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“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.

But these latest shifts challenge key infection control assumptions that go back a century, putting a lot of what went wrong last year in context

They may also signal one of the most important advancements in public health during this pandemic.

If the importance of aerosol transmission had been accepted early, we would have been told from the beginning that it was much safer outdoors, where these small particles disperse more easily, as long as you avoid close, prolonged contact with others.

We would have tried to make sure indoor spaces were well ventilated, with air filtered as necessary.

Instead of blanket rules on gatherings, we would have targeted conditions that can produce superspreading events: people in poorly ventilated indoor spaces, especially if engaged over time in activities that increase aerosol production, like shouting and singing

We would have started using masks more quickly, and we would have paid more attention to their fit, too. And we would have been less obsessed with cleaning surfaces.

The implications of this were illustrated when I visited New York City in late April — my first trip there in more than a year.

A giant digital billboard greeted me at Times Square, with the message “Protecting yourself and others from Covid-19. Guidance from the World Health Organization.”

That billboard neglected the clearest epidemiological pattern of this pandemic: The vast majority of transmission has been indoors, sometimes beyond a range of three or even six feet. The superspreading events that play a major role in driving the pandemic occur overwhelmingly, if not exclusively, indoors.

The billboard had not a word about ventilation, nothing about opening windows or moving activities outdoors, where transmission has been rare and usually only during prolonged and close contact. (Ireland recently reported 0.1 percent of Covid-19 cases were traced to outdoor transmission.)

Mary-Louise McLaws, an epidemiologist at the University of New South Wales in Sydney, Australia, and a member of the W.H.O. committees that craft infection prevention and control guidance, wanted all this examined but knew the stakes made it harder to overcome the resistance. She told The Times last year, “If we started revisiting airflow, we would have to be prepared to change a lot of what we do.” She said it was a very good idea, but she added, “It will cause an enormous shudder through the infection control society.”

In contrast, if the aerosols had been considered a major form of transmission, in addition to distancing and masks, advice would have centered on ventilation and airflow, as well as time spent indoors. Small particles can accumulate in enclosed spaces, since they can remain suspended in the air and travel along air currents. This means that indoors, three or even six feet, while helpful, is not completely protective, especially over time.

To see this misunderstanding in action, look at what’s still happening throughout the world. In India, where hospitals have run out of supplemental oxygen and people are dying in the streets, money is being spent on fleets of drones to spray anti-coronavirus disinfectant in outdoor spaces. Parks, beaches and outdoor areas keep getting closed around the world. This year and last, organizers canceled outdoor events for the National Cherry Blossom Festival in Washington, D.C. Cambodian customs officials advised spraying disinfectant outside vehicles imported from India. The examples are many.

Meanwhile, many countries allowed their indoor workplaces to open but with inadequate aerosol protections. There was no attention to ventilation, installing air filters as necessary or even opening windows when possible, more to having people just distancing three or six feet, sometimes not requiring masks beyond that distance, or spending money on hard plastic barriers, which may be useless at best

clear evidence doesn’t easily overturn tradition or overcome entrenched feelings and egos. John Snow, often credited as the first scientific epidemiologist, showed that a contaminated well was responsible for a 1854 London cholera epidemic by removing the suspected pump’s handle and documenting how the cases plummeted afterward. Many other scientists and officials wouldn’t believe him for 12 years, when the link to a water source showed up again and became harder to deny.

Along the way to modern public health shaped largely by the fight over germs, a theory of transmission promoted by the influential public health figure Charles Chapin took hold

Dr. Chapin asserted in the early 1900s that respiratory diseases were most likely spread at close range by people touching bodily fluids or ejecting respiratory droplets, and did not allow for the possibility that such close-range infection could occur by inhaling small floating particles others emitted

He was also concerned that belief in airborne transmission, which he associated with miasma theories, would make people feel helpless and drop their guard against contact transmission. This was a mistake that would haunt infection control for the next century and more.

It was in this context in early 2020 that the W.H.O. and the C.D.C. asserted that SARS-CoV-2 was transmitted primarily via these heavier, short-range droplets, and provided guidance accordingly

Amid the growing evidence, in July, hundreds of scientists signed an open letter urging the public health agencies, especially the W.H.O., to address airborne transmission of the coronavirus.

Last October, the C.D.C. published updated guidance acknowledging airborne transmission, but as a secondary route under some circumstances, until it acknowledged airborne transmission as crucial on Friday. And the W.H.O. kept inching forward in its public statements, most recently a week ago.

Linsey Marr, a professor of engineering at Virginia Tech who made important contributions to our understanding of airborne virus transmission before the pandemic, pointed to two key scientific errors — rooted in a lot of history — that explain the resistance, and also opened a fascinating sociological window into how science can get it wrong and why.

Dr. Marr said that if you inhale a particle from the air, it’s an aerosol.

biomechanically, she said, nasal transmission faces obstacles, since nostrils point downward and the physics of particles that large makes it difficult for them to move up the nose. And in lab measurements, people emit far more of the easier-to-inhale aerosols than the droplets, she said, and even the smallest particles can be virus laden, sometimes more so than the larger ones, seemingly because of how and where they are produced in the respiratory tract.

Second, she said, proximity is conducive to transmission of aerosols as well because aerosols are more concentrated near the person emitting them. In a twist of history, modern scientists have been acting like those who equated stinky air with disease, by equating close contact, a measure of distance, only with the larger droplets, a mechanism of transmission, without examination.

Since aerosols also infect at close range, measures to prevent droplet transmission — masks and distancing — can help dampen transmission for airborne diseases as well. However, this oversight led medical people to circularly assume that if such measures worked at all, droplets must have played a big role in their transmission.

Another dynamic we’ve seen is something that is not unheard-of in the history of science: setting a higher standard of proof for theories that challenge conventional wisdom than for those that support it.

Another key problem is that, understandably, we find it harder to walk things back. It is easier to keep adding exceptions and justifications to a belief than to admit that a challenger has a better explanation.

The ancients believed that all celestial objects revolved around the earth in circular orbits. When it became clear that the observed behavior of the celestial objects did not fit this assumption, those astronomers produced ever-more-complex charts by adding epicycles — intersecting arcs and circles — to fit the heavens to their beliefs.

In a contemporary example of this attitude, the initial public health report on the Mount Vernon choir case said that it may have been caused by people “sitting close to one another, sharing snacks and stacking chairs at the end of the practice,” even though almost 90 percent of the people there developed symptoms of Covid-19

So much of what we have done throughout the pandemic — the excessive hygiene theater and the failure to integrate ventilation and filters into our basic advice — has greatly hampered our response.

Some of it, like the way we underused or even shut down outdoor space, isn’t that different from the 19th-century Londoners who flushed the source of their foul air into the Thames and made the cholera epidemic worse.

Righting this ship cannot be a quiet process — updating a web page here, saying the right thing there. The proclamations that we now know are wrong were so persistent and so loud for so long.

the progress we’ve made might lead to an overhaul in our understanding of many other transmissible respiratory diseases that take a terrible toll around the world each year and could easily cause other pandemics.

So big proclamations require probably even bigger proclamations to correct, or the information void, unnecessary fears and misinformation will persist, damaging the W.H.O. now and in the future.

I’ve seen our paper used in India to try to reason through aerosol transmission and the necessary mitigations. I’ve heard of people in India closing their windows after hearing that the virus is airborne, likely because they were not being told how to respond

The W.H.O. needs to address these fears and concerns, treating it as a matter of profound change, so other public health agencies and governments, as well as ordinary people, can better adjust.

It needs to begin a campaign proportional to the importance of all this, announcing, “We’ve learned more, and here’s what’s changed, and here’s how we can make sure everyone understands how important this is.” That’s what credible leadership looks like. Otherwise, if a web page is updated in the forest without the requisite fanfare, how will it matter?

each industry, as it (mostly) legally can, designs products that are difficult to resist and sometimes addictive.

The issues of auto and gun safety, of drug, alcohol and tobacco addiction, and of hyperconsumption of unhealthy food are not as distinct as we’ve long believed; really, they’re quite similar. For example, the argument for protecting people against marketers of junk food relies in part on the fact that antismoking regulations and seatbelt laws were initially attacked as robbing us of choice; now we know they’re lifesavers.

Until now (and, sadly, perhaps well into the future), corporations have been both more nimble and more flush with cash than the public health arms of government

“What we need,” Freudenberg said to me, “is to return to the public sector the right to set health policy and to limit corporations’ freedom to profit at the expense of public health.”

The turning point in the tobacco wars was when the question changed from the industry’s — “Do people have the right to smoke?” — to that of public health: “Do people have the right to breathe clean air?” Note that both questions are legitimate, but if you address the first (to which the answer is of course “yes”) without asking the second (to which the answer is of course also “yes”) you miss an opportunity to convert the answer from one that leads to greater industry profits to one that has literally cut smoking rates in half.

Similarly, we need to be asking not “Do junk food companies have the right to market to children?” but “Do children have the right to a healthy diet?”

The question is not only, “Do we have a right to bear arms?” but also “Do we have the right to be safe in our streets and schools?”

n short, says Freudenberg: “The right to be healthy trumps the right of corporations to promote choices that lead to premature death and preventable illnesses. Protecting public health is a fundamental government responsibility

“Shouldn’t science and technology be used to improve human well-being, not to advance business goals that harm health?” Two other questions that can be answered “yes.”

It is clear that these products are designed to be maximally addictive, in order to harvest as much of our attention as they can. Tech humanists say this business model is both unhealthy and inhumane – that it damages our psychological well-being and conditions us to behave in ways that diminish our humanity

The main solution that they propose is better design. By redesigning technology to be less addictive and less manipulative, they believe we can make it healthier – we can realign technology with our humanity and build products that don’t “hijack” our minds.

its most prominent spokesman is executive director Tristan Harris, a former “design ethicist” at Google who has been hailed by the Atlantic magazine as “the closest thing Silicon Valley has to a conscience”. Harris has spent years trying to persuade the industry of the dangers of tech addiction.

In February, Pierre Omidyar, the billionaire founder of eBay, launched a related initiative: the Tech and Society Solutions Lab, which aims to “maximise the tech industry’s contributions to a healthy society”.

the tech humanists are making a bid to become tech’s loyal opposition. They are using their insider credentials to promote a particular diagnosis of where tech went wrong and of how to get it back on track

The real reason tech humanism matters is because some of the most powerful people in the industry are starting to speak its idiom. Snap CEO Evan Spiegel has warned about social media’s role in encouraging “mindless scrambles for friends or unworthy distractions”,

In short, the effort to humanise computing produced the very situation that the tech humanists now consider dehumanising: a wilderness of screens where digital devices chase every last instant of our attention.

After years of ignoring their critics, industry leaders are finally acknowledging that problems exist. Tech humanists deserve credit for drawing attention to one of those problems – the manipulative design decisions made by Silicon Valley.

these decisions are only symptoms of a larger issue: the fact that the digital infrastructures that increasingly shape our personal, social and civic lives are owned and controlled by a few billionaires

Because it ignores the question of power, the tech-humanist diagnosis is incomplete – and could even help the industry evade meaningful reform

Taken up by leaders such as Zuckerberg, tech humanism is likely to result in only superficial changes

they will not address the origin of that anger. If anything, they will make Silicon Valley even more powerful.

To the litany of problems caused by “technology that extracts attention and erodes society”, the text asserts that “humane design is the solution”. Drawing on the rhetoric of the “design thinking” philosophy that has long suffused Silicon Valley, the website explains that humane design “starts by understanding our most vulnerable human instincts so we can design compassionately”

this language is not foreign to Silicon Valley. On the contrary, “humanising” technology has long been its central ambition and the source of its power. It was precisely by developing a “humanised” form of computing that entrepreneurs such as Steve Jobs brought computing into millions of users’ everyday lives

Facebook had a new priority: maximising “time well spent” on the platform, rather than total time spent. By “time well spent”, Zuckerberg means time spent interacting with “friends” rather than businesses, brands or media sources. He said the News Feed algorithm was already prioritising these “more meaningful” activities.

Tech humanists say they want to align humanity and technology. But this project is based on a deep misunderstanding of the relationship between humanity and technology: namely, the fantasy that these two entities could ever exist in separation.

They believe we can use better design to make technology serve human nature rather than exploit and corrupt it. But this idea is drawn from the same tradition that created the world that tech humanists believe is distracting and damaging us.

The story of our species began when we began to make tools

All of which is to say: humanity and technology are not only entangled, they constantly change together.

This is not just a metaphor. Recent research suggests that the human hand evolved to manipulate the stone tools that our ancestors used

The ways our bodies and brains change in conjunction with the tools we make have long inspired anxieties that “we” are losing some essential qualities

Yet as we lose certain capacities, we gain new ones.

The nature of human nature is that it changes. It can not, therefore, serve as a stable basis for evaluating the impact of technology

Yet the assumption that it doesn’t change serves a useful purpose. Treating human nature as something static, pure and essential elevates the speaker into a position of power. Claiming to tell us who we are, they tell us how we should be.

Messaging, for instance, is considered the strongest signal. It’s reasonable to assume that you’re closer to somebody you exchange messages with than somebody whose post you once liked.

Harris and his fellow tech humanists also frequently invoke the language of public health. The Center for Humane Technology’s Roger McNamee has gone so far as to call public health “the root of the whole thing”, and Harris has compared using Snapchat to smoking cigarettes

The public-health framing casts the tech humanists in a paternalistic role. Resolving a public health crisis requires public health expertise. It also precludes the possibility of democratic debate. You don’t put the question of how to treat a disease up for a vote – you call a doctor.

They also remain confined to the personal level, aiming to redesign how the individual user interacts with technology rather than tackling the industry’s structural failures. Tech humanism fails to address the root cause of the tech backlash: the fact that a small handful of corporations own our digital lives and strip-mine them for profit.

This is a fundamentally political and collective issue. But by framing the problem in terms of health and humanity, and the solution in terms of design, the tech humanists personalise and depoliticise it.

Far from challenging Silicon Valley, tech humanism offers Silicon Valley a useful way to pacify public concerns without surrendering any of its enormous wealth and power.

these principles could make Facebook even more profitable and powerful, by opening up new business opportunities. That seems to be exactly what Facebook has planned.

reported that total time spent on the platform had dropped by around 5%, or about 50m hours per day. But, Zuckerberg said, this was by design: in particular, it was in response to tweaks to the News Feed that prioritised “meaningful” interactions with “friends” rather than consuming “public content” like video and news. This would ensure that “Facebook isn’t just fun, but also good for people’s well-being”

Zuckerberg said he expected those changes would continue to decrease total time spent – but “the time you do spend on Facebook will be more valuable”. This may describe what users find valuable – but it also refers to what Facebook finds valuable

not all data is created equal. One of the most valuable sources of data to Facebook is used to inform a metric called “coefficient”. This measures the strength of a connection between two users – Zuckerberg once called it “an index for each relationship”

Facebook records every interaction you have with another user – from liking a friend’s post or viewing their profile, to sending them a message. These activities provide Facebook with a sense of how close you are to another person, and different activities are weighted differently.

Holding humanity and technology separate clears the way for a small group of humans to determine the proper alignment between them

Why is coefficient so valuable? Because Facebook uses it to create a Facebook they think you will like: it guides algorithmic decisions about what content you see and the order in which you see it. It also helps improve ad targeting, by showing you ads for things liked by friends with whom you often interact

emphasising time well spent means creating a Facebook that prioritises data-rich personal interactions that Facebook can use to make a more engaging platform.

“time well spent” means Facebook can monetise more efficiently. It can prioritise the intensity of data extraction over its extensiveness. This is a wise business move, disguised as a concession to critics

industrialists had to find ways to make the time of the worker more valuable – to extract more money from each moment rather than adding more moments. They did this by making industrial production more efficient: developing new technologies and techniques that squeezed more value out of the worker and stretched that value further than ever before.

there is another way of thinking about how to live with technology – one that is both truer to the history of our species and useful for building a more democratic future. This tradition does not address “humanity” in the abstract, but as distinct human beings, whose capacities are shaped by the tools they use.

It sees us as hybrids of animal and machine – as “cyborgs”, to quote the biologist and philosopher of science Donna Haraway.

The cyborg way of thinking, by contrast, tells us that our species is essentially technological. We change as we change our tools, and our tools change us. But even though our continuous co-evolution with our machines is inevitable, the way it unfolds is not. Rather, it is determined by who owns and runs those machines. It is a question of power

The various scandals that have stoked the tech backlash all share a single source. Surveillance, fake news and the miserable working conditions in Amazon’s warehouses are profitable. If they were not, they would not exist. They are symptoms of a profound democratic deficit inflicted by a system that prioritises the wealth of the few over the needs and desires of the many.

If being technological is a feature of being human, then the power to shape how we live with technology should be a fundamental human right

The decisions that most affect our technological lives are far too important to be left to Mark Zuckerberg, rich investors or a handful of “humane designers”. They should be made by everyone, together.

Rather than trying to humanise technology, then, we should be trying to democratise it. We should be demanding that society as a whole gets to decide how we live with technology

What does this mean in practice? First, it requires limiting and eroding Silicon Valley’s power.

Antitrust laws and tax policy offer useful ways to claw back the fortunes Big Tech has built on common resources

democratic governments should be making rules about how those firms are allowed to behave – rules that restrict how they can collect and use our personal data, for instance, like the General Data Protection Regulation

This means developing publicly and co-operatively owned alternatives that empower workers, users and citizens to determine how they are run.

we might demand that tech firms pay for the privilege of extracting our data, so that we can collectively benefit from a resource we collectively create.

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.

Mr. Trachtenberg understood the centrality of the university as a physical place. New structures were a visceral sign of progress. They told visitors, donors and civic leaders that the institution was, like beams and scaffolding rising from the earth, ascending. He added new programs, recruited more students, and followed the dictate of constant expansion.

the American research university had evolved into a complicated and somewhat peculiar organization. It was built to be all things to all people: to teach undergraduates, produce knowledge, socialize young men and women, train workers for jobs, anchor local economies, even put on weekend sports events. And excellence was defined by similarity to old, elite institutions. Universities were judged by the quality of their scholars, the size of their endowments, the beauty of their buildings and the test scores of their incoming students.

John Silber embarked on a huge building campaign while bringing luminaries like Saul Bellow and Elie Wiesel on board to teach and lend their prestige to the B.U. name, creating a bigger, more famous and much more costly institution. He had helped write a game plan for the aspiring college president.

GWU is, for all intents and purposes, a for-profit organization. Best example: study abroad. Their top program, a partnering with Sciences Po, costs each student (30 of them, on a program with 'prestige' status?) a full semester's tuition. It costs GW, according to Sciences Po website, €1000. A neat $20,000 profit per student (who is in digging her/himself deeper and deeper in debt.) Moreover, the school takes a $500 admin fee for the study abroad application! With no guarantee that all credits transfer. Students often lose a partial semester, GW profits again. Nor does GW offer help with an antiquated, one-shot/no transfers, tricky registration process. It's tough luck in gay Paris.Just one of many examples. Dorms with extreme mold, off-campus housing impossible for freshmen and sophomores. Required meal plan: Chick-o-Filet etc. Classes with over 300 students (required).This is not Harvard, but costs same.Emotional problems? Counselors too few. Suicides continue and are not appropriately addressed. Caring environment? Extension so and so, please hold.It's an impressive campus, I'm an alum. If you apply, make sure the DC experience is worth the price: good are internships, a few colleges like Elliot School, post-grad.GWU uses undergrad $$ directly for building projects, like the medical center to which students have NO access. (Student health facility is underfunded, outsourced.)Outstanding professors still make a difference. But is that enough?

Mr. Trachtenberg, however, understood something crucial about the modern university. It had come to inhabit a market for luxury goods. People don’t buy Gucci bags merely for their beauty and functionality. They buy them because other people will know they can afford the price of purchase. The great virtue of a luxury good, from the manufacturer’s standpoint, isn’t just that people will pay extra money for the feeling associated with a name brand. It’s that the high price is, in and of itself, a crucial part of what people are buying.

Mr. Trachtenberg convinced people that George Washington was worth a lot more money by charging a lot more money. Unlike most college presidents, he was surprisingly candid about his strategy. College is like vodka, he liked to explain.

The Absolut Rolex plan worked. The number of applicants surged from some 6,000 to 20,000, the average SAT score of students rose by nearly 200 points, and the endowment jumped from $200 million to almost $1 billion.

The university became a magnet for the children of new money who didn’t quite have the SATs or family connections required for admission to Stanford or Yale. It also aggressively recruited international students, rich families from Asia and the Middle East who believed, as nearly everyone did, that American universities were the best in the world.

U.S. News & World Report now ranks the university at No. 54 nationwide, just outside the “first tier.”

The watch and vodka analogies are correct. Personally, I used car analogies when discussing college choices with my kids. We were in the fortunate position of being able to comfortably send our kids to any college in the country and have them leave debt free. Notwithstanding, I told them that they would be going to a state school unless they were able to get into one of about 40 schools that I felt, in whatever arbitrary manner I decided, that was worth the extra cost. They both ended up going to state schools.College is by and large a commodity and you get out of it what you put into it. Both of my kids worked hard in college and were involved in school life. They both left the schools better people and the schools better schools for them being there. They are both now successful adults.I believe too many people look for the prestige of a named school and that is not what college should be primarily about.

In 2013, only 14 percent of the university’s 10,000 undergraduates received a grant — a figure on a par with elite schools but far below the national average. The average undergraduate borrower leaves with about $30,800 in debt.

When I talk to the best high school students in my state I always stress the benefits of the honors college experience at an affordable public university. For students who won't qualify for a public honors college. the regular pubic university experience is far preferable to the huge debt of places like GW.

Carey would do well to look beyond high ticket private universities (which after all are still private enterprises) and what he describes as the Olympian heights of higher education (which for some reason seems also to embitter him) and look at the system overall . The withdrawal of public support was never a policy choice; it was a political choice, "packaged and branded" as some tax cutting palaver all wrapped up in the argument that a free-market should decide how much college should cost and how many seats we need. In such an environment, trustees at private universities are no more solely responsible for turning their degrees into commodities than the administrations of state universities are for raising the number of out-of-state students in order to offset the loss of support from their legislatures. No doubt, we will hear more about market based solutions and technology from Mr. Carey

I went to GW back in the 60s. It was affordable and it got me away from home in New York. While I was there, Newsweek famously published a article about the DC Universities - GW, Georgetown, American and Catholic - dubbing them the Pony league, the schools for the children of wealthy middle class New Yorkers who couldn't get into the Ivy League. Nobody really complained. But that wasn't me. I went because I wanted to be where the action was in the 60s, and as we used to say - "GW was literally a stone's throw from the White House. And we could prove it." Back then, the two biggest alumni names were Jackie Kennedy, who's taken some classes there, and J. Edgar Hoover. Now, according to the glossy magazine they send me each month, it's the actress Kerry Washington. There's some sort of progress there, but I'm a GW alum and not properly trained to understand it.

This explains a lot of the modern, emerging mentality. It encompasses the culture of enforced grade inflation, cheating and anti-intellectualism in much of higher education. It is consistent with our culture of misleading statistics and information, cronyism and fake quality, the "best and the brightest" being only schemers and glad handers. The wisdom and creativity engendered by an honest, rigorous academic education are replaced by the disingenuous quick fix, the winner-take-all mentality that neglects the common good.

I attended nearby Georgetown University and graduated in 1985. Relative to state schools and elite schools, it was expensive then. I took out loans. I had Pell grants. I had work-study and GSL. I paid my debt of $15,000 off in ten years. Would I have done it differently? Yes: I would have continued on to graduate school and not worried about paying off those big loans right after college. My career work out and I am grateful for the education I received and paid for. But I would not recommend to my nieces and nephews debts north of $100,000 for a BA in liberal arts. Go community. Then go state. Then punch your ticket to Harvard, Yale or Stanford — if you are good enough.

American universities appear to have more and more drifted away from educating individuals and citizens to becoming high priced trade schools and purveyors of occupational licenses. Lost in the process is the concept of expanding a student's ability to appreciate broadly and deeply, as well as the belief that a republican democracy needs an educated citizenry, not a trained citizenry, to function well.Both the Heisman Trophy winner and the producer of a successful tech I.P.O. likely have much in common, a college education whose rewards are limited to the financial. I don't know if I find this more sad on the individual level or more worrisome for the future of America.

This is now a consumer world for everything, including institutions once thought to float above the Shakespearean briars of the work-a-day world such as higher education, law and medicine. Students get this. Parents get this. Everything is negotiable: financial aid, a spot in the nicest dorm, tix to the big game. But through all this, there are faculty - lots of 'em - who work away from the fluff to link the ambitions of the students with the reality and rigor of the 21st century. The job of the student is to get beyond the visible hype of the surroundings and find those faculty members. They will make sure your investment is worth it

My experience in managing or working with GW alumni in their 20's or 30's has not been good. Virtually all have been mentally lazy and/or had a stunning sense of entitlement. Basically they've been all talk and no results. That's been quite a contrast to the graduates from VA/MD state universities.

More and more, I notice what my debt-financed contributions to the revenue streams of my vendors earn them, not me. My banks earned enough to pay ridiculous bonuses to employees for reckless risk-taking. My satellite tv operator earned enough to overpay ESPN for sports programming that I never watch--and that, in turn, overpays these idiotic pro athletes and college sports administrators. My health insurer earned enough to defeat one-payor insurance; to enable the opaque, inefficient billing practices of hospitals and other providers; and to feed the behemoth pharmaceutical industry. My church earned enough to buy the silence of sex abuse victims and oppose progressive political candidates. And my govt earned enough to continue ag subsidies, inefficient defense spending, and obsolete transportation and energy policies.

as the parent of GWU freshman I am grateful for every opportunity afforded her. She has a generous merit scholarship, is in the honors program with some small classes, and has access to internships that can be done while at school. GWU also gave her AP credits to advance her to sophomore status. Had she attended the state flagship school (where she was accepted into that exclusive honors program) she would have a great education but little else. It's not possible to do foreign affairs related internship far from D.C. or Manhattan. She went to a very competitive high school where for the one or two ivy league schools in which she was interested, she didn't have the same level of connections or wealth as many of her peers. Whether because of the Common Application or other factors, getting into a good school with financial help is difficult for a middle class student like my daughter who had a 4.0 GPA and 2300 on the SAT. She also worked after school.The bottom line - GWU offered more money than perceived "higher tier" universities, and brought tuition to almost that of our state school system. And by the way, I think she is also getting a very good education.

This article reinforces something I have learned during my daughter's college application process. Most students choose a school based on emotion (reputation) and not value. This luxury good analogy holds up.

The entire education problem can be solved by MOOCs lots and lots of them plus a few closely monitored tests and personal interviews with people. Of course many many people make MONEY off of our entirely inefficient way of "educating" -- are we even really doing that -- getting a degree does NOT mean one is actually educated

As a first-generation college graduate I entered GW ambitious but left saddled with debt, and crestfallen at the hard-hitting realization that my four undergraduate years were an aberration from what life is actually like post-college: not as simple as getting an [unpaid] internship with a fancy titled institution, as most Colonials do. I knew how to get in to college, but what do you do after the recess of life ends?I learned more about networking, resume plumping (designated responses to constituents...errr....replied to emails), and elevator pitches than actual theory, economic principles, strong writing skills, critical thinking, analysis, and philosophy. While relatively easy to get a job after graduating (for many with a GW degree this is sadly not the case) sustaining one and excelling in it is much harder. It's never enough just to be able to open a new door, you also need to be prepared to navigate your way through that next opportunity.

this is a very telling article. Aimless and directionless high school graduates are matched only by aimless and directionless institutes of higher learning. Each child and each parent should start with a goal - before handing over their hard earned tuition dollars, and/or leaving a trail of broken debt in the aftermath of a substandard, unfocused education.

it is no longer the most expensive university in America. It is the 46th.Others have been implementing the Absolut Rolex Plan. John Sexton turned New York University into a global higher-education player by selling the dream of downtown living to students raised on “Sex and the City.” Northeastern followed Boston University up the ladder. Under Steven B. Sample, the University of Southern California became a U.S. News top-25 university. Washington University in St. Louis did the same.

I currently attend GW, and I have to say, this article completely misrepresents the situation. I have yet to meet a single person who is paying the full $60k tuition - I myself am paying $30k, because the school gave me $30k in grants. As for the quality of education, Foreign Policy rated GW the #8 best school in the world for undergraduate education in international affairs, Princeton Review ranks it as one of the best schools for political science, and U.S. News ranks the law school #20. The author also ignores the role that an expanding research profile plays in growing a university's prestige and educational power.

And in hundreds of regional universities and community colleges, presidents and deans and department chairmen have watched this spectacle of ascension and said to themselves, “That could be me.” Agricultural schools and technical institutes are lobbying state legislatures for tuition increases and Ph.D. programs, fitness centers and arenas for sport. Presidents and boards are drawing up plans to raise tuition, recruit “better” students and add academic programs. They all want to go in one direction — up! — and they are all moving with a single vision of what they want to be.

this is the same playbook used by hospitals the past 30 years or so. It is how Hackensack Hospital became Hackensack Medical Center and McComb Hospital became Southwest Mississippi Regional Medical Center. No wonder the results have been the same in healthcare and higher education; both have priced themselves out of reach for average Americans.

a world where a college is rated not by the quality of its output, but instaed, by the quality of its inputs. A world where there is practically no work to be done by the administration because the college's reputation is made before the first class even begins! This is isanity! But this is the swill that the mammoth college marketing departments nationwide have shoved down America's throat. Colleges are ranked not by the quality of their graduates, but rather, by the test scores of their incoming students!

The Pew Foundation has been doing surveys on what students learn, how much homework they do, how much time they spend with professors etc. All good stuff to know before a student chooses a school. It is called the National Survey of Student Engagement (NSSE - called Nessy). It turns out that the higher ranked schools do NOT allow their information to be released to the public. It is SECRET.Why do you think that is?

The article blames "the standard university organizational model left teaching responsibilities to autonomous academic departments and individual faculty members, each of which taught and tested in its own way." This is the view of someone who has never taught at a university, nor thought much about how education there actually happens. Once undergraduates get beyond the general requirements, their educations _have_ to depend on "autonomous departments" because it's only those departments know what the requirements for given degree can be, and can grant the necessary accreditation of a given student. The idea that some administrator could know what's necessary for degrees in everything from engineering to fiction writing is nonsense, except that's what the people who only know the theory of education (but not its practice) actually seem to think. In the classroom itself, you have tremendously talented people, who nevertheless have their own particular strengths and approaches. Don't you think it's a good idea to let them do what they do best rather than trying to make everyone teach the same way? Don't you think supervision of young teachers by older colleagues, who actually know their field and its pedagogy, rather than some administrator, who knows nothing of the subject, is a good idea?

it makes me very sad to see how expensive some public schools have become. Used to be you could work your way through a public school without loans, but not any more. Like you, I had the advantage of a largely-scholarship paid undergraduate education at a top private college. However, I was also offered a virtually free spot in my state university's (then new) honors college

My daughter attended a good community college for a couple of classes during her senior year of high school and I could immediately see how such places are laboratories for failure. They seem like high schools in atmosphere and appearance. Students rush in by car and rush out again when the class is over.The four year residency college creates a completely different feel. On arrival, you get the sense that you are engaging in something important, something apart and one that will require your full attention. I don't say this is for everyone or that the model is not flawed in some ways (students actually only spend 2 1/2 yrs. on campus to get the four yr. degree). College is supposed to be a 60 hour per week job. Anything less than that and the student is seeking himself or herself

This. Is. STUNNING. I have always wondered, especially as my kids have approached college age, why American colleges have felt justified in raising tuition at a rate that has well exceeded inflation, year after year after year. (Nobody needs a dorm with luxury suites and a lazy river pool at college!) And as it turns out, they did it to become luxury brands. Just that simple. Incredible.I don't even blame this guy at GWU for doing what he did. He wasn't made responsible for all of American higher ed. But I do think we all need to realize what happened, and why. This is front page stuff.

I agree with you, but, unfortunately, given the choice between low tuition, primitive dorms, and no athletic center VS expensive & luxurious, the customers (and their parents) are choosing the latter. As long as this is the case, there is little incentive to provide bare-bones and cheap education.

Wesleyan University in CT is one school that is moving down the rankings. Syracuse University is another. Reed College is a third. Why? Because these schools try hard to stay out of the marketing game. (With its new president, Syracuse has jumped back into the game.) Bryn Mawr College, outside Philadelphia hasn't fared well over the past few decades in the rankings, which is true of practically every women's college. Wellesley is by far the highest ranked women's college, but even there the acceptance rate is significantly higher than one finds at comparable coed liberal arts colleges like Amherst & Williams. University of Chicago is another fascinating case for Mr. Carey to study (I'm sure he does in his forthcoming book, which I look forward to reading). Although it has always enjoyed an illustrious academic reputation, until recently Chicago's undergraduate reputation paled in comparison to peer institutions on the two coasts. A few years ago, Chicago changed its game plan to more closely resemble Harvard and Stanford in undergraduate amenities, and lo and behold, its rankings shot up. It was a very cynical move on the president's part to reassemble the football team, but it was a shrewd move because athletics draw more money than academics ever can (except at engineering schools like Cal Tech & MIT), and more money draws richer students from fancier secondary schools with higher test scores, which lead to higher rankings - and the beat goes on.

College INDUSTRY is out of control. Sorry, NYU, GW, BU are not worth the price. Are state schools any better? We have the University of Michigan, which is really not a state school, but a university that gives a discount to people who live in Michigan. Why? When you have an undergraduate body 40+% out-of-state that pays tuition of over $50K/year, you tell me?Perhaps the solution is two years of community college followed by two at places like U of M or Michigan State - get the same diploma at the end for much less and beat the system.

In one recent yr., the majority of undergrad professors at Harvard, according to Boston.com, where adjuncts. That means low pay, no benefits, no office, temp workers. Harvard.Easily available student loans fueled this arms race of amenities and frills that in which colleges now engage. They moved the cost of education onto the backs of people, kids, who don't understand what they are doing.Students in colleges these days are customers and the customers must be able to get through. If it requires dumbing things down, so be it. On top of tuition, G.W. U. is known by its students as the land of added fees on top of added fees. The joke around campus was that they would soon be installing pay toilets in the student union. No one was laughing.

You could written the same story about my alma mater, American University. The place reeked of ambition and upward mobility decades ago and still does. Whoever's running it now must look at its measly half-billion-dollar endowment and compare it to GWU's $1.5 billion and seethe with envy, while GWU's president sets his sights on an Ivy League-size endowment. And both get back to their real jobs: 24/7 fundraising,Which is what university presidents are all about these days. Money - including million-dollar salaries for themselves (GWU's president made more than Harvard's in 2011) - pride, cachet, power, a mansion, first-class all the way. They should just be honest about it and change their university's motto to Ostende mihi pecuniam! (please excuse my questionable Latin)Whether the students are actually learning anything is up to them, I guess - if they do, it's thanks to the professors, adjuncts and the administrative staff, who do the actual work of educating and keep the school running.

When I was in HS (70s), many of my richer friends went to GW and I was then of the impression that GW was a 'good' school. As I age, I have come to realize that this place is just another façade to the emptiness that has become America. All too often are we faced with a dilemma: damned if we do, damned if we don't. Yep, 'education' has become a trap for all too many of our citizen.

I transferred to GWU from a state school. I am forever grateful that I did. I wanted to get a good rigorous education and go to one of the best International Affairs schools in the world. Even though the state school I went to was dirt-cheap, the education and the faculty was awful. I transferred to GW and was amazed at the professors at that university. An ambassador or a prominent IA scholar taught every class. GW is an expensive school, but that is the free market. If you want a good education you need to be willing to pay for it or join the military. I did the latter and my school was completely free with no debt and I received an amazing education. If young people aren't willing to make some sort of sacrifice to get ahead or just expect everything to be given to then our country is in a sad state.We need to stop blaming universities like GWU that strive to attract better students, better professors, and better infrastructure. They are doing what is expected in America, to better oneself.

"Whether the students are actually learning anything is up to them, I guess." How could it possibly be otherwise??? I am glad that you are willing to give credit to teachers and administrators, but it is not they who "do the actual work of educating." From this fallacy comes its corollary, that we should blame teachers first for "under-performing schools". This long-running show of scapegoating may suit the wallets and vanity of American parents, but it is utterly senseless. When, if ever, American culture stops reeking of arrogance, greed and anti-intellectualism, things may improve, and we may resume the habit of bothering to learn. Until then, nothing doing.

Universities sell knowledge and grade students on how much they have learned. Fundamentally, there is conflict of interest in thsi setup. Moreover, students who are poorly educated, even if they know this, will not criticize their school, because doing so would make it harder for them to have a career. As such, many problems with higher education remain unexposed to the public.

I've lectured and taught in at least five different countries in three continents and the shortest perusal of what goes on abroad would totally undermine most of these speculations. For one thing American universities are unique in their dedication to a broad based liberal arts type education. In France, Italy or Germany, for example, you select a major like mathematics or physics and then in your four years you will not take even one course in another subject. The amount of work that you do that is critically evaluated by an instructor is a tiny fraction of what is done in an American University. While half educated critics based on profoundly incomplete research write criticism like this Universities in Germany Italy, the Netherlands, South Korea and Japan as well as France have appointed committees and made studies to explain why the American system of higher education so drastically outperforms their own system. Elsewhere students do get a rather nice dose of general education but it ends in secondary school and it has the narrowness and formulaic quality that we would just normally associate with that. The character who wrote this article probably never set foot on a "campus" of the University of Paris or Rome

The university is part of a complex economic system and it is responding to the demands of that system. For example, students and parents choose universities that have beautiful campuses and buildings. So universities build beautiful campuses. State support of universities has greatly declined, and this decline in funding is the greatest cause of increased tuition. Therefore universities must compete for dollars and must build to attract students and parents. Also, universities are not ranked based on how they educate students -- that's difficult to measure so it is not measured. Instead universities are ranked on research publications. So while universities certainly put much effort into teaching, research has to have a priority in order for the university to survive. Also universities do not force students and parents to attend high price institutions. Reasonably priced state institutions and community colleges are available to every student. Community colleges have an advantage because they are funded by property taxes. Finally learning requires good teaching, but it also requires students that come to the university funded, prepared, and engaged. This often does not happen. Conclusion- universities have to participate in profile raising actions in order to survive. The day that funding is provided for college, ranking is based on education, and students choose campuses with simple buildings, then things will change at the university.

This is the inevitable result of privatizing higher education. In the not-so-distant past, we paid for great state universities through our taxes, not tuition. Then, the states shifted funding to prisons and the Federal government radically cut research support and the GI bill. Instead, today we expect universities to support themselves through tuition, and to the extent that we offered students support, it is through non-dischargeable loans. To make matters worse, the interest rates on those loans are far above the government's cost of funds -- so in effect the loans are an excise tax on education (most of which is used to support a handful of for-profit institutions that account for the most student defaults). This "consumer sovereignty" privatized model of funding education works no better than privatizing California's electrical system did in the era of Enron, or our privatized funding of medical service, or our increasingly privatized prison system: it drives up costs at the same time that it replace quality with marketing.

There are data in some instances on student learning, but the deeper problem, as I suspect the author already knows, is that there is nothing like a consensus on how to measure that learning, or even on when is the proper end point to emphasize (a lot of what I teach -- I know this from what students have told me -- tends to come into sharp focus years after graduation).

Michael (Baltimore) has hit the nail on the head. Universities are increasingly corporatized institutions in the credentialing business. Knowledge, for those few who care about it (often not those paying for the credentials) is available freely because there's no profit in it. Like many corporate entities, it is increasingly run by increasingly highly paid administrators, not faculty.

GWU has not defined itself in any unique way, it has merely embraced the bland, but very expensive, accoutrements of American private education: luxury dorms, food courts, spa-like gyms, endless extracurricular activities, etc. But the real culprit for this bloat that students have to bear financially is the college ranking system by US News, Princeton Review, etc. An ultimately meaningless exercise in competition that has nevertheless pushed colleges and universities to be more like one another. A sad state of affairs, and an extremely expensive one for students

It is long past time to realize the failure of the Reagonomics-neoliberal private profits over public good program. In education, we need to return to public institutions publicly funded. Just as we need to recognize that Medicare, Social Security, the post office, public utilities, fire departments, interstate highway system, Veterans Administration hospitals and the GI bill are models to be improved and expanded, not destroyed.

George Washington is actually not a Rolex watch, it is a counterfeit Rolex. The real Rolexes of higher education -- places like Hopkins, Georgetown, Duke, the Ivies etc. -- have real endowments and real financial aid. No middle class kid is required to borrow $100,000 to get a degree from those schools, because they offer generous need-based financial aid in the form of grants, not loans. The tuition at the real Rolexes is really a sticker price that only the wealthy pay -- everybody else on a sliding scale. For middle class kids who are fortunate enough to get in, Penn actually ends up costing considerably less than a state university.The fake Rolexes -- BU, NYU, Drexel in Philadelphia -- don't have the sliding scale. They bury middle class students in debt.And really, though it is foolish to borrow $100,000 or $120,000 for an undergraduate degree, I don't find the transaction morally wrong. What is morally wrong is our federal government making that loan non-dischargeable in bankruptcy, so many if these kids will be having their wages garnished for the REST OF THEIR LIVES.There is a very simple solution to this, by the way. Cap the amount of non-dischargeable student loan debt at, say, $50,000

The slant of this article is critical of the growth of research universities. Couldn't disagree more. Modern research universities create are incredibly engines of economic opportunity not only for the students (who pay the bills) but also for the community via the creation of blue and white collar jobs. Large research university employ tens of thousands of locals from custodial and food service workers right up to high level administrators and specialist in finance, computer services, buildings and facilities management, etc. Johns Hopkins University and the University of Maryland system employ more people than any other industry in Maryland -- including the government. Research universities typically have hospitals providing cutting-edge medical care to the community. Local business (from cafes to property rental companies) benefit from a built-in, long-term client base as well as an educated workforce. And of course they are the foundry of new knowledge which is critical for the future growth of our country.Check out the work of famed economist Dr. Julia Lane on modeling the economic value of the research university. In a nutshell, there are few better investments America can make in herself than research universities. We are the envy of the world in that regard -- and with good reason. How many *industries* (let alone jobs) have Stanford University alone catalyzed?

What universities have the monopoly on is the credential. Anyone can learn, from books, from free lectures on the internet, from this newspaper, etc. But only universities can endow you with the cherished degree. For some reason, people are will to pay more for one of these pieces of paper with a certain name on it -- Ivy League, Stanford, even GW -- than another -- Generic State U -- though there is no evidence one is actually worth more in the marketplace of reality than the other. But, by the laws of economics, these places are actually underpriced: after all, something like 20 times more people are trying to buy a Harvard education than are allowed to purchase one. Usually that means you raise your price.

Overalll a good article, except for - "This comes on the heels of Richard Arum and Josipa Roksa’s “Academically Adrift,” a study that found “limited or no learning” among many college students." The measure of learning you report was a general thinking skills exam. That's not a good measure of college gains. Most psychologists and cognitive scientists worth their salt would tell you that improvement in critical thinking skills is going to be limited to specific areas. In other words, learning critical thinking skills in math will make little change in critical thinking about political science or biology. Thus we should not expect huge improvements in general critical thinking skills, but rather improvements in a student's major and other areas of focus, such as a minor. Although who has time for a minor when it is universally acknowledged that the purpose of a university is to please and profit an employer or, if one is lucky, an investor. Finally, improved critical thinking skills are not the end all and be all of a college education even given this profit centered perspective. Learning and mastering the cumulative knowledge of past generations is arguably the most important thing to be gained, and most universities still tend to excel at that even with the increasing mandate to run education like a business and cultivate and cull the college "consumer".

As for community colleges, there was an article in the Times several years ago that said it much better than I could have said it myself: community colleges are places where dreams are put on hold. Without making the full commitment to study, without leaving the home environment, many, if not most, community college students are caught betwixt and between, trying to balance work responsibilities, caring for a young child or baby and attending classes. For males, the classic "end of the road" in community college is to get a car, a job and a girlfriend, one who is not in college, and that is the end of the dream. Some can make it, but most cannot.

as a scientist I disagree with the claim that undergrad tuition subsidizes basic research. Nearly all lab equipment and research personnel (grad students, technicians, anyone with the title "research scientist" or similar) on campus is paid for through federal grants. Professors often spend all their time outside teaching and administration writing grant proposals, as the limited federal grant funds mean ~%85 of proposals must be rejected. What is more, out of each successful grant the university levies a "tax", called "overhead", of 30-40%, nominally to pay for basic operations (utilities, office space, administrators). So in fact one might say research helps fund the university rather than the other way around. Flag

It's certainly overrated as a research and graduate level university. Whether it is good for getting an undergraduate education is unclear, but a big part of the appeal is getting to live in D.C..while attending college instead of living in some small college town in the corn fields.

It summarized and condemned the scientific and medical fraud that the British researcher Andrew Wakefield perpetrated. Years earlier, he had falsely linked the measles, mumps, and rubella (MMR) vaccine to autism. The editorial lamented that “the damage to public health continues, fuelled by unbalanced media reporting and an ineffective response from government, researchers, journals, and the medical profession.”

Reporters also seek to ensure that viewers, listeners, or readers understand that measles can afflict a victim more powerfully than does a mere passing ailment.

Measles doesn’t spread in most U.S. communities because people are protected by “herd immunity,” meaning that 92% to 94% of the population is vaccinated or immune. That level of protection makes it hard for one case of measles to spread even from one unvaccinated person to another without direct contact.

a study that “found that only 51 percent of Americans were confident that vaccines are safe and effective, which is similar to the proportion who believe that houses can be haunted by ghosts.”

In some parts of California, resistance to vaccinations including the MMR shot is stronger than ever, despite cases of measles hitting five US states.

“Vaccines are a great idea, but they are poisoning us, adding things that kick in later in life so they can sell us more drugs.”

Health professionals say those claims are unfounded or vastly overstated.

“the anti-vaccination movement is fueled by an over-privileged group of rich people grouped together who swear they won’t put any chemicals in their kids (food or vaccines or whatever else), either because it’s trendy to be all-natural or they don’t understand or accept the science of vaccinations. Their science denying has been propelled further by celebrities

the outbreak “should worry and enrage the public.” It indicted the anti-vaxxers’ “ignorant and self-absorbed rejection of science” and declared, “Getting vaccinated is good for the health of the inoculated person and also part of one’s public responsibility to help protect the health of others.”

“It’s wrong,” the editors emphasized, “to allow public health to be threatened while everyone else waits for these science-denying parents to open their eyes.”

“It’s because these people are highly educated and they get on the Internet and read things and think they can figure things out better than their physician.”

linked vaccination opposition to the “political left, which has long been suspicious of the lobbying power of the pharmaceutical industry and its influence on government regulators, and also the fringe political right, which has at different times seen vaccination, fluoridisation and other public-health initiatives as attempts by big government to impose tyrannical limits on personal freedom.”

Attempts to increase concerns about communicable diseases or correct false claims about vaccines may be especially likely to be counterproductive.

“attempting balance by giving vaccine skeptics and pro-vaccine advocates equal weight in news stories leads people to believe the evidence for and against vaccination is equally strong.”

A recent edition of the Washington Post carried a letter defending anti-vaxxers as “people who generally are pro-science and highly educated, who have high incomes and who have studied this issue carefully before coming to the conclusion that the risk to their children is greater than the slim possibility of contracting a childhood disease that [in many cases leaves] little or no residual consequences.”

anecdotal evidence suggests that some journalists, rather than omitting anti-vaxxers’ views, prefer to expose them and then oppose them.

“unwarranted fear . . . an assault on one of the greatest public-health inventions in world history.”

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

“Sometimes, I feel like we’re practicing in the 1950s,” said Dr. Eric Ball, a pediatrician in southern Orange County, where some schools report that 50 to 60 percent of their kindergartners are not fully vaccinated and that 20 to 40 percent of parents have sought a personal beliefs exemption to vaccination requirements. “It’s very frustrating. It’s hard to see a kid suffer for something that’s entirely preventable.”

Dr. Ball said he spent many days trying to persuade parents to vaccinate their children. He tries to alleviate their concerns. He shows parents his own children’s vaccine records. But it has not worked, and lately, as worries and anger over this outbreak have spread, some families who support vaccines have said they do not want to be in the same waiting room as unvaccinated families. The clinic where Dr. Ball works has treated unvaccinated children for years, but its staff is meeting next week to discuss a ban.“Our patients are really scared,” Dr. Ball said. “Our nightmare would be for someone to show up at our door with the measles.”

Norm Warren, the manager of the supermarket in Kearny, Gordon’s IGA, has changed his thinking toward those who do not vaccinate their children.“Before, I thought, ‘If you think your child will become autistic, fine.’ But now they’re pushing their beliefs on everybody, and I feel differently,“ he said. “How many lives have been saved by vaccination?“

Members of the anti-vaccine movement said the public backlash had terrified many parents. “People are now afraid they’re going to be jailed,” said Barbara Loe Fisher, the president of the National Vaccine Information Center, a clearinghouse for resisters. “I can’t believe what I’m seeing. It’s gotten so out of hand, and it’s gotten so vicious.”

In San Geronimo, Calif., a mostly rural community of rolling hills and oak trees about 30 miles north of San Francisco, 40 percent of the students walking into Lagunitas Elementary School have not been inoculated against measles, according to the school’s figures. Twenty-five percent have not been vaccinated for polio. In all, the state says that 58 percent of Lagunitas kindergartners do not have up-to-date vaccine records.

“A lot of people here have personal beliefs that are faith based,” said John Carroll, the school superintendent, who sent a letter home to parents last week encouraging them to vaccinate their children. The faith, Mr. Carroll said, is not so much religious as it is a belief that “they raise their children in a natural, organic environment” and are suspicious of pharmaceutical companies and big business.

Some parents forgo shots altogether. Others split vaccine doses or stretch out their timeline, worried about somehow overwhelming their children’s immune system. Kelly McMenimen, a Lagunitas parent, said she “meditated on it a lot” before deciding not to vaccinate her son Tobias, 8, against even “deadly or deforming diseases.” She said she did not want “so many toxins” entering the slender body of a bright-eyed boy who loves math and geography.

Tobias has endured chickenpox and whooping cough, though Ms. McMenimen said the latter seemed more like a common cold. She considered a tetanus shot after he cut himself on a wire fence but decided against it: “He has such a strong immune system.”

“It’s good to explore alternatives rather than go with the panic of everyone around you,” she said. “Vaccines don’t feel right for me and my family.”

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.

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.”

An overwhelming majority of American adults (88%) say the benefits of the measles, mumps and rubella (MMR) vaccine outweigh the risks, according to a new Pew Research Center survey.And last year, 14 states proposed eliminating religious exemptions for vaccines -- a marked increase from years past, according to the American Academy of Pediatrics.

"When you choose not to vaccinate, you're putting your child at risk of disease, but you're also putting other people at risk," O'Leary said.

"We need to have the ability in our country, if we find a commercial pharmaceutical product is not as safe and effective as we're being told it is, we should have the right to make informed consent to use the product," she said.

"Science is really on the side of vaccinations," said O'Leary, who is an associate professor of pediatrics at the University of Colorado School of Medicine. "They're one of the best public health interventions in history in terms of the numbers of lives saved. The benefits far outweigh the risk."

"When vaccination rates fall, we see disease, and people suffer. Protecting children in schools is a worthy goal of government, regardless of political affiliation," he said. "There's really no good reason to exempt your child from vaccination -- only medical."

New York, California and Washington state took action after massive measles outbreaks in 2019, a year that saw the highest reported measles cases since the disease was declared eliminated nationwide in 2000.

Many of the religious exemption laws are not new. Several states first passed them in the 1960s and 1970s, thanks to an influx of lobbyists from the Christian Science Church, which doesn't ban members from using vaccines but encourages healing through prayer.

Supporters of vaccine exemptions see laws like those passed in New York and Washington as "fundamentally a threat to their ability to make informed consent about vaccinations," said Fisher, president of the National Vaccine Information Center.

Proponents on both sides of the debate have found allies across the political spectrum. Republican lawmakers have sponsored stricter bills, and Democratic governors have drawn the line at mandating vaccines.

"It's a tough balance, but you're using a public -- and private -- resource in conjunction with lots of other kids," Harris told CNN. "There are other venues where they can be educated, they can still have their freedom, but they're not going into a public school and spread their disease."

Regulatory review and approval. If a medication or drug is proven safe and effective in clinical trials, the U.S. Food and Drug Administration gets involved to evaluate the vaccine and administer an approval. The International Federation of Pharmaceutical Manufacturers and Associations reports that, typically, 1 in 10 experimental vaccines make it all the way through regulatory approval.

Each one of those steps can take years, and a potential vaccine can get stalled indefinitely at any one of them.

There's not a whole lot that can be done to speed up the process and still arrive at a safe and effective vaccine. Currently, most medical and public health experts say we're at least 12 to 18 months away from having a usable vaccine against COVID-19.

Because of the lengthy timeline associated with vaccine development, nearly three dozen companies and academic institutions around the world are now directing resources towards the search

While these new approaches could speed a vaccine to market, it does raise some ethical questions about safety. It's also unclear just yet whether the rush will result in an effective vaccine faster

"In the beginning of the process, the research usually involves searching through tons of sources of data to uncover opportunities that may not be so obvious.

The trial will assess "safety and antibody production, meaning that testing various doses' safety and whether these doses are producing an immune response. This phase 1 trial is not studying the effectiveness of the vaccine in preventing coronavirus infection. That will come at a later phase of the research,

But the sense of urgency surrounding the need for a safe, effective vaccine to prevent COVID-19 is driving public health officials, private pharmaceutical companies and others to work as quickly as they can to find a solution. The sooner these vaccines and other medications can be tested, the sooner we might have a viable vaccine that can halt a global pandemic that shows few signs of slowing on its own. But right now, experts say that it will take at least a year and likely longer before such a vaccine is available

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.

Compared with five years ago, both citizens and scientists are less upbeat about the scientific enterprise. Citizens are still broadly positive about the place of U.S. scientific achievements and its impact on society, but slightly more are negative than five years ago. And, while a majority of scientists think it is a good time for science, they are less upbeat than they were five years ago.

While a majority of the public sees U.S. scientific achievements in positive terms, the share saying U.S. scientific achievements are the best in the world or above average is down 11 points to 54% today, compared with 65% in 2009.

The largest differences between the public and the AAAS scientists are found in beliefs about the safety of eating genetically modified (GM) foods.

In an Atlantic essay, “Why The Past Ten Years of American Life have Been Uniquely Stupid,” and in a follow-up piece, Haidt argued that the Age of Gutenberg–of books and the depth understanding that comes with them–ended somewhere around 2014 with the rise of “Share,” “Like” and “Retweet” buttons that opened the way for trolls, hucksters and Trumpists

The new age of “hyper-virality,” he writes, has given us both January 6 and cancel culture–ugly polarization in both directions. On the subject of stupidification, we should add the fact that high school students now get virtually their entire stock of knowledge about the world from digital platforms.

Haidt proposed several reforms, including modifying Facebook’s “Share” function and requiring “user verification” to get rid of trolls. But he doesn’t really believe in his own medicine

Haidt said that the era of “shared understanding” is over–forever. When I asked if he could envision changes that would help protect democracy, Haidt quoted Goldfinger: “Do you expect me to talk?” “No, Mr. Bond, I expect you to die!”

Social media is a public health hazard–the cognitive equivalent of tobacco and sugary drinks. Adopting a public health model, we could, for examople, ban the use of algorithms to reduce virality, or even require social media platforms to adopt a subscription rather than advertising revenue model and thus remove their incentive to amass ev er more eyeballs.

We could, but we won’t, because unlike other public health hazards, digital platforms are forms of speech. Fox New is probably responsible for more polarization than all social media put together, but the federal government could not compel it–and all other media firms–to change its revenue model.

If Mark Zuckerberg or Elon Musk won’t do so out of concern for the public good–a pretty safe bet–they could be compelled to do so only by public or competitive pressure. 

Taiwan has provide resilient because its society is resilient; people reject China’s lies. We, here, don’t lack for fact-checkers, but rather for people willing to believe them. The problem is not the technology, but ourselves.

you have to wonder if people really are repelled by our poisonous discourse, or by the hailstorm of disinformation, or if they just want to live comfortably inside their own bubble, and not somebody else’

If Jonathan Haidt is right, it’s not because we’ve created a self-replicating machine that is destined to annihilate reason; it’s because we are the self-replicating machine.

"In these kinds of public health emergencies, we need to be able to trust our leaders, be it public health, scientific or political leaders," Omer said. This will become particularly important in the coronavirus outbreak if there comes a time when the government needs to recommend major lifestyle adjustments to curtail the spread of the disease.

Avoid public transportation when possible, limit nonessential travel, work from home and skip social gatherings. Don’t go to crowded restaurants or busy gyms. You can go outside, as long as you avoid being in close contact with people.

If you develop a high fever, shortness of breath or another, more serious symptom, call your doctor. (Testing for coronavirus is still inconsistent — there are not enough kits, and it’s dangerous to go into a doctor’s office and risk infecting others.) Then, check the Centers for Disease Control and Prevention website and your local health department for advice about how and where to be tested.

Wash your hands, wash your hands, wash your hands. That splash-under-water flick won’t cut it anymore.

Also, clean “high-touch” surfaces, like phones, tablets and handles. Apple recommends using 70 percent isopropyl alcohol, wiping gently. “Don’t use bleach,” the company said.

To disinfect any surface, the C.D.C. recommends wearing disposable gloves and washing hands thoroughly immediately after removing the gloves. Most household disinfectants registered by the Environmental Protection Agency will work.

There’s a lot of information flying around, and knowing what is going on will go a long way toward protecting your family.

Right now, there’s no reason for parents to worry, the experts say; coronavirus cases in children have been very rare. The flu vaccine is a must, as vaccinating children is good protection for older people. And take the same precautions you would during a normal flu season: Encourage frequent hand-washing, move away from people who appear sick and get the flu shot.

Unless you are already infected, face masks won’t helpFace masks have become a symbol of coronavirus, but stockpiling them might do more harm than good. First, they don’t do much to protect you. Most surgical masks are too loose to prevent inhalation of the virus. (Masks can help prevent the spread of a virus if you are infected. The most effective are the so-called N95 masks, which block 95 percent of very small particles.)Second, health care workers and those caring for sick people are on the front lines. Last month, the surgeon general urged the public to stop stockpiling masks, warning that it might limit the amount of resources available to doctors, nurses and emergency professionals.

Stock up on a 30-day supply of groceries, household supplies and prescriptions, just in case.That doesn’t mean you’ll need to eat only beans and ramen. Here are tips to stock a pantry with shelf-stable and tasty foods

No. The first testing in humans of an experimental vaccine began in mid-March. Such rapid development of a potential vaccine is unprecedented, but even if it is proved safe and effective, it probably will not be available for 12 to18 months.