january 1998

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.

Americans will soon begin to fall back into the rhythms of pre-pandemic life—attending sunny summer weddings, squishing into booths at chain restaurants, laughing together at movies on the big screen—and it will feel like a victory over the coronavirus. But the virus might not actually be gone. In pockets of the country, vaccination rates could stay low, creating little islands where the coronavirus survives and thrives—sickening and killing people for months after the pandemic has ebbed elsewhere. In a worst-case scenario, the virus could mutate, becoming a highly transmissible and much more lethal version of itself. Eventually, the new variant could leak from these islands and spread into the broader population, posing a threat to already-vaccinated people.

Washington in the first days of the Biden administration is a place for double takes: A president associated with the politics of austerity is spending money with focused gusto, a crisis isn’t going to waste, and Senator Bernie Sanders is happy.

People like to tell you they saw things coming. But as I talked to many of the campers in Joe Biden’s big tent, particularly those who, like me, were skeptical of Biden, I found that the overwhelming sentiment was surprise. Few of us expected that this president—given his record, a knife’s-edge Congress, and a crisis that makes it hard to look an inch beyond one’s nose—would begin to be talked about as, potentially, transformational.

Biden, after all, was a conservative Democrat who has exuded personal decency more than he has pushed for structural decency. One conservative publication labeled him “the senator from MBNA” for his friendliness to credit-card companies. He conducted the Clarence Thomas–Anita Hill hearings in a way that hurt Hill, for which he later expressed regret. He voted for the Iraq War and eulogized the segregationist Senator Strom Thurmond. He began his 2020 campaign telling wealthy donors that, in his vision, “nobody has to be punished. No one’s standard of living will change, nothing would fundamentally change.”

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.

Dear Therapist,

Our daughter is engaged to a very nice man who is neither American nor of her religion. They are living together and working in his country. She is beautiful and talented, and has a graduate degree. She had a hard time securing work in that country, and now that she has found a job, she is miserable in it. She calls me every few weeks, but beyond the cursory “How are you?” she calls only to complain, whether it’s about her boss, or the work itself not being what she thought it would be, or the language barrier.

She gave up a very successful and lucrative career in the States to go to graduate school abroad, intending to stay there for work and romance. I had advised her against it.