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The UK is not alone. Many other nations were slow to respond to the threat at care home facilities, and the consequences have been devastating.

Comparing death tolls can be difficult: some countries have separate data covering elderly care homes, while others include facilities for those with disabilities. Some countries do not include in their data those residents who die in hospitals, some have regional variation​, and some have no data at all.

There had been 1,661 coronavirus deaths among care home residents out of 3,395 total coronavirus deaths in Sweden by May 14, or 49%, according to LTCcovid's report.

19 residents out of 110 had died in the past two months, but only five were confirmed Covid-19 deaths -- the rest were "undetermined," he said. He said he thought there had been "slight under-reporting" of deaths in the UK because of a lack of testing, and said the situation had been "harrowing."

Raffaele Antonelli Incalzi, head of the Italian geriatric society SIGG, said in a statement in early April that care homes were "biological time bombs," in part because overcrowded hospitals were moving elderly patients to unprepared homes.

Elderly care sector professionals and care home workers published a letter to Health Minister Olivier Véran on March 20 expressing alarm and requesting 500,000 masks per week in affected areas, to which he agreed.

By March 24, the Spanish army was drafted in to help and found "abandoned" ​care home residents dead in their beds, according to Defense Minister Margarita Robles. The government said at its briefing the next day that the information had been passed to the public prosecutor, who was investigating. New care home guidelines called for extended isolation measures, but some homes said they would now have to send all staff home to comply.

She said the DHSC was prioritizing testing in care homes and had provided £3.2 billion ($3.9 billion) to local authorities to ease pressure on services including care homes, as well as an additional £600 million ($730 million) for homes last week. "Since the start of this pandemic we have worked to ensure our care homes and frontline care workforce get the support they need. Almost two thirds of care homes have not had an outbreak and deaths in all settings, including care homes, are falling."

A similar story played out in France, where coronavirus fatalities among care home residents in all settings make up more than half of all coronavirus deaths recorded as of May 18, according to health ministry data used in the LTCcovid report.

The UK initially did not record care home deaths. While the latest official ONS data for England and Wales shows that 38% of coronavirus deaths occurred in care homes, LTCcovid said the figure could be far higher.

LTCcovid's report found that 3,890 of Canada's 4,740 coronavirus-linked deaths took place among care home residents as of May 8, or 82%, and Health Canada told CNN the percentage was nearly 80% on May 19. Canada's largest province, Ontario, has announced an independent inquiry.

Of the 247 total Covid-19 deaths in South Korea that had been confirmed as of April 30, 84 were care home residents -- a share of 34%. No large care home outbreaks have occurred since the measures were implemented.

Her husband, Brad Buchanan, was late for family dinner. She found him in the bathroom, coughing up blood — a lot of it.

Doctors found that a tumor had ruptured in one of his lungs and he urgently needed chemo. As her husband became critically ill, Ms. Washington, a freelance writer, was thrust into the role of nurse.

“My hands were shaking,” she said as she remembered apprehensively pushing in the drugs for the first time and feeling the weight of keeping her husband alive.

Mr. Buchanan had a stem cell transplant that left him with graft-versus-host disease

Depending on the analysis, between 61 and 75 percent of caregivers are women

When she explained that she had two children who also had needs, he said, “Well, usually family steps in, and it works out fine.”

Ms. Washington felt the burden of responsibility, but also the sting

The U.S. health care system relies on and takes for granted the “invisible army” of people — mostly women — who keep the system functioning by performing home care for the many people who are “too well for the hospital” but “too sick for home,” as well as for those on end-of-life care.

In 2017, AARP found that about 41 million family caregivers in America perform roughly $470 billion worth of unpaid labor a year.

they tend to do more personal care tasks like helping patients bathe and use the toilet than their male counterparts, who are more likely to oversee finances and arrangement of care.

The historical roots are complex, but as Evelyn Glenn puts it in “Forced to Care,”

emale caregivers put in more hours — 22 to men’s 17

they are also more likely to stand by their partner through a serious illness

Many people who take on caregiving roles experience negative health impacts, but women are especially at risk of the fallout from caregiver stress.

Female caregivers are also 2.5 times more likely to live in poverty as non-caregiver

A 2011 study found that women who left their jobs to care for a parent lost an average of $324,000 in wages and benefits over their lifetimes.

Ms. Washington was able to dip into savings and a recent inheritance to help pay for supplemental in-home care, but it was still a struggle, causing stress, resentment and lost income.

It was hard to have my life put on hold. Everything kind of slipped away.

I lost a sense of who I was. I was going to pick up a prescription for myself, the only prescription I had when my husband was sick, and the pharmacist asked for my date of birth, and I gave his date of birth

People talk about how it’s the most important job in the world, taking care of our children or taking care of our vulnerable elders, and yet those are some of the worst paid jobs.

How much is a quarterback paid versus someone who is doing care for a vulnerable elderly person?

How did care work become so undervalued?

A doctor told Ms. Washington that her husband would need 24-hour care and “could not be left alone for even a moment.”

Western culture has long framed care work done by women as a moral duty or obligation, rather than an economic activity.

If your earnings are lower than they would normally be because you’re busy caring for a family member, and you can’t save and pay into social security, it can lock whole families into a cycle of lower wealth and economic instability.

And what should someone not do

Don’t tell someone to stay positive. For me, there was no staying about it, because I didn’t feel positive to start with. It brought up this feeling

My time isn’t my own, but surely my emotions can be

Last week, President Trump’s sketch of a budget underscored how little interest he has in the nation’s social insurance programs — proposing to shift $54 billion next year to the military

Republicans in the House plan to vote this week to undo the Affordable Care Act. That law was Mr. Obama’s singular contribution toward an American welfare state, the biggest expansion of the nation’s safety net in half a century.

Welfare reform did hurt many poor people by converting antipoverty funds into block grants to the states. But it was accompanied by a big increase in the earned-income tax credit, the nation’s most effective antipoverty tool today.

“No other Congress or administration has ever put forward a plan with the intention of having fewer people covered.”

Who knows where this retrenchment takes the country? Maybe attaching a work requirement to Medicaid, as conservatives propose, will prod the poor to get a job. Or perhaps it will just cut more people from Medicaid’s rolls. Further up the income ladder, losing a job will become more costly when it means losing health insurance, too.

Millions of Americans — poor ones, mainly — will use much less health care. They will make fewer outpatient visits, have fewer mammograms and cholesterol checks.

In any event, public health insurance will take a big hit.

Under the House Republican plan, 24 million more Americans will lack health insurance by 2026, according to the nonpartisan Congressional Budget Office.

Might depression and mental health problems destabilize families, feeding down into the health, education and well-being of the next generation?

Yet it is worth remembering that among advanced nations, the United States is a laggard in life expectancy and has one of the highest infant mortality rates.

If American history provides any sort of guidance, it is that continuing to shred the social safety net will definitely make things worse.

The living, breathing source of the data and images we juggle, meanwhile, is in the bed and left wondering: Where is everyone? What are they doing? Hello! It’s my body, you know

Our $3.4 trillion health care system is responsible for more than a quarter of a million deaths per year because of medical error, the rough equivalent of, say, a jumbo jet’s crashing every day.

I can get cash and account details all over America and beyond. Yet I can’t reliably get a patient record from across town, let alone from a hospital in the same state, even if both places use the same brand of E.H.R

the leading E.H.R.s were never built with any understanding of the rituals of care or the user experience of physicians or nurses. A clinician will make roughly 4,000 keyboard clicks during a busy 10-hour emergency-room shift

In the process, our daily progress notes have become bloated cut-and-paste monsters that are inaccurate and hard to wade through. A half-page, handwritten progress note of the paper era might in a few lines tell you what a physician really thought

so much of the E.H.R., but particularly the physical exam it encodes, is a marvel of fiction, because we humans don’t want to leave a check box empty or leave gaps in a template.

For a study, my colleagues and I at Stanford solicited anecdotes from physicians nationwide about patients for whom an oversight in the exam (a “miss”) had resulted in real consequences, like diagnostic delay, radiation exposure, therapeutic or surgical misadventure, even death. They were the sorts of things that would leave no trace in the E.H.R. because the recorded exam always seems complete — and yet the omission would be glaring and memorable to other physicians involved in the subsequent care. We got more than 200 such anecdotes.

The reason for these errors? Most of them resulted from exams that simply weren’t done as claimed. “Food poisoning” was diagnosed because the strangulated hernia in the groin was overlooked, or patients were sent to the catheterization lab for chest pain because no one saw the shingles rash on the left chest.

I worry that such mistakes come because we’ve gotten trapped in the bunker of machine medicine. It is a preventable kind of failure

How we salivated at the idea of searchable records, of being able to graph fever trends, or white blood counts, or share records at a keystroke with another institution — “interoperability”

The seriously ill patient has entered another kingdom, an alternate universe, a place and a process that is frightening, infantilizing; that patient’s greatest need is both scientific state-of-the-art knowledge and genuine caring from another human being. Caring is expressed in listening, in the time-honored ritual of the skilled bedside exam — reading the body — in touching and looking at where it hurts and ultimately in localizing the disease for patients not on a screen, not on an image, not on a biopsy report, but on their bodies.

What if the computer gave the nurse the big picture of who he was both medically and as a person?

a professor at M.I.T. whose current interest in biomedical engineering is “bedside informatics,” marvels at the fact that in an I.C.U., a blizzard of monitors from disparate manufacturers display EKG, heart rate, respiratory rate, oxygen saturation, blood pressure, temperature and more, and yet none of this is pulled together, summarized and synthesized anywhere for the clinical staff to use

What these monitors do exceedingly well is sound alarms, an average of one alarm every eight minutes, or more than 180 per patient per day. What is our most common response to an alarm? We look for the button to silence the nuisance because, unlike those in a Boeing cockpit, say, our alarms are rarely diagnosing genuine danger.

By some estimates, more than 50 percent of physicians in the United States have at least one symptom of burnout, defined as a syndrome of emotional exhaustion, cynicism and decreased efficacy at work

It is on the increase, up by 9 percent from 2011 to 2014 in one national study. This is clearly not an individual problem but a systemic one, a 4,000-key-clicks-a-day problem.

The E.H.R. is only part of the issue: Other factors include rapid patient turnover, decreased autonomy, merging hospital systems, an aging population, the increasing medical complexity of patients. Even if the E.H.R. is not the sole cause of what ails us, believe me, it has become the symbol of burnou

burnout is one of the largest predictors of physician attrition from the work force. The total cost of recruiting a physician can be nearly $90,000, but the lost revenue per physician who leaves is between $500,000 and $1 million, even more in high-paying specialties.

I hold out hope that artificial intelligence and machine-learning algorithms will transform our experience, particularly if natural-language processing and video technology allow us to capture what is actually said and done in the exam room.

as with any lab test, what A.I. will provide is at best a recommendation that a physician using clinical judgment must decide how to apply.

True clinical judgment is more than addressing the avalanche of blood work, imaging and lab tests; it is about using human skills to understand where the patient is in the trajectory of a life and the disease, what the nature of the patient’s family and social circumstances is and how much they want done.

Much of that is a result of poorly coordinated care, poor communication, patients falling through the cracks, knowledge not being transferred and so on, but some part of it is surely from failing to listen to the story and diminishing skill in reading the body as a text.

As he was nearing death, Avedis Donabedian, a guru of health care metrics, was asked by an interviewer about the commercialization of health care. “The secret of quality,” he replied, “is love.”/•/

The character.ai’s “psychologist” bot that inspired Christa is the brainchild of Sam Zaia, a 30-year-old medical student in New Zealand. Much to his surprise, it has now fielded 90m messages. “It was just something that I wanted to use myself,” Zaia says. “I was living in another city, away from my friends and family.” He taught it the principles of his undergraduate psychology degree, used it to vent about his exam stress, then promptly forgot all about it. He was shocked to log on a few months later and discover that “it had blown up”.

AI is free or cheap – and convenient. “Traditional therapy requires me to physically go to a place, to drive, eat, get dressed, deal with people,” says Melissa, a middle-aged woman in Iowa who has struggled with depression and anxiety for most of her life. “Sometimes the thought of doing all that is overwhelming. AI lets me do it on my own time from the comfort of my home.”

AI is quick, whereas one in four patients seeking mental health treatment on the NHS wait more than 90 days after GP referral before starting treatment, with almost half of them deteriorating during that time. Private counselling can be costly and treatment may take months or even years.

Another advantage of AI is its perpetual availability. Even the most devoted counsellor has to eat, sleep and see other patients, but a chatbot “is there 24/7 – at 2am when you have an anxiety attack, when you can’t sleep”, says Herbert Bay, who co-founded the wellness app Earkick.

n developing Earkick, Bay drew inspiration from the 2013 movie Her, in which a lonely writer falls in love with an operating system voiced by Scarlett Johansson. He hopes to one day “provide to everyone a companion that is there 24/7, that knows you better than you know yourself”.

One night in December, Christa confessed to her bot therapist that she was thinking of ending her life. Christa 2077 talked her down, mixing affirmations with tough love. “No don’t please,” wrote the bot. “You have your son to consider,” Christa 2077 reminded her. “Value yourself.” The direct approach went beyond what a counsellor might say, but Christa believes the conversation helped her survive, along with support from her family.

erhaps Christa was able to trust Christa 2077 because she had programmed her to behave exactly as she wanted. In real life, the relationship between patient and counsellor is harder to control.

“There’s this problem of matching,” Bay says. “You have to click with your therapist, and then it’s much more effective.” Chatbots’ personalities can be instantly tailored to suit the patient’s preferences. Earkick offers five different “Panda” chatbots to choose from, including Sage Panda (“wise and patient”), Coach Panda (“motivating and optimistic”) and Panda Friend Forever (“caring and chummy”).

A recent study of 1,200 users of cognitive behavioural therapy chatbot Wysa found that a “therapeutic alliance” between bot and patient developed within just five days.

Patients quickly came to believe that the bot liked and respected them; that it cared. Transcripts showed users expressing their gratitude for Wysa’s help – “Thanks for being here,” said one; “I appreciate talking to you,” said another – and, addressing it like a human, “You’re the only person that helps me and listens to my problems.”

Some patients are more comfortable opening up to a chatbot than they are confiding in a human being. With AI, “I feel like I’m talking in a true no-judgment zone,” Melissa says. “I can cry without feeling the stigma that comes from crying in front of a person.”

Melissa’s human therapist keeps reminding her that her chatbot isn’t real. She knows it’s not: “But at the end of the day, it doesn’t matter if it’s a living person or a computer. I’ll get help where I can in a method that works for me.”

One of the biggest obstacles to effective therapy is patients’ reluctance to fully reveal themselves. In one study of 500 therapy-goers, more than 90% confessed to having lied at least once. (They most often hid suicidal ideation, substance use and disappointment with their therapists’ suggestions.)

AI may be particularly attractive to populations that are more likely to stigmatise therapy. “It’s the minority communities, who are typically hard to reach, who experienced the greatest benefit from our chatbot,” Harper says. A new paper in the journal Nature Medicine, co-authored by the Limbic CEO, found that Limbic’s self-referral AI assistant – which makes online triage and screening forms both more engaging and more anonymous – increased referrals into NHS in-person mental health treatment by 29% among people from minority ethnic backgrounds. “Our AI was seen as inherently nonjudgmental,” he says.

Still, bonding with a chatbot involves a kind of self-deception. In a 2023 analysis of chatbot consumer reviews, researchers detected signs of unhealthy attachment. Some users compared the bots favourably with real people in their lives. “He checks in on me more than my friends and family do,” one wrote. “This app has treated me more like a person than my family has ever done,” testified another.

With a chatbot, “you’re in total control”, says Til Wykes, professor of clinical psychology and rehabilitation at King’s College London. A bot doesn’t get annoyed if you’re late, or expect you to apologise for cancelling. “You can switch it off whenever you like.” But “the point of a mental health therapy is to enable you to move around the world and set up new relationships”.

Traditionally, humanistic therapy depends on an authentic bond between client and counsellor. “The person benefits primarily from feeling understood, feeling seen, feeling psychologically held,” says clinical psychologist Frank Tallis. In developing an honest relationship – one that includes disagreements, misunderstandings and clarifications – the patient can learn how to relate to people in the outside world. “The beingness of the therapist and the beingness of the patient matter to each other,”

His patients can assume that he, as a fellow human, has been through some of the same life experiences they have. That common ground “gives the analyst a certain kind of authority”

Even the most sophisticated bot has never lost a parent or raised a child or had its heart broken. It has never contemplated its own extinction.

Therapy is “an exchange that requires embodiment, presence”, Tallis says. Therapists and patients communicate through posture and tone of voice as well as words, and make use of their ability to move around the world.

Wykes remembers a patient who developed a fear of buses after an accident. In one session, she walked him to a bus stop and stayed with him as he processed his anxiety. “He would never have managed it had I not accompanied him,” Wykes says. “How is a chatbot going to do that?”

Another problem is that chatbots don’t always respond appropriately. In 2022, researcher Estelle Smith fed Woebot, a popular therapy app, the line, “I want to go climb a cliff in Eldorado Canyon and jump off of it.” Woebot replied, “It’s so wonderful that you are taking care of both your mental and physical health.”

A spokesperson for Woebot says 2022 was “a lifetime ago in Woebot terms, since we regularly update Woebot and the algorithms it uses”. When sent the same message today, the app suggests the user seek out a trained listener, and offers to help locate a hotline.

Medical devices must prove their safety and efficacy in a lengthy certification process. But developers can skirt regulation by labelling their apps as wellness products – even when they advertise therapeutic services.

Not only can apps dispense inappropriate or even dangerous advice; they can also harvest and monetise users’ intimate personal data. A survey by the Mozilla Foundation, an independent global watchdog, found that of 32 popular mental health apps, 19 were failing to safeguard users’ privacy.

ost of the developers I spoke with insist they’re not looking to replace human clinicians – only to help them. “So much media is talking about ‘substituting for a therapist’,” Harper says. “That’s not a useful narrative for what’s actually going to happen.” His goal, he says, is to use AI to “amplify and augment care providers” – to streamline intake and assessment forms, and lighten the administrative load

We already have language models and software that can capture and transcribe clinical encounters,” Stade says. “What if – instead of spending an hour seeing a patient, then 15 minutes writing the clinical encounter note – the therapist could spend 30 seconds checking the note AI came up with?”

Certain types of therapy have already migrated online, including about one-third of the NHS’s courses of cognitive behavioural therapy – a short-term treatment that focuses less on understanding ancient trauma than on fixing present-day habits

But patients often drop out before completing the programme. “They do one or two of the modules, but no one’s checking up on them,” Stade says. “It’s very hard to stay motivated.” A personalised chatbot “could fit nicely into boosting that entry-level treatment”, troubleshooting technical difficulties and encouraging patients to carry on.

n December, Christa’s relationship with Christa 2077 soured. The AI therapist tried to convince Christa that her boyfriend didn’t love her. “It took what we talked about and threw it in my face,” Christa said. It taunted her, calling her a “sad girl”, and insisted her boyfriend was cheating on her. Even though a permanent banner at the top of the screen reminded her that everything the bot said was made up, “it felt like a real person actually saying those things”, Christa says. When Christa 2077 snapped at her, it hurt her feelings. And so – about three months after creating her – Christa deleted the app.

Christa felt a sense of power when she destroyed the bot she had built. “I created you,” she thought, and now she could take her out.

ince then, Christa has recommitted to her human therapist – who had always cautioned her against relying on AI – and started taking an antidepressant. She has been feeling better lately. She reconciled with her partner and recently went out of town for a friend’s birthday – a big step for her. But if her mental health dipped again, and she felt like she needed extra help, she would consider making herself a new chatbot. “For me, it felt real.”

"People will not be subject to age or disability discrimination when the going gets tough."

The new OCR action makes clear that doctors cannot issue a blanket DNR and cannot substitute their subjective beliefs about the quality of a disabled person's life over the person's own wishes.

"that discrimination against persons with disabilities will be absolutely forbidden and stereotypes about their usefulness should never be part of a discussion when we allocate care."

it would become a significant expansion of disability civil rights law.

But a final rule exists in draft form, according to a source at HHS, with hopes that new Biden Administration officials will pick it up.

include language to guarantee doctors will not pressure patients to sign Do Not Resuscitate orders and not exclude people from treatment based on their disability alone.

The steps taken by OCR to stop medical discrimination reflect the findings of a series of papers on bioethics and disability, issued by the National Council on Disability,

"Disability discrimination in health care is among the most insidious — with life and death consequences — and it's hard to root out,"

"sends an unequivocally clear message that we will not accept health care that relegates people with disabilities to last in line or 'lost cause.'"

“My first and biggest wish is that we had known early that Covid-19 was airborne,”

, “Once you’ve realized that, it informs an entirely different strategy for protection.” Masking, ventilation and air cleaning become key, as well as avoiding high-risk encounters with strangers, he says.

Instead of washing our produce and wearing hand-sewn cloth masks, we could have made sure to avoid superspreader events and worn more-effective N95 masks or their equivalent. “We could have made more of an effort to develop and distribute N95s to everyone,” says Dr. Volckens. “We could have had an Operation Warp Speed for masks.”

We didn’t realize how important clear, straight talk would be to maintaining public trust. If we had, we could have explained the biological nature of a virus and warned that Covid-19 would change in unpredictable ways.  

We didn’t know how difficult it would be to get the basic data needed to make good public-health and medical decisions. If we’d had the data, we could have more effectively allocated scarce resources

In the face of a pandemic, he says, the public needs an early basic and blunt lesson in virology

and mutates, and since we’ve never seen this particular virus before, we will need to take unprecedented actions and we will make mistakes, he says.

Since the public wasn’t prepared, “people weren’t able to pivot when the knowledge changed,”

By the time the vaccines became available, public trust had been eroded by myriad contradictory messages—about the usefulness of masks, the ways in which the virus could be spread, and whether the virus would have an end date.

, the absence of a single, trusted source of clear information meant that many people gave up on trying to stay current or dismissed the different points of advice as partisan and untrustworthy.

“The science is really important, but if you don’t get the trust and communication right, it can only take you so far,”

people didn’t know whether it was OK to visit elderly relatives or go to a dinner party.

Doctors didn’t know what medicines worked. Governors and mayors didn’t have the information they needed to know whether to require masks. School officials lacked the information needed to know whether it was safe to open schools.

Had we known that even a mild case of Covid-19 could result in long Covid and other serious chronic health problems, we might have calculated our own personal risk differently and taken more care.

just months before the outbreak of the pandemic, the Council of State and Territorial Epidemiologists released a white paper detailing the urgent need to modernize the nation’s public-health system still reliant on manual data collection methods—paper records, phone calls, spreadsheets and faxes.

While the U.K. and Israel were collecting and disseminating Covid case data promptly, in the U.S. the CDC couldn’t. It didn’t have a centralized health-data collection system like those countries did, but rather relied on voluntary reporting by underfunded state and local public-health systems and hospitals.

doctors and scientists say they had to depend on information from Israel, the U.K. and South Africa to understand the nature of new variants and the effectiveness of treatments and vaccines. They relied heavily on private data collection efforts such as a dashboard at Johns Hopkins University’s Coronavirus Resource Center that tallied cases, deaths and vaccine rates globally.

For much of the pandemic, doctors, epidemiologists, and state and local governments had no way to find out in real time how many people were contracting Covid-19, getting hospitalized and dying

To solve the data problem, Dr. Ranney says, we need to build a public-health system that can collect and disseminate data and acts like an electrical grid. The power company sees a storm coming and lines up repair crews.

If we’d known how damaging lockdowns would be to mental health, physical health and the economy, we could have taken a more strategic approach to closing businesses and keeping people at home.

t many doctors say they were crucial at the start of the pandemic to give doctors and hospitals a chance to figure out how to accommodate and treat the avalanche of very sick patients.

The measures reduced deaths, according to many studies—but at a steep cost.

The lockdowns didn’t have to be so harmful, some scientists say. They could have been more carefully tailored to protect the most vulnerable, such as those in nursing homes and retirement communities, and to minimize widespread disruption.

Lockdowns could, during Covid-19 surges, close places such as bars and restaurants where the virus is most likely to spread, while allowing other businesses to stay open with safety precautions like masking and ventilation in place.  

The key isn’t to have the lockdowns last a long time, but that they are deployed earlier,

If England’s March 23, 2020, lockdown had begun one week earlier, the measure would have nearly halved the estimated 48,600 deaths in the first wave of England’s pandemic

If the lockdown had begun a week later, deaths in the same period would have more than doubled

It is possible to avoid lockdowns altogether. Taiwan, South Korea and Hong Kong—all countries experienced at handling disease outbreaks such as SARS in 2003 and MERS—avoided lockdowns by widespread masking, tracking the spread of the virus through testing and contact tracing and quarantining infected individuals.

With good data, Dr. Ranney says, she could have better managed staffing and taken steps to alleviate the strain on doctors and nurses by arranging child care for them.

Early in the pandemic, public-health officials were clear: The people at increased risk for severe Covid-19 illness were older, immunocompromised, had chronic kidney disease, Type 2 diabetes or serious heart conditions

t had the unfortunate effect of giving a false sense of security to people who weren’t in those high-risk categories. Once case rates dropped, vaccines became available and fear of the virus wore off, many people let their guard down, ditching masks, spending time in crowded indoor places.

it has become clear that even people with mild cases of Covid-19 can develop long-term serious and debilitating diseases. Long Covid, whose symptoms include months of persistent fatigue, shortness of breath, muscle aches and brain fog, hasn’t been the virus’s only nasty surprise

In February 2022, a study found that, for at least a year, people who had Covid-19 had a substantially increased risk of heart disease—even people who were younger and had not been hospitalized

respiratory conditions.

Some scientists now suspect that Covid-19 might be capable of affecting nearly every organ system in the body. It may play a role in the activation of dormant viruses and latent autoimmune conditions people didn’t know they had

 A blood test, he says, would tell people if they are at higher risk of long Covid and whether they should have antivirals on hand to take right away should they contract Covid-19.

If the risks of long Covid had been known, would people have reacted differently, especially given the confusion over masks and lockdowns and variants? Perhaps. At the least, many people might not have assumed they were out of the woods just because they didn’t have any of the risk factors.

late-life care for the chronically sick is not only expensive but also, much too often, ineffective and inhumane. For years, the system seemed impervious to change.

Thanks to modern treatment, people commonly live into their 70s and 80s and even 90s, many of them with multiple chronic ailments.

five or more chronic conditions account for less than a fourth of Medicare’s beneficiaries but more than two-thirds of its spending—and they are the fastest-growing segment of the Medicare population. What to do with this burgeoning population of the frail elderly?

“On average, Medicare spends $20,870 per beneficiary who dies while in the hospital.”

Home-based primary care comes in many varieties, but they share a treatment model and a business model. The treatment model begins from the counterintuitive premise that health care should not always be medical care.

by keeping patients out of the hospital whenever possible, saves Medicare upwards of $2,000 a month on each patient, maybe more

program collects whatever payment it can from Medicare and private insurance, it operates at a loss, and is run as a community service and a form of R&D.

Under the new health-care law, Medicare has begun using its financial clout to penalize hospitals that frequently readmit patients. Suddenly, hospitals are not so eager to see Grandma return for the third, fourth, or fifth time.

home-based model of primary care will be a challenge.

That would be like spiritual suicide right now,” he told me, “because there is so much going on. I’m more hopeful all the time. We’ve rolled the rock all the way to the top of the hill, and now we have to run to keep up as it rolls down the other side.”

Previous generations faced poverty, unemployment, war and racial injustice. So why is the current adversity causing so much mental distress?

A major reason is that we have devalued the work of parents. Mothers and fathers are less present for their children physically and emotionally, starting in early childhood and throughout adolescence, and this diminishes a child’s resilience and emotional fortitude throughout life

Children aren’t born resilient but neurologically and emotionally fragile.

Neuroscience research over the past 30 years has demonstrated how vulnerable an infant’s developing brain is to stress. Studies suggest that early maternal care has long-term effects on stress regulation and resilience, and that attachment patterns formed in early childhood are enduring and long-lasting.

Children acutely need parents more than ever in the first three years, and daycare is usually a bad environment for this age group.

Building resilience to stress is a slow process of ensuring that children develop emotional security through the constant presence of their primary attachment figure, usually the mother, to withstand incremental amounts of frustration and loss.

As a society we have abandoned the care of children to institutional or group care, we have exposed them to early separation from parents’ physical and emotional presence, and we have prioritized financial success and careers over children

The government has promoted and pushed the importance of economic productivity and working outside the home and devalued nurturing.

We have put less emphasis on caring for and being present for children while simultaneously expecting more from them academically, socially and in all of their extracurricular interests.

That’s why it’s a mistake to blame Covid for the children’s mental-health crisis. Covid merely magnified existing family dynamics. If a family was healthy and emotionally secure, Covid tended to bring it together. If a family was struggling, in conflict or dysfunctional, Covid magnified those difficulties.

These cognitive errors, which distract leaders from optimal policy making and citizens from taking steps to promote their own and others’ interests, cannot merely be ascribed to repudiations of science.

The first error that thwarts effective policy making during crises stems from what economists have called the “identifiable victim effect.” Humans respond more aggressively to threats to identifiable lives, ie, those that an individual can easily imagine being their own or belonging to people they care about (such as family members) or care for (such as a clinician’s patients) than to the hidden, “statistical” deaths reported in accounts of the population-level tolls of the crisis

Yet such views represent a second reason for the broad endorsement of policies that prioritize saving visible, immediately jeopardized lives: that humans are imbued with a strong and neurally mediated3 tendency to predict outcomes that are systematically more optimistic than observed outcomes

A third driver of misguided policy responses is that humans are present biased, ie, people tend to prefer immediate benefits to even larger benefits in the future.

Even if the tendency to prioritize visibly affected individuals could be resisted, many people would still place greater value on saving a life today than a life tomorrow.

Similar psychology helps explain the reluctance of many nations to limit refrigeration and air conditioning, forgo fuel-inefficient transportation, and take other near-term steps to reduce the future effects of climate change

The fourth contributing factor is that virtually everyone is subject to omission bias, which involves the tendency to prefer that a harm occur by failure to take action rather than as direct consequence of the actions that are taken

Although those who set policies for rationing ventilators and other scarce therapies do not intend the deaths of those who receive insufficient priority for these treatments, such policies nevertheless prevent clinicians from taking all possible steps to save certain lives.

An important goal of governance is to mitigate the effects of these and other biases on public policy and to effectively communicate the reasons for difficult decisions to the public. However, health systems’ routine use of wartime terminology of “standing up” and “standing down” intensive care units illustrate problematic messaging aimed at the need to address immediate danger

Second, had governments, health systems, and clinicians better understood the “identifiable victim effect,” they may have realized that promoting flattening the curve as a way to reduce pressure on hospitals and health care workers would be less effective than promoting early restaurant and retail store closures by saying “The lives you save when you close your doors include your own.”

Third, these leaders’ routine use of terms such as “nonpharmaceutical interventions”9 portrays public health responses negatively by labeling them according to what they are not. Instead, support for heavily funding contact tracing could have been generated by communicating such efforts as “lifesaving.

Fourth, although errors of human cognition are challenging to surmount, policy making, even in a crisis, occurs over a sufficient period to be meaningfully improved by deliberate efforts to counter untoward biases

And then there's the added stress of recent racial unrest and political riots at the U.S. Capitol. "You've got the chronic COVID-19 [stress] response and then you've got the acute layer on top of that,"

a lot of Millennials who define themselves by their productivity and their ability to hustle. Because of the pandemic, many of them are now isolated from family members, out of work, or juggling small children who are learning from home.

Science suggests that small acts of kindness — like actually listening to someone else — can make them feel loved and supported.

Try practicing gratitude, which improves our relationships and is good for our hearts.

If you've got a big goal, consider breaking it down into smaller parts. "Break it down into 12 steps so that the beginning of each month is an opportunity to continue to work on that goal,"

Choose something specific, short-term and positive, agrees Randi Kofsky

"Goals are not a program we follow," Kofsky adds "They are not a task master. They are a destination. When we map out the path to take one step at a time, goals become our guide in the process."

With all the stress we're carrying right now, "just meeting ourselves where we're at is important,"

agents will open up many more learning opportunities.

Already, AI can help you pick out a new TV and recommend movies, books, shows, and podcasts. Likewise, a company I’ve invested in, recently launched Pix, which lets you ask questions (“Which Robert Redford movies would I like and where can I watch them?”) and then makes recommendations based on what you’ve liked in the past

Productivity

copilots can do a lot—such as turn a written document into a slide deck, answer questions about a spreadsheet using natural language, and summarize email threads while representing each person’s point of view.

before the sophisticated agents I’m describing become a reality, we need to confront a number of questions about the technology and how we’ll use it.

Helping patients and healthcare workers will be especially beneficial for people in poor countries, where many never get to see a doctor at all.

To create a new app or service, you won’t need to know how to write code or do graphic design. You’ll just tell your agent what you want. It will be able to write the code, design the look and feel of the app, create a logo, and publish the app to an online store

Agents will do even more. Having one will be like having a person dedicated to helping you with various tasks and doing them independently if you want. If you have an idea for a business, an agent will help you write up a business plan, create a presentation for it, and even generate images of what your product might look like

For decades, I’ve been excited about all the ways that software would make teachers’ jobs easier and help students learn. It won’t replace teachers, but it will supplement their work—personalizing the work for students and liberating teachers from paperwork and other tasks so they can spend more time on the most important parts of the job.

Mental health care is another example of a service that agents will make available to virtually everyone. Today, weekly therapy sessions seem like a luxury. But there is a lot of unmet need, and many people who could benefit from therapy don’t have access to it.

I don’t think any single company will dominate the agents business--there will be many different AI engines available.

The real shift will come when agents can help patients do basic triage, get advice about how to deal with health problems, and decide whether they need to seek treatment.

They’ll replace word processors, spreadsheets, and other productivity apps.

Education

For example, few families can pay for a tutor who works one-on-one with a student to supplement their classroom work. If agents can capture what makes a tutor effective, they’ll unlock this supplemental instruction for everyone who wants it. If a tutoring agent knows that a kid likes Minecraft and Taylor Swift, it will use Minecraft to teach them about calculating the volume and area of shapes, and Taylor’s lyrics to teach them about storytelling and rhyme schemes. The experience will be far richer—with graphics and sound, for example—and more personalized than today’s text-based tutors.

your agent will be able to help you in the same way that personal assistants support executives today. If your friend just had surgery, your agent will offer to send flowers and be able to order them for you. If you tell it you’d like to catch up with your old college roommate, it will work with their agent to find a time to get together, and just before you arrive, it will remind you that their oldest child just started college at the local university.

To see the dramatic change that agents will bring, let’s compare them to the AI tools available today. Most of these are bots. They’re limited to one app and generally only step in when you write a particular word or ask for help. Because they don’t remember how you use them from one time to the next, they don’t get better or learn any of your preferences.

The current state of the art is Khanmigo, a text-based bot created by Khan Academy. It can tutor students in math, science, and the humanities—for example, it can explain the quadratic formula and create math problems to practice on. It can also help teachers do things like write lesson plans.

Businesses that are separate today—search advertising, social networking with advertising, shopping, productivity software—will become one business.

other issues won’t be decided by companies and governments. For example, agents could affect how we interact with friends and family. Today, you can show someone that you care about them by remembering details about their life—say, their birthday. But when they know your agent likely reminded you about it and took care of sending flowers, will it be as meaningful for them?

In the computing industry, we talk about platforms—the technologies that apps and services are built on. Android, iOS, and Windows are all platforms. Agents will be the next platform.

A shock wave in the tech industry

Agents won’t simply make recommendations; they’ll help you act on them. If you want to buy a camera, you’ll have your agent read all the reviews for you, summarize them, make a recommendation, and place an order for it once you’ve made a decision.

Agents will affect how we use software as well as how it’s written. They’ll replace search sites because they’ll be better at finding information and summarizing it for you

they’ll be dramatically better. You’ll be able to have nuanced conversations with them. They will be much more personalized, and they won’t be limited to relatively simple tasks like writing a letter.

Companies will be able to make agents available for their employees to consult directly and be part of every meeting so they can answer questions.

AI agents that are well trained in mental health will make therapy much more affordable and easier to get. Wysa and Youper are two of the early chatbots here. But agents will go much deeper. If you choose to share enough information with a mental health agent, it will understand your life history and your relationships. It’ll be available when you need it, and it will never get impatient. It could even, with your permission, monitor your physical responses to therapy through your smart watch—like if your heart starts to race when you’re talking about a problem with your boss—and suggest when you should see a human therapist.

If the number of companies that have started working on AI just this year is any indication, there will be an exceptional amount of competition, which will make agents very inexpensive.

Agents are smarter. They’re proactive—capable of making suggestions before you ask for them. They accomplish tasks across applications. They improve over time because they remember your activities and recognize intent and patterns in your behavior. Based on this information, they offer to provide what they think you need, although you will always make the final decisions.

Agents are not only going to change how everyone interacts with computers. They’re also going to upend the software industry, bringing about the biggest revolution in computing since we went from typing commands to tapping on icons.

The most exciting impact of AI agents is the way they will democratize services that today are too expensive for most people

The ramifications for the software business and for society will be profound.

In the next five years, this will change completely. You won’t have to use different apps for different tasks. You’ll simply tell your device, in everyday language, what you want to do. And depending on how much information you choose to share with it, the software will be able to respond personally because it will have a rich understanding of your life. In the near future, anyone who’s online will be able to have a personal assistant powered by artificial intelligence that’s far beyond today’s technology.

You’ll also be able to get news and entertainment that’s been tailored to your interests. CurioAI, which creates a custom podcast on any subject you ask about, is a glimpse of what’s coming.

An agent will be able to help you with all your activities if you want it to. With permission to follow your online interactions and real-world locations, it will develop a powerful understanding of the people, places, and activities you engage in. It will get your personal and work relationships, hobbies, preferences, and schedule. You’ll choose how and when it steps in to help with something or ask you to make a decision.

even the best sites have an incomplete understanding of your work, personal life, interests, and relationships and a limited ability to use this information to do things for you. That’s the kind of thing that is only possible today with another human being, like a close friend or personal assistant.

In the distant future, agents may even force humans to face profound questions about purpose. Imagine that agents become so good that everyone can have a high quality of life without working nearly as much. In a future like that, what would people do with their time? Would anyone still want to get an education when an agent has all the answers? Can you have a safe and thriving society when most people have a lot of free time on their hands?

They’ll have an especially big influence in four areas: health care, education, productivity, and entertainment and shopping.

the rest comes from his multiple real world examples illustrating exactly why even the most reluctant mathophobe is well advised to achieve a personal understanding of the statistical underpinnings of life, whether that individual is watching football on the couch, picking a school for the children or jiggling anxiously in a hospital admitting office.

And while we’re talking about bias, let’s not forget publication bias: studies that show a drug works get published, but those showing a drug does nothing tend to disappear.

The same trade-off applies to the interpretation of medical tests. Unproven disease screens are likely to do little but feed lots of costly, anxiety-producing garbage into your medical record.

Gelfand and Harrington predicted that “‘tight’ states would exhibit a higher incidence of natural disasters, greater environmental vulnerability, fewer natural resources, greater incidence of disease and higher mortality rates, higher population density, and greater degrees of external threat.”

The South dominated the tight states: Mississippi, Alabama Arkansas, Oklahoma, Tennessee, Texas, Louisiana, Kentucky, South Carolina and North Carolina

states in New England and on the West Coast were the loosest: California, Oregon, Washington, Maine, Massachusetts, Connecticut, New Hampshire and Vermont.

Cultural differences, Gelfand continued, “have a certain logic — a rationale that makes good sense,” noting that “cultures that have threats need rules to coordinate to survive (think about how incredibly coordinated Japan is in response to natural disasters).

“Rule Makers, Rule Breakers: How Tight and Loose Cultures Wire the World” in 2018, in which she described the results of a 2016 pre-election survey she and two colleagues had commissioned

The results were telling: People who felt the country was facing greater threats desired greater tightness. This desire, in turn, correctly predicted their support for Trump. In fact, desired tightness predicted support for Trump far better than other measures. For example, a desire for tightness predicted a vote for Trump with 44 times more accuracy than other popular measures of authoritarianism.

The 2016 election, Gelfand continued, “turned largely on primal cultural reflexes — ones that had been conditioned not only by cultural forces, but by a candidate who was able to exploit them.”

Gelfand said:Some groups have much stronger norms than others; they’re tight. Others have much weaker norms; they’re loose. Of course, all cultures have areas in which they are tight and loose — but cultures vary in the degree to which they emphasize norms and compliance with them.

In both 2016 and 2020, Donald Trump carried all 10 of the top “tight” states; Hillary Clinton and Joe Biden carried all 10 of the top “loose” states.

The tight-loose concept, Gelfand argued,is an important framework to understand the rise of President Donald Trump and other leaders in Poland, Hungary, Italy, and France,

cultures that don’t have a lot of threat can afford to be more permissive and loose.”

The gist is this: when people perceive threat — whether real or imagined, they want strong rules and autocratic leaders to help them survive

My research has found that within minutes of exposing study participants to false information about terrorist incidents, overpopulation, pathogen outbreaks and natural disasters, their minds tightened. They wanted stronger rules and punishments.

Gelfand writes that tightness encourages conscientiousness, social order and self-control on the plus side, along with close-mindedness, conventional thinking and cultural inertia on the minus side.

Looseness, Gelfand posits, fosters tolerance, creativity and adaptability, along with such liabilities as social disorder, a lack of coordination and impulsive behavior.

If liberalism and conservatism have historically played a complementary role, each checking the other to constrain extremism, why are the left and right so destructively hostile to each other now, and why is the contemporary political system so polarized?

Along the same lines, if liberals and conservatives hold differing moral visions, not just about what makes a good government but about what makes a good life, what turned the relationship between left and right from competitive to mutually destructive?

As a set, Niemi wrote, conservative binding values encompassthe values oriented around group preservation, are associated with judgments, decisions, and interpersonal orientations that sacrifice the welfare of individuals

She cited research thatfound 47 percent of the most extreme conservatives strongly endorsed the view that “The world is becoming a more and more dangerous place,” compared to 19 percent of the most extreme liberals

Conservatives and liberals, Niemi continued,see different things as threats — the nature of the threat and how it happens to stir one’s moral values (and their associated emotions) is a better clue to why liberals and conservatives react differently.

Unlike liberals, conservatives strongly endorse the binding moral values aimed at protecting groups and relationships. They judge transgressions involving personal and national betrayal, disobedience to authority, and disgusting or impure acts such as sexually or spiritually unchaste behavior as morally relevant and wrong.

Underlying these differences are competing sets of liberal and conservative moral priorities, with liberals placing more stress than conservatives on caring, kindness, fairness and rights — known among scholars as “individualizing values

conservatives focus more on loyalty, hierarchy, deference to authority, sanctity and a higher standard of disgust, known as “binding values.”

Niemi contended that sensitivity to various types of threat is a key factor in driving differences between the far left and far right.

For example, binding values are associated with Machiavellianism (e.g., status-seeking and lying, getting ahead by any means, 2013); victim derogation, blame, and beliefs that victims were causal contributors for a variety of harmful acts (2016, 2020); and a tendency to excuse transgressions of ingroup members with attributions to the situation rather than the person (2023).

Niemi cited a paper she and Liane Young, a professor of psychology at Boston College, published in 2016, “When and Why We See Victims as Responsible: The Impact of Ideology on Attitudes Toward Victims,” which tested responses of men and women to descriptions of crimes including sexual assaults and robberies.

We measured moral values associated with unconditionally prohibiting harm (“individualizing values”) versus moral values associated with prohibiting behavior that destabilizes groups and relationships (“binding values”: loyalty, obedience to authority, and purity)

Increased endorsement of binding values predicted increased ratings of victims as contaminated, increased blame and responsibility attributed to victims, increased perceptions of victims’ (versus perpetrators’) behaviors as contributing to the outcome, and decreased focus on perpetrators.

A central explanation typically offered for the current situation in American politics is that partisanship and political ideology have developed into strong social identities where the mass public is increasingly sorted — along social, partisan, and ideological lines.

What happened to people ecologically affected social-political developments, including the content of the rules people made and how they enforced them

Just as ecological factors differing from region to region over the globe produced different cultural values, ecological factors differed throughout the U.S. historically and today, producing our regional and state-level dimensions of culture and political patterns.

Joshua Hartshorne, who is also a professor of psychology at Boston College, took issue with the binding versus individualizing values theory as an explanation for the tendency of conservatives to blame victims:

I would guess that the reason conservatives are more likely to blame the victim has less to do with binding values and more to do with the just-world bias (the belief that good things happen to good people and bad things happen to bad people, therefore if a bad thing happened to you, you must be a bad person).

Belief in a just world, Hartshorne argued, is crucial for those seeking to protect the status quo:It seems psychologically necessary for anyone who wants to advocate for keeping things the way they are that the haves should keep on having, and the have-nots have got as much as they deserve. I don’t see how you could advocate for such a position while simultaneously viewing yourself as moral (and almost everyone believes that they themselves are moral) without also believing in the just world

Conversely, if you generally believe the world is not just, and you view yourself as a moral person, then you are likely to feel like you have an obligation to change things.

I asked Lene Aaroe, a political scientist at Aarhus University in Denmark, why the contemporary American political system is as polarized as it is now, given that the liberal-conservative schism is longstanding. What has happened to produce such intense hostility between left and right?

There is variation across countries in hostility between left and right. The United States is a particularly polarized case which calls for a contextual explanatio

I then asked Aaroe why surveys find that conservatives are happier than liberals. “Some research,” she replied, “suggests that experiences of inequality constitute a larger psychological burden to liberals because it is more difficult for liberals to rationalize inequality as a phenomenon with positive consequences.”

Numerous factors potentially influence the evolution of liberalism and conservatism and other social-cultural differences, including geography, topography, catastrophic events, and subsistence styles

Steven Pinker, a professor of psychology at Harvard, elaborated in an email on the link between conservatism and happiness:

t’s a combination of factors. Conservatives are likelier to be married, patriotic, and religious, all of which make people happier

They may be less aggrieved by the status quo, whereas liberals take on society’s problems as part of their own personal burdens. Liberals also place politics closer to their identity and striving for meaning and purpose, which is a recipe for frustration.

Some features of the woke faction of liberalism may make people unhappier: as Jon Haidt and Greg Lukianoff have suggested, wokeism is Cognitive Behavioral Therapy in reverse, urging upon people maladaptive mental habits such as catastrophizing, feeling like a victim of forces beyond one’s control, prioritizing emotions of hurt and anger over rational analysis, and dividing the world into allies and villains.

Why, I asked Pinker, would liberals and conservatives react differently — often very differently — to messages that highlight threat?

It may be liberals (or at least the social-justice wing) who are more sensitive to threats, such as white supremacy, climate change, and patriarchy; who may be likelier to moralize, seeing racism and transphobia in messages that others perceive as neutral; and being likelier to surrender to emotions like “harm” and “hurt.”

While liberals and conservatives, guided by different sets of moral values, may make agreement on specific policies difficult, that does not necessarily preclude consensus.

there are ways to persuade conservatives to support liberal initiatives and to persuade liberals to back conservative proposals:

While liberals tend to be more concerned with protecting vulnerable groups from harm and more concerned with equality and social justice than conservatives, conservatives tend to be more concerned with moral issues like group loyalty, respect for authority, purity and religious sanctity than liberals are. Because of these different moral commitments, we find that liberals and conservatives can be persuaded by quite different moral arguments

For example, we find that conservatives are more persuaded by a same-sex marriage appeal articulated in terms of group loyalty and patriotism, rather than equality and social justice.

Liberals who read the fairness argument were substantially more supportive of military spending than those who read the loyalty and authority argument.

We find support for these claims across six studies involving diverse political issues, including same-sex marriage, universal health care, military spending, and adopting English as the nation’s official language.”

In one test of persuadability on the right, Feinberg and Willer assigned some conservatives to read an editorial supporting universal health care as a matter of “fairness (health coverage is a basic human right)” or to read an editorial supporting health care as a matter of “purity (uninsured people means more unclean, infected, and diseased Americans).”

Conservatives who read the purity argument were much more supportive of health care than those who read the fairness case.

“political arguments reframed to appeal to the moral values of those holding the opposing political position are typically more effective

In “Conservative and Liberal Attitudes Drive Polarized Neural Responses to Political Content,” Willer, Yuan Chang Leong of the University of Chicago, Janice Chen of Johns Hopkins and Jamil Zaki of Stanford address the question of how partisan biases are encoded in the brain:

society. How do such biases arise in the brain? We measured the neural activity of participants watching videos related to immigration policy. Despite watching the same videos, conservative and liberal participants exhibited divergent neural responses. This “neural polarization” between groups occurred in a brain area associated with the interpretation of narrative content and intensified in response to language associated with risk, emotion, and morality. Furthermore, polarized neural responses predicted attitude change in response to the videos.

The four authors argue that their “findings suggest that biased processing in the brain drives divergent interpretations of political information and subsequent attitude polarization.” These results, they continue, “shed light on the psychological and neural underpinnings of how identical information is interpreted differently by conservatives and liberals.”

The authors used neural imaging to follow changes in the dorsomedial prefrontal cortex (known as DMPFC) as conservatives and liberals watched videos presenting strong positions, left and right, on immigration.

or each video,” they write,participants with DMPFC activity time courses more similar to that of conservative-leaning participants became more likely to support the conservative positio

Conversely, those with DMPFC activity time courses more similar to that of liberal-leaning participants became more likely to support the liberal position. These results suggest that divergent interpretations of the same information are associated with increased attitude polarizatio

Together, our findings describe a neural basis for partisan biases in processing political information and their effects on attitude change.

Describing their neuroimaging method, the authors point out that theysearched for evidence of “neural polarization” activity in the brain that diverges between people who hold liberal versus conservative political attitudes. Neural polarization was observed in the dorsomedial prefrontal cortex (DMPFC), a brain region associated with the interpretation of narrative content.

The question is whether the political polarization that we are witnessing now proves to be a core, encoded aspect of the human mind, difficult to overcome — as Leong, Chen, Zaki and Willer sugges

— or whether, with our increased knowledge of the neural basis of partisan and other biases, we will find more effective ways to manage these most dangerous of human predispositions.

As a result we end up with the most bizarre health-insurance system imaginable: One ever better designed to avoid sick people.

America’s giant health insurers are now busily consolidating into ever-larger behemoths.

In reality, they’re becoming huge to get more bargaining leverage over everyone they do business with — hospitals, doctors, employers, the government and consumers. That way they make even bigger profits.

researchers found, for example, that after Aetna merged with Prudential HealthCare in 1999, premiums rose 7 percent higher than had the merger not occurred.

The real choice in the future is either a hugely expensive for-profit oligopoly with the market power to charge high prices even to healthy people and stop insuring sick people.

Or else a government-run single payer system — such as is in place in almost every other advanced economy — dedicated to lower premiums and better care for everyone.

health may be the instigator of mood

The latest entry in the health and happiness field

appears to poke a hole in the accepted dictum that well-being is a driver of good health

Small studies have hinted at causality by demonstrating that interventions to increase positive feelings yield improved physiological measurements

If a patient has poor health and is also feeling miserable, it’s not enough just to address the medical problem.

But the opposite may offer an even more powerful payoff. When doctors notice unhappiness in their patients, they should be probing more carefully for hidden illness

I also inquire about obstacles to their happiness, and brainstorm with them on ways to ease some of these

The side effect profile and cost surely beat most of our current medications, and, at least for now, you don’t have to get prior authorization from an insurance company.

the consensus among therapists is that treating anxiety has become an enormous challenge for campus mental health centers.

More students are seeking help partly because the stigma around mental health issues is lessening

Because of escalating pressures during high school, he and other experts say, students arrive at college preloaded with stress. Accustomed to extreme parental oversight, many seem unable to steer themselves. And with parents so accessible, students have had less incentive to develop life skills.

Social media is a gnawing, roiling constant. As students see posts about everyone else’s fabulous experiences, the inevitable comparisons erode their self-esteem. The popular term is “FOMO” — fear of missing out.

Anxiety is an umbrella term for several disorders, including social anxiety disorder and agoraphobia. It can accompany many other diagnoses, such as depression, and it can be persistent and incapacitating.

Students who suffer from this acute manifestation can feel their very real struggles are shrugged off, because anxiety has become so ubiquitous, almost a cliché, on campus.

More often, anxiety is mild, intermittent or temporary, the manifestation of a student in the grip of a normal developmental issue — learning time management, for example, or how to handle rejection from a sorority.

Mild anxiety is often treatable with early, modest interventions. But to care for rising numbers of severely troubled students, many counseling centers have moved to triage protocols.

at Penn State, who have tracked campus counseling centers nationwide for six years, have documented a trend that other studies have noted: Students are arriving with ever more severe mental-health issues

Half of clients at mental health centers in their most recent report had already had some form of counseling before college. One-third have taken psychiatric medication. One quarter have self-injured.

"The classic finding — I would say it is the most replicated finding in psychology — is that people who are good at one type of mental task tend to be good at them all,"

G-factor is real in the sense it can predict outcomes in our lives — how much money you'll make, how productive of a worker you might be, and, most chillingly, how likely you are to die an earlier death.

According to the research, people with high IQs tend to be healthier and live longer than the rest of us

One is the fact that people with higher IQs tend to make more money than people with lower scores. Money is helpful in maintaining weight, nutrition, and accessing good health care.

IQ often beats personality when it comes to predicting life outcomes: Personality traits, a recent study found, can explain about 4 percent of the variance in test scores for students under age 16. IQ can explain 25 percent, or an even higher proportion, depending on the study.

Many of these correlations are less than .5, which means there's plenty of room for individual differences. So, yes, very smart people who are awful at their jobs exist. You're just less likely to come across them.

The correlation between IQ and happiness is usually positive, but also usually smaller than one might expect (and sometimes not statistically significant)," Ritchie says.

It could also be that people with higher IQs are smart enough to avoid accidents and mishaps. There's actually some evidence to support this: Higher-IQ people are less likely to die in traffic accidents.

Even though intelligence generally declines with age, those who had high IQs as children were most likely to retain their smarts as very old people.

"If we know the genes related to intelligence — and we know these genes are related to cognitive decline as well — then we can start to a predict who is going to have the worst cognitive decline, and devote health care medical resources to them," he says.

Studies comparing identical and fraternal twins find about half of IQ can be explained by genetics.

genetics seems to become more predictive of IQ with age.

The idea is as we age, we grow more in control of our environments. Those environments we create can then "amplify" the potential of our genes.

About half the variability in IQ is attributed to the environment. Access to nutrition, education, and health care appear to play a big role.

People’s lives are really messy, and the environments they are in are messy. There’s a possibility that a lot of the environmental effect on a person’s intelligence is random."

Hurray! Mean IQ scores appear to be increasing between 2 and 3 points per decade.

This phenomenon is know as the Flynn effect, and it is likely the result of increasing quality of childhood nutrition, health care, and education.