Thanassis Cambanis

For weeks, Americans looked on as other countries grappled with case reports of rare, sometimes fatal blood abnormalities among those who had received the AstraZeneca vaccine against COVID-19. That vaccine has not yet been authorized by the FDA, so restrictions on its use throughout Europe did not get that much attention in the United States. But Americans experienced a rude awakening this week when public-health officials called for a pause on the use of the Johnson & Johnson vaccine, after a few cases of the same, unusual blood-clotting syndrome turned up among the millions of people in the country who have received it.

The world is now engaged in a vaccination program unlike anything we have seen in our lifetimes, and with it, unprecedented scrutiny of ultra-rare but dangerous side effects. An estimated 852 million COVID-19 vaccine doses have been administered across 154 countries, according to data collected by Bloomberg. Last week, the European Medicines Agency, which regulates medicines in the European Union, concluded that the unusual clotting events were indeed a side effect of the AstraZeneca vaccine; by that point, more than 220 cases of dangerous blood abnormalities had been identified. Only half a dozen cases have been documented so far among Americans vaccinated with the Johnson & Johnson vaccine, and a causal link has not yet been established. But the latest news suggests that the scope of this problem might be changing.

Last week, the CDC acknowledged what many of us have been saying for almost nine months about cleaning surfaces to prevent transmission by touch of the coronavirus: It’s pure hygiene theater.

“Based on available epidemiological data and studies of environmental transmission factors,” the CDC concluded, “surface transmission is not the main route by which SARS-CoV-2 spreads, and the risk is considered to be low.” In other words: You can put away the bleach, cancel your recurring Amazon subscription for disinfectant wipes, and stop punishing every square inch of classroom floor, restaurant table, and train seat with high-tech antimicrobial blasts. COVID-19 is airborne: It spreads through tiny aerosolized droplets that linger in the air in unventilated spaces. Touching stuff just doesn’t carry much risk, and more people should say so, very loudly.

Illustrations by Leonardo Santamaria

This article was published online on April 15, 2021.

The Motel El Encanto in Hermosillo, Mexico, served a lavish breakfast that John and Andra Patterson liked to eat on the tiled deck near their suite. The couple would discuss the day ahead over fresh pineapple and pan dulces while their 4-year-old daughter, Julia, watched the gray cat that skulked about the motel’s Spanish arches.

On the morning of March 22, 1974, the Pattersons’ breakfast chatter centered on their search for a permanent home. They were nearing their two-month anniversary of living in Hermosillo, where John was a junior diplomat at the American consulate, and the motel was feeling cramped.

After breakfast, Andra dropped John off at work. Because this was his first posting as a member of the United States Foreign Service, the 31-year-old Patterson had been given an unglamorous job: He was a vice consul responsible for promoting trade between the U.S. and Mexico, which on this particular Friday meant driving out to meet with a group of ranchers who hoped to improve their yield of beef.

The president was insistent as he left office: “We’re not going anywhere.” It had been a turbulent end of the presidency—impeachment, appalling pardons, and a lengthy dispute over the outcome of the presidential election—but he knew that he had a devoted following, and he had every intention to remain a force in politics. And not just him: His family was eager to cash in on his electoral success, too. Usually a former president laid low for a while after leaving office. He wasn’t going to do that. He’d remain a political force, and the dominant figure in his party.

But the plan didn’t go well. The president sat at his new home—he had decamped from his longtime home state—guzzling Diet Cokes and calling friends to rage about how unfairly he’d been treated and complain about overzealous prosecutors. “You get tired of listening to it,” one friend confessed.

The Johnson & Johnson shot is teetering on the precipice of becoming America’s “dudes only” vaccine. On Tuesday, the CDC and FDA advised halting the vaccine’s nationwide rollout to investigate six cases of a rare blood-clotting disorder that’s occurred in people within about two weeks of receiving the vaccine—all of them women under the age of 50. In an emergency meeting convened Wednesday by the CDC, experts raised the possibility of limiting its future use to males, reserving Johnson & Johnson’s vaccine, as some have unfortunately put it, for johnsons alone.

That idea, crude though it may be, has something to it. The demographic pattern that’s emerged is striking, and many of the experts I talked with this week told me they suspect that, if the vaccine is ultimately linked to these clots, the relationship will come with a clear-cut sex or gender difference too. (These questions are also being debated with regard to the AstraZeneca vaccine, which contains comparable ingredients and might very rarely cause a similar or identical type of clotting disorder.)

Each installment of “The Friendship Files” features a conversation between The Atlantic’s Julie Beck and two or more friends, exploring the history and significance of their relationship.

This week she talks with Judie, an introvert, and Kristi, an extrovert, about their opposites-attract friendship, and how Judie leaned on it when her daughter was diagnosed with cancer during the pandemic. They discuss their years as roommates, how “Auntie Kristi” is an important part of Judie’s daughters’ lives, and how Kristi showed up for Judie and her daughters when they desperately needed support in a time of social distance.

The Friends:

Kristi Dusek, 45, a project manager at a research nonprofit, who lives in Baltimore
Judie Hyun, 45, the chief of the division of infectious-disease surveillance for the Maryland Department of Health, who lives in Baltimore

On February 25, I got my first shot of the Pfizer vaccine bright and early, picked up a breakfast burrito on the walk home, and spent the rest of the day sitting in my desk chair, doing what can only be described as vibing. I felt a little bit stoned, like I had taken a low-grade edible instead of being shot up with cutting-edge technology that would help end a year-long global disaster. This acute, mildly high feeling—“brain fog,” a known side effect of the vaccines—lasted about two days. As potential side effects go, it was rad.

More durable, though, was the strange feeling that began when I made my appointment. In the hours after scheduling my shot, I blew a deadline and was late to meet up with friends for a very cold outdoor hang. I was overcome with relief, everything felt slightly unreal, and the time-dependent obligations of my life faded to the periphery of my consciousness. In the two months since, the delirium has settled into something duller, less frantic—the keys are in the ignition, but my mind simply will not turn over.

This article is a collaboration between The Atlantic and the Fuller Project.

On a summer afternoon nearly four years ago, Maryam Muhammet thought her family’s long journey to freedom was almost complete. The Uyghur woman had arrived in Istanbul from Egypt weeks prior with her two sons, a toddler and an infant, after fleeing the Chinese region of Xinjiang. Her husband had not yet joined the family in Turkey. The couple had heard from others in their community that Egyptian immigration officials—ostensibly acting at the behest of the Chinese government—were hassling Uyghur men as they left, so they decided he would come later, on his own.

That afternoon, he sent Muhammet a WhatsApp message to say he was en route to the port and would travel by ship to Turkey. Soon, they would be together. But the tone of his updates quickly changed. He had encountered problems, and officials were taking him away. He loved her, he wrote. His last message came through at 6:06 p.m. “I will not lose faith in God,” he texted. He never made it to Istanbul.

A year ago, when the United States decided to go big on vaccines, it bet on nearly every horse, investing in a spectrum of technologies. The safest bets, in a way, repurposed the technology behind existing vaccines, such as protein-based ones for tetanus or hepatitis B. The medium bets were on vaccines made by Johnson & Johnson and AstraZeneca, which use adenovirus vectors, a technology that had been tested before but not deployed on a large scale. The long shots were based on the use of mRNA, the newest and most unproven technology.

The protein-based vaccines have moved too slowly to matter so far. J&J’s and AstraZeneca’s vaccines are effective at preventing COVID-19—but a small number of recipients have developed a rare type of blood clot that appears to be linked to the adenovirus technology and may ultimately limit those shots’ use. Meanwhile, with more than 180 million doses administered in the U.S, the mRNA vaccines have proved astonishingly effective and extremely safe. The unusual blood clots have not appeared with Pfizer’s or Moderna’s mRNA technology. A year later, the risky bet definitely looks like a good one.

Dear Therapist,

My husband used to take our two dogs for walks and would let them off their leash to run in an abandoned field. Three weeks ago, he woke up early in the morning to take them out. Around 9:30, he came down to the basement, where I was working out, and said Lager, our Boston terrier, had run off.

I called a good friend to come help me look for Lager, and we searched for him until dark. We posted pictures of him on Facebook, Ring, and dog sites but heard nothing back. My son, who is 14, also went to look for him. Meanwhile, my husband went out downtown with a friend, and I was disappointed that he would leave while our dog was still missing.

The next morning, there were still no responses to our online posts about Lager, so I was sad and worried. Then my friend who had helped me look for him called to ask what color his collar was; I texted my husband, and he said it was blue. My friend put me on with dispatch, and they said Lager was deceased—he had been hit by a car while trying to come home. I was devastated and broke down, but I needed to get it together so I could tell my son. As soon as I told him, he started to cry and said he would never speak to Dad again, because he killed our dog.