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The study of 100 patients from 21 states, published on Tuesday in The Annals of Clinical and Translational Neurology, found that 85 percent of them experienced four or more neurological issues like brain fog, headaches, tingling, muscle pain and dizziness.

Participants in the study were overwhelmingly white, and 70 percent were women. Dr. Navis and others said that the lack of diversity quite likely reflected the demographics of people able to seek care relatively early in the pandemic rather than the full spectrum of people affected by post-Covid neurological sympto

In the Northwestern study, 43 percent of the patients had depression before having Covid-19; 16 percent had previous autoimmune diseases, the same percentage of patients who had previous lung disease or had struggled with insomnia.

“Waking up every day in this body, sometimes hope feels a little dangerous,” said Ms. Khan, who will soon start the cognitive rehab program. “I have to wonder: Am I going to recover, or am I going to just figure out how to live with my new brain?”

In 2015, OSHA fined the company for 12 violations, which included issues related to machinery safeguards, according to those records. In two separate incidents from 2017, two employees suffered finger amputations after getting their hands stuck in equipment. No other violations involved issues with refrigeration or gas leaks.

Whether or not the strategy pays off in 2022, the culture wars are fueling support for the far right today. Polls ahead of this month’s regional elections, where 17 regional presidencies are up for grabs, show the National Rally with a solid shot of capturing majority control of a region for the first time ever — while Ms. Le Pen is within striking distance of Mr. Macron in the presidential election.

t’s also striking to see the depths to which political discourse has sunk in a country that prides itself on its capacity for highbrow public debate and the spotlight it reserves for intellectuals. In the middle of a pandemic and after the country’s worst economic crisis since the end of World War II, the French news cycle isn’t led by discussion over truly universal issues like wealth inequality, the health system or climate change. Instead it’s focused on navel-gazing debates about identity, fueled by television personalities.

“At the end of the day, I still come down in the place that the best interests of the country would not be served by giving him that Donald Trump daily drama in our nation’s capital for three years as part of the United States versus Trump. That would give him the oxygen and the attention that he so craves and make it so much harder for a new president to heal the country both spiritually and physically, and to get some people out of the fog of lies that they’re trapped in.

“I just think, on balance, the country is better served by impeaching him, convicting him in the Senate and letting local prosecutors in New York pursue him for the fraudster he was before he took office. That mixture accommodates the important public interest of the rule of law being asserted, but doesn’t do it in a way that makes it impossible for a new president to move the country on.”

US democracy had a near-death experience, but survived. “I’m deeply optimistic,” Comey says. “America is a wonderful, complicated, screwed-up country, but it’s always getting better. It usually gets worse before it gets better, but the better succeeds, so we make progress. I am optimistic this will be the inflection point that we so desperately needed. I wish it weren’t so, but this, I think, is going to awaken Americans to the things that matter.”

the Great Smog of 1952, pollutants from factories and home fireplaces mixed with air condensation killed at least 4,000 people in London over the course of several days.

However, in 2007, almost half (46 percent) of all Americans resided in counties with unhealthy levels of either ozone or particle pollution, according to the American Lung Association (ALA).

It irritates the respiratory tract and can lead to a number of health problems, including asthma attacks, chest pain and even death.

It causes many other health effects, premature births to serious respiratory disorders, even when the particle levels are very low. It makes asthma worse and causes wheezing, coughing and respiratory irritation in anyone with sensitive airways. It also triggers heart attacks, strokes, irregular heartbeat, and premature death.”

For centuries, humans unknowingly contaminated sources of drinking water with raw sewage, which led to diseases such as cholera and typhoid.

Water pollution intensified with the advent of the Industrial Revolution,

Over half the American population (including the majority of those living in rural areas) relies on groundwater for drinking water, according to The Groundwater Foundation

The disaster, which created a 3,000-square-mile oil slick, instantly killed hundreds of thousands of birds, fish and other wildlife and devastated the area for years afterward.

Indeed, doctors are reporting similar cases across the country and around the world. A small number of Covid patients who had never experienced mental health problems are developing severe psychotic symptoms weeks after contracting the coronavirus

Beyond individual reports, a British study of neurological or psychiatric complications in 153 patients hospitalized with Covid-19 found that 10 people had “new-onset psychosis.”

Although the coronavirus was initially thought primarily to cause respiratory distress, there is now ample evidence of many other symptoms, including neurological, cognitive and psychological effects, that could emerge even in patients who didn’t develop serious lung, heart or circulatory problems.

Medical experts say they expect that such extreme psychiatric dysfunction will affect only a small proportion of patients. But the cases are considered examples of another way the Covid-19 disease process can affect mental health and brain function.

Experts increasingly believe brain-related effects may be linked to the body’s immune system response to the coronavirus and possibly to vascular problems or surges of inflammation caused by the disease process.

Also striking is that most patients have been in their 30s, 40s and 50s. “It’s very rare for you to develop this type of psychosis in this age range,”

Some post-Covid patients who developed psychosis needed weeks of hospitalization in which doctors tried different medications before finding one that helped.

Persistent immune activation is also a leading explanation for brain fog and memory problems bedeviling many Covid survivors,

How long the psychosis lasted and patients’ response to treatment has varied. The woman in Britain — whose symptoms included paranoia about the color red and terror that nurses were devils who would harm her and a family member — took about 40 days to recover, according to a case report.

The whistleblower added that no one in the government knew the true figure of the dead because “we have lost contact with major divisions”.

FSB officers had been ordered to assess the effects of western sanctions, they said, but were told that it was a hypothetical box-ticking exercise. “You have to write the analysis in a way that makes Russia the victor . . . otherwise you get questioned for not doing good work,” they wrote. “Suddenly it happens and everything comes down to your completely groundless analysis.

“[We are] acting intuitively, on emotion . . . our stakes will have to be raised ever higher with the hope that suddenly something might come through for us.

“By and large, though, Russia has no way out. There are no options for a possible victory, only defeat.”

The letter said that Ramzan Kadyrov, the Chechen leader and an ally of Putin, was on the verge of outright conflict with the Russians after his “hit squad”, sent to kill President Zelensky, was destroyed by Ukrainian forces.

Even if Zelensky were killed, the report said, Russia would have no hope of occupying Ukraine. “Even with minimum resistance from the Ukrainians we’d need over 500,000 people, not including supply and logistics workers.”

The analyst said that the SVR, Russia’s foreign intelligence service, was trying to “dig up dirt” to claim that Ukraine had built nuclear weapons, a pretext for a pre-emptive strike.

The 2,000-word document was published by Vladimir Osechkin, a Russian human rights activist who runs the anti-corruption website Gulagu.net.

Christo Grozev, an expert on the Russian security services, said he had shown the letter to two FSB officers, both of whom had had “no doubt it was written by a colleague”.

The war, the writer said, had been given a “provisional deadline” of June because by then the Russian economy will have collapsed. “I have hardly slept at all recently, working all hours, in a brain-fog,” they wrote. “Maybe it’s from overwork, but I feel like I am in a surreal world. Pandora’s Box has been opened.”

The author said they could not rule out international conflict and that they were expecting “some f***ing adviser to convince the leadership” to send an ultimatum to the West threatening war if sanctions were not lifted.

“What if the West refuses?” they wrote. “In that instance I won’t exclude that we will be pulled into a real international conflict, just like Hitler in 1939.” Elsewhere in the letter they said: “Our position is like Germany in 1943-44 — but that’s our starting position.”

Putin’s behavior shocked many people because they bought into his image as a grand master of intricate policy maneuvers, which assumes intentionality, adroitness, and cunning. A more accurate judgment followed from saying to oneself: This is an aging dictator, who after 20 years of absolute power gets no pushback; who is paranoid, dismissive, and brutal

, he is someone who has deteriorated both physically and—as seen in his delivery of rambling, querulous speeches—mentally.

The personality of the Ukrainian president has made all the difference. Volodymyr Zelensky is an Everyman hero: reluctant, initially unsure, but patriotic and courageous.

A second explanation is narrower. It has to do with military analysts’ focus on technology at the expense of the human element in war.

War is a contest of wills; it is unpredictable; it is the domain of accident and contingency; nothing goes as planned; and events are smothered in a fog created by misinformation and fear.

less international-relations theory and more Carl von Clausewitz would have helped

Finally, the democratic pessimism of the past two decades has obscured from many the extraordinary power of freedom, and the innate resilience of liberal-democratic countries and institutions.

A culture of lies is corrosive, breeding cynicism and eventually self-doubt. Truth is not only more powerful but open to all of us, hence Václav Havel’s dictum that the way to resist tyranny is to live in truth.

“My first and biggest wish is that we had known early that Covid-19 was airborne,”

, “Once you’ve realized that, it informs an entirely different strategy for protection.” Masking, ventilation and air cleaning become key, as well as avoiding high-risk encounters with strangers, he says.

Instead of washing our produce and wearing hand-sewn cloth masks, we could have made sure to avoid superspreader events and worn more-effective N95 masks or their equivalent. “We could have made more of an effort to develop and distribute N95s to everyone,” says Dr. Volckens. “We could have had an Operation Warp Speed for masks.”

We didn’t realize how important clear, straight talk would be to maintaining public trust. If we had, we could have explained the biological nature of a virus and warned that Covid-19 would change in unpredictable ways.  

In the face of a pandemic, he says, the public needs an early basic and blunt lesson in virology

“The science is really important, but if you don’t get the trust and communication right, it can only take you so far,”

and mutates, and since we’ve never seen this particular virus before, we will need to take unprecedented actions and we will make mistakes, he says.

Since the public wasn’t prepared, “people weren’t able to pivot when the knowledge changed,”

By the time the vaccines became available, public trust had been eroded by myriad contradictory messages—about the usefulness of masks, the ways in which the virus could be spread, and whether the virus would have an end date.

, the absence of a single, trusted source of clear information meant that many people gave up on trying to stay current or dismissed the different points of advice as partisan and untrustworthy.

We didn’t know how difficult it would be to get the basic data needed to make good public-health and medical decisions. If we’d had the data, we could have more effectively allocated scarce resources

For much of the pandemic, doctors, epidemiologists, and state and local governments had no way to find out in real time how many people were contracting Covid-19, getting hospitalized and dying

Doctors didn’t know what medicines worked. Governors and mayors didn’t have the information they needed to know whether to require masks. School officials lacked the information needed to know whether it was safe to open schools.

people didn’t know whether it was OK to visit elderly relatives or go to a dinner party.

just months before the outbreak of the pandemic, the Council of State and Territorial Epidemiologists released a white paper detailing the urgent need to modernize the nation’s public-health system still reliant on manual data collection methods—paper records, phone calls, spreadsheets and faxes.

While the U.K. and Israel were collecting and disseminating Covid case data promptly, in the U.S. the CDC couldn’t. It didn’t have a centralized health-data collection system like those countries did, but rather relied on voluntary reporting by underfunded state and local public-health systems and hospitals.

doctors and scientists say they had to depend on information from Israel, the U.K. and South Africa to understand the nature of new variants and the effectiveness of treatments and vaccines. They relied heavily on private data collection efforts such as a dashboard at Johns Hopkins University’s Coronavirus Resource Center that tallied cases, deaths and vaccine rates globally.

With good data, Dr. Ranney says, she could have better managed staffing and taken steps to alleviate the strain on doctors and nurses by arranging child care for them.

To solve the data problem, Dr. Ranney says, we need to build a public-health system that can collect and disseminate data and acts like an electrical grid. The power company sees a storm coming and lines up repair crews.

If we’d known how damaging lockdowns would be to mental health, physical health and the economy, we could have taken a more strategic approach to closing businesses and keeping people at home.

t many doctors say they were crucial at the start of the pandemic to give doctors and hospitals a chance to figure out how to accommodate and treat the avalanche of very sick patients.

The measures reduced deaths, according to many studies—but at a steep cost.

The lockdowns didn’t have to be so harmful, some scientists say. They could have been more carefully tailored to protect the most vulnerable, such as those in nursing homes and retirement communities, and to minimize widespread disruption.

Lockdowns could, during Covid-19 surges, close places such as bars and restaurants where the virus is most likely to spread, while allowing other businesses to stay open with safety precautions like masking and ventilation in place.  

If England’s March 23, 2020, lockdown had begun one week earlier, the measure would have nearly halved the estimated 48,600 deaths in the first wave of England’s pandemic

If the lockdown had begun a week later, deaths in the same period would have more than doubled

The key isn’t to have the lockdowns last a long time, but that they are deployed earlier,

It is possible to avoid lockdowns altogether. Taiwan, South Korea and Hong Kong—all countries experienced at handling disease outbreaks such as SARS in 2003 and MERS—avoided lockdowns by widespread masking, tracking the spread of the virus through testing and contact tracing and quarantining infected individuals.

Had we known that even a mild case of Covid-19 could result in long Covid and other serious chronic health problems, we might have calculated our own personal risk differently and taken more care.

Early in the pandemic, public-health officials were clear: The people at increased risk for severe Covid-19 illness were older, immunocompromised, had chronic kidney disease, Type 2 diabetes or serious heart conditions

t had the unfortunate effect of giving a false sense of security to people who weren’t in those high-risk categories. Once case rates dropped, vaccines became available and fear of the virus wore off, many people let their guard down, ditching masks, spending time in crowded indoor places.

it has become clear that even people with mild cases of Covid-19 can develop long-term serious and debilitating diseases. Long Covid, whose symptoms include months of persistent fatigue, shortness of breath, muscle aches and brain fog, hasn’t been the virus’s only nasty surprise

In February 2022, a study found that, for at least a year, people who had Covid-19 had a substantially increased risk of heart disease—even people who were younger and had not been hospitalized

respiratory conditions.

Some scientists now suspect that Covid-19 might be capable of affecting nearly every organ system in the body. It may play a role in the activation of dormant viruses and latent autoimmune conditions people didn’t know they had

 A blood test, he says, would tell people if they are at higher risk of long Covid and whether they should have antivirals on hand to take right away should they contract Covid-19.

If the risks of long Covid had been known, would people have reacted differently, especially given the confusion over masks and lockdowns and variants? Perhaps. At the least, many people might not have assumed they were out of the woods just because they didn’t have any of the risk factors.

Three years since its start we are still more likely to see the pandemic in partisan rather than world-historical terms. And the grandly tragic story of the pandemic takes on a profoundly different shape and color depending on the nature of its first act.

In a world where a natural origin was confirmed beyond all doubt, we might look back and narrate the pandemic as one particular kind of story: a morality tale showcasing the incomplete triumph of modern civilization and the enduring threats from nature, and highlighting the way that, whatever we might have told ourselves in 2019 or 2009 about the fortress of the wealthy world, pandemic disease remained a humbling civilization-scale challenge no nation had very good answers for.

in a world where a lab-leak origin had been confirmed instead, we would probably find ourselves telling a very different set of stories — primarily about humanity’s Icarian hubris, or perhaps about scientists’ Faustian indifference to the downside risks of new research, or the way in which very human impulses to cover up mistakes and wrongdoing might have compounded those mistakes to disastrous global effect.

It would have been, “We brought this on ourselves.” Or perhaps, if we were feeling xenophobic rather than humbly human, “They brought this on us,”

the pandemic would probably have joined nuclear weapons as a conventional illustration of the dark side of human knowledge, perhaps even surpassed them — 20 million dead is nothing to trifle with, after all, though it remains less than the overall death toll of World War II or even the Great Leap Forward.

the horror would also offer a silver lining: If human action was responsible for this pandemic, then in theory, human action could prevent the next one as well.

if the figures are even mostly reliable, they reflect a remarkable indifference on the part of the country to the source of a once-in-a-century disease disaster

It is as though we’ve decided both that the pandemic was “man-made” and that its emergence was a kind of inevitability we can’t do much about.

a definitive confirmation of a lab origin probably would not mean that responsibility lay in any simplistic way with China. But that isn’t to say the case wouldn’t have been made, probably in a variety of forms — calls for “reparations,” demands for global provision of free vaccines — that would only have contributed additional antagonism and resentment to the world stage, further polarizing the great-power landscape.

It would be as though following a catastrophic earthquake, we didn’t bother to sort out whether it had been caused by local fracking but instead argued endlessly about the imperfections of disaster response

as we piece together a working history of the past few years, you might hope we’d grow more focused on nailing the story down.

it seems likely to me that in the very earliest days of 2020, with cases exploding in China but not yet elsewhere, knowing that the disease was a result of gain-of-function research and had escaped from a lab probably would have produced an even more significant wave of global fear

n a world where neither narrative has been confirmed, and where pandemic origins are governed by an epistemological fog, I worry we have begun to collate the two stories in a somewhat paradoxical and self-defeating way

presumably, many fewer people contemplating the initial news would’ve assumed that the outbreak would be largely limited to Asia, as previous outbreaks had been; public health messengers in places like the United States probably would not have so casually reassuring; and even more dramatic circuit-breaking responses like a monthlong international travel ban might’ve been instituted quite quickly

As the pandemic wore on, I suspect that effect would have lingered beyond the initial panic. At first, it might’ve been harder to decide that the virus was just something to live with if we knew simultaneously that it was something introduced to the world in error.

And later, when the vaccines arrived, I suspect there might have been considerably less resistance to them, particularly on the American right, where anxiety and xenophobia might have trumped public-health skepticism and legacy anti-vaccine sentiment

the opposite counterfactual is just as illuminating

The question and its unresolvability have mattered enormously for geopolitics,

it is hard to think “superbug” and not panic.

The disease and global response may well have accelerated our “new Cold War,” as Luce writes, but it is hard to imagine an alternate history where a known lab-leak origin didn’t move the world there much faster.

On the other hand, the natural logic of a confirmed zoonotic origin would probably have been to push nations of the world closer together into networks of collaboration and cooperation

the direction of change would have most likely been toward more integration rather than less. After all, this is to some degree what happened in the wake of the initial outbreaks of SARS and MERS and the Ebola outbreaks of the past decade.

Instead, the geopolitics remain unsteady, which is to say, a bit jagged

The United States can weaponize a narrative about lab origin — as China hawks in both the Trump and Biden administrations have repeatedly done — without worrying too much about providing real proof or suffering concrete backlash.

And China can stonewall origin investigations by citing sovereignty rights and a smoke screen story about the disease originating in frozen food shipped in from abroad without paying much of an international price for the intransigence or bad-faith argumentation, either.

each has carried forward a gripe that needn’t be substantiated in order to be deployed.

ambiguity also offers plausible deniability, which means that without considerably more Chinese transparency and cooperation, those pushing both stories will find themselves still making only probabilistic cases. We’re probably going to be living with that uncertainty, in a political and social world shaped by it, for the foreseeable future

In the 1960s fantasyland goes into overdrive. Psychedelics, academic scholarship and the New Age movement conspire to make reason and reality the realms of idiots and squares.

After the Kennedy assassinations, conspiracy theories become not just a fringe hobby but a “permanent feature of the American mental landscape.” U.F.O. sightings explode, and the stories become ever more elaborate

In the meantime, a kind of comfort with small fibs settles into the populace. When Andersen was young, he recalls, it was rare to see a woman over 50 whose hair was not gray or white. And apparently there were only eight plastic surgeons in all of Manhattan. But the market for hair color and plastic surgery explodes, as America starts writing its “national fiction of permanent youthfulness.”

the most persistent thread in “Fantasyland” is Christianity — the astounding number of Americans who believe in heaven and angels, which most of Europe gave up decades ago

Andersen reserves a starring role for the secular spiritualists. They were supposed to be a counterpoint to narrow-minded evangelicals, but Andersen says the New Agers committed an even greater sin than the faithful. What Anne Hutchinson started, Gestalt therapy finished off in the ’60s. Fritz Perls, a psychotherapist and Gestalt founder, simply put it: “I do my thing and you do your thing. I am not in this world to live up to your expectations, and you are not in this world to live up to mine.” Or put more simply: You do you.

If there’s a flaw in this book, it’s repetitiveness. Andersen seems by nature a collector. He goes for wide rather than deep. So he doesn’t examine, for example, how we would separate the junk from the gems

What we Americans need, it would seem, is something more powerful. A story to end all stories, preached by someone with the fire of Anne Hutchinson. A collective delusion so seductive that it will have us all, in Locke-step, bowing down to reason and reality.

our real progenitors were the Puritans, who passed the weeks on the trans-Atlantic voyage preaching about the end times and who, when they arrived, vowed to hang any Quaker or Catholic who landed on their shores. They were zealots and also well-educated British gentlemen, which set the tone for what Andersen identifies as a distinctly American endeavor: propping up magical thinking with elaborate scientific proof.

In Andersen’s telling, you can easily trace the line from the self-appointed 17th-century prophet Anne Hutchinson to Kanye West: She was, he writes, uniquely American “because she was so confident in herself, in her intuitions and idiosyncratic, subjective understanding of reality,” a total stranger to self-doubt.

As he explains in what must have been an alarmingly self-confirming last chapter: Donald Trump is “stupendous Exhibit A” in the landscape of “Fantasyland,” a fitting leader for a nation that has, over the centuries, nurtured a “promiscuous devotion to the untrue.”

easy money. In an eye-opening new book, “What Went Wrong With Capitalism,” he makes a convincing case.

“When the price of borrowing money is zero,” Sharma told me this week, “the price of everything else goes bonkers.”

To take just one example: In 2010, as the era of ultralow and even negative interest rates was getting started, the median sale price for a house in the United States hovered around $220,000. By the start of this year, it was more than $420,000.

Nowhere has inflation (in the broad sense of the term) been more evident than in global financial markets. In 1980 they were worth a total of $12 trillion — equal to the size of the global economy at the time. After the pandemic, Sharma noted, those markets were worth $390 trillion, or around four times the world’s total gross domestic product.

But the worst hit is to capitalism itself: a pervasive and well-founded sense that the system is broken and rigged, particularly against the poor and the young. “A generation ago, it took the typical young family three years to save up to the down payment on a home,” Sharma observes in the book. “By 2019, thanks to no return on savings, it was taking 19 years.”

First, there was inflation in real and financial assets, followed by inflation in consumer prices, followed by higher financing costs as interest rates have risen to fight inflation

For wealthier Americans who own assets or had locked in low-interest mortgages, this hasn’t been a bad thing. But for Americans who rely heavily on credit, it’s been devastating.

Since investors “can’t make anything on government bonds when those yields are near zero,” he said, “they take bigger risks, buying assets that promise higher returns, from fine art to high-yield debt of zombie firms, which earn too little to make even interest payments and survive by taking on new debt.”

The hit to the overall economy comes in other forms, too: inefficient markets that no longer deploy money carefully to their most productive uses, large corporations swallowing smaller competitors and deploying lobbyists to bend government rules in their favor, the collapse of prudential economic practices.

“The most successful investment strategy of the 2010s,” Sharma writes, citing the podcaster Joshua Brown, “would have been to buy the most expensive tech stocks and then buy more as they rose in price and valuation.”

In theory, easy money should have broad benefits for regular people, from employees with 401(k)s to consumers taking out cheap mortgages. In practice, it has destroyed much of what used to make capitalism an engine of middle-class prosperity in favor of the old and very rich.

The social consequence of this is rage; the political consequence is populism.

“He promised to deconstruct the administrative state but ended up adding new rules at the same pace as his predecessor — 3,000 a year,” Sharma said of Trump. “His exercise of presidential authority to personal ends shattered historic precedents and did more to expand than restrict the scope of government. For all their policy differences, both leading U.S. candidates are committed and fearless statists, not friends of competitive capitalism.”

We are wandering in fog. And the precipice is closer than we think.