vox--2020-08-05--TikTok clone Instagram Reels is just one of the many times Facebook has copied its competitors

Facebook ’ s TikTok knockoff , Instagram Reels , is making its big United States debut today .
The feature is Instagram ’ s answer to TikTok , the wildly popular short-form video streaming app .
It would be a big deal if this copycat product is as successful as Instagram Stories , but that ’ s hardly guaranteed .
Reels lets users make 15-second edited videos overlaid with music directly in their Stories , Feed , or a new Reels section in the Instagram Explore tab , as my Vox colleague Rebecca Jennings explains here .
It ’ s @ @ @ @ @ @ @ similarly lets people upload lip-sync videos .
The timing of the US release of Reels , which Facebook has been testing in other countries since late last year , has also been surprisingly fortuitous .
After threatening to ban TikTok in the US , Trump now appears to be forcing a sale of TikTok to an American company like Microsoft .
Though the Reels launch is drawing attention for all kinds of reasons , let ’ s not forget that Facebook has a long history of creating knockoffs .
To put the latest @ @ @ @ @ @ @ of the more notable times the social media giant has tried to copy its competitors — with varying levels of success .
Reels actually isn ’ t the first time Facebook has tried to clone TikTok .
The last time did not end well .
Back in November 2018 , not long after TikTok first bought China-based lip-syncing app Musical.ly and launched in the US , Facebook quietly came out with a standalone app called Lasso that , just like Reels , allowed users to take 15-second videos and overlay them with music @ @ @ @ @ @ @ , a Facebook spokesperson called it a “ standalone app for short-form , entertaining videos — from comedy to beauty to fitness and more , ” which sounds very similar to TikTok and a lot like how the company is now describing Reels .
But as a standalone app without a built-in userbase , Lasso struggled to win users .
By June 1 , 2019 , the app reportedly had fewer than 80,000 daily active Android users in Mexico , its biggest market , according to metrics from App Annie that TechCrunch reported @ @ @ @ @ @ @ of this year ahead of its expected Instagram Reels launch .
On a call with reporters on Wednesday , Instagram ’ s head of product Vishal Shah said that Instagram has learned lessons from Lasso .
“ A new standalone app , while it gives you a lot of flexibility , also requires to kind of build an audience , ” said Shah on the call .
Stories , the most successful clone to date Instagram ’ s ephemeral Stories feature is now one of the most-used parts of the app .
But @ @ @ @ @ @ @ , Instagram was all about the Feed , the chronological collection of your photos that lives more permanently in a user ’ s profile .
The arrival of Stories was immediately controversial as it was seen as a blatant copy of a Snapchat feature with the same exact name .
Like Instagram Stories , Snapchat Stories let users share with their friends content that expired within 24 hours .
That came after Facebook tried , unsuccessfully , to acquire Snapchat back in 2013 ; when Snap CEO Evan Spiegel refused to sell , @ @ @ @ @ @ @ Poke ( more on that later ) .
Zuckerberg reportedly approached Spiegel again in 2016 before launching Stories .
At that time , Facebook defended itself from criticism that it was copying its rising competitor using very similar language to how they ’ re talking about the similarity between Reels and TikTok today .
“ They deserve all the credit , ” Instagram co-founder Kevin Systrom told TechCrunch about Snapchat .
“ This isn ’ t about who invented something .
This is about a format , and how you take it to @ @ @ @ @ @ @ on it.
” Compare that to what Instagram ’ s Shah said about TikTok on a press call before the Reels launch : “ We ’ re inspired by other companies , too .
We were clear on that with Stories with Snap , we ’ re clear on that with TikTok short-form video , ” Shah said .
“ At the same time , you know , these things are not invented in any one place.
” It wasn ’ t at all clear how Stories would fare when it launched .
@ @ @ @ @ @ @ already launched another failed ephemeral messaging app called Slingshot .
But Instagram Stories turned out to be a huge success .
Instagrammers were suddenly relieved of the pressure to have a perfectly curated lifestyle to permanently document in their “ grid ” of forever-photos , and instead could share content more freely in their disappearing Stories section .
About half of Instagram ’ s 1 billion users in 2018 used the Stories feature every day .
The number of Instagram Stories users also quickly surpassed Snapchat users , effectively weakening one of its @ @ @ @ @ @ @ the most successful of Facebook ’ s competitor clones to date .
Hobbi , the Pinterest clone that never took off Pinterest has long cornered a market of users that any company running ads finds attractive .
These include people planning weddings , redecorating their homes , or exploring a new hobby — all activities that generally involve buying new things .
So it ’ s no surprise that Facebook launched an app that looked awfully similar to Pinterest , called Hobbi , early in 2020 .
Facebook marketed the app as one @ @ @ @ @ @ @ your creative process ” for activities like cooking , home decor , and gardening , according to a Verge report around its release in February .
The app was meant for people to document their crafts , and then the app would help publish a highlights reel when the project was done .
But only four months after launch , Facebook shut down Hobbi .
One problem with it : The app was “ fairly bare bones , ” TechCrunch wrote at the time , only allowing users to view their own videos @ @ @ @ @ @ @ of a feed of peers ’ content .
In the end , Hobbi became an example of Facebook seeming to half-commit to copying an important competitor — and failing .
Videoconference chat app Zoom has been one of the breakout stars of the tech startup world in the past few years , its success cemented by the pandemic forcing people to take more virtual meetings than ever .
So of course , Facebook launched a competing video chat service in April called Rooms .
The feature is built into the Facebook Messenger app @ @ @ @ @ @ @ up to 50 people at a time .
Facebook says it will later expand to Whatsapp , Instagram , and Portal as well .
As my colleague Sara Morrison previously explained , Rooms seems to positions itself as more secure than its competition , with features like making Rooms links intentionally difficult for hackers to guess .
This claim may sound a bit rich considering that Facebook has repeatedly publicly stumbled on privacy .
( Just hours before the Rooms launch , Facebook announced it settled a $ 5 billion case with the @ @ @ @ @ @ @ in the Cambridge Analytica scandal . )
Also , Rooms stands to win big in the video chat space because Facebook already has a broad built-in user base .
Facebook already owns wildly popular messaging app Whatsapp , and Facebook says 700 million users of Whatsapp and Messenger participate in calls every day .
Zoom , for comparison , had about 300 million daily participants in meetings back in April .
Zoom has also faced criticism for routing some calls through China-based computer servers , which it says was a mistake .
This @ @ @ @ @ @ @ increased his crackdown of major US companies that have ties to China .
If Zoom ends up following TikTok in the regulatory hot seat , Facebook ’ s Rooms could , like Instagram Reels , be positioned to take advantage of the competition ’ s political baggage .
But with Rooms and all of the examples above , there ’ s concern that Facebook is running into antitrust problems when it blatantly copies its competition .
Just last week , Congress pressed Facebook CEO Mark Zuckerberg on concerns that his company has engaged @ @ @ @ @ @ @ Instagram acquisition .
Instagram co-founder Kevin Systrom worried that if he didn ’ t sell his company to Facebook back in 2012 that Zuckerberg would go into “ destroy mode ” to crush the competition , according to recently released text messages between Systrom and an Instagram investor .
Some critics argue that Facebook is going into “ destroy mode ” yet again , with TikTok as its latest target .
It ’ s true that Facebook seems to be unbothered by potential regulatory concerns about the similarities between Reels and TikTok .
@ @ @ @ @ @ @ about Facebook yet again releasing a copycat app of one of its biggest competitors , Reels is only a viable threat to TikTok if it actually succeeds .
For now , it ’ s too soon to say if Reels will become another now-forgotten Lasso or Hobbi , or whether it will be the next Instagram Stories .
Every day at Vox , we aim to answer your most important questions and provide you , and our audience around the world , with information that has the power to save lives .
Our @ @ @ @ @ @ @ it is in this moment : to empower you through understanding .
Vox ’ s work is reaching more people than ever , but our distinctive brand of explanatory journalism takes resources — particularly during a pandemic and an economic downturn .
Your financial contribution will not constitute a donation , but it will enable our staff to continue to offer free articles , videos , and podcasts at the quality and volume that this moment requires .
Please consider making a contribution to Vox today .

Facebook’s TikTok knockoff, Instagram Reels, is making its big United States debut today. The feature is Instagram’s answer to TikTok, the wildly popular short-form video streaming app. It would be a big deal if this copycat product is as successful as Instagram Stories, but that’s hardly guaranteed.
Reels lets users make 15-second edited videos overlaid with music directly in their Stories, Feed, or a new Reels section in the Instagram Explore tab, as my Vox colleague Rebecca Jennings explains here. It’s a near clone of TikTok, which similarly lets people upload lip-sync videos. The timing of the US release of Reels, which Facebook has been testing in other countries since late last year, has also been surprisingly fortuitous. After threatening to ban TikTok in the US, Trump now appears to be forcing a sale of TikTok to an American company like Microsoft.
Though the Reels launch is drawing attention for all kinds of reasons, let’s not forget that Facebook has a long history of creating knockoffs. To put the latest effort into perspective, here are some of the more notable times the social media giant has tried to copy its competitors — with varying levels of success.
Lasso, the TikTok clone that didn’t work
Reels actually isn’t the first time Facebook has tried to clone TikTok. The last time did not end well.
Back in November 2018, not long after TikTok first bought China-based lip-syncing app Musical.ly and launched in the US, Facebook quietly came out with a standalone app called Lasso that, just like Reels, allowed users to take 15-second videos and overlay them with music. At the time of the launch, a Facebook spokesperson called it a “standalone app for short-form, entertaining videos — from comedy to beauty to fitness and more,” which sounds very similar to TikTok and a lot like how the company is now describing Reels.
But as a standalone app without a built-in userbase, Lasso struggled to win users. By June 1, 2019, the app reportedly had fewer than 80,000 daily active Android users in Mexico, its biggest market, according to metrics from App Annie that TechCrunch reported. Facebook shut down Lasso in July of this year ahead of its expected Instagram Reels launch.
On a call with reporters on Wednesday, Instagram’s head of product Vishal Shah said that Instagram has learned lessons from Lasso. “A new standalone app, while it gives you a lot of flexibility, also requires to kind of build an audience,” said Shah on the call.
Stories, the most successful clone to date
Instagram’s ephemeral Stories feature is now one of the most-used parts of the app. But back when the feature launched in 2016, Instagram was all about the Feed, the chronological collection of your photos that lives more permanently in a user’s profile. The arrival of Stories was immediately controversial as it was seen as a blatant copy of a Snapchat feature with the same exact name. Like Instagram Stories, Snapchat Stories let users share with their friends content that expired within 24 hours.
That came after Facebook tried, unsuccessfully, to acquire Snapchat back in 2013; when Snap CEO Evan Spiegel refused to sell, Mark Zuckerberg launched a copycat app called Poke (more on that later). Zuckerberg reportedly approached Spiegel again in 2016 before launching Stories. At that time, Facebook defended itself from criticism that it was copying its rising competitor using very similar language to how they’re talking about the similarity between Reels and TikTok today.
“They deserve all the credit,” Instagram co-founder Kevin Systrom told TechCrunch about Snapchat. “This isn’t about who invented something. This is about a format, and how you take it to a network and put your own spin on it.”
Compare that to what Instagram’s Shah said about TikTok on a press call before the Reels launch: “We’re inspired by other companies, too. We were clear on that with Stories with Snap, we’re clear on that with TikTok short-form video,” Shah said. “At the same time, you know, these things are not invented in any one place.”
It wasn’t at all clear how Stories would fare when it launched. In addition to Poke, Facebook had already launched another failed ephemeral messaging app called Slingshot. But Instagram Stories turned out to be a huge success. Instagrammers were suddenly relieved of the pressure to have a perfectly curated lifestyle to permanently document in their “grid” of forever-photos, and instead could share content more freely in their disappearing Stories section. About half of Instagram’s 1 billion users in 2018 used the Stories feature every day.
The number of Instagram Stories users also quickly surpassed Snapchat users, effectively weakening one of its biggest competitors and making it one of the most successful of Facebook’s competitor clones to date.
Hobbi, the Pinterest clone that never took off
Pinterest has long cornered a market of users that any company running ads finds attractive. These include people planning weddings, redecorating their homes, or exploring a new hobby — all activities that generally involve buying new things. So it’s no surprise that Facebook launched an app that looked awfully similar to Pinterest, called Hobbi, early in 2020.
Facebook marketed the app as one that helps you “capture and organize your creative process” for activities like cooking, home decor, and gardening, according to a Verge report around its release in February. The app was meant for people to document their crafts, and then the app would help publish a highlights reel when the project was done.
But only four months after launch, Facebook shut down Hobbi. One problem with it: The app was “fairly bare bones,” TechCrunch wrote at the time, only allowing users to view their own videos and snippets of other top users instead of a feed of peers’ content. In the end, Hobbi became an example of Facebook seeming to half-commit to copying an important competitor — and failing.
Rooms, the Zoom clone
Videoconference chat app Zoom has been one of the breakout stars of the tech startup world in the past few years, its success cemented by the pandemic forcing people to take more virtual meetings than ever. So of course, Facebook launched a competing video chat service in April called Rooms. The feature is built into the Facebook Messenger app and lets users hold group chats with up to 50 people at a time. Facebook says it will later expand to Whatsapp, Instagram, and Portal as well.
As my colleague Sara Morrison previously explained, Rooms seems to positions itself as more secure than its competition, with features like making Rooms links intentionally difficult for hackers to guess. This claim may sound a bit rich considering that Facebook has repeatedly publicly stumbled on privacy. (Just hours before the Rooms launch, Facebook announced it settled a $5 billion case with the FTC over the company’s role in the Cambridge Analytica scandal.)
Also, Rooms stands to win big in the video chat space because Facebook already has a broad built-in user base. Facebook already owns wildly popular messaging app Whatsapp, and Facebook says 700 million users of Whatsapp and Messenger participate in calls every day. Zoom, for comparison, had about 300 million daily participants in meetings back in April.
Zoom has also faced criticism for routing some calls through China-based computer servers, which it says was a mistake. This comes at a time when Trump has increased his crackdown of major US companies that have ties to China. If Zoom ends up following TikTok in the regulatory hot seat, Facebook’s Rooms could, like Instagram Reels, be positioned to take advantage of the competition’s political baggage.
But with Rooms and all of the examples above, there’s concern that Facebook is running into antitrust problems when it blatantly copies its competition. Just last week, Congress pressed Facebook CEO Mark Zuckerberg on concerns that his company has engaged in anti-competitive behavior, particularly around its Instagram acquisition. Instagram co-founder Kevin Systrom worried that if he didn’t sell his company to Facebook back in 2012 that Zuckerberg would go into “destroy mode” to crush the competition, according to recently released text messages between Systrom and an Instagram investor. Some critics argue that Facebook is going into “destroy mode” yet again, with TikTok as its latest target.
It’s true that Facebook seems to be unbothered by potential regulatory concerns about the similarities between Reels and TikTok. But while there are serious anti-competitive questions about Facebook yet again releasing a copycat app of one of its biggest competitors, Reels is only a viable threat to TikTok if it actually succeeds.
For now, it’s too soon to say if Reels will become another now-forgotten Lasso or Hobbi, or whether it will be the next Instagram Stories.


vox--2020-08-05--Mortality, mass psychosis, and how we live today

The question has the ring of one posed by a street-corner preacher : If you knew you were going to die tomorrow , how would you spend today ?
Answers , presumably , will vary .
You might visit your family , or break off a relationship , or go careening down the highway at top speed on your motorcycle .
You might get incredibly drunk , or go to church , or hug your child .
It ’ s just a thought experiment , but it ’ s a revealing one .
Wait , back up — is it @ @ @ @ @ @ @ know for sure that we ’ ll die tomorrow , but we also don ’ t know that we won ’ t .
Calamity waits around every corner .
Freak accidents and aneurysms occur .
The scariest obituaries are those memorializing people who didn ’ t know death was imminent , but it came for them anyhow .
Many of us live our lives sustained by a wholly unsupportable illusion we rarely confront : Death is out in the distance somewhere , not nearby .
But that fantasy is upended if you receive @ @ @ @ @ @ @ live with severe chronic illness .
It dissipates as you get older .
It pauses , curiously , when someone close to you dies — at least for a time — but tends to return if and when you manage to bat away the looming specter of your own end .
And , of course , it changes dramatically when an invisible virus threatens the normal balance of life and the world turns upside down .
We shine lights of distraction to keep the shadows of our own mortality at bay , but @ @ @ @ @ @ @ Amy Seimetz ’ s new movie She Dies Tomorrow imagines the premonition of death as not only something we occasionally experience but also a virus of its own , spreading from person to person , similar to an infection or a mania .
But it ’ s the kind of mania that appears , under some lights , like sanity .
Kate Lyn Sheil plays Amy , a recovering alcoholic who becomes convinced her death will happen the next day .
She ’ s not suicidal ; she just knows her death is @ @ @ @ @ @ @ house she just bought , she cracks open a bottle of wine , browses cremation urns online , and listens to Mozart ’ s Requiem on repeat .
We don ’ t really know , at first , why she ’ s slipped into this state — and even when we eventually find out , the explanation just adds more mystery .
When Amy tells her friend Jane ( played by Jane Adams ) about her impending demise , Jane initially worries for her .
But all of a sudden , she becomes @ @ @ @ @ @ @ die tomorrow .
And then Jane attends her sister-in-law ’ s birthday party , with her new foreboding hanging around her almost visibly , and it ’ s highly contagious .
She Dies Tomorrow is designed to infect you , too , at least a little — colored lights , unidentifiable soundscapes , a heavy pace , and the never-ending strains of the Requiem ( traditionally a mass for the dead ) cast a spell of existential dread .
It ’ s catching .
Humanity is “ the only creature that pretends to @ @ @ @ @ @ @ ” Jane reminds the birthday party guests .
And She Dies Tomorrow challenges both what we pretend to be and what we really are by forcing us to remember that we ’ re real , living in bodies that won ’ t last forever .
I happened to see She Dies Tomorrow on the same day I watched Strasbourg 1518 , a 10-minute film directed by Jonathan Glazer ( Under the Skin ) that was shot entirely in isolation during this spring ’ s coronavirus quarantine and then distributed online .
Dancers across @ @ @ @ @ @ @ rooms to an intoxicating new composition by musician Mica Levi .
A voice intones throughout : “ How are you , from 10 to one ?
Ten to two ?
” and “ Every morning , when I wake up , for 10 seconds I am free.
” It ’ s a bit of performance art that captures the frustrations of being a physical body trapped by a pandemic , but in the way only artists of the 21st century could pull off .
Strasbourg 1518 was so haunting that I felt compelled @ @ @ @ @ @ @ I had to look up the title .
The results made it more disturbing and magnetic .
In 1518 , a mysterious “ dancing plague ” — that is , an epidemic of dancing — broke out in Germany .
The details vary from account to account , but essentially , one woman began dancing alone in a Strasbourg street in July .
Within a week , more had joined her .
For the participants , the urge to dance was uncontrollable and contagious .
Local doctors said the culprit was “ hot @ @ @ @ @ @ @ as the cure .
By August , according to some reports , more than 400 people were dancing frantically and uncontrollably in the streets of Strasbourg , some of them collapsing and even dying .
The dancing didn ’ t end until September , when , depending on who you read , either priests or doctors intervened .
The Strasbourg incident wasn ’ t the only European “ dancing mania ” of the Middle Ages , though it was apparently the biggest .
Technically nobody knows why the manias happened , with some @ @ @ @ @ @ @ could have been caused by ingesting molds or being bitten by a scorpion .
But the most common suggestion — and probably the most unnerving one , by today ’ s standards — is that there was no reason at all , that dancing fevers are simply one type of mass psychogenic illness ( MPI ) .
Sometimes called “ mass hysteria , ” MPIs occur when symptoms of some kind of illness spread among a cohesive group of people as though they ’ re contagions , but with no underlying virus or @ @ @ @ @ @ @ that the symptoms tend to spread through visual contact , seem to be exacerbated by media coverage , and appear very real to the people who experience them .
There are a whole bunch of tricky ethical and historical concerns inherent in how we think about MPIs , not least of which is the long history of women and other marginalized groups being kept in their place by those who , for one reason or another , deem them psychotic .
But the kernel of the idea , even interpreted outside the medical @ @ @ @ @ @ @ intoxicating one for filmmakers .
Take , for instance , Anna Rose Holmer ’ s The Fits , in which teen girls in a dance troupe start to fall to the ground in shivers and convulsions .
There ’ s no explanation , and our main character , Toni ( Royalty Hightower ) , desperate to fit in with the group , starts to experience symptoms as well .
For Toni , the fits become her hungry , isolated soul ’ s unconscious way to feel like she ’ s part of something @ @ @ @ @ @ @ made for a world in the state ours is in , evokes isolation in its exploration of mortality .
And the movie doesn ’ t provide any definitive answer on whether its characters , in coming to believe they have only one day left , are contracting a psychosis or , perhaps , finally coming to their senses .
It clings mostly to the effects of feeling alone while facing existence : Living with loneliness is dark , and difficult , and more life-sapping than thinking you ’ re going to die .
@ @ @ @ @ @ @ just because they ’ re convinced they ’ re going to die tomorrow , but also because they feel like they ’ re facing that knowledge by themselves .
Each realizes anew how much they ’ ve messed up their own relationships .
They ’ ve severed or strained ties between themselves and others , and now they are definitely not okay .
Strasbourg 1518 , in contrast , is a direct product of our moment of isolation and depicts it elliptically .
Dancers caught in and stranded by a plague , alone @ @ @ @ @ @ @ hearing the same beat and the same voice asking the same questions .
“ How are you , from 10 to one ?
Ten to two ?
” These are questions we ask one another , in little boxes on our screens or over the phone , and we answer ( more or less ) with honesty .
“ Every morning , when I wake up , for 10 seconds I am free.
” The art grasps , harnesses , and redirects the controlled explosion of feeling trapped , the emotional swings that @ @ @ @ @ @ @ rational response of all to a totally enraging situation .
The dancers throw themselves against their walls , whip their hair around — things I have wanted to do most every day when I remember that I am not , in fact , free .
I confess that living through this moment sometimes feels like I ’ m trying to decide which mass psychosis to engage in , or , alternately , figure out if I ’ m just coming to my senses .
People tweeted early on about wondering whether they were @ @ @ @ @ @ @ anxiety — if that cough or chest tightness was “ real , ” or just the effect of allergies or the news .
All these months later , I ’ m less worried about tangible symptoms and more about intangible tricks my mind plays on me .
Is it foolish to think I am somehow completely protected when I go outside , taking proper precautions , wiping things down , because I “ feel safe ” ?
What if I lose patience and choose to live as if nothing is wrong ?
What @ @ @ @ @ @ @ and others would make me weak — isn ’ t that a delusion ?
Will seeing other people living one way or another cause me to think I ought to as well ?
I lived through April 2020 in New York and listened to sirens all day and night ; I know what ’ s real ; I believe in facts ; I cover my face and wash my hands and stay out of restaurants .
But if anything , those sirens made me — and my neighbors , and people I tweet @ @ @ @ @ @ @ of our mortality .
I ’ m more aware now than I was eight months ago that I , or anyone I love , could die tomorrow .
That awareness is good .
I belong to a religious tradition that , similar to many others , has yearly rituals designed to remind us that we are made of dust , the same stuff as the rest of the universe .
But those reminders have a dark side ; I have to balance the doom with living , look away from the feverish panic @ @ @ @ @ @ @ tree that ’ s been there since long before I was born and that will probably outlast me by a century .
Properly respecting the virus that would like to kill me — no , not even like , a virus has no motivation , replication is just its ontological purpose — without tipping into fantasy is hard .
I want to believe I can cheat death with soap and cloth .
Or that if I can only feel the same level of sleep-sapping panic as the people on my Twitter feed , @ @ @ @ @ @ @ , be able to propel myself out of this timeline .
Only one of those actions has any effect on the situation .
But nothing you or I do can erase reality .
So in the face of our own mortality , we keep dancing in our rooms alone .
We try to beat loneliness however we can .
We remind each other what matters , who matters .
We make things to share our exhaustion and frustration and exhilaration with one another .
In the midst of what can feel like solitary @ @ @ @ @ @ @ ’ re lucky , find the wisdom we usually ignore .
She Dies Tomorrow opened July 31 in select drive-in theaters and premieres on digital platforms including Apple TV and Google Play beginning August 7 .
In the US , Strasbourg 1518 is streaming on its website .
The Fits is streaming on the Criterion Channel .
Every day at Vox , we aim to answer your most important questions and provide you , and our audience around the world , with information that has the power to save lives .
Our mission @ @ @ @ @ @ @ is in this moment : to empower you through understanding .
Vox ’ s work is reaching more people than ever , but our distinctive brand of explanatory journalism takes resources — particularly during a pandemic and an economic downturn .
Your financial contribution will not constitute a donation , but it will enable our staff to continue to offer free articles , videos , and podcasts at the quality and volume that this moment requires .
Please consider making a contribution to Vox today .

The question has the ring of one posed by a street-corner preacher: If you knew you were going to die tomorrow, how would you spend today? Answers, presumably, will vary. You might visit your family, or break off a relationship, or go careening down the highway at top speed on your motorcycle. You might get incredibly drunk, or go to church, or hug your child. It’s just a thought experiment, but it’s a revealing one.
Wait, back up — is it a thought experiment? None of us know for sure that we’ll die tomorrow, but we also don’t know that we won’t. Calamity waits around every corner. Freak accidents and aneurysms occur. The scariest obituaries are those memorializing people who didn’t know death was imminent, but it came for them anyhow.
Many of us live our lives sustained by a wholly unsupportable illusion we rarely confront: Death is out in the distance somewhere, not nearby.
But that fantasy is upended if you receive a terminal diagnosis, or if you live with severe chronic illness. It dissipates as you get older. It pauses, curiously, when someone close to you dies — at least for a time — but tends to return if and when you manage to bat away the looming specter of your own end. And, of course, it changes dramatically when an invisible virus threatens the normal balance of life and the world turns upside down.
We shine lights of distraction to keep the shadows of our own mortality at bay, but some events cast a broader pall. Amy Seimetz’s new movie She Dies Tomorrow imagines the premonition of death as not only something we occasionally experience but also a virus of its own, spreading from person to person, similar to an infection or a mania. But it’s the kind of mania that appears, under some lights, like sanity.
Kate Lyn Sheil plays Amy, a recovering alcoholic who becomes convinced her death will happen the next day. She’s not suicidal; she just knows her death is coming. Devastated and alone in the house she just bought, she cracks open a bottle of wine, browses cremation urns online, and listens to Mozart’s Requiem on repeat. We don’t really know, at first, why she’s slipped into this state — and even when we eventually find out, the explanation just adds more mystery.
When Amy tells her friend Jane (played by Jane Adams) about her impending demise, Jane initially worries for her. But all of a sudden, she becomes certain that she, too, will die tomorrow. And then Jane attends her sister-in-law’s birthday party, with her new foreboding hanging around her almost visibly, and it’s highly contagious.
She Dies Tomorrow is designed to infect you, too, at least a little — colored lights, unidentifiable soundscapes, a heavy pace, and the never-ending strains of the Requiem (traditionally a mass for the dead) cast a spell of existential dread. It’s catching. Humanity is “the only creature that pretends to be what it’s not,” Jane reminds the birthday party guests. And She Dies Tomorrow challenges both what we pretend to be and what we really are by forcing us to remember that we’re real, living in bodies that won’t last forever.
I happened to see She Dies Tomorrow on the same day I watched Strasbourg 1518, a 10-minute film directed by Jonathan Glazer (Under the Skin) that was shot entirely in isolation during this spring’s coronavirus quarantine and then distributed online. Dancers across Europe gyrate and spin alone in empty rooms to an intoxicating new composition by musician Mica Levi. A voice intones throughout: “How are you, from 10 to one? Ten to two?” and “Every morning, when I wake up, for 10 seconds I am free.” It’s a bit of performance art that captures the frustrations of being a physical body trapped by a pandemic, but in the way only artists of the 21st century could pull off.
Strasbourg 1518 was so haunting that I felt compelled to rewatch it immediately, and then I had to look up the title. The results made it more disturbing and magnetic.
In 1518, a mysterious “dancing plague” — that is, an epidemic of dancing — broke out in Germany. The details vary from account to account, but essentially, one woman began dancing alone in a Strasbourg street in July. Within a week, more had joined her. For the participants, the urge to dance was uncontrollable and contagious. Local doctors said the culprit was “hot blood,” and prescribed more dancing as the cure. By August, according to some reports, more than 400 people were dancing frantically and uncontrollably in the streets of Strasbourg, some of them collapsing and even dying. The dancing didn’t end until September, when, depending on who you read, either priests or doctors intervened.
The Strasbourg incident wasn’t the only European “dancing mania” of the Middle Ages, though it was apparently the biggest. Technically nobody knows why the manias happened, with some experts speculating that the urge to dance could have been caused by ingesting molds or being bitten by a scorpion. But the most common suggestion — and probably the most unnerving one, by today’s standards — is that there was no reason at all, that dancing fevers are simply one type of mass psychogenic illness (MPI).
Sometimes called “mass hysteria,” MPIs occur when symptoms of some kind of illness spread among a cohesive group of people as though they’re contagions, but with no underlying virus or bacteria causing it. Researchers have found that the symptoms tend to spread through visual contact, seem to be exacerbated by media coverage, and appear very real to the people who experience them.
Related The haunting of Girlstown
There are a whole bunch of tricky ethical and historical concerns inherent in how we think about MPIs, not least of which is the long history of women and other marginalized groups being kept in their place by those who, for one reason or another, deem them psychotic. But the kernel of the idea, even interpreted outside the medical framework, has proven to be an intoxicating one for filmmakers. Take, for instance, Anna Rose Holmer’s The Fits, in which teen girls in a dance troupe start to fall to the ground in shivers and convulsions. There’s no explanation, and our main character, Toni (Royalty Hightower), desperate to fit in with the group, starts to experience symptoms as well. For Toni, the fits become her hungry, isolated soul’s unconscious way to feel like she’s part of something.
She Dies Tomorrow, though not made for a world in the state ours is in, evokes isolation in its exploration of mortality. And the movie doesn’t provide any definitive answer on whether its characters, in coming to believe they have only one day left, are contracting a psychosis or, perhaps, finally coming to their senses. It clings mostly to the effects of feeling alone while facing existence: Living with loneliness is dark, and difficult, and more life-sapping than thinking you’re going to die. Each character spins out of control not just because they’re convinced they’re going to die tomorrow, but also because they feel like they’re facing that knowledge by themselves. Each realizes anew how much they’ve messed up their own relationships. They’ve severed or strained ties between themselves and others, and now they are definitely not okay.
Strasbourg 1518, in contrast, is a direct product of our moment of isolation and depicts it elliptically. Dancers caught in and stranded by a plague, alone in their homes, all dance, hearing the same beat and the same voice asking the same questions. “How are you, from 10 to one? Ten to two?” These are questions we ask one another, in little boxes on our screens or over the phone, and we answer (more or less) with honesty. “Every morning, when I wake up, for 10 seconds I am free.” The art grasps, harnesses, and redirects the controlled explosion of feeling trapped, the emotional swings that seem irrational but are probably the most rational response of all to a totally enraging situation.
The dancers throw themselves against their walls, whip their hair around — things I have wanted to do most every day when I remember that I am not, in fact, free.
I confess that living through this moment sometimes feels like I’m trying to decide which mass psychosis to engage in, or, alternately, figure out if I’m just coming to my senses. People tweeted early on about wondering whether they were feeling the symptoms of infection or just anxiety — if that cough or chest tightness was “real,” or just the effect of allergies or the news. All these months later, I’m less worried about tangible symptoms and more about intangible tricks my mind plays on me. Is it foolish to think I am somehow completely protected when I go outside, taking proper precautions, wiping things down, because I “feel safe”? What if I lose patience and choose to live as if nothing is wrong? What if I decide that to protect myself and others would make me weak — isn’t that a delusion? Will seeing other people living one way or another cause me to think I ought to as well?
I lived through April 2020 in New York and listened to sirens all day and night; I know what’s real; I believe in facts; I cover my face and wash my hands and stay out of restaurants. But if anything, those sirens made me — and my neighbors, and people I tweet with all day long — more aware of our mortality. I’m more aware now than I was eight months ago that I, or anyone I love, could die tomorrow.
That awareness is good. I belong to a religious tradition that, similar to many others, has yearly rituals designed to remind us that we are made of dust, the same stuff as the rest of the universe. But those reminders have a dark side; I have to balance the doom with living, look away from the feverish panic, and maybe go sit under a tree that’s been there since long before I was born and that will probably outlast me by a century.
Properly respecting the virus that would like to kill me — no, not even like, a virus has no motivation, replication is just its ontological purpose — without tipping into fantasy is hard. I want to believe I can cheat death with soap and cloth. Or that if I can only feel the same level of sleep-sapping panic as the people on my Twitter feed, I might, by force of will, be able to propel myself out of this timeline. Only one of those actions has any effect on the situation.
But nothing you or I do can erase reality. So in the face of our own mortality, we keep dancing in our rooms alone. We try to beat loneliness however we can. We remind each other what matters, who matters. We make things to share our exhaustion and frustration and exhilaration with one another. In the midst of what can feel like solitary madness, we might, if we’re lucky, find the wisdom we usually ignore.
She Dies Tomorrow opened July 31 in select drive-in theaters and premieres on digital platforms including Apple TV and Google Play beginning August 7. In the US, Strasbourg 1518 is streaming on its website. The Fits is streaming on the Criterion Channel.


vox--2020-08-05--Covid-19 is pushing red states to finally expand Medicaid

For the second time this summer , voters in a solidly Republican state have decided now is the moment to expand Medicaid coverage through the Affordable Care Act .
Missouri voters passed a ballot initiative to expand Medicaid during Tuesday ’ s primary elections ; 53 percent of voters supported the measure and 47 percent opposed it .
That vote comes about a month after Oklahoma voters also decided to expand Medicaid via ballot referendum by less than 1 percentage point .
Once the expansion takes effect in those two states next year , an estimated 340,000 people who currently @ @ @ @ @ @ @ become eligible for Medicaid .
That still leaves nearly 2 million people in 12 states nationwide who are stuck in the Medicaid expansion gap — ineligible for coverage because their state refuses to expand the program but with an income too low to qualify for tax credits to buy private insurance — but it is yet another step toward the universal Medicaid expansion Obamacare authors envisioned .
In the last few years , voters in Idaho , Maine , Nebraska , and Utah have also approved Medicaid expansion via ballot initiative .
Those @ @ @ @ @ @ @ the objections of Republican elected officials , as was the case in Missouri .
Conservative interest groups sued to try to stop the Missouri ballot question from being put before voters .
Republican Gov .
Mike Parson also opposed it , saying Missouri could not afford expansion even though the federal government will pick up 90 percent of the costs .
The Missouri initiative was actually written to prevent tampering by the state legislature or the governor .
Medicaid expansion would be enshrined in the state constitution , and the state can not @ @ @ @ @ @ @ on benefits .
Supporters argued Medicaid expansion would save rural hospitals in the state .
As I have previously reported , one in four rural hospitals nationwide is in danger of closing , and one of the strongest indicators of a hospital ’ s vulnerability is being located in a non-expansion state .
It is difficult to ignore that these ballot initiatives passed in right-leaning states in the middle of the coronavirus pandemic , when millions of Americans have lost their jobs and , with them , their employer-sponsored health insurance .
This @ @ @ @ @ @ @ were collected to put the Medicaid expansion questions on the ballot long before Covid-19 ever arrived in the US — but the relatively narrow margins made me wonder if the pandemic and its economic and medical consequences proved decisive .
Crises have a way of changing political attitudes .
And right now , disapproval of the Affordable Care Act is at a low ebb , with just 36 percent of Americans saying they have an unfavorable view of the law in the Kaiser Family Foundation ’ s July 2020 poll .
More than @ @ @ @ @ @ @ for providing more financial assistance to help people who don ’ t get health insurance through their jobs and for increasing federal funding for state Medicaid programs .
Ashley Kirzinger , a member of Kaiser ’ s polling team , told me that their surveys had detected an uptick in support for Medicaid during the pandemic , as more people say they or somebody they know is relying on the program .
It is too soon to say whether any shift in the public ’ s policy preferences will be permanent .
But @ @ @ @ @ @ @ a crisis as disruptive as the coronavirus pandemic leaves a long-lasting mark on our politics .
How much is coronavirus going to change health care politics ?
This is a question I have been pondering for months : How much will the pandemic change us ?
Or , to put it the other way , how quickly do things snap back to normal .
“ Really big events do have substantial effects on political attitudes and preferences , ” Jacob Hacker , a Yale University political scientist , told me in the spring @ @ @ @ @ @ @ , comparable to what we see in military conflicts.
” Hacker and some colleagues found this to be true in research they conducted after the Great Recession .
Personal experiences with economic insecurity during that crisis led to a shift in policy attitudes of a magnitude that they said “ rivals partisanship and ideology.
” People who experienced more profound personal shocks ended up supporting a bigger government role in mitigating their economic risks .
This has been a consistent finding in social science for decades ; two sociologists examined how social attitudes @ @ @ @ @ @ @ World War II .
There was greater social solidarity , so there were not many objections when taxes had to be raised to fund the war effort and rebuilding .
And there was more support for progressive taxation and equal treatment in the fallout of that global crisis .
As Hacker put it : “ The middle and working classes lose their lives , the rich and business at least have to lose their money.
” Joe Biden has developed a health care agenda that is more progressive than that of any Democratic @ @ @ @ @ @ @ the Medicaid expansion issue , he has proposed allowing low-income people who live in states that have refused expansion to enroll in a new public insurance plan with no premiums or cost-sharing .
The Trump administration , on the other hand , is currently asking the US Supreme Court to overturn the ACA entirely — meaning the 12.5 million people who gained coverage through Medicaid expansion could lose their insurance .
So a significant expansion of health coverage probably depends on the outcome of the presidential election .
A President Joe Biden would @ @ @ @ @ @ @ reform bill that patches up holes revealed by the recent crisis .
( Democrats would also need to win the Senate and hold onto the House for major reforms to be possible . )
“ Many of the biggest coverage expansions both in the US and in similar countries happened in the context of wars and social upheavals , as well as financial crises .
One theory is that those circumstances redefine social solidarity , thus expanding views of the role of government , ” Cynthia Cox , director of the Peterson-Kaiser Health @ @ @ @ @ @ @ year .
“ I think one factor that will determine the permanency of these changes is how long this disruption continues .
The longer this goes on , the more likely this social solidarity becomes ingrained.
” In the meantime , Americans are registering at the ballot box their willingness to expand the social safety net .
The success of Medicaid expansion with voters in Missouri and Oklahoma could portend bigger changes ahead .
This story appears in VoxCare , a newsletter from Vox on the latest twists and turns in America ’ @ @ @ @ @ @ @ to get VoxCare in your inbox along with more health care stats and news .
Every day at Vox , we aim to answer your most important questions and provide you , and our audience around the world , with information that has the power to save lives .
Our mission has never been more vital than it is in this moment : to empower you through understanding .
Vox ’ s work is reaching more people than ever , but our distinctive brand of explanatory journalism takes resources — particularly during a @ @ @ @ @ @ @ financial contribution will not constitute a donation , but it will enable our staff to continue to offer free articles , videos , and podcasts at the quality and volume that this moment requires .
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For the second time this summer, voters in a solidly Republican state have decided now is the moment to expand Medicaid coverage through the Affordable Care Act.
Missouri voters passed a ballot initiative to expand Medicaid during Tuesday’s primary elections; 53 percent of voters supported the measure and 47 percent opposed it. That vote comes about a month after Oklahoma voters also decided to expand Medicaid via ballot referendum by less than 1 percentage point.
Once the expansion takes effect in those two states next year, an estimated 340,000 people who currently have no affordable health insurance option will become eligible for Medicaid. That still leaves nearly 2 million people in 12 states nationwide who are stuck in the Medicaid expansion gap — ineligible for coverage because their state refuses to expand the program but with an income too low to qualify for tax credits to buy private insurance — but it is yet another step toward the universal Medicaid expansion Obamacare authors envisioned. In the last few years, voters in Idaho, Maine, Nebraska, and Utah have also approved Medicaid expansion via ballot initiative.
Those initiatives have almost always been passed over the objections of Republican elected officials, as was the case in Missouri. Conservative interest groups sued to try to stop the Missouri ballot question from being put before voters. Republican Gov. Mike Parson also opposed it, saying Missouri could not afford expansion even though the federal government will pick up 90 percent of the costs. The Missouri initiative was actually written to prevent tampering by the state legislature or the governor. Medicaid expansion would be enshrined in the state constitution, and the state cannot add work requirements or any other limits on benefits.
Supporters argued Medicaid expansion would save rural hospitals in the state. As I have previously reported, one in four rural hospitals nationwide is in danger of closing, and one of the strongest indicators of a hospital’s vulnerability is being located in a non-expansion state.
It is difficult to ignore that these ballot initiatives passed in right-leaning states in the middle of the coronavirus pandemic, when millions of Americans have lost their jobs and, with them, their employer-sponsored health insurance. This is partly a coincidence — the signatures were collected to put the Medicaid expansion questions on the ballot long before Covid-19 ever arrived in the US — but the relatively narrow margins made me wonder if the pandemic and its economic and medical consequences proved decisive.
Crises have a way of changing political attitudes. And right now, disapproval of the Affordable Care Act is at a low ebb, with just 36 percent of Americans saying they have an unfavorable view of the law in the Kaiser Family Foundation’s July 2020 poll. More than 80 percent of Americans also signaled support for providing more financial assistance to help people who don’t get health insurance through their jobs and for increasing federal funding for state Medicaid programs. Ashley Kirzinger, a member of Kaiser’s polling team, told me that their surveys had detected an uptick in support for Medicaid during the pandemic, as more people say they or somebody they know is relying on the program.
It is too soon to say whether any shift in the public’s policy preferences will be permanent. But we shouldn’t be surprised if a crisis as disruptive as the coronavirus pandemic leaves a long-lasting mark on our politics.
How much is coronavirus going to change health care politics?
This is a question I have been pondering for months: How much will the pandemic change us? Or, to put it the other way, how quickly do things snap back to normal.
“Really big events do have substantial effects on political attitudes and preferences,” Jacob Hacker, a Yale University political scientist, told me in the spring. “We could see attitudinal changes, comparable to what we see in military conflicts.”
Hacker and some colleagues found this to be true in research they conducted after the Great Recession. Personal experiences with economic insecurity during that crisis led to a shift in policy attitudes of a magnitude that they said “rivals partisanship and ideology.” People who experienced more profound personal shocks ended up supporting a bigger government role in mitigating their economic risks.
This has been a consistent finding in social science for decades; two sociologists examined how social attitudes changed in Great Britain during and after World War II. There was greater social solidarity, so there were not many objections when taxes had to be raised to fund the war effort and rebuilding. And there was more support for progressive taxation and equal treatment in the fallout of that global crisis.
As Hacker put it: “The middle and working classes lose their lives, the rich and business at least have to lose their money.”
Joe Biden has developed a health care agenda that is more progressive than that of any Democratic Party nominee in recent memory. On the Medicaid expansion issue, he has proposed allowing low-income people who live in states that have refused expansion to enroll in a new public insurance plan with no premiums or cost-sharing.
The Trump administration, on the other hand, is currently asking the US Supreme Court to overturn the ACA entirely — meaning the 12.5 million people who gained coverage through Medicaid expansion could lose their insurance.
So a significant expansion of health coverage probably depends on the outcome of the presidential election. A President Joe Biden would have a mandate to pass another health reform bill that patches up holes revealed by the recent crisis. (Democrats would also need to win the Senate and hold onto the House for major reforms to be possible.)
“Many of the biggest coverage expansions both in the US and in similar countries happened in the context of wars and social upheavals, as well as financial crises. One theory is that those circumstances redefine social solidarity, thus expanding views of the role of government,” Cynthia Cox, director of the Peterson-Kaiser Health System Tracker, told me earlier this year. “I think one factor that will determine the permanency of these changes is how long this disruption continues. The longer this goes on, the more likely this social solidarity becomes ingrained.”
In the meantime, Americans are registering at the ballot box their willingness to expand the social safety net. The success of Medicaid expansion with voters in Missouri and Oklahoma could portend bigger changes ahead.
This story appears in VoxCare, a newsletter from Vox on the latest twists and turns in America’s health care debate. Sign up to get VoxCare in your inbox along with more health care stats and news.


vox--2020-08-05--Just 2 states meet these basic criteria to reopen and stay safe

All 50 states have moved to reopen their economies , at least partially , after shutting down businesses and gatherings in response to the coronavirus pandemic .
But a Vox analysis suggests that most states haven ’ t made the preparations needed to contain outbreaks — putting themselves at risk for a rise in Covid-19 cases and deaths should they continue to reopen , as many states have already seen .
Experts told me states need three things to be safe to open .
State leaders , from the governor to the legislature to health departments , need to ensure @ @ @ @ @ @ @ unabated .
They need the testing capacity to track and isolate the sick and their contacts .
And they need the hospital capacity to handle a potential surge in Covid-19 cases .
More specifically , states should meet at least five basic criteria .
They should see a two-week drop in coronavirus cases , indicating that the virus is actually abating .
They should have fewer than four daily new cases per 100,000 people per day — to show that cases aren ’ t just dropping but are also below dangerous levels .
@ @ @ @ @ @ @ per 100,000 people per day , letting them quickly track and contain outbreaks .
They need an overall positive rate for tests below 5 percent — another critical indicator for testing capacity .
And states should have at least 40 percent of their ICU beds free to actually treat an influx of people stricken with Covid-19 should it be necessary .
These metrics line up with a range of expert recommendations , as well as the various policy plans put out by both independent groups and government officials to deal with the coronavirus @ @ @ @ @ @ @ mean that a state is ready to safely reopen its economy — a process that describes a wide range of local and state actions .
And failing them doesn ’ t mean a state is in immediate danger of a coronavirus outbreak if it starts to reopen ; with Covid-19 , there ’ s always an element of luck and other factors .
But with these metrics , states can gauge if they have repressed the coronavirus while building the capacity to contain future outbreaks should they come .
In other words , @ @ @ @ @ @ @ for the next phase of the fight .
So far , most states are not there .
As of August 5 , just two states — New York and Vermont — met four or five of the goals , which demonstrates strong progress .
Twenty-five states and Washington , DC , hit two or three of the benchmarks .
The other 22 achieved zero or one .
( Minnesota is excluded due to recent changes in how it reports tests . )
Even the states that have made the most progress aren ’ @ @ @ @ @ @ @ a vaccine or similar treatment , the threat of the coronavirus is still out there .
Especially in states that suffered big outbreaks , such as Arizona and New York , even a lot of progress or some progress doesn ’ t mean all the underlying problems that led to an epidemic are gone .
Nor do the metrics cover everything that states should do before they can safely reopen .
They don ’ t show , for example , if states have the capacity to do contact tracing , in which people @ @ @ @ @ @ @ ’ s sick with Covid-19 are tracked down by “ disease detectives ” and quarantined .
Contact tracing is key to containing an epidemic , but states don ’ t track how many contact tracers they ’ ve hired in a standardized , readily available way .
States also don ’ t have ready data for health care workers ’ access to personal protective equipment , such as masks and gloves — a critical measure of the health care system ’ s readiness that ’ s difficult to track .
But the map @ @ @ @ @ @ @ states have made toward containing the coronavirus and keeping it contained .
States will have to follow these kinds of metrics as they reopen .
If the numbers — especially coronavirus cases — go in the wrong direction again , experts said governments should be ready to bring back restrictions .
If states move too quickly to reopen or respond too slowly to a turn for the worse , they could see a renewed surge in Covid-19 cases .
“ Planning for reclosing is part of planning for reopening , ” Mark McClellan @ @ @ @ @ @ @ , told me .
“ There will be outbreaks , and there will be needs for pauses and going back — hopefully not too much if we do this carefully.
” So this will be a work in progress , at least until we get a Covid-19 vaccine or the pandemic otherwise ends , whether by natural or human means .
But the metrics can at least help give states an idea of how far along they are in the fight against the coronavirus .
What ’ s the goal ?
A 10 @ @ @ @ @ @ @ compared to two weeks ago and a 5 percent drop in cases compared to one week ago , based on data from the New York Times .
Which states meet the goal ?
Alabama , Arizona , California , Delaware , Florida , Idaho , New Mexico , North Carolina , South Carolina , Utah , Vermont , and Washington — just 12 states .
Why is this important ?
Guidance from the White House and several independent groups emphasize that states need to see coronavirus cases drop consistently over two weeks before @ @ @ @ @ @ @ to begin reopening .
After all , nothing shows you ’ re out of an outbreak like a sustained reduction in infections .
“ The first and foremost [ metric ] is you want to have a continued decrease in cases , ” Saskia Popescu , an infectious disease epidemiologist , told me .
“ It ’ s a huge piece.
” A simple reduction in cases compared to two weeks prior isn ’ t enough ; it has to be a significant drop , and it has to be sustained over the @ @ @ @ @ @ @ s map , states need at least a 10 percent drop in daily new cases compared to two weeks prior and at least a 5 percent drop compared to one week prior .
Reported cases can be a reflection of testing capacity : More testing will pick up more cases , and less testing will pick up fewer .
So it ’ s important that the decrease occur while testing is either growing or already sufficient .
And since states have recently boosted their testing abilities , increases in Covid-19 cases can also @ @ @ @ @ @ @ meeting this benchmark , continued caution is warranted .
If a state meets the goal of a reduction in cases compared to one and two weeks ago but cases seemed to go up in recent days , then perhaps it ’ s not time to reopen just yet .
And if cases have dropped but only from a very high baseline of cases , then that ’ s less comforting than a drop from a lower baseline .
“ You have to use common sense , ” Cyrus Shahpar , a director at @ @ @ @ @ @ @ Save Lives , told me .
What ’ s the goal ?
Fewer than four daily new coronavirus cases per 100,000 people per day , based on data from the New York Times and the Census Bureau .
Which states meet the goal ?
Maine , New Hampshire , New York , and Vermont — just four states .
Why is this important ?
One of the best ways to know you ’ re getting away from a disease outbreak is to no longer see a high number of daily new infections .
@ @ @ @ @ @ @ number , experts said that four daily new coronavirus cases per 100,000 people is a decent ceiling .
“ If I go from one to two to three [ coronavirus cases a day ] , it ’ s different than going from 1,000 to 2,000 to 3,000 , even though the percent difference is the same , ” Shahpar said .
“ That ’ s why you have to take into account the overall level , too.
” To put it another way , it ’ s not enough for daily new Covid-19 @ @ @ @ @ @ @ .
Cases also should fall below a certain level before a state can be deemed truly safe .
For example , Arizona has seen its daily new cases drop over the past two weeks .
But its daily new cases are still , after controlling for population , the third highest in the country .
That indicates an epidemic that remains out of control .
At the same time , if your state is now below four daily new cases per 100,000 but it ’ s seen a recent uptick in cases , @ @ @ @ @ @ @ .
Even the worst-hit states , after all , began with a handful of cases before they saw an exponential surge .
But if your state is below the threshold , it ’ s in a pretty solid place relative to most states .
What ’ s the goal ?
At least 150 tests per 100,000 people per day , based on data from the Covid Tracking Project and the Census Bureau .
Which states meet the goal ?
Alabama , Alaska , Arizona , Arkansas , California , Connecticut , Delaware , @ @ @ @ @ @ @ , Louisiana , Maine , Maryland , Massachusetts , Michigan , Missouri , Montana , Nebraska , Nevada , New Jersey , New Mexico , New York , North Carolina , North Dakota , Ohio , Oklahoma , South Carolina , Tennessee , Texas , Vermont , Virginia , West Virginia , Wisconsin — for a total of 34 states .
Washington , DC , did as well .
( Minnesota is excluded due to recent changes in how it reports tests . )
Why is this important ?
Since the beginning of @ @ @ @ @ @ @ that the US needs the capacity for at least 500,000 Covid-19 tests a day .
Controlling for population , that adds up to about 150 new tests per 100,000 people per day .
Testing is crucial to getting the coronavirus outbreak under control .
When paired with contact tracing , testing lets officials track the scale of the outbreak , isolate the sick , quarantine those the sick came into contact with , and deploy community-wide efforts as necessary .
Testing and tracing are how other countries , like South Korea and Germany @ @ @ @ @ @ @ and started to reopen their economies .
The idea , experts said , is to have enough surveillance to detect embers before they turn into full wildfires .
“ States should be shoring up their testing capacity not just for what it looks like right now while everyone ’ s in their homes , but as people start to move more , ” Jen Kates , the director of global health and HIV policy at the Kaiser Family Foundation , told me .
“ As people start doing more movement , you ’ @ @ @ @ @ @ @ people are going to come into contact with each other more.
” The 500,000-a-day goal is the minimum .
Some experts have recommended as many as millions of tests nationwide each day .
But 500,000 is the most often-cited goal , and it ’ s , at the very least , a good start .
It ’ s preferable if states report this number by how many people they ’ ve tested , not just the total number of tests .
For containing an outbreak , it ’ s generally more useful to @ @ @ @ @ @ @ test one person 500,000 times .
But some states report the figures for total tests , not the number of tested individuals — counting tests for a single person multiple times .
That could skew the numbers .
This goal is also supposed to be for diagnostic tests , not antibody tests .
Diagnostic tests gauge whether a person has the virus in their system and is , therefore , sick right at the moment of the test .
Antibody tests check if someone ever developed antibodies to the virus to see if @ @ @ @ @ @ @ past .
Since diagnostic tests give a more recent gauge of the level of infection , they ’ re seen as much more reliable for evaluating the current state of the Covid-19 outbreak in a state .
But some states have mixed up numbers for diagnostic and antibody tests , which could skew the data collected by the Covid Tracking Project .
“ The virus isn ’ t going to care whether they were manipulating the numbers or not in order to look more favorable ; it ’ s going to continue to @ @ @ @ @ @ @ senior scholar at the Johns Hopkins Center for Health Security , told me .
“ It ’ s better to really understand what ’ s going on and report that accurately.
” For states honestly reporting these numbers , though , they ’ re a critical measure of their ability to detect , control , and contain coronavirus outbreaks .
What ’ s the goal ?
Below 5 percent of coronavirus tests coming back positive over the past week , based on data from the Covid Tracking Project .
Which states meet the @ @ @ @ @ @ @ , Illinois , Maine , Massachusetts , Michigan , Minnesota , Montana , New Hampshire , New Jersey , New Mexico , New York , Vermont , and West Virginia — 15 states .
Washington , DC , did as well .
( Minnesota is excluded due to recent changes in how it reports tests . )
Why is this important ?
The positive or positivity rate , which tracks how many tests come back positive for Covid-19 , is another way to measure testing capacity .
Generally , a higher positive rate @ @ @ @ @ @ @ happening .
An area with adequate testing should be testing lots and lots of people , many of whom don ’ t have the disease or don ’ t show severe symptoms .
The positive testing rate in South Korea , for example , is below 1 percent .
High positive rates indicate only people with obvious symptoms are getting tested , so there ’ s not quite enough testing to match the scope of an outbreak .
Previously , the World Health Organization ( WHO ) recommended a maximum positive rate of @ @ @ @ @ @ @ recently recommended 5 percent , which is in line with the rate for countries that have managed to better control their outbreaks , like Germany , New Zealand , and South Korea .
“ Even lower is better , ” Shahpar said .
The positive rate data is subject to the same limitations as the overall testing data from the Covid Tracking Project .
So if a state includes antibody tests in its test count , it could skew the positive rate to look better than it is .
States only risk hurting @ @ @ @ @ @ @ ’ s the goal ?
Below 60 percent occupancy of ICU beds in hospitals , based on data from the US Department of Health and Human Services .
Which states meet the goal ?
Alaska , Colorado , Connecticut , Hawaii , Idaho , Illinois , Iowa , Kansas , Massachusetts , Montana , Nebraska , New Hampshire , New Jersey , New York , North Dakota , Ohio , South Dakota , Utah , Washington , Wisconsin , and Wyoming — 21 states .
Why is this important ?
If a pandemic @ @ @ @ @ @ @ to be ready to treat the most severe cases and potentially save lives .
That ’ s the key goal of “ flattening the curve ” and “ raising the line , ” in which social distancing helps reduce the spread of the disease so the health care system can maintain and grow its capacity to treat an influx of Covid-19 patients .
“ There ’ s this idea that in six weeks we can open more things , ” Amesh Adalja , a senior scholar at the Johns Hopkins Center for Health @ @ @ @ @ @ @ the virus is still there .
It ’ s all about making sure that the case count isn ’ t too immense for our hospital system to deal with.
” The aim is to avoid the nightmare scenario that Italy went through when it had more Covid-19 cases than its health care system could handle , leading to hospitals turning away even dangerously ill patients .
To gauge this , experts recommended looking at ICU capacity , with states aiming to have at most 60 percent occupancy in their ICUs .
Hitting the @ @ @ @ @ @ @ end Vox ’ s map is just one way of tracking success against the coronavirus .
Other groups have come up with their own measures , including Covid Act Now , Covid Exit Strategy , and Test and Trace .
Vox ’ s model uses more up-to-date data than some of these other examples , while focusing not just on the state of the pandemic but also on states ’ readiness to contain Covid-19 outbreaks in the future .
Very few states hit all the marks recommended by experts .
But even those @ @ @ @ @ @ @ pandemic over .
They should continue to improve — for example , getting the positive rate below 1 percent , as in New Zealand — and look at even more granular metrics , such as at the city or county level .
Meeting the benchmarks , however , indicates a state is better equipped to contain future coronavirus outbreaks as it eases previous restrictions .
Experts emphasized that states have to keep hitting all these goals week after week and day after day — Covid-19 cases must remain low , testing ability needs @ @ @ @ @ @ @ should be good enough for an influx of patients — until the pandemic is truly over , whether thanks to a vaccine or other means .
Otherwise , a future wave of coronavirus cases , as seen in past pandemics , could kill many more people .
“ You need to have all the metrics met , ” Popescu said .
“ This needs to be a very incremental , slow process to ensure success.
” And if the numbers do start trending in the wrong direction , states should be ready to @ @ @ @ @ @ @ the economy again .
Maybe not as much as before , as we learn which places are truly at risk of increasing spread .
But experts caution that future shutdowns will likely be necessary to some extent .
“ I do worry we ’ re going to see surges of cases and hot spots , ” Watson said .
“ We do need to keep pushing on building those capacities .
… Otherwise , we ’ re just rolling the dice on the spread of the virus .
It ’ s better if @ @ @ @ @ @ @ ” That ’ s another reason these metrics , along with broader coronavirus surveillance , are so important : They not only help show how far along states are in dealing with their current Covid-19 outbreaks , but will help track progress to stop and prevent future crises as well .
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All 50 states have moved to reopen their economies, at least partially, after shutting down businesses and gatherings in response to the coronavirus pandemic.
But a Vox analysis suggests that most states haven’t made the preparations needed to contain outbreaks — putting themselves at risk for a rise in Covid-19 cases and deaths should they continue to reopen. Some states have already had to backtrack on reopening measures.
Experts told me states need three things to be safe to open. State leaders, from the governor to the legislature to health departments, need to ensure the SARS-CoV-2 virus is no longer spreading unabated. They need the testing capacity to track and isolate the sick and their contacts. And they need the hospital capacity to handle a potential surge in Covid-19 cases.
More specifically, states should meet at least five basic criteria. They should see a two-week drop in coronavirus cases, indicating that the virus is actually abating. They should have fewer than four daily new cases per 100,000 people per day — to show that cases aren’t just dropping but are also below dangerous levels. They need at least 150 new tests per 100,000 people per day, letting them quickly track and contain outbreaks. They need an overall positive rate for tests below 5 percent — another critical indicator for testing capacity. And states should have at least 40 percent of their ICU beds free to actually treat an influx of people stricken with Covid-19 should it be necessary.
These metrics line up with a range of expert recommendations, as well as the various policy plans put out by both independent groups and government officials to deal with the coronavirus.
Meeting these metrics doesn’t mean that a state is ready to safely reopen its economy — a process that describes a wide range of local and state actions. And failing them doesn’t mean a state is in immediate danger of a coronavirus outbreak if it starts to reopen; with Covid-19, there’s always an element of luck and other factors.
But with these metrics, states can gauge if they have repressed the coronavirus while building the capacity to contain future outbreaks should they come. In other words, the benchmarks show how ready states are for the next phase of the fight.
So far, most states are not there. Just four states — Colorado, Connecticut, New Jersey, and New York — met four or five of the goals, which demonstrates strong progress. Twenty-five states and Washington, DC, hit two or three of the benchmarks. The remaining 19 achieved zero or one. (Alabama and Florida are excluded due to recent issues with test reporting.)
Even the states that have made the most progress aren’t safe to fully reopen. Without a vaccine or similar treatment, the threat of the coronavirus is still out there. Especially in states that suffered big outbreaks, such as Arizona and New York, even a lot of progress or some progress doesn’t mean all the underlying problems that led to an epidemic are gone.
Nor do the metrics cover everything that states should do before they can safely reopen. They don’t show, for example, if states have the capacity to do contact tracing, in which people who came into contact with someone who’s sick with Covid-19 are tracked down by “disease detectives” and quarantined. Contact tracing is key to containing an epidemic, but states don’t track how many contact tracers they’ve hired in a standardized, readily available way.
States also don’t have ready data for health care workers’ access to personal protective equipment, such as masks and gloves — a critical measure of the health care system’s readiness that’s difficult to track.
But the map gives an idea of how much progress states have made toward containing the coronavirus and keeping it contained.
States will have to follow these kinds of metrics as they reopen. If the numbers — especially coronavirus cases — go in the wrong direction again, experts said governments should be ready to bring back restrictions. If states move too quickly to reopen or respond too slowly to a turn for the worse, they could see a renewed surge in Covid-19 cases.
“Planning for reclosing is part of planning for reopening,” Mark McClellan, a health policy expert at Duke, told me. “There will be outbreaks, and there will be needs for pauses and going back — hopefully not too much if we do this carefully.”
So this will be a work in progress, at least until we get a Covid-19 vaccine or the pandemic otherwise ends, whether by natural or human means. But the metrics can at least help give states an idea of how far along they are in the fight against the coronavirus.
Goal 1: A sustained two-week drop in coronavirus cases
What’s the goal? A 10 percent drop in daily new coronavirus cases compared to two weeks ago and a 5 percent drop in cases compared to one week ago, based on data from the New York Times.
Which states meet the goal? Arizona, California, Colorado, Georgia, Mississippi, Nevada, Oregon, Texas, and Wyoming — a total of nine states.
Why is this important? Guidance from the White House and several independent groups emphasize that states need to see coronavirus cases drop consistently over two weeks before they can say they’re ready to begin reopening. After all, nothing shows you’re out of an outbreak like a sustained reduction in infections.
“The first and foremost [metric] is you want to have a continued decrease in cases,” Saskia Popescu, an infectious disease epidemiologist, told me. “It’s a huge piece.”
A simple reduction in cases compared to two weeks prior isn’t enough; it has to be a significant drop, and it has to be sustained over the two weeks. So for Vox’s map, states need at least a 10 percent drop in daily new cases compared to two weeks prior and at least a 5 percent drop compared to one week prior.
Reported cases can be a reflection of testing capacity: More testing will pick up more cases, and less testing will pick up fewer. So it’s important that the decrease occur while testing is either growing or already sufficient. And since states have recently boosted their testing abilities, increases in Covid-19 cases can also reflect improvements in testing.
Even after meeting this benchmark, continued caution is warranted. If a state meets the goal of a reduction in cases compared to one and two weeks ago but cases seemed to go up in recent days, then perhaps it’s not time to reopen just yet. And if cases have dropped but only from a very high baseline of cases, then that’s less comforting than a drop from a lower baseline.
“You have to use common sense,” Cyrus Shahpar, a director at the public health policy group Resolve to Save Lives, told me.
Goal 2: A low number of daily new Covid-19 cases
What’s the goal? Fewer than four daily new coronavirus cases per 100,000 people per day, based on data from the New York Times and the Census Bureau.
Which states meet the goal? Connecticut, Maine, New Hampshire, New Jersey, New York, and Vermont — just six states.
Why is this important? One of the best ways to know you’re getting away from a disease outbreak is to no longer see a high number of daily new infections. While there’s no universally accepted number, experts said that four daily new coronavirus cases per 100,000 people is a reasonable ceiling.
“If I go from one to two to three [coronavirus cases a day], it’s different than going from 1,000 to 2,000 to 3,000, even though the percent difference is the same,” Shahpar said. “That’s why you have to take into account the overall level, too.”
To put it another way, it’s not enough for daily new Covid-19 cases to drop, even for weeks. Cases also should fall below a certain level before a state can be deemed truly safe.
For example, Arizona has seen its daily new cases drop over the past two weeks. But its daily new cases are still, after controlling for population, the third-highest in the country. That indicates an epidemic that remains out of control.
At the same time, if your state is now below four daily new cases per 100,000 but it’s seen a recent uptick in cases, that’s a reason for caution. Even the worst-hit states, after all, began with a handful of cases before they saw an exponential surge.
But if your state is below the threshold, it’s in a pretty solid place relative to most states.
Goal 3: High coronavirus testing capacity
What’s the goal? At least 150 tests per 100,000 people per day, based on data from the Covid Tracking Project and the Census Bureau.
Which states meet the goal? Alaska, Arkansas, California, Colorado, Connecticut, Delaware, Georgia, Hawaii, Illinois, Indiana, Iowa, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nebraska, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Rhode Island, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, and West Virginia — 37 states. Washington, DC, did as well. (Alabama and Florida are excluded due to recent issues with test reporting.)
Why is this important? Since the beginning of the coronavirus pandemic, experts have argued that the US needs the capacity for at least 500,000 Covid-19 tests a day. Controlling for population, that adds up to about 150 new tests per 100,000 people per day.
Testing is crucial to getting the coronavirus outbreak under control. When paired with contact tracing, testing lets officials track the scale of the outbreak, isolate the sick, quarantine those the sick came into contact with, and deploy community-wide efforts as necessary. Testing and tracing are how other countries, like South Korea and Germany, have managed to control their outbreaks and started to reopen their economies.
The idea, experts said, is to have enough surveillance to detect embers before they turn into full wildfires.
“States should be shoring up their testing capacity not just for what it looks like right now while everyone’s in their homes, but as people start to move more,” Jen Kates, the director of global health and HIV policy at the Kaiser Family Foundation, told me. “As people start doing more movement, you’ll have to test more, because people are going to come into contact with each other more.”
The 500,000-a-day goal is the minimum. Some experts have recommended as many as millions of tests nationwide each day. But 500,000 is the most often-cited goal, and it’s, at the very least, a good start.
It’s preferable if states report this number by how many people they’ve tested, not just the total number of tests. For containing an outbreak, it’s generally more useful to test 500,000 people one time than to test one person 500,000 times. But some states report the figures for total tests, not the number of tested individuals — counting tests for a single person multiple times. That could skew the numbers.
This goal is also supposed to be for diagnostic tests, not antibody tests. Diagnostic tests gauge whether a person has the virus in their system and is, therefore, sick right at the moment of the test. Antibody tests check if someone ever developed antibodies to the virus to see if they had ever been sick in the past. Since diagnostic tests give a more recent gauge of the level of infection, they’re seen as much more reliable for evaluating the current state of the Covid-19 outbreak in a state.
But some states have mixed up numbers for diagnostic and antibody tests, which could skew the data collected by the Covid Tracking Project.
“The virus isn’t going to care whether they were manipulating the numbers or not in order to look more favorable; it’s going to continue to spread,” Crystal Watson, a senior scholar at the Johns Hopkins Center for Health Security, told me. “It’s better to really understand what’s going on and report that accurately.”
For states honestly reporting these numbers, though, they’re a critical measure of their ability to detect, control, and contain coronavirus outbreaks.
Goal 4: A low test positive rate
What’s the goal? Below 5 percent of coronavirus tests coming back positive over the past week, based on data from the Covid Tracking Project.
Which states meet the goal? Alaska, California, Colorado, Connecticut, Delaware, Illinois, Louisiana, Maine, Maryland, Massachusetts, Michigan, New Hampshire, New Jersey, New Mexico, New York, Ohio, Oregon, Pennsylvania, Rhode Island, Vermont, Washington, West Virginia, and Wyoming — 23 states. Washington, DC, did as well. (Alabama and Florida are excluded due to recent issues with test reporting.)
Why is this important? The positive or positivity rate, which tracks how many tests come back positive for Covid-19, is another way to measure testing capacity.
Generally, a higher positive rate suggests there’s not enough testing happening. An area with adequate testing should be testing lots and lots of people, many of whom don’t have the disease or don’t show severe symptoms. The positive testing rate in South Korea, for example, is below 1 percent. High positive rates indicate only people with obvious symptoms are getting tested, so there’s not quite enough testing to match the scope of an outbreak.
Previously, the World Health Organization (WHO) recommended a maximum positive rate of 10 percent. But the WHO more recently recommended 5 percent, which is in line with the rate for countries that have managed to better control their outbreaks, like Germany, New Zealand, and South Korea. “Even lower is better,” Shahpar said.
The positive rate data is subject to the same limitations as the overall testing data from the Covid Tracking Project. So if a state includes antibody tests in its test count, it could skew the positive rate to look better than it is. States only risk hurting themselves if they do this.
Goal 5: Availability of ICU beds
What’s the goal? Below 60 percent occupancy of ICU beds in hospitals, based on data from the US Department of Health and Human Services.
Which states meet the goal? Alaska, Colorado, Connecticut, Idaho, Illinois, Iowa, Massachusetts, Nebraska, New Hampshire, New Jersey, New Mexico, New York, North Dakota, South Dakota, Utah, Wisconsin, and Wyoming — 17 states.
Why is this important? If a pandemic hits, the health care system needs to be ready to treat the most severe cases and potentially save lives. That’s the key goal of “flattening the curve” and “raising the line,” in which social distancing helps reduce the spread of the disease so the health care system can maintain and grow its capacity to treat an influx of Covid-19 patients.
“There’s this idea that in six weeks we can open more things,” Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security, told me. “But the virus is still there. It’s all about making sure that the case count isn’t too immense for our hospital system to deal with.”
The aim is to avoid the nightmare scenario that Italy went through when it had more Covid-19 cases than its health care system could handle, leading to hospitals turning away even dangerously ill patients.
To gauge this, experts recommended looking at ICU capacity, with states aiming to have at most 60 percent occupancy in their ICUs.
Hitting the benchmarks is the beginning, not the end
Vox’s map is just one way of tracking success against the coronavirus. Other groups have come up with their own measures, including Covid Act Now, Covid Exit Strategy, and Test and Trace. Vox’s model uses more up-to-date data than some of these other examples, while focusing not just on the state of the pandemic but also on states’ readiness to contain Covid-19 outbreaks in the future.
Very few states hit all the marks recommended by experts. But even those that do shouldn’t consider the pandemic over. They should continue to improve — for example, getting the positive rate below 1 percent, as in New Zealand — and look at even more granular metrics, such as at the city or county level.
Meeting the benchmarks, however, indicates a state is better equipped to contain future coronavirus outbreaks as it eases previous restrictions.
Experts emphasized that states have to keep hitting all these goals week after week and day after day — Covid-19 cases must remain low, testing ability needs to stay high, and hospital capacity should be good enough for an influx of patients — until the pandemic is truly over, whether thanks to a vaccine or other means. Otherwise, a future wave of coronavirus cases, as seen in past pandemics, could kill many more people.
“You need to have all the metrics met,” Popescu said. “This needs to be a very incremental, slow process to ensure success.”
And if the numbers do start trending in the wrong direction, states should be ready to shut down at least some parts of the economy again. Maybe not as much as before, as we learn which places are truly at risk of increasing spread. But experts caution that future shutdowns will likely be necessary to some extent.
“I do worry we’re going to see surges of cases and hot spots,” Watson said. “We do need to keep pushing on building those capacities. … Otherwise, we’re just rolling the dice on the spread of the virus. It’s better if we have more control of the spread.”
That’s another reason these metrics, along with broader coronavirus surveillance, are so important: They not only help show how far along states are in dealing with their current Covid-19 outbreaks, but will help track progress to stop and prevent future crises as well.
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