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anonymous

Weight Gain and Stress Eating Are Downside of Pandemic Life - The New York Times - 0 views

www.nytimes.com/...pandemic-weight-gain.html

shared by anonymous on 26 Mar 21 - No Cached
  • Yes, Many of Us Are Stress-Eating and Gaining Weight in the Pandemic
  • A global study confirms that during the pandemic, many of us ate more junk food, exercised less, were more anxious and got less sleep.
  • Not long ago, Stephen Loy had a lot of healthy habits. He went to exercise classes three or four times a week, cooked nutritious dinners for his family, and snacked on healthy foods like hummus and bell peppers.
  • ...20 more annotations...
  • But that all changed when the pandemic struck. During the lockdowns, when he was stuck at home, his anxiety levels went up. He stopped exercising and started stress eating. Gone were the hummus and vegetables; instead, he snacked on cookies, sweets and Lay’s potato chips. He ate more fried foods and ordered takeout from local restaurants.
  • “We were feeding the soul more than feeding the stomach,”
  • “We were making sure to eat things that made us feel better — not just nutritional items.
  • Now a global survey conducted earlier this year confirms what Mr. Loy and many others experienced firsthand: The coronavirus pandemic and resulting lockdowns led to dramatic changes in health behaviors, prompting people around the world to cut back on physical activity and eat more junk foods.
  • While they tended to experience improvements in some aspects of their diets, such as cooking at home more and eating out less, they were also the most likely to report struggling with their weight and mental health.
  • With months to go before a vaccine becomes widely available and we can safely resume our pre-pandemic routines, now might be a good time to assess the healthy habits we may have let slip and to find new ways to be proactive about our physical and mental health.
  • The researchers found that the decline in healthy behaviors during the pandemic and widespread lockdowns was fairly common regardless of geography.
  • Alone
  • “Individuals with obesity were impacted the most — and that’s what we were afraid of,”
  • “They not only started off with higher anxiety levels before the pandemic, but they also had the largest increase in anxiety levels throughout the pandemic.”
  • The pandemic disrupted everyday life, isolated people from friends and family, and spawned an economic crisis, with tens of millions of people losing jobs or finding their incomes sharply reduced.
  • despite snacking on more junk foods, many people showed an increase in their “healthy eating scores,” a measure of their overall diet quality, which includes things like eating more fruits and fewer fried foods.
  • The researchers said that the overall improvements in diet appeared to be driven by the fact that the lockdowns prompted people to cook, bake and prepare more food at home.
  • Other recent surveys have also shown a sharp rise in home cooking and baking this year, with many people saying they are discovering new ingredients and looking for ways to make healthier foods.
  • But social isolation can take a toll on mental wellness, and that was evident in the findings.
  • About 20 percent said that their symptoms, such as experiencing dread and not being able to control or stop their worrying, were severe enough to interfere with their daily activities.
  • Dr. Flanagan said it was perhaps not surprising that people tended to engage in less healthful habits during the pandemic, as so many aspects of health are intertwined.
  • Stress can lead to poor sleep, which can cause people to exercise less, consume more junk foods, and then gain weight, and so on.
  • But she said she hoped that the findings might inspire people to take steps to be more proactive about their health, such as seeking out mental health specialists, prioritizing sleep and finding ways to exercise at home and cook more, in the event of future lockdowns.
  • “Being aware is really the No. 1 thing here.”
caelengrubb

Pandemic caused 'staggering' economic, human impact in developing counties, research sa... - 1 views

www.sciencedaily.com/...210205150150.htm

shared by caelengrubb on 28 Mar 21 - No Cached
  • The onset of the COVID-19 pandemic last year led to a devastating loss of jobs and income across the global south, threatening hundreds of millions of people with hunger and lost savings and raising an array of risks for children,
  • , in the journal Science Advances, found "staggering" income losses after the pandemic emerged last year, with a median 70% of households across nine countries in Africa, Asia and Latin America reporting financial losses.
  • By April last year, roughly 50% or more of those surveyed in several countries were forced to eat smaller meals or skip meals altogether, a number that reached 87% for rural households in the West African country of Sierra Leone.
  • ...14 more annotations...
  • In the early months of the pandemic, the economic downturn in low- and middle-income countries was almost certainly worse than any other recent global economic crisis that we know of, whether the Asian financial crisis of the late 1990s, the Great Recession that started in 2008, or the more recent Ebola crisis,
  • The pandemic has produced some hopeful innovations, including a partnership between the government of Togo in West Africa and UC Berkeley's Center for Effective Global Action (CEGA) on a system to provide relief payments via digital networks.
  • The new study -- the first of its kind globally -- reports that after two decades of growth in many low- and middle-income countries, the economic crisis resulting from the COVID-19 pandemic threatens profound long-term impact: Reduced childhood nutrition could have health consequences later in life.
  • The study was launched in spring 2020, as China, Europe and the U.S. led global efforts to check spread of the virus through ambitious lockdowns of business, schools and transit. Three independent research teams, including CEGA, joined to conduct surveys in the countries where they already worked.
  • "COVID-19 and its economic shock present a stark threat to residents of low- and middle-income countries -- where most of the world's population resides -- which lack the social safety nets that exist in rich countries,
  • Between April and early July 2020, they connected with 30,000 households, including over 100,000 people, in nine countries with a combined population of 500 million: Burkina Faso, Ghana, Kenya, Rwanda and Sierra Leone in Africa; Bangladesh, Nepal and the Philippines in Asia; and Colombia in South America. The surveys were conducted by telephone.
  • In Colombia, 87% of respondents nationwide reported lost income in the early phase of the pandemic. Such losses were reported by more than 80% of people nationwide in Rwanda and Ghana.
  • In the Philippines, 77% of respondents nationwide said they faced difficulty purchasing food because stores were closed, transport was shut down or food supplies were inadequate. Similar reports came from 68% of Colombians and 64% of respondents in Sierra Leone; rates were similar for some communities within other countries.
  • Food insecurity rose sharply.
  • : In Bangladesh, 69% of landless agricultural households reported that they were forced to eat less, along with 48% of households in rural Kenya
  • Reports early in the pandemic suggested that developing countries might be less vulnerable because their populations are so much younger than those in Europe and North America.
  • The evidence we've collected shows dire economic consequences ... which, if left unchecked, could thrust millions of vulnerable households into poverty."
  • In North America and Europe, nations may be struggling with vaccination plans, but vaccines have barely arrived in most low-income countries, he said
  • If we can spread the wealth in terms of pandemic relief assistance and vaccine distribution, we're all going to get out of this hole faster."
anonymous

'I Cry on Tuesdays and Fridays' - The New York Times - 0 views

www.nytimes.com/...coronavirus-mental-health.html

shared by anonymous on 28 Mar 21 - No Cached
  • ‘I Cry on Tuesdays and Fridays’
  • Moms are still primal screaming their hearts out.
  • Michelle Pasos, 46, describes herself as someone who has “always been extremely healthy.”
  • ...25 more annotations...
  • That is until the pandemic, when she ended up in the emergency room because she had a bad reaction to a drug prescribed to bring down her elevated blood pressure.
  • when the hospital gave her the option of going home and monitoring herself, or staying an extra night, she chose to stay. It was the first time she had felt calm in a year.
  • Primal Scream phone line
  • explored the emotional and economic pressures on a generation of moms,
  • hough there is additional federal support to families, more Americans are vaccinated every day and job loss is not quite as dire as it was in the early days of the pandemic, unemployment claims remain higher than they were in previous economic crises
  • And moms are still not OK.
  • “Despite the increased labor force participation of mothers, mothers are still having a really hard time,”
  • Despite their return to the labor force, they are not having much relief at home, and by that I mean, many children are still home-schooling.
  • She added that the burden of remote school has fallen disproportionately on the shoulders of mothers
  • Almost every mother I have spoken to during the pandemic, no matter what their financial and family circumstances, has expressed guilt about complaining
  • Lower-income parents have already been hit harder by unemployment than their higher-income and college-educated counterparts.
  • Research has shown that in states where children received only remote instruction during the pandemic, mothers’ labor force participation has been lower than in those where children attended school in person.
  • “Now it’s like 76 percent of moms and 94 percent of dads with college degrees,” he said. This suggests that where families could afford for one parent to step back from work to deal with domestic labor, mothers were bearing the brunt.
  • While I can list these labor market statistics all day, the emotional impact of Covid-19 is ongoing, devastating and harder to quantify.
  • “I cry on Tuesdays and Fridays. Sometimes I have an extra bonus day, like on this Monday,”
  • when she called into the Primal Scream line
  • Why Tuesdays and Fridays? On Tuesdays, her husband has a lot of meetings, and her day isn’t light either, so even though she is trading off baby care, it’s “really high octane all day.”
  • It’s a matter of having kept things nominally together all week, and then you have this big letdown,”
  • She said she has felt “terrified” for two years, after being anxious during her pregnancy as well, because she wanted her daughter so badly.
  • “I must have buckets of cortisol,”
  • “More than parental status or gender, education has been most decisive in who has lost jobs during the pandemic,”
  • But mothers shouldn’t have to slap on a Pollyanna smile.
  • , there was already a gender gap in caregiving before the pandemic, and moms were more likely than dads to step back from paid work to fill any family needs.
  • The past year has only exacerbated the difficulties caregivers face in the United States.
  • We can acknowledge that things could be worse, but at the same time honor the fact that our circumstances are still so far from good.
ilanaprincilus06

The 'Time Has Come' For A Global Pandemic Treaty, WHO's Tedros Says : Coronavirus Updat... - 0 views

www.npr.org/...ndemic-treaty-whos-tedros-says

Covid-19 government pandemic

shared by ilanaprincilus06 on 05 Jun 21 - No Cached
  • The COVID-19 pandemic proves that the world needs a pandemic treaty, says WHO Director-General Tedros Adhanom Ghebreyesus.
  • It's the one major change, Tedros said, that would do the most to boost global health security and also empower the World Health Organization.
  • More than two dozen world leaders said in March that they support an international treaty or framework on pandemic preparedness and response, signing a letter whose signatories notably did not include the U.S., China or Russia.
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  • "The United States was one of the countries that supported the resolution to hold the special session," the WHO said Monday in response to an NPR inquiry. "That is not to say it has committed to support the treaty yet, as the process of moving forward was only confirmed today."
  • "The safety of the world's people cannot rely solely on the goodwill of governments."
  • A treaty would make countries more accountable to one another, he said.
  • The lack of sharing — of information, technology, resources and data — is the COVID-19 pandemic's defining characteristic, the WHO leader said.
  • "a monumental error for any country to think the danger has passed."
  • Tedros' remarks echoed the frustrations he raised last year, when he said the pandemic was presenting humanity with a test — one that we are failing.
  • "Are we unable to distinguish or identify the common enemy?"
Javier E

Pandemic-Era Politics Are Ruining Public Education - The Atlantic - 0 views

www.theatlantic.com/...622824

learning teaching trends school history ideology books reading research social social media technology psychology

shared by Javier E on 11 Mar 22 - No Cached
  • You’re also the nonvoting, perhaps unwitting, subject of adults’ latest pedagogical experiments: either relentless test prep or test abolition; quasi-religious instruction in identity-based virtue and sin; a flood of state laws to keep various books out of your hands and ideas out of your head.
  • Your parents, looking over your shoulder at your education and not liking what they see, have started showing up at school-board meetings in a mortifying state of rage. If you live in Virginia, your governor has set up a hotline where they can rat out your teachers to the government. If you live in Florida, your governor wants your parents to sue your school if it ever makes you feel “discomfort” about who you are
  • Adults keep telling you the pandemic will never end, your education is being destroyed by ideologues, digital technology is poisoning your soul, democracy is collapsing, and the planet is dying—but they’re counting on you to fix everything when you grow up.
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  • It isn’t clear how the American public-school system will survive the COVID years. Teachers, whose relative pay and status have been in decline for decades, are fleeing the field. In 2021, buckling under the stresses of the pandemic, nearly 1 million people quit jobs in public education, a 40 percent increase over the previous year.
  • These kids, and the investments that come with them, may never return—the beginning of a cycle of attrition that could continue long after the pandemic ends and leave public schools even more underfunded and dilapidated than before. “It’s an open question whether the public-school system will recover,” Steiner said. “That is a real concern for democratic education.”
  • The high-profile failings of public schools during the pandemic have become a political problem for Democrats, because of their association with unions, prolonged closures, and the pedagogy of social justice, which can become a form of indoctrination.
  • The party that stands for strong government services in the name of egalitarian principles supported the closing of schools far longer than either the science or the welfare of children justified, and it has been woefully slow to acknowledge how much this damaged the life chances of some of America’s most disadvantaged students.
  • Public education is too important to be left to politicians and ideologues. Public schools still serve about 90 percent of children across red and blue America.
  • Since the common-school movement in the early 19th century, the public school has had an exalted purpose in this country. It’s our core civic institution—not just because, ideally, it brings children of all backgrounds together in a classroom, but because it prepares them for the demands and privileges of democratic citizenship. Or at least, it needs to.
  • What is school for? This is the kind of foundational question that arises when a crisis shakes the public’s faith in an essential institution. “The original thinkers about public education were concerned almost to a point of paranoia about creating self-governing citizens,”
  • “Horace Mann went to his grave having never once uttered the phrase college- and career-ready. We’ve become more accustomed to thinking about the private ends of education. We’ve completely lost the habit of thinking about education as citizen-making.”
  • School can’t just be an economic sorting system. One reason we have a stake in the education of other people’s children is that they will grow up to be citizens.
  • Public education is meant not to mirror the unexamined values of a particular family or community, but to expose children to ways that other people, some of them long dead, think.
  • If the answer were simply to push more and more kids into college, the United States would be entering its democratic prime
  • So the question isn’t just how much education, but what kind. Is it quaint, or utopian, to talk about teaching our children to be capable of governing themselves?
  • The COVID era, with Donald Trump out of office but still in power and with battles over mask mandates and critical race theory convulsing Twitter and school-board meetings, shows how badly Americans are able to think about our collective problems—let alone read, listen, empathize, debate, reconsider, and persuade in the search for solutions.
  • democratic citizenship can, at least in part, be learned.
  • The history warriors build their metaphysics of national good or evil on a foundation of ignorance. In a 2019 survey, only 40 percent of Americans were able to pass the test that all applicants for U.S. citizenship must take, which asks questions like “Who did the United States fight in World War II?” and “We elect a President for how many years?” The only state in which a majority passed was Vermont.
  • he orthodoxies currently fighting for our children’s souls turn the teaching of U.S. history into a static and morally simple quest for some American essence. They proceed from celebration or indictment toward a final judgment—innocent or guilty—and bury either oppression or progress in a subordinate clause. The most depressing thing about this gloomy pedagogy of ideologies in service to fragile psyches is how much knowledge it takes away from students who already have so little
  • A central goal for history, social-studies, and civics instruction should be to give students something more solid than spoon-fed maxims—to help them engage with the past on its own terms, not use it as a weapon in the latest front of the culture wars.
  • Releasing them to do “research” in the vast ocean of the internet without maps and compasses, as often happens, guarantees that they will drown before they arrive anywhere.
  • The truth requires a grounding in historical facts, but facts are quickly forgotten without meaning and context
  • The goal isn’t just to teach students the origins of the Civil War, but to give them the ability to read closely, think critically, evaluate sources, corroborate accounts, and back up their claims with evidence from original documents.
  • This kind of instruction, which requires teachers to distinguish between exposure and indoctrination, isn’t easy; it asks them to be more sophisticated professionals than their shabby conditions and pay (median salary: $62,000, less than accountants and transit police) suggest we are willing to support.
  • To do that, we’ll need to help kids restore at least part of their crushed attention spans.
  • staring at a screen for hours is a heavy depressant, especially for teenagers.
  • we’ll look back on the amount of time we let our children spend online with the same horror that we now feel about earlier generations of adults who hooked their kids on smoking.
  • “It’s not a choice between tech or no tech,” Bill Tally, a researcher with the Education Development Center, told me. “The question is what tech infrastructure best enables the things we care about,” such as deep engagement with instructional materials, teachers, and other students.
  • The pandemic should have forced us to reassess what really matters in public school; instead, it’s a crisis that we’ve just about wasted.
  • Like learning to read as historians, learning to sift through the tidal flood of memes for useful, reliable information can emancipate children who have been heedlessly hooked on screens by the adults in their lives
  • Finally, let’s give children a chance to read books—good books. It’s a strange feature of all the recent pedagogical innovations that they’ve resulted in the gradual disappearance of literature from many classrooms.
  • The best way to interest young people in literature is to have them read good literature, and not just books that focus with grim piety on the contemporary social and psychological problems of teenagers.
  • We sell them insultingly short in thinking that they won’t read unless the subject is themselves. Mirrors are ultimately isolating; young readers also need windows, even if the view is unfamiliar, even if it’s disturbing
  • connection through language to universal human experience and thought is the reward of great literature, a source of empathy and wisdom.
  • The culture wars, with their atmosphere of resentment, fear, and petty faultfinding, are hostile to the writing and reading of literature.
  • W. E. B. Du Bois wrote: “Nations reel and stagger on their way; they make hideous mistakes; they commit frightful wrongs; they do great and beautiful things. And shall we not best guide humanity by telling the truth about all this, so far as the truth is ascertainable?”
  • The classroom has become a half-abandoned battlefield, where grown-ups who claim to be protecting students from the virus, from books, from ideologies and counter-ideologies end up using children to protect themselves and their own entrenched camps.
  • American democracy can’t afford another generation of adults who don’t know how to talk and listen and think. We owe our COVID-scarred children the means to free themselves from the failures of the past and the present.
  • Students are leaving as well. Since 2020, nearly 1.5 million children have been removed from public schools to attend private or charter schools or be homeschooled.
  • “COVID has encouraged poor parents to question the quality of public education. We are seeing diminished numbers of children in our public schools, particularly our urban public schools.” In New York, more than 80,000 children have disappeared from city schools; in Los Angeles, more than 26,000; in Chicago, more than 24,000.
anonymous

For Some Teens, It's Been a Year of Anxiety and Trips to the E.R. - The New York Times - 0 views

www.nytimes.com/...virus-mental-health-teens.html

shared by anonymous on 27 Mar 21 - No Cached
  • For Some Teens, It’s Been a Year of Anxiety and Trips to the E.R.
  • During the pandemic, suicidal thinking is up. And families find that hospitals can’t handle adolescents in crisis.
  • stability didn’t last.
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  • “The social isolation since then, over all this time, it just got to him,”
  • “This is a charming, funny kid, also sensitive and anxious,” she said. “He couldn’t find a job; he couldn’t really go out. And he started using marijuana again, and Xanax.”
  • The teenager’s frustration finally boiled over this month, when he deliberately cut himself.
  • The doctors sent him home, she said, “with no support, no therapy, nothing.”
  • Surveys and statistics show that for young people who are anxious by nature, or feeling emotionally fragile already, the pandemic and its isolation have pushed them to the brink
  • Rates of suicidal thinking and behavior are up by 25 percent or more from similar periods in 2019, according to a just-published analysis of surveys of young patients coming into the emergency room.
  • For these teenagers, there aren’t many places to turn.
  • Finally, when a crisis hits, many of these teenagers end up in the local emergency department — the one place desperate families so often go for help.
  • “This is a national crisis we’re facing,”
  • For the young people coming undone, however, pandemic life presents unusual challenges, pediatricians say
  • “What parents and children are consistently reporting is an increase in all symptoms — a child who was a little anxious before the pandemic became very anxious over this past year,”
  • “This giant boy, crying — it’s terrible to see.” The young man has had panic attacks, twice followed by a blackout. During one, he fell and injured his face.
  • These young people do not necessarily qualify for a psychiatric diagnosis, nor are they “traumatized” in the strict sense of having had a life-threatening experience (or the perception of one).
  • Rather, they are trying to manage an interruption in their
  • The result is grief, but grief without a name or a specific cause, an experience some psychologists call “ambiguous loss.”
  • “Everything that used to be familiar and give structure to their lives, and predictability, and normalcy, is gone,” said Sharon Young, a therapist in Hendersonville. “Kids need all these things even more than adults do, and it’s hard for them to feel emotionally safe when they’re no longer there.”
  • Nationwide Children’s Hospital in Columbus, Ohio, has an emergency department that is a decent size for a pediatric hospital, with capacity for 62 children or adolescents
  • “This was huge problem pre-pandemic,” said Dr. David Axelson, chief of psychiatry and behavioral health at the hospital. “We were seeing a rise in emergency department visits for mental health problems in kids, specifically for suicidal thinking and self-harm. Our emergency department was overwhelmed with it, having to board kids on the medical unit while waiting for psych beds.”
  • “We have to say no,” Dr. Axelson said.
  • Like many other parents, she is now looking after an unstable child and wondering where to go next. A drug rehab program may be needed, as well as regular therapy.
  • “Covid has put our system under a microscope in terms of the things that don’t work,”
  • “We had a shaky system of care in pediatric mental health prior to this pandemic, and now we have all these added stressors on it, all these kids coming in for pandemic-related issues. Hospitals everywhere are scrambling to adjust.”
anonymous

Pandemic Social Life, One Year In - The New York Times - 0 views

www.nytimes.com/...d-19-one-year-anniversary.html

shared by anonymous on 28 Mar 21 - No Cached
  • One Year Together, Apart
  • The pandemic redefined relationships and self-reliance.
  • In the year since the pandemic began, people learned to be together while apart and navigated the pain of feeling apart while together
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  • Screens, small and large, became crucial links to the rest of the world.
  • In doing so, they rediscovered each other, and experienced the joys of bonding and the suffocation of constant proximity.
  • In some instances, these revelations were not happy ones: lawyers and mediators saw a spike in clients looking to divorce as soon as courts reopened.
  • Engagements and pregnancy announcements seemed to pop up constantly on social media. And there were plenty of weddings.
  • Couples in quarantine learned a lot about their significant others.
  • Young people around the world, cut off from their usual social lives, faced a “mental health pandemic.”
  • In one study, almost one-third of the teens interviewed said they had felt unhappy or depressed.
  • Parents, especially mothers, left the work force quickly and in large numbers in the spring.
  • Those who continued working had to balance the demands of their jobs with domestic chores, child care and online schooling, putting strain on their mental health.
  • Retirees put off plans that had been years in the making, like travel and volunteer work.
  • Inside nursing homes, Covid-19 outbreaks became all too regular, with more than 163,000 residents and workers dying of the virus.
  • Delivery drivers dealt with health risks, theft and assault.
  • Airline workers who weren’t furloughed had to confront passengers who refused to wear masks.
  • hospital staff around the country dealt with the gut-wrenching horrors of a steep surge in cases.
  • Doctors and nurses agonized over putting their families at risk, and dealt with intense burnout and pay cuts.
  • Some said that being characterized as heroes by the public left them little room to express vulnerability.
  • a toll higher than in any other country.
  • The world’s struggle to contain the coronavirus was often compared to a war
  • in this case, the enemy claimed more Americans than World War I, World War II and the Vietnam War combined
  • Grief and loss defined the last year
  • Funerals and final goodbyes took place over video calls, if at all.
  • a sign that people will soon be finding their way back to each other.
  • If you’re wondering what comes after, we are, too.Are you anxious that things will never be the same? Or are you fearful that we’ll return to “the same” much too quickly? Or maybe there is something seemingly small that you will cherish being able to do?
Javier E

Opinion | Why Covid's Airborne Transmission Was Acknowledged So Late - The New York Times - 0 views

www.nytimes.com/...rus-airborne-transmission.html

who cdc transmission Covid-19 Science research psychology bias

shared by Javier E on 08 May 21 - No Cached
  • A week ago, more than a year after the World Health Organization declared that we face a pandemic, a page on its website titled “Coronavirus Disease (Covid-19): How Is It Transmitted?” got a seemingly small update.
  • The revised response still emphasizes transmission in close contact but now says it may be via aerosols — smaller respiratory particles that can float — as well as droplets. It also adds a reason the virus can also be transmitted “in poorly ventilated and/or crowded indoor settings,” saying this is because “aerosols remain suspended in the air or travel farther than 1 meter.”
  • on Friday, the Centers for Disease Control and Prevention also updated its guidance on Covid-19, clearly saying that inhalation of these smaller particles is a key way the virus is transmitted, even at close range, and put it on top of its list of how the disease spreads.
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  • 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?
Javier E

Pandemic Advice From Athletes - The New York Times - 0 views

www.nytimes.com/...athletes-pandemic-advice.html

pandemic climate change psychology endurance resilience toughness mental health goals process pacing perseverance

shared by Javier E on 08 Nov 20 - No Cached
  • There’s a special kind of exhaustion that the world’s best endurance athletes embrace. Some call it masochistic, others may call it brave. When fatigue sends legs and lungs to their limits, they are able to push through to a gear beyond their pain threshold. These athletes approach fatigue not with fear but as a challenge, an opportunity.
  • It’s a quality that allows an ultramarathoner to endure what could be an unexpected rough segment of an 100-mile race, or a sailor to push ahead when she’s in the middle of the ocean, racing through hurricane winds alone.
  • The drive to persevere is something some are born with, but it’s also a muscle everyone can learn to flex. In a way, everyone has become an endurance athlete of sorts during this pandemic, running a race with no finish line that tests the limits of their exhaustion.
  • ...31 more annotations...
  • One message they all had: You are stronger than you think you are, and everyone is able to adapt in ways they didn’t think possible.
  • there are a few techniques to help you along — 100-mile race not required.
  • There’s a pacing in living day to day, just as there’s pacing in climbing.
  • Training to become an elite endurance athlete means learning to embrace discomfort. Instead of hiding from pain, athletes must learn to work with it. A lot of that comes down to pacing
  • Similarly, as you muscle through an ongoing pandemic, you must look for ways to make peace with unknowns and new, uncomfortable realities. “When we think about the coronavirus, we are in it for the long run; so how do you pace yourself?”
  • She recommends thinking about your routines, practicing positive self-talk and focusing on processes instead of outcomes
  • You don’t know when the pandemic will end, but you can take control of your daily habits
  • “always have a little in reserve.”
  • Deplete your resources early and you’ll be in trouble. Focusing on day-to-day activities will pay off in the long run.
  • If you burn out all your mental energy in one day or week, you may find it more difficult to adapt when things don’t return to normal as quickly as you would hope.
  • Pace Yourself
  • “Don’t play all your cards at once and keep a little something in reserve.”
  • Create Mini-Goals
  • Sports psychologists frequently recommend creating mini milestones en route to a big goal. There are many steps on the path from base camp to a mountain’s summit. Likewise, there are smaller, more achievable milestones to reach and celebrate as you venture ahead into the unknown.
  • Focus on Something New
  • “I’m really good at breaking things down into small increments and setting micro-goals,” he said. How micro?
  • “I break things down to 10 seconds at a time,” Mr. Woltering continued. “You just have to be present in what you are doing and you have to know that it may not be the most fun — or super painful — now, but that could change in 10 seconds down the road.”
  • And it may not change quickly. Mr. Woltering said he has spent six-hour stretches counting to 10 over and over again. “You just keep moving and keep counting,” he said. “And you have to have faith that it will change at some point.”
  • Create Structure
  • “Part of expedition life is having a routine that you’re comfortable with. When I’m on expedition, I always start the day with a basin of warm water and soap. I wash my hands, face, neck and ears and get the sand out of my eyes,” he said. “It’s something that’s repeated that gets you a sense of comfort and normalcy.”
  • During the pandemic, he has found comfort and normalcy by getting outdoors, and climbing whenever possible to “run the engine.”
  • Dee Caffari, a British sailor and the first woman to sail solo, nonstop, around the world in both directions, said structure is imperative to fight back loneliness and monotony.
  • “In your day you need structure,” Ms. Caffari said. “You need to get up in the morning knowing you’re going to make something happen.”
  • “Setting goals that are controllable makes it easier to adapt,” Dr. Meijen said. “If you set goals that are controlled by other people, goals that aren’t realistic or are tough or boring, those are much harder to adapt to.”
  • When all else fails, look to something new: a new hobby, a new goal, a new experience
  • During a particularly hard patch of a competition, some athletes say they focus on a different sense, one that perhaps is not at the forefront of their mind when the pain sets in. A runner could note the smells around her and a climber could note the way his hair is blowing in the wind.
  • When athletes are injured, sports psychologists and coaches frequently encourage them to find a new activity to engage their mind and body. The key is to adapt, adapt and then adapt again.
  • “We all want mental toughness, it’s an important part of dealing with difficult things,”
  • “The current definition of mental toughness is the ability to pivot and to be nimble and flexible.”
  • “The next moment is always completely uncertain, and it’s always been that way,” Dr. Gervais said. But adapting, adjusting expectations and discovering new goals or hobbies can allow you to continue to build the muscle that is mental toughness.
  • Bottom line? “Optimism is an antidote to anxiety,”
Javier E

Reasons for COVID-19 Optimism on T-Cells and Herd Immunity - 0 views

nymag.com/...t-cells-and-herd-immunity.html

immunity Covid-19 research science

shared by Javier E on 13 Aug 20 - No Cached
  • It may well be the case that some amount of community protection kicks in below 60 percent exposure, and possibly quite a bit below that threshold, and that those who exhibit a cross-reactive T-cell immune response, while still susceptible to infection, may also have some meaningful amount of protection against severe disease.
  • early returns suggest that while the maximalist interpretation of each hypothesis is not very credible — herd immunity has probably not been reached in many places, and cross-reactive T-cell response almost certainly does not functionally immunize those who have it — more modest interpretations appear quite plausible.
  • Friston suggested that the truly susceptible portion of the population was certainly not 100 percent, as most modelers and conventional wisdom had it, but a much smaller share — surely below 50 percent, he said, and likely closer to about 20 percent. The analysis was ongoing, he said, but, “I suspect, once this has been done, it will look like the effective non-susceptible portion of the population will be about 80 percent. I think that’s what’s going to happen.”
  • ...31 more annotations...
  • one of the leading modelers, Gabriela Gomes, suggested the entire area of research was being effectively blackballed out of fear it might encourage a relaxation of pandemic vigilance. “This is the very sad reason for the absence of more optimistic projections on the development of this pandemic in the scientific literature,” she wrote on Twitter. “Our analysis suggests that herd-immunity thresholds are being achieved despite strict social-distancing measures.”
  • Gomes suggested, herd immunity could happen with as little as one quarter of the population of a community exposed — or perhaps just 20 percent. “We just keep running the models, and it keeps coming back at less than 20 percent,” she told Hamblin. “It’s very striking.” Such findings, if they held up, would be very instructive, as Hamblin writes: “It would mean, for instance, that at 25 percent antibody prevalence, New York City could continue its careful reopening without fear of another major surge in cases.”
  • But for those hoping that 25 percent represents a true ceiling for pandemic spread in a given community, well, it almost certainly does not, considering that recent serological surveys have shown that perhaps 93 percent of the population of Iquitos, Peru, has contracted the disease; as have more than half of those living in Indian slums; and as many as 68 percent in particular neighborhoods of New York City
  • overshoot of that scale would seem unlikely if the “true” threshold were as low as 20 or 25 percent.
  • But, of course, that threshold may not be the same in all places, across all populations, and is surely affected, to some degree, by the social behavior taken to protect against the spread of the disease.
  • we probably err when we conceive of group immunity in simplistically binary terms. While herd immunity is a technical term referring to a particular threshold at which point the disease can no longer spread, some amount of community protection against that spread begins almost as soon as the first people are exposed, with each case reducing the number of unexposed and vulnerable potential cases in the community by one
  • you would not expect a disease to spread in a purely exponential way until the point of herd immunity, at which time the spread would suddenly stop. Instead, you would expect that growth to slow as more people in the community were exposed to the disease, with most of them emerging relatively quickly with some immune response. Add to that the effects of even modest, commonplace protections — intuitive social distancing, some amount of mask-wearing — and you could expect to get an infection curve that tapers off well shy of 60 percent exposure.
  • Looking at the data, we see that transmissions in many severely impacted states began to slow down in July, despite limited interventions. This is especially notable in states like Arizona, Florida, and Texas. While we believe that changes in human behavior and changes in policy (such as mask mandates and closing of bars/nightclubs) certainly contributed to the decrease in transmission, it seems unlikely that these were the primary drivers behind the decrease. We believe that many regions obtained a certain degree of temporary herd immunity after reaching 10-35 percent prevalence under the current conditions. We call this 10-35 percent threshold the effective herd immunity threshold.
  • Indeed, that is more or less what was recently found by Youyang Gu, to date the best modeler of pandemic spread in the U.S
  • he cautioned again that he did not mean to imply that the natural herd-immunity level was as low as 10 percent, or even 35 percent. Instead, he suggested it was a plateau determined in part by better collective understanding of the disease and what precautions to take
  • Gu estimates national prevalence as just below 20 percent (i.e., right in the middle of his range of effective herd immunity), it still counts, I think, as encouraging — even if people in hard-hit communities won’t truly breathe a sigh of relief until vaccines arrive.
  • If you can get real protection starting at 35 percent, it means that even a mediocre vaccine, administered much more haphazardly to a population with some meaningful share of vaccination skeptics, could still achieve community protection pretty quickly. And that is really significant — making both the total lack of national coordination on rollout and the likely “vaccine wars” much less consequential.
  • At least 20 percent of the public, and perhaps 50 percent, had some preexisting, cross-protective T-cell response to SARS-CoV-2, according to one much-discussed recent paper. An earlier paper had put the figure at between 40 and 60 percent. And a third had found an even higher prevalence: 81 percent.
  • The T-cell story is similarly encouraging in its big-picture implications without being necessarily paradigm-changing
  • These numbers suggest their own heterogeneity — that different populations, with different demographics, would likely exhibit different levels of cross-reactive T-cell immune response
  • The most optimistic interpretation of the data was given to me by Francois Balloux, a somewhat contrarian disease geneticist and the director of the University College of London’s Genetics Institute
  • According to him, a cross-reactive T-cell response wouldn’t prevent infection, but would probably mean a faster immune response, a shorter period of infection, and a “massively” reduced risk of severe illness — meaning, he guessed, that somewhere between a third and three-quarters of the population carried into the epidemic significant protection against its scariest outcomes
  • the distribution of this T-cell response could explain at least some, and perhaps quite a lot, of COVID-19’s age skew when it comes to disease severity and mortality, since the young are the most exposed to other coronaviruses, and the protection tapers as you get older and spend less time in environments, like schools, where these viruses spread so promiscuously.
  • Balloux told me he believed it was also possible that the heterogeneous distribution of T-cell protection also explains some amount of the apparent decline in disease severity over time within countries on different pandemic timelines — a phenomenon that is more conventionally attributed to infection spreading more among the young, better treatment, and more effective protection of the most vulnerable (especially the old).
  • Going back to Youyang Gu’s analysis, what he calls the “implied infection fatality rate” — essentially an estimated ratio based on his modeling of untested cases — has fallen for the country as a whole from about one percent in March to about 0.8 percent in mid-April, 0.6 percent in May, and down to about 0.25 percent today.
  • even as we have seemed to reach a second peak of coronavirus deaths, the rate of death from COVID-19 infection has continued to decline — total deaths have gone up, but much less than the number of cases
  • In other words, at the population level, the lethality of the disease in America has fallen by about three-quarters since its peak. This is, despite everything that is genuinely horrible about the pandemic and the American response to it, rather fantastic.
  • there may be some possible “mortality displacement,” whereby the most severe cases show up first, in the most susceptible people, leaving behind a relatively protected population whose experience overall would be more mild, and that T-cell response may play a significant role in determining that susceptibility.
  • That, again, is Balloux’s interpretation — the most expansive assessment of the T-cell data offered to me
  • The most conservative assessment came from Sarah Fortune, the chair of Harvard’s Department of Immunology
  • Fortune cautioned not to assume that cross-protection was playing a significant role in determining severity of illness in a given patient. Those with such a T-cell response, she told me, would likely see a faster onset of robust response, yes, but that may or may not yield a shorter period of infection and viral shedding
  • Most of the scientists, doctors, epidemiologists, and immunologists I spoke to fell between those two poles, suggesting the T-cell cross-immunity findings were significant without necessarily being determinative — that they may help explain some of the shape of pandemic spread through particular populations, but only some of the dynamics of that spread.
  • he told me he believed, in the absence of that data, that T-cell cross-immunity from exposure to previous coronaviruses “might explain different disease severity in different people,” and “could certainly be part of the explanation for the age skew, especially for why the very young fare so well.”
  • the headline finding was quite clear and explicitly stated: that preexisting T-cell response came primarily via the variety of T-cells called CD4 T-cells, and that this dynamic was consistent with the hypothesis that the mechanism was inherited from previous exposure to a few different “common cold” coronaviruses
  • “This potential preexisting cross-reactive T-cell immunity to SARS-CoV-2 has broad implications,” the authors wrote, “as it could explain aspects of differential COVID-19 clinical outcomes, influence epidemiological models of herd immunity, or affect the performance of COVID-19 candidate vaccines.”
  • “This is at present highly speculative,” they cautioned.
Javier E

Covid-19 pandemic and chaos theory: Why the future is impossible to precisely predict -... - 0 views

www.vox.com/...covid-19-future-pandemic-chaos

pandemic chaos theory future modeling model

shared by Javier E on 09 Oct 21 - No Cached
  • In Washington state, a person with the virus attended a choir practice, and more than half of the other singers subsequently got sick. In South Korea, a 29-year-old man went out to nightclubs; he was Covid-19 positive, and he has since been linked to at least 54 new cases. In China, nine people sitting in the path of an air conditioning vent in a restaurant all got sick, most likely from one person, as the duct blew viral particles across their faces.
  • Small things could have changed these outcomes. The clubber could have decided to watch TV instead of going out dancing. If the choir practice was rescheduled for the next day, maybe the person would have felt sick and stayed home. The air conditioner in the restaurant could have been turned off.
  • “Little shifts can have really disproportionately sized impacts” in a pandemic. And scientists have a name for systems that operate like this: chaos.
  • ...16 more annotations...
  • An outbreak isn’t a double pendulum; it’s much more convoluted. Myriad chains of events, operating in overlapping networks, conspire to chart its course.
  • It’s the double pendulum, and as a physical object, it’s very simple: A pendulum (a string and a weight) is attached to the bottom of another. Its movement is explained by the laws of motion written by Isaac Newton hundreds of years ago.
  • But slight changes in the initial condition of the pendulum — say it starts its swing from a little higher up, or if the weight of the pendulum balls is a little heavier, or one of the pendulum arms is a bit longer than the other — lead to wildly different outcomes that are very hard to predict.
  • The double pendulum is chaotic because the motion of the first pendulum influences the motion of the second, which then influences the entire apparatus. There isn’t a simple scale or ratio to describe how the inputs relate to the outputs. A one-gram change to the weight of a pendulum ball can result in a very different swing pattern than a two-gram change.
  • It teaches us to understand the mechanics of a system — the science of how it works — without being able to precisely predict its future. It helps us visualize how something that seems like it should be linear and predictable just isn’t.
  • That’s why, when pressed, epidemiologists have to say they don’t know what’s going to happen.
  • Climate scientists clearly tell us adding CO2 to the air will increase global temperatures. Yet they argue about when the worst effects of climate change will be felt and how bad it will be
  • Still, they know the mechanics of outbreaks. The chaos “doesn’t necessarily mean we know nothing,” Kissler says. They understand the conditions that make an outbreak worse and the conditions that make it better.
  • There is a tough tension of the current moment that we all need to work through: The future is clouded in chaos, but we know the mechanics of this system
  • Here are the mechanics. Scientists know that if we let up on social distancing, without an alternative plan in place, the virus can infect more people. They know this virus is likely to persist for at least a few years without a vaccine. They know it’s very contagious. That it’s very deadly. They also know that its pandemic potential is hardly spent, and that most of the population of the United States and the world is still vulnerable to it.
  • Will residents keep up with mask-wearing and social distancing, even when their leaders relax regulations? Plus, there are scientific questions about the virus still not understood: Will it diminish transmission in a seasonal pattern? Do children contribute greatly to its spread? How long does immunity last after an infection? Why do some people breathe out more of the virus than others? The answers to these questions will influence the future, and we do not know the answers.
  • Scientists are still unraveling what makes the difference between a sprawling outbreak in one city and a more manageable one in another. Some of it is the result of policy, some is the result of demographics, some is about structural inequality and racism, and some comes down to individual behavior. Some of it is just luck. That’s chaos for you.
  • “I don’t see uncertainty as a lack of knowledge,” says Philipp Lorenz-Spreen, a physicist who studies the chaos of a different sort of viral dynamics. “I think it’s a fundamental part of how our world works. It’s not our fault we do not know where this all will go.”
  • Newton clearly told us what happens when an object drops from the sky. But follow his laws, and find that the path of a double pendulum is very, very difficult to predict.
  • There’s a simple mechanism that is helping me understand the many possible futures we face with the Covid-19 pandemic.
  • Epidemiologists are clearly telling us what happens when you bring masses of people together during a pandemic. But they can’t tell us the exact shape this outbreak will take.
Javier E

If We Knew Then What We Know Now About Covid, What Would We Have Done Differently? - WSJ - 0 views

www.wsj.com/...covid-lessons-learned-9dd5566f

politics us history crisis culture policy trump pandemic response science psychology

shared by Javier E on 12 Mar 23 - No Cached
  • For much of 2020, doctors and public-health officials thought the virus was transmitted through droplets emitted from one person’s mouth and touched or inhaled by another person nearby. We were advised to stay at least 6 feet away from each other to avoid the droplets
  • A small cadre of aerosol scientists had a different theory. They suspected that Covid-19 was transmitted not so much by droplets but by smaller infectious aerosol particles that could travel on air currents way farther than 6 feet and linger in the air for hours. Some of the aerosol particles, they believed, were small enough to penetrate the cloth masks widely used at the time.
  • The group had a hard time getting public-health officials to embrace their theory. For one thing, many of them were engineers, not doctors.
  • ...37 more annotations...
  • “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.
cvanderloo

Culture matters a lot in successfully managing a pandemic - and many countries that did... - 0 views

theconversation.com/had-one-thing-in-common-152375

research covid pandemic world women egalitarian

shared by cvanderloo on 26 Mar 21 - No Cached
  • Culture matters more than a leader’s gender in how a nation survives a global pandemic, according to a study I conducted on gender and COVID-19 management, which was published in December in the journal PLOS ONE.
  • We identified no statistically significant differences in deaths based on the gender of the country’s leader.
  • Instead, we found that pandemic outcomes hinged primarily on how egalitarian a country is.
    • cvanderloo
      cvanderloo on 26 Mar 21
       
      egalitarian: relating to or believing in the principle that all people are equal and deserve equal rights and opportunities
  • ...4 more annotations...
  • We identified two cultural variables with a statistically significant effect on death rate: individualism and “power distance”
  • Leaders do have important power during a crisis. They can institute emergency policies – from mask requirements to stay-at-home orders – to halt the virus’s spread. But it takes everyone’s cooperation to make these measures work.
  • Egalitarian countries also tend to reject traditional gender roles, so are more likely to elect women leaders. All 16 women-led countries in our study rated as “egalitarian.”
  • Women leaders enjoyed rare latitude during COVID-19 that allowed them to do everything in their power to manage it.
anonymous

Suicide and Self-Harm: Bereaved Families Count the Costs of Lockdowns - The New York Times - 0 views

www.nytimes.com/...uicide-self-harm-pandemic.html

shared by anonymous on 27 Mar 21 - No Cached
  • Suicide and Self-Harm: Bereaved Families Count the Costs of Lockdowns
  • The psychological toll on young people of months in isolation and great global suffering is becoming more clear after successive lockdowns.
  • Joshua Morgan was hopeful he could find a job despite the pandemic, move out of his mother’s house and begin his life.
  • ...23 more annotations...
  • lockdowns in Britain dragged on and no job emerged, the young man grew cynical and self-conscious, his sister Yasmin said.
  • Mr. Morgan was “exceptionally careful” about her health.
  • But days before the end of his quarantine last month, Mr. Morgan, 25, took his own life.
  • “He just sounded so deflated,” his sister said of their last conversation, adding that he said he felt imprisoned and longed to go outside.
  • “The cost of the pandemic was my brother’s life,” she said. “It’s not just people dying in a hospital — it’s people dying inside.”
  • Editors’ Picks
  • More than 2.7 million people have died from the coronavirus — and at least 126,000 in Britain alone
  • Those numbers are a tangible count of the pandemic’s cos
  • public health officials in some areas that have seen a surge of adolescent suicides have pushed for schools to reopen, although researchers say it is too early to conclusively link restrictions to suicide rates.
  • But bereaved families of young people who have died during the pandemic are haunted by questions over whether lockdowns — which not only shut stores and restaurants but required people to stay home for months — played a role.
  • They are calling for more resources for mental health and suicide prevention.
  • “Mental health has become a buzzword during the pandemic, and we need to keep it that way,”
  • While people may have felt a sense of togetherness during the first lockdowns, that feeling began to wear thin for some as it became clear that restrictions were hitting disadvantaged groups, including many young people, harder.
  • “If you are a young person, you are looking for hope,”
  • “But the job market is going to be constrained, and opportunities to build your life are going to be slimmer.”
  • “Imagine a young person in a small room, who takes their course online and has limited social life due to restrictions,”
  • “They may be tempted to consume more drugs or drink more alcohol, and may have less physical activity, all of which can contribute to symptoms of depression, anxiety and poor sleep.”
  • “We would ask him if he was depressed, and he would say, ‘Depressed? I don’t know what depressed is, I don’t think I am. I feel bored, but I don’t feel depressed,’”
  • “With the pandemic, the things that spiced his life, that made it worth going to school, were gone,” he added.
  • After a series of lockdowns in Britain last year, one suicide hotline for young people, Papyrus, saw its calls increase by 25 percent, in line with an increase of about 20 percent each year.
  • “Lockdown put Lily in physical and emotional situations she would never have in normal times.”
  • “It’s OK for a young child to fall over and let their parents know that their knee hurts,” Ms. Arkwright said. “This same attitude needs to be extended to mental health.”
  • People should be praised for adapting and finding resilience during these difficult times, Mr. Flynn said. “Even the need to reach out to a help-line shows resilience,” he said, adding that considering the circumstances, many people were doing “really well.”
martinelligi

What the Pandemic Is Doing to Our Brains - The Atlantic - 0 views

www.theatlantic.com/...618221

pandemic brain science psychology

shared by martinelligi on 12 Mar 21 - No Cached
  • This is the fog of late pandemic, and it is brutal. In the spring, we joked about the Before Times, but they were still within reach, easily accessible in our shorter-term memories. In the summer and fall, with restrictions loosening and temperatures rising, we were able to replicate some of what life used to be like, at least in an adulterated form: outdoor drinks, a day at the beach. But now, in the cold, dark, featureless middle of our pandemic winter, we can neither remember what life was like before nor imagine what it’ll be like after.
  • The sunniest optimist would point out that all this forgetting is evidence of the resilience of our species. Humans forget a great deal of what happens to us, and we tend to do it pretty quickly—after the first 24 hours or so. “Our brains are very good at learning different things and forgetting the things that are not a priority,” Tina Franklin, a neuroscientist at Georgia Tech, told me. As the pandemic has taught us new habits and made old ones obsolete, our brains have essentially put actions like taking the bus and going to restaurants in deep storage, and placed social distancing and coughing into our elbows near the front of the closet. When our habits change back, presumably so will our recall.
  • The share of Americans reporting symptoms of anxiety disorder, depressive disorder, or both roughly quadrupled from June 2019 to December 2020, according to a Census Bureau study released late last year. What’s more, we simply don’t know the long-term effects of collective, sustained grief. Longitudinal studies of survivors of Chernobyl, 9/11, and Hurricane Katrina show elevated rates of mental-health problems, in some cases lasting for more than a decade
clairemann

Jonathan Haidt on the Pandemic and America's Polarization - The Atlantic - 0 views

www.theatlantic.com/...612025

thinking Politics Democrats Republicans reason rational pandemic

shared by clairemann on 26 Oct 20 - No Cached
  • The best way to approach this question, he replied, is to look at the trajectory of American democracy over the past decade and a half or so.
  • increasingly concerned by how politically polarized America was becoming, and polarization has only worsened over the past dozen years. “
  • Things change, sometimes for the better, sometimes for the worse; you can’t just extrapolate from the present. “
  • ...6 more annotations...
  • “You can’t get compromise. You get exactly the situation that the Founders feared, that [James] Madison wrote about in ‘Federalist 10,’ which is faction, which is people care more about defeating the other side than they do about the common good.”
  • Social media essentially gives a megaphone to the extremes, so it’s very hard to know what most people really think.
  • it’s quite clear that this pandemic is turning into just another culture-war issue, where people on the left see what they want to see and people on the right see what they want to see.”
  • the pandemic is having the sort of unifying effect that major crises tend to have.
  • For example, 90 percent of Americans believe that “we’re all in it together,” compared to just 63 percent in the fall of 2018. The share of Americans who describe the country as “unified” has grown from 4 percent in 2018 to 32 percent today
  • Other polls show that the divide between Republicans and Democrats on social-distancing measures isn’t all that large.
Javier E

'Follow the science': As Year 3 of the pandemic begins, a simple slogan becomes a polit... - 0 views

www.washingtonpost.com/...logan-becomes-political-weapon

science pandemic slogan philosophy implications truth knowledge bias

shared by Javier E on 13 Feb 22 - No Cached
  • advocates for each side in the masking debate are once again claiming the mantle of science to justify political positions
  • pleas to “follow the science” have consistently yielded to use of the phrase as a rhetorical land mine.
  • “so much is mixed up with science — risk and values and politics. The phrase can come off as sanctimonious,” she said, “and the danger is that it says, ‘These are the facts,’ when it should say, ‘This is the situation as we understand it now and that understanding will keep changing.’
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  • The pandemic’s descent from medical emergency to political flash point can be mapped as a series of surges of bickering over that one simple phrase. “Follow the science!” people on both sides insisted, as the guidance from politicians and public health officials shifted over the past two years from anti-mask to pro-mask to “keep on masking” to more refined recommendations about which masks to wear and now to a spotty lifting of mandates.
  • demands that the other side “follow the science” are often a complete rejection of another person’s cultural and political identity: “It’s not just people believing the scientific research that they agree with. It’s that in this extreme polarization we live with, we totally discredit ideas because of who holds them.
  • “I’m struggling as much as anyone else,” she said. “Our job as informed citizens in the pandemic is to be like judges and synthesize information from both sides, but with the extreme polarization, nobody really trusts each other enough to know how to judge their information.
  • Many people end up putting their trust in some subset of the celebrity scientists they see online or on TV. “Follow the science” often means “follow the scientists” — a distinction that offers insight into why there’s so much division over how to cope with the virus,
  • although a slim majority of Americans they surveyed don’t believe that “scientists adjust their findings to get the answers they want,” 31 percent do believe scientists cook the books and another 16 percent were unsure.
  • Those who mistrust scientists were vastly less likely to be worried about getting covid-19 — and more likely to be supporters of former president Donald Trump,
  • A person’s beliefs about scientists’ integrity “is the strongest and most consistent predictor of views about … the threats from covid-19,”
  • When a large minority of Americans believe scientists’ conclusions are determined by their own opinions, that demonstrates a widespread “misunderstanding of scientific methods, uncertainty, and the incremental nature of scientific inquiry,” the sociologists concluded.
  • Americans’ confidence in science has declined in recent decades, especially among Republicans, according to Gallup polls
  • The survey found last year that 64 percent of Americans said they had “a great deal” or “quite a lot” of confidence in science, down from 70 percent who said that back in 1975
  • Confidence in science jumped among Democrats, from 67 percent in the earlier poll to 79 percent last year, while Republicans’ confidence cratered during the same period from 72 percent to 45 percent.
  • The fact that both sides want to be on the side of “science” “bespeaks tremendous confidence or admiration for a thing called ‘science,’ ”
  • Even in this time of rising mistrust, everybody wants to have the experts on their side.
  • That’s been true in American debates regarding science for many years
  • Four decades ago, when arguments about climate change were fairly new, people who rejected the idea looked at studies showing a connection between burning coal and acid rain and dubbed them “junk science.” The “real” science, those critics said, showed otherwise.
  • “Even though the motive was to reject a scientific consensus, there was still a valorization of expertise,”
  • “Even people who took a horse dewormer when they got covid-19 were quick to note that the drug was created by a Nobel laureate,” he said. “Almost no one says they’re anti-science.”
  • “There isn’t a thing called ‘the science.’ There are multiple sciences with active disagreements with each other. Science isn’t static.”
  • The problem is that the phrase has become more a political slogan than a commitment to neutral inquiry, “which bespeaks tremendous ignorance about what science is,”
  • t scientists and laypeople alike are often guilty of presenting science as a monolithic statement of fact, rather than an ever-evolving search for evidence to support theories,
  • while scientists are trained to be comfortable with uncertainty, a pandemic that has killed and sickened millions has made many people eager for definitive solutions.
  • “I just wish when people say ‘follow the science,’ it’s not the end of what they say, but the beginning, followed by ‘and here’s the evidence,’
  • As much as political leaders may pledge to “follow the science,” they answer to constituents who want answers and progress, so the temptation is to overpromise.
  • It’s never easy to follow the science, many scientists warn, because people’s behaviors are shaped as much by fear, folklore and fake science as by well-vetted studies or evidence-based government guidance.
  • “Science cannot always overcome fear,”
  • Some of the states with the lowest covid case rates and highest vaccination rates nonetheless kept many students in remote learning for the longest time, a phenomenon she attributed to “letting fear dominate our narrative.”
  • “That’s been true of the history of science for a long time,” Gandhi said. “As much as we try to be rigorous about fact, science is always subject to the political biases of the time.”
  • A study published in September indicates that people who trust in science are actually more likely to believe fake scientific findings and to want to spread those falsehoods
  • The study, reported in the Journal of Experimental Social Psychology, found that trusting in science did not give people the tools they need to understand that the scientific method leads not to definitive answers, but to ever-evolving theories about how the world works.
  • Rather, people need to understand how the scientific method works, so they can ask good questions about studies.
  • Trust in science alone doesn’t arm people against misinformation,
  • Overloaded with news about studies and predictions about the virus’s future, many people just tune out the information flow,
  • That winding route is what science generally looks like, Swann said, so people who are frustrated and eager for solid answers are often drawn into dangerous “wells of misinformation, and they don’t even realize it,” she said. “If you were told something every day by people you trusted, you might believe it, too.”
  • With no consensus about how and when the pandemic might end, or about which public health measures to impose and how long to keep them in force, following the science seems like an invitation to a very winding, even circular path.
clairemann

Experts Predict What Summer 2021 Will Be Like With The COVID-19 Pandemic | HuffPost Life - 1 views

www.huffpost.com/...-19_l_60535bc4c5b672d70982294c

COVID pandemic research science

shared by clairemann on 27 Mar 21 - No Cached
  • Certain feelings have practically vanished since the beginning of the coronavirus pandemic ― the most major of which is hope.
  • “Speaking for the U.S., I’m really hopeful that this summer will be remarkably different from last summer,” said Jennifer Nuzzo, a senior scholar at the Johns Hopkins Center for Health Security. “We’re on a good path right now and I just hope that we can stay on the path that we’re on.”
  • “These vaccines are absolutely our way out of this pandemic,” said David Aronoff, director of the Division of Infectious Diseases at Vanderbilt University Medical Center.
  • ...4 more annotations...
  • “One of the things that we are feeling better about is the data around SARS-CoV-2 transmission and recognizing that outdoor activities have not turned out, as best as we can tell, to be a significant factor in pushing the pandemic forward,” Brewer said, referring to the fact that the threat of virus spread is low in socially distant, outdoor settings
  • People who are vaccinated can also spend time indoors with unvaccinated, low-risk people from a single household.
  • “If you look at what’s happening with cases in particular, they’ve really fallen off since the beginning of January,” Brewer said. “It’s really hard to attribute that to population changes; something else has to be driving that. It couldn’t have been vaccines at that point, we didn’t have as many vaccines as we do now.”
  • “I continue to look for signals and continue to scrutinize the data, but so far I’m encouraged by the fact that we haven’t seen a real rise in case numbers particularly in the states where they have reported the variants,” said Nuzzo, who has been tracking COVID-19 trends and data since the pandemic’s beginning.
edencottone

Joe Biden to highlight gains and face tough scrutiny in first formal news conference - ... - 0 views

www.cnn.com/...index.html

Politics us

shared by edencottone on 25 Mar 21 - No Cached
  • President Joe Biden's first two months in power went remarkably smoothly considering he took office amid a once-in-a-century pandemic, a consequent economic crisis and his predecessor's refusal to recognize his victory.
  • The doubling of the pace of vaccinations in the last two months represents tangible progress on the one issue on which Biden's first year will likely be mostly judged -- the quest to revive a semblance of normal life.
  • "Now is not the time to let down our guard. If we all do our part, after a long, dark year, we can show once again that we are the United States of America. ... We're going to beat this pandemic," Biden said in Ohio on Tuesday, striking the balance between caution and hope that has marked his management of the pandemic, which polls show wins the approval of a majority of Americans.
  • ...9 more annotations...
  • A surge in border crossings by migrant children appeared to catch a White House focused on the pandemic off guard and offered Republicans an opening as they seek to slow his momentum -- and build their 2022 attack lines against Biden's narrow Democratic congressional majority.
  • And with its customary sense of timing, North Korea is testing the new commander-in-chief with missile launches that are ratcheting up tensions in a showdown that no president in the last 70 years has managed to solve.
  • The President has maintained approval ratings above 50% in his early months in office because he arrived with a mandate to tackle the pandemic head on and executed his agenda with a steady approach that was the antithesis of the erratic
  • Unlike the coronavirus crisis that has killed more than half-a-million Americans, the issues that are now at the top of the nightly newscasts have defied bipartisan consensus for decades -- and will provide a severe test of the President's calls for national unity and cooperation between Democrats and Republicans.
  • Two years ago, Democrats excoriated Trump administration officials for its handling of the crisis at the border. Now the problem is squarely within Biden's domain and government resources are once again strained to the brink as more than 600 unaccompanied children cross the Mexico border each day.
  • "We're not seeing any action. Our experience has taught us that now is the time to act. We need Congress to get on board. We need a recognition of the fact that there's a crisis on the Southwest border," Roy Villareal, who served as chief patrol agent in the Tucson sector from 2018 to 2020, told CNN's Priscilla Alvarez.
  • "This is just the first step in a process of providing greater access to the media," Psaki said during a news briefing.
  • "It's a huge problem. I'm not going to pretend that it's not. It's a huge problem," Harris said in remarks that appeared to be somewhat of a do-over of the administration's initial downplaying of the situation.
  • "I asked her, the VP today, because she's the most qualified person to do it, to lead our efforts with Mexico and the Northern Triangle, and the countries that can help, need help in stemming the movement of so many folks, stemming the migration to our southern border," Biden said on Wednesday.
Javier E

How Do You Know When Society Is About to Fall Apart? - The New York Times - 1 views

www.nytimes.com/...societal-collapse.html

collapse civilization decline history crisis politics economics culture complexity

shared by Javier E on 21 Dec 20 - No Cached
  • Tainter seemed calm. He walked me through the arguments of the book that made his reputation, “The Collapse of Complex Societies,” which has for years been the seminal text in the study of societal collapse, an academic subdiscipline that arguably was born with its publication in 1988
  • It is only a mild overstatement to suggest that before Tainter, collapse was simply not a thing.
  • His own research has moved on; these days, he focuses on “sustainability.”
  • ...53 more annotations...
  • He writes with disarming composure about the factors that have led to the disintegration of empires and the abandonment of cities and about the mechanism that, in his view, makes it nearly certain that all states that rise will one day fall
  • societal collapse and its associated terms — “fragility” and “resilience,” “risk” and “sustainability” — have become the objects of extensive scholarly inquiry and infrastructure.
  • Princeton has a research program in Global Systemic Risk, Cambridge a Center for the Study of Existential Risk
  • even Tainter, for all his caution and reserve, was willing to allow that contemporary society has built-in vulnerabilities that could allow things to go very badly indeed — probably not right now, maybe not for a few decades still, but possibly sooner. In fact, he worried, it could begin before the year was over.
  • Plato, in “The Republic,” compared cities to animals and plants, subject to growth and senescence like any living thing. The metaphor would hold: In the early 20th century, the German historian Oswald Spengler proposed that all cultures have souls, vital essences that begin falling into decay the moment they adopt the trappings of civilization.
  • that theory, which became the heart of “The Collapse of Complex Societies.” Tainter’s argument rests on two proposals. The first is that human societies develop complexity, i.e. specialized roles and the institutional structures that coordinate them, in order to solve problems
  • All history since then has been “characterized by a seemingly inexorable trend toward higher levels of complexity, specialization and sociopolitical control.”
  • Eventually, societies we would recognize as similar to our own would emerge, “large, heterogeneous, internally differentiated, class structured, controlled societies in which the resources that sustain life are not equally available to all.”
  • Something more than the threat of violence would be necessary to hold them together, a delicate balance of symbolic and material benefits that Tainter calls “legitimacy,” the maintenance of which would itself require ever more complex structures, which would become ever less flexible, and more vulnerable, the more they piled up.
  • Social complexity, he argues, is inevitably subject to diminishing marginal returns. It costs more and more, in other words, while producing smaller and smaller profits.
  • Take Rome, which, in Tainter's telling, was able to win significant wealth by sacking its neighbors but was thereafter required to maintain an ever larger and more expensive military just to keep the imperial machine from stalling — until it couldn’t anymore.
  • This is how it goes. As the benefits of ever-increasing complexity — the loot shipped home by the Roman armies or the gentler agricultural symbiosis of the San Juan Basin — begin to dwindle, Tainter writes, societies “become vulnerable to collapse.”
  • haven’t countless societies weathered military defeats, invasions, even occupations and lengthy civil wars, or rebuilt themselves after earthquakes, floods and famines?
  • Only complexity, Tainter argues, provides an explanation that applies in every instance of collapse.
  • Complexity builds and builds, usually incrementally, without anyone noticing how brittle it has all become. Then some little push arrives, and the society begins to fracture.
  • A disaster — even a severe one like a deadly pandemic, mass social unrest or a rapidly changing climate — can, in Tainter’s view, never be enough by itself to cause collapse
  • The only precedent Tainter could think of, in which pandemic coincided with mass social unrest, was the Black Death of the 14th century. That crisis reduced the population of Europe by as much as 60 percent.
  • Whether any existing society is close to collapsing depends on where it falls on the curve of diminishing returns.
  • The United States hardly feels like a confident empire on the rise these days. But how far along are we?
  • Scholars of collapse tend to fall into two loose camps. The first, dominated by Tainter, looks for grand narratives and one-size-fits-all explanations
  • The second is more interested in the particulars of the societies they study
  • Patricia McAnany, who teaches at the University of North Carolina at Chapel Hill, has questioned the usefulness of the very concept of collapse — she was an editor of a 2010 volume titled “Questioning Collapse” — but admits to being “very, very worried” about the lack, in the United States, of the “nimbleness” that crises require of governments.
  • We’re too vested and tied to places.” Without the possibility of dispersal, or of real structural change to more equitably distribute resources, “at some point the whole thing blows. It has to.”
  • In Turchin’s case the key is the loss of “social resilience,” a society’s ability to cooperate and act collectively for common goals. By that measure, Turchin judges that the United States was collapsing well before Covid-19 hit. For the last 40 years, he argues, the population has been growing poorer and more unhealthy as elites accumulate more and more wealth and institutional legitimacy founders. “The United States is basically eating itself from the inside out,
  • Inequality and “popular immiseration” have left the country extremely vulnerable to external shocks like the pandemic, and to internal triggers like the killings of George Floyd
  • Societies evolve complexity, he argues, precisely to meet such challenges.
  • Eric H. Cline, who teaches at the George Washington University, argued in “1177 B.C.: The Year Civilization Collapsed” that Late Bronze Age societies across Europe and western Asia crumbled under a concatenation of stresses, including natural disasters — earthquakes and drought — famine, political strife, mass migration and the closure of trade routes. On their own, none of those factors would have been capable of causing such widespread disintegration, but together they formed a “perfect storm” capable of toppling multiple societies all at once.
  • Collapse “really is a matter of when,” he told me, “and I’m concerned that this may be the time.”
  • In “The Collapse of Complex Societies,” Tainter makes a point that echoes the concern that Patricia McAnany raised. “The world today is full,” Tainter writes. Complex societies occupy every inhabitable region of the planet. There is no escaping. This also means, he writes, that collapse, “if and when it comes again, will this time be global.” Our fates are interlinked. “No longer can any individual nation collapse. World civilization will disintegrate as a whole.”
  • If it happens, he says, it would be “the worst catastrophe in history.”
  • The quest for efficiency, he wrote recently, has brought on unprecedented levels of complexity: “an elaborate global system of production, shipping, manufacturing and retailing” in which goods are manufactured in one part of the world to meet immediate demands in another, and delivered only when they’re needed. The system’s speed is dizzying, but so are its vulnerabilities.
  • A more comprehensive failure of fragile supply chains could mean that fuel, food and other essentials would no longer flow to cities. “There would be billions of deaths within a very short period,” Tainter says.
  • If we sink “into a severe recession or a depression,” Tainter says, “then it will probably cascade. It will simply reinforce itself.”
  • Tainter tells me, he has seen “a definite uptick” in calls from journalists: The study of societal collapse suddenly no longer seems like a purely academic pursuit
  • Turchin is keenly aware of the essential instability of even the sturdiest-seeming systems. “Very severe events, while not terribly likely, are quite possible,” he says. When he emigrated from the U.S.S.R. in 1977, he adds, no one imagined the country would splinter into its constituent parts. “But it did.”
  • He writes of visions of “bloated bureaucracies” becoming the basis of “entire political careers.” Arms races, he observes, presented a “classic example” of spiraling complexity that provides “no tangible benefit for much of the population” and “usually no competitive advantage” either.
  • It is hard not to read the book through the lens of the last 40 years of American history, as a prediction of how the country might deteriorate if resources continued to be slashed from nearly every sector but the military, prisons and police.
  • The more a population is squeezed, Tainter warns, the larger the share that “must be allocated to legitimization or coercion.
  • And so it was: As U.S. military spending skyrocketed — to, by some estimates, a total of more than $1 trillion today from $138 billion in 1980 — the government would try both tactics, ingratiating itself with the wealthy by cutting taxes while dismantling public-assistance programs and incarcerating the poor in ever-greater numbers.
  • “As resources committed to benefits decline,” Tainter wrote in 1988, “resources committed to control must increase.”
  • The overall picture drawn by Tainter’s work is a tragic one. It is our very creativity, our extraordinary ability as a species to organize ourselves to solve problems collectively, that leads us into a trap from which there is no escaping
  • Complexity is “insidious,” in Tainter’s words. “It grows by small steps, each of which seems reasonable at the time.” And then the world starts to fall apart, and you wonder how you got there.
  • Perhaps collapse is not, actually, a thing. Perhaps, as an idea, it was a product of its time, a Cold War hangover that has outlived its usefulness, or an academic ripple effect of climate-change anxiety, or a feedback loop produced by some combination of the two
  • if you pay attention to people’s lived experience, and not just to the abstractions imposed by a highly fragmented archaeological record, a different kind of picture emerges.
  • Tainter’s understanding of societies as problem-solving entities can obscure as much as it reveals
  • Plantation slavery arose in order to solve a problem faced by the white landowning class: The production of agricultural commodities like sugar and cotton requires a great deal of backbreaking labor. That problem, however, has nothing to do with the problems of the people they enslaved. Which of them counts as “society”?
  • Since the beginning of the pandemic, the total net worth of America’s billionaires, all 686 of them, has jumped by close to a trillion dollars.
  • If societies are not in fact unitary, problem-solving entities but heaving contradictions and sites of constant struggle, then their existence is not an all-or-nothing game.
  • Collapse appears not as an ending, but a reality that some have already suffered — in the hold of a slave ship, say, or on a long, forced march from their ancestral lands to reservations faraway — and survived.
  • The current pandemic has already given many of us a taste of what happens when a society fails to meet the challenges that face it, when the factions that rule over it tend solely to their own problems
  • the real danger comes from imagining that we can keep living the way we always have, and that the past is any more stable than the present.
  • If you close your eyes and open them again, the periodic disintegrations that punctuate our history — all those crumbling ruins — begin to fade, and something else comes into focus: wiliness, stubbornness and, perhaps the strongest and most essential human trait, adaptability.
  • When one system fails, we build another. We struggle to do things differently, and we push on. As always, we have no other choice.
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