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Trump's obstruction will slow and complicate the delivery of the vaccine that brings the tantalizing prospect of a return to normal life amid stunning news from trials showing doses are effective in stopping more than 90% of coronavirus infections.

Attacks by the President and aides on governors stepping into his leadership vacuum as the pandemic rips across all 50 states mean the situation Biden will inherit will be worse than it needed to be.

The inoculation campaign will require a high level of public trust and will involve sharp ethical debates among officials about who should get the vaccine first.

The entire program could be damaged if it is politicized.

The distribution operation will be a massively complex and historic public vaccination effort targeting hundreds of millions of Americans

The victims of this neglect will be thousands of Americans whom health experts expect to die or get sick in the absence of a coordinated national response to the winter spike in infections and workers caught up in new restrictions imposed on business by local leaders trying to get the virus under control -- as well as the millions of schoolchildren who are already falling behind while classrooms remain shuttered

"More people may die if we don't coordinate," Biden warned bluntly

Biden does have a sense of urgency and new proposals, and he is calling for a coordinated national effort to mitigate the harrowing impact of the nationwide spike in infections.

CNN reported on Monday that Trump has no intention of abandoning his false attacks on the election to initiate an orderly transition process or to accept that Biden is the rightful next president.

Two weeks after the election, it remains surreal and extraordinary that the President is refusing to accept Biden's victory, which matched the 306 Electoral College votes that he himself stacked up in 2016.

consistently prioritized his own goals and gratification over a traditional view of the national interest.

Military commanders expect orders in the coming days from the commander in chief to begin significant drawdowns in Iraq and Afghanistan to be completed by January 15, CNN's Barbara Starr reported on Monday. If there are consequences from such a move -- like a collapse of the Afghan government under a Taliban resurgence -- it will be up to Biden to deal with the fallout.

There are also expectations that the President will take steps in foreign policy, including stiffened tariffs on China or strengthened sanctions on Iran, that will further trim the next White House's negotiating room.

The New York Times reported Monday that the President sought options to strike Iran after his "maximum pressure" policy failed to rein in its nuclear program.

Such action would make it almost impossible for Biden to revive the Obama administration's agreement with Tehran and international powers.

In recent years, presidents of both parties have prioritized a peaceful and effective transfer of power over personal political pique, recognizing their duty to secure the health, security and welfare of the American people.

Warm letters of welcome left in the Oval Office desk -- for instance, from President George H.W. Bush to Bill Clinton -- have become the norm.

The 44th President then ordered his team to make life as easy as possible for Trump's incoming White House -- a fact Michelle Obama recalled in a tartly worded Instagram post Monday: "I was hurt and disappointed -- but the votes had been counted and Donald Trump had won. ... My husband and I instructed our staffs to do what George and Laura Bush had done for us: run a respectful, seamless transition of power -- one of the hallmarks of American democracy."

Ironically, Trump's mood, characterized by wild tweets divorced from any factual anchor, is detracting from his administration's own undeniable achievement in shepherding the swift development of vaccines.

Moderna vaccine currently in trials is 94.5% effective against the coronavirus. This followed news that Pfizer's vaccine was more than 90% effective. The news brought the prospect of a return to normal life and economic activity in 2021.

One of Trump's few recent references to the worsening pandemic was a tweet on Monday in which he demanded that historians recognize his role in the vaccine breakthroughs.

Biden initially reacted with circumspection to the move, apparently eager not to further antagonize Trump as the President comes to terms with his dashed hopes of winning a second term. But increasingly, the President-elect is warning of the damage caused by the impasse and is highlighting the vaccine in particular.

"The sooner we have access to the administration's distribution plan, the sooner this transition would be smoothly moved forward,"

"Transitions are important, and if you don't have a smooth transition, you would not optimize whatever efforts you're doing right now," Fauci told CNN's Jim Sciutto on "Newsroom" Tuesday morning, comparing the task to a "relay race in which you're passing the baton and you don't want to slow down what you're doing, but you want the person to whom you're giving the baton to be running with it as opposed to stopping and starting all over again."

obstruction from the administration on the vaccine could have a serious impact on its eventual distribution.

"The Vice President clearly articulated a strategy for distributing the vaccines across the country," Brown said. "But the conversation was extremely disingenuous when we have a new administration coming in in a matter of weeks. There was no conversation about what the hand-off was going to be and how they were going to ensure that the Biden-Harris administration would be fully prepared and ready to accept the baton."

The authors identify the survey respondents who are most resistant to immigration:

These respondents are the oldest of any class and possess many of the traits typical of conservative southern whites. Many live in small towns or rural areas in the U.S. south and identify as Republicans. Further, many of them are retirees with low levels of education. Interestingly, these respondents live in the least diverse communities relative to all other classes as judged by the presence of few immigrants and ethnic/racial minorities in their ZIP codes, which highlights the subjective nature of immigrant archetypes.

The authors conducted a survey in which they explicitly provided information rebutting negative stereotypes of immigrants’ impact on crime, tax burdens and employment. They found that respondents in many cases shifted their views of immigrants from more negative to more positive assessments.

But shifts in a liberal direction on policies were short-lived, at best: “In sum,” Abascal, Huang and Tran wrote, the effects of the stereotype-challenging information “on beliefs about immigration are more durable than the effects on immigration policy preferences, which themselves decay rapidly

The decision to remove barriers to trade in goods and capital flows have had profound effects on immigration. Trade has meant the closure of businesses in developed countries that rely on low-skill labor. When these firms closed, they took their support for low-skill immigration with them.

The Republican Party was once the party of big business and the party that supported immigration as a source of cheap labor. What happened to turn it into the anti- immigration party?

corporate America’s need for cheap labor had been falling before the advent of Trump, and that that decline opened to door for Republican politicians to campaign on anti-immigrant themes.

These findings recommend caution when deploying factual information to change attitudes toward immigration policy.”

The ability of capital to move intensified this trend: whereas once firms needed to bring labor to their capital, they can now take their capital to labor. Once these firms move, they have little incentive to fight for immigration at home.

Finally, increased productivity, as both a product of and response to globalization, has meant that firms can do more with fewer workers, again decreasing demands for immigration. Together, these changes have led to less business support for immigration, allowing politicians to move to the right on immigration and pass restrictions to appease anti-immigration forces.

On the other side of the aisle, Democrats, in the view of Douglas Massey, a sociologist at Princeton, have failed to counter Republican opposition to immigration with an aggressive assertion of the historical narrative of the United Statesas a nation of immigrants, tapping into the fact that nearly all Americans are descendant from immigrants who arrived into a land they did not originally populate, and that despite epochs of xenophobia and restriction, in the end the US has been a great machine of immigrant integration that has benefited the United States and made us an exceptional nation.

the intertwined forces of climate change, state failure, violence, and criminal economics will greatly complicate efforts to create a counternarrative by producing surges of asylum seekers and refugees, which could be managed with effective immigration and border policies, but which under current circumstances instead serves to produce images of chaos along the southern border.

The question for the future of the broader consensus on immigration is whether Republicans can continue to be successful despite the anti-immigrant pandering that is largely out of step with the broad American consensus on immigration. If they are electorally successful — and there is reason to believe they will be, given forecasts for Democratic losses in 2022 — then this broad consensus might break down permanently and a large portion of the American public may follow their Republican leaders toward more fully adopting anti-immigrant ideology.

There are potentially tragic consequences if the Democratic Party proves unable to prevent anti-immigration forces from returning to take over the debate

The average undocumented immigrant has been in the U.S. for ten years The problems of the undocumented spill over onto the large population of U.S. citizens, who are the children, mates, relatives of the undocumented and whose lives are adversely affected by the increasingly repressive policy environment.

for all intents and purposes, most undocumented immigrants — and perhaps especially the Dreamers — are Americans deserving of full citizenship.

But these Americans are on the political chopping block, dependent on a weakened Democratic Party to protect them from a renewal of the savagery an intensely motivated Republican Party has on its agenda.

Reading or rereading a collection of such books today is like watching an old movie that feels more anguishing and frustrating than you remember. The anguish comes from knowing how the tale will unfold; the frustration from realizing that this was hardly the only possible outcome.

This conclusion is laid bare in the sprawling literature to emerge from 9/11 over the past two decades

Whatever individual stories the 9/11 books tell, too many describe the repudiation of U.S. values, not by extremist outsiders but by our own hand.

In these works, indifference to the growing terrorist threat gives way to bloodlust and vengeance after the attacks. Official dissembling justifies wars, then prolongs them. In the name of counterterrorism, security is politicized, savagery legalized and patriotism weaponized.

that state of exception became our new American exceptionalism.

The latest works on the legacy of 9/11 show how war-on-terror tactics were turned on religious groups, immigrants and protesters in the United States. The war on terror came home, and it walked in like it owned the place.

It happened fast. By 2004, when the 9/11 Commission urged America to “engage the struggle of ideas,” it was already too late; the Justice Department’s initial torture memos were already signed, the Abu Ghraib images had already eviscerated U.S. claims to moral authority.

“It is for now far easier for a researcher to explain how and why September 11 happened than it is to explain the aftermath,” Steve Coll writes in “Ghost Wars,” his 2004 account of the CIA’s pre-9/11 involvement in Afghanistan. Throughout that aftermath, Washington fantasized about remaking the world in its image, only to reveal an ugly image of itself to the world.

“We anticipate a black future for America,” bin Laden told ABC News more than three years before the 9/11 attacks. “Instead of remaining United States, it shall end up separated states and shall have to carry the bodies of its sons back to America.”

bin Laden also came to grasp, perhaps self-servingly, the benefits of luring Washington into imperial overreach, of “bleeding America to the point of bankruptcy,” as he put it in 2004, through endless military expansionism, thus beating back its global sway and undermining its internal unity.

To an unnerving degree, the United States moved toward the enemy’s fantasies of what it might become — a nation divided in its sense of itself, exposed in its moral and political compromises, conflicted over wars it did not want but would not end.

“The most frightening aspect of this new threat . . . was the fact that almost no one took it seriously. It was too bizarre, too primitive and exotic.” That is how Lawrence Wright depicts the early impressions of bin Laden and his terrorist network among U.S. officials

The books traveling that road to 9/11 have an inexorable, almost suffocating feel to them, as though every turn invariably leads to the first crush of steel and glass.

With the system “blinking red,” as CIA Director George Tenet later told the 9/11 Commission, why were all these warnings not enough? Wright lingers on bureaucratic failings

Clarke’s conclusion is simple, and it highlights America’s we-know-better swagger, a national trait that often masquerades as courage or wisdom. “America, alas, seems only to respond well to disasters, to be undistracted by warnings,” he writes. “Our country seems unable to do all that must be done until there has been some awful calamity.”

The problem with responding only to calamity is that underestimation is usually replaced by overreaction. And we tell ourselves it is the right thing, maybe the only thing, to do.

A last-minute flight change. A new job at the Pentagon. A retirement from the fire station. The final tilt of a plane’s wings before impact. If the books about the lead-up to 9/11 are packed with unbearable inevitability, the volumes on the day itself highlight how randomness separated survival from death.

Had the World Trade Center, built in the late 1960s and early 1970s, been erected according to the city building code in effect since 1938, Dwyer and Flynn explain, “it is likely that a very different world trade center would have been built.

Instead, it was constructed according to a new code that the real estate industry had avidly promoted, a code that made it cheaper and more lucrative to build and own skyscrapers. “It increased the floor space available for rent . . . by cutting back on the areas that had been devoted, under the earlier law, to evacuation and exit,” the authors write. The result: Getting everybody out on 9/11 was virtually impossible.

The towers embodied the power of American capitalism, but their design embodied the folly of American greed. On that day, both conditions proved fatal.

Garrett Graff quotes Defense Department officials marveling at how American Airlines Flight 77 struck a part of the Pentagon that, because of new anti-terrorism standards, had recently been reinforced and renovated

“In any other wedge of the Pentagon, there would have been 5,000 people, and the plane would have flown right through the middle of the building.” Instead, fewer than 200 people were killed in the attack on the Pentagon, including the passengers on the hijacked jet. Chance and preparedness came together.

The bravery of police and firefighters is the subject of countless 9/11 retrospectives, but these books also emphasize the selflessness of civilians who morphed into first responders

The passengers had made phone calls when the hijacking began and had learned the fate of other aircraft that day. “According to one call, they voted on whether to rush the terrorists in an attempt to retake the plane,” the commission report states. “They decided, and acted.”

The civilians aboard United Airlines Flight 93, whose resistance forced the plane to crash into a Pennsylvania field rather than the U.S. Capitol, were later lionized as emblems of swashbuckling Americana

Such episodes, led by ordinary civilians, embodied values that the 9/11 Commission called on the nation to display. Except those values would soon be dismantled, in the name of security, by those entrusted to uphold them.

Lawyering to death.The phrase appears in multiple 9/11 volumes, usually uttered by top officials adamant that they were going to get things done, laws and rules be damned

“I had to show the American people the resolve of a commander in chief that was going to do whatever it took to win,” Bush explains. “No yielding. No equivocation. No, you know, lawyering this thing to death.” In “Against All Enemies,” Clarke recalls the evening of Sept. 11, 2001, when Bush snapped at an official who suggested that international law looked askance at military force as a tool of revenge. “I don’t care what the international lawyers say, we are going to kick some ass,” the president retorted.

The message was unmistakable: The law is an obstacle to effective counterterrorism

Except, they did lawyer this thing to death. Instead of disregarding the law, the Bush administration enlisted it. “Beginning almost immediately after September 11, 2001, [Vice President Dick] Cheney saw to it that some of the sharpest and best-trained lawyers in the country, working in secret in the White House and the United States Department of Justice, came up with legal justifications for a vast expansion of the government’s power in waging war on terror,

Through public declarations and secret memos, the administration sought to remove limits on the president’s conduct of warfare and to deny terrorism suspects the protections of the Geneva Conventions by redefining them as unlawful enemy combatants. Nothing, Mayer argues of the latter effort, “more directly cleared the way for torture than this.”

Tactics such as cramped confinement, sleep deprivation and waterboarding were rebranded as “enhanced interrogation techniques,” legally and linguistically contorted to avoid the label of torture. Though the techniques could be cruel and inhuman, the OLC acknowledged in an August 2002 memo, they would constitute torture only if they produced pain equivalent to organ failure or death, and if the individual inflicting such pain really really meant to do so: “Even if the defendant knows that severe pain will result from his actions, if causing such harm is not his objective, he lacks the requisite specific intent.” It’s quite the sleight of hand, with torture moving from the body of the interrogated to the mind of the interrogator.

the memo concludes that none of it actually matters. Even if a particular interrogation method would cross some legal line, the relevant statute would be considered unconstitutional because it “impermissibly encroached” on the commander in chief’s authority to conduct warfare

You have informed us. Experts you have consulted. Based on your research. You do not anticipate. Such hand-washing words appear throughout the memos. The Justice Department relies on information provided by the CIA to reach its conclusions; the CIA then has the cover of the Justice Department to proceed with its interrogations. It’s a perfect circle of trust.

In these documents, lawyers enable lawlessness. Another May 2005 memo concludes that, because the Convention Against Torture applies only to actions occurring under U.S. jurisdiction, the CIA’s creation of detention sites in other countries renders the convention “inapplicable.”

avid Cole describes the documents as “bad-faith lawyering,” which might be generous. It is another kind of lawyering to death, one in which the rule of law that the 9/11 Commission urged us to abide by becomes the victim.

Similarly, because the Eighth Amendment’s prohibition on cruel and unusual punishment is meant to protect people convicted of crimes, it should not apply to terrorism detainees — because they have not been officially convicted of anything. The lack of due process conveniently eliminates constitutional protections

Years later, the Senate Intelligence Committee would investigate the CIA’s post-9/11 interrogation program. Its massive report — the executive summary of which appeared as a 549-page book in 2014 — found that torture did not produce useful intelligence, that the interrogations were more brutal than the CIA let on, that the Justice Department did not independently verify the CIA’s information, and that the spy agency impeded oversight by Congress and the CIA inspector general.

“The CIA’s effectiveness representations were almost entirely inaccurate,” the Senate report concluded. It is one of the few lies of the war on terror unmasked by an official government investigation and public report, but just one of the many documented in the 9/11 literature.

Officials in the war on terror didn’t deceive or dissemble just with lawmakers or the public. In the recurring tragedy of war, they lied just as often to themselves.

“The decision to invade Iraq was one made, finally and exclusively, by the president of the United States, George W. Bush,” he writes.

n Woodward’s “Bush at War,” the president admitted that before 9/11, “I didn’t feel that sense of urgency [about al-Qaeda], and my blood was not nearly as boiling.”

A president initially concerned about defending and preserving the nation’s moral goodness against terrorism found himself driven by darker impulses. “I’m having difficulty controlling my bloodlust,” Bush confessed to religious leaders in the Oval Office on Sept. 20, 2001,

Bloodlust, moral certainty and sudden vulnerability make a dangerous combination. The belief that you are defending good against evil can lead to the belief that whatever you do to that end is good, too.

Draper distills Bush’s worldview: “The terrorists’ primary objective was to destroy America’s freedom. Saddam hated America. Therefore, he hated freedom. Therefore, Saddam was himself a terrorist, bent on destroying America and its freedom.”

The president assumed the worst about what Hussein had done or might do, yet embraced best-case scenarios of how an American invasion would proceed.

“Iraqis would rejoice at the sight of their Western liberators,” Draper recaps. “Their newly shared sense of national purpose would overcome any sectarian allegiances. Their native cleverness would make up for their inexperience with self-government. They would welcome the stewardship of Iraqi expatriates who had not set foot in Baghdad in decades. And their oil would pay for everything.”

It did not seem to occur to Bush and his advisers that Iraqis could simultaneously hate Hussein and resent the Americans — feelings that could have been discovered by speaking to Iraqis and hearing their concerns.

few books on the war that gets deep inside Iraqis’ aversion to the Americans in their midst. “What gives them the right to change something that’s not theirs in the first place?” a woman in a middle-class Baghdad neighborhood asks him. “I don’t like your house, so I’m going to bomb it and you can rebuild it again the way I want it, with your money?

The occupation did not dissuade such impressions when it turned the former dictator’s seat of government into its own luxurious Green Zone, or when it retrofitted the Abu Ghraib prison (“the worst of Saddam’s hellholes,” Shadid calls it) into its own chamber of horrors.

Shadid hears early talk of the Americans as “kuffar” (heathens), a 51-year-old former teacher complains that “we’ve exchanged a tyrant for an occupier.”

Shadid understood that governmental legitimacy — who gets to rule, and by what right — was a matter of overriding importance for Iraqis. “The Americans never understood the question,” he writes; “Iraqis never agreed on the answer.

When the United States so quickly shifted from liberation to occupation, it lost whatever legitimacy it enjoyed. “Bush handed that enemy precisely what it wanted and needed, proof that America was at war with Islam, that we were the new Crusaders come to occupy Muslim land,” Clarke writes. “It was as if Usama bin Laden, hidden in some high mountain redoubt, were engaging in long-range mind control of George Bush, chanting ‘invade Iraq, you must invade Iraq.’ ”

The foolishness and arrogance of the American occupation didn’t help. In “Imperial Life in the Emerald City: Inside Iraq’s Green Zone,” Rajiv Chandrasekaran explains how, even as daily security was Iraqis’ overwhelming concern, viceroy L. Paul Bremer, Bush’s man in Baghdad, was determined to turn the country into a model free-market economy, complete with new investment laws, bankruptcy courts and a state-of-the-art stock exchange.

a U.S. Army general, when asked by local journalists why American helicopters must fly so low at night, thus scaring Iraqi children, replied that the kids were simply hearing “the sound of freedom.”Message: Freedom sounds terrifying.

For some Americans, inflicting that terror became part of the job, one more tool in the arsenal. In “The Forever War” by Dexter Filkins, a U.S. Army lieutenant colonel in Iraq assures the author that “with a heavy dose of fear and violence, and a lot of money for projects, I think we can convince these people that we are here to help them.”

Chandrasekaran recalls the response of a top communications official under Bremer, when reporters asked about waves of violence hitting Baghdad in the spring of 2004. “Off the record: Paris is burning,” the official told the journalists. “On the record: Security and stability are returning to Iraq.”

the Iraq War, conjured in part on the false connections between Iraq and al-Qaeda, ended up helping the terrorist network: It pulled resources from the war in Afghanistan, gave space for bin Laden’s men to regroup and spurred a new generation of terrorists in the Middle East. “A bigger gift to bin Laden was hard to imagine,” Bergen writes.

“U.S. officials had no need to lie or spin to justify the war,” Washington Post reporter Craig Whitlock writes in “The Afghanistan Papers,” a damning contrast of the war’s reality vs. its rhetoric. “Yet leaders at the White House, the Pentagon and the State Department soon began to make false assurances and to paper over setbacks on the battlefield.” As the years passed, the deceit became entrenched, what Whitlock calls “an unspoken conspiracy” to hide the truth.

Afghanistan was where al-Qaeda, supported by the Taliban, had made its base — it was supposed to be the good war, the right war, the war of necessity and not choice, the war endorsed at home and abroad.

If Iraq was the war born of lies, Afghanistan was the one nurtured by them

Whitlock finds commanding generals privately admitting that they long fought the war “without a functional strategy.” That, two years into the conflict, Rumsfeld complained that he had “no visibility into who the bad guys are.”

That Army Lt. Gen. Douglas Lute, a former coordinator of Iraq and Afghanistan policy, acknowledged that “we didn’t have the foggiest idea of what we were undertaking.”

That U.S. officials long wanted to withdraw American forces but feared — correctly so, it turns out — that the Afghan government might collapse. “Bin Laden had hoped for this exact scenario,” Whitlock observes. “To lure the U.S. superpower into an unwinnable guerrilla conflict that would deplete its national treasury and diminish its global influence.”

All along, top officials publicly contradicted these internal views, issuing favorable accounts of steady progress

Bad news was twisted into good: Rising suicide attacks in Kabul meant the Taliban was too weak for direct combat, for instance, while increased U.S. casualties meant America was taking the fight to the enemy.

deceptions transpired across U.S. presidents, but the Obama administration, eager to show that its first-term troop surge was working, “took it to a new level, hyping figures that were misleading, spurious or downright false,” Whitlock writes. And then under President Donald Trump, he adds, the generals felt pressure to “speak more forcefully and boast that his war strategy was destined to succeed.”

in public, almost no senior government officials had the courage to admit that the United States was slowly losing,” Whitlock writes. “With their complicit silence, military and political leaders avoided accountability and dodged reappraisals that could have changed the outcome or shortened the conflict.”

Deputy Secretary of State Richard Armitage traveled to Moscow shortly after 9/11 to give officials a heads up about the coming hostilities in Afghanistan. The Russians, recent visitors to the graveyard of empires, cautioned that Afghanistan was an “ambush heaven” and that, in the words of one of them, “you’re really going to get the hell kicked out of you.”

a war should not be measured only by the timing and the competence of its end. We still face an equally consequential appraisal: How good was this good war if it could be sustained only by lies?

In the two decades since the 9/11 attacks, the United States has often attempted to reconsider its response

They are written as though intending to solve problems. But they can be read as proof that the problems have no realistic solution, or that the only solution is to never have created them.

the report sets the bar for staying so high that an exit strategy appears to be its primary purpose.

he counterinsurgency manual is an extraordinary document. Implicitly repudiating notions such as “shock and awe” and “overwhelming force,” it argues that the key to battling an insurgency in countries such as Iraq and Afghanistan is to provide security for the local population and to win its support through effective governance

It also attempts to grasp the nature of America’s foes. “Most enemies either do not try to defeat the United States with conventional operations or do not limit themselves to purely military means,” the manual states. “They know that they cannot compete with U.S. forces on those terms. Instead, they try to exhaust U.S. national will.” Exhausting America’s will is an objective that al-Qaeda understood well.

“Counterinsurgents should prepare for a long-term commitment,” the manual states. Yet, just a few pages later, it admits that “eventually all foreign armies are seen as interlopers or occupiers.” How to accomplish the former without descending into the latter? No wonder so many of the historical examples of counterinsurgency that the manual highlights, including accounts from the Vietnam War, are stories of failure.

“Soldiers and Marines are expected to be nation builders as well as warriors,” the manual proclaims, but the arduous tasks involved — reestablishing government institutions, rebuilding infrastructure, strengthening local security forces, enforcing the rule of law — reveal the tension at the heart of the new doctrine

In his foreword, Army Lt. Col. John Nagl writes that the document’s most lasting impact may be as a catalyst not for remaking Iraq or Afghanistan, but for transforming the Army and Marine Corps into “more effective learning organizations,” better able to adapt to changing warfare. And in her introduction, Sarah Sewall, then director of Harvard’s Carr Center for Human Rights Policy, concludes that its “ultimate value” may be in warning civilian officials to think hard before engaging in a counterinsurgency campaign.

“The thing that got to everyone,” Finkel explains in the latter book, “was not having a defined front line. It was a war in 360 degrees, no front to advance toward, no enemy in uniform, no predictable patterns, no relief.” It’s a powerful summation of battling an insurgency.

Hitting the wrong house is what counterinsurgency doctrine is supposed to avoid. Even successfully capturing or killing a high-value target can be counterproductive if in the process you terrorize a community and create more enemies. In Iraq, the whole country was the wrong house. America’s leaders knew it was the wrong house. They hit it anyway.

Another returning soldier, Nic DeNinno, struggles to tell his wife about the time he and his fellow soldiers burst into an Iraqi home in search of a high-value target. He threw a man down the stairs and held another by the throat. After they left, the lieutenant told him it was the wrong house. “The wrong f---ing house,” Nic says to his wife. “One of the things I want to remember is how many times we hit the wrong house.”

“As time passes, more documents become available, and the bare facts of what happened become still clearer,” the report states. “Yet the picture of how those things happened becomes harder to reimagine, as that past world, with its preoccupations and uncertainty, recedes.” Before making definitive judgments, then, they ask themselves “whether the insights that seem apparent now would really have been meaningful at the time.”

Two of the latest additions to the canon, “Reign of Terror” by Spencer Ackerman and “Subtle Tools” by Karen Greenberg, draw straight, stark lines between the earliest days of the war on terror and its mutations in our current time, between conflicts abroad and divisions at home. These works show how 9/11 remains with us, and how we are still living in the ruins.

When Trump declared that “we don’t have victories anymore” in his 2015 speech announcing his presidential candidacy, he was both belittling the legacy of 9/11 and harnessing it to his ends. “His great insight was that the jingoistic politics of the War on Terror did not have to be tied to the War on Terror itself,” Ackerman writes. “That enabled him to tell a tale of lost greatness.” And if greatness is lost, someone must have taken it.

“Trump had learned the foremost lesson of 9/11,” Ackerman writes, “that the terrorists were whomever you said they were.”

The backlash against Muslims, against immigrants crossing the southern border and against protesters rallying for racial justice was strengthened by the open-ended nature of the global war on terror.

the war is not just far away in Iraq or Afghanistan, in Yemen or Syria, but it’s happening here, with mass surveillance, militarized law enforcement and the rebranding of immigration as a threat to the nation’s security rather than a cornerstone of its identity

the Authorization for Use of Military Force, drafted by administration lawyers and approved by Congress just days after the attacks, as the moment when America’s response began to go awry. The brief joint resolution allowed the president to use “all necessary and appropriate force” against any nation, organization or person who committed the attacks, and to prevent any future ones.

It was the “Ur document in the war on terror and its legacy,” Greenberg writes. “Riddled with imprecision, its terminology was geared to codify expansive powers.” Where the battlefield, the enemy and the definition of victory all remain vague, war becomes endlessly expansive, “with neither temporal nor geographical boundaries.”

This was the moment the war on terror was “conceptually doomed,” Ackerman concludes. This is how you get a forever war.

There were moments when an off-ramp was visible. The killing of bin Laden in 2011 was one such instance, Ackerman argues, but “Obama squandered the best chance anyone could ever have to end the 9/11 era.”

The author assails Obama for making the war on terror more “sustainable” through a veneer of legality — banning torture yet failing to close the detention camp at Guantánamo Bay and relying on drone strikes that “perversely incentivized the military and the CIA to kill instead of capture.”

There would always be more targets, more battlefields, regardless of president or party. Failures became the reason to double down, never wind down.

The longer the war went on, the more that what Ackerman calls its “grotesque subtext” of nativism and racism would move to the foreground of American politics

Absent the war on terror, it is harder to imagine a presidential candidate decrying a sitting commander in chief as foreign, Muslim, illegitimate — and using that lie as a successful political platform.

Absent the war on terror, it is harder to imagine a travel ban against people from Muslim-majority countries. Absent the war on terror, it is harder to imagine American protesters labeled terrorists, or a secretary of defense describing the nation’s urban streets as a “battle space” to be dominated

In his latest book on bin Laden, Bergen argues that 9/11 was a major tactical success but a long-term strategic failure for the terrorist leader. Yes, he struck a vicious blow against “the head of the snake,” as he called the United States, but “rather than ending American influence in the Muslim world, the 9/11 attacks greatly amplified it,” with two lengthy, large-scale invasions and new bases established throughout the region.

“A vastly different America has taken root” in the two decades since 9/11, Greenberg writes. “In the name of retaliation, ‘justice,’ and prevention, fundamental values have been cast aside.”

the legacy of the 9/11 era is found not just in Afghanistan or Iraq, but also in an America that drew out and heightened some of its ugliest impulses — a nation that is deeply divided (like those “separated states” bin Laden imagined); that bypasses inconvenient facts and embraces conspiracy theories; that demonizes outsiders; and that, after failing to spread freedom and democracy around the world, seems less inclined to uphold them here

Seventeen years after the 9/11 Commission called on the United States to offer moral leadership to the world and to be generous and caring to our neighbors, our moral leadership is in question, and we can barely be generous and caring to ourselves.

Still reeling from an attack that dropped out of a blue sky, America is suffering from a sort of post-traumatic stress democracy. It remains in recovery, still a good country, even if a broken good country.

9/11 was a test. Thebooks of the lasttwo decades showhow America failed.

Deep within the catalogue of regrets that is the 9/11 Commission report

Japan’s complicated relationship with vaccines can be traced to successful class-action lawsuits brought against the health ministry by a small number of parents who claimed – without presenting evidence of a causal link – their children had experienced serious side-effects from the MMR vaccine in the 1990s.

“There was also an element of ‘negativity’ in spurring people to get vaccinated. People decided they should have the vaccine so they could tell other people that they were not a threat. It was a social courtesy, and to protect themselves, of course.”

Iwata has been critical of the government’s handling of the pandemic, but praised its approach to inoculations. “The Covid vaccination programme has been a great success,” he said. “I have never seen something implemented this pragmatically in the history of vaccinations in Japan.”

Initially, however, even government politicians and health experts were cautious about encouraging people to have the Covid jab. The turning point came in the summer, as Tokyo was preparing to host the 2020 Olympics in defiance of public opinion.

“Japanese bureaucrats are quite hesitant when it comes to advocating vaccines, however, particularly after the government lost lawsuits regarding side effects from the MMR vaccine,” he said.

The shift in attitudes is not limited to the Covid-19 vaccine. A panel on Friday said the health ministry should resume actively recommending the HPV vaccine – which is universally recognised as safe and effective – to teenage girls. Japan withdrew the recommendation – but kept the vaccine available free of charge – in 2013 after sensationalist media reports of alleged severe side-effects.

Although no causal link between the vaccine and side-effects was established, the rate of HPV inoculation fell from 70% in 2013 to less than 1%.

Sakikawa, who said she and almost all of her initially vaccine-hesitant friends were now fully jabbed, acknowledged that peer pressure had influenced their decision.

“There was definitely a feeling that we should have the vaccine, since everyone else seemed to be having it, and we promised we would meet up once we were double jabbed. Now it’s easier to go out and meet friends and do the all the things we couldn’t do before.”

Voters in some major cities, in addition to choosing their next mayor, will also have the opportunity to weigh in on an important issue that has been heavily debated in their communities.

Proposition 6 would codify the right for long-term care residents to designate an essential caregiver for in-person visitation.

Texas -- Proposition 3 Read MoreWritten in response to Covid-19 restrictions, Texans will consider a constitutional amendment that would prohibit the state or a political subdivision, such as an elected official, from "prohibiting or limiting religious services of religious organizations."

Like Proposition 3, Proposition 6 was also influenced by the Covid-19 restrictions enforced during the height of the pandemic.

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Question 2 would replace Minneapolis Police Department with a new "Department of Public Safety" overseen by the mayor and city council.

Cleveland -- Issue 24 Ballot initiative Issue 24 would establish a new civilian commission, called the Community Police Commission, whose members will have final authority over the police department's policy and procedures, hiring and training, and disciplinary action.

Proposal 7, also known as Local Law J, asks city residents whether to expand a civilian police review board's authority to conduct investigations and "to exercise oversight, review, and resolution of community complaints alleging abuse of police authority."

Austin, Texas -- Proposition A Voters in Austin, Texas are being asked whether to bulk up the city's police department with Proposition A, as its supporters argue that the city is in the midst of a "crime wave" and a shortage of police officers.Proposition A would require that the Austin police department employs at least two police officers for every 1,000 residents.

Detroit -- Proposal R A "yes" vote on Proposal R would be in favor of the Detroit City Council establishing a task force that would recommend housing and economic programs that "address historical discrimination against the Black community in Detroit."

New Jersey -- Question No. 1 Question No. 1 asks New Jersey voters whether to allow betting on college sports. Currently, sports betting on college events in the state and on college events in which New Jersey teams participate is prohibited.

Richmond, Virginia -- Local ReferendumResidents of Virginia's capital city will decide whether to approve the construction of a new casino and 250-room luxury hotel in south Richmond along the I-95 highway.

New York -- Ballot Proposal 1New Yorkers are being reminded to flip over their ballots to answer five statewide ballot proposals.

New York -- Ballot Proposal 3New York currently requires that its residents register to vote at least 10 days before an election. Ballot Proposal 3 would remove that requirement, clearing the way for state lawmakers to enact new laws that would allow a resident to register to vote in less than 10 days -- such as same-day voter registration.

New York -- Ballot Proposal 4As it stands now, New York voters may vote by absentee ballot if they are unable to appear at their polling place due to illness or physical disability or expect to be absent from their county of residence, or New York City if they're residents, on Election Day.Ballot Proposal 4 asks whether to eliminate the requirement that a voter provide a reason if they wish to vote by absentee ballot.

Philadelphia -- Question #1: Asks whether to amend the city charter so it urges the Pennsylvania legislature and governor to legalize cannabis for recreational use in the state.

I had other doubts, too. It seemed hubristic, or worse, to make multitrillion-dollar policy bets based on computer models trying to forecast climate patterns decades into the future. Climate activists kept promoting policies based on technologies that were either far from mature (solar energy) or sometimes actively harmful (biofuels).

Expensive efforts to curb greenhouse gas emissions in Europe and North America seemed particularly fruitless when China, India and other developing countries weren’t about to curb their own appetite for fossil fuels

just how fast is Greenland’s ice melting right now? Is this an emergency for our time, or is it a problem for the future?

His pitch was simple: The coastline we have taken for granted for thousands of years of human history changed rapidly in the past on account of natural forces — and would soon be changing rapidly and disastrously by man-made ones. A trip to Greenland, which holds one-eighth of the world’s ice on land (most of the rest is in Antarctica) would show me just how drastic those changes have been. Would I join him?

Greenland is about the size of Alaska and California combined and, except at its coasts, is covered by ice that in places is nearly two miles thick. Even that’s only a fraction of the ice in Antarctica, which is more than six times as large

Greenland’s ice also poses a nearer-term risk because it is melting faster. If all its ice were to melt, global sea levels would rise by some 24 feet. That would be more than enough to inundate hundreds of coastal cities in scores of nations, from Jakarta and Bangkok to Copenhagen and Amsterdam to Miami and New Orleans.

There was also a millenarian fervor that bothered me about climate activism, with its apocalyptic imagery (the Statue of Liberty underwater) and threats of doom unless we were willing to live far more frugally.

“We haven’t had a good positive mass balance year since the late 1990s,” he told me in a follow-on email when I asked him to explain the data for me. The losses can vary sharply by year. The annualized average over the past 30 years, he added, is 170 gigatons per year. That’s the equivalent of about 5,400 tons of ice loss per second. That “suggests that Greenland ice loss has been tracking the I.P.P.C. worse-case, highest-carbon-emission scenario.

The data shows unmistakably that Greenland’s ice is not in balance. It is losing far more than it is gaining.

scientists have been drilling ice-core samples from Greenland for decades, giving them a very good idea of climatic changes stretching back thousands of years. Better yet, a pair of satellites that detect anomalies in Earth’s gravity fields have been taking measurements of the sheet regularly for nearly 20 years, giving scientists a much more precise idea of what is happening.

it’s hard to forecast with any precision what that means. “Anyone who says they know what the sea level is going to be in 2100 is giving you an educated guess,” said NASA’s Willis. “The fact is, we’re seeing these big ice sheets melt for the first time in history, and we don’t really know how fast they can go.”

His own educated guess: “By 2100, we are probably looking at more than a foot or two and hopefully less than seven or eight feet. But we are struggling to figure out just how fast the ice sheets can melt. So the upper end of range is still not well known.”

On the face of it, that sounds manageable. Even if sea levels rise by eight feet, won’t the world have nearly 80 years to come to grips with the problem, during which technologies that help us mitigate the effects of climate change while adapting to its consequences are likely to make dramatic advances?

Won’t the world — including countries that today are poor — become far richer and thus more capable of weathering the floods, surges and superstorms?

The average rate at which sea level is rising around the world, he estimates, has more than tripled over the past three decades, to five millimeters a year from 1.5 millimeters. That may still seem minute, yet as the world learned during the pandemic, exponential increases have a way of hitting hard.

“When something is on a straight line or a smooth curve, you can plot its trajectory,” Englander said. “But sea level, like earthquakes and mudslides, is something that happens irregularly and can change rather quickly and surprise us. The point is, you can no longer predict the future by the recent past.”

In The Wall Street Journal’s editorial pages, where I used to work, the theoretical physicist Steven Koonin, a former under secretary for science in the Obama administration’s Energy Department, cast doubt on the threat from Thwaites in a voice that could have once been mine. He also thinks the risks associated with Greenland’s melting are less a product of human-induced global warming than of natural cycles in North Atlantic currents and temperatures, which over time have a way of regressing to the mean.

Even the poorest countries, while still unacceptably vulnerable, are suffering far fewer human and economic losses to climate-related disasters.

Another climate nonalarmist is Roger Pielke Jr., a professor of environmental studies at the University of Colorado Boulder. I call Pielke a nonalarmist rather than a skeptic because he readily acknowledges that the challenges associated with climate change, including sea-level rise, are real, serious and probably unstoppable, at least for many decades.

“If we have to have a problem,” he told me when I reached him by phone, “we probably want one with a slow onset that we can see coming. It’s not like an asteroid coming from space.”

“Since the 1940s, the impact of floods as a proportion of U.S. gross domestic product has dropped by 70 percent-plus,” Pielke said. “We see this around the world, across phenomena. The story is that fewer people are dying and we are having less damage proportional to G.D.P.”

“Much climate reporting today highlights short-term changes when they fit the narrative of a broken climate but then ignores or plays down changes when they don’t, often dismissing them as ‘just weather,’” he wrote in February.

Global warming is real and getting worse, Pielke said, yet still it’s possible that humanity will be able to adapt to, and compensate for, its effects.

A few years ago, I would have found voices like Koonin’s and Pielke’s persuasive. Now I’m less sure. What intervened was a pandemic.

That’s what I thought until the spring of 2020, when, along with everyone else, I experienced how swiftly and implacably nature can overwhelm even the richest and most technologically advanced societies. It was a lesson in the sort of intellectual humility I recommended for others

It was also a lesson in thinking about risk, especially those in the category known as high-impact, low-probability events that seem to be hitting us with such regularity in this century: the attacks of Sept. 11, 2001; the tsunamis of 2004 and 2011, the mass upheavals in the Arab world

What if the past does nothing to predict the future? What if climate risks do not evolve gradually and relatively predictably but instead suddenly soar uncontrollably? How much lead time is required to deal with something like sea-level rise? How do we weigh the risks of underreacting to climate change against the risks of overreacting to it?

I called Seth Klarman, one of the world’s most successful hedge-fund managers, to think through questions of risk. While he’s not an expert on climate change, he has spent decades thinking deeply about every manner of risk

And we will almost certainly have to do it from sources other than Russia, China, the Democratic Republic of Congo and other places that pose unacceptable strategic, environmental or humanitarian risks

“If you face something that is potentially existential,” he explained, “existential for nations, even for life as we know it, even if you thought the risk is, say, 5 percent, you’d want to hedge against it.”

“One thing we try to do,” he said, “is we buy protection when it’s really inexpensive, even when we think we may well not need it.” The forces contributing to climate change, he noted, echoing Englander, “might be irreversible sooner than the damage from climate change has become fully apparent. You can’t say it’s far off and wait when, if you had acted sooner, you might have dealt with it better and at less cost. We have to act now.”

In other words, an ounce of prevention is worth a pound of cure. That’s particularly true if climate change is akin to cancer — manageable or curable in its earlier stages, disastrous in its later ones.

As I’ve always believed, knowing there is grave risk to future generations — and expecting current ones to make immediate sacrifices for it — defies most of what we know about human nature. So I began to think more deeply about that challenge, and others.

For the world to achieve the net-zero goal for carbon dioxide emissions by 2050, according to the International Energy Agency, we will have to mine, by 2040, six times the current amounts of critical minerals — nickel, cobalt, copper, lithium, manganese, graphite, chromium, rare earths and other minerals and elements — needed for electric vehicles, wind turbines and solar panels.

The poster child for this kind of magical thinking is Germany, which undertook a historic Energiewende — “energy revolution” — only to come up short. At the turn of the century, Germany got about 85 percent of its primary energy from fossil fuels. Now it gets about 78 percent, a puny reduction, considering that the country has spent massive sums on renewables to increase the share of electricity it generates from them.

As in everything else in life, so too with the environment: There is no such thing as a free lunch. Whether it’s nuclear, biofuels, natural gas, hydroelectric or, yes, wind and solar, there will always be serious environmental downsides to any form of energy when used on a massive scale. A single industrial-size wind turbine, for instance, typically requires about a ton of rare earth metals as well as three metric tons of copper, which is notoriously destructive and dirty to mine.

no “clean energy” solution will easily liberate us from our overwhelming and, for now, inescapable dependence on fossil fuels.

Nobody brings the point home better than Vaclav Smil, the Canadian polymath whose most recent book, “How the World Really Works,” should be required reading for policymakers and anyone else interested in a serious discussion about potential climate solutions.

“I’ve talked to so many experts and seen so much evidence,” he told me over Zoom, “I’m convinced the climate is changing, and addressing climate change has become a philanthropic priority of mine.”

Things could turn a corner once scientists finally figure out a technical solution to the energy storage problem. Or when governments and local actors get over their NIMBYism when it comes to permitting and building a large energy grid to move electricity from Germany’s windy north to its energy-hungry south. Or when thoughtful environmental activists finally come to grips with the necessity of nuclear energy

Till then, even as I’ve come to accept the danger we face, I think it’s worth extending the cancer metaphor a little further: Just as cancer treatments, when they work at all, can have terrible side effects, much the same can be said of climate treatments: The gap between an accurate diagnosis and effective treatment remains dismayingly wide

Only when countries like Vietnam and China turned to a different model, of largely bottom-up, market-driven development, did hundreds of millions of people get lifted out of destitution.

the most important transformation has come in agriculture, which uses about 70 percent of the world’s freshwater supply.

Farmers gradually adopted sprinkler and drip irrigation systems, rather than more wasteful flood irrigation, not to conserve water but because the technology provided higher crop yields and larger profit margins.

Water shortages “will spur a revolutionary, aggressive approach to getting rid of flood irrigation,” said Seth Siegel, the chief sustainability officer of the Israeli AgTech company N-Drip. “Most of this innovation will be driven by free-market capitalism, with important incentives from government and NGOs.

meaningful environmental progress has been made through market forces. In this century, America’s carbon dioxide emissions across fuel types have fallen to well below 5,000 million metric tons per year, from a peak of about 6,000 million in 2007, even as our inflation-adjusted G.D.P. has grown by over 50 percent and total population by about 17 percent.

1) Engagement with critics is vital. Insults and stridency are never good tools of persuasion, and trying to cow or censor climate skeptics into silence rarely works

the biggest single driver in emissions reductions from 2005 to 2017 was the switch from coal to natural gas for power generation, since gas produces roughly half the carbon dioxide as coal. This, in turn, was the result of a fracking revolution in the past decade, fiercely resisted by many environmental activists, that made the United States the world’s largest gas producer.

In the long run, we are likelier to make progress when we adopt partial solutions that work with the grain of human nature, not big ones that work against it

Renewables, particularly wind power, played a role. So did efficiency mandates.

The problem with our civilization isn’t overconfidence. It’s polarization, paralysis and a profound lack of trust in all institutions, including the scientific one

Devising effective climate policies begins with recognizing the reality of the social and political landscape in which all policy operates. Some thoughts on how we might do better:

They may not be directly related to climate change but can nonetheless have a positive impact on it. And they probably won’t come in the form of One Big Idea but in thousands of little ones whose cumulative impacts add up.

2) Separate facts from predictions and predictions from policy. Global warming is a fact. So is the human contribution to it. So are observed increases in temperature and sea levels. So are continued increases if we continue to do more of the same. But the rate of those increases is difficult to predict even with the most sophisticated computer modeling

3) Don’t allow climate to become a mainly left-of-center concern. One reason the topic of climate has become so anathema to many conservatives is that so many of the proposed solutions have the flavor, and often the price tag, of old-fashioned statism

4) Be honest about the nature of the challenge. Talk of an imminent climate catastrophe is probably misleading, at least in the way most people understand “imminent.”

A more accurate description of the challenge might be a “potentially imminent tipping point,” meaning the worst consequences of climate change can still be far off but our ability to reverse them is drawing near. Again, the metaphor of cancer — never safe to ignore and always better to deal with at Stage 2 than at Stage 4 — can be helpful.

5) Be humble about the nature of the solutions. The larger the political and financial investment in a “big fix” response to climate change on the scale of the Energiewende, the greater the loss in time, capital and (crucially) public trust when it doesn’t work as planned

6) Begin solving problems our great-grandchildren will face. Start with sea-level rise

We can also stop providing incentives for building in flood-prone areas by raising the price of federal flood insurance to reflect the increased risk more accurately.

7) Stop viewing economic growth as a problem. Industrialization may be the leading cause of climate change. But we cannot and will not reverse it through some form of deindustrialization, which would send the world into poverty and deprivation

8) Get serious about the environmental trade-offs that come with clean energy. You cannot support wind farms but hinder the transmission lines needed to bring their power to the markets where they are needed.

9) A problem for the future is, by its very nature, a moral one. A conservative movement that claims to care about what we owe the future has the twin responsibility of setting an example for its children and at the same time preparing for that future.

we can’t simply replace one simplistic narrative, about the super power of mitigation policy, for another, focused only on the burdens it imposed and not at all on the costs of doing much less — or nothing at all.

Let’s start with the title. What is the big failure, as you see it?

McLean: I think it gets at things that had happened in America even before the pandemic hit. And among those things were, I think, a failure to recognize the limits of capitalism, a failure of government to set the right rules for it, particularly when it comes to our health care system; a focus on profits that may have led to an increase in the bottom line but created fragility in ways people didn’t understand; and then our growing polarization that made us incapable of talking to each other

How big is the failure? When I look at The Economist’s excess mortality data, I see the U.S. had the 53rd-worst outcome in the world — worse than all of Western Europe, but better than all of Eastern Europe.

McLean: I think one way to quantify it is to take all those numbers and then put them in the context of our spending on health care. Given the amount we spend on health care relative to other countries, the scale of the failure becomes more apparent.

o me, the most glaring example is the schools. They were closed without people thinking through the potential consequences of closing down public schools, especially for disadvantaged kids.

to compound it, in my view, public health never made the distinction that needed to be made between the vulnerabilities of somebody 70 years old and the vulnerabilities of somebody 10 years old.

In the beginning of the book you write, in what almost feels like a thesis statement for the book: “A central tenet of this book is that we could not have done better, and pretending differently is a dangerous fiction, one that prevents us from taking a much needed look in the mirror.”

This claim, that the U.S. could not have done any better, runs against your other claim, that what we observed was an American failure. It is also a pretty extreme claim, I think, and I wanted to press you on it in part because it is, in my view, undermined by quite a lot of the work you do in the book itself.

Would the U.S. not have done better if it had recognized earlier that the disease spread through the air rather than in droplets? Would it not have done better if it hadn’t bungled the rollout of a Covid test in the early months?

McLean: Everything that you mentioned — the point of the book is that those were set by the time the pandemic hit.

in retrospect, what we were doing was to try to delay as much spread as we could until people got vaccinated. All the things that we did in 2020 were functionally serving or trying to serve that purpose. Now, given that, how can you say that none of that work saved lives?

McLean: I think that the test failure was baked into the way that the C.D.C. had come to operate

But the big question I really want to ask is this one: According to the C.D.C., we’ve had almost 1.2 million deaths from Covid. Excess mortality is nearly 1.4 million. Is it really your contention that there was nothing we might’ve done that brought that total down to 1.1 million, for instance, or even 900,000?

McLean: It’s very — you’re right. If you went through each and every thing and had a crystal ball and you could say, this could have been done, this could have been moved up by a month, we could have gotten PPE …

When I came to that sentence, I thought of it in terms of human behavior: What will humans put up with? What will humans stand for? How do Americans act? And you’ve written about Sweden being sort of average, and you’ve written about China and the Chinese example. They lock people up for two years and suddenly the society just revolts. They will not take it anymore. They can’t stand it. And as a result, a million and a half people die in a month and a half.

Well, I would tell that story very differently. For me, the problem is that when China opened up, they had fully vaccinated just under two-thirds of their population over 80. So to me, it’s not a failure of lockdowns. It’s a failure of vaccinations. If the Chinese had only achieved the same elderly vaccination rate as we achieved — which by global standards was pretty poor — that death toll when they opened up would have been dramatically lower.

What do you mean by “lockdown,” though? You use the word throughout the book and suggest that China was the playbook for all countries. But you also acknowledge that what China did is not anything like what America did.

Disparities in health care access — is it a dangerous fiction to think we might address that? You guys are big champions of Operation Warp Speed — would it not have been better if those vaccines had been rolled out to the public in nine months, rather than 12

. But this isn’t “lockdown” like there were lockdowns in China or even Peru. It’s how we tried to make it safer to go out and interact during a pandemic that ultimately killed a million Americans.

McLean: I think that you’re absolutely right to focus on the definition of what a lockdown is and how we implemented them here in this country. And I think part of the problem is that we implemented them in a way that allowed people who were well off and could work from home via Zoom to be able to maintain very much of their lives while other people couldn’t

And I think it depends on who you were, whether you would define this as a lockdown or not. If you were a small business who saw your small business closed because of this, you’re going to define it as a lockdown.

n the book you’re pretty definitive. You write, “maybe the social and economic disasters that lockdowns created would have been worth it if they had saved lives, but they hadn’t.” How can you say that so flatly?

I think there are still open questions about what worked and how much. But the way that I think about all of this is that the most important intervention that anybody did anywhere in the world was vaccination. And the thing that determined outcomes most was whether your first exposure came before or after vaccination.

Here, the shelter-in-place guidelines lasted, on average, five to seven weeks. Thirty nine of the 40 states that had issued them lifted them by the end of June, three months in. By the summer, according to Google mobility data, retail and grocery activity was down about 10 percent. By the fall, grocery activity was only down about 5 percent across the country

Nocera: Well, on some level, I feel like you’re trying to have it both ways. On the one hand, you’re saying that lockdowns saved lives. On the other hand, you said they weren’t real lockdowns because everybody was out and about.

I don’t think that’s having it both ways. I’m trying to think about these issues on a spectrum rather than in binaries. I think we did interrupt our lives — everybody knows that. And I think they did have an effect on spread, and that limiting spread had an effect by delaying infections until after vaccination.

Nocera: Most of the studies that say lockdowns didn’t work are really less about Covid deaths than about excess mortality deaths. I wound up being persuaded that the people who could not get to the hospital, because they were all working, because all the doctors were working on Covid and the surgical rooms were shut down, the people who caught some disease that was not Covid and died as a result — I wound up being persuaded about that.

We’re in a pandemic. People are going to die. And then the question becomes, can we protect the most vulnerable? And the answer is, we didn’t protect the most vulnerable. Nursing homes were a complete disaster.

There was a lot of worry early on about delayed health care, and about cancer in particular — missed screenings, missed treatments. But in 2019, we had an estimated 599,600 Americans die of cancer. In 2020, it was 602,000. In 2021, it was 608,000. In 2022, it was 609,000.

Nocera: See, it went up!But by a couple of thousand people, in years in which hundreds of thousands of Americans were dying of Covid.

Nocera: I think you can’t dispute the excess mortality numbers.I’m not. But in nearly every country in the world the excess mortality curves track so precisely with Covid waves that it doesn’t make sense to talk about a massive public health problem beyond Covid. And when you add all of these numbers up, they are nowhere near the size of the footfall of Covid. How can you look back on this and say the costs were too high?

Nocera: I think the costs were too high because you had school costs, you had economic costs, you had social costs, and you had death.

McLean: I think you’re raising a really good point. We’re making an argument for a policy that might not have been doable given the preconditions that had been set. I’m arguing that there were these things that had been put in place in our country for decades leading up to the pandemic that made it really difficult for us to plant in an effective way, from the outsourcing of our PPE to the distrust in our health care system that had been created by people’s lack of access to health care with the disparities in our hospital system.

How would you have liked to see things handled differently?Nocera: Well, the great example of doing it right is San Fran

I find the San Francisco experience impressive, too. But it was also a city that engaged in quite protracted and aggressive pandemic restrictions, well beyond just protecting the elderly and vulnerable.

McLean: But are we going to go for stay-at-home orders plus protecting vulnerable communities like San Francisco did? Or simply letting everybody live their lives, but with a real focus on the communities and places like nursing homes that were going to be affected? My argument is that we probably would’ve been better off really focusing on protecting those communities which were likely to be the most severely affected.

I agree that the public certainly didn’t appreciate the age skew, and our policy didn’t reflect it either. But I also wonder what it would mean to better protect the vulnerable than we did. We had testing shortages at first. Then we had resistance to rapid testing. We had staff shortages in nursing homes.

Nocera: This gets exactly to one of our core points. We had spent 30 years allowing nursing homes to be owned by private equity firms that cut the staff, that sold the land underneath and added all this debt on

I hear you saying both that we could have done a much better job of protecting these people and that the systems we inherited at the outset of the pandemic would’ve made those measures very difficult, if not impossible, to implement.

But actually, I want to stop you there, because I actually think that that data tells the opposite story.

And then I’m trying to say at the same time, but couldn’t we have done something to have protected people despite all of that?

I want to talk about the number of lives at stake. In the book, you write about the work of British epidemiologist Neil Ferguson. In the winter of 2020, he says that in the absence of mitigation measures and vaccination, 80 percent of the country is going to get infected and 2.2 million Americans are going to die. He says that 80 percent of the U.K. would get infected, and 510,000 Brits would die — again, in the abs

In the end, by the time we got to 80 percent of the country infected, we had more than a million Americans die. We had more than 200,000 Brits die. And in each case most of the infections happened after vaccination, which suggests that if those infections had all happened in a world without vaccines, we almost certainly would have surpassed two million deaths in the U.S. and almost certainly would’ve hit 500,000 deaths in the U.K.

In the book, you write about this estimate, and you endorse Jay Bhattacharya’s criticism of Ferguson’s model. You write, “Bhattacharya got his first taste of the blowback reserved for scientists who strayed from the establishment position early. He co-wrote an article for The Wall Street Journal questioning the validity of the scary 2 to 4 percent fatality rate that the early models like Neil Ferguson’s were estimating and that were causing governments to panic. He believed, correctly as it turns out, that the true fatality rate was much lower.”

Nocera: I know where you’re going with this, because I read your story about the nine pandemic narratives we’re getting wrong. In there, you said that Bhattacharya estimated the fatality rate at 0.01 percent. But if you actually read The Wall Street Journal article, what he’s really saying is I think it’s much lower. I’ve looked at two or three different possibilities, and we really need some major testing to figure out what it actually is, because I think 2 percent to 4 percent is really high.

He says, “if our surmise of 6 million cases is accurate, that’s a mortality rate of 0.01%. That is ⅒th the flu mortality rate of 0.1%.” An I.F.R. of 0.01 percent, spread fully through the American population, yields a total American death toll of 33,000 people. We have had 1.2 million deaths. And you are adjudicating this dispute, in 2023, and saying that Neil was wrong and Jay was right.

hird, in the Imperial College report — the one projecting two million American deaths — Ferguson gives an I.F.R. estimate of 0.9 percent.

Bhattacharya’s? Yes, there is some uncertainty around the estimate he offers. But the estimate he does offer — 0.01 percent — is one hundred times lower than the I.F.R. you yourselves cite as the proper benchmark.

Nocera: In The Wall Street Journal he does not say it’s 0.01. He says, we need to test to find out what it is, but it is definitely lower than 2 to 4 percent.

Well, first of all, the 2 percent to 4 percent fatality rate is not from Neil Ferguson. It’s from the W.H.O.

But I think that fundamentally, at the outset of the pandemic, the most important question orienting all of our thinking was, how bad could this get? And it turns out that almost all of the people who were saying back then that we shouldn’t do much to intervene were extremely wrong about how bad it would be

The argument then was, more or less, “We don’t need to do anything too drastic, because it’s not going to be that big a deal.” Now, in 2023, it’s the opposite argument: “We shouldn’t have bothered with restrictions, because they didn’t have an impact; we would have had this same death toll anyway.” But the death toll turned out to be enormous.

Now, if we had supplied all these skeptics with the actual numbers at the outset of the pandemic, what kind of audience would they have had? If instead of making the argument against universal mitigation efforts on the basis of a death toll of 40,000 they had made the argument on the basis of a death toll of more than a million, do you think the country would’ve said, they’re right, we’re doing too much, let’s back off?

McLean: I think that if you had gone to the American people and said, this many people are going to die, that would’ve been one thing. But if you had gone to the American people and said, this many people are going to die and a large percentage of them are going to be over 80, you might’ve gotten a different answer.

I’m not arguing we shouldn’t have been trying to get a clearer sense of the true fatality rate, or that we shouldn’t have been clearer about the age skew. But Bhattacharya was also offering an estimate of fatality rate that turned out to be off by a factor of a hundred from the I.F.R. that you yourselves cite as correct. And then you say that Bhattacharya was right and Ferguson was wrong.

And you, too, Joe, you wrote an article in April expressing sympathy for Covid skeptics and you said ——Nocera: This April?No, 2020.Nocera: Oh, oh. That’s the one where I praised Alex Berenson.You also cited some Amherst modeling which said that we were going to have 67,000 to 120,000 American deaths. We already had, at that point, 60,000. So you were suggesting, in making an argument against pandemic restrictions, that the country as a whole was going to experience between 7,000 and 60,000 additional deaths from that point.

when I think about the combination of the economic effects of mitigation policies and just of the pandemic itself and the big fiscal response, I look back and I think the U.S. managed this storm relatively well. How about each of you?

in this case, Congress did get it together and did come to the rescue. And I agree that made a ton of difference in the short term, but the long-term effects of the fiscal rescue package were to help create inflation. And once again, inflation hits those at the bottom of the socioeconomic distribution much harder than it does those at the top. So I would argue that some of what we did in the pandemic is papering over these long-term issues.

I think as with a lot of the stuff we’ve talked about today, I agree with you about the underlying problems. But if we take for granted for a moment that the pandemic was going to hit us, when it did, under the economic conditions it did, and then think about the more narrow context of whether, given all that, we handled the pandemic well. We returned quickly to prepandemic G.D.P. trends, boosted the wealth of the bottom half of the country, cut child poverty in half, pushed unemployment to historical lows.

What sense do you make of the other countries of the world and their various mitigation policies? Putting aside China, there’s New Zealand, Australia, South Korea — these are all places that were much more aggressive than the U.S. and indeed more than Europe. And had much, much better outcomes.

Nocera: To be perfectly honest, we didn’t really look, we didn’t really spend a lot of time looking at that.

McLean: But one reason that we didn’t is I don’t think it tells us anything. When you look at who Covid killed, then you have to look at what the pre-existing conditions in a country were, what percentage of its people are elderly. How sick are people with pre-existing conditions?

I just don’t think there’s a comparison. There’s just too many factors that influence it to be able to say that, to be able to compare America to any other country, you’d have to adjust for all these factors.

But you do spend a bit of time in the book talking about Sweden. And though it isn’t precisely like-for-like, one way you can control for some of those factors is grouping countries with their neighbors and other countries with similar profiles. And Sweden’s fatality rate in 2020 was 10 times that of Norway, Finland and Iceland. Five times that of Denmark. In the vaccination era, those gaps have narrowed, but by most metrics Sweden has still done worse, overall, than all of those countries.

On the matter of omniscience. Let’s say that we can send you back in time. Let’s put you both in charge of American pandemic response, or at least American communication about the pandemic, in early 2020. What would you want to tell the country? How would you have advised us to respond?

McLean: What I would want is honesty and communication. I think we’re in a world that is awash in information and the previous methods of communication — giving a blanket statement to people that may or may not be true, when you know there’s nuance underneath it — simply doesn’t work anymore

o I would’ve been much more clear — we think masks might help, we don’t know, but it’s not that big of an ask, let’s do it. We think the early data coming out of Italy shows that these are the people who are really, really at risk from Covid, but it’s not entirely clear yet. Maybe there is spread in schools, but we don’t know. Let’s look at this and keep an open mind and look at the data as it comes in.

Then, in March 2022, the Fed changed course, first tightening the money supply by increasing the federal-funds rate and then introducing quantitative tightening. Between July 2022 and August 2023, the M2 supply contracted by 3.9%, the most extreme contraction since 1933.

The first factor contributing to the contraction of the money supply is the Fed’s quantitative tightening

Quantitative tightening has already produced a dramatic selloff in the bond market. But just as they did ahead of the September 2019 crunch in the repurchase-agreement market, Fed officials keep repeating their mistaken mantras that quantitative tightening can operate “in the background” and “on autopilot,” implying minimal market effect

But basic balance-sheet accounting shows that unless commercial banks are creating enough “new money” through their lending activity to offset the Fed’s balance-sheet shrinkage, quantitative tightening has a contractionary effect on the money supply.

The second factor contributing to shrinking M2 is the decreased availability of commercial bank credit—the sum of loans and bank holdings of securities. With the steep rise in rates, bank lending has slowed, and banks have been selling off securities.

This brings us to the stock-market crash of 1987. In that year the key 10-year bond yield rose steeply from January onward (from 7% in January to 10% by Black Monday in October) and the money supply slowed sharply.

In 1987 growth of M2 declined by almost half, from 9.7% year-on-year in January to 4.9% in September, while M3—no longer published by the Fed—slowed from 8.7% to 3.6% over the same period

A bond-market crunch and monetary squeeze together led to a sudden, drastic reassessment of equity-market valuations. The same could happen today, particularly since the current jump in bond yields and monetary squeeze are much more pronounced than in 1987.

So far, only the remaining excess money the Fed created between 2020 and 2021—the cumulative excess savings from the Covid handouts—has been keeping businesses hiring and consumers spending. The effects of the excess money are still giving the economy a lift, but that extra fuel is almost exhausted. When it dries up, the economy will run on fumes.

In all of this, an appreciation for time lags is critical. The Fed ignored the huge acceleration in the quantity of money and thus failed to anticipate the ensuing inflation. When inflation struck in early 2021, Fed officials tried to argue it was “transitory,” caused by supply-chain disruptions.

The Fed continues to ignore the money supply, and we now face the opposite problem. The money supply has been contracting for 18 months, and soon, after the overhanging extra money from 2020-21 has been used up, spending will plunge and inflation will fall, not simply to 2%, but below—and perhaps even into deflation in 2025.

Since Fed officials pay no attention to either monetary aggregates or their credit counterparts, they are overlooking these signals

Monetary analysis tells a very different story than the measures the Fed follows. The first effect of a monetary contraction is higher market interest rates for a brief period. Then comes an economic slump. The economy goes into recession and inflation falls. This results in a second and more permanent effect of subpar money growth, namely lower interest rates and a weaker currency.

The way that people tend to argue today, particularly online, makes things worse.

hilosophers and social scientists have long pondered the question of why people hold different beliefs and values

odds are that neither camp is having any effect on the other; on the contrary, the attacks make opponents dig in deeper.

If you want a chance at changing minds, you need a new strategy: Stop using your values as a weapon, and start offering them as a gift.

You wouldn’t blame anyone involved for feeling as if they’re under fire, and no one is likely to change their mind when they’re being attacked.

even when two groups agree on a moral foundation, they can radically disagree on how it should be expressed

Extensive survey-based research has revealed that almost everyone shares at least two common values: Harming others without cause is bad, and fairness is good. Other moral values are less widely shared

political conservatives tend to value loyalty to a group, respect for authority, and purity—typically in a bodily sense, in terms of sexuality—more than liberals do.

Sometimes conflict arises because one group holds a moral foundation that the other simply doesn’t feel strongly about

One of the most compelling explanations comes from Moral Foundations Theory, which has been popularized by Jonathan Haidt, a social psychologist at NYU. This theory proposes that humans share a common set of “intuitive ethics,” on top of which we build different narratives and institutions—and therefore beliefs—that vary by culture, community, and even person.

When people fail to live up to your moral values (or your expression of them), it is easy to conclude that they are immoral people.

Further, if you are deeply attached to your values, this difference can feel like a threat to your identity, leading you to lash out, which won’t convince anyone who disagrees with you.

research shows that if you insult someone in a disagreement, the odds are that they will harden their position against yours, a phenomenon called the boomerang effect.

3. Listen more.

effective missionaries present their beliefs as a gift. And sharing a gift is a joyful act, even if not everyone wants it.

so it is with our values. If we want any chance at persuasion, we must offer them happily. A weapon is an ugly thing, designed to frighten and coerce

A gift is something we believe to be good for the recipient, who, we hope, may accept it voluntarily, and do so with gratitude. That requires that we present it with love, not insults and hatred.

1. Don’t “other” others.

Go out of your way to welcome those who disagree with you as valued voices, worthy of respect and attention. There is no “them,” only “us.”

2. Don’t take rejection personally.

just as you are not your car or your house, you are not your beliefs. Unless someone says, “I hate you because of your views,” a repudiation is personal only if you make it so

he solution to this problem requires a change in the way we see and present our own values

when it comes to changing someone’s mind, listening is more powerful than talking. They conducted experiments that compared polarizing arguments with a nonjudgmental exchange of views accompanied by deep listening. The former had no effect on viewpoints, whereas the latter reliably lowered exclusionary opinions.

when possible, listening and asking sensitive questions almost always has a more beneficial effect than talking.

howing others that you can be generous with them regardless of their values can help weaken their belief attachment, and thus make them more likely to consider your point of view

for your values to truly be a gift, you must weaken your own belief attachment first

we should all promise to ourselves, “I will cultivate openness, non-discrimination, and non-attachment to views in order to transform violence, fanaticism, and dogmatism in myself and in the world.”

if I truly have the good of the world at heart, then I must not fall prey to the conceit of perfect knowledge, and must be willing to entertain new and better ways to serve my ultimate goal: creating a happier world

generosity and openness have a bigger chance of making the world better in the long run.

Besides teenage girls, another new group was referred to us: young people from the inpatient psychiatric unit, or the emergency department, of St. Louis Children’s Hospital. The mental health of these kids was deeply concerning—there were diagnoses like schizophrenia, PTSD, bipolar disorder, and more. Often they were already on a fistful of pharmaceuticals.

Being put on powerful doses of testosterone or estrogen—enough to try to trick your body into mimicking the opposite sex—-affects the rest of the body. I doubt that any parent who's ever consented to give their kid testosterone (a lifelong treatment) knows that they’re also possibly signing their kid up for blood pressure medication, cholesterol medication, and perhaps sleep apnea and diabetes. 

There are rare conditions in which babies are born with atypical genitalia—cases that call for sophisticated care and compassion. But clinics like the one where I worked are creating a whole cohort of kids with atypical genitals—and most of these teens haven’t even had sex yet. They had no idea who they were going to be as adults. Yet all it took for them to permanently transform themselves was one or two short conversations with a therapist.

Other girls were disturbed by the effects of testosterone on their clitoris, which enlarges and grows into what looks like a microphallus, or a tiny penis. I counseled one patient whose enlarged clitoris now extended below her vulva, and it chafed and rubbed painfully in her jeans. I advised her to get the kind of compression undergarments worn by biological men who dress to pass as female. At the end of the call I thought to myself, “Wow, we hurt this kid.”

How little patients understood what they were getting into was illustrated by a call we received at the center in 2020 from a 17-year-old biological female patient who was on testosterone. She said she was bleeding from the vagina. In less than an hour she had soaked through an extra heavy pad, her jeans, and a towel she had wrapped around her waist. The nurse at the center told her to go to the emergency room right away.

We found out later this girl had had intercourse, and because testosterone thins the vaginal tissues, her vaginal canal had ripped open. She had to be sedated and given surgery to repair the damage. She wasn’t the only vaginal laceration case we heard about.

Bicalutamide is a medication used to treat metastatic prostate cancer, and one of its side effects is that it feminizes the bodies of men who take it, including the appearance of breasts. The center prescribed this cancer drug as a puberty blocker and feminizing agent for boys. As with most cancer drugs, bicalutamide has a long list of side effects, and this patient experienced one of them: liver toxicity. He was sent to another unit of the hospital for evaluation and immediately taken off the drug. Afterward, his mother sent an electronic message to the Transgender Center saying that we were lucky her family was not the type to sue.

Here’s an example. On Friday, May 1, 2020, a colleague emailed me about a 15-year-old male patient: “Oh dear. I am concerned that [the patient] does not understand what Bicalutamide does.” I responded: “I don’t think that we start anything honestly right now.”

There are no reliable studies showing this. Indeed, the experiences of many of the center’s patients prove how false these assertions are. 

Many encounters with patients emphasized to me how little these young people understood the profound impacts changing gender would have on their bodies and minds. But the center downplayed the negative consequences, and emphasized the need for transition. As the center’s website said, “Left untreated, gender dysphoria has any number of consequences, from self-harm to suicide. But when you take away the gender dysphoria by allowing a child to be who he or she is, we’re noticing that goes away. The studies we have show these kids often wind up functioning psychosocially as well as or better than their peers.” 

When a female takes testosterone, the profound and permanent effects of the hormone can be seen in a matter of months. Voices drop, beards sprout, body fat is redistributed. Sexual interest explodes, aggression increases, and mood can be unpredictable. Our patients were told about some side effects, including sterility. But after working at the center, I came to believe that teenagers are simply not capable of fully grasping what it means to make the decision to become infertile while still a minor.

To begin transitioning, the girls needed a letter of support from a therapist—usually one we recommended—who they had to see only once or twice for the green light. To make it more efficient for the therapists, we offered them a template for how to write a letter in support of transition. The next stop was a single visit to the endocrinologist for a testosterone prescription. 

The doctors privately recognized these false self-diagnoses as a manifestation of social contagion. They even acknowledged that suicide has an element of social contagion. But when I said the clusters of girls streaming into our service looked as if their gender issues might be a manifestation of social contagion, the doctors said gender identity reflected something innate.

Frequently, our patients declared they had disorders that no one believed they had. We had patients who said they had Tourette syndrome (but they didn’t); that they had tic disorders (but they didn’t); that they had multiple personalities (but they didn’t).

The girls who came to us had many comorbidities: depression, anxiety, ADHD, eating disorders, obesity. Many were diagnosed with autism, or had autism-like symptoms. A report last year on a British pediatric transgender center found that about one-third of the patients referred there were on the autism spectrum.

This concerned me, but didn’t feel I was in the position to sound some kind of alarm back then. There was a team of about eight of us, and only one other person brought up the kinds of questions I had. Anyone who raised doubts ran the risk of being called a transphobe. 

I certainly saw this at the center. One of my jobs was to do intake for new patients and their families. When I started there were probably 10 such calls a month. When I left there were 50, and about 70 percent of the new patients were girls. Sometimes clusters of girls arrived from the same high school. 

Until 2015 or so, a very small number of these boys comprised the population of pediatric gender dysphoria cases. Then, across the Western world, there began to be a dramatic increase in a new population: Teenage girls, many with no previous history of gender distress, suddenly declared they were transgender and demanded immediate treatment with testosterone. 

Soon after my arrival at the Transgender Center, I was struck by the lack of formal protocols for treatment. The center’s physician co-directors were essentially the sole authority.

At first, the patient population was tipped toward what used to be the “traditional” instance of a child with gender dysphoria: a boy, often quite young, who wanted to present as—who wanted to be—a girl. 

During the four years I worked at the clinic as a case manager—I was responsible for patient intake and oversight—around a thousand distressed young people came through our doors. The majority of them received hormone prescriptions that can have life-altering consequences—including sterility. 

I left the clinic in November of last year because I could no longer participate in what was happening there. By the time I departed, I was certain that the way the American medical system is treating these patients is the opposite of the promise we make to “do no harm.” Instead, we are permanently harming the vulnerable patients in our care.

Today I am speaking out. I am doing so knowing how toxic the public conversation is around this highly contentious issue—and the ways that my testimony might be misused. I am doing so knowing that I am putting myself at serious personal and professional risk.

Almost everyone in my life advised me to keep my head down. But I cannot in good conscience do so. Because what is happening to scores of children is far more important than my comfort. And what is happening to them is morally and medically appalling.

For almost four years, I worked at The Washington University School of Medicine Division of Infectious Diseases with teens and young adults who were HIV positive. Many of them were trans or otherwise gender nonconforming, and I could relate: Through childhood and adolescence, I did a lot of gender questioning myself. I’m now married to a transman, and together we are raising my two biological children from a previous marriage and three foster children we hope to adopt. 

The center’s working assumption was that the earlier you treat kids with gender dysphoria, the more anguish you can prevent later on. This premise was shared by the center’s doctors and therapists. Given their expertise, I assumed that abundant evidence backed this consensus. 

All that led me to a job in 2018 as a case manager at The Washington University Transgender Center at St. Louis Children's Hospital, which had been established a year earlier. 

Teachers are not only burnt out and undercompensated, they are also demoralized. They are being asked to do things in the name of teaching that they believe are mis-educational and harmful to students and the profession. What made this work good for them is no longer accessible. That is why we are hearing so many refrains of “I’m not leaving the profession, my profession left me.”

We find there are at least 36,000 vacant positions along with at least 163,000 positions being held by underqualified teachers, both of which are conservative estimates of the extent of teacher shortages nationally.

“The current problem of teacher shortages (I would further break this down into vacancy and under-qualification) is higher than normal.” The data, Nguyen continued, “indicate that shortages are worsening over time, particularly over the last few years

a growing gap between the pay of all college graduates and teacher salaries from 1979 to 2021, with a sharp increase in the differential since 2010

The number of qualified teachers is declining for the whole country and the vast majority of states.

Wages are essentially unchanged from 2000 to 2020 after adjusting for inflation. Teachers have about the same number of students. But, teacher accountability reforms have increased the demands on their positions.

The pandemic was very difficult for teachers. Their self-reported level of stress was about as twice as high during the pandemic compared to other working adults. Teachers had to worry both about their personal safety and deal with teaching/caring for students who are grieving lost family members.

the number of students graduating from college with bachelor’s degrees in education fell from 176,307 in 1970-71 to 104,008 in 2010-11 to 85,058 in 2019-20.

We do see that southern states (e.g., Mississippi, Alabama, Georgia and Florida) have very high vacancies and high vacancy rates.”

By 2021, teachers made $1,348, 32.9 percent less than what other graduates made, at $2,009.

These gaps play a significant role in determining the quality of teachers,