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“But it’s also much worse than the spring because this virus is now much more widespread,” she said. “It’s not just one region of the country experiencing the surge. It’s every state.”

Dr. Watson said she worried that hospitals in many cities would soon become overwhelmed, as they were in New York City and other places on the East Coast during the spring peak.

The country is now recording more than 150,000 new cases each day on average, more than ever before.

The governors of Michigan, New Mexico, Oregon and Washington who have announced new restrictions in the last few days are all Democrats.

During that time, all roads in the

Navajo Nation are closed to visitors, residents must stay at home except for urgent trips, and most government offices will be closed. Essential businesses like gas stations and groceries are allowed to open, but only from 7 a.m. to 3 p.m.

The virus killed about 1,700 people in Philadelphia in the early months of the pandemic, overwhelming the city’s funeral homes. With Covid-19 hospitalizations soaring again in the city, Dr. Farley warned that the virus could kill a similar number of Philadelphians this fall and winter if left unchecked.

“The bottom line is this: If we don’t do something to change the trajectory of this epidemic, the hospitals will become full,” Dr. Farley said. “They’ll have difficulty treating people, and we’ll have between several hundred and a thousand deaths by just the end of this year.”

Infection numbers in Massachusetts are eight times what they were on Labor Day and hospitalizations have quadrupled.

In Illinois, the virus is now the third leading cause of death behind heart disease and cancer.

More than 250,000 Americans have so far died of the virus -- a higher death toll than any other country -- and a forecast by the US Centers for Disease Control and Prevention projects that number could rise up to 298,000 by December 12.

"It's all about absolute adherence to wearing a mask, avoiding crowds, and yes, we can keep the economy open but we're going to have to diminish indoor places like indoor dining and restaurants."

Only one US state, Hawaii, is showing a decrease in new cases greater than 10% compared to the previous week. Five others -- Idaho, North Dakota, Iowa, Illinois and Arkansas -- are holding steady, while the remaining 44 states are showing increases in new cases greater than at least 10% compared to the week prior.

the 7-day average of new cases is at its highest ever: 161,165 cases a day. That's up 27% compared to last week.

"Virtual gatherings remain the safest way to bring friends and family together from distant points. Outdoor settings can reduce the risks of gatherings with people outside of your household," the group said, also highlighting the importance of face coverings.

New Jersey Gov. Phil Murphy told CNN he wanted people to stay with their immediate family on Thanksgiving and to keep gatherings small -- "not just for next Thursday ... but for the next couple of months."

"This is not a normal year, it's not a normal Thanksgiving, Hanukkah, Christmas, New Year's. Folks have got to stay small, stay within the bubble of their own loved ones, and if we do that, that will be a down payment on a back-to-normal holiday season next year."

There were 79,410 hospitalizations reported on Wednesday, a record high for the United States, according to the Covid Tracking Project. The country is now averaging 72,120 hospitalizations over the last 7 days -- a 19.76% increase compared to last week.

"As a health care provider we are on 250 days of having a Covid patient in our ICU right now,"

"So every day, you walk into work, someone is super sick, someone is potentially dying that day."

"On a normal day, I don't have people dying every day," she said, adding that first week she had three people die in one day -- two of them, from Covid-19.

Students in the country's largest school district are transitioning to remote learning on Thursday following the closure of New York City schools. The decision came after the city's test infection rate reached 3%, a threshold Mayor Bill de Blasio said would trigger such a closure.

Kentucky Gov. Andy Beshear also announced new measures that will go into effect Friday, including limiting social gatherings to a maximum of two people from no more than two households, and prohibiting indoor service for restaurants and bars. And starting Monday, schools should begin remote learning, the governor said.

In Minnesota, the governor said the state is at a "breaking point" and announced a four-week dial back that will "help prevent more families from losing a loved one and ensure our hospitals can treat those who fall ill."

"As hospitals near the crisis of turning away new patients, continuing as things are is simply not sustainable," Gov. Tim Walz said.

A final analysis of the Phase 3 trial of Pfizer's Covid-19 vaccine shows it was 95% effective in preventing infections, even in older adults and caused no serious safety concerns, the company said Wednesday. It said it will seek a US Food and Drug Administration emergency use authorization "within days."

The Pfizer analysis came just days after a separate vaccine maker, Moderna, released early data showing its vaccine was about 95% effective.

Distribution is expected to begin within 24 hours after a vaccine receives the green light, according to Gen. Gustave Perna, who is helping oversee Operation Warp Speed.

"We'll be more ready next week, and if the vaccine is available, we have to go with what we have. We may not be perfect, but every day we're more prepared than we were the day before," he added.

one of Mr. Trump’s most consistent lines of attack has been that Mr. Biden is actually a leftist or even a socialist masquerading as a centrist.

Mr. Biden repeatedly took the opportunities on Tuesday to distance himself from his party’s left wing — without denouncing them. And he left little doubt who was in charge.

But he mostly emerged unscathed, and for most Democrats, anything but a loss was welcomed as a clear win.

The president declined to condemn white supremacists again on Tuesday, despite being asked directly by Mr. Wallace if he would do so.

From the opening bell, Mr. Trump came out as an aggressor, speaking over Mr. Biden in what seemed to be almost din-by-design: Pull the former vice president, who has run as a statesman promising to restore the soul of America, into a mud-slinging contest.

Instead, he kept turning — physically — to face the cameras and address the American people instead of his chattering rival.

The former vice president was strongest and most comfortable on the issues that he has focused on overwhelmingly in the last six months: the coronavirus pandemic and the resulting economic downturn.

it was at times a hard attack for Mr. Biden to answer. But unlike her, he had Mr. Trump’s record to slash at.

Mr. Trump seemed principally focused on undercutting and disorienting Mr. Biden, rather than on presenting an agenda or a vision for a second term in the White House.

Eventually, after Mr. Biden suggested he condemn the Proud Boys, a far-right organization widely condemned as a hate group, Mr. Trump declared, “Proud Boys: Stand back and stand by.”

Conley acknowledged that his evasive answers "came off that we were trying to hide something" but said that "wasn't necessarily true,"

Conley acknowledged that the President has experienced "two episodes of transient drops in his oxygen saturation"

When asked if they had dropped below 90, he replied, "We don't have any recordings here of that." Pressed again on whether they had dropped below 90, Conley said the President's blood oxygen levels didn't get down into "the low 80s."

"There's some expected findings, but nothing of any major clinical concern," Conley said, not explaining whether they were expected findings in a normal patient or a Covid-19 patient.

Some seven months into a pandemic that has killed more than 209,000 Americans, the nation is now facing a grave governing crisis with its commander in chief hospitalized

Late Saturday night, the public learned new details about why Trump was airlifted to the hospital Friday, when chief of staff Mark Meadows said during an interview with Fox News that Trump had a fever on Friday morning and his oxygen level had "dropped rapidly." Meadows added that Trump has made "unbelievable improvements from yesterday morning."

"made substantial progress" since his diagnosis but "is not yet out of the woods."

Speaking from a White House that already has a huge credibility problem with the public, Meadows' statement capped a 24-hour period that served as a master class in opacity and contradiction that raised major questions about the President's health

Trump has been watching and critiquing coverage of his hospitalization from the presidential suite at Walter Reed

Those people told CNN that Trump seemed particularly upset when he saw a quote saying he was displaying "concerning" symptoms on Friday

The President's construct crumbled Friday when he was airlifted to Walter Reed after contracting the virus,

The White House seemed to be continuing to downplay concerns about the severity of the virus Saturday morning when the President's physician, Navy Cmdr. Dr. Sean Conley, gave a news conference at Walter Reed where he described the President as upbeat and feeling good, without revealing any of the alarming developments with his oxygen levels the day before.

Many of the Trump aides or contacts who have recently tested positive for Covid-19 attended the White House festivities honoring Supreme Court nominee Amy Coney Barrett on September 26, in the Rose Garden.

It "seems highly likely this originated at the SCOTUS announcement last week," a senior administration official told CNN's Jake Tapper of the outbreak among GOP officials. "It may have come from the Hill. The next major concern will be securing Capitol Hill and protecting lawmakers," the official added.

The President said he was "starting to feel good" and that he was receiving therapeutics he said are like "miracles coming down from God."

"I had to be out front and this is America, this is the United States, this is the greatest country in the world, this is the most powerful country in the world," Trump continued in the video. "I can't be locked up in a room upstairs and totally safe, and just say, hey whatever happens, happens. I can't do that."

The President tweeted that he had tested positive for coronavirus around 1 a.m. ET Friday, hours after attending a Thursday night fundraiser in Bedminster, New Jersey, where he met with a small group of donors indoors with no masks, before addressing a larger crowd outdoors. Trump got his first positive coronavirus test result Thursday after returning from that trip, a White House official said Saturday evening.

He declined to say whether medical tests had revealed any damage to the President's lungs.

Conley said Trump had been fever-free for 24 hours and had experienced an "extremely mild cough," nasal congestion and fatigue.

"The President's vitals over the last 24 hours were very concerning and the next 48 hours will be critical in terms of his care. We are still not on a clear path to a full recovery," the source later identified as Meadows told pool reporters.

Once Trump was at Walter Reed, doctors initiated the antiviral drug remdesivir. He is receiving a five-day course of the drug, which has been shown to shorten recovery time for some coronavirus patients.

deliberate, systematic use of its digital health infrastructure.

Every person in Taiwan has a health card with a unique ID that all doctors and hospitals use to access online medical records. Providers use the card to document care episodes for reimbursement from the Ministry of Health. As a result, the card gives the ministry regular, nearly real-time data on physician and hospital visits and use of specific services.

When Covid-19 hit, the health card and electronic health records system were repurposed to fight the spread of the virus.

“Taiwan enhanced Covid-19 case finding by proactively seeking out patients with severe respiratory symptoms (based on information from the National Health Insurance [NHI] database) who had tested negative for influenza and retested them for Covid-19.” The availability of almost immediate data on patient visits allowed the country to efficiently identify, test, trace, and isolate cases. This has dramatically reduced Covid-19 spread without the need for extensive lockdowns.

we seem reluctant to allow the Department of Health and Human Services to monitor patient encounters, as Taiwan does, to track disease and determine what medical tests and treatments to order.

Insurers already get data based on hospital and physician claims, but only weeks or months after encounters, making the information less useful for tracking infectious outbreaks

Biden could help control the virus, some say, by encouraging Americans to wear masks, but he could also mandate changes to make workplaces safer.

Many economists believe additional congressional spending is vital right now, but if that's not feasible, then it's worth considering what Biden could do autonomously.

"It is my belief that the new president — President Biden — within the first few weeks of becoming president can simply sign an executive order and eliminate, end, $50,000 of student debt from every student,"

the best way the president can directly stimulate the economy is by tackling the public health crisis and ensuring vaccines are deployed efficiently.

"The Trump administration stretched the bounds of what maybe almost anyone thought would be possible with multiple billions of dollars to payments to farmers [and] diversions of billions of dollars from defense budget to building the wall,"

The president also adopted a number of COVID-19 relief measures without Congress, issuing a moratorium on evictions and taking disaster money away from FEMA to pay for expanded temporary unemployment assistance.

Shierholz also questions how much some of these unilateral moves — such as canceling student loan debt, which might provide a "more equitable economy" in the long run — would actually tackle the immediate financial problems people are facing.

But the president can't dole out more money to state governments — Congress would need to allocate those funds.

"The thing he'll have to resort to is trying to lean on his nearly 50 years of experience in Washington," Shierholz said. "That is what it will come down to. Can President Biden convince [current Senate Majority Leader] Mitch McConnell to move on some of that stuff because that is what it will take to get the stimulus that is needed."

Staff on the frontlines say they are increasingly battling burnout after months of devastation and with a dark winter ahead. “I’ve seen younger people come in through the door, and be admitted right away to the ICU,”

It was frustrating that the public no longer seemed to be taking Covid protocols seriously, Santini said. “Every day we go to work, we’re putting our lives and our family’s lives on the line.”

“Even lower-risk activities now carry substantial risk because there is more virus out there than ever before. Simply put and bluntly put, we can’t get away with things that we’ve been able to get away with so far.”

Some restaurants have invested thousands in outdoor dining infrastructure they hoped would last them through the pandemic, only to see those facilities ordered to close.

the organization’s research has shown that 43% of restaurant owners are unsure whether their business will survive the next six months. “People who started out frustrated – today they are feeling just outright desperate.”

the latest Covid surge continues to shine a harsh light on inequality. California has seen record levels of unemployment and countless businesses have been shuttered for good, yet some sectors – notably the tech industry – have continued to rake in revenue.

post-pandemic, California could see a so-called “K-shaped recovery”, where the incomes of the highest earners continue to rise just as quickly as they plummet for those who are struggling.

Latinos in LA county, many of whom are working essential jobs, are also contracting the virus at more than double the rate of white residents. The toll in working-class neighborhoods has been especially devastating for undocumented people, who have been unable to access aid.

“We have the confluence of factors where people are facing financial instability, and feel like they have no choice but to work even if they get sick,” she said. “And particularly in California, we have a large population of undocumented people who have been demonized by the federal government and are especially vulnerable.”

"I have asked that this adjustment be made," he said. "I am not scheduled to take the vaccine, but look forward to doing so at the appropriate time. Thank you!"

"Senior officials across all three branches of government will receive vaccinations pursuant to continuity of government protocols established in executive policy," National Security Council spokesman John Ullyot said in a statement. "The American people should have confidence that they are receiving the same safe and effective vaccine as senior officials of the United States government on the advice of public health professionals and national security leadership."

The President and other White House staff have regularly flouted US Centers for Disease Control and Prevention guidelines for safety during the pandemic such as the wearing of face masks and social distancing.

There have been several Christmas parties held at the White House recently where those guidelines weren't followed, and Trump held many events during the campaign where large crowds gathered, maskless.

Traditionally, a scientist submits her paper to a journal, which sends it to a (surprisingly small) group of peers for (several rounds of usually anonymous) comments; if the paper passes this (typically months-long) peer-review gantlet, it is published (often behind an expensive paywall). Languid and opaque, this system is ill-suited to a fast-moving outbreak. But biomedical scientists can now upload preliminary versions of their papers, or “preprints,” to freely accessible websites, allowing others to immediately dissect and build upon their results. This practice had been slowly gaining popularity before 2020, but proved so vital for sharing information about COVID‑19 that it will likely become a mainstay of modern biomedical research. Preprints accelerate science, and the pandemic accelerated the use of preprints. At the start of the year, one repository, medRxiv (pronounced “med archive”), held about 1,000 preprints. By the end of October, it had more than 12,000.

The U.S. is now catching up. In April, the NIH launched a partnership called ACTIV, in which academic and industry scientists prioritized the most promising drugs and coordinated trial plans across the country. Since August, several such trials have started.

Researchers have begun to uncover how SARS‑CoV‑2 compares with other coronaviruses in wild bats, the likely reservoir; how it infiltrates and co-opts our cells; how the immune system overreacts to it, creating the symptoms of COVID‑19. “We’re learning about this virus faster than we’ve ever learned about any virus in history,” Sabeti said.

Similar triumphs occurred last year—in other countries. In March, taking advantage of the United Kingdom’s nationalized health system, British researchers launched a nationwide study called Recovery, which has since enrolled more than 17,600 COVID‑19 patients across 176 institutions. Recovery offered conclusive answers about dexamethasone and hydroxychloroquine and is set to weigh in on several other treatments. No other study has done more to shape the treatment of COVID‑19.

SARS‑CoV‑2’s genome was decoded and shared by Chinese scientists just 10 days after the first cases were reported. By November, more than 197,000 SARS‑CoV‑2 genomes had been sequenced. About 90 years ago, no one had even seen an individual virus; today, scientists have reconstructed the shape of SARS‑CoV‑2 down to the position of individual atoms

Respiratory viruses, though extremely common, are often neglected. Respiratory syncytial virus, parainfluenza viruses, rhinoviruses, adenoviruses, bocaviruses, a quartet of other human coronaviruses—they mostly cause mild coldlike illnesses, but those can be severe. How often? Why? It’s hard to say, because, influenza aside, such viruses attract little funding or interest.

COVID‑19 has developed a terrifying mystique because it seems to behave in unusual ways. It causes mild symptoms in some but critical illness in others. It is a respiratory virus and yet seems to attack the heart, brain, kidneys, and other organs. It has reinfected a small number of people who had recently recovered. But many other viruses share similar abilities; they just don’t infect millions of people in a matter of months or grab the attention of the entire scientific community

Thanks to COVID‑19, more researchers are looking for these rarer sides of viral infections, and spotting them.

These factors pull researchers toward speed, short-termism, and hype at the expense of rigor—and the pandemic intensified that pull. With an anxious world crying out for information, any new paper could immediately draw international press coverage—and hundreds of citations.

“There’s a perception that they’re just colds and there’s nothing much to learn,” says Emily Martin of the University of Michigan, who has long struggled to get funding to study them. Such reasoning is shortsighted folly. Respiratory viruses are the pathogens most likely to cause pandemics, and those outbreaks could potentially be far worse than COVID‑19’s.

Their movements through the air have been poorly studied, too. “There’s this very entrenched idea,” says Linsey Marr at Virginia Tech, that viruses mostly spread through droplets (short-range globs of snot and spit) rather than aerosols (smaller, dustlike flecks that travel farther). That idea dates back to the 1930s, when scientists were upending outdated notions that disease was caused by “bad air,” or miasma. But the evidence that SARS‑CoV‑2 can spread through aerosols “is now overwhelming,”

Another pandemic is inevitable, but it will find a very different community of scientists than COVID‑19 did. They will immediately work to determine whether the pathogen—most likely another respiratory virus—moves through aerosols, and whether it spreads from infected people before causing symptoms. They might call for masks and better ventilation from the earliest moments, not after months of debate

They will anticipate the possibility of an imminent wave of long-haul symptoms, and hopefully discover ways of preventing them. They might set up research groups to prioritize the most promising drugs and coordinate large clinical trials. They might take vaccine platforms that worked best against COVID‑19, slot in the genetic material of the new pathogen, and have a vaccine ready within months

the single-minded focus on COVID‑19 will also leave a slew of negative legacies. Science is mostly a zero-sum game, and when one topic monopolizes attention and money, others lose out.

Long-term studies that monitored bird migrations or the changing climate will forever have holes in their data because field research had to be canceled.

negligence has left COVID‑19 long-haulers with few answers or options, and they initially endured the same dismissal as the larger ME community. But their sheer numbers have forced a degree of recognition. They started researching, cataloging their own symptoms. They gained audiences with the NIH and the World Health Organization. Patients who are themselves experts in infectious disease or public health published their stories in top journals. “Long COVID” is being taken seriously, and Brea hopes it might drag all post-infection illnesses into the spotlight. ME never experienced a pivot. COVID‑19 might inadvertently create one

Other epistemic trespassers spent their time reinventing the wheel. One new study, published in NEJM, used lasers to show that when people speak, they release aerosols. But as the authors themselves note, the same result—sans lasers—was published in 1946, Marr says. I asked her whether any papers from the 2020 batch had taught her something new. After an uncomfortably long pause, she mentioned just one.

The incentives to trespass are substantial. Academia is a pyramid scheme: Each biomedical professor trains an average of six doctoral students across her career, but only 16 percent of the students get tenure-track positions. Competition is ferocious, and success hinges on getting published

Conservationists who worked to protect monkeys and apes kept their distance for fear of passing COVID‑19 to already endangered species.

Among scientists, as in other fields, women do more child care, domestic work, and teaching than men, and are more often asked for emotional support by their students. These burdens increased as the pandemic took hold, leaving women scientists “less able to commit their time to learning about a new area of study, and less able to start a whole new research project,

published COVID‑19 papers had 19 percent fewer women as first authors compared with papers from the same journals in the previous year. Men led more than 80 percent of national COVID‑19 task forces in 87 countries. Male scientists were quoted four times as frequently as female scientists in American news stories about the pandemic.

American scientists of color also found it harder to pivot than their white peers, because of unique challenges that sapped their time and energy.

Science suffers from the so-called Matthew effect, whereby small successes snowball into ever greater advantages, irrespective of merit. Similarly, early hindrances linger. Young researchers who could not pivot because they were too busy caring or grieving for others might suffer lasting consequences from an unproductive year. COVID‑19 “has really put the clock back in terms of closing the gap for women and underrepresented minorities,”

In 1848, the Prussian government sent a young physician named Rudolf Virchow to investigate a typhus epidemic in Upper Silesia. Virchow didn’t know what caused the devastating disease, but he realized its spread was possible because of malnutrition, hazardous working conditions, crowded housing, poor sanitation, and the inattention of civil servants and aristocrats—problems that require social and political reforms. “Medicine is a social science,” Virchow said, “and politics is nothing but medicine in larger scale.”

entists discovered the microbes responsible for tuberculosis, plague, cholera, dysentery, and syphilis, most fixated on these newly identified nemeses. Societal factors were seen as overly political distractions for researchers who sought to “be as ‘objective’ as possible,” says Elaine Hernandez, a medical sociologist at Indiana University. In the U.S., medicine fractured.

New departments of sociology and cultural anthropology kept their eye on the societal side of health, while the nation’s first schools of public health focused instead on fights between germs and individuals. This rift widened as improvements in hygiene, living standards, nutrition, and sanitation lengthened life spans: The more social conditions improved, the more readily they could be ignored.

The ideological pivot away from social medicine began to reverse in the second half of the 20th century.

Politicians initially described COVID‑19 as a “great equalizer,” but when states began releasing demographic data, it was immediately clear that the disease was disproportionately infecting and killing people of color.

These disparities aren’t biological. They stem from decades of discrimination and segregation that left minority communities in poorer neighborhoods with low-paying jobs, more health problems, and less access to health care—the same kind of problems that Virchow identified more than 170 years ago.

In March, when the U.S. started shutting down, one of the biggest questions on the mind of Whitney Robinson of UNC at Chapel Hill was: Are our kids going to be out of school for two years? While biomedical scientists tend to focus on sickness and recovery, social epidemiologists like her “think about critical periods that can affect the trajectory of your life,” she told me. Disrupting a child’s schooling at the wrong time can affect their entire career, so scientists should have prioritized research to figure out whether and how schools could reopen safely. But most studies on the spread of COVID‑19 in schools were neither large in scope nor well-designed enough to be conclusive. No federal agency funded a large, nationwide study, even though the federal government had months to do so. The NIH received billions for COVID‑19 research, but the National Institute of Child Health and Human Development—one of its 27 constituent institutes and centers—got nothing.

The horrors that Rudolf Virchow saw in Upper Silesia radicalized him, pushing the future “father of modern pathology” to advocate for social reforms. The current pandemic has affected scientists in the same way

COVID‑19 could be the catalyst that fully reunifies the social and biological sides of medicine, bridging disciplines that have been separated for too long.

“To study COVID‑19 is not only to study the disease itself as a biological entity,” says Alondra Nelson, the president of the Social Science Research Council. “What looks like a single problem is actually all things, all at once. So what we’re actually studying is literally everything in society, at every scale, from supply chains to individual relationships.”

Again and again, the Facebook Papers show staffers sounding alarms about the dangers posed by the platform—how Facebook amplifies extremism and misinformation, how it incites violence, how it encourages radicalization and political polarization. Again and again, staffers reckon with the ways in which Facebook’s decisions stoke these harms, and they plead with leadership to do more.

And again and again, staffers say, Facebook’s leaders ignore them.

Facebook has dismissed the concerns of its employees in manifold ways.

One of its cleverer tactics is to argue that staffers who have raised the alarm about the damage done by their employer are simply enjoying Facebook’s “very open culture,” in which people are encouraged to share their opinions, a spokesperson told me. This stance allows Facebook to claim transparency while ignoring the substance of the complaints, and the implication of the complaints: that many of Facebook’s employees believe their company operates without a moral compass.

When you stitch together the stories that spanned the period between Joe Biden’s election and his inauguration, it’s easy to see Facebook as instrumental to the attack on January 6. (A spokesperson told me that the notion that Facebook played an instrumental role in the insurrection is “absurd.”)

what emerges from a close reading of Facebook documents, and observation of the manner in which the company connects large groups of people quickly, is that Facebook isn’t a passive tool but a catalyst. Had the organizers tried to plan the rally using other technologies of earlier eras, such as telephones, they would have had to identify and reach out individually to each prospective participant, then persuade them to travel to Washington. Facebook made people’s efforts at coordination highly visible on a global scale.

The platform not only helped them recruit participants but offered people a sense of strength in numbers. Facebook proved to be the perfect hype machine for the coup-inclined.

In November 2019, Facebook staffers noticed they had a serious problem. Facebook offers a collection of one-tap emoji reactions. Today, they include “like,” “love,” “care,” “haha,” “wow,” “sad,” and “angry.” Company researchers had found that the posts dominated by “angry” reactions were substantially more likely to go against community standards, including prohibitions on various types of misinformation, according to internal documents.

In July 2020, researchers presented the findings of a series of experiments. At the time, Facebook was already weighting the reactions other than “like” more heavily in its algorithm—meaning posts that got an “angry” reaction were more likely to show up in users’ News Feeds than posts that simply got a “like.” Anger-inducing content didn’t spread just because people were more likely to share things that made them angry; the algorithm gave anger-inducing content an edge. Facebook’s Integrity workers—employees tasked with tackling problems such as misinformation and espionage on the platform—concluded that they had good reason to believe targeting posts that induced anger would help stop the spread of harmful content.

By dialing anger’s weight back to zero in the algorithm, the researchers found, they could keep posts to which people reacted angrily from being viewed by as many users. That, in turn, translated to a significant (up to 5 percent) reduction in the hate speech, civic misinformation, bullying, and violent posts—all of which are correlated with offline violence—to which users were exposed.

Facebook rolled out the change in early September 2020, documents show; a Facebook spokesperson confirmed that the change has remained in effect. It was a real victory for employees of the Integrity team.

But it doesn’t normally work out that way. In April 2020, according to Frances Haugen’s filings with the SEC, Facebook employees had recommended tweaking the algorithm so that the News Feed would deprioritize the surfacing of content for people based on their Facebook friends’ behavior. The idea was that a person’s News Feed should be shaped more by people and groups that a person had chosen to follow. Up until that point, if your Facebook friend saw a conspiracy theory and reacted to it, Facebook’s algorithm might show it to you, too. The algorithm treated any engagement in your network as a signal that something was worth sharing. But now Facebook workers wanted to build circuit breakers to slow this form of sharing.

Experiments showed that this change would impede the distribution of hateful, polarizing, and violence-inciting content in people’s News Feeds. But Zuckerberg “rejected this intervention that could have reduced the risk of violence in the 2020 election,” Haugen’s SEC filing says. An internal message characterizing Zuckerberg’s reasoning says he wanted to avoid new features that would get in the way of “meaningful social interactions.” But according to Facebook’s definition, its employees say, engagement is considered “meaningful” even when it entails bullying, hate speech, and reshares of harmful content.

This episode, like Facebook’s response to the incitement that proliferated between the election and January 6, reflects a fundamental problem with the platform

Facebook’s megascale allows the company to influence the speech and thought patterns of billions of people. What the world is seeing now, through the window provided by reams of internal documents, is that Facebook catalogs and studies the harm it inflicts on people. And then it keeps harming people anyway.

“I am worried that Mark’s continuing pattern of answering a different question than the question that was asked is a symptom of some larger problem,” wrote one Facebook employee in an internal post in June 2020, referring to Zuckerberg. “I sincerely hope that I am wrong, and I’m still hopeful for progress. But I also fully understand my colleagues who have given up on this company, and I can’t blame them for leaving. Facebook is not neutral, and working here isn’t either.”

It is quite a thing to see, the sheer number of Facebook employees—people who presumably understand their company as well as or better than outside observers—who believe their employer to be morally bankrupt.

I spoke with several former Facebook employees who described the company’s metrics-driven culture as extreme, even by Silicon Valley standards

Facebook workers are under tremendous pressure to quantitatively demonstrate their individual contributions to the company’s growth goals, they told me. New products and features aren’t approved unless the staffers pitching them demonstrate how they will drive engagement.

e worries have been exacerbated lately by fears about a decline in new posts on Facebook, two former employees who left the company in recent years told me. People are posting new material less frequently to Facebook, and its users are on average older than those of other social platforms.

One of Facebook’s Integrity staffers wrote at length about this dynamic in a goodbye note to colleagues in August 2020, describing how risks to Facebook users “fester” because of the “asymmetrical” burden placed on employees to “demonstrate legitimacy and user value” before launching any harm-mitigation tactics—a burden not shared by those developing new features or algorithm changes with growth and engagement in mind

The note said:We were willing to act only after things had spiraled into a dire state … Personally, during the time that we hesitated, I’ve seen folks from my hometown go further and further down the rabbithole of QAnon and Covid anti-mask/anti-vax conspiracy on FB. It has been painful to observe.

Current and former Facebook employees describe the same fundamentally broken culture—one in which effective tactics for making Facebook safer are rolled back by leadership or never approved in the first place.

That broken culture has produced a broken platform: an algorithmic ecosystem in which users are pushed toward ever more extreme content, and where Facebook knowingly exposes its users to conspiracy theories, disinformation, and incitement to violence.

One example is a program that amounts to a whitelist for VIPs on Facebook, allowing some of the users most likely to spread misinformation to break Facebook’s rules without facing consequences. Under the program, internal documents show, millions of high-profile users—including politicians—are left alone by Facebook even when they incite violence

whitelisting influential users with massive followings on Facebook isn’t just a secret and uneven application of Facebook’s rules; it amounts to “protecting content that is especially likely to deceive, and hence to harm, people on our platforms.”

Facebook workers tried and failed to end the program. Only when its existence was reported in September by The Wall Street Journal did Facebook’s Oversight Board ask leadership for more information about the practice. Last week, the board publicly rebuked Facebook for not being “fully forthcoming” about the program.

As a result, Facebook has stoked an algorithm arms race within its ranks, pitting core product-and-engineering teams, such as the News Feed team, against their colleagues on Integrity teams, who are tasked with mitigating harm on the platform. These teams establish goals that are often in direct conflict with each other.

“We can’t pretend we don’t see information consumption patterns, and how deeply problematic they are for the longevity of democratic discourse,” a user-experience researcher wrote in an internal comment thread in 2019, in response to a now-infamous memo from Andrew “Boz” Bosworth, a longtime Facebook executive. “There is no neutral position at this stage, it would be powerfully immoral to commit to amorality.”

Zuckerberg has defined Facebook’s mission as making “social infrastructure to give people the power to build a global community that works for all of us,” but in internal research documents his employees point out that communities aren’t always good for society:

When part of a community, individuals typically act in a prosocial manner. They conform, they forge alliances, they cooperate, they organize, they display loyalty, they expect obedience, they share information, they influence others, and so on. Being in a group changes their behavior, their abilities, and, importantly, their capability to harm themselves or others

Thus, when people come together and form communities around harmful topics or identities, the potential for harm can be greater.

The infrastructure choices that Facebook is making to keep its platform relevant are driving down the quality of the site, and exposing its users to more dangers

hose dangers are also unevenly distributed, because of the manner in which certain subpopulations are algorithmically ushered toward like-minded groups

And the subpopulations of Facebook users who are most exposed to dangerous content are also most likely to be in groups where it won’t get reported.

And it knows that 3 percent of Facebook users in the United States are super-consumers of conspiracy theories, accounting for 37 percent of known consumption of misinformation on the platform.

Zuckerberg’s positioning of Facebook’s role in the insurrection is odd. He lumps his company in with traditional media organizations—something he’s ordinarily loath to do, lest the platform be expected to take more responsibility for the quality of the content that appears on it—and suggests that Facebook did more, and did better, than journalism outlets in its response to January 6. What he fails to say is that journalism outlets would never be in the position to help investigators this way, because insurrectionists don’t typically use newspapers and magazines to recruit people for coups.

Facebook wants people to believe that the public must choose between Facebook as it is, on the one hand, and free speech, on the other. This is a false choice. Facebook has a sophisticated understanding of measures it could take to make its platform safer without resorting to broad or ideologically driven censorship tactics.

Facebook knows that no two people see the same version of the platform, and that certain subpopulations experience far more dangerous versions than others do

Facebook knows that people who are isolated—recently widowed or divorced, say, or geographically distant from loved ones—are disproportionately at risk of being exposed to harmful content on the platform.

It knows that repeat offenders are disproportionately responsible for spreading misinformation.

All of this makes the platform rely more heavily on ways it can manipulate what its users see in order to reach its goals. This explains why Facebook is so dependent on the infrastructure of groups, as well as making reshares highly visible, to keep people hooked.

It could consistently enforce its policies regardless of a user’s political power.

Facebook could ban reshares.

It could choose to optimize its platform for safety and quality rather than for growth.

It could tweak its algorithm to prevent widespread distribution of harmful content.

Facebook could create a transparent dashboard so that all of its users can see what’s going viral in real time.

It could make public its rules for how frequently groups can post and how quickly they can grow.

It could also automatically throttle groups when they’re growing too fast, and cap the rate of virality for content that’s spreading too quickly.

Facebook could shift the burden of proof toward people and communities to demonstrate that they’re good actors—and treat reach as a privilege, not a right

You must be vigilant about the informational streams you swim in, deliberate about how you spend your precious attention, unforgiving of those who weaponize your emotions and cognition for their own profit, and deeply untrusting of any scenario in which you’re surrounded by a mob of people who agree with everything you’re saying.

It could do all of these things. But it doesn’t.

Lately, people have been debating just how nefarious Facebook really is. One argument goes something like this: Facebook’s algorithms aren’t magic, its ad targeting isn’t even that good, and most people aren’t that stupid.

All of this may be true, but that shouldn’t be reassuring. An algorithm may just be a big dumb means to an end, a clunky way of maneuvering a massive, dynamic network toward a desired outcome. But Facebook’s enormous size gives it tremendous, unstable power.

Facebook takes whole populations of people, pushes them toward radicalism, and then steers the radicalized toward one another.

When the most powerful company in the world possesses an instrument for manipulating billions of people—an instrument that only it can control, and that its own employees say is badly broken and dangerous—we should take notice.

The lesson for individuals is this:

Facebook could say that its platform is not for everyone. It could sound an alarm for those who wander into the most dangerous corners of Facebook, and those who encounter disproportionately high levels of harmful content

Without seeing how Facebook works at a finer resolution, in real time, we won’t be able to understand how to make the social web compatible with democracy.

The problem was that, once the initial euphoria wore off, the public wasn’t much interested in it. Coverage in print media remained solid, but cable-news coverage of Afghanistan dropped off quickly, especially once

“America’s not at war” was a common refrain among the troops. “We’re at war. America’s at the mall.”

nor did they want to think about whether “draining the swamp” and modernizing and developing Afghanistan (which would mean a lot more than a few elections) was worth the cost and effort.

Not that they care that intensely about it; as the foreign-policy scholar Stephen Biddle recently observed, the war is practically an afterthought in U.S. politics. “You would need an electron microscope to detect the effect of Afghanistan on any congressional race in the last decade,” Biddle said early this year. “It’s been invisible.”

What the public does care about, however, is using Afghanistan as raw material for cheap patriotism and partisan attacks (some right and some wrong, but few of them in good faith) on every president since 2001.

now those same Americans have the full withdrawal from Afghanistan they apparently want: Some 70 percent of the public supports a pullout.

Maybe it would have been worth it. Or maybe such a project was impossible. We’ll never know for certain, because American political and military leaders only tried pieces of several strategies, never a coherent whole, mostly to keep the costs and casualties down and to keep the war off the front pages and away from a public that didn’t want to hear about it

Nor did Americans ever consider whether or when Afghanistan, as a source of terrorist threats to the U.S., had been effectively neutralized. Nothing is perfect, and risks are never zero. But there was no time at which we all decided that “close enough” was good enough, and that we’d rather come home than stay.

Biden’s policy, of course, is not that different from Trump’s, despite all the partisan howling about it from Republicans. As my colleague David Frum has put it: “For good or ill, the Biden policy on Afghanistan is the same as the Trump policy, only with less lying.”

But as comforting as it would be to blame Obama and Trump, we must look inward and admit that we told our elected leaders—of both parties—that they were facing a no-win political test. If they chose to leave, they would be cowards who abandoned Afghanistan. If they chose to stay, they were warmongers intent on pursuing “forever war.”

A serious people—the kind of people we once were—would have made serious choices, long before this current debacle was upon them. They would today be trying to learn something from nearly 2,500 dead service members and many more wounded

Biden was right, in the end, to bite the bullet and refuse to pass this conflict on to yet another president

His execution of this resolve, however, looks to be a tragic and shameful mess and will likely be a case study in policy schools for years to come. But there was no version of “Stop the forever war” that didn’t end with the fall of Kabul

before we move on, before we head back to the mall, before we resume posting memes, and before we return to bickering with each other about whether we should have to mask up at Starbuck’s, let us remember that this day came about for one reason, and one reason only.Because it is what we wanted.

In fact, “public health has actively participated in its own marginalization,” Daniel Goldberg, a historian of medicine at the University of Colorado, told me. As the 20th century progressed, the field moved away from the idea that social reforms were a necessary part of preventing disease and willingly silenced its own political voice. By swimming along with the changing currents of American ideology, it drowned many of the qualities that made it most effective.

Germ theory offered a seductive new vision for defeating disease: Although the old public health “sought the sources of infectious disease in the surroundings of man; the new finds them in man himself,” wrote Hibbert Hill in The New Public Health in 1913

“They didn’t have to think of themselves as activists,” Rosner said. “It was so much easier to identify individual victims of disease and cure them than it was to rebuild a city.”

As public health moved into the laboratory, a narrow set of professionals associated with new academic schools began to dominate the once-broad field. “It was a way of consolidating power: If you don’t have a degree in public health, you’re not public health,”

Mastering the new science of bacteriology “became an ideological marker,” sharply differentiating an old generation of amateurs from a new one of scientifically minded professionals,

Hospitals, meanwhile, were becoming the centerpieces of American health care, and medicine was quickly amassing money and prestige by reorienting toward biomedical research

Public health began to self-identify as a field of objective, outside observers of society instead of agents of social change. It assumed a narrower set of responsibilities that included data collection, diagnostic services for clinicians, disease tracing, and health education.

Assuming that its science could speak for itself, the field pulled away from allies such as labor unions, housing reformers, and social-welfare organizations that had supported city-scale sanitation projects, workplace reforms, and other ambitious public-health projects.

That left public health in a precarious position—still in medicine’s shadow, but without the political base “that had been the source of its power,”

After World War II, biomedicine lived up to its promise, and American ideology turned strongly toward individualism.

Seeing poor health as a matter of personal irresponsibility rather than of societal rot became natural.

Even public health began to treat people as if they lived in a social vacuum. Epidemiologists now searched for “risk factors,” such as inactivity and alcohol consumption, that made individuals more vulnerable to disease and designed health-promotion campaigns that exhorted people to change their behaviors, tying health to willpower in a way that persists today.

This approach appealed, too, to powerful industries with an interest in highlighting individual failings rather than the dangers of their products.

“epidemiology isn’t a field of activists saying, ‘God, asbestos is terrible,’ but of scientists calculating the statistical probability of someone’s death being due to this exposure or that one.”

In 1971, Paul Cornely, then the president of the APHA and the first Black American to earn a Ph.D. in public health, said that “if the health organizations of this country have any concern about the quality of life of its citizens, they would come out of their sterile and scientific atmosphere and jump in the polluted waters of the real world where action is the basis for survival.”

a new wave of “social epidemiologists” once again turned their attention to racism, poverty, and other structural problems.

The biomedical view of health still dominates, as evidenced by the Biden administration’s focus on vaccines at the expense of masks, rapid tests, and other “nonpharmaceutical interventions.”

Public health has often been represented by leaders with backgrounds primarily in clinical medicine, who have repeatedly cast the pandemic in individualist terms: “Your health is in your own hands,” said the CDC’s director, Rochelle Walensky, in May

the pandemic has proved what public health’s practitioners understood well in the late 19th and early 20th century: how important the social side of health is. People can’t isolate themselves if they work low-income jobs with no paid sick leave, or if they live in crowded housing or prisons.

Public health is now trapped in an unenviable bind. “If it conceives of itself too narrowly, it will be accused of lacking vision … If it conceives of itself too expansively, it will be accused of overreaching,

“Public health gains credibility from its adherence to science, and if it strays too far into political advocacy, it may lose the appearance of objectivity,”

In truth, public health is inescapably political, not least because it “has to make decisions in the face of rapidly evolving and contested evidence,” Fairchild told me. That evidence almost never speaks for itself, which means the decisions that arise from it must be grounded in values.

Those values, Fairchild said, should include equity and the prevention of harm to others, “but in our history, we lost the ability to claim these ethical principles.”

“Sick-leave policies, health-insurance coverage, the importance of housing … these things are outside the ability of public health to implement, but we should raise our voices about them,” said Mary Bassett, of Harvard, who was recently appointed as New York’s health commissioner. “I think we can get explicit.”

The future might lie in reviving the past, and reopening the umbrella of public health to encompass people without a formal degree or a job at a health department.

What if, instead, we thought of the Black Lives Matter movement as a public-health movement, the American Rescue Plan as a public-health bill, or decarceration, as the APHA recently stated, as a public-health goal? In this way of thinking, too, employers who institute policies that protect the health of their workers are themselves public-health advocates.

“We need to re-create alliances with others and help them to understand that what they are doing is public health,

The meanness of the public has forced many public-facing industries to rethink what used to be an article of faith: that the customer is always right. If employees are now having to take on many unexpected roles — therapist, cop, conflict-resolution negotiator — then workplace managers are acting as security guards and bouncers to protect their employees.

It’s not just your imagination; behavior really is worse. In a study of 1,000 American adults during the pandemic, 48 percent of adults and 55 percent of workers said that in November 2020, they had expected that civility in America would improve after the election.

By August, the expectations of improvement had fallen to 30 percent overall and 37 percent among workers. Overall, only 39 percent of the respondents said they believed that America’s tone was civil.

The study also found that people who didn’t have to work with customers were happier than those who did.

“It’s mentally exhausting to have to police adults over this matter,” wrote Adam Mosley, a 51-year-old flight attendant, responding to a request by The New York Times to describe conditions in the service industry at this odd juncture.

In part, the problem is the disconnect between expectation and reality

Before the pandemic, she said, consumers had been seduced into the idea of the “frictionless economy” — the notion that you could get whatever you wanted, the moment you wanted it.

“There’s a lack of outlets for people’s anger,” Ms. Swift said. “That waiter, that flight attendant — they become a stand-in for everything coming between what we experience and what we think we are entitled to.”

Customer Care Measurement and Consulting, has been conducting studies of consumer anger. The next iteration is set to come out this spring. He almost can’t believe what he has seen during the pandemic.

“When we founded the study, I never thought that the environment would be like it was today,” he said. “I would never in my wildest dreams have imagined that we would be seeing people fighting on planes and beating each other up.”

“There’s a growing delta between office workers and those that are interacting with consumers,”

“There is definitely a subset of people that don’t seem to think that any of the rules apply to them,”

most of the bad consumer behavior is low-grade — a persistent hum of incivility rather than an explosion of violence.

“Customers have been superaggressive and impatient lately,”

Such interactions used to make her weep. “But I’ve been calloused by it,” she said. “Now, instead of crying, I’m just really pessimistic and judgmental against the people around me.”

From across the country, workers responded with similar stories: of customers flying off the handle when the products they wanted were unavailable; of customers blaming the store, rather than supply-chain disruptions, for delays; of customers demanding refunds on nonrefundable items; of customers so wound up with worry and anxiety that the smallest thing sends them into a tailspin of hysteria.

The worst, she said, is the political commentary. Once a customer went into a diatribe against Dr. Anthony S. Fauci, saying she had it on good authority that he was about to be jailed for his “crimes.” Others have called Ms. Ashburn a “sheep” and a “fraidy-cat” for wearing a mask.Her go-to response — looking noncommittal and murmuring “hmm” — seems to make matters worse. “I am very discouraged at the polarization and at the unkind way that people treat each other,” she said.

Ms. Miller, from the Wisconsin trade association, said the pressures of the pandemic and the deterioration of elected officials’ behavior — the shouting, the threats, the hatred — had given normal people license to act out, too.

The judge’s ruling highlighted several safety flaws, including that the doctors were given only one face mask per week and had to reuse gowns. The ruling also noted that hospitals kept protective gear locked up. The equipment shortages lasted until June 2020, three months after the pandemic took hold in Spain.

Spain’s judiciary has been flooded with lawsuits related to shortcomings in its health care system during the pandemic, including suits over cancers that went undetected while hospitals were focused on coping with Covid-19.

For all the challenges confronting him, the president attempted to stay optimistic. As Biden departed the news conference, he offered a thumbs up when asked if West Virginia Sen. Joe Manchin and Arizona Sen. Kyrsten Sinema — key Democratic votes — were on board with his $1.75 trillion spending package for families, health care and renewable energy. The president also shrugged off his recent decline in the polls, saying that numbers go up and down

Biden’s overall take on his efforts: On climate change, he’s got $900 billion planned for renewable energy, and Congress will vote this coming week.

The president did leave the G-20 with commitments by his fellow leaders on a global minimum tax that would make it harder for large companies to avoid taxes by assigning their profits to countries with low tax rates.

The president met Sunday with Turkish President Recep Tayyip Erdogan, whose office said the meeting was held in a “positive atmosphere” despite tensions over human rights and Turkey’s purchase of a Russian missile system, among other issues.

Biden heads Monday to the U.N. climate summit in Scotland, where he’ll once again face questions about whether the world’s wealthiest are doing enough to stop the warming of the Earth by moving away from fossil fuels.

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.

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.)

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.

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.

even after the 7 October massacre had stirred memories of the bleakest chapters of the Jewish past – and prompted a surge in antisemitism across the world – Jews were being told exactly how they can and cannot speak about their pain. We’re not to mention the Holocaust, one scholar advised, because that would be “weaponising” it. Historical context about the Nakba, the 1948 dispossession of the Palestinians, is – rightly – deemed essential. But mention the Nazi murder of 6 million Jews – the event that finally secured near-universal agreement among the Jewish people, and the United Nations in 1947, that Jews needed a state of their own – and you’ve broken the rules. Because it’s impossible that both sides might have suffered historic pain.

Instead, a shift is under way that has been starkly revealed during these past three weeks. It squeezes the Israel-Palestine conflict into a “decolonisation” frame it doesn’t quite fit, with all Israelis – not just those in the occupied West Bank – defined as the footsoldiers of “settler colonialism”, no different from, say, the French in Algeria

They have been framed as the modern world’s ultimate evildoer: the coloniser.

That matters because, in this conception, justice can only be done once the colonisers are gone

What’s more, such a framing brands all Israelis – not just West Bank settlers – as guilty of the sin of colonialism. Perhaps that explains why those letter writers could not full-throatedly condemn the 7 October killing of innocent Israeli civilians. Because they do not see any Israeli, even a child, as wholly innocent.

the late Israeli novelist and peace activist Amos Oz was never wiser than when he described the Israel/Palestine conflict as something infinitely more tragic: a clash of right v right. Two peoples with deep wounds, howling with grief, fated to share the same small piece of land.

With consumers buying so little, at least relative to the Chinese economy’s productive capacity, how can the nation generate enough demand to keep that capacity in use? The main answer, as Michael Pettis points out, has been to promote extremely high rates of investment, more than 40 percent of G.D.P. The trouble is that it’s hard to invest that much money without running into severely diminishing returns.

financial repression — paying low interest on savings and making cheap loans to favored borrowers — that holds down household income and diverts it to government-controlled investment, a weak social safety net that causes families to accumulate savings to deal with possible emergencies, and more.

Part of the answer is bad leadership. President Xi Jinping is starting to look like a poor economic manager, whose propensity for arbitrary interventions — which is something autocrats tend to do — has stifled private initiative.

But China’s working-age population peaked around 2010 and has been declining ever since. While China has shown impressive technological capacity in some areas, its overall productivity also appears to be stagnating.

very high rates of investment may be sustainable if, like China in the early 2000s, you have a rapidly growing work force and high productivity growth as you catch up with Western economies

This, in short, isn’t a nation that can productively invest 40 percent of G.D.P. Something has to give.

the government was able to mask the problem of inadequate consumer spending for a number of years by promoting a gigantic real estate bubble. In fact, China’s real estate sector became insanely large by international standards.

what China must do seems straightforward: end financial repression and allow more of the economy’s income to flow through to households, and strengthen the social safety net so that consumers don’t feel the need to hoard cash. And as it does this it can ramp down its unsustainable investment spending.

But there are powerful players, especially state-owned enterprises, that benefit from financial repression

And when it comes to strengthening the safety net, the leader of this supposedly communist regime sounds a bit like the governor of Mississippi, denouncing “welfarism” that creates “lazy people.”

Japan ended up managing its downshifting well. It avoided mass unemployment, it never lost social and political cohesion, and real G.D.P. per working-age adult actually rose 50 percent over the next three decades, not far short of growth in the United States.

My great concern is that China may not respond nearly as well. How cohesive will China be in the face of economic trouble? Will it try to prop up its economy with an export surge that will run headlong into Western efforts to promote green technologies? Scariest of all, will it try to distract from domestic difficulties by engaging in military adventurism?