Costs — hospital bills, physician services, pharmaceutical spending — are relatively easy to observe. Benefits, by contrast, are diffuse, multidimensional and often realized over long time horizons. Improvements in longevity, functional ability and quality of life (QOL) are not easily quantified. Even more complicating is attribution: When health outcomes improve, how much is due to medical care versus broader societal changes such as nutrition, environment, or behavior?

As a result, conventional productivity metrics systematically understate the true value created by healthcare. They focus on measurable transactions rather than meaningful outcomes. This mismeasurement is not merely a technical issue — it shapes policy decisions, investment flows and ultimately the direction of innovation itself.

The measurement problem

Traditional healthcare rely heavily on service volume — how many procedures were performed, how many patients were treated, how much revenue was generated. This approach implicitly assumes that more services equate to more output. But healthcare is not a manufacturing process. Performing more procedures does not necessarily mean better health outcomes. In some cases, it may even indicate inefficiency.

The deeper problem lies in the definition of output. If the goal of healthcare is to improve human well-being, then output should reflect improvements in health, not simply the number of services delivered. Yet most official statistics fail to incorporate this dimension. They do not adequately account for improvements in survival rates, reductions in disability or enhancements in quality of life.

This disconnect creates a paradox. Healthcare appears to be a low-productivity sector, even as medical innovation continues to generate profound improvements in human health. The paradox is not real — it is a consequence of flawed measurement.

Healthcare as welfare creation

by Calvin Ackley, Abe Dunn, and John A. Romley provides a compelling alternative framework. Their approach redefines healthcare productivity by aligning it with fundamental economic principles: Productivity should measure how effectively inputs are transformed into welfare-enhancing outputs.

Instead of counting treatments, they measure output in terms of utility — specifically, gains in longevity and quality-adjusted life years (QALYs). Inputs, meanwhile, are measured using underlying treatment costs rather than regulated prices, which often distort the true resource use in healthcare systems. 

The results are striking. Applying this framework to nine major medical conditions over two decades, they estimate annual productivity growth of approximately 7.5%. This is dramatically higher than conventional estimates, which often suggest stagnation or decline. The implication is profound: Healthcare has been far more productive than we thought — not because it delivers more services, but because it delivers better outcomes.

This framework also highlights an important insight: Improvements in health outcomes often outweigh increases in costs. Rising healthcare spending, therefore, should not automatically be interpreted as inefficiency. In many cases, it reflects investment in technologies and treatments that generate substantial welfare gains.

Regenerative medicine

Within this conceptual shift, emerges as a defining frontier. If traditional healthcare is akin to maintaining aging machinery — repairing parts, managing wear and tear — regenerative medicine represents a transition toward rebuilding the system itself.

Regenerative therapies aim not merely to manage symptoms, but to restore biological function. Stem cell therapies, gene editing and tissue engineering seek to reverse disease processes at their root. Instead of lifelong treatment, the goal is durable recovery — sometimes even a functional cure.

This distinction is critical from a productivity perspective. Conventional treatments often generate continuous costs with incremental benefits. Regenerative therapies, by contrast, may involve high upfront costs but produce long-term, sustained improvements in health outcomes.

In economic terms, regenerative medicine transforms healthcare from a flow-based model (ongoing treatment) into a stock-based model (building health capital). The value lies not in the number of interventions but in the lasting change to the patient’s health trajectory.

Despite its transformative potential, regenerative medicine faces a structural challenge: Its value unfolds over time, while markets and evaluation frameworks are often short-term oriented.

Most reimbursement systems, clinical trials and valuation models focus on near-term endpoints — 12-month survival rates, short-term efficacy or immediate cost-effectiveness. These metrics fail to capture the durability of regenerative therapies, which may deliver benefits over decades.

This creates a mismatch between intrinsic value and perceived value. A therapy that eliminates the need for chronic treatment may appear expensive in the short run, even if it generates substantial long-term savings and welfare gains.

The result is systematic undervaluation.

Lessons from recent biotech market failures

This misalignment is vividly illustrated by recent developments in the biotechnology sector. Over the past few years, several regenerative medicine and advanced therapy companies have experienced sharp declines in market valuation, despite promising scientific progress.

Companies in gene therapy, cell therapy and Clustered Regularly Interspaced Short Palindromic Repeats () -based platforms saw significant capital inflows during the early 2020s, driven by optimism about transformative cures. However, as macroeconomic conditions tightened and interest rates rose, investor sentiment shifted dramatically. Many firms faced declining stock prices, funding constraints and delayed commercialization timelines.

This is not merely a cyclical phenomenon — it reflects a deeper structural issue.

Capital markets often struggle to price long-duration assets. Regenerative medicine is, by nature, a long-duration investment. Its returns are uncertain, delayed, and dependent on complex clinical and regulatory pathways. Traditional valuation models, which heavily discount future cash flows, tend to undervalue such opportunities.

Moreover, the lack of standardized outcome-based metrics exacerbates the problem. Without clear frameworks to quantify long-term benefits, investors rely on short-term indicators, such as trial milestones or quarterly earnings, that may not reflect the technology’s true potential. In this sense, the recent “failures” in biotech markets are not failures of science — they are failures of measurement and expectation alignment.

To unlock the full value of regenerative medicine, a fundamental reframing is required. These therapies should not be viewed as high-cost interventions, but as investments in long-term health capital.

This perspective shifts the focus from cost minimization to value maximization. The relevant question is not “How expensive is this therapy?” but “How much long-term health does it create?”

Embedding this logic into strategy requires several key changes:

1.  Outcome-Based Metrics: Clinical development should prioritize metrics that capture long-term outcomes, such as quality-adjusted life years, functional independence and durability of treatment effects. These metrics align more closely with the true value proposition of regenerative therapies.
2. Longitudinal Data and Evidence: Demonstrating sustained benefits over time is critical. Real-world evidence, long-term follow-up studies and patient-reported outcomes can provide a more comprehensive picture of value creation.
3. Value Communication: Companies must articulate their value proposition in terms that resonate with both payers and investors. This involves translating clinical outcomes into economic and societal benefits, such as reduced lifetime healthcare costs and increased productivity.
4. Innovative Payment Models: Traditional reimbursement models are ill-suited for regenerative therapies. Alternative approaches, such as outcome-based payments or annuity models, can better align costs with realized benefits over time.

Capital markets and the repricing of healthcare innovation

As measurement frameworks evolve, capital markets will also need to adapt. Investors increasingly recognize the limitations of short-term metrics in evaluating long-term innovation. The shift toward outcome-based valuation is already underway in some areas, but it remains incomplete.

Regenerative medicine represents a test case for this transition. If markets can develop tools to accurately assess long-term value, capital allocation will become more efficient, directing resources toward technologies with the greatest societal impact. Conversely, failure to adapt may result in persistent underinvestment in high-impact innovations, slowing progress in areas where breakthroughs are most needed.

The implications of this paradigm shift extend beyond healthcare. It challenges the very definition of productivity.

In a traditional sense, productivity is about producing more with less. In healthcare, however, the goal is not efficiency alone, but effectiveness — improving human well-being. This requires a broader conception of output, one that incorporates qualitative dimensions of life. Regenerative medicine embodies this shift. It does not simply improve efficiency within the existing system; it redefines what the system produces.

Aligning measurement, innovation, and value

Healthcare stands at a crossroads. On one path lies the continuation of existing measurement frameworks, with their inherent biases and limitations. On the other lies a new paradigm, grounded in welfare-based metrics and long-term value creation. The framework provides a crucial foundation for this transition, demonstrating that healthcare productivity may be far higher than previously believed. 

Regenerative medicine, in turn, represents the frontier of this new paradigm. Its true value cannot be captured by traditional metrics. It requires a rethinking of how we measure, evaluate and invest in healthcare innovation.

The recent volatility in biotech markets should not be interpreted as a rejection of regenerative medicine, but as a signal of misalignment between value creation and value recognition. Bridging this gap is both a strategic and systemic challenge.

Ultimately, the future of healthcare productivity depends not only on scientific breakthroughs but on our ability to measure what truly matters. When we shift from counting treatments to valuing health, from short-term costs to long-term outcomes, we unlock a more accurate — and more optimistic — understanding of progress.

In that sense, regenerative medicine is more than a technological advance. It is a lens through which we can rethink the economics of health itself.

[ edited this piece.]

The views expressed in this article are the author’s own and do not necessarily reflect 51�Թ�’s editorial policy.

The post Rethinking Healthcare Productivity and the Strategic Role of Regenerative Medicine appeared first on 51�Թ�.

Now, I’m beginning to think that a third time for the charm would be a good deal, especially in the case of a medical diagnosis. 

The beautiful thing about Indian hospitals is that they are always understaffed and overburdened with patients. The residents are on a constant lookout for exploitable human beings — those with any semblance to the medical profession, no matter how minute. It’s beautiful not only in a selfish sense but also in an educational sense. The selfish perspective is that I have plenty of opportunities to learn as a medical student. In the educational sense, it means that whenever I bump into a resident at the hospital, regardless of the reason for the happenstance, I will get drafted as a five-minute unpaid and uninsured intern.

And so, last year, when, on one occasion, I happened to enter the emergency department pushing a wheelchair on which my friend, minus one anterior cruciate ligament (ACL), was sitting, a resident pulled me away from my wheelchair to evaluate someone on another wheelchair who had just arrived. The resident told me to take a brief history of the patient before his blue surgical scrubs disappeared in a violent, epilepsy-inducing swarm of nurses, stretchers, patients and their attendants. 

I turned to my new wheelchair. I was expecting a confused, perhaps condescending scrutiny of my sweaty t-shirt and shorts, exposed hairy legs and football cleats. I wouldn’t have faulted the patient for wondering why a young, panting kid fresh off the football field was eyeing her meaningfully. I’d gotten that look once before while inserting a foley’s catheter into a man’s urethra before a resident explained to him that I was a medical student. And I hadn’t even been in sweaty shorts at that time. Still, they were shorts all the same.

My ego was grateful that the patient gave no such reaction, but that was only because she seemed disoriented to time, place and person, which of course made my job significantly harder. I asked the patient’s attendant what was wrong. The older lady, who it turned out was the patient’s mother-in-law, said that she had been having stomach pain for three days after her husband had died in an accident. I asked her where exactly the pain was, whether in the chest or abdomen. She said something in the Marwadi language that I didn’t catch and opened her hand as wide as possible before smothering it all over her chest and abdomen. I gave her an exasperated expression. After subsequent questioning, I managed to determine that the pain was in her epigastric region, she was 40 years old, and she also felt pain around her shoulders. She also had difficulty breathing and a history of hypertension. Thinking something along the lines of myocardial infarction (MI), I proudly presented my findings to the resident. 

The resident cut me off midway and said, “After her husband died, she didn’t eat anything for three days, and that led to gastritis.” She promptly walked away, leaving me in the dust with a dumb expression on my face. I felt both disgraced and betrayed: disgraced because I hadn’t even thought of the possibility of gastritis and betrayed because the resident had just tested me and proved me stupid for no apparent reason.

I walked back to my ACL-less human-wheelchair complex and leaned on the handle. My friend asked me what I had been up to. I told him I had gone to diagnose a patient. I didn’t bother mentioning that the diagnosis had been off by 180°.

Unsanctioned employment

A few hours ago, my father and I had walked through the doors of a Turkish Airlines airplane at the San Francisco airport before being greeted by yet another stereotypical, heavily made-up, textureless white-skinned flight attendant exuding so much fake enthusiasm that I couldn’t bring myself to outwardly acknowledge her false kindness due to my backwardness in expressing emotions. I ended up letting out something of a grunt accompanied by a grimace. 

That was when a thought struck me. Even though I was not technically a doctor yet, I had just passed the exams that certified me to be one, and I was now entering the bowels of an airtight capsule that would be cruising at 800 kilometers per hour thousands of feet above the ground with only a few centimeters of an aluminum alloy separating everyone from a low-pressure, -40° C environment. What if someone fell sick?

When I was young, or rather, relatively younger, I had developed a technique to stay happy that bypassed the interplay of destiny. When I wanted something from my parents and asked them for it, I kept rehearsing in my mind the classic scenario in which they would not agree under any circumstances. This left two possible outcomes. My parents would now say they were helping me build character, which was tantamount to their refusal to grant my request. That is how it played out 95% of the time. And in such cases, because I was expecting a refusal, I wouldn’t feel bad. On the other hand, if they agreed, I would feel elated since I had been expecting rejection. Either outcome was a win.

But I had forgotten this useful technique. So when the thought of someone falling sick came to my mind, I told myself it was just one of those … rare kinds of events that … rarely happened. That was where I went wrong. My childhood technique may not have circumvented fate, but had I called upon it, I would have been mentally prepared.

Two hours into the flight and one hour into one of the worst DC movies I had ever watched, my backseat TV screen paused. I felt almost relieved at being given a break from the horrendous action scene. A sign stating ‘announcement in progress’ popped up, and an air hostess asked over the speaker if there was a doctor on board. 

I looked at my father. He told me to go. I conveniently reminded him that technically I wasn’t a doctor yet. He rolled his eyes as I got up and moved toward the back of the plane, hobbling on my hastily put-on shoes amid the turbulence.

As I moved, my vision tunneled, and all the surrounding passengers in their seats blurred and stretched out to the sides as if I were nearing the limits of the space-time continuum. I could only see a scene of gathered people and flight attendants around one of the seats. That was when I had a feeling of enlightenment, and my eyes widened – male cabin crew members existed. I had never seen one before in India. Could it be that male cheerleaders also existed?

I told this rare specimen of a flight attendant that I was a medical student, and he shifted to the side to give me space to see the patient. I took a brief history of the patient, my mouth ejecting words encoded by my brain running on autopilot. On the other hand, my conscious mind was busy trying to analyze what I was feeling. Everything felt so surreal as if I were in a dream or a videogame. I couldn’t contemplate the stakes of what I was dealing with.

Formulating a diagnosis

The patient was male, had difficulty breathing and a diffuse chest pain radiating to his left shoulder and arm that had been gradually increasing since the time he got onto the flight. I sighed internally. That’s not a good sign. Why couldn’t it have been stomach pain or a headache? 

The good thing was that his age was 34 and he had no history of diabetes, hypertension or any similar pain in the past, all features inconsistent with ischemic heart disease. The bad thing was that his typical clinical features screamed of a myocardial infarction or, in layman’s terms, a heart attack. I knew from my emergency department experience that it could be gastritis or GERD (gastroesophageal reflux disease). I asked if he had any history of reflux, and he said he did.

That should have been a good sign since it pointed in the direction of GERD rather than a myocardial infarction. The only issue was that it would mean giving him a simple drug like pantoprazole to manage his stomach acidity. And the thought of giving pantoprazole to someone with clinical features that flashed a myocardial infarction sounded absurd. Right then, I knew that I wouldn’t be able to establish the patient’s diagnosis confidently. The evidence said that it wasn’t a heart attack, but the fear of incorrectly diagnosing him as a false negative loomed in my mind. 

The fact was, I just didn’t have enough clinical experience yet to make a call as to what was more likely, especially taking into account all the circumstances and the possible outcomes. Should I suggest giving him nitrates, as is given for a suspected myocardial infarction, or perhaps an emergency landing into a foreign country? I doubted an ECG would be available on board. Should I give him pantoprazole? Or maybe there was another possibility I hadn’t thought of again. But my most prominent thought was how on earth wasn’t another doctor on the flight coming to see the patient? During my clinical postings in the hospital, it was so consoling and reassuring to have a senior with me who could redeem all my mistakes. But here, in this situation, would I have to validate everything on my own?

The flight attendant told me they were thinking of moving the patient to the back of the plane and start giving him oxygen. I told them it was a good idea. And so our impromptu medical team got to work. While I took the man’s pulse, I asked him to tell me more about the pain and if it felt like a crushing sensation. He was Turkish, and his English wasn’t so good, but in words I could comprehend, he told me that the pain increased on breathing in. His pulse rate was elevated, around 110 beats per minute, and the forceful movements of his heightened respiratory rate was visible through his shirt.

I pulled the male flight attendant away from the patient and told him that it could be something mild like reflux, but there was a chance that it was a heart attack, even though it seemed unlikely. Again, the possibility of it being a myocardial infarction, however improbable it seemed, was a big fat cloud in my mind pushing away everything else. I was not confident enough to completely rule it out. I told him that we could give him pantoprazole and that we should check if there were nitrates on board the flight. He asked me if I had a medical license, to which I shook my head, but reminded him that pantoprazole at least was an over-the-counter drug even in the US. He nodded, said he’d try to find another doctor one last time, and made another announcement call.

All’s well that doesn’t end ill

A woman walked up to me and told me that the patient had a history of neck pain on his left side. I asked her politely who she was. She replied that she was the patient’s wife and a pharmacist by profession. She said that his condition might not be anything serious. I couldn’t help but notice how calm she seemed, even though it was her husband who was currently sick. She radiated maturity and rationality. I nodded to her in agreement, but I was worried that it could be angina, and perhaps we should consider sublingual nitroglycerin. She agreed with me and told the flight attendant as well, but he once again said that they couldn’t give drugs without it being administered by someone with a license. I wasn’t sure whether to feel relieved at the indirect implication that my assistance was no longer required or to be concerned that this was an obstacle I might need to tackle. I briefly wondered if it was possible for me to illegally prescribe a drug that might cause me to lose my license, even before obtaining a license. Would the US rules apply, the Indian rules or perhaps even the Turkish rules? Or maybe if the matter ended up in court, they would seek to determine which country our plane had been flying over the moment I gave the patient the nitrates?

I asked the patient if he was feeling better as I pondered my hypothetical legal battles in the back of my mind. He said he felt slight improvement.I wasn’t sure what exactly this new piece of information meant for my next line of management as it didn’t move the pointer along the scale of a battle between a myocardial infarction and GERD any further away from the more dire condition. 

I felt some of my uncertainty and fear dissipate when I saw the flight attendant come back with a doctor, who he claimed was Iranian. I felt a little irked at how long it had taken him to respond to the situation. It had been well over five minutes. And why had it taken him three announcements of a medical emergency to finally show up?

He asked what was wrong, and I chipped in with my evaluation. A 34-year-old male patient with shortness of breath and chest pain radiating to his left shoulder and arm. There was no history of diabetes, hypertension or similar episodes of pain in the past. There was a positive history of gastroesophageal reflux. Perhaps the doctor didn’t realize I had training in medicine. He didn’t seem to give my words much weight. He turned to the patient and asked the same questions I had, which, while it felt insulting, was also gratifying because it proved that I had at least been on the right track. But then he embarked on an entirely different line of thought.

He asked if the patient had been on flights before, to which the patient answered yes. Did he have a history of anxiety? The wife responded, “Occasionally, but he’s never had a panic attack”. The doctor told the flight attendants to remove the oxygen mask and moved closer to the patient. “ You don’t have a heart attack.” He said firmly. “I just need you to calm down. You’re having anxiety. You don’t need oxygen or any medicine. You’ll be just fine.”

He said some other things after that that I didn’t register because I was too busy feeling stupid once more. It was the second time I had been unable to rule out ischemic heart disease. The first time, it had been gastritis, and this time, it was … anxiety. Sure, I had guessed it probably wasn’t MI, but to rule out that deadly differential and come to a lame possibility like anxiety was something I would not have been able to do. I was reminded of the popular saying on the TV show House MD: “It’s never lupus.” However statistically improbable, perhaps I was in a similar predicament: “It’s never MI.”

As the Iranian doctor moved away, another late coming doctor approached and promptly disappeared upon hearing that the situation had been resolved. But I was too busy feeling dumb to mind his tardiness. 

The patient’s wife turned to me and thanked me. Her smile was bright, but unlike the air hostess before, it appeared earnest and genuine. I was so confused about how to respond, not feeling quite deserving of her gratitude, that I can no longer remember how I reacted. It was probably a mixture of an embarrassed head rub and a “no problem.” I wanted to reassure her by suggesting that she could tell me if there was any issue in the future, but I decided to let the more competent doctors handle that part.

As it turned out, I was feeling more responsible than I had realized. Another hour into the boring finale of my movie, I got up and asked the pharmacist if her husband was feeling better. She said he was and that he was sleeping at the back of the plane. She once again thanked me with the same insistence as she had done before. I’m not sure why, but this time, I accepted her appreciation with far more maturity. Perhaps it was because I felt I had, in some part, done my duty by responding to the request for medical assistance quickly and going to check up on him again.

I went back to my seat, no longer in the mood to finish the stupid movie. I told myself that I should try to sleep since I would be severely jetlagged back in India while having to start my internship the very next day. And then I realized how ironic it was that just a while back I had been thinking I would learn how to manage such patients in my internship and had encountered one at the very moment I was getting back to college to start it. If this was destiny, the responsible power was laughing at me.

But perhaps the third time, I’ll be able to produce the correct diagnosis with confidence.

The views expressed in this article are the author’s own and do not necessarily reflect 51�Թ�’s editorial policy.

The post My First Emergency Diagnosis Happened 20,000 Leagues Over the Sea appeared first on 51�Թ�.

Previous generations also contended with misinformation. False narratives, malicious gossip and political spin are as old as time. Before the advent of the scientific method, everyone marinated in a rich stew of fairy tales, myths and superstitions. Like us, our ancestors trusted quack cures and fell for conspiracy theories.

But now, quite suddenly, we find ourselves in a brave new world, one riddled with rabbit holes and confounded by clickbait. We have fake news and flame wars, cancel culture and contested speech norms, echo chambers and “.” We’ve seen culture warriors weaponize Facebook and Twitter, science denial grow into a , and conspiracy theories mutate into monstrous forms (). Is it any wonder so many of us are lost?

We all see others taken in by the BS. We think, “Children get faked out by fairy tales, but ��’v�� outgrown them. Voters are bamboozled by propaganda, but that’s them, not us. Followers of other religions are misled, but I practice the true faith.” Eventually, though, the more thoughtful among us think to ask pivotal questions. “Am I really so exceptional? Or am I, too, being played? Would I know if I was? Do I really know what I think I know? What misconceptions do I harbor?”

They say there’s a sucker born every minute, but in truth, we’re all born suckers. We’re fairly gullible by default, probably because our ancestors had to learn rapidly when young. That’s why children believe in the tooth fairy. The problem is that, even as adults, we remain strangely susceptible to evolved forms of nonsense: Without guidance, we remain lost.

An unusual few, though, exhibit what I call “deep immunity.” These folks think differently. Somehow, they ward off troublesome information with ease and exhibit uncommonly sound judgment. They cultivate mental habits that can grow into something we could all use more of these days: the precious trait called wisdom.

But how do we cultivate these habits? Half a lifetime ago, I began studying the matter in earnest. Decades of research led me to an astonishing, transformative, but almost unknown fact: The human mind has an immune system of its own. Just as the body has a system for spotting and neutralizing infectious microbes, the mind has a system for spotting and shedding infectious ideas. So I wrote a about it. The book helped launch an upstart science — what we in the business call cognitive immunology.

The field illuminates the workings of the mind’s defenses. It explains why these defenses sometimes break down and how we can fortify them against corruption. Critical thinking (CT), it turns out, is at best a haphazard approach to achieving misinformation immunity. CT is not enough. The good news? Outbreaks of viral nonsense are not inevitable. “Infodemics” can be prevented. The trick is to apply the science and proactively cultivate mental immunity.

In what follows, I distill an ocean of research into four actionable steps. Taking them should give your mind’s defenses an immediate boost. I hope, though, that the guide will also spur more ardent, long-term striving. If we keep these guidelines in mind and work patiently toward mastery, we can all grow substantially wiser.

Step 1: Shift your reference frame

Many of us default to a certain outlook on information. I call it the info consumer frame (or ICF). On this view, the infosphere is like a marketplace. (Hence the metaphor “marketplace of ideas.”) We humans are like shoppers: We browse the aisles looking for ideas that strike our fancy. Ideas are assumed to be like products that sit obediently on shelves. Meanwhile, our minds are like shopping carts — passive containers for the mental stuff we acquire. Learning is fundamentally a matter of filling your cart with information commodities; the ideas we “buy” into become our beliefs, and everyone is entitled to believe what they like.

This frame is pernicious. It breeds a sense of cognitive entitlement, exacerbates preexisting biases and obstructs higher-order thinking. In the information age, it is proving especially dangerous. Its influence is seen in the polarization that threatens the world’s democracies and the ideological entrenchment of today’s culture warriors. Whenever propaganda goes viral and incites unruly mobs, the invisible hand of the ICF is at work. In our time, we’re called to rethink this prevailing understanding of our relationship with ideas.

Happily, an is taking hold in the sciences. Here’s the gist: Ideas are more like microbes than groceries. Bundles of information obey an : The “fittest” tend to find hosts, survive and reproduce. Our minds host some that are good for us and others that are bad for us. Good ideas (roughly, true and useful ones) amount to mind-symbionts and bad ideas (the false or harmful ones) amount to mind-parasites.

Sometimes the latter — “infobugs” — proliferate at our expense. For example, beliefs about witchcraft have incited moral panics (), extremist ideologies have inspired terrorist attacks (9/11) and fake news has galvanized sedition (the January 6 ). Some infobugs even induce us to spread them. Think of the clever but misleading meme that gets you to share it, or the religious notions that inspire proselytizing. Just as a virus can hijack a cell for its purposes, an ideology can hijack a mind for its “purposes.”

Call this the microbial ecosystem frame. Minds are not passive receptacles. They’re active, infection-prone contraptions cobbled together by natural selection. In fact, our minds co-evolved in a rich stew of ideas, many of them prone to replicate in spite of our best interests. Crucially, every one of us is susceptible to mind-infections. In fact, every one of us is infected. We play host to countless infobugs. Misconceptions, false assumptions, overgeneralizations, limiting beliefs, crippling doubts — all of these are, in a very real sense, mind-parasites. Minds teem with them, and precautions must be taken to keep them from running wild.

This frame has a key implication: Each and every one of us has a lot to learn — and unlearn. Much of what we think we know doesn’t truly amount to knowledge. Admit this, embrace the consequent humility, and you take an important step toward deep immunity.

Step 2: Have standards

We need shared cognitive standards. Otherwise, our beliefs become arbitrary. Opinions diverge, ideologies harden, and worldviews become irreconcilable. Historically, it works like this: Excuses that license irresponsible talk spread, sowing the seeds of mental decadence. Then, unaccountable talk proliferates, belief systems diverge and societies succumb to mistrust, division and conflict.

The outbreaks of irresponsible thinking in our time can be traced to ideas like these: “Our beliefs are fundamentally private and no one else’s concern”; “Everyone is entitled to their opinion”; “Values are fundamentally subjective”; “Articles of faith should not be questioned”; “Criticism is tantamount to the policing of thought.” A related idea — that “no one has standing to uphold standards” — is conveyed by the sneaky rhetorical question, “Who’s to say?”

Philosophers call this nexus of ideas “,” and intellectual historians know that their appearance presages periods of turmoil and civic decline. Why? Because they weaken the centripetal pull of objective evidence. Without reality-based cognitive standards, “,” and “mere anarchy is loosed.”

Cognitive immunologists classify relativistic ideas as mental immune disruptors. People employ them to evade accountability norms. This subverts those norms, leading to cognitive dysfunction. Shedding the disruptors is thus one way to build mental immunity. If you haven’t already done so, I suggest renouncing the ones in quotation marks above.

Try this also: Apply the Golden Rule to the life of the mind. Ask yourself what cognitive standards you would have others observe, then hold yourself to those same standards. Want others to be honest? Be honest yourself. Want others to be fair-minded and persuadable? Make yourself fair-minded and persuadable. Are you troubled that others believe things they have no business believing? Then don’t believe things you have no business believing. Apply the “Law of the ” to the world of information and — voila! — you get a rich and beneficial ethics of belief.

Norms of accountable talk are the cornerstone of human civilization. When they are generally observed, constructive means exist for resolving conflicts, and everyone benefits. When bad actors defy these norms, it chips away at the trust that makes cooperative living possible. Imagine a world where decayed norms of accountable talk afford no protection against malicious accusations. Imagine a rival employing unfounded allegations to get you locked up. You’d have no recourse. If that’s not the world you want, help strengthen the norms of accountable talk.

Also, dump the idea that it’s enough to have a good reason for whatever you want to do or believe. You can manufacture a serviceable reason for anything, so that standard is too lax. (I call this the Platonic standard, because it occupies center stage in two Platonic dialogues.) This standard encourages wishful thinking and rationalization. It also exacerbates confirmation bias

The antidote is the Socratic standard: beliefs and decisions should be able to withstand tough questioning, including the objections of those who disagree. Standards like this give us a mechanism for resolving our differences with words. They also bring the defects of troublesome ideas to light and help us shed them. The true test of responsible belief is not, “Can I find a reason for this?” but, “Can it withstand questioning?”

You know how we update our antivirus software to protect our computers from the latest digital pathogens? We need to do the same with our brains. Here’s how. Learn how bad actors “hack” minds: how they play on fears, encourage wishful thinking and float seductive conspiracy theories. How they weaponize doubt, cultivate cynicism and compromise mental immune systems. Build your mental library of mind-viruses, fallacies and mental immune disruptors, and you’ll spot manipulative information more easily.

Step 3: Practice basic cognitive hygiene

Many of us dislike uncertainty, so we “tune out” our doubts. But cognitive immunology explains why this is a grave mistake. Doubts are quite literally the antibodies of the mind. The mind generates them to fight off problematic information. Learn to listen to them. Often, they’ll draw attention to an idea’s defects, thereby reducing the risk of mind-infection. Better yet, befriend your doubts: learn to enjoy their company and enjoy the benefits of next-level BS-detection.

Your mind also generates reasons. Sometimes, it does this to rationalize what it wants, but more often, it does this to draw your attention to a consideration that really does count for or against something. A basic principle of cognitive hygiene, then, is to give good reasons their due. Whether they count for your position or against it, credit them. Let them change your mind. (In practice, this often means letting them nudge your degree of confidence in something up or down a bit.)

Willingness to yield to “better reasons” is the very heart of rational accountability, so submit to each and every relevant consideration that comes along. Often, there are important considerations on both sides of an issue; when this happens, reject the myopic foolishness of “either…or” and embrace the wisdom of “both…and.” Grown-ups can credit competing considerations.

You can strengthen the “muscle” at the core of your mind’s immune system by habitually yielding to evidence. Simply allow evidence to shape your outlook and your mind’s immune system will grow stronger. Push back against evidence (that is, defy reason on behalf of a favored position), and it will grow weaker. The on this is, I believe, conclusive: Even small concessions to willful belief damage the mind’s immune system. By all means, be resolutely hopeful, but renounce willful believing.

When exploring contentious topics, it’s also important to sideline your identity. Here’s why: When people hitch their identity to a set of views, a called “identity-protective cognition” kicks in. They begin experiencing legitimate challenges as threats — and overreact. More precisely, your mind’s immune system will overreact. When mere words trigger a heated response in you, you’re experiencing an unhealthy auto-immune reaction. Immunologists call some immune system overreactions “autoimmunity.” Yes, auto-immune disorders of the mind also exist.

Good cognitive hygiene also requires that you practice subtractive learning. Most of us think of learning as adding to the mind’s knowledge stockpile. But it’s equally important to subtract out the stuff that doesn’t belong. Notice inconsistencies in your beliefs and take time to address them. (Usually, this means letting go of one of the inconsistent beliefs.) Fail to do this and inconsistencies will accumulate; your belief system will grow increasingly unreliable, and your capacity for sound judgment will degrade.

Step 4: Mind your mindset

It’s easy to slip into a mindset that compromises mental immune function. If you’re too trusting, a lot of bad information will get past your filters; if you’re unduly suspicious, good information will get caught in those same filters. You can be too gullible, but you can also be too cynical. You wouldn’t know it from all the emphasis we place on critical thinking, but you really can be too critical for your own good.

Critical thinking is mostly a fine thing, but the combative attitude of a culture warrior is corrosive of mental immune health. Culture warriors fixate on points that can be wielded as weapons against “them” — and become blind to considerations that weigh against “us.” Treat the space of reasons as a battlefield and you’ll develop an acute case of what psychologists call “myside bias.” This can fatally compromise your mind’s immune system. That’s why partisan zeal unhinges minds.

To avoid this fate, be curious, not critical. Maintain a collaborative spirit. Treat conversation partners as collaborators. Never wield reasons as weapons; instead, employ them as pointers meant to guide attention to relevant considerations. Don’t reason to win; reason to find out. I call this mode the way of inquiry: Make it your default mindset and, over time, you’ll achieve something akin to wisdom.

Of course, we do need to test each other’s ideas. Our mind-infections are largely invisible to us, so we need the help of others to spot them. It doesn’t help, though, if conversational idea-testing becomes contentious. Then, pride and fear interfere with falsehood removal. Two habits of mind can help here. First, think of challenges as opportunities, not threats. They’re opportunities to unlearn and should generally be welcomed. Master this, and you won’t overreact to cognitive conflict.

Second, convert your objections into clarifying questions. Even if the view at issue seems unworthy, approach it as something worth understanding. Show genuine interest. Be curious and patient. If the claim in question is problematic, ask for help understanding it. Do this, and a lot of times the claimant will discover its problematic qualities for themself. Once you’ve won a person’s trust, you can place countervailing considerations alongside their reasons — “This is true too, right?” — but let them weigh up the pros and cons. And let them draw their own conclusions.

So there you have it: a four-step guide to developing mental immunity. To sum up: (1) shift your reference frame, (2) uphold standards of accountable talk, (3) practice sound cognitive hygiene and (4) mind your mindset. As you weed out misconceptions and replace them with understanding, your immunity will deepen. You’ll become less prone to mind-infections. As those around you do the same, they become less likely to infect you.

We can build herd immunity to cognitive contagion. Imagine a world where outbreaks of unreason are routinely nipped in the bud, where truculent ideologies are easily dissolved and pointless partisanship no longer frustrates human aspirations. Can we evolve such a world? Absolutely. With cognitive immunology to light the path, each of us just needs to do our part.

[ edited this piece.]

The views expressed in this article are the author’s own and do not necessarily reflect 51�Թ�’s editorial policy.

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Andy Norman: People are right to be concerned. AI promises to be hugely disruptive. Here’s one reason why: AI-governed algorithms amplify information with “viral” properties. Nearly everyone now is plugged into the web, where infectious nonsense can spread like wildfire. Propagandists can now reach millions of vulnerable minds in a matter of minutes. We don’t like to admit it, but our connectedness makes us more vulnerable to sketchy information. Toxic polarization and conspiracy theories are symptoms of a deep imbalance: Our ability to spot nonsense has not kept pace with our ability to spread it.  

An exciting new science, though, is teaching us how to fight back. Each of us possesses a highly evolved capacity to filter out false and malicious information. The suite of mechanisms that does this work deserves a name; we call it the mind’s “immune system.” Scientists from around the world have joined our call to understand it so we can better cultivate mental immunity. Here’s what we’ve learned: these systems can go haywire, but they can also perform at a very high level. The key is to learn habits of mind that keep your mind’s immune system grounded. The Mental Immunity Project is all about freeing ourselves from false and manipulative information.

Q: How real is the mind’s immune system?

Norman: Philosophers are going to be arguing this one for a long time! Here’s what we know: the mind does something deeply analogous to bodily immune function: It actively monitors for false, harmful, and infectious stuff — “viral” information, basically — and does its best to shed it. The body’s immune system manufactures antibodies to fight off pathogens, and the mind manufactures doubts to fight off problematic ideas.

Both systems function best in a “Goldilocks zone” that lies between extreme trust and extreme suspicion. Both tend to go haywire when they stray out of this zone.

Fortunately, our minds are inoculable, just like our bodies. And bodies are inoculable because they have immune systems. So what does that tell you? Both systems evolved by natural selection to solve similar problems. Each functions to protect an evolved thing from infectious and parasitic stuff. The similarities are really quite striking.

To sum up: Yes, I think that mental immune systems are very real. I have smart colleagues who disagree, though, and that’s fine. We differ on a subtle philosophical question, but agree on the important thing: We need to understand and care for the mind’s capacity to spot and filter misinformation.

Q: In your book, Mental Immunity, and with the Mental Immunity Project, you aim to advance the science of cognitive immunology. You also aim to share actionable ideas that people can employ in their day-to-day lives. What are some of the most exciting recent findings? 

Norman: There’s so much neat work going on, it’s hard to know where to begin. Here are a few findings that I think have the power to change lives. First, the science should change the way we feel about doubt. Most people dislike doubt; it makes them uncomfortable. They prefer certainty. But ultimately, doubts are our friends. They’re quite literally the antibodies of the mind. The mind sends them to try and alert us to the problematic features of bad ideas. If you pay attention to them, appreciate them, and update your beliefs regularly — sometimes by letting go of them — you will grow wiser over time.

My second favorite finding has to do with other people’s doubts. Each of us harbors beliefs. We grow attached to them, and are usually blind to their defects. (Like love, belief can be blind.) This means that we need the help of others to spot our mind-infections. We need to listen to other people’s objections, fight down the urge to get defensive and learn to appreciate them for what they are: opportunities to “unlearn.” Simply put: Treat challenges to your worldview as opportunities, not threats. The mind’s immune system can freak out and attack the bearers of conflicting information; it’s up to us to calm it down so we can learn from that information.

Q: What are some practical things people can do to start strengthening their mental immune systems? How can people help their kids and their families from falling for bad information?

Norman: We’ve developed a Guide to Mental Immune Health designed to help everyone build their immunity. In it, we identify ten key habits of mind. We call them principles of mental immune system care, and each one is pretty simple. For example, we should monitor our motives for believing. A lot of times, we believe things because we want them to be true, not because they really are true. This is problematic, though, because it can make us prone to wishful thinking. The antidote is to notice why you believe what you believe. Believing something because it’s useful to believe it is one thing, and believing it because it’s probably true is something else. Responsible thinkers keep track of which is which.

Another principle of mental immune system care: Embrace shades of gray thinking. Life is full of uncertainties, so complete certainty is almost always a mistake. Make your peace with intermediate confidence levels. If you’re only about 85% certain that something is true, own that. Say, “I think it’s true,” rather than, “I know it’s true.” The world’s best thinkers are continually adjusting their confidence levels as new evidence comes in. If a new consideration weighs against a belief, but only a little, it’s usually best to reduce your confidence a bit.

A third example: Play for team truth. It’s easy to get caught up in a culture war and feel outraged by the things “they” are saying and doing. When this happens, resist the urge to indulge in righteous indignation. Why? Because continually reacting to the latest outrage from the other side can damage your mind’s immune system. It tends to compromise your ability to think objectively. When you encounter an objectionable half-truth, appreciate the truthful part of it before you criticize the not-so-true part. Give the other side’s reasonable points their due. Don’t react, reflect. Be fair-minded. Seek truth and common ground, not victory.

Q: Can you offer some examples where techniques like pre-bunking have effectively neutralized bad information, or at least made it less damaging?

Norman: Sure. Here are two important ones. In the run-up to Russia’s Ukraine war, US intelligence learned that Vladimir Putin was planning an invasion. They learned that Putin was going to use Russia’s powerful propaganda machine to sell a false narrative of Ukrainian aggression. The Biden administration took this information and began warning allies. His ambassadors alerted other nations of a coming disinformation campaign. Representatives of his administration warned news outlets. When the invasion and the influence campaign arrived, dozens of governments and media outlets were prepared not to drink Putin’s Kool-Aid. Biden had successfully “prebunked” Putin’s false narrative, so it fell flat. This is a big reason why Putin’s power grab failed.

“Prebunking,” by the way, is another name for mind-inoculation.

Second example: In the run-up to the 2020 presidential election, Donald Trump made it clear that he was planning to claim that the election was rigged. He concocted a false narrative and began selling it months in advance. He knew instinctively that simple and emotionally charged messages can hijack minds, and he repeated his claims again and again. He was actually hacking his supporter’s minds. Fortunately, the Department of Homeland Security saw that this could result in electoral chaos. They worked closely with one of our colleagues — Sander van der Linden, a Cambridge University psychologist — and they warned election officials all over the country. They used prebunking to prevent these election officials from falling for the big election lie. When the time came to count the votes, these officials were effectively inoculated. They did their jobs and American democracy survived. Prebunking prevented a constitutional crisis.

Q: Are certain people more prone to believing misinformation than others?

Norman: Absolutely. Just as people vary in their susceptibility to the flu, people vary in their susceptibility to misinformation. Those who know how to spot and disregard sketchy information (those with well-functioning mental immune systems) can shrug off the very same information that seriously addles others (those with poorly functioning systems).

There are three major reasons why we fall for misinformation. First, we tend to trust information that confirms our biases. If information “fits” with our worldview, we’re less likely to be skeptical and more likely to accept it as true. Fail to understand this, and your worldview can become rigid and self-validating. Second, we’re more likely to fall for misinformation that triggers strong emotions. Anger, outrage and fear are especially potent: They reduce our ability to think well. Third, we’re more likely to fall for misinformation when it’s repeated. This bias is known as the illusory truth effect, and it’s especially powerful in “echo chambers” where false information is repeated uncritically.

Learn a bit about your mind’s misleading tendencies, though, and you can begin to mitigate them. For example, make a habit of asking yourself: “Am I accepting this at face value because it’s genuinely reliable, or am I accepting it because I find it validating?” If there’s some mix of the latter, you probably ought to give the information a second, more critical look.

Q: What is it about conspiracy theories that allow them to infect minds so successfully?

Norman: Conspiracy theories are like traps. Buy into one and it provides ready-made excuses for doubling down on the narrative. Why is there no evidence for the conspiracy? Because the conspirators covered it up! Why is there evidence against the conspiracy? Because the conspirators planted it!

Those prone to conspiratorial thinking share similar traits. They tend to be low in intellectual humility. They rely more on intuition and less on analytical thinking. They have a need for certainty and prefer simple answers for complex events. They see patterns where none exist, connecting unrelated events into a larger plot. They view themselves as heroic victims and blame others when things go wrong. Conspiracy beliefs give you a sense of control; they boost your self-esteem and make you feel part of a special group that’s “in the know.”

Often, conspiracy theorists are hyper-critical thinkers. Their suspicions are overblown. They’re unable to trust where trust is warranted. And, ironically, conspiratorial thinking won’t help uncover real conspiracies (which do exist!). For that, we need measured skepticism and genuine critical thinking.

Q: How did the Mental Immunity Project come together? 

Norman: In my book about mental immunity, I proposed a new approach to our world’s misinformation problem: one centered on the idea that minds have “immune systems” that can do a lot of the work for us — provided we care for them properly. I founded the Cognitive Immunology Research Collaborative (CIRCE), an institute dedicated to understanding the mind’s defenses and cultivating mental immune health.

In 2022, we convened a blue ribbon panel composed of the world’s leading experts on misinformation and cognitive immunology. The panel drafted a bold declaration highlighting the science, which has now been signed by over 100 scholars and domain experts.

The panel also concluded that we could use the science to begin cultivating mental resilience at scale. So, in 2023, CIRCE teamed with to launch the Mental Immunity Project, which translates the science into tools anyone can use. We developed the first-of-its-kind guide to mental immune system care and put it . Anyone can go there and learn how to spot the worst kinds of misinformation — extremism, hate, pseudoscience, conspiracy theories, propaganda, etc. We’re developing tools to protect loved ones, kids, and organizations too.

Q: What do you think the future of cognitive immunology holds?

Norman: The science of immunology turned the tables on infectious microbes. It gave us the upper hand in the battle against disease. This fundamentally changed the human condition. Now, the science of cognitive immunology promises to turn the tables on infectious misinformation. We think it will give us the upper hand in the battle against viral nonsense — a battle we think is every bit as consequential. To get there, though, we need partners. We need foundations that can invest in the science. We need school districts committed to equipping their students. We need citizens who can spot propaganda and call it out. We need everyone to acknowledge their susceptibility to manipulative information, and take steps to mitigate it.

The views expressed in this article are the author’s own and do not necessarily reflect 51�Թ�’s editorial policy.

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��’m a cheek biter. Mmm. That’s what she says to her assistant every time I come in. In the middle of a session or whatever you call it. She’ll count the teeth. “1, 2, 3, 4, he’s a cheek biter, 5,6, keep an eye on 6, 7, 8.” It surprises me every time.

A father and a husband, that’s how other people might think of me. That’s what they’d put on my tombstone presumably, or my memorial bench. But you can’t be two things, not at the same time. 

What about husband? Am I a husband every time I speak to my wife, or am I simply just someone to speak to? If the postman can speak to her without becoming her husband, why can’t I? 

��’m not attached to my dentist like some people. ��’v�� seen her for what, five years now. But I wouldn’t have cared if today she’d been someone else. My doctor’s always changing, it doesn’t bother me at all. Some people really don’t like that. 

[Doe Wilmann first released this piece on his short story podcast, .]

The views expressed in this article/podcast are the author’s own and do not necessarily reflect 51�Թ�’s editorial policy.

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Eventually, we acquired Macintosh computers, trekking to a local copy shop to pay $0.25 a page for laser-printed originals. We still had to paste them together the old-fashioned way to create our tabloid-sized pages. The finished boards would then go to a local commercial printing press where our run of 2,000 copies would be printed.

This was, of course, before ordinary people had even heard of email. Our entire editorial process was mediated through the US Postal Service, with letters flying constantly between our two cities. On the upside, through 12 years and 48 issues, we only had to hold four in-person meetings.

All of which is to say that ��’m old. That fact, along with recent events in the lives of several friends, has brought to mind the first article I ever published in LesCon: “Who’s Going to Run the Old Dykes’ Home?” It’s a question that’s no less pertinent today, and not just for lesbians. My worldview was more parochial back then; I naively believed that someone — the state or families — would look out for heterosexual elders, but that we lesbians were on our own. It turns out that we, the people of this country, are all on our own.

Aging is not easy

These days, my partner and I seem to be doing a lot of elder care. Actually, ��’v�� long been a source of tech support for the octogenarian set, beginning with my own father. (“OK, you’re sure you saved the file? Can you remember what name you gave it?”) With our aging friends, we also help out with transport to doctors’ offices, communications issues (with landlines, cell phones, and the Internet) and occasionally just relieving the loneliness of it all.

In recent months, elderly friends of ours have faced losing their housing, their spouses, their mobility or their cognitive abilities. I find it terrifying, and I ache because there’s so little I can do to help them.

I shouldn’t be surprised, but ��’m daily reminded that getting older can indeed be frustrating and frightening. It pains me to know that my bones are weakening, that I don’t hear as well as I used to, that my skin’s drier and wrinkling, that my once familiar face in the mirror is growing ever stranger. ��’m lucky that — like my father who used to say, “After 70, it’s all maintenance” — ��’v�� managed to maintain a fair amount of brown hair on my head. But I especially hate the way words that used to leap down my tongue in merry cadence now frequently lurk sullenly in the backwaters of my brain.

In a piece about our aging political class, Robert Reich, secretary of labor for President Bill Clinton, charmingly about the “diminutions” that come with growing older and his own decision to stop teaching after decades of doing so. His take on is similar to mine. He laments his trouble remembering people’s names, noting that some “nouns have disappeared altogether. Even when rediscovered, they have a diabolical way of disappearing again.” I know what he means. For some years now, whenever I want to talk about cashew nuts, all I can initially think of is “carob.” Some devious gremlin has switched those words somewhere in the card catalog of my brain.

But even as I grieve for capacities lost and departing, ��’m still not ready to come face to face with the only true alternative to aging: not some tech bro’s , but the reality of death. ��’m opposed to dying, and had the universe consulted me, I’d have left mortality out of its design completely.

Aging people need help — and not just the lesbians

Written more than 40 years ago, parts of my piece “The Old Dykes’ Home” are flat-out embarrassing now. Getting old seemed so strange and far off before I was 30. When I imagined being aged then, I think it was with the piercing sorrow of Paul Simon’s song “Old Friends/Bookends”:

Can you imagine us years from today

Sharing a park bench quietly?

How terribly strange to be seventy

In other ways, my article was depressingly prescient about just how much this country would expect aging people to fend for themselves by the time I reached that strange period of my own life. Not only old dykes, but pretty much anyone who isn’t affluent, can find that old age brings economic desperation.

Yes, US citizens and permanent residents over 65 can get medical attention through Medicare, but the standard program only covers 80% of your bills. , we gained access to some prescription drug coverage, but that requires sifting through an ever-changing menu of medications and the ability to predict today what meds you might need tomorrow.

Most people who live long enough will receive some monthly income from Social Security, although the amount depends in part on how much they were able to earn during their working lives. But we’re constantly staving off attacks on Social Security, including attempts to it, reduce benefit amounts or increase the age at which people can collect because Americans are living longer. That last proposal, as economist Paul Krugman , is really another way of penalizing low-wage workers. As he wrote,

Life expectancy has indeed risen a lot for the affluent, but for the less well-paid members of the working class, it has hardly risen at all. What this means is that calling for an increase in the retirement age is, in effect, saying that janitors can’t be allowed to retire because lawyers are living longer. Not a very nice position to take.

Suppose the disabilities of age mean you can no longer safely live in your own home. Well, you’re on your own. Unless you can afford to move to some kind of assisted living facility, you’re in real trouble. Your main alternative is to most of what you own, so you qualify for the pittance that your state Medicaid program will pay a (most likely for-profit) nursing home to warehouse you until you die.

The threat of being old and unhoused is very real. A recent major study of unhoused people in California that almost half of them are over 50 and 7% over 65. As housing costs continue to rise, we can only expect that more old people will find themselves on the street.

Back then, I wrote that, under capitalism, we could expect the “owners of wealth” to do very little for people who are no longer creating profits through their labor — or indirectly, by doing the work “to make it physically and emotionally possible for the paid laborers to go out in the world and work one more day.” Why, after all, should capital take any interest in people who are no longer a source of profit?

These are the people — old, disabled, permanently unemployed — who, to the political philosopher Iris Marion Young, experience a particularly sinister form of oppression: marginalization. “Marginalization,” writes Young, “is perhaps the most dangerous form of oppression. A whole category of people is expelled from useful participation in social life and thus potentially subjected to severe material deprivation and even extermination.”

Volunteering isn’t going to fix the problem by itself

There were some other missing pieces in that article. I left out the fact that it’s easier to justify low pay for the art (and science) of caregiving when most of its practitioners are women. I failed to envision caretakers organizing on their own. I never imagined that, decades later, a National Domestic Workers would arise to represent the interests of the poorly paid, disrespected workforce of immigrants and women of color who largely do the work of caring for the aged in this country.

I had just lived through an episode in which on the bus to work I suddenly fainted from pain caused by a herniated disk in my back. I found myself lying on my bed for several months recovering while living on a monthly welfare check of $185 and food stamps. Still, the lesson I drew was that the solution to caring for people with chronic disabilities was what had then worked for me: drawing on a community of volunteers, a roster of almost 30 women who took turns shopping for my groceries, doing my laundry and ferrying me to doctors’ appointments. Why couldn’t that work for everyone?

That network of support existed, however, because I belonged to a lesbian community self-consciously constructing a parallel society tucked inside the larger city of Portland, Oregon. It was packed with institutions like a women’s bookstore, a drop-in community center, a women’s mental health project and a feminist credit union, among others. I acted with a women’s theater company and, at times, worked as a secretary at a women’s law cooperative.

In reality, though, we weren’t nearly as independent as we thought we were. Most of those institutions were staffed by women paid through the Comprehensive Education and Training , passed during the presidency of Richard Nixon and continued under Jimmy Carter. When Ronald Reagan and his new brand of Republicans took over in Washington in 1981, those salaries disappeared almost overnight — and with them, most of our community’s infrastructure.

So, my answer to the problem of aging then was to endorse an ethic of volunteerism rooted in specific communities, like our lesbian one. “Feminists,” I wrote, “are rightly uneasy about asking each other to perform any more unpaid work in our lives than we, and centuries of women before us, have already done.”

Nevertheless, I argued, “The truth is … no one is going to pay us to take care of each other … and we can’t afford to believe the capitalist and patriarchal lie that we are cheating each other when we ask each other — even strangers — to do that work for free.”

In retrospect, it seems clear to me that I was then inching my way toward an ethos that could free the project of caring for each other from the claws of capitalism. But I was naïve about the amount of time and energy people would be able to spare outside of their day’s labor — especially as real wages were about to stagnate and then begin to fall. I didn’t imagine a time to come when people without much money would need to work two or even three jobs just to get by. I didn’t think, as I do now, that it would be better, instead, to focus on raising the status and pay of caring work.

Even back in the 1980s, however, I recognized the limits of volunteerism. I knew that I’d been lucky during my period of temporary disability. I was an outgoing person with quite a sizeable set of acquaintances. With a reasonable levity of spirit and a dependable store of gossip, I knew then that I could make taking care of me relatively pleasant.

But I also knew that no one’s survival should depend on having a winning personality. Instead, as I wrote at the time, we needed to “develop simple, dependable structures to serve those among us who require physical care.”

How hard could that be, after all? “A file of volunteers and a rotating coordinator could do the job,” I wrote then. Here, too, I was more sadly prescient than I even realized. In recent years, the market for aging care has indeed found a way to commercialize volunteer efforts like the ones I imagined in the form of Internet-based options like and .

Mutual aid is not an emergency measure, but a fundamental principle

My point back then was that, as lesbians, we were on our own. No one was going to run the Old Dykes’ Home if we didn’t do it ourselves. (Perhaps I should have foreseen then that someone might indeed run it, if they could make money doing so!) I figured we had 10 to 15 years to develop “formal networks of support to deal with illness and disability,” because eventually each of us would need such structures. We lesbians would have to look out for ourselves because we lived then “on the edges of society.” I didn’t realize at the time that we shared those edges with so many other people.

Building volunteer structures was, I thought, just the short-term goal. The longer-term project was something much more ambitious: to build “a world in which the work of caring for each other happens not at the fringes of society, but at its heart.”

I still believe in that larger goal, and not because it’s a lovely fantasy, but because it’s a response to a fundamental reality of life. It’s a fact that human beings, like all beings, live in a web of interdependence. Every one of us is implicated, folded into that web, simultaneously depending on others, while others depend on us. The self-reliant individual is an illusion, which means that constructing societies based on that chimera is a doomed enterprise, bound in the end (just as we’ve seen) to fail so many on whom — though we may not know it — we depend.

Aging really is a roulette game. My partner and I are gambling that good genes, regular exercise, a reasonable diet and sufficient mental stimulation will keep our limbs, organs and minds healthy enough to, as they say, “age in place.” We plan to stay in the house we’ve occupied for more than 30 years, in the neighborhood where we can walk to the library and the grocery store. We don’t plan to get Parkinson’s or Alzheimer’s or congestive heart failure or (like yet another friend) take a life-changing fall down a flight of stairs. Having somehow forgotten to have children (and never wanting to burden even our hypothetical offspring in any case), we’re planning to take care of ourselves.

The truth is that we have much less control than we’d like to believe over how we’ll age. Tomorrow, one of us could lose the disability lottery, and like so many of our friends, we could be staring at the reality of growing old in a society that treats preparation for — and survival during — old age as a matter of individual personal responsibility.

It’s time to take a more realistic approach to the fact that all of us lucky enough to live that long will become ever more dependent as we age. It’s time to face reality and place caring for one another at the heart of the human endeavor.

[ first published this piece.]

[ edited this piece.]

The views expressed in this article are the author’s own and do not necessarily reflect 51�Թ�’s editorial policy.

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However, the concept of Long Covid also raises a broader question. If we can have Long Covid, can we also have long versions of other supposedly short diseases? What about Long Malaria? Long Pneumonia? Long Shingles?

 A look at Long Covid

When people first started reporting symptoms after the acute stage of covid had passed and they were testing negative, the initial response of the medical community was to label it as either ‘anxiety’ if the patient was young and particularly female, or as ‘natural aging’ if the patient was elderly. Not only did doctors dismiss the symptoms of the general public, they also dismissed the post-Covid symptoms of their fellow workers. Then the research began and the results started coming in—first in a trickle and then in a torrent.

COVID-19 has been generally viewed as a severe acute respiratory disease caused by the SARS-CoV-2 coronavirus. Long Covid refers to its after-effects, which can be broad in nature, evolving, and continue for an indefinite time. defines it as “an inflammatory or host response towards a virus that occurs approximately four weeks after initial infection and continues for a yet uncharacterized duration.” One meta-analysis looking at 14 to 110 days after infection listed 55 Long Covid , with the most common ones being fatigue, headache, attention disorder, hair loss, and shortness of breath. 

Another involving patients six months after ‘recovery’ found “functional mobility impairments, pulmonary abnormalities, mental health disorders.” Other studies also refer to brain fog, cognitive dysfunction, loss of taste and smell, pain in muscles and joints, depression, autoimmune diseases, and neurological impairments. A recent 2023 says the following: “More than 200 symptoms have been identified with impacts on multiple organ systems. At least 65 million individuals worldwide are estimated to have long COVID, with cases increasing daily.”

Such after-effects of covid should not have been a surprise to the medical community given the documented after-effects of previous pandemics.

Long-Term effects of 1918 Influenza Epidemic and other illnesses

After the 1918 Influenza Epidemic, many people suffered for weeks, months, and years. And were never quite the same again. Fatigue, insomnia, and depression were common post-flu symptoms. Admissions in psychiatric hospitals significantly for six years following the pandemic. People born during or just after the 1918 flu pandemic were on average slightly shorter as adults, and, some 60 years later, they showed a greater of heart disease and diabetes.

Given the past documented long-term effects of the 1918 Flu, not to mention SARS and MERS, and the current well-researched COVID-19, long-term effects of other illnesses seem not only plausible but .

 The discovery of Long Covid has led to the recent development of the term “post-acute sequelae of Covid-19” (PASC) — a medical term for the lingering after-effects of COVID-19. And by association, we’ve seen a renaissance of older, more general, terms such as ‘post-acute sequelae’ (PAS) and ‘post viral syndrome’.

The PAS of some illnesses are easy to believe because they affect the same primary organ and present similar symptoms as during the acute stage – only much later in life. Early childhood Pneumonia can in adult conditions of lung function deficits as well as “an increased risk of adult asthma, non-smoking related COPD, and bronchiectasis.”

Tuberculosis comes in two forms: active or latent. This means we can carry the tuberculosis bacteria within our body and it becomes active when our immunity is low. This can happen years or even decades into our life. Shingles is defined as an acute viral infection, but it could be said to be chronic on two counts. First, after the rash has disappeared, the pain can linger on for months or even years. And second, even once all symptoms are gone and the patient is said to have , “the virus remains latent in the dorsal root ganglia.” And so, similar to tuberculosis, shingles can recur, even years later, in times of stress.

The PAS of other illnesses are more difficult to accept because they are more varied.

Malaria is a parasitic mosquito-borne disease and has been found to be complex in its progress. After the mosquito bite, it can have an incubation period alone of anywhere from six days to one year before any symptoms show. Then, there is , which can continue for years. We seem to think that we have an illness and an infection only as long as we have a fever—but a silent infection can linger. Chronic malaria causes anemia, increased susceptibility to other infections, and even maternal complications. Furthermore, children who get the more dangerous version, cerebral malaria, have been shown to suffer from lifelong issues such as “cognitive, motor skills, and visual coordination impairment, as well as seizures and attention deficit hyperactivity disorder.” 

Dengue is a viral mosquito-borne disease. It is lesser known than malaria but equally or more prevalent. And since it is lesser known in the western world, dengue is relatively under-researched. Its febrile period is about a week, but its PAS—body pain, fatigue, and depression—continue much longer. Most studies did follow-ups for only a maximum of six months. But a Cuban study covering two years actually showed an increase in after the one-year mark.

A study looking at patients who had had more than two years earlier found they still struggled with impairment of vision, hearing, swallowing, sleeping, and arthralgias as well as memory loss, mental confusion, and chronic health problems.

For more than the past 50 years, research has shown how viral infections in general can have a long lasting impact. A 1970 showed that neonatal virus infection in mice affected their behavior and weight, which in turn affected their aging process. A 1985 showed exposure to viral infections in utero increased risk of cancer and diabetes in adulthood. And now it’s known that acute infections of respiratory and gastrointestinal systems can long-term inflammatory disorders.

Even a condition very limited in time and space like burns can have a “long lasting on the quality of people’s lives, with persisting problems related to scarring, contractures, weakness, thermoregulation, itching, pain, sleep, body image and psychosocial wellbeing.”

Three hurdles seem to be limiting our imagination to see these illnesses in their entirety and therefore our complete treatment of them: we seem desperate to see all illnesses as short duration, implying fully curable; if illnesses cannot all be curable, then we want to at least neatly categorize them as acute versus chronic; and we wish to clearly allocate each illness to a single organ.

How long is long?

We like to see people as either well or sick. And if we’re going to be sick, we want to be sick only for a limited and well-defined number of days. So we haven’t wanted to think of the long-term effects of diseases. But unfortunately, they exist. With coronaviruses, a found fatigue in 60% of so-called recovered patients at the 12-month mark. With dengue, a found clinical symptoms in patients two years after infection. With SARS, a found fatigue in 40% of the subjects at the four-year mark. And the 12 months, 2 years, and 4 years did not signify the end of the PAS – merely the end of the studies.

How long is “long”? Why should a disease that has somehow remained active in the body for so long suddenly subside at the 4-year mark? It may not work in accordance with our hope, our calendar, nor our attention span. A 2021 of post viral syndrome shows how the viral load and inflammation often subside immediately after the acute stage but then gradually increase years later, bringing in their wake old and new symptoms. Some that the 1918 Flu may have been responsible for the surge in coronary disease in the 1960s—some 40 years later.

Doing longitudinal studies of 10, 20, or even 40 years requires time, money, a long attention span, not to mention a historical bent. And we’ll have to wait to do truly long-duration studies of COVID-19. But in the meantime, we would be unhelpful and irresponsible to dismiss patients’ post-illness symptoms just because we can’t prove them, we don’t understand them, or we don’t yet have research evidence. What we don’t yet know about diseases and medical science will fill many textbooks in the future. We need to be humble and open-minded.

Rethink “acute” versus “chronic” and “single system” versus “multi system”

We also like to neatly categorize things. With illnesses, our practice has been to categorize them into chronic and acute. A chronic illness is slow developing and long lasting: like diabetes or hypothyroidism. An acute illness is sudden in onset and short in duration: like a broken bone or a heart attack or influenza (flu). But a broken bone can be the result of slowly evolving osteoporosis and a heart attack can be the result of plaque slowly building up in the blood vessels. And even a can have long PAS.

Perhaps there are no such distinct categories as acute and chronic. Perhaps it’s more of a spectrum. And perhaps one leads to another. An acute condition can be the result of a chronic illness. And what begins as an acute infection may have a chronic avatar. And furthermore, that chronic avatar may or may not be identical to the original disease.

We are prone to thinking of one illness as affecting one organ or, in other words, a single system. But this perspective is being questioned. Many autoimmune diseases—and even and —are now viewed as multisystemic.

Furthermore, Dr. Barbara Starfield, a physician and an academic, has said that many diseases themselves are not distinct entities, but rather entities, which are all associated with each other. She gave the that “people with hypothyroidism are four times more likely to have rheumatoid arthritis and cardiovascular diseases.” Dr. Debby van Riel, a virologist at Erasmus University in the Netherlands, even the flu as a multisystemic disease that affects not just the respiratory tract but many parts of the body.

And while COVID-19 is thought of as primarily a respiratory illness, Long Covid is “a multisystem disorder that commonly affects the respiratory, cardiovascular, and hematopoietic systems,” not to mention the neurological, cognitive, and musculoskeletal systems.

A recent German gives a list of over 25 ‘non-persistent viruses’ and an even longer list of their associated PAS. These PAS concern not only the primary infection organ, but also various other organs – making the long-term effects multisystem in nature.

Getting a fuller picture 

The reason we’re not getting the full picture of illnesses is primarily due to our refusal to see it. And our refusal to see the full picture is contributing to the partial treatment and persistence of such illnesses, not to mention the frustration and continuing disability of patients.

A 1939 study the following: “Malaria is a chronic disease, not alone an infection of the blood stream characterized by chills and fever”. And yet, even today, the World Health Organization (WHO) malaria as “an acute febrile illness.” That 1939 study also warned that “Failure to comprehend or detect its insidious course and its strong tendency to relapse, even after months or years, accounts for the fact that it still ranks as one of the serious social and economic problems.”  And yet an in the Lancet just last year was titled “Malaria: (still) a global health priority.” A 1987 presented the term ‘post-viral syndrome’ and hoped that “awareness of the syndrome will lead to an increase in its diagnosis in general practice”. More than three decades on, we’re still waiting.

In the spirit of optimism, our society likes to see diseases as short, clearly defined, and easily curable. Speedy onset, obvious symptoms, crisp diagnosis, a magic potion, and fast resolution. Long-term chronic conditions that do not arrive in a dramatic fashion, that have no clearly visible symptoms, and that dribble on are – let’s face it – boring. Doctors lose interest and sometimes even the families lose interest. The patients may not lose interest but they get exhausted by their struggle to be heard and believed over a course of weeks, months, and sometimes years. But with such myopic and dismissive behavior, we will continue to see only the fiery heads of the comets and miss their debilitating long tails. And in doing so, we’re failing to fully treat these diseases and we’re doing a huge disservice to the sufferers of PAS—leading to economic costs to our society as well as costs in lives only partially lived.

If we are to fully and effectively manage the long tail of diseases, we need an evolution in the perspective of the academic research community as well as the practicing medical community to view illnesses more holistically both in terms of time, encompassing years, and space, encompassing multiple body systems.

Today, we can use the unprecedented opportunity thrown up by the current discovery of, attention to, and momentum concerning Long Covid to finally do three things: ignite researchers to look into the long-term effects of other illnesses, convince medical practitioners to accept the possibility that seemingly short-term diseases can have long-term consequences, and help millions of patients to attain more complete treatment and support, giving them the opportunity to live fuller lives.

The views expressed in this article are the author’s own and do not necessarily reflect 51�Թ�’s editorial policy.

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The Netflix series also examines the advent of psychedelics in Western science in the 1950s, their unlikely but important role in the American public’s perception of the Vietnam war and the psychedelic ‘renaissance’ in recent decades. In the foreword to his book, Pollan explains the term “trip” is used to describe a psychedelic experience because of its potential to make users feel transported to an unfamiliar environment. Similar to traveling to a country where we don’t speak the native language and find our senses sharpened to sucessfully navigate our stay. Pollan also explains that he grew up suspicious of psychedelics but still felt pulled to investigate if there was more to psychedelics than just moral panic or frivolous excitement.

Pollan had heard of teams at New York University and UCLA working on using psychedelic drugs to help relieve emotional stress in terminally-ill patients. However, it was a research paper by a team at John Hopkins University that truly grabbed his attention.The titled  Psilocybin Can Occasion Mystical-Type Experiences Having Substantial and Sustained Personal Meaning and Spiritual Significance published in 2006, noted the results of a randomized controlled trial where 30 volunteers were either given doses of psilocybin or a placebo. Those in the former category reported having an experience of the “beyond” and rated it as one of the most significant experiences of life on par with the birth of a child or the loss of a loved one.

While he mentions some of the risks associated with psychedelics, he believes these findings challenge modern science, which is often dismissive of anything deemed too “spiritual”. This evidence also challenges our notions of consciousness, reality, and how humans deal with difficult and traumatic emotions. A self-proclaimed philosophical materialist, Pollan embarked on a well-intentioned journey to understand psychedelics and what they can do to the human mind.

Powerful Evidence for Psychedelic Healing

The Netflix series features several poignant examples supporting Pollan’s beliefs. A man in Switzerland, who took a high dose of LSD in a controlled study, reported experiencing the feeling of being in his mother’s womb as a baby with the umbilical cord wrapped around his neck. He said he could experience the fear of death, the choice to push the cord away and the relief afterward. Experiencing these memories allowed him to discuss his feelings with his mother and held great meaning for him.

In another case, a woman who had lost her brother to a drug overdose and her mother to suicide, participated in a study about MDMA in an effort to process her memories and emotions connected to these two events which were otherwise blocked. The drug made it possible for her to confront these events that were so deeply painful and shocking for her conscious mind, they had been repressed in her subconscious. Finally giving voice to her fear, pain, and sadness, she was able to move on and build a new life for herself.

Another beneficial substance that shows promising healing benefits is Mescaline.This substance is acquired from a plant called Peyote Cacti and is typically used by Native American communities. The show details the story of a man who struggled with substance abuse for 15 years and had requested a formal ceremony to help him overcome his addiction. This involved ingesting the drug but in a more religious and ritualized manner. After the ceremony, he reported feeling more grounded and clear about himself and his life.

Using these real life examples illustrates that psychedelics can help people process their emotions and manifest more refined realities for themselves that they otherwise were unable to envision because of the limitations of their conscious mind. While there is promising evidence to the benefits of psychadelics, there are still questions to consider. 

Opportunities and Questions to Explore

First, what does it really mean to change our mind? Is it merely the clearing of psychological pathways? Many people would argue that it is impossible to remove or edify certain imprints in our subconscious. Often, when we feel afraid or fearful, we recognize the feeling as a stomach ache or even shortness of breath. When we are happy and joyful, our body language becomes much more open and relaxed. Whatever our mind experiences subconsciously, our bodies experience it consciously and we are often aware of it.  Working through emotions and recognizing our subconscious thoughts, in our minds and bodies, might require meditation and therapy and psychedelic studies should incorporate these measures in near future.

Additionally, can the majority of such experiences genuinely lead to a deeper meaning in life? Even though we may be able to game our way out of certain mental blocks through psychedelics, can we change the societal realities that persist around us? If anything, this has the potential to widen the conflict between the mystical insights of such experiences and the hard materialist worldview of Western societies. There has to be greater acceptance of the spiritual and mystical aspects of life rather than just psychedelic drugs in the West.

Finally, while it sounds exciting to expand our scientific understanding of consciousness, does a more democratized use of such substances have the potential to destabilize societal conventions? Ayahuasca ceremonies are now notoriously commercialized and there is the risk that an excessive use of such substances can lead to disastrous consequences which may lead to the barring of these ceremonies. In their original contexts, such practices are carried out with utmost secrecy and the knowledge is held by a select few. This approach prevents exploitation and irresponsible use of psychedelics.

How To Change Your Mind, the book and series, provide valuable insights on the future of psychedelics in mainstream healing and medicine. Although Pollan’s optimism about the use of substances to change the human mind is inspiring, it is important to balance these findings with curiosity and caution. 

[edited this piece.]

The views expressed in this article are the author’s own and do not necessarily reflect 51�Թ�’s editorial policy.

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Every country – rich and poor, scrambled to find a balance between reducing the impact of the virus while keeping the economy running. Every country faced its unique challenges, but none more than India. The scale, complexity and diversity of the country coupled with its deep global economic integration meant India had to find counters to the pandemic required evolving its own financial, healthcare and social models.

And India did just that. With decisive political leadership of Prime Minister Narendra Modi, ingenuity of Indian pharmaceutical firms and their scientists, and adoption of a whole of government approach, India overcame the worst fears and potential downside scenarios. India created its own vaccine intellectual property, leveraged its technology and infrastructure backbone to distribute them, and helped the world in the true spirit of vasudhaiv kutumbakam: a Sanskrit word that means the world is one family.

India’s fortitude and collective resolve was based on its self-belief, which played a key role in the country’s resilience in facing the pandemic. India’s response to COVID has put India on a path of an ingrained aatmanirbhar, which literally  means self-reliance.

The views expressed in this article are the author’s own and do not necessarily reflect 51�Թ�’s editorial policy.

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Dr. Eric Dickson, president and CEO of UMass Memorial Health in Central Massachusetts told the : “When health officials ordered an end to elective surgeries during Covid-19, it was understood to be temporary. The difference now is we don’t see the end. We’re not seeing the light at the end of the tunnel. This isn’t a surge we’re dealing with. This is the new reality.”

Boarding is wrecking emergency departments

One significant cause of the trouble is something called which occurs when a patient is held in the emergency department after they have been admitted to the hospital because there are no inpatient beds available. In a written to President Joseph Biden by more than 30 medical academies and national associations, including the American College of Emergency Physicians (ACEP), the American Academy of Emergency Medicine (AAEM) and the Emergency Nurses Association, healthcare leaders implore the administration to recognize and address these most pressing issues. “Boarding has become its own public health emergency and our nation’s safety net is on the verge of breaking beyond repair.” 

The letter goes on to outline the underlying issues caused by boarding, “while the causes of ED boarding are multifactorial, unprecedented and rising staffing shortages throughout the healthcare system have recently brought this issue to a crisis point, further spiraling the stress and burnout driving the current exodus of excellent physicians, nurses and other healthcare professionals.” 

The winter months have brought this crisis to a head. In many parts of the United States, a “triple threat” of flu, Covid-19 surges and RSV or respiratory syncytial virus in the pediatric population is placing an insurmountable burden on the emergency departments across the country. The letter goes on to ask the President: “the  undersigned organizations hereby urge the Administration to convene a summit of stakeholders from across the healthcare system to identify immediate and long-term solutions to this urgent problem. The letter explains that the “breaking point” is completely outside the control of the workers and looks to the administration for help.

Since the Start of the Pandemic, Americans Are Drinking Too Much

Doctors, nurses and other healthcare workers burnout

Another issue compounding the present crisis is healthcare worker burnout. The American Medical Association (AMA) recently released a revealing that almost 63% of physicians felt burned out in 2021. And these statistics aren’t reserved solely for doctors; nurses, physician assistants, technicians and other healthcare workers are reporting similar burnout numbers. Feelings of burnout and being overwhelmed are plaguing the American health workforce and reflect a systemic breakdown in healthcare. According to Chrisine Sinsky, MD, AMA vice president of professional satisfaction: “While burnout manifests in individuals, it originates in systems.” Burnout is not the result of a deficiency in resiliency among physicians, rather it is due to the systems in which physicians work.”

Looking for a Safe Place in Facebook’s Digital Universe

The rate of burnout is a major contributing factor to staffing shortages and needs to be addressed. The letter addressed to President Biden recognizes this issue and calls for solutions: “Overcrowding and boarding in the emergency department is a significant and ever-growing contributor to physician and nurse burnout, as they must watch patients unnecessarily decompensate or die despite their best efforts to keep up with the growing flood of sicker and sicker patients coming in.” 

Healthcare workers who experience burnout have a much higher rate of early retirement and/or leaving the practice of medicine altogether. It also directly contributes to the loss of skilled healthcare professionals, adding more strain to those left behind. The letter states: “It is critical that we end the burnout cycle in the emergency departments to ensure our nation’s health care workforce can meet the needs of its patient population.”

It is quite clear what problems are facing the healthcare system in the United States. And with this crisis looming over the heads of millions of Americans, it will be imperative for the government and its agencies to recognize the scope of the problem and to act accordingly. 

The views expressed in this article are the author’s own and do not necessarily reflect 51�Թ�’s editorial policy.

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I have been thinking about this subject matter for some time now and could not help noticing that there are as many International Financial Institutions/Regional Development Banks/Funds as there are SDG’s! That is as inefficient as it is unsustainable.

COVID-19 has to a large degree pushed back the realization of these global goals and slowed down whatever dynamic previously existed. It’s time to get the machine going again and full throttle this time. The long and the short of it is that all the development partners must urgently reconsider deploying their current approach towards the delivery of their development finance work aimed at the recipient countries. This is the only way we can cover the lost ground and hope to achieve the SDGs by 2030. 

The UN must exercise its leadership

The first idea that comes to mind is for the United Nations (UN) to step in and encourage the International Financial Institutions, the Regional Development Banks and Funds to refocus their future country partnership frameworks, strategies and programming priorities. They must move away from the present overstretched exposure and instead zoom in on just a couple of SDG’s. That  means that each IFI/MDB/Regional Bank/Fund should be thinking about taking the lead in targeting at least two key SDGs while studiously avoiding overlap from the others. At the same time it means pulling back and placing less emphasis on the remaining SDGs. This would be a vast improvement over the current muddle in which each International Financial Institution Bank and Funds tries to target all the SDGs at once.

For example, the World Bank Group could take the lead in SDG1 & SDG10. At the same time the International Fund for Agricultural Development (IFAD) would focus on SDG2 & SDG15 and so on. These are just examples. But if this is done, each developing country in the world will have a diverse (and a more specialized) set of institutions, banks and funds addressing all its 17 SDGs. This contrasts with the current ineffective way in which everyone is trying to do too much at once and then wondering why nothing is successful! 

Of course, each country will still have the obligation to continue to address all its applicable SDGs. But the International Financial Institutions, Regional Development Banks and Funds need not be distracted by attempting to attain all the development goals of the same country at the same time. When each development institution focuses on what it does best, it has a much better chance of supporting the developing countries in their quest to catch up on what is missing or lagging behind concerning their SDGs.

Is Sustainable Finance More Hype Than Hope?

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Moreover, it would become paramount for all the International Financial Institutions, Regional Development Banks and Funds to meet regularly, preferably every quarter until 2030, which has been designated as the final year set to reach the global goals. This should become the most urgent global development agenda item today. It would be the ideal means of reaffirming the message of seriousness in the pursuit of these goals. We absolutely must redouble all our efforts in the fight against poverty since development partners and developing countries need to be continuously involved in a dialogue permitting them to discuss among themselves and report on progress. More crucially they must decide on the redistribution of the SDGs among themselves, in other words, which partner will be leading, and which one will be supporting which goal.

This in my opinion is a much more efficient way of allocation of scarce resources. It takes into consideration the spirit of the “Paris Declaration” by instilling amongst all the development partners and countries the ‘H.O.R.M.A.’ principles: H=harmonization, O= Ownership, R= Results, M=Mutual-accountability, and A=Alignment.” That is the best way of putting back on the agenda of development cooperation the question of “who is jointly-responsible for which country’s development program and results”.

An SOS call

The above proposal is a “Save Our Ship/Souls” call. It is required since there seems to be no other way today to reach these global targets by 2030 other than seriously rethinking, refocusing and redefining our current process in “delivering development.” This is also an open call for International Financial Institutions, Regional Development Banks and Funds to refrain from their current “keeping up with the Joneses” routine, which has led to many replicating and duplicating each other’s work, with the added effect that they become stretched so thin they accomplish little or nothing at all. As one famous Arabic saying goes, these global goals end up looking a bit like “blood spilt among the tribes” as no single International Financial Institution, Regional Development Bank or Fund can be explicitly held responsible for the realization of any single goal.

How the G7 and UN Can Make Multilateralism Sustainable

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In summary, each development partner would focus on its comparative advantages and what it can deliver best rather than trying to address all the 17 goals or 169 targets under the SDGs. This should also move the current dialogue from being an internal ‘beauty contest’ to an external “global plan for action.” And since the developing countries will always be in the driving seat, the institutions, banks and funds must continue to facilitate this process and shoulder more responsibility with regard to the decaying human condition.

On a final note, we have a UN Security Council that seeks to prevent the killings of innocent people by preventing wars or conflicts. We now urgently need more than ever a similar but Socio-Economic Council within the UN with the teeth to prevent the death of millions of humans who die every day as a result of abject poverty, hunger, and spreading diseases due to the misallocation of scarce natural and human resources. This might be the last chance for the UN system to make a real impact and a difference to unite for peace and development.

I do hope and pray that the SDG’s will be achieved by 2030, but for this to happen, we must all act together and NOW, and embrace with utmost care the delivery of development cooperation.

The views expressed in this article are the author’s own and do not necessarily reflect 51�Թ�’s editorial policy.

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Hand-in-glove with UHC is the establishment of a National Health Service (NHS) charged with delivering it. There is no set template for an NHS and have developed different schemes, all with greater or lesser involvement of state or state-backed insurance schemes and patient contributions. In general, NHS systems have proven effective in their provision and very popular with patients. There is little evidence of patients being unable to obtain care owing to inability to pay or denial of insurance, since coverage is a statutory requirement. However, most countries continue to face NHS challenges arising from aging populations, increased demand, pandemic crises, staff shortages, and new and often expensive treatments. In some countries, especially the UK, such challenges have translated into chronic delays in treatment and long waiting lists, often running into years.

Universal Health Care versus Private Provision

Some countries have eschewed UHC, the most prominent being the US, which by far spends the most per capita on health care, some US$3.6 trillion in total in 2018 or US$11,172 per person. This represents at least 1.5 times that spent per capita by European countries. Despite such expenditure, timely treatments, full staffing, and the latest technology, the US only 22^nd in the global list of effective health care. There are many reasons for this discrepancy (e.g.; Dorn’s classic 2008 ), including a highly fragmented non-national system and differential standards, insurer disavowal of cover for certain conditions, and patient inability to pay premiums owing to poverty or unemployment. showed that some 28.1 million citizens had no health care insurance. Over the next three years, the figure remained relatively static and it was still 27.96m or 8.6% of the population.

Thus, it may appear that, ideologically speaking, there exist two directly opposed approaches to health care – UHC and private provision. While in UHC countries there has always been a degree of private health care, the standard expectation and culture is that “UHC rules.”  However, the pressures to accept greater private provision have grown inexorably, and especially in countries such as the UK that have elected radical-right governments continuously since 2010. Privatization of the NHS has always been an ultimate objective of the Conservative (Tory) Party since 2010. At the same time, Tory governments have deliberately masked and downplayed their intentions, owing to the population’s jealous ownership of “their” NHS and the risk of political suicide for any party openly advocating dismantling the NHS. Ironically, while the UK radical-right government has been keen to introduce a US-style private health care provision, in the US there have been for UHC as a means to counter the worst characteristics of a US system that perceive as broken.

Rather than seek to answer the question ‘which approach is best?’, this article presents a case study of one example of the tensions between the two competing ideologies. 

70+ Years of the UK’s National Health Service

The National Health Service Act 1946, which came into effect in July 1948, had as its the provision of health care universally available to all and free at the point of use. While 74 years later that principle remains the public mantra of all mainstream political parties in the UK, nevertheless Conservative governments since 2010 have initiated an accelerating drive to change  its fundamental structure, funding and delivery of health care. These changes are encapsulated in the new. Services ‘free at the point of use’, while still guaranteed, are now open to much greater private competition. 

Will this result in private fee-based provision, currently a lesser part of the existing two-tier health service provision, potentially overtaking free NHS delivery? This has already emerged in dentistry, for example, where so many dentists have quit NHS provision to go private that some localities no longer have a single NHS dentist. Will general practitioner (GP) practices follow the same pattern, or will they cater for both NHS and private patients but with an access and delivery bias towards private patients? Other high demand, low provision services, such as podiatry, physiotherapy and mental health, are under similar threat of a private practice bias.

Continuously increasing pressure on NHS finances and resources have provoked these changes that correlate with a variety of convergent causes. First is demographic changes, such as population increase and an increasing proportion of the elderly. The emergence of  many more effective but often expensive treatments has seen the rise of more demanding patient expectations in a society of ‘consumerist entitlement,’ fed on internet and social media information. Then there is a long-term trend that has produced a shortfall in medical staff and state funding And, of course, the Covid crisis has added to the woes of an NHS creaking at the seams. Long-term underfunding of the NHS has led to long waiting times, and created pressures for private care as a solution. NHS commissioners are now compelled to increase contracted provision and, under political direction, to choose private contractors.

Governments face the dilemma of maintaining and improving health care provision in line with medical advances and public demands, while finding ways to pay for it all. UK political parties and the health care professions concur that the ‘old model’ NHS is no longer fit for purpose. However, will the model of the new 2022 Act produce the promised ‘salvation’ the present government asserts? Or, will it degenerate into a “dog’s dinner:” a dysfunctional, systemic mess from which the only beneficiaries will be private doctors and surgeons, insurers, private corporations, their investors, and financially secure patients, while the mass of patients without adequate finances will be taken back to a primitive pre-NHS reality on a par with third-world health care?

A Climate of Amoral Calculation

Right-wing politicians in the UK reflexively insist on pushing for greater private funding and provision of services, arguing that a wholly publicly funded and run health service is bound to be cost-inefficient, top-heavy with administrators, unwieldy, and unresponsive to changing contexts and needs. Private health care providers, they argue, are much faster and more cost-efficient. Such providers, they assert, are entitled to be profitably paid for their services and, as respectable and ethical enterprises, they would never extract excessive profits or engage in any underhand or lazy practices to the detriment of patients. Unfortunately, in practice the evidence shows that all are not such paragons of virtue.

Examples are legion. The private sector – including many of the contractors to the NHS – has come in for considerable criticism. Especially egregious practices include the failure to address adequately and resolutely growing evidence over several years of mass clinical fraud, negligence and cover-up. The of Ian Paterson –  a surgeon jailed for 20 years, who for over 14 years falsely diagnosed healthy patients as having cancers requiring mastectomies –  resulted in “well over 1,000” unnecessary breast removals at two Spire private clinics and three NHS Hospitals. The in 2020 found that the managements of these hospitals had a “culture of avoidance and denial” and exercised willful blindness to mounting evidence and ‘whistleblower’ reports. It concluded that the private clinics had not demonstrated that they were yet capable of meeting the high standards required. It recommended a new more stringent regime for all such facilities.

Of course, this does not mean that all private health care provision is incompetent, poor value for money, fraudulent, or worse, damaging or dangerous for patients. Nor does it mean that the long-standing public/private partnership arrangement that characterizes the NHS cannot and should not continue both in principle and in practice, so long as there are stringent monitoring, control and independent auditing systems in place, reinforced by both NHS and government determination to stamp out unethical, harmful and, especially, criminal conduct.

Therein lies the rub. It has become abundantly clear that throughout the life-cycle of private contracting to the NHS, from bidder approval, tendering, terms and conditions, pricing, award decision and onwards to delivery and termination, “light touch” laissez-faire oversight predominates. Moreover, one is left with a feeling that a cozy “turning a blind eye” collusion exists whereby a culture driven by the strategy of “what can we get away with?” has been allowed to develop. A pursuit of profit above all other considerations encourages, if not ensures, a heavy reliance on amoral calculation by some of those engaged in private health care.

Who Are the Private Companies?

In the public’s perception, the most visible and longstanding private healthcare companies are those established by, such as BUPA, AXA, and PHP. The major ‘medex’ insurers have also acquired hospitals and GP group practices. Many citizens receive free private health care from such companies as a result of employee benefit schemes, although, increasingly, others are prepared to pay from their own pockets. A disincentive for self-funders is that annual premiums increase markedly with the insured’s age and tend to become prohibitive by late middle-age, especially if claims experience is poor. Premium renewals are heavily affected by “claims made” e.g. operations, treatment for serious illness, or frequent consultations. Thus, typically cover for self-funding individuals is for ‘major medical only’ while excluding routine GP-type provision. Nevertheless, via the 2022 Act the government clearly intends to encourage, if not persuade, the mass of patients to acquire private medical insurance, and this would include cover for GP services.

Other major corporations operating in the UK health care sector include Spire (now owned by the Australian company Ramsay Health Care), Circle, and HCA, which run extensive networks of private hospitals and clinics. They are high-profile bidders for NHS clinical provision contracts, although following Circle’s business failure in 2015 of its management franchise running of the NHS, such major ‘whole facility’ contracts are less likely.

However, many other companies, often foreign-based, operate in the UK private health care sector that contract services to the NHS unobtrusively. Ownership of GP services, typically group practices, by private corporations (often US-based) rather than the GPs themselves, has become increasingly commonplace. These include Centene, Babylon, Operose, Livi, SRCL, and First Practice Management. Continuing corporatization for profit, if not strictly controlled, would totally undermine the ‘not-for-profit’ foundation of the NHS and enable excessive extraction of profits by foreign beneficiaries.

GP Services in Privatization’s Crosshairs

According to the research body, the amount spent by the NHS on private sector delivery overall in 2019-20 totaled £14.4bn, much higher than the £9.7bn shown in the Department of Health and Social Care’s accounts, since the latter excluded a number of categories including GPs and other primary care services.

For several reasons, GP services have become the new target for private corporations. One is the fact that, whereas the public may imagine that GPs are employees of the NHS, in fact GPs have always been private outsourced contractors to the NHS, working on “contracts for services” and not “contracts of service.” Another is that GP patient lists –  the basis of NHS payments to GP practices –  are growing. In addition, new GP numbers continue to fall while many experienced GPs are quitting early, long before normal retirement, or going part-time, owing to feeling overworked, under-paid and under-valued. One in six GP posts remains typically vacant for long periods. Both the and the report that in some cities there are now fewer than 50 GPs per 100,000 patients, or 25% more patient load per GP than the accepted NHS ‘safe’ ratio. According to NHS data, GPs typically now have 2,500 patients each instead of 1,600, and in some cases over 6,000.

Increased demand and decreased provision establishes an attractive context for private corporate acquisition of group GP practices running perhaps half-a-dozen or more surgeries, typically in urban locales. Their business model is to move away from traditional face-to-face consultations with an attentive, caring “usual” GP, and replace them with remote online and phone consultations randomly from a bank of GPs. The Covid crisis and avoidance of face-to-face appointments presented an unexpected opportunity to introduce and test the new model in practice as an operational and regulatory necessity. As a result, some patients (including the authors) have not seen their usual, or any, GP since 2019. This loss of face-to-face access risks damaging accurate and timely diagnosis. The cross-party Health and Social Care Committee of the House of Commons has examined the future of GP services. Its latest parliamentary report is of the degenerating GP experience for many patients, which has resulted from this new business model.

Profits Before Patients

With corporate-owned GP practices, emphasis on extraction of profits increases at the expense of reinvestment into, for example, additional GPs, nurses, ancillary staff, and improved phone call handling systems. These are  needed to cope with increased patient demand by enforced remote access in an ‘online and phone only’ health care environment. For example, Operose Health UK, the UK’s largest group of GP practices and owned by the US Centene corporation, has some 600,000 NHS patients. In June 2022, BBC Panorama ran a damning, alleging that patient referral documents remained unread for months and that Operose routinely used poorly supervised ‘physician associates’ as less qualified but cheaper substitutes for fully qualified GPs.

In a group of six GP practices owned by another hierarchy of corporate owners in a South Coast city, patients (including the authors) typically experience up to a 1 hour or more wait in phone queues for routine access, only to be cut off by a time limit. Their online e-consult facility also has a daily quota and time cut-off, thereby similarly forcing patients into an unwelcome and stressful ‘first come, first served’ competition with each other. Often, the e-consult facility is unavailable for days at a time. In response to a formal complaint about its dysfunctional call handling system, the practice”s management stated in writing that a decision had been taken to “reduce the number of phone lines into the center” so as to save patients’ money caused by long waits. It added, “we are not currently looking to change this decision.” Investing in an improved phone and call handling system appears trumped by the focus on profit extraction.

Moreover, the ultimate ownership of such practices is usually impossible to establish, owing to intricate layers and networks of corporate shareholdings that block transparency. Similarly, determining just how much profits are being taken is almost impossible, as many avoid filing full UK accounts by using subsidiary account rules. Intentional opacity is a salient characteristic of such companies.

The next logical step by corporately-owned GP practices is likely to be to an expansion of a “private patients only” regime, whereby consultations, treatments, blood tests, vaccinations etc will all be fee-based and no longer fall within the free NHS provision. This move will follow in the footsteps of UK dentists, many of whom have withdrawn from NHS provision. Thus far, the withdrawal of GPs as NHS contracted providers is a minority, but the trend is likely to accelerate as more GP practices are acquired by profit-driven companies. The prospect of having to pay for GP services will hit the poorest, and, for many, it may deny them the “provision of health care universally available to all and free at the point of use” warranted by law for over 70 years.

Private health care take-up has been increasing, especially via employment benefit schemes and particularly by those in the 20-40 age group who are more willing to self-fund insurance premiums or fees. They tend to perceive private health care as an essential commodity, comparable to other lifestyle purchases, such as online multimedia packages, Netflix, and expensive gym subscriptions. However, the big risk is that in times of economic downturn or cost-of-living crises, such necessities will be dispensed with as unaffordable luxuries. 

Is the NHS Safe in Tory Hands?

Despite the Conservative government’s Health and Care Act 2022, which is reassuringly intended to ‘reform’ the NHS and its provision, including a much greater emphasis on private sector outsourcing, concerns abound. One is that its main impact will be to sanctify in law private profit at the expense of patient health care, while exempting delivery from standards of public responsibility and proper accountability. A detailed study by Goodair and Reeves published in in July 2022 showed that over the period 2013-2020 “private sector outsourcing corresponded with significantly increased rates of treatable mortality, potentially as a result of a decline in the quality of health-care services.”

Thus far, the public seems unaware of this new stealth assault – literally “hidden in plain sight” – on what they still imagine will continue to be a guaranteed free-at-the-point-of-use NHS. Not that they don’t care. Few have heard about the changes. Fewer still know about the scope, scale, content and impact the 2022 Act will have on them as patients. As the truth dawns  – that perhaps the NHS is not safe in this particular government’s hands and that patients may increasingly find that they will have to pay for GP services among others – it is likely to become a major general election issue. The government and NHS will have a tough job ‘selling’ this new regime to the public, and any hint of ‘economy with the truth’, deception, outright lies, or brazen confidence trickery will prove unwise.

Increasing corporate ownership of GP services could be made to work satisfactorily for patient care, but that would require new stringent criteria and robust monitoring, control and transparency arrangements that are currently missing. These would include: (a) complete transparency of GP ownership and accounts; (b) independently audited publicly available accounts of GP practices; (c) regular independent audits of management and clinical provision by GPs. 

Rigorous assurance of contract compliance will be crucial. The Care and Quality Commission will not be robust enough for these audit tasks. If it is to provide any benefit let alone maintain its credibility, the level of independent auditing (and corrective action) cannot be ‘tick the box’ or appear as superficial ‘window dressing.’.

Failure Is Not an Option

The 2022 Act is one heck of a gamble. The larger and more complex any system is, the higher the likelihood of dysfunctionality or even total failure. In particular, if the new ICBs (Integrated Care Boards) fail, that alone could result in an end of the NHS. The headline preventive elements that may be required –  but thus far are not evident –  include:

• Compulsory liability/surety bonds amounting to, say, 10% of pre-tax turnover imposed on all corporate entities and their individual board members that seek to provide services to the NHS. This is to focus their attention on their duty-of-care obligations and the penalties for failure.
• Compulsory fit-for-purpose registration and competence certification of all insurance entities and their professional and sales staff engaged in offering Private Medical Expenses Insurance. This is to deter fly-by-night opportunists and scammers.
• Regular compulsory independent validation and verification audits (to national criteria, standards and certified auditors) of all corporate policies, strategies, operations, and management systems, in relation to contracted provision of services to the NHS, including GP services. This is to provide systems assurance that requirements are appropriate and are in fact being implemented, and to counter the “what can we get away with?”tactic.
• Regular review of speed of implementation and effectiveness of remedial recommendations in compulsory audit reports. This is to ensure that remedies for system defects are in fact implemented promptly and effectively, and to counter the ‘what can we get away with?”attitude.
• Legal penalties for corporate wrong-doers (both organizations and individuals), including, say, 10% of pre-tax profits and where appropriate (according to the nature and scale of the offense as well as repetition), jail sentences, and/or fines, asset confiscation, compensation orders, directorship bans, and compulsory “name-and-shame” orders. This is to ensure that duty-holders are made accountable for serious offenses.

While some legal difficulties in imposing such controls exist, these must be overcome so as to prevent abuses that favor private contractors while harming patient health care, personal finances, taxpayers, and public trust and confidence in government. Analogues for such tough controls exist. For example, following years of uncontrolled public harm by cavalier online and social media platform owners, the Online Safety Bill will likely impose a number of broadly similar controls on such companies and senior executives. In health care, the government must place the emphasis on prevention and fairness now, rather than on future corrective reaction to malpractice or malfeasance. Failure to do risks  fomenting widespread social discontent and even public disorder. The UK experience should also provide a salutary warning to other countries.

The views expressed in this article are the author’s own and do not necessarily reflect 51�Թ�’s editorial policy.

The post UK’s NHS is Broken: Is Private Medicine the Answer? appeared first on 51�Թ�.

The effects of conspiracy theories in Italy were particularly noticeable when a wave of spread across various moderate to large cities last year. A small portion of the Italian population protested all over the country against the government’s mandatory vaccinations and use of the , a document needed until April 1, 2022 to enter public places and given only to those who had been given both vaccine doses. The conspiracies fuelling these protests focused on the government’s handling of the pandemic, the dangers of vaccines, and the basic existence of COVID-19. While most protests were peaceful, conspiratorial belief pushed some individuals to carry out violent attacks.   

Conspiracy Theories and COVID-19

Conspiracy theories can be as “attempts to explain the ultimate causes of significant social and political events… with claims of secret plots by… powerful actors.”  Scholars find that they tend to arise in correspondence to incomprehensible and unexpected worldwide events that feelings of fear, uncertainty, lack of control, and stress. Individuals who possess these feelings tend to believe in conspiracies because they provide alternative and simplistic answers to events which would otherwise be difficult to understand. 

The COVID-19 pandemic has created the perfect environment for conspiracy theories to flourish. Given its uncertain and inexplicable environment, people have turned to conspiracies to better understand the situation they are living in. In addition, thanks to the stay-at-home orders, people have spent the majority of their time on social media platforms, which are rife with conspiracy theories. 

Myriads of radical right extremists were and continue to be extremely active on social media platforms. They spread numerous conspiracies regarding the origins of COVID-19. While some were new in nature, others were readapted old tropes which came to include the pandemic. Some of the most common conspiracies disseminated by the radical right were: anti-Asian (with many different scenarios speculating as to whether poor food hygiene was to blame or whether Asian governments intentionally created and spread the virus to secure global dominance), anti-Semitic (the Jewish population was blamed for spreading the virus to advance its financial goals), anti-immigrant (with a readaptation of the Great Replacement theory, itself often imbued with implicit anti-Semitism, in addition to anti-black and Islamophobic elements), anti-government (governments were blamed for controlling and suppressing societies by taking away individual freedoms) and anti-vaccine (governments were criticised for using them to monitor people). 

Conspiracy Theories in Italy: Dangerous or Not? 

Last year and early this year, Italy experienced a wave of nationwide protests, with individuals expressing their anger towards imposed by the government. The government imposed vaccinations for workers in almost every sector. Workers who refused to be vaccinated were to have their employment terminated. The Green Pass was mandatory too. Italians utilized their right to protest to express their anger against these policies. Sadly, this anger is often fuelled by nefarious, conspiratoracies. Some of these clearly encourage individuals to carry out violence during or after the protests.  

Between September 2020 and April 2021, during the first wave of nationwide protests , Italian citizens against the government’s mandatory lockdowns, they questioned the existence of the virus, and doubted the COVID-19 vaccine. Their anger was reinforced by a series of conspiracy theories that had spread on social media. Most of these stated that COVID-19 did not really exist, but was actually a falsehood perpetrated by governments to control individuals. They claimed that the Italian media was exaggerating the number of deaths and cases in the country. They also argued that governments had created vaccines to monitor individuals. Furthermore, these vaccines were believed to be dangerous as they were created far too quickly and without enough tests to prove their efficacy.

This more recent wave of protests was also founded on conspiracies ranging from anti-government to anti-vaccine. A portion of the Italian population is convinced that the government is consolidating its power over its citizens by controlling them, taking away their individual rights and freedoms, and controlling the country’s money supply. They also believe that vaccines are still harmful and should not be administered to young children. Protestors have come to define the Italian government as a “health dictatorship or tyranny.” In November 2021, a massive crowd in Milan greeted the well-known vaccine skeptic , praising his words against the Green Pass and mandatory vaccination. 

Unfortunately, as mentioned earlier, not all protests were peaceful. Some resulted in violent attacks. On April 3. 2021, attacked a vaccination hub in Brescia, Lombardy with multiple incendiary devices. Investigators and prosecutors argued that the main of the perpetrators was to damage the hub and interrupt the vaccination campaign in the city. 

The attack was a direct outcome of Pluda’s journey into conspiracy theories. On his Facebook page, Pluda shared a variety of posts, pictures and memes of different conspiracies ranging from anti-government to anti-immigration, from anti-vaccination to anti-COVID. He believed that COVID-19 was a hoax and that the government had created it for its own agenda and that vaccines were created to control the population. Because of his beliefs, Pluda took part in many of the anti-vaccination and anti-COVID protests, which he advertised on his Facebook page with the aim of  gathering as many of his friends and followers as possible.

Other protests at taking down the government and changing the social and political order. These protests turned violent when on , protestors guided by the leaders of Italy’s far-right groups, such as Forza Nuova, broke into the headquarters of the Italian General Confederation of Labor (CGIL — Italy’s most important trade union) in Rome and caused havoc. Protestors managed to overtake police officers at the entrance and gradually make their way through the offices, damaging furniture, destroying objects and breaking windows. 

How to Curb Violence?

After the violent attack in Rome, Italian prosecutors and investigators have been working to arrest any individual with extreme and radical views who was tied to the protests. Many of the individuals arrested were part of a Telegram channel called “” (“Stop the Dictatorship”), which has been taken down because of its hateful comments. The channel boasted several thousand members that talked about taking up arms, committing attacks on Italian institutions and taking down the health dictatorship. 

While this is a step in the right direction, the Italian government can implement more information campaigns — both online and offline — which could be crucial to avoid the spread of conspiracies. By increasing the amount of factually correct information on vaccines and COVID-19 and by taking down posts, videos, and memes that spread conspiracies, the Italian government could mitigate violent attacks in the future. 

Conspiracy theories can be dangerous and can push individuals to commit violence, especially when the environment is stressful, inexplicable, and uncertain. The conspiracies related to the COVID-19 pandemic have pushed individuals worldwide to commit violent attacks. Italy is no exception and, like other nations, must act speedily to curb such violence.

The views expressed in this article are the author’s own and do not necessarily reflect 51�Թ�’s editorial policy.

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The post How Dangerous Are COVID-19 Conspiracy Theories In Italy? appeared first on 51�Թ�.

[We’re going to try something new here at 51�Թ�. I live in a small, quirky carriage house in Washington, DC, and this column is my view of DC as I see things. If I don’t get too much hate mail, then maybe we’ll keep it rolling. On the other hand, if I get enough hate mail, maybe I’ll keep doing it “just for the sake of my own stupid pleasure.” Let’s find out.

P.S. Each heading is a quote from something somewhere or other. To the person who emails me 11 correct identifications, I’ll buy you a drink at Martin’s Tavern…or we can have a friendly chat over the phone while ��’m at Martin’s having a drink. Why 11? Because that’s how we play around here.]

“Water, water every where, / Nor any drop to drink.”

After spending trillions and trillions of dollars on COVID, much of it recklessly, Congress is digging through the couch cushions to find another $10 billion for actual COVID treatment. How did this happen? 

Start off with the fact that most of the money was thrown at transfer payments, not on treatment. To a degree this was entirely understandable, but the level of fraud that has come to light is staggering. Both parties spent like drunken sailors, but the most egregious was US President Joe Biden’s $1.9 trillion extravaganza as the pandemic was waning. That law, amongst other things, bought tremendous “relief” to the poor, pitiful state governments that are presently drowning in cash. We also had a million other things that were tangentially related to treating the coronavirus. Oh, and we bought inflation with that money. Maybe you’ve heard something about that?

��’m not saying the Republicans were any less scattershot, but they spent the money when a) the virus was a real unknown, and we were going into the lockdown blind, and b) we had not developed an actual, real, very good vaccine. When Biden splurged cash, several vaccines were already in production. The issue now seems to be whether to use unspent funds from other COVID programs to spend it on… wait for it… actual COVID treatment. What an idea! Yet here we are in a panic over what is, relative to other COVID spending, a drop in the bucket.

Speaking of panic… 

“It was like when you make a move in chess and just as you take your finger off the piece, you see the mistake you’ve made, and there’s this panic because you don’t know yet the scale of disaster you’ve left yourself open to.”

Senator Mark Kelly of Arizona must be in a panic these days. Around the turn of the year he was perp-walked into a volley of machine gun fire on the Build Back Better bill that failed, and his “yea” vote has come back to haunt him. Perhaps that’s why he’s so eager to embrace . 

Title 42 was a Trump administration program that prevented immigrants from entering the US during COVID. Lifting such a restriction is understandable now that the pandemic is on the wane. However, this does not jive with retaining restrictions that the Biden administration seems to be fond of. The Department of Justice is appealing the revocation of the public transportation mask mandate by the court. 

This inconsistency is largely immaterial relative to the burning issue of asylum seekers. The “Remain in Mexico” policy keeps asylum seekers south of the border while their claims are heard in the US. The Biden administration sought to end this policy, which Texas is currently enforcing. The administration’s lawyers took Texas to the Supreme Court on Tuesday, April 26. Clearly, immigration will be on the ballot come midterms in November.

The combination of “Remain in Mexico” and Title 42 prevented the spread of COVID and avoided a bum-rush to the US border. If both of them were to go, there would be a tsunami of immigration. The Democrats in swing states might find voters would like them to be giving a damn about this issue, which hits headlines as immigrants surge and families are inevitably broken up every summer.

“This is family business,
And this is for everybody standin’ with us”

And while we’re talking about dealing with families, there’s a distinct disjoint between the rhetoric surrounding Florida’s “Don’t say gay” , a mischievously if ingeniously labeled piece of legislation, and its popularity. This law does not want kindergarten children taught liberal sex education. When told what’s in the law and not just spoonfed the hashtag du jour, folks seem to like it. Go figure.

Polite circles won’t mention this, but according to a by Public Opinion Strategies, Democratic voters support the law by 55% to 29%. Biden voters swing 53% to 30% in its favor. Even those who “know someone LGBTQ” go 61% for and 28% against, and just to show that Disney is on the wrong side of this, parents like the law to the tune of 67% to 24%. Disney brought a knife to a gunfight by supporting this law. 

Social mores may have brought “a whole new world,” but Disney seemed to have wished upon the wrong star, and its special treatment by the state of Florida is over. Governor Ron DeSantis signed a bill into law that revokes the status of Disney’s independent district, Reedy Creek. There’s now even talk of taking away the entertainment behemoth’s preferential copyright treatment.

Turns out running your own independent “Magic Kingdom” is a lot less expensive than letting the government run the show. Sure, Disney could probably fix potholes and run emergency services and utilities better and cheaper. Once the new law takes effect, Disney will also lose control of land use, building standards, and environmental protection that it has enjoyed for decades. Insiders predict Disney will have to pony up of dollars annually to the government now and join the hoi polloi.

If Disney is going to support progressive policies, what could be more progressive than letting government get more involved? frets that Disney will no longer be able “to manage its own streets, permitting, bond issuance, and so forth.“ Wait, I thought corporate control over things government usually does was a great threat to “our democracy.” At least that is what left-leaning publications like Slate tell me.

But lo and behold, even Mother Jones is defending corporate personhood, an idea hitherto hated by Democrats, with a stating Disney’s Civil Rights were violated. To be fair, Mother Jones has said it stands against corporate personhood but dislikes Republican hypocrisy. However, the defense of Disney’s special privileges by blue-blooded Democrat-supporting publications certainly seems incongruous. However, there might be a way out of this Disney-Florida impasse. The law doesn’t come into force until June 1, 2023, so there’s plenty of negotiating to be had.

Part of the problem was the over-the-top language Disney’s CEO Bob Chapek chose when he the Florida bill “yet another challenge to basic human rights.” Mr. Chapek, Bob. May I call you Bob? Bob, didja read the bill? This isn’t Bucha where basic human rights are being violated. No cluster munitions spray labeled “for the children” are being dropped. These are first world concerns at best. A pertinent section of the law reads “Classroom instruction by school personnel or third parties on sexual orientation or gender identity may not occur in kindergarten through grade 3 or in a manner that is not age-appropriate.” Bob, take a deep breath: this is not exactly a Nuremberg Trial transcript.

When I think of Bob’s situation, it reminds me of what happened to Rob Manfred, the commissioner of Major League Baseball (MLB). He moved last year’s All-Star Game from Georgia to Colorado in the wake of the supposed “voting rights” kerfuffle. He was then reminded of MLB’s cozy relationship with China and the fact that though he opposed showing ID to vote, you needed one just to work concessions at the game. So, Mr. Manfred was against IDs for the purposes of voting, but in favor of them if you wanted to hawk beer under his banner. Because… yeah, that totally makes sense. Finally, there was this . Turns out the Commish is a member of the tony Augusta National Golf Club in Georgia. Was he going to stand by his principles and resign from such a toxic Georgian institution? Apparently not. All of this over a bill he likely didn’t or understand.

I have no horse in this race, except I wish companies would simply stick to their knitting and stop virtue signaling at every turn. For years companies figured it was worth the signal to prevent marches, employee walkouts, and internet shenanigans, and that more conservative minds would grit their teeth and get on with life, but that thinking may be coming to an end. Fine by me.

One of the underreported friends lost by the US is Saudi Arabia. Recently the Saudis have cogitated on the idea of accepting yuan for oil, thus undermining the petrodollar. Who can blame them? Biden has done everything possible to infuriate our ally.

Those in the Biden Administration scratch their heads and wonder why the Saudis won’t play ball and just pump more oil, but a quick recap leaves little to the imagination. Start off by campaigning with the friendly of calling the House of Saud a “pariah.” Then declare that Saudi Arabia would “pay the price” for, amongst other things, having a government with “very little social redeeming value,” and you start to get the picture.

After such pronunciations, Biden went on to withhold support for Saudis’ defense against the Houthis and no longer designate this Yemeni group as terrorist. His administration withheld Patriot missiles from the Saudis, fundamentally breaking the long understanding that the US provided the Saudis defense cover while they dutifully pumped oil. Also of note was Biden’s decision to release a CIA report in February 2021 that said Mohammed bin Salman, AKA MBS, was responsible for the killing of journalist Jamal Khashoggi. Come September, MBS was so hot on the subject he started at Jake Sullivan, Biden’s national security adviser, when asked about the murder.

To top it off, the Biden administration has further inflamed relations with Saudi Arabia by trying to cobble together a nuclear pact with the Iranian regime, the sworn enemy of the Arabs. This project seems doomed. For all the humiliating US prostrations before Iran, including an offer to drop the Iranian Revolutionary Guard Corps from the terrorist list, the Ayatollahs appear unmoved. US flirtations with Iran might not have succeeded but it has caught the eye of Saudi Arabia, and it’s not winning Biden any friends over there. Even before recent Saudi-US tensions, the Asia Pivot under Barack Obama and the flaming dumpster fire left behind by Biden in Afghanistan were perceived as waning US interest in the Middle East.

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Having run an expensive election campaign, Biden should know that money talks. Beijing purchases 1.8 million barrels of Saudi oil per day and the Kingdom has become China’s. The petrodollar may soon be in limbo, and with it the old deal between the US and Saudi Arabia that originally propped up the dollar. Starting in 1974, Saudi Arabia agreed to price oil in dollars in return for Washington providing arms, oilfield security, and defense cover to Riyadh. Now we have a situation where Saudi and the United Arab Emirates won’t even take Biden’s call, won’t pump more oil, and MBS is yelling that the US should “forget about its request to boost oil production.” Hell’s bells.

HMU @: christopher.roper.schell@fairobserver.com

The views expressed in this article are the author’s own and do not necessarily reflect 51�Թ�’s editorial policy.

The post DC Deconstructed: The View from the Carriage House appeared first on 51�Թ�.

The PCR test is the gold standard for determining if a person has COVID-19. It’s a very good test that gives us the yes-or-no binary information that we value so much for making decisions. Unfortunately, the test is not always readily available and it’s also expensive. And timing is critical. If you take the test too soon after you are infected, the virus may not have yet traveled to your nose where the sample is taken, and thus the result may be a false negative — you have COVID but the test indicates you don’t. Also, it often takes time in a laboratory to process the results — will you isolate or carry on while you’re waiting?

COVID Failure: A Matter of Principle

READ MORE

Finally, what would prompt you to get a COVID test? Perhaps some event prompts you or requires a test by policy, but otherwise, you might take a test because you feel sick. If so, you already know you may be infectious. In that case, a positive COVID test merely confirms what you already suspect, and you normally get that confirmation a couple of days too late to do any good. Despite our heavy reliance on testing, it’s not as simple or as timely as we would like for deciding when to isolate.

We’ve had another way to separate the healthy from the sick during the COVID-19 pandemic: symptoms. For example, if you have a fever, then you may be infectious. But temperature-based screening has not been very effective at all, and a big reason why is that the US government has historically defined fever as 100.4°F (38°C) or above. If a person’s body temperature is 100.3°F, then according to the government, that person does not have a fever. Does that make sense?

Unfortunately, one of the distinguishing characteristics of COVID is the tendency of many infected people to have mild or even unnoticeable symptoms, including only slightly elevated body temperature, below 100.4°F. So, the government’s definition of “fever,” although simple and binary, has only confused the situation. Some people who were asymptomatic with COVID-19 took their temperature, found it to be below 100.4°F and assumed they did not have a fever. So, they carried on with normal day-to-day activities, often infecting others. Temperature-based screening systems typically use the government’s 100.4°F fever threshold, and, as a result, failed to prevent entry by many infected persons. Relying on the government’s 100.4°F fever definition has contributed to the spread of COVID-19. Where did this government standard come from, how can it be improved, and why has the US resisted change?

Origins of 100.4°F

In 1868, a German physician, psychiatrist and medical professor named Carl Reinhold August Wunderlich published a describing his assessment that normal body temperature is relatively constant, varies from 97.9°F to 99.3°F (36.6°C to 37.4°C), and averages 98.6°F (37°C). He found that patients with a disease often exhibited a symptom of fever that he found to average at or above 100.4°F. He based these findings on 1 million temperature measurements for 25,000 patients.

For the time, this scientific result was quite remarkable, and it changed medicine forever because it gave physicians the newfound ability to objectively assess the presence and severity of many diseases. However, Wunderlich’s patients were mostly German rather than being from different cultures, his thermometer may have been less accurate than those we have today, and people are a little now than they were then.

These are reasons to suspect that Wunderlich’s ideas of normal body temperature and fever are somewhat different today than they were in the mid-1800s. But, to be fair, Wunderlich observed differences in temperature based on many variables when healthy, and he advised that temperature averages have many “shades of gray.” In particular, Wunderlich noted that even smaller rises in temperature are cause for concern, and that there is no definite temperature threshold over which a person transitions from health to sickness. He said that any “elevation of the axillary [under the arm] temperature above 99.5°F (37.5°C) or any depression below 97.2°F (36.5°C) is always very suspicious.” He added: “But even when every precaution has been taken in making the observations, it is impossible to draw a hard and fast line to indicate by temperature the exact limits of health and disease.”

Today, clinical research suggests that Wunderlich’s findings should be , that the normal temperature range by the individual, and that there is no arbitrary fever threshold that works for everyone. Yet, the US government and some medical experts still regard 98.6°F as normal body temperature and 100.4°F or above as a fever. For COVID019, this is simple, easy and, for most people, wrong.

Improving on 100.4°F as a Fever Threshold

If you’re interested in seeing if 100.4°F is an appropriate fever threshold for you, try taking your temperature. Use a normal, digital, under-the-tongue thermometer for at least 60 seconds. Make sure you haven’t consumed anything for 15 minutes — a hot or cold drink or food will change your measurement. Keep your mouth closed during the reading. Assuming you are healthy, if your temperature is below 98.6°F, then it’s a good bet that your fever threshold is under 100.4°F.

If you were to take your temperature every day, preferably in the morning when you first wake, you would see that your normal temperature varies in a range of one degree or so. For example, in the image below is the normal temperature data for a person we’ll call JRDA5.

From this graph, we can see that JRDA5’s normal body temperature varies from 96.6°F to 97.4°F when healthy, and you can expect your own normal temperature to vary also.

In modern medicine, a fever is to be a temperature elevation above a person’s normal range. This definition of fever is more accurate than an arbitrary fever threshold like 100.4°F that is based on population averages and data from 150 years ago. A person’s normal temperature range depends on many such as age, sex, nutrition and level of activity, and so different people will have different fever thresholds.

Almost always, a fever threshold defined as above your normal temperature range is below 100.4°F. Therefore, if we use this new definition, there is significant potential for identifying sick people using temperature-based screening. Relying on 100.4°F is insufficient for identifying mild, pre-symptomatic or asymptomatic cases of COVID-19.

Why the Government Has Resisted Changing the Definition of “Fever”

A pandemic is not the best time for complicated methods. Perhaps the US government chose to stick with 100.4°F for simplicity and consistency. But, in this pandemic, nothing has been simple. We’ve learned to take advantage of vaccines that need boosting, tests that need repeating and symptoms that keep changing. People can figure out their normal temperature range and their own personal fever threshold if that means effective screening. Having a fever or not is still binary, even if we define fever as above your normal range. It’s still pretty simple.

Elevated temperature is not definitive proof you have COVID-19. We all like certainty, and the PCR test will remain the gold standard for COVID. But we don’t need certainty to make a decision to isolate. A fever should prompt isolation, even though it may not be caused by COVID. The next step is to get tested and then wait for the results. We can stop the pandemic if people isolate if they get a fever. Fever is the most timely indicator we may be infectious.

Asymptomatic cases may not exhibit any elevated temperature, so we cannot depend on temperature screening anyway. It’s possible that there are some people infected with COVID-19 who do not have any fever, perhaps because their immune system doesn’t work at all. However, we know that many asymptomatic cases are accompanied by elevated body temperature lower than 100.4°F. We can catch those people using the more correct definition of fever. The perfect should not be the enemy of the good.

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People hate change and the government is no different. It takes a lot to pass federal legislation and to modify federal regulations. But the government’s 100.4°F fever threshold isn’t working. The effort to change will help us control the pandemic.

How Redefining “Fever” Helps

Since the omicron variant of COVID-19 emerged, we’ve seen increased demand for testing, with many people standing in line for hours waiting to get a test. In the United States, the government has been ordering more tests to address the shortages. However, the demand for testing can evidently overrun our testing resources. By using a more accurate definition of “fever,” people will have a better idea of when they need to get tested. Today, about 75% of tests come back negative. We have clinical that fever and other readily available health data can predict test results. By redefining “fever,” we can make testing more efficient.

We can also monitor our health every day, conveniently, in our own homes. We can’t afford to give everyone a daily PCR test, and hardly anyone wants that anyway. In contrast, it’s easy, fast and affordable to take our temperature every day. It’s a smart, safe way to help keep our friends and family safe and do our part to fight the pandemic. A lot of people would self-monitor if they knew it would help.

The coronavirus that causes COVID-19 evidently mutates easily, giving rise to variants, and we don’t expect that to change. It’s possible there are already variants that are not caught by current tests. Redefining “fever” can help identify cases that PCR tests miss. So far, fever is a symptom of all variants. More broadly, fever is a symptom of many other infectious illnesses, such as the flu. Isolating when you have a fever is appropriate for new variants and other viruses to help prevent the spread and keep everyone safer.

It’s high time for the government to redefine “fever” as body temperature above a person’s normal, healthy range. With a more accurate definition, temperature-based screening can be a powerful new tool for fighting the pandemic — and one well-suited to use by anyone, at home and in time to make a difference. Americans want to help fight the pandemic. It’s about time the government helps them do just that.

The views expressed in this article are the author’s own and do not necessarily reflect 51�Թ�’s editorial policy.

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Since the Start of the Pandemic, Americans Are Drinking Too Much

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But this new relaxation of standards might be a problem when it comes to posture. The usual office equipment people relied upon didn’t come home with them at the beginning of the lockdown. Futons and laptops ergonomic chairs and desktop computers for weeks, then months and now years. Working from a laptop computer is one of the worst for one’s back. Working from a sofa might be the worst. 

From Back Problems to Developing an App

Three years ago, I suffered from spinal disc subluxation. This isn’t typical for a teen. In fact, it’s so rare that, in a on the prevalence of subluxation, people under the age of 65 were excluded because researchers didn’t see them as a statistically significant population. As I waited in line for care, I talked to other patients who explained to me how much my problem might be caused by poor posture.

Movies like “My Fair Lady” and even “Pretty Woman” taught us that there’s one correct posture. It’s a classist and sexist idea that someone has to be in on the polite secret that there’s one right way to sit or stand. But no one-size-fits-all optimizes health. Rather, everyone has their own correct posture. 

Because of my experience, I developed an app called whereby users can take a photo of their backs and see if their posture is optimal. It’s not a replacement for medical advice, of course, but it’s a nudge to get people to see that how they’re sitting and standing might not be up to snuff — for their particular bodies. 

Balancing a book on one’s head Eliza Doolittle-style seems petty next to a global pandemic, but posture isn’t a trifling concern. About of a country’s population will develop lower back pain in their lives and suboptimal posture contributes to it. It’s the number-one of disability worldwide. The way chronic back pain impacts quality of life makes it a real threat. 

And that threat has actually been magnified by the conditions imposed by the global health crisis. Between shifting all activity to our home spaces, the challenges to our mood (there’s an undeniable link between posture and — change one and the other follows) and a deterioration of our behavioral standards, people aren’t attuned to the same details they once were. We’re so off our game that some workers may have to “” politeness when offices open back up. Virtual work/school may benefit many, but regardless of one’s appreciation of the home office or school, we must admit that we don’t act the same when we work or study outside of the office or classroom. We get lax.

Are You Sitting Upright?

No one has studied this specifically, but I would venture that posture has deteriorated population-wise during the pandemic. It’s a mere matter of common sense. As the world crumbles, people likely aren’t sitting and standing ramrod straight. In the scrum for masks, tests and toilet paper, posture wasn’t a characteristic that made a person more likely to survive. And the invitation to slump and relax was too good to pass up. 

It can be alarmist to predict spin-off epidemics. Between anxiety and to to sleep to substance , the COVID-19 pandemic caused a cascade of health problems. It’s unclear how we stay out of a permanent state of panic.  

But panic prods prevention, and prevention is good politics. And back pain, a preventable chronic condition, costs us a lot of money every year. It’s the second-highest of health burden in China. It also costs $67.5 and $94.1 billion globally. It’s also the leading cause of sick , the days when employees accomplish little to nothing, whether they’re in the office or not. It’s the sixth-largest on the health economy in the United States, and it causes of billions of pounds in lost productivity in the United Kingdom.

Work From Home and Remote Learning

Neither working from home nor learning remotely is over. As of September 2021, of full-time employees in the US were working from home. Now, of them want to stay put. The city of Flint, Michigan will be schooling its students for the near future. Even without pandemic risks, some school districts have come to lean on distance learning because of school . That means we will probably continue to cut ourselves slack with how we sit and stand. 

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In China, 45% of offer work-from-home situations. Around 57% of employees like a hybrid model of three days in the office and two at home. Students in the city of Xi’an were allowed back to in-person school in January after another lockdown. Schools throughout China are preparing for the eventuality of to distance learning, if not for COVID-19, then for another reason. The preparation comes as most parents in China realized that the initial switch to remote school was implemented quickly, which meant that education over virtual portals was less than ideal.

At-home employees and remote-based students can buy better computers, desks and chairs if they can afford them. But none of that will help if they don’t know what position works best for them. Just being aware that posture is at risk is important for long-term health. 

Even a return to the workplace or school doesn’t guarantee that people will sit upright. And some medical experts that posture and back pain aren’t connected. My experience tells me otherwise. 

I don’t think that differing opinions on posture and back pain should be enough to convince people not to take their posture more seriously in a post-pandemic world. My pain was so bad that I often curled up in pain and I suffered for months. People should pay more attention to their posture as we climb out of this terrible time. There’s no reason to risk feeling even worse one day in the future when we’re supposed to be feeling better. 

The views expressed in this article are the author’s own and do not necessarily reflect 51�Թ�’s editorial policy.

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March 10: True Toll

In this month of March, the world is understandably somewhat reluctant to commemorate the second anniversary of the moment when the nations of the world unanimously declared COVID-19 a pandemic and began their largely concerted actions of lockdown. The story that unfolded afterward included a variety of traumatic episodes, including speculation about a diversity of possible preventive and curative treatments, sporadic outbreaks of revolt against enforced public policies and a scientifically successful campaign to produce effective vaccines. Despite their promise, the effectiveness of those vaccines nevertheless proved to be far from absolute.

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A group of over 100 public health, medical and epidemiology experts, after assessing the global results, has chosen this second anniversary to react and call into question the decisions taken by governments presumably capable of doing more. From the very early days, the scientific experts knew that, given the capacity of the coronavirus to mutate over time, any complication or holdup related to manufacturing and global distribution could undermine the entire logic of vaccines. They should have known that the biggest complication would come from a political and economic system that works according to principles that make it impervious to understanding the logic of a virus.

On March 9, the group of experts addressed a letter to the Biden administration to express their frustration with a situation that has evolved very slowly and largely inadequately outside the wealthy nations. This is not the first time concerned experts have urged “the administration to share Covid-19 vaccine technology and increase manufacturing around the world,” Politico . For the past two years, they have regularly been rebuffed, as governments preferred to pat themselves on the back for the short-term efforts they were making to protect their own populations, while creating the conditions that would allow the virus to mutate and gain strength elsewhere before returning to provoke new research and the promise of further commercial exploitation with boosters and new treatments.

Principles vs. Ideals

The experts should have realized by now that there is a principle at work that overrides every other scientific or medical consideration. It was established early on by the coterie established around Bill Gates, big pharma executives and other important influencers sharing their industrial mindset. It can all be traced back to the wisdom of Milton Friedman, who loved to repeat the slogan, “There’s no such thing as a free lunch.” The principle is self-explanatory: In a competitive world, the idea of sharing simply cannot compete with the idea of competing. If you can’t afford lunch, you’ll just have to go without eating. That works when the only outcome is seeing people starve. It doesn’t work when the effects of their starvation are somehow transmitted back to those who have a permanent place at the banquet.

US culture has cultivated the idea that life itself is a competitive race for advantage and the promotion of self-interest stands as the highest of virtues. Health like wealth must play by the rules of the competitive game. That same culture insists heavily on a form of discipline based on the idea of respecting “principles,” which it sometimes perversely confounds with “laws of nature.” The divinely ordained requirement to solve all problems through competition is a prominent one, but not the only one. 

The problem with such principles that are taken to be universal laws is that once you believe it is a law, you no longer need to reflect on its appropriateness or assess its very real effects. We are witnessing an example of it today in the Ukraine conflict. The United States has invoked the defense of the sacred principle of “sovereignty,” reformulated as the right of a nation to determine its own foreign policy, including the choice to join a distant empire. That may be a principle, but is it a law? Insisting on it instead of reflecting and debating the question has provoked a disastrous and increasingly out of control war that, like the COVID-19 pandemic, has already had severe unintended knock-on effects, wreaking havoc on the global economy as well as destruction in Ukraine itself. 

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Every culture must realize that its own principles may not be universally applicable, that they may not be perceived by others to have the status of laws. Any attempt to apply them as universal truths may cause immense human suffering. And that reveals the very dimension of the problem the health experts are pointing to. A potentially criminal complacency exists when the suffering caused by the inflexible application of the principle is directed toward others, at the same time when the purveyors of the principle are taking measures to protect their society and their environment. The principle of Ukraine’s sovereignty is already damaging not just Ukraine itself and now Russia, thanks to the application of the principle, but also Europe, the Middle East and Africa, which will be cut off from vital supplies of energy, food and fertilizer.

For the past two years, the concerted defense of the ideal of competition by the pharmaceutical companies in their supposed combat to defeat COVID-19 has clearly aggravated the effects of a pandemic that might have been contained if the idea of sharing had been elevated to the status of principle. But sharing doesn’t deserve to be regarded as a principle. For Americans, it is based on soft ideas like empathy and compassion rather than hard reasoning about what might be financially profitable.

Reflecting on two years of struggle, the group of experts noted “that the development of U.S. vaccines was largely successful, bringing protection to the public in record time,” Politico reports. That’s the good news. And now for the bad news: “But getting shots in arms in low- and middle-income countries has been a ‘failure.’”

Out for the Count

No precise statistics can account for the difference between the damage actually done by COVID-19 and what might have happened had governments effectively managed the global response in the earlier phases of the pandemic. “The true toll of this failure will never be known,” the experts explain, “but at this point almost surely includes tens of millions of avoidable cases and hundreds of thousands of deaths from Covid.”

The “true toll” they cite reminds us of John Donne’s on the bells rung for the dying in a time of plague. The poet and dean of St Paul’s affirmed that “any man’s death diminishes me, because I am involved in mankind, and therefore never send to know for whom the bell tolls; it tolls for thee.” Might we hope that 400 years after Donne wrote these words, pharmaceutical companies and politicians could, for once, take them to heart?

But there is yet another much more concrete  meaning of “toll,” as in “toll road.” It is the price humanity is expected to pay, in dollars and cents, to the pharmaceutical companies that have so diligently used their patents to protect their exclusive rights to exploit and enrich themselves thanks to the global potential for suffering of others.

The final and fundamentally political irony of this sad tale relates to the fact that to do what the experts insist needs doing requires “more funding from Congress.” At a time when prominent members of Congress have become obsessed by the threat of inflation, while at the same time unabashedly inflating military budgets and responding urgently to the “sacred” needs of NATO in times of peril, the likelihood that Congress might suddenly address a global problem it has avoided addressing for two years seems remote.

One of the experts, Gavin Yamey, suggests that COVID-19 “could follow the path of diseases like HIV or tuberculosis: become well controlled in wealthier countries but continue to wreak havoc in poorer nations.” Geopolitics in this increasingly inegalitarian world appears to be following a trend of domestic demographics in the US, marked by the separating of society itself into two groups: the denizens of gated communities and the rabble, everyone else out there.

Why Monitoring Language Is Important

Language allows people to express thoughts, theories, ideas, experiences and opinions. But even while doing so, it also serves to obscure what is essential for understanding the complex nature of reality. When people use language to hide essential meaning, it is not only because they cynically seek to prevaricate or spread misinformation. It is because they strive to tell the part or the angle of the story that correlates with their needs and interests.

In the age of social media, many of our institutions and pundits proclaim their intent to root out “misinformation.” But often, in so doing, they are literally seeking to miss information.

Is there a solution? It will never be perfect, but critical thinking begins by being attentive to two things: the full context of any issue we are trying to understand and the operation of language itself. In our schools, we are taught to read and write, but, unless we bring rhetoric back into the standard curriculum, we are never taught how the power of language to both convey and distort the truth functions. There is a largely unconscious but observable historical reason for that negligence. Teaching establishments and cultural authorities fear the power of linguistic critique may be used against their authority.

Remember, 51�Թ�’s Language and the News seeks to sensitize our readers to the importance of digging deeper when assimilating the wisdom of our authorities, pundits and the media that transmit their knowledge and wisdom.

The views expressed in this article are the author’s own and do not necessarily reflect 51�Թ�’s editorial policy.

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The Contradictory Musings of Biden’s Speculator of State

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The Forbes article, an excerpt from Bourla’s book, “Moonshot,” ends with a moving story about how Pfizer boldly resisted the pressure of the evil Jared Kushner, Donald Trump’s son-in-law, who had no qualms about depriving the rest of the world — even civilized countries such as Canada and Japan — of access to the COVID-19 vaccine to serve the US in their stead.

“He insisted,” the good doctor explains, “that the U.S. should take its additional 100 doses before we sent doses to anyone else from our Kalamazoo plant. He reminded me that he represented the government, and they could ‘take measures’ to enforce their will.”

Today’s Weekly Devil’s Dictionary definition:

Take measures:

Go well beyond any measured response in an act of intimidation

Contextual Note

Bourla begins his narrative at the beginning, before the development of the vaccine, by asserting his company’s virtuous intentions and ethical credentials that would later be challenged by bureaucrats and venal politicians. “Vaccine equity was one of our principles from the start,” he writes. “Vaccine diplomacy, the idea of using vaccines as a bargaining chip, was not and never has been.”

Some readers may note that vaccine equity was only “one” of the principles. There were, of course, other more dominant ones, such as maximizing profit. But Bourla never mentions these other principles, instead offering a step-by-step narrative meant to make the reader believe that his focus was on minimizing profit. That, after all, is what a world afflicted by a raging and deadly pandemic might expect. A closer examination of the process Bourla describes as well as the very real statistics about vaccine distribution reveals that, on the contrary, Pfizer would never even consider minimizing profits. It simply is not in their DNA.

Bourla proudly describes the phases of his virtuous thinking. The CEO even self-celebrates his out-of-the-ordinary sense of marketing, serving to burnish the image not only of his company but of the entire pharmaceutical industry. “We had a chance,” he boasts, “to gain back our industry’s reputation, which had been under fire for the last two decades. In the U.S., pharmaceuticals ranked near the bottom of all sectors, right next to the government, in terms of reputation.”

Thanks to his capacity to tone down his company’s instinctive corporate greed, Bourla now feels he has silenced his firm’s if not the entire industry’s critics when he makes this claim, “No one could say that we were using the pandemic as an opportunity to set prices at unusually high levels.” Some might, nevertheless, make the justifiable claim that what they did was set the prices at “usually” high levels. A close look at Bourla’s description of how the pricing decisions were made makes it clear that Pfizer never veered from seeking “high levels,” whether usual or unusual, during a pandemic that required as speedy and universal a response as possible.

Thanks to a subtle fudge on vocabulary, Bourla turns Pfizer’s vice into a virtue. He writes that when considering the calculation of the price Pfizer might charge per dose, he rejected the standard approach that was based on a savant calculation of the costs to patients theoretically saved by the drug. He explains the “different approach” he recommended. “I told the team to bring me the current cost of other cutting-edge vaccines like for measles, shingles, pneumonia, etc.” But it was the price and not the cost he was comparing. When his team reported prices of “between $150 and $200 per dose,” he agreed “to match the low end of the existing vaccine prices.”

If Pfizer was reasoning, as most industries do, in terms of cost and not price, he would be calculating all the costs related to producing the doses required by the marketplace — in this case billions — and would have worked out the price on the basis of fixed costs, production and marketing costs plus margin. That would be the reasonable thing to do in the case of a pandemic, where his business can be compared to a public service and for which there is both a captive marketplace (all of humanity shares the need) and in which sales are based entirely on advanced purchase orders. That theoretically reduces marketing costs to zero.

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But Bourla wrote the book to paint Pfizer as a public benefactor and himself as a modern Gaius Maecenas, the patron saint of patrons. Once his narrative establishes his commitment to the cause of human health and the renunciation of greed, he goes into detail about his encounter with Kushner. After wrangling with the bureaucrats at Operation Warp Speed created to meet the needs of the population during a pandemic, Bourla recounts the moment “when President Trump’s son-in-law and advisor, Jared Kushner, called me to resolve the issue.” That is when Kushner, like any good mafia boss, evokes his intent to “take measures,” a threat the brave Bourla resists in the name of the health of humanity and personal honor.

That leads to the heartwarming, honor-saving denouement, the happy ending that Bourla calls a miracle. “Thankfully, our manufacturing team continued to work miracles, and I received an improved manufacturing schedule that would allow us to provide the additional doses to the U.S. from April to July without cutting the supply to the other countries.”

Historical Note

Investopedia up the reasoning of pharmaceuticals when pricing their drugs: “Ultimately, the main objective of pharmaceutical companies when pricing drugs is to generate the most revenue.” In the history of Western pharmacy, that has not always been the case. Until the creation of the pharmaceutical industrial sector in the late 19^th century, apothecaries, chemists and druggists worked in their communities to earn a living and like most artisans calculated their costs and their capacity for profit.

The Industrial Revolution changed all that, permitting large-scale investment in research and development that would have been impossible in an earlier age. But it also introduced the profit motive as the main driver of industrial strategy. What that meant is what we can see today. Pharmaceutical companies have become, as Albert Bourla himself notes, “ranked near the bottom of all sectors.” They exist for one reason: to make and accumulate profit. Industrial strategies often seek to prolong or extend a need for drugs rather than facilitate cures. Advising a company, Goldman Sachs famously asked, “Is curing patients a sustainable business model?” The implied answer was “no.” The greatest fear of the commercial health industry is of a cure that “exhaust[s] the available pool of treatable patients.”

In any case, COVID-19 has served Pfizer handsomely and is continuing to do so. In late 2021, the Peoples Vaccine Alliance “that the companies behind two of the most successful COVID-19 vaccines —Pfizer, BioNTech and Moderna— are making combined profits of $65,000 every minute.” Furthermore, they “have sold the majority of doses to rich countries, leaving low-income countries out in the cold. Pfizer and BioNTech have delivered less than one percent of their total vaccine supplies to low-income countries.”

At the beginning of the COVID-19 “project,” Bourla boasts, “I had made clear that return on investment should not be of any consideration” while patting himself on the back for focusing on the needs of the world. “In my mind, fairness had to come first.” With the results now in, he got his massive return on investment, while the world got two years and counting of a prolonged pandemic that will continue making a profit for Pfizer. At least he had the satisfaction of putting the ignoble Jared Kushner in his place.

*[In the age of Oscar Wilde and Mark Twain, another American wit, the journalist Ambrose Bierce, produced a series of satirical definitions of commonly used terms, throwing light on their hidden meanings in real discourse. Bierce eventually collected and published them as a book, The Devil’s Dictionary, in 1911. We have shamelessly appropriated his title in the interest of continuing his wholesome pedagogical effort to enlighten generations of readers of the news. Read more of The 51�Թ� Devil’s Dictionary.]

The views expressed in this article are the author’s own and do not necessarily reflect 51�Թ�’s editorial policy.

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There is a multitude of factors that contributed to the increase in alcohol consumption during the COVID-19 pandemic. According to from the Centers for Disease Control and Prevention, anxiety and depression rose dramatically among the general population, and alcohol consumption often increases for those who use it as a way to cope. “Stress and boredom likely were main drivers for a substantial increase in alcohol intake,” explains Dr. Jagpreet Chhatwal, associate director of the Massachusetts General Hospital’s Institute for Technology Assessment and assistant professor at Harvard Medical School.

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Measures that were designed to help businesses stay afloat during the pandemic may have also affected drinking habits. According to Chhatwal, “cocktails-to-go laws that allowed customers to pick up mixed cocktails at local bars and direct-to-consumer laws that allowed liquor stores to deliver alcohol directly to homes” point to a potential link between access and consumption. 

Regardless of the reason, these numbers are going to translate to significant morbidity and mortality rates for Americans in the future. According to new a by researchers at Harvard’s Massachusetts General Hospital published in Hepatology, due to the pandemic uptick in alcohol use, there will be close to 20,000 cases of liver failure, 1,000 cases of liver cancer and 8,000 deaths over the next two decades. 

Addressing this pressing issue will be complicated in a country that has long glamorized the use of alcohol among its population. From Super Bowl advertisements to film and music references, alcohol has long been associated with celebration, letting loose and having a good time. Consuming alcohol, even excessively, is normalized to the point that it is integrated into daily life on a regular basis: after-work happy hours, relaxing at home, birthdays, weddings, sporting events, etc. Alcohol has become so fused into the fabric of American society that in 2019, the industry was already over $250 billion.

Putting a positive spin on alcohol is dangerous because it creates the mirage that there are no negative consequences on a person’s physical or mental health, which is both untrue and potentially harmful. “Not everyone is aware of the safe drinking limits or realizes when to stop,” says Chhatwal. Excessive drinking can cause a myriad of health problems including high blood pressure, heart attacks, stroke, increase the risk for cancer, liver and GI problems, a weakened immune system, depression and anxiety as well as socialization issues and job loss.

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In a country where more than 14 million American adults 18 years and older had a , according to statistics from National Institute for Alcohol Abuse and Alcoholism, the challenge will be raising awareness, confronting a booming business model and reevaluating new laws that made alcohol more accessible during the pandemic.

In Chhatwal’s opinion, “One of the foremost steps is to create awareness about the risk of an increase in alcohol consumption, especially high-risk drinking among women and minority populations who are more vulnerable.” He also stressed the importance of enlisting primary care providers to do more extensive screening for alcohol consumption patterns. There is also an obligation to take a hard look at new laws: “We need to evaluate the effect of cocktail-to-go and direct-to-consumer laws — if such laws contribute to increased drinking then there is a need to make policy-level changes.”

*[The Wider Lens provides commentary on trending stories in the world of health, covering a wide variety of topics in medicine and health care.]

The views expressed in this article are the author’s own and do not necessarily reflect 51�Թ�’s editorial policy.

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First, the COVID-19 pandemic is obviously far from over. While global vaccine distribution continues to be spotty and a matter of economic and political privilege rather than equality and fairness, new variants of the virus such as Omicron continue to emerge and suggest that the largest global health crisis in at least a century is here to stay for the foreseeable future.

It is tragic that the shortsighted, irresponsible attitude to just and equitable global vaccine distribution has now become the root cause for a seemingly infinite loop of viral mutations and spread. Indeed, the policies that are adopted by some countries allow new variants to incubate where vaccines are scarce, only to soon boomerang back to nations that are hoarding doses and patents alike.

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Second, the rapidly deteriorating situation, the stunning collapse of the status quo and public order, and the ongoing humanitarian and human rights crisis in Afghanistan remind us of the inherent vulnerability and fragility of the international order and its institutions. Afghanistan is but one example of a fundamental shift in global and regional geopolitics and balance of power that is now ubiquitous. The consequence is that human security and justice seem to become even more disposable than before.

Third, the 6^th Assessment Report of the Intergovernmental Panel on Climate Change (IPCC) affirmed that the global climate crisis is not only real and impactful but certain to increase, perhaps exponentially, and become even much more destructive, disruptive and deadly than previously projected.

Keeping the Goal Alive

At the same time, the COP26 climate summit in Glasgow reinforced the widespread fear that it is increasingly unlikely that the 1.5˚C goal sealed in the Paris Agreement — perhaps even the 2˚C fallback position — can still be reached, meaning that unimaginable threats like mega heatwaves, floods, droughts, hurricanes and blizzards, food crises and famines, mass migration and violent conflicts are to be expected to rise throughout this century.

COP26, unfortunately, was more of the same: cynical delegations of certain industrialized countries, as well as ruthless fossil fuel lobbyists, coerced poor countries already hit hard by climate change into a defensive mode and dictated a watered-down compromise that is far from adequate. Despite some mitigation pundits — typically white, male and Western — praising COP26 for “keeping the 1.5-degree goal alive,” the point is not about what’s hypothetically feasible but is very much about what has been done and continues to be done to this world’s poor, marginalized, underdeveloped, disenfranchised and remote people?

Much of the Conference of Parties process carries the handwriting of neoliberalism and neocolonial rule. If those people in the South Pacific, Africa, the Middle East, Latin America and elsewhere count, then why has the 2009 promise of COP15 in Copenhagen to make $100 billion in support of adaptation needs available still not been met, even to 50%?

Why do the world’s worst greenhouse gas emitters still refuse to pay a single penny for the loss and damage to developing nations that they are responsible for? How dare wealthy carbon-emitting countries refuse to commit to immediate and drastic emission reductions knowing that their selfishness will kill millions of people, wipe out entire species and make much of this planet uninhabitable?

See a pattern? What COVID-19, Afghanistan and climate policy as a global phenomenon have in common is the toxic mix of short-sightedness, selfishness and ruthlessness with which international solidarity, collective action and the noble cause of pursuing equality, dignity and justice in international relations are being sacrificed for short-term gain, dominance and privilege.

Forty years of largely unregulated capitalism, economic globalization and neoliberal rule have not furthered the spirit and goals of the UN Charter. They have ruined our planet, its ecosystems and habitats, and left humanity in a state of shock, turmoil and disintegration — closer to what Hobbes’ “Leviathan” described as the state of nature.

International Threat

By the way, climate change adds to other global risks and threats: It is intersectional, cross-cutting and compounding. , and therefore epidemics and pandemics, are on the rise also because of changing climates, temperatures, precipitation, humidity, biomes and expanding human habitats. Wars such as those in Sudan, Yemen and Syria have been precipitated by climate change, desertification, water shortage, crop failure and hunger — as is forced migration as a mass phenomenon. The list goes on.

We simply can no longer afford a business-as-usual approach or even a moderately progressive approach, let alone a backward approach. This century of complex crises requires a whole new type of global action and response unlike anything before it because peace, security, prosperity and statehood are at risk globally. New, innovative and disruptive legal, economic and political tools are needed, paired with technological advances, ethical and sustainable investments, social movements and large-scale behavioral change.

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Ultimately, the climate agenda — and with it, many other issues of global concern — is a matter of global justice and survival. Measures and instruments must be atoned to yield the safety and well-being of the poor, the marginalized, the disenfranchised and the underserved. The resilience of the weak will determine the fate of the whole. If that is the case, humanity — and alongside it, other species, ecosystems and the planet — will benefit as a whole. If it isn’t, today’s hubris, ignorance and selfishness will come back as a mighty boomerang, much like Omicron, to haunt many wealthy nations.

*[This article is submitted on behalf of the author by the HBKU Communications Directorate. The views expressed are the author’s own and do not necessarily reflect the University’s official stance.]

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A new published by JAMA Network reveals that the number of hospitalizations for eating disorders including anorexia, bulimia and binge-eating disorders, among others, increased dramatically during the pandemic. According to Dr. Kelly Allison, one of the researchers on the study and the director of the Center for Weight and Eating Disorders at the Perelman School of Medicine at the University of Pennsylvania, the results “suggest that disordered eating became more severe in disorders of extreme restriction, as well as in those with loss of control eating.” What’s even more troubling is that the average age of the patients has decreased over time. 

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Eating disorders are mental health conditions typified by significant and persistent disturbances in eating behaviors, accompanied by distressing emotions. People who suffer from eating disorders often display a preoccupation with body weight and food intake. These disorders can affect people of all ages, racial and ethnic backgrounds as well as genders, although they are more common in girls and women. People are particularly vulnerable during the adolescence and teen years and are most often diagnosed between the ages of 12 and 35.  

There are many reasons why the COVID-19 pandemic created a breeding ground for eating disorders. For many people, eating habits changed significantly. Shopping at a grocery store was already incredibly stressful for the general population; for people with disordered eating behavioral patterns, it was most likely worse.

Those who restrict food intake may have limited their shopping excursions or curtailed their purchases; for those who binged, they may have the added temptation of bulk purchases of processed foods. “They were then in close proximity to that food all day while working or schooling from home, so the temptation to eat those foods was likely increased during this time,” says Allison.

Obesity is often cited as a for severe COVID disease and poor outcomes even in younger people. This news may have triggered disordered eating patterns in vulnerable people. Excess weight is often a modifiable risk factor and could have been the impetus for extreme dieting. “I have been overweight for a long time, hearing that extra pounds could land me on a ventilator in the hospital was enough for me to diet,” says Shaunda F., a 27-year-old mom from New York state. “I lost more than 12 pounds in two months at the beginning of the pandemic fearing for my life. I basically starved myself.”

There are other considerations with regard to an increase in the diagnosis of eating disorders and subsequent hospitalizations. Family members were able to pick up on pathological behaviors because they were together more frequently than normal. According to Allison, “Middle school, high school and college-aged individuals were home all day, and their eating behaviors and weight changes were more evident.” Under normal circumstances, these behaviors may have gone unnoticed but were more difficult to hide during the pandemic.  

Access to care was likely another factor responsible for the uptick in hospitalizations for eating disorders. “In the beginning of the pandemic, access was limited as providers were transitioning to virtual outpatient care,” says Allison. “This could have led to a time delay that progressed the severity of symptoms to a state where hospitalization was needed.”

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It is imperative that parents and loved ones have this issue on their radar screen, as treating disordered eating patterns often requires clinical intervention. Keeping an eye out for warning signs can be life-saving. “If someone you care about starts avoiding eating with family and friends, along with noticing changes in weight (sudden increases or decreases), these should be considered concerning,” Allison points out. Using a bathroom directly after a meal could be a red flag for vomiting or laxative use. Other include hoarding food, a preoccupation with body weight, food or calories, wearing baggy clothes to hide weight loss, frequent checking in the mirror, skipping meals, etc.

Regardless of the reason, the pandemic has driven a rise in eating disorders and, like with COVID-19, a lot depends on everyone doing their bit to make sure those at risk are protected.

*[The Wider Lens provides commentary on trending stories in the world of health, covering a wide variety of topics in medicine and health care.]

The views expressed in this article are the author’s own and do not necessarily reflect 51�Թ�’s editorial policy.

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Not everyone is convinced. After all, why believe a bunch of scientists when the eminent universal genius of our time, Donald Trump, has vouched for the safety of the drug, normally used to treat parasites in animals, and its effectiveness against COVID-19. Effective it might be, safe less so.

In Switzerland, the COVID-19 Certificate Divides Opinions

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Over the past year, dozens of American ivermectin enthusiasts have paid for their trust in The Donald with their health and even their . Yet relatives of seriously ill COVID-19 patients have continued to demand that hospitals administer ivermectin to their loved ones, in some cases going so far as to involve the courts. The courts have invariably to force the medical staff to administer the drug, much to the doctors’ relief.

The Ivermectin Crowd

The Ivermectin crowd, on the other hand, has been irate, claiming that politics, not medical reasons, is behind the drug’s bad press. Rand Paul, the Republican senator from Kentucky who is “undecided” on the drug (“I don’t know if it works, but I keep an open mind”), earlier this year blamed the bad press on an : “The hatred for Trump,” Rand claimed, “deranged [medical researchers] so much, that they’re unwilling to objectively study it.” The same was true, he continued, for hydroxychloroquine, the anti-malaria drug the former president had promoted as a treatment for COVID. This is the very same senator who on YouTube that masks were not effective against the virus.

Ironically enough, this is exactly what Merck, the pharma giant that manufactures ivermectin, has said with regard to the drug. Earlier this year, the company that “there is no scientific basis for a potential therapeutic effect against Covid-19 from pre-clinical studies.” Again, why believe what scientists say when the ultimate authority on everything assures us of the drug’s enormous benefits.

Europeans have a tendency to sneer at Americans and their naiveté, gullibility and simplemindedness. After all, quite a few Americans are convinced that , even more that the Earth was some 10,000 years ago, and even more still (at least among Republicans) that Donald Trump was a great president who was of a second mandate. The rapid diffusion of even the most absurd conspiracy theories has done nothing to correct these impressions. On the contrary, it seems no idea is silly or outright stupid enough that there won’t be people eagerly gobbling it up.

My personal favorite is the notion that dinosaurs alongside Adam and Eve in the Garden of Eden. There they all — including the T-Rex — fed on leaves and vegetables. Only Adam’s fall from God’s grace turned them into carnivores. The silliness goes on and on. Those interested might want to explore the Creationist Museum in Rand Paul’s Kentucky. It is a true revelation.

Sadly enough, Americans don’t have a monopoly on credulity and viridity. The past year and a half have clearly shown that Europeans are hardly immune to the siren songs of conspiracy hucksters and “lateral thinkers” who claim for themselves that they think outside the box. In Germany, the lateral thinker movement has been behind a number of mass demonstrations against the government’s pandemic measures. In late August, lateral thinkers, together with various right-wing extremist groups, instigated the failed attempt to , the seat of the German parliament in Berlin.

Miracle Drug

Under the circumstances, it is perhaps not entirely surprising that ivermectin has gained growing popularity among Europe’s “corona skeptics” and anti-vax circles. In a number of countries, prominent personalities have established themselves as advocates and promoters of the drug. More often than not, the result has been suboptimal, to put it mildly. A case in point is Herbert Kickl, the leader of the Austrian Freedom Party (FPÖ), one of Western Europe’s most prominent radical right-wing populist parties.

Like some of its counterparts in other West European countries, the FPÖ has made great strides in establishing a reputation as a resolute, uncompromising opponent of the government’s anti-COVID-19 policies and as a defender of freedom and liberty of individual choice. A few weeks ago, in a major speech, Kickl that the Austrian government — a coalition between the center-right People’s Party and the Greens — had subjected its citizens to an “inhuman and contemptuous propaganda.” The time had come to liberate Austria’s citizens from this “system of oppression and coercion” and to stand up for the “protection of basic liberal values.”

Vaccination was unnecessary, he agreed. There were enough ways to treat the infection, such as vitamins and zinc, aspirin and ibuprofen. And, of course, there was ivermectin, the miracle drug, which, as a recent scientific study had shown, was highly effective against the virus. Or so Kickl claimed.

Unfortunately, it soon turned out that the “study” was a fraud. This was too bad. Ivermectin might have protected Kickl from catching the virus a few days after his endorsement of the drug. Otherwise, however, Kickl’s promotion of proved to be a great success, at least for Merck and those peddling ivermectin without scruples.

Inspired by their leader, FPÖ supporters started to hoard the drug, much to the detriment of Austria’s cows and horses suffering from pesky parasites. In parts of Austria, pharmacies temporarily of ivermectin. In many of these cases, customers managed to get a hold on larger amounts with prescriptions that had been . In the meantime, hospitals had to admit patients suffering from major drug and vitamin-related . As it turned out, warnings that taking high doses of ivermectin could have severe, even fatal consequences were anything but fake.

Yet the populist right continues to promote ivermectin, and for good reasons. The drug is as though tailor made for populist mobilization. For one, initial studies did in fact show that it was effective against the virus, but under : in a lab (in vitro), at very high dosages, way above the tolerance level for humans. At a human-appropriate level, or so a recent of the findings of several international studies suggests, ivermectin failed to improve a patient’s condition or reduce the number of COVID-related deaths.

As a result, the authors that, given current available evidence, “the use of Ivermectin for the treatment or prevention of Covid-19 is not warranted.” This was also the reached by the European Medicines Agency in early 2021. As a result, it issued a warning against the use of ivermectin “for the prevention or treatment of COVID-19 outside randomised clinical trials.”

Some American physicians disagree. Among them is the , which has called ivermectin a “miracle drug” and “the penicillin of COVID.” The alliance consists of a group of physicians and scientists “who champion ivermectin, along with other drugs and vitamins with dubious efficacy against COVID.” Promoting themselves as heterodox challengers of orthodoxy and the medical establishment, their informationals have swept across the vaccine skeptic community with apparent success.

According to a from late August, 45% of those who considered ivermectin to be very effective against the virus said they would never get vaccinated; 35% who believed in the drug’s effectiveness said they never wear a mask outside the home.

Toward Serfdom

In today’s world, refusing to get vaccinated or wear a mask counts as an act of resistance against authority, standing up for freedom and warding off tyranny. Nowhere is this more pronounced than in Switzerland, where any attempt of the federal government to contain the pandemic is seen as a potential step toward serfdom. This comes from none other than , the influential former leader of the Swiss People’s Party (SVP), the country’s largest and a for Switzerland’s COVID skeptics and anti-vaxxers.  

Blocher expressed a sentiment shared by many opponents of the federal government’s pandemic measures. In the run-up to the recently held referendum on the Swiss COVID-19 certificate — a green pass for the vaccinated — these sentiments infused the of the “no” campaign. The opponents claimed that the certificate represented a fundamental encroachment on the freedom of the individual, a first step on the road to authoritarianism and worse.

With the certificate, the federal government put pressure on all those who did not want to or could not get vaccinated. This was nothing but the beginning of mandatory vaccination, similar to what the Austrian government had ordered. Despite all the hyperbole and hysteria generated by the “no” side, a large majority of the Swiss electorate came out in favor of the certificate, a painful defeat for the skeptics and their parliamentary arm, the SVP.

Like in Austria, those opposed to the federal government’s policies have put their hope on Ivermectin. At the same time, they that the federal government refused to approve the drug as a treatment for the virus in order not to jeopardize the vaccination campaign. Among the most prominent promoters of this theory — and of ivermectin — is a retired professor from the University of Zurich, Martin Janssen, who himself as a “liberal dissident.” A member of one of the committees that organized and financed the “no” campaign, he accused the government of doing everything to prevent those infected with the virus “to get well at home.”

This is why the rejection of the certificate by the Swiss electorate was of such great importance. Otherwise, would become a state like all the others, where “citizens were no longer in a position to defend themselves against their politicians.” As a result, like in , Swiss customs authorities a growing number of seizures of illegally imported medicine, among them, as the officials put it, drugs “against worms and other parasites that contain Ivermectin.”

In the meantime, even before the outcome of the referendum was known, the it would continue to fight against the COVID-19 measures, especially the so-called 2G rule (the Gs stand for the German words geimpft and genesen — vaccinated and recovered) that would limit the validity of the certificate to people in these two categories. In the eyes of the SVP, this amounted to nothing less than a disguised obligation to get vaccinated.

Unfortunately for a party that claims to listen to the concerns of ordinary people, a published in Blick am Sonntag, a popular tabloid, found a substantial majority of more than 60% of respondents favoring the 2G rule. More than 50% came out in favor of mandatory vaccination for all, and a bit less than half were in favor of a lockdown for the unvaccinated.

All of this suggests that things are going to heat up in the weeks and months to come and, with it, the question of ivermectin and other “alternatives” to the vaccine.

Russian Roulette

The case of ivermectin tells us a lot about the appeal of right-wing populism, its nature and the reasons why a substantial number of citizens have been drawn into its orbit. Why would anyone in their right mind subject themselves to a drug that has not only proven to be ineffective against the virus, but even harmful, if not worse? It boggles the mind that the very same people who are worried about the potential side effects of COVID-19 vaccines have absolutely no qualms playing Russian roulette with their health when it comes to ivermectin and other household remedies and cures.

A profound distrust of the “establishment” in all of its forms suspected of collusion against the interests of ordinary people is part of the explanation. In a universe populated by self-proclaimed mavericks, dissidents and lateral thinkers, anyone with an official degree is suspect. It is hardly a coincidence that a retired professor from the University of Zurich held a position in finance and banking. This makes him ideally positioned to evaluate the effectiveness of drugs — at least among the COVID skeptics crowd.

He is part the parallel universe of outsiders and what in German is known as Quereinsteiger — lateral career movers — who command trust for the simple reason that they don’t belong to the establishment. That’s their seal of approval. This allows them to peddle even the most bizarre ideas and narratives — and find eager takers. This is what got Trump elected in 2016 and what has propelled the likes of Eric Zemmour into the political limelight. Unfortunately, unlike drugs, they don’t come with a warning label. But then, today’s COVID-19 skeptics and anti-vaxxers would in all probability not read them anyway.

The reality is, COVID-19 denial in all its different forms is like a cult. Cults don’t tolerate dissenting opinions. This is the ultimate irony. Those who insist on liberty and freedom for themselves don’t accord them to those who disagree or deviate from the pure doctrine. When it became known that Christoph Blocher got vaccinated and publicly advised that everybody should do so, he received implying that he was a “murderer” and even . Although he denied it, it was more than likely that the authors were disappointed SVP supporters.

Scientists have had similar experiences. David Hill, a pharmacologist from the University of Liverpool, in the pages of The Guardian how he received death threats after he and his team published a meta analysis that found “several examples of medical fraud in the clinical trials of ivermectin.” Their study concluded that after filtering out “all the poor-quality trials, there was no longer any clinical benefit for ivermectin.”

A few weeks ago, Nature published the results of a based on a sample of scientists who in the past had commented on the pandemic. More often than not, their opinion provoked harassment and abuse, in some cases death threats. Apparently, ivermectin is not only harmful to those who use it to treat COVID-19 infections, but it is also dangerous to those who study its usefulness as a treatment against the virus.

One last thought. Let’s assume for the sake of argument that ivermectin is the wonder drug the cult pretends it is. Also, let’s assume Merck is fully aware of the fact. It stands to reason — I hesitate to say, in this context — that Merck has all the interest in the world to promote ivermectin as an effective and safe alternative to vaccines. After all, it would make a fortune, its stock would rise high, Wall Street would be happy, and Merck would gain the reputation of having saved the world.

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There is only one reason why Merck would withhold the information. It is in on “the plot,” whatever it is. Like other Big Pharma, it supports injecting everybody with microscopic chips that make us into submissive, remote-controlled automatons at the beck and call of a shadowy world government, pawns in a sinister ploy hatched out by the International Monetary Fund, the World Economic Forum, the Queen of England and god knows who else. It knows that these injection contain agents that turn enough of us infertile to solve the problem of climate change. The permutations are endless for ingenious minds.

There is, of course, an alternative scenario. Let’s assume Merck knows that ivermectin is totally ineffective against the virus and that, on top of it, it is harmful if taken in high doses. Now let’s assume Merck could care less about the drug’s potential harm to human health and life. Under the circumstances, wouldn’t it make sense for Merck to hire agents well versed in the art of marketing and persuasion to get as many people as possible to buy the drug? It is rather amazing that those who believe in whatever conspiracy theory comes their way have not wised up to this possibility. Let’s hope they will soon.

*[51�Թ� is a  partner of the .]

The views expressed in this article are the author’s own and do not necessarily reflect 51�Թ�’s editorial policy.

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In Switzerland, the COVID-19 Certificate Divides Opinions

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As a result, Joshua Kimmich has become one of Germany’s most admired football players — quite a feat, given that he plays for one of Germany’s most disliked clubs — a model and icon for many youngsters. Yet these days, his image has become somewhat tarnished. The reason: A few weeks ago, it was made public that Kimmich refused to get vaccinated. Put on the spot, he explained that he wanted to wait for the results of “long-term studies.” Long-term studies, by definition, take a long time. In other words, it’s going to take a while for Kimmich to get the jabs.

We Are What We Are

Two weeks ago, the German national team played the last two World Cup qualifiers, the first against Liechtenstein, the second against Armenia. Germany won both, without Kimmich — not because he didn’t want to play or because the coach had decided that the two matches were unimportant enough to allow Kimmich to take a well-deserved time out. The reason was much simpler: A defender from Bayern Munich had tested positive for COVID-19 and had to go into quarantine, as did his contacts, among them Kimmich.

Last Friday, the German Bundesliga resumed play, with Bayern confronting Augsburg, again without Kimmich. His quarantine had ended, but in the days before the match, another Bayern player had tested positive and, once again, Kimmich was sent into quarantine. Bayern lost the match.

Needless to say, Bayern’s management is not amused. But until now, the club has maintained that it was up to its players to get vaccinated — or not. This is likely to change. Patience is running out, and not only in Germany. Bayern Munich is Bavaria’s source of pride, the poster child of regional identity and lifestyle, reflected in the club’s unofficial slogan, “Mia san mia” — “We Are What We Are.”

Its connotation is that we won’t allow others to tell us what we should do, that we are our own masters. This has a long tradition in Bavaria. Bavaria’s official name is Freistaat Bayern — the Free State of Bavaria, whose people have always valued their freedom, particularly against Prussia and Berlin.

Then the fourth wave of infections hit the Freistaat. Bavarians love their freedom, including the freedom to refuse to get vaccinated. As a result, vaccination rates here are significantly below the average for the former Federal Republic. They are even lower in the eastern part of the country, where the radical right-wing populist Alternative for Germany (AfD) has been particularly successful in mobilizing the population against anti-COVID-19 measures. A recent has shown that infection rates are particularly high in areas where the AfD has done well in recent elections, and this not only in the east but also in the western part of the country.

Nowhere, however, is the situation as critical as in Bavaria. Over the past several weeks, infection rates in the region have exploded. I was born in Mühldorf, a small town between Munich and Salzburg, in Austria. A few weeks ago, Mühldorf boasted a sad record of having second-most new infections in Germany. At the time, the rate of new per 100,000 habitants stood at more than 600 per week. As of November 22, it stood at more than 1,130 — and rising.

Zero Tolerance

In the face of these rates, which threaten to overwhelm the German health care system, patience is running out. A recent in Der Spiegel, Germany’s premier news magazine, sets the tone: “Zero tolerance for the unvaccinated.” Enough is enough, the author maintains. Germany has been far too indulgent with those who refuse to get vaccinated and, in the process, not only “play the lottery with their own health” but “endanger everybody else.” It cannot be that a minority “dictates” to the rest of society how to live.

An in the Süddeutsche Zeitung, a major left-of-center daily paper from Munich, takes the same line. Dismissing the charge that forcing the unvaccinated to take the shot would lead to societal polarization, the author declares that “the unreasonable rob the reasonable of their freedom — and the governments have let themselves be intimidated by them.”

Such commentary reflects a dramatic change of mood in German society. It finds its confirmation in a recent commissioned by Germany’s major commercial TV station, RTL, that found a two-thirds majority of respondents coming out in support of general mandatory vaccination against COVID-19. Commenting on the results, the deputy head of the station’s politics department that this would mean a restriction of basic rights. At the same time, it would avert further harm to society and the state. That’s what ultimately counts more.

Until recently, in the context of COVID-19, freedom was to a large extent defined as the liberty to choose whether to be vaccinated or not. Any attempt on the part of the government to introduce restrictive measures was seen as an assault on fundamental rights and freedoms. In Switzerland, for instance, like Bavaria a bastion of freedom, those opposed to the country’s COVID-19 certificate have equated restrictive measures as the beginning of the road to authoritarianism à la China, if not outright tyranny.

Good Advice

It appears that this pandemic poses a fundamental challenge to our notion of freedom, which is now being pushed to its limits. One’s freedom stops there, Immanuel Kant has said, where the freedom of the other begins. This sounds perfectly reasonable, as does the notion, advanced by Matthias Claudius, an 18th-century journalist and poet, that freedom consists in being allowed to do whatever does not harm others. The fact is that today, the vast majority of those who end up in intensive care units have not been vaccinated. When ICUs fill up to capacity with COVID-19 patients, the beds are no longer available for emergency cases.

to the Dutch National Institute for Public Health and the Environment, the likelihood “that a fully vaccinated person will end up in ICU due to COVID-19 is 33 times lower than for a non-vaccinated person.” With the dramatic upsurge in infections, the number of patients ending up in hospital is bound to increase significantly, with serious consequences for personnel and care facilities. Already in late August, in Switzerland, COVID-19 patients for around 30% of those in intensive care. As a result, some hospitals began to delay non-urgent operations. 

The same was true for other countries. In the UK, late last year, cancer patients had scheduled operations postponed or even because of the upsurge of patients needing intensive care during the second wave of the pandemic. It stands to reason that this is going to happen once again with the most recent fourth wave. In countries like Austria and Germany, the situation is already critical, as Bavaria’s health minister a few days ago: “The numbers are rising drastically. The intensive care units are filling up. Our health system is about to collapse.”

Under the circumstances, there can be no doubt that those who insist on their freedom not to get vaccinated put those who don’t get the medical attention they would otherwise receive unnecessarily in harm’s way.

In the meantime, Bayern Munich’s management talked to Kimmich and his four unvaccinated teammates — without success. In response, the club it would stop paying players who refuse to get vaccinated, including Kimmich, while they are in quarantine. 

For many of Kimmich’s critics this does not go far enough. They have that unvaccinated players should be excluded from practice and matches altogether, if only to send out a strong signal at a time when Germany is heading into a health crisis. The situation is serious, in some regions dramatic — with dramatic consequences: RB Leipzig will have to play its next home matches in front of an , a result of Saxony’s low vaccination and high infection rates.

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Under the circumstances, it might be time to rethink what we mean by freedom. One point of departure might be a point made by in 1947 during a prayer in the US Senate. Freedom, he said, is “not the right to do as we please, but the opportunity … to do what is right.” This jibes with a quote from the German philosopher Georg Wilhelm Friedrich Hegel, later adopted by Friedrich Engels and still later by the ecologist Garrett Hardin in his famous essay on the “,” which states that freedom “is the recognition of necessity.”

In an age characterized by hyper-individualism, where, as Margaret Thatcher famously quipped, society does not exist, these quotes might sound hollow. Given the urgency of the current situation, and not as populist sirens would like us to believe, they might be the best advice we can give ourselves in order to find the way out of this crisis.

The views expressed in this article are the author’s own and do not necessarily reflect 51�Թ�’s editorial policy.

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Instagram, a photo-sharing app that is owned by Facebook, Inc., is popular among school-aged children and teenagers worldwide. Studies have that young people spend up to nine hours on social media and digital technology, posting pictures, streaming videos, listening to music and engaging socially.

Return of Jane: Would Stricter Rules Bring Back Illegal Abortion?

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The Wall Street Journal into the leaked internal Facebook documents confirmed that studies commissioned by the social media giant found that its subsidiary, Instagram, has negatively impacted the mental health of its users, particularly teenage girls. In addition, the company failed to act to remedy the potential harm that it is directly and knowingly causing.

Leaked documents reveal that more than 30% of teenage girls using Instagram feel worse about their bodies after accessing the app. Another document outlined how Instagram can contribute to and exacerbate anxiety and depression in users. 

This isn’t the first time a study has linked teenage depression, anxiety and other stress-related conditions to social media use. Studies conducted across the globe have sought to establish the notion of “digital age vulnerability” to mental health conditions in users.

The research has been conclusive. A 2018 British published in The Lancet tied social media use to decreased, disrupted and delayed sleep, which is associated with depression, memory loss and poor academic performance. Another in the Journal of Adolescent Health concluded that depression and eating disorders are higher in young people who use social media outlets on a regular basis.

It is the first time, however, that leaked documents have shown the company’s acknowledgment of the harms it may be causing and subsequently failing to act. Facebook places a lot of importance on Instagram in capturing a younger audience. Adolescents and teens across the United States spend much more time on Instagram than on Facebook, and with ever-evolving features, Instagram competes with other teen favorites like TikTok and Snapchat. 

Brooke T., a 17-year-old girl from New York, spends roughly six to seven hours per day on Instagram and other social media platforms. She was recently diagnosed with anorexia nervosa, an eating disorder characterized by very low body weight, a fear of gaining weight and a skewed perception of weight in general. “Every time I would go on Instagram, all I saw were pictures of perfect bodies everywhere,” she told me. “It made me feel pretty bad about myself.” When asked directly if her time on Instagram contributed to her recent diagnosis, she answered: “Definitely.”

Alarm bells have sounded before and organizations across the United States have conducted research that reflects this upsetting trend. Between 2010 and 2018, depression rates have doubled among teenage girls, according to from the Department of Health and Human Services. The Centers for Disease Control and Prevention that suicide rates among girls in the same period of time have nearly doubled as well.

Back in December 2017, Mark Zuckerberg, the founder, chairman and CEO of Facebook, was pressed in an interview to comment on the data linking an increased risk of mental health conditions tied directly to Facebook, he that “protecting our community is more important than maximizing our profits.” Unfortunately, the leaked documents tell another story.

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If Facebook has full knowledge of the harm and risk it poses to people who use its platforms, the company has an ethical and moral obligation to acknowledge it publicly and work to make its products safer for children, teens and adults. This is particularly true in light of Facebook’s recent announcement of the plan to develop a metaverse platform, that will subsume consumers even more deeply into its digital world. Simply won’t effect the necessary change.

The COVID-19 pandemic has wreaked havoc on the mental health of men and women, boys and girls around the world. Social media has helped connect so many people when social distancing has kept them apart. But if the platforms are knowingly harming the mental health and well-being of its users, companies like Facebook need to be held accountable and measures must be taken to ensure the health and safety of users.

 *[The Wider Lens provides commentary on trending stories in the world of health, covering a wide variety of topics in medicine and health care.]

The views expressed in this article are the author’s own and do not necessarily reflect 51�Թ�’s editorial policy.

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Do Americans Still Trust Their Public Health Agencies? 

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Yet over a million travel to the US every year for their medical care, including heads of state, the wealthy and elite, who presumably could have received care in their home country or anywhere else in the world. The numbers cited above do not even include the millions who are cared for by the international satellite campuses of the Mayo Clinic, Cornell, Harvard and Johns Hopkins systems, to name just a few, that have been established to bring American health care to the rest of the world.

Around 100,000 Canadians, whose nationalized health system is rated above the United States, are likely to cross the each year for medical care. These medical tourists recognize that, on the whole, health care in the US is the best in the world.

Leading the Way

The United States leads the world as a juggernaut of medical research and innovation. More Americans have received the Nobel Prize in medicine than Europe, Canada, Japan and Australia combined, which together have double the aggregate population of the US. Half of the top 10 diagnostic or therapeutic innovations in the past 50 years have come in whole or in part from the US, along with 75% of the top 30.

When it comes to pharmaceuticals, half of the top 30 blockbusters have come from the United States alone. The advanced medical milieu that Americans enjoy has led to the world’s best cancer rates, a life expectancy for those that is actually greater than anywhere else, and lower mortality rates for and than in comparable countries.

There are many reasons that have been put forth to explain this dominance, but the most basic and powerful is very likely money. The free-market health care economy of the US, along with lower regulatory and tax burdens, strongly incentivizes corporations to focus their business in America.

At a fundamental level, greater financial compensation also provides individuals and their families the potential for a better quality of life, while greater autonomy spurs innovation. This is why the United States is routinely listed as one of the best in the world to practice medicine. One-quarter of all doctors in America are foreign-trained. Licensure is a daunting process that nearly always requires “starting over” for the immigrant physician. These physicians are often fully licensed and practicing in their home country, but must now sit for the US Medical Licensing Examination (USMLE) and spend years redoing all of residency and fellowship.

Despite this challenge, estimates suggest that over $2 billion is lost annually from physicians leaving sub-Saharan Africa alone to set up shop in the US. This so-called is rampant in India, Mexico and Central America and is not limited to physicians. In , about 14,000 nurses left the Philippines, while only 5,000 graduated nursing school. The United States represents 5% of the world’s population, accounts for around 5% of the world’s disease burden, but employs 20% of the global health .

The UK and Canada

Contrast this environment with the nationalized health systems of the United Kingdom and Canada, which each year rank higher than the US. When resources are controlled by a single-payer system, the waiting time for care invariably lengthens.

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In 2019, the National Health Service (NHS) in England reported that one-quarter of all cancer patients did not treatment on time despite an urgent referral from their physician. Even before the COVID-19 pandemic, wait times for medically necessary treatments in Canada averaged three months, which the treating physicians documented as one month longer than .

Universal health care also leads to an increased tax burden. The tax-to-GDP ratio in the United States is 26%, which is the lowest of 34 advanced nations. In Canada, that number sits at 32%, in the UK at 34% and in France at 45%. Some estimate that a single-payer conversion in America would potentially by up to 20%.

For those with the means to pay, there is a booming secondary private insurance industry in most socialized health care economies, which has essentially created a two-tier of “haves” and everyone else. Self-pay for health care in the UK rises annually by 10%, leading to a 50% increase over the last half decade, and this excludes cosmetics or costs paid by the NHS. One result is that nearly all general practices are private now in the UK, contracting their services out to the government while providing direct-pay services for the affluent.

Another outcome is that 43% of all physicians in the country are part time, which usually coincides with the switch to private practice. In Canada, one-third of all health care funding is private multiple legal challenges to forbid a two-tier system and resultant line-jumping.

The US Is Not Flawless

All of this is not to say that the US health care system is flawless, or that lessons cannot be learned from countries with nationalized care. Between 1975 and 2010, the number of physicians grew by 150%, while the number of administrators by 3,200%; there are now 10 administrators for every physician in the United States. Administrative account for 25% of total hospital expenditures in the US, while the average among other affluent countries is closer to 10%.

America is also a very litigious society, at cost to the system. The amount equals 2.5% of total health care spending or $60 billion a year, $45 billion of which is “defensive medicine” to avoid lawsuits. One-third of all American physicians have been sued in their lifetime, while that number is 1% for Canadian doctors. The average malpractice lawsuit in Canada for $95,000, with close to $400,000 in the United States. While the adjusted number of uninsured Americans is not the 10% — adjusted meaning those who were not eligible for any aid/coverage, and not offered insurance by any entity — but closer to 1% or around 3 million, this still should be unacceptable as health care is a basic human right.

For generations, the United States has been a shining beacon of health care hope, paving the way to healthier, longer living and whose entrepreneurial milieu has led to innovations enjoyed worldwide. While greater scrutiny over the past few decades have highlighted areas for improvement, the market never lies and recognizes that America is still the best place in the world for health care.

The views expressed in this article are the author’s own and do not necessarily reflect 51�Թ�’s editorial policy.

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Religion has always played a role in low vaccination rates. A 2015 literature review on to measles vaccination that examined major religious groups around the world — Judaism, Hinduism, Christianity, Roman Catholicism, Protestant Christianity, Amish, Jehovah’s Witnesses and Islam — found that, although there are always social determinants that explain religious objections, there were also specific issues such as the possible use of aborted human fetus tissue in the making of the vaccine (Christian, Roman Catholic) or the use of animal-based gelatins (pork and cow for Islam, Judaism and Hinduism).

The Colorful World of Coronavirus Conspiracies

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Another analysis of Europe’s identified five that are at a higher risk: Orthodox Protestant communities, anthroposophists (Steiner schools), Roma, Irish Travelers and Orthodox Jewish communities. In , before the pandemic, Muslim families had significantly lower vaccination outcomes compared to other religious groups.

The Alt-Medicine Crowd

The alternative medicine/wellness crowd became another predictor of low vaccination when Andrew Wakefield’s 1998 paper in The Lancet sparked an international wave of vaccine hesitancy at a time when vaccination drives had achieved the eradication of several deadly diseases around the world. Wakefield’s scientific deception is skillfully summarized in Brian Deer’s “,” where conflicts of interest (Wakefield had filed his own single measles vaccine patent before publishing this research) and reports of abuse (invasive and unnecessary tests on autistic and neurodivergent children) are documented.

Wakefield’s now-discredited publication, which connected the MMR (measles, mumps, rubella) vaccine to gut inflammation and falsely correlated it with a diagnosis of autism, effectively launched the modern reincarnation of the anti-vaccination movement.

Contrary to the vaccine hesitancy among religious communities, alt-medicine groups have managed to monetize their opposition to vaccination. A report by the Center for Countering Digital Hate (CCDH) estimates that the anti-vax media complex is , with estimated annual profits at around $36 million, based on publicly available data.

Some of the leading figures in the business earn six-figure salaries (Robert F. Kennedy Jr. earns $255,000 a year as the chairman of Children’s Health Defense). Anti-Vax groups also applied and received more than $1.5 million in loans from the federal Paycheck Protection Program in the US to help them to survive a pandemic they questioned.

More disturbingly, the CCDH report estimates that anti-vaccination-related traffic is extremely valuable for Big Tech, worth estimated at around $1.1 billion. An analysis of showed that the majority of anti-vax advertisement is funded by two campaigners, Robert F. Kennedy Jr. and Larry Cook.

Dabbing in Extremist Hatred

Before the pandemic, anti-vax groups were a public health concern in terms of various that became more frequent since the early 2000s. However, once the anti-mask protests of 2020 evolved into the anti-vaccination protests of 2021, the far right has managed to successfully traditional anti-vax communities, turning a public health concern into a political problem of .

This anti-vax, anti-government, far-right nationalist protest medley is evident anywhere from Canada to Australia, where COVID-19 anti-lockdown protests have turned to violence and conspiracy-driven . In France, the ubiquitous used by protesters to denote unvaccinated status became a stark reminder of how the pain of Holocaust survivors can be easily appropriated.

Similarly, the movement has used opposition to the relatively mild COVID-19 restrictions in the country as a vehicle for anti-Semitic and radical-right extremism. In both Greece and Cyprus, where a SafePass — proof of vaccination or a negative test — is required to enter any commercial or public space, large anti-vax protests turned violent, in the case of Cyprus attempting to a TV station.

Some evidence suggests behind these protests: a German group, the Free Citizens of Kassel, seems to be behind the “World Wide Rallies for Freedom” organized since March 2021 in all corners of the world, even in tiny countries such as Cyprus and Luxembourg, using the hashtag #WewillALLbethere.

Another German movement promoting anti-vax conspiracy theories is called Querdenken, which translates as “lateral thinking.” It is now by Facebook and it has been linked to the far-right Alternative for Germany party. According to some , Querdenken has managed to infiltrate teenagers’ social media channels and successfully spread COVID-19 misinformation and conspiracy theories.

Satanic Vials

Religious symbols at these anti-vax rallies, however, reveal that their message is not only about religion. Behind the bizarre circulation of the “” card is the fact that Christian symbolism is simply the metaphor, not the substance, in demonstrating against a “satanic” vaccine or an oppressive government that will lead to the “apocalypse.” The history of Christian thought and scientific consensus is much more than simple refusal. In fact, Christian religious leaders in the US have vaccinations despite debates on the use of fetal cells for research.

However, in the US, anti-vax protests are less about religious beliefs and more about the awakening of that is pro-Trump and QAnon-positive. The group has skillfully embraced Christian nationalism and engulfed religious beliefs in an ideological mix of anti-mask, anti-vax, MAGA white nationalism.

Among US Christian groups, represent the largest block in anti-vaccination ideology. Although they may use the Bible as a source of vaccine hesitancy, more often they resort to a rhetoric of condemnation toward the “” that resembles the anti-establishment language of right-wing extremism.

In Greece, countrywide anti-vaccination protesters brandished Greek flags, big Greek Orthodox crosses and chants of the national anthem and “Christ Has Risen.” At the same time, priests and monks marched alongside Golden Dawn followers who brought their neo-Nazi arguments to the anti-vax demonstration. During one of these protests, Elias Kassidiaris, a former Golden Dawn MP, joined the protesters from prison via phone. All of these phenomena beg the question of how much the seemingly religion-inspired anti-vax movement is another expression of Christianism.

Conspirituality and Vaccine Refusal

The term “” was coined in 2011 by Charlotte Ward and David Voas to signify a productive merging of the mostly male-dominated world of conspiracy theories with the feminine New Age spiritual wave. The term has since taken on and found a revived relevance during the current pandemic. The Conspirituality podcast, launched in May 2020, has been a brilliant weekly take on the “converging right-wing conspiracy theories and faux-progressive wellness utopianism.”

The phenomenon is directly relevant to the alt-medicine crowd that has always emphasized the idea of one’s sovereign, meditative body that exerts control over its immune system and is impervious to the replication of the virus.

The main message throughout the pandemic has been to question the scientific existence of COVID-19 — for example, Kelly Brogan’s Questioning Covid website — but also to interpret the pandemic through the concept of “the great reset,” which Brogan’s partner, Sayer Ji, explains as “Tyranny. Technocracy. Experimental Jabs.” It is a form of neoliberal spirituality that places emphasis on individual responsibility and deflects from the role of public health research.

But the synergies between those spreading “medical freedom” and the far-right crowds should not be underestimated. One of the leading entrepreneurs of the anti-vaccination movement, Del Bigtree, spoke at the January 6 “MAGA Freedom Rally D.C.” just a block from the US Capitol. The creator of the Facebook group “Stop Mandatory Vaccination” Larry Cook also launched the YouTube channel, “Medical Freedom Patriots,” describing it as pro-God, pro-Trump, anti-vaccine and QAnon-friendly.

The Bollingers, an anti-vax couple with a large social media following and even larger revenues, founded the United Medical Freedom Super PAC that campaigned against vaccination during the 2020 election. Sherri Tenpenny, a trained physician who advocates against vaccination, is an adviser to Mike Lindell and a promoter of the so-called “election fraud” debate in the US.

In many ways, COVID-19 has made possible a backslide from the alt-medicine to the alt-right: your yoga teacher, organic food guru and meditation partner who advised you on how to keep your immune system strong in order to avoid vaccines is now talking about the government’s plan to microchip you to facilitate the trafficking of young children.

In effect, the far right has the leftist side of the anti-vax movement through a shared anti-establishment stance. As Andreas Önnerfors has pointed out, these anti-vaccination protests represent a of the left (green/progressive/liberal) with the socially conservative right.

Vaccine Hesitancy vs. Anti-Vaccination

The Strategic Advisory Group of Experts on Immunization defines as “delay in acceptance or refusal of vaccines despite availability of vaccine services.” It notes that it is a complex societal and cultural phenomenon related to three factors: complacency, convenience and confidence. This largely psychological approach, however, misses the political dimension of anti-vax ideology.

Currently, the challenge is to understand how reasonable fears and valid questions surrounding vaccination mutate into radical and extremist anti-democratic ideology. Part of the explanation is how narratives of have succeeded in appropriating anti-establishment sentiments. A recent study by analyzed narrative tropes and rhetorical strategies in anti-vax platforms and found that the narrative of “corrupt elites” and the strategy of appealing to the vulnerability of children were most frequently used.

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As Mark Davis argues, even before the current pandemic, anti-vaccination websites oppositional and antagonistic strategies to produce an anti-public discourse that mostly resembles white supremacist, alt-right and conspiracy forums.

The COVID-19 pandemic has revealed that vaccine hesitancy is not just about the vaccine. It showcases the algorithmic traction of the antagonistic discourse on social media that shuts down arguments with a concern for the “ordinary” people or “defenseless” children. Ultimately, it is about mistrust of authority, the specter of corrupted elites and a misplaced desire for freedom and choice.

*[51�Թ� is a  partner of the .]

The views expressed in this article are the author’s own and do not necessarily reflect 51�Թ�’s editorial policy.

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Kyrsten Sinema’s True Motive Revealed

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Since the bulk of humanity, including those already vaccinated, is still susceptible to being infected by SARS-CoV-2 — the virus that causes COVID-19 — we should all rejoice, though not quite as gleefully as Merck, the pharmaceutical company that has produced the pill. “It makes sense,” MarketWatch explains, “that pharmaceutical companies are trying to figure out whether antivirals can reduce the risk of someone dying or ending up with organ damage and an expensive hospital stay.”

Today’s Daily Devil’s Dictionary definition:

Make sense:

Make dollars, when applied to the actions of any large pharmaceutical firm

Contextual Note

“Finally, we have another potential tool,”, declared the media’s omnipresent guru, Dr. Anthony Fauci. More significantly, Merck will have a windfall estimated at $7 billion from its sales of molnupiravir by the end of the year. The US government “has already placed an order for 1.7 million courses of treatment, at a cost of $700 per patient.” Newsweek it “one of the most lucrative drugs ever.”

As American media rejoices, British media seem somewhat more reserved. The Independent out that “an analysis of drug pricing by Harvard School of Public Health and King’s College Hospital in London found that it takes about $17.74 to produce a five-day course.” In its lengthy article that explores all the difficulties of deploying the drug across the globe, The New York Times never the gap between the cost of production and the price at which Merck is pitching the treatment. Instead, it endorses the reasoning cited by one expert who calls for “donors to step up with funds to make sure treatments reach everyone.” Bill Gates, the guarantor of global health, are you listening?

In contrast with The New York Times, The Independent notes a simple historical fact: “The pill, hailed as a breakthrough in the treatment of coronavirus, was originally developed to treat influenza using government funds.” In other words, it was the public and not Merck who paid for the product’s development. It’s a classic narrative of pharmaceutical opportunism. Emory University received $29 million in grants between 2013 to 2020 to develop the drug with no input from Merck or anyone else in the industry. In May 2020, in the midst of the pandemonium provoked by the pandemic, sensing that it might be a goldmine, Merck “bought the exclusive rights to sell and manufacture the drug worldwide.” This sums up the logic of today’s rentier capitalism.

Historical Note

One thing the saga of successive surges of COVID-19 should have taught humanity is that neither prevention (vaccination) nor treatment will be effective if the effort is not shared and coordinated globally. The history of COVID-19 offers an even more fundamental and imperative lesson. Health is the one feature of human life that should never be individualized and subjected to the logic of consumer culture.

Consumer culture assumes that individuals will make wise economic decisions to purchase what is best or most attractive to meet their personal needs. It also assumes that those who want something — whether it’s a shampoo, a kitchen robot, a surgical mask or a vaccination — will make the effort to afford the purchase. For most people, this means seeking employment. Finally, it assumes that those who accumulate excess means — the capitalists — will decide to use those means to produce goods or services, not with a view to meeting the needs of humanity or of society, but for the prospect of making sales pitched at those individuals who have the means to pay.

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If the tyranny of consumer logic wasn’t enough to complicate humanity’s response to COVID-19, the acceptance of the notion that nation-states are the only legitimate arbiters of global decisions constitutes another obstacle to problem-solving. The Times assesses the state of the marketplace for Merck’s magic pill and fatalistically concludes, “All this means that treatments could remain largely with nations able to pay for early access, as they have done with vaccines.” As usual, The Times tells us: Don’t argue with the logic of either capitalism or nationalism.

Newsweek’s account flirts with the comedy of misplaced optimism. It quotes Nicholas Kartsonis, a senior Merck executive who explains the logic behind Merck’s $712 price tag. “We set that price before we had any data, so that’s just one contract. Obviously we’re going to be responsible about this and make this drug as accessible to as many people around the world as we can.” The Times uncritically accepts the “obvious.” After usefully reminding its readers that “Merck was criticized two decades ago for selling its H.I.V. drugs at prices unaffordable in Africa,” it claims that the lesson has been learned. “This time, the company recognized the imperative of widening access early.” When total access is the only solution, “widening access” could justifiably be called a crime.

When challenged on their addiction to greed (for which no treatment appears to exist), Big Pharma predictably trots out their standard argument. A Merck spokesperson explained to Newsweek “that estimates of production cost of manufacturing by generics makers don’t take into account the ‘billions that are invested by the research-based pharmaceutical industry’ into research and development.” The spokesperson’s use of the passive to assert that “billions that are invested” cleverly hides the fact that the pharmaceutical companies are not the ones making the investment. Pharmaceutical firms prefer to buy the rights to promising drugs after they have been developed with public funds. What they own is the right to price the drug, which is then sold back at an exorbitant profit to the people who financed its development. 

The New York Times offers another statement by a Merck executive that flirts with comedy. Jenelle Krishnamoorthy, Merck’s vice president for global policy, explains the reasoning behind the company’s generosity in offering lower prices outside of wealthy markets. It is “to make sure that, especially in low- and middle-income countries where they don’t have the strongest health care systems, that this would have very wide �����������.”

Krishnamoorthy appears to assume that the US is an example of one of “the strongest health care systems.” If so, her idea of “strong” correlates with the ability of some people — including the government — to pay a high price. The US has the world’s most expensive health care system. It also has arguably the most dysfunctional system of any developed nation. From Merck’s point of view, a government that will buy 1.7 million units at $712 is a “strong” health care system. As usual, strength and even purpose are measured in monetary value.

The Times evokes the possibility that Merck may allow governments in the poorest nations to “buy molnupiravir for well under $20 per five-day course, compared with $712 in the U.S. deal.” It later quotes an “industry executive who was not authorized to speak on the record” who “said he expected his firm to produce the drug for less than $10 per course.” What entrepreneur in the world would not accept to make immediate massive sales of a product they took no risk investing in with the guarantee of at least a 100% markup even in the world’s poorest markets?

The Times article goes on to reveal other anomalies that will prevent a global solution. All the calculations are based on how much restraint the pharmaceutical companies are likely to accept in shaving a few percentage points off their exorbitant, no-risk margins. The article even calls this kind of grudging concession “a smart business move for the company,” citing the fact that the firms “know that if they don’t address the access challenges, they will be slammed.”

All this reasoning leads to the inexorable conclusion that pandemics may rage, human lives will be sacrificed through the failure to concert and coordinate, and political chaos may ensue. But a world regulated by the profits of monopolistic companies is here to stay. It remains the unassailable foundation of the modern economy.

*[In the age of Oscar Wilde and Mark Twain, another American wit, the journalist Ambrose Bierce, produced a series of satirical definitions of commonly used terms, throwing light on their hidden meanings in real discourse. Bierce eventually collected and published them as a book, The Devil’s Dictionary, in 1911. We have shamelessly appropriated his title in the interest of continuing his wholesome pedagogical effort to enlighten generations of readers of the news. Read more of The Daily Devil’s Dictionary on 51�Թ�.]

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According to the , abortion was so dangerous that in 1965, roughly 17% of deaths relating to pregnancy and childbirth were the result of illegal abortions. The shocking statistic is unsurprising given that in the 1950s and 1960s, the number of illegal procedures ranged from 200,000 to 1.2 million per year.

For Americans, Abortion Is More Controversial Than Same-Sex Marriage

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Women from lower socioeconomic backgrounds and women of color were disproportionately affected by strict regulations as many couldn’t afford to travel to places where they could obtain a legal abortion. The levels of morbidity and mortality among this demographic were astounding. While among white women as a result of abortion stood at one in four in New York City in the early 1960s, the number was one in two for nonwhite and Puerto Rican women.

Born out of this predicament was the Abortion Counseling Service of Women’s Liberation, also known as the , founded by Heather Booth as an underground service headquartered in Chicago, Illinois. The main goal of the “Service,” as it became known, was to assist women in gaining access to safe and affordable abortions. Many women who were part of Jane were taught to perform abortions for others in need and did so successfully without a medical license. 

Laura Kaplan, a member of Jane and of “The Story of Jane: The Legendary Underground Feminist Abortion Service,” was not surprised when Texas Governor Greg Abbott signed into law one of the country’s strictest abortion rules, banning the procedure from as early as six weeks into pregnancy, but she was angry: “I am outraged by this, but even more than Texas, I am the most angry at the Supreme Court’s decision to let this blatantly unconstitutional ruling stand.”

The six-week mark stipulated by the new legislation means that many women will be barred from accessing abortion services before they even realize they are pregnant. The legislators went a step further by incentivizing private citizens to report and sue providers or anyone helping a woman get an abortion for $10,000.

Under the new law, the government doesn’t enforce the bill — the private citizens of Texas do. This provision was designed to make the law harder to contest in court, but lawsuits are expected. The US Department of Justice has already mounted a , positing that it stands “in open defiance of the Constitution.”

At the same time, several Latin American countries are loosening their restrictions on abortions. “Predominantly Catholic countries like Argentina and Mexico are making progress, while we are moving backwards,” says Kaplan. 

Could there be a return of Jane in Texas now that abortion rights are being curtailed? “Women are not going to let women suffer,” says Kaplan. “We didn’t back then.” Starting in 1969, Jane groups popped up all over the country, with women finding their way to one of the services when they were in need.

After New York state legalized abortion, it changed the landscape. White middle-class women could get on a plane and get to New York, but it meant that many young, poor and many women of color were left behind. Kaplan thinks history may repeat itself: “Women with the most need didn’t have access to abortion and that will happen again.”

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It’s important to note that after abortion was legalized, less than 0.3% of women, regardless of age, experienced serious complications post-procedure. If the real debate is about the preservation of life — and, indeed, the sanctity of life — we have to look beyond the life of the developing fetus and to the life of the mother as well. 

Any rational policy should look at promoting access to birth control and prioritizing the health of the mother by assuring that she has access to safe procedures. Outlawing abortion doesn’t work — the story of the Jane Collective has shown that. It won’t change people’s motivation to terminate an unwanted pregnancy.

As a democratic society, we don’t want to throw ourselves back to an underworld that offers subpar care, creates a greater public health problem and endangers the health of women.

*[The Wider Lens provides commentary on trending stories in the world of health, covering a wide variety of topics in medicine and health care.]

The post Return of Jane: Would Stricter Rules Bring Back Illegal Abortion? appeared first on 51�Թ�.

Addressing the Fragile Limits of Female Autonomy

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As written, the law allows private individuals to pursue legal action against anyone suspected of assisting an abortion past when a is detectable, which is generally agreed to be around the sixth week of pregnancy. According to the , prior to the enforcement of Texas’ new anti-abortion law, while there were barriers to dissuade or prevent women from having abortions, no state directly forbade the procedure before the 20-week mark.

However, the lack of judicial deterrence against the new Texas law indicated trends moving forward that will severely curtail women’s bodily autonomy and ability to make personal health decisions.

Six Weeks

Globally, 36% of countries allow abortions upon request, including the United States. The most common across these countries is 12 weeks — far less than US national regulations and the typical viability of a pregnancy but twice the allowance for women under the new Texas law.

In Texas, it is estimated that between who obtain abortions are at least six weeks into their pregnancies, meaning that the new law will effectively nullify the vast majority of abortions in the state. As Texas is the second-largest US state after California, its more than making up approximately 8.8% of the total US population as of 2020, around 7 million Texans are directly affected by the new legislation.

Additionally, due to the implementation of S.B. 8, the distance for a woman who is over six weeks pregnant to find abortion services has increased from . While clinics that provide abortions, such as Planned Parenthood, remain open, they are preemptively turning away patients that are over the six-week mark in order to protect themselves from lawsuits.

One bright spot amid Texas’ new “sue thy neighbor” law was the temporary issued by a local Texas District Court that prevents the organization Texas Right to Life and its associates from suing abortion providers and health care workers.

While S.B. 8 doesn’t criminalize abortion, upcoming laws, including that is due to take effect on November 1, will. As currently written, the Oklahoma law would make any person who performs or induces an abortion on a pregnant woman without first testing for embryotic cardiac activity guilty of homicide.

This bears a passing resemblance to the strict anti-abortion of the Revised Penal Code of the Philippines, which allow for the imprisonment of women and anyone who would assist them in conducting an abortion. These laws have lead a World Health Organization study to declare the reduction of safe abortion options as one of three key challenges for women’s health, accounting for up to 20% of

If legal abortion in the US is further restricted, Americans should expect to see upticks in death rates of women and people who can become pregnant, particularly among the most vulnerable and poor populations in areas that severely restrict abortion.

In comparison to a wave of anti-abortion laws in the United States and , other nations have been working to decriminalize abortion. After a decades-long struggle, abortion was decriminalized in on January 1 this year. Most recently, on September 7, has ruled that it is unconstitutional to punish abortion as a crime, which will provide a path for the legalization of the procedure across the country.

However, in both countries laws to facilitate abortion procedural processes remain nebulous, and Mexico is likely to face future internal resistance as only three states and Mexico City previously allowed abortions on request.

Long-Term Impacts

By failing to halt the implementation of S.B. 8, the Texas government and the Supreme Court have paved the way for further restrictions on abortions and the oppression of women. While the Justice Department, led by Attorney General Merrick B. Garland, it would protect women who seek abortions under the new Texan law and the state on September 9, the immediate increase in fear, repression and the inevitable long-term negative impacts among both patients and health care providers cannot be understated.

The Supreme Court is expected to hear several other anti-abortion laws in the upcoming year, most critically the of Dobbs v. Jackson Women’s Health Organization in Mississippi, which is attempting to ban all abortions beyond 15 weeks. If the Supreme Court decides in favor of the law, as it is expected to, experts like believe it will lead to the overturn of Roe v. Wade and the dissolution of the right to abortion in the United States.

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In turn, this could dismantle the national right to abortion, and activists fear there will be no protection against further disenfranchisement of the rights and bodily autonomy of all pregnant individuals.

In opposing this, abortion rights advocates like Kathryn Kolbert of the Center for Reproductive Rights emphasize the need to turn to the legislative process, win elections and develop long-term strategies. However, the polarized nature of the American state and the parallel advance of restrictive voting laws means that the future of women’s rights and bodily autonomy in the US remains dim.

The views expressed in this article are the author’s own and do not necessarily reflect 51�Թ�’s editorial policy.

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So where does that leave public confidence in our health agencies? Not in a good place. According to a recent conducted by the Harvard T.H. Chan School of Public Health and the Robert Wood Johnson Foundation, 48% of those polled reported little to no trust in the CDC and even less for state and local health departments. 

These low numbers have dire consequences. Public health recommendations that include mask-wearing, proof of vaccination status and compliance are necessary for the United States to effectively combat the COVID-19 Delta variant and minimize morbidity and mortality. If the general public is skeptical and doesn’t have faith in these recommendations, containing the spread of new variants becomes nearly impossible.

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It is not hard to understand the reasons behind eroding trust in the United States. From the start, the COVID-19 pandemic has been highly politicized. “There are deep divisions in this country affecting how people look at public health institutions tied to political views and philosophy,” explains , professor emeritus of health policy and political analysis at the Harvard T.H. Chan School of Public Health and co-director of the recent poll.

The CDC was once viewed as a neutral agency. Back in 2009, during the H1N1 (swine flu) pandemic, all of the messaging came directly out of the CDC headquarters in Atlanta, Georgia. The messaging was not politically charged. “The minute you start doing discussions out of the White House,” says Blendon, the message gets lost. “It’s no longer the CDC’s goals — it becomes the president’s goals.” In order to lower the political climate in this country, the White House should not be placed at the center of discussions.

In addition to the political climate, there has been mixed messaging from the scientific community. “Data has changed, data moves,” explains Dr. Arthur Caplan, professor and founding head of the Division of Medical Ethics at the NYU School of Medicine. “The public doesn’t fully understand or accept that.” There was a great deal of uncertainty with COVID-19, especially at the beginning of the pandemic. There was a wide expectation among many people that the scientific community would have immediate and definitive answers. It didn’t, and that bred feelings of anxiety, fear and distrust.

Convincing people to get the vaccine is critical at this point in the pandemic. But the tactics need to evolve. “We discovered in the data polling from the variety of unvaccinated people that they are not worried about the disease,” says Blendon. “If you look at other diseases from the past, parents first got worried about polio when they saw pictures of children disabled for their whole lives.” Pictures, personal stories that relay the importance of vaccination and what is at stake will work better than statistics.

“There was a critical care physician from Alabama who had two patients near dying, they wanted the vaccine but it was too late,” explains Blendon. According to both Blendon and the results from the poll that he oversaw, this is very powerful and this is what it will take to move the needle: “We need to convince people through iron lung pictures, not statistics.”

In addition, Blendon thinks that the public seems to trust their own health care provider: “We need to emphasize local physicians — those voices in Tennessee, Mississippi, Missouri, Alabama will move people over time.” The pandemic is being fought on the ground and has nothing to do with politicians and the presidential administration. 

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Looking back on the past year, it’s become clear that the US could have handled the flow of information better. Had there been more transparency at the beginning of the pandemic, with public health officials explaining that they are learning about the disease in real time and that the recommendations may change, the public may have had more tolerance for an evolving situation. 

We were isolated from each other, connected largely online, with social media serving as the ultimate connector. Everyone became an expert, and every account became a megaphone. Ethical issues emerged from diminishing trust in science. “As science erodes, it opens the door wide for cooks, nuts and bigots,” says Caplan. “If science doesn’t have control over the message, anybody and everybody can pile in,” he points out. There is a large platform of misinformation and, in some egregious cases, so-called experts profiting over the fallacies they espouse. 

American public health agencies have a tough job ahead of them of fixing the distrust among the people who used to rely heavily upon them for guidance and information. But they also need to streamline their messaging and strategize effective recommendations to become a central voice in the fight against this virus so that we can soon look at this pandemic in the rearview mirror. 

 
The views expressed in this article are the author’s own and do not necessarily reflect 51�Թ�’s editorial policy.

The post Do Americans Still Trust Their Public Health Agencies?  appeared first on 51�Թ�.

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Avoiding global catastrophe from the more infectious Delta variant of COVID-19 doesn’t require a huge commitment from people and governments. Richer countries just have to ensure more widespread availability of vaccines, and individuals have to get vaccinated. COVID-19 is not an asteroid on a collision course with the planet. It’s not an imminent nuclear war. It’s an invisible enemy that humanity has demonstrated it can beat. It just requires a bit of cooperation. So, what’s the problem?

Three Problems

Actually, there are three problems. The first has to do with supply, since the richest nations have cornered the vaccine market and have been criminally slow to get doses to poorer countries. On the entire continent of Africa, for instance,  of the population has been fully vaccinated.

The second problem, on the demand side, is the commonplace resistance to the newfangled, in this case a vaccine that was developed very quickly, hasn’t yet been approved by the Food and Drug Administration and has some side effects that are harmful for a very small number of people. Hesitation is understandable. But not when placed against the obvious lethality of COVID-19 and the clear benefits of herd immunity.

The third problem is political. The far right has jumped on the anti-vaccination bandwagon, seized control of the wheel and is driving the vehicle, al-Qaeda-style, straight into oncoming traffic.

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Both in the United States and globally, the far right has long been infected by various harmful delusions — the superiority of white people, the fiction of climate change, the evils of government. As the far right has spread, thanks to vectors like Donald Trump and Jair Bolsonaro and Viktor Orbán and Narendra Modi, those delusions have mutated.

Now, with its anti-vaccine opportunism, the far right is circulating a new Delta variant of global stupidity: virally through social media, in a shower of spit and invective on the street and through top-down lunacy from politicians and political parties. COVID-19 and all of its variants will eventually burn themselves out, though at who knows what cost. The latest versions of global stupidity promoted by the far right, however, are proving far more resistant to science, reason and just plain common sense.

Hijacking the Anti-Vax Movement

The Brothers of Italy is a neo-fascist formation that is now polling the  of any political party in the country today. With 21% support, this pro-Mussolini throwback is just ahead of the far-right Lega party. Throw in Silvio Berlusconi’s Forward Italy party at 7% and the hard right looks as if it could form the next government in Italy whenever the next elections are held.

How did the Brothers of Italy grow in several months from a few percent to the leading party in the polls? Led by Giorgia Meloni, a woman who predictably decries Islam and immigrants, the Brothers of Italy started out as a booster of vaccines, which seemed like a pretty safe position in a country that has suffered so much at the hands of COVID-19.

But Meloni abruptly shifted the party’s stance when the Italian government, currently led by technocrat Mario Draghi, introduced a “green pass” that allows the vaccinated to eat in restaurants, go to bars and enter various public places like museums. Meloni  the pass “the final step on the road to the creation of an Orwellian society,” which “limits the freedom of citizens, further devastates the economy and de facto introduces a vaccine mandate.”

Limits the freedom of citizens? The freedom to infect other people with a deadly virus? Effectively, Meloni wants to grant all citizens the same right that James Bond famously possessed: the license to kill. Unfortunately, such nonsense has support outside Italy as well.

Batting for a Pathogen

In France, the government of Emmanuel Macron has instituted a similar health pass as well as mandating that all medical professionals get vaccinated. The response has been ferocious, with several demonstrations of over 100,000 people mobilizing around the country.

It might seem at first glance that the French protestors are just ordinary folks who are sick and tired of government intrusions in their lives, similar to the yellow vests protestors from 2018. But the organizers of these anti-vax protests are the usual suspects from the far right like Florian Philippot, a former top aide of the National Rally’s Marine Le Pen. National Rally and the equally rabid Stand Up France have come out against Macron’s policies. Unfortunately, some leading members of the left-wing France Unbowed party have also endorsed the rallies. As in the United States, French anti-vaxxers are resorting to anti-system conspiracy theories .

Despite the size of these rallies whipped up by the far right, a majority of French  the health pass and nearly 70% of the population has gotten , compared to only 58% in the United States. But the far right sees the anti-vaccine movement as an opportunity to worm its way into the mainstream in France and elsewhere, such as the  in Germany, the  in Poland and  in the Philippines.

Toward this end, the far right has eagerly employed the services of such “useful idiots” as Robert Kennedy, Jr., perhaps the most famous face of the anti-vaccine movement. The Polish far-right party Confederation invited Kennedy to speak on-ine to a Polish parliamentary group on vaccines. Kennedy also put his  behind a global day against vaccines that took place last October in 15 countries from Europe to Latin America, which a number of far-right parties helped to organize.

Originally in the United States, vaccine skepticism circulated mainly on the left, where suspicions of chemicals and corporations created a resistance to having just any substance injected into one’s arm. But then along came Donald Trump, the dark conspiracy theories of the alt-right and ultimately QAnon, which focused latent anti-government sentiments against the medical establishment and its COVID-19 vaccines. Suddenly, videos like “Plandemic” were , and prominent anti-vaxxers like “healthy lifestyle advocate”  fell under the sway of QAnon.

Today, in a tired repeat of 2020, US anti-maskers and anti-vaxxers are again protesting in front of , bringing their message to and shutting down . If COVID-19 were a wealthy corporation that underwrote such disruptions, these actions would make at least some economic sense. If COVID-19 were a wildly popular musical group or a subversively attractive religious cult that governments were trying to suppress, the frenzy of crowds would be somewhat understandable. But COVID-19 is a deadly virus. Why on earth would anyone go to bat for a pathogen?

The Far Right Has Its Reasons

Conservatives have traditionally supported the powerful pillars of society: the police, the army, the state. Today’s far right is not conservative. It detests the state. It prefers vigilante justice — everyone standing their ground with gun in hand — to the police and the army, since these latter are representatives of the state.

Effectively, the far right embraces the old Hobbesian concept of a “war of all against all,” which was the status quo before the emergence of the state. To achieve this “golden age” of general mayhem, the far right pursues any means necessary. It supports homeschooling to destroy public education, privatization of state assets to weaken the government, and deregulation to tilt the playing field in favor of corporations.

And now, in the age of COVID-19, the far right is even willing to support germ warfare. For that’s what the anti-mask and anti-vaccine ideology amounts to: siding with the novel coronavirus against the sensible policies of the state. One wonders: If the state issued a mandate that required people not to jump off cliffs, would the far right suddenly launch a Lemming Crusade simply to spite the state?

I can well imagine the segment on Newsmax.

Reporter: ��’m here with patriot James Q. Public. He and his family are standing at the edge of the Grand Canyon. Tell me, James, why are you about to take a big step into the unknown?

James Q. Public: The government can’t tell me what to do. I believe in choice. And this is my choice.

Reporter: Do you think of yourself as a pioneer?

James Q. Public: Absolutely. This socialist government with its Five Year Plans sickens me. I take it one day at a time. One minute at a time.

Reporter: Your youngest child doesn’t look happy about your choice.

James Q. Public: Oh, he’s just a crybaby. He’ll get used to it.

Reporter: Get used to falling off a cliff?

James Q. Public: What makes you think we’ll fall?

Reporter: Well, uh, gravity —

James Q. Public: Come on, man, you believe in all that nonsense those scientists are trying to force down our throats? Vaccines? Climate change? Gravity? Okay, everyone, let’s go. One small step for the Public family, one large step for arrgghhh….!

It would all be grimly amusing, like some pandemic version of the Darwin Awards, if the far right’s Lemming Crusade wasn’t threatening to drag the rest of us off the cliff with it.

*[This article was originally published by .]

The views expressed in this article are the author’s own and do not necessarily reflect 51�Թ�’s editorial policy.

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Unfortunately, transgender people are still being “othered.” Most recently, the on the official COVID-19 vaccine portal of the government of India has three gender categories: male, female and others. “It sounds discriminating and demeaning,” Dhananjay Chauhan, a leading transgender activist from Punjab, told me over the phone.

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What came as an even greater disappointment was the fact that participation data for transgender persons have been removed from the of the CoWIN online vaccine registration portal. The infographic now reflects only the data for males and females under the vaccination category, delineated in blue and pink respectively.

The figure for “others” can’t even be determined by calculating the difference between the total number of vaccinated and the vaccinated males and females added together because the dashboard lists the overall number of doses administered to date, which includes both the first and second shots. This erasure becomes a journey from “othering” toward rendering the “others” invisible, revealing just how problematic the transgender community’s situation in India really is.

No, I Haven’t Been Vaccinated

On January 16, India began its vaccination drive. However, data show that by May 16, only of “others” have received at least one shot, just 0.013% of the overall number of vaccinated. With the third wave of infections ravaging through the country, the third-gender population is still waiting for vials to get allotted for their vaccination camps. Pushpa Mai, a leading trans activist from Rajasthan, says: “So far, we have been able to vaccinate only 50 transgender persons in Jaipur and we are waiting for our another camp date. As soon as we are sanctioned the vials, we shall proceed further. Till then, what else is in hand than to wait — such is the situation everywhere.”

Simran, from Rajasthan, was coughing during the phone call. She was out of the town to participate in a kinnar sammelan, the community congregation. When asked about getting vaccinated, she snapped: “Didi, why do you keep on asking the same question every time you call? Don’t you know the state already? I HAVEN’T been vaccinated. Would you arrange it for me? Can you?” She said that none of her dera (community house) friends were vaccinated, which has caused a lot of problems.

Sometimes, transgender people who live in deras, those who prefer to call themselves kinnars or hijra and are engaged in traditional community-specific roles, often keep a distance from the transgender people running NGOs and community-based organizations (CBOs). Simran relies on badhai for her livelihood, a practice where the hijra or kinnars — who are said to be bestowed with a divine gift — go door to door on festive occasions asking for presents and alms in return for blessings. During the pandemic, this source of income has largely dried up, leaving many helpless and reliant on begging and worse. A vaccination certificate would go a long way to help them return to their traditional way of life.

According to Mai, pooling in NGOs and CBOs is not enough because there are districts and villages that don’t have educated transgender representation to be able to organize such camps or even know whom to approach. With large parts of the transgender population lacking education and tech literacy, many are unable to register online, which is the only option to get in touch with vaccination centers. There is a need to raise awareness through television, newspapers and other media to get transgender people to get vaccinated and convince their friends to do so as well. Mai’s proposal is that besides the approach of looping in NGOs and CBOs, local chief medical health officers should take initiative to get the transgender population vaccinated in their respective areas.

Another roadblock to registering for vaccination is a lack of identity documents. Due to the stigma surrounding them, many transgender people have abandoned their parental homes at a young age or have dropped out of school due to discrimination and outright assault. This means that the majority are left with either no proof of identity at all or only with one that states the gender they were assigned at birth, which they no longer identify with. The provisions of providing them with transgender identity cards are still being discussed out by the government, which couldn’t come soon enough at this critical time.

Vaccine Hesitancy

Alisha (not her real name), from Chandani Chowk, had to resort to prostitution in order to survive during lockdown and is now exposed to a higher risk of catching the virus through her clients. “Initially, I was scared to death of getting this vaccination,” she tells me. “But then I decided that anyhow I am going to die, better take a chance by getting vaccinated; probably I might survive. And I contacted an NGO and got vaccinated through their vaccination ��������.”

This initial vaccine hesitancy Alisha describes has deep roots and is among the factors affecting the low uptake rates among the community. Transgender people often report discrimination at hospitals and public places because of their non-conformity. In colonial times, transgender people, then commonly known as eunuchs, were categorized as habitual offenders or natural-born criminals under the Criminal Tribes Act of 1871 and were punished for their cross-dressing practice. Historic persecution not only rendered transgender people invisible in the public sphere but also laid the foundations of a transphobic society.  

To this day, transgender people are seen as a matter of curiosity. “There are various layers of discrimination in health care access in this country. The doctors are curious about the transgender identity, and so exploit them in the process,” Shuvojit Moulik, founder of Civilian Welfare Foundation, a Kolkata-based NGO, LiveMint. During my research, many reported that doctors and medical professionals would examine their genitals even when the only complaint is a cold or a cough. Many report . It is hardly a surprise that transgender people try to evade these discriminating and transphobic spaces, preferring to rely on traditional medicine or local quacks for treatment.

Shreya Reddy, who identifies as a transwoman and works as a clinic manager at a transgender health center in Hyderabad, points out the irony that even those transgender volunteers running the vaccination camps aren’t taking the jabs. This often creates further skepticism among those who come to the vaccine camps.

Exposure to hormone therapies, HIV and complex sex reassignment surgeries leave transgender people immunocompromised and thus more vulnerable, and understandably more skeptical about the side effects of a new vaccine. According to , “communities that are underrepresented in medical trials, including those for vaccines, have developed considerable mistrust in the overall effect certain medicines and products will have on their health.” This is compounded by the fact that the scarcity of doctors who specialize in gender reassignment has resulted in many transgender people reporting being treated like subjects of an experiment by plastic surgeons who lack the necessary expertise.

Reddy shares her own experience of vaccine hesitancy. She says that there is no information regarding the possible side effects of the COVID-19 vaccine, like fatigue, fever and body pain. Because of this, the severity of post-vaccination symptoms made many like herself who have undergone gender reaffirmation surgery believe that they were going to die. She herself felt pain and dizziness for two days after receiving a shot, thinking that something has gone wrong. Despite being a health worker, Reddy had no one to assuage her fears.

A Time for Recognition

Following criticism of the low vaccine uptake among the community, the Ministry of Social Justice and Empowerment issued to states and union territories to facilitate unhindered and indiscriminate vaccination for transgender persons. The states invited community organizations to act as a bridge to get the transgender population vaccinated. But since transphobia has them to live on the margins of society, unidentified, local authorities don’t even have proper records of the transgender population and need the community to help them reach this most vulnerable group.  

The complete erasure of vaccination data on a site like CoWin deals a further blow to representation and equality. It is high time that the Indian government and society acknowledge that if transgender persons are being “othered” or neglected in something as seemingly innocuous as writing, this will inevitably translate to deadly neglect in real-life terms. Thus, the primary need here is to impart their transgender identity on registration forms and certificates and abandon the anonymous and dismissing “others” classification. There must be the inclusion of the transgender population in other sets of government data to address their needs and demands. Only then will there be a realistic hope for the emancipation of this long-marginalized community.

The views expressed in this article are the author’s own and do not necessarily reflect 51�Թ�’s editorial policy.

The post India’s COVID-19 Vaccination Drive Is Failing the Transgender Community appeared first on 51�Թ�.

So, what happened? First, a lot of ignorant and selfish people decided not only to stay that way, but to avoid COVID vaccinations as well. They started getting sick and dying, but not enough of them did so to end the plague. Instead, they just spread the disease, now a highly contagious variant, to other unvaccinated people. Then, something really bad happened: It was soon discovered that those ignorant and selfish people were also spreading the disease to vaccinated people, who just haven’t started dying in large numbers, at least not yet.

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Meanwhile, the commercial machine and its political allies were ramping up to open everything and let the good times roll. It quickly became hard to find a seat at the bar or a hotel room at the beach. Airports and airplanes were filled again with vacationing families, rental cars were so scarce that it is hard to imagine that turnaround time included a drop of disinfectant, and those ever-popular buffet tables were dusted off for the hungry hoards. Forgetting your mask at home or in the car was deemed to be of little consequence.

The US federal government response was to go all in on vaccines as the obvious path to public health and commercial revitalization. The vaccines are now everywhere to be had and free of charge. The only problem with this plan is that it is playing out in America, where freedom is defined by way too many as not having to do anything you don’t want to do that you can get away with. The well-being of others be damned.

This situation would be easy to ignore if it involved only a fringe group of pock-marked anti-vaccine individualists whose children regularly get the measles and who never go to school. But this time, for some reason, the vaccine-resistant crowd also includes a large percentage of Republicans who are not pock-marked and whose children get a whole raft of vaccines so they can go to school. Then throw in a bunch of members of religious covens whose leaders are chatting with their god about this issue and then let the flock in on the big secret that their god definitely isn’t vaccinated against COVID-19 (even though there seems to be some disagreement about god’s smallpox vaccination status).

“F������dz�”

There are more ironies here than I can keep up with. Let’s start with “freedom” of choice. Many of those resistant to vaccines resist government “interference” in personal health choices, even though many of those same people are fully engaged in trying to get that same government to prevent women from making their own reproductive choices. Think about that for a moment.

More ironic yet, many of those in the “freedom” crowd seem untroubled by most government health mandates, yet all of a sudden, putting a vaccine in their bodies to help themselves and others avoid the ravages of a relentless virus has become some political and social litmus test for them. Seatbelt requirements, drinking and driving prohibitions, no smoking in restaurants, a host of required vaccines for employment, travel and schooling all make the good health mandate list. Meanwhile, mindless resistance to life-saving COVID vaccines and masking requirements has become a right-wing badge of honor, generally until the bodies of right-wing family and friends start piling up.

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However, maybe the grandest irony of all is that the leader of the pack of virus resisters, Donald Trump, is himself fully , as are at least his wife and the precious . It is bad enough that the Trump clan lied its way to prominence and supposed wealth and that when empowered to do the right thing almost always did the wrong thing. Then, when a pandemic was inserted into the mix, the whole crew conspired to undermine any meaningful national response while over 500,000 people in America died on their watch. While others were gasping for their last breath, Trump got vaccinated just to make sure it wouldn’t be him on that ventilator.

You would think that as the actions of the Trump clan played out before adoring eyes, those ignorant and selfish acolytes would be pushing others out of the way to get vaccinated. But instead, they can’t wait to parade their “freedom” from vaccine tyranny at every super spreader event they can find, while the vaccinated and protected leader of the pack cheers them on. This seems to work really well until that stairway to heaven leads to a COVID ward in a local hospital surrounded by other ignorant and selfish people, many of whom now use their last breathes to beg for the vaccine.

Another Wave

In the face of this insanity, it seems that it is slowly dawning on some public officials that another wave of deadly COVID disease and disorder is closing in. Lots of parents are suddenly worried about their children, some private concerns are worried about something other than their short-term bottom line, and lots of people anticipating a return to crowded workplaces and those already there are staying home. There are even a few people with September travel plans suddenly concerned that playa wherever will be a petri dish when they get there. More importantly, it may be sinking in that there is only one way out of this: mandated vaccines wherever the authority exists to mandate them.

To do this, there can be no more coddling of the ignorant and selfish. Get vaccinated or get out. Everywhere that the federal government has the authority to do so should require proof of vaccine for employment and entry. Start with federal buildings, museums and entertainment venues, airplanes and trains, and the military and military bases. Examine every interstate commerce authority for ways to tighten the vise. No vaccine, no entry, period.

In those pathetic states and localities where resistance overwhelms public health, everything that can be done to isolate those populations from the rest of us needs to be done. No conventions in Atlanta, no cruise ships docking in Miami, interstate highway dead zones, hotel and restaurant chains shuttering their venues, testing and mask mandates for those who knowingly come in contact with the unvaccinated while engaging in interstate commerce, and no event licenses or advertising dollars to sports and entertainment venues that won’t mandate vaccines for entry.

If this gets done before the viability of today’s vaccines begins to wane or is crushed by new COVID-19 mutations, Americans, at least, have a chance to put the pandemic behind them. We are lucky that we have this opportunity at all, but we can only take advantage of it if we move swiftly and decisively to mandate vaccines and isolate those who won’t comply. If accomplished, America might then have the moral authority, the scientific and manufacturing strength, and the financial resources to lead the rest of the world to the same place.

*[This article was co-published on the author’s , Hard Left Turn.]

The views expressed in this article are the author’s own and do not necessarily reflect 51�Թ�’s editorial policy.

The post “F������dz�” Failed to Set Americans Free appeared first on 51�Թ�.

The significance of the problem is often overlooked by the general public, with attitudes ranging from indifference to the glorification of sleep deprivation. It isn’t uncommon for a medical resident or a new mother to brush off concerns of not getting a good night’s rest, as it is equally common for pop culture to glamorize all-nighters. As a result, sleep hygiene is not regularly discussed and often goes under-reported by patients.

Health Consequences

But the health consequences are real and should not be ignored. Deficient sleep is inextricably linked with a wide range of negative outcomes that affect a person’s physical and mental well-being and performance. In fact, the National Center for Health Statistics has that decreased sleep duration has been associated with seven out of the 15 top causes of mortality across the US. These include cardiovascular disease, stroke, cancer, accidents, diabetes, hypertension and septicemia. Clearly, the impact of insufficient sleep has sweeping effects across global societies and constitutes a major public health concern. 

The duration of sleep varies among people based on age. According to a state-based by the Centers for Disease Control and Prevention (CDC), fewer than 65% of adults reported the necessary number of hours per night. The survey revealed that over 80 million American adults were sleeping under the recommended seven hours each day.

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The same pattern is pervasive among adolescents and young adults, and the consequences can be devastating. These years are especially formative, with the brain and body undergoing remarkable development. Although sleep is essential, research reveals that many teens and young adults get far less of it than their bodies require. As a result, mental health issues, a decline in academic performance, accidents and injuries, poor judgment, risk-taking and obesity are rampant among this demographic.

It’s no coincidence that long-term sleep deprivation has been historically used as a form of torture, resulting in both negative physical and mental side effects. While chronic sleep insufficiency does not equate with institutionalized torture, it does result in a significant burden to public health, the labor force and academic performance.

Making Change

This begs the question: What are we doing as a global society to address this widespread and pervasive public health epidemic? How can changes in individual behavior, actions by employers and public policy measures be implemented in a meaningful way to make long-term, substantial change? 

In the workplace, lack of sleep can put employees and other people at risk, especially if, for example, the duties include patient care, transportation or law enforcement. Sleep hygiene needs to be an integral part of every workplace program. Employers can utilize the CDC’s , which contains education, training and assessment tools, in addition to strategies to modify the workplace to increase alertness, incorporate dedicated breaks and spot warning signs of fatigue and exhaustion. 

According to from the Johns Hopkins School of Public Health, up to two-thirds of patients have not discussed their issues around sleep with their doctors, while a significant percentage of health care providers fail to ask. Sleep habits should be routinely discussed at yearly physicals and histories, and patients should be given ample tools to manage sleep difficulties. These must include more than just a prescription.

Colleges and universities should take measures to curtail the unnecessary glamorization of sleep deprivation. Students largely ignore sleep requirements as academic, social and extra-curricular pressures get in the way. Students of all ages are spending an inordinate amount of time on social media, and a study from the National Sleep Foundation revealed that nighttime social media use negatively correlates with a good night’s sleep.

Schools and universities alike need to address these concerns that are so pervasive on school grounds across the globe. The inclusion of sleep education in health classes should be universal, as should education materials that include guidelines as to when to turn off electronic devices before bed. 

The last 16 months have resulted in global upheaval, leaving policymakers struggling to catch their breath. The COVID-19 pandemic and the ensuing quarantine forced many of us to work from home. In doing so, it inadvertently helped many to reestablish a work-life balance that was off-kilter for a very long time. As we reexamine our world and our lives, a better balance for our collective health must include the prioritization of sleep. 

The views expressed in this article are the author’s own and do not necessarily reflect 51�Թ�’s editorial policy.

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We don’t know how Naomi Osaka, the world 2, will react to “the long bouts of depression” she has experienced since 2018. The Japanese tennis player was a 20-year-old when they started. She is now 23 and faces something of a crossroads, having withdrawn from both the French Open and, more recently, the . She now has to decide whether to enter Wimbledon, which starts on June 28.

Osaka may storm back powerfully, bursting with confidence and fresh resolve, as Nietzsche would have predicted. She could also recede into obscurity, like another young tennis player, Andrea Jaeger, who was ranked number 2 at the age of 16 and looked set for superstardom, but retired at 19 in 1986, a victim of what was then called “burnout.” Now, we have a more sophisticated understanding of why some professional athletes, particularly young ones, suffer inwardly: anxiety, stress and depression that affect the rest of the population may be more prevalent in sports.

Athletes operate in a risk-riven, competitive environment that deliberately cultivates aims, targets and achievable goals. Reaching goals is rewarding, but falling short can be devastating. Even a single defeat can be ruinous. There is also a ceaseless series of expectations. Literally everyone, from the people who serve in the canteen to journalists who report to the media, harbors expectations. In themselves, expectations have no potency, but the manner in which competitors assimilate and respond to them is crucial. Some athletes thrive, while others wither. Responding to the expectations of others is the mainspring of depression. Yet, sometimes, the condition seems unrelated to athletic performance and is barely intelligible.

Robert Enke

The case that alerted the world to the problem of mental illness in sport was that of 32-year-old , one of Germany’s leading football stars. Widely tipped to be the number-1 goalkeeper in the national squad for the 2010 FIFA World Cup, Enke walked onto the tracks in front of an oncoming train in 2009. The football world was stunned: why? After all, he was an affluent, young sports celebrity with a chance of winning one of the most coveted prizes in sport.

Enke’s wife, Teresa, revealed that he had been tormented with depression for years. He tried to hide his mental condition, fearful it might damage his professional career. Worse, he thought it might cause authorities to take away his 8-month-old daughter, whom he and his wife had adopted earlier in 2009. The couple lost their 2-year-old daughter through a rare heart condition in 2006.

As a youth, the precociously proficient Enke was often required to play in teams with older players and his father, Dirk, told how his son grew anxious. “There were always crises back then because he was scared that he would not be able to keep up with the older ones  …He did not have faith in himself,” Dirk in 2009. Of course, most top athletes do have faith in themselves. They are usually self-confident and often ebullient. Or at least they appear to be. Enke probably did too. Like other athletes, he learned to conceal his apprehension.

Medicalizing Mental Illness

Athletes are coached to do this: If they can’t hide their emotions, they won’t last long in sports. This should make us wonder not why there is so much mental illness in sports, but why there is so little. In the 20^th century, mental illness carried a stigma, especially in sports. But we’ve now transmuted what was once seen as a weakness into an illness, much like physical ailments. The process is known as medicalization: We treat mental illness as we would diseases. Whether or not the reader accepts that depression and associated mental disorders are, in fact, illnesses or just cognate — that is, related in certain respects — to illnesses, the reality is that this is how they are diagnosed and treated.

Today, issues and problems that have origins in social, cultural or environmental conditions are viewed and treated as medical ailments. One of the beneficial consequences is that much of the disgrace has been removed, leaving athletes who have suffered to open up about their experiences. They share a common matrix: a culture that inhibits, yet promotes illness. The ethos of mastery, striving and bearing pain mitigates against admitting a susceptibility to attacks that can neither be seen nor beaten with sheer persistence or the kind of hard work urged by coaches. The same ethos fosters ambition and an achievement orientation satisfied only by levels of attainment reached by the elite few.

Most sports careers involve unexpected reverses brought about by defeats or injuries. Mental health problems are regarded in a similar way to an anterior cruciate ligament injury: fixable. first won the world heavyweight title in 2015. He then sunk into depression and binge drinking, but resumed his boxing career with renewed vigor. Kelly Holmes self-harmed with scissors for two months in 2003. A year later, she won two gold medals in the 800 meters and 1,500 meters at the Olympics. Five-time Olympic swimming gold medalist lost motivation completely, retired in 2006 but later returned, yet without ever finding his best form.

Some never quite recover. interrupted his tour of India with the England cricket team, suffering from depression in 2011. He didn’t play for the national team again. Other athletes, such as rugby’s Jonny Wilkinson and cricket’s Marcus Trescothick, simply lived with mental health conditions from childhood and learned to tolerate the symptoms to a greater or lesser extent.

Who Wants to Be a Sports Star?

Of the myriad causes of mental illnesses, Naomi Osaka’s is unusual: She says finds the media demands unbearable. Major sports are now part of the entertainment industry and their stars are warrantable celebrities. Audiences want access to all parts of their lives, public and private. Osaka has made her to Black Lives Matter clear. She may feel that, as a black woman, she is inordinately questioned about her loyalties, though she hasn’t said as much and appears comfortable making her convictions known.

But she won’t expect any special considerations from tennis , who broker lucrative broadcasting and sponsorship deals on the understanding that players will cooperate. Osaka is presumably bright enough to realize that much of the $37 million she earned last year was made possible by her media presence. Actually playing sports is just part of the Faustian pact.

All of which prompts an obvious question: Who would want to be a top sports star in an environment so competitive that mental disorders go with the territory? There are obvious benefits: money, fame and a job that pays for doing something you would have probably carried on doing for fun even if you weren’t getting paid. But the point about pursuing something for fun is that you don’t get paid for doing it. Once you do, it becomes a job of work. Many, perhaps most, athletes don’t enjoy competing. Andre Agassi famously hated tennis. Other athletes, including Barcelona’s Lionel Messi, are sick before competitions.

In May, Olympic bronze medal-winning hammer thrower Sophie Hitchon announced her retirement, aged 29. “I have never really done it for the love of the sport or the enjoyment,” she . “I do it because I was good at it, and was succeeding at it.” Hitchon’s approach may not be representative, though I suspect it is.

No rational person willingly wants to train repetitiously every day, risking physical injury, sometimes resulting in death and always facing the possibility of mental indispositions — unless they are succeeding and, presumably, making a good living from it. The recent life-threatening cardiac arrest suffered by Denmark’s Christian Eriksen at the UEFA European Championship reminds us that being fit, well-dieted and regularly tested is no defense against the intensity of constant competition. Polish footballer recently issued the reminder, “we’re humans, we’re not machines.”

So, Osaka’s options are either to overcome her anxieties with the media or cease playing, at least till such time when she is able to cope. This sounds like a pitiless pair of options, but there seems little latitude. Her premature retirement would be an awful loss to tennis. But is money and success worth it, if the price is her mental health?

It’s not a rhetorical question: Many athletes and entertainers persist with their careers despite depression. They include , and Paltrow. All three have found relief, sometimes through medication or therapy. Lady Gaga has integrated her experiences with mental illness into her work. At 35, she is the youngest of the group. It’s an age when most athletes have either retired or are contemplating it, and perhaps the relative brevity of a competitive career increases the mental duress. I don’t know whether these entertainers would endorse Nietzsche’s apothegm, but all of them have had long, garlanded careers. Mental illness didn’t become a salient influence on any of their lives.

Mental health is a corner of the sports landscape that was ignored for many decades. While a fuller understanding of the causes of depression involves analysis beyond the physical, the newfound confidence of athletes like Naomi Osaka to disclose their mental problems is due in large part to a medicalized understanding of its status and public acceptance that it is treatable. 

*[Ellis Cashmore is the author of “.”]

The views expressed in this article are the author’s own and do not necessarily reflect 51�Թ�’s editorial policy.

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Paul Polman, who formerly chaired the International Chamber of Commerce (ICC), believes the sustainability of liberal capitalism will depend on its ability to demonstrate a sense of social responsibility. Prior to his position at the ICC, Polman was chief executive of Unilever, a major supplier of consumer products designed to “feel good, look good and get more out of life.” Before that, he had earned his stripes at Proctor & Gamble (“Stepping forward as a good corporate citizen”) and Nestlé, the world’s largest food and beverage conglomerate.

The World Needs a People’s Vaccine

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Those three organizations reflect the core reality of the consumer society, a two-century long historical phenomenon that has offered the world a cornucopia of convenient merchandise to make life more enjoyable, while organizing a monumental assault on the viability of planet Earth.

Nestlé has been accused of massively from the natural environment and “drying up surface water resources,” to resell it at a profit in plastic bottles. As Nestlé’s chief financial officer, Polman was undoubtedly aware of that activity. His experience at Nestlé may have inspired him to inaugurate the Unilever Sustainable Living Plan as a way of redeeming past sins. His status as an ecologically-minded capitalist is now publicly confirmed. On the occasion of his resignation from Unilever in 2018, the Irish Independent that “the Unilever Sustainable Living Plan, marks him out as one of the most far-sighted business leaders of his generation.”

Polman served as chair of the International Chamber of Commerce for two years. Its current chairman, Ajay Banga, militates for at “promoting greater prosperity and opportunity for all,” the core values of the consumer society. He prudently adds that its vocation “includes being a crucial voice in the re-building of a sustainable and inclusive global economy.” That nod in the direction of sustainability is Polman’s legacy.

Consistent with a recent study by the ICC on the impact of COVID-19 on the global economy, Polman is now speaking out on the urgent and compelling need to vaccinate the entire world, not just the populations of developed countries. He is alarmed by what the International Chamber of Commerce condemns as “vaccine nationalism.” The ICC study claims that “the global economy stands to lose as much as $9.2 trillion if governments fail to ensure developing economy access to COVID-19 vaccines, as much as half of which would fall on advanced economies.”

Some may nevertheless find it paradoxical that the ICC failed to support or even mention the proposal of waivers on COVID vaccine patents. Instead, in a press release with the title, “How intellectual property can strengthen our response to climate change and COVID-19,” it the sacrosanct nature of intellectual property (IP) as championed by world-famous divorcee Bill Gates.

A Guardian highlighting British Prime Minister Boris Johnson’s politically motivated call for a universal deployment of COVID vaccines cites Polman’s assessment of the risk. “We can’t have global solidarity and trust around tackling climate change if we do not show solidarity around vaccines. Developing countries will not come with more ambitious targets [on emissions] if they do not see developed countries showing some solidarity on vaccines, and climate funding,” Polman said.

Today’s Daily Devil’s Dictionary definition:

Global solidarity:

An ideal insisted on by prominent public figures, despite being in total contradiction with the aggressively competitive values they promote as the key to prosperity

Contextual Note

Polman wants developed countries to show “some solidarity.” That is probably what they will do, but showing is not doing. The first sentence of the ICC’s mission statement : “Everything we do at ICC aims to promote international trade and investment as vehicles for inclusive growth and prosperity.” In its defense of IP, it proclaimed: “We in the business community pledge to do our part to facilitate this ethical, humanitarian and economic solution to the pandemic as quickly as possible.” Pledging to do one’s part is typically an act of showing that falls short of doing.

Growth is the first and perhaps only serious principle at the core of the consumer society. The ICC has good reasons to prefer growth that is inclusive and that leads to prosperity. That is the key to stability. But when the motive that drives growth is to overtake and even neutralize or cancel your competition, which has become the norm in the competitive culture of capitalism, not only does inclusivity become unattainable and prosperity reserved for the few, but stability itself can only be guaranteed through coercion. The security state becomes the means of maintaining stability. This is a far cry from the “ethical, humanitarian and economic solution” the ICC says it supports. Its refusal to take the leap and propose waivers for vaccine IP makes this paradox clear. The language it uses tells the story.

Polman’s warning about the need to “showing some solidarity” concerning COVID-19 vaccines is correct, so long as the solidarity is real and engaged. Showing solidarity means acting, accomplishing something, not just pronouncing a wish for solidarity. The most realistic and, ultimately, depressing corollary of Polman’s assertion is that because we can now clearly see that the current system has not allowed us to “show solidarity around vaccines,” we may reasonably give up any serious hope of mobilizing the solidarity required to address the much more universal and compelling problem of climate change.

Historical Note

The history of the 20^th century was dominated by a logical chain of events stemming from the triumph of industrial organization in the 19^th century. Because the West’s success in industrializing depended on the brutal asymmetry of colonial domination and the sheer exercise of power, the kind of rivalries it produced among the industrializing nations inevitably led to two world wars initiated in Europe. The cataclysm associated with those two conflicts inaugurated the period of European decolonization. That, in turn, ushered in a new phase of neocolonialism, managed and governed by the emerging dominant power, the United States.

Once the communist block led by the Soviet Union was eliminated, due to its incompatibility with the dominant system, the concept of neoliberal globalization had a clear path to end up dominating every serious person’s thinking and every government’s economic organization, including that of communist China. It also inevitably consolidated and perpetuated the driving force behind industrialization itself, with its celebration of growth. It meant the inevitable global triumph of the consumer society culture whose founding principle, at least in material terms, is the transformation a maximum number of resources into waste. Waste, paradoxically, becomes the most accurate measure of industrial success. Not only does industrial production massively produce waste, it consistently encourages the wasteful behavior of consumers as the means of keeping demand alive and stimulating growth. Plastic has become the ultimate symbol of the culture of waste.

Unilever and the International Chamber of Commerce may make a public display of regretting this reality, but to fulfil their missions, they must support its logic, even while “pledging” to do it in a more reasonable way. But this clearly will not be enough. A published by the Swiss Re Institute and Oxfam indicates the consequences of this trend, all of which Paul Polman will undoubtedly agree should worry us.

The Guardian summarizes its conclusion in these : “The economies of rich countries will shrink by twice as much as they did in the Covid-19 crisis if they fail to tackle rising greenhouse gas emissions, according to research.” Jerome Haegeli, group chief economist at Swiss Re, makes the point concerning climate change that “staying where we are is not an option — we need more progress by the G7. That means not just obligations on cutting CO2 but helping developing countries too, that’s super-important.”

In other words, all that’s required is to substitute a culture of global solidarity for today’s culture of hyper-competition. Can we really count on the G7 to make that happen?

*[In the age of Oscar Wilde and Mark Twain, another American wit, the journalist Ambrose Bierce, produced a series of satirical definitions of commonly used terms, throwing light on their hidden meanings in real discourse. Bierce eventually collected and published them as a book, The Devil’s Dictionary, in 1911. We have shamelessly appropriated his title in the interest of continuing his wholesome pedagogical effort to enlighten generations of readers of the news. Read more of The Daily Devil’s Dictionary on 51�Թ�.]

The views expressed in this article are the author’s own and do not necessarily reflect 51�Թ�’s editorial policy.

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Pandemic Family Life: The Struggles Behind Closed Doors

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Vietnam is a COVID success , with one of the lowest rates of infection and death in the world. Vietnam’s excellent community-based public health system prevented the coronavirus from spreading beyond isolated cases and localized outbreaks, without a nationwide lockdown. With a population of 98 million people, Vietnam has had only 8,983 confirmed cases and 53 deaths. However, more than half of Vietnam’s cases and deaths have come in the last two months, and three-quarters of the new cases have been infected with a new “hybrid” variant that combines the two mutations detected separately in the Alpha (UK) and Delta (India) variants.

Vietnam is a canary in the pandemic coal mine. The way this new variant has spread so quickly in a country that has defeated every previous form of the virus suggests that this one is much more infectious.

COVID-19 Variants

This variant must surely also be spreading in other countries, where it will be harder to detect among thousands of daily cases, and will therefore be widespread by the time public health officials and governments respond to it. There may also be other highly infectious new variants spreading undetected among the millions of cases in Latin America and other parts of the world.

A new published in The Lancet medical journal has found that the Alpha, Beta (South Africa) and Delta variants are all more resistant to existing vaccines than the original COVID-19 virus, and the Delta variant is still spreading in countries with aggressive vaccination programs, including the United Kingdom. 

The Delta variant accounts for a two-month high in new cases in Britain and a new of infections in Portugal, just as developed countries ease restrictions before the summer vacation season, almost certainly opening the door to the next wave. The UK, which has a slightly higher vaccination rate than the United States, had planned a further relaxation of restrictions on June 21, but that is now in question.    

China, Vietnam, New Zealand and other countries defeated the pandemic in its early stages by prioritizing public health over business interests. The US and Western Europe instead tried to strike a balance between public health and their neoliberal economic systems, breeding a monster that has now killed millions of people. The World Health Organization (WHO) that 6 to 8 million people have died, about twice as many as have been counted in official figures. 

Vaccinating the World

Now, the WHO is recommending that wealthier countries that have good supplies of doses vaccinating healthy young people and instead prioritize sending vaccines to poorer countries where the virus is running wild. President Joe Biden has announced that the US is releasing 25 million doses from its stockpiles, most of which will be distributed through COVAX, the WHO’s global vaccine-sharing program, with another 55 million to follow by the end of June. But this is a tiny fraction of what is needed. 

Biden has also agreed to waive patent rights on vaccines under the World Trade Organization’s (WTO) TRIPS rules, formally known as the Agreement on Trade-Related Aspects of Intellectual Property Rights. But that has so far been held up at the WTO by Canada and right-wing governments in the UK, Germany, Brazil, Australia, Japan and Colombia. People have taken to the in many countries to insist that a TRIPS Council meeting on June 8-9 must agree to waive patent monopolies.

Since all the countries blocking the TRIPS waiver are US allies, this will be a critical test of the Biden administration’s promised international leadership and diplomacy. So far, Biden’s team has taken a back seat to dangerous saber-rattling against China and Russia, foot-dragging on the nuclear deal with Iran, and war-crime-fueling weapons peddling to Israel and Saudi Arabia.

Ending international vaccine apartheid is not just a matter of altruism or even justice. It is a question of whether we will end this pandemic before vaccine-resistant, super-spreading and deadlier variants fuel even more toxic new waves. The only way humanity can win this struggle is to act collectively in our common interest.

Public Citizen has what it would take to vaccinate the world and concluded that it would cost only $25 billion — 3% of the annual US budget for weapons and war — to set up manufacturing plants and distribution hubs across the world and vaccinate all of humanity within a year. Forty-two progressives in Congress have signed a addressed to President Biden to urge him to fund such a plan.

If the world can agree to make and distribute a people’s vaccine, it could be the silver lining in this dark cloud. The ability to act globally and collectively in the public interest is precisely what we need to solve so many of the most serious problems facing humanity. For example, the UN Environment Program (UNEP) warns that we are in the midst of a of climate change, mass extinction and pollution. Our neoliberal political and economic system has not just failed to solve these problems. It actively to undermine efforts to do so, granting people, corporations and countries that profit from destroying the natural world the freedom to do so without constraint. 

Neoliberalism

That is the very meaning of laissez-faire — to let the wealthy and powerful do whatever they want, regardless of the consequences for the rest of us or even for life on Earth. As economist John Maynard Keynes reputedly said in the 1930s, laissez-faire capitalism is the absurd idea that the worst people, for the worst reasons, will do what is best for us all. Neoliberalism is the reimposition of 19^th-century laissez-faire capitalism, with all its injustices, inequality and oppression, on the people of the 21^st century, prioritizing markets, profits and wealth over the common welfare of humanity and the natural world our lives depend on.     

Berkeley and Princeton political theorist Sheldon Wolin called the US political system, which facilitates this neoliberal economic order, “inverted totalitarianism.” Like classical totalitarianism, it concentrates ever more wealth and power in the hands of a small ruling class, but instead of abolishing parliaments, elections and the superficial trappings of representative government as classical totalitarianism did, it simply coopts them as tools of plutocracy, which has proved to be a more marketable and sustainable strategy.

But now that neoliberalism has wreaked its chaos for a generation, popular movements are rising up across the world to demand systemic change and to build new systems of politics and economics that can actually solve the huge problems that neoliberalism has produced. 

In response to the 2019 uprising in Chile, its rulers were forced to agree to an election for a constitutional , to draft a constitution to replace the one written during the Augusto Pinochet dictatorship, one of the vanguards of neoliberalism. That election has now taken place, and the ruling party of President Sebastian Pinera and other traditional parties won less than a third of the seats. So, the constitution will instead be written by a super-majority of citizens committed to radical reform and social, economic and political justice.

In Iraq, which was also swept by a popular uprising in 2019, a new government seated in 2020 has launched an investigation to recover $150 billion in Iraqi oil revenues and smuggled out of the country by the corrupt officials of previous governments. In 2003, former flew into Iraq on the heels of the US-led invasion “with empty pockets to fill,” as a Baghdad taxi driver told a Western reporter at the time. While American forces and US-trained Iraqi death squads destroyed their country, they hunkered down in the Green Zone in Baghdad and controlled and looted Iraq’s oil revenues for the next 17 years. Now, maybe Iraq can recover the stolen money its people so desperately need and start using its oil wealth to rebuild that country.

In Bolivia, also in 2019, a US-backed overthrew its popular indigenous president, Evo Morales. But the people of Bolivia rose up in a general strike to demand a new election and Morales’ Movement for Socialism (MAS) party was restored to power. Now, Luis Arce, the economy minister under Morales, is Bolivia’s president.

Around the world, we are witnessing what can happen when people rise up and act collectively for the common good. That is how we will solve the serious problems we face, from the COVID-19 pandemic to the climate crisis to the terminal danger of nuclear war. Humanity’s survival into the 22^nd century and all our hopes for a bright future depend on building new political and economic systems that will simply and genuinely “do what is best for all of us.”

The views expressed in this article are the author’s own and do not necessarily reflect 51�Թ�’s editorial policy.

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As a child, I experienced the difficulties of dyslexia firsthand. Growing up, I often felt dumb, lacked confidence and had low self-esteem. I couldn’t read until much later than my classmates, albeit slowly, and continue to have difficulties with math. When paying bills, for example, I still say each number out loud, highlight each digit and review it several times before I hit send on my laptop.

To this day, I still have stomach aches weekday mornings Monday through Friday, but not Saturday or Sunday. This was caused by the anxiety I felt waiting for the school bus and knowing that when I arrived at school, I would not be able to complete tasks, somehow embarrass myself and feel stupid.

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Before the Christmas vacation in first grade, I recall being very excited hearing bells ringing in the hallway. Our teacher told us it was Santa’s elves putting candy in our boots. We all darted out of the classroom into the hallway. I was shocked to find sticks in my boots. Was I a bad kid? My teacher, not being familiar with dyslexia, probably thought I was lazy.

Needless to say, I failed first grade. However, I was fortunate to repeat it at a nearby school that had an excellent special education teacher. Her instruction, along with support from my family and friends, helped me cope, build much-needed confidence and self-esteem. My father repeatedly told me that I could achieve anything I wanted if I was willing to work hard. He also told me that if it took me twice as long as other students to complete my homework or study for tests, that’s what I had to do.

Other dyslexics are not as fortunate as I was and don’t have the educational assistance, emotional support or encouragement I received as a child. Consequently, it’s estimated — and is no surprise — that dyslexics include over 30% of , 50% of all adolescents involved in rehabilitation and nearly half of all those in the United States.

The brains of dyslexics are wired differently. On the upside, dyslexics think outside the box in a non-linear way, in pictures, not words. Research indicates dyslexics are highly creative, insightful and intuitive, and are able to identify complex patterns much more easily than the average person. I credit this characteristic, which I identify as big-picture thinking, for my ability to connect the dots in seemingly unrelated economic trends and other factors.

In the United States, it’s that dyslexics, who may as much as 10% to 20% of the population, comprise approximately 35% of entrepreneurs, 40% of all self-made millionaires, and 50% of rocket scientists at NASA. Dyslexia is so common at the Massachusetts Institute of Technology, it’s called “the MIT disease.” Interestingly, years ago, the American Astronomical Society noted that astrophysicists with dyslexia at times outperformed their non-dyslexic colleagues in identifying the distinctive characteristics of black holes.

Many of the world’s most famous and successful people are dyslexics. This reportedly includes Albert Einstein, Pablo Picasso, Leonardo DaVinci, Bill Gates, Alexander Graham Bell, Thomas Edison, Winston Churchill, Woodrow Wilson, Walt Disney, Henry Ford, Steven Spielberg, Steve Jobs, Richard Branson, and Charles Schwab. Their genius didn’t occur in spite of dyslexia but, more likely, because of it.

In addition to its advantages, dyslexics also often learn to cope with difficulties and deal with failure, which is part of any successful process. I suspect many of my early achievements were motivated by my need to prove I wasn’t a failure.

The advantages of dyslexia are extensive, but they often remain untapped if dyslexic students don’t have access to quality special education services. Although mandated by US federal law, students don’t always get an adequate individualized education plan or the help they need.

According to Annual Performance Reports from the US Department of Education, the cost of schooling a child receiving a special education can be more than twice the average. Since poorer school districts are not as well financed as wealthier ones, and teachers are not always sufficiently trained, many children with dyslexia fall through the cracks, as the numbers above make obvious. This needs to change.

Just as important, the advantages of dyslexia will not be obtained if the child has a negative attitude or a poor opinion of themselves. I’m reminded of the wise words from Henry Ford: “Whether you think you can, or think you can’t … you’re right.”

The views expressed in this article are the author’s own and do not necessarily reflect 51�Թ�’s editorial policy.

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The basis of guacamole is smashed ripe avocados. Most of the avocados sold in European supermarkets originate from a handful of countries. In Switzerland, for instance, most avocados are imported from Chile, Peru and Spain. In 2020, imported roughly 19,000 tons of avocados. Over the past several decades, avocado imports have skyrocketed across Europe. In , for instance, between 2010 and 2015, avocado imports rose from 28,000 tons to 45,000 tons; by 2020, it more than 118,000 tons, reflecting an ever-growing demand. Once considered an exotic fruit, today the avocado has become a staple as common as the good old potato.

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The reason for the popularity of avocados is hardly a secret. Like blueberries and quinoa, avocados count among today’s “.” They are not only a great source of nutrients and fibers but also, more importantly, of “heart-healthy monounsaturated fatty acids.” Avocados are supposed to be able to lower cholesterol and triglyceride levels and thus reduce the risk of heart disease. At the same time, they contain antioxidants that might of contracting certain types of cancer. Health-conscious consumers buy avocados, so do trendy urban Green-voting hipsters, vegetarians and .

For many of them, avocados are not only a delicious ingredient, but a . Unfortunately, more often than not, the environmental consequences of a healthy diet are disastrous, particularly in the case of avocados.

The Right to Water

Avocado production is highly water-intensive, roughly , more than 12 times as much as it takes to grow a tomato. (Avocados, like tomatoes, are a fruit, not a vegetable.) Ironically enough, most avocados are grown in relatively arid regions. In California, for instance, whose avocado output amounts to several hundred million pounds per year, the fruit is in the southern parts of the state, from San Luis Obispo to San Diego, in the desert. For that is what is — a “natural desert irrigated by man into a sense of artificial lushness.” It takes a bit less than 75 gallons (about 280 liters) of “blue” water to grow a pound of avocados. Blue water comes from rivers, lakes, streams and aquifers; it does not include rainfall (“green” water) or recycled (“grey”) water.

In late 1972, Albert Hammond stormed the charts with his song “It Never Rains in Southern California.” The title was a bit of an exaggeration. It does rain, on occasion, yet hardly enough, particularly in recent years. In the mid-2010s, California was faced with one of the most severe prolonged droughts in its history. With climate change, the situation is likely to get even worse. At the time of the drought, one commentator her readers that “you should think twice before eating avocados.” That was in 2015. Yet her words are as pertinent today — and arguably even more so — as they were then.

Take the case of Chile, a top exporter of avocados. In 2019, Chile exported some 145 thousand metric tons of its avocado crop. Most of the exports went to Western Europe, with the Netherlands topping the list. In fact, the imports more avocados from non-EU countries than all other member states combined. By 2019, the country accounted for almost two-thirds of EU avocado imports from non-EU countries. More than 90% of imported avocados are reexported to the rest of the European Union after being inspected and repackaged.

Chile is a main supplier of “Dutch” avocados, second only to Peru. In Chile, avocados are primarily grown in the Petorca province, the northernmost part of the Valparaiso region, some 200 km north of the capital, Santiago. In Petorca, , “with droughts happening once every seven years.” Yet as an in The Guardian has claimed, in Petorca, “every cultivated hectare requires 100,000 litres of water per day, an amount equivalent to what a thousand people would use in a day.” In 2019, the Chilean government declared a water emergency in the province.

Since 2016, the people living in Petorca have been allocated 50 liters of water per day, a fraction of what avocado trees need. In fact, the water shortage has been so acute that water was being delivered by trucks. When the water was tested, it contained far above the legal limit, among children.

The fact is that in the major avocado exporting countries in Latin America — Mexico, Chile and Peru — the primary has been “through plantations where avocados are grown in monoculture. This type of agriculture is associated with high water usage due to a heavy reliance on irrigation systems and management practices that degrade soil quality and thus, its water-holding capacity.”

According to international conventions, access to safe water is a fundamental human right. In 2020, Leo Heller, the UN special rapporteur on the human rights to drinking water and sanitation, the Chilean government that it failed to meet its international human rights obligations if it continued to prioritize “economic development projects over the human rights to water and health.” In April 2020, the Chilean government resolved to increase the daily water allowance for Petorca’s residents to 100 liters.

A week later, it revoked the resolution, most likely in response to pressure from the avocado industry. For, as Heller noted, in the meantime, the Chilean government not only continued to “grant new water rights to agricultural companies” but also failed “to control the illegal and excessive use of water by avocado companies.” So much for sustainable development.

Avocado Superpower

This holds true even more for the globe’s number one avocado exporter — Mexico. Most of the Mexican avocados are produced in the state of Michoacan, just west of Mexico City. Most of these avocados are exported to the United States. When it comes to avocados, Mexico is a superpower. In fact, , Mexico “controls half of global avocado trade.” Avocados are a lucrative commodity, attracting unsavory characters, most notably Mexico’s notorious , extorting “producers, transporters and packers to gain control over the sector.”

At the same time, the expansion of avocado production for export to the Unites States has had a devastating impact on the region’s flora. According to every year, more than 20,000 hectares of forest land have been converted into avocado plantations, resulting in massive deforestation, which in turn has taken a toll on . At the same time, the focus on avocados has jeopardized food security in the region, with the cultivation of the cash crop supplanting local staples.

Finally, there is the problem of virtual water. Virtual water refers to the amount of water embedded in the production of a commodity. The virtual water content of avocados is exceedingly high. Avocados exported from Mexico, Peru and other developing countries to Western Europe and North America translate into massive amounts of virtual water imported from water-scarce to generally water-rich countries.

The UK is a case in point. In 2017, the country’s from its five most important suppliers (Peru, South Africa, Chile, Israel and Spain) was estimated at over 25 million cubic meters annually, “equivalent to 10,000 Olympic-sized swimming pools.” As a result, a recent notes, “the overexploitation of water underlying the avocado trade flows may end up worsening environmental conditions in many relatively poor countries in which the export of avocado is often regarded as an important source of economic growth.”

The situation is likely to get even worse given the growing demand from China. Both Chile and Peru have free trade agreements with China, granting them privileged access to the Chinese market. In the six years between 2012 and 2017, the amount of avocados exported to China from 1,500 tons to over 32,000 tons. In Latin America, avocados are seen as “green gold.” Unfortunately, as been the case throughout history, gold tends to cloud the human mind and, eventually, turn into a curse.

The views expressed in this article are the author’s own and do not necessarily reflect 51�Թ�’s editorial policy.

The post Green Gold: The Curse of the Avocado appeared first on 51�Թ�.

Women Become Collateral Damage in COVID-19 Pandemic

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COVID-19 has exacerbated many of the injustices that face vulnerable families, women and children in every country, but especially in those nations undergoing political and economic turmoil, from inadequate internet access to housing instability, tacit unschooling and food insecurity. Dr. Hans Henri P. Kluge, the World Health Organization’s regional director for Europe, recently that “the cards have been stacked against them in terms of jobs, housing, community, social support and health care.” In turn, new and different types of inequality, such as the mental health and wellbeing gap or digital and gender inequalities, are exacerbated. Each is a threat to the human dimension of the UN Sustainable Development Goals (SDGs).

Facing the Crisis

There is empirical evidence that families, women and children are experiencing mental health stress in the face of the unfolding crisis. The cross-sectional COVID-19 Family Life Study initiated at the College of Public Policy, Hamad Bin Khalifa University, carried out online surveys among 123,845 parents of children under 18 spanning every continent between March and October 2020. The results show the worrying incidence of parents’ and children’s mental health, wellbeing, behavioral and emotional difficulties. 

During the pandemic, anxiety was the most pervasive symptom among parents, followed by depression, then stress. The prevalence differed significantly according to gender, education and employment status. Symptoms of depression, anxiety and stress were found in mothers, parents with primary and intermediate educational levels, as well as retired and unemployed parents.

Parents reported elevated levels of anxiety in their children across high-income, upper-middle-income and lower-middle-income countries, as by the World Bank. In countries facing political instability or conflict, such as Yemen, Syria, Lebanon, Libya, Venezuela, Iraq and Syria, however, the pandemic has had a severe impact on children’s levels of anxiety. Palestine had the highest percentage of children experiencing elevated and severe levels of anxiety compared to countries with high incomes such as Greece, Norway, Poland, Italy and Australia, which had the lowest.

In Asia, children in early adolescence living in single-parent households experienced higher levels of anxiety. In the Gulf region, over 30% of parents reported their children experiencing an elevated level of anxiety and over 20% reported severe difficulties in their child’s emotional, behavioral and attentional abilities. The study also shows that teens are struggling under the oppressive weight of anxiety and depression, many of whom live in low and middle-income countries.

Children’s activity, eating and sleep routines have been disrupted globally, which may have detrimental effects on their health and overall development. More than half of parents surveyed in the UAE, Lebanon, Indonesia, the United States, the Netherlands, China, Pakistan, Singapore, the Philippines, South Africa, Sudan and Peru reported an increase in their children’s sleep problems. Over 50% of parents in Qatar, Bahrain, Italy, the US, Oman, Kuwait, Germany, China, Chile, Venezuela, Malaysia, Nigeria, India and Iraq reported an increase in their children’s reading difficulties. In Saudi Arabia, Qatar, Sweden, Oman, the UAE, Singapore, France, the US, Norway, Brazil, Jordan, Nigeria, Tunisia, Kenya, Algeria, Angola, Ecuador and Chile, more than half reported an increase in their screen time.

The results reflect humanitarian crises that predate the pandemic. Many already vulnerable refugees have been plunged into even greater precariousness, for example. The data shows an increasing inequality between countries, with children in high-income countries experiencing fewer mental health problems than those in the global south. While the challenges of the pandemic are overwhelming for all of us, the more pronounced psychological symptoms among children and teenagers may also be a reflection of the inequities inside their homes and in some cases the utter lack of protection offered by national systems. It is also in these countries where mental health counseling is too often unavailable for those who need it most.

The disruptions to children’s physical activities, sleeping and eating routines, reading and screen time will have a long-lasting effect on their physical and mental health. These must be addressed if we are to guard children’s wellbeing and prevent the onset of more severe behavioral and emotional problems.

Facing the Future

Parents are facing serious challenges and need support if they are to continue fulfilling their foundational role in providing secure, stable and healthy home environments for their children. The most vulnerable families, those who are plagued by poverty, those mired down by gender inequality, and those living in conflict zones, must receive the support they need and deserve.

These more vulnerable families do not have the personal resources to manage the multi-layered pandemic crisis. Their vulnerabilities are too easily exploited, whether within the labor or the housing market, with the most vulnerable often willing to accept abusive conditions to stave off complete destitution. Negative coping strategies may include behavioral disengagement, self-blame, denial and substance abuse, leading to further social exclusion.

On the International Day of Families, we must be mindful that the global SDGs will be difficult, if not impossible, to fulfill unless strategies to achieve them focus on the family. Our policy choices today will determine how quickly countries can overcome the pandemic’s impact. Otherwise, we risk aggravating the already deep inequalities both within and between countries.

Technology and digital tools can help in many respects, offering mental health support or giving parents access to essential public health information and tips on how to recognize and cope with the symptoms of anxiety in their children and teens. But for that to work, the widening digital gap must be addressed. The challenges ahead include the need to develop global, regional and national intervention programs to offset the effects of the pandemic. Evidence-based policy interventions can do much to ensure a fair global order that recognizes the inherent dignity of all persons and all families.

Far beyond the span of current COVID-19 stimulus packages, there is an urgent need for investment and support by governments to protect families, as evidenced by the study. Over 90% of parents surveyed reported an urgent need for financial support for families and the elderly, work-family balance arrangements, mental health programs for parents, children and adolescents, and parenting and relationship education programs. The pandemic has illuminated positive opportunities for shaping family and childcare policies, and family policies must be the foundation of post-pandemic recovery.

The views expressed in this article are the author’s own and do not necessarily reflect 51�Թ�’s editorial policy.

The post Pandemic Family Life: The Struggles Behind Closed Doors appeared first on 51�Թ�.

China was the early face of COVID-19, but it hasn’t faced many infections since spring 2020. Europe, like the United States, has experienced successive outbreaks. Brazil continues to be hit hard, while Turkey is seeing a reduction of cases from a mid-April surge. Thailand and Cambodia are only now dealing with their first major upticks in the disease.

Where India Went Wrong

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But the real surprise has been India. Early on in the pandemic, journalists and scientists were trying to  why the coronavirus had made so little mark on the subcontinent and left so few deaths in its wake. Now, after a collective sigh of relief following a modest surge in late summer and fall last year, India is now overwhelmed by over 400,000 cases and more than 4,000 a day, which are both likely to be undercounts.

There are several reasons for India’s current catastrophe. A more infectious variant  to appear in the population, which the World Health Organization this week  a global health risk. The Indian government was not only unprepared for the crisis, but it was dangerously cavalier in its approach to the disease. After last year’s surge, it grew lax on testing and contact tracing. Nor did it put resources into the country’s inadequate medical system or in stockpiling key supplies like oxygen.

Then there are the errors of commission. The government did nothing, for instance, to  Kumbh Mela, a Hindu religious event last month that drew millions of pilgrims to a holy location on the Ganges, from turning into the largest super-spreader event on the planet. Prime Minister Narendra Modi even  to hold mass political rallies as the COVID numbers began to rise.

When it comes to vaccines, the government has been  to order doses, distribute them to the population and secure the raw materials to scale up manufacturing. Although India is the world’s largest producer of COVID vaccines, less than 3% of Indians are fully inoculated against the disease.

Well, that’s India, you might be saying to yourself. They have a Trump-like fanatic for a leader. Their medical system has long been inadequate. It’s an obvious place for COVID to have a final encore.

In the United States, meanwhile, the number of cases has fallen dramatically since January. Hospitals no longer face overcrowding. More than a third of the population is fully vaccinated. The Biden administration is expecting that the country will return to some semblance of normality this July. But wasn’t it a similar complacency that proved India’s undoing? So, is India the ghost of America’s past or a taste of things to come.

Our Herd Problem

In early 2020, the scientific community went into hyperdrive to develop not one but several vaccines against COVID-19. In the US, the government and the medical community worked overtime to set up the infrastructure to get doses into arms around the country. Clinics and volunteers have jumped into action at a community level to make sure, as of this week, that 58% of adults have gotten at least one shot and  of those older than 65 are fully vaccinated.

But all this effort is now hitting up against resistance. Or hesitancy. Or barriers to access. States are cutting back on their vaccine orders from the federal authorities. Daily vaccination rates have dropped  from last week. Employers are basically bribing people to get their shots. Millions of  aren’t even bothering to show up for their second doses.

Barriers to access is perhaps the easiest problem to address. According to a , 72% of African-Americans and Latinos want to get vaccinated, but 63% reported that they didn’t have enough information about where to get a shot.

While lack of information may well be the reason why some Americans have yet to sign up for their vaccinations, a hard-core resistance has developed to vaccines in this country — and COVID vaccines in particular. According to polling in April, around 45% of Republicans  that they’ll never get the vaccine. In all, as much as 37% of Americans are now saying that they’re going to opt-out. That means that tens of millions of doses are now chasing the remaining 5% of Americans who want to be vaccinated and haven’t yet gotten their first shot.

This resistance has nothing to do with a lack of information about how to sign up for a shot. It’s all about : that the vaccine is unnecessary, that it’s dangerous, that it comes with a microchip that will track you forever.

Recently, Republican pollster Frank Luntz set up a  of vaccination-hesitant, Donald Trump voters to see what it would take to convince them to get shots. It was not an easy crowd. The husband of one of the participants had gotten seriously ill from COVID — and she stilldidn’t want to get vaccinated. In over two hours of discussion, Luntz brought in such vaccine-boosters as a former head of the Centers for Disease Control and Prevention (CDC), Senator Bill Cassidy, and House Minority Leader Kevin McCarthy — and still, the participants barely budged.

Only after several emotional stories from former New Jersey Governor Chris Christie and a final round of facts from the CDC official did they start to change their minds. “I would say I was probably 80% against when this started today,” one man said. “Now ��’m probably 50-50-ish.”

Luntz considered that a success. But in this age of Twitter, it’s not a workable model to expect skeptics to sit still for more than two hours while Republican Party grandees and noted doctors barrage one small group after another with stories and facts.

A more representative reaction to such attempts by Republican Party influencers is what happened when Ivanka Trump posted selfies of her own vaccination. Twitter responses : “‘Love your family but this is a huge NO for me & my family. Will be praying you do not get any of the horrible [side-effects].’ Others replied, ‘Please stop promoting this nonsense,’ ‘HARD PASS,’ and ‘Sorry, don’t trust it.’”

Even more concerning, some anti-vaxxers are already planning to use fake vaccination  to get into public events. Hundreds of sellers have  on eBay, Facebook and Twitter to hawk such cards. In this way, “live free or die” is quickly becoming “live free and kill.”

In a nutshell, the US won’t achieve herd immunity because a significant portion of the herd is suffering from mad cow disease. Whatever the reasons for this obstinacy — anti-government, anti-science, anti-liberal — it will ensure that large pockets of this country will continue to play host to a very infectious disease.

This resistance potentially puts the US in the same category as the Seychelles. An island nation in the Indian Ocean, the Seychelles has the highest rate of vaccination in the world. More than 60% of the population is fully vaccinated. But that still hasn’t been enough to ward off COVID. The Seychelles is now experiencing its largest outbreak, which, on a per capita basis, is  than what has overtaken India.

The same thing might happen again in America, for instance in states with very low vaccination rates, like Mississippi and Idaho. When it comes to COVID-19, the US is only as strong as its weakest links.

Perennial Pandemic

When I lived in New York City, I used to wonder why my apartment was so overheated in the winter. It  that the heating systems in old buildings had been designed (or redesigned) to accommodate open windows in winter. During the flu pandemic in 1918-19, open windows and greater circulation of air were supposed to guard against infection.

Modern societies were once structured to handle periodic outbreaks of infectious diseases, from the steam heating in buildings to the TB sanatoriums that dotted the landscape. Americans braced for outbreaks with greater frequency than the cyclical reappearance of the cicadas. Three major waves of cholera  the United States between 1832 and 1866. Typhoid killed 25,000 people in New York in 1906-07. The flu in 1918, diphtheria in the 1920s, polio in the first half of the 20^th century: Americans became accustomed to infectious diseases as a way of life.

COVID-19 isn’t going to disappear completely. It will return, again and again, just like variants of the flu or that other coronavirus, the common cold. If we’re lucky, it will come back in a less virulent form or the antibodies in our systems — those of us who received vaccinations — will render it so. If we’re not lucky, COVID-19 will generate ever more infectious strains that overwhelm us on a periodic basis.

In the best-case scenario, what’s happening in India today is COVID-19’s last gasp. With the worst-case scenario, India is our future. So, don’t delete your Zoom app or give up your home office. Don’t throw away those masks. When it comes to infectious disease, we are all dependent on the herd.

That’s great if you’re living in South Korea or New Zealand where compliance is second nature. But in America, the home of the free, the brave and the stupid, the herd may prove to be our collective undoing.

*[This article was originally published by .]

The views expressed in this article are the author’s own and do not necessarily reflect 51�Թ�’s editorial policy.

The post Why the US Will Not Achieve Herd Immunity appeared first on 51�Թ�.

The New York Times legitimately called Biden’s with a principle promoted by more than 100 countries “a breakthrough,” after noting that until Wednesday the US had been “a major holdout at the World Trade Organization over a proposal to suspend intellectual property protections in an effort to ramp up vaccine production.” Biden’s representative to the WTO, Katherine Tai, nevertheless emphasized that this dramatic reversal should be thought of as exceptional: “This is a global health crisis, and the extraordinary circumstances of the Covid-19 pandemic call for extraordinary measures. The administration believes strongly in intellectual property protections, but in service of ending this pandemic, supports the waiver of those protections for Covid-19 vaccines.”

For a Few Billion Dollars More

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Digging a little deeper into the perspective for change, Michael Safi at The Guardian the Biden administration “two cheers” rather than the three The Times appears to believe it deserves. This follows from Tai’s realistic assessment of how things are likely to play out: “Those negotiations will take time given the consensus-based nature of the institution and the complexity of the issues involved.”

Today’s Daily Devil’s Dictionary definition:

Consensus-based:

Designed to protect vested interests, even in the face of a majority and the logic of history and health itself

Contextual Note

Times reporters Thomas Kaplan and Sheryl Gay Stolberg remain faithful to the patented meliorist approach the paper applies to nearly all policies conducted by a Democratic president. They emphasize the constructive process now underway at the WTO in a piece that echoes The Beatles song, “Getting Better All the Time.” The Biden administration seems to be telling the world: ��’m changing my scene and doing the best that I can.

In contrast, the coverage by The Washington Post (owned by Amazon’s founder, Jeff Bezos) spends most of its ink suggesting the proposed waiver probably is fundamentally a flawed idea, leaving the impression that not much if anything will come of it. According to its pessimistic take, “Tai cautioned that the discussions to proceed with negotiations over the waiver’s text would ‘take time.’ Current and former officials said that a final agreement could differ significantly from the proposed waiver, which India and South Africa first introduced in October, and that deliberations could fall apart entirely.”

CNN more prudently the fact that the US proposal “is preliminary and will not guarantee the global patent rules are lifted right away. But the Biden administration’s signal of support amounts to a major step that aid groups and Democrats had been pressing for.” It nevertheless appears to offer Biden his third cheer when it explains that the president “ultimately decided to support the waiver in line with his campaign pledge.” It quotes US Surgeon General Vivek Murthy’s claim that Biden “put people over patents.” 

But CNN points clearly to the true obstacle: “Members of the WTO must unanimously decide whether to loosen the restrictions. And while the US had been a hold out, other countries — including the European Union and Switzerland — have also resisted the step.” In other words, Biden may have killed two birds with one stone. By letting Europeans do the dirty work, he could save his standing with Big Pharma — surely the main reason for his hesitation — while appearing to stay true to the progressive principle of putting people over patents. Interestingly, France’s President Emmanuel Macron may be .

Historical Note

The Guardian reminds its readers that the proposal is limited to “waiving patents on Covid vaccines — but not on treatments or other technology used to fight the disease.” Whereas the US media presented the question as one of moral duty versus economic interest, both The Guardian and point to the practical question implied by the waiver: “If approved, the waiver would theoretically allow drugmakers around the world to produce coronavirus jabs without the risk of being sued for breaking IP rules.” For the developing world, feeling free from an imminent attack by corporate lawyers is indeed a kind of liberation.

In other words, the proposed waiver would leave the world a long way from the optimistic scenario originally evoked by health experts and scientists in early 2020 that Alexander Zaitchik in his exposé of Bill Gates’ influence on the WTO: “Battle-scarred veterans of the medicines-access and open-science movements hoped the immensity of the pandemic would override a global drug system based on proprietary science and market monopolies.” The idea at the time was to mobilize everyone and maximize resources. This implied .

The health professionals facing the outbreak of COVID-19 understood both the scope of its threat and the dangers of an insufficiently coordinated organization to counter it. They also knew what the consequences of patent protection might turn out to be. The adoption of the agreement Trade-Related Aspects of Intellectual Property Rights (TRIPS) in 1995 and TRIPS-plus in 1999 marked a landmark moment in the trend economists and politicians have celebrated with the term “globalization.” The specific rules applying to pharmaceuticals have been in place since 2005. In 2015, the website Infojustice the fact that the TRIPS agreement had established a regime in which “patents grant the patent holder a monopoly on the market that allows the blocking of price-lowering generic competition and the raising of prices which restricts affordable access to medicines.”

The history of the past two decades has demonstrated to the global south the risk existing patent laws represent for their health and welfare. In 2015, the United Nations Office of the High Commissioner for Human Rights “attention to the potential detrimental impact these treaties and agreements … may have on the enjoyment of human rights as enshrined in legally binding instruments, whether civil, cultural, economic, political or social. Our concerns relate to the rights to life, food, water and sanitation, health, housing, education, science and culture, improved labour standards, an independent judiciary, a clean environment and the right not to be subjected to forced resettlement.” 

COVID-19 changed everyone’s perception. So long as the world was not faced by a politically toxic pandemic, the developed world was free to use its superior wealth and force to impose its rules on the rest of humanity. Any serious campaign to understand the fundamental asymmetry that was continually and silently aggravating the gap between the rich and poor nations was easily stifled. Thomas Piketty could write erudite books about the gap and what was driving it. But most people in the West had bought into the belief system promoted by New York Times columnist and best-selling author Thomas Friedman, conveying the message that thanks to globalization and American technology, the world was now flat.

In an ideal scenario, the Biden administration will now begin to put pressure on Europe and Switzerland to emulate America’s courage in backing the proposed waiver. It will also pressure US vaccine providers to share their technology and know-how with the rest of humanity by convincing them to show not just their leadership but also their commitment to human health above profit. With or without patent protection, there is no danger of their becoming unprofitable, not with the power they have and an ever-expanding marketplace for health. But what we are witnessing, as they resist even temporary waivers, is the rentier’s obsession with automatically induced maximum profit making the question of health benefits a secondary consideration.

In the months to come, the world will be attentively observing the political and economic games now being played out. At some point, COVID-19 will begin to fade away. The world will then face the fear of the next contagion and perhaps begin seriously to struggle with a strategy to counter the effects of climate change. Awareness of the stakes is already much higher than in the past. It is time for the political class to begin assessing the risk that represents for their own future.

*[In the age of Oscar Wilde and Mark Twain, another American wit, the journalist Ambrose Bierce, produced a series of satirical definitions of commonly used terms, throwing light on their hidden meanings in real discourse. Bierce eventually collected and published them as a book, The Devil’s Dictionary, in 1911. We have shamelessly appropriated his title in the interest of continuing his wholesome pedagogical effort to enlighten generations of readers of the news. Read more of The Daily Devil’s Dictionary on 51�Թ�.]

The views expressed in this article are the author’s own and do not necessarily reflect 51�Թ�’s editorial policy.

The post After Long Wavering, a Waiver appeared first on 51�Թ�.

Before the start of the second wave of COVID-19 infections in March, the pandemic seemed to be under control in India. In September 2020, the country an average of 95,000 daily cases of COVID-19 during the peak of the first wave. By January 2021, that figure had dropped to under 20,000.

At the same time, the United States went from around 35,000 confirmed cases per day in September to a peak of over in January. At the start of the year, the United Kingdom was in the midst of a deadly second wave of infections, which reached over cases a day. At that time, Britain was battling a more contagious of COVID-19 known as the “Kent variant,” which is named after the region where it was first discovered in England. Countries in Europe and around the world raced to halt flights to and from the UK in a bid to control the spread of the new strain, which they feared would soon go beyond the British isles.

India’s Health-Care System Is in Shambles

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To put these figures in perspective, the UK population is 66.6 million, the US is 328 million and India is around 1.36 billion. That means at the start of 2021, the infection ratio per 100,000 people in India was far lower than in the UK and the US.

Lax Safety Measures

As a result, Indians thought the country was beyond the worst of the pandemic. In March, Harsh Vardhan, the Indian health minister, said the country had entered the “” of the health crisis. This led to a false sense of hope, which made the public and the central and state governments complacent. Restrictions that were brought in to curb the spread of the coronavirus were quickly eased. Life had almost returned to normal in January with the opening up of , restaurants, hotels, tourist locations and public transport.

At the same time, were announced in five states, including West Bengal, which the ruling Bharatiya Janata Party (BJP) had set its sights on winning. All political parties and their supporters held rallies with tens of thousands of people in attendance. The Hindu festival of attracted millions of people who took a dip in the Ganges, a river considered sacred in Hinduism. Nearly 60,000 were also allowed to enter stadiums to watch cricket matches. All of these events took place with lax safety measures in place, with no social distancing or wearing of masks.

In hindsight, India did not anticipate a second wave of COVID-19. It lifted the lid on public restrictions at a time when countries such as the UK were battling a winter wave of infections. As mainland Europe realized, it was inevitable that the more contagious strain of COVID-19 discovered in the UK would spread. India failed to understand this despite repeated .

Now, India is battling its own second wave. The country has repeatedly broken the record for the daily number of confirmed cases of COVID-19. On May 2, India recorded more than new daily infections. The actual number of cases is believed to be far higher due to a of testing kits and people getting tested. Many Indians are not getting checked because they have no symptoms but are contagious or they are worried about testing positive for the virus. States like , and have been accused of manipulating and the number of positive cases and deaths from COVID-19 to avoid criticism over inefficient governance. Worryingly, epidemiologists that India has not yet hit the peak of the second wave and that the worst is yet to come.

No Improvement to Health Care

It has been argued by many that the pandemic will not come to an end until it is under control everywhere. This is “viruses naturally mutate over time.” There are currently thousands of mutations of the coronavirus around the world, but only a few of them are variants of concern for scientists. As more people contract the virus and spread it to others, it is inevitable that different strains will emerge. This is why despite the successful vaccination rollout in countries like Israel, the UK and the US, authorities have been cautious as they reopen economies and reduce restrictions for the public. The fear is that some variants, such as the one in South Africa, will evade the existing vaccines and render them less effective.

India has a worrying COVID-19 variant of its own that is officially called B.1.617. This new strain — which is also known as the “double mutant” due to two mutations coming in the same variant — accounts for 61% of infections in Maharashtra, a major epicenter in India. It is unclear whether the Indian variant is driving the second wave, but it is believed to be more transmissible than previous strains of the virus. This is in addition to fear over the UK strain, which has to more than 50 countries.

Complacency by the central and state governments has made the health care system as Indians desperately seek medical assistance. When the pandemic first hit India in March 2020, authorities failed to strengthen the infrastructure at hospitals. As of 2018, the Indian government spent only on health care. Other emerging economies such as Brazil and South Africa spent 9.51% and 8.25%, respectively. In India, there is doctor per 1,445 people, which is far lower than the figure the World Health Organization recommends. At public hospitals, there were only 0.7 beds available per 1,000 people.

In July 2020, state governments opted to build temporary centers for COVID-19 patients instead of buying additional beds for existing hospitals and allocating more resources. These centers were barely used. Due to their high maintenance costs, they were dismantled a couple of months before the second wave hit. Now, as hospitals face a short supply of beds and a high demand for them, some state governments are considering whether to rebuild the centers.

In March 2020, Modi 150 billion rupees ($2.03 billion) to strengthen the infrastructure of health care in India. The government purchased personal protective equipment (PPE) and an additional 60,000 ventilators. Yet as of last fall, just under of the ventilators had been installed in hospitals across the country. Both public and private hospitals are currently short of beds, ventilators and oxygen in many major cities.

As COVID-19 infections sweep the country, social media networks have been flooded with posts calling for help. Friends and families of those suffering from the virus have desperately sought to find available beds in hospitals, oxygen supplies or medication to combat COVID-19. Disturbing reports of people dying after being unable to access treatment have been heard all over the country. Ambulances and other vehicles with COVID-19 victims inside them have lined up hospitals that no longer have space available. Many hospitals have reported that patients they were treating died as the supply ran out. Outside crematoriums, the number of dead bodies is mounting.

The Government’s “Vaccine Diplomacy”

With the situation worsening, the BJP-led government has been by Indian courts for focusing on state election campaigns instead of taking preemptive action to combat the second wave. Aside from easing restrictions too quickly and not reinforcing the health care system in time, many states face of COVID-19 vaccines. In January, Prime Minister Narendra Modi to have rolled out the “world’s largest vaccination drive,” aiming to get jabs in the arms of 300 million people by July. At the time of writing, only of the Indian population — 29 million — has been fully vaccinated with two doses. This is compared to in the UK and in the US, both of which focused on vaccinating their most vulnerable citizens first to drive down new infections and deaths.

India had other things in mind. It sought to distribute doses worldwide as part of its vaccine diplomacy. With the world’s largest manufacturer of vaccines, India has so far 66 million doses to 95 countries. Yet, earlier this year, the Modi government implemented an to donate free batches in an attempt to boost the country’s soft power when the pandemic was seemingly under control. Many observers questioned whether the move was necessary instead of focusing on vaccinating Indians themselves. Toward the end of March, as infections increased and vaccines decreased, the Modi government realized that its decision to export millions of doses was premature. It decided to halt the export of doses and instead vaccinate Indians over the age of 45. Yet the damage had already been done due to poor planning by the BJP-led government.

Meanwhile, state administrations in Maharashtra, Delhi and Andhra Pradesh that are not ruled by the BJP have claimed they are running short of vaccines. Critics have accused Modi of playing politics with as states with BJP governments, such as Gujarat, were given almost the same number of vaccine doses as Maharashtra, which has a population double that of Gujarat. Vardhan denied that regions were short of supplies and instead blamed state governments for the poor rollout of vaccines.

In order to counter criticism over its inefficient planning, the central government announced on April 19 that all citizens above 18 would be able to get from May 1; it had previously focused on health and frontline workers and those over 45. By opening the door for all adults, an additional 600 million citizens are now eligible. Yet with vaccines in short supply, some states have the rollout. The website through which citizens can book a jab minutes after it went live for the new age group.

The government has approved al funds for vaccine manufacturers to ramp up production. However, the increased production is unlikely to be available for a few months as vaccines go through a lengthy process of packaging and safety checks. To make up for this shortage, the government has fast-tracked the process for foreign-produced vaccines. These include Johnson and Johnson from Belgium and Sputnik V from Russia, which cost more than domestically-produced ones.

Public Image

In an attempt to maintain his public image, Modi the nation on April 20. Indians needed assurances and demanded answers, but the prime minister offered none. He neither informed the public about plans to tackle the crisis, nor did he give any reasons about why the country is facing a horrific second wave. This is despite him previously boasting that India’s handling of the pandemic had been exemplary and should a model for the world. It seems the central government is content with placing the blame on state administrations and the public instead of admitting that it made mistakes.

Earlier this week, the BJP to win in the state of West Bengal despite heavy election campaigning. It seems that Indians are beginning to realize that Modi’s preoccupation with his public image, and his need to win votes, is costing the country dearly. In fact, the obsession with elections on the part of Indian politicians has contributed to the second wave of COVID-19 infections. India can only hope that Modi and other politicians shift their focus from politics to health care before it is too late.

The views expressed in this article are the author’s own and do not necessarily reflect 51�Թ�’s editorial policy.

The post Where India Went Wrong appeared first on 51�Թ�.

The crisis was still “unfolding” more than a year after the outbreak precisely due to Gates’ effective dictatorship over the global effort to combat the virus. Insisting on protecting Big Pharma’s intellectual property, Gates single-handedly blocked the one solution scientists and health experts were eager to run with: the sharing of industrial procedures to avoid hoarding and scarcity while addressing the needs of humankind.

Is Bill Gates a Danger to Humanity?

Now, even after massive coverage of the scandal provoked by Gates’ adamant opposition to intellectual property waivers that effectively limits the capacity to manufacture vaccines on the scale required for a pandemic, Neate once again expresses his effusive admiration, citing Gates’ willingness to spare no expense in the name of the cause: “It’ll be a few billion dollars we’ll waste on manufacturing for the constructs that don’t get picked because something else is better. But a few billion in this, the situation we’re in, where there’s trillions of dollars … being lost economically, it is worth it.”

Today’s Daily Devil’s Dictionary definition:

A few billion (dollars):

Chump change for the hyperwealthy

Contextual Note

Gates’ statement deserves some careful unpacking. It reveals more than he may have intended about his worldview. It may even hold a clue to Melinda Gates’ this week, also covered by Neate. Gates mentions “constructs,” apparently referring to research projects declared stillborn when their results prove to be inferior to other projects bet on by the same philanthropist. He calls it “waste,” but he should know that the whole purpose of research is to distinguish what doesn’t work from what works well.

There is nothing wasteful about that effort. Wasted “constructs” are an essential consequence of the structure and logic of research. But focused on the naive idea of building the proverbial “better mousetrap,” Gates apparently deems anything wasteful that fails to pass the intellectual property test, pointing to guaranteed future profits.

After regretting the waste, Gates goes on to explain why such waste can be tolerated. It’s not because it is a stage in advancing the cause of human health. No, as James Carville once told candidate Bill Clinton, “It’s the economy, stupid.” Gates talks about “the situation we’re in” and makes it clear that the threat he worries about isn’t to millions of people in the global south, but to the loss of trillions of dollars of economic activity. Gates is a man who knows his priorities. Those trillions produce the fortunes of multibillionaires whose philanthropy can save the human race. Unlike McKenzie Scott, Gates may not have noticed that the pandemic has comforted and increased the wealth of the current generation of multibillionaires, such as himself. The longer it lasts, the more durable will be the results.

Gates esteems that losing “a few billion” when your estimated fortune is around $124 billion is “worth it,” if what you’re doing is designed to save not so much people as the capitalist economy. He has repeatedly insisted not only that the protection of intellectual property is the key to the economy, but that a prosperous capitalist economy dominated by global powerhouses like Microsoft and Big Pharma is the key to human health. He sincerely believes this, even if along the way some “waste” occurs as hundreds of thousands die in India and Brazil and other places handicapped by a deficit of intellectual property.

Historical Note

Neate uses the occasion of the philanthropic couple’s impending divorce to heap more praise on Bill’s exemplary generosity: “Bill is the world’s fourth-richest person with his estimated $124bn (£90bn) fortune, but he would have been even more vastly wealthy if he had not committed to giving away at least half of his fortune before he dies.” That is technically true in terms of Gates’ personal holdings, but a foundation represents personal wealth in a different form.

Moreover, if wealth is power — as most people would admit — foundations offer direct political power in ways that personal wealth can never do. Those who shovel massive amounts of their personal wealth into foundations bearing their name and which they control are investing in their own political power far more than they are contributing to that collective idea that Adam Smith, the father of capitalist theory, once referred to as “the wealth of nations.”

Gates was certainly the luckiest techno-creator in the history of information technology’s triumph over the past 40 years. If IBM hadn’t gifted him the development and the intellectual property of MS-DOS — which IBM itself marketed across the globe in its PCs — he might have gone done in history as just another Harvard dropout addicted to experimenting with computer code. Anyone who spent the decade of the 1980s using MS-DOS can understand why Gates will never be remembered as among the most brilliant of a tribe that included Steve Jobs but also people like Tim Berners-Lee and Linus Torvalds.

The latter two never sought to become billionaires or business icons. Gates’ genius was focused on understanding how to leverage dropout. His story is similar in some ways to that of his friend, Warren Buffett, who honestly attributes his own success to his understanding of the mystery of . These hyperwealthy individuals share traits that some would call autistic.

In the course of his panegyric, Neate does have the decency to quote Anand Giridharadas, whom he identifies as “one critic of billionaire benefactors.” Giridharadas predicts that the Gates divorce will have ramifications in “the worlds of business, education, public health, civil society, philanthropy, and beyond.” He explains that it “is because our society has made the colossal error of allowing wealth to purchase the chance to make quasi-governmental decisions as a private citizen.”

We may wonder if the divorce is in any way related to the latest controversy about Gates’ role in the vaccine fiasco. Has Melinda read Zaitchik’s article or dared to listen to Giridharadas’s reasoning? Will we ever know? There is most likely a in the offing, possibly resembling McKenzie Scott’s $38-billion divorce arrangement with Jeff Bezos in 2019. 

Ms. Scott’s net worth today is estimated at $68 billion. Her commitment to philanthropy appears more sincere than her former husband’s or Gates’, especially as it is significantly less self-aggrandizing and reflects a more refined sense of . For Scott, “there’s no question in my mind that anyone’s personal wealth is the product of a collective effort, and of social structures which present opportunities to some people, and obstacles to countless others.” She even dared to offer this that most billionaires avoid evoking out of fear of brandished pitchforks: “Economic losses and health outcomes alike have been worse for women, for people of color, and for people living in poverty. Meanwhile, it has substantially increased the wealth of billionaires.”

One serious question remains, and it concerns the media. Why do prestigious papers such as The Guardian and The New York Times consistently cheerlead philanthropists like Gates, refraining from any even mildly serious criticism? On the topic of vaccines, The Times featured a in March that contained, hidden in its depths, observations worthy of serious reporting. Investigative reporter Megan Twohey confessed that “we found time and again that there were a lot of people in the world of public health who would talk to us off the record about their concerns about Gates and his growing power and influence in the world of public health, but they were very reluctant to say so on the record, in large part because his money was everywhere.”

Twohey also remarks that “as he’s become more powerful, it has also become very difficult for people to imagine any more radical reform without his support.” Her editors apparently have never asked her to pen an article on Gates’ influence. With media like that, “radical reform” is indeed difficult to imagine in our current economy.

*[In the age of Oscar Wilde and Mark Twain, another American wit, the journalist Ambrose Bierce, produced a series of satirical definitions of commonly used terms, throwing light on their hidden meanings in real discourse. Bierce eventually collected and published them as a book, The Devil’s Dictionary, in 1911. We have shamelessly appropriated his title in the interest of continuing his wholesome pedagogical effort to enlighten generations of readers of the news. Read more of The Daily Devil’s Dictionary on 51�Թ�.]

The views expressed in this article are the author’s own and do not necessarily reflect 51�Թ�’s editorial policy.

The post For a Few Billion Dollars More appeared first on 51�Թ�.

To use a factory analogy, every position along the assembly line needs to be operational and dependable. But, as a scientist and engineer, I argue that public investments at the beginning of the spectrum of discovery — basic curiosity-driven research — should outpace the investment at the end, finding technology solutions.

Trusting Science in Times of Uncertainty

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The importance of curiosity-driven research cannot be overstated. The of the COVID-19 vaccines, for instance, arose from decades-long in cell biology. As a researcher who studies fluid flow, I know that answers to fluid mechanics questions posed a hundred years ago — about how air swirls, how water moves and pools or how blood flows — have enabled us to invent airplanes, imagine ocean wave energy extraction and improve drug delivery. Really, all inventions, from to , from to , are the offspring of curiosity-driven research of the past. 

Despite its importance, funding sources for basic research are less diverse compared to funding for technology solutions. This is, in part, because private industry, which is often motivated by short-term profits, is in curiosity-driven research. Instead, scientists who are willing to dedicate their time to questions that may not pay off for decades depend almost entirely on . 

Certainly, not every basic research project will, in the short term, lead to a technological solution. And that’s precisely the why we should invest heavily in basic research upfront, to make sure we have plenty of raw materials at hand when we search for technology solutions. Investment in technology and innovation can then be more selective, with metrics requiring a clear return on investment. We seed liberally and water selectively.

However, the current budget request privileges funding toward technology. To be sure, it includes a 20% boost to the budget of the (NSF), bringing it to $10.2 billion. Much of this funding will go toward funding basic curiosity-driven research. But the budget request also calls for the creation of a new directorate within the NSF for technology and innovation, which would receive $50 billion — five times the NSF science budget — as part of President Biden’s . These funds would be used to turn new scientific insights into technology solutions. 

Without a doubt, these investments are important. But if we invest only in efforts that lead to known desired outcomes, we will be bound by our imagination of what is possible. Furthermore, even a short interruption to funding for curiosity-driven research could mean a serious gap. We wouldn’t feel the effects right away, but we would be denying our grandchildren the they will need to find solutions to their problems in a hundred years. 

Thankfully, the budget request and the infrastructure bill unveiled by the Biden administration are signaling support for the entire spectrum of research activities. But I ask lawmakers and the public to recognize that funding for technological advancement and immediate solutions must come alongside larger, perhaps even fivefold, investments in basic research — open-ended scholarship inspired not by immediate needs but by curiosity and wonder. It is only when we engage with no end goal in mind that we can discover the building blocks for the solutions we never dreamed of. 

The views expressed in this article are the author’s own and do not necessarily reflect 51�Թ�’s editorial policy.

The post It’s Time to Invest in Curiosity appeared first on 51�Թ�.

Four months later, Trump began and blaming Xi’s China by claiming “that the virus originated in a laboratory and was accidentally released.” In September, he preferred to to his voters that COVID-19 was the result of an Asian conspiracy designed to undermine his presidency. This sparked a wave of anti-Asian attacks in the US that have continued to this day.

Prominent scientists today that Trump’s initial assessment may have been right. Their colleagues who dismissed the idea of an accidental release of the virus from a Wuhan laboratory were either misled or disingenuously defensive of an equally unproven thesis. The scientists may have been impelled to reject the suspicion of a laboratory accident not only out of a lack of direct evidence, but also out of fear of the political blame game the president was beginning to exploit to distract attention from his own failure to respond appropriately to the crisis.

Trump obviously preferred to see the war against a virus as a PR opportunity to bolster his image as a fearless leader. Allowing politicians to place blame on China, even for an accident, might have become as dangerous for the world as the virus itself, adding to the reigning misery rather than resolving the mystery of the origin of the disease.

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Science itself and its public image have taken a hit from this ongoing catastrophe. The honored, if not revered Dr. Anthony Fauci to prioritizing the distribution of masks among the medical community above the general public at a time when little was still known about how contagious COVID-19 was and how it spread. Political leaders across the globe, including Trump, all found themselves in a thankless position as they were required to demonstrate their leadership with insufficient knowledge of the nature of the challenge and a penury of material means to confront it.

Many deserve to share the blame for a situation that, despite progress with vaccines, is still in many ways worsening. But, as Alexander Zaitchik exposes in an important in The New Republic, the person perhaps most to blame for our global failure to respond effectively is neither a scientist nor a politician. His name is Bill Gates.

Most rational people would reason that a global crisis requires a global response. Most realists recognize that in a civilization dominated by sovereign nation-states, summoning a unified response to any global crisis will never be easy. Humanity’s quasi-universal awareness of the problem of global warming over the decades demonstrates the difficulty of mobilizing humankind to implement even a minimalist response.

In his article, “How Bill Gates Impeded Global Access to Covid Vaccines,” Zaitchik narrates a depressing story that began in February 2020, when the nature of the COVID-19 threat had become clear. In conformity with its mission, the World Health Organization (WHO) a “research and innovation forum to mobilize international action” aimed at combating the spreading epidemic. It sought to “maintain broad and open channels of communication, since collaboration and information-sharing minimize duplication and accelerate discovery.”

Collaboration and sharing of science would be critical to any effective response. With most research publicly funded — a point Mariana Mazzucato made this week — it specifically recommended . Zaitchik notes that optimism was still possible: “Battle-scarred veterans of the medicines-access and open-science movements hoped the immensity of the pandemic would override a global drug system based on proprietary science and market monopolies.”

Today’s Daily Devil’s Dictionary definition:

Proprietary science:

An oxymoron to the extent that “science” simply means human knowledge and cannot be owned or commodified.

Contextual Note

The WHO was thus prepared to play the role assigned to as stated in its constitution: “The health of all peoples is fundamental to the attainment of peace and security and is dependent upon the fullest co-operation of individuals and States.” Aware of the challenge lying ahead of them, the team began to prepare its campaign. Alas, it hadn’t counted on the intervention of the globe’s self-appointed Mr. World Health, Bill Gates, whose title derives from his contributing billions of dollars to the causes he believes in (the Bill and Melinda Gates Foundation has $1.75 billion in the development and distribution of the COVID-19 vaccine). Among them is the most sacred of all causes: intellectual property. 

Zaitchik describes in detail how Gates — a man with no skills in science, security or politics — has positioned himself to dictate to the world how contemporary science will affect every human being’s security. The key, following the logic of all capitalistic projects, is the management of scarcity. Without scarcity, industry cannot survive and prosper. Little does it matter that because of scarcity many humans simply will not survive.

Before Gates’s intervention, the group sought “to create a voluntary intellectual property pool inside the WHO.” In so doing, they demonstrated their naivety: “That pharmaceutical companies and their allied governments would allow intellectual property concerns to slow things down — from research and development to manufacturing scale-up — does not seem to have occurred to them.” But that is exactly what happened, thanks to Gates’s overpowering voice (measured by billions of dollars rather than decibels) and his “reputation as a wise, beneficent, and prophetic leader.” When the dust cleared, what emerged was “a zero-sum vaccination battle that has left much of the world on the losing side.”

Zaitchik documents the ensuing catastrophe due largely to “Gates’s dedication to monopoly medicine” and his “unwavering commitment to drug companies’ right to exclusive control over medical science and the markets for its products.” No one other than powerful governments can hope to compete with Gates’s cash reserves. But Gates’s own government, in Washington, DC, — whether under a Democrat or a Republican president — would never compete as a matter of principle. Competition is a private game. No other government in the world has the power to compete. The US government, like Gates himself, appears addicted to “politically constructed and politically imposed monopolies.”

Historical Note

The egregious oxymoron “proprietary science” would have seemed strange to the ears of anyone living before the industrial revolution. Were he alive today and imbued with modern economic culture, the 15^th-century German printer, Johannes Gutenberg, would be claiming a percentage of every book, journal or magazine produced thanks to his invention of the printing press. Instead, Adolph II of Nassau, Archbishop of Maintz rewarded Gutenburg — the Bill Gates or Elon Musk of his day — for his innovation “with the title of ‘Gentleman of the Court’.” He also received “a court outfit, a stipend and two tonnes of grain and wine, tax-free.” The wine can be explained by the fact that Gutenberg’s inspiration for the printing press came from observing a wine press.

Gates deserves to be similarly honored for his invention of MS-DOS. Rather than the billions extracted from the Earth’s entire population thanks to his skill at monopoly creation and predatory business practices, he should have received from the governor of the state of Washington an appropriate title (“Gentleman of the coding room”), a flashy suit of clothes with a matching raincoat (for Seattle weather), a generous stipend (a million of two per year would be appropriate) and maybe an unlimited supply of canned foods, since he is a believer in and expert practitioner of canned economic and scientific wisdom.

As many of the rest of us queue up for one of the competing vaccines that promise to bail us all out — despite their disparities in performance adding to the confusion created by the incompetence of competitive governments — we should reflect on what all this tells us about an economic system whose vaunted efficiency Gates believes in and practices while using his money and clout to impose it on an unwilling world.

*[In the age of Oscar Wilde and Mark Twain, another American wit, the journalist Ambrose Bierce, produced a series of satirical definitions of commonly used terms, throwing light on their hidden meanings in real discourse. Bierce eventually collected and published them as a book, The Devil’s Dictionary, in 1911. We have shamelessly appropriated his title in the interest of continuing his wholesome pedagogical effort to enlighten generations of readers of the news. Read more of The Daily Devil’s Dictionary on 51�Թ�.]

The views expressed in this article are the author’s own and do not necessarily reflect 51�Թ�’s editorial policy.

The post Bill Gates and the Zero-Sum Vaccination Game appeared first on 51�Թ�.

How Did India Combat COVID-19 in 2020?

Last year, Indian Prime Minister Narendra Modi a stringent lockdown that brought economic activity to a shuddering halt. This lockdown led to a dramatic contraction of India’s GDP by in the April-June 2020 quarter. The economy recovered somewhat in later quarters, but it experienced a recession in the 2020-21 financial year for the first in 25 years.

Arguably, the lockdown was a success in preventing a rapid spread of COVID-19 last year. In percentage terms, India did not do too badly. After all, it has nearly 1.4 billion people in contrast to the US population of 330 million. The daily new cases in India dramatically until recently when the second wave hit the country. Thanks to a young population and public health measures, India experienced a remarkably low rate.

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India has low per capita income and poor health care facilities. So, its achievement in controlling the COVID-19 outbreak has been hailed by many public health experts, the World Health Organization (WHO). In January, India launched a massive vaccination program to fight the pandemic. This was possible because the country has a track record of mass vaccination and massive vaccine production.

Indian manufacturers supply than 60% of the world’s vaccines against diseases like polio and measles. Early on, the country began mass production of two COVID-19 vaccines: Covishield and Covaxin. The Serum Institute of India (SII), which partnered with the University of Oxford and AstraZeneca, had already produced and stocked approximately 70 million Covishield even before India granted emergency approval to their vaccine. 

On January 16, India launched an ambitious plan to vaccinate around 300 million people by June. The world’s largest vaccination focused first on those with high vulnerability to the coronavirus. First on the list were health care workers. They were followed by those who were 65 years or older. This ensured that the vaccine was not monopolized by the richest sections of Indian society. 

As vaccinations have increased, the Modi government has eased restrictions in the country. Crowds have gathered at large weddings, sporting events and festival celebrations. The government lifted restrictions to stimulate economic activity. A poor country like India with a large population could not afford a lockdown for too long. However, the easing of restrictions has not only led to increased economic growth, but also rising cases of COVID-19 infections. India faces a tough balancing act between stimulating economic activity and curtailing a pandemic.

India’s Vaccine Diplomacy

During the pandemic, India has embarked on an ambitious foreign policy initiative. Modi announced the Vaccine Maitri to supply COVID-19 vaccines to other nations only four days after India began domestic vaccinations. With the world’s largest of vaccines, India has approximately 61 million doses to 84 countries, which have included free batches. It has pledged 200 million doses for the WHO’s COVID-19 Vaccines Global Access () initiative to ensure vaccines for 92 low and middle-income countries.

India began its vaccine diplomacy by distributing doses to its immediate neighbors:,, and the . The country has also exported vaccines to faraway places such as the, where the likes of , and have benefited from Indian aid. Leaders of countries such as and have publicly thanked Modi for his country’s generosity.

As per some foreign policy experts, India’s vaccine distribution is a diplomatic masterstroke. It helps the country gain goodwill and increase its soft power. It could lead to a more peaceful neighborhood. In the future, India might win much support, strengthen its claim to a permanent seat at the UN Security Council and emerge as a great world power.

Vaccine diplomacy might be giving a rare chance to counter China, which has launched the Belt and Road Initiative to increase its global footprint. For decades, China has backed Pakistan and, for the last few years, has increased its presence in Myanmar, Bangladesh, Sri Lanka and Nepal. With Chinese influence growing in India’s closest neighbors, the country has understandably become anxious.

In June 2020, Chinese and Indian troops engaged in a bloody hand-to-hand combat with many dying in the process. Since that clash, relations between India and China have been fraught. India has over 200 Chinese apps and restricted Chinese investment into the country. COVID-19 has given a unique opportunity to India — the “” — to compete with China. By shipping vaccines to low and middle-income countries, India is gaining influence at the Chinese expense whose vaccines have been by Western media.

Rich countries have failed poorer ones because they have focused on domestic programs. Unlike India, the United States, the European Union and the United Kingdom are focused completely on vaccinating their domestic populations. India’s generosity is unique and might lead to long-term gains.

Masterstroke or Distraction?

However, there is a counterargument that India has been premature in kicking off vaccine diplomacy. It did so before setting its own house in order. According to the Johns Hopkins Coronavirus Resource Center, as of April 2, India has nearly 69 million doses, fully inoculating only 9.6 million people. That is just 0.71% of its population. India’s focus should have been getting every one of its citizens vaccinated instead of basking in complimentary tweets from foreign leaders. Such goodwill might turn out to be very transient. 

Recently, India has down its vaccine exports and speeded up its vaccination program. The government has now enrolled private hospitals in its vaccination drive, and everyone above the of 45 is now eligible for the vaccine. Modi himself got vaccinated on March 1, boosting public faith in COVID-19 vaccines and increasing their uptake four-fold. It seems that the government is paying attention to its critics.

Time will tell whether India’s vaccine diplomacy was a bold masterstroke or an unwise distraction. It reveals that there are no easy choices for any nation during a raging pandemic.

The views expressed in this article are the author’s own and do not necessarily reflect 51�Թ�’s editorial policy.

The post Is India’s Vaccine Diplomacy a Good Idea? appeared first on 51�Թ�.

How Stable Is Antony Blinken’s Idea of Stability?

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Natasha Frost at The New York Times reports on how inequality has led to vaccine inequality, with the potentially disastrous effect of prolonging an already year-old global pandemic. She blames the various political establishments that have allowed this to happen. “It didn’t have to be like this,” she writes. “Western governments have resisted the call from global health officials to use rarely employed aggressive powers that could have forced companies to publish vaccine recipes, share their knowledge and ramp up manufacturing, in turn leading to broader vaccine �����������.”

Today’s Daily Devil’s Dictionary definition:

Aggressive powers:

Special tools of government designed to address real, serious and urgent problems, sometimes mobilized to prosecute wars, but never employed to modify practices that might compromise the prospect of profit by private companies

Contextual Note

Military aggression (invasion, war, bombing campaigns) and economic aggression (sanctions, embargoes, boycotts) are the two policy instruments contemporary governments privilege to defend what they deem to be their “national interest.” Democratic nations continue to claim, against all evidence, that aggressive and fundamentally destructive actions taken against other peoples or nations — to kill, maim or simply create economic deprivation — are efficient means designed to protect their own people’s interest. Since commercial media never question this logic, discussion of what “national interest” implies never even enters the public’s field of awareness. War and sanctions sound virile and so must be good. 

Whereas the English language has easily accepted “military aggression” and “economic aggression” as useful descriptive terms, the idea of “health aggression” has no place in anyone’s vocabulary. Health is not something the political infrastructure believes it can or should do anything “aggressive” about. It is both too personal and too profitable. In the US in particular, health is not considered to be something to strive for, but simply as a marketplace in which, as Cole Porter once , anything goes (to make a profit).

In an AP by Cheng and Lori Hinnant that appeared earlier this month, the authors explain that the marketing policies of pharmaceutical companies are the source of what is quickly becoming a desperate situation for the majority of humankind. Companies “that took taxpayer money from the U.S. or Europe to develop inoculations at unprecedented speed say they are negotiating contracts and exclusive licensing deals with producers on a case-by-case basis because they need to protect their intellectual property and ensure safety.”

Any rational human being with a basic understanding of language should be shocked by two words in the concluding phrase of that sentence. The first is “their.” The companies believe they exclusively own what a community built and paid for. Analyzing the logic of a supply chain and production line makes it clear that the areas they have invested in turn out to be testing, redesign, packaging and delivery. These are important features of any product. But they do not justify the claim of exclusive ownership.

The second shocking term is “safety.” The firms deem themselves protectors of their customers’ “safety.” Their role in the process of combating the virus consists of refining the product and testing it to meet public safety standards. But the marketing attitude that guides their actions continues to privilege the idea of hoarding, seeking monopolistic advantage and exploiting scarcity in a marketplace. This poses a serious risk of undermining public safety and preventing the coordinated action that alone could lead to the elimination of a global pandemic.

Historical Note

During the discussions to fund the vaccines, the private companies selected for the honor of producing the vaccines destined to save the world in all probability declined to take on the burden without the assurance that the research would be fully funded and the intellectual property (IP) would be assigned to them as a guarantee of future profit. The politicians who accepted those terms were undoubtedly guided by the wisdom of the economics 101 course they attended decades ago in their youth that taught them how the focus on profit is the key to economic efficiency. The higher the profit, the greater the efficiency, they were told.

In the past four decades, this logic has even been applied to the universities that offered those courses. They have become profit-focused institutions, dedicated to supporting the bloated salaries of the administration that “ensures” efficiency rather than the educational vocation of the institution.

Today’s drama could stand as a model lesson for a future economics 101 course, though few would imagine that profit-driven universities will be very keen on the update. If the universities refuse, it should be taught in every high-school civics class on earth. Economics 101.1 would emphasize the perversity of an economic system that forces ordinary citizens in wealthy countries to finance through taxes the research that their government will then donate to private companies that, in turn, will inevitably claim the IP without ever investing a penny of their own money.

This pattern of socializing private companies and endowing them with product lines that ensure massive future profits through monopolistic exploitation is not limited to the pharmaceutical sector. The giants of Silicon Valley have grown into mastodons who control not just their highly-profitable marketplace, but also people’s lives (their behavior) and minds (their thoughts), thanks to the same process.

How did we get to this point? To answer that question would require an encyclopedia delving into questions of finance, technology, politics and culture. One obvious factor is the triumph of the idea of globalization that became an article of faith for all “serious thinkers” and most politicians in recent decades. Thomas Friedman famously summed it up with the idea that “the world is flat.” It turns out that when the only recognized motivator of any kind of action concerning human health and safety — or indeed anything else — is money and profit, any other of the needs we expect the economy to address become secondary. In classic economics, a situation of needs not being met will create the demand that a new enterprise will seek to fulfil.

Our pundits and economic thinkers imagine that, in a global economy, the process will be even more efficient because competition can come from any direction and supply chains can be easily reconfigured. In no time at all, the needs will be effectively and efficiently addressed. But the conditions for any new competitor to realize such a scenario require three largely unattainable conditions: extravagant funding to attain a scale of credible performance, recognition by public authorities (which often requires prior contributions to their political campaigns), and the belief in the possibility of a monopolistic position. 

Guaranteed monopoly is the hardest to achieve for a newcomer, which is why over the past two decades, pundits have highlighted the necessity of innovation. This generally means focusing on a specific market opportunity rather than addressing a fundamental need. It also means that if the need is global, there is absolutely no chance of a newcomer having an impact. The major players are safe from new competition. Disruptive innovation is a wonderful way to spawn new gadgets or convenience products. Unfortunately, global societal needs require global societal reflection, research, coordination and concerted action.

During the wars of the 20^th century, democratic nations mobilized the “aggressive powers” provided by their laws to respond to the emergency of global conflict. This posed no challenge to the principles of democracy, where all shared the idea that such measures were required for the safety of the national population. War profiteering existed, since any intense effort creates new areas of economic opportunity, but governments were guided by the collective needs of the nation. They refused to allow policy to be dictated by the profiteers.

With the first of what may become a series of pandemics converging with an impending global climate crisis, it might just be time for politicians to show their aggression by putting public safety ahead of private profit, even if it means revising the syllabus of economics 101.

*[In the age of Oscar Wilde and Mark Twain, another American wit, the journalist Ambrose Bierce, produced a series of satirical definitions of commonly used terms, throwing light on their hidden meanings in real discourse. Bierce eventually collected and published them as a book, The Devil’s Dictionary, in 1911. We have shamelessly appropriated his title in the interest of continuing his wholesome pedagogical effort to enlighten generations of readers of the news. Read more of The Daily Devil’s Dictionary on 51�Թ�.]

The views expressed in this article are the author’s own and do not necessarily reflect 51�Թ�’s editorial policy.

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Germany’s Handling of the Pandemic: A Model of Incompetence?

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Both acts were hugely symbolic, especially since they occurred within hours of Biden’s inauguration, as they set a fundamentally new tone in US foreign policy and sent a strong signal to the world, paraphrased as: We are back, count on us. But other than being symbolic, these acts constitute a material and substantial backing of global efforts to address two of the 21st century’s most severe world crises — the COVID-19 pandemic and climate change — under the aegis of the United Nations.

When the Trump administration announced in July 2020, in the middle of the most devastating pandemic in at least a century, that the US would withdraw from the WHO — having already frozen payments of mandatory membership dues and thereby violating international law months earlier — that move was widely regarded as not only hugely counterproductive but as outright insane.

The World Needs the US as Well

Clearly, the country hit hardest by the pandemic — both in terms of total infections and deaths — is better off as a member of the very global community that ensures the fast sharing of research, data and best practices, coordinates responses, and comes together to devise evidence-based solutions to the world’s most pressing public health issues, be it malaria, tuberculosis, HIV or COVID-19. But the international community needs the US as well.

In fact, the US has been the single most important independent variable in international relations and global affairs since President Franklin D. Roosevelt’s signing of the Declaration of the United Nations on January 1, 1942. Hence, a WHO without the active participation and support of the US government is unthinkable. This engagement extends well beyond funding. Since its inception in 1948, the US has been the single largest contributor to the WHO — which budgeted $4.84 billion for the biennium 2020-21, not including COVID-19-related expenses — with a steady share of 22% of the organization’s assessed core budget and significant additional voluntary contributions made every single year.

Yet the active support of medical research data, analysis, know-how, logistics, supplies and people power to the WHO’s multifold programs and emergency operations by the US, such as during the West African Ebola crisis of 2013-15, is priceless and virtually irreplaceable. Indeed, a great sense of relief was voiced in unison by scientists, senior government officials and UN leaders alike when the Biden administration applied common sense and restored the United States’ bond with the WHO on the day of its inception. This step will have an immediately relevant and measurable impact on the global response to SARS-CoV-2, the virus that causes COVID-19.

With the unfreezing of previously withheld payments and the allocation of additional, fresh sums of money targeted at global health emergency relief efforts, research and development, and the provision of supplies and teams, the global fight against COVID-19 will experience an important boost. This will be particularly important in the context of WHO’s COVAX initiative, which is a historic, unprecedented fundraising effort to make effective and safe vaccines available to all countries, especially developing ones. Moreover, COVAX entails a proprietary vaccine development program, including the building of manufacturing capabilities, and provides technical and logistical support to countries in need.

COVAX Initiative

The new US administration has quickly become COVAX’s largest funder and pledged to donate surplus vaccine stocks in addition to its financial contributions. Also, efforts to assist developing countries by deploying on-the-ground technical assistance where needed are underway.

However, COVAX still has a long way to go to meet its goal of buying supply so that 2 billion doses can be fairly and equitably distributed by the end of 2021. To date, financial support by OECD countries to the facility has been lukewarm at best, although the US and Germany stand out. The apparent lack of solidarity and tangible support by wealthy nations is disappointing and recently prompted UN Secretary-General Antonio Guterres to global vaccine distribution “wildly uneven and unfair,” describing the goal of providing vaccines to all as “the biggest moral test before the global community.”

In the case of the COVID-19 pandemic with its rapidly-emerging mutations and variants, quick, unequivocal and substantial support — both financial and technical — to developing countries and those behind in getting access to effective vaccines is not only a moral obligation for developed countries, but also a mere matter of rationality and self-interest.

As long as over 100 countries globally have not even received a single dose of a COVID-19 vaccine, even the most ambitious and aggressive vaccine rollout campaigns in wealthy countries may be in vain as new variants of SARS-CoV-2 can emerge and cause new viral strains at any time. The Biden administration, along with other governments, is well advised to massively support multilateral solutions and collective action. It is the only reasonable, promising approach to tackling the world’s biggest crises in the 21st century.

*[This article was submitted on behalf of the author by the Hamad bin Khalifa University Communications Directorate. The views expressed are the author’s own and do not necessarily reflect the university’s official stance.]

The views expressed in this article are the author’s own and do not necessarily reflect 51�Թ�’s editorial policy.

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The findings of the project are explained in a titled “Deploying an Artificial Intelligence System for COVID-19 Testing at the Greek Border,” authored by , a Wharton professor of operations, information and decisions and affiliated faculty at Analytics at Wharton;  and  from the University of Southern California; Jon Vlachogiannis from investment advisory firm Agent Risk;  from the University of Thessaly; and , Gkikas Magiorkinis,  and  from the University of Athens.

The analysis showed that Eva on average identified 1.85 times more asymptomatic, infected travelers than what conventional, random surveillance testing would have achieved. During the peak travel season of August and September, the detection of infection rates was up to two to four times higher than random testing.

How Artificial Intelligence Can Slow the Spread of COVID-19

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“Our work paves the way for leveraging [artificial intelligence] and real-time data for public health goals, such as border control during a pandemic,” the paper stated. With the rapid spread of a new coronavirus , Eva also holds the promise of maximizing the already overburdened testing infrastructure in most countries.

“The main issue was, given the fixed budget for tests, whether we could conduct the tests in a smarter way with dynamic surveillance to identify more infected travelers,” said Bastani. One of the biggest challenges governments face in dealing with COVID-19 is the inability of the testing infrastructure at their national borders to realistically check every arriving passenger. Such comprehensive testing would be both costly and time-consuming, which is why most countries screen either arriving passengers from specific countries or conduct random testing for COVID-19.

Eva also allowed Greece to identify when a country was exhibiting a spike in COVID-19 infections a median of nine days earlier than what would have been possible with machine learning-based algorithms using only publicly available data.

The underlying technology of Eva is a “contextual bandit algorithm,” a machine-learning framework built for “sequential decision-making,” taking into account various practical challenges like time-varying information and port-specific testing budgets, Bastani explained. The algorithm balances the need to maintain high-quality surveillance estimates of COVID-19 prevalence across countries and the allocation of limited testing results to catch likely infected travelers. Eva is the first instance of that technology being applied to address a public health challenge, although such algorithms have found use in online advertising and A/B testing, she added.

Overcoming Data Challenges

Eva is an advancement over conventional border control policies because it does not rely on publicly reported data, which has a number of issues.

Publicly reported data is of “poor quality” chiefly because different countries follow different reporting protocols and testing strategies. It is common to focus testing resources on symptomatic patients, but the resulting prevalence rate may not be reflective of the asymptomatic population that is likely to travel. There is often also a reporting delay due to poor infrastructure, said Bastani. “We can tell, based on the data we’re actively collecting at borders, that a country’s COVID cases are spiking typically nine days before you will see that reflected in the public data.”

“Testing is usually targeted towards symptomatic individuals rather than asymptomatic individuals,” Bastani said in an interview with the Wharton Business Daily radio show on SiriusXM last July, as the Greek deployment was getting underway. “You can imagine tourists who are coming in are probably asymptomatic.” That underscores the criticality of not relying on publicly reported data, but using data that accurately reflects the prevalence of asymptomatic COVID-19 travelers across countries.

Eva’s algorithm overcomes the poor quality of public data by dynamically collecting testing results at the Greek border, thereby maintaining high-quality surveillance estimates of the prevalence in each country. “By adaptively adjusting border policies nine days earlier, Eva prevented additional infected travelers from arriving,” the paper noted, referring to the Greece deployment. “That is a long period of time in which a lot of high-risk people would probably have come in and infected other citizens,” said Bastani.

It is common for border control policies to use publicly reported data, but such data is often unreliable and inconsistent across countries, said Bastani. The inconsistencies arise from censorship of testing data by some countries, and even varying definitions of a COVID-19 death, she added. She pointed to the recent  of undercounting of COVID-19 deaths in nursing homes in New York City as an example of flawed data. “That issue is exacerbated when you compare death counts in different countries because in some places they’re accounting very accurately and in other places they’re not.”

Greece is the first country to design border controls based on the dynamic random surveillance testing approach that Eva uses. The model specifies the infrastructure required to collect COVID-19 test results, using those to form estimates and to inform future testing decisions in a dynamic feedback loop.

In using the Eva model, Greece required every individual or family planning to enter the country to fill out 24 hours before arrival a digitized “passenger locator form,” where they provided some basic information about themselves such as other countries they have visited in the past year. All those who submitted those forms received a QR code that allowed tracking. Eva’s algorithm processes the information in the forms to identify those who need to get tested for COVID-19. Greece’s border control authorities processed an average of 38,500 forms each day; some 18% of those who submitted the forms did not eventually show up.

Keeping COVID-19 at Bay

Eva’s targeted testing that allowed for adaptive border control policies helped Greece keep its case count “very low pretty much all of the summer,” said Bastani. The country was able to maintain some economic activity, unlike many others that had to completely shut down, she noted. Greece  a second lockdown and travel restrictions in November after a  in COVID-19 cases.

The Greek government acknowledged Eva’s accomplishments in a press conference last July. “The AI system developed by Bastani, Drakopoulos, Gupta, and Vlachogiannis has been an asset both for preparing the opening of the country to visitors from all over the world, as well as for allowing flexibility in decision-making regarding our COVID-19 strategy,” said Nikos Hardalias, Greece’s civil protection and deputy minister for crisis management, who heads the COVID-19 Response Taskforce for the country.

Free-to-use Technology

Eva is an open-source technology, which means Bastani and her team will provide it free of cost to any country that might want it. They have made presentations to COVID task forces in several countries in the European Union. Adapting it to other countries would involve designing passenger locator forms that are appropriate for different immigration processes and dovetailing back-end resources such as testing labs.

Bastani made a strong pitch for governments to capture private data such as that generated by the passenger locator forms used in the Greece deployment, and customize them to suit their specific situations. “No country should just be relying on public data; they should be actively monitoring who is coming to their borders, testing at least a subset of them, and using that to make informed decisions about border control,” she said. “That said, if a country doesn’t have the resources to do that, it’s probably better to use a policy that mimics another country that is doing that rather than relying only on public data.”

Bastani and her colleagues are working on refining Eva to incorporate more passenger-specific information than they used in the Greece deployment. Europe’s General Data Protection Regulation limited the scope of data they could use with Eva; they used only anonymized and aggregated data with limited demographic information. Other countries with less stringent data protection regulations could gather a wider range of data, such as on occupation, Bastani said. “We know that certain occupations carry a much higher COVID-19 risk than others.”

Eva could also be trained to incorporate pooling to mitigate constraints faced by testing labs, she added. Overloaded labs could share their samples with other labs that may have spare capacity at any given point in time, she explained. In much the same way, Eva could also use dynamic data to help determine optimal staffing levels at labs and other locations in the testing infrastructure, she added.

*[This article was originally published by .]

The views expressed in this article are the author’s own and do not necessarily reflect 51�Թ�’s editorial policy.

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