Health | The Atlantic

Anthony Fauci’s Group Chat Is Making People Lose Their Minds

2026-08-15T08:00:00-04:00

Did Anthony Fauci really get a text from Joan Baez, as his private diary suggests, wishing him a “happy fucking birthday” in the midst of the pandemic? Until now, the answer to that question has remained blessedly unclear. But soon we may have access to the former National Institutes of Health official’s phone. Senator Ron Johnson announced this week that he’d retrieved tens of thousands of messages and hundreds of voicemails from Fauci’s government-issued device and made them fully searchable. In the meantime, though, Johnson has shared just a single set of texts: a Fauci group chat that he considered so explosive in its implications that it had to be released forthwith. “This is a blockbuster revelation,” the senator said on Tuesday. The public had to know.

The texts in question were from a short exchange that Fauci had with two other public-health officials—former U.S. Surgeon General Vivek Murthy and former CDC Director Rochelle Walensky—in January 2021. Murthy had asked whether either of them knew of “any data or theoretical reason” why an expectant mother might choose to vaccinate early versus late in pregnancy. Walensky answered no, that this was all “data free.”

Fauci agreed, but a couple of hours later, he followed up. After asking around, he’d heard about a theoretical concern: A second dose of the vaccine could lead to fever and cytokine storm—an overactivation of the immune system, also linked to COVID itself—which in turn might lead to early-term miscarriage. In an interview that Fauci gave just one week later, he alluded to the need for balanced thinking on vaccination during pregnancy, given the lack of clinical-trial data. But he noted that thousands of expectant mothers had already gotten shots by then, and no issues had arisen. “We’ve got to be careful,” he said, but “I would rather take my chances with a vaccine than getting infected while I’m pregnant.”

Fauci’s critics now assert that this was tantamount to murder. Fauci knew that COVID shots were killing babies, they argue—he said so in a private text—and then he went out and pretended that the shots were safe. Representative Anna Paulina Luna called this “a crime against humanity and the most evil thing that could’ve ever been done.” Meghan McCain demanded that the 85-year-old be handcuffed, perp-walked, and put in a jail cell for the rest of his life. (“This is not hyperbole,” she noted, rather unconvincingly.) Senator Roger Marshall called for the appointment of a special counsel to investigate the matter—either that, he said, or “a full 9/11-style commission.”

Even a cursory reading of the context at the time suggests that Fauci’s group chat doesn’t quite reach the level of a “crime against humanity.” In fact, the new material is unremarkable, unrevealing, and—worst of all—maddeningly irrelevant to the many, far more interesting questions that still surround one of our most important public-health leader’s behavior and decision making during the pandemic.

Despite this week’s operatic calls for justice, there wasn’t really any gap between what Fauci typed into his phone and what he said in public at the time. Indeed, according to the messages released this week, Fauci sent another text to the same two colleagues just one day after he’d voiced his “theoretical” concern about the risks of vaccination. In that message, he gave essentially the same assessment that he’d offer to the public shortly after. He even used similar language: “No red flags” had yet emerged from real-world use, but even so, in the absence of clinical-trial data, “one must weigh the potential risks against the benefits.” (Senator Johnson’s office told me that the records show that “Dr. Fauci withheld information from pregnant women that they had the right to know,” and in doing so he robbed them of informed consent. Fauci, Murthy, and Walensky did not respond to requests for comment.)

That logic still applies. The safety and efficacy of the COVID shot during pregnancy were never tested in a full-scale, randomized clinical trial. But observational data—of which we now possess a very large quantity, after many millions of vaccinations—have not identified any reason to believe that any risk of miscarriage, if present, is significant. If the mRNA shots really were abortions in a needle, as some of Fauci’s critics have alleged—if they really caused a loss of pregnancy in 82 percent of cases, as Senator Ted Cruz and many others claim—then this catastrophic harm would surely have caused at least a blip in U.S. birthrates in 2021, when more than 200 million Americans were fully vaccinated. (As it happens, the number of Americans born that year went up.)

More tempered critics acknowledge that the COVID shots never did turn out to be dramatically unsafe for pregnant women—but then, no one could be confident about the risk at the start of 2021. The text message shows that Fauci clearly was aware of the uncertainty, they argue, yet he buried it in public statements; his crime, in other words, was one of clinical duplicity in the first degree. “He essentially told the public that it was safe for pregnant women to take it when he didn’t know that,” NIH Director Jay Bhattacharya said this week.

But Fauci and the public-health establishment did signal their uncertainty. If anything, they were unusually direct about the known unknowns around this topic—at least compared with their messaging on COVID origins, the value of masking, and the importance of school closures, among other squirrelly, scientific questions. When it came to vaccination during pregnancy, no one hid the fact that the most conclusive safety data were lacking. Fauci made this point both in public and in private; he also said repeatedly, both in public and in private, that the systems used to track vaccines’ adverse events had not yet picked up on any reasons for concern—an assessment that more formal analyses would later confirm. In the meantime, the CDC had already found that getting COVID was itself a major threat to pregnant women’s health, associated with a tripled likelihood of going to the ICU and a 70 percent higher risk of death.

What was this, if not transparency? Vaccines had been made available; the CDC’s official advice was that expectant mothers should discuss the matter with their doctors and reach their own conclusions. In the face of all this cautious, careful guidance, many women did decide to skip the shots: By the end of July 2021, fewer than one-quarter of all the pregnant women in the country had been vaccinated, according to CDC data from the time. That lack of uptake may well have had a grave human cost all its own, given that maternal mortality rates doubled in that year.

In other words, this week’s attacks on Fauci haven’t just inflated the importance of his text message; they’ve reversed its meaning altogether, transfiguring a moment of humility into one of arrogance and self-contradiction. The resulting tangle of misinformation has done little more than bring disgrace to the actual work of determining whether, and how, Fauci and other public-health officials might really have misused their power.

The case against Fauci has always been diverse; its most aggressive prosecutors are a big-tent assemblage of anti-vaxxers, libertarians, and lab-leak truthers. Some believe that he lied about the safety of the COVID shots; others say that he was the capo of immoral lockdown measures, or that he played a role in paying for (and then concealing) the research that started the pandemic. So far, the entire spectacle of this investigation—the email dumps, the diary, and now the texts, as well as the Senate hearing where Fauci refused to answer any questions—has only cast a scattered, insufficient light across a range of matters large and small. To choose just one: Do Fauci’s emails really show, as Senator Josh Hawley and others have asserted, that Fauci cajoled his institute’s grantees for help in winning large cash prizes for himself? The documentary evidence doesn’t indicate that he violated any ethics laws, but it is at least suggestive of self-dealing—and it does at least invite further questions about his use of public office. (When pressed on this during his Senate testimony, Fauci responded as he did to every question, by pleading the Fifth.)

And what about the mystery of COVID’s origins? Released emails and private chats do seem to show that virologists in Fauci’s circle took seriously, over many months, the possibility of a lab’s involvement—yet this idea was rarely given credence in the public sphere. Did Fauci help coordinate some sort of message discipline? How much did he really know about the coronavirus work in China that his institute had funded, and what does he think about that sort of research now? The information we have is inconclusive on these points and many others too.

Fauci remains, in the eyes of many experts, a public-health hero whose work on treating and preventing AIDS and other infectious diseases has saved millions of lives. But there are real uncertainties in his pandemic record and questions as to how he and others led the government’s response to COVID—and these points are only getting lost amid the rampant lust for retribution and the wild overreading of his private records. Fauci’s critics say he papered over gaps in knowledge and in doing so misled the public. Now they’re doing just the same.

Our Last Wi-Fi-Less Refuge Is Gone

2026-08-13T12:07:58-04:00

This article was featured in the One Story to Read Today newsletter. Sign up for it here.

Until very recently, airplanes were one of the last places where you couldn’t count on having good Wi-Fi. Even the Amazon’s most remote villages have high-speed internet, but for years, the typical in-flight connectivity experience could have been best summed up by the aviation Reddit thread titled “WiFi horrible?”

Now major airlines have started rolling out Wi-Fi that is both free and usable. In June, United announced that by the end of this year, nearly 1,000 of its planes would be getting high-speed Wi-Fi via Starlink, the network of low-Earth-orbit satellites owned by SpaceX. Other major airlines, including Delta, JetBlue, and Alaska, are partnering with either Starlink or its closest competitor, Amazon Leo, to offer better Wi-Fi in the next year or two. This new technology provides almost the same internet experience you’d get on the ground, Seth Miller, an airline-industry analyst, told me. This is not Wi-Fi that’s “good for an airplane.” It’s just … good.

As technology conquers this final Wi-Fi frontier, air travel will never be the same. The fickleness that made in-flight Wi-Fi infuriating was also its own kind of luxury: Planes were a bastion of unreachability. And once that luxury is gone, we may miss it.

Delivering the internet to a metal tube traveling at 500 miles per hour, 30,000 feet above the Earth, is so difficult because the tube is both far from internet sources and constantly moving. In the early days of plane Wi-Fi, aircraft had what were essentially giant mobile hot spots attached to their bellies, which would connect to cell towers on the ground. (This was Gogo’s in-flight Wi-Fi which, let’s be honest, never really Gogo’d.) For the past decade or so, major airlines have connected instead to satellites about 22,000 miles above the Earth, which provided Wi-Fi good enough to send an email (sometimes) but too slow for Instagram. The satellites that Starlink and Amazon Leo use travel much closer to the Earth and the plane, so they’re about 10 times less laggy, Miller said. With these connections, people can use social media, play online poker, and—in theory—Zoom, though many airlines still forbid or discourage video calls.

This level of connectivity might sound like a win: Airplane travel is a cramped, chaotic experience; the least you might ask is for the ability to scroll through TikTok when the limited catalog of in-flight movies gets stale. The pitch, as Grant Milstead, the vice president of digital technology at United Airlines, told me, is that with faster, free Wi-Fi, the plane can become a “living room in the sky”—where, just like in a living room on the ground, people can have the TV on for entertainment, their laptop out for productivity, and their phones nearby for messages and social media. Some people are clearly embracing that reality: On a recent 10-hour flight, the guy next to me prepped a slide deck, listened to Spotify, and flirted over DM with someone I sincerely hoped was his girlfriend.

But this level of connectivity also means that, on a plane, you can no longer be blissfully unaware of what’s happening back on the ground. Before Starlink, someone on a business trip might still decide to expense suboptimal Wi-Fi to keep up the pretense of working. But for the rest of us, “Sorry, I was on a plane” was one of the last socially acceptable reasons a person could be unreachable while doing nothing except eating Biscoff cookies. A plane ride meant hours set aside to watch movies, read, or doodle, free of guilt and earthbound demands. Instead of responding to a message from your mother-in-law, you could look out the window and see rivers transformed into green ribbons. While my seatmate worked on his slide deck, all I did was watch Top Gun and Top Gun: Maverick and slam Bloody Mary mix. It was glorious.

The level of disconnection on a plane might have once been an inconvenience, but now people pay good money for enforced breaks from their phone. Sixteen years ago, when Starbucks started offering free Wi-Fi, this magazine declared, “It’s about time!” These days, many cafés withhold Wi-Fi and ban laptops as a selling point. At least 10 million people use the Opal app, whose premium tier costs $100 annually, to lock themselves out of distracting apps, while others pay $59 for the Brick to do the same. Subpar airplane Wi-Fi included this kind of detox with the price of your ticket.

No one will argue that breathing stale air in a seat that offers 30 inches of leg room counts as a wellness retreat, and the research on how much dedicated tech detoxes actually improve well-being is mixed. Still, a disconnected plane ride “might create an opportunity to temporarily remove some of the demands that normally compete for our attention—email, work messages, social media, news, and notifications,” Lisa Walsh, a psychology professor who researches happiness at Nanyang Technological University in Singapore, told me. Flying was a rare, bounded period of time untethered from the world below. Whether or not someone might benefit from that time depends on how they spend it, Kostadin Kushlev, a psychology professor at Georgetown who studies technology and well-being, told me. A nice use of a plane ride might include actually talking to the strangers next to you (an act tied to well-being, he said), letting your mind wander (also linked to well-being), or even just really focusing on Top Gun (research has yet to link Tom Cruise to well-being, but you never know). Kushlev told me about how, during grad school, he once set aside a flight to journal about what he wanted from his life and future. “It really kind of changed my trajectory,” he said. Now, with enough to keep him busy on the plane, he said, “I don’t bother.”

Of course, passengers don’t have to log into the Wi-Fi. But as fast connections become ubiquitous on planes, expectations may begin to shift. We already spend just about every moment of our life near our phones—at work, at the grocery store, at parties, at concerts, in bed, and, for the 75 percent of Americans who’ve copped to this, in the bathroom—where anyone can message us. Now people could easily expect a response while we’re hurtling through the lower stratosphere, too. (And if you don’t reply, people will know it’s because you wanted to eat Biscoff cookies and ignore them.) Connectivity also means the plane becomes just another place to be productive. Milstead, the United executive, told me that one of the company’s customers vibe-coded a website for his new business from the air. Meanwhile, people have already started complaining online about fellow passengers taking Zoom calls and Microsoft Teams meetings onboard. When your seatmate is leading a Q1 strategy session, staring out the window and daydreaming—one of the most distinct opportunities of flying—may seem like time wasted.

If 30,000 feet is yet another place where Zoom meetings are unavoidable, it’s hard not to see a future in which we are nostalgic for the recent past when the Wi-Fi was bad. The early aviator Anne Morrow Lindbergh once wrote that flying is “a miracle that has nothing to do with any of its practical purposes—purposes of speed, accessibility, and convenience.” Instead, a plane ride was an opportunity to watch the familiar world grow strange. Most people who fly no longer treat the experience like a miracle, but now we barely need to notice we are up in the air. It’s just another place to check Instagram.

Nobody Knows What Ultra-Processed Food Is

2026-08-12T13:27:27-04:00

You might know a tomato when you see one, but for the federal government, identifying one is harder. Is a tomato a fruit or a vegetable? In 1893, this question went all the way to the Supreme Court, which decided that, for tax purposes, at least, a tomato was a vegetable. What about milk? For a bureaucrat setting standards, a straightforward explanation such as “liquid from a cow’s udders” won’t quite cut it; according to the FDA, milk is “the lacteal secretion, practically free from colostrum, obtained by the complete milking of one or more healthy cows.”

Even for the government, however, tomatoes and milk are relatively simple to define compared with ultra-processed foods. Although many researchers agree that these creations are negatively affecting people’s health, they cannot agree on what foods do and don’t belong in that category. That’s not keeping Robert F. Kennedy Jr. from trying: After months of promising the federal government’s first formal definition of ultra-processed foods, the secretary of Health and Human Services announced on Monday that the department is finalizing one.

He stopped short, though, of sharing the exact text in either the public announcement or at a “food policy celebration” held Monday at HHS’s Washington headquarters; the definition is still being reviewed by the White House. This effort may have real upsides. Having a regulatory definition of ultra-processed foods (or UPF, as they’re often referred to) could at the very least advance inquiries into the harms of these products. But the effort also raises the question: Can the government adequately define a problem before researchers know its true cause?

So far, scientific efforts to define UPF have revealed only how fuzzy the category is. The most commonly used definition, which was developed by Brazilian researchers, takes the most expansive approach: It lumps all foods with industrial ingredients, such as sweeteners and emulsifiers, into the ultra-processed category. A classification system created by academics at the University of North Carolina at Chapel Hill, meanwhile, defines “highly processed foods” as products “processed to the extent that they are no longer recognizable as their original plant/animal source.” Yet another well-respected system, this one designed by a French analytics company, attempts to incorporate additional factors, such as a food’s salt, sugar, and fat content, as well as the “function, number, and potential health risk of additives.”

These rubrics are distinct enough from one another that flavored yogurt is an ultra-processed food under the Brazilian system and a moderately processed food under the UNC system. Under the French system, the classification depends entirely on the yogurt itself (even though a paper from the group found that 95 percent of flavored yogurts in French grocery stores were indeed ultra-processed).

Researchers disagree on how to define these foods, because the science around how and why they may be harmful is ambiguous. Epidemiological studies have found that UPF-heavy diets have consistently been associated with a range of maladies including cardiovascular disease and type 2 diabetes. But although researchers suspect that certain additives are causing dietary issues, the number of industrial ingredients or additives in Americans’ food is so large that many more may also be causing trouble. Nor do researchers know what processing steps cause everyday food ingredients to go from healthful to harmful. That means Kennedy and his department are essentially trying to define a food group that no one really understands.

Kennedy is under no illusions about how little we know about the American food supply. He has frequently criticized a decades-old loophole that allows food companies to put new additives in their food without even telling the FDA. On Monday, he announced a new proposal to fix this issue; if finalized, the rule would require companies to let the FDA know when they’re introducing a new additive. But even that won’t fully solve America’s additive problem.

Researchers at the Pew Health Group estimated in 2011 that America’s food supply already features more than 10,000 additives. The new rule would require manufacturers that quietly introduced such compounds to tell the FDA what those additives are but not to submit any scientific proof of the additives’ safety. And although the FDA can do its own review of such ingredients, that process is often glacially slow. (The agency still hasn’t completed its rereview of several chemicals nearly a year after announcing that it was taking a second look at their safety.) Plus, certain additives may be safe when consumed on their own but harmful when consumed alongside other additives. A study published last year found, for example, that consuming a cocktail of emulsifiers, a preservative, and a dye was associated with higher rates of type 2 diabetes but that several other industrial concoctions were not.

If anything, researchers know less about how processing changes the ways humans digest certain foods. As the term ultra-processed implies, researchers believe that the ways food companies process individual ingredients has had a profound impact on our health. But because that concept is so new, very little research has been done on it. The Brazilian researchers, for example, have cited pre-frying as a mark of ultra-processing, even though it’s hard to imagine that precooking chicken nuggets could meaningfully affect how they’re digested. And although research does suggest that extrusion, which is used to make products such as cereal by pushing ingredients through a heated tube with rotating screws, makes it easier for the body to break down starches, the evidence of any ill effect on humans is limited.

All of this makes Kennedy’s push to define UPF difficult. Any earnest effort to “Make America Healthy Again” cannot ignore the fact that a majority of the calories Americans consume come from ultra-processed foods, and that something in those foods seems to be making people ill. Creating a definition is an obvious first step toward addressing the issue, and the previous definitions for ultra-processed foods have undoubtedly advanced researchers’ understanding of those foods’ impact on our health. A 2019 study using the Brazilian definition found, for example, that people ate faster and gained more weight when fed an ultra-processed diet compared with an unprocessed one.

But for researchers, the definition of UPF serves more as a hypothesis—an idea that they can test and adjust about how to think about this category of food. A government definition of UPF has a different purpose—it can prompt research, but it can also be used to make rules about how foods are tested, advertised, and sold. An overbroad definition could cost food companies millions in unnecessary costs and stoke unsubstantiated fear in consumers; a narrower definition, based on a hunch, could cause the same problems.

Government definitions are not written in stone: In 2024, the FDA overhauled an outdated definition of healthy foods, which was issued amid the low-fat craze of the 1990s and excluded foods such as nuts and fatty fish. But the process of revising the definition took eight years. As Kennedy said Monday, “If you can’t define a problem, you can’t solve it.” But if you define a problem in the wrong way, you probably can’t solve it either.

The 108-Degree Eviction

2026-08-10T07:00:00-04:00

Photographs by Mikayla Whitmore

On any other day when the high was forecast to be 108 degrees, Susie Tyson would not have left her Las Vegas apartment. The stroke she’d had at 30 made her sensitive to the heat, she found; at 67, going out during Nevada’s hottest months would make her dizzy, nauseous, and, in her words, “hurting everywhere.” But on June 17, she had no choice. That morning, a Clark County constable came to evict her and her daughter Shelby from the apartment they’d lived in for nearly 20 years.

The three-bedroom unit was in a stuccoed two-story building, the generic type found in suburban Vegas’s gated complexes, with a spindly olive tree out front. In the summer, they cloistered the place, hanging blankets over their blinds to make the apartment darker and save on the energy bill. Sometimes, they skimped on air-conditioning. Susie and Shelby had wanted to stay in their apartment, and had cleared their clutter enough to pass a housing-authority inspection in June. But that month, their landlord had terminated their lease, saying they’d violated it by leaving the apartment in disrepair and letting their personal property become a fire hazard.

During the weeks that followed the eviction, Susie and Shelby scrambled to find housing, trying not to think about their worst-case scenario—that they could be forced to live outside during a heat wave.

In Las Vegas, heat is the backstory to every summer. It kills car batteries, skyrockets energy bills, makes steering wheels hot to the touch. Heat can make a good day bad, and a bad day worse, for anyone, but some people bear more of its burden than others. For people who are old or work outside or don’t have a stable place to live, the heat is particularly dangerous. When a person’s core temperature gets too hot, their organs can fail, and they can go into cardiac arrest. In recent summers in Vegas, hundreds of deaths have been attributed to heat; one study found that in recent years half of all deaths of homeless people in this county were heat-related.

Mikayla Whitmore for The Atlantic

Susie Tyson moves her belongings from the apartment where she and her daughter lived for 20 years.

Mikayla Whitmore for The Atlantic

Shelby and Susie Tyson’s home on July 15, 2026

Mikayla Whitmore for The Atlantic

The two women were given 30 days to move out and packed what they could.

People have lived in the area that’s now Las Vegas for thousands of years, but only in the past century have they lived like this—tethered to air-conditioning, reliant on year-round shelter. The increasing temperatures threaten to render the city inhospitable. The summer of 2024, which featured one record-breaking 120-degree day, was the city’s hottest ever, and about 400 people in Clark County died of heat-related illness.

In mid-July, when Susie and Shelby had run out of money to pay for the weekly rental where they’d moored themselves for the time being, the temperatures were ticking up to 114 degrees. They could handle the heat or the housing uncertainty, but facing both stresses at once felt impossible. An urgent question loomed: In the middle of a Las Vegas summer, where would they go?

This city was not Susie’s first choice of hometown. Originally from Buffalo, New York, she had lived in California and Oregon before she landed in Las Vegas. Her brother was here, her parents were coming, and she could use child-care help after leaving her husband. The stroke had made her right side weak and, in combination with back issues and a degenerative disc disease, made it necessary to use a cane. She couldn’t work much, and her health issues made driving difficult, in a place where a single errand might send a person a dozen or more miles from home.

Immediately after the eviction, Susie had Ubered to a hospital; the heat and stress had made her sick. Then, she Ubered to Arizona Charlie’s, a casino hotel 10 miles from the apartment, where she and Shelby stayed six nights and paid about $50 for each one. After bouncing for four more nights between two other casinos, they ended up at Siegel Suites, a weekly rental studio, the cheapest option they could find. Even that cost them $1,000 a month more than the rent they’d been paying.

Mikayla Whitmore for The Atlantic

Shelby and Susie, on the last day they had access to their home

The studio was also more than an hour’s journey via rideshares and buses to the Macy’s and Target where Shelby, who’s 32, worked part-time, and more than 20 miles from their old apartment. According to Nevada law, they had 30 days to collect any belongings remaining there. On an oppressive July morning, Susie and Shelby took an $8 Lyft to a U-Haul facility near the weekly rental, where they met up with Mia Kells, a woman from a local mutual-aid Facebook group. Susie’s parents and brother had died years earlier, and without family to help, she and Shelby had enlisted Kells as a driver.

Susie was talkative and apologetic, and quick to smile; Shelby was quiet and firm. During the school year, Shelby taught as a substitute teacher in the Clark County School District and had recently started a bachelor’s degree in early-childhood education, on a scholarship. The two were close—so close, Susie said, that the radio psychic Gary Spivey once told them they were bound together in a past life, but in that reality Shelby was the mother and Susie was the daughter. In this life, Shelby was Susie’s primary caregiver, helping her walk and sometimes dressing her. They were rarely apart.

Mikayla Whitmore for The Atlantic

The two women took a paratransit bus to the apartment for the last time on July 15, 2026.

Even with air-conditioning, their apartment was stuffy inside. As they sorted through cups, coats, Christmas ornaments, dresses, dolls, DVDs, makeup, and old schoolwork, they moved with a detached sense of purpose, their apartment of two decades no longer feeling like home. In anticipation of the eviction, they’d found a new apartment close to Shelby’s retail jobs. But now they’d lost their housing voucher—public-housing programs can revoke assistance after lease violations—and couldn’t afford the rent.

Susie collapsed into the couch to sip water. She was winded, and the small fans she’d plugged into the wall were still.

“The air doesn’t even seem to be working,” Shelby said. She, too, suffered in the heat, especially when her legs swelled and she couldn’t wear the knee braces that helped her manage the pain of her scoliosis.

“I’m melting, literally. I’m sweating,” Susie said.

By 1 p.m., it was 107 outside. It felt, said Kells, like 107 inside. Their faces were shimmering and flushed, and the mood was grim.

This was just the beginning of a week of accounting and logistics, during which they would attempt to reinstate the housing voucher and request a social-services payment to cover housing in the next weeks. Their costs were mounting, and the 10 nights in casino hotels, along with the weekly rental—paid only through July 18—had used up Susie’s monthly disability and Social Security checks. At one point, after they’d trekked to the regional housing authority, then been sent to a legal-aid office, an aid worker from another group called to say that they’d been approved for temporary housing—if they could be ready within two hours. But getting back to the rental they’d just paid for and packing up everything they’d be able to bring seemed too tall an order.

Mikayla Whitmore for The Atlantic

A visit to the Division of Social Services in Henderson, Nevada

Mikayla Whitmore for The Atlantic

The weekly rental at Siegel Suites was the cheapest option they could find.

Mikayla Whitmore for The Atlantic

Susie and Shelby Tyson at Siegel Suites

A few days later, their best chance of staying even in temporary housing was a friend from social media who had offered to pay for an extra week in the Siegel Suites, Susie said. But the friend’s payment wasn’t going through.

Susie and Shelby took a paratransit bus one last time to the old apartment, to gather jewelry, clothing, and a few pieces of family memorabilia. They couldn’t take anything else.

“Doesn’t it feel strange to even be here now?” Susie asked Shelby.

A little after 1 p.m., a staffer for the complex locked the apartment. It was 106 degrees out.

Two days later, the heat had broken; the temperature was in the 90s. Shelby took a $9 Uber to a bus stop, so that she was 40 minutes early; sometimes the buses came early, too. In the sky, dark clouds were billowing: The summer monsoon season promised some measure of relief. When the bus arrived, Shelby took a seat near the front. The bus passed her middle school, then the Strip, and then, more than an hour into the trip, climbed to the wealthier area of town, Summerlin, where she worked.

After the exertion of the week, her mother was unable to stand for more than five minutes before her back started hurting, a stabbing pain. Still, Shelby was feeling hopeful, at least about the next couple of weeks. The online friend’s payment had gone through, so they could stay at Siegel Suites through July 25. Using a payment plan—$40 a month for 12 months—Shelby reserved the studio until August 1. When Susie received her monthly disability payment, they could use that check to pay for a few more weeks and hope to sort out the housing voucher before running out of money again.

Mikayla Whitmore for The Atlantic

Shelby takes a public bus to work.

Mikayla Whitmore for The Atlantic

Shelby Tyson waits before her shift at a retail store in downtown Summerlin.

Shelby arrived at the mall before her shift started and looked for a place to do her homework; school took her mind off things. She chose a seat in the outdoor plaza. The more forgiving temperatures didn’t change the fact that she and her mother were still unhoused. Nor did it change the long-term outlook for Las Vegas. The city was in drought, and Lake Mead, the reservoir that fed the city—along with millions of other people in Arizona, California, and Mexico—was projected to hit a record low within a month. Most people in Las Vegas could avoid the heat by hunkering down in air-conditioned cars and air-conditioned buildings. But low lake levels could threaten the power supply of much of the Southwest—and the region’s water supply, too. Drought is hard to escape.

The next day, July 18, Shelby and her mother would celebrate Shelby’s recent birthday by seeing Ed Sheeran at Allegiant Stadium. They’d bought the tickets back in October, on payments, before they were worried about eviction. When she was younger, her mother had made a habit of calling into radio programs in order to win concert tickets, restaurant gift cards, even a cruise to Ensenada. This would be their first concert in ages. It was difficult to think much further ahead than that.

The Most Basic Step of the Ebola Response Is Falling Short

2026-08-07T09:13:54-04:00

The fight against Ebola is not going well. Last week, the head of Africa CDC, Jean Kaseya, announced that the ongoing outbreak of the virus in the Democratic Republic of the Congo had ballooned into the second worst of all time, a milestone he had thought was possible to avoid only weeks before. Rather than the spread of the virus slowing, cases are doubling about every 10 days; more than 1,800 people have died, though the actual toll is likely at least twice as high. His organization is now fighting to keep this Ebola outbreak from becoming the worst on record, Kaseya said at a press conference.

This outbreak is spreading more quickly than any other in history partly because one of the basic tools needed to control infectious disease—testing for the pathogen—is not working. So the Congolese government, along with scientists, aid groups, the World Health Organization, and the world’s biotech companies, is racing to fix it.

In its early stages, Ebola can resemble several more common viruses, including malaria, so health-care workers rely on tests, rather than symptoms, to diagnose the disease. After the 2014 West African Ebola outbreak, which killed more than 11,000 people, Congo began stockpiling machines that could detect the Zaire species of Ebola virus, which causes most outbreaks. Hundreds of these GeneXpert devices are now in hospitals all over Congo, along with cartridges that can test a patient’s sample for the virus within an hour, Christian Happi, a molecular biologist who leads a team in Congo working on surveilling this outbreak, told me.

Health officials in Congo began using those stockpiles to test patients for Ebola on April 30, after a smattering of health-care-worker deaths, a calling card of the virus. The results came back negative. So did more samples a couple of weeks later. Ebola, we now know, was circulating. But the species turned out to be Bundibugyo, which is far rarer than Zaire, and which cannot be detected by the existing supply of GeneXpert cartridges. That didn’t become clear until officials had sent samples more than 1,000 miles away, to Kinshasa, for more robust PCR testing, creating a disastrous four-week gap between when the first known patient developed symptoms and when officials received laboratory confirmation of a new Ebola outbreak.

PCR testing is still the only reliable way to detect the Bundibugyo strain in Congo. Under the current system, a car drives to Ebola-treatment centers in affected regions, picks up tests, then drives back to labs that can run the tests, Trish Newport, a lead on Doctors Without Borders’ Ebola programs, explained to me. Some routes take longer than they otherwise would because the samples have to be driven over uneven roads that are frequently blocked by fighting between the Congolese military and the armed group known as M23. After the PCR is run, the car returns handwritten results to the centers.

Nineteen laboratories in Congo can now run PCR tests to detect Bundibugyo, which is a major improvement since the beginning of the outbreak, when only two labs had that capacity in a country of more than 116 million people. But according to figures released by Africa CDC in July, one in eight Ebola tests still took more than 72 hours to return a result. Despite the increase in Ebola testing, the proportion of tests that come back positive has stayed constant, about 45 percent. That probably means the country is still dramatically undertesting, Abraar Karan, an epidemiologist at Stanford, told me.

Meanwhile, Ebola is expanding into new parts of the country. Bringing the outbreak to heel will almost certainly require upping testing to catch more cases, trace chains of transmission, and isolate people who are contagious before they spread the disease further. Modeling done after the 2014 Ebola outbreak suggested that diagnosing 60 percent of patients within one day rather than within five days could have drastically reduced the infection rate.

The fastest solution to Congo’s testing crisis would be to distribute GeneXpert cartridges that can detect Bundibugyo. After all, hundreds of hospitals already have the machines, and each can run 80 or so patient samples at once, which would allow many patients to get same-day results, Happi said. A GeneXpert cartridge that tests for every human strain of Ebola does exist: The U.S. Department of Defense funded its development as part of a biothreat-preparedness program in 2020. The FDA approved the panel earlier this year—but only for use by labs at DOD, which intended to continue conducting research on them. (The Department of Defense did not respond to repeated requests for comment.)

In June, with DOD’s permission, Cepheid, the company that makes GeneXpert machines, donated at least some of the tests meant for U.S. government research to Congo’s national health system, Larry Kelmar, the vice president of government relations for Cepheid, told me. (Kelmar did not say how many.) But before they can be used, their accuracy will still need to be compared with PCR tests. Shanelle Hall, a principal adviser at Africa CDC, told me that the GeneXpert cartridges have been tested and that data from those tests are currently being analyzed. A decision on approval is expected in a matter of “weeks, maybe days.”

Other companies and institutions are scrambling to speed up testing, too. Last month, the Gates Foundation issued a Global Grand Challenge to fund teams that will work urgently to develop “field-ready” diagnostics. The WHO has selected eight Ebola diagnostics capable of detecting Bundibugyo—including the GeneXpert cartridges—for fast-track testing, and has already approved two. A test made by a South Korean company, the RADIONE, was approved for use in patients earlier this summer and has become the cornerstone of the WHO’s plan to decentralize and speed up Ebola testing. A senior official at Africa CDC told reporters in early June that 50 RADIONE machines would be in Congo by the end of that month. As of this week, 37 have been delivered. But the machines can test only 24 or so patient blood samples at once, too few to make the dent in diagnosis times needed, Happi said. In a statement, a spokesperson from the WHO said the organization has “established a joint validation platform to rapidly evaluate the performance of a selection of diagnostic products” and that the introduction of new PCR machines has increased testing capacity from 200 tests a day to more than 2,000. KH Medical, the small manufacturer that makes the RADIONE tests, did not respond to a request for comment.

Meanwhile, Happi told me, some Ebola-treatment centers without enough isolation wards are sending suspected Ebola patients home to wait for test results and, potentially, expose other people during that wait. Africa CDC also plans to intensify its contract-tracing efforts by sending thousands of health workers door-to-door, which would require still more testing capacity to support.

The wait for results can discourage the feverish from presenting themselves for testing, Newport, who has been in Congo most of this summer, said. In part because of the delays—and in part because many people in Congo are skeptical of international responders, or believe that treatment centers are places people go to die—those who show up to the hospital typically do so late in disease progression. That’s a real problem, not just because they stay in the community infectious for longer, but also because Ebola cases are far more survivable when they’re caught early, Newport said. Currently, most Ebola deaths are happening at home, rather than in a treatment center or hospital, meaning that many of these infections are never recorded and that teams meant to disinfect homes and sanitarily bury the dead to prevent further spread of the disease never intervene.

The shortage of tests throughout this outbreak has resulted in a shortage of answers to fundamental questions about how the disease has been spreading. Experts still disagree on whether the outbreak began in January or in April. Patient zero remains a mystery. Currently, 80 percent of people who test positive for Ebola haven’t had contact with any other confirmed patients. If that number doesn’t go down, Kaseya told reporters last week, “we will not stop this outbreak.”

Running From a Fire Should Not Be This Routine

2026-08-06T10:40:41-04:00

In the western United States, particularly in fire-prone areas, people have become well versed at preparing to flee. They’re experts at using the tools and technology for monitoring a wildfire’s advance; they consult the Watch Duty app as often as checking the time. They know the three levels of evacuation—Ready, Set, Go—and many perform a running calculation of how much time they might need to get to safety.

On Saturday afternoon, Rita Gregovich was following that script. She wasn’t much concerned about the small wildfire burning across a river from her home in Spokane, Washington, although she’d noticed neighbors running sprinklers on their roofs to make them less immediately flammable and was tracking the fire’s progress on her phone. She was not too worried, either, when she lowered her American flag so that it wouldn’t get too smoky, she told me. Then she stepped around her garage and saw a wall of smoke. “And it was right on top of us,” she said. She and her husband, Dan, would learn, in a moment of rising distress, how much heavier their automatic garage door becomes when the power is out. She would discover what a burning ember feels like when it falls into your shoe.

Nearly 100 large wildfires are burning across the country at the moment, more than half of them in Oregon and Washington, and many of those have prompted evacuations. The three fires converging on Spokane, Washington’s second-largest city, have destroyed 800 to 1,100 homes and other buildings, fire authorities have said, and displaced more than 65,000 people. As more people have moved into forested exurbs and wildfires’ footprints have grown, such evacuations have become a distressingly familiar summer ordeal: a dayslong limbo in relatives’ spare rooms or emergency shelters, pets in hotel lobbies, possessions lugged around in plastic bags. In France and Spain this summer, record-breaking wildfires forced more than 300,000 people from their homes, an exodus that one French minister described as the largest peacetime evacuation in the country’s modern history.

An evacuee, for however long, steps into a kind of parallel existence, in which locations remain familiar but the rhythms of navigating them have changed. The route home is the same, but now a National Guard checkpoint stands in the way. Your boss is still eager to see you at work, but suddenly you’re living in a van at the fairgrounds. Almost as soon as the calculation to flee is complete, you must begin the harder, more uncertain calculation about how to hold together your life until you can return, if you choose to do so. At the Spokane County Fairgrounds, an evacuation site for animals, Jennifer Hynek was trying to ease her anxious horses, which were kicking and pacing, unaccustomed to city water and the confines of a stable after living on an 18-acre ranch, a nonprofit horse-boarding facility. (She also brought five goats, two pigs, two dogs, and four cats, but she “left the chickens all at home,” she told me. “Fend for themselves.”) In one evacuation zone in Spokane that was at the highest level of alert—leaving was mandatory—a sign on the door of the closed Little Garden Cafe read Still level 3, hoping for Weds.

But swaths of devastated land are still smoldering, and more heat and wind are in the forecast. Authorities have not yet been able to say when most evacuees can return home. “I know people want to have certainty about ‘When can I get back to my property? When can I get back to my homes?’ We don’t have it,” Spokane Mayor Lisa Brown told reporters on Monday. “It could be a week. It could be weeks.”

Randall Barkley, a 65-year-old retired Green Beret, spent his first night after leaving home in his Lotus Evora. He loves the two-seat sports car, but he never expected to sleep in it at a park, let alone with another person. He fled on Saturday when he saw flames near a dumpster outside his townhouse and heard the pop of exploding transformers. “The two booms was my cue,” he told me. As he drove away, he watched firefighters hoist patients into vehicles at the Alzheimer’s and dementia-care facility across the street, leaving dozens of tipped-over wheelchairs splayed outside. He and his brother Brian followed the night in the Lotus with one at a “price gouging” motel, as he put it, then a night at Brian’s boss’s house. They never know quite where each day of evacuation will end. “We might sleep in the car downtown,” Barkley told me on Tuesday. “We’re running out of resources.”

The lucky evacuees whose houses still stand may wonder, as they return home to retrieve birth certificates, heart medication, or a pair of pants, whether the gas leak audibly hissing in the wreckage next door will blow them up while they are on their errand. They must consider the inexorably melting side of beef in the now lifeless freezer. The unlucky ones must start thinking about what to buy a teenage daughter who has just lost all of her belongings.

Donna Light learned that her apartment, in a 12-unit building, was gone before she could get there. A friend sent her a photo the day after the fire. She discovered on Facebook that her parents’ home, not far away, had also burned down. On Tuesday afternoon, Light, a 48-year-old who works in hospital administration, poked through the ruins of her apartment, looking for her jewelry and her collection of Polish pottery. Her Honda CR-V was still in its parking spot, charred down to its metal frame. Light had recently given up her rental insurance on her apartment because “nothing ever happens here,” she told me. Her 14-year-old daughter, who kept belongings at both houses, lost everything except for her electronics and a spare pair of pajamas. “We just start from scratch,” Light said.

This is what a successful evacuation looks like, by the most basic measure, at least: So far, in the face of multiple fast-moving wildfires, nobody has been found dead, and first responders have reported no major injuries. The familiarity of evacuation math—when to go, how long to stay away—can be its own kind of protection. Disasters tend to be less disastrous, in certain ways, when the people who face them know what to expect and what’s expected of them.

Police and National Guard soldiers have tended to let people walk or take bikes and scooters back to their properties, but not drive to them. For some people, the walk home covers multiple miles, in the heat of summer, through a bitter pall of smoke. On her way into the disaster zone, Nikki Martin, a 33-year-old caregiver whose home survived, has felt the pang of passing others who had little to retrieve. “One guy held up a brick and a metal Welcome door sign,” she told me. “He said, ‘This is my house, right here.’”

Kill the Ticks

2026-08-03T13:17:33-04:00

In parks, in backyards, in woods that are lovely, dark, and deep, a many-legged menace now stalks the land. I speak of ticks, and I come bearing absolutely no good news. In recent decades, ticks have made the leap from nuisance to genuine public-health threat: Their numbers are rising. Their ranges are expanding. And the diseases they carry are multiplying. Lyme cases have more than doubled since 2000, in which time scientists have also discovered eight new tick-borne diseases—plus an unusual and potentially dangerous tick-induced meat allergy called alpha-gal syndrome.

“The ticks are winning,” a CDC scientist wrote in a recent paper. To put it even more bluntly, humans are losing and are on the retreat. Ilia Rochlin, a tick researcher at Stony Brook University, told me he stopped hiking in the Pine Barrens of New Jersey after he and his wife came across hundreds and hundreds of newly hatched lone star ticks on a trail several summers ago. And on Long Island, where he lives, “it is impossible to go hiking in most areas,” Rochlin said. “Just because of ticks.”

Tick prevention today is a matter of individual responsibility. If you can’t avoid ’em, you’re supposed to pretreat clothes with the pesticide permethrin, tuck your pants into your socks, and check your entire body for ticks—a real pain, honestly, just to hang out in your backyard. Maria Diuk-Wasser, a tick researcher at Columbia, told me her own family doesn’t always listen to this advice. “I’m like, oh my God, if we don’t even do it here …” The tick problem has reached an inflection point: It is too big to address with personal protective measures alone.

What we need, tick experts now argue, is widespread tick control, akin to mosquito control that has been carried out by state and local agencies for more than a century. Rochlin, who used to work in mosquito control, pointed out that his predecessors in New York were chiefly concerned with malaria. Yes, malaria—now known as a tropical disease—once killed hundreds of New Yorkers every year. In the early 20th century, a massive national mosquito-eradication effort, which led to the CDC’s creation, ultimately expunged the disease from the country. “Compare this huge success story of malaria control in the United States,” Rochlin said, with “this humongous failure to control tick-borne disease.” Today, the number of Americans who contract diseases from tick bites dwarfs the number falling ill from mosquito bites.

To beat the ticks, we need new tools, such as pesticides and vaccines. We need the political will to actually use existing ones, namely, killing deer. We need to make the United States into an environment hostile to ticks—something Americans have accomplished once before, just not on purpose.

When the colonists arrived in what would become the United States, they began turning forests into farmland and hunting white-tailed deer, which neared extinction by 1900. This turned out to be an excellent, if unintended, tick-control strategy. It deprived the parasites of habitat and, more crucial, their key host animal. In low numbers, infected ticks crossed over only occasionally to bite humans.

But as farming declined in the 20th century, forests regenerated. Deer populations rebounded, this time without natural predators such as wolves to keep them in check. Ticks flourished too. In recent decades, two formerly obscure tick species have enormously expanded their reach: the black-legged or deer tick, which is best known for spreading Lyme, and the lone star tick, best known for causing alpha-gal syndrome. (The lone star tick, at least, seems to be reclaiming its former range; it was likely in modern-day New York in the 1700s, before disappearing to the south and not reappearing this far north again until the 1990s.) The two species collectively carry a number of other, lesser-known pathogens, too, including anaplasmosis, babesiosis, Powassan virus, Ehrlichia, and Bourbon virus. These diseases likely once circulated primarily among animals, but they are now spilling over into humans because of the sheer number of ticks that are out and looking for blood.

No one thinks we should solve our modern tick problem by chopping down all of the trees. But everyone I spoke with agreed: We have to do something about the deer. “Deer are the key.” The “common denominator.” The “crux of the issue.” The “main driver of all that is evil today in the northeastern United States.”

That last quote is from Sam Telford III, an epidemiologist studying tick-borne diseases at Tufts University, who calls himself “the nation’s biggest advocate for killing deer.” Ticks rely on the blood of deer to reproduce, his argument goes. A single deer, Telford told me, can feed 1,500 female deer ticks, each of which can lay 2,000 eggs. That’s 3 million deer ticks per deer, over one breeding season—even higher for the more fecund lone star tick. Killing deer is therefore “the biggest bang for your buck,” he said. This strategy was most convincingly implemented in 1997 on Monhegan Island, off the coast of Maine, where residents fed up with Lyme disease hired a sharpshooter to cull all of the deer. After that, Lyme virtually disappeared from the island.

We know very well how to kill deer (“Rifle,” Rochlin deadpanned), but doing so is unpopular. It makes animal-rights activists livid, the general population squeamish, and even hunters unhappy about competing for fewer deer. Lately, though, Telford said, people have become desperate enough about ticks to reconsider. On Martha’s Vineyard, which has come under recent siege by lone star ticks, hunting is having a resurgence. The island extended its hunting season and plans to build a new deer-processing facility.

Hunting can accomplish only so much, though. It can reduce the density of deer from 70 to 40 per square mile, but breaking the disease-transmission cycle requires going below 10, according to Kirby Stafford III, an emeritus chief scientist at the Connecticut Agricultural Experiment Station, where his department studied this exact issue. Moreover, hunting in many of the suburbs home to tick-infested deer is impossible because of all the people who live there, too. On New York City’s Staten Island, where hunting is illegal, the city has been giving vasectomies to male deer for the past 10 years. The deer population has fallen by nearly half, but the tick story is more complicated; while tick numbers have gone down, the proportion carrying Lyme has gone up.

An alternative idea: Make the deer themselves tick resistant. A device called the “4-poster” station lures deer with corn as bait, before rubbing permethrin—the same pesticide we humans use—onto the animals as they snack. But that approach has not proved terribly successful. (Too expensive; limited range.) “Not practical,” concludes Stephen Rich, a microbiologist at the University of Massachusetts at Amherst, who has tested these bait stations on Cape Cod and nearby Chappaquiddick Island. Lately, he’s homed in on a different idea: Turn the blood of deer into tick poison, as we already do to dogs. Rich is exploring the use of fluralaner, sold for dogs as Bravecto: He hopes to apply it to captive deer this fall, before expanding to Chappaquiddick next year, where his team will be pouring the fluralaner onto deer that have been tranquilized.

Or perhaps a vaccine could make ticks simply fall off their host. Animals such as rabbits and cattle naturally become resistant to ticks after repeated bites, likely by mounting an immune response to tick saliva; this is the biological basis for anti-tick vaccines that scientists are trying to develop in humans. Durland Fish, a tick researcher at Yale, argues a deer version could be simpler to develop for biological and regulatory reasons. The challenge then becomes how to vaccinate deer. The USDA currently air-drops fish-meal-flavored oral rabies vaccines to raccoons, and researchers are now studying how to similarly entice deer. “I’m like, what kind of deer crack can we put in there?” says Jean Tsao, a tick researcher at Michigan State University who has tested baits locally. Currently, it’s alfalfa, which has not quite hit the “deer crack” threshold.

In speaking with tick researchers, I sometimes got a sense of mosquito envy. “I’m still amazed,” Tsao told me, when she goes to mosquito-control meetings. “They know what size droplet to spray that will be effective as the plane is flying over to kill mosquitoes down below.” They know what time of day to spray and where. And those same conferences discuss all kinds of ideas for new mosquito pesticides, Diuk-Wasser, the researcher at Columbia, said. “But there’s funding to do that,” which is not the case for ticks.

Existing chemicals are very effective at killing ticks, but they are very effective at killing friendlier bugs, including pollinators, too. Scientists are studying how to target their application—to certain habitats or certain times of the year—to minimize harm to other bugs. (Tick researchers I spoke with were largely skeptical of popular natural yard sprays that are derived from essential oils.) And they are searching for more specific alternatives, such as fungi that kill only ticks.

Ultimately, tick control will likely require a combination of strategies, rather than any one magical solution. Hunting, vaccines, and pesticides applied both to deer and in the larger environment could all play some role. When Lyme first appeared in isolation in the U.S., we conceived of it as a medical problem, Fish told me, putting the bulk of public research dollars into medical treatments. But the subsequent appearance of so many novel tick-borne conditions points to a larger ecology problem. Better than finding stand-alone treatments for each of these conditions is preventing Americans from getting sick in the first place—by making ticks less abundant across the land.

The Real Antidepressant Crisis

2026-07-30T15:49:34-04:00

Robert F. Kennedy Jr. is vocal about his view that Americans overuse psychiatric medications, particularly antidepressants. As a general rule, the health and human services secretary is skeptical of pharmaceuticals, but he’s gone further in his critiques of SSRIs, suggesting without credible evidence that their use might be linked to violent behavior, including school shootings. This past spring, he announced plans to discourage doctors from prescribing antidepressants and encourage them to de-prescribe the drugs—that is, to help patients who have previously been prescribed SSRIs stop taking them.

According to a recent survey, about 17 percent of American adults take an antidepressant. Some of them are my patients, many of whom were upset or infuriated by Kennedy’s move to rein in the prescribing of drugs whose benefits they have experienced firsthand. One of my patients, who has tried to stop taking Zoloft several times only for his depression to recur, told me that he couldn’t understand why the nation’s health secretary might want to discourage people from taking the SSRIs they’ve been prescribed.

Kennedy’s claim that antidepressants are overprescribed contains a grain of truth. Some patients receive antidepressants without really needing them or stay on them for longer than necessary. Earlier this year, an independent task force of psychiatrists suggested that more attention be paid to how and when patients and their doctors test whether tapering off these medications would be reasonable. In fact, inappropriate prescribing creates the impression among both patients and doctors that antidepressants are less effective than they are.

When Kennedy talks about de-prescribing antidepressants, exactly what he’s proposing remains unclear. He doesn’t specify which groups of depressed patients he believes can stop their medication. In fact, contrary to his often-heated rhetoric about SSRIs, he said in May when announcing the de-prescription measures that “if you are taking psychiatric medication, we are not telling you to stop”—and then encouraged such patients to “make the right decision” in consultation with their doctor. The benefits of antidepressants vary greatly. There is abundant evidence that antidepressants are effective for people who have moderate or more severe forms of depression. If you feel persistently sad, believe that life isn’t worth living, and lose your energy, appetite, concentration, or ability to experience pleasure, you likely have clinical depression, and your symptoms would be good targets for antidepressant treatment. But the same is not true of people experiencing what psychiatrists call everyday distress. Feeling, say, unhappy in a soul-sucking job or grief-stricken over the loss of a loved one are painful but entirely appropriate emotional responses. They call for changing your situation or contacting a friend for support, not for an antidepressant.

[Read: Talk to your doctor about your distrust of public health]

Taking an SSRI in such a scenario would be like prescribing an antibiotic for a common cold: a waste of resources that’s likely to only give the patient side effects and leave them questioning the efficacy of the drug. Some providers nevertheless prescribe antidepressants for everyday distress. I’ve seen patients going through grief or job loss who were prescribed SSRIs by my colleagues, perhaps because they thought the patients were right on the edge of depression. And in the clinic where I teach and supervise residents, I’ve met many people who were unnecessarily prescribed a cocktail of antidepressants by other clinicians in the community. Many of my colleagues have come across such patients too.

Even people who have chronic mild depression can respond well to antidepressants, some studies have found. But a 2010 meta-analysis showed that people with the most severe depression experienced the greatest improvement from antidepressant treatment, whereas the benefit for those with milder depression was smaller, in some cases near zero. One possible explanation for this finding is that placebo responses tend to be higher in patients with milder depression (perhaps because they start to feel better when researchers ask how they’re doing throughout the study), so drug-placebo differences in that group are slight. Another explanation is that people with more severe depression likely have more biological abnormalities in the brain, such as elevated levels of the stress hormone cortisol and exaggerated responses in the fear circuit, which can be good targets for antidepressants.

No national data prove that antidepressant overuse is rampant, though. The closest approximation we have is a landmark 2014 study that examined the health records of more than 1 million patients during one year of treatment and found that about 40 percent of antidepressant prescriptions were written without a documented psychiatric diagnosis. This, however, doesn’t prove that the prescriptions were medically unnecessary: Antidepressants are legitimately prescribed for other reasons, including pain, quitting smoking, and insomnia. And the fact that nearly a fifth of Americans are taking an antidepressant is in line with the actual burden of psychiatric illness in the general population: In the most recent national data available, which were published in 2005, 7 percent of survey respondents reported having major depressive disorder, 4 percent reported PTSD, and others reported additional diagnoses for which SSRIs can be appropriate.

[Read: 20-somethings are in trouble]

Of course, some patients don’t like being on antidepressants, even if they experience an improvement in their mood. A small proportion of SSRI users experience side effects such as decreased libido, weight gain, and tiredness. Although these effects can understandably be distressing, they are also commonly transient and manageable. If Kennedy’s efforts lead to widespread de-prescribing of antidepressants, it would be a potentially harmful overreaction to a limited problem.

Meanwhile, Kennedy’s focus on antidepressant overprescribing ignores—and may even deepen—a more urgent crisis in psychiatry. The 2023 National Survey on Drug Use and Health found that roughly one in three adults who experienced a major depressive episode received no treatment for their illness that year. Evidence suggests that several common barriers drive this undertreatment of depression: People don’t know where to go for help, think they can manage without help, or cannot afford help. In my experience, some depressed patients avoid treatment because they feel that a depression diagnosis is stigmatizing and connotes that they are weak rather than medically ill. The more doubts Kennedy and other officials instill about antidepressants, the more likely some people who really need them may be to turn them down. “The United States is facing a growing challenge of overmedicalization in behavioral health care,” Emily Hilliard, an HHS spokesperson, told The Atlantic in an email. “Under Secretary Kennedy’s leadership, HHS is committed to ensuring that patients and clinicians have transparent information about the benefits, risks, side effects, and potential withdrawal effects of psychiatric medications so they can make informed, evidence-based treatment decisions.”

Depression is a serious illness, and discouraging people who need antidepressants from seeking them—or enacting policies that impede access to them—would only spur on its greatest harms. Roughly half of people who experience an episode of major depression will go on to have a chronic course of the illness. That means many patients cannot stop taking antidepressants without a significant risk of relapse or worse: Depression carries a lifetime suicide risk of about 2 to 9 percent, with more severe forms of the disease corresponding to higher risk. In this sense, depressed patients are dependent on their SSRIs in the same way that people with high blood pressure are dependent on their antihypertensive drugs. To mitigate the risk of fatal complications of the illness, you might have to stay on the treatment for life. That kind of dependency is something that competent clinicians and health-policy experts should encourage.

[Jeffrey Ruoff: Between not wanting to live and not wanting to die]

Kennedy, by contrast, has likened antidepressant dependence to heroin addiction. “Listen, I know people, including members of my family, who’ve had a much worse time getting off of SSRIs than people have getting off heroin,” he told a Senate committee at his confirmation hearing last year. But the fact is that, unlike an opiate such as heroin, antidepressants do not make people high and do not result in habituation, which requires users to take ever-larger doses to maintain their clinical effect. And although research on tapering is somewhat limited, one of the largest available studies shows that any withdrawal symptoms tend to be mild and dissipate within weeks.

Kennedy’s desire to reduce Americans’ reliance on antidepressants fits in with his larger antipathy toward pharmaceuticals, especially vaccines. He generally seems to believe that eating and exercising well is all that is necessary for health. In the case of depression, he favors non-drug alternatives, such as psychotherapy, exercise, and “real food.” But I’ve seen many patients in exemplary physical health—for example, triathletes and serious swimmers who adhere to strict diets—become suicidally depressed. Taking an antidepressant after you have tried exercise, a healthy diet, and psychotherapy isn’t a sign of weakness or a character flaw. It’s a recognition that disease has an underlying biological basis—and that sometimes, you need medication to get better.

The Cities That Said Yes to Drugs

2026-07-30T07:00:00-04:00

Photographs by Dana Golan

Late last year, I walked roughly a mile from downtown Seattle to the working-class neighborhood of Little Saigon and came upon a montage of human despair. An open-air drug market stretched along the intersection of 12th and Jackson: about 250 people, many smoking fentanyl or bent over in the thrall of the drug, tilting as if mid-fall. Three women lay passed out on the sidewalk, their chests slowly rising and falling, while fellow addicts stepped over them and dealers made sales. Young boys, schoolbags on their backs, stood on a far corner and watched.

I walked around the block to the Hoa Mai playground, named for a Vietnamese flower that signifies rebirth. City workers had installed gates to keep drug users away, but at 4 p.m. on a Wednesday, I counted 27 people smoking drugs and nodding off. No children were in sight.

Half a mile to the south, in the Beacon Hill neighborhood, I visited a 10-acre park named after the Filipino nationalist Jose Rizal. It has a playground and the remnants of an apple orchard, and at night you can peer downtown and see the city lights. As I arrived, a drug user squatted next to a child’s slide and relieved himself. Others had set up tents and colonized the park pavilion, where they heated fentanyl on tinfoil and inhaled the fumes with glass pipes. A few went old-school and injected it.

Across the street, I spoke with Angelina Monsegur as she waited at a bus stop. When she was a kid, she told me, she and her father ate candied apples in the park and watched Fourth of July fireworks. A few weeks earlier, she and her 6-year-old daughter had gotten on the bus and seen a man smoking fentanyl on board. “Are you serious?” she’d shouted at him. “My daughter has asthma.” I asked if she had called the police, and she smiled at my naivete. “All the city does is send out teams who hand out aluminum foil and fentanyl pipes.”

Seattle is one of the wealthiest and best-educated cities in the world. It can afford to try various strategies to address its drug epidemic and high rate of fatal overdoses. Yet many of the city’s leaders, apparently supported by voters, view enforcing bans on the open sale and use of narcotics, and forcing addicts off the streets and into treatment, as akin to an act of state repression.

Seattle, like a striking number of other liberal American cities, has embraced a radical form of “harm reduction,” which is more a philosophy about treating addiction than a scientific approach to it. Harm reduction’s adherents hold that police and outreach workers should “meet the addicted where they are,” which is to say without judgment. The New York State Department of Health, a bastion of harm reduction, describes it as a “social movement” committed to “building leadership” among drug users. In these places, de facto and sometimes legal restrictions on narcotics use have been greatly loosened; cities fund teams of workers to hand out drug paraphernalia, and in some rare cases they’ve created dedicated spaces for addicts to shoot up. Meanwhile, police departments struggling with staffing shortages and budget cuts have stopped devoting resources to sweeping users and dealers off the streets or out of parks and playgrounds.

Harm reduction was born 50 years ago of an admirable humanitarian impulse. Its most basic ideas, such as providing clean needles to users, deservedly draw broad support. There’s a debate to be had, though, about whether this approach has saved lives or added to the carnage of America’s terrible drug epidemic. From 2014 to 2024, roughly 862,000 Americans died of drug overdoses, more than twice the toll of the previous decade. Several studies have shown that addicts who shoot up at official injection sites are far less likely to die of overdoses than those who use drugs in, say, alleyways and parks. Over the past decade, however, overdose-death rates climbed sharply in nearly every city where the strongest harm-reduction policies were in place, and even with declines in the past two years, the rates remain well above those of previous decades. From 2016 to 2025, 7,089 people died of overdoses in King County, which includes Seattle—seven times the number of homicides in that period.

Harm reduction isn’t just a problem for addicts. In many cities, the autonomy of drug users has taken precedence over nearly everything and everyone else, not least working-class families like Monsegur’s who must live alongside addicts and accept dystopian decay. Keith Humphreys, a Stanford psychiatry and behavioral-sciences professor and a former adviser to President Obama, supports needle exchanges and opposes the widespread jailing of users. But when he argues that drug policy must take into account the impact on communities, he told me, some critics dismiss him as a reactionary. Their arguments, he said, “sound a lot more like gun rights and vaccine refusal. It’s no longer about the whole population; it’s about the subset who use drugs.”

In recent years, officials in cities such as San Francisco and Philadelphia have moved to rein in the excesses of harm-reduction policies. Nevertheless, these policies retain a powerful hold on public-health and political leaders in blue parts of the country. I witnessed this in visits to Seattle and Burlington, Vermont—two of America’s more progressive cities. Both are afflicted by high overdose rates, overwhelmed police forces, parks and public squares often captive to drug use, and the theft and disorder that accompany all of that. Yet many of their elected officials continue to insist, despite everything, that harm reduction is the most effective and moral solution to addiction.

[Listen: Can San Francisco be saved?]

Dana Golan for The Atlantic

In Seattle’s working-class Little Saigon neighborhood, where hundreds of people gather in open-air drug markets, businesses and playgrounds have installed gates to keep addicts away.

Harm reduction took root in the 1970s in the Netherlands, where addicts formed unions—the Junkiebond in Rotterdam, for instance—that distributed needles and pushed back against official insistence on abstinence from hard drugs. Not long afterward, this philosophy gained support in some American and Canadian cities. I first encountered it when I reported on a heroin-shooting gallery in Bushwick, Brooklyn, in 1991. The work of harm-reduction advocates at the time undoubtedly saved lives. HIV-infection rates for drug users in Bushwick had reached 50 percent or higher, at a time when that diagnosis was close to a death sentence. Activists risked arrest to distribute clean needles and bleach to disinfect used ones. But some began to argue for a more radical step: There would be less death, they said, if addicts could inject drugs without fear of arrest.

That momentous step came about not in New York but in Vancouver, a city whose political culture was left-wing and libertarian, celebrating the rights of the individual. In 2003, as overdose deaths surged, the Liberal Party of Canada carved out an exemption to federal drug laws and established North America’s first sanctioned injection site, in Vancouver’s Downtown Eastside, a troubled dockside neighborhood. Addicts could bring their heroin and cocaine to a 13-seat center where staff dispensed needles, swabs, and sterile water to cook the drugs and offered advice on vein maintenance. Clinic staff were trained to reverse overdoses, and if that failed, to call a hospital for help.

Initial opinion surveys found broad public support for the center, and it shone like a beacon for some activists, academics, and journalists in the United States and other parts of Canada. A stream of studies and articles celebrated Vancouver’s legal shooting gallery, which resulted in fewer cases of AIDS and other infections, and fewer deaths. Public-health officials coined a nonjudgmental nomenclature that persists to this day. The word addict was stigmatizing; better to refer to people who use drugs. People used rather than abused narcotics. They did not fail a drug test ; they tested positive.

Vancouver’s model spawned dozens of injection sites across Canada. Health officials in British Columbia went still further, championing a program known as “safer supply”: Former government officials started companies that provided addicts with free opioid alternatives such as pharmaceutical-grade hydromorphone pills—considerably more powerful than heroin. Drug users obtained these pills from pharmacies and specially designed vending machines.

By 2020, the rights of addicts in the province had edged toward the fantastical. In 2023, the province decriminalized small amounts of certain hard drugs. One hospital instructed nurses not to confiscate fentanyl or meth from patients and not to restrict suspected dealers from visiting patients. When British Columbia banned illicit-drug use within 50 feet of a public park, playground, or swimming pool, the provincial supreme court blocked the law, ruling that it could cause “irreparable harm” to drug users. “Harm reductionists had the force of a bulldozer,” Julian Somers, who studies addiction at Simon Fraser University, told me.

Some addicts learned to game the system by obtaining daily allotments of hydromorphone pills—15 or more a day was typical—and then selling them to dealers in exchange for stronger fentanyl concoctions. Dealers could then sell the original pills on the street. An investigation by the National Post reported a price drop of 70 percent or more for black-market pills in cities that had instituted safer supply. This, in turn, expanded the circle of the addicted and led to more overdoses.

Gary Coronado / Los Angeles Times / Getty

Medics attend to a man who overdosed on drugs in Vancouver’s Downtown Eastside neighborhood. Thousands of addicts have poured into the city since it opened North America’s first sanctioned injection site, inspiring similar programs across the U.S. and Canada.

The consequences were predictable. Over the course of two decades, many thousands of drug users poured into the Downtown Eastside and other Canadian neighborhoods in search of narcotics and places to shoot up. Overdoses spiked. In 2014, British Columbia recorded 369 overdose deaths; in 2023, the figure peaked at more than 2,500. Fatal overdoses last year decreased to 1,826, as Canada moved to reverse decriminalization and tighten regulation of narcotics, but that still represents a nearly ninefold increase over 15 years. Advocates of harm reduction have long held that more addicts would die if officials closed injection centers. But a recent study found that after an injection site in Alberta closed, there was no increase in the number of overdose deaths, and more addicts sought treatment. Advocates have also insisted that crime does not spike near injection centers, but the data are more mixed than they admit.

Not long ago, I walked through a park in Toronto to a fence with hundreds of purple ribbons tied to it. Each represented a resident who had died of an overdose, and I was unavoidably moved. Then, as I read a leaflet, I realized that the memorial was the work of the Harm Reduction Advocacy Collective, “a liberation movement of people who use drugs,” along with public-health professionals and academics who “stand up for the rights of drug users.” It’s one of a number of similar groups in Canada, such as the Substance Use Health Network, which condemns “anti-euphoria prohibitionist principles” such as “the idea that illicit drugs are inherently bad.”

British Columbia is starting to rethink its runaway experiment. In 2025, the province began requiring addicts using the safer-supply program to consume their prescribed narcotics in front of pharmacists, and earlier this year, the drug-decriminalization program expired. Provincial health authorities are now making attempts to encourage addicts to get treatment. The sense is of a political culture reluctantly shaking off a decades-long stupor. In 2024, the premier of British Columbia appointed Daniel Vigo, a psychiatrist and public-health researcher, as the province’s chief scientific adviser on toxic drugs. Vigo has spoken of the terrible toll that repeat overdoses take on addicts’ brains, and has advocated for a new policy of mandating treatment for some addicts. Progressive activists and journalists tend to talk about forced treatment as a conservative-driven return to a carceral state, but considerable data show that addicts who enter mandated treatment are as likely to avoid drug use and rearrest as the relatively small number who seek treatment voluntarily.

Vigo’s words today would have amounted to heresy a few years ago. “It’s as if we forgot that the goal was to try and stop people from getting addicted,” he told me, adding later: “Harm reduction gets people in trouble when it stops being one part of a holistic strategy and it becomes an ideological movement.”

But even as Vancouver has begun the painful process of revising its harm-reduction policies, the city still exerts a powerful hold on the imagination of liberal leaders in the United States. In New York City, which established two injection sites in 2021, health officials and academics point to the perceived success of Vancouver as inspiration. Rhode Island, where an injection center opened in Providence in 2024, also holds up Vancouver as a model. The Washington State legislature appointed a working group that in 2025 recommended establishing a safe supply of narcotics for addicts, and officials repeatedly cited the Vancouver program.

The shadow cast by Vancouver extends to Burlington. Last year, the city council approved the establishment of an injection center. The group that the city chose to run it noted that Vancouver “remains the source of much of the evidence” showing the benefits of such spaces for drug users and the community.

Burlington sits on Lake Champlain, the Adirondack Mountains rising on the far shore. It’s a beautiful city, but its drug scene is not covert, spreading over downtown and several other neighborhoods. Users pitch tents in churchyards and parks and along the waterfront. When I sat in City Hall Park last September, I counted at least 70 users and dealers, many looking hyperkinetic in the way of the strung out. I walked through an alley next to city hall where, a few weeks earlier, a group of young people had allegedly beaten a man to death in an argument over drugs.

Vermont has strict laws against possession of heroin and cocaine, but users in Burlington are rarely arrested or prosecuted for possessing small amounts. Although it’s hard to isolate the effects of these policies, in 2024, the city of almost 45,000 recorded 585 drug overdoses, 28 of which were fatal. That is more than twice the rate of fatal overdoses per capita in New York City the same year.

Beth Sightler walked me around her working-class neighborhood in the Old North End. Burlington’s progressive political culture and tradition of caring for the poor are well established; Bernie Sanders served four terms as mayor in the 1980s. Sightler, a liberal who runs a mental-health center, said she has fished needles out of her flower boxes and seen people overdosing in cars and cemeteries. She carries naloxone, a medication that can reverse an opioid overdose, when she walks her dog. One morning she saw a young woman on the grass near her porch wearing underwear, a bra, and sandals. “There was this beautiful woman, absolutely beautiful, sitting there trying to find a vein and inject,” Sightler recalled. “I told her, ‘Sweetie, you gotta move along.’”

Many people in Burlington offer similar stories. A block from City Hall Park, the King Street Center provides tutoring and recreation programs for families living in poverty. Staff members arrive early to sweep up needles outside the building. When drug dealers began playing dice out front last summer, Shabnam Nolan, the executive director, called the police, who eventually chased the dealers away. “We’ve tried to sound the alarm, and yet people are not taking us seriously enough about what’s happening,” Nolan told me. Why does a drug user’s “right to ‘dignity’ violate children’s right to come to our center without seeing blood and needles?”

“It’s as if,” she said of Burlington and its culture, “we are frozen with fear that someone might see us as uncompassionate.”

The city’s political class has compounded these problems. In 2020, activists launched a campaign to defund the police department, although it was regarded as relatively progressive and community-oriented. The city council cut almost $1 million from the police budget. Six years ago, Burlington had about 100 officers; now it has fewer than 70. The current city-council president, Ben Traverse, a liberal Democrat who has grown uncomfortable with Burlington’s direction, told me that sometimes as few as five officers are on duty citywide after midnight on the weekends. It used to be that if you wanted to deal drugs, “you did not come to Burlington,” Traverse said. But that’s changed: “Open-air drug sales are a common occurrence here.”

State’s Attorney Sarah George, the prosecutor for the county that includes Burlington, is a progressive Democrat who once wrote that the American legal system “was built on the oppression and caging of black, brown, and poor people.” She told me that the combination of COVID, ever less affordable housing, and a cascade of evictions fed a drug crisis that has devastated Vermont. But she doesn’t blame addicts, who she said are “rarely dangerous” and are suffering. “I’m very frustrated with this narrative that City Hall Park is the end of the world,” George added. “That park is still a very safe place to be.”

I asked her how Burlington might balance drug users’ sometimes dominant presence in the city’s parks and streets with the desire of residents to use and enjoy those same places. The city, she replied, should start by opening its planned injection center so that addicts can use drugs in private. The state legislature has allocated about $2 million that it obtained from a national opioid settlement to help fund the center, though potential neighbors have pushed back against the sites that have been floated so far. More broadly, George opposes pushing addicts to the margins. “They cannot be disappeared,” she said. “They are part of our community.”

In 2022, George announced a new policy: If police officers stopped cars with broken taillights, tinted windows, or expired licenses and found a cache of narcotics, her office would most likely decline to prosecute the cases, on the grounds that racial discrimination could have motivated the traffic stops. She emphasized to me that police officers could in any case confiscate and destroy the drugs. But she questioned the need to go beyond that. “Is prosecution needed?” she said. “Or have we done enough already?” George has been reelected twice and is running for a third term.

In April, I spoke with Burlington’s mayor, Emma Mulvaney-Stanak, of the Vermont Progressive Party, which has governed the city for much of the past four decades. She has seen firsthand the effects of the drug epidemic. When she lived in the Old North End and her child was a toddler, they awoke to drug dealers beating on their door. She told me that she supports police and Drug Enforcement Administration investigations that target dealers, although she noted the “whack-a-mole” nature of that work, as new dealers replace those who are arrested. She said that without more help from the county and state, the city lacks the funds to build larger shelters that could help keep addicts off the streets. She is aware that Burlingtonians have grown impatient living with a drug-abuse epidemic. “We are fatigued with our compassion,” she told me. “All of the attention on harm reduction and public health—I get that.”

But, like George, Mulvaney-Stanak has not backed away from harm-reduction policies that she sees as humane and essential. Last summer, she opposed a city-council resolution calling for police officers to be stationed in City Hall Park to clear out users and dealers, arguing that the drug traffic would only go elsewhere and that there were not enough officers to enforce the policy. She signed off on the resolution, but she shares George’s philosophical objections: “Displacement and removal of people is not the solution,” the mayor said.

Wouldn’t an injection center, I asked her, draw more addicts and dealers to Burlington? She acknowledged the possibility, but framed it as a necessary risk. She repeated the harm-reduction maxim: “It helps people where they are at.” The city’s problems, Mulvaney-Stanak insisted, were more image than reality: “People need to ignore the clickbaity articles that distort the nature of Burlington.”

Recently, Traverse and other Democrats on the city council have begun to challenge the mayor on harm reduction. Jennifer Morrison, the state’s public-safety commissioner, has also spoken up. She served as Burlington’s interim police chief for six months in 2020 before quitting, in part because of what she described as the city’s “mismanagement” and “social activism.” She and Governor Phil Scott, a moderate Republican, have clashed with Mulvaney-Stanak. They have periodically, at the city’s request, sent state troopers to Burlington to help local police with drug enforcement and patrolling the central business district. “I lived through the decisions that got us to the place that we are now,” Morrison told me. “We are exposing our youth to terrible consequences by normalizing drug use and addiction.”

The business community in Burlington has also pushed back. In more than a dozen interviews, local merchants spoke of feeling abandoned. In testimony before the state legislature, the owner of Outdoor Gear Exchange reported that in 2024, the business lost an estimated $400,000 to shoplifting, as addicts stole to support their habit. At Homeport, a 40-year-old home-furnishings store downtown, a co-owner, Mark Bouchett, told me that he lost $95,000 to shoplifting in 2024 and was forced to hire a security guard. Drug users defecate in the doorways of businesses.

Bouchett joined 170 other business owners and restaurateurs who last year wrote an open letter to the mayor warning that the city was in crisis. Their tone was reasonable; they sought treatment for addicts, not incarceration. But a broad coalition of the political left in Burlington—unions, harm-reduction groups, pro-Palestine and trans-rights activist groups, and the local chapter of the Democratic Socialists of America—countered with their own letter, in which they denounced the business owners and demanded that they open bathrooms and sheltered doorways to addicts. To call for more police to help address the city’s drug problem, this group wrote, would “further harm our most vulnerable community members.” One of the signatories, Food Not Cops Burlington, posted and then deleted a boycott map targeting the business owners.

Overdose deaths in Vermont dropped last year to 170, a 37 percent decrease from the peak in 2022, but still far above the 78 deaths recorded in 2010. At the Ben & Jerry’s on Church Street, I saw staff hand out cards to customers who asked to use the bathroom: “Vermont is experiencing a tragic increase in overdose fatalities. Our bathroom has also become a destination for folks seeking to inject drugs.” The bathroom was permanently locked.

Families and children speak of being left on their own to navigate these harsh realities. Through the King Street Center, I met a young woman who was earning top grades at the University of Vermont. When she walks her younger sisters home from school, they pass drug dealers on the way. A Burlington High School student told me that her teachers have instructed students to avoid eye contact with dealers and users. A week earlier, she said, an addict had trailed her home after volleyball practice. She broke into a run, yelling for help, and the person eventually turned away.

Then there was Britany, a mother of three young children, who moved two years ago from a homeless shelter to an apartment on King Street. (She asked me not to use her last name, fearing for her family’s safety.) She said that she often found drug paraphernalia in the apartment building and, on some nights, encountered an addict sleeping in the hallway; her next-door neighbor was a fentanyl dealer. She had constructed a safe room for her children to flee to in case of gunfire. “Everyone talks about needle exchange and harm reduction,” she said. “I mean, okay. But it’s like my children and I are living in the zombie apocalypse.”

Just a few years ago, voters in Seattle seemed primed for a change. In 2021, they elected Ann Davison, a moderate and independent-minded Republican, as city attorney. Sara Nelson, a Democrat who had advertised her willingness to challenge the harm-reduction consensus, won a seat on the city council the same year and became its president two years later. With support from Davison, she passed laws cracking down on open drug use, prostitution, and dealing downtown, and substantially increasing the number of surveillance cameras in high-crime neighborhoods. Nelson persuaded the city council to redirect money to on-demand addiction treatment. “You can’t meet people where they’re at, because where they’re at is on death’s door,” she told me, adding that she believes many addicts can be saved only by a firm push toward treatment.

Dana Golan for The Atlantic

An encampment in South Queen Anne, Seattle. Since taking office in January, Mayor Katie Wilson has authorized sweeps of encampments and signaled an openness to pulling back on harm-reduction policies.

Nelson also asked pointed questions about what had become the received wisdom in Seattle, such as why the county government paid millions of dollars to supply kits to addicts with tinfoil, pipes, and instructions on how to smoke fentanyl. (Incongruously, these kits came emblazoned with an image of Martin Luther King Jr., the namesake of King County.) What harm was reduced, Nelson asked at a 2023 council hearing, by helping addicts get high? Amber Tejada, an employee of a health nonprofit that had partnered with the city, raised her hand to answer. “I know it can be a little controversial,” she told the councilwoman, “but one of the key tenets of harm reduction that I see is that we want to be able to facilitate and champion autonomy of people who use drugs.” Tejada added, “There are folks for whom abstinence is not something by which they measure their success in life.”

Nelson was no hard-line conservative. She pushed to expand the number of treatment beds for addicts and talked openly of her own past struggles with alcohol. But in elections last November, voters turned out both her and Davison. Their replacements had concerns over the use of surveillance cameras and opposed laws that barred repeat public drug users from certain areas in the city. I spoke with Davison in her office shortly before her term was up. She wrestled with her sense of a job not completed. “It’s really sad to watch the slow death of so many people,” she said, adding later, “You cannot act like this is a victimless crime.”

[Read: Crime in Chicago is a choice]

I asked Sandeep Kaushik, a Democratic political consultant who has lived in Seattle for decades, if he could explain the persistent attraction of radical harm-reduction policies in his city. Kaushik described himself as an “unreconstructed Obama Democrat,” which he noted “codes me as a conservative in some circles here.” He told me that local leaders “really believe the city should be on the leading edge of translating progressive ideas into policy.” There is also a curious disconnect between the policies that political leaders put in place and the desires of voters. In many polls, Seattle residents list crime and illegal drug use as among their greatest concerns, and a Seattle Times survey three years ago found that 60 percent of respondents wanted police to arrest those who used drugs in public places.

Last year, the city elected a new mayor, Katie Wilson, a self-described democratic socialist with no experience in elected office. Wilson has signaled an openness to pulling back some harm-reduction policies. Before she officially entered the race, she wrote an essay for Seattle’s alt-weekly, The Stranger, in which she cautioned fellow leftists against smugness. “The central weakness of the left narrative,” she wrote, “is a habit of deflection that makes it sound, at best, as though we are in denial about the grim reality on the streets.” The left, she continued, should not trivialize “what anyone who spends some time walking around Seattle’s streets can plainly observe: People with acute mental illness whose behavior is disturbed and occasionally aggressive. People using drugs, often incapacitated or passed out on the ground.”

Since she took office, Wilson has backed up her words by signing off on sweeps of large encampments in parks. Police and city workers have dismantled tents and carted away garbage. In late June, the mayor emerged from what she described in a statement as a period of “deep listening” and promised to “disrupt the drug dealing” and “public disorder” that plague the city’s Little Saigon and Beacon Hill neighborhoods. The police, she said, would commit more officers to those areas, and arrest users and dealers or press them to accept treatment. For a Seattle politician to argue that tolerating drug crime and disorder amounts to harm enhancement registered as something close to startling news.

Yet Wilson runs a political risk. By pledging to crack down, she has broken with many of her allies and supporters. Now she will be judged by her ability to clear the city’s streets. Andrea Suarez leads a group, We Heart Seattle, that combines care for the homeless with a hardheaded insistence on legal consequences and addiction treatment for drug users. She was in Jose Rizal Park when police swept it one day in April, and watched users and dealers amble off into the woods or walk over to Little Saigon. They returned a few hours later, she told me. A day or two after that, the tents reappeared. “Everyone who lives in this park knows there is no consequence for being swept multiple times or doing drugs or vandalizing a park,” Suarez said.

Dana Golan for The Atlantic

People who live in Jose Rizal Park know “there is no consequence for being swept multiple times or doing drugs or vandalizing a park,” one community activist says.

What’s baffling is that none of this lies beyond the ability of city officials to address. San Francisco Mayor Daniel Lurie has instructed police to crack down on dealers and dismantle tent cities. Philadelphia Mayor Cherelle Parker has sent officers into drug-scarred neighborhoods and established a treatment court, which offers first-time felony drug offenders a chance to avoid jail if they enter a treatment program. San Jose, California, has put more police officers in targeted neighborhoods, built emergency housing as police dismantle homeless encampments, and increased fines for landlords whose abandoned buildings are used by dealers to sell drugs and guns. In Boston, Mayor Michelle Wu was once enamored of harm reduction and injection centers. But she has ordered police to clear street encampments, and her administration now puts more emphasis on pushing addicts into treatment, by detaining them if necessary. Wu has also dropped all mention of injection centers from her plans.

In Seattle, by contrast, efforts to reduce public drug use force afflicted neighborhoods to pay a high price. For years, when playgrounds and parks became drug hot spots, the city reacted by fencing them off, depriving families of access. In May, police and city workers returned to Jose Rizal Park and again booted out dealers and addicts, preparing the park for a renovation. As a first step, city workers dismantled the picnic pavilion where addicts smoked and shot up, its condition having deteriorated from all the misuse. Park officials do not plan on replacing it, acknowledging the obvious in bureaucratese: The park “has been impacted by activities not aligned with intended use.” The bus shelter around the corner, where drug users gathered day and night, was also ripped out “because of an increase in loitering, littering and vandalism,” a King County Metro representative told me by email. All of this felt like another admission of defeat—officials destroying Seattle in the name of saving it.

This article appears in the September 2026 print edition with the headline “The Cities That Said Yes to Drugs.”

What Anthony Fauci Didn’t Say

2026-07-29T17:01:34-04:00

Sign up for Inside the Trump Presidency, a newsletter featuring coverage of the second Trump term.

Sitting in front of the Senate Committee on Homeland Security and Governmental Affairs today, Anthony Fauci twirled his pen. He huffed and straightened his shoulders. He glanced down at a set of papers. He muted and unmuted his microphone.

But other than a brief initial statement, in which he referred to Chairman Rand Paul’s “unhinged obsession” with slandering his reputation and putting him in prison, the only words the former director of the National Institute of Allergy and Infectious Diseases spoke into the public record—as senators interrogated him about his institute’s funding choices, maligned him as an egomaniacal money-grabber, and accused him of shattering American trust in public health—were these: “On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution.”

“Nothing says honesty like taking the Fifth, huh, Doc?” Senator Josh Hawley, a Republican from Missouri, asked him at one point. “Let’s try something. What day of the week is it today?”

Fauci consulted the paper in front of him: “On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution.”

“What color tie are you wearing?”

Fauci consulted the paper in front of him: “On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution.”

Senator Paul had said he called the hearing—billed simply as “Testimony of Anthony Fauci”— because “the American people deserve answers” about Fauci’s role in the origins of the coronavirus pandemic. Instead, the American people got something absurd: a three-hour spectacle of unchallenged allegations and distorted facts.

That Fauci would stonewall the committee was entirely predictable. Paul has led a yearslong effort to punish him for allowing NIAID to fund research that allegedly enhanced the coronavirus’s ability to harm people, and for allegedly lying to Congress and the American people about that fact. (Some federal intelligence agencies favor the theory that the pandemic started with a virus that leaked from a lab in Wuhan, China; Fauci, in keeping with the consensus among virologists and other infectious-disease experts, has said that the preponderance of biological evidence points instead to the virus having a natural origin, likely spilling over from a wild animal into humans.) In January 2025, during the final hours of Joe Biden’s term, Fauci received a sweeping, preemptive presidential pardon for “any offenses against the United States which he may have committed or taken part in” over the previous 11 years.

That pardon doesn’t cover Fauci’s actions past the end of Biden’s presidency, or protect him from prosecution over any statements he might have made today. “He could perjure himself now,” Health Secretary Robert F. Kennedy Jr. said this week on Fox News. “If he lies again, then he could be subject to perjury prosecution.”

But the most obvious distortions at the hearing came from the Senate panel. Senator Ron Johnson, a Republican from Wisconsin, proposed that the pulmonary infarction Fauci experienced in 2021—the details of which were revealed in the pages from Fauci’s private diary that Paul released last weekend—may have resulted from COVID vaccination and booster shots. More than 39,000 deaths had resulted from COVID-19 vaccination, he said, and although Facebook had censored his supporters when they tried to share that fact, “this wasn’t disinformation, this was the truth.”

Fauci only sat there with his fingers clasped. He did not point out that this was not the truth at all, and that Johnson’s data—derived from unvetted, user-submitted information in the Vaccine Adverse Events Reporting System—are likely to overestimate the real total by about 1,000 times. When Johnson finally ended his remarks with a question—he asked whether Fauci knew about the “dozens of safety signals associated with the COVID injection”—Fauci gave only his standard 21-word response: “On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution.”

Paul claimed on multiple occasions that Fauci had been so dogmatic in his support for dangerous and irresponsible gain-of-function research that he’d written a 2011 op-ed for The Washington Post in support of an experiment that made avian influenza more transmissible in ferrets. According to Paul, Fauci wrote in that op-ed that “even if a scientist is bitten, even if a pandemic should occur, the knowledge is worth the risks.” Fauci did write in the Post that he thought that the benefits of that experiment likely outweighed the risk. But he did not make the preposterous argument that such research would have been worth doing even if it had kicked off a pandemic.

In the past, Fauci could easily have corrected the record and provided a nuanced description of this work. Over decades, he had built a reputation as the nation’s “nonpolitical” spokesperson for public health—the role he stepped into most publicly in early 2020, when the coronavirus was first burning across the U.S. When President Trump touted ineffective drugs as cures and insisted the coronavirus would vanish “like a miracle,” Fauci refuted those claims.

Now Fauci wasn’t talking, and no one else could speak on his behalf. Early on in the hearing, one of his lawyers, David Schertler, spoke up to defend his client against Paul, but was escorted out of the chamber by security at Paul’s request, after the senator repeatedly told him, “You are not recognized!”

Democrats, meanwhile, shied away from asking Fauci questions at all—if they had, he almost certainly would have deferred every question from them, too. Instead, they spent their time scolding Paul for convening the panel at all, thanking Fauci for his service, and criticizing the Trump administration for its attacks on science and public health. The Republicans’ most aggressive allegations went unchallenged in the room.

Fauci seemed to want to say more. At least once, he leaned behind him to consult his panel of lawyers before, once again, invoking his Fifth Amendment rights; at other times, he tensed his shoulders or sighed heavily. In a 2021 Senate hearing, Paul accused him of being responsible, by funding gain-of-function research, for the deaths of millions of people. At the time, Fauci briefly broke his composure. “You are implying that what we did resulted in the deaths of individuals,” Fauci said, pointing his finger at Paul. “I totally resent that, and if anyone is lying here, Senator, it is you.”

Faced with personal attacks this morning, he offered no response. “You became a narcissist and a megalomaniac and a liar,” Hawley said. “You’ve done more to harm science than anybody in my lifetime.” Paul called the hearing the “capstone” to Fauci’s career and said he’d displayed “hubris the likes of which the world has rarely seen.” Rick Scott, a Republican from Florida, told Fauci he was a “villain” who had “destroyed the federal government’s credibility when it comes to public health” because he wanted to fuel his own ego. “What would you do differently, knowing what you know today, Dr. Fauci?” Scott asked him.

Fauci consulted the paper in front of him. “On the advice of counsel, I respectfully decline to answer based upon my rights under the Fifth Amendment to the Constitution.”

The Unmaking of Anthony Fauci

2026-07-28T08:00:00-04:00

This article was featured in the One Story to Read Today newsletter. Sign up for it here.

When Anthony Fauci arrives on Capitol Hill tomorrow to testify before Congress, he will be trailed by a security detail he’s paying for himself. Fauci has been testifying before the nation’s elected officials for roughly four decades now, since his days at the forefront of early AIDS research. In years past, he would have prepped by consulting colleagues and poring over data—he would have been there, as he might say, to speak for science. Now he’s under a subpoena from the Senate Homeland Security and Governmental Affairs Committee, and has been conferring with his lawyers on how best to navigate a grilling about his own actions—and what seems to be an effort to catch him in a lie, one that isn’t covered by the blanket presidential pardon he received from Joe Biden. Once famed for being America’s consummate nonpartisan scientist, Fauci is now a far more polarizing kind of public figure: beloved and reviled for what he’s said to represent; targeted by threats to end his life. The more he talks, the more he stands to lose.

This is not the professional coda that Fauci’s half century in government once seemed to be heading toward. For decades, he has been one of the nation’s best-known and most-respected scientists. In the late 1960s, Fauci helped lead a team at the National Institutes of Health that repurposed cancer therapies as cures for several once-fatal rheumatological conditions. His later partnerships with AIDS activists and his push to accelerate experimental-drug trials for HIV helped transform the infection into a survivable condition. He went on to serve as a chief architect of PEPFAR, a global HIV-prevention-and-care program that has prevented an estimated 25 million deaths since 2003. And over the course of his nearly 40 years as the head of the National Institute of Allergy and Infectious Diseases, he turned one of the NIH’s quietest branches into a $6 billion research juggernaut. Fauci has “saved more lives, created more amazing infrastructures for developing research opportunities, cured more people, provided health care to more people both in the United States and abroad, probably, than any single scientist in his lifetime,” Larry Corey, an infectious-disease expert at the Fred Hutchinson Cancer Center, told me.

His achievements speak to his scientific credentials, but also to his ambition and savvy. Fauci was a master of the system: He knew how to acquire and maintain scientific power; he had the ear of both academics and politicians. He eagerly courted attention, while maintaining that he was “completely nonpolitical,” to the point that even his close colleagues at NIAID had no idea how he voted in elections. “Congress really saw him as a straight shooter,” Judith Feinberg, an infectious-disease researcher who worked at NIAID early in her career, told me, without “a particular political axe to grind.” Fauci was that rare bureaucrat who could be given a Presidential Medal of Freedom by George W. Bush and then be praised as a “once-in-a-century public health leader” by Barack Obama.

But ever since President Trump retook office in 2025, his administration has engaged in a systematic effort to obliterate Fauci’s legacy. One of Trump’s first actions in office—just days after Biden issued his pardon—was to strip away Fauci’s government-funded security detail. Fauci’s image was cut out from a mural on the NIH campus around the same time. By the end of spring, the administration had rerouted government webpages once dedicated to information on COVID resources to a new site, alleging that Fauci had tried to hide the “true origins” of COVID. Trump officials went on to largely dismantle PEPFAR, imperiling many of the 20 million people the program has supplied with lifesaving therapies. They ousted most of NIAID’s long-standing leadership, including several officials who served under Fauci for years, as well as Jeanne Marrazzo, the director who succeeded him; they forced out Fauci’s wife, Christine Grady, once a bioethicist at the NIH, and arrested David Morens, one of Fauci’s longtime advisers. (Morens has pleaded not guilty to charges of conspiring to hide and destroy government records.) “Anything that he had his name on, or that was under his accomplishments, is being destroyed,” Judith Currier, an infectious-disease expert at UCLA, told me. (The White House and the Department of Health and Human Services did not respond to requests for comment.)

The attacks haven’t let up. In recent days, Rand Paul, now the chair of the Senate Homeland Security and Governmental Affairs Committee, has released troves of documents related to Fauci; among them are more than 1,500 pages from Fauci’s private diary. In one set of entries, which runs from the end of 2019 through his retirement from government at the end of 2022, Fauci meticulously chronicled his growing fame. “Truly unbelievable,” he wrote in May of 2020. “People naming their dogs after me. Sally Quinn saying that I was the erotic lead male in a book she wrote in 1994.”

Fauci has observed this campaign of vengeance and humiliation mostly without public comment—marking one of the quietest stretches of his career to date. (He declined to be interviewed for this article.) Tomorrow, though, Paul is forcing him to talk. At the age of 85, Fauci will be dragged onto the Senate floor to defend his reputation, but something bigger will be contested too: not what Fauci did during his years in government but how he did it—the way he wielded his nonpartisanship to gain resources for his institute and stay in the good graces of powerful people. That approach was once routine, and Fauci perhaps its most skilled practitioner. Now its future is in doubt.

For all of Fauci’s fame and clout, he was not necessarily the most obvious choice, in early 2020, to be the public face of the United States’ response to COVID. In title alone, the CDC director, then Robert Redfield, would have been a far more obvious choice, Georges Benjamin, the executive director of the American Public Health Association, told me. But the Trump administration instead put Fauci onstage.

Through the early months of the pandemic, as people scrubbed down their groceries and watched news clips of bodies being piled into refrigerated trucks, Fauci’s calm, science-focused statements were a stabilizing force. Eventually some came to regard him with a singular reverence—as if public health were a new religion, and Fauci its living idol. His likeness appeared on T-shirts, socks, and buttercream-frosted donuts; there were Fauci bobbleheads and face-masked Fauci action figures; people put up yard signs declaring In Fauci we trust. On votive candles dedicated to “Saint Fauci,” artists ringed his gray hair with a golden halo. At times, Fauci appeared to embrace his status as expertise personified. “A lot of what you’re seeing as attacks on me, quite frankly, are attacks on science,” he told MSNBC in 2021.

[Anthony Fauci: What I saw inside the government’s response to COVID]

But his fame quickly began to cut both ways. If some Americans (especially establishment-minded Democrats) designated him the heroic embodiment of public health, others (including the MAGA and proto-MAHA crowds) quickly cast him as its lead villain: a power-drunk official who overhyped the benefits of masking, tanked the economy, annihilated small businesses, and pointlessly disrupted learning for millions of children. For the first time, Fauci was openly and repeatedly clashing with a president, too. He masked in public when Trump would not, and he contradicted Trump’s wild claims about injecting bleach and taking hydroxychloroquine. His strategy of aligning himself with the public-health consensus, which had once endeared him to politicians, now made him appear to be a partisan opponent. In the early months of COVID, Fauci’s staff at NIAID began to flag the most violent emails in his inbox for a security team. One man said that Fauci and his family would be “dragged into the street, beaten to death, and set on fire.” (That man was convicted of threatening a federal official and sentenced to more than three years in federal prison.) By the end of 2020, he was traveling with bodyguards.

Certainly, Fauci made mistakes. Early on, for instance, he advised against the widespread use of masks amid a shortage of them and then reversed that position. “I don’t think the communication around that was particularly good,” Emily Erbelding, a former director of NIAID’s Division of Microbiology and Infectious Diseases who was ousted from her role last year, told me. “It was just No masks, and then all of a sudden Everybody’s wearing masks, and you must wear a mask.” But Fauci was also asked to weigh in on seemingly every pandemic policy, including many far outside his purview, and he was doing so as everyone’s understanding of the virus was evolving rapidly and in real time. When Fauci said that sending kids back to school without a vaccine could be risky, and that opening schools in areas experiencing intense viral transmission would not be prudent, many people took that to mean Fauci said to keep all kids home, indefinitely. (School closures were ultimately up to individual states and districts, and decisions about them were complicated by demands from teachers’ unions.)

If Fauci was the patron saint of all that was good about public health, he was also demonized for all of its failings. By the fall of 2020, the apolitical persona that Fauci had cultivated over nearly half a century had started to come apart.

Anthony Fauci in his office in Bethesda, Maryland, 2003 (Michael Geissinger / LOC / Getty)

Fauci has described the principles that drive him—public service, integrity, clarity of thought and speech—as the yield of his Jesuit schooling. He came to understand that, as a doctor working at the NIH, he could aid not just individual patients or a single hospital, but potentially entire nations that stood to benefit from cutting-edge research. And despite repeated offers to be nominated for NIH director, he chose to remain at NIAID—in part to remain in proximity to the HIV/AIDS research that he felt closest to, his colleagues told me, but also because he didn’t want the baggage that came with being a political appointee. He preferred to maintain unchallenged influence, they said, over almost his entire field.

That penchant for control was coupled with a sizable ego. I spoke with 15 of Fauci’s friends and former colleagues, and they described him as someone who adored the attention that came with being a go-to health expert for journalists and presidents alike. “He certainly embraced that role—sometimes, I thought, a little too much,” Hugh Auchincloss, Fauci’s former deputy director at NIAID who retired in 2024, told me. The pandemic diary entries fit that assessment: The phrase prolonged standing ovation appears seven times throughout; his admirers are repeatedly described as being brought to tears by his presence. “As soon as people recognized me there was a wave of applause and squealing and screaming and clapping and thanking me with multiple people coming and asking for selfies,” he wrote in May of 2021. “It was a little bit embarrassing, but it was just a manifestation of how people need a symbol of integrity and truth.”

[Read: America is thirsty for Anthony Fauci]

Many people told me that Fauci could be a challenging supervisor. He was a chronic workaholic who expected the same of his top officials. In his institute, everyone knew that if you were early to a meeting with Fauci, you were on time; if you were on time, you were late; if you were late, you were in serious trouble. “He has a very Italian temper, and he’s famous for losing it,” especially at people who pretended to understand what they did not, Judith Feinberg told me. To get on Fauci’s good side was to earn his confidence, his respect, and the benefits of his network of resources; to land on his bad side was to be carved into shreds inside his office, the worst of his rampages audible through the closed door.

Fauci could inspire others’ fury, too, even well before the pandemic. During the early days of the HIV/AIDS epidemic, activists from the gay community lambasted him and his institute for the plodding pace of research on the virus. In 1988, the playwright and activist Larry Kramer wrote an open letter describing Fauci as a murderer and a “fucking son of a bitch of a dumb idiot”; two years later, the group ACT UP surged onto the NIH campus to burn Fauci in effigy, carrying a casket that read Fuck you, Fauci. (He later invited those same activists to weigh in on the state of AIDS research, eventually converting them into allies.)

His biggest adversaries now, though, are not representatives of a marginalized group that many Americans once condemned, but some of the country’s most influential figures in media and politics. Joe Rogan has described him as a “monster”; Elon Musk has said he was a “freaking demon.” Health Secretary Robert F. Kennedy Jr. published a 500-page book called The Real Anthony Fauci, which accuses him of having organized a “historic coup d’état against Western democracy” and seized a “power enjoyed by few rulers and no doctor in history.” (Meanwhile, the book lionizes people who promote AIDS denialism and anti-vaccine views.) Trump has referred to Fauci as a “disaster” and an idiot “who got it wrong.”

Fauci’s most extreme critics don’t just contend that he endorsed wrongheaded pandemic-era mitigations; they allege that he played a role in starting the pandemic—that under his direction, NIAID knowingly funded dangerous research that boosted coronaviruses’ ability to infect and kill humans. Fauci “knows a lot more than he’s told so far,” Jeffrey Sachs, a Columbia University economist who chaired The Lancet’s COVID commission and has been publicly critical of Fauci, told me. (Sachs has argued that the coronavirus may have originated from U.S.-funded research, and that Fauci knew this very early on and tried to hide that fact.)

The consensus view among virologists is that the virus that causes COVID likely spilled into humans from a wild animal—a known and common cause of new epidemics. Several agencies within the U.S intelligence community agree, but a few others have come to the opposite conclusion. In any case, some senior leaders in the Trump administration, as well as members of the GOP majorities in Congress, feel certain that the pathogen first emerged from a Chinese laboratory. To them, Fauci is a prime culprit in this story: As they see it, he concealed evidence linking NIAID to the Chinese facility where that research occurred. Rand Paul, in particular, seems bent on getting Fauci prosecuted for allegedly bribing and coercing intelligence officials to aid in his cover-up. “He has not really gotten his just deserts,” Paul recently told Fox News. “There needs to be repercussions.” (Paul’s office did not respond to repeated requests for comment.)

[Read: Lab-leak payback has begun]

Fauci, for his part, has vehemently denied that NIAID bankrolled irresponsible research, and maintains that his former institute is not to blame for COVID; he has called the notion of a cover-up “preposterous” and pointed to an email from February 2020—in which he said that if legitimate evidence of a lab leak emerged, it should be reported to intelligence officials—as confirmation of his transparency. Fauci has also openly favored the natural-origin hypothesis, as have most others in his field. All along the way, he has continued to present himself as someone whose primary allegiance is to the facts—a “nonpolitical” person to the end. Yet much of the public has long since stopped perceiving him as such. By the 2020 election, Fauci had become a campaign talking point; Trump mocked Biden for trusting Fauci, and accused Fauci of being a Democrat. (Fauci has long been registered as an independent.)

In December 2020, Fauci accepted Biden’s offer to become the president’s chief medical adviser, a position he’d never previously held. And in early 2025, hours before Biden left office, the president issued Fauci a full and unconditional pardon for “any offenses against the United States which he may have committed or taken part in” over the previous 11 years. Many on the right took that as an admission of Fauci’s guilt for COVID-related crimes. At the very least, it was an indication that Fauci’s strategy of scientific separatism had come up short. Now he needed politics to protect him.

For many Americans, Fauci remains a public-health icon. A recent poll shows that, nearly four years after he left government, more than half of Americans still have confidence in what he said about public health. In that regard, he polls far better than health officials who are currently in office, including Kennedy and Mehmet Oz.

But polling also suggests that trust in Fauci has ticked down over time. Several of his former colleagues told me they worry that Americans will continue to sour on him as the political fight over his legacy drags out. For the moment, Fauci is constrained in his ability to defend himself. Paul has argued that Fauci’s sweeping pardon precludes him from invoking his Fifth Amendment right. But whether he could plead the Fifth throughout the hearing comes down to whether there is “a realistic threat of prosecution,” which still seems highly plausible, Richard Hughes IV, a legal expert at George Washington University, told me. But that defensive strategy, even if effective, could also leave a lasting mark on Fauci’s legacy: For the scientist who never shied away from attention, and who came with all the answers, the repetitive demurral would surely be excruciating.

Even if Fauci emerges unscathed, several of his friends told me they despair at the disruption this saga is causing to his life. (Although the death threats against his three daughters have mostly subsided, he and his wife have continued to receive them.) Fauci still holds a teaching position at Georgetown University and regularly travels to give talks—accompanied by security guards. But at 85, he is weary; some of his closest friends told me they want nothing more for him than peace. Barney Graham, a former deputy director of the NIH’s Vaccine Research Center, told me that he and some of his colleagues feel some survivor’s guilt as they watch Fauci endure attack after attack: “He kind of martyred himself for the sake of all the other scientists.” Several were reluctant to criticize Fauci in any way, on the theory that doing so would only give more fodder to his right-wing critics. (A few of his close friends and colleagues declined to speak with me at all, citing fears that their words would not help Fauci.)

If Fauci’s legacy now seems fragile, that may be partly due to how he built it, Jeanne Marrazzo, the most recent NIAID director, told me. Many of the researchers in top leadership positions at NIAID were Fauci’s longtime colleagues; the institute’s priorities were heavily shaped by his personal research goals. Fauci “owned an empire,” she said, and when you own an empire, “it lives and dies with you.” The first time she walked into the director’s office after Fauci had retired, it still resembled a self-curated shrine, its walls covered with awards and celebrity-studded photographs that hadn’t yet been cleared. Fauci obviously wanted his own presence at the NIH to last, she told me. In the days after Trump’s second inauguration, Fauci emailed her to ask what would happen to an expensive portrait of him, completed in 2023, that had never been hung.

Marrazzo inherited Fauci’s throne in the fall of 2023; the Trump administration forced her into administrative leave less than two years later. (Kennedy personally fired her at the end of 2025, after she filed a whistleblower complaint criticizing recent shake-ups at the NIH; Marrazzo has since sued the Trump administration for wrongful termination.) Unlike many other members of NIAID’s leadership, she had never been personally close to Fauci, and she took over NIAID eager to nudge the institute in new directions. But as far as she could tell, succeeding him seemed enough to make her a target.

Several of Fauci’s friends and former colleagues told me that they were hopeful that, with the passage of time, the vitriol would fade, administrations would change over, and the history books would ultimately memorialize Fauci for the scientific advances he spearheaded and the lives he saved. At the same time, several of the people I talked with admitted that Fauci’s recent experiences had forced them to reflect on what it meant to be a scientist in the modern era, when the practice of research and public health is under political attack.

They may understand that the approach to scientific leadership at which Fauci most excelled—moving through the nation’s politics, instead of being caught up in them—no longer works the way it did before. Americans have been advised by top health officials to second-guess traditional scientific expertise; some of those same officials now profess neutrality as they make “gold-standard science” their euphemism for political control. For decades, Fauci stood before the nation to offer steady and nonpartisan advice. In tomorrow’s hearing, that voice of science may not be heard at all.

America Is About to Go Over a Peptide Cliff

2026-07-24T11:19:59-04:00

BPC-157 is rumored to heal almost anything: a sore shoulder, a bum knee, a pulled hamstring, ulcerative colitis. Maybe even traumatic brain injuries and multiple sclerosis, too. The drug—part of a class called peptides—has been around for decades. But it has recently experienced a surge in popularity, thanks in part to great peptide publicity from influencers, podcasters, and Robert F. Kennedy Jr., the secretary of health and human services. Thousands of Americans are taking it. And almost all of them are sourcing it from sketchy online vendors, many of which are supplied by manufacturers in China.

But BPC-157 may soon become easier to obtain through more reputable channels. An advisory committee to the Food and Drug Administration voted yesterday to recommend that compounding pharmacies be allowed to make the peptide, even though it has little human-safety data and hasn’t passed through the normal FDA drug-approval process. For BPC-157 enthusiasts—and they seem to be legion—it’s welcome news. For telehealth companies, it might mark the beginning of a peptide gold rush.

Before yesterday’s vote, the prospects for BPC-157 appeared bleak. At the meeting of the Pharmacy Compounding Advisory Committee—which last month added eight new members, many with ties to telehealth companies and wellness clinics—FDA researchers argued that the scientific evidence supporting BPC-157 was weak. They insisted there weren’t enough data to be sure that BPC-157 is safe, that it works, or even which sequence of amino acids it necessarily contains. As one FDA official put it: “We don’t actually know with any certainty what it is.”

[Read: The peptide boom is getting out of hand]

Those doubts didn’t convince the committee, which voted 8–6 to recommend that BPC-157 compounding be allowed. Among those who voted yes was Kris Wusterhausen, a recent addition to the committee who is a doctor and the founder of a Texas wellness clinic that recommends peptides, including BPC-157. “Once you’ve seen the effects of BPC, you can’t unsee it,” Wusterhausen said after his vote. (“All committee members underwent the same ethics review and vetting process required of all FDA advisory committee members,” Emily Hilliard, a spokesperson for the Department of Health and Human Services, told me in an email.) The decision is only a recommendation, and the FDA would still need to sign off on an actual rule change. But ultimate approval seems likely given Kennedy’s demonstrated enthusiasm for peptides. In a conversation with the podcaster Joe Rogan in February, Kennedy called himself a “big fan” and said he was eager to make them more accessible.

Several telehealth companies have said they intend to offer BPC-157 to customers if the FDA follows through on the committee’s recommendation. The telehealth industry, after all, is more or less built on compounding pharmacies; Hims & Hers actually bought its own in 2024. Anant Vinjamoori, the chief medical officer of Hims, told the committee that allowing his company and others to sell the drug is the safer choice. The published human data supporting BPC-157 may not be strong, but, he argued, forbidding American companies from providing it would “move it deeper into a market with no production or sourcing standards, no physician, no monitoring, and no record.” That view was echoed by Jeffrey Egler, the chief medical officer at the telehealth company Noom.

Vinjamoori and Egler do have a point. Many popular peptides are readily available online because they’re marketed for “research use only.” That loophole allows companies to get around the regulations for human use, and customers to avoid a conversation with a health-care provider. The companies making and selling them are generally difficult to track down or not based in the U.S., which means American authorities have little recourse to enforce standards for quality or legality. In some cases, the drugs contain impurities; customers have no way of knowing whether they’re actually receiving the peptide they purchased unless they pay for third-party testing. U.S.-based compounding pharmacies, by contrast, are licensed by state boards of pharmacy. And in order to get BPC-157 from one, patients would need to get a prescription from a doctor.

Then again, allowing American companies to sell BPC-157 for human use could create the impression that the peptide, which hasn’t passed through the rigorous process the FDA uses to approve new drugs, nonetheless has the agency’s blessing. Brian Lee, an associate professor of clinical medicine at the University of Southern California, who serves on the committee, argued as much yesterday. He voted against allowing compounding pharmacies to sell it.

[Read: The longevity scam]

BPC-157 isn’t the only peptide the committee voted to recommend. TB-500, which is often paired with BPC-157 in a combo known informally as the “Wolverine Stack” (named after the comic-book character who can heal quickly after being injured), also received the go-ahead yesterday. So did the peptides KPV, which is promoted for reducing inflammation, and MOTS-c, which is touted for boosting metabolism and improving endurance. This morning, the committee finally rejected one peptide: Emideltide, which is thought to induce sleep. Two more will be voted on later today.

Each peptide that’s recommended this week represents the possibility of a new profit stream for compounders and telehealth companies. By some estimates, the total market for these seven peptides could be worth billions of dollars. And, if they’re ultimately approved, it will also serve as another example of Kennedy getting his way over the objections of the researchers who work for him.

The Worst Part of the Cyclosporiasis Response

2026-07-22T16:10:11-04:00

If you’re confused about whether you can eat the shredded lettuce on your Doritos Locos tacos again, you’re not alone. I cover food safety for a living—and I love Taco Bell—and I’m not sure when I’ll be comfortable living más.

At the end of last week, the worst concerns about the ongoing cyclosporiasis outbreak seemed to be behind us. Parasite-laden lettuce should no longer be anywhere near a Taco Bell, because all of the iceberg that’s been linked to the outbreak has, according to the company that produced it, been recalled. And yet, somehow, the response has generated only more drama this week. Communication has been shaky from the start. As I’ve previously written, the CDC was slow to alert the public to the warning signs that a multistate outbreak was brewing, even as cases were rising dramatically in Michigan and other states. The messaging got only worse as the government began to figure out why people were getting sick.

Late Thursday, the CDC and the FDA announced that the Midwest cluster of cyclosporiasis cases stemmed from contaminated iceberg lettuce produced at a single farm in Mexico (later revealed to be a supplier for a large chain called Taylor Farms) and shipped to Taco Bells in five states. That should have been a breakthrough, giving consumers confidence that they could resume their normal eating habits (sans tacos). But almost immediately, the outbreak seemed to be bigger than the government was letting on. Taco Bell’s official statement encouraged “all relevant restaurants, retailers, and foodservice operators”—not just Taco Bells in the five states that the government had identified—to act responsibly, as Taco Bell did by pulling lettuce off their menu. And Taylor Farms’ initial recall included lettuce shipped not just to Taco Bell, but also to a number of major companies such as Sysco, which provides food for restaurants, hospitals, and schools. By Friday evening, Walmart had pulled certain Marketplace-branded bagged lettuce off of shelves in 15 states.

[Read: Cyclosporiasis is solved! Right?]

Then, on Saturday, the FDA posted a since-deleted announcement that it had found cyclospora (the parasite that causes the illness) on iceberg lettuce that was produced by Taylor Farms de Mexico but not part of the initial recall. The result promised to be the most definitive evidence to date that regulators had linked Taylor Farms to the problem. But the FDA reversed course the next day after agency staff reexamined the sample and deemed the earlier result a false positive. The embarrassing mistake was only compounded by Taylor Farms, which issued a statement that began with: “Today, FDA apologized to us.” But the FDA denied that it had issued a formal apology.

The FDA still seems confident that lettuce linked to Taco Bell and Taylor Farms is the culprit behind the spike in cyclosporiasis cases. More than 1,600 people who have tested positive for cyclospora across the five-state outbreak have reported eating Taco Bell, according to the FDA’s website. Seems straightforward! And yet, that website also prominently displays the warning “Don’t eat recalled lettuce at any Taco Bell location or other restaurants.” What other restaurants? The Department of Health and Human Services, Taylor Farms, and Taco Bell did not immediately respond to requests for comment.

Perhaps, as a Chicagoan, I’m particularly sensitive to the uncertainty; after all, the government has not explained how my local Taco Bell is safe when one 40 minutes to the south in Indiana is part of the outbreak. And as regulators continue to try to explain the Midwest’s cyclospora mess, the question remains of what is going on with elevated cyclosporiasis cases in the rest of the country, which the FDA has not publicly linked to iceberg lettuce, Taylor Farms, or Taco Bell. Cyclosporiasis has for decades flared in the United States during summer, which has made pinpointing where cases are truly elevated this year difficult business. The FDA told reporters on Monday that it has investigated five clusters of cyclosporiasis cases across the United States since May, three of which are over, but it has not publicly explained where these clusters have been, which ones are considered over, and what foods have caused the various outbreaks. North Carolina, for example, reported an 83 percent spike in cases over the past week, bringing its total cases to 561 since May. State officials have hinted that the outbreak could be caused by parsley, cilantro, or lettuce, but apparently not Taco Bell’s lettuce. In a press release Friday, the health department said, “At this time, the increase in cyclosporiasis cases in North Carolina does not appear to be associated with the outbreak in other states involving Taco Bell.”

[Read: America’s homegrown-parasite problem]

In the absence of clear information, Americans seem to be doing the only thing they can to protect themselves: opting out. Foot traffic to chain restaurants—not just Taco Bell—is down significantly over the past week, according to news reports. America is still likely in a much better situation than it was just a week ago, before the Taco Bell link was announced: Cyclosporiasis is notoriously hard to trace, and state and federal experts have managed to interview people who caught the bug about everything they ate prior to getting sick and identify a major commonality. It’s a shame that their work has been overshadowed by enough confusing communication that we all still have to look skeptically at a salad.

Just Ask the Dinosaurs How Bad Air Quality Can Get

2026-07-17T18:42:59-04:00

The air quality this week is bad. Smoke from Canadian wildfires has turned the sky orange in Philadelphia. It has veiled the Statue of Liberty in Manhattan. In Detroit, which has dealt with some of the worst conditions in the country, the smoke has almost entirely blurred the city’s skyline. The eastern United States isn’t exactly accustomed to smoke days, which can prompt someone like me, from the wildfire-prone West, to brag about how they’ve seen far worse. But those smoke days are nothing compared with the ones 66 million years ago. If you want to talk about bad air quality, ask the dinosaurs.

The asteroid that spelled the beginning of their end struck the Earth at about 40,000 miles an hour, blasting a 112-mile-wide crater into Mexico’s Yucatán Peninsula. The explosion was so big that it punched a hole into the atmosphere, bringing “outer space down to the surface of the Earth,” Kirk Johnson, the director of the Smithsonian National Museum of Natural History, told me. The impact flung trillions of tons of debris into the sky, and much of it headed right into that yawning atmosphere and into Earth’s orbit. As the planet continued to rotate, “you basically got a global cloud of dust and debris that blocked sunlight from hitting the ground,” Johnson said. And it blocked virtually all of the sunlight—plunging the world into solar-eclipse-level darkness. Some hot debris fell back down from the atmosphere, and within minutes, wildfires were spreading. Enormous conflagrations combusted “all the biomass on the planet, not just some forests in Canada,” Johnson said—and with debris blocking the sun, those wildfires were “burning in a dark world.”

Given the worldwide fires, dinosaurs would have been trapped in a level of smoke far more intense than the kind of downwind exposure that the U.S. experienced this week, Brian Toon, a senior research scientist at the Laboratory for Atmospheric and Space Physics at the University of Colorado Boulder, told me. Unfortunately—or maybe fortunately for them—many dinosaurs were not alive to experience this global-wildfire-pitch-black hellscape. The asteroid-impact event was a “massive, atomic-blast-scale thing, like 1 billion Hiroshimas of energy released,” Johnson said. The dinosaurs within about 1,000 miles of the impact site died “just by being exploded, basically,” he said—and given the magnitude of the blast, “if you were a human-sized animal standing anywhere on the planet at the surface, your survival of the first week is pretty unlikely.”

Other creatures perished during the ensuing climate mayhem. Within a week, maybe for months, the brightest day would have looked more like a moonlit night, Ken MacLeod, a geology professor at the University of Missouri, told me. The air wasn’t just smoky, he said; it was loaded with dust and gases. The gloom lasted for about two years, as particulates from the asteroid impact remained in the atmosphere and soot from wildfires added to them. The next couple of decades were “very low light, very difficult for photosynthesis to occur,” which led herbivores to starve, Brian Huber, a research geologist at the Smithsonian National Museum of Natural History, told me.

At what point would the atmosphere of this dark, foreign planet have settled into something like the haze hanging over Detroit today? No one was totally sure: “I would bet years, decades after,” Huber said. Johnson estimated that it would have been about a couple of years after impact; curators at New York City’s American Museum of Natural History found that 40 percent of sunlight was still blocked two years after the asteroid event, the museum told me. Although most soot and dust particles went away within a few years, sulfate aerosols continued to create “a global, orange-brown smog,” the dinosaur-extinction exhibit notes. According to the museum, it was only about four years after the asteroid arrived that full sunlight reappeared. The era in which the dinosaurs perished would be unrecognizable to a modern person. Compared with that, the air pollution Americans are facing right now, Huber said, “ain’t nothin’.”

Scientists know all of this in part because the sheer amount of charcoal and soot—millions and millions of tons of it—that fell to the ground left traces that are still detectable today. The asteroid itself also left a thin layer of debris made of meteorite and ancient parts of what we now call Mexico. You can touch it in Trinidad Lake State Park, in southern Colorado, Toon said—evidence from a time in this planet’s history when things looked pretty much as apocalyptic as one could imagine.

So, yes, the smoke this week is bad. The outdoor air quality is poor, and people should take precautions to limit the amount of it they’re breathing. And yet, there is something to be grateful for each day. And today, it is that we are not dinosaurs.

Cyclosporiasis Is Solved! Right?

2026-07-17T18:22:10-04:00

Produce lovers of the Midwest, rejoice! It seems that parents can stop fretting about serving their kids berries, Redditors can stop trying to do their own epidemiological investigations, and I can stop cooking my salads. The mystery of what food caused an outbreak of cyclosporiasis, the diarrhea-causing parasitic illness, across several midwestern states appears to be solved: It was shredded lettuce served at Taco Bell, federal health agencies announced yesterday.

As far as foodborne outbreaks go, this result is about as good as it gets. Yes, thousands of people got sick, but no one died. And the fact that regulators found not just the vegetable at issue, but also the source—a supplier in Mexico—means that they can now get to the bottom of what went wrong, and perhaps Americans can enjoy the spoils of summer produce with less fear. Even so, the nation’s collective freak-out should serve as a wake-up call to both the food industry and regulators. Behind jokes about “diarrhea lettuce” and bingeing on processed foods was a real fear that the system is failing to keep Americans safe.

The cyclosporiasis outbreak seemed to confirm Americans’ suspicions about our food-safety system and the people in charge of it. Trust in the safety of the U.S. food supply is at its lowest in at least 13 years, according to recent survey data from the International Food Information Council, an industry-funded group; many respondents said they believe that companies put profit over safety and that regulations aren’t strict enough. Surveys have found that confidence in the CDC and FDA is similarly in the dumps, reflecting both Americans’ long-standing issues of trust in the agencies, as well as a particular response among Democrats to the Trump administration’s changes to the agencies.

The current cyclosporiasis outbreak was handled poorly by the industry and regulators alike. Many Americans suspected that Taco Bell was the culprit after photos surfaced last week of signs posted outside Taco Bell branches announcing that they weren’t serving certain toppings. But the company’s PR team failed to provide a clear explanation of what was going on and how widespread the potential problem might have been. Yesterday, Taco Bell posted on its website that it was acting “out of an abundance of caution” by removing produce from some stores but still did not explain what had gone wrong. When I reached out today to ask whether Taco Bell is confident that the issue was isolated to midwestern states, the company directed me to a statement that did not address the question, but confirmed that it “has completed removal of affected Taylor Farms lettuce from our restaurants.”

Meanwhile, late last week, when Michigan had reported upwards of 1,500 positive tests for the bug, the CDC’s website still said that fewer than 200 cases had been identified nationwide. The delay may have stemmed from CDC officials scrutinizing preliminary data from states in an attempt to put together a true national count of confirmed cyclosporiasis cases, but from the outside, it looked as if the agency had no idea what was going on.

Federal officials didn’t call a press conference until earlier this week. By that point, Michigan had announced that 3,309 people had gotten sick and publicly identified lettuce as the likely cause of the outbreak, and the lettuce-less Taco Bells had already gone viral. When NBC News asked whether officials were looking at Taco Bell as a potential culprit, the acting head of the FDA’s food center, Donald Prater, demurred: “FDA certainly is continuing its traceback investigation on multiple produce items, also including locations that are reported by the case patients before they became sick.” The first confirmation that Taco Bell was actually being investigated came not from the company or the CDC, but from anonymous sources who spoke with The Washington Post.

The advice that Americans received about how to keep themselves safe has been confusing too. Prater said during the press conference that washing produce was “very helpful in lowering the risk of this parasite.” But food-safety experts told me that they don’t know how much washing actually helps. Yesterday’s CDC advisory offers more actionable advice: “Do not eat shredded iceberg lettuce served at Taco Bell locations in Indiana, Kentucky, Michigan, Ohio, and West Virginia.” But it makes no mention of what might be causing states such as New York and North Carolina to report spikes in cyclosporiasis cases as well, or what, if anything, residents should do to stay safe.

Plus, news outlets are reporting that the facility in Mexico is associated with Taylor Farms, an enormous operation that supplies lettuce to restaurants and grocery stores around the country. The CDC, which made no mention of Taylor Farms in its announcement, has not communicated why it believes that the only product affected is the shredded iceberg lettuce served at specific Taco Bell locations. The brief notice Taco Bell posted on its website makes the issue seem much bigger. The company wrote that it encourages “all relevant restaurants, retailers, and foodservice operators” to take similar precautionary action. The CDC’s website also says that the FDA “is working directly with the supplier to determine if contaminated shredded iceberg lettuce went to other places.”

In a statement, Taylor Farms’ parent company, Taylor Fresh Foods, told me that although the FDA’s investigation pinpointed one “independent farm,” the company has indefinitely removed all iceberg lettuce sourced from Central Mexico. The company also said that the affected farm “represents less than 1% of the U.S.’s iceberg lettuce supply,” and “no other Taylor Fresh Foods products across the country are impacted.” The company did not respond to my follow-up questions about whether the farm had supplied iceberg lettuce to any entity other than the Taco Bell locations identified in the investigation.

Perhaps the iceberg lettuce from the farm in Mexico really did go only to Taco Bells in the Midwest. It’s possible, too, that the apparent spikes outside of this epicenter are not a sign of a larger outbreak. After all, cyclosporiasis cases traditionally rise in the summer, and the frenzy of news around the parasite likely prompted people who typically would have weathered the illness at home to get tested. But Americans won’t know that unless the CDC says something. When I asked today what is causing cyclosporiasis cases outside the Midwest, and why the CDC was confident that other Taylor Farms products were not affected, an agency spokesperson ignored my questions and directed me to the government’s previous statements.

The Lessons About Ebola the U.S. Wants to Forget

2026-07-16T15:45:55-04:00

The Ebola outbreak in the Democratic Republic of the Congo is now the third-largest Ebola outbreak ever recorded. It will likely pass the second largest, an outbreak in the same region of Congo from 2018 to 2020. Already, the current outbreak has grown past 2,000 cases and to 754 deaths; according to the World Health Organization, it is likely to reach more than 8,000 cases and 1,400 deaths by mid-September. The CDC’s worst-case scenario projects more than 20,000 cases by mid-August.

I worked as a physician and epidemiologist in Guinea during the outbreak in West Africa that began in 2013. In 2014, I survived Ebola myself. I’ve followed every outbreak since, and this one worries me more than any other of the dozen that the world has undergone in the past decade.

Certainly, the world is better at containing and controlling Ebola than it was when I worked in Guinea. Much of that knowledge now lives in Kinshasa and Kampala and at the Africa CDC, in institutions that didn’t exist or weren’t ready a decade ago. When this outbreak is stopped, it will be stopped largely by people who learned what the previous outbreaks taught. Yet this outbreak is also revealing how much the United States, once the backbone of the response to crises like this one, seems willing to forget.

One of the earliest challenges in the 2013 West Africa epidemic was the monthslong delay in detecting initial cases in Guinea, where Ebola’s presentation was unfamiliar to health-care providers. In Congo, too, cases were likely occurring for months because testing was looking for the Zaire species of the virus, not the less common Bundibugyo species that was circulating.

Despite this delay, detection has improved in the past decade. The number of Ebola outbreaks is increasing: Climate change and more frequent contact between people and the animals that carry the virus mean more chances for it to spread. But most outbreaks are picked up far earlier than they once were. In 2017, for instance, an outbreak in DRC was detected at just eight cases.

And when an outbreak is declared, the ability to quickly start testing for Ebola has scaled up dramatically. In West Africa, testing often took days, during which infected people were exposing other patients in treatment centers to the virus. At the start of this outbreak, two months ago, Congo had essentially no ability to test for the Bundibugyo strain; today, capacity exists for thousands of tests a day.

Performing research and clinical trials during outbreaks is more possible than it was a decade ago, too. While treating Ebola patients in 2014, I had no vaccine or specific treatment to offer. Trials during that epidemic were slow to start, and poor methods meant that few produced conclusive results.

Since then, research has yielded a vaccine and antibody treatments for the Zaire strain. Now that a vaccine stockpile is in place, doses can be quickly deployed when an outbreak is declared. Trials are also moving faster. In a 2022 outbreak in Uganda, caused by the Sudan species of Ebola, an investigational vaccine was ready to test within three months. By then, cases were waning, but by preparing protocols and prepositioning vaccine candidates in the country, Uganda was able to launch a trial in four days when the next outbreak emerged, in 2025. Multiple organizations are now racing to manufacture vaccines for the Bundibugyo strain; one trial to evaluate potential treatments has already kicked off.

What ultimately determines the trajectory of outbreaks, however, is the speed and scale of the response. In 2014, the world did not take the outbreak seriously until Ebola threatened Western countries. An international emergency was declared within days of the first Americans getting sick, a coincidence that didn’t escape my colleagues in West Africa who had been watching the outbreak expand for months. The WHO declared the current outbreak an emergency within two days of Congo’s and Uganda’s own declarations. Community mistrust and widespread conflict still makes the work of finding the sick and persuading them to come in for treatment difficult. But the machinery is faster and is now being run together by the WHO, the Africa CDC—an organization started in the aftermath of West Africa’s Ebola outbreak—and the Congolese government.

If in 2014 the international community was slow to respond to Ebola’s threat, it did eventually respond at scale. The U.S. committed billions of dollars in funding and extensive logistical support to ending the outbreak; USAID helped with essential tasks, such as training burial teams and setting up airport screening.

Since then, much of the capacity to find outbreaks early—whether for Ebola or other pathogens—was built with international investment, especially from the United States. The U.S. helped construct the infrastructure that now catches the sparks of what would otherwise become larger outbreaks, bankrolled much of the research and development for Ebola vaccines and treatment, and has played a central role in responding to nearly every Ebola outbreak—until the one declared in Uganda in February 2025.

For that outbreak, the CDC didn’t send specialists, USAID wasn’t deployed, and Elon Musk’s DOGE canceled multiple contracts dedicated to responding to the outbreak. The response to the current outbreak is a partial correction. The Trump administration has committed more than $700 million and has requested another $1.4 billion from Congress. It deployed a group of highly trained specialists and has finally filled the long-vacant top role at the Office of Pandemic Preparedness and Response. The secretary of state is reportedly considering appointing an Ebola czar, as the Obama administration did in 2014.

But these actions reflect deep reflexes, triggered by a big outbreak. A strong, successful response to an outbreak relies on not just quick responses, but systems that require maintenance and constant training. And the U.S. appears to be forgetting the lessons about those systems.

This amnesia is reflected in where the U.S. has aimed its effort—on keeping disease “over there” at all costs. Americans infected with Ebola have been transferred to Germany, rather than specialized treatment centers built in the U.S. after 2014; soon, Americans exposed to the virus may quarantine at a quickly constructed center in Kenya. These actions are part of a broader bet that the virus can be kept out of the U.S. It can’t. Ebola has many ways to cross a border; as we learned a decade ago, the only reliable way to protect Americans is to end the outbreak.

That work has been made harder by the Trump administration’s deep cuts to global health funding and disinterest in international coordination. After 2014, the U.S.—along with the rest of the world—spent years building a more nimble, operational World Health Organization. Now the U.S. does not appear to be fully engaging with the WHO, despite the organization’s role in leading this response. The Trump administration has also been trading disease-specific programs for transactional deals struck country by country, and a proposed plan at the State Department would remake the CDC’s overseas work along the same lines. Countries would pay à la carte for the agency’s help and skip whatever they choose to forgo, including surveillance designed to catch an outbreak like this one. The plan could close roughly a third of the CDC’s 60 overseas offices within a few years. This country-by-country approach may be advantageous politically, but it will lower our defenses against pathogens.

The world’s capacity to control infectious disease has never been fully self-sustaining. It lives in lab technicians and community health workers detecting outbreaks, in stockpiles that expire and need replenishing, and in institutions whose budgets can go up or down each year. It was built over decades, with American support and expertise, and once that support is withdrawn, the gains of the past decade are not guaranteed to hold.

American leaders are betting that the rest of the world will keep doing the work we taught it to do, with less and less help from us. White House spokesperson Kush Desai said as much in response to a request for comment, arguing that bringing global health functions once housed at USAID to the State Department “has made our Ebola response efforts more effective” and that “nothing is stopping other wealthy nations from also stepping up and contributing more to these and other efforts.” (A spokesperson for the State Department emphasized the speed of the U.S.’s response to this outbreak and said that its current strategy is still focused “on building the capacity of national and regional actors.”)

For a while, that bet may pay off. But the weakness of the systems that do exist are already showing. The health workers on whom so much of this response depends recently went on strike: They report not being paid and working without the supplies needed to safely do their job—so far, 112 health-care workers have been infected, and 35 have died. Some version of this has occurred in nearly every outbreak over the past decade, and it erodes the trust needed for a response to function successfully. When communities hear that money is pouring in, and watch Western aid workers speed by in expensive Land Rovers while local workers go unpaid, they stop believing the help is for them. Treatment reaches them just as unevenly. Since the Zaire drugs were approved in 2020, only a third of Congolese Ebola patients have received them, even though one was developed from the blood of a Congolese survivor and both were approved after a trial in Congo. The doses exist, but their manufacturers control them and most sit in American stockpiles.

Rather than work to close those gaps, the United States is testing how much stress the system can take before breaking. The outcome of the next outbreak will rest not on what we know, but on what we’ve bothered to keep.

Pete Hegseth Wants YOU to Test Your Testosterone

2026-07-15T21:43:01-04:00

Updated at 1:38 p.m. ET on July 16, 2026

Pete Hegseth wants a manly military. And he really, really wants you to know how badly he wants a manly military. In his 2024 book, The War on Warriors, Hegseth worried that the military risked becoming “effeminate, and apologetic”; he insisted that what liberals really want is “soft men, and a weak military,” and he scolded “Pentagon pussies” who refuse to stand up for soldiers on the battlefield. As secretary of defense, Hegseth has blocked the promotion of female military officers, removed the first woman to lead the Navy, and ordered a review of women’s “effectiveness” in ground-combat roles. He has also used the Defense Department’s social-media channels to post a steady stream of tougher-than-thou videos.

The latest entry in this genre came earlier today, when Hegseth announced that he is requiring every service member over 30 to have their testosterone tested annually. He let this be known in a video posted on X captioned “The High-T Department of War.” In the video, he tells soldiers that if they’re found to have low testosterone, they might be recommended for testosterone-replacement therapy but that it won’t be mandatory. Then again, given what he then says about testosterone “restoring and optimizing your natural capabilities,” it sure seems like he believes that everyone should partake. How much this new initiative will cost taxpayers, and the question of whether the military health system’s labs even have the capacity for such testing, is unclear. But the bigger question is whether this is in any way a good idea.

The military’s interest in testosterone predates Hegseth’s tenure. For years, the idea that low testosterone might be a problem for Special Forces personnel in particular has been flagged by both researchers and members of Congress. Representative Jimmy Panetta of California has called for a study of the “link between the stress of military service and decreased testosterone levels.” A 2020 paper cited low testosterone as one possible contributor to so-called operator syndrome, a cluster of conditions including depression and cognitive impairment among Special Forces.

But when Army researchers have examined whether taking testosterone might help soldiers recover more quickly following the physical demands of combat, they’ve found mixed results. A 2019 paper, for example, found that civilian men who received testosterone injections during a 28-day period of intense exercise and restricted diet—meant to simulate the rigors of training and combat—held on to more muscle than those who received a placebo, but the extra testosterone didn’t improve their strength or endurance. A follow-up study three years later reached similar conclusions. Crucially, both of those studies focused on short-term use under specific circumstances, not on the broader screening and routine therapy that Hegseth is advocating.

At least within the general population, universal testosterone screening for men is not considered standard practice. The Endocrine Society recommends against testing for hypogonadism—the medical term for when the body doesn’t produce enough testosterone or sperm—unless a man has symptoms such as erectile dysfunction. The American Urological Association’s guidelines say that a low-testosterone diagnosis shouldn’t be made based solely on a test. That’s because testosterone levels can vary widely, and a man with a lower-than-average number might still be perfectly healthy. The threshold for diagnosing low testosterone remains a matter of debate even among medical organizations. Many of those who favor testosterone “optimization” argue that the cutoff has been set too low and that even men with hormone levels in the normal range would benefit from replacement therapy. A Department of Defense official declined to say whether it had settled on an acceptable baseline.

In the video, Hegseth notes that testosterone levels go down with age. That’s true of everyone; in men, levels usually start to decline around age 40. But they don’t fall off a cliff: They tend to dip about 1 to 2 percent a year. Other factors, such as maintaining a healthy weight and getting enough sleep, can also play a significant role.

Testosterone therapy is the only treatment Hegseth cites in the announcement video. But even if a man’s testosterone level drops below what’s considered normal, doctors don’t automatically recommend testosterone-replacement therapy. For starters, non-pharmaceutical interventions might work. It’s not obvious that, say, a 33-year-old man with low testosterone levels needs to start getting shots. It might be that he needs to start taking the stairs and going to bed at a reasonable hour. Cutting back on drinking could help too: Excess alcohol consumption is known to lower testosterone.

Testosterone-replacement therapy also comes with real side effects. Hegseth and other proponents of testosterone therapy, including Health and Human Services Secretary Robert F. Kennedy Jr., sometimes talk about the drug like it’s just another supplement. (Kennedy has acknowledged using testosterone himself; the Defense Department official didn’t respond to a question about whether Hegseth, who is 46, takes the steroid.) But taking testosterone is not the same as popping a vitamin for a B12 deficiency. Testosterone therapy suppresses a man’s natural production of the hormone and decreases sperm count. That’s why experts caution against its use by men trying to conceive. In 2023, a large study published in The New England Journal of Medicine alleviated decades-old fears that middle-aged and older men who take testosterone might be at increased risk of having a heart attack. But last year, the Food and Drug Administration added a warning to testosterone’s label noting that it can increase blood pressure.

The new edict doesn’t apply just to men. In response to a question about whether women will have to have their testosterone tested, the DOD official wrote that “everyone over 30 years old will be tested annually.” Although women do produce the hormone, albeit usually in much lower amounts than men, replacement therapy is rarely recommended except in cases of low sexual desire after menopause. (In practice, middle-aged women have recently been flocking to testosterone to alleviate all sorts of symptoms of menopause and perimenopause.) What women are supposed to make of their test results, and what it has to do with turning them into more effective soldiers, is unclear. Hegseth has made a point of emphasizing the differences between the sexes and of questioning the ability of women to serve in combat. But in this instance, he has inexplicably opted for a gender-neutral policy.

Checking the testosterone levels of military members isn’t necessarily going to hurt anyone. But it also isn’t supported by current medical guidelines. Neither, for that matter, was Hegseth’s decision in April to make the annual influenza vaccine optional. (After a flu outbreak at a base in San Antonio, Texas, last month, the military reinstated the mandate for some new recruits.)

Although Hegseth insists in his video that the new order is about keeping soldiers on “the leading edge of lethality,” it’s hard to see how requiring a blood test they probably don’t need contributes to military readiness. Instead, like Hegseth’s chest-thumping workout videos, his fat-shaming of generals, and his denouncement of anything he deems weak or woke, it is an exercise in projecting a masculine image. His announcement comes at a moment when the Iran war is once again heating up, which is certain to put more strain on the military’s already depleted missile stockpiles. Maybe that’s the number Hegseth should be worried about.

All the Cool Kids Are Birding

2026-07-15T09:30:04-04:00

Not long before the sun rose on a Saturday in May, five men in their mid-20s were standing alongside an unassuming wetland in New Jersey, searching for birds. Ryan Zucker, a 23-year-old who could do an impressive impersonation of an eastern screech owl, had just taken a small branch to the eye, but still the group was exuberant.

Since midnight, they’d heard that owl, a common gallinule, and—after following some freight-rail tracks through the dark—the high-pitched, near-electronic trill of a sedge wren, the first recorded in Sussex County in 13 years. (A police officer had asked what exactly they thought they were doing on the tracks at 2 a.m., but took “We’re looking for birds” as answer enough.) In the previous 10 minutes, they had seen a sandhill crane raise its head above the reeds, watched a mallard chase an otter away from her ducklings, and heard a brown thrasher in the distance.

Each species put the five men one notch closer to being the repeat championship team in the World Series of Birding, a 24-hour contest to identify as many species as possible, by eye or ear, throughout New Jersey. The birds would start singing in earnest soon, and to cover the state before midnight came again, the guys needed to leave, now.

As one, the men—called ***mega (pronounced star-star-star-mega, or Team Mega if you can’t be bothered)—took off sprinting toward their van. William von Herff, a fast-talking 26-year-old originally from Canada, told me that he took up running ahead of his first World Series, in 2024. He needed to be sure he could race into a bog, then control his heart rate enough to sense the drumming of a ruffed grouse’s wings.

Birding has historically been the domain of the AARP crowd, but in the World Series, young people have an edge. And these days, birders in their 20s (and 30s and 40s) are showing up not just at birding competitions, but seemingly everywhere. Some of my friends who, like me, are in their early 30s now bring binoculars on vacation; so do a number of my sister’s friends, who are younger and cooler than mine. Young birding influencers are all over TikTok and Instagram. The National Audubon Society had 10 college chapters in 2019; today, it has 117. South by Southwest hosted its first bird lovers’ meetup last year and its first birding panel in March.

Andrew Marden, the 27-year-old who drove ***mega’s van, has been competing in the World Series since age 15, and he told me that only in the past few years have people his age started perking up when he mentions his hobby. Oh, that’s really cool, they might say. Some have even said they wanted to go birding too.

Virtually all of the 20 or so birders and bird-adjacent professionals I spoke with attributed the shift to two watershed events. The first is the coronavirus pandemic: At a moment when many Americans spent far too much time anxiously bouncing around their own home, birding represented a low-stress, low-screen, outdoor activity that could be done without travel.

The second is a revolution in birding tech. Birders have always used the newest tools available to them, whether vinyl records of bird calls, rare-bird hotlines, or push notifications. (***mega is lingo for an ultrarare species noted on eBird, a forum where birders report sightings.) But soon after the bird-identification app Merlin introduced Sound ID, a sort of Shazam for bird calls, in 2021, millions of people started using the app, including the 29-year-old Super Bowl champion Sam Darnold and the 33-year-old pop star Ariana Grande.

Merlin and similar tools have upended the culture of birding. Ten years ago, aspiring birders had little choice but to learn from the old-timers, who might be less than cool or less than welcoming. Jessica Wills, a 43-year-old birder who works in the restaurant industry in Tucson, Arizona, told me that older birders have sometimes walked up to her to explain things she already knows, or rudely corrected beginner birders when they make a mistaken ID. The apps have freed new birders to learn a good deal on their own. Instead of memorizing birds’ sounds and physical appearances, you can start a Merlin recording, see what songs it picks up, see what the birds singing them look like, and then try to locate them in your binoculars. And instead of staking out bird habitats for days on end in the hopes of seeing an elusive species, you can browse bird sightings on Discord or eBird. Several people I interviewed described birding as akin to Pokémon Go. (Really, Pokémon Go is a knockoff of birding.)

With or without an app, the basic activity is the same: You spend hours and hours standing around, straining your eyes and ears, and you get to know a lot about birds. If you’re really dedicated, you also get to know “habitats within the habitats, the very specific ways in which birds behave and when they’re active, and what sounds they might make, and what times of day are best, and what weather patterns are best for them,” Zucker told me in the van. Many of the birders I spoke with praised the benefits of such close attention to nature—María-Elena Montero, the president of the D.C. Bird Alliance, described birding as a practice, similar to yoga and meditation. Jax Quamme, a 33-year-old hearing-aid technician in Tucson who’d struggled with postpartum depression and then her brother’s unexpected death, told me that birding gave her the sense of purpose and “hits of dopamine” that she’d been lacking.

I also get a significant portion of my dopamine outdoors, but birding has always seemed to me like a mightily inefficient way to do so. Backpacking can get you sensational views along with the mental-health benefits of exercise. Skiing and cycling provide reliable thrills. Why would I spend countless hours studying a bird that may or may not choose to appear when I go looking for it? After ***mega heard the sedge wren at 2:30 a.m., we trudged back down the tracks and waited in the cold, rainy dark for marsh birds that mostly didn’t show. The only thrill was the latent possibility of an oncoming train. At one point, von Herff sat down and dozed off as we all stood by the tracks, and I began wondering what any of us were doing there.

But an hour and a canned espresso later, I understood. We’d arrived before dawn at the marsh under a light-polluted sky; I could just make out the hills behind it. And for the most part, we stood still, contemplating the faint landscape and the quiet around us, broken by the calls of frogs and, occasionally, a target bird. After a few minutes watching the hills’ dark reflections spread across the water, I noticed that a sense of calm and expansiveness—awe, even—had crept up on me.

In some ways, the young men of ***mega are like their peers who are more recent converts to birding. Older birders tend to have money and time to invest in regular bird-driven travel; these guys are more likely to be found at their local green spaces—Central Park for Zucker, D.C.’s Rock Creek Park for von Herff—amid work, school, and social commitments. They let tech into their sacred hobby: Marden has a life list of birds, 408 species so far, that his friends have shown him on FaceTime. (A previous generation might be scandalized by the list’s existence.) And whereas older birders have a reputation for being interested mostly in birds, the members of ***mega and others in their cohort tend to see the hobby as part of a broader commitment to conservation. Three of the five are studying or work full-time in green energy or environmental science; during the World Series, the team wasted precious seconds stopping the van so that Zucker could carry a wood turtle safely across an exurban road.

In other respects, the ***mega crew is a relic of an older model of birder. They’ve all been avid birders since childhood; most of them have a story about a relative who took them birding, or bought them binoculars, or left a field guide lying around to be devoured by a curious elementary schooler. Von Herff, Zucker, and Marden met as teenage birders, and Zucker and the two remaining team members—Benjamin Hack and David Benvent—knew one another at Cornell. (The school’s Lab of Ornithology is one of birding’s nerve centers and created both eBird and the Merlin app, and had factored heavily into Hack’s, Benvent’s, and Zucker’s decision to enroll.) Because they started birding so young, they all have longtime mentors several generations older than them.

Hack and von Herff had stayed with two of those mentors—Louise Zemaitis, 67, and Michael O’Brien, 61—at their home in Cape May the week before the World Series. Zemaitis and O’Brien are both bird guides and run birding summer camps for teenagers; O’Brien is also a co-author of an upcoming guide to North American birds, designed to be used alongside Merlin and eBird. Their yard is full of bird feeders and is apparently among the most reliable ruby-throated-hummingbird hangouts in New Jersey.

The first time ***mega’s route took the teammates past the house, they bickered over whether they had time to stop, and whether failing to do so would be too rude to bear. They pulled over, everyone yelled at one another while looking for hummingbirds out the window, and then Marden kept on driving to a nearby boardwalk, where they hoped to spot several crucial seabirds. But later, they stopped at Zemaitis and O’Brien’s house after all. (They still needed a hummingbird, Hack needed his overnight bag, and someone needed to pee.)

Zemaitis and O’Brien, who met at the 1994 World Series of Birding, are deeply invested in young birders. Many of their former campers, including most of ***mega, were competing in the World Series; they could recall who was friends with whom, and who grew up as part of the same birding clubs. They are enthusiastic about how birding has changed in their lifetime, and told me that the growing popularity of the hobby and the apps has meant that their campers arrive with more knowledge (and their own ideas about what birds they want to see). But Merlin alone can’t give you a fundamental understanding of ecology. Neither, I thought as I watched hummingbirds and a Baltimore oriole visit the feeders scattered through the yard, can it give you friends like Zemaitis and O’Brien.

Spending the day with ***mega, I was struck, too, by how its members cared for and respected one another even as they disagreed over their next move, or got frustrated when one of them couldn’t train their binoculars on a bird that everyone else had seen. Gen Z is notoriously lonely, and young men supposedly have it worst of all. But those narratives were difficult to reconcile with the guys’ mature, loving way of interacting. When I pressed the teammates on why they were birders and how that shared love had bonded them together, Hack, who had been stuck in the third row of the van with me for most of the day, told me the motivation was simple enough: “I think it’s just fun to do this with my friends.”

When I woke up in a Wildwood motel the morning after the World Series, ***mega was still waiting to find out if it had held on to its title. I decided to go for a walk, and before I left the room, I hesitated, as if on the precipice of a great personal choice. Then I grabbed my binoculars and my phone and set up a Merlin account before heading down to the beach. When I got the text from von Herff— “WE WON!!!”—I was standing in the surf, trying to figure out whether I was looking at a sanderling or a semipalmated sandpiper.

America’s Homegrown-Parasite Problem

2026-07-11T09:00:00-04:00

The other night, I found myself in the unenviable position of trying to cook a salad. And I mean cook a salad: I spread fresh, delicious-looking gem lettuce in a pan and watched it wilt away into a sad, heated blob.

America appears to be in the midst of an outbreak of—I’m sorry, but there’s no better way to say this—explosive diarrhea. More than 2,900 people nationwide have reportedly been sickened by the parasite Cyclospora cayetanensis, which has historically been spread through raw produce, including basil, cilantro, raspberries, and, yes, lettuce. The resulting illness, cyclosporiasis, causes bouts of diarrhea that, if left untreated, can wreak havoc on the digestive system for a month.

Cyclospora is most common in tropical climates and areas with substandard sanitation. It’s spread through contact with bits of human waste that have sat in a warm environment for a week or two, allowing the parasite to mature and become infectious. One of the first documented large-scale outbreaks of foodborne cyclosporiasis in the United States, for example, was caused by raspberries imported from Guatemala. In recent years, though, it’s started to seem that the U.S. has a homegrown-parasite problem on its hands. Americans were sickened in both 2018 and 2020 by outbreaks that were believed to be caused by domestic produce. The FDA set up a task force to deal with the issue in 2019. It apparently hasn’t stopped what is looking like a dramatic uptick in cases this summer. Michigan usually sees about 50 cyclosporiasis cases a year. During this current outbreak, it has recorded upwards of 1,500.

Officials and scientists are not yet sure just how dire the apparent rise in cyclosporiasis is and whether the cases around the country are actually connected. Although the CDC reports that 31 states are seeing cases, the majority are reporting fewer than 10, which is close to normal for the summer months.

They also don’t know what is behind this spate of illness. Don Schaffner, a food scientist at Rutgers University, told me his theory is that perhaps the largest cluster of cases came from people swimming in or otherwise consuming water from a common water source, such as Lake Erie, which borders the affected states of Michigan and Ohio. Michigan’s chief medical executive has said, however, that the state’s working theory is that the cases are tied to produce.

That lack of clarity has led public-health officials to offer somewhat unsatisfactory advice on how to keep yourself safe. My home state of Illinois suggests that people avoid food and water “that may have been contaminated with feces,” as if that were not always the goal. Other states recommend washing produce, but that won’t eliminate all of the risk, Schaffner said. Some experts believe that washing might help reduce the number of infectious particles that a person takes in, but they don’t know for sure how many a person needs to ingest to actually get sick, and some data suggest that the number may be very low. The only way to reliably kill the parasite is to cook your food thoroughly—hence my feast of wilted, warm greens.

Americans have little other recourse to protect themselves from cyclosporiasis and, thanks to ongoing uncertainty about the outbreak’s size, little way of knowing how likely they are to catch it. In healthy people, cyclosporiasis causes mostly mild (if uncomfortable) symptoms. But that lack of control still makes cyclosporiasis, like other foodborne illnesses, unsettling and frustrating. Right now, choosing to eat only cooked produce is one of the few decisions I can make to protect my fast-approaching wedding from being interrupted by frantic trips to the bathroom, so I’m going with it.

When a foodborne outbreak happens, public-health officials’ goal is to quickly identify its cause and warn people to stay away from the suspect food. Sometimes that happens quickly—in 2018, for example, investigators took just nine days to tie an E. coli outbreak to chopped romaine. The current investigation into cyclospora has already been happening for nearly a month. In the coming weeks, Americans might learn the cause, or causes, of the surge, which would make taking precautions much easier. And if the parasite has been in fact spread by raw produce, the contaminated products may already be off grocery-store shelves.

Cyclosporiasis, though, is particularly tough to track. Scientists can analyze the genetic sequence of most pathogens to identify clusters of related diseases, but that process doesn’t work as well for cyclospora, because the parasite is difficult to extract from stool and can’t be grown in a laboratory for testing the same way other pathogens can. And even if officials zero in on specific foods that they believe were contaminated, the public may never learn what specifically went wrong. The CDC’s website notes that “no one fully knows how Cyclospora gets into food and water.” Although past investigations of the parasite have turned up suspected sources, they have stopped short of concluding how those sources became contaminated. When bagged lettuce caused a cyclospora outbreak in 2020, for example, officials suspected that the parasite had been introduced to farms through a municipal water canal, but they were ultimately unable to definitively establish a causal link. The investigation may also be hindered by the Trump administration’s recent cuts to the CDC and the FDA. Until yesterday morning, the CDC was reporting that fewer than 200 people in the U.S. had contracted the parasite, despite ample evidence from states that the situation was much more severe. It has since updated that count to 843. (A CDC spokesperson declined to explain the earlier discrepancy between state reporting and its own case count, and did not respond to a follow-up request for comment after the new numbers were released.)

Cyclosporiasis, thankfully, is not the most serious foodborne illness that the world has to deal with. Although cyclosporiasis has landed nearly 100 Americans in the hospital so far this summer, no one has died. That’s much preferable to, say, the 2024 listeria outbreak tied to lunch meat that killed 10 people. In that case, a clear culprit was identified, and there were consequences for the company that produced the tainted meat, which has paid out millions in settlements. The United States may never get the same closure to its cyclospora problem.

The Newest Way to Go Analog

2026-07-09T12:33:21-04:00

When the iPod Nano was first released, in 2005, it cost $199 and was sold on the promise of limitlessness. This year, Celeste Stange bought her magenta 8-gigabyte model on eBay for $69 and the exact opposite reason. Every time she’d pick a song on Spotify to stream, she’d think about the millions of other songs she could listen to instead and get paralyzed by musical FOMO, she told me. “Now I only have what’s on here.”

Stange, who is 29, is part of a recent “analog” movement in which people—usually those in Gen Z—opt for less distracting alternatives to their “everything” device. Those alternatives are not always, in fact, analog, but are in many cases older digital devices: an iPod, a digital Canon PowerShot, a DVD player. Tiffany Ng, the 25-year-old author of the newsletter Cyber Celibate, now has a first-generation iPhone, an 11-year-old iPod, two CD players, a Walkman radio, and a 1986 Macintosh Plus that takes 45 seconds to load the “Welcome to Macintosh” screen.

Ng lives in Williamsburg, Brooklyn, where 20 years ago, the word analog would’ve conjured hipsters getting into vinyl. The argument then was that a record player produced real, textured music in a way an iPod’s digital files could not. But today, people are “going analog,” as they call it, to escape devices that offer endless options, in favor of those that offer a modicum of constraint.

The iPod’s original tagline—“1,000 songs in your pocket”—suggested that you could dance like the carefree silhouettes in the ads because you didn’t have to lug around CDs. This was the era when technology was “convenient, but not connected,” Tony Fadell, a former senior vice president at Apple who is known as the “father of the iPod,” told me; then the iPod became the iPhone, which soon had an app store, and convenience and connectivity became inextricably linked. People had their library of songs, but now they also had app notifications and Angry Birds and Instagram posts from that girl they went to middle school with. Eventually, streamable Apple Music replaced iTunes, and tens of thousands of songs became 100 million songs. “I can’t go through all of it,” Stange said.

Stange could still carve out her own corner of Spotify through playlists, but on her Nano, she truly has only music she chooses, with artist photos she uploads manually. For many people, that little bit of added friction is part of the appeal. Jess Fisher, a 29-year-old actor in Los Angeles, now buys new CDs each month, which she puts on her Innioasis Y1, an iPod-esque MP3 player that the company started making in 2023, after users complained that their touch-screen MP3 devices were too distracting. “I am more excited about music because I am restricting myself from it,” she told me. When we spoke, she’d just gotten a new CD. “I’m going to sit down and listen to it and relish it, because I’ve been waiting a week to get it.” She also looks forward to the five free weekly MP3 downloads she gets with her library card, through a music site called Freegal. She has an alert set to repeat every Monday: “It’s Freegal Time!”

I spoke with nearly a dozen people trying out similar technology. Isaac Mosna, who creates YouTube videos about tech under the handle Canoopsy, started taking photographs on a first-generation iPhone because he was nostalgic for a time when “everything was a little more physical and real.” (The older camera also makes the pictures look warmer, he said.) Others told me about their Nintendo DSes and emulators they’d filled with vintage games, so they could play without distractions. These choices have become popular enough that they’re juicing secondhand markets for older tech. On eBay, people searched iPod 1,300 times an hour on average last year, and prices of certain models are up by more than 50 percent, according to data provided by the site. Back Market, a refurbished-technology company, started carrying iPods, Game Boys, and other retro tech after a limited run of Nokia 3310 phones (which can basically be used only to call, text, and play Snake) sold out much faster than expected, Thibaud Hug de Larauze, the company’s CEO, told me.

For at least some people buying into this trend, the logic goes something like: I get a DVD player, therefore I learn how to exist comfortably in the present moment. Ng has been replacing a different modern piece of technology with its older counterpart every month, an experiment she began after her iPhone broke. For the five or so hours that the Genius Bar was repairing it, she “felt so, so stupid.” She didn’t have a way to tell time. She didn’t know how to get around Manhattan without Google Maps. She decided then that she wanted to know she could live without modern technology. When she posted a newsletter titled “I chained my phone to a wall for a week,” people DMed her to ask where she’d bought the chain. (It was an old belt.)

Going “analog” is also one of the few ways to own an actual copy of a song, a movie, or a game these days. And buying those products means a person has to commit to their own taste more than they would by just pressing “Play” on “Fun Upbeat Mix” curated by Spotify. It has given Stange the ability to say, “I’m not going to pretend that Geese is the second coming of God” just because everyone else is listening to them. She’d gotten so used to streaming, though, that she wasn’t sure what to put on her iPod at first. She looked up a Rolling Stone “Greatest Albums” list and downloaded some of the recommendations. Fisher did the same.

A CD or DVD is more work to buy and can physically break down in a way a Spotify playlist cannot, but the people I spoke with generally framed those inconveniences as part of the experience. “If I want to listen to an album that I really love, it involves me spending maybe $20 on a CD, it involves me putting that CD on, it involves me using the physical remote,” Mosna said—it’s “an experience.” (Cleaning and maintaining his CD player is a bit of a pain, though.) Dan Cohen, a 24-year-old fashion designer, told me his professors couldn’t imagine why anyone would want the cross-body CD holder he’d made for his undergraduate thesis: They’d lived through the annoyance of CDs getting scratched, iPods crashing and deleting music, and DVDs getting stuck on their menu pages for eternity. And some of these devices were outmoded for a reason. Ng, the newsletter writer, got the 1986 Macintosh in part to play around with PageMaker and its word processor, but she’s still trying to figure out exactly how to use the computer.

After all, modern “analog” enthusiasts still have backups. Everyone I talked with had kept their smartphone. When Stange and I met, she took out her magenta Nano and her laptop, to show me how she downloaded her music onto the iPod. The Nano promptly died. She plugged it into the laptop to charge, but still, no dice. “I’m pretty sure it broke on the way here,” she said, and told me she’d need to figure out how to fix it. She sounded a little excited about the challenge. In the meantime, she still had her Spotify subscription.

*Illustration sources: Adam Rountree / Bloomberg / Getty; Jaap Arriens / NurPhoto / Getty; Jacobs Stock Photography / Getty; liangpv / Getty; Nick Dolding / Getty; trumzz / Getty; Yoshikazu Tsuno / AFP / Getty.

Lab-Leak Payback Has Begun

2026-07-07T13:09:31-04:00

Updated at 5:43 p.m. on July 10, 2026

The origins of the coronavirus pandemic remain contested; the evidence is incomplete. But pundits, activists, and members of the Trump administration have long insisted that the case is closed, and that the virus slipped out from a lab in China. They’ve maintained the view that U.S. scientists were involved and later tried to hide the facts. They’ve said that justice must be served.

Now the reckoning they want appears to have arrived. An expert on the flu got hauled off by the FBI. A coronavirus researcher was indicted in Detroit. Two prominent virologists stepped down or were removed from senior roles. And a fifth infectious-disease researcher—Anthony Fauci, the central figure in an alleged “lab-leak” cover-up—was recently subpoenaed to appear before the U.S. Senate.

The precise timing of these cases, which have all come to light since April, may be a coincidence. Yet all five are centered on a small community of scientists affiliated with the National Institute of Allergy and Infectious Diseases, which Fauci ran for nearly 40 years. “There has been a snowballing of developments recently,” Richard Ebright, a molecular biologist at Rutgers University who focuses on biosafety issues and has repeatedly denounced Fauci and his “criminal associates,” told me. “I can’t provide an explanation for why it’s taken so long for that process to begin.”

The first case was Ralph Baric, a 72-year-old virologist and bat-coronavirus expert at the University of North Carolina at Chapel Hill. Baric worked closely with researchers at the Wuhan Institute of Virology, which many adherents to the lab-leak theory posit as the source of the pandemic; one contingent thinks that Baric might have been the creator of the SARS-CoV-2 virus. On April 15, the NIH, which has in the past provided Baric’s lab with hundreds of millions of dollars in research funds, referred him for debarment from all federal contracts for at least three years. The claims against him focus on some inconsistencies in paperwork and a series of decade-old experiments that the agency says were carried out in violation of a pause of a “gain-of-fuction” research. Baric told Science magazine’s Jon Cohen that he’s fighting the debarment, and that he’d been targeted on account of the furor over COVID origins; he appears to have retired from UNC on June 1. (Neither Baric nor the Department of Health and Human Services, which oversees NIH, responded to requests for comment.)

The day after the government kicked off Baric’s debarment proceedings, David Morens, a 78-year-old influenza specialist and one of Fauci’s close advisers at NIAID, was indicted for conspiring to hide or falsify discussions of coronavirus research grants. “We have to keep all communications like this on private email so that it can’t be retrieved via a FOIA,” he wrote in one message from 2021. On April 27, per Cohen’s reporting, armed federal agents in bulletproof vests arrived at Morens’s home in Chester, Maryland, and handcuffed him in his underwear. Morens pleaded not guilty to the charges. (The FBI told Science that this description of the arrest was “inaccurate”; Morens’s attorney declined to comment for this story.)

Just a few weeks later, news came out that the acting head of NIAID—the virologist Jeffrey Taubenberger, a very close colleague of Morens’s—had either stepped down or been fired from his role. He and Morens had worked together on more than 60 academic papers, including 13 that also list Fauci as an author—and both had been on the radar of the lab-leak hard-liners. (Taubenberger did not respond to a request for comment.)

News also broke in May that the FBI was investigating another NIAID virologist, Vincent Munster, who had been called out for collaborating with Baric and the scientists in Wuhan. Since then, prosecutors have filed an indictment charging Munster and another researcher from his lab with a conspiracy to smuggle mpox into the U.S. and with making false statements to federal agents. The government claims that on January 25, Munster and that colleague arrived at an airport in Detroit from the Republic of the Congo with a black plastic case containing samples of the mpox virus, seemingly deactivated and noninfectious, and that they both lacked proper documentation for these materials and misled the customs agents who questioned them. The two virologists have pleaded not guilty. (Munster’s attorney did not respond to a request for comment.)

[Read: Trump thinks he knows what started the pandemic]

The strongest argument for connecting all of these cases is that lab-leak activists themselves have done the same. Anthony Bellotti, the founder and president of the White Coat Waste Project, an animal-activist group that has leveraged the lab-leak theory in pursuit of its goal of ending all taxpayer-funded animal testing, declared that “Morens’ indictment should be the beginning—not the end—of long-overdue lab leak accountability at NIH.” Just two weeks before Munster was indicted on charges that seem to have no connection with the pandemic, Bellotti’s group joined the right-wing activist Laura Loomer in hawking what they called a “whistleblower report” about the virologist’s alleged misdeeds. That document describes Munster as a “Fauci acolyte and all around egotistical, arrogant foreigner that joined his research project (to aerosolize covid virus) to Ralph Baric’s project (to weaponize it).” (I could find no evidence that Munster, who is a Dutch citizen, ever worked on a project to “aerosolize” SARS-CoV-2 in order to engineer a new virus, as the whistleblower document seems to suggest. He did work on several papers that tested its stability in aerosols.)

In the meantime, Senator Rand Paul has linked Munster’s name to an early draft of a Defense Advanced Research Projects Agency grant application, with Baric listed as a principal investigator, that proposed to gauge the spillover risk associated with bat coronaviruses. The project’s ultimate goal was to limit that threat but involved altering the viruses in ways that might have made them more infectious—and more like SARS-CoV-2. (The final version of that proposal does not mention Munster, and the extent to which he knew its details are unclear.)

If you believe, as Paul and others do, that this unfunded DARPA project may have been a blueprint for generating the pandemic virus—and that, one way or another, virologists’ disregard for biosafety helped cause the deaths of millions—then seeking justice would be natural. If you’re also sure that COVID got its start in studies funded by the U.S. government, and specifically through NIAID, then there is no greater villain in this story than Fauci. Just last week, Paul announced that he’d subpoenaed the lab-leak theory’s final boss to testify in Congress at the end of this month. “He has not really gotten his just deserts,” Paul said in a weekend interview on Fox. He later added: “There needs to be repercussions.” A hearing is one of the clearest avenues to pursue such measures: The blanket pardon that Fauci received from President Biden wouldn’t cover any charges of lying to Congress that arose from new sworn testimony. (Neither Fauci nor Paul responded to requests for comment.)

Those repercussions may yet extend to other scientists. Ebright, the Rutgers professor, gave me a long list of names of researchers who he says should be held accountable. Justin Goodman, the senior vice president for advocacy at White Coat Waste, told me that every holdover from the “Fauci era” at NIH ought to be fired for their involvement in gain-of-function research, which the group sees as responsible for creating COVID. “I would throw Morens, Munster, and Taubenberger all in the same box of reckless and arrogant animal experimenters who fucked around and are finding out,” he said.

Even if this thirst for COVID retribution could be satisfied, its supposed higher purpose—to help prevent the next pandemic, by promoting more responsible research—hasn’t yet been served. Despite the years of Sturm und Drang about pandemic origins, and the wholesale adoption of the lab-leak theory by the party that controls both Congress and the White House, a shaky status quo still persists in biosafety. The rules for how to work on dangerous pathogens and which sorts of experiments should be allowed aren’t clear; oversight is spotty.

A better, more comprehensive system remains a worthy goal. Shortly after President Trump took office, his administration took a few half steps in that direction. Last May, the president issued an executive order meant to limit and track all research that involves the potential enhancement of dangerous pathogens. “This is an historic day—the end of gain-of-function-research funding by the federal government,” HHS Secretary Robert F. Kennedy Jr. told reporters at the signing ceremony; NIH director Jay Bhattacharya said gain-of-function work would “go away forever.” Yet Ebright and others told me that this project has stalled out. The Office of Science and Technology Policy had been placed in charge of revising the rules on this research by the end of last summer and implementing a national strategy for tracking all gain-of-function research before the end of last year. Those deadlines came and went. No such policies were put in place. (In response to a request for comment on this delay, the White House said that the administration “continues to implement our updated framework to govern, limit, and track dangerous gain-of-function research across the United States.”)

[Read: The lab leak will haunt us forever]

In the absence of that administrative work and with little progress being made on the various biosafety laws that have been proposed in Congress, the nation has been left with just the vengeful spectacle of lab-leak prosecutions. In effect, research policy is being handled by the Department of Justice. America’s doctor may soon be dragged out to testify once more: The science that he championed appears to be unfettered; the scientists he funded are at risk of ending up in chains.

This piece was updated to clarify that Munster worked on several projects that involved the generation of SARS-CoV-2 aerosols.

The Genes That Could Cancel Out a Fatal Diagnosis

2026-07-07T09:38:28-04:00

When Ludivine Verboogen and Romain Alderweireldt’s third child was born in Belgium in late 2015, they marveled at his long fingers. Perhaps one day he will be a famous pianist, they thought. But soon Ludivine grew worried that her son was not developing as well as his two older sisters had. His muscles seemed weak, and the physiotherapy appointments she was taking him to three times a week didn’t seem to be helping. “A lot of doctors were telling us that he was fine, nothing was wrong with him,” Romain recalled to me.

Ludivine persisted, and shortly before their son was a year old, she and Romain found out that his long fingers and lack of muscle tone had a devastating explanation. He was diagnosed with a disease called Marfan syndrome, which generally involves mutations in a gene that helps build connective tissue in the body. Many people with Marfan are exceptionally tall—Abraham Lincoln, for one, may have had the syndrome—and are at very high risk of a kind of fatal rupture in the heart. Ludivine and Romain learned that their son had the neonatal form of the condition, and they were told that he probably would not live past 16 months.

When Romain got the news, he lay down on his office floor, overwhelmed with emotions. His boss found him there and encouraged him to get back up and start working on a solution. Before long, Romain and Ludivine came across a new paper describing how scientists had combed through genetic data from more than 500,000 people and identified 13 adults who defied their genetic destinies—who were alive and healthy despite having multiple or dominant genetic mutations that normally cause grave illness beginning in childhood. The hope of such studies, they learned, is to identify “modifier” genes within the human genome that can be manipulated to mitigate or cancel out genetic conditions.

“I had a look to see if something like that had been done in the field of Marfan, and it had not,” Romain said. Marfan syndrome is particularly mysterious because members of a family who carry the same exact mutation can have wildly different health trajectories, Catherine Boileau, a geneticist at the French health research institution INSERM, told me. Within a given family, she said, the disease can appear at very different ages and with starkly different severity. Some people might experience a fatal tear in their aorta early in life; their relatives might have only mild symptoms and not require surgery.

Romain began combing through databases of genetic information to see if he could find people with Marfan mutations who did not appear to have symptoms of the disease. He found 122 of them, including 24 who had errors in the gene thought to cause the neonatal version of Marfan. Perhaps one of these people, or someone like them, held in their genes the possibility of a different life for his son.

Boileau knows from experience that finding modifier genes can pave the way to lifesaving therapies. She was involved in early research into a gene called PCSK9: Mutations that lower the gene’s activity, it turns out, can avert sky-high cholesterol levels usually caused by inherited errors in another gene. That discovery helped create a class of drugs that mimic the effects of disabling PCSK9.

Modifier genes also have a role in sickle cell disease, one of the most common inherited disorders in the world. In the disease, the body produces an abnormal form of the oxygen-carrying molecule hemoglobin. Scientists identified genetic mutations causing sickle cell disease decades ago, but around the mid-2000s, they began discovering modifier genes, including one that could help jump-start hemoglobin production. Normally, this modifier gene suppresses the creation of a second kind of hemoglobin, typically made only during fetal development; repressing the gene prompts cells to start making the fetal form of hemoglobin again, which acts as a backup. One of the very first gene-editing therapies that the FDA approved for sickle cell disease works precisely by shutting down this modifier gene.

In recent years, more scientific groups have been identifying genetic outliers who might possess helpful variants of modifier genes. A study published in March from researchers in Singapore and Australia, for example, examined the genomes of almost 10,000 healthy people and looked for errors in more than 1,600 genes associated with severe pediatric disease. They found nine individuals ranging in age from 12 to 62 years old who showed no signs of illness despite having DNA profiles presumed to cause grave health issues in childhood. Last month, researchers presented new data at the European Human Genetics Conference in which they searched for 15 genetic conditions in about 900,000 individuals and found that, for some illnesses, the degree of severity is more variable than previously believed.

The research that first inspired Ludivine and Romain’s was part of an effort called the Resilience Project, which was led by scientists at the Icahn School of Medicine at Mount Sinai and has been paused for a number of years. Stephen Friend, a physician-scientist who helped spearhead the original project, told me that, a decade ago, confirming the beneficial effects of suspected modifier genes was difficult, but the advent of techniques such as CRISPR editing has made running such tests far easier. Now the scientists behind the project are looking to reboot it. In the new iteration, the project will apply AI tools to scan more than 2 million genomes for more than 500 rare and ultra-rare diseases, Eric Schadt, a computational biologist at the Icahn School of Medicine, told me. Schadt is working with Friend, and they have assembled a team that spans multiple institutions; their goal is to identify the modifying genes in outliers and develop drugs that replicate their beneficial effects. In a paper published last week, Friend and other scientists note that modifier genes that suppress symptoms have so far been found in around 100 different human diseases.

The mystery of why some people who carry a deadly gene variant might not have symptoms traces back a century, to when biologists were trying to understand how traits were passed from one generation to the next. In fruit flies, they noticed, the expected mutations sometimes caused only partial changes in the insects’ anatomy. Some other factor, or factors, helped determine the flies’ fate.

In the intervening years, scientists have identified modifier genes and other forces that can influence whether a particular trait manifests. Environmental factors can play a huge role. For example, people with phenylketonuria, an inherited metabolic disorder, usually develop severe cognitive impairment, but won’t if they follow a diet that omits foods with specific proteins. Scientists also now know that chemical tags on DNA known as epigenetic markers can switch genes on and off, affecting the degree to which genetic traits produce symptoms.

Identifying the factors that influence the intensity of symptoms caused by inherited mutations is getting easier—and really “has only recently become possible to study systematically,” according to Caroline Wright, a geneticist at the University of Exeter Medical School, in England. Wright, who was involved in the report on 900,000 people, told me that looking at large populations has made it more possible to identify people with other changes in their genomes that mitigate congenital diseases. These large studies have also shown that the symptoms caused by pathogenic mutations are commonly milder than doctors had believed. Focusing scrutiny on the DNA of people who were unwell—a reasonable choice when genetic analysis tools were neither cheap nor fast—might have introduced a bias toward believing that the mutations were always extremely harmful.

And better understanding the flip side—the ways in which worrisome gene mutations might not always cause severe illness—is the key to knowing “if and when to start treatment for those that carry the mutation but still don’t have the disease,” Dusan Bogunovic, the director of the Center for Genetic Errors of Immunity at Columbia University Irving Medical Center, told me.

Bogunovic published a paper in March that highlighted how much we don’t understand about these phenomena. Each of us inherits a set of genes from each of our parents, but recent studies have suggested that the copy from one parent is four times as active as the other version. So if a person’s healthy copy is more active than the mutated one, they might have far fewer symptoms than expected. This kind of skewing has become much easier for scientists to track with new sequencing technology. For as many as half of the genes we carry, one copy might be at least 50 percent more active than the other, Bogunovic estimated.

Gene skewing might even influence outcomes of Marfan syndrome: A small number of case reports have hinted that skewed gene activity might happen with the fibrillin-1 gene. One study, in which 80 people with Marfan were compared with 80 healthy volunteers, found a roughly fourfold difference in fibrillin-1 gene activity in both groups, suggesting that it might be prone to skewing. This skewing has been hypothesized as a contributor to the variability in symptoms of Marfan in families with the same mutation.

Romain and Ludivine’s son has not yet needed heart surgery, but they are still eager to identify outliers with Marfan and learn which factors are helping those people. They started the 101 Genomes Foundation in an attempt to create a database of complete, “whole genome” data from that many people with Marfan mutations. In the past decade, the effort has amassed more than 230 genomes, and it continues to add more each month. (Boileau, the geneticist in France, is an adviser to the project.) The puzzle of why some people with neonatal forms of Marfan’s succumb within months and others live with mild effects weighs on Ludivine and Romain: They have met countless patients and parents like themselves, and although their son is doing relatively well, they know children who have died from the condition in infancy.

They now have a glimmer of insight into genetic variation outside the fibrillin-1 gene that determines whether Marfan patients get sick early in life or remain relatively healthy. At the European Conference on Rare Diseases in June, the 101 Genomes team presented what their years of research had uncovered: five potential modifier genes that had a chance of explaining some of those wild variations. And in as-yet-unpublished data, they have identified a variant of an additional modifier gene that affects the heart’s ability to contract and has a strong protective effect against Marfan mutations, according to Bart Loeys, a clinical geneticist at the University of Antwerp who is helping to lead the research supported by the 101 Genomes Foundation. “If nature has the means of correcting or buffering the effects of a pathogenic variant in one gene, we can learn from that,” he told me. “Maybe we can try to mimic that in other patients.”

At Least You’re Not Playing in the World Cup Right Now

2026-07-02T10:48:38-04:00

Last June, England’s men’s national soccer team went to Spain for a training camp. Next to the pitch were tents artificially heated to a minimum of 95 degrees Fahrenheit, where players completed fitness tests on exercise bikes while staff measured their performance. Each player swallowed a biometric tablet, about the size of a large vitamin, so that scientists could see how well his body cooled itself. At the time, England’s head coach, Thomas Tuchel, told reporters, “I will be very surprised if we do not suffer” at the 2026 World Cup in North America, where his athletes would be tested not just against other teams but against the hot and humid summer.

The weather in the United States in the coming days will provide such a test—for World Cup athletes and for millions of Americans alike. The heat wave sweeping across the country will hit several World Cup locations, including New Jersey, Kansas City, and Philadelphia, where stadiums lack roofs and air-conditioning. The last time North America hosted the World Cup, in 1994, games were infamously hot, and this tournament could give it a run for its money. Tomorrow, temperatures in Kansas City, Missouri, are expected to reach into the 90s, and they’ll get close to 100 in Philadelphia when the city hosts a game on Saturday. Both cities have been placed under extreme-heat warnings by the National Weather Service. If we mere mortals are made miserable by the heat, these footballers will be miserable and vigorously exercising—they usually run about seven miles during a game, Orlando Laitano, a professor of applied physiology and kinesiology at the University of Florida who works with Brazil’s national team, told me.

For months, teams have strategized about how best to prepare their athletes for this kind of heat and humidity—with post-training saunas, hot-water immersion, sweaty outdoor workouts, and heat-training camps. In an ideal world, athletes would spend about 15 days working out in the heat to get used to a region’s climate in the lead-up to the tournament, Lee Taylor, an exercise and environmental physiologist at Loughborough University who consults with several soccer teams competing in the World Cup, told me. Many teams try to do exactly that. Norway’s squad—probably especially in need of some heat training—went to Greensboro, North Carolina, where, at one point, it got so hot that the coaches reportedly cut practice short. Brazil’s team, meanwhile, decamped to Orlando, Florida, where Laitano affixed players with sweat-collection patches and analyzed their fluid and electrolyte loss during workouts to concoct a hydration regimen for each person.

But many players get less than 15 days of acclimatization time. Although England’s team held a 10-day training camp in Miami ahead of the World Cup, some players arrived late because they were busy with the Champions League finals. Laitano still ruminates over Brazil’s loss in the 2014 World Cup, which the country hosted not long after he started working with the team. Brazil chose to train in the mountains of Rio de Janeiro, a region that, during the Southern Hemisphere’s winter, was colder than the other parts of the country where they’d be playing, he told me. Germany, which won the tournament, trained in Brazil’s sweltering state of Bahia. “I can’t say they won only because they stayed in the heat,” Laitano said, “but they did choose to have their base in a hot environment, because they knew it could be an edge for them.”

Acclimatized or not, players are still dragged down by the heat. Research has shown that athletes generally don’t play as intensely during hot matches—not sprinting as often, for instance—and just as a heat wave can zap a person’s energy over multiple days, the fatiguing effects of heat accumulate during the tournament. Still, trainers have a few tricks that can help athletes—or anyone, really—withstand the heat. To lower their core body temperature, athletes might don an ice-filled vest (admittedly, not a household item) or, before a match, dunk themselves in an ice bath (easier to try at home). FIFA has mandated periodic hydration breaks throughout this year’s games, too, during which players can drink ice slurries and wrap themselves in cold towels. (Again—not a bad idea when air-conditioning leaves something to be desired.)

For those of us who haven’t spent months preparing for heat under the care of dozens of experts, the options are somewhat limited. People take about eight to 10 days to get well acclimated to heat, Michael Sawka, an exercise physiologist and heat-adaptation expert at Georgia Tech, told me. When heat waves come on suddenly, people have little chance to acclimatize, and many of the areas affected this week, such as New York City, have had fairly reasonable temperatures recently, Carol Ewing Garber, an exercise physiologist at Columbia University’s Teachers College, told me. Most people will just have to get through it. Garber suggests that those of us not competing in the World Cup follow a few basics: In lieu of a mandated uniform, we should wear breathable clothing; entire nations are not fiercely anticipating our performance on a soccer pitch, so we can choose to spend time in the shade and to exercise in the cooler hours of the day. And on one count, the advice is the same for both normies and World Cup players: Take frequent water breaks.

The Beef Administration’s Blind Spot

2026-06-27T12:00:00-04:00

If there’s one message that Robert F. Kennedy Jr.’s campaign to redefine healthy eating has imparted, it’s that Americans need to eat their beef. In January, the health secretary rolled out the new food pyramid—with a marbled rib eye in the pole position. Weeks later, Kennedy modeled good beef-eating behavior, posing for a pic on his 72nd birthday while tucking in to a bone-in steak decked out with candles. In February, he dropped by the trade show CattleCon and begged the assembled ranchers to increase the size of their herds. “I eat beef every day, twice a day,” Kennedy boasted to the hooting crowd.

The secretary’s beef-intensive diet, which is shared by other members of the Cabinet, including Vice President Vance, is informed by the idea that people should be eating as our prehistoric ancestors did. When the Department of Health and Human Services put out its update to the food pyramid, it also published a 90-page document laying out the “scientific foundation” for the new advice. The report cited several papers on the benefits of the Paleo diet. One specifically endorses eating wild game, and argues that every person should strive to change their diet to “become a 21st-century hunter-gatherer.”

This mode of thinking can be traced back to at least the 19th century, but its current incarnation—the version that has wormed its way inside the U.S. government—dates to the 1970s, when the growing plague of heart disease and obesity was starting to receive sustained attention on Capitol Hill. That’s also when a Seattle gastroenterologist named Walter Voegtlin published a pale volume with a drawing of a loincloth-wearing hominid on the cover. His book was called The Stone Age Diet, and on the title page was a modest proclamation: “It’s Safe, It’s Sane, It’s Simple, and It Really Works!”

Voegtlin’s approach to nutrition may not have been any of those things, but it set the model for the glut of Paleo-diet books that were to come. The book laid out its author’s odd ideas and strong opinions, such as his profound loathing of “baleful salads” and especially the garlicky Caesar, which he regarded as a “gastric atrocity.” Beef, on the other hand, is an excellent source of protein, Voegtlin said. He noted that the man who eats a roast-beef sandwich gets all the amino acids he needs while the peanut-butter-sandwich eater does not. But Voegtlin wasn’t wedded to any single flavor of carnivory. In fact, he had some beef misgivings. Eating cows might not be sustainable, he argued, in a world teeming with billions of slavering Homo sapiens.

Perhaps another beast could be used for making hamburgers instead. Voegtlin had a notion: Instead of land cows, we should eat sea cows, or manatees. And he was not the first American scientist—and far from the most famous one—to hit on this very notion. In fact, schemes to radically expand the nation’s deli counter have been a strange motif in U.S. history.

Voegtlin’s book laid out the premise for the modern Paleo diet. According to its basic theory, Homo sapiens as a species moved so rapidly from hunting and gathering to buying food at supermarkets that our genes never caught up. We’re Stone Agers on the inside, built to eat whatever could be plucked from the bushes or clubbed to death on the savanna, but now we’re marooned in a sickening landscape of nachos and pizza. The goal, for Voegtlin and the people he inspired, was to get back to eating whatever it was that our primitive ancestors ate. The challenge was to figure out what exactly appeared on the caveman food pyramid.

Given the patchy nature of Paleolithic evidence, this matter has provoked many disagreements, which began long before the publication of The Stone Age Diet. In his 1913 book, My Life With the Eskimo, Vilhjalmur Stefansson, an Arctic explorer and anthropologist, described how he believed an Inuit community he’d met in Canada’s far North provided a window into the lifestyles and dietary habits of our Stone Age ancestors. Stefansson’s polar adventures made him famous, especially for the all-meat diet he ate while camping in an igloo: seal flipper and whale tongue; raw and boiled caribou; grizzly-bear jerky and polar-bear steaks; blood soup and tallow-dipped ptarmigan feathers; and, on one desperate occasion, his own bootlaces.

[From the November 1945 issue: Vilhjalmur Stefansson reports on the dental benefits of an all-meat diet]

Tales of Stefansson’s gastronomical feats circulated at a moment when Americans were also exploring new kinds of food. The First World War brought meat shortages and a national austerity campaign, launched in 1917, that encouraged “Meatless Tuesdays” and “Porkless Thursdays.” For years, naturalists with the American Museum of Natural History, which funded some of Stefansson’s expeditions, had been arguing that Americans should really eat more whale. During the war, the U.S. government got on board, promoting the consumption of fresh and canned leviathan and explaining that because these sea monsters were mammals, their flesh tasted like beef or venison, not fish. The feds published a bulletin with 32 cetacean recipes, including “Stuffed Roast Whale,” “Whale Croquettes,” and “Corned Porpoise.” And the museum hosted a widely publicized “whale steak luncheon,” which more than one newspaperman described as sweet revenge for poor Jonah.

[Read: I ate whale meat]

Meanwhile, Alexander Graham Bell, the renowned inventor and a co-founder of the American Telephone and Telegraph Company, was out with a related plan for solving America’s meat crisis. In a statement published in the Journal of Heredity, Bell suggested that the government should look into the possibility of domesticating manatees. Although Florida lawmakers had recently criminalized the killing of these charismatic animals, which one 1891 children’s-book author had called “as amiable, mild, gentle, playful, kindly a creature as ever drew breath,” Bell noted that the sea cow offered “many points of superiority” over even such a promising candidate for husbandry as the pygmy hippopotamus, which the journal had previously considered. “Dr. Bell wants to see the south dotted with manatee ranches,” The Augusta Herald reported in an article about the idea that included recipes for broiled, stewed, and curried manatee, and explained that the sea cow’s tail was usually pickled and served cold.

This was not a bonkers notion. Manatees had been a coveted food source for the Seminole peoples and for southern Americans extending into even the 20th century. “The fattest, juiciest Tennessee beef is by no means equal to it and I doubt if there is anything in the animal kingdom that is so utterly delicious,” one manatee enthusiast wrote in 1885. Bell’s scheme, presented in a journal devoted to eugenics and geared toward optimizing dietary protein, would later resurface at another moment of food anxiety, when Walter Voegtlin was inventing the Paleo diet in the 1970s.

newspapers.com

The Knoxville Sentinel, November 27, 1917

University of Georgia / Georgia Historic Newspapers

The Augusta Herald, September 21, 1917

After training as a doctor and specializing in gastroenterology, Voegtlin had devoted most of his career to trying to find a cure for alcoholism. But on the side he was a nutritional contrarian, arguing in talks that human digestion is better suited to a diet rich in fat and protein than one based on carbohydrates. To prove this point, he cited Stefansson’s tales of Stone Age eating and his own early lab research on dogs.

Voegtlin’s anti-starch opinions spread, at first, on the basis of these lectures. By the 1950s, they were being touted in Prevention, a magazine known for its back-to-nature ethos and openness to vaccine-skeptical views. The Stone Age Diet, his first and only published work on caveman nutrition, did not come out until 1975, just months before his death. Voegtlin saw Mother Nature’s food chain in simple terms: Herbivores eat plants, and carnivores eat herbivores. Humans are in the latter group, with digestive tracts that are “practically identical” to those of dogs, he said. (Voegtlin conceded that omnivores exist, but he argued they are merely “transitional forms.”) But if man is a “pure carnivore,” as Voegtlin claimed, he is flexible as to what kinds of meat ought to go in the tank. Bugs, snails, worms, snakes, leeches, monkeys, lizards, the stomach contents of sharks: All are regarded as delicacies by some human societies, according to the book.

Indeed, for Voegtlin, the future of the species might depend on man’s willingness to broaden his horizons with respect to meat. Writing at a time when concerns about the impending human “population bomb” were widespread, Voegtlin thought the world was not harvesting enough protein to fend off malnutrition. He argued that people might need to start eating up the world’s predators, because they competed with humans for flesh. “There are four thousand tigers left in India and each tiger eats six thousand pounds of meat each year,” Voegtlin noted with alarm. Alligators, crocodiles, lions, tigers, and bears might have to become supper. Ocean predators such as the seal, whale, dolphin, and walrus would be hunted down and made into supermarket steaks. And in the brutal, man-eat-dog world of the book’s imagination, human populations, too, would need to be controlled: Voegtlin proposed that reproduction should be limited to “superior types of individuals” under the watch of an “omnipotent Bureau of World Census.”

As for nature’s mermaid—the gentle, seagrass-chewing sea cow—she might carry on her lineage in water farms, domesticated as a novel form of floating livestock. “This marine mammal, as does its dry land counterpart, eats only vegetation, totally unfit for human consumption,” Voegtlin noted. Sea cows are superior to land cows, Voegtlin suggested, because land cows eat grains, which humans could survive on in a pinch. Since manatees live on baleful sea-salads and don’t deplete the world’s meat supply, they could live alongside humans in peace—until such time as they were ground into meatballs.

Voegtlin’s book did not initially garner much attention. One of its few reviews, in the journal Medical History, described it as full of “opinions that oppose accepted belief and substantiated fact.” Academics who promoted Paleolithic nutrition in the 1980s called for plenty of plant foods in the diet and ignored Voegtlin, perhaps on account of his endorsement of eugenics. But by the time the Paleo world was coalescing online in the ’90s, Voegtlin’s book was cited as a pioneering work. Its message would be channeled through the 2010s as the Paleo lifestyle became associated with zealous meat-eating and an emerging band of popular “meatfluencers.”

But as it turned out, the archaeology would prove Voegtlin wrong: It wasn’t true that Stone Age humans never touched a processed grain. Starch residue found on 30,000-year-old grinding stones indicates that Paleolithic peoples may have eaten bread. Ancient bits of DNA suggest that genes for starch-digesting enzymes might have been proliferating as early as 800,000 years ago, when cave-chefs started roasting primordial potatoes. Marlene Zuk, an evolutionary biologist and the author of a 2013 book that debunked some of Voegtlin’s arguments, recalled how the Paleo community dealt with this evidence that challenged their largely carb-avoidant worldview. “They liked the word tuber,” Zuk told me. “The word tuber was very popular because it sounded more caveman-y.”

[Read: How close are manatees to extinction?]

Even for its time, The Stone Age Diet missed the mark with its sharp dichotomy between herbivores and carnivores (and its bizarre denial of omnivores). These distinctions can be fuzzy: Crocodilians, for example, may eat kumquats and pond apples in the wild, while cows and sheep will snack on baby birds. Even the kindly Florida manatee, connoisseur of bayou seagrass, sometimes flies into a carnivorous rage, snapping up fish and gnashing them in its terrible teeth.

Yet no branch of science has debunked the idea that humans are neglecting lots of opportunities for ingesting animals. Indeed, the notion that we should be eating strange meats has been backed by a range of influential authorities. Voegtlin got his vision of sea-cow cuisine not directly from Bell but from Scientific American, which had proposed that we domesticate not just the manatee but also the “palatable” capybara, and from The Journal of the American Medical Association, which lent its weight to the idea of building enormous blue-whale farms in the Pacific Ocean, fenced in by coral reefs. More recently, advocates of livestock alternatives have zeroed in on smaller animals: In 2013, the United Nations released a report on global food security that argued for the mass cultivation of edible insects. The report noted that various groups have made a habit of consuming beetles, caterpillars, wasps, mealworms, and dragonflies.

I’m not here to suggest that the logic of evidence-based nutrition demands that we consume more manatee meatloaf or chili con capybara or dragonfly dumplings. But there’s something ho-hum about the fact that a norm-breaking MAHA administration, led by a carnivorous health secretary who has boasted that he’s a “very adventurous eater” and will “eat virtually anything,” has stuck so monotonously to beef. It’s not as if beef has been shown to be healthier than any other meat. Examined through a political lens, though, Kennedy’s bovine-forward dietary approach makes perfect sense, Amy Bentley, a food historian, told me. The burger is the quintessential American meal, and beef-related imagery calls to mind the virile cowboys who drove cattle and made America great by filling its larders with sirloin. There’s a resonance between this sentimentality for the Old West and the Paleo-nostalgia that animates the carnivore community, she said, in that both are romantic fantasies about a time when men were unapologetic warriors. “When gender roles are being questioned, there’s often renewed interest in the vitality-giving properties of animal flesh,” Adrienne Bitar, a food scholar who has written about Voegtlin, told me.

Proposals to put manatees or mealworms on the food pyramid would face challenges. On the left, a plan to farm sea cows would enrage conservationists, even though Trichechus manatus has in recent years been downgraded from “endangered” to “threatened.” On the right, the UN’s edible-insect report sparked an “I will not eat the bugs” campaign from skeptics of climate-driven policies. Perhaps that’s why, for all of the MAHA bluster about remaking the American diet, the architects of our new dietary guidelines have turned out to be picky eaters when it comes to meat. We’re all a bit afraid to try new things. That tendency, which may have been with us since the Stone Age, today serves the interests of our cumbersome friends in the Florida Everglades. For now, at least, pickled manatee tail is off the table.

Europe’s Come-to-AC Moment

2026-06-26T14:10:37-04:00

In stifling apartments and sweaty row houses in England, Germany, and even Scandinavia, some Europeans are considering a very American idea: They really need an air conditioner.

One of their most accessible options, though, might feel unfamiliar to anyone accustomed to central air. Among Europe’s commonly used types of air-conditioning is a clunky, inefficient unit that stands a few feet high and has a wide exhaust tube meant to go out a window. Such units are typically “a panic-buy on a hot weekend,” Brian Motherway, the head of energy efficiency at the International Energy Agency, told me. People grab the first machine they see and end up living with it for a decade, he said. Many people leave the window gap around the exhaust tube uncovered, letting hot air right back in. Walking down a Paris street last week, I saw three different stores where such units stood beside a door propped open by the tube.

Sales of air conditioners of all sorts are climbing in Britain too. I’ve lived in London for 25 years, and I don’t recall ever hearing anyone talk about buying a home air conditioner—until three acquaintances mentioned, unprompted, on the same sweltering day, that they had purchased one, or were considering it.

Much of Europe wasn’t built for air-conditioning, or for coping with hot weather at all. In Britain, for instance, which has been long accustomed to cool summers and dark, rainy winters, older houses like mine are poorly insulated and often leave inhabitants baking when outside temperatures climb. But many newer buildings are designed to retain heat and maximize sunlight, making them also poorly suited for the new normal, Andy Love, a sustainability consultant who founded Shade the UK, an advocacy group that presses for smarter building regulations, told me. However sleek and modern the big glass apartment towers going up around London look, he said that many residents are “moving into those flats in the winter to then find out in the summer, it’s a furnace.” Britain’s Climate Change Committee, which advises the government, put the problem bluntly in a report in May: “The UK was built for a climate that no longer exists.”

All across the continent, Europeans enduring heat waves that are growing more frequent and intense are coming to similar realizations about their own buildings and cities. The zinc roofs that top nearly four-fifths of Parisian apartment buildings, for instance, create baking conditions for those beneath. Temperatures are brutal, too, in the concrete towers on the city’s poorer outskirts, where high electricity prices make some people wary even of running fans. France’s housing minister, Vincent Jeanbrun, said that one in three dwellings in the country was “like a thermal kettle.” Many European nations have worked hard to improve buildings’ energy efficiency, but although insulation can help modulate temperatures in summer as well as winter, many homes have also been made airtight to retain heat.

Now Europeans urgently need ways to cool down. Although climate change will cause the biggest absolute increases in heat in African nations, eight of the 10 countries likely to see the most “dramatic relative increases in the number of days that require cooling” are in northwestern Europe, a study by researchers from the University of Oxford and the University of Bristol found. That list includes Switzerland, Britain, and Norway, and all of those places, the study warns, are unprepared.

Already this summer, two major heat waves have broiled Europe. During the first, Ireland, France, and the United Kingdom sweated through their hottest-ever May temperatures. A month later, France notched its two hottest days and its hottest night since records began: Thermometers soared past 110 degrees Fahrenheit in the west and 104 degrees in Paris. Spain reported its two hottest June days since at least 1950, and Britain, where temperatures reached 99 degrees, recorded its three hottest June days. The temperature in Basel, Switzerland, hit 100 degrees. Germany and Austria are enduring heat in the 90s, and braced for worse as the weather moves east. Temperatures this high can be life-threatening: More than 200,000 people have died because of heat in Europe in just the past four years, the World Health Organization estimates.

The imperative of reducing that toll prompted Britain’s Climate Change Committee to warn that although installing shades, awnings, and shutters can and should help lower temperatures, air-conditioning and other cooling systems will be needed in many homes, hospitals, long-term-care facilities, and schools. That need couldn’t have been clearer this week, as patients sweltered and radiation and MRI machines broke down in hospitals just as emergency rooms were swamped with heat-stricken arrivals.

Making changes like those the committee recommends will take money—potentially $10 billion annually between now and 2050—and time. A 2021 report estimated that less than 5 percent of U.K. homes had air-conditioning, although one market survey reported more recently that the number with an AC had doubled in the past three years. Even so, air-conditioning the country will take decades. The climate panel recommended that temperatures be kept to safe levels in all hospitals by 2035, in long-term-care facilities by 2040, and in schools and prisons by 2050.

The shift to AC is happening across Europe, where only about 20 percent of homes currently have air-conditioning. (Compare that with about 90 percent in the United States.) Ownership is skewed toward the south of Europe—about half of homes in Italy and 40 percent in Spain use it, for example. But a survey in Germany found that AC ownership jumped by 6 percent between 2023 and 2024. Even residents of Scandinavia and the Baltic countries are buying air conditioners, Simon Pezzutto, who studies cooling demand at the Institute for Renewable Energy at Eurac Research, in Northern Italy, told me.

Those clunky portable units do ease discomfort, at least; another widely available air-conditioning option, known as a split unit, is typically more efficient, but also more expensive and harder to install. Reversible air-to-air heat pumps, which are gaining popularity, are an even more efficient option and can both heat homes in winter and cool them in summer.

In Europe, where electricity prices are significantly higher than in the United States and incomes are typically lower, the price of cooling can mean a painful surprise when the power bill comes. If air-conditioning use spikes rapidly, it could also burden a grid that is not yet ready for big new peaks. In a taste of that possible future, tens of thousands of French homes lost power during this week’s brutal heat. Electricity prices spiked as demand climbed, and some nuclear reactors had to curtail generation. Britain’s grid operator coughed up an estimated $13 million to get extra generation online.

Roxana Slavcheva, a buildings expert at the World Resources Institute, told me that the continent would benefit from making sure that the air conditioners it does use are as efficient as possible. But it also needs to prioritize less energy-hungry cooling measures, including better ventilation and more shade for both streets and buildings, she said. In southern Europe, Italy’s wooden shutters and the Greek islands’ thick white walls moderate temperatures, Anna Mavrogianni, a built-environment professor at University College London, told me. Street trees, pergolas, and parks can make being outside more enjoyable, and even help reduce the urban heat-island effect, which makes cities hotter than surrounding areas. Awnings stop heat before it gets inside, as does orienting new homes to minimize direct sunlight on big windows. Light-colored or reflective paint keeps temperatures down, and ceiling fans help too.

Such upgrades aren’t all easy—or quick. In Paris, for instance, officials sometimes decline permission to modify those hot zinc roofs because they’re part of the city’s distinctive look. Elsewhere, too, local planning rules aimed at preserving historic buildings’ aesthetics can mire exterior changes in red tape. In Britain, windows that typically open out instead of in mean that external shutters can’t be installed. Love, the sustainability consultant, knows that retrofitting millions of homes and thousands of neighborhoods is a daunting project that will take years, if it happens at all. Done right, the changes he envisions could make Britain “feel a little bit more Mediterranean than we’re currently used to,” he said. But with the heat here today, “people now just want solutions.”