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Researchers expected the details in the study to dispel doubts about the likelihood that many years of head trauma can lead to C.T.E. The growing connections between head trauma and contact sports, though, have led some nervous parents and coaches to assume that any concussion could lead to long-term impairment. Some doctors say that oversimplifies matters. Rather, the total amount of head trauma, including smaller subconcussive hits, as well as how they were treated, must be considered

For every COVID death, many more older people develop serious illness. Risk increases with age, and people older than 70 “have a substantially higher rate of hospitalizations” than those ages 60 to 69,

Where America has landed is hardly a new way of life but rather one that is simply more onerous. “One way to think about it is that this is a new risk that’s out there” alongside other natural causes of death, such as diabetes and heart failure,

The antiviral Paxlovid was supposed to help blunt the wave of old people falling sick and ending up in the hospital—and it can reduce severe disease by 50 to 90 percent. But unfortunately, it is not widely used; as of July, just a third of Americans 80 or older took Paxlovid.

The reality is that as long as the virus continues to be prevalent, older Americans will face these potential outcomes every time they leave their home. That doesn’t mean they will barricade themselves indoors, or that they even should. Still, “every decision that we make now is weighing that balance between risk and socialization,”

Persistent coughs, aches, and joint pain can linger long after serious illness, together with indirect impacts such as loss of muscle strength and flexibility, which can affect older people’s ability to be independent, Rivers said. Older COVID survivors may also have a higher risk of cognitive decline. In some cases, these ailments could be part of long COVID, which may be more prevalent in older people.

Before the pandemic, the association between loneliness and higher mortality rates, increased cardiovascular risks, and dementia among older adults was already well established. Increased isolation during COVID amplified this association.

Even older adults who have weathered the direct and indirect effects of the pandemic still face other challenges that COVID has exacerbated. Many have long relied on personal caregivers or the staff at nursing facilities. These workers, already scarce before the pandemic, are even more so now because many quit or were affected by COVID themselves

“Long-term care has been in a crisis situation for a long time, but it’s even worse now,” Muramatsu said, noting that many home care workers are older adults themselves

Older people won’t have one single approach to contending with this sad reality. “Everybody is trying to figure out what is the best way to function, to try to have some level of everyday life and activity, but also keep your risk of getting sick as low as possible,”

Again, many of these people did not have it great before the pandemic, even if the rest of the country wasn’t paying attention. “We often don’t provide the basic social support that older people need,” Kenneth Covinsky, a clinician-researcher at the UCSF Division of Geriatrics, said. Rather, ageism, the willful ignorance or indifference to the needs of older people, is baked into American life.

It is perhaps the main reason older adults were so badly affected by the pandemic in the first place, as illustrated by the delayed introduction of safety precautions in nursing homes and the blithe acceptance of COVID deaths among older adults. If Americans couldn’t bring themselves to care at any point over the past three years, will they ever?

The binary race norms, when they are used in the testing, assume that Black patients start with worse cognitive function than whites and other non-Blacks. That makes it harder for them to show a deficit and qualify for an award

The awards so far have averaged $516,000 for the 379 players with early-stage dementia and $715,000 for the 207 players with moderate dementia. Retirees can also seek payouts for Alzheimer's disease and a few other diagnoses. The settlement ended thousands of lawsuits that accused the NFL of long hiding what it knew about the link between concussions and traumatic brain injury.

But the F.D.A. advisory committee, along with an independent think tank and several prominent experts — including some Alzheimer’s doctors who worked on the aducanumab clinical trials — said the evidence raised significant doubts about whether the drug is effective.

The F.D.A. authorized the drug under a program called accelerated approval, which has been applied to therapies for some cancers and other serious diseases for which there are few, if any, treatments.

The risks with aducanumab involve brain swelling or bleeding experienced by about 40 percent of Phase 3 trial participants receiving the high dose. Most were either asymptomatic or had headaches, dizziness or nausea. But such effects prompted 6 percent of high-dose recipients to discontinue. No Phase 3 participants died from the effects, but one safety trial participant did.

About two million Americans may fit the description of the patients the drug was tested on: people in the early stages of Alzheimer’s or the stage just before that, Alzheimer’s-related mild cognitive impairment. About six million people in the United States and roughly 30 million globally have Alzheimer’s, a number expected to double by 2050. Currently, five medications approved in the United States can delay cognitive decline for several months in various Alzheimer’s stages.

The crux of the controversy over aducanumab involved two Phase 3 trials with results that contradicted each other: One suggested the drug slightly slowed cognitive decline while the other trial showed no benefit. The trials were stopped early by a data monitoring committee that found aducanumab didn’t appear to be showing any benefit. Consequently, over a third of the 3,285 participants in those trials were never able to complete them.

Aducanumab, a monoclonal antibody, targets a protein, amyloid, that clumps into plaques in the brains of Alzheimer’s patients and is considered a biomarker of the disease. One thing both critics and supporters of approval agree on is that the drug substantially reduces levels of amyloid, and the F.D.A. said that the drug’s effect on a biomarker qualified it for the accelerated approval program.

He estimates 25 to 40 percent of the clinic’s roughly 3,000 patients might be eligible, but it doesn’t have enough neurologists.

we may swear simply because it makes us feel better

The war effort itself went badly during 1917. Wilson tapped General John J. Pershing to command the American Expeditionary Force, but he gave him complete autonomy — unlike war leaders such as Abraham Lincoln and Franklin D. Roosevelt, who supervised their generals closely and played an active role in formulating strategy

Wilson, after declaring that the war should “make the world safe for democracy,” became complicit in one of the worst governmental assaults upon freedom of speech in American history, via the Espionage Act of 1917, and the Sedition Act of 1918.

In the autumn of 1917, as German victory approached on the eastern front, Wilson sent Col. House to discuss war aims with the British and the French. The timing could not have been worse: American troops had not taken part in any fighting and Gen. Pershing was completely noncommittal as to when they would be ready for battle.

The British and the French knew that within a few months the Germans would be able to shift massive numbers of troops to the western front for the knock-out blow in France. They needed troops from the United States right away. Wilson refused to order Pershing to speed up his timetable. Not surprisingly, the British and the French refused to agree to the principle of a non-vindictive peace.

in January 1918, with American influence at low ebb, he and House created his soon-to-be famous “Fourteen Points.” These principles for a peace settlement were composed by these two men in total secrecy. No members of Wilson’s cabinet were consulted, no members of Congress were consulted, no foreign heads of state or foreign ministers were consulted.

a League of Nations, the Fourteenth Point of Wilson’s manifesto, was supported by a great many influential people on both sides of the Atlantic. Again and again, such people reached out to Wilson in 1918 to offer their assistance. Wilson spurned them.

The British leaders, David Lloyd George and Georges Clemenceau, were beside themselves with frustration and fury as Pershing committed only minimal numbers of American troops to battle and Wilson refused to order his commander to increase the American effort.

He said that “the return of a Republican majority to either House of the Congress would . . . certainly be interpreted on the other side of the water as a repudiation of my leadership.” And so, by his very own proclamation, he stood repudiated, for the Republicans captured both houses of Congress. As usual, he had not taken time to engage in any worst-case contingency planning

What was wrong? There is reason to believe that the medical theorists may well be correct — that for more than a year (and perhaps for several years) before the stroke of October 2, 1919, Wilson suffered from cerebro-vascular degeneration that led to episodic dementia.

As the German position fell apart in the fall of 1918, Wilson botched the negotiations for the armistice. As usual, he sent Col. House as his representative and he gave him no written instructions at all except to emphasize his own commitment to freedom of the seas and the other principles set forth within the Fourteen Points. And so as House obsessed about freedom of the seas, harsh armistice terms were imposed upon the Germans

For those who file claims, the vast majority would be for players who received diagnoses of Alzheimer’s disease or advanced dementia. They would be expected to receive more than $800 million in awards.

both sides expected only several dozen former players to receive the largest monetary awards, up to $5 million for diagnoses of Parkinson’s disease, amyotrophic lateral sclerosis or C.T.E.

about 28 percent of former players, totaling 5,900, will develop compensable injuries. Only about 60 percent, or 3,600, of those players are expected to file claims,

“It took something high profile to get people to understand, and it needed something in the media to make people aware,” Dr. Stewart said, referring to Benjamin’s death. “Even if it just means we’re preventing another Ben Robinson and not addressing dementia, that’s still very important. We’ve got to get things to change.”

Much of what Mr. Robinson and Dr. Stewart have accomplished is second nature in the United States, where concussions have been a growing part of the public dialogue for several years. Coaches and players in many sports are now taught that concussions, brain injuries resulting from a blow to the head or whiplash, can lead to headaches, memory loss, dizziness, sensitivity to light and other problems.

After an outcry from scientists, retired players and family members of injured and deceased athletes, the N.F.L. and other leagues have adopted protocols during games to detect concussions, pull players from the field, administer on-the-spot tests and detail when they can return to play.

hris Nowinski, a co-founder of the Concussion Legacy Foundation, an American nonprofit group that pushes for safe sports, said that concussion management in Britain lags five to six years behind the United States. Photo

“Scotland is a great example of a team of passionate advocates creating change in their community,” he said. “It’s a template that I hope others follow.”

Concussions were far from Mr. Robinson’s mind when his son joined his teammates from Carrickfergus Grammar School to play their rivals from Dalriada that day.

Soccer was Benjamin’s first love, but when he was 11, he took up rugby, which was mandatory at his new school. Initially, he did not enjoy the sport. But he warmed to it after winning the award for most improved player. He did strength and conditioning drills to add muscle, and arm wrestled with his father.

The night before the game, his son watched “Invictus,” the film about South Africa’s victory in the 1995 Rugby World Cup. He slept that night in his uniform. When his mother dropped him off at the field the next day, Benjamin flashed a thumbs-up sign.

But just minutes into the second half, Benjamin collided with another player, whose shoulder hit him in the chest, according to Mr. Robinson, who obtained a DVD of the match from the police. His son’s head whipped back, and he fell. The coach came to look at Benjamin, who was on the ground for about 90 seconds, and helped him to his feet. A doctor who was watching his son play for Dalriada briefly walked onto the field but then turned back.

As time ran down, Benjamin made a tackle and then collapsed. The game was stopped. Ms. Walton ran onto the field, where Benjamin’s teammate told her that he was out cold. He was rushed to Royal Victoria Hospital in Belfast.

When Mr. Robinson and his wife, Carol, arrived at the hospital, he knew the situation was dire from the faces of the staff. His son was on life support. The doctors said that his brain injury looked like it was sustained in a car accident and that he had a slim chance of surviving.

Initially, though, a police investigator deferred to the schools when it came to gathering comments from Benjamin’s teammates and opponents. Officials at Carrickfergus declined to discuss the case.

Ms. Walton and Mr. Robinson, though, had to piece together much of what happened on their own. One break came while Ms. Walton was visiting her son’s grave — which she said she did every day — and met one of his teammates, who was out jogging. He told her that Benjamin had been knocked out during the match, not just hit at the end, as had been contended.

The big break came when a police officer gave Mr. Robinson a copy of a video taken of the match by a student. Mr. Robinson watched the shaky footage repeatedly and confirmed that his son suffered not one big blow, but at least three, and that the coach attended to him several times.

Yet she effectively absolved the coach and referee, who were not “made aware of Benjamin’s neurological complaints,” even though the coach can be seen on the video checking on him after a hit during the match. She implied that Benjamin could have let them know about his condition, even though experts say concussion victims often cannot adequately communicate what they are experiencing.

Soon after, Mr. and Ms. Robinson, Dr. Stewart and James Robson, the chief medical officer of Scottish Rugby, met with Scotland’s sport and education officials to lobby for change. A concussion-awareness leaflet was produced at the beginning of 2014.

It has been an unlikely road for Mr. Robinson and Dr. Stewart, an avid bike rider with no experience as a sideline doctor. But about five years ago, even before Benjamin’s death, Dr. Stewart began to get calls from former professional players and had conversations with Scottish Rugby as it tried to address brain trauma and degenerative brain disease.

Still, some sports executives have anonymously challenged Dr. Stewart. In one match in April in London, Oscar, the Brazilian star player on Chelsea who is known by one name, collided violently with the goalkeeper yet was not immediately taken out of the game. There are no concussion spotters at Premier League matches, but team and league officials could watch a replay of the game later. That is why Dr. Stewart — an adviser to the Football Association — was dismayed that Oscar was in uniform three days later, violating the league’s return-to-play guidelines that require at least six days of rest.

“I don’t need to stand up in front of a conference of sports medicine and be personally criticized,” he said. “But then I’ll get a call from Peter, who is enthused about something we’ve done with the leaflets, or some research collaborators who are keen to move forward, and I say, ‘Ah, for all the small minds that are critical and obviously trying to deny the inevitable signs, there are a whole bunch of people who are having a positive effect on it.’

On a chilly evening in late October, with teenagers practicing on a nearby field, Lianne Brunton, the club’s physical therapist, showed off the test on a tablet computer. At the start of the season, hundreds of youth and adult players are timed as they read aloud a series of numbers on several screens. If a player is suspected of having a concussion during a match, he or she is taken off and asked to read the numbers again. Players who take longer are evaluated further.

The test, which is widely used in the United States, is another example of how the grass-roots campaign to improve safety standards after Benjamin’s death has changed attitudes.

In a review of 148 independent studies on loneliness, covering more than 300,000 participants, Julianne Holt-Lunstad of Brigham Young University and colleagues found that greater social connection was associated with a 50% lower risk of early death.

Research suggests that those who are isolated are at an increased risk of depression, cognitive decline and dementia, and that social relationships influence their blood pressure and immune functioning, as well as whether people take their medications.

the forces that take hold late in life often compound it. Retirement shrivels social networks formed through work. Hearing loss and worsening mobility impede talking face-to-face and participating in group activities.

The baby boomers prized individuality and generally had fewer children and ended marriages in greater numbers than previous generations. More than one in four boomers is divorced or never married, census figures show. About one in six lives alone

Along with financial issues including high debt and declining pensions, social factors such as loneliness are another reason boomers are experiencing more difficult retirement years than previous generations.

In the current wave, fewer patients recovering from Covid are being taken to nursing homes, such as Mr. Padgham’s, where they have a dedicated floor. The risks remain steep.

Under the government’s new changes — set to take effect on March 8, one week before Mother’s Day in Britain — his charges would be allowed visits by a family member under strict conditions. No hugs. No kisses. But hand-holding is OK.

Inevitably, those on the front lines — funeral workers, doctors and nurses — are often most exposed. So are their kin.

But that October, Biogen announced it found benefit in one trial after evaluating data from 318 participants who finished before the trials were stopped but after the cutoff point for results the monitoring committee assessed.

Both trials were stopped early, in March 2019, when an independent data monitoring committee said aducanumab didn’t appear to be working. Consequently, 37 percent of participants never completed the 78-week trials.

Aducanumab, a monoclonal antibody, targets a protein, amyloid, that clumps into plaques in the brains of Alzheimer’s patients. Many amyloid-reducing drugs failed to slow symptoms in trials, a history that, some experts say, makes it especially important that aducanumab’s data be convincing. If effective, it would support a long-held, unproven theory that attacking amyloid can help if done early enough.

By contrast, Dr. Stephen Salloway, who has received research and consulting fees from Biogen but wasn’t paid for being an aducanumab trial site principal investigator, called himself a “passionate” supporter of approval. He considers the evidence sufficient because Alzheimer’s is so disabling.

Advocates and many patients say delaying deterioration even slightly is meaningful. But some experts say the single trial’s slowing of 0.39 on an 18-point scale rating memory, problem-solving skills and function may be imperceptible to patients’ experience and doesn’t justify approving a drug that floundered in another trial and carries risk of harm.

Dr. Salloway said one trial patient whose dementia had remained mild considerably longer than he’d expected was Henry Magendantz, a retired obstetrician-gynecologist in Providence, R.I. Dr. Magendantz, 84, started the safety trial after his wife, Kathy Jellison, noticed him having trouble following steps to assemble furniture.

Dr. Woskie said the couple yearns for treatments but that if the F.D.A. told Biogen, “‘No, we don’t fast-track approve you; come back when you have more data,’ that wouldn’t surprise me, and it might make sense.”

She said she gets frustrated when she hears about young people flouting social distancing rules. “I think, ‘Because of you guys, I’m stuck in my room. I would like to put you in my room for a week and see how you like it.’”

We waited until 4 p.m. for another test result, also negative, and I got her soon after. She had two bags packed and was practically running out the door — away from the boredom, loneliness, scary and confusing events, unknown staff members with covered faces.

When Covid-19 hit, all family visits were halted. Dorothy was OK at first, already accustomed to the staff feeding her twice a day. But after a while, I think it hit her. Her family was gone. We could not tell her why or where they were. We could not reassure her, although we tried.Dorothy slowly went downhill, and in July, she died. She is the collateral damage, the many who decline simply from the isolation and loss of routine, but most important, from the loss of the people who love them. She was one of many here, and she deserves a voice.

My mother is fortunate that she is in an assisted-living facility that cares. It adheres to the guidelines. Unfortunately, the very rules that keep its residents physically protected do not support their emotional health. There are no easy answers.

the benefits are really vivid, they are really clear. Everybody agrees that the world will be better off the faster we move. And that really wasn’t the case five or 10 years ago. There was much more muddled analysis and messaging then. And I think we have to take advantage of the new unanimity and not let people fall back on the logic of status quo bias and incumbency and just think that change is expensive and difficult

david wallace-wellsMy basic feeling is that the changes that we need are all systemic. And so the things that individuals can do to make that change are primarily through the political realm, not through their individual behavior. If we want to really halt this problem and get a handle on it, it means large, large scale changes that are beyond the capacity of individuals to enact on their own.

jane coastonHow do we get our house in order? What do I as an individual or the people listening to this podcast, how do I make this happen on my level? Knowing all of that, what do I do? What do I personally need to do? Give me a thing to do, Genevieve!

If you want to learn more about personal responsibility, I recommend Jason Marks’s article in the Sierra Club magazine, “Yes, actually, individual responsibility is essential to solving the climate crisis,” and the New York Times guest essay by Auden Schendler, “Worrying About Your Carbon Footprint is Exactly What Big Oil Wants You to Do.”

david wallace-wells

I don’t know that we have to all take on a feeling of guilt for the rise of G.D.P. under neoliberalism, because I don’t know that most of us have actually even seen that money.

ultimately, the things that we need to do to really get a hold of this are way bigger than cutting your food emissions by 10 percent or 50 percent or whatever. It’s like, the three of us in this room, we can’t build an electric grid, a solar farm. We can’t make sure that there are Tesla charging stations all across the country. We can’t re-imagine land use policy or agricultural policy. We can’t put an honest price on carbon so that when you’re buying gas, you’re actually paying for the environmental damage that’s being caused or when you’re buying an airplane ticket. Those are just things that are well outside of our capacity to control

jane coastonCould you explain what climate justice means to an audience that is me?genevieve guentherBasically, it means that the global north historically has been responsible for the vast majority of carbon pollution. And the global south has been responsible for almost none of it. Since 1990, for example, the top 10 percent of earners have been responsible for 52 percent of the growth of global emissions. And the poorest, 50 percent, who largely live in the global south, have been responsible for about 7 percent of global emissions. But that hasn’t grown at all. Historically, they have contributed nothing to the exponential growth of emissions and the increased and accelerating global heating that we’re already seeing. So the idea of climate justice is that global north nations have a moral responsibility to reduce their emissions first and faster so that there is some room left in whatever carbon budget we still have for the global south to pull themselves out of poverty.

jane coastonDavid, what do you make of what Genevieve said about the messaging about good and evil there?

david wallace-wellsI would say even more importantly, we can’t set our standard at extinction. It’s not like if we survive and avoid extinction, that that’s a success. There is huge suffering between here and there. And every degree of temperature rise is going to create more suffering. And every degree we avoid can help us avoid that.

The climate crisis has begun in the United States, too. But the real violence of it is in the global south. And I would argue that the global north doesn’t see it because the news media isn’t reporting on it and because the kind of white supremacy prevents people in this country from really recognizing that this is a violence that would feel unimaginable if it happened to their children.

genevieve guentherOK, so the first part is understanding why we have to do this. And I would argue that most Americans still don’t know enough about global heating and the climate crisis.

jane coastonYeah, but and a benefit when? Because I think a lot of this messaging relies on something that, in general, people do not like, which is, you may need to do a thing or change a thing about your life for a future that we have not yet defined. From a messaging perspective, how do we message the urgency

To think about the concrete impacts, 350,000 Americans, it’s estimated, die every single year from the air pollution from the burning of fossil fuels. That is a death toll literally equal to the 2020 death toll from COVID.

Or is it going to take so long that, in fact, things are going to spiral out of control?

within the space of a few years, by simply refusing to accept their own impotence, they have literally remade the entire landscape of global climate politics. Like in the U.S., when we have Joe Biden who Sunrise gave an F to in the primary, talking about this as an existential threat, that is because the protests worked. And they worked in an incredibly short amount of time

I personally think the high consumption, and particularly the flying of people who are in the public eye, trying to communicate the urgency of the climate crisis, is incredibly destructive to building a political movement. They’re actually doing something extremely counterproductive in my interpretation. They’re reinforcing everybody’s cognitive dissonance with their behavior, which is also a form of speech. They’re communicating that they’re not willing to make transformative changes and not willing to support transformative policies, and that, in fact, you need to use fossil fuels even to do climate work. And so, for me, I feel like the people who need to worry about their carbon footprints insofar as anybody does are the 1 percent and people in the climate movement.

here are huge, huge health consequences from this pollution. It may be the case that air pollution may even be a bigger crisis than climate change. That is how dramatic these impacts are. They happen to be caused largely by the same thing so we can solve them at the same time, but we’re talking about rising rates of respiratory disease and coronary disease and cancers of all kinds and Alzheimer’s and dementia and ADHD and criminality and premature birth and low birth weight. And just every aspect of human flourishing is damaged by the pollution that is produced by the burning of fossil fuels

david wallace-wellsIt’s really, really stark, as Genevieve lays out, that it is the wealthy countries of the world and the wealthy people of the world who have engineered this crisis. So whenever we hear about the problem of India, the problem of electrifying sub-Saharan Africa, these are problems. We need to figure them out and do them clean in a way that doesn’t imperil the future of the planet. But those are only problems that we have to deal with now because of the development patterns that countries like ours and across northern Europe went through over the last few decades and centuries.

Half of all emissions in the entire history of humanity have come in the last 30 years. Now since Al Gore published his first book on warming, you know I often joke it’s since the premiere of “Friends,” which means that, actually, the people who have done the lion’s share of the damage to the planet are alive today. And it is true, of course, that the people who have been running Shell and Chevron and ExxonMobil have much more responsibility than I do or Genevieve does or Jane does. But it is also the case that all of us have benefited in significant ways from economic activity that has been powered by fossil fuels and to which we could have raised louder objections earlier.

genevieve guentherI think it’s worthwhile to point out that the vast majority of Americans are literally going to be richer once we have decarbonized, because their electricity, their heating, their transportation, and their health care costs are going to go down significantl

genevieve guentherPick one. Do it once a week, and things will change. First thing is vote. You can’t do that once a week, but vote in every election. Vote

some of the actions that you’re talking about, the individual actions, I think can be useful in terms of generating small scale political energy that can eventually sort of trickle up into politics. Leaders see that we’re making changes. They see that we’re demanding changes. They may feel more comfortable making those changes themselves.

We as a culture need to normalize that it’s actually healthy not to be happy in the face of climate change and that it doesn’t mean we’re failed Americans. It means that we’re actually human beings who are having an appropriate and ethical moral response to the suffering that is coming in the pipe for everybody, also our own children

Or you can donate to groups that are working on electoral politics directly, like the Environmental Voter Project or Stacey Abrams’s Verified Action

david wallace-wellsHonestly, the person I was talking to was the United States. I mean, that is the perspective that we have as a country. And as guilty as I feel as responsible as I feel, as I’m sure, Genevieve, and to some extent, Jane, you feel, all of us are actually behaving in ways that are imposing that kind of suffering on people elsewhere in the world. It’s almost unavoidable, given the systems that we live in today. And that is really horrifying. But I think the more clearly that we can see that, the more likely we are to be demanding real change of our leaders and the systems in which we live

david wallace-wellsWell, some of them can matter in limiting your carbon footprint. So if you don’t eat beef, if you don’t take airplanes, if you drive an electric car, you’re probably pretty far along in reducing your own carbon footprint. And that is one measure of climate responsibility, carbon responsibility

The ability to put your preferred candidates in office is a huge part of the climate fight

david wallace-wellsI think that this story is one about our responsibility towards other humans, in which collectively, human behavior has imperiled the future of the planet. I think as a result, we have to talk about it in terms of good and evil, that there are very obvious sides.

And it is borne disproportionately by Black and Brown and poor people.

genevieve guentherI actually agree with David. This is a systemic problem that is only going to be solved by governments and large corporations leading the transformation of our economies to zero-emission economies. That said, rich people across the globe have a responsibility, a personal responsibility, to reduce their discretionary emissions, to reduce their consumption, both for climate justice reasons and also simply because we need them to do it if we’re going to meet our emissions targets and halt global heating.

what is hopeful about these net zero pledges, even as they are greenwashing, is the fact that these companies feel pressure to make them at all, right? This is a sea change in politics. If they can’t actually transform, they’re going to be pushed out, and new incumbents are going to come in. And the question is, can we do this fast enough to halt global warming in time to preserve much of the habitable world?

The second piece is a kind of climate communication that shows people how this is going to affect them. Most people think of this as a crisis that’s for the global south or for the distant future or for our grandchildren’s grandchildren or whatever. And it’s up to every single communicator, as far as I’m concerned, to make it clear in really concrete embodied terms what this crisis is going to mean for the children who are alive today.

When I started writing about climate five years ago, I would not have thought that this kind of political change was at all possible. We are living through what is a genuinely unprecedented global climate awakening, which has totally changed the landscape of what is possible. And it really has made the world and the future look sunnier

famously last year, Drew Shindell, who’s an air pollution expert at Duke, testified before U.S. Congress saying that a green transition of the American energy system would entirely pay for itself through the public health benefits of cleaner air. You could put aside all of the climate impacts. You could put aside all the benefits of cheaper electricity. And just because we would be healthier as a result, even in the U.S. where air is already clean, the dollars and cents would add up and make that a very, very clear win for all of us

here’s another thing you can do. You can organize your workplace to ask your company to make greener business decisions or to lobby Congress for climate policies

once they’re in office, keep pressuring them. Call their D.C. offices. Call their local offices. Send them emails regularly

he dynamic is even more horrifying elsewhere in the world where other countries have much dirtier air than we do. Estimates are as high as 10 million people globally dying of air pollution every single year, 8.7 million of them from the burning of fossil fuels

then the third piece of that is really showing how making these changes that are required would be such a benefit to them.

that you have to live like a monk to make this work. That may have been, to some degree, true 25, 30 years ago when the alternative systems that we now see right around the corner were much farther away in the distance and much more expensive. But it just isn’t the case now that to green our economy will require an enormous burden

when we think of it simply in terms of, is the economy going to grow faster or is it going to go slower, I think we really, really miss the huge, huge public health consequences of continuing running the systems as we are running them today, and also the huge benefits we would get from getting off those systems

david wallace-wellsIn 2070, we’re in a net zero world. Nobody has a carbon footprint. So having more kids is not going to make one difference in either direction. And I think we’re still in a place where we can keep that goal in mind and fight to make that possible so that we don’t have to do things like reduce family size.

I had this interaction just before the pandemic at an event I did. I keep thinking about it. I think about it maybe every week, maybe every day, where I gave a talk about looking at how dire some of these situations could be. And afterwards, somebody came up to me who assured me that he was not a climate denier. And then he said, so really, how bad is it going to get? And I said, well, at two degrees, we’re talking about 150 million people dying of air pollution. And he said, but that’s out of 8 billion. And I said, well, yeah, I mean, I’m not talking about the total extinction of the human race here, but 150 million is 150 million. That’s 25 Holocausts. And he said, but out of 8 billion.

the true, are we going to make humans extinct, kind of futures that we were talking about as slim but real possibilities a few years ago, I think are much, much less likely today. And that is in large part the result of climate protests by people who started their activism within the last few years.

genevieve guentherAnd just say that the word “responsibility” has two different definitions, right? There’s the sense of responsibility as guilt. Who is responsible for this crime? Who has to pay the price? But then there’s responsibility as duty. Who’s going to take responsibility for cleaning up this mess?

There is a very small ask that can be made, which is just to support the people who support aggressive climate action. We’re talking about massive, immediate, or quasi immediate payback for all of the investments we’re making.

If you don’t have the time to do that, donate money. Donate money to organizations that are putting their bodies on the line. Here are some of them— Sunrise, Fridays for Future

finally, one of the most impactful things that you can do is simply talk about climate change in your social networks, especially when it feels most socially awkward and embarrassing. Because unless we continue to break the kind of conspiracy of climate silence that allows people to look away, we’re not actually going to have the kind of pressure internally and psychologically in people that will help them join the climate movemen

genevieve guentherWell, let me contextualize this for a moment. The concept of the carbon footprint is actually a legitimate concept in sustainability research. It was developed by two researchers in the 1990s

What is the 1 percent? In the United States, I would define the 1% as people making $450,000 a year and above. So it’s hard to imagine how much consumption is normalized among these people. It is not at all considered wasteful to buy a new SUV every two or three years as new models come out. It is not all considered extravagant to fly up to 20 times a year. It is not at all horrific to buy an entirely new wardrobe two or three times a year and throw it all away. In fact, this is considered a signal that you are in the rich group and that you are living your best life.

it actually has to be done right now. We don’t get another shot at this.

Do my personal actions, be they avoiding plastic straws or composting or calculating my personal carbon footprint, as oil companies seem to really want me to do, or switching light bulbs or becoming a vegetarian, in the scheme of averting climate change or mitigating climate change, do those actions really matter?

I think that there are certain actors who have played hugely disproportionate, often toxic, roles in that story, namely the fossil fuel industry and their allies in political power, not just in the U.S. but all around the world.

that’s not to say that that person is as culpable as the CEOs of ExxonMobil. Obviously, there’s a huge spectrum of culpability, but I think that a huge majority of Americans are understandably viewed by people elsewhere in the world as contributing to the problem as opposed to contributing to the solution, and that we should not dismiss that judgment because we happen to think, well, I was just doing it for myself, or I was just acting in the system in which I live. We should take seriously that judgment and try to think about what we can do to sort of make it right, so to speak.

But BP extracted this concept from academia and created a multimillion dollar campaign, trying to change the discourse of the climate crisis and make, as you said, Jane, everybody feel responsible for causing the climate crisis, but also feeling responsible for solving it by doing things like no longer driving or no longer flying or no longer eating beef or turning off lights or using plastic straws. And as David said, this is impossible. Even if every single one of us brought our personal carbon emissions down to zero, we would not halt global heating.

number two, join a campaign or an activist group. There are local chapters of groups called the Sunrise Movement and 350.org in many communities. If you’re really hardcore, you can join Extinction Rebellion

It will require an investment, but that will sort of pay for itself in the relatively short term. And so we’re now in a situation where a lot of people often think that moving into a sustainable future is going to make their lives suck. And the truth is that just isn’t the case, but that is what the companies that are profiting from the status quo would like you to think because nobody wants their lives to suck.

I think we need to really tell the climate story as a story of good and evil because these people have known for decades what their products were going to do. And not only did they keep producing and selling fossil fuels, they lied about it. They lied about what they knew. And they tried to do everything they could to capture our political system just to sustain their own wealth and power. I think that’s pretty bad. It’s criminal. It’s absolutely criminal.

some of the changes that you’re talking about, people are compelled to do because they don’t want to feel a part of the ugliness of the destruction of the planet, more than because they’re making a rational calculation about how best to use their time and what they can do that has the highest impact

But the fossil fuel industry, as part of their disinformation campaign, wants to make everyone feel helpless, feel overwhelmed, and wants to shift our attention away from the political action that has a chance of resolving the climate crisis to what can’t possibly work, which is focusing on our carbon footprint.

I just don’t think that that’s the end all, be all of it, because I do think that many people, even today, think, OK, I want the future to be stable and green and prosperous. But I don’t want to pay $1 more at the pump for a gallon of gas and may actually vote in an election on that basis

That said, reducing the discretionary emissions of the top 1 percent is actually a piece of the decarbonization puzzle. So, if the top 10 percent reduced their carbon emissions do

n to the level of the average European, which is still quite significant — eight tons a year — we would be about one-third of the way to decarbonizing our systems. So we emit as a globe about 30 gigatons of carbon dioxide a year. And this reduction in luxury consumption would reduce emissions by about 10 gigatons a year. So that is just a staggering number.

Most of the people who are listening to this podcast and nobody in this room, for sure, is responsible for causing the climate crisis. But we’re all responsible for now solving it to the best way that we can.

Greenpeace. And here are some social justice organizations — UPROSE and WE ACT. There are also two new organizations who are writing climate policy in a new way and lobbying on the Hill to get them passed. They are Climate Power and Evergreen Action.

While there is a sort of transition bump and we should have public policy that addresses it, especially for communities who are already suffering, it’s also the case that the obvious economic logic is also the obvious environmental logic here. These are no longer in tension.

for me, that answer is really exclusively through a political engagement and political activism because we really need to shake the whole infrastructure of the world. And the only people who are capable of doing that are the people who are in corridors of power in politics and the corporate worl

“If a boy expresses too much emotion or too much need for connection, is too giddy, is too joyful, what we say to that boy is, ‘What are you, a sissy? What are you, a girl? What are you, gay?’” Greene said. “It’s your job to dominate those around you, or you will lose status, and that will increase the number of individuals above you who can dish out dominance to you. And what we find is that in that system, in that structure, men are constantly in competition with each other and constantly driven by this sense of anxiety.”

many boys are raised with what she called “the cowboy mentality — ‘I can do it myself, I don’t need others,’” often perpetuated by “the father wanting the son to man up and not be so soft. … The whole model of getting help is part of so-called femininity.”

As a result, she said, “Women end up being the therapist for their husband, and more are getting sick of it.”

some men are looking for alternatives, and some are finding them in fellowship organizations with names like EvryMan, the ManKind Project and the Journeymen, the group doing breathwork that night in D.C.

“We have all these groups that are just spontaneously coming into being, as men say, ‘I want a circle of men that I can call my brothers, I want a circle of men that I can express what’s going on for me emotionally, and I want a circle of men who will hold me accountable in positive ways,’”

The theme of the Journeymen’s gathering in April, their first in-person meeting in D.C. since the pandemic, was “heartbreak and grief.” As the sky turned cobalt, Williamson implored the men to sense their emotions and “let them flow freely,” to raise their voices and “release them into the darkness.”

“People here have gone through a lot in our lives, some in the last few months. As we move through the world as men, sometimes it can be hard to have a sense of that,” he said. “All that which has been unnamed and unfelt, it’s actually been felt, it just hasn’t been dealt with. We put up a stiff arm and won’t let the other guy into our lane of traffic, we don’t want to make eye contact because if we did, we’d have to let him into our lane and show up really differently in the world.”

As a man, he said, “you can sense that there are deeper things that are happening in men’s lives, but when you bring it up the subject is changed. If guys’ lives are a house, they only let you see the living room with the plastic on the furniture. And you’re like, ‘Hey, I’m hearing some baying in the basement.’ But we don’t talk about that.”

Going around the circle, they began to talk about what lurked in the basement. One had lost his sister a few months earlier. Many talked of fraught or violent relationships with their fathers — or of not having a father around.

The toll of American loneliness is steep. The condition can increase the risk of premature death to a degree comparable to smoking 15 cigarettes a day and correlates with an increased risk of heart disease, stroke and dementia. “Humans are wired for social connection,” said Murthy, the surgeon general, “but we’ve become more isolated over time.”

“I saw guys suffering with their sense of identity, their sense of self-worth, their sense of belonging, their sense of their rights to their pain,” he said. “I’d see a guy who’d be drinking really heavily. … They’d come over and start talking about their relationship or lack of relationship. Next minute they’d sober up, they didn’t want to talk about it anymore.”

Cogan, now 47, had been working through his own personal difficulties: the end of a previous relationship; his at-times fraught relationship with his father; the bullying he had suffered as a child. Now, he said, he was often the only man his male friends were talking to. “My intuition is that I was modeling openness,” he said. “They saw me talk about my relationship, crying, going to therapy. They saw me as a safe harbor.”

For many men, he said, “The world isn’t safe. There’s no expectation that a guy in our culture can say, ‘I’m scared, I’ve got fear.’ There’s no expectation that a guy can ask for safety in our culture. A lot of the guys I know, they can’t even do this with their partner.”

in recent years, Way said, men have witnessed societal movements such as the #MeToo movement and Black Lives Matter, which also challenged old paradigms. “Then covid happens, and we hit the bottom of the barrel on connections,” she noted. “We can’t walk out of our homes. We woke up to see we are a mess, and we’re not having the connections we want, and we’re not actually happy.

Beyond Crispr and Covid vaccines, there are countless potential applications of mRNA tools for other diseases; a new frontier for immunotherapy and next-generation cancer treatment; a whole new world of weight-loss drugs; new insights and drug-development pathways to chase with the help of machine learning; and vaccines heralded as game-changing for some of the world’s most intractable infectious diseases.

the vaccine innovations stretch beyond mRNA: A “world-changing” vaccine for malaria, which kills 600,000 globally each year, is being rolled out in Ghana and Nigeria, and early trials for next-generation dengue vaccines suggest they may reduce symptomatic infection by 80 percent or more.

the mRNA sequence of the first shot was designed in a weekend, and the finished vaccines arrived within months, an accelerated timeline that saved perhaps several million American lives and tens of millions worldwide — numbers that are probably larger than the cumulative global death toll of the disease.

As the first of their kind to be approved by the Food and Drug Administration, they brought with them a very long list of potential future mRNA applications: H.I.V., tuberculosis, Zika, respiratory syncytial virus (R.S.V.), cancers of various and brutal kinds.

A Nobel laureate, Doudna is known primarily for Crispr, the gene-editing Swiss Army knife that has been called “a word processor” for the human genome and that she herself describes as “a technology that literally enables the rewriting of the code of life.”

many of their back stories do rhyme, often stretching back several decades through the time of the Human Genome Project, which was completed in 2003, and the near-concurrent near-doubling of the National Institutes of Health’s budget, which helped unleash what Donna Shalala, President Bill Clinton’s secretary for health and human services, last year called “a golden age of biomedical research.”

A couple of decades later, it looks like a golden age for new treatments. New trials of breast-cancer drugs have led to survival rates hailed in The Times as “unheard-of,” and a new treatment for postoperative lung-cancer patients may cut mortality by more than half. Another new treatment, for rectal cancer, turned every single member of a small group of cases into cancer-free survivors.

Ozempic and Wegovy have already changed the landscape for obesity in America

although the very first person to receive Crispr gene therapy in the United States received it just four years ago, for sickle-cell disease, it has since been rolled out for testing on congenital blindness, heart disease, diabetes, cancer and H.I.V

all told, some 400 million people worldwide are afflicted by one or more diseases arising from single-gene mutations that would be theoretically simple for Crispr to fix.

in theory, inserting a kind of genetic prophylaxis against Alzheimer’s or dementia.

In January, a much-talked-about paper in Nature suggested that the rate of what the authors called disruptive scientific breakthroughs was steadily declining over time — that, partly as a result of dysfunctional academic pressures, researchers are more narrowly specialized than in the past and often tinkering around the margins of well-understood science.

when it comes to the arrival of new vaccines and treatments, the opposite story seems more true: whole branches of research, cultivated across decades, finally bearing real fruit

Does this mean we are riding an exponential curve upward toward radical life extension and the total elimination of cancer? No. The advances are more piecemeal and scattered than tha

“The biology and the science that we need is already in place,” he says. “The question now to me is: Can we actually do it?”

Sometimes these things just take a little time.