Group items matching

in title, tags, annotations or url

Average voters weren’t moved by Trump’s obstruction of justice in the Mueller investigation, or his quid-pro-quo with Ukraine, or his many personal scandals. But when people are unemployed, or dying, and the streets are on fire, they want a president who isn’t winging it.

Donald Trump and his campaign think they can stop the bleeding with women by leaning into the culture wars and highlighting looters, rioters, and vandals pulling down statues. But this is a fundamental misunderstanding of these voters. They don’t see Trump as someone who can protect them from the chaos—they think he’s the source of it.

Trump has spent years weaponizing executive power for his political and personal gain: he was impeached, after all, for trying to get Ukraine to interfere in the election,

His rhetoric escalated as he yet again politicized the effort to quell the pandemic by threatening to override regulators on the question of whether a newly developed vaccine would be safe in a highly irregular move.

his anti-democratic instincts and prioritization of his own political goals amid a national emergency show he plans to allow nothing -- not the health of Americans, the sanctity of US elections or the reputation of the Supreme Court -- to prevent him from winning a second term.

Trump's latest attempts to create uproar came amid new efforts to subvert the traditional mechanisms of government for his own gain

Trump is advancing a fake reality that Covid-19 is dying out at a moment when alarm bells are ringing about a possible winter second wave

The revelations from inside the West Wing, which came a day after the United States recorded its 200,000th death from the pandemic, show how the White House effort to end the crisis has been systematically repurposed to service Trump's hopes of a second term

Trump's near simultaneous warning on Wednesday that he thinks the election will end up being decided by the Supreme Court also raises the risk of a constitutional imbroglio likely to be worse than the disputed 2000 election.

he is driving America to a dangerous place in the weeks leading up to the election, and that the most tense and divisive days for many years could be ahead

Washington was already on edge, given the raised stakes of a looming election and the sudden vacancy on the Supreme Court, which is promising the most confrontational confirmation battle in years

Trump is well within his rights to nominate a replacement for Ginsburg -- a move that will enshrine an unassailable conservative majority, potentially for decades.

But the President's suggestion that the Supreme Court could be called in to adjudicate the election threatens to trigger new fury over the nominating process. If a candidate is installed in the coming weeks it will raise the possibility that a new justice who is recently beholden to the President for a lifetime appointment could be called upon to rule on his political fate in a clear and obvious conflict of interest.

"I think this will end up in the Supreme Court and I think it's very important that we have nine justices," Trump said, referring to the election

"because I think this scam that the Democrats are pulling, it's a scam, this scam will be before the United States Supreme Court and I think having a four-four situation is not a good situation if you get that."

In recent days, the President has declared the US is turning the "corner" on the pandemic, even though experts warn that a second wave of infections could build off an already elevated base and lead to tens of thousands more deaths.

Political interference also rippled through Trump's response to reports that the Federal Drug Administration was considering tougher standards for a Covid-19 vaccine to ensure that volunteers used to test it did not suffer side effects.

"I would classify this as a silver lining to what has been quite a hard time for many people,"

Doctors around the country say that they're doing a lot of things differently in the fight against COVID-19 and that treatment is improving. "In March and April, you got put on a breathing machine, and we asked your family if they wanted to enroll you into some different trials we were participating in, and we hoped for the best," says Khalilah Gates, a critical care pulmonologist at Northwestern Memorial Hospital in Chicago. "Six plus months into this, we kind of have a rhythm, and so it has become an everyday standard patient for us at this point in time."

Horwitz believes that mask-wearing may be helping by reducing the initial dose of virus a person receives, thereby lessening the overall severity of illness for many patients.

And Mateen says that his data strongly suggest that keeping hospitals below their maximum capacity also helps to increase survival rates.

Gates adds that the takeaway definitely should not be to cast the mask aside. There is still no cure for this disease, and even patients who recover can have long-term side effects. "A lot of my patients are still complaining of shortness of breath," she says. "Some of them have persistent changes on their CT scans and impacts on their lung functions."

"I do think this is good news," Horwitz says of her research findings, "but it does not make the coronavirus a benign illness."

There’s plenty of blame to go around, involving Democrats as well as Republicans, but Trump in particular “recklessly squandered lives,” in the words of an unusual editorial this month in the New England Journal of Medicine. Death certificates may record the coronavirus as the cause of death, but in a larger sense vast numbers of Americans died because their government was incompetent.

As many Americans are dying every 10 days of Covid-19 as U.S. troops died during 19 years of war in Iraq and Afghanistan

The paradox is that a year ago, the United States seemed particularly well positioned to handle this kind of crisis. A 324-page study by Johns Hopkins found last October that the United States was the country best prepared for a pandemic.

Then there’s an immeasurable cost in soft power as the United States is humbled before the world.

“It’s really sad to see the U.S. presidency fall from being the champion of global health to being the laughingstock of the world,”

in terms of destruction of American lives, treasure and well-being, this pandemic may be the greatest failure of governance in the United States since the Vietnam War.

the economists David Cutler and Lawrence Summers estimate that the economic cost of the pandemic in the United States will be $16 trillion, or about $125,000 per American household — far more than the median family’s net worth.

It’s true that the Obama administration did not do enough to refill the national stockpile with N95 masks, but Republicans in Congress wouldn’t provide even the modest sums that Obama requested for replenishment. And the Trump administration itself did nothing in its first three years to rebuild stockpiles.

The Obama administration updated this playbook and in the presidential transition in 2016, Obama aides cautioned the Trump administration that one of the big risks to national security was a contagion. Private experts repeated similar warnings. “Of all the things that could kill 10 million people or more, by far the most likely is an epidemic,” Bill Gates warned in 2015.

Credit for that goes to President George W. Bush, who in the summer of 2005 read an advance copy of “The Great Influenza,” a history of the 1918 flu pandemic. Shaken, Bush pushed aides to develop a strategy to prepare for another great contagion, and the result was an excellent 396-page playbook for managing such a health crisis.

Trump argues that no one could have anticipated the pandemic, but it’s what Bush warned about, what Obama aides tried to tell their successors about, and what Joe Biden referred to in a blunt tweet in October 2019 lamenting Trump’s cuts to health security programs and adding: “We are not prepared for a pandemic.”

When the health commission of Wuhan, China, announced on Dec. 31 that it had identified 27 cases of a puzzling pneumonia, Taiwan acted with lightning speed. Concerned that this might be an outbreak of SARS, Taiwan dispatched health inspectors to board flights arriving from Wuhan and screen passengers before allowing them to disembark. Anyone showing signs of ill health was quarantined.

If either China or the rest of the world had shown the same urgency, the pandemic might never have happened.

In hindsight, two points seem clear: First, China initially covered up the scale of the outbreak. Second, even so, the United States and other countries had enough information to act as Taiwan did. The first two countries to impose travel restrictions on China were North Korea and the Marshall Islands, neither of which had inside information.

That first half of January represents a huge missed opportunity for the world. If the United States, the World Health Organization and the world media had raised enough questions and pressed China, then perhaps the Chinese central government would have intervened in Wuhan earlier. And if Wuhan had been locked down just two weeks earlier, it’s conceivable that this entire global catastrophe could have been averted.

the C.D.C. devised a faulty test, and turf wars in the federal government prevented the use of other tests. South Korea, Germany and other countries quickly developed tests that did work, and these were distributed around the world. Sierra Leone in West Africa had effective tests before the United States did.

It’s true that local politicians, Democrats and Republicans alike, made disastrous decisions, as when Mayor Bill de Blasio of New York City urged people in March to “get out on the town despite coronavirus.” But local officials erred in part because of the failure of testing: Without tests, they didn’t know what they faced.

t’s unfair to blame the testing catastrophe entirely on Trump, for the failures unfolded several pay grades below him. Partly that’s because Trump appointees, like Robert Redfield, director of the C.D.C., simply aren’t the A team.

In any case, presidents set priorities for lower officials. If Trump had pushed aides as hard to get accurate tests as he pushed to repel refugees and migrants, then America almost certainly would have had an effective test by the beginning of February and tens of thousands of lives would have been saved.

Still, testing isn’t essential if a country gets backup steps right. Japan is a densely populated country that did not test much and yet has only 2 percent as many deaths per capita as the United States. One reason is that Japanese have long embraced face masks, which Dr. Redfield has noted can be at least as effective as a vaccine in fighting the pandemic. A country doesn’t have to do everything, if it does some things right.

Trump’s missteps arose in part because he channeled an anti-intellectual current that runs deep in the United States, as he sidelined scientific experts and responded to the virus with a sunny optimism apparently meant to bolster the financial markets.

Yet in retrospect, Trump did almost everything wrong. He discouraged mask wearing. The administration never rolled out contact tracing, missed opportunities to isolate the infected and exposed, didn’t adequately protect nursing homes, issued advice that confused the issues more than clarified them, and handed responsibilities to states and localities that were unprepared to act.

The false reassurances and dithering were deadly. One study found that if the United States had simply imposed the same lockdowns just two weeks earlier, 83 percent of the deaths in the early months could have been prevented.

A basic principle of public health is the primacy of accurate communications based on the best science. Chancellor Angela Merkel of Germany, who holds a doctorate in physics, is the global champion of that approach

Trump was the opposite, sowing confusion and conspiracy theories; a Cornell study found that “the President of the United States was likely the largest driver of the Covid-19 misinformation.”

A conservative commentariat echoed Trump in downplaying the virus and deriding efforts to stay safe.

A University of Chicago study found that watching the Sean Hannity program correlated to less social distancing, so watching Fox News may well have been lethal to some of its fans.

Americans have often pointed to the Soviet Union as a place where ideology trumped science, with disastrous results. Stalin backed Trofim Lysenko, an agricultural pseudoscientist who was an ardent Communist but scorned genetics — and whose zealous incompetence helped cause famines in the Soviet Union. Later, in the 1980s, Soviet leaders were troubled by data showing falling life expectancy — so they banned the publication of mortality statistics

It was in the same spirit that Trump opposed testing for the coronavirus in the hope of holding down the number of reported cases.

Most striking, Trump still has never developed a comprehensive plan to fight Covid-19. His “strategy” was to downplay the virus and resist business closures, in an effort to keep the economy roaring — his best argument for re-election.

This failed. The best way to protect the economy was to control the virus, not to ignore it, and the spread of Covid-19 caused economic dislocations that devastated even homes where no one was infected.

Eight million Americans have slipped into poverty since May, a Columbia University study found, and about one in seven households with children have reported to the census that they didn’t have enough food to eat in the last seven days.

More than 40 percent of adults reported in June that they were struggling with mental health, and 13 percent have begun or increased substance abuse, a C.D.C. study found

More than one-quarter of young adults said they have seriously contemplated suicide

So in what is arguably the richest country in the history of the world, political malpractice has resulted in a pandemic of infectious disease followed by pandemics of poverty, mental illness, addiction and hunger.

The rejection of science has also exacerbated polarization and tribalism

An old school friend shared this conspiracy theory on Facebook:Create a VIRUS to scare people. Place them in quarantine. Count the number of dead every second of every day in every news headline. Close all businesses …. Mask people. Dehumanize them. Close temples and churches …. Empty the prisons because of the virus and fill the streets with criminals. Send in Antifa to vandalize property as if they are freedom fighters. Undermine the law. Loot …. And, in an election year, have Democrats blame all of it on the President. If you love America, our Constitution, and the Rule of Law, get ready to fight for them.

During World War II, American soldiers died at a rate of 9,200 a month, less than one-third the pace of deaths from this pandemic, but the United States responded with a massive mobilization

Yet today we can’t even churn out enough face masks; a poll of nurses in late July and early August found that one-third lacked enough N95 masks

Trump and his allies have even argued against mobilization. “Don’t be afraid of Covid,” Trump tweeted this month. “Don’t let it dominate your life.”

It didn’t have to be this way. If the U.S. had worked harder and held the per capita mortality rate down to the level of, say, Germany, we could have saved more than 170,000 lives

And if the U.S. had responded urgently and deftly enough to achieve Taiwan’s death rate, fewer than 100 Americans would have died from the virus.

“It is a slaughter,” Dr. William Foege, a legendary epidemiologist who once ran the C.D.C., wrote to Dr. Redfield. Dr. Foege predicted that public health textbooks would study America’s response to Covid-19 not as a model of A-plus work but as an example of what not to do.

There is hope that with new tools and the experience and lessons learned, this could maybe work better this time,” said Ki-Zerbo, underlining the need to involve local communities and listen to them.

She is thought to have had Ebola and seven people who attended her funeral have tested positive for Ebola, with three dying, authorities said.“What worries us the most is the dangerousness of the disease given what we experienced five years ago. We do not want to relive such a situation,

“It’s easy to misunderstand [medical information],” says Wolf, who is also founding director of the medical school’s Health Literacy and Learning Program. Some will be too ashamed to say so while others won’t realize they missed a critical detail

Magnani has patients who don’t believe they have high blood pressure because their lives aren’t stressful. Or respond with “Great news!” when he tells them a test result was “positive.”

But low health literacy cuts across all demographics

“Given the right headache or stress about a sick child, [gaps in comprehension] can happen to anyone. When you don’t feel well, you don’t think as clearly.”

Health literacy is not about reading skills or having a college degree. It means you know how to ask a doctor the right questions, read a food label, understand what you’re signing on a consent form, and have the numeric ability to analyze relative risks when making treatment decisions.

“None of this is intuitive,”

“Covid has brought to fore the vast inequities in society,” says cardiologist Jared W. Magnani, associate professor of medicine at the University of Pittsburgh School of Medicine. If you don’t understand words such as “immunocompromised” or “comorbidity,” for instance, you miss cautionary information that could save your life.

Misunderstandings over hospital discharge or medication instructions can undo the best medical care. Yet, nearly 1 in 3 of the 17,309 people in a study by researchers from the Agency for Healthcare Research and Quality (AHRQ) responded that instructions from a health provider were “not easy to understand.”

Wolf says he was surprised during a study on reading prescription labels by how many high school graduates could not follow medication instructions. “Being able to read the label doesn’t mean you can interpret it,”

“Take two pills, twice daily” was frequently misunderstood. Replacing the awkward wording with “Take two in the morning and two at bedtime” would solve that, Wolf says. Health-care professionals “need to meet people where they’re at.”

Health literacy is the best predictor of someone’s health status, some physicians maintain. Decades of research consistently link low health literacy to poorer medical outcomes, more hospitalizations and emergency room visits, and higher health-care costs

Anatomy knowledge is another gap.

Explaining medical risk and probability is another challenge.

Over 3,000 studies found that health education materials far exceed the eighth-grade reading level of the average American, too. Beyond not using plain language (“joint pain,” not “arthritis”), texts assume the patient knows more than they do. Telling people to sanitize surfaces to kill the coronavirus means little if you don’t tell them what to use and how to do it, Caballero says. “What does it mean to practice good respiratory hygiene?” she asks. “These are not actionable instructions.”

Doctors are encouraged to employ the teach-back technique, meaning the doctor asks the patient to repeat what they’ve heard rather than simply asking, “Do you understand?”

In addition, “health care is becoming a harder test,” Wolf says. Health billing and insurance options can be impossible to navigate. We have an aging population with more chronic conditions and cognitive decline. And more is being asked of patients such as testing their own blood sugar or blood pressure.

I spent much of that year as an industry spokesman, my last after 20 years in the business, spreading AHIP’s “information” to journalists and lawmakers to create the impression that our health-care system was far superior to Canada’s, which we wanted people to believe was on the verge of collapse.

The campaign worked. Stories began to appear in the press that cast the Canadian system in a negative light. And when Democrats began writing what would become the Affordable Care Act in early 2009, they gave no serious consideration to a publicly financed system like Canada’s.

Today, the respective responses of Canada and the United States to the coronavirus pandemic prove just how false the ideas I helped spread were.

There are more than three times as many coronavirus infections per capita in the United States, and the mortality rate is twice the rate in Canada.

The most effective myth we perpetuated — the industry trots it out whenever major reform is proposed — is that Canadians and people in other single-payer countries have to endure long waits for needed care.

While it’s true that Canadians sometimes have to wait weeks or months for elective procedures (knee replacements are often cited), the truth is that they do not have to wait at all for the vast majority of medical services.

And, contrary to another myth I used to peddle — that Canadian doctors are flocking to the United States — there are more doctors per 1,000 people in Canada than here. Canadians see their doctors an average of 6.8 times a year, compared with just four times a year in this country.

Most important, no one in Canada is turned away from doctors because of a lack of funds, and Canadians can get tested and treated for the coronavirus without fear of receiving a budget-busting medical bill.

In America, exorbitant bills are a defining feature of our health-care system. Despite the assurances from President Trump and members of Congress that covid-19 patients will not be charged for testing or treatment, they are on the hook for big bills, according to numerous reports.

That is not the case in Canada, where there are no co-pays, deductibles or coinsurance for covered benefits. Care is free at the point of service. And those laid off in Canada don’t face the worry of losing their health insurance. In the United States, by contrast, more than 40 million have lost their jobs during this pandemic, and millions of them — along with their families — also lost their coverage.

Then there’s quality of care. By numerous measures, it is better in Canada. Some examples: Canada has far lower rates than the United States of hospitalizations from preventable causes like diabetes (almost twice as common here) and hypertension (more than eight times as common).

And even though Canada spends less than half what we do per capita on health care, life expectancy there is 82 years, compared with 78.6 years in the United States.

Of the many regrets I have about what I once did for a living, one of the biggest is slandering Canada’s health-care system. If the United States had undertaken a different kind of reform in 2009 (or anytime since), one that didn’t rely on private insurance companies that have every incentive to limit what they pay for, we’d be a healthier country today.

Living without insurance dramatically increases your chances of dying unnecessarily. Over the past 13 years, tens of thousands of Americans have probably died prematurely because, unlike our neighbors to the north, they either had no coverage or were so inadequately insured that they couldn’t afford the care they needed. I live with that horror, and my role in it, every day.

here were more specific reasons to be skeptical of those claims. We didn’t know, for example, who conducted that 2004 survey or anything about the sample size or methodology — or even what criteria were used to determine who qualified as a “business leader.” We didn’t know if the assertion about imaging equipment was based on reliable data or was an opinion. You could easily turn up comparable complaints about outdated equipment at U.S. hospitals.

Another bullet point, from the same book, quoted the CEO of the Canadian Association of Radiologists as saying that “the radiology equipment in Canada is so bad that ‘without immediate action radiologists will no longer be able to guarantee the reliability and quality of examinations.’ ”

Here’s an example from one AHIP brief in the binder: “A May 2004 poll found that 87% of Canada’s business leaders would support seeking health care outside the government system if they had a pressing medical concern.” The source was a 2004 book by Sally Pipes, president of the industry-supported Pacific Research Institute,

We enlisted APCO Worldwide, a giant PR firm. Agents there worked with AHIP to put together a binder of laminated talking points for company flacks like me to use in news releases and statements to reporters.

Clearly my colleagues and I would need a robust defense. On a task force for the industry’s biggest trade association, America’s Health Insurance Plans (AHIP), we talked about how we might make health-care systems in Canada, France, Britain and even Cuba look just as bad as ours.

That summer, Michael Moore was preparing to release his latest documentary, “Sicko,” contrasting American health care with that in other rich countries. (Naturally, we looked terrible.) I spent months meeting secretly with my counterparts at other big insurers to plot our assault on the film, which contained many anecdotes about patients who had been denied coverage for important treatments.

Julia Lyons saw an opportunity. Figuring nobody would have time to check her lack of credentials, she signed on at a home-nurse registry under various names. In late 1918, the Tribune chronicled the fake flu nurse’s escapades like a dime detective novel.

The police tapped the phone and learned Julia lived nearby. Detectives trailed Julia. One day she set off to marry Charlie the Greek, who ran the Victory Restaurant on West Madison Avenue. Before vows could be exchanged, Julia was in handcuffs.

Instead of transporting Julia to the courthouse in a patrol wagon, the deputy sheriff took her on a street car. In court, some 50 victims testified against her. She was held under $13,000 bond, the equivalent of more than $190,000 today.Deputy Hickey started back to the county jail with Julia in tow. An hour and a half later he called the police and “excitedly” told them she had jumped from a moving street car and hopped into a waiting automobile. Based on the reported location, one official speculated Hickey and his prisoner had been going to cabarets.

Soon Julia was back at her old tricks. In March 1919, the police traced her through the nurse registry to a home on Fullerton Boulevard. When Julia answered the door, the police nabbed her.

“These are interrelated crises — the crisis of racism and inequality that is now converging with the crisis of Covid-19,”

an analysis of data from 40 states and the District of Columbia, released last month by the nonpartisan APM Research Lab, found black Americans are more than twice as likely as whites, Latinos or Asian-Americans to die from the coronavirus. In some states, the disparity is much greater.

Devastating job losses are also “hitting black workers and their families especially hard,” according to a recent report by the Economic Policy Institute, a liberal think tank. The unemployment rate for black Americans is 16.8 percent, compared with 12.4 percent for white Americans

The mass incarceration of black people has only worsened the pandemic’s heavy toll on minorities. Black Americans are incarcerated in state prisons at five times the rate of whites,

“When people are released, what job opportunities do they have? What is their housing situation? All of these other factors relate back to the current pandemic.”

“While everyone is facing the battle against coronavirus, black people in America are still facing the battle against racism and coronavirus,” he said in a recent 18-minute monologue, adding, “Coronavirus exposed all of it.”

Mr. Shabazz wrote about it in a column for The Root, a black news and opinion site, under the headline “We Can’t Breathe: Covid-19 and Police Injustice are Suffocating Black People.”

In New York, Rashid Shabazz, the chief marketing officer of the online organization Color of Change, displayed symptoms of the coronavirus for several weeks, he said, but was unable to get tested. He said the respiratory illness reminded him of the dying words — “I can’t breathe” — of Mr. Floyd and another victim of police violence, Eric Garner, who was put in an illegal chokehold.

One patient, seeing the protective gear that covered Dr. Blackstock’s skin, asked if she was black, she said, because he wanted to make sure his concerns would be taken seriously. She said she worried that Covid-19 would become a disease of marginalized communities, just as AIDS was in the late 1990s, when white Americans had access to new medicines and health care while many black Americans, with fewer economic resources, did not.

“I’m worried about black communities and other communities of color being stigmatized, as those are the people with coronavirus,” she said, adding, “We need to equitably allocate resources to black communities as quickly as possible.”

More people are thinking that way now. In North Carolina, where African-Americans account for 28 percent of coronavirus cases but only 22 percent of the population, the state health secretary decried “structural racism” last week. In Ohio, where black people account for 18 percent of Covid-19 deaths but 13 percent of the population, officials in Franklin County have declared racism a public health crisis.

“This is a transformative moment,” she said. “I’m sad, I’m angry, but I have hope.”

After the Baltimore unrest in 2015, Dr. Wen, now a public health professor at George Washington University, declared racism a public health issue, which she said “raised a lot of eyebrows at the time.”

Why are more people dying of this disease in the United States than in anywhere else in the world? Because we live in a broken country, with a broken health care system. Because even though people of all races and backgrounds are suffering, the disease in the United States has hit black and brown and Indigenous people the hardest, and we are seen as expendable.

As I began to recover, others died.There was Idris Bey, 60, a U.S. Marine and New York City Fire Department E.M.T. instructor who received a medal for his actions after the Sept. 11 attack.There was Rana Zoe Mungin, 30, a New York City social studies teacher whose family said she died after struggling to get care in Brooklyn.There was Valentina Blackhorse, 28, a beautiful young Arizona woman who dreamed of leading the Navajo Nation.

That the rules are now dissolving amid ideological double talk from health authorities says something important about the American capacity for political delusion. But it doesn’t prove that we were wrong to implement them

not when there are thousands of people who are still alive, and whose lives emphatically matter, because we sustained restrictions for a time.

he progression I’ve described, though, in which all sides have embraced delusions or found something to value more than public health, does signal that there will be no further comprehensive attempt to fight the virus

Trump and conservatism won’t support it, the public health bureaucracy won’t be able to defend it, and we didn’t use the time the lockdowns bought to build the infrastructure to sustain a campaign of actual suppression.

it will not be political decisions or public health exhortations that save us. On the left and right we’ve exhausted those possibilities, and like the earthlings unexpectedly preserved from alien domination at the end of “The War of the Worlds,” now only some inherent weakness in our enemy can save us from many, many deaths to come.

After all, if they really cared about the economy, even ardent reopeners would want people to keep wearing face masks, which are a cheap way to limit viral spread. Instead, they’ve chosen to wage a culture war against this most reasonable of precautions.

And the White House has dealt with expert warnings about the risks of reopening by — surprise! — accusing the experts of conspiring against the president

The point is that the push to reopen doesn’t reflect any kind of considered judgment about risks versus rewards. It’s best seen, instead, as an exercise in magical thinking.

Trump and conservatives in general seem to believe that if they pretend that Covid-19 isn’t a continuing threat, it will somehow go away, or at least people will forget about it. Hence the war on face masks, which help limit the pandemic but remind people that the virus is still out there.

One hears a great deal of magical thinking on this point: Public health experts who believe covid-19 will spread among protesters but assert that, on net, they’ll save lives, because systemic racism already cuts short so many black lives.

The less fanciful experts acknowledge this, then add that the cause is worth it, unlike the earlier activities public health officials shut down. This, now, is a real argument: Some things are worth dying for. The equality of every American before the law certainly sounds like one of them to me.

In the happy scenario, the protests will have performed an enormous public service, even beyond agitating for justice. They are basically running a natural experiment that scientists could never have ethically undertaken: Do massive outside gatherings — including singing, chanting, screaming and coughing — spread covid-19, or not?

the second caveat: In a diverse and highly pluralistic society, authorities don’t get to declare some causes worthy and others worthless.

I’m quite positive that courts won’t let governments distinguish between assembling to protest police brutality and assembling to protest public health policy.

One can, of course, argue that there’s a moral difference. But moral distinctions have no force outside the community that makes them.

if it turns out that covid-19 can spread outside, if enough people gather close together, it will be too late to do anything about it. Public health officials will have forfeited their legal authority; media outlets and cultural leaders who have been much more sympathetic to protests than other sorts of gatherings will never persuade anyone who differs to go back inside. The disease will spread unhindered by anything except private, prudential decisions to avoid other people.

I have every hope that this won’t matter, and that in a few weeks we’ll find out that covid-19 simply doesn’t spread much outdoors. But I also have lots of fear that we won’t, and that private, prudential decisions won’t be enough to stop the resultant outbreak. Because, as a society, we’ve now got nothing else left.

Calls for police divestment are a dominant theme of protesters’ policy demands. The radical idea is a product of how increased policing “has eaten up so much state and national resources at the expense of investment in black and brown communities,” says Vanita Gupta, the president and CEO of the Leadership Conference on Civil and Human Rights, who worked to overhaul departments in Cleveland, Baltimore, Chicago, and Ferguson, Missouri, as the former head of the Justice Department’s Civil Rights Division.  

At the federal level, protesters and civil-rights groups are urging Congress to pass, among other reforms, a national prohibition on chokeholds; the elimination of federal programs that offer military equipment to local law enforcement; the creation of a national public database of abusive police officers; and an end to qualified immunity, a doctrine that prevents police from being held liable in certain cases for breaking the law.

“Moments of passion pass and then you have to have people who are still at the table pushing.”

But the protests aren’t all about politics or policy goals, organizers and protesters told me. They’ve been an outlet for black Americans to express their hurt and fury that 400 years after the start of slavery, five decades after the passage of the Civil Rights Act, and six years after the police shot and killed Michael Brown in Ferguson, black Americans are still two and a half times more likely to be killed by police than white people. They are dying of COVID-19 at three times the rate of white people. And they’re more likely than white Americans to have lost jobs in the economic catastrophe spawned by the pandemic

“I remember a movie called Network. I remember [the news anchor] going to the window and saying ‘I’m mad as hell, and I’m not going to take it anymore!’” she told me. That’s how she says she felt when she saw the video of Floyd’s arrest.

Moreover, there’s a strong possibility that the virus hit care facilities so hard not just because those elderly patients were so extra-vulnerable but because those elderly patients were in an institution, unable to isolate themselves

Another possibility is that we understand the risks but have collectively realized that long-term self-isolation is unsustainable, and that we’re all going to get it eventually, so we might as well start now.

If we’ve really decided to accept our own mortality with a certain cheerful fatalism, though, why go through the motions of carefully positioning those cafeteria chairs six feet apart?

a third possibility: Americans have neither the stoicism to actually bear the risk of dying from covid-19 nor the fortitude to embark on an indefinite period of rigorous self-isolation

Nor, even if we could muster those qualities, could we get a majority of our fellow countrymen to go along.

so, instead of deciding upon some basically rational course of action, we have collectively agreed to forget the things we could no longer bear to know.

The calamity we're now all living through offers the professional class an opportunity to reconsider assessments of the national condition issued so confidently pre-pandemic: Economists focus on material living standards partly for ease of quantification, but also because that is what free markets most reliably produce

But “material living standards,” measured in dollars of consumption (or inches of flat-screen TV), are not the same thing as “quality of life.” They say little about relationships, dignity, agency, or life satisfaction.

Ask yourself what matters to you right now. Consider whether new apps on your smartphone compensate for the loss of control, sense of powerlessness, and strain of unpredictability.

Speaking in March at the Heritage Foundation, Senator Pat Toomey, a Republican said, “many nuclear families are struggling, that families don’t have the community support that they once had, extended families live apart,” and “civil society” is in “decline.” Still, he argued, “the standard of living of middle-class and working class Americans has improved,” citing larger houses, better computers, and cars that are not only safer but also equipped with satellite radio and seat warmers.

Weighing these competing factors, he concluded, “For all the problems that we undoubtedly have, the fact is life is better today than it has ever been for the vast majority of the American people.”

What good does G.D.P. do, if people we love are falling seriously ill and dying in unprecedented numbers; if the rhythms of daily life vital to our happiness have gone haywire and our social connections have atrophied?

How much of that technology would you trade to erase the coronavirus? Put another way, how far back in history would you have to travel to find a time when Americans’ true quality of life was lower than today’s?

That this is even a question serves as damning refutation of Senator Toomey’s confidence that an improved standard of living more than compensates for weakened family bonds and waning community support.

While the right-of-center often dismisses working-class frustration with claims of economic prosperity, the left-of-center tends to dismiss their frustration as backward or racist.

America could slow, or partially reverse, elements of globalization that have most disrupted working-class lives, if that were our priority.

We could reorient our education system toward serving the majority of young people who still don’t earn even a community-college degree.

We could reform our system of organized labor to provide workers a genuine seat at the table and an institution in the community.

We could emphasize geography when we talk about diversity, aiming to distribute talent and investment more widely.

These are forms of social redistribution. The task is not to write a larger check but to relinquish power and realign institutions on behalf of those who have been left behind for decades.

the economists are saying, “the cure” doesn’t come at a cost at all when factoring in the economic value of the lives saved.

What these academics are doing — and what Trump’s tweet is getting at — is measuring how the extreme efforts to avoid covid-19 deaths compare to the devastating economic fallout.

They do this by putting a price tag on the deaths avoided. It’s something the federal government does all the time

Value of a Statistical Life or VSL — is the amount people are willing to spend to cut risk enough to save one life.

The VSL at most federal agencies, developed over several decades, is about $10 million. If a new regulation is estimated to avoid one death a year, it can cost up to $10 million and still make economic sense.

a cost-benefit analysis using VSL, while far from perfect, would force policymakers to confront the reality of their decisions in a much more precise way. Without it, they are left to gut feelings, educated guesses or political arguments.

“It’s missing from the discussion,” said Linda Thunstrom, an economist at the University of Wyoming, “so instead you have such loud voices on both sides — advocating that all lives should be saved or that, no, we need to open the economy. But there are trade-offs. It’s hard. But we should be talking about them.”

The economist’s answer is to ask people and observe their behavior.”

Economists use public opinion surveys on mortality risk. They look at how much more dangerous jobs pay. They study what people are willing to spend for safety devices, such as bike helmets. The information is then used to calculate VSL.

“Now we’re just trying to figure out how to balance two difficult things — lives lost and incomes lost.”

The White House’s Office of Management and Budget said it wasn’t doing a pandemic cost-benefit analysis, either

the CDC is not doing any cost-benefit analysis of the pandemic’s social distancing measures, agency spokesman Tom Skinner said.

The White House Council of Economic Advisers, through spokeswoman Rachael Slobodien, declined to comment on whether it has looked into the issue.

The Wyoming economists sent a copy of their cost-benefit study to the White House

The study estimated the U.S. economy would shrink less from an uncontrolled pandemic (GDP declines by $6.49 trillion) than a pandemic curtailed by social distancing (GDP declines by $13.7 trillion)

But social distancing would slash the peak infection rate in half, resulting in 1.2 million fewer deaths — leading to a VSL of $12 trillion

So the value of social distancing would work out to a net benefit of $5.16 trillion, the study estimated.

So far, the number of deaths has been lower than the study projected, Thunstrom said, “so social distancing has done more than what we assumed.

The Wyoming study also noted potential costs from the lack of cost-benefit analysis: The public health savings might not be well understood, so the public focuses solely on job losses and declining GDP, potentially eroding voluntary compliance with valuable social distancing measures.

It could be the pandemic’s VSL should be even higher than the traditional government number of $10 million — and thus the efforts to avoid covid-19 even more valuable.

The virus is dreaded, and studies have shown people are willing to pay more to avoid the risk of dying from cancer than an auto acciden

And it’s contagious. VSL doesn’t capture what people would pay to avoid a disease that could kill someone else.

The government’s VSL also doesn’t reflect willingness to avoid injury, such as the strokes or breathing problems associated with covid-19 cases.

The Chicago study examined this point, using a VSL that declines with age — finding that even though about 90 percent of the benefit would go to saving the lives of people at least 50 years old, social distancing still makes economic sense for the nation as a whole.

the most controversial aspect is whether older people should be assigned the same VSL as younger people. The Environmental Protection Agency in 2002 suggested a clean air rule would offer less of a benefit to senior citizens. Some academics agreed with the agency’s reasoning. But when critics decried it as a “senior discount,” it proved politically untenable.

We realize that emotion has both depth and breadth, that powerful feelings are inspired not just by deep personal loss, but by large, collective losses, too.

Americans find themselves where they have not been since the Second World War, or the Great Depression, no longer able to separate emotions into private feeling and public sentiment or opinion.

It’s strange, and disorienting as an American, to be an object of pity. Pity has always been our defense against the pain and suffering experienced in places that we condescended to think of as poor, or undeveloped or badly governed. But perhaps a good, deep, excoriating and brief acceptance of self-pity is the only hope we have, the only way forward, because it’s now clear that we are desperately sick.

“People began to fixate on individual liberties without understanding that one of the most fundamental civil liberties in the US is the right to health – the right to stay alive.”

Demographic data suggests that younger people, between the ages of 18 and 50, are fueling the current wave of infections, accounting for nearly 60% of cases statewide. “Maybe they feel invincible, so they go out to bars, they gather in big groups,” Riley said. “But then they can spread the virus to their grandmas and grandpas, their parents, their buddies with asthma or diabetes, who are more vulnerable.”

Among the hardest-hit regions are rural counties in the south and the Central Valley, where farmworkers have been toilin

The vast majority – more than 90% – of farmworkers in California are Latinx, working in precariously crowded environments. More than 60% of workers involved in food preparation are Latinx as well

Latinx, Black and other minority groups are disproportionately infected with and dying of Covid-19, according to a tracking tool designed by UCLA, and early metrics suggest that the state’s reopening has exacerbated disparities. Devastating outbreaks in California’s prisons and homeless shelters have further fueled inequities.

the state rushed its reopening plan. Initially, officials had set two weeks of declining as a benchmark for advancing through each phase of reopening. “We wanted to not only flatten the curve but see a downturn,” he said. “Then we began seeing the anti-lockdown protests, basically egged on with a wink and a nod from Donald Trump, and the governor faced increasing pressure to move faster.”

the governor’s recent orders pausing the California’s reopening, and his statewide mandate requiring residents to wear masks, are laudable, he said. “Still, we’re only successful if people follow the order – and right now, they’re not doing it.”

He’ll now always be known for working a political miracle — and for making clear, to borrow from JFK, that saving the planet is this generation’s long twilight struggle.