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The economic and social costs of the Chinese strategy have climbed with the rise of more easily transmitted variants. Retail sales, tourism and manufacturing have suffered from residential lockdowns, business closures and travel bans. A population that largely supported zero-Covid measures early on has tired of tight limits on the routines of daily life.

Her food is running low, she said. On Monday, Ms. Wang got her first food delivery from the government: two zucchini, a carton of milk, 10 sausages, noodles and a can of Spam. “As someone who hasn’t been infected by the virus, my biggest question is, ‘How long do we have to endure such lack of freedom?’ ” she said.

Before the latest outbreak, Mr. Xi and other top officials saw Shanghai as a model for China’s long-term goal of living with the virus, according to the people close to government decision-making. 

Shanghai, run by a close ally of Mr. Xi, never had serious problems. The few cases that had surfaced in the past two years were secured with limited apartment and neighborhood closures. Unlike the rest of China, mask-wearing wasn’t widely adopted by city residents.

in undisclosed comments to members of the Politburo Standing Committee, Mr. Xi made clear that China couldn’t back down from its stringent Covid approach, even if it meant slower economic growth, according to a person close to decision-making who was briefed on the remarks.

Then an influx of visitors arrived from Hong Kong, hoping to escape an outbreak there. Many stayed at a Shanghai hotel where officials say the virus spread in early March to the staff and beyond. At the time, city authorities said wide-ranging lockdowns wouldn’t be necessary.

A few days later, Shanghai initiated a two-stage lockdown. Speaking at a teleconference with other infectious-disease experts around that time, Mr. Wu, China CDC’s chief epidemiologist, said Shanghai didn’t act decisively enough in the latest outbreak and missed its chance to control the outbreak,

In Shanghai, people with Covid-19 are confined to home, and access to medical care for those with other illnesses has been limited. Food deliveries, arranged by local authorities, have been delayed in some neighborhoods, according to interviews with more than a dozen residents.

Local officials have reported no Covid-related fatalities. The Journal learned that at least two elder-care hospitals have been battling an outbreak, with more than 20 deaths at one of the facilities.

Thousands of users of Weibo, China’s Twitter-like social media platform, have shared stories of people with life-threatening illnesses such as cancer unable to get treatment, adding to citywide feelings of helplessness.

“Fighting all the previous variants was like putting out a forest fire, it can be done,” said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. “But Omicron is like the wind. How do you stop the wind?”

The government says it will get the Royal Navy to police the seas and send applicants away, reportedly to be processed in Ghana or Rwanda. None of that bluster survived the briefest encounter with reality.

This week the Tories took credit for the fact that Britain has the fastest annual growth rate in the G7 and that output regained its pre-pandemic level in November, ahead of forecasts. But they have not grappled with Brexit’s probable long-term hit to productivity, of about 4%.

unveiled plenty of big economy-boosting ideas, including levelling up prosperity across Britain, tearing down planning restrictions and making Britain a science superpower.

To get Brexit done, Mr Johnson agreed on a customs border in the Irish Sea and then proceeded to pretend he hadn’t.

He argued that Britain would escape the regulatory straitjacket of the European Union, but he has avoided doing much deregulating—which, however swashbuckling it sounds in a headline, tends in real life to be unpopular.

Mr Johnson has crumbled because he repeatedly failed to tell the truth to Parliament and the nation about Downing Street’s bacchanals.

almost half of Conservative Party members still believe that Mr Johnson’s account of Number 10’s revels is true, compared with just 13% of all voters in a poll published a few days earlier.

the excesses of Partygate have shown that the post-Brexit Tory party has lost touch with reality.

It is a strength of the parliamentary system that MPs can bring about a rapid change of direction. If the Conservative Party is to find its way, it will need a new leader. If reforms are to take root, they will need detailed planning and sustained application.

and he refused.

Wednesday was like no day I can recall in the history of the court, opening as it did with a “joint statement” released by Gorsuch and Sotomayor in which the two announced that the “reporting that Justice Sotomayor asked Justice Gorsuch to wear a mask surprised us. It is false. While we may sometimes disagree about the law, we are warm colleagues and friends.”

“I did not request Justice Gorsuch or any other Justice to wear a mask on the bench,” and further affirmed that Roberts would have no additional comment. In other words, everyone has clarified that Gorsuch refuses to mask, that Sotomayor cannot come to court, and that nobody has asked him to do otherwise, but also that there is nothing to see here, kindly move along.

as NPR stands behind its story, conservatives claim that NPR is lying, and liberals claim that the issue isn’t who said what, so much as one justice refusing to make the workplace safe for a colleague.

Mike Davis—a minor player in the push to confirm Donald Trump’s judges and, more importantly, a former clerk and current friend of Gorsuch. Davis criticized the NPR story on Fox News on Wednesday. He was quick to condemn Ruth Marcus at the Washington Post and Nina Totenberg at NPR for, he claimed, intentionally spreading misinformation to smear Gorsuch.

whether Gorsuch is a monster or a libertarian hero is kind of unknowable without more information and also kind of irrelevant. I just wanted the court to tell us what their public health rules were, and when, and if the justices declined to abide by their own rules, to explain why.

The Supreme Court spent a bunch of money to upgrade the air filtration system, and for months, all nine Justices sat through these oral arguments, eight of them without masks. It was not an issue. Justice Sotomayor wore a mask, the other eight didn’t. And so two Fridays ago for some reason, the science somehow changed for the two COVID [mandate] cases, and Gorsuch didn’t want to play along with that. He wasn’t going to play politics. So he continued to do what he did for the prior months and not wear his mask.

Gorsuch believes that to wear a mask in January if you were not wearing one in November is to “play politics,” rather to respond directly to the evolving situation that is the coronavirus pandemic. Which means, one must also infer, that Justices like Sam Alito and Clarence Thomas are “playing politics” by wearing masks now when they didn’t do so before. This is deeply strange not just because it denies that “the science changed” around omicron (it did). It’s deeply strange in that he expressly links the change in the court’s masking policy to the public oral arguments in the vaccine-or-test cases, suggesting that the two are somehow related, rather than simply coinciding in time.

His argument, ostensibly on behalf of Gorsuch—that the decision of justices to don masks this month is all gratuitous virtue signaling about an imaginary spike in a pandemic that coincides with oral arguments on the topic—is actually one of the most damning things I’ve read all week. He isn’t saying Gorsuch wants to infect his colleague. He seems to be saying that, the science notwithstanding, masks don’t make a lick of difference and everyone aside from himself is buckling to the creeping evil of the Fauci state.

Imagine if everyone had simply put on a mask for a few weeks, not because the science was perfect, but out of respect for a colleague they loudly claim to adore.

Gorsuch still isn’t wearing a mask, and Sotomayor is still phoning in from the safety of her chambers. Call it “playing politics,” but in another time, demonstrating out of an abundance of caution some regard for your colleagues’ health—without being asked—would have merely been “leadership,” or “empathy,” or even “humility.”  That other time is long gone. We are all of us scorpions in a bottle now.

President Biden first announced the rules in September as part of a broader strategy from his administration to combat the spread of the Delta variant, which drove a surge of infections toward the end of the summer. 

The Supreme Court was asked to intervene last month and swiftly held oral arguments to weigh the emergency requests.

"As a result of the court's decision, it is now up to states and individual employers to determine whether to make their workplaces as safe as possible for employees, and whether their businesses will be safe for consumers during this pandemic by requiring employees to take the simple and effective step of getting vaccinated," Mr. Biden said. "The court has ruled that my administration cannot use the authority granted to it by Congress to require this measure, but that does not stop me from using my voice as president to advocate for employers to do the right thing to protect Americans' health and economy."

The Biden administration estimated that more than 80 million employees could be impacted by the policy.

The Supreme Court received more than a dozen requests for emergency action in cases challenging the requirement after the 6th U.S. Circuit's ruling, with business associations, Republican-led states and private businesses covered by the rule arguing OSHA lacked the power to issue the vaccine requirement.

"Permitting OSHA to regulate the hazards of daily life — simply because most Americans have jobs and face those same risks while on the clock — would significantly expand OSHA's regulatory authority without clear congressional authorization," the court said.

The second rule examined by the Supreme Court was issued by the Centers for Medicare and Medicaid Services (CMS) in November and laid out vaccine requirements for staff at a wide range of facilities that participate in Medicare and Medicaid. The requirement does not have a daily or weekly testing option for unvaccinated workers, but does include medical and religious exemptions.

. Then, in a separate case brought by 14 states, a federal district court in Louisiana blocked the rule from taking effect nationwide, but the 5th Circuit narrowed the scope of the order to the 14 states that together sued the Biden administration. 

"After all, ensuring that providers take steps to avoid transmitting a dangerous virus to their patients is consistent with the fundamental principle of the medical profession: first, do no harm," the Supreme Court said.

"The omnibus rule is undoubtedly significant — it requires millions of healthcare workers to choose between losing their livelihoods and acquiescing to a vaccine they have rejected for months. Vaccine mandates also fall squarely within a state's police power, and, until now, only rarely have been a tool of the federal government," Thomas wrote. "If Congress had wanted to grant CMS authority to impose a nationwide vaccine mandate, and consequently alter the state-federal balance, it would have said so clearly. It did not."

It’s working and it looks normal. We are thrilled, but we don’t know what tomorrow will bring us. This has never been done before

Last year, some 41,354 Americans received a transplanted organ, more than half of them receiving kidneys,

But there is an acute shortage of organs, and about a dozen people on the lists die each day. Some 3,817 Americans received human donor hearts last year as replacements, more than ever before, but the potential demand is still higher.

Researchers hope procedures like this will usher in a new era in medicine in the future when replacement organs are no longer in short supply for the more than half a million Americans who are waiting for kidneys and other organs.

He is also being monitored for infections, including porcine retrovirus, a pig virus that may be transmitted to humans, although the risk is considered low.

But he added that there were many hurdles to overcome before such a procedure could be broadly applied, noting that rejection of organs occurs even when a well-matched human donor kidney is transplanted.

It takes a long time to mature a therapy like this.”

Mr. Bennett decided to gamble on the experimental treatment because he would have died without a new heart, had exhausted other treatments and was too sick to qualify for a human donor heart, family members and doctors said.

Mr. Bennett is still connected to a heart-lung bypass machine, which was keeping him alive before the operation, but that is not unusual for a new heart transplant recipient, experts said.

The new heart is functioning and already doing most of the work, and his doctors said he could be taken off the machine on Tuesday. Mr. Bennett is being closely monitored for signs that his body is rejecting the new organ, but the first 48 hours, which are critical, passed without incident.

It is the first successful transplant of a pig’s heart into a human being. The eight-hour operation took place in Baltimore on Friday, and the patient, David Bennett Sr. of Maryland, was doing well on Monday, according to surgeons at the University of Maryland Medical Center.

Xenotransplantation, the process of grafting or transplanting organs or tissues from animals to humans, has a long history. Efforts to use the blood and skin of animals go back hundreds of years.

In the 1960s, chimpanzee kidneys were transplanted into some human patients, but the longest a recipient lived was nine months.

In 1983, a baboon heart was transplanted into an infant known as Baby Fae, but she died 20 days later.

Two newer technologies — gene editing and cloning — have yielded genetically altered pig organs less likely to be rejected by humans.

the time to carry out better screening for infectious diseases, and the possibility of a new organ at the time that the patient needs it.

The heart transplanted into Mr. Bennett came from a genetically altered pig provided by Revivicor, a regenerative medicine company based in Blacksburg, Va.

The pig had 10 genetic modifications. Four genes were knocked out, or inactivated, including one that encodes a molecule that causes an aggressive human rejection response.

A growth gene was also inactivated to prevent the pig’s heart from continuing to grow after it was implanted,

In addition, six human genes were inserted into the genome of the donor pig — modifications designed to make the porcine organs more tolerable to the human immune system.

The team used a new experimental drug developed in part by Dr. Mohiuddin and made by Kiniksa Pharmaceuticals to suppress the immune system and prevent rejection.

“The anatomy was a little squirrelly, and we had a few moments of ‘uh-oh’ and had to do some clever plastic surgery to make everything fit,”

“the heart fired right up” and “the animal heart began to squeeze.”

He said his father had had a pig’s valve inserted about a decade ago, and he thought his father might be confused. But after a while, Mr. Bennett said, “I realized, ‘Man, he is telling the truth and not going crazy. And he could be the first ever.’”

“Don’t, don’t, don’t, don’t,” Mr. Trump said, waving his arm to dismiss the naysayers and downplaying the size of the reaction by pointing to what he said was “a very tiny group over there.”

micron is now the dominant version of new coronavirus cases in the United States, according to the Centers for Disease Control and Prevention.

Vaccinated people without booster shots are believed to be more vulnerable to infection by Omicron, and government officials nationwide say boosters are the best response to the new variant.

Just before the booing, Mr. Trump said that his supporters should get vaccinated because, he suggested, unwillingness to do so represented a victory for liberals. “What we’ve done is historic,” he said of the three Covid vaccines in use in the United States that were developed while he was in office. “Don’t let them take away, don’t take it away from ourselves. You’re playing right into their hands when you sort of like, ‘oh, the vaccine.’”

You shouldn’t be forced to take it, no mandates. But take credi

citing the high number of Austrians who had refused to get a shot and the divisive political climate that supported them.

the lead-time of several months was needed to prepare for the mandate, including clarifying the legal situation.

will last for at least 10 days and affect both vaccinated and unvaccinated people.

A handful of countries in Asia have imposed mandatory vaccinations against coronavirus for their adult populations

Current rates of vaccinations, albeit among the highest in the world, have not been enough to prevent a surge of infections as winter sets in and more people remain indoors.

Most inoculated people have been protected from hospitalization in intensive-care units and death from the virus.

Most of the advisory panel argued that the potential benefits of a fourth dose outweighed any risks,

Also Monday, the Israeli Health Ministry formally accepted another of the recommendations of the advisory board, shortening the period between administering a third booster shot after the second vaccine to three months from five months

Most of Israel’s population has received at least two doses, but about a million eligible citizens have not yet received a third booster shot, out of a total population of nine million.

Yet as more departments in recent weeks have considered requiring members to be vaccinated, officers and their unions have loudly pushed back,

“It’s a huge challenge, and I think mayors throughout the country are balancing the safety imperatives of responding to 911 calls against the safety imperatives of having a vaccinated work force,

Still, proponents of the mandate have noted that there were risks to the public in not requiring the shots.

Health departments generally do not publish vaccination data by occupation, but some cities have released figures showing that police department employees have been vaccinated at lower rates than most other government workers,

But some officials theorized that the daily dangers of police work may also make an invisible virus seem less of a hazard,

a vast majority of Americans hospitalized with or dying from Covid-19 are unvaccinated.

For more than a year, the chief has made daily phone calls to sick officers and delivered meals to officers in quarantine. When outbreaks have spread through his department, he has reshuffled schedules and asked officers to work overtime.

in the early 1340s, the disease had struck China, India, Persia, Syria and Egypt.

They know that the bacillus travels from person to person pneumonically, or through the air, as well as through the bite of infected fleas and rats.

The Black Death was terrifyingly, indiscriminately contagious

Today, scientists understand that the Black Death, now known as the plague, is spread by a bacillus called Yersina pestis.

However, Europeans were scarcely equipped for the horrible reality of the Black Death.

Not long after it struck Messina, the Black Death spread to the port of Marseilles in France and the port of Tunis in North Africa

Then it reached Rome and Florence, two cities at the center of an elaborate web of trade routes.

Today, this grim sequence of events is terrifying but comprehensible

No one knew exactly how the Black Death was transmitted from one patient to another, and no one knew how to prevent or treat it

Meanwhile, in a panic, healthy people did all they could to avoid the sick

Because they did not understand the biology of the disease, many people believed that the Black Death was a kind of divine punishment – retribution for sins against God such as greed, blasphemy, heresy, fornication and worldliness.

some South African scientists have pointed out that the travel ban may also be hampering the race to learn more about Omicron by blocking supplies of the reagents they need to study it.

Partly because of this South Africa was, until recently, recording less than one-tenth as many daily covid cases as Britain. “It boggles the mind that people in the United Kingdom can pile into a full football stadium and in the United States it appears as though it’s business as usual, but as soon as something happens on African soil, those countries go into a hysterical tailspin,”

The new travel restrictions will wallop the region’s tourism industry, just as hotels, game reserves and wine estates were preparing for their busiest months of the year

Because of the drop in tourism and the imposition of lockdowns the economy shrank by about 6% last year. Thousands of small businesses collapsed

The ripples may spread far beyond southern Africa to countries such as Kenya and Uganda that do not yet face travel restrictions.

South Africa’s health workers are gearing up for another December of mayhem as covid’s fourth wave washes over the country.

The emergence of Omicron, which seems to spread easily, will probably upset those estimates. “It looks like it's spreading quickly but there’s so much that’s unknown, specifically if it will evade the vaccines and its severity,”

the weird thing is the way that it infects attitudes on issues that don’t actually involve wokeism but are seen as woke-adjacent.

The now-classic example is the way hostility to mask mandates, which were mainly about protecting others, turned into highly partisan opposition to Covid vaccination, which is mainly about protecting yourself.

The same thing, I’d argue, applies to energy policy. At this point, investing in renewable energy is simply a good business proposition; Texas Republicans have had to abandon their own free-market, anti-regulation ideology in the effort to strangle wind and solar powe

But renewable energy is something environmentalists favor; it’s being promoted by the Biden administration. So in the minds of Texas right-wingers the wind has become woke, and wind power has become something to be fought even if it hurts business and costs the state both money and jobs.

In an ideal epidemiological scenario, everyone would willingly deploy the full arsenal of COVID precautions, such as masking and forgoing crowded indoor activities, especially during waves. But that kind of all-out response no longer makes sense. “It’s probably not realistic to expect people to take precautions every time, perpetually, or even every winter or fall, unless there is a particularly concerning reason to do that,

when so few people feel that the potential benefit of dodging an infection is worth the inconvenience of precautions, what does it even mean to care about COVID?

people over 50 account for 93 percent of COVID-related deaths in the U.S., even though they represent just 35.7 percent of the population. As long as the death rate remains as high as it is, caring about COVID should mean orienting precautions to protect them.

Barring another Omicron-esque event, we thankfully won’t ever return to a moment where Americans obsess over COVID en masse. But this virus isn’t going away, so we can’t escape having a population that is split between the high-risk minority and the low-risk majority

Right now, Nuzzo told me, the language we use to describe one’s position on COVID is “black-and-white, absolutist—you either care or you don’t.” There is space between those extremes. At least for now, it’s the only way to compromise between the world we have and the world we want.

Black mortality was 65 percent higher and Hispanic mortality 75 percent higher.

at least in Ohio and Florida, despite what seemed at the time to be almost unbridgeable divides over things like mask wearing and school closures, social distancing and lockdowns, the excess mortality gap between Republicans and Democrats in the pre-vaccine phase of the pandemic was relatively small, with Republican excess mortality only 22 percent higher than the death rate among Democrats.

The country clearly stumbled in 2020. And yet before vaccines were widely available, and when we tried to slow the spread of the disease through behavioral measures, the scale of the failure was relatively small compared with what followed in the years after.

In 2020, American death rates and excess mortality fell merely at the worse end of its peer countries — above Germany and barely France but below Britain, Italy and Spain, for instance

In the vaccine era of the pandemic, American performance has been much worse, with our death rates becoming much more conspicuous and dramatic outliers — enough to make the country by far the worst performing of its peers.

Overall — from the beginning of the pandemic until the arrival of Omicron — Republican excess mortality in Ohio and Florida was 76 percent higher than Democratic excess mortality.

only 62 percent of Republicans have completed their primary vaccinations, compared with 87 percent of Democrats.

income and education tell a similar story: Only 67 percent of Americans with household incomes below $40,000 have completed their primary vaccinations, compared with 85 percent with household incomes above $90,000

What does this all mean for the next pandemic fall and winter? Well, thankfully, the racial and ethnic gaps around vaccination have almost entirely closed, which is one major reason the mortality gap has, too: According to Kaiser, 74 percent of Black and Hispanic Americans have been vaccinated, compared with 77 percent of whites

The demographic gaps for boosters are slightly larger: 50 percent of white adults have been boosted, according to Kaiser, compared with 43 percent of Black adults and 40 percent of Hispanic adults. (Only 31 percent of Republicans have been boosted.)

while the news from Europe isn’t especially reassuring, it would probably take an Omicron-like curveball to deliver a new American peak like those we experienced each of the previous two winters, and there does not seem to be anything like that on the horizon.

But according to The Times’s global vaccination tracker, Americans are doing almost exactly as poorly with boosters as we did with the first round of vaccines, not worse. The country ranks 66th globally in the share of population that has completed a primary vaccination course. For a first booster, it ranks 71s

One set of answers is implied by the story of vaccination and mortality by race, and the way improvements on one measure changed the trajectory of the other: more first shots and more boosting. This is the central strategy offered by the Biden administration. But the vaccinated share of the country has barely grown in months, and the uptake of next generation bivalent boosters looks, in the early stages, quite abysmal.

yet Americans are still dying at an annualized rate above 100,000 — a rate that may well grow as we head deeper into the fall. What are we doing about that?

another possible set of responses suggests itself too, one that wouldn’t require a reversal of vaccination trends or a transformation of the pandemic culture war either: an approach to public health infrastructure, both literal and legal, that would reduce spread through background interventions without meaningfully burdening individual Americans at all.

in a perverse way the arrival of vaccines seemed to almost retire them from public discussion. They include better ventilation in public buildings, particularly schools

Testing could help, too, of course, though culturally it seems to have been dumped into a bucket with masks, as an individual tool and individual burden, rather than one with investments in ventilation improvements, as part of an invisible Covid-mitigating infrastructure

Over the last six months, an individual risk approach to Covid has predominated — both at the level of public health guidance and for most individuals navigating the new, quasi-endemic landscape

This argument is unhelpful, not just because it is needlessly toxic but also because the terms themselves are inadequate. One of the lessons of that early phase of the pandemic, and especially its racial disparities, is that mitigation is not strictly a matter of individual risk management. Spread matters, too, as do structural factors. We have tools to help both, without returning the country psychologically to the depths of Covid panic.

And although the partisan gap grew with the arrival of vaccines, it never grew as large as the racial gap had been in early 2020. In 2021, Republican excess mortality in those two states was at its highest, compared to Democratic levels: 153 percent. At the peak of racial disparity in the pandemic’s first wave, Black Americans were dying more than three times as much as white Americans.

structural factors — not only race but class and education, too — appear to loom just as large, complicating any intuitive model of what went wrong here that emphasizes the pandemic culture war above all else.

Especially in the initial phases of spread, it can be hard to disentangle the effects of policy and behavioral response from somewhat random drivers like where the virus arrived first, what sorts of places those were and what kinds of people populated them, and even what the weather was like

This dynamic changed almost on a dime with the introduction of vaccines, with an enormous gap opening up between Democrats and Republicans in 2021

the excess mortality data collected here suggests that however self-destructive red states and Republican individuals seemed to be, in 2020, the ultimate cost of that recklessness was less dramatic.

For Americans without college degrees, the number is also 67 percent, compared with 85 percent of college graduates. For uninsured adults under 65, it is just 60 percent

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Sometimes these things just take a little time.

Those criteria aren’t perfect. Given how the virus has evolved, even, say, an 85 percent vaccination rate probably wouldn’t have squelched the virus in a way public-health experts were envisioning in 2021 (and wouldn’t have absolved us of booster maintenance). And even if the death toll slipped below 100 deaths a day, the virus’s chronic effects would still pose an immense threat

“I’m not sure we ever set any goals at all” to designate when we’d have the virus beat, Céline Gounder, an infectious-disease physician at NYU and an editor-at-large for public health at Kaiser Family Foundation Health News, told me. And if they had been, we probably still would not have met them: Two years out, we certainly have not.

Instead, efforts to mitigate the virus have only gotten laxer. Most individuals are no longer masking, testing, or staying up to date on their shots; on community scales, the public goods that once seemed essential—ventilation, sick leave, equitable access to insurance and health care—have already faded from most discours

Should another SARS-CoV-2 variant sweep the world or develop resistance to Paxlovid, “we don’t have much in the way of a plan,” he said.

If and when the virus troubles us again, our lack of preparedness will be a reflection of America’s classically reactive approach to public health. Even amid a years-long emergency declaration that spanned national and international scales, we squandered the opportunity “to make the system more resilient to the next crisis,”

individuals are still largely being asked to fend for themselves—which means that as this emergency declaration ends, we are setting ourselves up for another to inevitably come, and hit us just as hard.

“Public interest is very binary—it’s either an emergency or it’s not,” says Saskia Popescu, an infection-prevention expert at George Mason University. With the PHEIC now gone, the world has officially toggled itself to “not.”

If anything, the reverse has been the case: responses to the pandemic sharply diverged, even within entities like the European Union, ostensibly committed to common policies.

Mercifully, it has not all been a zero-sum game. In late March 2021, 25 world leaders, including Emmanuel Macron, Johnson, Mario Draghi, Angela Merkel, Cyril Ramaphosa, Volodymyr Zelenskiy and the head of the European Council, Charles Michel, as well as the prime ministers of South Korea, Fiji, Thailand, Chile, Senegal and Tunisia – but, depressingly, missing the leaders of the US, Japan, Russia and China – issued a statement explicitly acknowledging the chain linking human and non-human lives and destinies. Invoking the multilateralist idealism of the years following the second world war that sought a reconnected world through the United Nations and agencies like the WHO, they proposed a legally binding international treaty to deal with future pandemics. Such a treaty would embody “an approach that connects the health of humans, animals and our planet”

To some extent, the raising of walls, psychological and institutional, is understandable. The instinctive reaction to contagion breaking out somewhere distant is to erect barriers against its importation

Before long, any possibility of a clear and honest understanding of the common worldwide conditions that allowed such disasters to happen, not least the biological consequences of environmental degradation, became swallowed up by this default vocabulary of competitive nationalism.

two years’ experience of the pandemic, in particular the unpredictable incidence of recurring outbreaks and viral mutations, has made the locking off of discrete zones of exclusion all but impossible. The need for an alternative, transnational approach to containment, mitigation and protection, coordinated by the WHO, has never been more urgent

This moment in world history is no less fraught for being so depressingly familiar: the immemorial conflict between “is” and “ought”; between short-term power plays and long-term security; between the habits of immediate gratification and the prospering of future generations; between the cult of individualism and the urgencies of common interest; between the drum beat of national tribalism and the bugle call of global peril; between native instinct and hard-earned knowledge

If it is a happy answer you want to the question as to which will prevail, it is probably best not to ask a historian. For history’s findings are more often than not tragic, and its boneyard littered with the remains of high-minded internationalist projects.

The appeals of idealists fill whole-page declarations in earnest broadsheets and win funds from far-sighted philanthropic foundations. But the plans and the planners are demonised by the tribunes of gut instinct as suspiciously alien, hatched by cosmopolitan elites: the work of foreign bodies.

a pro-life libertarian will recognize the humanity and dignity of both mother and child.

The entire philosophy of libertarianism depends on a healthy recognition of human dignity. A healthy libertarianism can still be individualistic, but it’s also deeply concerned with both personal virtue and the rights of others.

The difference between libertarianism and libertinism can be summed up as the difference between rights and desires. A libertarian is concerned with her own liberty but also knows that this liberty ends where yours begins

A libertine, by contrast, is dominated by his desires. The object of his life is to do what he wants, and the object of politics is to give him what he wants.

A libertarian is concerned with all forms of state coercion. A libertine rejects any attempt to coerce him personally, but he’s happy to coerce others if it gives him what he wants.

Donald Trump is the consummate libertine. He rejects restraints on his appetites and accountability for his actions. The guiding principle of his worldview is summed up with a simple declaration: I do what I want. Any movement built in his image will be libertine as well.

Trump’s movement dismisses the value of personal character. It mocks personal restraint. And it’s happy to inflict its will on others if it achieves what it wants

Libertinism says my desires are more important than your rights, and this means that libertines are terrible ambassadors for any cause that requires self-sacrifice.

I don’t think the pro-life movement has fully reckoned with the political and cultural fallout from the libertine right-wing response to the Covid pandemic

Here was a movement that was loudly telling women that they had to carry unwanted pregnancies to term, with all the physical transformations, risks and financial uncertainties that come with pregnancy and childbirth, at the same time that millions of its members were also loudly refusing the minor inconveniences of masking and the low risks of vaccination — even if the best science available at the time told us that both masking and vaccination could help protect others from getting the disease.

Even worse, many of the same people demanded that the state limit the liberty of others so that they could live how they wanted

This do-what-you-want ethos cost a staggering number of American lives. A 2022 study found that there were an estimated 318,981 vaccine-preventable deaths from January 2021 to April 2022.

Now there’s evidence from Ohio and Florida that excess mortality rates were significantly higher for Republicans than Democrats after vaccines were widely available.

It’s not just that libertinism robs Republicans of moral authority; it’s that libertinism robs Republicans of moral principle.

In each state, all the pro-life movement needed was consistent Republican support, and it would have sailed to victory. All the Democrats in the state could have voted to protect abortion rights, and they would have lost if Republicans held firm. But they did not.

“Do as I say and not as I do” is among the worst moral arguments imaginable.

A holistic pro-life society requires true self-sacrifice. It asks women to value the life growing inside of them even in the face of fear and poverty. It asks the community to rally beside these women to keep them and their children safe and to provide them with opportunities to flourish. It requires both individuals and communities to sublimate their own desires to protect the lives and opportunities of others.

An ethos that centers individuals’ desires will bleed over into matters of life and death. It did during Covid, and it’s doing so now, as even Republicans reject the pro-life cause.

The challenge is much more profound. Pro-life America has to reconnect with personal virtue. It has to model self-sacrifice. It has to show, not just tell, America what it would look like to value life from conception to natural death.

At present, however, the Republican Party is dominated by its id. It indulges its desires. And so long as its id is in control, the pro-life movement will fail. There is no selfish path to a culture of life.

World Health Organization data published in September showed there were twice as many cholera cases in 2022 than in 2021. Outbreaks were recorded in countries where cholera had been under control for years, including Yemen and Lebanon.

2. Mosquitoes on the march

Rising temperatures and frequent floods also unlock new places where disease-carrying insects thrive. The mosquitoes that carry the viruses that cause dengue fever and mala

Nor is the disease confined to developing countries. There are fears that it is spreading in southern Europe, partly owing to the warm weather. More than 8 billion people could be at risk of malaria and dengue fever by 2080, scientists have warned.

3. Human-animal contact

Many existing diseases will get more dangerous, but new illnesses could also emerge as people are increasingly forced into areas where there is wildlife. Diseases can jump from animals to humans. These diseases, such as Ebola, avian flu and Sars, are called “zoonoses” and they make up the majority of new illnesses.

Scientists have found that the climate crisis is helping to circulate diseases between species that previously did not encounter each other. As the planet heats up, many animal species are forced to move into new areas to find suitable conditions.

It has been estimated that zoonoses are responsible for as many as 2.5bn cases of human illness and 2.7m human deaths worldwide each year, and that animals have played a major part in nearly every major disease outbreak since 1970.

4. Severe weather events

Although governments are getting better at preparing for severe weather events, nine out of 10 deaths linked to weather disasters since 1970 happened in small island nations and developing countries in Africa, Asia and South America.

5. The air that we breathe

Outside air pollution has been linked to numerous cancers and diseases and is estimated to be responsible for more than 4m premature deaths globally each year.

Changing weather patterns are expected to make this already bad situation worse as more dust, rain and wildfire smoke are added to the mix. Children are especially likely to get sick from air pollution because their brains, lungs and other organs are still developing.

6. The psychological cost

Environmental deterioration has a knock-on effect on the economic and social systems that keep society productive and happy, setting in motion a downward spiral of psychological hardship.

If crops are destroyed during extreme weather events, children may get less nutritious food, the consumption of which is linked to psychological conditions such as anxiety and depression.

When people can’t get the help they need, they may self-medicate with alcohol or drugs, which in turn makes them more likely to engage in risky behaviour (such as unprotected sex) that could result in infections such as HIV, or illnesses that can result from spending time in crowded places, such as tuberculosis.

In 2021, scientists studying evidence of a potential link between heat exposure and mental health found a 2.2% increase in mental health-related mortality per 1C rise in temperature.

7. Salty water and perilous pregnancies

Drinking water is becoming saltier. One reason for this is that sea levels are rising, so there is more sea water flowing into rivers and other sources of fresh water during floods and tropical storms.

Taking in too much salt can lead to high blood pressure (hypertension). Over time, this condition damages the body’s veins, arteries and major organs (including the brain, heart, kidneys and eyes) since they’re working so much harder overall.

Hypertension is doubly dangerous for pregnant women and their babies

8. Food insecurity

More frequent and severe droughts and floods make it harder to grow the grains, fruit and vegetables that people need to eat to stay healthy. Small island states in the Caribbean, Atlantic, Pacific and Indian Ocean bear the brunt of the effects of the crisis, in part because most people live close to sea level.

As a result, people who live in one of the 39 small island nations are the most likely to die from one of the four main NCDs: cancer, diabetes, heart disease and lung disease.

9. The stress of extreme heat

The scorching temperatures this year broke records in Europe, China and North America. Heat is one of the most dangerous effects of the climate crisis and the top cause of weather-related deaths in the U

When it gets too hot, the body’s temperature rises faster than it can cool itself down, less blood flows to other organs, and the kidneys have to work harder. This puts strain on the heart and can lead to organ failure. Heatstroke is the most serious heat-related illness.

In particular, people whose jobs require long hours of physical labour in the sun face an increased risk of kidney disease as temperatures rise, research suggests. Repeated instances of heat stress can lead to permanent damage and chronic kidney disease.

In June, the Guardian revealed how young migrant workers were returning to Nepal with chronic kidney disease after working in extreme heat conditions in the Gulf and Malaysia. “One factor highlighted again and again is heat. Prolonged exposure to h

10. Millions on the move

It’s hard to predict exactly how many people will be on the move because of the climate crisis, but extreme weather events are likely to make conditions worse for the more than 100 million displaced people around the world.

If nothing changes, the number of people who need humanitarian aid to recover from floods, storms and droughts could double by 2050,

That means more than 200 million people will need aid annually. The displacement of millions of people also means cramped and often unsanitary living. For example, more than 900,000 Rohingya refugees live in makeshift shelters in Bangladesh, often built on unstable ground that’s prone to landslides.