vox--2020-10-28--Why Covid-19 death rates have fallen, and why they could rise again

When Theodore Iwashyna cared for his first Covid-19 patient in March , he felt a wave of terror wash over him .
“ I was convinced I was going to either die or get my family sick , ” the pulmonologist and professor of critical care medicine at the University of Michigan recalls .
Little was known about the novel coronavirus then , and Iwashyna couldn ’ t stop thinking back to the last pandemic coronavirus , SARS , when more than half of all deaths in a nearby hotspot , Toronto , were hospital-acquired infections .
Nowadays , Iwashyna @ @ @ @ @ @ @ family , or even his very ill patients .
“ I don ’ t expect my Covid patients to die , ” he says , “ I expect most of them to get through.
” By several measures , the coronavirus mortality rate has fallen over the course of the pandemic — even for those at the highest risk of death .
People who are diagnosed today appear to have better odds of surviving the disease compared to the first wave of patients .
“ It ’ s a silver lining in a @ @ @ @ @ @ @ , a clinical-academic at Kings College Hospital and an author on a new study focused on mortality in UK critical care units , “ but it ’ s by no means an excuse to take your foot off the pedal.
” That ’ s because even with the advances in Covid-19 treatment , there ’ s still a tipping point at which the mortality rate could spike — when there are far more patients than hospital beds , staff , and ventilators .
“ If hospitals get overwhelmed , obviously it ’ s @ @ @ @ @ @ @ said Tom Frieden , the CEO of the health nonprofit Resolve to Save Lives .
And hospitals are becoming overwhelmed again , on both sides of the Atlantic .
France is reporting the highest number of Covid-19 hospitalizations since April — with more than half of all ICU beds full in the country .
The Czech Republic — home to the fastest-growing epidemic in Europe — had to mobilize the army to build a Covid-19 field hospital and call its foreign health workers home to help with the emergency .
In Belgium , @ @ @ @ @ @ @ been asked to continue working while non-urgent surgeries have been called off .
The stateside outlook is equally grim .
Covid-19 hospitalizations have increased by 46 percent from a month ago , surpassing 44,000 on October 27 .
As Vox ’ s Dylan Scott reports , this has forced radical measures across the country : Wisconsin and Texas are building field hospitals , while Idaho is planning to transfer patients out of state , and Utah is ready to ration care .
So we may be approaching the tipping point at which the @ @ @ @ @ @ @ be sustained .
“ Each hospital ’ s overwhelmed point is different now than it was in April but there is a point that ’ s too much for any hospital , ” Iwashyna says .
“ There are only so many hands .
You can only be in so many rooms.
” Here ’ s what we know about the falling Covid-19 mortality rate — and why it might rise again .
From spring to summer , the Covid-19 death rate dropped in Europe and the US It ’ s been seven @ @ @ @ @ @ @ WHO ) declared the coronavirus a pandemic , and in that period , the mortality rate among people with Covid-19 improved in countries around the world .
At first , it wasn ’ t clear whether this trend could be explained mostly by shifting demographics of the disease ( people getting sick tended to be younger and healthier over time ) , more testing , or changes in medical treatments .
Researchers have been trying to unpack the data — and they ’ ve found , even after controlling for differences in patient @ @ @ @ @ @ @ hold .
Just take a look at these recent papers : • In this study , recently published in the journal Critical Care , researchers ( including Mateen ) in England looked at the 30-day mortality rate for 21,000 severely sick Covid-19 patients who were admitted to critical care units across England between March and June 2020 .
They found the odds of survival improved across the country — and the trend held even after adjusting for a patient ’ s underlying risks ( such as age or other illnesses ) .
In @ @ @ @ @ @ @ who had been admitted to the HDU — a type of critical care ward where patients can be looked after more intensively — were still alive at 30 days .
By the end of June , that number climbed to 93 percent .
For ICU patients , the number also shot up from 58 percent to 80 percent over that period .
• A second paper , published in the Journal of Hospital Medicine , focused on data from a 3-hospital health system : New York University Langone in New York .
This @ @ @ @ @ @ @ to August period and all Covid-19 hospital patients ( so not just the sickest patients who wind up in critical care ) .
They also adjusted the data to account for changes in demographics and severity of illness over time .
Here , too , they found the mortality rate among patients declined — 26 percent in March to 8 percent in August .
• In a third paper , just published in The Lancet , researchers took a slightly different approach : They used modeling to gauge the infection-fatality risk — or @ @ @ @ @ @ @ , not just those hospitalized — in New York City between March and June .
The overall risk of death decreased over time , especially for people in older age groups .
For those ages 65 to 74 , the estimated infection-fatality risk was 7 percent in April , and 4 percent by the end of May .
For people 75 years and older , the infection-fatality risk nearly halved — from 19 percent to 11 percent .
So , by several different measures , mortality from Covid-19 has declined throughout the pandemic @ @ @ @ @ @ @ understanding of Covid-19 and treating it has improved Now the important question : What ’ s driving this trend ?
This is where things get more complicated .
Let ’ s start with the low-hanging fruit .
In every study , researchers point to the most obvious explanation : At the start of the pandemic , we barely understood this disease .
Doctors thought they were dealing with a viral pneumonia that mainly affected the lungs .
“ We didn ’ t think about it as a whole body viral assault— and yet @ @ @ @ @ @ @ ” said Lewis Kaplan , president of the Society of Critical Care Medicine .
“ There ’ s virtually no organ system — from skin to blood vessels to brain to nose — that is not implicated in one way or another.
” With this shift in understanding has come better medical care .
In the spring , it was common to rush to use invasive mechanical ventilation — placing a tube in a patient ’ s throat and hooking them up to a ventilator to force air in and out the lungs @ @ @ @ @ @ @ on their behalf .
There were a couple of reasons for this approach : It was thought to be less risky for health care workers than other forms of oxygen therapy , because there ’ s a lower risk of aerosol spread .
Doctors also suspected patients needed help breathing as fast as possible , explained Leora Horwitz , an NYU medical professor and author on the NYU Langone paper .
“ The patients oxygen levels were so low , they ’ d get bad within hours , and we didn ’ t @ @ @ @ @ @ @ they stopped breathing before we had them on ventilators.
” But it turns out that unlike SARS , the novel coronavirus doesn ’ t easily spread in hospitals through aerosols when personal protective equipment — like N95 masks and face shields — is properly used .
So ventilation didn ’ t actually reduce the risk of hospital-acquired infections .
And less invasive forms of breathing support — like high flow nasal oxygen — were actually less damaging for the lungs and led to better outcomes .
“ We now understand we do not @ @ @ @ @ @ @ ventilators , ” Horwitz added .
Instead , doctors now try to avoid it all together .
There ’ s another important shift in coronavirus understanding .
At the beginning of the pandemic , many doctors thought “ there was something uniquely pro-inflammatory about Covid-19 , ” said Iwashyna .
They pointed to cytokine storm — patients ’ immune systems going into overdrive to fight the virus — as a leading cause of death , and thought drugs that suppress inflammation ( such as IL-6 inhibitors ) would help .
Those drugs didn @ @ @ @ @ @ @ Covid-19 “ as a critical illness is a lot like other critical illnesses , ” Iwashyna said .
Patients with severe disease often experience acute respiratory distress syndrome ( ARDS ) — a deadly form of sepsis , where inflammation leads the lungs to fill with cells and fluid , eventually causing other organs to fail .
Critical care doctors have long had a playbook for handling ARDS patients in ICU .
“ The very specific pathophysiology [ of Covid-19 ] at a molecular level will prove to be a bit different , @ @ @ @ @ @ @ helpful to patients without operating at that specific molecular level , ” Iwashyna added .
Now , there ’ s strong evidence that common steroids like dexamethasone can reduce the risk of mortality in severely sick in-patients .
Putting patients to rest on their stomachs instead of their backs ( a practice known as proning ) also seems to help .
Though there ’ s still a lot of progress to be made , the treatment approach has become more standardized over time , said Jen Manne-Goehler , an infectious disease doctor at @ @ @ @ @ @ @ General hospitals .
When she started treating Covid-19 patients in the spring , it felt like practice was changing every few days .
Now it ’ s more streamlined — and that ’ s undoubtedly helping with survival , too .
“ Whenever we standardize management [ of patients ] around a set of interventions — and we have at least some evidence [ of what works ] , ” Manne-Goehler said , “ we have the potential to do a better job of managing any condition.
” The most important factor in @ @ @ @ @ @ @ , however , are far from the whole story .
As much as doctors have uncovered things that help Covid-19 patients , they also tried a lot of things that— at best — failed to help , and at worst , harmed patients , King College ’ s Mateen pointed out .
( Think of early ventilation , or hydroxychloroquine . )
“ The size of the change we ’ re seeing [ in mortality ] can ’ t be explained by any one thing , ” he continued .
“ The mortality @ @ @ @ @ @ @ t explain this 50 percent drop we see from the peak of the pandemic.
” So what else could account for the falling death rate ?
Perhaps the studies can ’ t fully control for the shift in the demographics of the disease .
“ Maybe those who are at greatest risk early in the course of the virus succumbed at a very high rate and now those same patients are not as widespread and represented in all our communities , ” said Kaplan .
Another hypothesis is that , as masks became @ @ @ @ @ @ @ less virus when they get sick .
“ Perhaps you get infected with fewer virus particles and maybe having a lower dose of the virus causes less severe disease , ” Horwitz said .
“ We just can ’ t operate as well under real strain ” Because of more widespread testing — people are being diagnosed sooner than they were at the start of the pandemic , when there was essentially no testing — doctors can intervene earlier in the course of the disease .
But the most important factor driving the @ @ @ @ @ @ @ has nothing to do with medicines , viral exposure , or improved diagnosis , the critical care doctors told me : Hospitals have simply become less overwhelmed over time .
“ We just can ’ t operate as well under real strain , ” said intensive care doctor Lakshman Swamy , who works with the Cambridge Health Alliance , “ and overall strain has dropped considerably over the course of the surge.
” In Boston , for example , Swamy saw his whole hospital pivot toward Covid-19 care in the spring , with @ @ @ @ @ @ @ .
Back then , doctors , nurses and respiratory therapists were stretched every day .
“ ICU patients just didn ’ t get the same attention as they can get now , with the numbers so far down , ” he said .
“ This has consequences , ” he added .
ICU care is nuanced , labor intensive .
Without adequate supplies and staffing , “ Changes in condition are noticed a bit later than they would have been , interventions take a little longer to institute , and the ventilator — @ @ @ @ @ @ @ and longer intervals before some who knows what they are doing can give it the attention it needs.
” You can see a hint of the effect of overburdened hospitals in Mateen ’ s UK study .
He and his co-authors chose to use the week of March 29 as the reference point for how mortality changed over time , because it was the peak of hospital admissions in the UK .
But if they ’ d gone back to the first two weeks of March instead , pre-surge in the UK , @ @ @ @ @ @ @ in mortality .
Mateen and his colleagues decided to start at peak occupancy precisely because of the role they figured it played in mortality rates — a finding in another related study , currently in pre-print .
The ominous implication of the winter spike in cases and hospitalizations , Mateen said , is that “ we risk seeing what we saw at the beginning of the first wave , with a creeping up mortality rate.
” Horwitz also has little doubt increased hospital strain will impact care for the worse .
“ I @ @ @ @ @ @ @ mortality rates to come back up , ” she warned .
“ If you overwhelm the health system , you overwhelm the health system.
” As the new coronavirus wave grows , patients in small hospitals may fare particularly poorly , a recent JAMA Internal Medicine study suggests .
The researchers uncovered a large variation among mortality rates across US hospitals , and that hospital capacity prior to Covid-19 was a major predictor of outcomes .
Hospitals with the fewest ICU beds had more than three times the mortality rate compared to large-volume @ @ @ @ @ @ @ in patient populations .
Large or small , hospitals that didn ’ t use the summer to prepare for the crush of patients already arriving in their wards also “ face real risks , ” Iwashyna warned .
But overwhelming hospitals with Covid-19 patients is not an inevitability , said Wan Yang , an infectious disease modeler at Columbia University and author of The Lancet coronavirus mortality study .
Stopping the spread of Covid-19 requires collective action , she said .
“ It really depends on how people behave because it ’ s @ @ @ @ @ @ @ So if we reduce contacts and take preventive measures like wearing masks , we ’ ll be able to keep the infection rate in the population at a low level.
” If we fail to do that , Yang added , she doesn ’ t want to think about what might happen next .
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When Theodore Iwashyna cared for his first Covid-19 patient in March, he felt a wave of terror wash over him. “I was convinced I was going to either die or get my family sick,” the pulmonologist and professor of critical care medicine at the University of Michigan recalls.
Little was known about the novel coronavirus then, and Iwashyna couldn’t stop thinking back to the last pandemic coronavirus, SARS, when more than half of all deaths in a nearby hotspot, Toronto, were hospital-acquired infections.
Nowadays, Iwashyna is less worried about himself, his family, or even his very ill patients. “I don’t expect my Covid patients to die,” he says, “I expect most of them to get through.”
By several measures, the coronavirus mortality rate has fallen over the course of the pandemic — even for those at the highest risk of death. People who are diagnosed today appear to have better odds of surviving the disease compared to the first wave of patients.
“It’s a silver lining in a hard time,” said Bilal Mateen, a clinical-academic at Kings College Hospital and an author on a new study focused on mortality in UK critical care units, “but it’s by no means an excuse to take your foot off the pedal.”
That’s because even with the advances in Covid-19 treatment, there’s still a tipping point at which the mortality rate could spike — when there are far more patients than hospital beds, staff, and ventilators. “If hospitals get overwhelmed, obviously it’s difficult to provide optimal care,” said Tom Frieden, the CEO of the health nonprofit Resolve to Save Lives.
And hospitals are becoming overwhelmed again, on both sides of the Atlantic.
France is reporting the highest number of Covid-19 hospitalizations since April — with more than half of all ICU beds full in the country. The Czech Republic — home to the fastest-growing epidemic in Europe — had to mobilize the army to build a Covid-19 field hospital and call its foreign health workers home to help with the emergency. In Belgium, even doctors diagnosed with the disease have been asked to continue working while non-urgent surgeries have been called off.
The stateside outlook is equally grim. Covid-19 hospitalizations have increased by 46 percent from a month ago, surpassing 44,000 on October 27. As Vox’s Dylan Scott reports, this has forced radical measures across the country: Wisconsin and Texas are building field hospitals, while Idaho is planning to transfer patients out of state, and Utah is ready to ration care.
Covid-19 deaths by day have also recently risen somewhat in the US, although not yet to the height of earlier waves of the pandemic.
We may be approaching the moment at which progress saving lives can’t be sustained. “Each hospital’s overwhelmed point is different now than it was in April but there is a point that’s too much for any hospital,” Iwashyna says. “There are only so many hands. You can only be in so many rooms.” Here’s what we know about the falling Covid-19 mortality rate — and why it might start rising again soon.
From spring to summer, the Covid-19 death rate dropped in Europe and the US
It’s been seven months since the World Health Organization (WHO) declared the coronavirus a pandemic, and in that period, the mortality rate among people with Covid-19 improved in countries around the world.
At first, it wasn’t clear whether this trend could be explained mostly by shifting demographics of the disease (people getting sick tended to be younger and healthier over time), more testing, or changes in medical treatments. Researchers have been trying to unpack the data — and they’ve found, even after controlling for differences in patient populations, that mortality improvements appear to hold. Just take a look at these recent papers:
In this study, recently published in the journal Critical Care, researchers (including Mateen) in England looked at the 30-day mortality rate for 21,000 severely sick Covid-19 patients who were admitted to critical care units across England between March and June 2020. They found the odds of survival improved across the country — and the trend held even after adjusting for a patient’s underlying risks (such as age or other illnesses). In late March, 72 percent of patients who had been admitted to the HDU — a type of critical care ward where patients can be looked after more intensively — were still alive at 30 days. By the end of June, that number climbed to 93 percent. For ICU patients, the number also shot up from 58 percent to 80 percent over that period.
A second paper, published in the Journal of Hospital Medicine, focused on data from a 3-hospital health system: New York University Langone in New York. This time, they looked at the March to August period and all Covid-19 hospital patients (so not just the sickest patients who wind up in critical care). They also adjusted the data to account for changes in demographics and severity of illness over time. Here, too, they found the mortality rate among patients declined — 26 percent in March to 8 percent in August.
In a third paper, just published in The Lancet, researchers took a slightly different approach: They used modeling to gauge the infection-fatality risk — or risk of death among all infected people, not just those hospitalized — in New York City between March and June. The overall risk of death decreased over time, especially for people in older age groups. For those ages 65 to 74, the estimated infection-fatality risk was 7 percent in April, and 4 percent by the end of May. For people 75 years and older, the infection-fatality risk nearly halved — from 19 percent to 11 percent.
So, by several different measures, mortality from Covid-19 has declined throughout the pandemic.
Death rates fell because doctors’ understanding of Covid-19 and treating it has improved
Now the important question: What’s driving this trend? This is where things get more complicated.
Let’s start with the low-hanging fruit. In every study, researchers point to the most obvious explanation: At the start of the pandemic, we barely understood this disease. Doctors thought they were dealing with a viral pneumonia that mainly affected the lungs.
“We didn’t think about it as a whole body viral assault— and yet that’s what we have,” said Lewis Kaplan, president of the Society of Critical Care Medicine. “There’s virtually no organ system — from skin to blood vessels to brain to nose — that is not implicated in one way or another.”
With this shift in understanding has come better medical care.
In the spring, it was common to rush to use invasive mechanical ventilation — placing a tube in a patient’s throat and hooking them up to a ventilator to force air in and out the lungs, essentially doing the job of breathing on their behalf.
There were a couple of reasons for this approach: It was thought to be less risky for health care workers than other forms of oxygen therapy, because there’s a lower risk of aerosol spread. Doctors also suspected patients needed help breathing as fast as possible, explained Leora Horwitz, an NYU medical professor and author on the NYU Langone paper. “The patients oxygen levels were so low, they’d get bad within hours, and we didn’t want to risk someone dropping so much they stopped breathing before we had them on ventilators.”
But it turns out that unlike SARS, the novel coronavirus doesn’t easily spread in hospitals through aerosols when personal protective equipment — like N95 masks and face shields — is properly used. So ventilation didn’t actually reduce the risk of hospital-acquired infections. And less invasive forms of breathing support — like high flow nasal oxygen — were actually less damaging for the lungs and led to better outcomes. “We now understand we do not need to rush to put people on ventilators,” Horwitz added. Instead, doctors now try to avoid it all together.
There’s another important shift in coronavirus understanding. At the beginning of the pandemic, many doctors thought “there was something uniquely pro-inflammatory about Covid-19,” said Iwashyna. They pointed to cytokine storm — patients’ immune systems going into overdrive to fight the virus — as a leading cause of death, and thought drugs that suppress inflammation (such as IL-6 inhibitors) would help.
Those drugs didn’t help, and researchers learned Covid-19 “as a critical illness is a lot like other critical illnesses,” Iwashyna said. Patients with severe disease often experience acute respiratory distress syndrome (ARDS) — a deadly form of sepsis, where inflammation leads the lungs to fill with cells and fluid, eventually causing other organs to fail. Critical care doctors have long had a playbook for handling ARDS patients in ICU. “The very specific pathophysiology [of Covid-19] at a molecular level will prove to be a bit different, but our current excellent supportive care is helpful to patients without operating at that specific molecular level,” Iwashyna added.
Now, there’s strong evidence that common steroids like dexamethasone can reduce the risk of mortality in severely sick in-patients. Putting patients to rest on their stomachs instead of their backs (a practice known as proning) also seems to help.
Though there’s still a lot of progress to be made, the treatment approach has become more standardized over time, said Jen Manne-Goehler, an infectious disease doctor at Brigham and Women’s and Massachusetts General hospitals. When she started treating Covid-19 patients in the spring, it felt like practice was changing every few days. Now it’s more streamlined — and that’s undoubtedly helping with survival, too.
“Whenever we standardize management [of patients] around a set of interventions — and we have at least some evidence [of what works],” Manne-Goehler said, “we have the potential to do a better job of managing any condition.”
The most important factor in the mortality rate
Better treatment approaches, however, are far from the whole story. As much as doctors have uncovered things that help Covid-19 patients, they also tried a lot of things that— at best — failed to help, and at worst, harmed patients, King College’s Mateen pointed out. (Think of early ventilation, or hydroxychloroquine.)
“The size of the change we’re seeing [in mortality] can’t be explained by any one thing,” he continued. “The mortality improvement we saw with dexamethasone doesn’t explain this 50 percent drop we see from the peak of the pandemic.”
So what else could account for the falling death rate? Perhaps the studies can’t fully control for the shift in the demographics of the disease. “Maybe those who are at greatest risk early in the course of the virus succumbed at a very high rate and now those same patients are not as widespread and represented in all our communities,” said Kaplan.
Another hypothesis is that, as masks became more common, people are exposed to less virus when they get sick. “Perhaps you get infected with fewer virus particles and maybe having a lower dose of the virus causes less severe disease,” Horwitz said.
“We just can’t operate as well under real strain”
Because of more widespread testing — people are being diagnosed sooner than they were at the start of the pandemic, when there was essentially no testing — doctors can intervene earlier in the course of the disease.
But the most important factor driving the falling mortality rate is likely one that has nothing to do with medicines, viral exposure, or improved diagnosis, the critical care doctors told me: Hospitals have simply become less stressed over time.
“We just can’t operate as well under real strain,” said intensive care doctor Lakshman Swamy, who works with the Cambridge Health Alliance, “and overall strain has dropped considerably over the course of the surge.”
In Boston, for example, Swamy saw his whole hospital pivot toward Covid-19 care in the spring, with multiple new ICUs staffed by volunteer physicians. Back then, doctors, nurses and respiratory therapists were stretched every day. “ICU patients just didn’t get the same attention as they can get now, with the numbers so far down,” he said.
“This has consequences,” he added. ICU care is nuanced, labor intensive. Without adequate supplies and staffing, “Changes in condition are noticed a bit later than they would have been, interventions take a little longer to institute, and the ventilator — which requires round-the-clock attention — has longer and longer intervals before some who knows what they are doing can give it the attention it needs.”
The ominous reality of a winter surge
You can see a hint of the effect of overburdened hospitals in Mateen’s UK study. He and his co-authors chose to use the week of March 29 as the reference point for how mortality changed over time, because it was the peak of hospital admissions in the UK. But if they’d gone back to the first two weeks of March instead, pre-surge in the UK, the study would have found no improvement in mortality. Mateen and his colleagues decided to start at peak occupancy precisely because of the role they figured it played in mortality rates — a finding in another related study, currently in pre-print.
The ominous implication of the winter spike in cases and hospitalizations, Mateen said, is that “we risk seeing what we saw at the beginning of the first wave, with a creeping up mortality rate.”
Horwitz also has little doubt increased hospital strain will impact care for the worse. “I think it’s very possible for mortality rates to come back up,” she warned. “If you overwhelm the health system, you overwhelm the health system.”
As the new coronavirus wave grows, patients in small hospitals may fare particularly poorly, a recent JAMA Internal Medicine study suggests. The researchers uncovered a large variation among mortality rates across US hospitals, and that hospital capacity prior to Covid-19 was a major predictor of outcomes. Hospitals with the fewest ICU beds — and presumably, less experience handling the critically ill, had more than three times the mortality rate compared to large-volume hospitals, even after accounting for differences in patient populations.
Large or small, hospitals that didn’t use the summer to prepare for the crush of patients already arriving in their wards also “face real risks,” Iwashyna warned.
But overwhelming hospitals with Covid-19 patients is not an inevitability, said Wan Yang, an infectious disease modeler at Columbia University and author of The Lancet coronavirus mortality study. Stopping the spread of Covid-19 requires collective action, she said. “It really depends on how people behave because it’s a disease that thrives in people. So if we reduce contacts and take preventive measures like wearing masks, we’ll be able to keep the infection rate in the population at a low level.” If we fail to do that, Yang added, she doesn’t want to think about what might happen next.


vox--2020-10-28--During the worst summer of our lives, I didn’t have internet. It was the best.

I write about the internet for a living , so it may seem strange to report that I ’ m no longer very fond of it .
This summer , I found myself without regular internet access .
Ahead of the presidential elections , with the manic news cycle , widespread disinformation , and what feels like the constant need to refresh social media , I sometimes wish I were without it again .
About a week after giving birth to my baby in June , my partner and I moved into our mostly built house in upstate New York @ @ @ @ @ @ @ it would take the local internet provider an astounding month and a half to install internet .
Located on a mountain in the Catskills , there was no cell service to tide me over , either .
I was on maternity leave , so it was no longer vital to have internet for work , but I still really wanted it .
To be fair , if I really needed it , I could walk five minutes down the road and steal my neighbor ’ s wifi , but I ’ d have @ @ @ @ @ @ @ elements , and the baby .
So in practice , I didn ’ t do so very often .
On average , Americans spend about four and a half hours a day online , according to data from research firm Zenith .
People like me who work online spend even more time there .
In normal times , not only would I spend the whole workday online , I also spent a lot of my time before and afterwards there , too .
I was always up to date on every news story @ @ @ @ @ @ @ controversy .
People who were less online — most of them — could tell me nothing I hadn ’ t at least seen flash across my screen .
At first , not having the internet felt like a real hassle .
I felt like I was missing out or that something important might happen without my knowing .
I called the provider every day hoping for an earlier installation date .
But over time , not having internet was a blessing .
My sojourns onto the web were brief and more intentional .
@ @ @ @ @ @ @ to town or to my neighbor ’ s house and check Twitter and Instagram , where a relatively interesting backlog of posts and messages had time to build up , and then read a few important news stories .
Pretty quickly I ’ d turn to more practical matters that I kept track of through memos on my phone : “ to look up , ” “ to buy , ” “ to do.
” I got really into reference books , where I looked and failed to identify the bee-like flies that @ @ @ @ @ @ @ using the internet .
For baby information , instead of turning up every disparate answer in the world online , I had to sate myself with the conflicting guidance of just two parenting books .
The baby survived .
I tweeted and read Twitter less .
My tweets were better .
My mind was better .
My attention span seemed to grow longer .
I sat with my feelings without reprieve , and I feel like that made me emotionally stronger .
At the time , we were in the throes of the @ @ @ @ @ @ @ coronavirus in the US had recently surpassed its first 100,000 .
Americans were taking to the streets to protest police brutality against Black Americans , who were also being disproportionately ravaged by coronavirus .
I had felt like I needed to bear witness to it all , in order to show that I cared .
But not being online all the time didn ’ t mean I wasn ’ t informed about these very important news stories .
I would catch up after the fact , when there was more conclusive information , @ @ @ @ @ @ @ incremental development .
What it did was remind me what was within my power and what was not .
Reading every last tweet and news story about the coronavirus or police brutality or presidential election malfeasance only gives you the illusion of control .
Bearing witness is important , but so is your mental health .
Infinitely scrolling can feel like a stand-in for real action .
It ’ s not .
What I could actually do was donate money to causes I believe in , register to vote in my new home @ @ @ @ @ @ @ present in my own life .
People blame technology for a whole spate of ills from depression to decreased productivity — though there ’ s little definitive proof it ’ s actually doing that .
What ’ s certain to me , at least , is that continually pulling down on my phone to refresh Twitter or Instagram or the latest dire machinations of the president does not feel good .
What I learned was that things that seem important in the moment have the tendency to become less so with time .
@ @ @ @ @ @ @ haunting you but where your response isn ’ t mandatory ?
Try waiting till it ’ s no longer relevant .
Feel like you need to be on Slack at all hours ?
Log off and await what your coworkers can do without your presence .
( Of course , I ’ m fortunate enough to have a job where although people might Slack me at all hours , I ’ m not usually required to respond .
Not everyone has that . )
I found out about news hours or days later @ @ @ @ @ @ @ in .
No one needed my takes .
Did they ever ?
I read and listened to more books .
I completed a variety of construction projects around my new house .
I ate whole meals without opening my phone .
I learned how to parent .
Looking back , the best part of all this was getting to spend uninterrupted time with my baby and partner .
My baby ’ s first smile wasn ’ t missed because I was looking through a screen to somewhere else ( though , I guess @ @ @ @ @ @ @ pictures ) .
I was constantly , boringly present .
By the time the internet installation date drew near in August , I found myself dreading being online again .
It felt like this newly calm portion of my life was coming to an end .
I would eventually have to go back to work .
But I also felt a little restored and better able to deal with the hazards of the outside world .
I hadn ’ t realized how much the online world had burdened me .
Now , months @ @ @ @ @ @ @ and out of my bubble .
I wish I could say I ’ m more cautious in my internet usage , but that ’ s mostly untrue .
The lure of the internet and social media apps is strong , especially during this dramatic election year .
What we can do is try and recognize when something really is important , and when there really is something we can do about it .
Ahead of this election , vote .
Then consider logging off .
The events of the world will unfold regardless @ @ @ @ @ @ @ them every step of the way .
Help keep Vox free for all Millions turn to Vox each month to understand what ’ s happening in the news , from the coronavirus crisis to a racial reckoning to what is , quite possibly , the most consequential presidential election of our lifetimes .
Our mission has never been more vital than it is in this moment : to empower you through understanding .
But our distinctive brand of explanatory journalism takes resources .
Even when the economy and the news advertising market recovers @ @ @ @ @ @ @ part of sustaining our resource-intensive work .
If you have already contributed , thank you .
If you haven ’ t , please consider helping everyone make sense of an increasingly chaotic world : Contribute today from as little as $ 3 .

I write about the internet for a living, so it may seem strange to report that I’m no longer very fond of it.
This summer, I found myself without regular internet access. Ahead of the presidential elections, with the manic news cycle, widespread disinformation, and what feels like the constant need to refresh social media, I sometimes wish I were without it again.
About a week after I gave birth to my baby in June, my partner and I moved into our mostly built house in upstate New York. That’s when we learned it would take the local internet provider an astounding month and a half to install internet. Located on a mountain in the Catskills, there was no cell service to tide me over, either.
I was on maternity leave, so it was no longer vital to have internet for work, but I still really wanted it. To be fair, if I really needed it, I could walk five minutes down the road and steal my neighbor’s wifi, but I’d have to contend with the mosquitoes, the elements, and the baby. So in practice, I didn’t do so very often.
On average, Americans spend about four and a half hours a day online, according to data from the research firm Zenith. People like me who work online spend even more time there. In normal times, not only would I spend the whole workday online, I’d spend a lot of my time before and afterward there, too. I was always up to date on every news story, idle meme, and silly Twitter controversy. People who were less online — most of them — could tell me nothing I hadn’t at least seen flash across my screen.
At first, not having the internet felt like a real hassle. I felt like I was missing out or that something important might happen without my knowing. I called the provider every day hoping for an earlier installation date.
But over time, not having internet was a blessing. My sojourns onto the web were brief and more intentional. Every few days I’d go to town or to my neighbor’s house and check Twitter and Instagram, where a relatively interesting backlog of posts and messages had time to build up, and then read a few important news stories. Pretty quickly I’d turn to more practical matters that I kept track of through memos on my phone: “to look up,” “to buy,” “to do.”
I got really into reference books, where I looked and failed to identify the bee-like flies that attacked me while I was briefly outside using the internet. For baby information, instead of turning up every disparate answer in the world online, I had to sate myself with the conflicting guidance of just two parenting books. The baby survived.
I tweeted and read Twitter less. My tweets were better. My mind was better. My attention span seemed to grow longer. I sat with my feelings without reprieve, and I feel like that made me emotionally stronger.
At the time, we were in the throes of the pandemic. The death toll from the coronavirus in the US had recently surpassed 100,000. Americans were taking to the streets to protest police brutality against Black Americans, who were also being disproportionately ravaged by the coronavirus. I had felt like I needed to bear witness to it all, in order to show that I cared.
But not being online all the time didn’t mean I wasn’t informed about these very important news stories. I would catch up after the fact, when there was more conclusive information, but I wasn’t reading each incremental development.
What it did was remind me what was within my power and what was not. Reading every last tweet and news story about the coronavirus or police brutality or presidential election malfeasance only gives you the illusion of control. Bearing witness is important, but so is your mental health. Infinite scrolling can feel like a stand-in for real action. It’s not.
What I could actually do was donate money to causes I believe in, register to vote in my new home, and try my best to be present in my own life.
People blame technology for a whole spate of ills from depression to decreased productivity — though there’s little definitive proof it’s actually the cause. What’s certain to me, at least, is that continually pulling down on my phone to refresh Twitter or Instagram or the latest dire machinations of the president does not feel good.
What I learned was that things that seem important in the moment tend to become less so with time. Have an email that’s really haunting you but where your response isn’t mandatory? Try waiting till it’s no longer relevant. Feel like you need to be on Slack at all hours? Log off and await what your coworkers can do without your presence. (Of course, I’m fortunate enough to have a job where, although people might Slack me at all hours, I’m not usually required to respond. Not everyone has that.)
I found out about news hours or days later, when I was too late to weigh in. No one needed my takes. Did they ever? I read and listened to more books. I completed a variety of construction projects around my new house. I ate whole meals without opening my phone. I learned how to parent.
Looking back, the best part of all this was getting to spend uninterrupted time with my baby and partner. My baby’s first smile wasn’t missed because I was looking through a screen to somewhere else (though I guess I did take a lot of pictures). I was constantly, boringly present.
By the time the internet installation date drew near in August, I found myself dreading being online again. It felt like this newly calm portion of my life was coming to an end. I would eventually have to go back to work. But I also felt a little restored and better able to deal with the hazards of the outside world. I hadn’t realized how much the online world had burdened me.
Now, months later, I’m working online and out of my bubble. I wish I could say I’m more cautious in my internet usage, but that’s mostly untrue. The lure of the internet and social media apps is strong, especially during this dramatic election year.
What we can do is try to recognize when something really is important, and when there really is something we can do about it. Ahead of this election, vote. Then consider logging off. The events of the world will unfold whether or not we are watching them every step of the way.


vox--2020-10-28--Beef is bad for the planet. Can we make it better?

On the edge of the Amazon rainforest in Brazil , there ’ s a small city called Alta Floresta .
It was settled four decades ago when people came in to ranch cattle .
They cut down big tracts of the rainforest and set fire to the trees in an environmentally destructive process known as slashing and burning .
This land would quickly degrade , forcing ranchers to slash and burn more land .
And the cattle they brought in compounded the environmental problems by farting and burping out methane — a greenhouse gas that ’ s especially bad for @ @ @ @ @ @ @ tragedy that ’ s played out along huge tracts of the Amazon .
In Brazil alone , 450,000 square kilometers of rainforest have been cleared for beef .
Given how important the rainforest is for the Earth ’ s health — it ’ s sometimes known as “ the lungs of the planet ” — this phenomenon is a dangerous driver of climate change .
Vando Telles grew up in Alta Floresta .
His father is a cattle rancher .
So are many of his neighbors .
And he watched them go through @ @ @ @ @ @ @ So he decided to look for alternatives .
He went to university to study agriculture , and he learned a range of sustainable ranching techniques that he believed could turn things around for the ranchers back at home .
He realized that he could help the environment by working with the ranchers , not against them , and that this would help the ranchers , too .
It ’ s a win-win .
On this episode of the Future Perfect podcast , we talk to Vando Telles about his uphill battle to bring @ @ @ @ @ @ @ we speak with Christina Selby , a freelance reporter who traveled to Brazil to write about Vando Telles ’ s company , Pecsa , which has had some dramatic success : It has brought down greenhouse gas emissions on its ranches by a whopping 85 percent .
Together , Telles and Selby help us understand how Pecsa ’ s success might be scaled to other places , and what that might mean for the environment .
• Christina Selby ’ s story about Vando Telles ’ s company can be found at Scientific @ @ @ @ @ @ @ explainer on deforestation in the Amazon and on the invasion of indigenous land in Brazil • Vox video also has an explainer on why eating beef speeds up climate change • Vox ’ s Umair Irfan traveled to Brazil last year to report on deforestation and climate change • Want to fight climate change effectively ?
Sigal Samuel recommends donating to these high-impact organizations .
This podcast is made possible thanks to support from Animal Charity Evaluators .
They research and promote the most effective ways to help animals .
Sign up for @ @ @ @ @ @ @ week , you ’ ll get a roundup of ideas and solutions for tackling our biggest challenges : improving public health , decreasing human and animal suffering , easing catastrophic risks , and — to put it simply — getting better at doing good .
Help keep Vox free for all Millions turn to Vox each month to understand what ’ s happening in the news , from the coronavirus crisis to a racial reckoning to what is , quite possibly , the most consequential presidential election of our lifetimes .
Our mission @ @ @ @ @ @ @ is in this moment : to empower you through understanding .
But our distinctive brand of explanatory journalism takes resources .
Even when the economy and the news advertising market recovers , your support will be a critical part of sustaining our resource-intensive work .
If you have already contributed , thank you .
If you haven ’ t , please consider helping everyone make sense of an increasingly chaotic world : Contribute today from as little as $ 3 .

On the edge of the Amazon rainforest in Brazil, there’s a small city called Alta Floresta. It was settled four decades ago when people came in to ranch cattle. They cut down big tracts of the rainforest and set fire to the trees in an environmentally destructive process known as slashing and burning.
This land would quickly degrade, forcing ranchers to slash and burn more land. And the cattle they brought in compounded the environmental problems by farting and burping out methane — a greenhouse gas that’s especially bad for our planet.
It’s a tragedy that’s played out along huge tracts of the Amazon. In Brazil alone, 450,000 square kilometers of rainforest have been cleared for beef. Given how important the rainforest is for the Earth’s health — it’s sometimes known as “the lungs of the planet” — this phenomenon is a dangerous driver of climate change.
Sign up for the Meat/Less newsletter course Want to eat less meat but don’t know where to start? Sign up for Vox’s five-day newsletter full of practical tips — and food for thought — to incorporate more plant-based food into your diet.
Vando Telles grew up in Alta Floresta. His father is a cattle rancher. So are many of his neighbors. And he watched them go through economic difficulties as their land degraded. So he decided to look for alternatives.
He went to university to study agriculture, and he learned a range of sustainable ranching techniques that he believed could turn things around for the ranchers back at home. He realized that he could help the environment by working with the ranchers, not against them, and that this would help the ranchers, too. It’s a win-win.
On this episode of the Future Perfect podcast, we talk to Vando Telles about his uphill battle to bring those alternatives to his community. And we speak with Christina Selby, a freelance reporter who traveled to Brazil to write about Vando Telles’s company, Pecsa, which has had some dramatic success: It has brought down greenhouse gas emissions on its ranches by a whopping 85 percent.
Together, Telles and Selby help us understand how Pecsa’s success might be scaled to other places, and what that might mean for the environment.
Further reading:
This podcast is made possible thanks to support from Animal Charity Evaluators. They research and promote the most effective ways to help animals.
Sign up for the Future Perfect newsletter. Twice a week, you’ll get a roundup of ideas and solutions for tackling our biggest challenges: improving public health, decreasing human and animal suffering, easing catastrophic risks, and — to put it simply — getting better at doing good.


vox--2020-10-28--PPP loans were supposed to be forgiven. So far, that hasn’t happened.

Jackie Laundon was already on the phone when I called her , trying to get an answer from her bank about how to get her Paycheck Protection Program ( PPP ) loan forgiven .
She had been put on hold twice only to be shunted back to the original menu .
She had no more clarity than when she ’ d placed the call 45 minutes earlier .
It was the second time she ’ d tried reaching the bank by phone .
Laundon is a public health consultant in Denver , Colorado , where she works with state and @ @ @ @ @ @ @ of the business she started at the end of last year .
When the Covid-19 pandemic hit , two big contracts were about to end , and she wasn ’ t able to do the normal networking that brings in more work .
The public health agencies she usually works with are all suffering from budget cuts .
So she decided she needed some help to get through , and the PPP seemed like “ the most straightforward ” option , Laundon said with a laugh , especially if the money was essentially @ @ @ @ @ @ @ when it passed the CARES Act in March , aiming to funnel billions of dollars through banks to businesses that were suffering from widespread lockdowns during the pandemic .
The loans were mainly meant to cover payroll , a way to keep employees earning money while stopping companies from going under , and were designed to be completely forgiven if used properly .
“ I was like , ‘ Okay , it ’ s been eight weeks , where ’ s my forgiveness application ?
’ ” But getting the $ 15,000 Laundon @ @ @ @ @ @ @ .
She tried to find out what would be required to get forgiveness the day after she got her loan , but her lender didn ’ t have the information .
The Small Business Association ( SBA ) , the federal agency overseeing the program , had originally issued rules saying the money had to be spent in eight weeks , so Laundon did just that .
“ I was like , ‘ Okay , it ’ s been eight weeks , where ’ s my forgiveness application ?
’ ” Laundon kept @ @ @ @ @ @ @ the next five months to see if there was anything about how to apply for forgiveness , but it wasn ’ t until early October that she was told she could start applying .
By mid-October , she still hadn ’ t managed to submit her application .
There is a deadline for applying for forgiveness : business owners have to apply within 10 months of their PPP loan ending in order to avoid having to start payments .
The SBA released an “ EZ application ” for PPP forgiveness on June 16 @ @ @ @ @ @ @ submit the forms directly to the agency — they have to go through their lenders instead .
And both banks and the SBA have barely gotten things off the ground .
According to the Government Accountability Office , the SBA received only about 56,000 decisions on whether to forgive loans from banks by September 8 — which amounts to just 1 percent of the 5.2 million loans issued .
None had actually been forgiven as of October 1 .
Meanwhile , the SBA issued new information and rules on July 23 , August @ @ @ @ @ @ @ it still hadn ’ t finished creating a process for reviewing lenders ’ decisions as of August 14 .
On October 1 , the SBA said it would start forgiving loans after banks and borrowers complained .
Laundon is not the only small business owner anxiously waiting for the chance to get her PPP loan forgiven as the process drags out .
In a survey of 93 small business owners conducted in late September that was shared exclusively with Vox , the Main Street Alliance found that 39 percent have tried to start @ @ @ @ @ @ @ told their banks aren ’ t ready .
More than one-third are worried that the lengthy process leaves them sitting on potential debt , affecting their creditworthiness .
There is a lack of clarity as to whether PPP loans will be taxed as business income or as an expense , leaving year-end tax planning more complicated .
Minneapolis-based Kevin Brown , owner of print service company Smart Set , scrupulously followed the program ’ s rules , spending his $ 35,000 PPP loan on payroll and other expenses as allowed and within the @ @ @ @ @ @ @ it was like , ‘ Okay what ’ s next ?
’ ” he said .
“ The answer was , ‘ Good luck , you ’ re on your own.
’ ” As soon as the SBA published paperwork for forgiveness , Brown downloaded it and spent three hours going over it with his bookkeeper .
They didn ’ t even finish , but they were able to make a list of all the documents they needed and fill out the application .
At the end of June , he contacted his @ @ @ @ @ @ @ the paperwork .
His banker told him not to send it in yet .
That was the last time he had any communication from his banker about PPP forgiveness .
“ I ’ ve never asked for charity from the government , ” Brown said .
“ I ’ m very much committed to holding up my end of the bargain .
But at some point it ’ s like , what ’ s the government ’ s end of the bargain ?
” While he waits to submit his forgiveness application , @ @ @ @ @ @ @ a new piece of equipment that he had been set to buy in early March .
Back then , Brown had spoken to his banker about rolling over a loan for a different piece of equipment that he just paid off into a new one to cover the cost .
Now , as he ’ s facing his busy season in November and December , he ’ s eager to actually buy it .
But Brown has a $ 35,000 outstanding loan on his books , so his banker can ’ t issue @ @ @ @ @ @ @ both know the PPP loan should be forgiven .
“ I ’ m very much committed to holding up my end of the bargain .
But at some point it ’ s like , what ’ s the government ’ s end of the bargain ?
” Davis Senseman , an attorney who works with small business owners in Minneapolis , had assumed they would already be wrapping up work with clients to get their loans forgiven by now .
Instead , they have clients who call and anxiously say that they ’ @ @ @ @ @ @ @ loans .
“ It ’ s so hard to say to them … ‘ We can ’ t do the forgiveness yet , ’ ” Senseman said .
Others have decided not to use the PPP money in case it ’ s not forgiven .
Some clients have even held off on calling employees back to work .
Senseman is also waiting to apply to have their own $ 16,500 PPP loan forgiven .
They applied after realizing that all of their small business clients weren ’ t going to be able to @ @ @ @ @ @ @ and February as businesses shuttered in March .
They precisely followed the program ’ s rules .
Still , they said , they aren ’ t “ 100 percent sure ” that the rules won ’ t change again .
“ It takes an emotional toll , ” Senseman said .
“ I would like this debt that should not be a debt to not be a debt.
” And if it does turn into debt , even partially , it would be a “ burden , ” forcing Senseman to start demanding @ @ @ @ @ @ @ t pay .
Michael Fusco-Straub , the co-owner of bookstore Books Are Magic in Brooklyn , New York , still hasn ’ t been allowed to apply for forgiveness for his $ 100,000 loan .
He was told in July that it would start in August ; in August he was told September ; in September , October .
When we spoke in October , he said the last he ’ d been told was November .
He ’ s assuming that “ their goal is not to forgive it , ” so @ @ @ @ @ @ @ can to do it absolutely right .
It would be a hardship , he said , if it weren ’ t forgiven .
For Laundon , the delay in getting forgiveness means that she ’ s not using her PPP money the way it was intended .
“ I have been pinching pennies , ” she said , to make sure she has $ 15,000 in case she has to pay it back .
She ’ s been marketing herself for smaller research projects outside of what her business is supposed to focus @ @ @ @ @ @ @ .
She ’ s held off on getting a customized email suite and setting up her own website to build more business .
She can ’ t take the classes she would normally invest in to get her higher certifications and allow her to charge higher rates .
“ Anything I feel like I can cut back on , I ’ ve just cut back on , ” she said .
Even once the forgiveness process truly gets underway , many business owners aren ’ t sure exactly what paperwork will be required @ @ @ @ @ @ @ Main Street Alliance survey respondents were concerned that the process wasn ’ t clear , with two-thirds saying they don ’ t understand what ’ s eligible for forgiveness given the many changes in the program , and over half were confused about what documents are required .
The details matter : About two-thirds fear not getting their loans forgiven , while 43 percent are concerned they won ’ t have any recourse if they feel a decision isn ’ t fair .
It wasn ’ t too difficult for Laundon to apply @ @ @ @ @ @ @ profit and loss statements from January and February of this year , the months when she actually had income .
She was hoping the lengthy delay in her bank allowing her to apply for forgiveness was due to the bank setting up a portal that would make that process easy as well .
“ No one really seems to understand what is needed ” Instead , her bank told her that she needs to submit different documentation to be forgiven : It wants her to send a Form 941 , which small businesses @ @ @ @ @ @ @ show taxes withheld from workers ’ paychecks , and a Schedule C form for 2019 , which sole proprietors file with the IRS at tax time .
But she has no employees and was only in business for four weeks last year .
She hadn ’ t started making money but had startup costs , so she had a loss for that time period .
Each time Laundon sends an email explaining and asking what she can submit instead , she gets a form response telling her she needs to send a 941 @ @ @ @ @ @ @ is not really working with the left hand , and no one really seems to understand what is needed , ” she said .
Laundon has resorted to looking at the SBA ’ s website and accounting blogs to try to figure out what her lender should be asking her for .
“ This is a lot of unpaid time that we ’ re spending on trying to provide this documentation , ” she noted .
“ I ’ m someone who likes to make sure all of my Ts are crossed and @ @ @ @ @ @ @ want them to be very clear about what is needed.
” Brown ’ s situation is more straightforward .
And yet even he ’ s unsure , once he ’ s able to submit his forgiveness paperwork , if it will be wiped clean .
The program required business owners to spend 75 percent of the money on payroll , but it was never explained if it had to be on the same employees for the same hours as pre-pandemic , or if things could be shifted around — which is what he @ @ @ @ @ @ @ employees .
Even his banker didn ’ t know the answer .
If it ’ s not forgiven , he said , it “ would be pretty catastrophic.
” “ The whole thing has just been hilariously poorly executed , ” Laundon said .
“ But it ’ s incredibly unfunny because this is people ’ s livelihoods.
” Help keep Vox free for all Millions turn to Vox each month to understand what ’ s happening in the news , from the coronavirus crisis to a racial reckoning to what is , @ @ @ @ @ @ @ election of our lifetimes .
Our mission has never been more vital than it is in this moment : to empower you through understanding .
But our distinctive brand of explanatory journalism takes resources .
Even when the economy and the news advertising market recovers , your support will be a critical part of sustaining our resource-intensive work .
If you have already contributed , thank you .
If you haven ’ t , please consider helping everyone make sense of an increasingly chaotic world : Contribute today from as little as $ @ @

Jackie Laundon was already on the phone when I called her, trying to get an answer from her bank about how to get her Paycheck Protection Program (PPP) loan forgiven. She had been put on hold twice only to be shunted back to the original menu. She had no more clarity than when she’d placed the call 45 minutes earlier. It was the second time she’d tried reaching the bank by phone.
Laundon is a public health consultant in Denver, Colorado, where she works with state and local government agencies as the sole proprietor of the business she started at the end of last year. When the Covid-19 pandemic hit, two big contracts were about to end, and she wasn’t able to do the normal networking that brings in more work. The public health agencies she usually works with are all suffering from budget cuts. So she decided she needed some help to get through, and the PPP seemed like “the most straightforward” option, Laundon said with a laugh, especially if the money was essentially a grant.
Congress created the PPP when it passed the CARES Act in March, aiming to funnel billions of dollars through banks to businesses that were suffering from widespread lockdowns during the pandemic. The loans were mainly meant to cover payroll, a way to keep employees earning money while stopping companies from going under, and were designed to be completely forgiven if used properly.
“I was like, ‘Okay, it’s been eight weeks, where’s my forgiveness application?’”
But getting the $15,000 Laundon received forgiven has been anything but straightforward. She tried to find out what would be required to get forgiveness the day after she got her loan, but her lender didn’t have the information. The Small Business Association (SBA), the federal agency overseeing the program, had originally issued rules saying the money had to be spent in eight weeks, so Laundon did just that. “I was like, ‘Okay, it’s been eight weeks, where’s my forgiveness application?’”
Laundon kept checking her lender’s website over the next five months to see if there was anything about how to apply for forgiveness, but it wasn’t until early October that she was told she could start applying. By mid-October, she still hadn’t managed to submit her application. There is a deadline for applying for forgiveness: business owners have to apply within 10 months of their PPP loan ending in order to avoid having to start payments.
The SBA released an “EZ application” for PPP forgiveness on June 16, but business owners can’t submit the forms directly to the agency — they have to go through their lenders instead. And both banks and the SBA have barely gotten things off the ground.
According to the Government Accountability Office, the SBA received only about 56,000 decisions on whether to forgive loans from banks by September 8 — which amounts to just 1 percent of the 5.2 million loans issued. None had actually been forgiven as of October 1, although the SBA said it finally began sending forgiveness payments out on October 2. Meanwhile, the SBA issued new information and rules on July 23, August 4, and August 11, and it still hadn’t finished creating a process for reviewing lenders’ decisions as of August 14. On October 1, the SBA said it would start forgiving loans after banks and borrowers complained.
Laundon is not the only small business owner anxiously waiting for the chance to get her PPP loan forgiven as the process drags out. In a survey of 93 small business owners conducted in late September that was shared exclusively with Vox, the Main Street Alliance found that 39 percent have tried to start the forgiveness process, but have been told their banks aren’t ready. More than one-third are worried that the lengthy process leaves them sitting on potential debt, affecting their creditworthiness. There is a lack of clarity as to whether PPP loans will be taxed as business income or as an expense, leaving year-end tax planning more complicated.
Minneapolis-based Kevin Brown, owner of print service company Smart Set, scrupulously followed the program’s rules, spending his $35,000 PPP loan on payroll and other expenses as allowed and within the right time frame. “And then it was like, ‘Okay what’s next?’” he said. “The answer was, ‘Good luck, you’re on your own.’”
As soon as the SBA published paperwork for forgiveness, Brown downloaded it and spent three hours going over it with his bookkeeper. They didn’t even finish, but they were able to make a list of all the documents they needed and fill out the application. At the end of June, he contacted his banker about what he should do with the paperwork. His banker told him not to send it in yet. That was the last time he had any communication from his banker about PPP forgiveness.
“I’ve never asked for charity from the government,” Brown said. “I’m very much committed to holding up my end of the bargain. But at some point it’s like, what’s the government’s end of the bargain?” While he waits to submit his forgiveness application, he’s holding off on buying a new piece of equipment that he had been set to buy in early March.
Back then, Brown had spoken to his banker about rolling over a loan for a different piece of equipment that he just paid off into a new one to cover the cost. Now, as he’s facing his busy season in November and December, he’s eager to actually buy it. But Brown has a $35,000 outstanding loan on his books, so his banker can’t issue the new loan, even if they both know the PPP loan should be forgiven.
“I’m very much committed to holding up my end of the bargain. But at some point it’s like, what’s the government’s end of the bargain?”
Davis Senseman, an attorney who works with small business owners in Minneapolis, had assumed they would already be wrapping up work with clients to get their loans forgiven by now. Instead, they have clients who call and anxiously say that they’re watching interest accruing on their PPP loans. “It’s so hard to say to them … ‘We can’t do the forgiveness yet,’” Senseman said. Others have decided not to use the PPP money in case it’s not forgiven. Some clients have even held off on calling employees back to work.
Senseman is also waiting to apply to have their own $16,500 PPP loan forgiven. They applied after realizing that all of their small business clients weren’t going to be able to pay them for work done in January and February as businesses shuttered in March. They precisely followed the program’s rules. Still, they said, they aren’t “100 percent sure” that the rules won’t change again. “It takes an emotional toll,” Senseman said. “I would like this debt that should not be a debt to not be a debt.” And if it does turn into debt, even partially, it would be a “burden,” forcing Senseman to start demanding payment from clients who still can’t pay.
Michael Fusco-Straub, the co-owner of bookstore Books Are Magic in Brooklyn, New York, still hasn’t been allowed to apply for forgiveness for his $100,000 loan. He was told in July that it would start in August; in August he was told September; in September, October. When we spoke in October, he said the last he’d been told was November. He’s assuming that “their goal is not to forgive it,” so he is planning to do everything he can to do it absolutely right. It would be a hardship, he said, if it weren’t forgiven.
For Laundon, the delay in getting forgiveness means that she’s not using her PPP money the way it was intended. “I have been pinching pennies,” she said, to make sure she has $15,000 in case she has to pay it back. She’s been marketing herself for smaller research projects outside of what her business is supposed to focus on in order to make more income. She’s held off on getting a customized email suite and setting up her own website to build more business. She can’t take the classes she would normally invest in to get her higher certifications and allow her to charge higher rates. “Anything I feel like I can cut back on, I’ve just cut back on,” she said.
Even once the forgiveness process truly gets underway, many business owners aren’t sure exactly what paperwork will be required of them. Sixty-eight percent of the Main Street Alliance survey respondents were concerned that the process wasn’t clear, with two-thirds saying they don’t understand what’s eligible for forgiveness given the many changes in the program, and over half were confused about what documents are required. The details matter: About two-thirds fear not getting their loans forgiven, while 43 percent are concerned they won’t have any recourse if they feel a decision isn’t fair.
It wasn’t too difficult for Laundon to apply for a PPP loan: She submitted profit and loss statements from January and February of this year, the months when she actually had income. She was hoping the lengthy delay in her bank allowing her to apply for forgiveness was due to the bank setting up a portal that would make that process easy as well.
“No one really seems to understand what is needed”
Instead, her bank told her that she needs to submit different documentation to be forgiven: It wants her to send a Form 941, which small businesses with employees submit to the IRS to show taxes withheld from workers’ paychecks, and a Schedule C form for 2019, which sole proprietors file with the IRS at tax time. But she has no employees and was only in business for four weeks last year. She hadn’t started making money but had startup costs, so she had a loss for that time period.
Each time Laundon sends an email explaining and asking what she can submit instead, she gets a form response telling her she needs to send a 941 and Schedule C. “The right hand is not really working with the left hand, and no one really seems to understand what is needed,” she said.
Laundon has resorted to looking at the SBA’s website and accounting blogs to try to figure out what her lender should be asking her for. “This is a lot of unpaid time that we’re spending on trying to provide this documentation,” she noted. “I’m someone who likes to make sure all of my Ts are crossed and my Is are dotted. I just want them to be very clear about what is needed.”
Brown’s situation is more straightforward. And yet even he’s unsure, once he’s able to submit his forgiveness paperwork, if it will be wiped clean. The program required business owners to spend 75 percent of the money on payroll, but it was never explained if it had to be on the same employees for the same hours as pre-pandemic, or if things could be shifted around — which is what he ended up having to do with his employees. Even his banker didn’t know the answer. If it’s not forgiven, he said, it “would be pretty catastrophic.”
“The whole thing has just been hilariously poorly executed,” Laundon said. “But it’s incredibly unfunny because this is people’s livelihoods.”
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