The American Renaissance Has Begun
In 1982, the economist Mancur Olson set out to explain a paradox. West Germany and Japan endured widespread devastation during World War II, yet in the years after the war both countries experienced miraculous economic growth. Britain, on the other hand, emerged victorious from the war, with its institutions more intact, and yet it immediately entered a period of slow economic growth that left it lagging other European democracies. What happened?
In his book “The Rise and Decline of Nations,” Olson concluded that Germany and Japan enjoyed explosive growth precisely because their old arrangements had been disrupted. The devastation itself, and the forces of American occupation and reconstruction, dislodged the interest groups that had held back innovation. The old patterns that stifled experimentation were swept away. The disruption opened space for something new.
Something similar may be happening today. Covid-19 has disrupted daily American life in a way few emergencies have before. But it has also shaken things up and cleared the way for an economic boom and social revival.
Millions of Americans endured grievous loss and anxiety during this pandemic, but many also used this time as a preparation period, so they could burst out of the gate when things opened up. After decades of slowing entrepreneurial dynamism, 4.4 million new businesses were started in 2020, by far a modern record. A report from Udemy, an online course provider, says that 38 percent of workers took some additional training during 2020, up from only 14 percent in 2019.
After decades in which consumption took preference over savings, Americans socked away trillions of dollars in 2020, reducing their debt burdens to lows not seen since 1980 and putting themselves in a position to spend lavishly as things open up.
The biggest shifts, though, may be mental. People have been reminded that life is short. For over a year, many experienced daily routines that were slower paced, more rooted, more domestic. Millions of Americans seem ready to change their lives to be more in touch with their values.
The economy has already taken off. Global economic growth is expected to be north of 6 percent this year, and strong growth is expected to last at least through 2022. In late April, Tom Gimbel, who runs the recruiting and staffing firm LaSalle Network, told The Times: “It’s the best job market I’ve seen in 25 years. We have 50 percent more openings now than we did pre-Covid.” Investors are pouring money into new ventures. During the first quarter of this year U.S. start-ups raised $69 billion, 41 percent more than the previous record, set in 2018.
Already, this era of new creation seems to be rebalancing society in at least three ways:
First, power has begun shifting from employers to workers. In March, U.S. manufacturing, for example, expanded at the fastest pace in nearly four decades. Companies are desperate for new workers. Between April 2020 and March 2021, the number of unemployed people per opening plummeted to 1.2 from 5.
Workers are in the driver’s seat, for now, and they know it. The “quit rate” — the number of workers who quit their jobs because they are confident they can get a better one — is at the highest in two decades. Employers are raising wages and benefits to try to lure workers back.
Second, there seems to be a rebalancing between cities and suburbs. Covid-19 accelerated trends that had been underway for a few years, with people moving out of big cities like New York and San Francisco to suburbs, and to rural places like Idaho and the Hudson Valley in New York. Many are moving to get work or because of economic distress, but others say they moved so they could have more space, lead slower-paced lives, be closer to family or interact more with their neighbors.
Finally, there seems to be a rebalancing between work and domestic life. Stanford economist Nicholas Bloom expects that even when the pandemic is over, the number of working days spent at home will increase to 20 percent from 5 percent in the prepandemic era.
While this has increased pressures on many women, millions of Americans who could work remotely found that they liked being home, dining every night with their kids, not hassling with the commute. We are apparently becoming a less work-obsessed and a more domestic society.
In 1910 the educator Henry Van Dyke wrote, “The Spirit of America is best known in Europe by one of its qualities — energy.” That energy seemed to be fading away in recent years, as Americans came to move less and start new businesses less frequently. But the challenge of Covid-19 has summoned forth great dynamism, movement and innovation. Labor productivity rates have surged upward recently.
Americans are searching for ways to make more money while living more connected lives. Joel Kotkin, a professor of urban studies at Chapman University, points out that as the U.S. population disperses, economic and cultural gaps between coastal cities and inland communities will most likely shrink. And, he says, as more and more immigrants settle in rural areas and small towns, their presence might reduce nativism and increase economic competitiveness.
People are shifting their personal lives to address common problems — loneliness and loss of community. Nobody knows where this national journey of discovery will take us, but the voyage has begun.
https://www.nytimes.com/2021/06/17/opin ... 778d3e6de3
Post Pandemic Thinking/Issues
Post Pandemic Thinking/Issues
Last edited by kmaherali on Sat Apr 16, 2022 7:34 pm, edited 2 times in total.
Are You Dreading a Return to ‘Normal’? You’re Not Alone.
Featuring Kirsten Imani Kasai, Emily Ladau, Michael Reid
Ms. Kasai is a novelist. Ms. Ladau is a disability rights activist. Mr. Reid is a retired Episcopal priest.
Watch video at:
https://www.nytimes.com/2021/06/30/opin ... 778d3e6de3
As the pandemic winds down in the United States, people are emerging from their cocoons, all fired up and ready to celebrate in a communal explosion of relief and pent-up desire. The sense of anticipation is so great that some, with lusty hope, have called the coming months “The Summer of Love.”
But in the Opinion video above, we explore how not everyone is feeling this way. Many people across the country are harboring a deep anxiety as the world around them kicks back into gear.
In the video, you will hear from some of these quieter voices. They explain that as much as they want the pandemic to end, it has also provided them with some relief from challenges, inequities and injuries that were all too common in their prepandemic lives.
Kirsten Imani Kasai, 50, a novelist in San Diego and self-described introvert, describes how she found comfort and safety in the relative quietude of the past year — and fears the return of a noisier, more-demanding world. Emily Ladau, 29, a disability rights activist in Long Island, N.Y., says she worries that the shift back to in-person interactions will force her, once again, to navigate environments that weren’t designed for the physically disabled.
And for Michael Reid, 67, a retired Episcopal priest and former professional dancer in Santa Fe, N.M., the shutdowns unexpectedly gave him sanctuary from everyday racist interactions.
As the nation reckons with the collective trauma of the pandemic, they suggest, we should find lessons in it that will help shape a better society for everyone.
Featuring Kirsten Imani Kasai, Emily Ladau, Michael Reid
Ms. Kasai is a novelist. Ms. Ladau is a disability rights activist. Mr. Reid is a retired Episcopal priest.
Watch video at:
https://www.nytimes.com/2021/06/30/opin ... 778d3e6de3
As the pandemic winds down in the United States, people are emerging from their cocoons, all fired up and ready to celebrate in a communal explosion of relief and pent-up desire. The sense of anticipation is so great that some, with lusty hope, have called the coming months “The Summer of Love.”
But in the Opinion video above, we explore how not everyone is feeling this way. Many people across the country are harboring a deep anxiety as the world around them kicks back into gear.
In the video, you will hear from some of these quieter voices. They explain that as much as they want the pandemic to end, it has also provided them with some relief from challenges, inequities and injuries that were all too common in their prepandemic lives.
Kirsten Imani Kasai, 50, a novelist in San Diego and self-described introvert, describes how she found comfort and safety in the relative quietude of the past year — and fears the return of a noisier, more-demanding world. Emily Ladau, 29, a disability rights activist in Long Island, N.Y., says she worries that the shift back to in-person interactions will force her, once again, to navigate environments that weren’t designed for the physically disabled.
And for Michael Reid, 67, a retired Episcopal priest and former professional dancer in Santa Fe, N.M., the shutdowns unexpectedly gave him sanctuary from everyday racist interactions.
As the nation reckons with the collective trauma of the pandemic, they suggest, we should find lessons in it that will help shape a better society for everyone.
The Developing World Is a Tinderbox
The images flooding out of riot-torn South Africa are horrifying. On Tuesday, a woman in a high-rise building apparently set alight by looters tossed her child to the hoped-for safety of a crowd far below. Emergency workers have been attacked in several places; one medical service began transporting the injured in an armored ambulance. In much of the central district of the port city of Durban, the police were overwhelmed and shopping malls and stores were gutted.
The nation’s president, Cyril Ramaphosa, warned against ethnic conflict, a threat his critics called groundless and that only increased tensions.
But as I swiped through the pictures and videos flying across my South African relatives’ group chats this week, I was struck by the many posts that suggested an even bitterer flavor of doom — a kind of psychological crackup.
What began last week as scattered protests over the jailing of Jacob Zuma, the nation’s former president, has turned into a plunder free of meaning and intention, so indiscriminate that it seems almost cathartic. On Monday, just as Ramaphosa promised in a droning national address to get tough on looters, a split-screen showed a crowd meeting no resistance as they broke into a bank — but not an ordinary bank, a blood bank. All the while nobody seems to know what’s actually happening, as misinformation rockets through a locked-down, screen-dependent population.
South Africa has been a very fragile nation for a very long time — a place of persistent economic struggle and breathtaking inequality, intolerable violence, and racial animus still lurking beneath every national controversy. (Sound familiar?) But until this week I had never seriously entertained the idea that the place might suddenly fall apart. As was evident in the country’s bloodless handover from racist rule, troubled as it has been, there was a fundamental social stability undergirding South African society that I believed would hold.
But now it looks as if something key has been lost. The coronavirus may have dealt South Africa a blow that even AIDS could not, driving the country of my birth down the path of madness, a society slumping into the abyss.
The possibility of such collapse terrifies me — not just as a native South African, but as an American. Thanks to mass vaccination, it’s beginning to feel like morning in wealthy parts of the world, notwithstanding the social and political dislocations the virus has created in the United States. But on much of the rest of the planet it is still dark night.
What is happening in South Africa is different from what’s happening in Haiti, whose president was assassinated last week; or in Cuba, where thousands took to the streets in protest over rising poverty and state indifference; or in Colombia, Brazil, Lebanon and other places where protests and unrest have flared up in recent months. Yet there is an obvious common thread that suggests a systemic failure — a pandemic that refuses to abate is ripping societies apart. The coronavirus has gutted economies, depleted social, medical and security services, corroded trust and created opportunities for rampant violence and political persecution. And in the absence of effective vaccination programs, there isn’t any room for hope, either.
“These are fragile places with many underlying vulnerabilities,” said Masood Ahmed, the president of the Center for Global Development, a nonprofit that aims to reduce poverty in developing nations. “That is what we need to worry about — as the months wear on, you’re going to see a lot more countries where trust levels and tolerance will start fraying.”
This isn’t just their problem. Because the virus respects no borders, it’s ours, too. But it’s also important to remember that how we address today’s pandemic will have consequences for the many global threats to come. If the billions of people in the world’s middle- and low-income countries continue to feel hopelessly locked out of any chance at liberation from the virus, what will happen as the world is transformed by climate change?
Global poverty has declined significantly over the last 40 years — but because climate change could pose severe threats to Africa and South Asia, where most of the world’s poorest people live, the World Bank warns that, without swift action, it will be extremely difficult to further reduce extreme poverty. Among scholars of development, there remains a great deal of debate about the effectiveness of international aid to address international problems. But as Ahmed pointed out, in the case of Covid-19, what the wealthy world owes the developing world is not any kind of mystery. The fix for South Africa’s most pressing threat is the same as the solution to ours: a well-organized, well-funded mass vaccination program. What’s missing is global leadership and determination — a serious effort by the international community, with the United States in the lead, to rid the planet of any place where the virus might thrive. Think the Berlin Airlift or the Marshall Plan, but for vaccines.
And things are urgent. The coronavirus has reversed decades of progress on global development. The number of people experiencing hunger shot up by hundreds of millions last year, the most since at least 2006. Global peacefulness declined for the ninth year in a row, with a marked increase in riots and other violent demonstrations.
It sure feels like the world is on the brink. To pull back it needs help from those on more solid ground.
https://www.nytimes.com/2021/07/15/opin ... 778d3e6de3
The images flooding out of riot-torn South Africa are horrifying. On Tuesday, a woman in a high-rise building apparently set alight by looters tossed her child to the hoped-for safety of a crowd far below. Emergency workers have been attacked in several places; one medical service began transporting the injured in an armored ambulance. In much of the central district of the port city of Durban, the police were overwhelmed and shopping malls and stores were gutted.
The nation’s president, Cyril Ramaphosa, warned against ethnic conflict, a threat his critics called groundless and that only increased tensions.
But as I swiped through the pictures and videos flying across my South African relatives’ group chats this week, I was struck by the many posts that suggested an even bitterer flavor of doom — a kind of psychological crackup.
What began last week as scattered protests over the jailing of Jacob Zuma, the nation’s former president, has turned into a plunder free of meaning and intention, so indiscriminate that it seems almost cathartic. On Monday, just as Ramaphosa promised in a droning national address to get tough on looters, a split-screen showed a crowd meeting no resistance as they broke into a bank — but not an ordinary bank, a blood bank. All the while nobody seems to know what’s actually happening, as misinformation rockets through a locked-down, screen-dependent population.
South Africa has been a very fragile nation for a very long time — a place of persistent economic struggle and breathtaking inequality, intolerable violence, and racial animus still lurking beneath every national controversy. (Sound familiar?) But until this week I had never seriously entertained the idea that the place might suddenly fall apart. As was evident in the country’s bloodless handover from racist rule, troubled as it has been, there was a fundamental social stability undergirding South African society that I believed would hold.
But now it looks as if something key has been lost. The coronavirus may have dealt South Africa a blow that even AIDS could not, driving the country of my birth down the path of madness, a society slumping into the abyss.
The possibility of such collapse terrifies me — not just as a native South African, but as an American. Thanks to mass vaccination, it’s beginning to feel like morning in wealthy parts of the world, notwithstanding the social and political dislocations the virus has created in the United States. But on much of the rest of the planet it is still dark night.
What is happening in South Africa is different from what’s happening in Haiti, whose president was assassinated last week; or in Cuba, where thousands took to the streets in protest over rising poverty and state indifference; or in Colombia, Brazil, Lebanon and other places where protests and unrest have flared up in recent months. Yet there is an obvious common thread that suggests a systemic failure — a pandemic that refuses to abate is ripping societies apart. The coronavirus has gutted economies, depleted social, medical and security services, corroded trust and created opportunities for rampant violence and political persecution. And in the absence of effective vaccination programs, there isn’t any room for hope, either.
“These are fragile places with many underlying vulnerabilities,” said Masood Ahmed, the president of the Center for Global Development, a nonprofit that aims to reduce poverty in developing nations. “That is what we need to worry about — as the months wear on, you’re going to see a lot more countries where trust levels and tolerance will start fraying.”
This isn’t just their problem. Because the virus respects no borders, it’s ours, too. But it’s also important to remember that how we address today’s pandemic will have consequences for the many global threats to come. If the billions of people in the world’s middle- and low-income countries continue to feel hopelessly locked out of any chance at liberation from the virus, what will happen as the world is transformed by climate change?
Global poverty has declined significantly over the last 40 years — but because climate change could pose severe threats to Africa and South Asia, where most of the world’s poorest people live, the World Bank warns that, without swift action, it will be extremely difficult to further reduce extreme poverty. Among scholars of development, there remains a great deal of debate about the effectiveness of international aid to address international problems. But as Ahmed pointed out, in the case of Covid-19, what the wealthy world owes the developing world is not any kind of mystery. The fix for South Africa’s most pressing threat is the same as the solution to ours: a well-organized, well-funded mass vaccination program. What’s missing is global leadership and determination — a serious effort by the international community, with the United States in the lead, to rid the planet of any place where the virus might thrive. Think the Berlin Airlift or the Marshall Plan, but for vaccines.
And things are urgent. The coronavirus has reversed decades of progress on global development. The number of people experiencing hunger shot up by hundreds of millions last year, the most since at least 2006. Global peacefulness declined for the ninth year in a row, with a marked increase in riots and other violent demonstrations.
It sure feels like the world is on the brink. To pull back it needs help from those on more solid ground.
https://www.nytimes.com/2021/07/15/opin ... 778d3e6de3
The Simplest Tool for Improving Cities Is Also Free
CAMBRIDGE, Mass. — For decades, a stretch of Memorial Drive here that runs along the Charles River has been closed to automobiles on Sundays for the warmer half of the year. In the absence of cars on a four-lane thoroughfare beside the water, all kinds of other street uses blossom: skateboards, bicycles, hoverboards, strollers, wheelchairs and walkers, people on feet and on wheels now moving slowly enough to witness the late spring goslings, the ever-present sea gulls or the rarer magic and grace of a heron feeding along the water’s edge. A towering line of stately, centenarian sycamores forms an unbroken canopy over several blocks.
This section of Memorial Drive is formally called “Riverbend Park” during its weekend closures, but it’s not a park in any physical, structural sense. It’s an open public space transformed into a park without any construction. State park employees arrive in trucks in the morning and again in the evening at junctures in the road, placing gates, cones, and signs that cut off traffic. By dusk, the gates disappear, and traffic returns. That’s it — a park that is “found” from what’s already there.
It happens in cities everywhere: design, or redesign, created by time. A weekend clock turns an open street into something else entirely — a time structure organized outside commuter efficiency or traffic flows. Urban planners sometimes call it “temporal zoning.”
In 2020 and 2021, in response to the need for outdoor recreation during the pandemic, the city of Cambridge added Saturday hours for Riverbend Park, doubling its recreational time. Two luxurious weekend days of an open street from April to November — a provisional state of the built environment, like hundreds of other pandemic-led pilot projects happening right now all over the world. Each of these urban innovations carries with it a question: Can this last? Should it?
As cities across the world open up, urban planners and architects — and the rest of us — are looking around, asking whether our streets and buildings will be, or should be, the same again. But whatever we decide, there’s one transformational tool for building the cities that’s right in front of us, calling for more sustained attention: the design of time. We can creatively reorganize our collective hours and days in ways that help more people enjoy our cities and institutions. Time might be our most valuable resource for building the environments we want.
Covid-19 brought about temporal designs of other kinds. Starting in spring 2020, cities from New York to Bethesda to Berkeley repurposed city streets for outdoor dining, allocated by hours of the day. Retail shops everywhere, from grocery stores to booksellers, dedicated “seniors-only” browsing hours to vulnerable customers. In London and other cities, crosswalk signals were extended in length, an accommodation for more pedestrians in a season of fewer transit rides. It took responsiveness under duress to refashion the streets and spaces of our lives. Some of that ingenuity used the invisible tool of the clock.
More...
https://www.nytimes.com/2021/07/16/opin ... 778d3e6de3
CAMBRIDGE, Mass. — For decades, a stretch of Memorial Drive here that runs along the Charles River has been closed to automobiles on Sundays for the warmer half of the year. In the absence of cars on a four-lane thoroughfare beside the water, all kinds of other street uses blossom: skateboards, bicycles, hoverboards, strollers, wheelchairs and walkers, people on feet and on wheels now moving slowly enough to witness the late spring goslings, the ever-present sea gulls or the rarer magic and grace of a heron feeding along the water’s edge. A towering line of stately, centenarian sycamores forms an unbroken canopy over several blocks.
This section of Memorial Drive is formally called “Riverbend Park” during its weekend closures, but it’s not a park in any physical, structural sense. It’s an open public space transformed into a park without any construction. State park employees arrive in trucks in the morning and again in the evening at junctures in the road, placing gates, cones, and signs that cut off traffic. By dusk, the gates disappear, and traffic returns. That’s it — a park that is “found” from what’s already there.
It happens in cities everywhere: design, or redesign, created by time. A weekend clock turns an open street into something else entirely — a time structure organized outside commuter efficiency or traffic flows. Urban planners sometimes call it “temporal zoning.”
In 2020 and 2021, in response to the need for outdoor recreation during the pandemic, the city of Cambridge added Saturday hours for Riverbend Park, doubling its recreational time. Two luxurious weekend days of an open street from April to November — a provisional state of the built environment, like hundreds of other pandemic-led pilot projects happening right now all over the world. Each of these urban innovations carries with it a question: Can this last? Should it?
As cities across the world open up, urban planners and architects — and the rest of us — are looking around, asking whether our streets and buildings will be, or should be, the same again. But whatever we decide, there’s one transformational tool for building the cities that’s right in front of us, calling for more sustained attention: the design of time. We can creatively reorganize our collective hours and days in ways that help more people enjoy our cities and institutions. Time might be our most valuable resource for building the environments we want.
Covid-19 brought about temporal designs of other kinds. Starting in spring 2020, cities from New York to Bethesda to Berkeley repurposed city streets for outdoor dining, allocated by hours of the day. Retail shops everywhere, from grocery stores to booksellers, dedicated “seniors-only” browsing hours to vulnerable customers. In London and other cities, crosswalk signals were extended in length, an accommodation for more pedestrians in a season of fewer transit rides. It took responsiveness under duress to refashion the streets and spaces of our lives. Some of that ingenuity used the invisible tool of the clock.
More...
https://www.nytimes.com/2021/07/16/opin ... 778d3e6de3
How Nations Are Learning to ‘Let It Go’ and Live With Covid
More officials are encouraging people to return to their daily rhythms and transition to a new normal. But scientists warn that it may be too soon to design exit strategies for the pandemic.
SINGAPORE — England has removed nearly all coronavirus restrictions. Germany is allowing vaccinated people to travel without quarantines. Outdoor mask mandates are mostly gone in Italy. Shopping malls remain open in Singapore.
Eighteen months after the coronavirus first emerged, governments in Asia, Europe and the Americas are encouraging people to return to their daily rhythms and transition to a new normal in which subways, offices, restaurants and airports are once again full. Increasingly, the mantra is the same: We have to learn to live with the virus.
Yet scientists warn that the pandemic exit strategies may be premature. The emergence of more transmissible variants means that even wealthy nations with abundant vaccines, including the United States, remain vulnerable. Places like Australia, which shut down its border, are learning that they cannot keep the virus out.
So rather than abandon their road maps, officials are beginning to accept that rolling lockdowns and restrictions are a necessary part of recovery. People are being encouraged to shift their pandemic perspective and focus on avoiding severe illness and death instead of infections, which are harder to avoid. And countries with zero-Covid ambitions are rethinking those policies.
“You need to tell people: We’re going to get a lot of cases,” said Dale Fisher, a professor of medicine at the National University of Singapore who heads the National Infection Prevention and Control Committee of Singapore’s Health Ministry. “And that’s part of the plan — we have to let it go.”
More..
https://www.nytimes.com/2021/07/21/worl ... 778d3e6de3
More officials are encouraging people to return to their daily rhythms and transition to a new normal. But scientists warn that it may be too soon to design exit strategies for the pandemic.
SINGAPORE — England has removed nearly all coronavirus restrictions. Germany is allowing vaccinated people to travel without quarantines. Outdoor mask mandates are mostly gone in Italy. Shopping malls remain open in Singapore.
Eighteen months after the coronavirus first emerged, governments in Asia, Europe and the Americas are encouraging people to return to their daily rhythms and transition to a new normal in which subways, offices, restaurants and airports are once again full. Increasingly, the mantra is the same: We have to learn to live with the virus.
Yet scientists warn that the pandemic exit strategies may be premature. The emergence of more transmissible variants means that even wealthy nations with abundant vaccines, including the United States, remain vulnerable. Places like Australia, which shut down its border, are learning that they cannot keep the virus out.
So rather than abandon their road maps, officials are beginning to accept that rolling lockdowns and restrictions are a necessary part of recovery. People are being encouraged to shift their pandemic perspective and focus on avoiding severe illness and death instead of infections, which are harder to avoid. And countries with zero-Covid ambitions are rethinking those policies.
“You need to tell people: We’re going to get a lot of cases,” said Dale Fisher, a professor of medicine at the National University of Singapore who heads the National Infection Prevention and Control Committee of Singapore’s Health Ministry. “And that’s part of the plan — we have to let it go.”
More..
https://www.nytimes.com/2021/07/21/worl ... 778d3e6de3
The Pandemic Cured Me of My Mindless Shopping Habit
As Covid-19 vaccinations began to open up the world for some of us in pandemic-battered Los Angeles, going back to restaurants, dance clubs, bars or theaters was at the top of many wish lists. But at the top of mine was going back to malls.
I had missed browsing and shopping at will, wandering through favorite stores and boutiques with no real plan, fingering flowy blouses on hangers, rummaging through a table of purses on sale, inhaling the scent of a new body cream at the makeup counter — languidly weighing the decision of whether or not to buy. That lifelong shopping habit went into hibernation during the Covid-19 pandemic, but I figured it would return. While I’ve always been vaguely critical of its indolence, I could never shake it. This was the normal that I figured I’d return to.
But something amazing has happened: I’ve realized that I no longer want to shop. Even though I’m vaccinated and now can stroll the mall corridors again (masked, in accordance with the latest guidance as cases surge again), I have zero motivation to go forth and browse. At first I chalked it up to a lingering reticence to be indoors and among crowds — a hangover from my Covid paranoia (not so paranoid, given the new Delta variant). But that’s not entirely it.
A year-plus without shopping has wrought a whole new perspective on stores, and the nature of my attachment to them. Simply put, the thrill of the hunt that once was so integral to my life is gone. It’s like losing extra weight unexpectedly, without even trying or understanding why you lost it — mystifying, but undeniably liberating. Marie Kondo, the doyenne of declutter, would applaud my evolution. So would J.B. MacKinnon, the anti-overconsumption activist and author of “The Day the World Stops Shopping.” In a recent article, Mr. MacKinnon urges us to resist the calls for a “consumer-driven recovery” from the pandemic downturn, pointing out that overconsumption has “surpassed overpopulation as the greatest driver of our eco-crises.”
Mr. MacKinnon sees some hope in the disruption of our closet-stuffing, flash-sale-hunting habits. “It isn’t only that we know that our consumption comes at a tremendous cost to the environment,” he wrote. “The pandemic also gave us pause to reflect on what we want from consumer culture, and what we can happily live without.”
Looking back, I’m starting to realize how it happened for me. During the pandemic, whenever I was tempted to go to any retailer that wasn’t a grocery store, I asked myself: Is it worth the risk? The answer was always no. As Covid’s danger to me receded, the question has morphed into: Is it worth my time? Still no. Somewhere along the line, I became convinced that shopping without any real need for the items I might purchase presents its own kind of cost, in that it saps my most precious commodity — time. Definitely not a price worth paying.
Another experience that brought me to this new enlightened space, ironically, is online shopping. Pre-pandemic, I almost never indulged. Stripped of all the tactile and social stimulation of the in-person consumer experience, filling my online “shopping cart” seemed depressing. But last summer, I succumbed. Online shopping did offer some pleasures. Ordering things via a screen was like sending myself Christmas gifts to look forward to and unwrap. But the satisfaction was fleeting. The process made me keenly aware of how much stuff I was willing to buy just to amuse myself — to pass the time. Every empty UPS box I took out to the recycling bin was weighted with a certain remorse and, though I didn’t know it at the time, each helped me build my resolve to dispense with the enervating cycle of acquisition.
Finding that I can maintain that resolve has been gratifying. But I’m still uneasy. What am I going to do with all the time that shopping used to take up? Where will that dopamine hit of finding the perfect pair of jeans at 75 percent off come from now? Without routinely plunging myself into the marketplaces of my world, will I still be part of the world? What will I do if I’m not preparing my face “to meet the faces that you meet,” as T.S. Eliot’s Prufrock put it?
Shopping itself was mindless, true, but the wandering it required was gold. Wandering brought me into random contact with people, attitudes, conversations, trends, feelings in the air. All of this informed me, gave me much to ponder and measure myself against. The price of my new enlightened shopping-free state is that I am feeling less defined. Not quite so sure of who I am.
But maybe that’s appropriate for this moment. The country itself is going through a Big Shift, perilously unsure of what it is, and what it wants. The flux and social upheavals of 2020 have continued into 2021, with more developments virtually every day. This is maybe the biggest reason shopping has lost its luster: The distraction that was so pleasant and rejuvenating — not to mention so quintessentially American — now feels totally superfluous. It feels wrong.
Market analysts say Americans are regaining their comfort with shopping at malls and other retailers. But many of us are also feeling the urgent need to keep tabs on everything going on, to connect the dots of current events from one day to the next, even one hour to the next. With the backdrop of this nation’s existential crisis, shopping looks more and more like an attempt to ignore and forget. That is to say, it looks more and more like what it’s always been.
I still shop for the things I actually need for my survival or comfort. But my shopping is now far more focused and intentional — for example, I patronize Black-owned businesses in my neighborhood more. Instead of drifting in and out of stores for hours looking for bargains or serendipitous finds, I go to specific places knowing exactly why I’m there and what I want to buy. This engagement in the economic life of my community is pleasurable in its own way, and even fun — when I get what I need from a merchant who appreciates the business, I want to spike the ball, do a victory dance.
Still, the uneasiness persists. I am clear that I want progress more than I want stuff, a change that I think will last. But on its own my decision to buy less solves nothing, at least not the big things that need solving.
It’s proof, however, that positive change is doable, even to the activities so fundamental in our lives we don’t think about them. The Big Shifts will keep happening — from racism to antiracism, democracy on autopilot to democracy in peril. In that context, giving up browsing at the mall seems like a small shift. But it’s a start.
https://www.nytimes.com/2021/08/02/opin ... 778d3e6de3
As Covid-19 vaccinations began to open up the world for some of us in pandemic-battered Los Angeles, going back to restaurants, dance clubs, bars or theaters was at the top of many wish lists. But at the top of mine was going back to malls.
I had missed browsing and shopping at will, wandering through favorite stores and boutiques with no real plan, fingering flowy blouses on hangers, rummaging through a table of purses on sale, inhaling the scent of a new body cream at the makeup counter — languidly weighing the decision of whether or not to buy. That lifelong shopping habit went into hibernation during the Covid-19 pandemic, but I figured it would return. While I’ve always been vaguely critical of its indolence, I could never shake it. This was the normal that I figured I’d return to.
But something amazing has happened: I’ve realized that I no longer want to shop. Even though I’m vaccinated and now can stroll the mall corridors again (masked, in accordance with the latest guidance as cases surge again), I have zero motivation to go forth and browse. At first I chalked it up to a lingering reticence to be indoors and among crowds — a hangover from my Covid paranoia (not so paranoid, given the new Delta variant). But that’s not entirely it.
A year-plus without shopping has wrought a whole new perspective on stores, and the nature of my attachment to them. Simply put, the thrill of the hunt that once was so integral to my life is gone. It’s like losing extra weight unexpectedly, without even trying or understanding why you lost it — mystifying, but undeniably liberating. Marie Kondo, the doyenne of declutter, would applaud my evolution. So would J.B. MacKinnon, the anti-overconsumption activist and author of “The Day the World Stops Shopping.” In a recent article, Mr. MacKinnon urges us to resist the calls for a “consumer-driven recovery” from the pandemic downturn, pointing out that overconsumption has “surpassed overpopulation as the greatest driver of our eco-crises.”
Mr. MacKinnon sees some hope in the disruption of our closet-stuffing, flash-sale-hunting habits. “It isn’t only that we know that our consumption comes at a tremendous cost to the environment,” he wrote. “The pandemic also gave us pause to reflect on what we want from consumer culture, and what we can happily live without.”
Looking back, I’m starting to realize how it happened for me. During the pandemic, whenever I was tempted to go to any retailer that wasn’t a grocery store, I asked myself: Is it worth the risk? The answer was always no. As Covid’s danger to me receded, the question has morphed into: Is it worth my time? Still no. Somewhere along the line, I became convinced that shopping without any real need for the items I might purchase presents its own kind of cost, in that it saps my most precious commodity — time. Definitely not a price worth paying.
Another experience that brought me to this new enlightened space, ironically, is online shopping. Pre-pandemic, I almost never indulged. Stripped of all the tactile and social stimulation of the in-person consumer experience, filling my online “shopping cart” seemed depressing. But last summer, I succumbed. Online shopping did offer some pleasures. Ordering things via a screen was like sending myself Christmas gifts to look forward to and unwrap. But the satisfaction was fleeting. The process made me keenly aware of how much stuff I was willing to buy just to amuse myself — to pass the time. Every empty UPS box I took out to the recycling bin was weighted with a certain remorse and, though I didn’t know it at the time, each helped me build my resolve to dispense with the enervating cycle of acquisition.
Finding that I can maintain that resolve has been gratifying. But I’m still uneasy. What am I going to do with all the time that shopping used to take up? Where will that dopamine hit of finding the perfect pair of jeans at 75 percent off come from now? Without routinely plunging myself into the marketplaces of my world, will I still be part of the world? What will I do if I’m not preparing my face “to meet the faces that you meet,” as T.S. Eliot’s Prufrock put it?
Shopping itself was mindless, true, but the wandering it required was gold. Wandering brought me into random contact with people, attitudes, conversations, trends, feelings in the air. All of this informed me, gave me much to ponder and measure myself against. The price of my new enlightened shopping-free state is that I am feeling less defined. Not quite so sure of who I am.
But maybe that’s appropriate for this moment. The country itself is going through a Big Shift, perilously unsure of what it is, and what it wants. The flux and social upheavals of 2020 have continued into 2021, with more developments virtually every day. This is maybe the biggest reason shopping has lost its luster: The distraction that was so pleasant and rejuvenating — not to mention so quintessentially American — now feels totally superfluous. It feels wrong.
Market analysts say Americans are regaining their comfort with shopping at malls and other retailers. But many of us are also feeling the urgent need to keep tabs on everything going on, to connect the dots of current events from one day to the next, even one hour to the next. With the backdrop of this nation’s existential crisis, shopping looks more and more like an attempt to ignore and forget. That is to say, it looks more and more like what it’s always been.
I still shop for the things I actually need for my survival or comfort. But my shopping is now far more focused and intentional — for example, I patronize Black-owned businesses in my neighborhood more. Instead of drifting in and out of stores for hours looking for bargains or serendipitous finds, I go to specific places knowing exactly why I’m there and what I want to buy. This engagement in the economic life of my community is pleasurable in its own way, and even fun — when I get what I need from a merchant who appreciates the business, I want to spike the ball, do a victory dance.
Still, the uneasiness persists. I am clear that I want progress more than I want stuff, a change that I think will last. But on its own my decision to buy less solves nothing, at least not the big things that need solving.
It’s proof, however, that positive change is doable, even to the activities so fundamental in our lives we don’t think about them. The Big Shifts will keep happening — from racism to antiracism, democracy on autopilot to democracy in peril. In that context, giving up browsing at the mall seems like a small shift. But it’s a start.
https://www.nytimes.com/2021/08/02/opin ... 778d3e6de3
Book:
UNTIL PROVEN SAFE
The History and Future of Quarantine
Readers will likely come to this far-reaching cultural history of quarantine as a public health tool with more personal knowledge about its subject than Manaugh and Twilley anticipated when they began working on their book, long before our current pandemic.
The architecture and science writers marry the history of outbreaks both distant and modern (bubonic plague, yellow fever, H.I.V.-AIDS, Ebola) with anecdotes about their own research experiences. From traveling to Venice to understand how quarantines were deployed during the Black Death to watching the quarantine behaviors of social spiders with a Los Angeles researcher, the pair are friendly companions on a journey to understand what quarantine has been, and what it will become.
“We need a futurologist of quarantine,” one public health expert observes to the authors early on. If not quite futurologists, Twilley and Manaugh manage to remain forward-looking. The book introduces NASA officials, nuclear waste managers, architects and many others trying to reimagine quarantine. It also wrestles with the human-scale issues of emotion, connection and surveillance that we have become all too familiar with since 2020.
“Real-time infection-mapping and restricted-access technologies promise — or perhaps threaten — to make the whole world into a lazaretto, a virtual quarantine facility defined by regulations that force us to avoid the company of others,” the pair predict. “In the coming quarantine, you will be able to go anywhere — but you will be watched, measured and diagnosed the entire time.”
https://www.nytimes.com/2021/08/12/book ... ks_norm_20
UNTIL PROVEN SAFE
The History and Future of Quarantine
Readers will likely come to this far-reaching cultural history of quarantine as a public health tool with more personal knowledge about its subject than Manaugh and Twilley anticipated when they began working on their book, long before our current pandemic.
The architecture and science writers marry the history of outbreaks both distant and modern (bubonic plague, yellow fever, H.I.V.-AIDS, Ebola) with anecdotes about their own research experiences. From traveling to Venice to understand how quarantines were deployed during the Black Death to watching the quarantine behaviors of social spiders with a Los Angeles researcher, the pair are friendly companions on a journey to understand what quarantine has been, and what it will become.
“We need a futurologist of quarantine,” one public health expert observes to the authors early on. If not quite futurologists, Twilley and Manaugh manage to remain forward-looking. The book introduces NASA officials, nuclear waste managers, architects and many others trying to reimagine quarantine. It also wrestles with the human-scale issues of emotion, connection and surveillance that we have become all too familiar with since 2020.
“Real-time infection-mapping and restricted-access technologies promise — or perhaps threaten — to make the whole world into a lazaretto, a virtual quarantine facility defined by regulations that force us to avoid the company of others,” the pair predict. “In the coming quarantine, you will be able to go anywhere — but you will be watched, measured and diagnosed the entire time.”
https://www.nytimes.com/2021/08/12/book ... ks_norm_20
On Coronavirus Lockdown? Look for Meaning, Not Happiness
Why cultivating “tragic optimism” will help us weather this crisis — and even grow from it.
The coronavirus pandemic has not just threatened the physical health of millions but also wreaked havoc on the emotional and mental well-being of people around the world. Feelings of anxiety, helplessness and grief are rising as people face an increasingly uncertain future — and nearly everyone has been touched by loss. A nationally representative poll conducted by the Kaiser Family Foundation finds that nearly half of all Americans — 45 percent — feel that the coronavirus has negatively affected their mental health.
Which raises a question: Is there anything people can do to cope with the emotional fallout of this confusing and challenging time?
How people respond to adversity is a topic I’ve investigated for years as a journalist. Over the past decade, I’ve interviewed dozens of people about their experiences of extreme stress and have scoured the academic research in psychology on resilience to understand why some people are broken by crises while others emerge from stressful experiences even stronger than before.
What I’ve learned sheds light on how people can protect their mental health during the pandemic — and it upends some common ideas our culture carries about trauma and well-being. When researchers and clinicians look at who copes well in crisis and even grows through it, it’s not those who focus on pursuing happiness to feel better; it’s those who cultivate an attitude of tragic optimism.
The term was coined by Viktor Frankl, the Holocaust survivor and psychiatrist from Vienna. Tragic optimism is the ability to maintain hope and find meaning in life despite its inescapable pain, loss and suffering.
To understand how tragic optimism might serve us during the pandemic, it might help to recall how America responded to the Sept. 11, 2001, terrorist attacks. People reported increased feelings of fear, anxiety and hopelessness. These emotions were more debilitating for some than for others. To learn why, a group of researchers, led by Barbara Fredrickson, a psychologist at the University of North Carolina at Chapel Hill, studied the well-being of young adults in the weeks after the attacks. None of the students had lost loved ones on Sept. 11, but like the population at large, they reported feeling distressed. And yet, some of them were less likely to become depressed than others. What set those resilient students apart was their ability to find the good. Unlike the less resilient students, the resilient reported experiencing more positive emotions, like love and gratitude.
But that didn’t mean they were Pollyannas. They did not deny the tragedy of what happened. In fact, they reported the same levels of sadness and stress as less resilient people. This finding comes up frequently in psychology research: In general, resilient people have intensely negative reactions to trauma. They experience despair and stress, and acknowledge the horror of what’s happening. But even in the darkest of places, they see glimmers of light, and this ultimately sustains them.
But even more than helping them cope, adopting the spirit of tragic optimism enables people to actually grow through adversity.
For a long time, many psychologists embraced a victim narrative about trauma, believing that severe stress causes long-lasting and perhaps irreparable damage to one’s psyche and health. In 1980, the American Psychiatric Association added post-traumatic stress disorder to the Diagnostic and Statistical Manual of Mental Disorders, and since then, PTSD has received a lot of attention in the media and among ordinary individuals trying to understand what happens to people in the wake of tragic life events.
Yet psychologists now know that only a small percentage of people develop the full-blown disorder while, on average, anywhere from one half to two-thirds of trauma survivors exhibit what’s known as post-traumatic growth. After a crisis, most people acquire a newfound sense of purpose, develop deeper relationships, have a greater appreciation of life and report other benefits.
It’s not the adversity itself that leads to growth. It’s how people respond to it. According to the psychologists Richard Tedeschi and Lawrence Calhoun of the University of North Carolina at Charlotte, who coined the term “post-traumatic growth” in the 1990s, the people who grow after a crisis spend a lot of time trying to make sense of what happened and understanding how it changed them. In other words, they search for and find positive meaning.
In modern psychology research, this is known, a bit unfortunately, as “benefit finding.” Mr. Frankl called it “the human capacity to creatively turn life’s negative aspects into something positive or constructive.” Of course, some people are naturally more hopeful than others. But the success of psychological interventions like meaning-centered psychotherapy — developed by Dr. William Breitbart at Memorial Sloan Kettering Cancer Center and his colleagues to help terminal patients cope with death — reveals that even the most despairing individuals have the capacity to find meaning in a crisis.
It may seem inappropriate to call on people to seek the good in a crisis of this magnitude, but in study after study of tragedy and disaster, that’s what resilient people do. In a study of over a 1,000 people, 58 percent of respondents reported finding positive meaning in the wake of the Sept. 11 attacks, such as a greater appreciation of life and a deeper sense of spirituality. Other research shows that benefit finders grow not only psychologically but also physically. Heart attack survivors, for example, who found meaning in the weeks after their crisis were, eight years later, more likely to be alive and in better health than those who didn’t.
This doesn’t mean that people should endure adversities with a smiling face. In fact, Mr. Frankl specifically said that tragic optimism is not the same thing as happiness. “To the European,” he wrote, “it is a characteristic of the American culture that, again and again, one is commanded and ordered to ‘be happy.’ But happiness cannot be pursued; it must ensue. One must have a reason to ‘be happy.’”
He was right: In American culture, when people are feeling depressed or anxious, they are often advised to do what makes them happy. Much of the pandemic-related mental-health advice channels that message, encouraging people to distract themselves from bad news and difficult feelings, to limit their time on social media and to exercise.
I’m not suggesting those aren’t worthy activities. But if the goal is coping, they do not penetrate into the psyche as deeply as meaning does. When people do things that make them happy, like playing games or sleeping in, they feel better — but those feelings fade fast, according to research by Veronika Huta of the University of Ottawa and Richard Ryan of the University of Rochester.
When people search for meaning, though, they often do not feel happy. The things that make our lives meaningful, like volunteering or working, are stressful and require effort. But months later, the meaning seekers not only reported fewer negative moods but also felt more “enriched,” “inspired” and “part of something greater than myself.”
Though it has been only a few weeks since the pandemic started affecting life in the United States, I see people embracing meaning during this crisis. On my community listservs, people are organizing “help groups” to run errands for immuno-compromised people. They are rallying around struggling small businesses with “virtual tip jars.” Many companies and businesses, nationally and locally, are offering their services free. I’ve noticed people also say they are experiencing deeper connections to others — and feel more grateful to the caregivers, teachers, service workers and health care professionals among us. This certainly won’t be remembered as a happy period in the history of the world, but it may be remembered as a time of redemptive meaning and hope.
Does any of this mean the pandemic is a good thing? Of course not. It would be far better had the pandemic never occurred. But that’s not the world we live in. Life is, as Buddhists say, 10,000 joys and 10,000 sorrows. As much as we might wish, none of us can avoid suffering. That’s why it’s important to learn to suffer well.
https://www.nytimes.com/2020/04/07/opin ... pe=Article
Why cultivating “tragic optimism” will help us weather this crisis — and even grow from it.
The coronavirus pandemic has not just threatened the physical health of millions but also wreaked havoc on the emotional and mental well-being of people around the world. Feelings of anxiety, helplessness and grief are rising as people face an increasingly uncertain future — and nearly everyone has been touched by loss. A nationally representative poll conducted by the Kaiser Family Foundation finds that nearly half of all Americans — 45 percent — feel that the coronavirus has negatively affected their mental health.
Which raises a question: Is there anything people can do to cope with the emotional fallout of this confusing and challenging time?
How people respond to adversity is a topic I’ve investigated for years as a journalist. Over the past decade, I’ve interviewed dozens of people about their experiences of extreme stress and have scoured the academic research in psychology on resilience to understand why some people are broken by crises while others emerge from stressful experiences even stronger than before.
What I’ve learned sheds light on how people can protect their mental health during the pandemic — and it upends some common ideas our culture carries about trauma and well-being. When researchers and clinicians look at who copes well in crisis and even grows through it, it’s not those who focus on pursuing happiness to feel better; it’s those who cultivate an attitude of tragic optimism.
The term was coined by Viktor Frankl, the Holocaust survivor and psychiatrist from Vienna. Tragic optimism is the ability to maintain hope and find meaning in life despite its inescapable pain, loss and suffering.
To understand how tragic optimism might serve us during the pandemic, it might help to recall how America responded to the Sept. 11, 2001, terrorist attacks. People reported increased feelings of fear, anxiety and hopelessness. These emotions were more debilitating for some than for others. To learn why, a group of researchers, led by Barbara Fredrickson, a psychologist at the University of North Carolina at Chapel Hill, studied the well-being of young adults in the weeks after the attacks. None of the students had lost loved ones on Sept. 11, but like the population at large, they reported feeling distressed. And yet, some of them were less likely to become depressed than others. What set those resilient students apart was their ability to find the good. Unlike the less resilient students, the resilient reported experiencing more positive emotions, like love and gratitude.
But that didn’t mean they were Pollyannas. They did not deny the tragedy of what happened. In fact, they reported the same levels of sadness and stress as less resilient people. This finding comes up frequently in psychology research: In general, resilient people have intensely negative reactions to trauma. They experience despair and stress, and acknowledge the horror of what’s happening. But even in the darkest of places, they see glimmers of light, and this ultimately sustains them.
But even more than helping them cope, adopting the spirit of tragic optimism enables people to actually grow through adversity.
For a long time, many psychologists embraced a victim narrative about trauma, believing that severe stress causes long-lasting and perhaps irreparable damage to one’s psyche and health. In 1980, the American Psychiatric Association added post-traumatic stress disorder to the Diagnostic and Statistical Manual of Mental Disorders, and since then, PTSD has received a lot of attention in the media and among ordinary individuals trying to understand what happens to people in the wake of tragic life events.
Yet psychologists now know that only a small percentage of people develop the full-blown disorder while, on average, anywhere from one half to two-thirds of trauma survivors exhibit what’s known as post-traumatic growth. After a crisis, most people acquire a newfound sense of purpose, develop deeper relationships, have a greater appreciation of life and report other benefits.
It’s not the adversity itself that leads to growth. It’s how people respond to it. According to the psychologists Richard Tedeschi and Lawrence Calhoun of the University of North Carolina at Charlotte, who coined the term “post-traumatic growth” in the 1990s, the people who grow after a crisis spend a lot of time trying to make sense of what happened and understanding how it changed them. In other words, they search for and find positive meaning.
In modern psychology research, this is known, a bit unfortunately, as “benefit finding.” Mr. Frankl called it “the human capacity to creatively turn life’s negative aspects into something positive or constructive.” Of course, some people are naturally more hopeful than others. But the success of psychological interventions like meaning-centered psychotherapy — developed by Dr. William Breitbart at Memorial Sloan Kettering Cancer Center and his colleagues to help terminal patients cope with death — reveals that even the most despairing individuals have the capacity to find meaning in a crisis.
It may seem inappropriate to call on people to seek the good in a crisis of this magnitude, but in study after study of tragedy and disaster, that’s what resilient people do. In a study of over a 1,000 people, 58 percent of respondents reported finding positive meaning in the wake of the Sept. 11 attacks, such as a greater appreciation of life and a deeper sense of spirituality. Other research shows that benefit finders grow not only psychologically but also physically. Heart attack survivors, for example, who found meaning in the weeks after their crisis were, eight years later, more likely to be alive and in better health than those who didn’t.
This doesn’t mean that people should endure adversities with a smiling face. In fact, Mr. Frankl specifically said that tragic optimism is not the same thing as happiness. “To the European,” he wrote, “it is a characteristic of the American culture that, again and again, one is commanded and ordered to ‘be happy.’ But happiness cannot be pursued; it must ensue. One must have a reason to ‘be happy.’”
He was right: In American culture, when people are feeling depressed or anxious, they are often advised to do what makes them happy. Much of the pandemic-related mental-health advice channels that message, encouraging people to distract themselves from bad news and difficult feelings, to limit their time on social media and to exercise.
I’m not suggesting those aren’t worthy activities. But if the goal is coping, they do not penetrate into the psyche as deeply as meaning does. When people do things that make them happy, like playing games or sleeping in, they feel better — but those feelings fade fast, according to research by Veronika Huta of the University of Ottawa and Richard Ryan of the University of Rochester.
When people search for meaning, though, they often do not feel happy. The things that make our lives meaningful, like volunteering or working, are stressful and require effort. But months later, the meaning seekers not only reported fewer negative moods but also felt more “enriched,” “inspired” and “part of something greater than myself.”
Though it has been only a few weeks since the pandemic started affecting life in the United States, I see people embracing meaning during this crisis. On my community listservs, people are organizing “help groups” to run errands for immuno-compromised people. They are rallying around struggling small businesses with “virtual tip jars.” Many companies and businesses, nationally and locally, are offering their services free. I’ve noticed people also say they are experiencing deeper connections to others — and feel more grateful to the caregivers, teachers, service workers and health care professionals among us. This certainly won’t be remembered as a happy period in the history of the world, but it may be remembered as a time of redemptive meaning and hope.
Does any of this mean the pandemic is a good thing? Of course not. It would be far better had the pandemic never occurred. But that’s not the world we live in. Life is, as Buddhists say, 10,000 joys and 10,000 sorrows. As much as we might wish, none of us can avoid suffering. That’s why it’s important to learn to suffer well.
https://www.nytimes.com/2020/04/07/opin ... pe=Article
Reflection by ITREB Canada on “Planning for Tomorrow”
Video:
https://www.youtube.com/watch?v=4O-hf7QQEuk
Video:
https://www.youtube.com/watch?v=4O-hf7QQEuk
The World Is Still Short of Everything. Get Used to It.
Pandemic-related product shortages — from computer chips to construction materials — were supposed to be resolved by now. Instead, the world has gained a lesson in the ripple effects of disruption.
Like most people in the developed world, Kirsten Gjesdal had long taken for granted her ability to order whatever she needed and then watch the goods arrive, without any thought about the factories, container ships and trucks involved in delivery.
Not anymore.
At her kitchen supply store in Brookings, S.D., Ms. Gjesdal has given up stocking place mats, having wearied of telling customers that she can only guess when more will come. She recently received a pot lid she had purchased eight months earlier. She has grown accustomed to paying surcharges to cover the soaring shipping costs of the goods she buys. She has already placed orders for Christmas items like wreaths and baking pans.
“It’s nuts,” she said. “It’s definitely not getting back to normal.”
The challenges confronting Ms. Gjesdal’s shop, Carrot Seed Kitchen, are a testament to the breadth and persistence of the chaos roiling the global economy, as manufacturers and the shipping industry contend with an unrelenting pandemic.
Delays, product shortages and rising costs continue to bedevil businesses large and small. And consumers are confronted with an experience once rare in modern times: no stock available, and no idea when it will come in.
In the face of an enduring shortage of computer chips, Toyota announced this month that it would slash its global production of cars by 40 percent. Factories around the world are limiting operations — despite powerful demand for their wares — because they cannot buy metal parts, plastics and raw materials. Construction companies are paying more for paint, lumber and hardware, while waiting weeks and sometimes months to receive what they need.
More...
https://www.nytimes.com/2021/08/30/busi ... 778d3e6de3
Pandemic-related product shortages — from computer chips to construction materials — were supposed to be resolved by now. Instead, the world has gained a lesson in the ripple effects of disruption.
Like most people in the developed world, Kirsten Gjesdal had long taken for granted her ability to order whatever she needed and then watch the goods arrive, without any thought about the factories, container ships and trucks involved in delivery.
Not anymore.
At her kitchen supply store in Brookings, S.D., Ms. Gjesdal has given up stocking place mats, having wearied of telling customers that she can only guess when more will come. She recently received a pot lid she had purchased eight months earlier. She has grown accustomed to paying surcharges to cover the soaring shipping costs of the goods she buys. She has already placed orders for Christmas items like wreaths and baking pans.
“It’s nuts,” she said. “It’s definitely not getting back to normal.”
The challenges confronting Ms. Gjesdal’s shop, Carrot Seed Kitchen, are a testament to the breadth and persistence of the chaos roiling the global economy, as manufacturers and the shipping industry contend with an unrelenting pandemic.
Delays, product shortages and rising costs continue to bedevil businesses large and small. And consumers are confronted with an experience once rare in modern times: no stock available, and no idea when it will come in.
In the face of an enduring shortage of computer chips, Toyota announced this month that it would slash its global production of cars by 40 percent. Factories around the world are limiting operations — despite powerful demand for their wares — because they cannot buy metal parts, plastics and raw materials. Construction companies are paying more for paint, lumber and hardware, while waiting weeks and sometimes months to receive what they need.
More...
https://www.nytimes.com/2021/08/30/busi ... 778d3e6de3
How to Jump-Start Travel in a Covid-Infected World
Travel restrictions are disrupting international trade and holding back recovery from the trillions of dollars the pandemic has added to world debt. To stem the damage and open up the world safely, we need a global vaccine certification system — an undertaking that will require the political leadership that only the Group of 20 can provide.
Admirable attempts to reopen borders have been made, but these have often been piecemeal, unilateral and transitory. Frequent changes to entry protocols have left passengers confused, while mandatory quarantines and multiple tests are prohibitively expensive and impractical, and not necessarily science driven. This is not a sustainable model, given that we will be living alongside Covid for some time.
Consider the evidence. Restrictions have delivered a hammer blow to global tourism — responsible for one in 10 jobs around the world — and risk causing wider and deeper damage. Businesses are unable or reluctant to send employees to other countries to meet customers, stifling innovation and straining relations.
And on Monday, the European Union removed the United States from its list of countries whose residents are deemed safe to enter the union’s 27 nations without quarantine and testing requirements, though it will be up to each member state whether to follow the restrictions.
The solution lies in the global certification of effective vaccines for travel. We know vaccines can significantly reduce the likelihood of infection and transmission, and it is a testament to global science that we have developed vaccines and administered some 5.2 billion doses so quickly. But without recognition of these vaccines across borders and the ability of people to prove their vaccinated status, this progress will not result in easier travel.
This could be accomplished by a seamless, global, data-driven system to recognize vaccines for travel, track their changing effectiveness, and certify a person’s vaccination and possible booster status.
This requires two things: an interoperable, cross-border data system so countries can exchange information, and a global coordinated program in which countries recognize vaccines for travel that have not been approved by their domestic regulatory systems. This would allow individuals who have received effective vaccines to travel to any country that recognizes that vaccine for travel purposes.
The Good Health Pass Collaborative, a consortium of digital health credentials providers, has developed a set of technical standards for digital vaccine and health passes. These should be adopted by the global community. The QR code on these health passes should have the capability to work across the world. We believe the G20 can become the gatekeepers of these standards to assure they work globally while protecting people’s privacy.
This system is one side of the solution. Its success will be reduced if an effective vaccine is not recognized in the country where the health pass holder wants to travel. That is why the distinction between domestic regulatory approval of a vaccine and its recognition for cross-border travel is critical.
To complement this system, expanded global genomic surveillance systems run by international groups such as the World Health Organization and other entities would help track which vaccines work against which variants so that countries could update the vaccines they recognize based on the latest data.
A country shouldn’t be expected to approve every vaccine. This is unrealistic given the robust approval procedures of the regulatory bodies of many nations. Instead, there should be a central list of vaccines that countries recognize for travel purpose, based on data and real-world evidence of effectiveness.
A good starting point for such a list would be the seven vaccines approved by the W.H.O. The list has to be dynamic and data driven, because not all vaccines may work against all variants, and nations should have the ability to make science-driven decisions on allowing potential variant-susceptible individuals to cross their borders.
An overreliance on domestically approved vaccines will leave the world grounded. Of the vaccines recognized by the W.H.O. as effective, just four are approved in Britain and the European Union and three are conditionally or fully approved in the United States. There are some countries where people’s vaccinated status is not being recognized because of the vaccine received.
For example, Washington has not said whether it accepts Britain’s proof of Covid-19 vaccination, so the government there recommends that its citizens traveling to the United States follow entry rules for unvaccinated people. Since certain vaccines approved in Britain, such as AstraZeneca’s, are not approved in the United States yet, there is also confusion among British travelers about whether it is accepted in the United States.
We must act quickly. By the end of the year, at least a seventh of the world’s population could have received two doses of the AstraZeneca vaccine. Without recognition of this vaccine by the United States for travel purposes, it could mean that over a billion vaccinated people would not be eligible to enter the country without quarantine.
Of course, travel policy is a sovereign matter and each country or electorate must make up its own mind about what level of risk it is willing to take, but there needs to at least be the option to recognize the reduced risks of those travelers who are fully vaccinated.
We acknowledge all the challenges in taking effective action at the G20 level, but there’s an opportunity coming just next week as the G20 health ministers meet in Italy. The G20 should plan to put a system in place before the holiday travel season this winter. Establishing a consistent and workable travel policy is essential for a safe and expeditious global economic recovery.
https://www.nytimes.com/2021/09/01/opin ... 778d3e6de3
Travel restrictions are disrupting international trade and holding back recovery from the trillions of dollars the pandemic has added to world debt. To stem the damage and open up the world safely, we need a global vaccine certification system — an undertaking that will require the political leadership that only the Group of 20 can provide.
Admirable attempts to reopen borders have been made, but these have often been piecemeal, unilateral and transitory. Frequent changes to entry protocols have left passengers confused, while mandatory quarantines and multiple tests are prohibitively expensive and impractical, and not necessarily science driven. This is not a sustainable model, given that we will be living alongside Covid for some time.
Consider the evidence. Restrictions have delivered a hammer blow to global tourism — responsible for one in 10 jobs around the world — and risk causing wider and deeper damage. Businesses are unable or reluctant to send employees to other countries to meet customers, stifling innovation and straining relations.
And on Monday, the European Union removed the United States from its list of countries whose residents are deemed safe to enter the union’s 27 nations without quarantine and testing requirements, though it will be up to each member state whether to follow the restrictions.
The solution lies in the global certification of effective vaccines for travel. We know vaccines can significantly reduce the likelihood of infection and transmission, and it is a testament to global science that we have developed vaccines and administered some 5.2 billion doses so quickly. But without recognition of these vaccines across borders and the ability of people to prove their vaccinated status, this progress will not result in easier travel.
This could be accomplished by a seamless, global, data-driven system to recognize vaccines for travel, track their changing effectiveness, and certify a person’s vaccination and possible booster status.
This requires two things: an interoperable, cross-border data system so countries can exchange information, and a global coordinated program in which countries recognize vaccines for travel that have not been approved by their domestic regulatory systems. This would allow individuals who have received effective vaccines to travel to any country that recognizes that vaccine for travel purposes.
The Good Health Pass Collaborative, a consortium of digital health credentials providers, has developed a set of technical standards for digital vaccine and health passes. These should be adopted by the global community. The QR code on these health passes should have the capability to work across the world. We believe the G20 can become the gatekeepers of these standards to assure they work globally while protecting people’s privacy.
This system is one side of the solution. Its success will be reduced if an effective vaccine is not recognized in the country where the health pass holder wants to travel. That is why the distinction between domestic regulatory approval of a vaccine and its recognition for cross-border travel is critical.
To complement this system, expanded global genomic surveillance systems run by international groups such as the World Health Organization and other entities would help track which vaccines work against which variants so that countries could update the vaccines they recognize based on the latest data.
A country shouldn’t be expected to approve every vaccine. This is unrealistic given the robust approval procedures of the regulatory bodies of many nations. Instead, there should be a central list of vaccines that countries recognize for travel purpose, based on data and real-world evidence of effectiveness.
A good starting point for such a list would be the seven vaccines approved by the W.H.O. The list has to be dynamic and data driven, because not all vaccines may work against all variants, and nations should have the ability to make science-driven decisions on allowing potential variant-susceptible individuals to cross their borders.
An overreliance on domestically approved vaccines will leave the world grounded. Of the vaccines recognized by the W.H.O. as effective, just four are approved in Britain and the European Union and three are conditionally or fully approved in the United States. There are some countries where people’s vaccinated status is not being recognized because of the vaccine received.
For example, Washington has not said whether it accepts Britain’s proof of Covid-19 vaccination, so the government there recommends that its citizens traveling to the United States follow entry rules for unvaccinated people. Since certain vaccines approved in Britain, such as AstraZeneca’s, are not approved in the United States yet, there is also confusion among British travelers about whether it is accepted in the United States.
We must act quickly. By the end of the year, at least a seventh of the world’s population could have received two doses of the AstraZeneca vaccine. Without recognition of this vaccine by the United States for travel purposes, it could mean that over a billion vaccinated people would not be eligible to enter the country without quarantine.
Of course, travel policy is a sovereign matter and each country or electorate must make up its own mind about what level of risk it is willing to take, but there needs to at least be the option to recognize the reduced risks of those travelers who are fully vaccinated.
We acknowledge all the challenges in taking effective action at the G20 level, but there’s an opportunity coming just next week as the G20 health ministers meet in Italy. The G20 should plan to put a system in place before the holiday travel season this winter. Establishing a consistent and workable travel policy is essential for a safe and expeditious global economic recovery.
https://www.nytimes.com/2021/09/01/opin ... 778d3e6de3
Science Alone Can’t Heal a Sick Society
In the winter of 1848, a 26-year-old Prussian pathologist named Rudolf Virchow was sent to investigate a typhus epidemic raging in Upper Silesia, in what is now mostly Poland.
After three weeks of meticulous observation of the stricken populace — during which he carefully counted typhus cases and deaths by age, sex, occupation and social class — he returned with a 190-page report that ultimately blamed poverty and social exclusion for the epidemic and deemed it an unnecessary crisis. “I am convinced that if you changed these conditions, the epidemic would not recur,” he wrote.
Dr. Virchow was only a few years out of medical school, but his report became the foundational document of the new discipline of social medicine. His vision for health went far beyond individuals and the pathogens lurking inside them: He pioneered the careful epidemiological examination of social conditions such as housing, education, diet and lifestyle, and he denounced the rigid social stratification perpetuated at the time by the Catholic Church.
The same conditions of inequality that produced the Silesian typhus epidemic would soon foment a political revolution in Germany, and Dr. Virchow’s investigation helped turn him into a political revolutionary. “Medicine is social science and politics nothing but medicine on a grand scale,” he wrote.
For epidemiologists studying the coronavirus today, that scale is still gauged by the mundane act of counting. The counting starts with descriptive statistics on the daily state of the pandemic — who’s infected, who’s sick, how many have died. And then those numbers are used to forecast the pandemic’s future, which lets officials plan and mobilize resources. Epidemiologists use those data to discern patterns over time and among different groups of people, and to determine reasons some get sick and others don’t. That’s the hard part of epidemiology.
We know that the SARS-CoV-2 virus is the cause of Covid-19, and in that sense the story is very simple. But why does one exposed person get infected and not another? Despite more than 200 million detected cases worldwide, scientists still don’t understand much about transmission, nor what makes an infected person sick enough to be hospitalized, beyond simple demographics like age and sex.
Nearly half a million scientific papers have now been published on Covid-19, and they marshal a dizzying array of hypotheses to explain the patterns observed, but a vast majority of those conjectures quickly fizzle out. Numerous studies early on noted the relative absence of Covid-19 cases in Africa and South Asia, for example, leading to many environmental, genetic and behavioral conjectures, until suddenly African countries and India also were devastated by soaring caseloads. Thus so many epidemiological theories came and went, such as the impacts of altitude and blood type. But one consistent association held on, and it’s the same one that Dr. Virchow found in Upper Silesia: Our current pandemic is socially patterned.
This remains one of the few pervasive observations that consistently describes risks of infection, hospitalizations and death from Covid-19 around the world. Yet while wealth correlates with those who can work from home and order groceries online in rich countries, it explains less well the patterns among larger aggregations of people across states and nations. At this level, it appears that the more salient features that distinguish pandemic severity are relational factors like economic equality and social trust. It comes as no surprise to even the casual observer that the pandemic struck most ferociously in countries ridden with political division and social conflict.
For example, consider the number of excess deaths across countries during the pandemic. Looking at those countries most severely affected, such as Peru, Bolivia, South Africa and Brazil, one sees mostly middle-income countries in political turmoil and with weak social institutions. Countries that had fewer deaths than would be expected based on prepandemic trends, on the other hand, are often richer, but also distinguished by high levels of political cohesiveness, social trust, income equality and collectivism, like New Zealand, Taiwan, Norway, Iceland, Japan, Singapore and Denmark. Many investigators have reached similar conclusions in research within and among countries on measures of political polarization, social capital, trust in government and income inequality.
It makes sense that political polarization hampers effective pandemic response, but this is where explanatory inference gets trickiest, because we epidemiologists exist like everyone else inside the social forces that shape the pandemic. We are citizens as well as scientists, none of us immune to politicization and the way that it distorts perceptions and inferences.
For example, how did the effectiveness of a drug like hydroxychloroquine become a political litmus test, rather than a question for dispassionate clinical study? Nothing is gained when basic scientific and policy questions become ideological footballs to be inflated and tossed around. The United States is the dominant biomedical research entity in the world, and so its flagrant political dysfunction became a global problem. This infused everything that we epidemiologists did with doubt, suspicion and the whiff of partisanship.
Politics has dogged us at every turn in these past 18 months — astonishing failings at the C.D.C. and F.D.A. under political appointees, the politicization of proven interventions like masks and vaccines, and more. Take the return to in-person schooling. By April 2020, over three-quarters of the world’s schoolchildren were at home, yet we quickly learned enough to safely reopen schools for younger children — with measures like masking and ventilation — and this is indeed what happened in much of Canada, Europe and Asia.
But that progress from evidence to policy hit a brick wall in the United States when the Trump administration aggressively promoted resumption of in-person schooling as a crucial step toward economic recovery. When the former president threw his weight behind the priority that children should be back in classrooms, blue-state politicians, teachers unions and many epidemiologists were adamantly opposed. Rational discourse about the policy question became all but impossible. Every interpretation of evidence became colored by the suspicion that it was in the service of a political allegiance.
Science is a social process, and we all live amid the social soup of personalities, parties and power. The political dysfunction that holds America hostage also holds science hostage. Dr. Virchow wrote that “mass disease means that society is out of joint.” Society’s being out of joint means that epidemiological research is out of joint, because it exists inside the same society. This is not a new problem, but the dominant “follow the science” mantra misses the fact that the same social pathology that exacerbates the pandemic also debilitates our scientific response to it.
To restore faith in science, there must be faith in social institutions more broadly, and this requires a political reckoning. Of course one can cite many specific challenges for scientists: The wheels are coming off the peer review system, university research is plagued by commercialization pressures, and so on. But all of these are the symptoms, not the underlying disease. The real problem is simply that sick societies have sick institutions. Science is not some cloistered preserve in the clouds, but is buried in the muck with everything else. This is why, just eight days after his investigation in Upper Silesia, Dr. Virchow went to the barricades in Berlin to fight for the revolution.
https://www.nytimes.com/2021/09/10/opin ... 778d3e6de3
In the winter of 1848, a 26-year-old Prussian pathologist named Rudolf Virchow was sent to investigate a typhus epidemic raging in Upper Silesia, in what is now mostly Poland.
After three weeks of meticulous observation of the stricken populace — during which he carefully counted typhus cases and deaths by age, sex, occupation and social class — he returned with a 190-page report that ultimately blamed poverty and social exclusion for the epidemic and deemed it an unnecessary crisis. “I am convinced that if you changed these conditions, the epidemic would not recur,” he wrote.
Dr. Virchow was only a few years out of medical school, but his report became the foundational document of the new discipline of social medicine. His vision for health went far beyond individuals and the pathogens lurking inside them: He pioneered the careful epidemiological examination of social conditions such as housing, education, diet and lifestyle, and he denounced the rigid social stratification perpetuated at the time by the Catholic Church.
The same conditions of inequality that produced the Silesian typhus epidemic would soon foment a political revolution in Germany, and Dr. Virchow’s investigation helped turn him into a political revolutionary. “Medicine is social science and politics nothing but medicine on a grand scale,” he wrote.
For epidemiologists studying the coronavirus today, that scale is still gauged by the mundane act of counting. The counting starts with descriptive statistics on the daily state of the pandemic — who’s infected, who’s sick, how many have died. And then those numbers are used to forecast the pandemic’s future, which lets officials plan and mobilize resources. Epidemiologists use those data to discern patterns over time and among different groups of people, and to determine reasons some get sick and others don’t. That’s the hard part of epidemiology.
We know that the SARS-CoV-2 virus is the cause of Covid-19, and in that sense the story is very simple. But why does one exposed person get infected and not another? Despite more than 200 million detected cases worldwide, scientists still don’t understand much about transmission, nor what makes an infected person sick enough to be hospitalized, beyond simple demographics like age and sex.
Nearly half a million scientific papers have now been published on Covid-19, and they marshal a dizzying array of hypotheses to explain the patterns observed, but a vast majority of those conjectures quickly fizzle out. Numerous studies early on noted the relative absence of Covid-19 cases in Africa and South Asia, for example, leading to many environmental, genetic and behavioral conjectures, until suddenly African countries and India also were devastated by soaring caseloads. Thus so many epidemiological theories came and went, such as the impacts of altitude and blood type. But one consistent association held on, and it’s the same one that Dr. Virchow found in Upper Silesia: Our current pandemic is socially patterned.
This remains one of the few pervasive observations that consistently describes risks of infection, hospitalizations and death from Covid-19 around the world. Yet while wealth correlates with those who can work from home and order groceries online in rich countries, it explains less well the patterns among larger aggregations of people across states and nations. At this level, it appears that the more salient features that distinguish pandemic severity are relational factors like economic equality and social trust. It comes as no surprise to even the casual observer that the pandemic struck most ferociously in countries ridden with political division and social conflict.
For example, consider the number of excess deaths across countries during the pandemic. Looking at those countries most severely affected, such as Peru, Bolivia, South Africa and Brazil, one sees mostly middle-income countries in political turmoil and with weak social institutions. Countries that had fewer deaths than would be expected based on prepandemic trends, on the other hand, are often richer, but also distinguished by high levels of political cohesiveness, social trust, income equality and collectivism, like New Zealand, Taiwan, Norway, Iceland, Japan, Singapore and Denmark. Many investigators have reached similar conclusions in research within and among countries on measures of political polarization, social capital, trust in government and income inequality.
It makes sense that political polarization hampers effective pandemic response, but this is where explanatory inference gets trickiest, because we epidemiologists exist like everyone else inside the social forces that shape the pandemic. We are citizens as well as scientists, none of us immune to politicization and the way that it distorts perceptions and inferences.
For example, how did the effectiveness of a drug like hydroxychloroquine become a political litmus test, rather than a question for dispassionate clinical study? Nothing is gained when basic scientific and policy questions become ideological footballs to be inflated and tossed around. The United States is the dominant biomedical research entity in the world, and so its flagrant political dysfunction became a global problem. This infused everything that we epidemiologists did with doubt, suspicion and the whiff of partisanship.
Politics has dogged us at every turn in these past 18 months — astonishing failings at the C.D.C. and F.D.A. under political appointees, the politicization of proven interventions like masks and vaccines, and more. Take the return to in-person schooling. By April 2020, over three-quarters of the world’s schoolchildren were at home, yet we quickly learned enough to safely reopen schools for younger children — with measures like masking and ventilation — and this is indeed what happened in much of Canada, Europe and Asia.
But that progress from evidence to policy hit a brick wall in the United States when the Trump administration aggressively promoted resumption of in-person schooling as a crucial step toward economic recovery. When the former president threw his weight behind the priority that children should be back in classrooms, blue-state politicians, teachers unions and many epidemiologists were adamantly opposed. Rational discourse about the policy question became all but impossible. Every interpretation of evidence became colored by the suspicion that it was in the service of a political allegiance.
Science is a social process, and we all live amid the social soup of personalities, parties and power. The political dysfunction that holds America hostage also holds science hostage. Dr. Virchow wrote that “mass disease means that society is out of joint.” Society’s being out of joint means that epidemiological research is out of joint, because it exists inside the same society. This is not a new problem, but the dominant “follow the science” mantra misses the fact that the same social pathology that exacerbates the pandemic also debilitates our scientific response to it.
To restore faith in science, there must be faith in social institutions more broadly, and this requires a political reckoning. Of course one can cite many specific challenges for scientists: The wheels are coming off the peer review system, university research is plagued by commercialization pressures, and so on. But all of these are the symptoms, not the underlying disease. The real problem is simply that sick societies have sick institutions. Science is not some cloistered preserve in the clouds, but is buried in the muck with everything else. This is why, just eight days after his investigation in Upper Silesia, Dr. Virchow went to the barricades in Berlin to fight for the revolution.
https://www.nytimes.com/2021/09/10/opin ... 778d3e6de3
My Fellow Americans, Let’s Be Better Tourists
Americans have long had a reputation for being terrible tourists: loud, rude and too often clad in tube socks.
In the years leading up to the pandemic, we got even worse. Not more boisterous or more badly dressed. But — driven by cheap flights and cruises, an explosion of vacation rentals and social media-fueled FOMO — we were flooding the world, and wrecking it.
Countless people benefit from and depend on tourism. But travelers have also contributed to climate change, destroyed coral reefs, and driven residents out of cities once praised for their livability. In 2019, passenger planes blasted record amounts of carbon emissions into the air. That same year, Mount Everest was so overwhelmed with trash that China closed the base camp on its side of the peak to tourists without climbing permits. The Louvre got so jammed that workers walked out in protest.
It’s not just Americans who are to blame for this mess. There were 1.5 billion international overnight trips in 2019, according to the United Nations World Tourism Organization; Europeans accounted for roughly half of these stays, Asians a quarter. But we were the biggest spenders after the Chinese, lavishing some $150 billion on our holidays.
Then the pandemic forced a reset. Now that we are traveling again, we have a chance to usher in a better era. We can stop loving destinations to death.
To do that, we need to travel less — and more carefully.
The last time you planned a vacation, you probably spent a lot of time on research. You may have compared hotel costs and restaurant ratings, or tried to judge the cleanliness of a campground or the walking distance to ski lifts.
What if, in addition to asking how to maximize our enjoyment, we spent some time considering a different question: What impact will my presence have?
Travelers have to do research to get the answer. But if millions of people can scour Facebook, Twitter and other platforms for #travelinspiration, we can mine these sources for context, too. A search for “overtourism” on Twitter, for example, offers some useful information about fragile destinations to avoid.
This summer, Preethi Harbuck, a travel blogger, canceled a trip to Maui, which was struggling with a Covid surge, a water shortage and a tourist deluge. Her family could have blithely pressed ahead; many others did. But listening to locals on social media convinced her that doing so wouldn’t be considerate or responsible.
“The vast majority of Hawaiian voices that I could find were saying, ‘Please don’t come right now,’” Ms. Harbuck told me. Her family went to the U.S. Virgin Islands instead.
Approaching travel this way requires a mind-set shift. It may be more pleasurable to browse photos of five-star hotels than it is to review Friends of the Earth’s annual Cruise Ship Report Card. But there is a payoff: Caring about the places we travel to and the people who live there can make us feel more connected to them.
Some simple changes in how we plan travel can help. Rather than following the crowds, the hashtags or the influencers, look to old-fashioned sources of inspiration, from places mentioned in favorite books to memories of childhood holidays. You could even take that dusty globe off your shelf to get ideas.
Ask yourself what kind of trip you’re looking for — a beach escape? a culinary adventure? — then seek out a lower density version of the hot spot you initially had in mind. Opt out of Paris’s overheated restaurant scene, for example, and feast in Padua, Italy, or the Mexican state of Chiapas. Skip Yosemite National Park and try Pinnacles National Park, a few hours away. Travel during the off-season, stay in small inns and guesthouses, and explore the area’s cuisine as much as possible, to keep your dollars in local hands.
Of course, it’s always important to keep a close eye on any travel restrictions and recommendations from the places you want to visit — especially now, because of Covid — and make sure to comply with them fully, for your own sake and the safety of others.
One surprising way to be a more conscientious traveler is to book a group tour — with a responsible operator. Tours may get a bad rap from travelers who prize independence and authenticity, but some operators steer visitors away from over-touristed areas and use their deep local knowledge to support off-the-beaten track small businesses, says Megan Epler Wood, the managing director of the Sustainable Tourism Asset Management Program at Cornell University. “The kind of company you want to pick can show you how they’re measuring the impact of their travel,” she said. “That’s an important area where the consumer will have an impact.”
Governments and corporations have the most power when it comes to managing tourism, says Ms. Epler Wood, but they almost always opt for a more-is-more approach. Decisions about, say, how many flights can land in Maui are often disconnected from the desires and welfare of local communities. That’s why our own choices as travelers are so crucial.
Some of the most fundamental changes we can make start at home. Xavier Font, a professor of sustainability marketing at the University of Surrey in Britain, believes that often, we travel to escape unhappy daily lives. We even binge on travel the way we might on food.
“When you can no longer cope with your job and your bills and your pressures, getting on an airplane and going somewhere warmer and sunnier, where you’re not held to account, is really tempting,” he told me.
One antidote is to find more joy in your everyday life and community. We can start by getting to know our neighbors and neighborhoods better, as many people did during the pandemic. We can forgo the convenience of big box stores and deliveries, and patronize the kinds of small businesses we enjoy browsing in when we’re abroad.
Organize old-fashioned block parties, as the City of Santa Monica in California is encouraging residents to do, to channel Rome’s festive piazzas. Seek out nearby hot springs instead of spewing emissions all the way to Iceland. Grow — and share — tomatoes like those that your friend Instagrammed in Greece.
When travel is toxic, locals suffer the most. But it hurts tourists, too. We visit national parks to commune with nature, not overflowing parking lots. Being jostled by a crowd is no way to experience a great work of art or architecture. If we continue to exploit the world’s gifts, we may lose them as they degrade into ruins or are closed to outsiders.
Just as some of us are trying to stop stuffing our closets with disposable fast fashion, let’s stop gorging on cheap travel. Planning fewer, longer, more meaningful trips can mean more enduring memories — and destinations.
https://www.nytimes.com/2021/09/29/opin ... 778d3e6de3
Americans have long had a reputation for being terrible tourists: loud, rude and too often clad in tube socks.
In the years leading up to the pandemic, we got even worse. Not more boisterous or more badly dressed. But — driven by cheap flights and cruises, an explosion of vacation rentals and social media-fueled FOMO — we were flooding the world, and wrecking it.
Countless people benefit from and depend on tourism. But travelers have also contributed to climate change, destroyed coral reefs, and driven residents out of cities once praised for their livability. In 2019, passenger planes blasted record amounts of carbon emissions into the air. That same year, Mount Everest was so overwhelmed with trash that China closed the base camp on its side of the peak to tourists without climbing permits. The Louvre got so jammed that workers walked out in protest.
It’s not just Americans who are to blame for this mess. There were 1.5 billion international overnight trips in 2019, according to the United Nations World Tourism Organization; Europeans accounted for roughly half of these stays, Asians a quarter. But we were the biggest spenders after the Chinese, lavishing some $150 billion on our holidays.
Then the pandemic forced a reset. Now that we are traveling again, we have a chance to usher in a better era. We can stop loving destinations to death.
To do that, we need to travel less — and more carefully.
The last time you planned a vacation, you probably spent a lot of time on research. You may have compared hotel costs and restaurant ratings, or tried to judge the cleanliness of a campground or the walking distance to ski lifts.
What if, in addition to asking how to maximize our enjoyment, we spent some time considering a different question: What impact will my presence have?
Travelers have to do research to get the answer. But if millions of people can scour Facebook, Twitter and other platforms for #travelinspiration, we can mine these sources for context, too. A search for “overtourism” on Twitter, for example, offers some useful information about fragile destinations to avoid.
This summer, Preethi Harbuck, a travel blogger, canceled a trip to Maui, which was struggling with a Covid surge, a water shortage and a tourist deluge. Her family could have blithely pressed ahead; many others did. But listening to locals on social media convinced her that doing so wouldn’t be considerate or responsible.
“The vast majority of Hawaiian voices that I could find were saying, ‘Please don’t come right now,’” Ms. Harbuck told me. Her family went to the U.S. Virgin Islands instead.
Approaching travel this way requires a mind-set shift. It may be more pleasurable to browse photos of five-star hotels than it is to review Friends of the Earth’s annual Cruise Ship Report Card. But there is a payoff: Caring about the places we travel to and the people who live there can make us feel more connected to them.
Some simple changes in how we plan travel can help. Rather than following the crowds, the hashtags or the influencers, look to old-fashioned sources of inspiration, from places mentioned in favorite books to memories of childhood holidays. You could even take that dusty globe off your shelf to get ideas.
Ask yourself what kind of trip you’re looking for — a beach escape? a culinary adventure? — then seek out a lower density version of the hot spot you initially had in mind. Opt out of Paris’s overheated restaurant scene, for example, and feast in Padua, Italy, or the Mexican state of Chiapas. Skip Yosemite National Park and try Pinnacles National Park, a few hours away. Travel during the off-season, stay in small inns and guesthouses, and explore the area’s cuisine as much as possible, to keep your dollars in local hands.
Of course, it’s always important to keep a close eye on any travel restrictions and recommendations from the places you want to visit — especially now, because of Covid — and make sure to comply with them fully, for your own sake and the safety of others.
One surprising way to be a more conscientious traveler is to book a group tour — with a responsible operator. Tours may get a bad rap from travelers who prize independence and authenticity, but some operators steer visitors away from over-touristed areas and use their deep local knowledge to support off-the-beaten track small businesses, says Megan Epler Wood, the managing director of the Sustainable Tourism Asset Management Program at Cornell University. “The kind of company you want to pick can show you how they’re measuring the impact of their travel,” she said. “That’s an important area where the consumer will have an impact.”
Governments and corporations have the most power when it comes to managing tourism, says Ms. Epler Wood, but they almost always opt for a more-is-more approach. Decisions about, say, how many flights can land in Maui are often disconnected from the desires and welfare of local communities. That’s why our own choices as travelers are so crucial.
Some of the most fundamental changes we can make start at home. Xavier Font, a professor of sustainability marketing at the University of Surrey in Britain, believes that often, we travel to escape unhappy daily lives. We even binge on travel the way we might on food.
“When you can no longer cope with your job and your bills and your pressures, getting on an airplane and going somewhere warmer and sunnier, where you’re not held to account, is really tempting,” he told me.
One antidote is to find more joy in your everyday life and community. We can start by getting to know our neighbors and neighborhoods better, as many people did during the pandemic. We can forgo the convenience of big box stores and deliveries, and patronize the kinds of small businesses we enjoy browsing in when we’re abroad.
Organize old-fashioned block parties, as the City of Santa Monica in California is encouraging residents to do, to channel Rome’s festive piazzas. Seek out nearby hot springs instead of spewing emissions all the way to Iceland. Grow — and share — tomatoes like those that your friend Instagrammed in Greece.
When travel is toxic, locals suffer the most. But it hurts tourists, too. We visit national parks to commune with nature, not overflowing parking lots. Being jostled by a crowd is no way to experience a great work of art or architecture. If we continue to exploit the world’s gifts, we may lose them as they degrade into ruins or are closed to outsiders.
Just as some of us are trying to stop stuffing our closets with disposable fast fashion, let’s stop gorging on cheap travel. Planning fewer, longer, more meaningful trips can mean more enduring memories — and destinations.
https://www.nytimes.com/2021/09/29/opin ... 778d3e6de3
Thailand’s Quarantine-Island Experiment Is Showing (Modest) Results
Phuket, a resort island where vaccinated people who test negative for the coronavirus can roam freely, is starting to see some life return to its tourism industry.
PHUKET, Thailand — Three months ago, with great fanfare, Thailand began a campaign to start reviving its crucial tourism industry by letting visitors who follow strict Covid-19 protocols roam freely on the resort island of Phuket.
The so-called Phuket Sandbox program effectively turned Thailand’s largest island into a quarantine zone for overseas tourists who were fully vaccinated and had negative test results. If they continued to test negative for seven days, they could visit certain other islands; after 14 days, they could go anywhere in Thailand.
Roughly three months in, the campaign has drawn about 41,000 people, far short of the government’s goal of 100,000 in the first 90 days. Many have been residents returning from abroad, not tourists. Phuket had nearly 10 million international visitors in 2019, according to industry groups.
Still, hotel operators and small business owners say the program has helped the ravaged local economy, and other Southeast Asian countries with resort islands are considering emulating it.
“I see the Sandbox as far, far better than nothing because at least there are employees who are working again,” said Kanyaphak Lertjaraspong, who sells tour packages in Patong, a beach town at the heart of Phuket’s normally rowdy party scene. “At least they have some income.”
Indonesia’s tourism minister, Sandiaga Uno, told reporters last week that a similar program could be designed for the island of Bali, Indonesia’s largest tourist spot. Bali has had a recent decline in Covid cases, and Indonesia is hoping to open it to foreign visitors as early as this month.
“With the better situation now in Bali, we are discussing whether to adopt this,” Mr. Sandiaga said.
More...
https://www.nytimes.com/2021/10/04/worl ... 778d3e6de3
Phuket, a resort island where vaccinated people who test negative for the coronavirus can roam freely, is starting to see some life return to its tourism industry.
PHUKET, Thailand — Three months ago, with great fanfare, Thailand began a campaign to start reviving its crucial tourism industry by letting visitors who follow strict Covid-19 protocols roam freely on the resort island of Phuket.
The so-called Phuket Sandbox program effectively turned Thailand’s largest island into a quarantine zone for overseas tourists who were fully vaccinated and had negative test results. If they continued to test negative for seven days, they could visit certain other islands; after 14 days, they could go anywhere in Thailand.
Roughly three months in, the campaign has drawn about 41,000 people, far short of the government’s goal of 100,000 in the first 90 days. Many have been residents returning from abroad, not tourists. Phuket had nearly 10 million international visitors in 2019, according to industry groups.
Still, hotel operators and small business owners say the program has helped the ravaged local economy, and other Southeast Asian countries with resort islands are considering emulating it.
“I see the Sandbox as far, far better than nothing because at least there are employees who are working again,” said Kanyaphak Lertjaraspong, who sells tour packages in Patong, a beach town at the heart of Phuket’s normally rowdy party scene. “At least they have some income.”
Indonesia’s tourism minister, Sandiaga Uno, told reporters last week that a similar program could be designed for the island of Bali, Indonesia’s largest tourist spot. Bali has had a recent decline in Covid cases, and Indonesia is hoping to open it to foreign visitors as early as this month.
“With the better situation now in Bali, we are discussing whether to adopt this,” Mr. Sandiaga said.
More...
https://www.nytimes.com/2021/10/04/worl ... 778d3e6de3
Past Pandemics Remind Us Covid Will Be an Era, Not a Crisis That Fades
The skeletons move across a barren landscape toward the few helpless and terrified people still living. The scene, imagined in a mid-16th-century painting, “The Triumph of Death” by Pieter Bruegel the Elder, illuminated the psychic impact of the bubonic plague.
It was a terror that lingered even as the disease receded, historians say.
Covid-19’s waves of destruction have inflicted their own kind of despair on humanity in the 21st century, leaving many to wonder when the pandemic will end.
“We tend to think of pandemics and epidemics as episodic,” said Allan Brandt, a historian of science and medicine at Harvard University. “But we are living in the Covid-19 era, not the Covid-19 crisis. There will be a lot of changes that are substantial and persistent. We won’t look back and say, ‘That was a terrible time, but it’s over.’ We will be dealing with many of the ramifications of Covid-19 for decades, for decades.”
Especially in the months before the Delta variant became dominant, the pandemic seemed like it should be nearly over.
“When the vaccines first came out, and we started getting shots in our own arms, so many of us felt physically and emotionally transformed,” said Dr. Jeremy Greene, a historian of medicine at Johns Hopkins University School of Medicine. “We had a willful desire to translate that as, ‘The pandemic has ended for me.’”
He added, “It was a willful delusion.”
And that is a lesson from history that is often forgotten, Frank Snowden, a historian of medicine at Yale University, said: how difficult it is to declare that a pandemic has ended.
More...
https://www.nytimes.com/2021/10/12/heal ... 778d3e6de3
The skeletons move across a barren landscape toward the few helpless and terrified people still living. The scene, imagined in a mid-16th-century painting, “The Triumph of Death” by Pieter Bruegel the Elder, illuminated the psychic impact of the bubonic plague.
It was a terror that lingered even as the disease receded, historians say.
Covid-19’s waves of destruction have inflicted their own kind of despair on humanity in the 21st century, leaving many to wonder when the pandemic will end.
“We tend to think of pandemics and epidemics as episodic,” said Allan Brandt, a historian of science and medicine at Harvard University. “But we are living in the Covid-19 era, not the Covid-19 crisis. There will be a lot of changes that are substantial and persistent. We won’t look back and say, ‘That was a terrible time, but it’s over.’ We will be dealing with many of the ramifications of Covid-19 for decades, for decades.”
Especially in the months before the Delta variant became dominant, the pandemic seemed like it should be nearly over.
“When the vaccines first came out, and we started getting shots in our own arms, so many of us felt physically and emotionally transformed,” said Dr. Jeremy Greene, a historian of medicine at Johns Hopkins University School of Medicine. “We had a willful desire to translate that as, ‘The pandemic has ended for me.’”
He added, “It was a willful delusion.”
And that is a lesson from history that is often forgotten, Frank Snowden, a historian of medicine at Yale University, said: how difficult it is to declare that a pandemic has ended.
More...
https://www.nytimes.com/2021/10/12/heal ... 778d3e6de3
What We Know About Covid, the Flu and the Air We Breathe
Covid-19 is not the only respiratory infection the globe has been fighting, especially in the colder months. Last winter, the flu nearly disappeared worldwide because precautions taken against Covid-19, including masks and social distancing, also worked to prevent it. These precautions may have been especially powerful against the flu because they were layered upon some protective immunity people had built up from years of prior exposure to various flu viruses. There was no such protection from Covid-19, which was novel.
This year could be different, as people return to their usual activities and precautions are relaxed. But by embracing what’s been learned from SARS-CoV-2, the coronavirus that causes Covid-19 — including newer thinking on how respiratory viruses spread in general — the world can change the trajectory of flu seasons, potentially saving tens of thousands of lives in the process.
When Covid-19 first appeared, public health authorities worried mainly about the new coronavirus spreading through large fluid droplets — like from a cough or a sneeze. The guidance for individual behavior followed: Wash your hands, stay six feet apart and maybe even wipe down your groceries.
But a detailed understanding of flu transmission — developed over decades and recognized by precious few scientists until recently — laid the basis for scientists’ awakening to the reality of airborne transmission of SARS-CoV-2.
More...
https://www.nytimes.com/2021/10/19/opin ... 778d3e6de3
Covid-19 is not the only respiratory infection the globe has been fighting, especially in the colder months. Last winter, the flu nearly disappeared worldwide because precautions taken against Covid-19, including masks and social distancing, also worked to prevent it. These precautions may have been especially powerful against the flu because they were layered upon some protective immunity people had built up from years of prior exposure to various flu viruses. There was no such protection from Covid-19, which was novel.
This year could be different, as people return to their usual activities and precautions are relaxed. But by embracing what’s been learned from SARS-CoV-2, the coronavirus that causes Covid-19 — including newer thinking on how respiratory viruses spread in general — the world can change the trajectory of flu seasons, potentially saving tens of thousands of lives in the process.
When Covid-19 first appeared, public health authorities worried mainly about the new coronavirus spreading through large fluid droplets — like from a cough or a sneeze. The guidance for individual behavior followed: Wash your hands, stay six feet apart and maybe even wipe down your groceries.
But a detailed understanding of flu transmission — developed over decades and recognized by precious few scientists until recently — laid the basis for scientists’ awakening to the reality of airborne transmission of SARS-CoV-2.
More...
https://www.nytimes.com/2021/10/19/opin ... 778d3e6de3
Even With a Dream Job, You Can Be Antiwork
The world’s long-suffering workers have finally gained some measure of leverage over their bosses, and their new power is a glorious thing to behold.
In South Korea this week, tens of thousands of union members staged a one-day strike to demand better benefits and protections for temporary and contract workers. In Britain, where Brexit has contributed to severe shortages of goods and labor, Boris Johnson, the prime minister, has been taking dubious credit for what he calls a new era of higher pay.
And in the United States, a record nearly 4.3 million people quit their jobs in August, according to the Labor Department, and more than 10 million positions were vacant — slightly down from July, when about 11 million jobs needed filling. The shortage of workers has led to a growth in wages that has surpassed many economists’ expectations, and seems to have discombobulated bosses who are used to employees leaping at their every demand.
There are many potential reasons for workers’ reluctance to work terrible jobs. People who are flush with unemployment assistance and stimulus money might be holding out for better jobs to come along. Workers who spent the last year and half on the front lines of dangerous jobs in thankless industries — for instance, enforcing mask rules for belligerent customers in shops and restaurants — could be burned out by the experience. And many workers continue to fear for their health in an ongoing pandemic, while a lack of child and elder care has added costs and complications that have rendered many jobs just not worth the trouble.
All of this makes sense. But there might also be something deeper afoot. In its sudden rearrangement of daily life, the pandemic might have prompted many people to entertain a wonderfully un-American new possibility — that our society is entirely too obsessed with work, that employment is not the only avenue through which to derive meaning in life and that sometimes no job is better than a bad job.
“The pandemic gave us a kind of forced separation from work and a rare critical distance from the daily grind,” Kathi Weeks, a professor of gender, sexuality and feminist studies at Duke University, told me. “I think what you’re seeing with people refusing to go back is a kind of yearning for freedom.”
Weeks, the author of “The Problem With Work,” is among a handful of scholars who have been pushing for a wholesale reappraisal of the role that work plays in wealthy societies. Their ideas have been dubbed “post-work” or “antiwork,” and although they share goals with other players in the labor market — among them labor unions and advocates for higher minimum wages and a stronger social safety net — these scholars are calling for something even grander than improved benefits.
They’re questioning some of the bedrock ideas in modern life, especially life in America: What if paid work is not the only worthwhile use of one’s time? What if crushing it in your career is not the only way to attain status and significance in society? What if electing to live a life that is not driven by the neuroses and obsessions of paid employment is considered a perfectly fine and reasonable way to live?
Evidence for such a reappraisal is, admittedly, more anecdotal than rigorous. It might well be that as soon as labor markets loosen up, workers will again answer to their bosses’ every beck and call.
But David Frayne, a sociologist who is the author of “The Refusal of Work,” noted that traumatic events often cause people to reassess their lives and goals.
“The pandemic has had the potential to create that kind of disruption on a mass scale,” Frayne told me, and the disruption has created new political opportunities for regulating labor markets in a way that favors workers. He pointed out that in Britain, where he lives, politicians have begun to entertain the idea of a four-day workweek, a plan that was long considered a no-go.
In the United States, the Biden administration’s huge social policy legislation — now stalled in Congress — was also conceived in part as a way to address the kind of problems working people experienced during the pandemic. And the pandemic cracked open space to discuss more far-flung ideas for a society that is no longer centered on work — especially a universal basic income, a policy that is being tested in pilot programs across the country.
You can get a peek of a post-job world at /antiwork, a Reddit forum “for those who want to end work” that has gone viral in recent months, with hundreds of thousands following its subversive cause. /antiwork teems with posts from workers who are mad as hell and are not going to take it anymore — including many screenshots from folks saying they are telling off their managers, quitting in a rage after years of abuse.
I’ve been reading /antiwork for months, and I’ve been surprised to find myself joining in the visceral thrill of seeing people wrest the reins of their lives from the soul-sucking, health-destroying maw of capitalism.
I was surprised to find common cause with people on /antiwork because, of course, I have very little to complain about, job-wise. Indeed, at least once a day I revel in open-mouthed gratitude. What I do to make a living — writing this column — is less physically demanding and more intellectually rewarding than anything my ancestors had to endure to earn their supper, and — don’t tell my bosses — more than fair compensation for my time and effort.
It sounds perfect, right?
And yet, a lot of times my job can feel like an all-consuming hell. I’ve got a wife and kids and two lovely cats, but work is the first thing I think about every morning and the last thing I worry about every night. My job has dibs on my mind and my time, it gets the best of my attention and creativity, and it is the subject of my deepest neuroses and my most intractable stresses.
I’m embarrassed to say I didn’t really realize how much work ruled my life until the pandemic — until this huge meteor took aim at our lives and forced me to reconsider what I was doing.
I’m not saying I’m quitting — I hope to keep this gig for a long time. It’s just that I now have space in my mind for a truth that my prepandemic workaholism never allowed me to consider — that even a dream job is still a job, and in America’s relentless hustle culture, we have turned our jobs into prisons for our minds and souls. It’s time to break free.
https://www.nytimes.com/2021/10/22/opin ... 778d3e6de3
The world’s long-suffering workers have finally gained some measure of leverage over their bosses, and their new power is a glorious thing to behold.
In South Korea this week, tens of thousands of union members staged a one-day strike to demand better benefits and protections for temporary and contract workers. In Britain, where Brexit has contributed to severe shortages of goods and labor, Boris Johnson, the prime minister, has been taking dubious credit for what he calls a new era of higher pay.
And in the United States, a record nearly 4.3 million people quit their jobs in August, according to the Labor Department, and more than 10 million positions were vacant — slightly down from July, when about 11 million jobs needed filling. The shortage of workers has led to a growth in wages that has surpassed many economists’ expectations, and seems to have discombobulated bosses who are used to employees leaping at their every demand.
There are many potential reasons for workers’ reluctance to work terrible jobs. People who are flush with unemployment assistance and stimulus money might be holding out for better jobs to come along. Workers who spent the last year and half on the front lines of dangerous jobs in thankless industries — for instance, enforcing mask rules for belligerent customers in shops and restaurants — could be burned out by the experience. And many workers continue to fear for their health in an ongoing pandemic, while a lack of child and elder care has added costs and complications that have rendered many jobs just not worth the trouble.
All of this makes sense. But there might also be something deeper afoot. In its sudden rearrangement of daily life, the pandemic might have prompted many people to entertain a wonderfully un-American new possibility — that our society is entirely too obsessed with work, that employment is not the only avenue through which to derive meaning in life and that sometimes no job is better than a bad job.
“The pandemic gave us a kind of forced separation from work and a rare critical distance from the daily grind,” Kathi Weeks, a professor of gender, sexuality and feminist studies at Duke University, told me. “I think what you’re seeing with people refusing to go back is a kind of yearning for freedom.”
Weeks, the author of “The Problem With Work,” is among a handful of scholars who have been pushing for a wholesale reappraisal of the role that work plays in wealthy societies. Their ideas have been dubbed “post-work” or “antiwork,” and although they share goals with other players in the labor market — among them labor unions and advocates for higher minimum wages and a stronger social safety net — these scholars are calling for something even grander than improved benefits.
They’re questioning some of the bedrock ideas in modern life, especially life in America: What if paid work is not the only worthwhile use of one’s time? What if crushing it in your career is not the only way to attain status and significance in society? What if electing to live a life that is not driven by the neuroses and obsessions of paid employment is considered a perfectly fine and reasonable way to live?
Evidence for such a reappraisal is, admittedly, more anecdotal than rigorous. It might well be that as soon as labor markets loosen up, workers will again answer to their bosses’ every beck and call.
But David Frayne, a sociologist who is the author of “The Refusal of Work,” noted that traumatic events often cause people to reassess their lives and goals.
“The pandemic has had the potential to create that kind of disruption on a mass scale,” Frayne told me, and the disruption has created new political opportunities for regulating labor markets in a way that favors workers. He pointed out that in Britain, where he lives, politicians have begun to entertain the idea of a four-day workweek, a plan that was long considered a no-go.
In the United States, the Biden administration’s huge social policy legislation — now stalled in Congress — was also conceived in part as a way to address the kind of problems working people experienced during the pandemic. And the pandemic cracked open space to discuss more far-flung ideas for a society that is no longer centered on work — especially a universal basic income, a policy that is being tested in pilot programs across the country.
You can get a peek of a post-job world at /antiwork, a Reddit forum “for those who want to end work” that has gone viral in recent months, with hundreds of thousands following its subversive cause. /antiwork teems with posts from workers who are mad as hell and are not going to take it anymore — including many screenshots from folks saying they are telling off their managers, quitting in a rage after years of abuse.
I’ve been reading /antiwork for months, and I’ve been surprised to find myself joining in the visceral thrill of seeing people wrest the reins of their lives from the soul-sucking, health-destroying maw of capitalism.
I was surprised to find common cause with people on /antiwork because, of course, I have very little to complain about, job-wise. Indeed, at least once a day I revel in open-mouthed gratitude. What I do to make a living — writing this column — is less physically demanding and more intellectually rewarding than anything my ancestors had to endure to earn their supper, and — don’t tell my bosses — more than fair compensation for my time and effort.
It sounds perfect, right?
And yet, a lot of times my job can feel like an all-consuming hell. I’ve got a wife and kids and two lovely cats, but work is the first thing I think about every morning and the last thing I worry about every night. My job has dibs on my mind and my time, it gets the best of my attention and creativity, and it is the subject of my deepest neuroses and my most intractable stresses.
I’m embarrassed to say I didn’t really realize how much work ruled my life until the pandemic — until this huge meteor took aim at our lives and forced me to reconsider what I was doing.
I’m not saying I’m quitting — I hope to keep this gig for a long time. It’s just that I now have space in my mind for a truth that my prepandemic workaholism never allowed me to consider — that even a dream job is still a job, and in America’s relentless hustle culture, we have turned our jobs into prisons for our minds and souls. It’s time to break free.
https://www.nytimes.com/2021/10/22/opin ... 778d3e6de3
How I Became a Science Experiment
Trust the science. That was the mantra that many people repeated in the face of the Covid-19 pandemic — an entire worldview condensed into three words, with many implications. Trust Anthony Fauci, not Donald Trump. Trust authoritative medical bodies, not random doctors on the internet. Trust official knowledge, not conspiracy theories.
In some ways this worldview has been vindicated — the work of science brought forth vaccines with startling rapidity, while vaccine resistance has led to many unnecessary deaths. In other ways, the Covid era has offered case studies in why so many people mistrust official science — like the drip-drip-drip of information that has taken the so-called lab-leak theory of Covid’s origins from censored conspiracy theory to plausible and mainstream hypothesis.
But in the early days of the pandemic, the problem was that there was so little official science yet in which to put our trust. Instead, because Covid was a novel pathogen, we lived in a twilight zone for months, dealing with urgent questions to which there was no clear answer: how the disease spread and who was most at risk, whether masking or handwashing mattered most, whether to put patients on ventilators or try to keep them alive without them, what kind and variety of symptoms were associated with the sickness, what kind of therapeutic drugs should be thrown into the fight. We had to act in that twilight — as citizens, as doctors, as patients — without certainty, following supposition, speculation and hypothesis. And to the extent that confident medical pronouncements were issued in those days, they often had to be amended or reversed.
The experience of those chaotic months offers one way for outsiders to understand the world of chronic illness. Because to fall into that strange realm, as I did more than six years ago, is to live in the twilight all the time.
If you haven’t passed into this country, it can seem like a world where science is fundamentally mistrusted or rejected, because the chronically ill end up seeking out so many fringe ideas and treatments, trying out so many strange theories, bending an ear to so many oddballs and cranks.
But the reality is more complex. For chronically ill people trying desperately to get better, actual science — the world of hypothesis, experiment, result — matters in the most urgent way. It’s just that they have entered a territory where there aren’t any clear authorities, any definite consensus. And so a lot of the strange things they end up doing are just a kind of home-brew versions of the scientific method — what it looks like when ordinary people have to effectively become their own doctors and do science on themselves.
That is part of what happened to me, in the months and then years after the sudden summer-of-2015 descent into insomnia, disintegration and blazing pain that I wrote about last weekend. In that summer I experienced a truncated form of what many people with chronic illness experience over many, many years: not a medical system that offers answers that the patients then bullheadedly reject, but a system full of well-meaning doctors who offer you exactly nothing — no diagnosis whatsoever, just a lot of murmurs about stress and mystery when the blood tests come back negative and a suggestion that you simply wait and hope the pain somehow goes away.
More...
https://www.nytimes.com/2021/10/30/opin ... ience.html
Trust the science. That was the mantra that many people repeated in the face of the Covid-19 pandemic — an entire worldview condensed into three words, with many implications. Trust Anthony Fauci, not Donald Trump. Trust authoritative medical bodies, not random doctors on the internet. Trust official knowledge, not conspiracy theories.
In some ways this worldview has been vindicated — the work of science brought forth vaccines with startling rapidity, while vaccine resistance has led to many unnecessary deaths. In other ways, the Covid era has offered case studies in why so many people mistrust official science — like the drip-drip-drip of information that has taken the so-called lab-leak theory of Covid’s origins from censored conspiracy theory to plausible and mainstream hypothesis.
But in the early days of the pandemic, the problem was that there was so little official science yet in which to put our trust. Instead, because Covid was a novel pathogen, we lived in a twilight zone for months, dealing with urgent questions to which there was no clear answer: how the disease spread and who was most at risk, whether masking or handwashing mattered most, whether to put patients on ventilators or try to keep them alive without them, what kind and variety of symptoms were associated with the sickness, what kind of therapeutic drugs should be thrown into the fight. We had to act in that twilight — as citizens, as doctors, as patients — without certainty, following supposition, speculation and hypothesis. And to the extent that confident medical pronouncements were issued in those days, they often had to be amended or reversed.
The experience of those chaotic months offers one way for outsiders to understand the world of chronic illness. Because to fall into that strange realm, as I did more than six years ago, is to live in the twilight all the time.
If you haven’t passed into this country, it can seem like a world where science is fundamentally mistrusted or rejected, because the chronically ill end up seeking out so many fringe ideas and treatments, trying out so many strange theories, bending an ear to so many oddballs and cranks.
But the reality is more complex. For chronically ill people trying desperately to get better, actual science — the world of hypothesis, experiment, result — matters in the most urgent way. It’s just that they have entered a territory where there aren’t any clear authorities, any definite consensus. And so a lot of the strange things they end up doing are just a kind of home-brew versions of the scientific method — what it looks like when ordinary people have to effectively become their own doctors and do science on themselves.
That is part of what happened to me, in the months and then years after the sudden summer-of-2015 descent into insomnia, disintegration and blazing pain that I wrote about last weekend. In that summer I experienced a truncated form of what many people with chronic illness experience over many, many years: not a medical system that offers answers that the patients then bullheadedly reject, but a system full of well-meaning doctors who offer you exactly nothing — no diagnosis whatsoever, just a lot of murmurs about stress and mystery when the blood tests come back negative and a suggestion that you simply wait and hope the pain somehow goes away.
More...
https://www.nytimes.com/2021/10/30/opin ... ience.html
TRAVEL CHANGES THAT WILL OUTLAST A PANDEMIC
In today’s newsletter: making air travel green; easing the stress of holiday travel; why scientists are studying Maine … and the complex history of a fall rite of passage
For travelers, the pandemic has forced the adoption of technologies that might have been baffling—or even irritating—had it not been for the logic that makes them so … well, logical. Some of these inventions are now so common (I’m looking at you, non-woven polypropylene N95 masks) it’s amazing they were once as novel as SARS-CoV-2 used to be.
“These days it’s hard to be out in the world without encountering QR-coded menus or supplying digital vaccine passports,” writes Jackie Snow in our story about pandemic tech innovations that will change travel forever. Indeed, in the 20 months since the COVID-19 pandemic began, many things have gone from futuristic to familiar.
I don’t know if it’s ever cathartic for shopkeepers to aim temperature guns at their customers, but they certainly command respect when they do. Those gadgets are pedestrian compared to crowd-control technology like Singapore’s roaming, vaguely terrifying robots that announce people are too close together. (Pictured above, another robot, more of a guide, at Seoul’s Incheon International Airport.)
“As throngs of travelers return to popular destinations, similar methods and devices may be implemented to prevent overtourism,” Snow writes. “But while novel interventions such as real-time translation devices and facial recognition passport control may make travel safer and more efficient, there are downsides, including concerns about privacy, data security, and biased technology.”
PHOTOGRAPH BY NELSON ALMEIDA, AFP/GETTY IMAGES
Our story spotlights the growing application of augmented reality and virtual reality to create online exhibits and experiences; efforts to use UV-C light (pictured above) to halt viral spread at indoor public spaces including airports and planes; and amped-up contract-tracing tools for infectious disease prevention and control.
We are not out of the woods yet—the World Health Organization has just warned that spiraling infections place Europe again at the epicenter of the pandemic. But since we somehow managed to embrace elbow bumps, social distancing, and the phrase “the new normal,” surely we can learn to love rolling robots at train stations and airports. The future depends on it.
More and relevant links at:
https://email.nationalgeographic.com/H/ ... fdd58/HTML
In today’s newsletter: making air travel green; easing the stress of holiday travel; why scientists are studying Maine … and the complex history of a fall rite of passage
For travelers, the pandemic has forced the adoption of technologies that might have been baffling—or even irritating—had it not been for the logic that makes them so … well, logical. Some of these inventions are now so common (I’m looking at you, non-woven polypropylene N95 masks) it’s amazing they were once as novel as SARS-CoV-2 used to be.
“These days it’s hard to be out in the world without encountering QR-coded menus or supplying digital vaccine passports,” writes Jackie Snow in our story about pandemic tech innovations that will change travel forever. Indeed, in the 20 months since the COVID-19 pandemic began, many things have gone from futuristic to familiar.
I don’t know if it’s ever cathartic for shopkeepers to aim temperature guns at their customers, but they certainly command respect when they do. Those gadgets are pedestrian compared to crowd-control technology like Singapore’s roaming, vaguely terrifying robots that announce people are too close together. (Pictured above, another robot, more of a guide, at Seoul’s Incheon International Airport.)
“As throngs of travelers return to popular destinations, similar methods and devices may be implemented to prevent overtourism,” Snow writes. “But while novel interventions such as real-time translation devices and facial recognition passport control may make travel safer and more efficient, there are downsides, including concerns about privacy, data security, and biased technology.”
PHOTOGRAPH BY NELSON ALMEIDA, AFP/GETTY IMAGES
Our story spotlights the growing application of augmented reality and virtual reality to create online exhibits and experiences; efforts to use UV-C light (pictured above) to halt viral spread at indoor public spaces including airports and planes; and amped-up contract-tracing tools for infectious disease prevention and control.
We are not out of the woods yet—the World Health Organization has just warned that spiraling infections place Europe again at the epicenter of the pandemic. But since we somehow managed to embrace elbow bumps, social distancing, and the phrase “the new normal,” surely we can learn to love rolling robots at train stations and airports. The future depends on it.
More and relevant links at:
https://email.nationalgeographic.com/H/ ... fdd58/HTML
Could Covid Lead to Progress?
Mass tragedies sometimes have unexpected consequences.
A mystery has long surrounded the Great Influenza of 1918-19. Why did a pandemic that killed upward of 50 million people, many of them otherwise healthy young adults, leave such a limited imprint on humanity’s cultural memory — especially in contrast to World War I, which killed less than half as many people? Countless novels and films and monuments investigate or commemorate the trauma that the Great War inflicted on modern consciousness, but the Great Influenza, having torn a deadly path around the world for two years, seemed to be forgotten nearly overnight.
Perhaps the best explanation stems from the century of progress that separates us from its victims. Most of the people alive during the 1918 outbreak were born during the 19th century, when death from infections was tragically familiar, when losing a third of your children to disease was the norm. To them, the mechanized carnage of World War I, with its fighter planes, machine guns and chemical weapons, was a step change in the history of human violence. A terrible flu virus sweeping through your town and killing some of your friends and family — in an age when it was much more difficult to perceive how global the outbreak was, given the limited scope of most news coverage — didn’t seem all that novel an experience by comparison.
We are not likely to experience the same cultural amnesia with Covid-19. The global population that encountered the SARS-CoV-2 virus had grown accustomed to a world where the burden of infectious disease has been greatly reduced. Before Covid, the most terrifying and deadly new virus to attack the United States was H.I.V., which managed to kill 100,000 Americans in its first eight years of spread here. Covid pulled off the same gruesome feat in four months. You could make the case that Covid will prove to be the true “great war” of the early 21st century — the source of so many genuinely new and terrifying experiences, seared into our collective memory: the hauntingly empty streets of Manhattan and Madrid, the corpses stacked in temporary freezers. Decades from now I suspect I will still be able to conjure the backdrop of incessant sirens in Brooklyn in late March 2020, the creeping terror of it all, the dreadful urgency of trying to make decisions to keep your family safe when so little was understood about the nature of the virus itself.
Whatever is coming next — and let’s hope it is a relatively untraumatic descent, with Covid becoming a manageable if endemic disease, no worse than the flu — this particular plague is going to leave a profound legacy.
Which then raises the question: What will that legacy be? There are many examples of mass tragedies that inspired meaningful reforms or scientific breakthroughs — steps forward in human progress that, in the end, most likely saved more lives than the original tragedy claimed. The deadly concentration of the 1854 cholera epidemic in London enabled John Snow to prove that cholera was a disease caused by contaminated water, even though the bacterium itself hadn’t been identified yet; Snow’s insight probably prevented tens of thousands of deaths in the decades that followed. The occupational safety regulations put in place after the Triangle Shirtwaist factory fire in 1911 undoubtedly saved more lives than the 146 lost in that tragedy.
Of course, for meaningful lessons to be learned from a tragedy — whether a factory fire or a pandemic — you have to begin by acknowledging the facts of the event itself. The rise of Covid denialism, in America and elsewhere, is often taken as a reason to doubt that any progress will grow out of the tragedy of Covid-19. But as depressing as anti-science belligerence can sometimes be, there is abundant evidence that we are learning from this epidemic. To begin with, the period from March 2020 to May 2020 almost certainly marked the most significant short-term change ever in worldwide human behavior. Vast sections of the planet effectively froze in place for a few months, and then adopted, en masse, a whole new set of routines to flatten the curve and slow the spread — a genuinely new trick for Homo sapiens. It was not obvious in advance that such a thing was even possible.
Imagine, if you can bear it, what happens the next time word emerges of a novel virus devastating a midsize city somewhere in the world. The slow-motion reaction that characterized the global response to the news from Wuhan in early 2020 would be radically accelerated. Even without public-health mandates, a significant part of the world’s population, particularly in cosmopolitan cities that were hit hard in the early days of Covid, would instantly mask up; where possible, workers would switch back to Zoom; unnecessary travel would cease. No doubt some portion of the population would play down the magnitude of the threat or invent a preposterous conspiracy theory to explain it. But a meaningful number of people would switch back into the “pandemic mode” they learned in 2020-21.
Think about how Covid might have been different if, say, 50 percent of the world’s urban population had switched into this mode on Feb. 1, 2020. Could this have stopped the virus in its tracks? Perhaps not. But it might have resulted in a global outbreak that looked more like South Korea’s experience, or San Francisco’s, with death rates a tiny fraction of what they ultimately proved to be.
We are learning from Covid in a more obvious way as well: through the lens of science. After the Great Influenza, it took 13 years — thanks to a young virologist named Richard Edwin Shope, who noticed veterinary reports about an unusual outbreak of swine flu among pigs in fall 1918 — to prove that the pandemic had been caused by a virus at all. The contrast with Covid could not be more extreme: We isolated the SARS-CoV-2 virus about 20 days after the outbreak was first reported. Just over a week later, its genome had been sequenced and shared around the world, and the blueprint for what would become the mRNA vaccines (the ones manufactured, ultimately, by Pfizer and Moderna) was essentially complete.
It’s important to remember that mRNA vaccines were a promising, if unproven, line of inquiry for years before the pandemic hit; no one could say for sure that they even worked. But now BioNTech has announced that it’s ramping up development of a malaria vaccine using messenger RNA as the delivery mechanism, and Moderna and partners announced that they’re beginning trials of two mRNA candidate vaccines against H.I.V. Malaria kills roughly 400,000 people a year, H.I.V. nearly a million, and both diseases disproportionately affect the young. If the successful mass rollout of the Covid vaccines winds up accelerating the timeline for these other vaccines, the impact on human life will be enormous.
And just as the Great Influenza slowly nudged scientists toward the development of flu shots, which finally became commonplace in the 1940s, the Covid crisis will redirect vast sums of research dollars toward the development of universal vaccines to protect against all variants of both influenza and coronavirus. Given the relentless, year-in-and-year-out disease burden of flu around the world, a vaccine that reduced its virulence by an order of magnitude would be a life saver of historic proportions.
What about the more subtle psychological legacy of Covid? How will it change the way we perceive the world — and its risks — when the pandemic finally subsides? I have a memory from May of this year, taking my 17-year-old son to the Javits Center in Manhattan for his first vaccine, followed by a shopping trip to pick out a tie for his (masked, outdoor) senior prom. At some point waiting in line, I made a halfhearted joke about how we were embarking on the classic father-son ritual of heading out to the mass vaccination site to protect him from the plague. I meant it ironically, but the truth is that for my son’s generation, proms and plagues will be part of the rituals of growing up.
There is a loss of innocence in that, but also a hard-earned realism: the knowledge that rare high-risk events like pandemics are not just theoretically possible but likely, in an increasingly urban and interconnected world of nearly eight billion people. As a parent, you want to protect your children from unnecessary anxieties, but not when the threat in question is a real one. My son’s generation will forever take pandemics as a basic fact of life, and that assumption, painful as it is, will protect him when the next threat emerges. But maybe, if the science unleashed by this pandemic lives up to its promise, his children — or perhaps his grandchildren — could inherit a world where plagues are a thing of the past.
https://www.nytimes.com/2021/11/22/maga ... 778d3e6de3
Mass tragedies sometimes have unexpected consequences.
A mystery has long surrounded the Great Influenza of 1918-19. Why did a pandemic that killed upward of 50 million people, many of them otherwise healthy young adults, leave such a limited imprint on humanity’s cultural memory — especially in contrast to World War I, which killed less than half as many people? Countless novels and films and monuments investigate or commemorate the trauma that the Great War inflicted on modern consciousness, but the Great Influenza, having torn a deadly path around the world for two years, seemed to be forgotten nearly overnight.
Perhaps the best explanation stems from the century of progress that separates us from its victims. Most of the people alive during the 1918 outbreak were born during the 19th century, when death from infections was tragically familiar, when losing a third of your children to disease was the norm. To them, the mechanized carnage of World War I, with its fighter planes, machine guns and chemical weapons, was a step change in the history of human violence. A terrible flu virus sweeping through your town and killing some of your friends and family — in an age when it was much more difficult to perceive how global the outbreak was, given the limited scope of most news coverage — didn’t seem all that novel an experience by comparison.
We are not likely to experience the same cultural amnesia with Covid-19. The global population that encountered the SARS-CoV-2 virus had grown accustomed to a world where the burden of infectious disease has been greatly reduced. Before Covid, the most terrifying and deadly new virus to attack the United States was H.I.V., which managed to kill 100,000 Americans in its first eight years of spread here. Covid pulled off the same gruesome feat in four months. You could make the case that Covid will prove to be the true “great war” of the early 21st century — the source of so many genuinely new and terrifying experiences, seared into our collective memory: the hauntingly empty streets of Manhattan and Madrid, the corpses stacked in temporary freezers. Decades from now I suspect I will still be able to conjure the backdrop of incessant sirens in Brooklyn in late March 2020, the creeping terror of it all, the dreadful urgency of trying to make decisions to keep your family safe when so little was understood about the nature of the virus itself.
Whatever is coming next — and let’s hope it is a relatively untraumatic descent, with Covid becoming a manageable if endemic disease, no worse than the flu — this particular plague is going to leave a profound legacy.
Which then raises the question: What will that legacy be? There are many examples of mass tragedies that inspired meaningful reforms or scientific breakthroughs — steps forward in human progress that, in the end, most likely saved more lives than the original tragedy claimed. The deadly concentration of the 1854 cholera epidemic in London enabled John Snow to prove that cholera was a disease caused by contaminated water, even though the bacterium itself hadn’t been identified yet; Snow’s insight probably prevented tens of thousands of deaths in the decades that followed. The occupational safety regulations put in place after the Triangle Shirtwaist factory fire in 1911 undoubtedly saved more lives than the 146 lost in that tragedy.
Of course, for meaningful lessons to be learned from a tragedy — whether a factory fire or a pandemic — you have to begin by acknowledging the facts of the event itself. The rise of Covid denialism, in America and elsewhere, is often taken as a reason to doubt that any progress will grow out of the tragedy of Covid-19. But as depressing as anti-science belligerence can sometimes be, there is abundant evidence that we are learning from this epidemic. To begin with, the period from March 2020 to May 2020 almost certainly marked the most significant short-term change ever in worldwide human behavior. Vast sections of the planet effectively froze in place for a few months, and then adopted, en masse, a whole new set of routines to flatten the curve and slow the spread — a genuinely new trick for Homo sapiens. It was not obvious in advance that such a thing was even possible.
Imagine, if you can bear it, what happens the next time word emerges of a novel virus devastating a midsize city somewhere in the world. The slow-motion reaction that characterized the global response to the news from Wuhan in early 2020 would be radically accelerated. Even without public-health mandates, a significant part of the world’s population, particularly in cosmopolitan cities that were hit hard in the early days of Covid, would instantly mask up; where possible, workers would switch back to Zoom; unnecessary travel would cease. No doubt some portion of the population would play down the magnitude of the threat or invent a preposterous conspiracy theory to explain it. But a meaningful number of people would switch back into the “pandemic mode” they learned in 2020-21.
Think about how Covid might have been different if, say, 50 percent of the world’s urban population had switched into this mode on Feb. 1, 2020. Could this have stopped the virus in its tracks? Perhaps not. But it might have resulted in a global outbreak that looked more like South Korea’s experience, or San Francisco’s, with death rates a tiny fraction of what they ultimately proved to be.
We are learning from Covid in a more obvious way as well: through the lens of science. After the Great Influenza, it took 13 years — thanks to a young virologist named Richard Edwin Shope, who noticed veterinary reports about an unusual outbreak of swine flu among pigs in fall 1918 — to prove that the pandemic had been caused by a virus at all. The contrast with Covid could not be more extreme: We isolated the SARS-CoV-2 virus about 20 days after the outbreak was first reported. Just over a week later, its genome had been sequenced and shared around the world, and the blueprint for what would become the mRNA vaccines (the ones manufactured, ultimately, by Pfizer and Moderna) was essentially complete.
It’s important to remember that mRNA vaccines were a promising, if unproven, line of inquiry for years before the pandemic hit; no one could say for sure that they even worked. But now BioNTech has announced that it’s ramping up development of a malaria vaccine using messenger RNA as the delivery mechanism, and Moderna and partners announced that they’re beginning trials of two mRNA candidate vaccines against H.I.V. Malaria kills roughly 400,000 people a year, H.I.V. nearly a million, and both diseases disproportionately affect the young. If the successful mass rollout of the Covid vaccines winds up accelerating the timeline for these other vaccines, the impact on human life will be enormous.
And just as the Great Influenza slowly nudged scientists toward the development of flu shots, which finally became commonplace in the 1940s, the Covid crisis will redirect vast sums of research dollars toward the development of universal vaccines to protect against all variants of both influenza and coronavirus. Given the relentless, year-in-and-year-out disease burden of flu around the world, a vaccine that reduced its virulence by an order of magnitude would be a life saver of historic proportions.
What about the more subtle psychological legacy of Covid? How will it change the way we perceive the world — and its risks — when the pandemic finally subsides? I have a memory from May of this year, taking my 17-year-old son to the Javits Center in Manhattan for his first vaccine, followed by a shopping trip to pick out a tie for his (masked, outdoor) senior prom. At some point waiting in line, I made a halfhearted joke about how we were embarking on the classic father-son ritual of heading out to the mass vaccination site to protect him from the plague. I meant it ironically, but the truth is that for my son’s generation, proms and plagues will be part of the rituals of growing up.
There is a loss of innocence in that, but also a hard-earned realism: the knowledge that rare high-risk events like pandemics are not just theoretically possible but likely, in an increasingly urban and interconnected world of nearly eight billion people. As a parent, you want to protect your children from unnecessary anxieties, but not when the threat in question is a real one. My son’s generation will forever take pandemics as a basic fact of life, and that assumption, painful as it is, will protect him when the next threat emerges. But maybe, if the science unleashed by this pandemic lives up to its promise, his children — or perhaps his grandchildren — could inherit a world where plagues are a thing of the past.
https://www.nytimes.com/2021/11/22/maga ... 778d3e6de3
Europeans Ponder Living With, Not Defeating, Covid
On the eve of the biggest holidays in Europe, exhaustion with the pandemic is rising. So is resignation that the virus is endemic.
MADRID — Covid-19 infections were rising all across Spain, but the message from the country’s leader was clear: The government was not entering 2022 with the restrictions of 2020.
“The situation is different this time, and because of that, we’re taking different measures,” Pedro Sánchez, the prime minister, said this week, adding that he understood his people had grown impatient with the pandemic and that he was “fully aware of the fatigue.”
Across Europe, that fatigue is as palpable as the dampened Christmas spirit. The fatigue of another named variant of the coronavirus and another wave of infections. The fatigue of another grim year watching New Year’s Eve gatherings get canceled or curtailed, one by one.
But along with the exhaustion, another feeling is taking root: that the coronavirus will not be eradicated with vaccines or lockdowns, but has become something endemic that people must learn to live with, maybe for years to come.
“We’re tired, we’re inoculated and it’s not going anywhere,” said Caroline Orieux, who, despite surging Covid cases, had visited Paris with her nephews and nieces for a few days of vacation.
This week, the rough outlines of how Europe might manage its latest outbreak were taking shape, at least for now, driven by everything from politics to people’s desperation to move on, especially at Christmas. Full lockdowns have mainly given way to less intrusive — and less protective — measures.
Spain kept a light touch, issuing limited new requirements on Thursday, like mandating masks outdoors and increasing the vaccination drive.
Even Italy, which suffered a particularly cruel first wave, introduced new rules on Thursday that were far less rigid than those imposed during its worst days, shortening the time frame that health passes remained valid, making third shots indispensable; banning large outdoor events until the end of January; and opting for an outdoor mask mandate.
“Vaccines are and remain a fundamental weapon,” said Roberto Speranza, Italy’s health minister.
Beyond that, there is growing evidence that the new variant is more mild, at least for those who are vaccinated. Three studies — in South Africa, England and Scotland — all suggested that while the variant is more contagious, it likely results in a more mild illness.
And vaccines appear to be doing their jobs — reducing the risk of severe disease and hospitalization, according to recent studies.
Still, not everyone agrees with a scaled-down approach to fighting the virus, and it remains unclear if that notion will survive the possible Omicron crush of hospitalizations that many scientists fear. Even if most cases are mild, they argue, Omicron’s quick-fire spread could still lead to huge caseloads and overwhelming hospital admissions.
Antoine Flahault, the director of the Institute of Global Health in Geneva, said France’s strategy — which went little beyond health passes and had stopped short of imposing stricter measures like bar closures — was nowhere near what was needed to stave off a wave of Omicron cases.
“I think it’s not the most successful one from a health perspective, but also from a social and economic perspective,” he said, noting that a surge of new infections could disrupt health services as well as the country’s manufacturing and supply capacities.
Giovanni Maga, the director of the Institute of Molecular Genetics at Italy’s National Council for Research, noted that while hospitalizations were five times lower than they were last year — largely thanks to vaccines — that does not mean that the country is out of the woods.
“As Omicron is more infectious, contagions will rise,” he said.
Yet as the pandemic drags on, scientists are often losing out to politicians. And in the political and economic calculus that has become the core of public health messaging for weeks now, the Christmas season has loomed large.
Switzerland recently backtracked on travel restrictions to try to salvage a winter tourism season that is a cornerstone of its economy. In late November, it issued quarantine orders for travelers from Britain, the Netherlands and other countries where Omicron had spread — only to remove them, even as cases rose.
On Monday, the country also removed a requirement that travelers test after arriving, though it still requires negative tests before travel.
Asseghid Dinberu, the marketing director of the Victoria Hotel in the Swiss ski resort of Villars, said the Christmas season was feeling like “a lucky escape,” with only six of the hotel’s 138 rooms still vacant for Christmas Day, and the hotel fully booked for New Year’s.
“I’m glad that Switzerland has finally opted for a very pragmatic approach that will allow us to benefit economically compared to other countries,” he said.
Germany is coming out of a dramatic fourth wave that began in November, and although it is bracing for a wave of Omicron infections, government officials have played down the possibility of a surge in infections around Christmas gatherings. Many see that as an attempt to spare Germans from restrictions before their most important holiday.
“At the moment, we are in a strange interval,” Chancellor Olaf Scholz said Tuesday at a news conference. “The measures we put into place at the end of November are working.”
However, just before Mr. Scholz and state governors met to hammer out new measures this week, the Robert Koch Institute, Germany’s equivalent of the Centers for Disease Control and Prevention, called for strict lockdown measures to start immediately. The government did not adopt the measures.
The many conflicting messages have caused confusion among Europeans pining for the ease of Christmases past. Some carried on despite pangs of anxiety.
“I worry a bit because we don’t know much about Omicron,” Susanne Sesterer, 63, a retiree in Hanover, Germany, said on Thursday as she was doing her last shopping before Christmas. “But how much worse can it get?”
Others were giving up.
Dorotea Belli, a 42-year-old Italian who has had two vaccine doses, said she would not go to a family gathering for Christmas and instead stay home in Rome. Many of her colleagues had tested positive for the virus, she said, and her children, 4 and 1, are not eligible for vaccination.
“They and I will miss my parents very much,” she said. “But I don’t want to bring Covid around, and even if my husband and I are vaccinated, who knows?”
Spain’s calculus on new restrictions is not only factoring in the all-important holidays, but also legal barriers that emerged after measures taken by the government in 2020.
In July, Spain’s Constitutional Court ruled that the government did not have the authority to impose the lockdown measures that began in March 2020, which restricted Spaniards from leaving their homes except for essential trips like food shopping. Instead, the judges said, the measures required a full parliamentary vote, which few see passing with a majority in the future given how controversial the previous restrictions were.
“The government has its hands tied now,” said Luis Galán Soldevilla, a law professor at the University of Córdoba.
Spain’s lighter measures announced on Thursday received criticism from some sectors, like the Spanish Society of Public Health and Health Administration, a group that includes many health professionals.
“These measures don’t help much,” said Ildefonso Hernández, the group’s spokesman, saying limiting capacity indoors would be more effective. “It makes no sense that people walk the street with a mask and then take it off when they enter a bar.”
In Madrid, residents were charging ahead with their Christmas plans, despite the rising caseload and risks.
Fernando Sánchez, 55, a taxi driver, lost his mother and brother to Covid-19 six months ago. Nevertheless, he was unwilling to cancel his Christmas plans, which this year take place at the home of his in-laws, much as they had before the pandemic.
Antonio Jesús Navarro, 33, a software engineer, had been looking forward to spending Christmas with his girlfriend, who had traveled to Spain for the holidays from the United States. The two had not seen each other since before the pandemic began.
But then Mr. Navarro learned he had come into contact with someone who had tested positive for the coronavirus. The couple were isolating until he could get his own test results. He said he was frustrated with public messaging on how to stay safe from Omicron.
“Is an antigen test acceptable?” he said by telephone. “What happens if there are no symptoms?”
Hours later, Mr. Navarro called back to say he and his girlfriend had tested positive for Covid-19.
https://www.nytimes.com/2021/12/24/worl ... 778d3e6de3
On the eve of the biggest holidays in Europe, exhaustion with the pandemic is rising. So is resignation that the virus is endemic.
MADRID — Covid-19 infections were rising all across Spain, but the message from the country’s leader was clear: The government was not entering 2022 with the restrictions of 2020.
“The situation is different this time, and because of that, we’re taking different measures,” Pedro Sánchez, the prime minister, said this week, adding that he understood his people had grown impatient with the pandemic and that he was “fully aware of the fatigue.”
Across Europe, that fatigue is as palpable as the dampened Christmas spirit. The fatigue of another named variant of the coronavirus and another wave of infections. The fatigue of another grim year watching New Year’s Eve gatherings get canceled or curtailed, one by one.
But along with the exhaustion, another feeling is taking root: that the coronavirus will not be eradicated with vaccines or lockdowns, but has become something endemic that people must learn to live with, maybe for years to come.
“We’re tired, we’re inoculated and it’s not going anywhere,” said Caroline Orieux, who, despite surging Covid cases, had visited Paris with her nephews and nieces for a few days of vacation.
This week, the rough outlines of how Europe might manage its latest outbreak were taking shape, at least for now, driven by everything from politics to people’s desperation to move on, especially at Christmas. Full lockdowns have mainly given way to less intrusive — and less protective — measures.
Spain kept a light touch, issuing limited new requirements on Thursday, like mandating masks outdoors and increasing the vaccination drive.
Even Italy, which suffered a particularly cruel first wave, introduced new rules on Thursday that were far less rigid than those imposed during its worst days, shortening the time frame that health passes remained valid, making third shots indispensable; banning large outdoor events until the end of January; and opting for an outdoor mask mandate.
“Vaccines are and remain a fundamental weapon,” said Roberto Speranza, Italy’s health minister.
Beyond that, there is growing evidence that the new variant is more mild, at least for those who are vaccinated. Three studies — in South Africa, England and Scotland — all suggested that while the variant is more contagious, it likely results in a more mild illness.
And vaccines appear to be doing their jobs — reducing the risk of severe disease and hospitalization, according to recent studies.
Still, not everyone agrees with a scaled-down approach to fighting the virus, and it remains unclear if that notion will survive the possible Omicron crush of hospitalizations that many scientists fear. Even if most cases are mild, they argue, Omicron’s quick-fire spread could still lead to huge caseloads and overwhelming hospital admissions.
Antoine Flahault, the director of the Institute of Global Health in Geneva, said France’s strategy — which went little beyond health passes and had stopped short of imposing stricter measures like bar closures — was nowhere near what was needed to stave off a wave of Omicron cases.
“I think it’s not the most successful one from a health perspective, but also from a social and economic perspective,” he said, noting that a surge of new infections could disrupt health services as well as the country’s manufacturing and supply capacities.
Giovanni Maga, the director of the Institute of Molecular Genetics at Italy’s National Council for Research, noted that while hospitalizations were five times lower than they were last year — largely thanks to vaccines — that does not mean that the country is out of the woods.
“As Omicron is more infectious, contagions will rise,” he said.
Yet as the pandemic drags on, scientists are often losing out to politicians. And in the political and economic calculus that has become the core of public health messaging for weeks now, the Christmas season has loomed large.
Switzerland recently backtracked on travel restrictions to try to salvage a winter tourism season that is a cornerstone of its economy. In late November, it issued quarantine orders for travelers from Britain, the Netherlands and other countries where Omicron had spread — only to remove them, even as cases rose.
On Monday, the country also removed a requirement that travelers test after arriving, though it still requires negative tests before travel.
Asseghid Dinberu, the marketing director of the Victoria Hotel in the Swiss ski resort of Villars, said the Christmas season was feeling like “a lucky escape,” with only six of the hotel’s 138 rooms still vacant for Christmas Day, and the hotel fully booked for New Year’s.
“I’m glad that Switzerland has finally opted for a very pragmatic approach that will allow us to benefit economically compared to other countries,” he said.
Germany is coming out of a dramatic fourth wave that began in November, and although it is bracing for a wave of Omicron infections, government officials have played down the possibility of a surge in infections around Christmas gatherings. Many see that as an attempt to spare Germans from restrictions before their most important holiday.
“At the moment, we are in a strange interval,” Chancellor Olaf Scholz said Tuesday at a news conference. “The measures we put into place at the end of November are working.”
However, just before Mr. Scholz and state governors met to hammer out new measures this week, the Robert Koch Institute, Germany’s equivalent of the Centers for Disease Control and Prevention, called for strict lockdown measures to start immediately. The government did not adopt the measures.
The many conflicting messages have caused confusion among Europeans pining for the ease of Christmases past. Some carried on despite pangs of anxiety.
“I worry a bit because we don’t know much about Omicron,” Susanne Sesterer, 63, a retiree in Hanover, Germany, said on Thursday as she was doing her last shopping before Christmas. “But how much worse can it get?”
Others were giving up.
Dorotea Belli, a 42-year-old Italian who has had two vaccine doses, said she would not go to a family gathering for Christmas and instead stay home in Rome. Many of her colleagues had tested positive for the virus, she said, and her children, 4 and 1, are not eligible for vaccination.
“They and I will miss my parents very much,” she said. “But I don’t want to bring Covid around, and even if my husband and I are vaccinated, who knows?”
Spain’s calculus on new restrictions is not only factoring in the all-important holidays, but also legal barriers that emerged after measures taken by the government in 2020.
In July, Spain’s Constitutional Court ruled that the government did not have the authority to impose the lockdown measures that began in March 2020, which restricted Spaniards from leaving their homes except for essential trips like food shopping. Instead, the judges said, the measures required a full parliamentary vote, which few see passing with a majority in the future given how controversial the previous restrictions were.
“The government has its hands tied now,” said Luis Galán Soldevilla, a law professor at the University of Córdoba.
Spain’s lighter measures announced on Thursday received criticism from some sectors, like the Spanish Society of Public Health and Health Administration, a group that includes many health professionals.
“These measures don’t help much,” said Ildefonso Hernández, the group’s spokesman, saying limiting capacity indoors would be more effective. “It makes no sense that people walk the street with a mask and then take it off when they enter a bar.”
In Madrid, residents were charging ahead with their Christmas plans, despite the rising caseload and risks.
Fernando Sánchez, 55, a taxi driver, lost his mother and brother to Covid-19 six months ago. Nevertheless, he was unwilling to cancel his Christmas plans, which this year take place at the home of his in-laws, much as they had before the pandemic.
Antonio Jesús Navarro, 33, a software engineer, had been looking forward to spending Christmas with his girlfriend, who had traveled to Spain for the holidays from the United States. The two had not seen each other since before the pandemic began.
But then Mr. Navarro learned he had come into contact with someone who had tested positive for the coronavirus. The couple were isolating until he could get his own test results. He said he was frustrated with public messaging on how to stay safe from Omicron.
“Is an antigen test acceptable?” he said by telephone. “What happens if there are no symptoms?”
Hours later, Mr. Navarro called back to say he and his girlfriend had tested positive for Covid-19.
https://www.nytimes.com/2021/12/24/worl ... 778d3e6de3
As Protest Paralyzes Canada’s Capital, Far-Right Activists Abroad Embrace It
It may be only a few hundred demonstrators occupying Ottawa’s streets to protest government overreach, but their message has aroused passions around the world.
OTTAWA — Eleven days into an unruly occupation against coronavirus restrictions that has paralyzed Canada’s capital, the protests have become a rallying cry for powerful far-right and anti-vaccine groups around the world that have made the cause their own.
The demonstration in Ottawa started in January as a loosely organized convoy of truck drivers and protesters rumbling across the country to oppose the mandatory vaccination of truckers crossing the U.S.-Canada border. It soon attracted the support of other Canadians exhausted by nearly two years of pandemic restrictions.
Some were clearly on the fringe, wearing Nazi symbols and desecrating public monuments. But many described themselves as ordinary Canadians driven to take to the streets by desperation.
“They keep doing the same thing, and it’s not working,” said Nicole Vandelaar, a 31-year-old hairdresser protesting in the capital. “They have to do something else. No more lockdowns. Let us live our lives.”
On Sunday, after a weekend of boisterous demonstrations, the authorities in Ottawa declared a state of emergency and said the police were overwhelmed. “We continue to employ all available officers, there are no days off,” the Ottawa police chief, Peter Sloly, said Monday. “This is not sustainable.”
The message at the heart of the protests — that government has been overreaching for too long — has resonated far away across Canada’s borders.
Donors have contributed millions of dollars in online campaigns with hashtags, images and messages of support spreading widely across social media platforms.
The protest has also sparked discussion of similar demonstrations in the United States. American truckers are in the planning stages of launching their own convoy, from California to Washington, said Brian Brase, a trucker involved in organizing the effort.
More...
https://www.nytimes.com/2022/02/07/worl ... 778d3e6de3
It may be only a few hundred demonstrators occupying Ottawa’s streets to protest government overreach, but their message has aroused passions around the world.
OTTAWA — Eleven days into an unruly occupation against coronavirus restrictions that has paralyzed Canada’s capital, the protests have become a rallying cry for powerful far-right and anti-vaccine groups around the world that have made the cause their own.
The demonstration in Ottawa started in January as a loosely organized convoy of truck drivers and protesters rumbling across the country to oppose the mandatory vaccination of truckers crossing the U.S.-Canada border. It soon attracted the support of other Canadians exhausted by nearly two years of pandemic restrictions.
Some were clearly on the fringe, wearing Nazi symbols and desecrating public monuments. But many described themselves as ordinary Canadians driven to take to the streets by desperation.
“They keep doing the same thing, and it’s not working,” said Nicole Vandelaar, a 31-year-old hairdresser protesting in the capital. “They have to do something else. No more lockdowns. Let us live our lives.”
On Sunday, after a weekend of boisterous demonstrations, the authorities in Ottawa declared a state of emergency and said the police were overwhelmed. “We continue to employ all available officers, there are no days off,” the Ottawa police chief, Peter Sloly, said Monday. “This is not sustainable.”
The message at the heart of the protests — that government has been overreaching for too long — has resonated far away across Canada’s borders.
Donors have contributed millions of dollars in online campaigns with hashtags, images and messages of support spreading widely across social media platforms.
The protest has also sparked discussion of similar demonstrations in the United States. American truckers are in the planning stages of launching their own convoy, from California to Washington, said Brian Brase, a trucker involved in organizing the effort.
More...
https://www.nytimes.com/2022/02/07/worl ... 778d3e6de3
Re: Post Pandemic Thinking
We Must Learn to Look at Grief, Even When We Want to Run Away
Months ago, over Zoom, I told a patient’s wife that her husband was dying of Covid-19. She’d last seen him six weeks earlier when he first entered the hospital, but visitor restrictions had prevented her from being at his bedside.
I am a palliative medicine physician, and I met with her every week on a screen to guide her through the fog of grief as she made medical decisions for her husband. Covid had destroyed his lungs; he would most likely need a ventilator to breathe for him for the rest of his life. She said nothing for a long while. Then she told me he wouldn’t want to suffer anymore.
In the I.C.U. the next day, she wasn’t allowed to be at his side, but was given permission to see him from the other side of his room’s sliding doors. She stared at him, her slight frame swallowed by a billowing yellow P.P.E. gown. She removed her latex gloves and pressed her palms against the glass.
A nurse pushed pain medicine through his vein. The respiratory therapist removed his breathing tube in one graceful arc. My patient’s wife pressed harder against the door and inched closer. Her husband took slow, shallow breaths for a few minutes, and then he was still. She dropped her head and folded forward like paper curling toward the fire that consumes it. The imprint of her palms remained on the glass door.
More than 930,000 Americans have died of Covid-19. Many survivors still suffer from breathlessness, mind fog and debilitating fatigue. Though everyone was ground down by the continuance of the pandemic, we seem stuck in confusing divisiveness. Some people hesitate to see their elderly parents even when everyone is vaccinated, boosted and masked. Others suggest that it’s time to move on and find a new normal. We don’t have to be so divided. My work in palliative medicine offers a way to grapple with what has happened and to return more fully, together, to a world made smaller by who and what we have lost.
It’s natural and perhaps instinctive to want to look away from mortality, to deny its existence or banish it to a shadow world. But before us is an opportunity to examine, rather than bury, the loss and grief around us, even if — especially if — it is not our own.
Bearing witness is essential to everything I do in palliative care, be it treating a person’s cancer pain or discussing what matters most to them in their lives. I try to make visible to my patients and colleagues what is hard but necessary to see. Witnessing requires seeing another’s pain as no different from our own. This approach is a powerful way to move through the pandemic together.
In the throes of loss, people reach for certainty and control. My patient’s wife asked me what percentage of people as sick as her husband had survived and whether a risky therapy could promise life. I couldn’t offer her easy answers, only a willingness to stay and listen. Together, we wrestled with the burn of uncertainty. She shared photos of her husband over Zoom. They had sailed and cooked and taken selfies on the beach. Her photos said what words couldn’t. This is the person I have lost.
Earlier in my career, looking closely at this particular kind of pain was as blinding as looking at the sun. I distracted myself afterward with “S.N.L.” marathons and slabs of chocolate cake. Eventually, I realized that it wasn’t my job to protect people from their grief or to solve it.
I have learned to look when I want to look away. I have chosen to stay when I’d prefer to run out of the room and cry. The prelude to compassion is the willingness to see.
The memory of palm prints on that glass door cut through numbers and statistics and allowed me to process the human scale of suffering that had overwhelmed me throughout the pandemic. I thought about all the images of the past two years anew: body bags outside New York hospitals. Nurses using trash bags to protect themselves. Delhi’s skies darkened from mass cremations. Lists of my patients who died of Covid, most of whom were immigrants and people of color. The face of a teenager who stopped me outside my hospital and begged me to sit with her father because she wasn’t allowed inside.
This magnitude of suffering shook our world. Acknowledging it doesn’t require survivor’s guilt or forever dwelling on the past. We must allow ourselves to be moved by what happened and to understand that it happened, in different ways, to all of us.
One week before her husband died, my patient’s wife called to ask me how she could possibly move on with her life in a world where her husband didn’t exist anymore. I don’t believe in “moving on” and “finding closure.” This language distills the messy complexity of grief into tidy sound bites and asks people to leave something behind, bury it or lock it away. The challenge for my patients and their families is the challenge for all of us: Can we instead move forward with grief? Can we find a way to integrate loss into life, to carry it with us? Can we feel tragedy together, without an artificial line between those who are ready to move on and those who can’t see a way out?
We cannot simply be those who grieve and those who look away. To help one another, each of us must reach out, express condolences, write cards and offer to listen. Memorials can remind us that grief has affected people we see at the library or coffee shop. Sometimes we must endure the discomfort of seeing the pain of others without being able to intervene.
At different points over the past two years, so many of us pressed our palms against a glass door. We have pushed against what unfolded in front of us or tried desperately to grasp for what was six feet away, just out of reach. Covid may remain a pandemic for some time, or it may become endemic. But a change in nomenclature doesn’t mean we should forget the funeral pyres that burned like orange flowers, and it won’t change the fact that I didn’t make it to that teenager’s father before he died alone.
Our country can be united by seeing this suffering. We are all my patient and we are all his wife. Our collective grief, varied as our reactions to it may be, can bind us together when it seems like nothing else will. It is one lens through which we can recognize our shared humanity. None of this prevents life from moving forward, but it’s our best shot at bringing everybody along.
https://www.nytimes.com/2022/02/23/opin ... 778d3e6de3
Months ago, over Zoom, I told a patient’s wife that her husband was dying of Covid-19. She’d last seen him six weeks earlier when he first entered the hospital, but visitor restrictions had prevented her from being at his bedside.
I am a palliative medicine physician, and I met with her every week on a screen to guide her through the fog of grief as she made medical decisions for her husband. Covid had destroyed his lungs; he would most likely need a ventilator to breathe for him for the rest of his life. She said nothing for a long while. Then she told me he wouldn’t want to suffer anymore.
In the I.C.U. the next day, she wasn’t allowed to be at his side, but was given permission to see him from the other side of his room’s sliding doors. She stared at him, her slight frame swallowed by a billowing yellow P.P.E. gown. She removed her latex gloves and pressed her palms against the glass.
A nurse pushed pain medicine through his vein. The respiratory therapist removed his breathing tube in one graceful arc. My patient’s wife pressed harder against the door and inched closer. Her husband took slow, shallow breaths for a few minutes, and then he was still. She dropped her head and folded forward like paper curling toward the fire that consumes it. The imprint of her palms remained on the glass door.
More than 930,000 Americans have died of Covid-19. Many survivors still suffer from breathlessness, mind fog and debilitating fatigue. Though everyone was ground down by the continuance of the pandemic, we seem stuck in confusing divisiveness. Some people hesitate to see their elderly parents even when everyone is vaccinated, boosted and masked. Others suggest that it’s time to move on and find a new normal. We don’t have to be so divided. My work in palliative medicine offers a way to grapple with what has happened and to return more fully, together, to a world made smaller by who and what we have lost.
It’s natural and perhaps instinctive to want to look away from mortality, to deny its existence or banish it to a shadow world. But before us is an opportunity to examine, rather than bury, the loss and grief around us, even if — especially if — it is not our own.
Bearing witness is essential to everything I do in palliative care, be it treating a person’s cancer pain or discussing what matters most to them in their lives. I try to make visible to my patients and colleagues what is hard but necessary to see. Witnessing requires seeing another’s pain as no different from our own. This approach is a powerful way to move through the pandemic together.
In the throes of loss, people reach for certainty and control. My patient’s wife asked me what percentage of people as sick as her husband had survived and whether a risky therapy could promise life. I couldn’t offer her easy answers, only a willingness to stay and listen. Together, we wrestled with the burn of uncertainty. She shared photos of her husband over Zoom. They had sailed and cooked and taken selfies on the beach. Her photos said what words couldn’t. This is the person I have lost.
Earlier in my career, looking closely at this particular kind of pain was as blinding as looking at the sun. I distracted myself afterward with “S.N.L.” marathons and slabs of chocolate cake. Eventually, I realized that it wasn’t my job to protect people from their grief or to solve it.
I have learned to look when I want to look away. I have chosen to stay when I’d prefer to run out of the room and cry. The prelude to compassion is the willingness to see.
The memory of palm prints on that glass door cut through numbers and statistics and allowed me to process the human scale of suffering that had overwhelmed me throughout the pandemic. I thought about all the images of the past two years anew: body bags outside New York hospitals. Nurses using trash bags to protect themselves. Delhi’s skies darkened from mass cremations. Lists of my patients who died of Covid, most of whom were immigrants and people of color. The face of a teenager who stopped me outside my hospital and begged me to sit with her father because she wasn’t allowed inside.
This magnitude of suffering shook our world. Acknowledging it doesn’t require survivor’s guilt or forever dwelling on the past. We must allow ourselves to be moved by what happened and to understand that it happened, in different ways, to all of us.
One week before her husband died, my patient’s wife called to ask me how she could possibly move on with her life in a world where her husband didn’t exist anymore. I don’t believe in “moving on” and “finding closure.” This language distills the messy complexity of grief into tidy sound bites and asks people to leave something behind, bury it or lock it away. The challenge for my patients and their families is the challenge for all of us: Can we instead move forward with grief? Can we find a way to integrate loss into life, to carry it with us? Can we feel tragedy together, without an artificial line between those who are ready to move on and those who can’t see a way out?
We cannot simply be those who grieve and those who look away. To help one another, each of us must reach out, express condolences, write cards and offer to listen. Memorials can remind us that grief has affected people we see at the library or coffee shop. Sometimes we must endure the discomfort of seeing the pain of others without being able to intervene.
At different points over the past two years, so many of us pressed our palms against a glass door. We have pushed against what unfolded in front of us or tried desperately to grasp for what was six feet away, just out of reach. Covid may remain a pandemic for some time, or it may become endemic. But a change in nomenclature doesn’t mean we should forget the funeral pyres that burned like orange flowers, and it won’t change the fact that I didn’t make it to that teenager’s father before he died alone.
Our country can be united by seeing this suffering. We are all my patient and we are all his wife. Our collective grief, varied as our reactions to it may be, can bind us together when it seems like nothing else will. It is one lens through which we can recognize our shared humanity. None of this prevents life from moving forward, but it’s our best shot at bringing everybody along.
https://www.nytimes.com/2022/02/23/opin ... 778d3e6de3
Re: Post Pandemic Thinking
What Will Our Covid Future Be Like? Here Are Two Signs to Look Out For.
By Jeffrey Shaman
Dr. Shaman is an infectious disease modeler and epidemiologist at Columbia. His team built one of the first Covid-19 models.
Omicron cases, hospitalizations and deaths have been substantially declining across the United States for more than a month. In response, governors and mayors are rolling back restrictions like mask mandates and vaccine passports. Many wonder whether this period of low cases and decreasing demand on hospitals is a turning point in the pandemic or is simply a lull before a new variant causes another dangerous surge.
Even before Omicron swept across the world, scientists and public health officials pondered how Covid-19 would continue to affect society once the pandemic phase was behind us. It is the trillion-dollar question: Will outbreaks occur several times a year, once a year or every few years? And how much sickness and disease will those outbreaks produce?
Epidemiologists refer to the persistence of a pathogen in a community or population as endemicity. How endemicity manifests varies from pathogen to pathogen. In the United States, some respiratory viruses, such as influenza and respiratory syncytial virus, also known as RSV, are much more abundant during winter. These viruses regularly exact a toll on society in lost work, strained health care systems and deaths. An estimated 12,000 to 52,000 people die of the flu each year in the United States.
Yet not all respiratory viruses follow this pattern; some, such as rhinovirus, circulate year-round at lower levels and with less disruption to human health. Others, such as parainfluenza, may produce outbreaks more erratically or during other seasons.
So what will the pattern look like for SARS-CoV-2, the virus that causes Covid-19, once it becomes endemic? And how much disruption will it cause? The short answer is: We don’t know yet. The endemic pattern of any disease is more easily understood retrospectively, and the coronavirus has been with us for only about two years. However, there are signs and factors that we can all watch for, which provide indications of how Covid-19 will affect our lives in the seasons and years to come. Those signs are worth discussing and bookmarking in our brains as we move toward a more normal, functioning society.
An optimistic scenario is for SARS-CoV-2 to settle into a less disruptive flulike pattern, producing wintertime outbreaks with hospitalization and mortality rates lower than we saw in 2020 and 2021. A more pessimistic scenario is for the virus to continue to generate variants that evade immunity and are capable of infecting large numbers of the population.
While it is difficult to know how endemic coronavirus will manifest, there are two important characteristics worth monitoring in the coming months and years: the frequency and severity of outbreaks. These two factors will delineate the disruption caused by the coronavirus going forward.
The future frequency of coronavirus outbreaks is strongly linked to population immunity and how the virus changes. A population’s resistance to circulating variants depends on people’s history of infection, vaccination and boosting. Variants with only minor differences from a vaccine formulation or an older variant may not produce much disease. However, a variant with substantive changes — such as Omicron — may infect many people by evading immunity. During this past winter, many people who had good protection against Delta, the variant that Omicron displaced, were still susceptible to infection and disease from Omicron.
A big unknown is whether SARS-CoV-2 can continue to produce variants that skirt around the immune system like Delta and Omicron. If the virus has this capacity, outbreaks could occur several times a year, much like during 2021. This endemic pattern might hold for a few more years or indefinitely. On the other hand, if the capacity to produce highly immune evasive variants is tapped out, future versions of the virus might be less aggressive and produce fewer outbreaks, perhaps once a year during winter, much like the flu.
The severity of outbreaks will depend on a number of factors, including the intrinsic capacity of new variants to make people sick. To date, not all SARS-CoV-2 variants have produced identical levels of disease. Omicron, for instance, has typically produced milder illness.
A popular narrative is that the virus will become progressively milder over time and that perhaps Omicron is the first evidence of this progression. Unfortunately, this is most likely wishful thinking. Though Omicron has been milder, the next impactful variant could easily be more deadly, as Delta was.
While the virus is not driven toward becoming milder, other factors, like protection from prior infections, vaccinations, boosting and drugs, should help reduce disease severity, hospitalization rates, time spent in the hospital and the risk of death. For instance, mRNA vaccination has already reduced the likelihood of hospitalization and death roughly tenfold. It is important that vaccine effectiveness continues to be monitored and that vaccine formulations are updated as needed so that any loss of protection can be countered through boosting.
Given all this uncertainty, we should not become complacent. The coronavirus is wily and much more transmissible than influenza. We need to keep a watchful eye even though we now appear to be entering a lull in activity, because it is uncertain how long any lull will last. We shouldn’t assume Covid will ultimately become a mild flulike nuisance. Instead, stay prepared: Get vaccinated and boosted, listen to public health advisories, keep some at-home Covid tests on hand and use them if you’re exposed or feeling sick and mask up when needed. And keep an eye on the frequency and severity of future outbreaks.
https://www.nytimes.com/2022/03/04/opin ... 778d3e6de3
By Jeffrey Shaman
Dr. Shaman is an infectious disease modeler and epidemiologist at Columbia. His team built one of the first Covid-19 models.
Omicron cases, hospitalizations and deaths have been substantially declining across the United States for more than a month. In response, governors and mayors are rolling back restrictions like mask mandates and vaccine passports. Many wonder whether this period of low cases and decreasing demand on hospitals is a turning point in the pandemic or is simply a lull before a new variant causes another dangerous surge.
Even before Omicron swept across the world, scientists and public health officials pondered how Covid-19 would continue to affect society once the pandemic phase was behind us. It is the trillion-dollar question: Will outbreaks occur several times a year, once a year or every few years? And how much sickness and disease will those outbreaks produce?
Epidemiologists refer to the persistence of a pathogen in a community or population as endemicity. How endemicity manifests varies from pathogen to pathogen. In the United States, some respiratory viruses, such as influenza and respiratory syncytial virus, also known as RSV, are much more abundant during winter. These viruses regularly exact a toll on society in lost work, strained health care systems and deaths. An estimated 12,000 to 52,000 people die of the flu each year in the United States.
Yet not all respiratory viruses follow this pattern; some, such as rhinovirus, circulate year-round at lower levels and with less disruption to human health. Others, such as parainfluenza, may produce outbreaks more erratically or during other seasons.
So what will the pattern look like for SARS-CoV-2, the virus that causes Covid-19, once it becomes endemic? And how much disruption will it cause? The short answer is: We don’t know yet. The endemic pattern of any disease is more easily understood retrospectively, and the coronavirus has been with us for only about two years. However, there are signs and factors that we can all watch for, which provide indications of how Covid-19 will affect our lives in the seasons and years to come. Those signs are worth discussing and bookmarking in our brains as we move toward a more normal, functioning society.
An optimistic scenario is for SARS-CoV-2 to settle into a less disruptive flulike pattern, producing wintertime outbreaks with hospitalization and mortality rates lower than we saw in 2020 and 2021. A more pessimistic scenario is for the virus to continue to generate variants that evade immunity and are capable of infecting large numbers of the population.
While it is difficult to know how endemic coronavirus will manifest, there are two important characteristics worth monitoring in the coming months and years: the frequency and severity of outbreaks. These two factors will delineate the disruption caused by the coronavirus going forward.
The future frequency of coronavirus outbreaks is strongly linked to population immunity and how the virus changes. A population’s resistance to circulating variants depends on people’s history of infection, vaccination and boosting. Variants with only minor differences from a vaccine formulation or an older variant may not produce much disease. However, a variant with substantive changes — such as Omicron — may infect many people by evading immunity. During this past winter, many people who had good protection against Delta, the variant that Omicron displaced, were still susceptible to infection and disease from Omicron.
A big unknown is whether SARS-CoV-2 can continue to produce variants that skirt around the immune system like Delta and Omicron. If the virus has this capacity, outbreaks could occur several times a year, much like during 2021. This endemic pattern might hold for a few more years or indefinitely. On the other hand, if the capacity to produce highly immune evasive variants is tapped out, future versions of the virus might be less aggressive and produce fewer outbreaks, perhaps once a year during winter, much like the flu.
The severity of outbreaks will depend on a number of factors, including the intrinsic capacity of new variants to make people sick. To date, not all SARS-CoV-2 variants have produced identical levels of disease. Omicron, for instance, has typically produced milder illness.
A popular narrative is that the virus will become progressively milder over time and that perhaps Omicron is the first evidence of this progression. Unfortunately, this is most likely wishful thinking. Though Omicron has been milder, the next impactful variant could easily be more deadly, as Delta was.
While the virus is not driven toward becoming milder, other factors, like protection from prior infections, vaccinations, boosting and drugs, should help reduce disease severity, hospitalization rates, time spent in the hospital and the risk of death. For instance, mRNA vaccination has already reduced the likelihood of hospitalization and death roughly tenfold. It is important that vaccine effectiveness continues to be monitored and that vaccine formulations are updated as needed so that any loss of protection can be countered through boosting.
Given all this uncertainty, we should not become complacent. The coronavirus is wily and much more transmissible than influenza. We need to keep a watchful eye even though we now appear to be entering a lull in activity, because it is uncertain how long any lull will last. We shouldn’t assume Covid will ultimately become a mild flulike nuisance. Instead, stay prepared: Get vaccinated and boosted, listen to public health advisories, keep some at-home Covid tests on hand and use them if you’re exposed or feeling sick and mask up when needed. And keep an eye on the frequency and severity of future outbreaks.
https://www.nytimes.com/2022/03/04/opin ... 778d3e6de3
Re: Post Pandemic Thinking
Why Do Some People Never Get Covid?
By Daniela J. Lamas
Dr. Lamas, a contributing Opinion writer, is a pulmonary and critical-care physician at Brigham and Women’s Hospital in Boston.
This article is part of Times Opinion’s reflection on the two year mark of the coronavirus pandemic. Read more in a note from Alexandra Sifferlin, Opinion’s health and science editor, in our Opinion Today newsletter.
As an intensive care unit doctor, I often find myself thinking about the apparent randomness of infectious disease. Two people go out to dinner and have the same meal; one ends up in the emergency room with food poisoning, but the other does not. The seasonal flu runs through an entire family, except for one individual who remains healthy. A case of mono can be a bad memory for one person and turn into a death sentence for another. Doctors look for the vulnerabilities that we can see to explain these outcomes, like age, vaccination status and underlying conditions, but we are often left without answers.
The unpredictability of the coronavirus has made clear just how much we don’t know. Standing at the bedside in the Covid intensive care unit during the first wave, I wondered why young men without identifiable risk factors had become critically ill while their spouses and children were able to manage their symptoms at home. More recently, Omicron has swept through cities, infecting people at a far greater rate than before, and yet some continued to test negative — even if a roommate was positive.
Now physicians and researchers throughout the globe are asking, and attempting to answer, similar questions. Dr. Mayana Zatz was taking her usual stroll near her home in São Paulo, Brazil, when she realized she hadn’t seen one of her neighbors for several weeks. When she ran into his wife, Dr. Zatz learned that he had been sick at home with a high fever, a cough and flulike symptoms. Even then, in February 2020, these were telltale signs of Covid. The woman was caring for him by herself, without a mask, and though she had expected to fall ill, too, she was feeling just fine.
In the weeks that followed, Dr. Zatz, a geneticist at the University of São Paulo, could not stop thinking about her neighbors. Why had the woman not gotten sick? Could it be that she had avoided infection altogether? Or was she simply less severely affected by the coronavirus? Both her neighbors took coronavirus antibody tests and shared the results with Dr. Zatz; as expected, the man showed evidence of prior infection, but the woman did not.
Dr. Zatz spread the word that she wanted to study more discordant couples like her neighbors. She appeared on Brazilian television asking to hear from people who had shared a home and a bed with an infected partner but did not get sick. And to her great surprise, she was inundated with thousands of emails. Her neighbor’s story wasn’t so unusual, after all.
Since the World Health Organization declared Covid-19 a pandemic in March of 2020, almost exactly two years ago, scientists and health workers have learned a tremendous amount about the coronavirus. The uncertainty and fear of that first spring have given way to clear evidence for how best to treat those who fall ill. We understand routes of transmission, and in the United States we are lucky to have access to effective vaccines and testing. Many of us are fortunate to lead lives that are no longer so limited by this virus. But why some people do not become sick despite significant exposure remains a mystery — one of the most important of the pandemic. A global network of scientists, Zatz prominent among them, believes crucial clues may lie in our genes.
More...
https://www.nytimes.com/2022/03/08/opin ... 778d3e6de3
By Daniela J. Lamas
Dr. Lamas, a contributing Opinion writer, is a pulmonary and critical-care physician at Brigham and Women’s Hospital in Boston.
This article is part of Times Opinion’s reflection on the two year mark of the coronavirus pandemic. Read more in a note from Alexandra Sifferlin, Opinion’s health and science editor, in our Opinion Today newsletter.
As an intensive care unit doctor, I often find myself thinking about the apparent randomness of infectious disease. Two people go out to dinner and have the same meal; one ends up in the emergency room with food poisoning, but the other does not. The seasonal flu runs through an entire family, except for one individual who remains healthy. A case of mono can be a bad memory for one person and turn into a death sentence for another. Doctors look for the vulnerabilities that we can see to explain these outcomes, like age, vaccination status and underlying conditions, but we are often left without answers.
The unpredictability of the coronavirus has made clear just how much we don’t know. Standing at the bedside in the Covid intensive care unit during the first wave, I wondered why young men without identifiable risk factors had become critically ill while their spouses and children were able to manage their symptoms at home. More recently, Omicron has swept through cities, infecting people at a far greater rate than before, and yet some continued to test negative — even if a roommate was positive.
Now physicians and researchers throughout the globe are asking, and attempting to answer, similar questions. Dr. Mayana Zatz was taking her usual stroll near her home in São Paulo, Brazil, when she realized she hadn’t seen one of her neighbors for several weeks. When she ran into his wife, Dr. Zatz learned that he had been sick at home with a high fever, a cough and flulike symptoms. Even then, in February 2020, these were telltale signs of Covid. The woman was caring for him by herself, without a mask, and though she had expected to fall ill, too, she was feeling just fine.
In the weeks that followed, Dr. Zatz, a geneticist at the University of São Paulo, could not stop thinking about her neighbors. Why had the woman not gotten sick? Could it be that she had avoided infection altogether? Or was she simply less severely affected by the coronavirus? Both her neighbors took coronavirus antibody tests and shared the results with Dr. Zatz; as expected, the man showed evidence of prior infection, but the woman did not.
Dr. Zatz spread the word that she wanted to study more discordant couples like her neighbors. She appeared on Brazilian television asking to hear from people who had shared a home and a bed with an infected partner but did not get sick. And to her great surprise, she was inundated with thousands of emails. Her neighbor’s story wasn’t so unusual, after all.
Since the World Health Organization declared Covid-19 a pandemic in March of 2020, almost exactly two years ago, scientists and health workers have learned a tremendous amount about the coronavirus. The uncertainty and fear of that first spring have given way to clear evidence for how best to treat those who fall ill. We understand routes of transmission, and in the United States we are lucky to have access to effective vaccines and testing. Many of us are fortunate to lead lives that are no longer so limited by this virus. But why some people do not become sick despite significant exposure remains a mystery — one of the most important of the pandemic. A global network of scientists, Zatz prominent among them, believes crucial clues may lie in our genes.
More...
https://www.nytimes.com/2022/03/08/opin ... 778d3e6de3
Re: Post Pandemic Thinking
We Will Forget Much of the Pandemic. That’s a Good Thing.
By Scott A. Small
Dr. Small is the director of the Alzheimer’s Disease Research Center at Columbia University and the author of the book “Forgetting: The Benefits of Not Remembering.”
This article is part of Times Opinion’s reflection on the two year mark of the coronavirus pandemic. Read more in a note from Alexandra Sifferlin, Opinion’s health and science editor, in our Opinion Today newsletter.
As we approach another anniversary of the pandemic’s onset, many of us are reflecting on the past two years and thinking about the ways the virus has altered our lives. More than 950,000 Americans have died. Many more have lost a loved one, and millions are still grappling with the lingering aftereffects of infection.
As we begin to move toward a postpandemic future, it is vital that we remember the toll this virus has taken. The lessons of this pandemic should be carried with us so that — unlike what happened after the 1918 flu — it doesn’t fade from history, and so we can honor and memorialize those we have lost.
It is also inevitable that over time, many of our memories of these difficult years will fade. As a neuroscientist who studies memory and memory disorders like Alzheimer’s, I find this fact — perhaps counterintuitively — comforting. I have come to understand, through new research, that there is a danger in remembering too much and that forgetting is not only normal but in fact necessary for our mental health.
It used to be thought that forgetting anything — from minor things like the name of a casual acquaintance to the more painful loss of cherished memories experienced by my patients — was caused, to varying degrees, by a failure of the brain’s memory mechanisms. But new developments in neuroscience over the past decade or so refute this simple idea.
Neurons contain what are sometimes called nanomachines that are dedicated to the construction of new memories. But scientists have recently discovered that neurons are also endowed with a completely different set of nanomachines designed for the opposite purpose: to carefully disassemble — and thus forget — components of our stored memories.
In light of this new and growing body of research, normal everyday forgetting can no longer be thought of as a malfunction of our memory machinery; instead it should be considered a healthy and adaptive part of our brain’s normal functioning. Memory and forgetting work in unison. We depend on our memory to record, to learn and to recall, and we depend on forgetting to countervail, to sculpt and to squelch our memories. This balancing act is, as it turns out, vital for our cognitive functioning, creativity and mental health.
Of course, there are unhealthy kinds of forgetting. Alzheimer’s disease, for one, targets memory mechanisms and causes them to fail. But in other disorders, it appears that the brain’s forgetting mechanisms break down. The psychological condition that perhaps best exemplifies what can happen when people don’t forget properly is PTSD. While it is often beneficial to remember the facts of a traumatic experience, sometimes even in pointillist detail, it is equally — if not more — important to the healing process to let the emotional valence of it fade. If we don’t, we can get stuck in total emotional recall, reviving our distress in perpetuity.
Forgetting protects us from this debilitating anxiety not by deleting memories but by quieting their emotional scream. The same is true for more run-of-the-mill emotions. Intuitively, it makes sense that we sometimes need to “let go” of hurt and resentment to preserve close friendships and that we need to forget in order to forgive. “Letting go” is just one of the many colloquialisms that implicitly nod in recognition and gratitude toward our brain’s forgetting mechanisms.
In patients with PTSD, the area of the brain that stores fear memories is highly active, suggesting that the individual cannot properly engage the brain’s fear forgetting system and therefore cannot let go of the high anxiety associated with the memory of the traumatic event. Complex disorders should not be oversimplified, but it is possible to think about PTSD as a disorder stemming from too much memory, caused by an inability to forget a traumatic experience in a healthy way.
Turning down activity in this brain region effectively induces a healthy ability to forget feelings of fear. Drugs like MDMA do just that and are being tested as a treatment for PTSD. Some couples therapists have even used MDMA to accelerate the “forgetting and forgiving” process in their patients. From the testimonials of recreational users, quieting fear-related memories is apparently so potent in its “prosocial” effects — making people friendlier, more compassionate, even more loving — that it underscores how unchecked fear memories can make people antisocial and miserable.
Of course, we won’t — and shouldn’t — forget the pandemic. We should commemorate the selfless commitment of our fellow health care workers, and rewrite our government and medical manuals so that we are able to respond better and faster next time. But for many of us, particularly those on the front line, some degree of emotional forgetting will be a natural part of living in and moving forward from the pandemic.
As a society, one of the most beneficial things we can do to move forward in a healthy way will be to resume safe socializing. Several studies have shown that social isolation exacerbates the negative effects of trauma. Because this particular pandemic required us to socially isolate, we couldn’t make use of the most psychologically beneficial coping mechanism: gathering together.
One of the greatest risk factors for PTSD in soldiers is when, shortly post-trauma, they find themselves socially isolated, their minds exposed without a social fabric to protect them from the lashing loops of their fear and dread. Not every observation about the mind needs a neurological explanation, but it is nevertheless true that socializing causes our brains to secrete endogenous chemicals like oxytocin, which — similar to MDMA — induces fear forgetting. Gazing into one another’s eyes is all that is needed for oxytocin to be simultaneously secreted in the gazer and the gazed-upon, a feedback loop that induces a socially uplifting pas de deux. Preventing social isolation has become part of the standard of care for those returning from the battlefield and deemed at risk for PTSD.
We can predict that when it’s safe to do so, relaxing the recommendations for social isolation, encouraging people to get together at work, in schools and other social venues, will reduce the risk of long-lasting distress.
With luck, in the months and years ahead, the threat of the virus will abate and we will be able to let go of the fear that for many of us has been a near-constant companion over the past two years. With hope, the terrifying images of the pandemic’s ravages — the empty streets and crowded hospitals, the funeral pyres and freezer trucks — will cease to loom so large in our collective memory.
Forgetting some of this fear will allow us to more clearly recall the details we want to remember. For me, those include the astonishing resilience, bravery and sense of collective spirit that emerged two years ago this week as my hometown became an epicenter of this pandemic. Those memories make me hopeful for the future.
https://www.nytimes.com/2022/03/09/opin ... 778d3e6de3
By Scott A. Small
Dr. Small is the director of the Alzheimer’s Disease Research Center at Columbia University and the author of the book “Forgetting: The Benefits of Not Remembering.”
This article is part of Times Opinion’s reflection on the two year mark of the coronavirus pandemic. Read more in a note from Alexandra Sifferlin, Opinion’s health and science editor, in our Opinion Today newsletter.
As we approach another anniversary of the pandemic’s onset, many of us are reflecting on the past two years and thinking about the ways the virus has altered our lives. More than 950,000 Americans have died. Many more have lost a loved one, and millions are still grappling with the lingering aftereffects of infection.
As we begin to move toward a postpandemic future, it is vital that we remember the toll this virus has taken. The lessons of this pandemic should be carried with us so that — unlike what happened after the 1918 flu — it doesn’t fade from history, and so we can honor and memorialize those we have lost.
It is also inevitable that over time, many of our memories of these difficult years will fade. As a neuroscientist who studies memory and memory disorders like Alzheimer’s, I find this fact — perhaps counterintuitively — comforting. I have come to understand, through new research, that there is a danger in remembering too much and that forgetting is not only normal but in fact necessary for our mental health.
It used to be thought that forgetting anything — from minor things like the name of a casual acquaintance to the more painful loss of cherished memories experienced by my patients — was caused, to varying degrees, by a failure of the brain’s memory mechanisms. But new developments in neuroscience over the past decade or so refute this simple idea.
Neurons contain what are sometimes called nanomachines that are dedicated to the construction of new memories. But scientists have recently discovered that neurons are also endowed with a completely different set of nanomachines designed for the opposite purpose: to carefully disassemble — and thus forget — components of our stored memories.
In light of this new and growing body of research, normal everyday forgetting can no longer be thought of as a malfunction of our memory machinery; instead it should be considered a healthy and adaptive part of our brain’s normal functioning. Memory and forgetting work in unison. We depend on our memory to record, to learn and to recall, and we depend on forgetting to countervail, to sculpt and to squelch our memories. This balancing act is, as it turns out, vital for our cognitive functioning, creativity and mental health.
Of course, there are unhealthy kinds of forgetting. Alzheimer’s disease, for one, targets memory mechanisms and causes them to fail. But in other disorders, it appears that the brain’s forgetting mechanisms break down. The psychological condition that perhaps best exemplifies what can happen when people don’t forget properly is PTSD. While it is often beneficial to remember the facts of a traumatic experience, sometimes even in pointillist detail, it is equally — if not more — important to the healing process to let the emotional valence of it fade. If we don’t, we can get stuck in total emotional recall, reviving our distress in perpetuity.
Forgetting protects us from this debilitating anxiety not by deleting memories but by quieting their emotional scream. The same is true for more run-of-the-mill emotions. Intuitively, it makes sense that we sometimes need to “let go” of hurt and resentment to preserve close friendships and that we need to forget in order to forgive. “Letting go” is just one of the many colloquialisms that implicitly nod in recognition and gratitude toward our brain’s forgetting mechanisms.
In patients with PTSD, the area of the brain that stores fear memories is highly active, suggesting that the individual cannot properly engage the brain’s fear forgetting system and therefore cannot let go of the high anxiety associated with the memory of the traumatic event. Complex disorders should not be oversimplified, but it is possible to think about PTSD as a disorder stemming from too much memory, caused by an inability to forget a traumatic experience in a healthy way.
Turning down activity in this brain region effectively induces a healthy ability to forget feelings of fear. Drugs like MDMA do just that and are being tested as a treatment for PTSD. Some couples therapists have even used MDMA to accelerate the “forgetting and forgiving” process in their patients. From the testimonials of recreational users, quieting fear-related memories is apparently so potent in its “prosocial” effects — making people friendlier, more compassionate, even more loving — that it underscores how unchecked fear memories can make people antisocial and miserable.
Of course, we won’t — and shouldn’t — forget the pandemic. We should commemorate the selfless commitment of our fellow health care workers, and rewrite our government and medical manuals so that we are able to respond better and faster next time. But for many of us, particularly those on the front line, some degree of emotional forgetting will be a natural part of living in and moving forward from the pandemic.
As a society, one of the most beneficial things we can do to move forward in a healthy way will be to resume safe socializing. Several studies have shown that social isolation exacerbates the negative effects of trauma. Because this particular pandemic required us to socially isolate, we couldn’t make use of the most psychologically beneficial coping mechanism: gathering together.
One of the greatest risk factors for PTSD in soldiers is when, shortly post-trauma, they find themselves socially isolated, their minds exposed without a social fabric to protect them from the lashing loops of their fear and dread. Not every observation about the mind needs a neurological explanation, but it is nevertheless true that socializing causes our brains to secrete endogenous chemicals like oxytocin, which — similar to MDMA — induces fear forgetting. Gazing into one another’s eyes is all that is needed for oxytocin to be simultaneously secreted in the gazer and the gazed-upon, a feedback loop that induces a socially uplifting pas de deux. Preventing social isolation has become part of the standard of care for those returning from the battlefield and deemed at risk for PTSD.
We can predict that when it’s safe to do so, relaxing the recommendations for social isolation, encouraging people to get together at work, in schools and other social venues, will reduce the risk of long-lasting distress.
With luck, in the months and years ahead, the threat of the virus will abate and we will be able to let go of the fear that for many of us has been a near-constant companion over the past two years. With hope, the terrifying images of the pandemic’s ravages — the empty streets and crowded hospitals, the funeral pyres and freezer trucks — will cease to loom so large in our collective memory.
Forgetting some of this fear will allow us to more clearly recall the details we want to remember. For me, those include the astonishing resilience, bravery and sense of collective spirit that emerged two years ago this week as my hometown became an epicenter of this pandemic. Those memories make me hopeful for the future.
https://www.nytimes.com/2022/03/09/opin ... 778d3e6de3
Re: Post Pandemic Thinking
What Long Covid Shows Us About the Limits of Medicine
By Abigail A. Dumes
Dr. Dumes is a medical and cultural anthropologist and an assistant professor of women’s and gender studies at the University of Michigan.
Long Covid symptoms, such as fatigue, shortness of breath, cognitive difficulties, erratic heart rate, headache and dizziness, can be debilitating and wide-ranging. There is uncertainty about what ultimately causes long Covid and how to adequately respond to it.
In conventional medicine, illnesses without definitive markers of disease are often described as “medically unexplained.” As a medical anthropologist who has studied the controversy over whether treated Lyme disease can become chronic, I’ve been struck by the similarities between long Covid and other contested illnesses like chronic Lyme disease and myalgic encephalomyelitis, more familiarly known as chronic fatigue syndrome.
Patients with contested illnesses can often feel unseen and unheard, and their providers often feel frustrated that they can’t do more. As patient advocacy movements have emerged, so has scientific disagreement about what causes these illnesses and how to address them. Contested illnesses pull back the curtain on medicine itself: how it understands the human body, what counts as evidence and how medicine draws on that evidence to produce medical truths.
Long Covid has a bigger spotlight than other contested illnesses and was recognized much faster. Post-Covid clinics have been established in nearly every state, the National Institutes of Health have invested $1.15 billion to study it, and it’s now included in the Americans With Disabilities Act. Long Covid has brought increased attention to other marginalized illnesses, along with hope that the needle might finally be moved on overdue research and funding.
At the heart of conventional medicine is a foundational distinction between symptoms and signs. Symptoms like fatigue and joint pain are subjective markers of disease, while signs like fever and arthritis are considered objective markers. Unlike symptoms, signs can be observed and measured by a practitioner, often with the aid of technologies such as blood tests and radiologic imaging.
When it comes to making a diagnosis, signs trump symptoms. This enduring hierarchy can be traced to the late 18th and early 19th centuries in the United States and Europe, when physicians who had relied on external symptoms for diagnosis shifted to a focus on internal anatomy and pathology by using technologies like microscopes. The French philosopher Michel Foucault observed that during that time, medicine transitioned from a practice in which the physician asked, “What’s the matter with you?” to a practice in which the physician asked, “Where does it hurt?” The first question invites a patient’s description of symptoms; the second question leads to a location on the patient’s body that can be observed and measured by the physician.
The diagnostic importance of signs over symptoms was further cemented in the late 1980s and early 1990s with the establishment of evidence-based medicine. It aims to standardize clinical care through guidelines and a pecking order of scientific evidence, with objective evidence of randomized controlled trials at the top and subjective evidence of expert opinion at the bottom. The shift to evidence-based medicine solidified objective evidence as the strongest and most legitimate basis for the diagnosis of disease and reinforced contested illnesses as “medically unexplained,” a term that has often been used to describe physical distress caused by mental illness.
In the same way that conventional medicine prioritizes signs over symptoms, it often prioritizes mortality (risk of death) over morbidity (a diminished quality of life). During interviews, mainstream Lyme disease physicians and scientists often told me that “no one dies from Lyme.” Because Lyme disease is rarely fatal, the thinking goes, there are doubts about the extent to which it compromises the quality of life of those who suffer from it.
The death toll from Covid-19 has been staggering and disproportionate. But medicine’s emphasis on mortality over morbidity has consequences for how suffering is measured as well as the efforts undertaken to prevent disease transmission and the thresholds used for determining when the pandemic is over. If we expand suffering’s metric to include long Covid morbidity, then individual and collective decision making would not only take into account the risk of hospitalization and death but would also include the risk of long Covid.
When patients with contested illnesses don’t find answers in conventional medicine, they often seek out the symptom-centered practices of complementary and alternative medicine. One mainstream Lyme physician I interviewed surmised that although he did not “believe in alternative medicine,” patients’ gravitation toward it was a result of conventional medicine’s “failure to treat the symptoms that they have.” Validating patients’ symptomatic experience, even if the cause is unknown, is one possible remedy.
Patients with contested and chronic illnesses also tend to have long medical histories. These patients need longer than 15 minutes to tell their story, and providers need more than 15 minutes to listen to them. A broad-scale investment in primary care that would allow providers to offer longer appointments that are fully covered by insurance would help to address this need. Additionally, medical schools should introduce a social science-informed understanding of contested illnesses. Despite seeming marginal, “medically unexplained” illnesses are actually some of the most frequently seen conditions in primary care. The more familiar physicians are with these illnesses, the fewer opportunities there will be for misunderstanding.
“Acknowledging uncertainty” — what long Covid patients have called for — is a fitting refrain for our times. As much as they wanted answers, the Lyme patients I interviewed also wanted physicians who could admit what they didn’t know. Starting with what we don’t know — and leading with humility and empathy — seems like a good place to begin.
https://www.nytimes.com/2022/03/17/opin ... 778d3e6de3
By Abigail A. Dumes
Dr. Dumes is a medical and cultural anthropologist and an assistant professor of women’s and gender studies at the University of Michigan.
Long Covid symptoms, such as fatigue, shortness of breath, cognitive difficulties, erratic heart rate, headache and dizziness, can be debilitating and wide-ranging. There is uncertainty about what ultimately causes long Covid and how to adequately respond to it.
In conventional medicine, illnesses without definitive markers of disease are often described as “medically unexplained.” As a medical anthropologist who has studied the controversy over whether treated Lyme disease can become chronic, I’ve been struck by the similarities between long Covid and other contested illnesses like chronic Lyme disease and myalgic encephalomyelitis, more familiarly known as chronic fatigue syndrome.
Patients with contested illnesses can often feel unseen and unheard, and their providers often feel frustrated that they can’t do more. As patient advocacy movements have emerged, so has scientific disagreement about what causes these illnesses and how to address them. Contested illnesses pull back the curtain on medicine itself: how it understands the human body, what counts as evidence and how medicine draws on that evidence to produce medical truths.
Long Covid has a bigger spotlight than other contested illnesses and was recognized much faster. Post-Covid clinics have been established in nearly every state, the National Institutes of Health have invested $1.15 billion to study it, and it’s now included in the Americans With Disabilities Act. Long Covid has brought increased attention to other marginalized illnesses, along with hope that the needle might finally be moved on overdue research and funding.
At the heart of conventional medicine is a foundational distinction between symptoms and signs. Symptoms like fatigue and joint pain are subjective markers of disease, while signs like fever and arthritis are considered objective markers. Unlike symptoms, signs can be observed and measured by a practitioner, often with the aid of technologies such as blood tests and radiologic imaging.
When it comes to making a diagnosis, signs trump symptoms. This enduring hierarchy can be traced to the late 18th and early 19th centuries in the United States and Europe, when physicians who had relied on external symptoms for diagnosis shifted to a focus on internal anatomy and pathology by using technologies like microscopes. The French philosopher Michel Foucault observed that during that time, medicine transitioned from a practice in which the physician asked, “What’s the matter with you?” to a practice in which the physician asked, “Where does it hurt?” The first question invites a patient’s description of symptoms; the second question leads to a location on the patient’s body that can be observed and measured by the physician.
The diagnostic importance of signs over symptoms was further cemented in the late 1980s and early 1990s with the establishment of evidence-based medicine. It aims to standardize clinical care through guidelines and a pecking order of scientific evidence, with objective evidence of randomized controlled trials at the top and subjective evidence of expert opinion at the bottom. The shift to evidence-based medicine solidified objective evidence as the strongest and most legitimate basis for the diagnosis of disease and reinforced contested illnesses as “medically unexplained,” a term that has often been used to describe physical distress caused by mental illness.
In the same way that conventional medicine prioritizes signs over symptoms, it often prioritizes mortality (risk of death) over morbidity (a diminished quality of life). During interviews, mainstream Lyme disease physicians and scientists often told me that “no one dies from Lyme.” Because Lyme disease is rarely fatal, the thinking goes, there are doubts about the extent to which it compromises the quality of life of those who suffer from it.
The death toll from Covid-19 has been staggering and disproportionate. But medicine’s emphasis on mortality over morbidity has consequences for how suffering is measured as well as the efforts undertaken to prevent disease transmission and the thresholds used for determining when the pandemic is over. If we expand suffering’s metric to include long Covid morbidity, then individual and collective decision making would not only take into account the risk of hospitalization and death but would also include the risk of long Covid.
When patients with contested illnesses don’t find answers in conventional medicine, they often seek out the symptom-centered practices of complementary and alternative medicine. One mainstream Lyme physician I interviewed surmised that although he did not “believe in alternative medicine,” patients’ gravitation toward it was a result of conventional medicine’s “failure to treat the symptoms that they have.” Validating patients’ symptomatic experience, even if the cause is unknown, is one possible remedy.
Patients with contested and chronic illnesses also tend to have long medical histories. These patients need longer than 15 minutes to tell their story, and providers need more than 15 minutes to listen to them. A broad-scale investment in primary care that would allow providers to offer longer appointments that are fully covered by insurance would help to address this need. Additionally, medical schools should introduce a social science-informed understanding of contested illnesses. Despite seeming marginal, “medically unexplained” illnesses are actually some of the most frequently seen conditions in primary care. The more familiar physicians are with these illnesses, the fewer opportunities there will be for misunderstanding.
“Acknowledging uncertainty” — what long Covid patients have called for — is a fitting refrain for our times. As much as they wanted answers, the Lyme patients I interviewed also wanted physicians who could admit what they didn’t know. Starting with what we don’t know — and leading with humility and empathy — seems like a good place to begin.
https://www.nytimes.com/2022/03/17/opin ... 778d3e6de3
Re: Post Pandemic Thinking
We Study Virus Evolution. Here’s Where We Think the Corona virus Is Going.
By Sarah Cobey, Jesse Bloom, Tyler Starr and Nathaniel Lash
Dr. Cobey studies the interaction of immunity, virus evolution and transmission at the University of Chicago. Dr. Bloom and Dr. Starr study virus evolution at Fred Hutchinson Cancer Research Center in Seattle. Mr. Lash is a graphics editor for Opinion.
As scientists who study how viruses evolve, we are often asked about the future of the coronavirus. Will it go away? Get worse? Fade into the background of our lives? Become seasonal like the flu?
Here’s what we know: The virus’s Omicron variant was significantly more infectious and more resistant to vaccines than the original strain that first emerged in Wuhan, China. There’s no reason, at least biologically, that the virus won’t continue to evolve. The coronavirus variants that have emerged thus far sample only a fraction of the genetic space that is most likely available for evolutionary exploration.
A virus like SARS-CoV-2 faces one overriding pressure: to become better at spreading. Viruses that cause more infections will be more successful. The virus can do this by becoming more contagious and by skirting the immune system. This coronavirus has undergone several adaptations that make it better at spreading in humans.
But although many scientists, including us, expected SARS-CoV-2 would be under evolutionary pressure to transmit better, it’s been remarkable just how well the virus has responded to that pressure. Recent variants like Omicron and Delta are several times more transmissible than the strain that first spread around the globe in early 2020. That’s a huge increase, and makes SARS-CoV-2 more contagious than many other human respiratory viruses. These big jumps in contagiousness have played a major role in driving the pandemic so far.
How the coronavirus has mutated
Comparing coronavirus variants to early 2020 strains.
Estimated reduction in antibody effectiveness
Sources: Contagiousness is based on estimates of growth advantage by Marlin Figgins and Trevor Bedford. Antibody escape is based on antibody sera collected from patients treated with the Moderna vaccine. Note: Figures are approximate. Figures for Omicron reflect the variant’s BA.1 lineage and are extrapolated based on findings of a 105 percent growth advantage by Omicron compared to Delta.
How much more transmissible SARS-CoV-2 can become is an open question, but there are limits. Even evolution is constrained: a cheetah can’t evolve to be infinitely fast, and SARS-CoV-2 won’t become infinitely transmissible.
Other viruses have reached plateaus in their ability to spread. Some respiratory viruses such as measles are more contagious than today’s SARS-CoV-2. Others, such as influenza, are generally not as contagious as SARS-CoV-2. We don’t know when this coronavirus will hit its transmissibility plateau, but it will happen eventually.
Viruses such as this one can also spread better by “escaping” immunity to prior variants. Early in the pandemic, few people had immunity to SARS-CoV-2. But now much of the world has antibodies from vaccination or prior infection. Because these antibodies can block infection, variants with mutations that skirt them have an increasing advantage.
The importance of immune escape has become apparent with Omicron. Prior variants like Delta were only modestly able to sidestep antibodies, but Omicron has many mutations that reduce the ability of antibodies to recognize it. This, coupled with how contagious Omicron is, has enabled it to cause a huge wave of infections.
The fact that the virus developed the ability to infect people who had been vaccinated or previously infected shouldn’t have been a surprise, but how it happened with Omicron certainly was. Evolution often proceeds stepwise, with new successful variants descended from recent successful ones. That’s why six months ago many scientists, including us, thought the next variant would descend from Delta, which was dominant at the time. But evolution defied our expectations, and we got Omicron, which has a huge number of mutations and isn’t descended from Delta. It’s not known exactly how the virus made the big evolutionary jump that led to Omicron, although many scientists (including us) suspect the variant may have emerged from someone who couldn’t fight off the virus well, allowing it time to mutate.
It’s impossible to say whether future variants will have more big Omicron-like jumps or more typical stepwise changes, but we are confident SARS-CoV-2 will continue to evolve to escape immunity.
While transmissibility of viruses does plateau at a certain point, other human viruses that escape immunity keep doing so. The influenza vaccine has been updated annually for decades to chase viral evolution, and some influenza viruses show no sign of slowing down. Immune escape is an endless evolutionary arms race, because the immune system can always make new antibodies and the virus has a vast set of mutations to explore in response. For instance, Omicron has just a tiny fraction of the many mutations that have been observed in SARS-CoV-2 or related bat viruses, which are in turn just a small fraction of what lab experiments suggest the virus could potentially explore.
Taking all this together, we expect SARS-CoV-2 will continue to cause new epidemics, but they will increasingly be driven by the ability to skirt the immune system. In this sense, the future may look something like the seasonal flu, where new variants cause waves of cases each year. If this happens, which we expect it will, vaccines may need to be updated regularly similar to the flu vaccines unless we develop broader variant-proof vaccines.
And of course, how much all this matters for public health depends on how sick the virus makes us. That is the hardest prediction to make, because evolution selects for viruses that spread well, and whether that makes disease severity go up or down is mostly a matter of luck. But we do know that immunity reduces disease severity even when it doesn’t fully block infections and spread, and immunity gained from vaccination and prior infections has helped blunt the impact of the Omicron wave in many countries. Updated or improved vaccines and other measures that slow transmission remain our best strategies for handling an uncertain evolutionary future.
https://www.nytimes.com/interactive/202 ... 778d3e6de3
By Sarah Cobey, Jesse Bloom, Tyler Starr and Nathaniel Lash
Dr. Cobey studies the interaction of immunity, virus evolution and transmission at the University of Chicago. Dr. Bloom and Dr. Starr study virus evolution at Fred Hutchinson Cancer Research Center in Seattle. Mr. Lash is a graphics editor for Opinion.
As scientists who study how viruses evolve, we are often asked about the future of the coronavirus. Will it go away? Get worse? Fade into the background of our lives? Become seasonal like the flu?
Here’s what we know: The virus’s Omicron variant was significantly more infectious and more resistant to vaccines than the original strain that first emerged in Wuhan, China. There’s no reason, at least biologically, that the virus won’t continue to evolve. The coronavirus variants that have emerged thus far sample only a fraction of the genetic space that is most likely available for evolutionary exploration.
A virus like SARS-CoV-2 faces one overriding pressure: to become better at spreading. Viruses that cause more infections will be more successful. The virus can do this by becoming more contagious and by skirting the immune system. This coronavirus has undergone several adaptations that make it better at spreading in humans.
But although many scientists, including us, expected SARS-CoV-2 would be under evolutionary pressure to transmit better, it’s been remarkable just how well the virus has responded to that pressure. Recent variants like Omicron and Delta are several times more transmissible than the strain that first spread around the globe in early 2020. That’s a huge increase, and makes SARS-CoV-2 more contagious than many other human respiratory viruses. These big jumps in contagiousness have played a major role in driving the pandemic so far.
How the coronavirus has mutated
Comparing coronavirus variants to early 2020 strains.
Estimated reduction in antibody effectiveness
Sources: Contagiousness is based on estimates of growth advantage by Marlin Figgins and Trevor Bedford. Antibody escape is based on antibody sera collected from patients treated with the Moderna vaccine. Note: Figures are approximate. Figures for Omicron reflect the variant’s BA.1 lineage and are extrapolated based on findings of a 105 percent growth advantage by Omicron compared to Delta.
How much more transmissible SARS-CoV-2 can become is an open question, but there are limits. Even evolution is constrained: a cheetah can’t evolve to be infinitely fast, and SARS-CoV-2 won’t become infinitely transmissible.
Other viruses have reached plateaus in their ability to spread. Some respiratory viruses such as measles are more contagious than today’s SARS-CoV-2. Others, such as influenza, are generally not as contagious as SARS-CoV-2. We don’t know when this coronavirus will hit its transmissibility plateau, but it will happen eventually.
Viruses such as this one can also spread better by “escaping” immunity to prior variants. Early in the pandemic, few people had immunity to SARS-CoV-2. But now much of the world has antibodies from vaccination or prior infection. Because these antibodies can block infection, variants with mutations that skirt them have an increasing advantage.
The importance of immune escape has become apparent with Omicron. Prior variants like Delta were only modestly able to sidestep antibodies, but Omicron has many mutations that reduce the ability of antibodies to recognize it. This, coupled with how contagious Omicron is, has enabled it to cause a huge wave of infections.
The fact that the virus developed the ability to infect people who had been vaccinated or previously infected shouldn’t have been a surprise, but how it happened with Omicron certainly was. Evolution often proceeds stepwise, with new successful variants descended from recent successful ones. That’s why six months ago many scientists, including us, thought the next variant would descend from Delta, which was dominant at the time. But evolution defied our expectations, and we got Omicron, which has a huge number of mutations and isn’t descended from Delta. It’s not known exactly how the virus made the big evolutionary jump that led to Omicron, although many scientists (including us) suspect the variant may have emerged from someone who couldn’t fight off the virus well, allowing it time to mutate.
It’s impossible to say whether future variants will have more big Omicron-like jumps or more typical stepwise changes, but we are confident SARS-CoV-2 will continue to evolve to escape immunity.
While transmissibility of viruses does plateau at a certain point, other human viruses that escape immunity keep doing so. The influenza vaccine has been updated annually for decades to chase viral evolution, and some influenza viruses show no sign of slowing down. Immune escape is an endless evolutionary arms race, because the immune system can always make new antibodies and the virus has a vast set of mutations to explore in response. For instance, Omicron has just a tiny fraction of the many mutations that have been observed in SARS-CoV-2 or related bat viruses, which are in turn just a small fraction of what lab experiments suggest the virus could potentially explore.
Taking all this together, we expect SARS-CoV-2 will continue to cause new epidemics, but they will increasingly be driven by the ability to skirt the immune system. In this sense, the future may look something like the seasonal flu, where new variants cause waves of cases each year. If this happens, which we expect it will, vaccines may need to be updated regularly similar to the flu vaccines unless we develop broader variant-proof vaccines.
And of course, how much all this matters for public health depends on how sick the virus makes us. That is the hardest prediction to make, because evolution selects for viruses that spread well, and whether that makes disease severity go up or down is mostly a matter of luck. But we do know that immunity reduces disease severity even when it doesn’t fully block infections and spread, and immunity gained from vaccination and prior infections has helped blunt the impact of the Omicron wave in many countries. Updated or improved vaccines and other measures that slow transmission remain our best strategies for handling an uncertain evolutionary future.
https://www.nytimes.com/interactive/202 ... 778d3e6de3
Re: Post Pandemic Thinking
Bolstering healthcare beyond the pandemic
A nurse administers Covid-19 vaccine to a member of the public at Kencom Bus terminal on December 23, 2021.
By Amin Mawji
Diplomatic Representative of the Aga Khan Development Network
Aga Khan Development Network
What you need to know:
- The pandemic has affected us all, collectively and personally, albeit in unequal measure.
- Much has been written about why Africa appears to have been spared the worst effects that many had predicted.
It has now been two years since Africa identified its first case of Covid-19. The pandemic has affected us all, collectively and personally, albeit in unequal measure. The situation is still unfolding but as we look back on our collective experiences, what have we learnt so far?
The received wisdom in many corners used to be that infectious diseases – like HIV and Ebola - originate from the poorer parts of the world. The novel Coronavirus has disproved that theory. The global response to this virus also laid bare weaknesses in the effectiveness of current multilateral frameworks in the face of a global crisis.
Drawing from their previous experience of dealing with epidemics in the region, political leaders in East Africa rose well to the challenge. Uganda, for example, implemented lockdown even before the first case of Coronavirus was detected. Across East Africa, political leaders were sensitive to the need to avoid fragile healthcare systems being overrun by the virus. Those early actions helped to contain the expansion of COVID-19 in the region.
Much has been written about why Africa appears to have been spared the worst effects that many had predicted. It is perhaps too early to speculate. Nevertheless, there are strong grounds for pushing the case for strong community-based primary health care systems that promote wellness and healthy lifestyles, instead of the singular focus on treating diseases.
The Aga Khan Development Network’s approach to healthcare and education in the region recognises the importance of this through its focus on what are called the ‘social determinants of health’, including education and improving quality of life. For example, the network has long prioritised women’s access to quality maternal health care, adequate nutrition and the empowerment of boys and girls equally through quality education.
Disrupted supply chains
This week, a new crop of graduands across East Africa will enhance their professional credentials with degrees and diplomas from the Aga Khan University’s Medical College and the School of Nursing and Midwifery.
Since inception, these programmes have seen more than 300 medical specialists and sub-specialists, and more than 3,000 qualified nurses and midwives join the ranks of the medical profession in Kenya, Uganda and Tanzania. Guided by the principles of impact, quality, relevance and access, the Aga Khan University and Aga Khan Health Services continue to invest heavily in building health professionals capacity in East Africa.
Another important observation from the past two years concerns the risks of reliance on imported commodities, pharmaceutical products and equipment. Disrupted supply chains meant that many African countries were denied early access to personal protective equipment, oxygen, ventilators, testing equipment, medications and vaccines.
This is why the Aga Khan Fund for Economic Development is continuing to invest in diversified manufacturing capacity for pharmaceutical and medical products in the East African region.
But more is needed, and we must continue to make the case for development partners to support African efforts to build regional value chains and attract manufacturing.
New healthcare landscape
As we look to the future, it will be important to consider how Africa’s young population can help drive technological advancement and innovation. Today, the power of technology allows us to capture data that can help track the spread of a virus in granular detail.
Advanced IT systems provide data on health systems capacity in real time across large areas. We have the opportunity to exploit this technology. What is needed is an enabling environment that can spur innovation. And, of course, in the end this requires building trust in our governance and policy makers.
The pandemic has shown us that our region is resilient. The cost has been high – and it has been borne unequally across different sections of society, generations and geographies. But we have grounds to be optimistic about the future.
Regional collaboration, certainly across East Africa but also across the African continent, and institutions like the new African Medicines Agency, open up powerful possibilities. The time is now upon us to envision a new landscape for health and healthcare in our region.
Amin Mawji OBE is the Diplomatic Representative of the Aga Khan Development Network based in Kampala.
https://nation.africa/kenya/blogs-opini ... c--3729846
A nurse administers Covid-19 vaccine to a member of the public at Kencom Bus terminal on December 23, 2021.
By Amin Mawji
Diplomatic Representative of the Aga Khan Development Network
Aga Khan Development Network
What you need to know:
- The pandemic has affected us all, collectively and personally, albeit in unequal measure.
- Much has been written about why Africa appears to have been spared the worst effects that many had predicted.
It has now been two years since Africa identified its first case of Covid-19. The pandemic has affected us all, collectively and personally, albeit in unequal measure. The situation is still unfolding but as we look back on our collective experiences, what have we learnt so far?
The received wisdom in many corners used to be that infectious diseases – like HIV and Ebola - originate from the poorer parts of the world. The novel Coronavirus has disproved that theory. The global response to this virus also laid bare weaknesses in the effectiveness of current multilateral frameworks in the face of a global crisis.
Drawing from their previous experience of dealing with epidemics in the region, political leaders in East Africa rose well to the challenge. Uganda, for example, implemented lockdown even before the first case of Coronavirus was detected. Across East Africa, political leaders were sensitive to the need to avoid fragile healthcare systems being overrun by the virus. Those early actions helped to contain the expansion of COVID-19 in the region.
Much has been written about why Africa appears to have been spared the worst effects that many had predicted. It is perhaps too early to speculate. Nevertheless, there are strong grounds for pushing the case for strong community-based primary health care systems that promote wellness and healthy lifestyles, instead of the singular focus on treating diseases.
The Aga Khan Development Network’s approach to healthcare and education in the region recognises the importance of this through its focus on what are called the ‘social determinants of health’, including education and improving quality of life. For example, the network has long prioritised women’s access to quality maternal health care, adequate nutrition and the empowerment of boys and girls equally through quality education.
Disrupted supply chains
This week, a new crop of graduands across East Africa will enhance their professional credentials with degrees and diplomas from the Aga Khan University’s Medical College and the School of Nursing and Midwifery.
Since inception, these programmes have seen more than 300 medical specialists and sub-specialists, and more than 3,000 qualified nurses and midwives join the ranks of the medical profession in Kenya, Uganda and Tanzania. Guided by the principles of impact, quality, relevance and access, the Aga Khan University and Aga Khan Health Services continue to invest heavily in building health professionals capacity in East Africa.
Another important observation from the past two years concerns the risks of reliance on imported commodities, pharmaceutical products and equipment. Disrupted supply chains meant that many African countries were denied early access to personal protective equipment, oxygen, ventilators, testing equipment, medications and vaccines.
This is why the Aga Khan Fund for Economic Development is continuing to invest in diversified manufacturing capacity for pharmaceutical and medical products in the East African region.
But more is needed, and we must continue to make the case for development partners to support African efforts to build regional value chains and attract manufacturing.
New healthcare landscape
As we look to the future, it will be important to consider how Africa’s young population can help drive technological advancement and innovation. Today, the power of technology allows us to capture data that can help track the spread of a virus in granular detail.
Advanced IT systems provide data on health systems capacity in real time across large areas. We have the opportunity to exploit this technology. What is needed is an enabling environment that can spur innovation. And, of course, in the end this requires building trust in our governance and policy makers.
The pandemic has shown us that our region is resilient. The cost has been high – and it has been borne unequally across different sections of society, generations and geographies. But we have grounds to be optimistic about the future.
Regional collaboration, certainly across East Africa but also across the African continent, and institutions like the new African Medicines Agency, open up powerful possibilities. The time is now upon us to envision a new landscape for health and healthcare in our region.
Amin Mawji OBE is the Diplomatic Representative of the Aga Khan Development Network based in Kampala.
https://nation.africa/kenya/blogs-opini ... c--3729846
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Video:
https://www.youtube.com/watch?v=TSaBRaaakC4
Mohamed M Keshavjee reflects on life after the pandemic and some of the lessons we have learnt from it.
Dr Mohamed M Keshavjee is an author and scholar on Contemporary Islam. He is a Senior Research Scholar associated with the Institute of Ismaili Studies, London.
Video:
https://www.youtube.com/watch?v=TSaBRaaakC4
Mohamed M Keshavjee reflects on life after the pandemic and some of the lessons we have learnt from it.
Dr Mohamed M Keshavjee is an author and scholar on Contemporary Islam. He is a Senior Research Scholar associated with the Institute of Ismaili Studies, London.