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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.

That’s not a good idea. Even if you’re retired, having a balanced portfolio of stocks and bonds so that your money keeps up with inflation, or even grows, makes sense. But retirees may want to think about having enough cash set aside for a year’s worth of living expenses and big payments needed over the next five years.

Expectations surrounding education have spun out of control. On top of a seven-hour school day, our kids march through hours of nightly homework, daily sports practices and band rehearsals, and weekend-consuming assignments and tournaments. Each activity is seen as a step on the ladder to a top college, an enviable job and a successful life. Children living in poverty who aspire to college face the same daunting admissions arms race, as well as the burden of competing for scholarships, with less support than their privileged peers.

Yet instead of empowering them to thrive, this drive for success is eroding children’s health and undermining their potential. Modern education is actually making them sick.

Nearly one in three teenagers told the American Psychological Association that stress drove them to sadness or depression — and their single biggest source of stress was school. According to the Centers for Disease Control and Prevention, a vast majority of American teenagers get at least two hours less sleep each night than recommended — and research shows the more homework they do, the fewer hours they sleep. At the university level, 94 percent of college counseling directors in a survey from last year said they were seeing rising numbers of students with severe psychological problems.

At the other end of the age spectrum, doctors increasingly see children in early elementary school suffering from migraine headaches and ulcers. Many physicians see a clear connection to performance pressure.

chosen to start making a change. Teachers are re-examining their homework demands, in some cases reviving the school district’s forgotten homework guideline — no more than 20 minutes per class per night, and none on weekends. In fact, research supports limits on homework. Students have started a task force to promote healthy habits and balanced schedules.

A growing body of medical evidence suggests that long-term childhood stress is linked not only with a higher risk of adult depression and anxiety, but with poor physical health outcomes, as well.

Paradoxically, the pressure cooker is hurting, not helping, our kids’ prospects for success. Many college students struggle with critical thinking, a fact that hasn’t escaped their professors, only 14 percent of whom believe that their students are prepared for college work, according to a 2015 report.

At Irvington, it’s too early to gauge the impact of new reforms, but educators see promising signs. Calls to school counselors to help students having emotional episodes in class have dropped from routine to nearly nonexistent. The A.P. class failure rate dropped by half. Irvington students continue to be accepted at respected colleges.

That’s why, when pressed, epidemiologists have to say they don’t know what’s going to happen.

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.

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.

There’s a simple mechanism that is helping me understand the many possible futures we face with the Covid-19 pandemic.

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.

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

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.

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

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

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

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

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

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

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

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

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

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

The United States and many other nations with relatively low taxes and a smaller social safety net actually have substantially lower rates of employment.

In Denmark, someone who enters the labor force at an average salary loses 86 percent of earnings to a combination of taxes and lost eligibility for welfare benefits; that number is only 37 percent in the United States. Yet the percentage of Danes between the ages of 20 and 59 with a job is 10 percentage points higher than in the United States.

In short, more people may work when countries offer public services that directly make working easier, such as subsidized care for children and the old; generous sick leave policies; and cheap and accessible transportation. If the goal is to get more people working, what’s important about a social welfare plan may be more about what the money is spent on than how much is spent.

There are countless differences between Northern European countries and the rest of the world beyond child care policies and the like. The Scandinavian countries may have cultures that encourage more people to work, especially women.

In Scandinavian countries, working parents have the option of heavily subsidized child care. Leave policies make it easy for parents to take off work to care for a sick child. Heavily subsidized public transportation may make it easier for a person in a low-wage job to get to and from work. And free or inexpensive education may make it easier to get the training to move from the unemployment rolls to a job.

In the United States, the major policies aimed at helping the working poor are devised around tax subsidies that put more cash in people’s pockets so long as they work, most notably through the Earned-income tax credit and Child Tax Credit.

There is a solid correlation, by Mr. Kleven’s calculations, between what countries spend on employment subsidies — like child care, preschool and care for older adults — and what percentage of their working-age population is in the labor force.

Collectively, these policies and subsidies create flexibility such that a person on the fence between taking a job versus staying at home to care for children or parents may be more likely to take a job.

, it could mean that more direct aid to the working poor could help coax Americans into the labor force more effectively than the tax credits that have been a mainstay for compromise between Republicans and Democrats for the last generation.

wages for entry-level work are much higher in the Nordic countries than in the United States, reflecting a higher minimum wage, stronger labor unions and cultural norms that lead to higher pay

The employment subsidies Mr. Kleven cites surely help coax more Scandinavians into the work force, Mr. Greenstein agrees, but shouldn’t be viewed in isolation.

Every country has a mix of taxes, welfare benefits and policies to promote work that reflects its politics and culture. In the large, diverse United States, there is deep skepticism of social welfare programs and direct government spending, along with a greater commitment to keeping taxes low.

Along the banks of the Maniqui River and in adjacent forests, the Tsimane people hunt, fish and plant plantains, rice and sweet manioc. They live in villages that range in size from 30 to 700 people. During village meetings, decision making is consensus-based. No individual has the right to coerce anyone else.

that doesn’t mean there are no status distinctions. When you attend a Tsimane village meeting, you soon notice that the opinions of certain men are more influential during the consensus-building process. These same men are often solicited to mediate disputes or to represent villagers’ interests with outsiders.

My colleagues and I measured the social status of all the men from four Tsimane villages (nearly 200 men between the ages of 18 and 83), by asking them to evaluate one another on their informal political influence. The men also provided urine samples and received medical examinations from physicians

We found that Tsimane men with less political influence had higher levels of the stress hormone cortisol, which has many important physiological functions. This result persisted after controlling for other factors that might affect stress levels, including age, body size and personality.

In addition, we found that the less influential Tsimane men had a higher risk of respiratory infection, the most common cause of sickness and death in their society. Stress may contribute to this disparity in infection risk; when chronic, stress can dampen immune function.

Studying the same individuals over a four-year period, we also found that for men whose influence declined over time, greater declines were correlated with higher levels of cortisol and respiratory illness. Downward mobility is harmful, it seems, even in an egalitarian society.

Why might low status cause such stress for the Tsimane? One possibility is that status offers a greater sense of control.

Another is that status acts as a form of social insurance. Influential Tsimane men have more allies and food-production partners, who can be helpful in mitigating conflict, sickness and food shortage. The relative lack of such support may cause psychosocial stress.

It is interesting that even in industrialized societies, the status comparisons most consequential for psychosocial stress are often among individuals who live near one another or occupy the same social network, not individuals at opposite ends of the socioeconomic spectrum.

Those living just above the poverty line may resent welfare for those living just below it, and a millionaire may envy a multimillionaire more than he envies a billionaire.

The importance of relative status perceptions may have its roots in the small-scale societies of our ancestors, which were similar to that of the Tsimane. In such societies, both our political competitors and our cooperative partners were likely individuals with whom we interacted regularly.

As our society debates the effects of wealth inequality, the Tsimane help us understand why we care so deeply about relative social position — and why our health depends on it.

"The passing of this bill shows that once again New Zealand is leading the way for progressive and compassionate legislation, becoming only the second country in the world to provide leave for miscarriage and stillbirth,"

The other country that provides such leave is India, which allows women to take six weeks of leave after a miscarriage,

Washington, D.C., recently expanded its bereavement leave for public employees who lose a child, including those mourning a stillborn baby,

D.C.'s new policy offers two weeks of paid leave to city employees who lose a child under the age of 21, including stillbirths.

"You get three days' paid leave, maybe you bury your baby or you have a service, and then you go back to work, and you carry on — and then what? That's my concern,"

"I'm celebrating it," she said, "but I want to see us keeping this compassion going, and looking further into the needs of these parents."

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

How did care work become so undervalued?

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

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

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

And what should someone not do

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

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

She and others emphasized the apparent lack of severe health repercussions from reinfection — and the lack of evidence that reinfection is common.

Nearly 4 percent of people who had a previous infection were reinfected, an almost identical rate to those with no history of infection.

“Basically, it’s saying vaccination actually needs to be better than natural immunity. But vaccination is better than natural immunity.”

The study backs up recent laboratory data from South African researchers analyzing blood plasma from recovered patients. Nearly half of the plasma samples had no detectable ability to block the variant from infecting cells in a laboratory dish

The good news is that vaccine trials from Johnson & Johnson and Novavax show that vaccines can work — even against the B.1.351 variant, and particularly in preventing severe illness.

Novavax did not provide a breakdown of mild, moderate and severe cases, but severe cases of covid-19 were rare in the trial, suggesting that reinfection is unlikely to send people to the hospital.

“It is not surprising to see reinfection in individuals who are convalescent. And it would not be surprising to see infection in people who are vaccinated, especially a few months out from vaccine,”

“The key is not whether people get reinfected, it’s whether they get sick enough to be hospitalized.

“If the data holds true, it means we will need to walk the public back on the idea of how close we are to the finish line for ending this pandemic.”

Projections created by data scientist Youyang Gu — whose pandemic models have been cited by the Centers for Disease Control and Prevention — suggest that about 65 percent of America’s population will reach immunity by June 1. But built into that 65 percent is roughly 20 percent having immunity from past infections only.

In a separate study, scientists at Rockefeller University in New York took blood plasma from people who had been vaccinated and found that vaccine-generated antibodies were largely able to block mutations found on the B.1.351 variant.

I think the fact that we … now have data from two vaccines indicating that we can prevent serious disease, even against the new variant, is hopeful,”

A future concern needing close monitoring is whether the reformulation of vaccines to keep up with the evolving virus could drive the virus to continue evolving.

There is also a concern that subpar immunity could allow new resistant variants to emerge. That possibility, Nussenzweig said, is one reason that people should get both doses of a vaccine, on time.

People with persistent waking anxieties also tended to play out scenarios involving future work, relationships and life generally in their heads over the course of a day. Previous research has correlated this pattern to scene-shifting in dreams: the frequent changing of the setting, from indoors to outdoors, city to country, mountains to coast.

the continuity hypothesis. This framework holds that the content of dreams simply reflects what people thought, felt and did during the day — the good and the bad, the hopeful and the frightening.

dreamers during the first phase of the pandemic recorded far more such shifts in their REM mini-dramas.

“I wasn’t expecting this, but the findings suggest to me this idea that men are mainly experiencing fear of getting sick and dying, health fears,”

Women have been weathering more secondary effects; they tend to be the ones nursing sick family members, more often than males, for instance. I suspect this is the single most likely reason that sadness is up for women in these times.”

A false story is much more likely to go viral than a real story, the authors find. A false story reaches 1,500 people six times quicker, on average, than a true story does.

“In short, I don’t think there’s any reason to doubt the study’s results,” said Rebekah Tromble, a professor of political science at Leiden University in the Netherlands, in an email.

It’s a question that can have life-or-death consequences.“[Fake news] has become a white-hot political and, really, cultural topic, but the trigger for us was personal events that hit Boston five years ago,” said Deb Roy, a media scientist at MIT and one of the authors of the new study.

Ultimately, they found about 126,000 tweets, which, together, had been retweeted more than 4.5 million times. Some linked to “fake” stories hosted on other websites. Some started rumors themselves, either in the text of a tweet or in an attached image. (The team used a special program that could search for words contained within static tweet images.) And some contained true information or linked to it elsewhere.

Tweet A and Tweet B both have the same size audience, but Tweet B has more “depth,” to use Vosoughi’s term. It chained together retweets, going viral in a way that Tweet A never did. “It could reach 1,000 retweets, but it has a very different shape,” he said.Here’s the thing: Fake news dominates according to both metrics. It consistently reaches a larger audience, and it tunnels much deeper into social networks than real news does. The authors found that accurate news wasn’t able to chain together more than 10 retweets. Fake news could put together a retweet chain 19 links long—and do it 10 times as fast as accurate news put together its measly 10 retweets.

What does this look like in real life? Take two examples from the last presidential election. In August 2015, a rumor circulated on social media that Donald Trump had let a sick child use his plane to get urgent medical care. Snopes confirmed almost all of the tale as true. But according to the team’s estimates, only about 1,300 people shared or retweeted the story.

Why does falsehood do so well? The MIT team settled on two hypotheses.First, fake news seems to be more “novel” than real news. Falsehoods are often notably different from the all the tweets that have appeared in a user’s timeline 60 days prior to their retweeting them, the team found.Second, fake news evokes much more emotion than the average tweet. The researchers created a database of the words that Twitter users used to reply to the 126,000 contested tweets, then analyzed it with a state-of-the-art sentiment-analysis tool. Fake tweets tended to elicit words associated with surprise and disgust, while accurate tweets summoned words associated with sadness and trust, they found.

It suggests—to me, at least, a Twitter user since 2007, and someone who got his start in journalism because of the social network—that social-media platforms do not encourage the kind of behavior that anchors a democratic government. On platforms where every user is at once a reader, a writer, and a publisher, falsehoods are too seductive not to succeed: The thrill of novelty is too alluring, the titillation of disgust too difficult to transcend. After a long and aggravating day, even the most staid user might find themselves lunging for the politically advantageous rumor. Amid an anxious election season, even the most public-minded user might subvert their higher interest to win an argument.

With shortages of everything from auto parts to generic medicines and production delays in things like iPhones and Diet Coke, a great deal of pain is coming from the closing of Chinese factories. That proliferating damage has central banks and financial analysts talking about a global recession in the coming months.

As a baseline, several factors work against the United States. China’s authoritarian government can quarantine entire cities or order people off the streets in a way that would be hard to imagine in America, presumably giving China an advantage in slowing the spread of the disease. In addition, a large share of American workers lack paid sick days and millions lack health care coverage, so people may be less likely to stay home or to get proper medical care. And 41 percent of China’s population lives outside urban areas, more than twice the share in the United States. Diseases generally spread faster in urban areas.

When people pull back from interacting with others because of their fear of disease, the things they stop doing will frequently affect much bigger industries in the United States.

People may stop attending American sporting events. There have even been calls for the N.C.A.A. to play its March Madness college basketball tournament without an audience. But sports is a huge business in the United States. People spend upward of 10 times as much on sporting events as they do in China.

Who wants to go to the dentist or the hospital during an outbreak if a visit isn’t necessary? Yet health spending is 17 percent of the U.S. economy — more than triple the proportion spent in China.

But over all, the United States is substantially more reliant on services than China is.

A major coronavirus epidemic in the United States might be like a big snowstorm that shuts down most economic activity and social interaction only until the snow is cleared away. But the coronavirus could be a “Snowmaggedon-style storm” that hits the whole country and lasts for months.

Removing a mask requires special attention to avoid hand contamination, and it could also breed a false sense of security.

in some parts of Asia everyone now wears a mask by default - it is seen as safer and more considerate.

In mainland China, Hong Kong, Japan, Thailand and Taiwan, the broad assumption is that anyone could be a carrier of the virus, even healthy people. So in the spirit of solidarity, you need to protect others from yourself.

Some argue that ubiquitous mask wearing, as a very visual reminder of the dangers of the virus, could actually act as a "behavioural nudge" to you and others for overall better personal hygiene.

The 2003 Sars virus outbreak, which affected several countries in the region, also drove home the importance of wearing masks, particularly in Hong Kong, where many died as a result of the virus.So one key difference between these societies and Western ones, is that they have experienced contagion before - and the memories are still fresh and painful.

In East Asia, many people are used to wearing masks when they are sick or when it's hayfever season, because it's considered impolite to be sneezing or coughing openly.

But there are downsides of course. Some places such as Japan, Indonesia and Thailand are facing shortages at the moment, and South Korea has had to ration out masks.

There is the fear that people may end up re-using masks - which is unhygienic - use masks sold on the black market, or wear homemade masks, which could be of inferior quality and essentially useless.

People who do not wear masks in these places have also been stigmatised, to the point that they are shunned and blocked from shops and buildings.

In countries where mask wearing is not the norm, such as the West, those who do wear masks have been shunned or even attacked. It hasn't helped that many of these mask wearers are Asians.

"This is a serious matter and we have to maintain our practices even as many people are relaxing restrictions and the economy is opening back up," Reed said in a phone interview.

Social distancing and masks "really work," she said.

Most states across the country can ease some restrictions safely, but projects spikes in areas that have broadly reopened early, according to the model put together by a team at the Children's Hospital of Philadelphia and the University of Pennsylvania.

"While our models show that rising temperatures and humidity levels are having an impact on reducing the spread of Covid-19, those hot, humid days of summer are not going to eliminate the threat of virus resurgence," said PolicyLab's Dr. Gregory Tasian, senior scholar in the Center for Clinical Epidemiology and Biostatistics at the University of Pennsylvania's Perelman School of Medicine.

Jefferson County, where Birmingham is located, had 1,453 confirmed cases as of Thursday, according to the state's health department data -- which is a jump of 35% from the 1,075 cases reported two weeks ago. The county has had 85 deaths attributed to Covid-19.

As of May 11, restaurants and bars were allowed to serve customers on site, gyms and athletic facilities, hair and nail salons and barber shops were allowed to open. Groups of any size are allowed, as long as the 6 feet distance guidance is followed.

some activities, including dangerous ones, provide negative feedback only rarely. When I am in a rush, I often cross the street at a red light. I understand intellectually that this is stupid, but I’ve never once seen evidence of my stupidity.

Exposure to COVID-19 works the same way. Every time you engage in a risky activity—like meeting up with your friends indoors—the world is likely to send you a signal that you made the right choice. I saw my pal and didn’t get sick. Clearly, I shouldn’t have worried so much about socializing!

Let’s assume, for example, that going to a large indoor gathering gives you a one in 20 chance of contracting COVID-19—a significant risk. Most likely, you’ll get away with it the first time. You’ll then infer that taking part in such gatherings is pretty safe, and will do so again. Eventually, you are highly likely to fall sick.

2. Individually Rational, Collectively DisastrousWe tend to think behavior that is justifiable on the individual level is also justifiable on the collective level, and vice versa. If eating the occasional sugary treat is fine for me it’s fine for all of us. And if smoking indoors is bad for me, it’s bad for all of us.

The dynamics of contagion in a pandemic do not work like that

if everyone who isn’t at especially high risk held similar dinner parties, some percentage of these events would lead to additional infections. And because each newly infected person might spread the virus to others, everyone’s decision to hold a one-off dinner party would quickly lead to a significant spike in transmissions.

The dynamic here is reminiscent of classic collective-action problems. If you go to one dinner, you’ll likely be fine. But if everyone goes to one dinner, the virus will spread with such speed that your own chances of contracting COVID-19 will also rise precipitously.

3. Dangers Are Hard to Recognize and Avoid

Many of the dangers we face in life are easy to spot—and we have, over many millennia, developed biological instincts and social conventions to avoid them

When we deal with an unaccustomed danger, such as a new airborne virus, we can’t rely on any of these protective mechanisms.

The virus is invisible. This makes it hard to spot or anticipate. We don’t see little viral particles floating through the air

In time, we can overcome these biases (at least to some extent).

Social disapprobation can help

We all should do what we can to identify the biases from which we suffer—and try to stop them from influencing our behavior.

I think people are enervated not just by the Sisyphean pointlessness of their individual labors but also by the fact that they’re working in and for a society in which, increasingly, they have zero faith or investment. The future their elders are preparing to bequeath to them is one that reflects the fondest hopes of the same ignorant bigots a lot of them fled their hometowns to escape.

It turns out that millions of people never actually needed to waste days of their lives sitting in traffic or pantomime “work” under managerial scrutiny eight hours a day

We learned that nurses, cashiers, truckers and delivery people (who’ve always been too busy to brag about it) actually ran the world and the rest of us were mostly useless supernumeraries. The brutal hierarchies of work shifted, for the first time in recent memory, in favor of labor, and the outraged whines of former social Darwinists were a pleasure to savor.

Of course, everyone is still busy — worse than busy, exhausted, too wiped at the end of the day to do more than stress-eat, binge-watch and doomscroll — but no one’s calling it anything other than what it is anymore: an endless, frantic hamster wheel for survival.

The pandemic was the bomb cyclone of our discontents

American conservatism, which is demographically terminal and knows it, is acting like a moribund billionaire adding sadistic codicils to his will.

An increasingly popular retirement plan is figuring civilization will collapse before you have to worry about it

Midcentury science fiction writers assumed that the increased productivity brought on by mechanization would give workers an oppressive amount of leisure time, that our greatest threats would be boredom and ennui. But these authors’ prodigious imaginations were hobbled by their humanity and rationality; they’d forgotten that the world is ordered not by reason or decency but by rapacious avarice.

In the past few decades, capitalism has exponentially increased the creation of wealth for the already incredibly wealthy at the negligible expense of the well-being, dignity and happiness of most of humanity, plus the nominal cost of a mass extinction and the destruction of the biosphere — like cutting out the inefficient business of digestion and metabolism by pouring a fine bottle of wine directly into the toilet, thereby eliminating the middleman of you.

Everyone knows how productive you can be when you’re avoiding something. We are currently experiencing the civilizational equivalent of that anxiety you feel when you have something due the next day that you haven’t even started thinking about and yet still you sit there, helplessly watching whole seasons of mediocre TV or compulsively clicking through quintillions of memes even as your brain screams at you — the same way we scream at our politicians about guns and abortion and climate change — to do something.

Enough with the busywork already. We’ve been “productive” enough — produced way too much, in fact. And there is too much that urgently needs to be done: a republic to salvage, a civilization to reimagine and its infrastructure to reinvent, innumerable species to save, a world to restore and millions who are impoverished, imprisoned, illiterate, sick or starving. All while we waste our time at work.

But one piece of advice almost no one is giving? Be lucky. Pediatrician Neil Stone says that there’s no “secret” for staying Covid-19 free because there’s just too much luck involved.

As for me, I have some data that can, to an extent, quantify and explain my own good luck in avoiding Covid so far. I’m participating in a study on immunity which allowed me to learn that my blood still carries loads of antibodies induced by my vaccine and December booster shot, and no signs of any prior infection. Not everyone’s antibodies wane at the same rate, and in some people, the antibodies don’t wane much at all. (At some point it should become routine to collect this information to help people decide whether to get additional booster shots.)

My high level of vaccine antibodies probably explains my success more than my behavior. I make some effort to avoid Covid, but have been far from perfect. And I’ve been potentially exposed at least twice: Once last December, when someone at a small holiday gathering I’d attended developed symptoms the next day, and more recently, when I shared a large indoor space with two people who later tested positive. But according to my lab work, I’ve never had even a silent infection.

It’s possible I was protected by my high antibodies, or that some quirk of air flow meant I never breathed in enough virus to get sick. Or perhaps I benefited from a different form of luck. There’s another facet to immunity called the innate immune system, which acts as a first line of defense and sometimes knocks out a virus or other pathogen before it replicates enough to elicit the production of antibodies. Good innate immunity might help explain something many of us have experienced — not getting a cold or flu even when sleeping in the same bed with the sick person through the whole illness.

Stress, diet, general health and even sunlight might all affect innate immunity. So could other factors. There’s so much we still don’t know about the immune system. And that’s one reason we talk about “luck.”

understanding how the luck works could help other people avoid Covid, whether for the first time or for the second or third time. Taking a closer look at what passed for luck helped researchers like Gary Taubes discover that public health had obesity all wrong, and the standard high carb/low fat diets were causing people to gain weight.

It’s a trap, which maybe seeking out a little more deliberate boredom – also known as stillness - could help us avoid

Thomas Merton, whose praises I have sung in these pages before, framed it:

being bored might be a good start for healing what ails us.

But the purity of our conscience has a natural proportion with the depth of our being and the quality of our acts: and when our activity is habitually disordered, our malformed conscience can think of nothing better to tell us than to multiply the *quantity* of our acts, without perfecting their quality. And so we go from bad to worse, exhaust ourselves, empty our whole life of all content, and fall into despair

There are times, then, when in order to keep ourselves in existence at all we simply have to sit back for a while and do nothing. And for a man who has let himself be drawn completely out of himself by his activity, nothing is more difficult than to sit still and rest, doing nothing at all. The very act of resting is the hardest and most courageous act he can perform: and often it is quite beyond his power.

Our being is not to be enriched merely by activity or experience as such. Everything depends on the *quality* of our acts and our experiences. A multitude of badly performed actions and of experiences only half lived exhausts and depletes our being. By doing things badly we make ourselves less real. This growing unreality cannot help but make us unhappy and fill us with a sense of guilt

even with all the excitement, I couldn’t sustain any. I was bored by the excitement. Or rather, I craved boredom, finding all the excitement dull in a not-this-shitshow-again sort of way. For the last decade or so, we’ve been too over-excited, over-provoked, and overstimulated.