After an inept coronavirus response, will the United States do better when the next pandemic strikes? Experts generally agree that America learned from the past year, and that the next public-health crisis won’t be quite as bewildering. But America’s pandemic preparedness still has major gaps, some of which are too big for any one administration to fix. In recent weeks, I’ve called back many of the experts I interviewed over the past 18 months about masks, testing, contact tracing, quarantine, and more. I asked them, “Are we ready for another one?” The short answer is “Not quite.” The long answer is that being truly “ready” will be harder than anyone realizes.
The Trump administration mishandled the American response to Covid-19 so completely that it’s tempting to pin most of the pandemic carnage on him. But the more I read about the pandemic (Michael Lewis’s The Premonition is a recent example), the more I have come to believe that the majority of the American pandemic deaths were baked in, no matter who was President. Trump was definitely a worst-case scenario, but even a more competent person in the White House in Jan 2020 (like Clinton or Sanders or Romney) would not have done so much better. Poor public health infrastructure, politicized government agencies, no mandatory paid leave, an overpriced healthcare system that only works for some, uncoordinated national response (+ federalism), years of defunding government programs, a reactive (rather than proactive) CDC, unhealthy populace, poverty, systemic racism in medicine, entitled individualism, high rate of uninsured people, growing anti-science sentiment — the pandemic was destined to race through the United States like a brush fire no matter what.
Even the European Union, whose member nations do not share many of America’s aforementioned challenges (but have other issues), did only marginally better than the US in preventing Covid deaths. The UK did worse:
Olga Khazan, writing for the NY Times in an essay adapted from her book Weird, tells us that if we’re not satisfied with our personalities, we can change them.
After all, the person who emerges from quarantine doesn’t have to be the same old you. Scientists say that people can change their personalities well into adulthood. And what better time for transformation than now, when no one has seen you for a year, and might have forgotten what you were like in the first place?
It was long thought that people just are a certain way, and they’ll remain that way forever. The Greek physician Hippocrates believed that people’s personalities were governed by the amounts of phlegm, blood, black bile and yellow bile that flowed through their bodies.
Modern science, of course, has long since discarded notions of bile and humors. And now, it appears the idea that our personalities are immutable is also not quite true. Researchers have found that adults can change the five traits that make up personality — extroversion, openness to experience, emotional stability, agreeableness and conscientiousness — within just a few months. Much as in Dr. Steffel’s case, the traits are connected, so changing one might lead to changes in another.
Put more succinctly: “Remember that your personality is more like a sand dune than a stone.”
In an article that The Atlantic classifies as “politics” rather than “science” or “medicine”, Olga Khazan explores why, more than 8 months into the pandemic, Americans still have little idea about the safety of gathering with others indoors.
For months now, Americans have been told that if we want to socialize, the safest way to do it is outdoors, the better to disperse the droplets that spew from our mouths whenever we do anything but silently purchase grapefruit. But in many parts of the country, this is the last month that the weather will allow people to spend more than a few minutes outside comfortably. And next month, America will celebrate a holiday that is marked by being inside together and eating while talking loudly to old people.
In a nutshell, the lack of federal support/guidance/action is the main reason why people are still so confused about what safety measures to take to reduce their Covid risk:
Still, Ranney says, this [Covid risk] app is the kind of thing the federal government really should have developed by now. It’s odd that in a wealthy, industrialized country, a random researcher is the one designing a tool to keep citizens safe from public-health threats, using data she scraped from a newspaper.
One thing that Khazan doesn’t really get into is the whole aerosols thing, which in my mind is something that most people are still not familiar with, many local & state governments are not taking into account w/r/t recommended safety measures, and requires different risk guidance about the safety of the indoors than if we were just dealing with fomites & droplets. Again, from the excellent Time magazine piece by aerosol chemist Jose-Luis Jimenez:
When it comes to COVID-19, the evidence overwhelmingly supports aerosol transmission, and there are no strong arguments against it. For example, contact tracing has found that much COVID-19 transmission occurs in close proximity, but that many people who share the same home with an infected person do not get the disease. To understand why, it is useful to use cigarette or vaping smoke (which is also an aerosol) as an analog. Imagine sharing a home with a smoker: if you stood close to the smoker while talking, you would inhale a great deal of smoke. Replace the smoke with virus-containing aerosols, which behave very similarly, and the impact is similar: the closer you are to someone releasing virus-carrying aerosols, the more likely you are to breathe in larger amounts of virus. We know from detailed, rigorous studies that when individuals talk in close proximity, aerosols dominate transmission and droplets are nearly negligible.
If you are standing on the other side of the room, you would inhale significantly less smoke. But in a poorly ventilated room, the smoke will accumulate, and people in the room may end up inhaling a lot of smoke over time. Talking, and especially singing and shouting increase aerosol exhalation by factors of 10 and 50, respectively. Indeed, we are finding that outbreaks often occur when people gather in crowded, insufficiently ventilated indoor spaces, such as singing at karaoke parties, cheering at clubs, having conversations in bars, and exercising in gyms. Superspreading events, where one person infects many, occur almost exclusively in indoor locations and are driving the pandemic. These observations are easily explained by aerosols, and are very difficult or impossible to explain by droplets or fomites.
The science is there — it’s the lack of connection between scientists, public health experts & officials, and the government that continues to be a problem.
As summer ramps up in North America, people are looking to get out to enjoy the weather while also trying to keep safe from Covid-19 infection. Here in Vermont, I am very much looking forward to swim hole season and have been wondering if swimming is a safe activity during the pandemic. The Atlantic’s Olga Khazan wrote about the difficulty of opening pools back up this summer:
The coronavirus can’t remain infectious in pool water, multiple experts assured me, but people who come to pools do not stay in the water the entire time. They get out, sit under the sun, and, if they’re like my neighbors, form a circle and drink a few illicit White Claws. Social-distancing guidelines are quickly forgotten.
“If someone is swimming laps, that would be pretty safe as long as they’re not spitting water everywhere,” says Angela Rasmussen, a virologist at Columbia University. “But a Las Vegas-type pool party, that would be less safe, because people are just hanging out and breathing on each other.”
“There is no data that somebody got infected this way [with coronavirus],” said professor Karin B. Michels, chair of UCLA’s Department of Epidemiology, in a recent interview.
“I can’t say it’s absolutely 100% zero risk, but I can tell you that it would never cross my mind to get COVID-19 from a swimming pool or the ocean,” said Paula Cannon, a professor of molecular microbiology and immunology at USC’s Keck School of Medicine. “It’s just extraordinarily unlikely that this would happen.”
As long as you keep your distance of course:
Rather than worry about coronavirus in water, UCLA’s Michels and USC’s Cannon said, swimmers should stay well separated and take care before and after entering the pool, lake, river or sea.
“I would be more concerned about touching the same lockers or surfaces in the changing room or on the benches outside the pool. Those are higher risk than the water itself,” Michels said. “The other thing is you have to maintain distance. … More distance is always better.”
Interviews with laboratory directors and public-health experts reveal a Fyre-Festival-like cascade of problems that have led to a dearth of tests at a time when America desperately needs them. The issues began with onerous requirements for the labs that make the tests, continued because of arcane hurdles that prevented researchers from getting the right supplies, and extended to a White House that seemed to lack cohesion in the pandemic’s early days. Getting out lots of tests for a new disease is a major logistical and scientific challenge, but it can be pulled off with the help of highly efficient, effective government leadership. In this case, such leadership didn’t appear to exist.
The US has bungled the situation so badly that a pair of Chinese foundations announced this morning that they were donating 500,000 testing kits and 1 million masks to the US. Last month in my Asian travelogue, I wrote that my main observation after spending three weeks in Asia was: “America is a rich country that feels like a poor country”. That we have to rely on foreign aid in situations like this is a good example of what I was referring to.
I am the queen of cancellation.”Heyyyyy guyyyyyyyssss-” begins a typical email from me backing out of plans, yet again. (The Ys multiply the guiltier I feel, and the more recently I’ve no-showed.) A book thing came up, and it has to be done by Monday, so I can’t use that non-transferable ticket you got me after all. Or I’m sick, again. But actually sick this time — not pretending to be sick so I can run errands without making anyone mad. To make time to copyedit something, I canceled on a work party of my boyfriend’s, then canceled on my own work party for good measure. I’ve started feebly sending this same boyfriend to social engagements in my stead, like a sad foreign minister from Flake Nation.
Part of the secret is not to overbook yourself in the first place. I’m a long-time practitioner of this technique — I say a straightforward no to lots of things, and if I say yes to something, I almost never cancel. And lately I’ve been saying yes more often, because as Khazan writes, getting out and doing stuff, even if it’s potentially uncomfortable and maybe not even your cup of tea, is part of caring for yourself. Human souls are not meant to be left on shelves; they need to run and play with others in the real world. Still though, as an introvert, I have to admit that nothing feels better than when someone cancels plans with me. The pure luxury of unanticipated JOMO knows no equal.
One way to grease the groove is to just do the exercise whenever you think of it. Ben Greenfield, in Beyond Training, describes how he would do three to five pull-ups every time he walked under a pull-up bar installed in his office doorway. By the end of the day, he’d have performed 30 to 50 pull-ups with minimal effort.
McKay opted for something similar: He set up a pull-up bar in his door frame, and every time he walked under it, he would do one. “You’re allowing yourself to practice more without going to fatigue,” he says. “If you’re constantly thrashing your body, doing max sets every time you do a pull up, you’re gonna have a bad time.” Anyone who has tried to climb the stairs to their apartment on achy quads after an overly ambitious leg day knows the risks of overexertion. Within a month, McKay says, he went from being able to do about five pull-ups to about 15.
I read this piece with interest because I’ve been greasing the groove for the past several months without knowing what it was called or that it was even a thing. I work from home and sprinkle exercise throughout my day. Working at a standing desk makes it easy to walk away from the screen, do a few pull-ups, plank for a minute, do some jumping jacks, and then get right back into whatever I was doing. I also stretch and do a few exercises sometimes when I’m watching TV in the evening. It is almost never a full workout, but it keeps me active when I can’t get out to ski or hike or play sports with my kids.
According to the researchers who invented the quiz, the issues that most concern political liberals tend to fall under the category of “individualizing” moral foundations, which have more to do with personal standards: care versus harm and fairness versus cheating. Political conservatives, meanwhile, tend to be more concerned about group-focused “binding” foundations: loyalty versus betrayal, authority versus subversion, and disgust versus purity. If loyalty is extremely important to you, the research suggests, you might care deeply about supporting the troops, and therefore you might be more likely to be politically conservative.
She then goes on to describe the results of a new study that suggest that maybe our morals are determined by our political affiliation and not the other way around.
In a series of analyses published recently in the American Journal of Political Science, the three researchers found that people’s moral codes don’t cause or predict their political ideology; instead, people’s ideology appears to predict their answers on the moral-foundations questionnaire. As Peter Hatemi, one of the study’s authors and a political-science professor at Pennsylvania State University, puts it: “We will switch our moral compass depending on how it fits with what we believe politically.”
This could explain how the Republicans’ opinion of Russia changed so quickly in the wake of allegations that Donald Trump colluded in Russia’s meddling in the 2016 election, the Republican flip-flop on climate change, the evangelical Christian embrace of the most immoral President in recent history, and the leftward swing of many Democratic Party members, following their most visible politicians (Bernie, Warren, AOC) & most vocal supporters away from Obama’s centrism.
“There is good circumstantial evidence that’s growing that a number of mental illnesses are associated with immune dysfunction,” says Sandro Galea, a physician and epidemiologist at the Boston University School of Public Health.
If the link is in fact real, allergies could be causing anxiety and other mood disorders in a few different ways. For one, it’s stressful to be sick, and people with allergies frequently feel like they have a bad cold. The experience of straining to breathe, or of coughing and wheezing, could simply make people feel anxious.
Then there are biological explanations. Allergies trigger the release of the stress hormone cortisol, which can interfere with a feel-good brain chemical called serotonin. It’s not clear how the cortisol does this, Nanda says; it might inhibit the production of serotonin or make it fail to bind with its receptors properly. But when something goes wrong with serotonin, the theory goes, depression or anxiety might set in.
Huh. I definitely suffer from seasonal allergies (they have thankfully slacked off for the summer) and have struggled with anxiety since I was a kid (though I’ve never been clinically diagnosed). I’ll be following this research with interest.
Researchers at The Children’s Hospital of Philadelphia have succeeded in gestating premature lambs in artificial wombs. The abstract from the paper in Nature Communications:
In the developed world, extreme prematurity is the leading cause of neonatal mortality and morbidity due to a combination of organ immaturity and iatrogenic injury. Until now, efforts to extend gestation using extracorporeal systems have achieved limited success. Here we report the development of a system that incorporates a pumpless oxygenator circuit connected to the fetus of a lamb via an umbilical cord interface that is maintained within a closed ‘amniotic fluid’ circuit that closely reproduces the environment of the womb. We show that fetal lambs that are developmentally equivalent to the extreme premature human infant can be physiologically supported in this extra-uterine device for up to 4 weeks. Lambs on support maintain stable haemodynamics, have normal blood gas and oxygenation parameters and maintain patency of the fetal circulation. With appropriate nutritional support, lambs on the system demonstrate normal somatic growth, lung maturation and brain growth and myelination.
One reason preterm birth is so dangerous is that, for an underweight baby, the first few breaths of air halt the development of the lungs. “Infants that are currently born and supported in a neonatal intensive care unit with gas-based ventilation demonstrate an arrest of lung development,” Partridge says, “which manifests in a long-term, severe restriction of lung function.”
With the artificial womb, the infant would continue “breathing” through the umbilical cord as its floats in amniotic fluid, which would flow into and out of the bag. Using its tiny heart, the fetus would pump its own blood through its umbilical cord and into an oxygenator, where the blood would pick up oxygen and return it to the fetus-much like with a normal placenta. In addition to boosting lung growth, the amniotic fluid would protect the baby from infections and support the development of the intestines.
If this does work for humans, there’s a possibility that at some point using artificial wombs may be safer (or just preferable for some people) than women carrying babies to term…which would have an interesting effect on childbirth (to say the least). And as Khazan mentions, there are potential implications related to abortion rights:
If they ever materialize, artificial wombs may stir concerns among pro-choice advocates, since the devices could push the point of viability for human fetuses even lower. That might encourage even more states to curtail abortions after, say, 20 weeks’ gestation. But speaking with reporters Monday, the Philadelphia researchers emphasized they don’t intend to expand the bounds of life before the 23rd gestational week. Before that point, fetuses are too fragile even for the artificial wombs.
Update: There’s a short video clip of the lamb in the artificial womb as well:
Stay Connected