soul: Inside the Democrats' Campaigns to Defeat Trump
Chip Somodevilla / Getty; Ron Antonelli / Bloomberg … The Trump Suburban Squirm Democratic candidates in this fall’s elections are doing their best to make sure that the former president is still on the ballot.
Ray Chavez / MediaNews Group / The Mercury … What California’s Recall Election Says About America Gavin Newsom’s struggles could spell trouble for Democrats everywhere.
Seth Wenig / Getty The Threat of a Cuomo Comeback Absent further action by the state legislature, the governor could run for his old job next year—and a recent poll suggests he would have a shot at victory.
Alex Wong / Getty The Next Face of the Democratic Party Hakeem Jeffries could end up being the first Black speaker of the House—but not all progressives are happy about his rise.
Sarah Silbiger / Bloomberg / Getty; Win McNamee … Biden’s Strategy: Treat Trump Like a ‘Crazy Person’ The 46th president’s slate of problems to deal with includes the erratic behavior of the 45th.
Jim Watson / AFP / Getty What Is Pete Buttigieg Doing? The secretary of transportation is on the road, talking infrastructure with anyone who will listen.
Damon Winter / The New York Times / … Andrew Yang, Political Kardashian Yang is the first celebrity candidate who’s famous for being a celebrity candidate—and he’s defined the New York City mayoral race around him.
Eric Baradat / AFP / Getty What Biden Didn’t Realize About His Presidency In his first interview after his inauguration, Biden explained what he got wrong about Trump—and what he still hoped to squeeze out of Republicans.
Samuel Corum / Jim Watson / Getty / … The Inside Story of Joe Biden’s Most Fateful Decision His mind was made up about a 2020 presidential run—until it wasn’t.
Brendan Smialowski / AFP / Getty What Kamala Harris Has Learned About Being Vice President Everyone expects Harris to run for president again one day, but her job requires her to avoid even the appearance of preparing for her political future.
Adam Maida / The Atlantic The First Congressman to Take Parental Leave Is Ready to Fight for It Democrat Colin Allred of Texas wants to make paid parental leave possible for everyone. The White House appears poised to join him.
Yuri Gripas / Reuters Democrats’ No. 1 Target for 2022 If Senator Ron Johnson of Wisconsin seeks reelection, the race could be a key test of Trumpism’s viability in a swing state.
Getty / The Atlantic Vaccine Refusal Will Come at a Cost—For All of Us People who refuse to get the COVID-19 vaccine will have higher health-care costs. The rest of us will foot the bill.
Anna Moneymaker / Getty The Strange Life of a Congressional Trump Basher, After Trump Representative Eric Swalwell built a public profile criticizing the ex-president. He’s still figuring out what’s next.
Rahel Patrasso / Getty Democrats Are Failing the Schools Test The fight between politicians, parents, and teachers over school reopenings could soon affect elections.
Michael S. Williamson / The Washington Post via … The Left’s Answer to Trump Is 6 Foot 8 and Wears Shorts in February There’s never been a statewide politician like John Fetterman. Now he’s a front-runner for the U.S. Senate.
Mike Segar / Reuters Of Course Andrew Cuomo Isn’t Going to Resign But his dream of a fourth term is slipping away.
Logan Mock-Bunting / Redux The Window for D.C. Statehood Won’t Be Open Forever But Democrats are taking their time weighing their next move.
Getty / The Atlantic What Does This Man Know That Other Democrats Don’t? Governor Roy Cooper’s winning streak in North Carolina may be hard for purple- or red-state leaders to replicate.


Ian Bogost

Ian Bogost is a contributing writer at The Atlantic and the Ivan Allen College Distinguished Chair in Media Studies at the Georgia Institute of Technology .
His latest book is Play Anything Donald Trump won the presidency by using the social network ’ s advertising machinery in exactly the way the company wanted .
He ’ s poised to do it again .
• Suburbia was never as bad as anyone said it was .
Now it ’ s looking even better .
• The Silence of the Never Facebookers Even fed-up tech workers are paralyzed by Silicon Valley ’ @ @ @ @ @ @ @ the Pandemic The coronavirus will change grocery stores , and probably not for the better .
• In the midst of a pandemic , it ’ s delightful to imagine doing whatever you like without worrying about making a living .
• When the Checkpoints Come How will Americans react when restrictions on their movements are no longer voluntary ?
• Now Is the Time to Overreact If the measures we 're taking to fight the coronavirus work , they 'll look excessive later on .
But the alternative is worse .
• @ @ @ @ @ @ @ up at home has never been more pleasant .
• It Doesn ’ t Matter If Anyone Exists or Not What a website that generates infinite fake humans tells us about modern life • Every Place Is the Same Now With a phone , anywhere else is always just a tap away .
• On TikTok and Twitter , anxious posts about World War III recall a simpler era of global conflict .
• Even if Elizabeth Warren ’ s wealth tax were to become a reality • Video Games Are Better Without @ @ @ @ @ @ @ The problem is , all games are also work .
• Her picture books have sold 75 million copies in the past four decades .
What ’ s the secret to her far-reaching appeal ?
• WeWork was supposed to reinvent office life .
Unfortunately , it did .

More +
He is the director of the film- and media-studies program at Washington University in St. Louis, where he is also a computer-science and engineering professor. Bogost is the author of 10 books, most recently Play Anything: The Pleasure of Limits, the Uses of Boredom, and the Secret of Games. Bogost is also an award-winning game designer whose work has been played by millions of people and has been held in collections internationally, including the Smithsonian American Art Museum.


theatlantic--2020-02-24--You’re Likely to Get the Coronavirus

You’re Likely to Get the Coronavirus

The Harvard epidemiology professor Marc Lipsitch is exacting in his diction , even for an epidemiologist .
Twice in our conversation he started to say something , then paused and said , “ Actually , let me start again.
” So it ’ s striking when one of the points he wanted to get exactly right was this : “ I think the likely outcome is that it will ultimately not be containable.
” Containment is the first step in responding to any outbreak .
In the case of COVID-19 , the possibility ( however implausible ) of preventing a @ @ @ @ @ @ @ matter of days .
Starting in January , China began cordoning off progressively larger areas , radiating outward from the city of Wuhan and eventually encapsulating some 100 million people .
People were barred from leaving home , and lectured by drones if they were caught outside .
Nonetheless , the virus has now been found in 24 countries .
Despite the apparent ineffectiveness of such measures—relative to their inordinate social and economic cost , at least—the crackdown continues to escalate .
Under political pressure to “ stop ” the virus , last @ @ @ @ @ @ @ in Hubei province would be going door-to-door , testing people for fevers and looking for signs of illness , then sending all potential cases to quarantine camps .
But even with the ideal containment , the virus ’ s spread may have been inevitable .
Testing people who are already extremely sick is an imperfect strategy if people can spread the virus without even feeling bad enough to stay home from work .
Lipsitch predicts that within the coming year , some 40 to 70 percent of people around the world will be @ @ @ @ @ @ @ .
But , he clarifies emphatically , this does not mean that all will have severe illnesses .
“ It ’ s likely that many will have mild disease , or may be asymptomatic , ” he said .
As with influenza , which is often life-threatening to people with chronic health conditions and of older age , most cases pass without medical care .
( Overall , about 14 percent of people with influenza have no symptoms . )
Lipsitch is far from alone in his belief that this virus will continue @ @ @ @ @ @ @ among epidemiologists is that the most likely outcome of this outbreak is a new seasonal disease—a fifth “ endemic ” coronavirus .
With the other four , people are not known to develop long-lasting immunity .
If this one follows suit , and if the disease continues to be as severe as it is now , “ cold and flu season ” could become “ cold and flu and COVID-19 season.
” At this point , it is not even known how many people are infected .
As of Sunday , there have @ @ @ @ @ @ @ , according to the World Health Organization .
But Lipsitch ’ s “ very , very rough ” estimate when we spoke a week ago ( banking on “ multiple assumptions piled on top of each other , ” he said ) was that 100 or 200 people in the U.S. were infected .
That ’ s all it would take to seed the disease widely .
The rate of spread would depend on how contagious the disease is in milder cases .
On Friday , Chinese scientists reported in the medical journal @ @ @ @ @ @ @ of the virus , from a patient with a normal chest CT scan .
The researchers concluded with stolid understatement that if this finding is not a bizarre abnormality , “ the prevention of COVID-19 infection would prove challenging .
”

Updated at 7:43 p.m. on Feb. 25, 2020.
In May 1997, a 3-year-old boy developed what at first seemed like the common cold. When his symptoms—sore throat, fever, and cough—persisted for six days, he was taken to the Queen Elizabeth Hospital in Hong Kong. There his cough worsened, and he began gasping for air. Despite intensive care, the boy died.
Puzzled by his rapid deterioration, doctors sent a sample of the boy’s sputum to China’s Department of Health. But the standard testing protocol couldn’t fully identify the virus that had caused the disease. The chief virologist decided to ship some of the sample to colleagues in other countries.
Read: What you can do right now about the coronavirus
At the U.S. Centers for Disease Control and Prevention in Atlanta, the boy’s sputum sat for a month, waiting for its turn in a slow process of antibody-matching analysis. The results eventually confirmed that this was a variant of influenza, the virus that has killed more people than any in history. But this type had never before been seen in humans. It was H5N1, or “avian flu,” discovered two decades prior, but known only to infect birds.
By then, it was August. Scientists sent distress signals around the world. The Chinese government swiftly killed 1.5 million chickens (over the protests of chicken farmers). Further cases were closely monitored and isolated. By the end of the year there were 18 known cases in humans. Six people died.
This was seen as a successful global response, and the virus was not seen again for years. In part, containment was possible because the disease was so severe: Those who got it became manifestly, extremely ill. H5N1 has a fatality rate of about 60 percent—if you get it, you’re likely to die. Yet since 2003, the virus has killed only 455 people. The much “milder” flu viruses, by contrast, kill fewer than 0.1 percent of people they infect, on average, but are responsible for hundreds of thousands of deaths every year.
Read: The official coronavirus numbers are wrong, and everyone knows it
Severe illness caused by viruses such as H5N1 also means that infected people can be identified and isolated, or that they died quickly. They do not walk around feeling just a little under the weather, seeding the virus. The new coronavirus (known technically as SARS-CoV-2) that has been spreading around the world can cause a respiratory illness that can be severe. The disease (known as COVID-19) seems to have a fatality rate of less than 2 percent—exponentially lower than most outbreaks that make global news. The virus has raised alarm not despite that low fatality rate, but because of it.
Coronaviruses are similar to influenza viruses in that they both contain single strands of RNA.* Four coronaviruses commonly infect humans, causing colds. These are believed to have evolved in humans to maximize their own spread—which means sickening, but not killing, people. By contrast, the two prior novel coronavirus outbreaks—SARS (severe acute respiratory syndrome) and MERS (Middle East respiratory syndrome, named for where the first outbreak occurred)—were picked up from animals, as was H5N1. These diseases were highly fatal to humans. If there were mild or asymptomatic cases, they were extremely few. Had there been more of them, the disease would have spread widely. Ultimately, SARS and MERS each killed fewer than 1,000 people.
COVID-19 is already reported to have killed more than twice that number. With its potent mix of characteristics, this virus is unlike most that capture popular attention: It is deadly, but not too deadly. It makes people sick, but not in predictable, uniquely identifiable ways. Last week, 14 Americans tested positive on a cruise ship in Japan despite feeling fine—the new virus may be most dangerous because, it seems, it may sometimes cause no symptoms at all.
Read: The new coronavirus is a truly modern epidemic
The world has responded with unprecedented speed and mobilization of resources. The new virus was identified extremely quickly. Its genome was sequenced by Chinese scientists and shared around the world within weeks. The global scientific community has shared genomic and clinical data at unprecedented rates. Work on a vaccine is well under way. The Chinese government enacted dramatic containment measures, and the World Health Organization declared an emergency of international concern. All of this happened in a fraction of the time it took to even identify H5N1 in 1997. And yet the outbreak continues to spread.
The Harvard epidemiology professor Marc Lipsitch is exacting in his diction, even for an epidemiologist. Twice in our conversation he started to say something, then paused and said, “Actually, let me start again.” So it’s striking when one of the points he wanted to get exactly right was this: “I think the likely outcome is that it will ultimately not be containable.”
Containment is the first step in responding to any outbreak. In the case of COVID-19, the possibility (however implausible) of preventing a pandemic seemed to play out in a matter of days. Starting in January, China began cordoning off progressively larger areas, radiating outward from the city of Wuhan and eventually encapsulating some 100 million people. People were barred from leaving home, and lectured by drones if they were caught outside. Nonetheless, the virus has now been found in 24 countries.
Despite the apparent ineffectiveness of such measures—relative to their inordinate social and economic cost, at least—the crackdown continues to escalate. Under political pressure to “stop” the virus, last Thursday the Chinese government announced that officials in Hubei province would be going door-to-door, testing people for fevers and looking for signs of illness, then sending all potential cases to quarantine camps. But even with the ideal containment, the virus’s spread may have been inevitable. Testing people who are already extremely sick is an imperfect strategy if people can spread the virus without even feeling bad enough to stay home from work.
Lipsitch predicts that within the coming year, some 40 to 70 percent of people around the world will be infected with the virus that causes COVID-19. But, he clarifies emphatically, this does not mean that all will have severe illnesses. “It’s likely that many will have mild disease, or may be asymptomatic,” he said. As with influenza, which is often life-threatening to people with chronic health conditions and of older age, most cases pass without medical care. (Overall, about 14 percent of people with influenza have no symptoms.)
Lipsitch is far from alone in his belief that this virus will continue to spread widely. The emerging consensus among epidemiologists is that the most likely outcome of this outbreak is a new seasonal disease—a fifth “endemic” coronavirus. With the other four, people are not known to develop long-lasting immunity. If this one follows suit, and if the disease continues to be as severe as it is now, “cold and flu season” could become “cold and flu and COVID-19 season.”
At this point, it is not even known how many people are infected. As of Sunday, there have been 35 confirmed cases in the U.S., according to the World Health Organization. But Lipsitch’s “very, very rough” estimate when we spoke a week ago (banking on “multiple assumptions piled on top of each other,” he said) was that 100 or 200 people in the U.S. were infected. That’s all it would take to seed the disease widely. The rate of spread would depend on how contagious the disease is in milder cases. On Friday, Chinese scientists reported in the medical journal JAMA an apparent case of asymptomatic spread of the virus, from a patient with a normal chest CT scan. The researchers concluded with stolid understatement that if this finding is not a bizarre abnormality, “the prevention of COVID-19 infection would prove challenging.”
Read: 20 seconds to optimize hand wellness
Even if Lipsitch’s estimates were off by orders of magnitude, they wouldn’t likely change the overall prognosis. “Two hundred cases of a flu-like illness during flu season—when you’re not testing for it—is very hard to detect,” Lipsitch said. “But it would be really good to know sooner rather than later whether that’s correct, or whether we’ve miscalculated something. The only way to do that is by testing.”
Originally, doctors in the U.S. were advised not to test people unless they had been to China or had contact with someone who had been diagnosed with the disease. Within the past two weeks, the CDC said it would start screening people in five U.S. cities, in an effort to give some idea of how many cases are actually out there. But tests are still not widely available. As of Friday, the Association of Public Health Laboratories said that only California, Nebraska, and Illinois had the capacity to test people for the virus.
With so little data, prognosis is difficult. But the concern that this virus is beyond containment—that it will be with us indefinitely—is nowhere more apparent than in the global race to find a vaccine, one of the clearest strategies for saving lives in the years to come.
Over the past month, stock prices of a small pharmaceutical company named Inovio have more than doubled. In mid-January, it reportedly discovered a vaccine for the new coronavirus. This claim has been repeated in many news reports, even though it is technically inaccurate. Like other drugs, vaccines require a long testing process to see whether they indeed protect people from disease, and do so safely. What this company—and others—has done is copy a bit of the virus’s RNA that one day could prove to work as a vaccine. It’s a promising first step, but to call it a discovery is like announcing a new surgery after sharpening a scalpel.
Though genetic sequencing is now extremely fast, making vaccines is as much art as science. It involves finding a viral sequence that will reliably cause a protective immune-system memory but not trigger an acute inflammatory response that would itself cause symptoms. (While the influenza vaccine cannot cause the flu, the CDC warns that it can cause “flu-like symptoms.”) Hitting this sweet spot requires testing, first in lab models and animals, and eventually in people. One does not simply ship a billion viral gene fragments around the world to be injected into everyone at the moment of discovery.
Inovio is far from the only small biotech company venturing to create a sequence that strikes that balance. Others include Moderna, CureVac, and Novavax. Academic researchers are also on the case, at Imperial College London and other universities, as are federal scientists in several countries, including at the U.S. National Institutes of Health. Anthony Fauci, the head of the NIH’s National Institute of Allergy and Infectious Diseases, wrote in JAMA in January that the agency was working at historic speed to find a vaccine. During the SARS outbreak in 2003, researchers moved from obtaining the genomic sequence of the virus and into a phase 1 clinical trial of a vaccine in 20 months. Fauci wrote that his team has since compressed that timeline to just over three months for other viruses, and for the new coronavirus, “they hope to move even faster.”
New models have sprung up in recent years, too, that promise to speed up vaccine development. One is the Coalition for Epidemic Preparedness (CEPI), which was launched in Norway in 2017 to finance and coordinate the development of new vaccines. Its founders include the governments of Norway and India, the Wellcome Trust, and the Bill & Melinda Gates Foundation. The group’s money is now flowing to Inovio and other small biotech start-ups, encouraging them to get into the risky business of vaccine development. The group’s CEO, Richard Hatchett, shares Fauci’s basic timeline vision—a COVID-19 vaccine ready for early phases of safety testing in April. If all goes well, by late summer testing could begin to see if the vaccine actually prevents disease.
Read: Coronavirus is devastating Chinese tourism
Overall, if all pieces fell into place, Hatchett guesses it would be 12 to 18 months before an initial product could be deemed safe and effective. That timeline represents “a vast acceleration compared with the history of vaccine development,” he told me. But it’s also unprecedentedly ambitious. “Even to propose such a timeline at this point must be regarded as hugely aspirational,” he added.
Even if that idyllic year-long projection were realized, the novel product would still require manufacturing and distribution. “An important consideration is whether the underlying approach can then be scaled to produce millions or even billions of doses in coming years,” Hatchett said. Especially in an ongoing emergency, if borders closed and supply chains broke, distribution and production could prove difficult purely as a matter of logistics.
Fauci’s initial optimism seemed to wane, too. Last week he said that the process of vaccine development was proving “very difficult and very frustrating.” For all the advances in basic science, the process cannot proceed to an actual vaccine without extensive clinical testing, which requires manufacturing many vaccines and meticulously monitoring outcomes in people. The process could ultimately cost hundreds of millions of dollars—money that the NIH, start-ups, and universities don’t have. Nor do they have the production facilities and technology to mass-manufacture and distribute a vaccine.
Production of vaccines has long been contingent on investment from one of the handful of giant global pharmaceutical companies. At the Aspen Institute last week, Fauci lamented that none had yet to “step up” and commit to making the vaccine. “Companies that have the skill to be able to do it are not going to just sit around and have a warm facility, ready to go for when you need it,” he said. Even if they did, taking on a new product like this could mean massive losses, especially if the demand faded or if people, for complex reasons, chose not to use the product.
Making vaccines is so difficult, cost intensive, and high risk that in the 1980s, when drug companies began to incur legal costs over alleged harms caused by vaccines, many opted to simply quit making them. To incentivize the pharmaceutical industry to keep producing these vital products, the U.S. government offered to indemnify anyone claiming to have been harmed by a vaccine. The arrangement continues to this day. Even still, drug companies have generally found it more profitable to invest in the daily-use drugs for chronic conditions. And coronaviruses could present a particular challenge in that at their core they, like influenza viruses, contain single strands of RNA. This viral class is likely to mutate, and vaccines may need to be in constant development, as with the flu.
“If we’re putting all our hopes in a vaccine as being the answer, we’re in trouble,” Jason Schwartz, an assistant professor at Yale School of Public Health who studies vaccine policy, told me. The best-case scenario, as Schwartz sees it, is the one in which this vaccine development happens far too late to make a difference for the current outbreak. The real problem is that preparedness for this outbreak should have been happening for the past decade, ever since SARS. “Had we not set the SARS-vaccine-research program aside, we would have had a lot more of this foundational work that we could apply to this new, closely related virus,” he said. But, as with Ebola, government funding and pharmaceutical-industry development evaporated once the sense of emergency lifted. “Some very early research ended up sitting on a shelf because that outbreak ended before a vaccine needed to be aggressively developed.”
On Saturday, Politico reported that the White House is preparing to ask Congress for $1 billion in emergency funding for a coronavirus response. This request, if it materialized, would come in the same month in which President Donald Trump released a new budget proposal that would cut key elements of pandemic preparedness—funding for the CDC, the NIH, and foreign aid.
Read: It’s suddenly cold out. Am I going to get sick?
These long-term government investments matter because creating vaccines, antiviral medications, and other vital tools requires decades of serious investment, even when demand is low. Market-based economies often struggle to develop a product for which there is no immediate demand and to distribute products to the places they’re needed. CEPI has been touted as a promising model to incentivize vaccine development before an emergency begins, but the group also has skeptics. Last year, Doctors Without Borders wrote a scathing open letter, saying the model didn’t ensure equitable distribution or affordability. CEPI subsequently updated its policies to forefront equitable access, and Manuel Martin, a medical innovation and access adviser with Doctors Without Borders, told me last week that he’s now cautiously optimistic. “CEPI is absolutely promising, and we really hope that it will be successful in producing a novel vaccine,” he said. But he and his colleagues are “waiting to see how CEPI’s commitments play out in practice.”
These considerations matter not simply as humanitarian benevolence, but also as effective policy. Getting vaccines and other resources to the places where they will be most helpful is essential to stop disease from spreading widely. During the 2009 H1N1 flu outbreak, for example, Mexico was hit hard. In Australia, which was not, the government prevented exports by its pharmaceutical industry until it filled the Australian government’s order for vaccines. The more the world enters lockdown and self-preservation mode, the more difficult it could be to soberly assess risk and effectively distribute tools, from vaccines and respirator masks to food and hand soap.
Italy, Iran, and South Korea are now among the countries reporting quickly growing numbers of detected COVID-19 infections. Many countries have responded with containment attempts, despite the dubious efficacy and inherent harms of China’s historically unprecedented crackdown. Certain containment measures will be appropriate, but widely banning travel, closing down cities, and hoarding resources are not realistic solutions for an outbreak that lasts years. All of these measures come with risks of their own. Ultimately some pandemic responses will require opening borders, not closing them. At some point the expectation that any area will escape effects of COVID-19 must be abandoned: The disease must be seen as everyone’s problem.


theatlantic--2020-02-24--Democracies Are Better at Fighting Outbreaks

During a public-health crisis , governments in the United States and the rest of the world are forced to consider measures—such as requiring health checks , limiting movement , and instituting quarantines—that infringe on individual liberties .
The crisis now unfolding in China raises an uncomfortable question : Are authoritarian governments better equipped than democracies to meet the challenge of an epidemic ?
A decade into a global backlash against liberal democracy , that question is urgent .
Aspiring autocrats , from Hungary ’ s Viktor Orbán to Uganda ’ s Yoweri Museveni , cherry-pick from a menu of repressive @ @ @ @ @ @ @ banning independent media outlets—to exert control and retain power .
The “ China model ” is alluring to democracy ’ s critics , for whom China ’ s firm handling of the COVID-19 outbreak looks like another proof point for authoritarianism .
Yet good public-health practice doesn ’ t just require control .
It also requires transparency , public trust , and collaboration—habits of mind that allow free societies to better respond to pandemics .
Democracies ’ ability to cope with COVID-19 will soon be tested ; after a proliferation of cases in @ @ @ @ @ @ @ in recent days , officials are weighing how to respond .
But citizens of democratic nations can reasonably expect a higher level of candor and accountability from their governments .
American citizens , for example , can count on the objectivity and accuracy of the U.S. Centers for Disease Control and Prevention , whose weekly morbidity and mortality report has been a fixture of critical communication between the government and the public in one form or another since the late 1800s .
Reliable reporting enables epidemiologists to predict a disease ’ s trajectory @ @ @ @ @ @ @ , responders to trace transmission , and the public to protect itself .
In contrast , China actively hid the 2003 SARS outbreak from the international community , and , especially in the initial stages of COVID-19 , it appears to have done so again .
Local authorities deliberately suppressed early reports of the unknown virus , missing an early window responders had to stop the infectious disease before it spread .
Although researchers released the virus ’ s genetic sequence in record time , local officials underreported cases , downplayed the risk @ @ @ @ @ @ @ who discussed the disease .
When one of those doctors , Li Wenliang , tried to warn friends on the social-media service WeChat , he was summoned before authorities and required to disavow his concerns .
He later died of complications from COVID-19 .
When asked during a BBC interview about Li ’ s treatment , the Chinese diplomat Liu Ziaoming shrugged it off as the handiwork of overzealous local officials .
But that is precisely the point .
China ’ s cover-up of the virus was not the result of a system @ @ @ @ @ @ @ cover-ups happen by design .
The language of authoritarianism—the language of fear and force—is one that every low-ranked apparatchik from Pripyat to Wuhan understands when acting on his or her own initiative to bury bad news .

When Tedros Adhanom Ghebreyesus, the director-general of the World Health Organization, declared late last month that the outbreak of the novel coronavirus was an international public-health emergency, he took pains to commend China for its response to the pathogen. “In many ways, China actually is setting a new standard for outbreak response, and it’s not an exaggeration,” he said. As the new disease, now called COVID-19, grew into a health crisis, Chinese officials had quarantined entire cities in a matter of days, suspended travel, closed schools and businesses, and imposed severe restrictions on who could leave their homes. Local researchers rapidly sequenced and shared the virus’s genome, allowing labs around the world to work on their own diagnostic tools. Authorities built two new “specialized hospitals” in 10 days, footage of which China’s state-owned media pumped out to the world on social media. They leveraged their formidable surveillance powers to scale up contact tracing, an essential measure in stopping an outbreak. President Donald Trump tweeted in praise of China’s “great discipline.”
Even after subsequent reports indicated that the Chinese government’s secrecy and hostility to dissent had helped the outbreak spread, WHO officials have continued to laud Beijing’s response. At a conference in Munich earlier this month, Michael Ryan, the executive director of the organization’s Health Emergencies Programme, maintained that people in China feel protected. “They feel like their government has stepped in aggressively and quickly to protect them,” he said. “That is the ultimate social contract between any government and its people.”
During a public-health crisis, governments in the United States and the rest of the world are forced to consider measures—such as requiring health checks, limiting movement, and instituting quarantines—that infringe on individual liberties. The crisis now unfolding in China raises an uncomfortable question: Are authoritarian governments better equipped than democracies to meet the challenge of an epidemic?
Read: How the coronavirus revealed authoritarianism’s fatal flaw
A decade into a global backlash against liberal democracy, that question is urgent. Aspiring autocrats, from Hungary’s Viktor Orbán to Uganda’s Yoweri Museveni, cherry-pick from a menu of repressive tactics and technologies—from building surveillance systems to banning independent media outlets—to exert control and retain power. The “China model” is alluring to democracy’s critics, for whom China’s firm handling of the COVID-19 outbreak looks like another proof point for authoritarianism.
Yet good public-health practice doesn’t just require control. It also requires transparency, public trust, and collaboration—habits of mind that allow free societies to better respond to pandemics. Democracies’ ability to cope with COVID-19 will soon be tested; after a proliferation of cases in South Korea, Japan, and Italy in recent days, officials are weighing how to respond. But citizens of democratic nations can reasonably expect a higher level of candor and accountability from their governments.
American citizens, for example, can count on the objectivity and accuracy of the U.S. Centers for Disease Control and Prevention, whose weekly morbidity and mortality report has been a fixture of critical communication between the government and the public in one form or another since the late 1800s. Reliable reporting enables epidemiologists to predict a disease’s trajectory, researchers to develop treatments and vaccines, responders to trace transmission, and the public to protect itself.
In contrast, China actively hid the 2003 SARS outbreak from the international community, and, especially in the initial stages of COVID-19, it appears to have done so again. Local authorities deliberately suppressed early reports of the unknown virus, missing an early window responders had to stop the infectious disease before it spread. Although researchers released the virus’s genetic sequence in record time, local officials underreported cases, downplayed the risk of human-to-human transmission, and detained doctors who discussed the disease.
When one of those doctors, Li Wenliang, tried to warn friends on the social-media service WeChat, he was summoned before authorities and required to disavow his concerns. He later died of complications from COVID-19. When asked during a BBC interview about Li’s treatment, the Chinese diplomat Liu Ziaoming shrugged it off as the handiwork of overzealous local officials. But that is precisely the point. China’s cover-up of the virus was not the result of a system malfunction. In an authoritarian state, cover-ups happen by design. The language of authoritarianism—the language of fear and force—is one that every low-ranked apparatchik from Pripyat to Wuhan understands when acting on his or her own initiative to bury bad news.
Two months into the crisis, international researchers continue to warn of missing information from China. Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases, diplomatically referred to this gap recently as the difference between “numbers that are given to you in a press conference as opposed to numbers [where] you can actually look at the data.”
Full transparency is impossible without public trust, something authoritarian regimes have a steady deficit of. China’s Communist Party now says it wants to hear the truth. But public trust—the freedom citizens enjoy to think critically, the safety they feel to speak out, the confidence they require to overcome fearful or difficult circumstances—is not a resource a government can turn on and off like tap water. It is a habit forged over time.
Today, rampant fear and mistrust are perhaps the greatest barriers health-care workers face in the Democratic Republic of the Congo, for example, where an Ebola outbreak is continuing into its 18th month. During the 2014 Ebola response, community trust, not intimidation, was the key component in persuading people to adopt proven solutions—such as surrendering the infected bodies of deceased loved ones—that run counter to human instinct. In China, the lack of trust was precisely what forced discussion of a previously unknown coronavirus deep into the bowels of supposedly private-messenger programs.
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China’s reliance on coercion will only intensify as officials become more desperate to restart the country’s economic engine and reestablish normal ties with the world. There is no doubt that China can efficiently compel certain behavior changes in the short term. But the longer the crisis lasts, the less effective these tactics will be.
Democracies do not get everything right. In 2014, a returning Ebola nurse named Kaci Hickox was forced into quarantine at the Newark airport without clear medical cause and initially prohibited from seeing a lawyer or receiving visitors. But unlike in authoritarian systems, citizens in democracies have established channels through which they can reassert their rights and seek accountability for abuse. Although American courts typically defer to a state’s authority to enact necessary quarantine orders, Hickox’s suit against New Jersey state officials led to important changes to the law, including guaranteeing those in quarantine the right to legal counsel and privacy. Instead of undermining public trust, the incident helped replenish it.
The ease with which an infectious disease spreads around the world demands international collaboration to contain it, and democracies cooperate more than non-democracies. (The popular board game Pandemic, in which players must work together in order to win, isn’t far from the truth.) Historically, from the United Nations charter to the Paris climate accords, the nations that have had the wherewithal to identify shared problems and build partnerships behind common solutions have been democracies. In 2014, the United States led 62 countries to stop a major Ebola outbreak. Although nations like China and Cuba contributed to the response, it was the United States that also led the effort to prevent the next disaster. (At the time, I was working on the Ebola crisis response at the U.S. Agency for International Development.) At the height of the Ebola crisis, President Barack Obama convened 44 nations in Washington to advance the Global Health Security Agenda, a community that now includes 67 nations.
Unsurprisingly, China’s political system is incompatible with this approach. Recently, after weeks of negotiating, China finally agreed to allow in a senior WHO team, which includes two Americans. But Beijing continues to ignore the CDC’s offers to send its own expert team. Even in a public-health crisis, the Communist Party comes first. As cases of the virus first popped up around the world and nations started suspending flights, Taiwan—which Beijing views as a breakaway province—was excluded from fast-moving discussions. Barred from international organizations at Beijing’s behest, Taiwan struggled to gain access to timely information and technical meetings of the WHO and the International Civil Aviation Organization.
Members of the global community cannot stop new outbreaks, but they can work together to build systems that quickly detect and effectively respond to them, especially by protecting the most vulnerable. Democratic societies tend to have better health and human development indicators, and not just because democratic societies are wealthier. A study published in The Lancet in April 2019 found that a government responsive to voters is more likely to invest in durable health-care systems and asserted that policy makers concerned with health outcomes, particularly chronic conditions, “should also be concerned with democratic experience.”
Read: The coronavirus outbreak could bring out the worst in Trump
Yet the very advantages that a democracy has in a public-health emergency are also those under greatest threat today from Trump and like-minded populists and nationalists around the world. In the United States, Trump has eviscerated traditional sources of public trust and trampled on almost every form of international cooperation. He drove away science-policy advisers, dismantled the White House office tasked with preventing pandemics, and ousted its well-respected chief. Even as the number of COVID-19 cases multiplied, Trump proposed slashing more than $3 billion in overall funding for global health.
If and when the coronavirus is finally brought to heel, China will rightly celebrate its success but wrongly view it as validation of its system. The world may never know how many lives could have been saved if nations embraced democratic norms of transparency and collaboration. But as China expands its quarantine restrictions ever further, it offers a glimpse of the future should the world continue to lean away.


Timothy McLaughlin

Timothy McLaughlin is a Hong Kong–based contributing writer at The Atlantic .
• The Leader Who Killed Her City Carrie Lam has been a unique failure .
Yet she is merely a symptom of Hong Kong ’ s ills .
• The city ’ s force had dubbed itself “ Asia ’ s Finest.
” Now it is seen by many as an occupying force .
• The experience of eating out in Hong Kong illustrates what it ’ s like to visit a restaurant right now .
• China has moved to take away the city ’ s autonomy @ @ @ @ @ @ @ Beijing across the region .
• Countries “ are not backing down in the face of Chinese pressure ” over the island , its foreign minister says .
• The Fragility of the Global Nurse Supply Chain The pandemic has exposed how richer countries , including the United States , rely on health-care workers from poorer ones , such as the Philippines .
• Refugee camps such as those in Bangladesh are a tinderbox for the spread of the coronavirus .
• Get Used to It : This Lockdown Won ’ t Be @ @ @ @ @ @ @ show that a single round of constraints won ’ t be enough to beat the pandemic .
• A Glimpse of the Coronavirus ’ s Possible Legacy The imprint SARS has left on Hong Kong speaks to the legacy COVID-19 may well leave on much of the world .
• As the coronavirus spreads across the globe , so too does racism .
• What Could Happen if the Coronavirus Closed Schools for Days , Weeks , or Even Months We can get a sense of what to expect from Hong Kong , @ @ @ @ @ @ @ school for more than a month .
• Countries have closed off their borders with China , airlines have slashed flights , and hotels have seen a big drop-off in bookings .
• Growing numbers of people are joining unions in Hong Kong to pressure the authorities to respond to their demands .
• Newly elected representatives are among those trying to turn the demonstrations into a permanent prodemocracy movement .
• The city ’ s leaders believe a revamped education system will make its people more loyal to Beijing and less likely @ @ @

Timothy McLaughlin is a contributing writer at The Atlantic.
He has won two Best in Business awards from the Society of American Business Editors and Writers for his reporting on press freedom. He is also a two-time finalist for the Livingston Award for International Reporting for his work from Hong Kong, Myanmar, and India. He is a co-author of a forthcoming book on Hong Kong’s democracy struggle that will be published by Hachette.
Photo by Ye Aung Thu / AFP / … The Fracturing of Hong Kong’s Democracy Movement Andrew Chiu lost an ear defending protesters in Hong Kong. Now he’s testifying against his movement on behalf of Beijing.
Illustration by Ben Kothe / The Atlantic. Source: … The Choice the Philippines Didn’t Want to Make Thirty-two years ago, the departure of American troops from the archipelago symbolized the end of colonialism. Today, their return seems like the least bad option.
Aaron Favila / AP The Price of Being Principled in the Philippines Duterte is gone, but a former secretary of justice still faces a possible life sentence for criticizing his regime.
Daniel Zender / The Atlantic Singapore Wrestles With the Death Penalty The city-state has traditionally executed people for drug offenses, but cracks in the national consensus are appearing.
Tyler Comrie / The Atlantic Biden’s Military-First Posture in the East Is a Problem A singular focus on countering the threat of Chinese aggression made America neglect economic ties in the Indo-Pacific.
Alamy / The Atlantic Why Beijing Wants Jimmy Lai Locked Up Tightening its grip on Hong Kong, China is determined to make an example of the prodemocracy media tycoon.
Tyler Comrie / The Atlantic The Tech Site That Took On China’s Surveillance State How did a trade publisher in Pennsylvania become a principal source of investigative journalism on the repressive apparatus Beijing uses against the Uyghurs?
The O’Brien family; Getty; The Atlantic The Lives Changed Forever When Flight MH17 Was Shot Down As the trial of those accused of destroying a passenger plane over Ukraine in 2014 concludes, the O’Briens are still mourning their son, Jack.
Getty; The Atlantic Seeking Sanctuary in the Old Empire Many Hong Kongers are fleeing to Britain as Beijing imposes its own form of colonial rule and imperialist tendencies.
Lam Yik / Reuters Farewell to Hong Kong and Its Big Lie Falsehoods, gaslighting, and endless fabrications in the city are equaled only by the cowardice of the people partaking in the insulting ruse that it is still free.
Kin Cheung / AP The Symbol of a New, Darker Hong Kong John Lee’s elevation reflects the distrust and paranoia that have flourished in Beijing and among Hong Kong’s political elites.
Adam Maida / The Atlantic The Volunteer Movement Enraging China An informal, online network is translating publicly available articles and social-media posts. That has been enough to rile Beijing.
Adams Carvalho ‘Underneath, Everything Has Changed’ Three prodemocracy activists on the run from Beijing, three wild and bizarre journeys to—and through—America
Lui Siu Wai / Xinhua / Getty; The … Where the Language of Democracy Is a Cover To choose its next leader, Hong Kong uses words such as election, campaign, and vote to present the facade of freedom.
Tang Yan / Sipa / AP Where Foreign Correspondents Capitulated to Autocracy Hong Kong’s main press club has given up in the face of a new, repressive regime.
Dale de la Rey / AFP / Getty The Final Blow to Hong Kong The city deftly connected China and the world for decades. That historic balancing act won’t be revived.
Kevin Frayer / Getty Why the U.S. Finally Called a Genocide in Myanmar a ‘Genocide’ America used the word human-rights activists have long argued applies to the campaign against Rohingya Muslims.
Tyrone Siu / Reuters What Happened to Hong Kong? The city was once lauded for controlling the coronavirus’s spread. But this month, it recorded one of the highest death rates in the world.
The Atlantic ‘I’m Afraid That I Cannot Be a Journalist Anymore’ Government officials claim that Hong Kong’s media environment is “as vibrant as ever,” another addition to their accrescent portfolio of lies.


Dominic Tierney


Deborah Fallows

Brownsville is the southernmost U.S. border town with Mexico , down at the very tip of the map of Texas .
Across the Rio Grande is Matamoros .
Some 20 miles to the east is the Gulf of Mexico .
If you drive 60 miles to the north and west along the Old Military Highway to McAllen , you ’ ll see stretches of border wall , irregular in their size and design .
It was very hot when we were in Brownsville last month .
It reminded me of Nanjing , one of the so-called furnaces of China , @ @ @ @ @ @ @ into the soft tarmac of the roads .
Elon Musk has built his SpaceX site on the road from Brownsville to the coast .
It is an assembly site for now , in a clearing that looks like half moonscape , half desert , with giant , surreal , bright-silvery sections of rocket being welded together .
The plan is for rockets to launch from here one day .
Just beyond SpaceX , the Boca Chica road fades to sandy coastal beach .
It feels like the edge of the Earth .
Border @ @ @ @ @ @ @ around Brownsville .
One afternoon , as I was driving the highway north from downtown , a silent ambulance cruised by , with a Border Patrol SUV , caked with dust and dried mud , right on its tail .
I realized that I didn ’ t have a clue of all that was really going on in Brownsville .
Some things about Brownsville are easy to see .
The buildings of the downtown—many tattered now , featuring discount goods for the cross-border shopping market in Matamoros—still have great bones , as the @ @ @ @ @ @ @ their second chance .
Brownsville was too poor to raze those buildings when businesses went dark , an obvious advantage now .
( As we have seen elsewhere . )
A hip pizza and wine bar called Dodici opened recently in the old Fernandez building downtown .
One of the owners is Trey Mendez , a lawyer who was just elected mayor in a runoff contest while we were visiting .
The Market Square area is newly renovated , as part of a downtown-revival program under the mayor for the previous eight years @ @ @ @ @ @ @ outsize number of museums , including the Historic Brownsville Museum , which is a real gem .
The Mitte Cultural District boasts “ something for everyone , ” with its zoo , pool , pavilions , playhouse , and much more .
RJ Mitte ( who played Walter White ’ s son in Breaking Bad ) is of that Mitte family , and is carrying on the family philanthropic efforts of his grandfather .
Other buildings are works in progress .
More are still pipe dreams .
Of course , you can not @ @ @ @ @ @ @ near downtown ’ s Gateway International Bridge has been there for about 10 years , long enough that the landscaping and vegetation along its river pathway and the Alice Wilson Hope Park on the U.S. side have grown in to looking normal .
On our first evening in Brownsville , when the heat of the day had subsided a little , Jim and I decided to walk across the International Bridge into Matamoros .
How could we not ?
We had no chance of entering the detention centers that have become so notorious @ @ @ @ @ @ @ along the border .
We wanted to have at least a look at the routine daily flow north and south .
Our crossing was entirely simple and uneventful , of course , just like it is for residents of both Brownsville and Matamoros who cross the bridge daily for school , jobs , shopping , dinners out , or visiting friends and family .
( Brownsville ’ s population is roughly 95 percent Hispanic , and many people have long-standing ties across the border .
The interconnectedness of the two cities ’ lives @ @ @ @ @ @ @ recent novel set in Brownsville : Where We Come From , by Oscar Cásares .
When we were in town , then-Mayor Martinez gave us a copy of the book . )
Along with a small handful of people also making the trip on foot , we deposited four quarters in the turnstile and pushed our way through to Mexico .
I looked up and down the river , assessing it with my swimmer ’ s eye , thinking how surprisingly narrow and benign it seemed , maybe 50 yards wide .
The @ @ @ @ @ @ @ in the least inviting , even in the heat .
The Rio Grande appeared to have no current .
But of course we all know that surface appearances can deceive , as they most certainly did in the horrific episode when Óscar Alberto Martínez Ramírez of El Salvador and his 2-year-old daughter , Valeria , drowned trying to cross it not far from this spot , a few days after we were there .
Brownsville residents , who have lived all their life as part of a binational community extended on both sides @ @ @ @ @ @ @ sense of the border from those for whom it ’ s an abstraction .
“ We don ’ t think of it as a border , ” we heard from so many people that we stopped counting .
“ We think of it as a river.
” I realized that it was just the way those of us who live on the border between Washington , D.C. , and Virginia think of the Potomac .
Beyond these impressions of Brownsville , there are data points that are more quantifiable .
This is where @ @ @ @ @ @ @ , and they are stark .
( My thanks to The Atlantic ’ s Faith Hill for help collecting these data . )
Some 51 percent of the adult population in the area are obese ; an additional 34 percent are overweight .
Of children 8 to 17 years old , 54 percent are obese , compared with about 33 percent nationally .
Joseph McCormick , until just recently the dean of the Brownsville campus of the UTHealth School of Public Health , wrote in an email : “ These children have higher @ @ @ @ @ @ @ , higher systolic and diastolic blood pressures , higher triglycerides and LDL ( bad cholesterol ) , lower HDL ( good cholesterol ) ; They had higher insulin resistance ( a precursor to diabetes ) , and elevated liver enzymes suggestive of fatty liver disease , a very common problem in our population in adults.
” Some 27 percent of adults have diabetes , about three times the national level .
About one-third of those with diabetes didn ’ t know they had it before being tested .
Only 42 percent of Brownsville @ @ @ @ @ @ @ health-care insurance .
For more positive comparative news , life expectancy in Cameron County , which includes Brownsville , is about 80 years , four years longer than the national average .
And Texas has one of the country ’ s lowest rates of death from opioid-involved drug overdoses : 5.1 for every 100,000 people , compared with the national average of 14.6 .
Brownsville is a poor town ; nearly 31 percent of the residents live in poverty , 38 percent of children .
The median income is $ 35,000 .
Some @ @ @ @ @ @ @ qualify for free or reduced lunch .
I had lunch one day to talk about these statistics with Rose Zavaletta Gowen , a medical doctor who grew up in Brownsville , trained in Dallas , and returned to practice medicine .
She soon turned to public-health advocacy and added a new role as an elected city commissioner .
Gowen framed her thinking , advocacy , passion , and action plans for her hometown this way : “ We traditionally think we need economic development and education , and we ’ ll get to @ @ @ @ @ @ @ , “ But later may be too late , and putting it off hinders progress in economic development and education as well.
” Gowen is part of Brownsville ’ s Community Advisory Board ( CAB ) , a network of more than 200 Brownsville residents and individuals from health-care , education , business , and community groups , and the UTHealth campus , which , with its newly appointed dean of the campus , Belinda Reininger , has been key in the founding and support of CAB .
All together , they are @ @ @ @ @ @ @ lifestyle , in a very Brownsville-specific way .
Every community we have visited for our American Futures project and our subsequent book , Our Towns , has focused on the “ local ” as its guide and frame for plans and actions .
In Brownsville , that eye on local seemed to us as compelling and powerful as in any other community we have seen , and maybe even more so .
Sometimes “ local ” means a focus on physical assets , or geography , or demographics , or industry .
In @ @ @ @ @ @ @ talk , “ local ” seemed to be mainly about culture .
The culture of Brownsville was the backdrop to their master plan for health and wellness—and many other town issues .
“ We are fighters .
We stand by our family .
We are proud .
We may be poor , but we do not think of ourselves as just poor .
We think of ourselves as blessed to have our families , customs , and region surrounding us.
” And Gowen added in talking about outsiders ’ impressions of Brownsville , @ @ @ @ @ @ @ on the news.
” Those traits translated into action .
Brownsville is not looking or waiting for top-down solutions and proclamations .
Members of its community decided to : make local-government regulations that support their goals .
Get smart about seeking funding , from the government , foundations , and nonprofits .
Not let rebuffs from big funding stop them ; take it step by step ; and find corners to improve .
Educate the public and brand the message “ Health and wellness.
” Become a model for success .
This kind @ @ @ @ @ @ @ is one we ’ ve seen in niche initiatives and big plans in many of the towns we ’ ve visited .
Libraries in Bend , Oregon .
Arts and entrepreneurship in Fresno .
Education in Greenville .
Downtowns and Main Streets everywhere .
Workforce training and new industry in Mississippi ’ s Golden Triangle .
The entire town of Eastport , Maine .
Through its many initiatives , the Brownsville Wellness Coalition is all about healthy food and healthy bodies.The Community Gardens program teaches gardening classes and distributes free transplants and compost @ @ @ @ @ @ @ .
People can buy produce from the weekly farmers ’ market with cash or with vouchers from federally subsidized programs such as SNAP , WIC , and the Farm Fresh Voucher program , especially important in this low-income town .
Plans are under way through a coalition of funders to renovate an old town cannery , the Gutierrez Warehouse , into a permanent home for the farmers ’ market .
When finished , the Quonset hut plans also call for accommodating a food bank and a “ kitchen incubator ” with a commercial @ @ @ @ @ @ @ for those who can ’ t get to the farmers ’ market , the Fresco Mobile Market food trucks may come to them .
The Happy Kitchen/La Cocina Alegre holds classes on nutrition , food preparation , and healthy eating .
And for the bodies , the Wellness Coalition sponsors a walking-group program , the Walking Club , with motivational support and progress tracking .
An annual challenge program organized by the city and the UTHealth School of Public Health , and drawing help from local gyms , nutritionists , trainers , and @ @ @ @ @ @ @ loss , but also sustainable lifestyle changes toward better health .
Nearly 7,500 people participated in the three-month program this year .
The monthly CycloBia closes some Brownsville streets to cars and opens them to the 10,000 participating residents to walk , bike , skateboard , skate , and run .
And for the timid , who may be the most reluctant to begin , the UTHealth School of Public Health has prepared online resources , Tu Salud Si Cuenta , where people can tiptoe into exercise and healthy eating and weight loss @ @ @ @ @ @ @ stories poignant , and brave , and ended up rooting for them .
Brownsville is also part of a multiuse-trail program ( bikes !
paddling !
hiking ! )
throughout the lower Rio Grande Valley that will link several towns , beaches , preserves , waterways , and cultural sites over 400-plus miles , incorporating as well a dream of tourism potential .
Is any of this working ?
According to McCormick , the rates of obesity and diabetes have dropped about 3 to 4 percent in Brownsville in about the past five @ @ @ @ @ @ @ give lots of folks options for daily commutes to school or work or , as in our case , a visit to 1848 BBQ , a slow-cook barbecue named for the year Brownsville was founded .
As one who spent about five years living in Austin and got my graduate degree from the University of Texas , I feel that my Texas bona fides and palate entitle me to shout out Abraham Avila , the chef of 1848 .
Yeah , lots of calories , but sitting right on a hike-and-bike trail , @ @ @ @ @ @ @ later .
It ’ s worth it .
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