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Scientists call these two shapes the prefusion and postfusion forms of the spike. Antibodies against the prefusion shape work powerfully against the coronavirus, but postfusion antibodies don’t stop it.

they discovered a way to keep the protein locked in a tulip-like prefusion shape. All they had to do was change two of more than 1,000 building blocks in the protein into a compound called proline.

All three of the vaccines that have been authorized so far in the United States — from Johnson & Johnson, Moderna and Pfizer-BioNTech — use the 2P spike.

Other vaccine makers are using it as well. Novavax has had strong results with the 2P spike in clinical trials and is expected to apply to the Food and Drug Administration for emergency use authorization in the next few weeks. Sanofi is also testing a 2P spike vaccine and expects to finish clinical trials later this year.

Dr. McLellan’s ability to find lifesaving clues in the structure of proteins has earned him deep admiration in the vaccine world. “This guy is a genius,” said Harry Kleanthous, a senior program officer at the Bill & Melinda Gates Foundation. “He should be proud of this huge thing he’s done for humanity.”

The potency of the vaccine brought an extra benefit: The researchers needed fewer viruses for an effective dose. A single egg may yield five to 10 doses of NDV-HXP-S, compared to one or two doses of influenza vaccines.

once Dr. McLellan and his colleagues handed off the 2P spike to vaccine makers, he turned back to the protein for a closer look. If swapping just two prolines improved a vaccine, surely additional tweaks could improve it even more.

The winner contained the two prolines in the 2P spike, plus four additional prolines found elsewhere in the protein. Dr. McLellan called the new spike HexaPro, in honor of its total of six prolines.

The structure of HexaPro was even more stable than 2P, the team found. It was also resilient, better able to withstand heat and damaging chemicals. Dr. McLellan hoped that its rugged design would make it potent in a vaccine.

the University of Texas set up a licensing arrangement for HexaPro that allows companies and labs in 80 low- and middle-income countries to use the protein in their vaccines without paying royalties.

The first wave of authorized Covid-19 vaccines require specialized, costly ingredients to make. Moderna’s RNA-based vaccine, for instance, needs genetic building blocks called nucleotides, as well as a custom-made fatty acid to build a bubble around them. Those ingredients must be assembled into vaccines in purpose-built factories.

The way influenza vaccines are made is a study in contrast. Many countries have huge factories for making cheap flu shots, with influenza viruses injected into chicken eggs. The eggs produce an abundance of new copies of the viruses. Factory workers then extract the viruses, weaken or kill them and then put them into vaccines.

In March, he joined forces with two fellow University of Texas biologists, Ilya Finkelstein and Jennifer Maynard. Their three labs created 100 new spikes, each with an altered building block. With funding from the Gates Foundation, they tested each one and then combined the promising changes in new spikes. Eventually, they created a single protein that met their aspirations.

PATH then connected the Mount Sinai team with influenza vaccine makers. On March 15, Vietnam’s Institute of Vaccines and Medical Biologicals announced the start of a clinical trial of NDV-HXP-S. A week later, Thailand’s Government Pharmaceutical Organization followed suit. On March 26, Brazil’s Butantan Institute said it would ask for authorization to begin its own clinical trials of NDV-HXP-S.

n vaccine maker Avi-Mex as an intranasal spray. The company will start clinical trials to see if the vaccine is even more potent in that form.

The W.H.O. emergency use approval allows the Sinopharm vaccine to be included in Covax, a global initiative to provide free vaccines to poor countries. The possible inclusion in Covax raises hopes that more people — especially those in developing nations — will get access to shots at a crucial moment.

“This should be the golden time for China to practice its vaccine diplomacy. The problem is, at the same time, China itself is facing a shortage,”

“The whole world is short of this vaccine,” said a Sinovac spokesman, Pearson Liu. “The demand is just too great.”

Andrea Taylor, who analyzes global data on vaccines at the Duke Global Health Institute, called the potential addition of two Chinese vaccines into the Covax program a “game changer.”

“The situation right now is just so desperate for low and lower middle income countries that any doses we can get out are worth mobilizing,” Ms. Taylor said. “Having potentially two options coming from China could really change the landscape of what’s possible over the next few months.”

China’s vaccines have been rolled out to more than 80 countries, but they have faced significant skepticism, in part because the companies have not released Phase 3 clinical trial data for scientists to independently assess the vaccines’ efficacy rates. An advisory group to the W.H.O. published the data this week.

The Sinopharm vaccine developed with the Beijing Institute of Biological Products has an efficacy rate of 78.1 percent, according to the W.H.O. advisory group.

The Sinovac vaccine has varying efficacy rates of between 50 percent to 84 percent, depending on the country where Phase 3 trials were conducted.

for China’s leaders, the W.H.O. approval can still be seen as a badge of honor. Xi Jinping, China’s top leader, has pledged to make a Covid-19 vaccine a “global public good.”

After India announced export restrictions on vaccines last month, Indonesia and the Philippines said they would turn to China for help. Last week, China’s foreign minister offered to help South Asian nations get access to vaccines.

Indonesia said it would get additional doses from Sinovac after President Joko Widodo held talks with Mr. Xi. In a speech the same week, President Rodrigo Duterte of the Philippines said he owed “a debt of gratitude” to China for its vaccines.

“They don’t like to subsume their generosity in their products under some U.N. brand,” said J. Stephen Morrison, director of the global health policy center at the Center for Strategic and International Studies. “They are in a historic phase,” he said. “They want the recipients to know that this is China delivering.”

Like in so many smaller, less-wealthy countries in the world, Uganda's primary source of vaccines is the COVAX program run by the World Health Organization, the Coalition for Epidemic Preparedness Innovations and Gavi, the Vaccine Alliance.

Wakikona says if she could choose, she'd probably take the Moderna or Pfizer-BioNTech vaccine.

But Adam Finn, a vaccine expert at the University of Bristol, says concerns about the AstraZeneca vaccine are overblown.

The role of government is to help people build the kind of family they prefer, not tell them what kind of family they should prefer. Government should be neutral about what kind of family is best.

The child tax credit will help millions of families do what surveys show they already want to do — have more kids than they can now afford, and spend more time at home.

First, getting people working. “We want parents to be in the work force, especially mothers,” said Susan Rice, head of the Domestic Policy Council. Second, the administration wants kids in classroom settings, to extend the public school system down two years. The administration is aggressively expanding child care subsidies and pre-K programs.

“It turns out that putting money directly into the pockets of low-income parents, as many other countries do, produces substantially larger gains in children’s school achievement per dollar of expenditure than does a year of preschool or participation in Head Start.”

“Because the Biden administration is trying to be all things to all people,” Wilcox emailed me, “it partially funds a number of initiatives, including the child allowance. I’d much rather see the administration cut out the money promised for pre-K and child care and fully fund a generous child allowance.”

Over the past few decades the economy has placed enormous strain on American families, forcing people to have fewer kids and spend less time with them than they would prefer. A fully generous child tax credit would give some parents a chance to step back from the job market for a few years while their kids were young — if they so chose.

A widespread view among economic policy elites, after the runaway inflation in the 1970s and early 1980s, was that elevated unemployment was a necessary cost of keeping prices stable. Also, that the government can’t spend much more money than it takes in without crowding out private investment — leaving the economy weaker over time — and that policymakers should act pre-emptively to ward off these risks.

It may not have been the best economy ever, as he has repeatedly claimed, but it was easily the strongest since the late 1990s, and before that you have to go back to the late 1960s to find similar conditions.

And the Fed cut interest rates starting in 2019 despite a very low jobless rate, implicitly accepting the premise that it had moved too aggressively with rate increases to prevent inflation that never arrived.

Yet from spring of 2018 to the onset of the pandemic, the United States experienced a jobless rate of 4 percent or lower, with no obvious sign of inflation and many signs that less advantaged workers were able to find work.

She said that a high-pressure economy — one where unemployment is low and employers have to compete for workers — improves upward mobility

Mr. Mulligan and other allies of the president emphasize the role of deregulating major industries and lowering taxes on business investment — microeconomic strategies — as crucial to the economy’s success.

The Biden administration and Democratic Congress will view more aggressive regulation as a core goal, aimed at preventing corporate misbehavior, protecting the environment, and more. Indeed, left-leaning economists would argue that the very policies Mr. Mulligan credits with the boom are the least durable parts of the Trump-era expansion.

If you believe Mr. Mulligan and other Trump allies, the macroeconomic lessons of the Trump years — those having to do with things like deficits, inflation and interest rates — won’t be enough for the Biden administration to recreate the 2019 economy. In this view, the microeconomic details of how the president has governed will be crucial, and the policies that Mr. Biden has advocated — in areas as varied as tighter restrictions on carbon emissions and more aggressive regulation of banks — will prove counterproductive to the cause.

If inflation were to remain persistently low, she said, “a more radical rethinking of the economy’s productive potential would surely be in order.”

A central question for Mr. Biden will be: To what degree is the Trump-era economic success a result of policies that liberals disagree with, to what degree is it a result of policies that Mr. Biden might embrace, and to what degree is it just luck?

Mr. Powell, who will lead the Fed for roughly the first year of Mr. Biden’s term and then will be either reappointed or replaced in February 2022, has also become a vocal enthusiast for avoiding these mistakes of the past.In the strong pre-pandemic labor market, he said in an August speech on the Fed’s new policy framework, “many who had been left behind for too long were finding jobs, benefiting their families and communities, and increasing the productive capacity of our economy.”

President-elect Biden has embraced these lessons in shaping his agenda, as he made clear in a news conference Friday where he confirmed that his plans will add up to trillions of dollars when one includes both pandemic response money and longer-term plans.“With interest rates as low as they are,” Mr. Biden said, “every major economist thinks we should be investing in deficit spending to generate economic growth.”

Pax Americana is now faced with a dilemma that European empires had to contend with before. Even as it becomes clear that nations should be weaned from foreign hegemony, the transition is almost always messy and sometimes bloody.

Apart from the risk of war, Mr. Trump’s posturing is having another serious consequence. The strength of the United States never relied only on its often-misguided use of military power. American democracy, with all its flaws, was a model, even an ideal, for much of the world. Refugees from tyranny and war continued to see the United States as a haven

This is the true end of Pax Americana, the best of it anyway. The reckless unpicking of military alliances and the betrayal of allies are already bad enough. But there is something even worse afoot. People all over the world still look to the United States as an example. But now it is the enemies of liberal values who view with glee how American leadership is wrecking the very things that Mr. Roosevelt once fought for.

a more optimistic reading might be that the current division is actually a reasonable balance. Maybe it’s fair for men to work slightly longer hours overall because work outside the home really is less grueling (and certainly less so than pregnancy and childbirth). At the same time, maybe women’s longer home-hours reflect genuine female preferences, a widespread maternal desire for part-time work, and not just the dead hand of patriarchy.

The optimists, though, have to reckon with the fact that everyone is working longer hours, notwithstanding increased wealth and technological convenience, and the presumably related fact that parents everywhere seem harassed and exhausted, while marriage and childbearing both are falling out of fashion.

the sexes have fallen into two traps together. One is what I’ve called “the one-income trap” — the way that dual-earner couples establish a norm that forces everybody to work harder to keep up, leaving couples that might prefer a single breadwinner stressed or far behind.

The other trap is one of rising child-watching expectations, reflected in the fact that the overall parental time spent on child care has nearly doubled since the 1960s

reflects anxieties specific to our era — the fear of letting kids play together out of sight, the fear of giving them unsupervised hours, the fear that some well-meaning busybody will report you to child services

Deaton and the economist Anne Case, who is also his wife, coined the term “deaths of despair” to describe the surge of mortality from alcohol, drugs and suicide.

“The meaningfulness of the working-class life seems to have evaporated,” Angus Deaton, the Nobel Prize-winning economist, told us. “The economy just seems to have stopped delivering for these people.”

Only in America has life expectancy now fallen three years in a row, for the first time in a century, because of “deaths of despair.”

Even in this presidential campaign, the unraveling of working-class communities receives little attention. There is talk about the middle class, but very little about the working class

The suffering was invisible to affluent Americans, but the consequences are now evident to all: The survivors mostly voted for Trump, some in hopes that he would rescue them

The stock market is near record highs, but working-class Americans (often defined as those without college degrees) continue to struggle. If you’re only a high school graduate, or worse, a dropout, work no longer pays.

If the federal minimum wage in 1968 had kept up with inflation and productivity, it would now be $22 an hour. Instead, it’s $7.25.

we would return to the Kristof family farm in Yamhill and see a humanitarian crisis unfolding in a community we loved — and a similar unraveling was happening in towns across the country. This was not one town’s problem, but a crisis in the American system.

“I’m a capitalist, and even I think capitalism is broken,” says Ray Dalio, the founder of Bridgewater, the world’s largest hedge fund.

One consequence is that the bottom end of America’s labor force is not very productive, in ways that reduce our country’s competitiveness

we discuss college access but not the one in seven children who don’t graduate from high school.

“We have to stop being obsessed over impeachment and start actually digging in and solving the problems that got Donald Trump elected in the first place,”

We have to treat America’s cancer.

the situation is worsening, because families have imploded under the pressure of drug and alcohol abuse, and children are growing up in desperate circumstances

In the 1970s and ’80s it was common to hear derogatory suggestions that the forces ripping apart African-American communities were rooted in “black culture.” The idea was that “deadbeat dads,” self-destructive drug abuse and family breakdown were the fundamental causes, and that all people needed to do was show “personal responsibility.

A Harvard sociologist, William Julius Wilson, countered that the true underlying problem was lost jobs, and he turned out to be right. When good jobs left white towns like Yamhill a couple of decades later because of globalization and automation, the same pathologies unfolded there.

Men in particular felt the loss not only of income but also of dignity that accompanied a good job. Lonely and troubled, they self-medicated with alcohol or drugs, and they accumulated criminal records that left them less employable and less marriageable.

Family structure collapsed.

The problems are also rooted in disastrous policy choices over 50 years

The kids on the No. 6 bus rode into a cataclysm as working-class communities disintegrated across America because of lost jobs, broken families, gloom — and failed policies.

The United States wrested power from labor and gave it to business, and it suppressed wages and cut taxes rather than invest in human capital, as our peer countries did.

Americans also bought into a misconceived “personal responsibility” narrative that blamed people for being poor.

It’s true, of course, that personal responsibility matters: People we spoke to often acknowledged engaging in self-destructive behaviors.

But when you can predict wretched outcomes based on the ZIP code where a child is born, the problem is not bad choices the infant is making.

If we’re going to obsess about personal responsibility, let’s also have a conversation about social responsibility.

Why did deaths of despair claim Farlan, Zealan, Nathan, Rogena and so many others?

First, well-paying jobs disappeared

Second, there was an explosion of drugs

Third, the war on drugs sent fathers and mothers to jail, shattering families.

Both political parties embraced mass incarceration and the war on drugs, which was particularly devastating for black Americans, and ignored an education system that often consigned the poor — especially children of color — to failing schools

Since 1988, American schools have become increasingly segregated by race, and kids in poor districts perform on average four grade levels behind those in rich districts.

Women in Recovery has a recidivism rate after three years of only 4 percent, and consequently has saved Oklahoma $70 million in prison spending,

ob training and retraining give people dignity as well as an economic lifeline. Such jobs programs are common in other countries.

For instance, autoworkers were laid off during the 2008-9 economic crisis both in Detroit and across the Canadian border in nearby Windsor, Ontario. As the scholar Victor Tan Chen has showed, the two countries responded differently

The United States focused on money, providing extended unemployment benefits. Canada emphasized job retraining, rapidly steering workers into new jobs in fields like health care, and Canadian workers also did not have to worry about losing health insurance.

The focus on job placement meant that Canadian workers were ushered more quickly back into workaday society and thus today seem less entangled in drugs and family breakdown.

Another successful strategy is investing not just in prisons but also in human capital to keep people out of prisons.

We attended a thrilling graduation in Tulsa, Okla., for 17 women completing an impressive local drug treatment program called Women in Recovery.

The graduates had an average of 15 years of addiction each, and all were on probation after committing crimes. Yet they had quit drugs and started jobs

Yet it’s not hopeless. America is polarized with ferocious arguments about social issues, but we should be able to agree on what doesn’t work: neglect and underinvestment in children. Here’s what does work.

Bravo for philanthropy, but the United States would never build interstate highways through volunteers and donations, and we can’t build a national preschool program or a national drug recovery program with private money.

For individuals trying to break an addiction, a first step is to face up to the problem — and that’s what America should do as well

The WHO estimates one out of every 10 medical products in low- and middle-income countries, which includes most of Africa, is sub-standard or fake.

Analysis by the London School of Hygiene and Tropical Medicine for the WHO estimates substandard and fake anti-malarial drugs could be causing 116,000 extra deaths from the disease every year in sub-Saharan Africa at a cost to patients and health systems of on average $38.5m a year.

Fake medicine can often be indistinguishable from the real products, with the packaging as good if not better than the original.

There's also an issue with the cost of drugs in poorer countries. "If a good quality medicine from a known supplier is too expensive, people may try a cheaper one from an unlicensed supplier," the WHO says.

it has become much tougher for either to amass a commanding Senate majority.

The fact that neither side will control more than 52 seats after Tuesday means that either party has held at least 55 Senate seats in only three congressional sessions since 2000.

some observers believe that the narrow Senate division certain to emerge from Tuesday's election will encourage a return to bipartisan deal-making, like the agreement between centrist Republican and Democratic senators that helped break the months-long stalemate over Covid economic relief legislation.

The narrow majorities have also contributed to a Senate that has grown more rigid, with much more partisan conflict and less of the ad hoc bipartisan deal-making that characterized the body through the second half of the 20th century. The Senate will mark a new high -- or low -- in its rising partisanship on Wednesday when about a quarter or more of Republican senators will vote against recognizing Democrat Joe Biden's election as president

So I think the closeness of it -- whether it's 52-48 or 50-50 or 51-49 -- is probably good for him and good for the country, because he is going to know how to deal in that type of a Senate."

almost all of the senators in both parties who had won their split-ticket victories in the 2008 and 2012 presidential races lost their seats in the next midterm elections (2014 and 2018, respectively).

other observers note that the narrow Senate majorities of recent years have, in practice, produced very few bipartisan compromises.

With control constantly at risk, the majority party faces heightened pressure for lockstep unity, while the minority party never has much incentive to help the majority burnish its record with bipartisan accomplishments that could buttress its advantage in the next election.

Whatever the results of Tuesday's Georgia elections between Republicans David Perdue and Kelly Loeffler and Democrats Jon Ossoff and Raphael Warnock, respectively, those polarizing dynamics are guaranteed to remain in force, because the party that falls into the minority now will remain close enough to immediately begin plotting how to recapture the majority in 2022

The huge Democratic Senate majorities that persisted from the late 1950s through the mid-1990s were rooted in the party's continued dominance of Senate seats from Southern states that routinely voted Republican for president, notes Sarah Binder, a senior fellow in governance studies at the Brookings Institution. But over the past generation, it has become much more difficult for either party to win Senate seats in states that usually vote the other way in presidential elections.

As recently as 2008, six Senate candidates (five Democrats and Republican Sen. Susan Collins of Maine) won election in states that supported the other side's presidential candidate. In 2012, four Democrats and Republican Dean Heller of Nevada won Senate races in states that voted the other way for president.

in 2016, for the first time since the direct election of senators around World War I, the same party won the Senate and the presidential race in every state.

the meager three majorities of 55 seats or more since 2000 represent the fewest times that any party has accumulated at least 55% of the Senate seats over a 20-year span since the turn of the 20th century, according to official Senate records.

The "return of GOP South and decline in split-ticket voting and increased nationalization of US politics generally" explains "a good amount of the decline in Senate majority margins in recent decades," notes Binder.

Over the past two presidential elections, 20 states have voted both times against Trump; Democrats now hold fully 39 of their 40 Senate seats, all but Collins' in Maine. But 25 states have voted both times for Trump, and Republicans now hold 47 of their 50 seats, all but Joe Manchin's in West Virginia, Jon Tester's in Montana and Sherrod Brown's in Ohio.

In the five states (Arizona, Georgia, Michigan, Pennsylvania and Wisconsin) that backed Trump in 2016 but switched to Biden in 2020, Democrats now hold six Senate seats and Republicans two, pending the results in Georgia

from 1981 through 2000, Democrats held at least 55 seats in four sessions, while Republicans reached that level of control in three

One party also controlled at least 55% of the Senate seats (which were fewer than 100 at that point because there were fewer states) in eight of the 10 congressional sessions from 1921 through 1940 and seven of the 10 from 1901 through 1920. Only the 1950s saw anything like today's precarious balances: While Democrats controlled at least 55% of the seats four times from 1941 to 1950, neither side reached that level through four consecutive sessions beginning in 1951, until Democrats broke through with big gains in the 1958 election.

Unless Republicans win both of Tuesday's runoffs, the party controlling the Senate will hold a majority of two seats or fewer. That would mark the fifth time since 2000 that the majority party held such a narrow advantage.

Again, the growing correlation between presidential and Senate outcomes may be a key factor in the shift. Pending the Georgia results, only three senators in each party represent states that supported the other side's presidential candidate this year. That means the vast majority of Democratic senators have a strong electoral incentive to support Biden --and the vast majority of Republican senators have a comparable incentive to oppose him.

Breaux, the former Democratic senator, believes the narrow balance of power can overcome that centrifugal pressure by providing small groups of relatively centrist deal-makers from each party the leverage to build majority legislative coalitions.

"You can form coalitions starting in the middle and then moving out on each side until you create a majority," he says.

The existence of the world’s largest vaccine manufacturer helps to establish the basis for a domestic network of suppliers.

countries could take a leaf from India’s book when it comes to manufacturing crucial items that might encounter massive demand surges, and where national priorities come to the fore

Doing so is unrealistic for every small and middle-size country, but production could be organized at the level of regional blocs such as the Association of Southeast Asian Nations. The pandemic hit Latin America harder than many other parts of the world, but its limited vaccine production means most nations there have a long wait ahead of them.

the Serum Institute was founded as and remains a private company, though it cooperates closely with the government. Establishing similar capacity could be achieved by cooperation on health-care regulation to create large regional markets, and the right financial incentives.

Criticism about the lack of clarity on the data that the regulator examined came swiftly after the two vaccines were authorized for emergency use.

has been found to be safe.”

Already the effort has faced setbacks. The Serum Institute, an Indian drug maker that struck a deal to produce the Oxford vaccine even before its effectiveness had been proven, has managed to make only about one-tenth of the 400 million doses it had committed to manufacturing before the end of the year.

The Serum Institute says it is on track to increase production of the vaccine, which is known as Covishield in India.

Initially, the Serum Institute signed a pact with AstraZeneca to make one billion doses of the vaccine for low-and-middle-income countries.

Pending approval of the vaccine by the World Health Organization, Serum will begin supplying other developing nations with doses at manufacturing cost, Mr. Sen said.

India plans to begin a vaccination campaign in the first three months of the year that will cover about one-quarter of the population by August. The first 30 million people inoculated will be health care providers, then police and other frontline workers.

India’s first mass vaccination took place in 1802, to fight smallpox. Subsequent efforts suffered from misinformation and slow acceptance.

government officials aimed information campaigns at religious leaders, helping to nearly eradicate the disease.

The government plans to use the framework of its universal immunization program for pregnant women and newborns — one of the largest and cheapest public health interventions in the world.

India may have to double the number of health workers from the current 2.5 million, said Thekkekara Jacob John, a senior virologist in the southern state of Tamil Nadu.

the pandemic increasingly looks like one of the defining events of our time. The best-case scenarios are now out of reach

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if a vaccine remains out of reach for years, the long-term changes could be truly profound. Any industry that depends on close human contact would be at risk.

Large swaths of the cruise-ship and theme-park industries might go away. So could many movie theaters and minor-league baseball teams. The long-predicted demise of the traditional department store would finally come to pass. Thousands of restaurants would be wiped out

In this scenario, a vaccine will arrive sometime in 2021. Until then, the world will endure waves of sickness, death and uncertainty.

is a loss of the gains we’ve made over the past 20 years in the access for first-generation and minority students.”

“It’s only when the tide goes out,” Warren Buffett likes to say, “that you learn who’s been swimming naked.”

Local newspapers will be one casualty. They were already struggling

Traditional department stores are another example. In recent years, they have lost significant business to online retailers and quietly lost even more to big-box stores

It could easily be the most important global experience since World War II and the Great Depression

enrollment and tuition revenue are likely to drop sharply, creating existential crises for many less selective private colleges and smaller public universities.

“The biggest danger that we face as a sector

If they do, they will create spillover victims — the hundreds of malls that rely on department stores for rent and foot traffic

for many white-collar workers, the remote-work experiment shows no sign of ending — a trend that could depress the commercial real-estate market and business travel long after a vaccine is available.

Consolidation, in turn, tends to increase income and wealth inequality, in part because the largest companies are run by highly paid executives, typically based in major metro areas, and the companies’ stock is disproportionately owned by the affluent.

“My basic fear,” Heather Boushey, a leading progressive economist, said, “is that it leads to a rule by the oligarchs.”

“Even Republicans — younger Republicans — have recognized that the center of gravity is shifting on the relationship between the state and the market.” The virus, he added, “will only accelerate that.”

That agenda is shaping up to have two defining features

The first is reducing inequality — through higher taxes on the rich, greater scrutiny of big companies, new efforts to reduce racial injustice and more investments and programs for the middle class and poor, including health care, education and paid leave

The second is acting on climate change, which could cause even more global misery than the coronavirus. “Climate change cannot be solved by the private sector,”

while Mr. Obama’s team had only a couple of months to plan for taking office amid a national crisis, Mr. Biden’s team would have almost a year. “There is a whole vision that I think is ready,” Ms. Boushey added. “And there is a lot more runway.”

If there is a single lesson of the current era of American politics, it’s that change can happen more quickly than we imagined.

the 10 countries with the highest deaths per capita were all in Latin America or the Caribbean.

deep-seated skepticism among people like Mr. Arriaga — the workers who feed Mexico City and much of the nation — turned to shock, and eventually to resignation, as their neighbors, friends and loved ones died and their neighborhood became ground zero for the outbreak.

Officials had posted signs warning of Covid-19 and urging workers to report illnesses. In the beginning, most ignored them.“I think they made it up, to raise prices on the poor,” Mr. Arriaga said of the virus in March

A new reality set in for many: A prolonged economic shutdown was clearly impossible. People could wear masks, and distance as much as possible, but almost no one could afford to stay home. They had to keep working.

For the vast majority of people, risking illness or death has simply become the price of survival.

Mr. Arriaga’s own attempts to stay away from the market lasted only a month before he blew through his life savings and trudged back to work in fear.“I’ve got nothing left,” he said on a recent weekend, bracing himself for another long night in the market. “It’s either go out there and face the virus, or sit here and starve.”

Now, Mexico has the fourth-highest death toll in the world, with more than 70,000 lives officially lost to the virus. Experts say the real number may be tens of thousands more than that.

Tomas BravoMexico City8h agoGreat article. Even living in the same city there are different realities playing out, and this gives a good insight into the stories of some of the worst struck by the pandemic. Some local media have talked of these issues, but there is an ongoing effort from the government to deny these allegations. It is nice to see a story told from the perspective of individuals through which the bigger issues that have paved the way for this crisis are highlighted

(b) we see no arguments about mask wearing in CDMX stores/areas, and witnessed concerns about customers shooting up USA grocery stories if masks are enforced,

gtodonGuanajuato, Mexico3h ago@Ignacio Colin Perhaps in your neighborhood of sprawling Mexico City, the "community is strong and doing its part." Where I live, in Guanajuato, about half the people on the streets, and even in the stores, decline to wear masks, and half of those who do wear masks don't wear them properly; they appear to think they're chin-guards. The same is true in nearby León, a much larger city. In the state of Guanajuato, only San Miguel de Allende, with its large foreign population, takes Covid seriously.

BVINew York7h agoPowerful article with powerful images. I felt close to the shopkeepers and their families. The intimacy of these stories and revealing personal impact in such detail, without judgment, makes the story so much more human. "At every level, there is simply less." A sadly perfect summation of this pandemic's impact.

IvanMemphis, TN9h agoTwo failures seem to be conspiring to make this a catastrophe. First the governments failure to institute simple low cost and effective measures to reduce the spreed - like mandatory and enforced masks in crowded public areas. Second the failure of the public to take it serious and follow common sense guidance - because of paranoia about the motives of experts and government. I guess they are not that different from the US, except they have less resources to counter the predictable outcomes of these failures.

gnacio ColinMexico City8h agoOnce again, we are portrayed as a country that diminishes the virus’ impact and downplays it. It’s a great read but tbh most of the responsibility lays on the President, who has been adamant about employing techniques that do not combat the virus. Nonetheless, Mexico City’s government led by a PhD, Claudia Sheinbaum has done a great job and has countered the President in many ways regarding the management. We have a dormant President who chooses to look elsewhere instead of looking for solutions (he’s done the same with medication purchases, education, ecology, human rights commissions, to say the least). The Mexican community is strong and is doing its part on mitigating this national (and global) tragedy.

D. HendersonMexico City4h ago@Jorge Romero and @ E. Voigt, you have points and they are well taken. I live in CMDX and work in rural MX. In July, we made a "necessary" risky cross-country drive to see Ohio family b/c we suspect that such is impossible until a vaccine in spring 2021 or later. We used masks, face shields, alcohol solutions when at two hotels & gas stations. Some anectodal sharing

Like many people in Iztapalapa, they felt a sense of shame associated with the virus.“There’s a stigma,” said Mr. Dominguez, the organizer. “No one wants to admit they had it.”

ExPatMXAjijic, Jalisco Mexico7h ago@observer " We shouldn't be reporting on these "poor countries" as if we are so far removed on our American pedestal any longer." Thank you. Mexico is a magnificent country and the people remind me of how Americans treated each other with kindness and friendliness when I was young. They make eye contact on the streets, wish you a good day, you'll see teenage boys taking young siblings places with care and loving. There are some places in the US that this happens but a lot more places that it doesn't. Is the government corrupt? Certainly. But they are open about it while the US government is equally corrupt but hides it behind religion or other convenient excuses. We have been adopted" into a few Mexican families and attend birthdays, wedding, and fiestas. This article made me want to cry. The poor in Mexico are struggling to survive just as the poor in the US are similarly struggling. This article put faces on the essential workers who are risking their lives to feed their families (and the rest of the country) which I think is needed so the rest of us who are lucky can identify with what this disease is doing to people.

(c) CDMX is MASSIVE, centro de abastos is massive, hard to relay really its size and diversity and intensity. It IS "formally" and "informally" opening up again for many of the reasons explained in this article; it "feels" like a deal is being made with the COVID-19 devil (only time and the virus will dictate outcomes).

ONE. Thank you NYT for this article and to the commentators for their sharing. Good. TWO. When comparing citizen behavior in CDMX streets to what we saw in TX, TN, AR, KY, OH we note (a) NOW 95-100% of people in CDMX streets, metro, tianguis (markets) use masks, compared with 40-50% (or less depending on USA area),

PaulRio de Janeiro10h agoI cannot speak for Mexico, but I can speak for Brazil, where many cities have seen their numbers plummet, sometimes by over 90%. This is the case in Rio where much has been open for weeks, months in the case of malls and many other public places, without dire consequences.

At this very moment I personally know more people sick in Europe than I do here in Rio or even in Brazil. This is not to minimize the impact that Covid had on Latin America, on Brazil and on Rio. The opposite in fact: it is close to undeniable that some measure of herd immunity was attained in many of the hardest hit places, including New York City, northern Italy and several Brazilian cities.

d) urban CDMX life is different than rural MX life (and other MX cities) always and now; yet, there is a general lack of trust across the board about info and institutions, so much so that we know the death rate IS not accurate, many die in their homes rather than go to hospitals). Survive is what we all must do.

The recovery of places like Manaus, Recife, Rio, São Paulo and other Brazilian cities has been woefully underreported by the New York Times and others. It is too bad because an analysis of the data and of the facts on the ground could yield valuable insight for other countries and cities, especially in poor or emerging countries.

misinformation was as rampant as the virus itself.Ms. Aquino’s cellphone brimmed with clips sent via WhatsApp. Some claimed that the virus was a Chinese conspiracy, others that bleach was a cure. Even President Andrés Manuel López Obrador offered his own theories, contending that a clean conscience helped prevent infection.

“I’ve heard government is paying people to claim their loved ones died from Covid,” Ms. Aquino whispered. “I have two friends who were offered money.”At best, the rumors sowed confusion and doubt. At worst, they were a death sentence.

A dull acceptance of the new reality filled Iztapalapa: Coronavirus is a necessary risk, and the reward for taking it is merely survival.

Thank you for this story about our new home country. We live far from Mexico City in the state of Jalisco where the governor and local officials took the virus seriously. So far their efforts have been rewarded with per capita numbers of cases around 20 per 100,000, some of the consistently best results anywhere in the world.

I was born and raised in Mexico and all my family is still there. Back in March I received video in which a central de abastos worker mocks the pandemic and people who are quarantining calling them lazy, and those wearing masks, gullible. The video to me helped illustrate the hard truth that México, like the USA, has parallel narratives. There are those who believe the science and consume fact-checked news, like my relatives. And there are also many who believe conspiracy theories or folk remedies, including misinformation on YouTube. I believe the official tally of the sick and dead is much lower than the real numbers. This disease is exposing the fragility of Mexico’s institutions, much like it has American ones.

As a full-time resident of Mexico I can attest that most Mexicans either have had a family member ill from Covid and/or have lost a family member to Covid. It has attacked not only low income but also middle and upper classes. It is rampant here but unfortunately the wealthy have better access to adequate health care. Most Mexicans I know are very vigilant about mask wearing; unfortunately the American tourists who come to holiday here are not vigilant and are reluctant to wear masks.

ilToronto

Rachael EiermannLos Cabos, Mexico

Brad BurnsMexico

As a writer, I know that such a choice exists in the middle of a story. It is the turning point. A hero — in this case, the American body politic, not to mention the president — is faced with a crucial decision that will reveal who he or she fundamentally is.

We are not yet at the halfway point of our drama. We have barely made it to the end of the first act, when we slowly awaken to the threat coming our way and realize we must take some kind of action. That action, for now, is simply doing what we must to fight off Covid-19 and survive as a country, weakened but alive.

The halfway point comes only when the hero meets a worthy opponent — not one who is weak or marginal or different, but someone or something that is truly monstrous. Covid-19, however terrible, is only a movie villain.

Our real enemy does not come from the outside, but from within. Our real enemy is not the virus but our response to the virus — a response that has been degraded and deformed by the structural inequalities of our society.

America has a history of settler colonization and capitalism that ruthlessly exploited natural resources and people, typically the poor, the migratory, the black and the brown.

That history manifests today in our impulse to hoard, knowing that we live in an economy of self-reliance and scarcity; in our dependence on the cheap labor of women and racial minorities; and in our lack of sufficient systems of health care, welfare, universal basic income and education to take care of the neediest among us.

What this crisis has revealed is that, while almost all of us can become vulnerable — even corporations and the wealthy — our government prioritizes the protection of the least vulnerable.

If this was a classic Hollywood narrative, the exceptionally American superhero, reluctant and wavering in the first act, would make the right choice at this turning point. The evil Covid-19 would be conquered, and order would be restored to a society that would look just as it did before the villain emerged.

But if our society looks the same after the defeat of Covid-19, it will be a Pyrrhic victory. We can expect a sequel, and not just one sequel, but many, until we reach the finale: climate catastrophe

amid the bumbling, there are signs of hope and courage: laborers striking over their exploitation; people donating masks, money and time; medical workers and patients expressing outrage over our gutted health care system; a Navy captain sacrificing his career to protect his sailors; even strangers saying hello to other strangers on the street

Ventilation systems in schools, nursing homes, residences and businesses may need to minimize recirculating air and add powerful new filters.

in an open letter to the W.H.O., 239 scientists in 32 countries have outlined the evidence showing that smaller particles can infect people, and are calling for the agency to revise its recommendations

Whether carried aloft by large droplets that zoom through the air after a sneeze, or by much smaller exhaled droplets that may glide the length of a room, these experts said, the coronavirus is borne through air and can infect people when inhaled

But the infection prevention and control committee in particular, experts said, is bound by a rigid and overly medicalized view of scientific evidence, is slow and risk-averse in updating its guidance and allows a few conservative voices to shout down dissent.

“If we started revisiting airflow, we would have to be prepared to change a lot of what we do,” she said. “I think it’s a good idea, a very good idea, but it will cause an enormous shudder through the infection control society.”

In early April, a group of 36 experts on air quality and aerosols urged the W.H.O. to consider the growing evidence on airborne transmission of the coronavirus. The agency responded promptly, calling Lidia Morawska, the group’s leader and a longtime W.H.O. consultant, to arrange a meeting.

But the discussion was dominated by a few experts who are staunch supporters of handwashing and felt it must be emphasized over aerosols, according to some participants, and the committee’s advice remained unchanged.

Dr. Morawska and others pointed to several incidents that indicate airborne transmission of the virus, particularly in poorly ventilated and crowded indoor spaces. They said the W.H.O. was making an artificial distinction between tiny aerosols and larger droplets, even though infected people produce both.

We’ve known since 1946 that coughing and talking generate aerosols,

Scientists have not been able to grow the coronavirus from aerosols in the lab.

Most of the samples in those experiments have come from hospital rooms with good air flow that would dilute viral levels.

In most buildings, she said, “the air-exchange rate is usually much lower, allowing virus to accumulate in the air and pose a greater risk.”

The W.H.O. also is relying on a dated definition of airborne transmission, Dr. Marr said. The agency believes an airborne pathogen, like the measles virus, has to be highly infectious and to travel long distances.

Dr. Marr and others said the coronavirus seemed to be most infectious when people were in prolonged contact at close range, especially indoors, and even more so in superspreader events — exactly what scientists would expect from aerosol transmission.

Experts all agree that the coronavirus does not behave that way.

“We have this notion that airborne transmission means droplets hanging in the air capable of infecting you many hours later, drifting down streets, through letter boxes and finding their way into homes everywhere,”

The agency lagged behind most of its member nations in endorsing face coverings for the public. While other organizations, including the C.D.C., have long since acknowledged the importance of transmission by people without symptoms, the W.H.O. still maintains that asymptomatic transmission is rare.

Many experts said the W.H.O. should embrace what some called a “precautionary principle” and others called “needs and values” — the idea that even without definitive evidence, the agency should assume the worst of the virus, apply common sense and recommend the best protection possible.

“There is no incontrovertible proof that SARS-CoV-2 travels or is transmitted significantly by aerosols, but there is absolutely no evidence that it’s not,

So at the moment we have to make a decision in the face of uncertainty, and my goodness, it’s going to be a disastrous decision if we get it wrong,” she said. “So why not just mask up for a few weeks, just in case?”

he agency also must consider the needs of all its member nations, including those with limited resources, and make sure its recommendations are tempered by “availability, feasibility, compliance, resource implications,” she said.

if the W.H.O. were to push for rigorous control measures in the absence of proof, hospitals in low- and middle-income countries may be forced to divert scarce resources from other crucial programs.

That’s the balance that an organization like the W.H.O. has to achieve,” he said. “It’s the easiest thing in the world to say, ‘We’ve got to follow the precautionary principle,’ and ignore the opportunity costs of that.”

In interviews, other scientists criticized this view as paternalistic. “‘We’re not going to say what we really think, because we think you can’t deal with it?’ I don’t think that’s right,”

Even cloth masks, if worn by everyone, can significantly reduce transmission, and the W.H.O. should say so clearly, he added.

The W.H.O. tends to describe “an absence of evidence as evidence of absence,” Dr. Aldis added. In April, for example, the W.H.O. said, “There is currently no evidence that people who have recovered from Covid-19 and have antibodies are protected from a second infection.”

The statement was intended to indicate uncertainty, but the phrasing stoked unease among the public and earned rebukes from several experts and journalists. The W.H.O. later walked back its comments.

In a less public instance, the W.H.O. said there was “no evidence to suggest” that people with H.I.V. were at increased risk from the coronavirus. After Joseph Amon, the director of global health at Drexel University in Philadelphia who has sat on many agency committees, pointed out that the phrasing was misleading, the W.H.O. changed it to say the level of risk was “unknown.”

But W.H.O. staff and some members said the critics did not give its committees enough credit.“Those that may have been frustrated may not be cognizant of how W.H.O. expert committees work, and they work slowly and deliberately,”

“We are at the brink of a technological revolution that promises not just to fundamentally alter the structure of our economy, but also to reshape the social fabric more broadly. History tells us anxiety tends to accompany rapid technological change, especially when technology takes the form of capital which threatens people’s jobs.” 

Over the past two centuries we’ve learned that there’s a significant time lag, between the broad acceptance of major new transformative technologies and their long-term economic and productivity growth.

In their initial phase, transformative technologies require massive complementary investments, such as business process redesign, co-invention of new products and business models, and the re-skilling of the workforce.  The more transformative the technologies, the longer it takes them to reach the harvesting phase

The time lags between the investment and harvesting phases are typically quite long.

While James Watt’s steam engine ushered the Industrial Revolution in the 1780s, “British factories were for the most part powered by water up until the 1840.”

Similarly, productivity growth did not increase until 40 years after the introduction of electric power in the early 1880s.  

In their early stages, the extensive investments required to embrace a GPT like AI will generally reduce productivity growth.

“the short run consequences of rapid technological change can be devastating for working people, especially when technology takes the form of capital which substitutes for labor.

In the long run, the Industrial Revolution led to a rising standard of living, improved health, and many other benefits.  “Yet in the short run, the lives of working people got nastier, more brutish, and shorter. And what economists regard as ‘the short run’ was a lifetime, for some,”

A 2017 McKinsey study concluded that while a growing technology-based economy will create a significant number of new occupations, as has been the case in the past, “the transitions will be very challenging - matching or even exceeding the scale of shifts out of agriculture and manufacturing we have seen in the past.” 

The US and other industrial economies have seen a remarkable rise in the polarization of job opportunities and wage inequality by educational attainment, with the earnings of the most-educated increasing, and the earnings of the least-educated falling in real terms

Since the 1980s, the earnings of those with a four year college degree have risen by 40% to 60%, while the earnings of those with a high school education or less have fallen among men and barely changed among women.

When upskilling is lagging behind, entire social groups might end up being excluded from the growth engine.”

The Tyranny of Merit is Sandel’s response to Brexit and the election of Donald Trump

By championing an “age of merit” as the solution to the challenges of globalisation, inequality and deindustrialisation, the Democratic party and its European equivalents, Sandel argues, hung the western working-class and its values out to dry – with disastrous consequences for the common good.

Sandel charts the rise of what he sees as a corrosive leftwing individualism: “The solution to problems of globalisation and inequality – and we heard this on both sides of the Atlantic – was that those who work hard and play by the rules should be able to rise as far as their effort and talents will take them

It became an article of faith, a seemingly uncontroversial trope

We will make a truly level playing field, it was said by the centre-left, so that everyone has an equal chance. And if we do, and so far as we do, then those who rise by dint of effort, talent, hard work will deserve their place, will have earned it.”

The recommended way to “rise” has been to get a higher education. Or, as the Blair mantra had it: “Education, education, education.

For those willing to make the requisite effort, there was the promise that: “This country will always be a place where you can make it if you try.”

First, and most obvious, the fabled “level playing field” remains a chimera. Although he says more and more of his own Harvard students are now convinced that their success is a result of their own effort, two-thirds of them come from the top fifth of the income scale.

social mobility has been stalled for decades. “Americans born to poor parents tend to stay poor as adults.”

Even a perfect meritocracy, he says, would be a bad thing. “The book tries to show that there is a dark side, a demoralising side to that,” he says. “The implication is that those who do not rise will have no one to blame but themselves.

A relentless success ethic permeated the culture: “Those at the top deserved their place but so too did those who were left behind. They hadn’t striven as effectively.

“On globalisation,” says Sandel, “these parties said the choice was no longer between left and right, but between ‘open’ and ‘closed’. Open meant free flow of capital, goods and people across borders.” Not only was this state of affairs seen as irreversible, it was also presented as laudable. “To object in any way to that was to be closed-minded, prejudiced and hostile to cosmopolitan identities.”

Centre-left elites abandoned old class loyalties and took on a new role as moralising life-coaches, dedicated to helping working-class individuals shape up to a world in which they were on their own.

As centre-left parties and their representatives became more and more middle-class, the focus on upward mobility intensified. “They became reliant on the professional classes as their constituency, and in the US as a source of campaign finance.

Blue-collar workers were in effect given a double-edged invitation to “better” themselves or carry the burden of their own failure

Many took their votes elsewhere, nursing a sense of betrayal. “The populist backlash of recent years has been a revolt against the tyranny of merit, as it has been experienced by those who feel humiliated by meritocracy and by this entire political project.”

Does he empathise, then, with Trumpism?

my book conveys a sympathetic understanding of the people who voted for him. For all the thousands and thousands of lies Trump tells, the one authentic thing about him is his deep sense of insecurity and resentment against elites

A new respect and status for the non-credentialed, he says, should be accompanied by a belated humility on the part of the winners in the supposedly meritocratic race

the Democratic party will not succeed unless it redefines its mission to be more attentive to legitimate grievances and resentment, to which progressive politics contributed during the era of globalisation.”

The only way out of the crisis, Sandel believes, is to dismantle the meritocratic assumptions that have morally rubber-stamped a society of winners and losers

“This is a moment to begin a debate about the dignity of work; about the rewards of work both in terms of pay but also in terms of esteem.

There must be a radical re-evaluation of how contributions to the common good are judged and rewarded.

The money to be earned in the City or on Wall Street, for example, is out of all proportion with the contribution of speculative finance to the real economy. A financial transactions tax would allow funds to be channelled more equably.

the word “honour” is as important as the question of pay. There needs to be a redistribution of esteem as well as money, and more of it needs to go to the millions doing work that does not require a college degree.

“We need to rethink the role of universities as arbiters of opportunity,” he says, “which is something we have come to take for granted. Credentialism has become the last acceptable prejudice

Greater investment is important not only to support the ability of people without an advanced degree to make a living. The public recognition it conveys can help shift attitudes towards a better appreciation of the contribution to the common good made by people who haven’t been to university.”

Am I tough on the Democrats? Yes, because it was their uncritical embrace of market assumptions and meritocracy that prepared the way for Trump.

To those who, like many of his Harvard students, believe that they are simply the deserving recipients of their own success, Sandel offers the wisdom of Ecclesiastes: “I returned, and saw under the sun, that the race is not to the swift

“Humility is a civic virtue essential to this moment,” he says, “because it’s a necessary antidote to the meritocratic hubris that has driven us apart.”

The Tyranny of Merit is the latest salvo in Sandel’s lifelong intellectual struggle against a creeping individualism that, since the Reagan and Thatcher era, has become pervasive in western democracies

“To regard oneself as self-made and self-sufficient. This picture of the self exerts a powerful attraction because it seems on the face of it to be empowering – we can make it on our own, we can make it if we try.

It’s a certain picture of freedom but it’s flawed. It leads to a competitive market meritocracy that deepens divides and corrodes solidarity.”

Sandel draws on a vocabulary that challenges liberal notions of autonomy in a way that has been unfashionable for decades. Words such as “dependency”, “indebtedness”, “mystery”, “humility” and “luck” recur in his book.

vulnerability and mutual recognition can become the basis of a renewed sense of belonging and community. It is a vision of society that is the very opposite of what came to be known as Thatcherism, with its emphasis on self-reliance as a principal virtue.

There are, he believes, optimistic sign

“The Black Lives Matter movement has given moral energy to progressive politics. It has become a multiracial, multigenerational movement and is opening up space for a public reckoning with injustice. It shows that the remedy for inequality is not simply to remove barriers to meritocratic achievement.”

“The moral of Henry Aaron’s story is not that we should love meritocracy but that we should despise a system of racial injustice that can only be escaped by hitting home runs.”

“Tawney argued that equality of opportunity was at best a partial ideal. His alternative was not an oppressive equality of results. It was a broad, democratic ‘equality of condition’ that enables citizens of all walks of life to hold their heads up high and to consider themselves participants in a common venture.

The attack comes weeks after the International Atomic Energy Agency, the top nuclear watchdog, said that Iran now has 12 times the amount of enriched uranium that is permitted under the 2015 nuclear accord.

President-elect Joe Biden has said he will renew efforts to negotiate with Tehran over its nuclear program when he takes office and any escalation following Fakhrizadeh's death would only complicate an already tough task.

Experts tell CNN that the episode underscores shifting dynamics in the Middle East as Trump leaves office and countries fearful of Iranian aggression ally together in solidarity against Iran.

"I think it goes without question that Israel did it," said Simon Henderson, Baker fellow at The Washington Institute and a specialist on Iran's nuclear program. "If you are Israel, you want to set the program back months if not years."

Ben Rhodes, who served as deputy national security adviser under President Barack Obama, tweeted that the attack was "an outrageous action aimed at undermining diplomacy between an incoming US administration and Iran. It's time for this ceaseless escalation to stop."

In a 2018 speech, Secretary of State Mike Pompeo accused the Iranian government of going out of its way to protect, hide and preserve him because he was so critical to their nuclear program.

The US military view right now is that unless there is a direct provocation against the United States by Iran, there is no justification for a US strike.

The US has currently just more than 50,000 troops in the region, which is not enough to carry out a sustained military campaign against Iran.

Pompeo spoke of the danger emanating from Iran and elsewhere during an interview broadcast on Fox News Thursday referencing the aftermath of the January strike by the United States that killed Soleimani.

CNN reported earlier this month that President Trump floated the idea of a military strike on Iran during the remaining days of his term but was dissuaded by senior officials. It's not clear if the administration would considering sabotage, cyber action or other clandestine alternatives were Trump to order up some sort of action.

years of painstakingly worded treaties, high-level visits and cutting-edge disease surveillance—all meant to encourage good-faith cooperation—have only bitten around the edges of the problem.

“It can’t demand entry into a country because they think something bad is happening.”

Nearly 200 countries were counting on an agency whose budget—roughly $2.4 billion in 2020—is less than a sixth of the Maryland Department of Health’s. Its donors, largely Western governments, earmark most of that money for causes other than pandemic preparedness.

In 2018 and 2019, about 8% of the WHO’s budget went to activities related to pandemic preparedness

the agency’s bureaucratic structure, diplomatic protocol and funding were no match for a pandemic as widespread and fast-moving as Covid-19.

To write its recommendations, the WHO solicits outside experts, which can be a slow process.

It took those experts more than four months to agree that widespread mask-wearing helps, and that people who are talking, shouting or singing can expel the virus through tiny particles that linger in the air. In that time, about half a million people died.

As months rolled on, it became clear that governments were reluctant to allow the U.N. to scold, shame or investigate them.

In particular, The Wall Street Journal found:

* China appears to have violated international law requiring governments to swiftly inform the WHO and keep it in the loop about an alarming infectious-disease cluster

—there are no clear consequences for violations

* The WHO lost a critical week waiting for an advisory panel to recommend a global public-health emergency, because some of its members were overly hopeful that the new disease wasn’t easily transmissible from one person to another.

* The institution overestimated how prepared some wealthy countries were, while focusing on developing countries, where much of its ordinary assistance is directed

Public-health leaders say the WHO plays a critical role in global health, leading responses to epidemics and setting health policies and standards for the world. It coordinates a multinational effort every year to pick the exact strains that go into the seasonal flu vaccine, and has provided public guidance and advice on Covid-19 when many governments were silent.

The world’s public-health agency was born weak, created in 1948 over U.S. and U.K. reluctance. For decades, it was legally barred from responding to diseases that it learned about from the news. Countries were required to report outbreaks of only four diseases to the WHO: yellow fever, plague, cholera and smallpox, which was eradicated in 1980.

Nearly three times that amount was budgeted for eradicating polio, a top priority for the WHO’s two largest contributors: the U.S. and the Bill & Melinda Gates Foundation.

SARS convinced governments to retool the WHO. The next year, delegates arrived in the Geneva palace where the League of Nations once met to resolve a centuries-old paradox: Countries don’t report outbreaks, because they fear—correctly—their neighbors will respond by blocking travel and trade.

“Everybody pushed back. No sovereign country wants to have this.”

China wanted an exemption from immediately reporting SARS outbreaks. The U.S. argued it couldn’t compel its 50 states to cooperate with the treaty. Iran blocked American proposals to make the WHO focus on bioterrorism. Cuba had an hourslong list of objections.

Around 3:15 a.m. on the last day, exhausted delegates ran out of time. The treaty they approved, called the International Health Regulations, imagined that each country would quickly and honestly report, then contain, any alarming outbreaks

In return, the treaty discouraged restrictions on travel and trade. There would be no consequences for reporting an outbreak—yet no way to punish a country for hiding one.

The treaty’s key chokepoint: Before declaring a “public health emergency of international concern,” or PHEIC, the WHO’s director-general would consult a multinational emergency committee and give the country in question a chance to argue against such a declaration.

Delegates agreed this could give some future virus a head start but decided it was more important to discourage the WHO from making any unilateral announcements that could hurt their economies.

On Jan. 22, a committee of 15 scientists haggled for hours over Chinese data and a handful of cases in other countries. Clearly, the virus was spreading between people in China, though there was no evidence of that in other countries. The question now: Was it mainly spreading from very sick people in hospitals and homes—or more widely?

On Jan. 3, representatives of China’s National Health Commission arrived at the WHO office in Beijing. The NHC acknowledged a cluster of pneumonia cases, but didn’t confirm that the new pathogen was a coronavirus, a fact Chinese officials already knew.

That same day, the NHC issued an internal notice ordering laboratories to hand over or destroy testing samples and forbade anyone from publishing unauthorized research on the virus.

China’s failure to notify the WHO of the cluster of illnesses is a violation of the International Health Regulations

China also flouted the IHR by not disclosing all key information it had to the WHO

The WHO said it’s up to member states to decide whether a country has complied with international health law, and that the coming review will address those issues.

While Chinese scientists had sequenced the genome and posted it publicly, the government was less forthcoming about how patients might be catching the virus.

WHO scientists pored over data they did get, and consulted with experts from national health agencies, including the CDC, which has 33 staff detailed to the WHO.

Then a 61-year-old woman was hospitalized in Thailand on Jan. 13.

The next day, Dr. van Kerkhove told reporters: “It’s certainly possible that there is limited human-to-human transmission.” MERS and SARS, both coronaviruses, were transmissible among people in close quarters. Epidemiological investigations were under way, she said.

Over the next few years, emergency committees struggled over how to determine whether an outbreak was a PHEIC. It took months to declare emergencies for two deadly Ebola epidemics

The committee met over two days, but was split. They mostly agreed on one point: The information from China “was a little too imprecise to very clearly state that it was time” to recommend an emergency declaration,

On Jan. 28, Dr. Tedros and the WHO team arrived for their meeting with Mr. Xi

Leaning across three wooden coffee tables, Dr. Tedros pressed for cooperation. In the absence of information, countries might react out of fear and restrict travel to China, he repeated several times throughout the trip. Mr. Xi agreed to allow a WHO-led international team of experts to visit. It took until mid-February to make arrangements and get the team there.

China also agreed to provide more data, and Dr. Tedros departed, leaving Dr. Briand behind with a list of mysteries to solve. How contagious was the virus? How much were children or pregnant women at risk? How were cases linked? This was vital information needed to assess the global risk, Dr. Briand said

Back in Geneva, Dr. Tedros reconvened the emergency committee. By now it was clear there was human-to-human transmission in other countries. When it met on Jan. 30, the committee got the information the WHO had been seeking. This time the committee recommended and Dr. Tedros declared a global public-health emergency.

President Trump and New York Gov. Andrew Cuomo both assured constituents their health systems would perform well. The U.K.’s chief medical officer described the WHO’s advice as largely directed at poor and middle-income countries. As for keeping borders open, by then many governments had already closed them to visitors from China.

The WHO shifted focus to the developing world, where it believed Covid-19 would exact the heaviest toll. To its surprise, cases shot up just across the border, in northern Italy.