Hungary passes law that will let Orbán rule by decree

Hungary passes law that will let Orbán rule by decree
Fears over coronavirus legislation that gives no time limit for state of emergency
By Shaun Walker & Jennifer Rankin
Mar 30 2020

Hungary’s parliament has passed a new set of coronavirus measures that includes jail terms for spreading misinformation and gives no clear time limit to a state of emergency that allows the nationalist prime minister, Viktor Orbán, to rule by decree.

Parliament voted by 137 to 53 to pass the measures on Monday afternoon, with the two-thirds majority enjoyed by Orbán’s Fidesz party enough to push them through in spite of opposition from other parties, which had demanded a time limit or sunset clause on the legislation.

The bill introduces jail terms of up to five years for intentionally spreading misinformation that hinders the government response to the pandemic, leading to fears that it could be used to censor or self-censor criticism of the government response.

As of Monday morning, Hungary had 447 confirmed cases of coronavirus and 15 deaths, although the real figures are likely to be higher. The country is under a partial lockdown, with people discouraged from going outside except for essential activities, and schools, restaurants and many shops closed.

Rights groups and government critics say that while it is clear coronavirus brings extraordinary challenges, checks and balances should be placed on the government response, especially given Orbán’s erosion of democratic norms during his 10 years in power.

“This bill would create an indefinite and uncontrolled state of emergency and give Viktor Orbán and his government carte blanche to restrict human rights,” said Dávid Vig, Amnesty International’s Hungary director. “This is not the way to address the very real crisis that has been caused by the Covid-19 pandemic.”

Hungary’s liberal opposition had said that although it had concerns over a number of elements of the law, it was willing to overlook them in the spirit of compromise as long as a sunset clause was introduced.

“Of course we support the emergency situation. We agree with the government that there’s an emergency and that they have to do everything to combat it. We offered almost everything, but we asked for the time limit,” said Ágnes Vadai, an MP with the opposition Democratic Coalition party.

However, the ruling party had made it clear that it was not willing to back down over the sunset clause, she claimed. “I think from the very beginning, they didn’t want an agreement, because they have used the whole thing for political communication,” said Vadai.

Immediately after the vote, the senior Fidesz minister Katalin Novák wrote on Twitter: “The parliament authorized the government to continue fighting effectively against #Covid_19 … Regrettably, the opposition parties do not support this fight.”

Gwendoline Delbos-Corfield, a French Green MEP who leads the European parliament’s work on Hungary and the rule of law, said the EU had left it late to respond to decade-old concerns about democratic backsliding and the weakening of the rule of law under the Orbán government. “Sadly for Hungary, we have been so far [behind] that I am a bit lost [as to] what we can do now,” she said.

Critics of the bill have said it is unclear the government can be trusted to rescind the measures when the pandemic is over, pointing out that a state of emergency related to the migration crisis, brought in in 2016, is still in force.

Asked who would decide when it could be declared over, the justice minister, Judit Varga, said on Friday: “Life will give the answer to this. I’m not a doctor, I’m not a scientist, but I think it will be crystal clear for everyone in Europe when the crisis is over.”

Orbán’s spokesman Zoltán Kovács wrote in a blogpost on Monday: “Just as in wartime, a state of emergency could extend until the end of hostilities. Today, we confront not a military power but are in a war-like state to defend our people against a pandemic the likes of which we have not seen in a century.”

He sharply attacked critics of the law, singling out a Guardian editorial for taking “liberal media cynicism to new, despicable lows”. 


Restrictions Are Slowing Coronavirus Infections, New Data Suggest

[Note:  This item comes from friend David Rosenthal.  DLH]

Restrictions Are Slowing Coronavirus Infections, New Data Suggest
A database of daily fever readings shows that the numbers declined as people disappeared indoors.
By Donald G. McNeil Jr.
Mar 30 2020

Harsh measures, including stay-at-home orders and restaurant closures, are contributing to rapid drops in the numbers of fevers — a signal symptom of most coronavirus infections — recorded in states across the country, according to intriguing new data produced by a medical technology firm.

At least 248 million Americans in at least 29 states have been told to stay at home. It had seemed nearly impossible for public health officials to know how effective this measure and others have been in slowing the coronavirus.

But the new data offer evidence, in real time, that tight social-distancing restrictions may be working, potentially reducing hospital overcrowding and lowering death rates, experts said.

The company, Kinsa Health, which produces internet-connected thermometers, first created a national map of fever levels on March 22 and was able to spot the trend within a day. Since then, data from the health departments of New York State and Washington State have buttressed the finding, making it clear that social distancing is saving lives.

The trend has become so obvious that on Sunday, President Trump extended until the end of April his recommendation that Americans stay in lockdown. Mr. Trump had hoped to lift restrictions by Easter and send Americans back to work.

“That would have been the worst possible Easter surprise,” said Dr. Peter J. Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston, who added that he thought the Kinsa predictions were based on “very robust technology.”

Kinsa’s thermometers upload the user’s temperature readings to a centralized database; the data enable the company to track fevers across the United States.

Owners of Kinsa’s thermometers can type other symptoms into a cellphone app after taking their temperature. The app offers basic advice on whether they should seek medical attention.

Kinsa has more than one million thermometers in circulation and has been getting up to 162,000 daily temperature readings since Covid-19 began spreading in the country.

The company normally uses that data to track the spread of influenza. Since 2018, when it had more than 500,000 thermometers distributed, its predictions have routinely been two to three weeks ahead of those of the Centers for Disease Control and Prevention, which gathers flu data on patient symptoms from doctors’ offices and hospitals.

To identify clusters of coronavirus infections, Kinsa recently adapted its software to detect spikes of “atypical fever” that do not correlate with historical flu patterns and are likely attributable to the coronavirus.

As of noon Wednesday, the company’s live map showed fevers holding steady or dropping almost universally across the country, with two prominent exceptions.

One was in a broad swath of New Mexico, where the governor had issued stay-at-home orders only the day before, and in adjacent counties in Southern Colorado.

The second was in a ring of Louisiana parishes surrounding New Orleans, but 100 to 150 miles away from it. That presumably was caused by the outward local spread of the explosion of infections in New Orleans, which officials believe was set off by crowding during Mardi Gras.

By Friday morning, fevers in every county in the country were on a downward trend, depicted in four shades of blue on the map.

Fevers were dropping especially rapidly in the West, from Utah to California and from Washington down to Arizona; in many Western counties, the numbers of people reporting high fevers fell by almost 20 percent. The numbers were also declining rapidly in Maine.

The parts of New Mexico and Colorado that had been slightly “warm” on Wednesday were in light blue, indicating that they were cooling. So were the Louisiana counties.

As of Monday morning, more than three-quarters of the country was deep blue. A separate display of the collective national fever trend, which had spiked upward to a peak on March 17, had fallen so far that it was actually below the band showing historical flu fever trends — which meant that the lockdown has cut not only Covid-19 transmission but flu transmission, too.

“I’m very impressed by this,” said Dr. William Schaffner, a preventive medicine expert at Vanderbilt University. “It looks like a way to prove that social distancing works.”

“But it does shows that it takes the most restrictive measures to make a real difference,” he added.

For some hard-hit cities, Kinsa also sent The New York Times fever data plotted on a timeline of restrictions enacted by mayors or governors.


Inside the Fossil-Fuel Industry’s Plan to Profit From Climate Change

[Note:  This item comes from friend David Rosenthal.  DLH]

Inside the Fossil-Fuel Industry’s Plan to Profit From Climate Change
The fossil-fuel companies expect to profit from climate change. I went to a private planning meeting and took notes.
By Malcolm Harris
Mar 3 2020

“We think democracy is better,” said the jet-fuel salesperson. “But is it? In terms of outcomes?”

In a conference room overlooking the gray Thames, a group of young corporate types tried to imagine how the world could save itself, how the international community could balance the need for growth with our precarious ecological situation. For the purposes of our speculative scenarios, everything except for carbon was supposed to be up in the air, and democracy’s track record is mixed.

A graph from Chinese social media showing how many trees the country is planting — a patriotic retort to the Swedish climate activist Greta Thunberg — had a real effect on the room. Combine that with the Chinese state-led investment in clean-energy technology and infrastructure and everyone admired how the world’s largest source of fossil-fuel emissions was going about transition. That’s what the salesperson meant by “outcomes”: decarbonization.

Regional experts from sub-Saharan Africa and the Middle East–North Africa also entertained the democracy question, pointing to Iraqi disillusionment with voting and economic growth in Rwanda under Paul Kagame (“He’s technically a dictator, but it’s working”). The China expert said the average regional Communist Party official is probably more accountable for his or her performance than the average U.K. member of Parliament, a claim no one in the room full of Brits seemed to find objectionable. The moderator didn’t pose the question to me, the American expert, presumably because our national sense of democratic entitlement is inviolable.

Actually, the moderator didn’t ask me any questions during the plenary that followed our regional-perspectives panel, either. That might have had something to do with my talk, which included bullet points like “Green growth is a myth” and “Your corporate existence is incompatible with a livable future for cohorts that are already born.” But I didn’t get that impression, not really. I was repeatedly asked to be honest, and everyone was really nice about it. Everyone was really nice in general.

Since 2017, when I published a book about American millennials, I’ve had the occasional cold call from corporations to come talk about my work, all but one of which I’ve turned down. But last fall, the Shell Scenarios team — as in Royal Dutch Shell, one of the biggest oil companies in the world — offered me £2,000 in exchange for a 15-minute talk and my participation in a group exercise. Its internal corporate think tank was holding a daylong conference about how generational change would affect the hopefulness projected in what the company calls the “Sky Scenario,” which it describes as “a technically possible but challenging pathway for society to achieve the goals of the Paris Agreement.” I’m not a climate expert, but apparently I qualify as a generational whisperer, at least to Shell, and to talk to me about global warming, the giant energy conglomerate wanted to fly me to London from Philadelphia, business class. I warned them that I couldn’t keep their money and asked if I’d need to sign an NDA. When they said no, I saw an opportunity to report on the oil company, undercover while in plain sight, without technically lying to anyone. It was too good to pass up. I said yes, then I emailed my editor.

The October 2019 workshop, it turned out, was timely. Fossil-fuel divestment used to be a fringe, college-campus concern, but over the past year, it has become increasingly in vogue in the world’s financial centers, including Davos, where it recently dominated conversation at the World Economic Forum. In December, a couple of months after the Shell workshop, the Bank of England proposed a new climate stress test to measure the resiliency of its banks in the face of warming — a move echoing that of Christine Lagarde of the European Central Bank and reportedly being considered by the chair of the U.S. Federal Reserve, Jerome Powell. Germany announced major coal phaseouts in January with coal-fired power generation scheduled to halt by 2038 at the latest. In a much-celebrated letter the same month, Larry Fink, the CEO of BlackRock, the world’s largest asset manager, declared an about-face on fossil fuels, saying climate change was now a “defining factor in companies’ long-term prospects.” The entire country of Finland proclaimed it would go carbon neutral by 2035. Even the investor cartoon Jim Cramer, of Mad Money, got in on divestment, tweeting, “I am taking a hard pass on anything fossil.” Now ExxonMobil is down $184 billion-with-a-b since its 2014 peak.

From a certain vantage, the momentum looks almost definitive, as though nothing could stand in the way of a renewable future. But unlike coal, oil and gas companies are still definitely profitable, even investable, and more oil and gas are being produced, and used, every year — which helps explain why carbon emissions keep rising too. There’s little doubt that fossil-fuels are, culturally speaking, on the wrong side of history. But there is still a lot more money to extract from those wells, and the fossil-fuel businesses are intent on extracting as much as they can. It’s not necessarily such a bad time to be an oil and gas company, in other words, but it is a bad time to look like one. These companies aren’t planning for a future without oil and gas, at least not anytime soon, but they want the public to think of them as part of a climate solution. In reality, they’re a problem trying to avoid being solved.

Few organizations have been paying as much attention to global warming for as long as the companies that have helped cause it. Journalists at the Dutch publication The Correspondent tracked down an educational video Shell released in 1991 called “Climate of Concern,” which warned, “Global warming is not yet certain, but many think that to wait for final proof would be irresponsible. Action now is seen as the only safe insurance.” There’s good evidence Exxon knew a decade earlier. But not only did these companies continue exploiting their reserves, not only did they explore for new sources and develop new modes of extraction, like fracking, but they funded politicians and groups that claimed not to believe in global warming, agents that have worked to delay the same action they knew was “our only safe insurance.” So far, the oil and gas companies’ calculations — that delay would make them money and that they could avoid consequences for misleading the public — have been spot on. But denial-backed delay is no longer sufficient, it seems. They’re now hoping to leverage their incumbency, and fossil-fuel wealth, to lay claim to the world’s clean-energy future as well. To do that, they’ll have to persuade young people to forget who caused climate change in the first place, or at least to let bygones be bygones. And if they can transition their corporate profiles from fossil fuel to green energy without missing a profitable quarter, that wouldn’t be a repudiation of their delay strategy; it would be a vindication.

Of course, to judge by the advertisements, the transition to renewables has already happened. British Petroleum is now a solar-energy company called BP, ExxonMobil brews giant swimming pools of cool green-algae fuel, and Shell maintains mountain canyons lined with wind turbines floating in fog. All these initiatives actually do exist, though they are a tiny fraction of each company’s budget; so far, the main product of Exxon’s algae program seems to be propaganda. Right now, these companies have to convince governments and their publics to let them run out the clock with fossil fuels, and they’ve decided the best way to do that is to appear to be an essential partner for whatever’s coming next. I was ostensibly there to help plan the timing.

Organizers broke the conference up into three parts: first, a panel on polling and millennial politics; then the regional-perspectives panel; and finally, a collaborative exercise in which “deductive” and “inductive” groups imagined different paths to 2050. By gathering millennial employees from throughout the company, along with experts on the cohort and senior management, the strategies team surely hoped to infuse the firm’s leadership with a drip of youth consciousness, the way some oligarchs are rumored to inject themselves with young people’s blood. It’s supposed to help them stay agile. Other than the eight outside experts, there were a couple dozen people from Shell, ranging from HR specialists in their 20s to senior global executives (mostly Gen X and boomers). Staffers quoted me the figure “90,000 employees” (roughly the size of the company as a whole) a few times when explaining that virtually none of them knew one another.

Some of the most revealing insights came the night before the sessions at a group dinner at a minor Gordon Ramsay restaurant. The venue had two party spaces, and it wasn’t immediately clear where we were supposed to go, but when someone suggested putting up a sign rather than having wait staff direct the party one by one, the younger Shell employees grimaced. “Extinction Rebellion,” one said, less than half-joking. The climate-protest group has a major presence in the city with flyers and volunteers everywhere. “XR” targeted Shell locally in April 2019, smashing windows at the company’s London headquarters. In the U.K., it has succeeded at creating an ambient sense of fear or at least shame. We gathered in the mezzanine dining area and milled around doing introductions, and I asked young workers from the far-flung corners of the Shell empire, “Oh, what’s that like?” I tried to remember not to talk like a reporter.

When they called us to the table for dinner, I was lucky enough to be seated next to one of the senior Shell participants, Steven Fries, the firm’s chief economist. We met over arancini, the likes of which you might find at an upscale food court in a baseball stadium. Based in Shell’s global headquarters in the Hague, Fries pronounces his words with a precision that defies accent; even after speaking with him, his colleagues didn’t realize he’s an American until he told them. Like many people who studied economics at elite Western institutions between 1975 and 1986 would, he blames the lack of affordable housing in London on too much government regulation, which is why his support for big public investments to transition society away from oil and gas surprised me. That is, until I realized that, in his mind, those big public investments would be going to energy companies. When the proverbial light bulb went on above my head, he gave me a look that seemed to say, “Come on, man. What do you think we’re doing here?”


It’s Too Late to Avoid Disaster, but There Are Still Things We Can Do

It’s Too Late to Avoid Disaster, but There Are Still Things We Can Do
Our leaders need to speak some hard truths and then develop a strategy to prevent the worst.
By Michael T. Osterholm and Mark Olshaker
Mar 27 2020

Of all the resources lacking in the Covid-19 pandemic, the one most desperately needed in the United States is a unified national strategy, as well as the confident, coherent and consistent leadership to see it carried out. The country cannot go from one mixed-message news briefing to the next, and from tweet to tweet, to define policy priorities. It needs a science-based plan that looks to the future rather than merely reacting to latest turn in the crisis.

Let’s get one thing straight: From an epidemiological perspective, the current debate, which pits human life against long-term economics, presents a false choice. Just as a return to even a new normal is unthinkable for the foreseeable future — and well past Easter, Mr. Trump — a complete shutdown and shelter-in-place strategy cannot last for months. There are just too many essential workers in our intertwined lives beyond the health care field — sanitation workers; grocery clerks, and food handlers, preparers and deliverers; elevator mechanics; postal workers — who must be out and about if society is to continue to function.

A middle-ground approach is the only realistic one — and defining what that looks like means doing our best to keep all such workers safe. It also means leadership. Above all, it means being realistic about what is possible and what is not, and communicating that clearly to the American public.

When leaders tell the truth about even near-desperate situations, when they lay out a clear and understandable vision, the public might remain frightened, but it will act rationally and actively participate in the preservation of its safety and security.

Our leaders need to begin by stating a number of hard truths about our situation. The first is that no matter what we do at this stage, numerous hospitals in the United States will be overrun. Many people, including health care workers, will get sick and some will die. And the economy will tank. It’s too late to change any of this now.

In three to four weeks, there will be a major shortage of chemical reagents for coronavirus testing, the result of limited production capacity, compounded by the collapse of global supply chains when the epidemic closed down manufacturing in China for weeks.

The second hard truth is that at this stage, any public health response that counts on widespread testing in the United States is doomed to fail. No one planned on the whole world experiencing a health conflagration of this magnitude at once, with the need to test many millions of people at the same time. Political leaders and talking heads should stop proffering the widespread-testing option; it simply won’t be available.

Much better, instead, to immediately gear up for epidemic intelligence, based on techniques used for many decades. Among those is so-called illness surveillance, in which epidemiologists survey a sample of doctors’ offices in a given geographic region each day to learn how many patients sought care for illnesses with symptoms of fever, cough and muscle aches. The increasing or decreasing occurrence of patients with these symptoms provides a reliable estimate of influenza activity during the winter months — or now, the incidence of Covid-19.

A third hard truth is that shortages of personal protective equipment — particularly N-95 masks — for health care workers will only get worse in the United States as global need continues to rise precipitously. There is no point holding out the false hope that the Defense Production Act will save the residents of the United States. Not enough manufacturing activities can be converted to produce masks in a matter of weeks. You can’t turn engine-making machinery into an N-95 respirator assembly line just because you want to.

For example, even as 3M was producing at 100 percent of its capacity (35 million N-95 masks a month), a single hospital in New York City used up more than two million masks in February, before the surge in Covid-19 cases there. And new production won’t happen for many months.

If you can’t make nearly enough masks to meet the need, then you must conserve the masks you can make. Unfortunately, some hospitals in the United States are not employing science-based methods for conserving these invaluable lifesaving masks.

Making ventilators — machines that breathe for patients who cannot effectively do so on their own — poses an even more formidable challenge. For example, a Medtronic ventilator has about 1,500 parts, supplied by 14 separate countries. More machines might, at best, be manufactured by the hundreds a month — but not by the thousands, as is needed right now.

It is precisely in the face of such hard truths that a national strategy and leadership are crucial. Otherwise, hospitals, governors and politicians will only vie against one another in the reasonable service of their own constituencies.

“Respirators, ventilators, all of the equipment — try getting it yourselves,” Mr. Trump said on a recent conference call with governors. “We will be backing you, but try getting it yourselves. Point of sales, much better, much more direct if you can get it yourself.”

This is exactly the wrong message. The White House must take charge, keeping track of national inventory, purchasing the precious resources and distributing them where they are most needed at the moment. As Andrew Cuomo, the governor of New York, has suggested, ventilators could then be redistributed as outbreak hot spots shift around the country.


The U.S. Tried to Build a New Fleet of Ventilators. The Mission Failed.

[Note:  This item comes from friend David Rosenthal.  DLH]

The U.S. Tried to Build a New Fleet of Ventilators. The Mission Failed.
As the coronavirus spreads, the collapse of the project helps explain America’s acute shortage.
By Nicholas Kulish, Sarah Kliff and Jessica Silver-Greenberg
Mar 29 2020

Thirteen years ago, a group of U.S. public health officials came up with a plan to address what they regarded as one of the medical system’s crucial vulnerabilities: a shortage of ventilators.

The breathing-assistance machines tended to be bulky, expensive and limited in number. The plan was to build a large fleet of inexpensive portable devices to deploy in a flu pandemic or another crisis.

Money was budgeted. A federal contract was signed. Work got underway.

And then things suddenly veered off course. A multibillion-dollar maker of medical devices bought the small California company that had been hired to design the new machines. The project ultimately produced zero ventilators.

That failure delayed the development of an affordable ventilator by at least half a decade, depriving hospitals, states and the federal government of the ability to stock up. The federal government started over with another company in 2014, whose ventilator was approved only last year and whose products have not yet been delivered.

Today, with the coronavirus ravaging America’s health care system, the nation’s emergency-response stockpile is still waiting on its first shipment. The scarcity of ventilators has become an emergency, forcing doctors to make life-or-death decisions about who gets to breathe and who does not.

The stalled efforts to create a new class of cheap, easy-to-use ventilators highlight the perils of outsourcing projects with critical public-health implications to private companies; their focus on maximizing profits is not always consistent with the government’s goal of preparing for a future crisis.

“We definitely saw the problem,” said Dr. Thomas R. Frieden, who ran the Centers for Disease Control and Prevention from 2009 to 2017. “We innovated to try and get a solution. We made really good progress, but it doesn’t appear to have resulted in the volume that we needed.”

The project — code-named Aura — came in the wake of a parade of near-miss pandemics: SARS, MERS, bird flu and swine flu.

Federal officials decided to re-evaluate their strategy for the next public health emergency. They considered vaccines, antiviral drugs, protective gear and ventilators, the last line of defense for patients suffering respiratory failure. The federal government’s Strategic National Stockpile had full-service ventilators in its warehouses, but not in the quantities that would be needed to combat a major pandemic.

In 2006, the Department of Health and Human Services established a new division, the Biomedical Advanced Research and Development Authority, with a mandate to prepare medical responses to chemical, biological and nuclear attacks, as well as infectious diseases.

In its first year in operation, the research agency considered how to expand the number of ventilators. It estimated that an additional 70,000 machines would be required in a moderate influenza pandemic.

The ventilators in the national stockpile were not ideal. In addition to being big and expensive, they required a lot of training to use. The research agency convened a panel of experts in November 2007 to devise a set of requirements for a new generation of mobile, easy-to-use ventilators.

In 2008, the government requested proposals from companies that were interested in designing and building the ventilators.

The goal was for the machines to be approved by regulators for mass development by 2010 or 2011, according to budget documents that the Department of Health and Human Services submitted to Congress in 2008. After that, the government would buy as many as 40,000 new ventilators and add them to the national stockpile.

The ventilators were to cost less than $3,000 each. The lower the price, the more machines the government would be able to buy.

Companies submitted bids for the Project Aura job. The research agency opted not to go with a large, established device maker. Instead it chose Newport Medical Instruments, a small outfit in Costa Mesa, Calif.

Newport, which was owned by a Japanese medical device company, only made ventilators. Being a small, nimble company, Newport executives said, would help it efficiently fulfill the government’s needs.

Ventilators at the time typically went for about $10,000 each, and getting the price down to $3,000 would be tough. But Newport’s executives bet they would be able to make up for any losses by selling the ventilators around the world.

“It would be very prestigious to be recognized as a supplier to the federal government,” said Richard Crawford, who was Newport’s head of research and development at the time. “We thought the international market would be strong, and there is where Newport would have a good profit on the product.”

Federal officials were pleased. In addition to replenishing the national stockpile, “we also thought they’d be so attractive that the commercial market would want to buy them, too,” said Nicole Lurie, who was then the assistant secretary for preparedness and response inside the Department of Health and Human Services. With luck, the new generation of ventilators would become ubiquitous, helping hospitals nationwide better prepare for a crisis.

The contract was officially awarded a few months after the H1N1 outbreak, which the C.D.C. estimated infected 60 million and killed 12,000 in the United States, began to taper off in 2010. The contract called for Newport to receive $6.1 million upfront, with the expectation that the government would pay millions more as it bought thousands of machines to fortify the stockpile.

Project Aura was Newport’s first job for the federal government. Things moved quickly and smoothly, employees and federal officials said in interviews.

Every three months, officials with the biomedical research agency would visit Newport’s headquarters. Mr. Crawford submitted monthly reports detailing the company’s spending and progress.

The federal officials “would check everything,” he said. “If we said we were buying equipment, they would want to know what it was used for. There were scheduled visits, scheduled requirements and deliverables each month.”

In 2011, Newport shipped three working prototypes from the company’s California plant to Washington for federal officials to review.

Dr. Frieden, who ran the C.D.C. at the time, got a demonstration in a small conference room attached to his office. “I got all excited,” he said. “It was a multiyear effort that had resulted in something that was going to be really useful.”


The Ibuprofen Debate Reveals the Danger of Covid-19 Rumors

The Ibuprofen Debate Reveals the Danger of Covid-19 Rumors
An online furor over whether it’s safe to use the fever reducer reveals how people are sharing incomplete—and sometimes bad—information.
Mar 26 2020

Two weeks ago, national and world health authorities—and armchair experts and worried well-meaning people—were warning anyone concerned about Covid-19 to avoid ibuprofen. Now, facing contradictory evidence, they’ve backed off that claim. 

But the brief online furor over whether it’s safe to use the fever reducer, and the attention paid to the claim that it might be dangerous, are important, both for how people protect themselves in this pandemic and also for how we consume news about it.

Health institutions and agencies are begging people who believe they are ill to stay at home unless their symptoms are severe enough for hospital admission—so permitting people to use the medications they have on hand, rather than forcing them out to pharmacies, is an important accommodation. And researchers who study acetaminophen, the drug briefly touted as the only appropriate fever remedy, warn that it isn’t risk-free either.

That the advice against ibuprofen got circulated at all is a study in good intentions complicated by biases and possibly by misinformation as well. It showcases how the stress of a global pandemic is causing bad and incomplete information to rise as people rush to deploy whatever protections might be available on the shelf.

The trouble over ibuprofen began March 11, when researchers at University Hospital Basel, in Switzerland, and Aristotle University of Thessaloniki, in Greece, published a letter in The Lancet Respiratory Medicine. The letter reviewed three early sets of case reports from China, covering almost 1,300 patients gravely ill with Covid-19. The letter’s authors observed that significant numbers of those patients had high blood pressure and diabetes, from 12 percent to 30 percent depending on the study, and theorized that higher rates of expression of a particular enzyme, known for short as ACE2, might be raising the risk of coronavirus infection.

ACE2 provides a place on cell surfaces for the coronavirus to attach and enter in order to replicate. High blood pressure and diabetes are treated with drugs that suppress inflammation, called ACE inhibitors; the inhibitors, paradoxically, cause ACE2 to rise. That interaction is where the authors spotted a possible connection between patients experiencing chronic diseases and then becoming infected with Covid-19.

And that’s where ibuprofen entered the unfolding story, too. The over-the-counter drug doesn’t only knock down fever. It also reduces inflammation (the class of drugs it belongs to are known as NSAIDs, non-steroidal anti-inflammatory drugs). That effect, as with the anti-inflammatory drugs given to chronic disease patients, can cause ACE2 to rise.

The letter was speculative. But, three days after it was published, the French Ministry of Health circulated a warning against using ibuprofen for Covid-19 fevers, citing “serious adverse events” occurring in “possible or confirmed cases.” The same day, the French minister of health, a physician, tweetedadvice to avoid ibuprofen and other anti-inflammatories because they could be “an aggravating factor” in Covid-19 infections. The minister, Olivier Véran, recommended that people with fevers take paracetamol, the European generic name for acetaminophen, and didn’t offer any evidence to back up the recommendation. Still, his advice whipped around the world: It was repeated in media outlets from the United States to the United Kingdom to Israel to Singapore to New Zealand.

But it’s hard to figure out where the ministry’s information came from, and whether subsequent media retellings are accurate, have been conflated with different stories, or are even fake. The French ministry’s bulletins about ibuprofen don’t link to any case reports. French media reported later that day that the ministry had received information from unidentified doctors describing deaths from Covid-19 among unidentified young people who took “massive doses” of NSAIDs. (French reporters subsequently put names to some deaths in which ibuprofen may have played a role, such as France’s youngest Covid-19 victim, a 28-year-old man who died on Sunday and was reportedly taking it for pain from a spinal operation.) But at the same time as Véran’s warning, fact checkers at the BBC were finding fake stories of Covid-19 deaths due to ibuprofen circulating on Twitter, Facebook, and WhatsApp, all citing “four young people” in various countries.

What went unreported in the rush to condemn ibuprofen was that France already had been reevaluating NSAIDs, setting the country’s medical experts up to be suspicious of them. In 2018, the nation’s drug safety agency began looking into whether ibuprofen and similar drugs were causing unpredicted complications in bacterial infections.

Ibuprofen has some known risks; overdoses can damage the kidneys in vulnerable patients. But the agency reported in April 2019 that between the years 2000 and 2018, there had been almost 400 cases in France of severe skin infections, brain inflammation, and sepsis that occurred within a few days of people taking ibuprofen along with antibiotics. It’s a warning that seems to be unique to the French health ministry. Acting on it, this January the French drug agency put restrictions on pharmacy sales of both ibuprofen and paracetamol, taking them off the shelves and requiring shoppers to discuss the drugs with a pharmacist before buying them.

In the swirl of panic over Covid-19, some national health authorities supported the French advice, and others pushed back against it. At the end of last week, both the European Medicines Agency (the European Union’s equivalent of the FDA) and the World Health Organization tried to tamp down the furor. They both weighed in to say there is no reason to stop using ibuprofen to home-treat fever from Covid-19.

And the writers of the original letter to The Lancet journal have also distanced themselves from the internet warnings against ibuprofen use. An updatepublished on the University of Basel’s website quoted Michael Roth, one of the authors and a professor on the university’s biomedical faculty: “It does not constitute a recommendation to use certain drugs or not.” He advises patients to consult with their own doctors, and urges further research into the effects on Covid-19 patients of drugs that raise ACE2 levels.

The ibuprofen furor left researchers and physicians exasperated over the distress it caused people already frightened by the virus, and also for the apparent lack of evidence. The publication in The Lancet journal, after all, was what that journal calls a commentary. Unlike scientific articles, these are not peer-reviewed. “Commentary means: These are our opinions,” says Krutika Kuppalli, an infectious disease physician in California and Emerging Leader in Biosecurity Fellow at the Johns Hopkins Center for Health Security. “It does not mean there is medical evidence. I don’t think there is any literature on this.”

That’s a problem precisely because scared citizens are looking for sources of authority, and for things that can keep them safe. See, for instance, the hunger with which people latched onto the malaria drug hydroxychloroquine, touted (with varying degrees of certainty) by Elon Musk and President Donald Trump. Patients who take that drug for lupus and autoimmune diseases are now complaining of shortages, and an Arizona couple poisoned themselves—one of them died—after consuming a version made for aquariums, used to kill parasites that attack fish.

When they’re being cautious about associating phenomena and diseases, epidemiologists will say something represents “correlation, not causation.” In other words, just because two things occurred at the same time doesn’t mean that they’re linked. But to this point, the connection between ibuprofen and severe Covid-19 may not even be a correlation, since no statistical relationship has been found.

In fact, it’s equally possible that ibuprofen has no effect on Covid-19, whether or not it influences the production of ACE2. Though the enzyme allows the virus to enter cells in the lining of the lungs, it doesn’t play any role in how well the virus copies itself, or how efficiently it releases its daughter viruses into the body, worsening illness as their numbers increase.


Turning Back the Clock on Aging Cells

Turning Back the Clock on Aging Cells
Researchers report that they can rejuvenate human cells by reprogramming them to a youthful state.
By Nicholas Wade
Mar 24 2020

Researchers at Stanford University report that they can rejuvenate human cells by reprogramming them back to a youthful state. They hope that the technique will help in the treatment of diseases, such as osteoarthritis and muscle wasting, that are caused by the aging of tissue cells.

A major cause of aging is thought to be the errors that accumulate in the epigenome, the system of proteins that packages the DNA and controls access to its genes. The Stanford team, led by Tapash Jay Sarkar, Dr. Thomas A. Rando and Vittorio Sebastiano, say their method, designed to reverse these errors and walk back the cells to their youthful state, does indeed restore the cells’ vigor and eliminate signs of aging.

In their report, published on Tuesday in Nature Communications, they described their technique as “a significant step toward the goal of reversing cellular aging” and could produce therapies “for aging and aging-related diseases.”

Leonard P. Guarente, an expert on aging at M.I.T., said the method was “one of the most promising areas of aging research” but that it would take a long time to develop drugs based on RNA, the required chemical.

The Stanford approach utilizes powerful agents known as Yamanaka factors, which reprogram a cell’s epigenome to its time zero, or embryonic state.

Embryonic cells, derived from the fertilized egg, can develop into any of the specialized cell types of the body. Their fate, whether to become a skin or eye or liver cell, is determined by chemical groups, or marks, that are tagged on to their epigenome.

In each type of cell, these marks make accessible only the genes that the cell type needs, while locking down all other genes in the DNAs. The pattern of marks thus establishes each cell’s identity.

As the cell ages, it accumulates errors in the marking system, which degrade the cell’s efficiency at switching on and off the genes needed for its operations.

In 2006 Dr. Shinya Yamanaka, a stem-cell researcher at Kyoto University, amazed biologists by showing that a cell’s fate could be reversed with a set of four transcription factors — agents that activate genes — that he had identified. A cell dosed with the Yamanaka factors erases the marks on the epigenome, so the cell loses its identity and reverts to the embryonic state. Erroneous marks gathered during aging are also lost in the process, restoring the cell to its state of youth. Dr. Yamanaka shared the 2012 Nobel Prize in medicine for the work.

But the Yamanaka factors are no simple panacea. Applied to whole mice, the factors made cells lose their functions and primed them for rapid growth, usually cancerous; the mice all died.

In 2016, Juan Carlos Izpisua Belmonte, of the Salk Institute for Biological Studies in San Diego, found that the two effects of the Yamanaka factors — erasing cell identity and reversing aging — could be separated, with a lower dose securing just age reversal. But he achieved this by genetically engineering mice, a technique not usable in people.

In their paper on Tuesday, the Stanford team described a feasible way to deliver Yamanaka factors to cells taken from patients, by dosing cells kept in cultures with small amounts of the factors.

If dosed for a short enough time, the team reported, the cells retained their identity but returned to a youthful state, as judged by several measures of cell vigor.


Coronavirus vaccine: when will it be ready?

Coronavirus vaccine: when will it be ready?
Human trials will begin imminently – but even if they go well and a cure is found, there are many barriers before global immunisation is feasible
By Laura Spinney
Mar 30 2020

Even at their most effective – and draconian – containment strategies have only slowed the spread of the respiratory disease Covid-19. With the World HealthOrganization finally declaring a pandemic, all eyes have turned to the prospect of a vaccine, because only a vaccine can prevent people from getting sick.

About 35 companies and academic institutions are racing to create such a vaccine, at least four of which already have candidates they have been testing in animals. The first of these – produced by Boston-based biotech firm Moderna – will enter human trials imminently.

This unprecedented speed is thanks in large part to early Chinese efforts to sequence the genetic material of Sars-CoV-2, the virus that causes Covid-19. China shared that sequence in early January, allowing research groups around the world to grow the live virus and study how it invades human cells and makes people sick.

But there is another reason for the head start. Though nobody could have predicted that the next infectious disease to threaten the globe would be caused by a coronavirus – flu is generally considered to pose the greatest pandemic risk – vaccinologists had hedged their bets by working on “prototype” pathogens. “The speed with which we have [produced these candidates] builds very much on the investment in understanding how to develop vaccines for other coronaviruses,” says Richard Hatchett, CEO of the Oslo-based nonprofit the Coalition for Epidemic Preparedness Innovations(Cepi), which is leading efforts to finance and coordinate Covid-19 vaccine development.

Coronaviruses have caused two other recent epidemics – severe acute respiratory syndrome (Sars) in China in 2002-04, and Middle East respiratory syndrome (Mers), which started in Saudi Arabia in 2012. In both cases, work began on vaccines that were later shelved when the outbreaks were contained. One company, Maryland-based Novavax, has now repurposed those vaccines for Sars-CoV-2, and says it has several candidates ready to enter human trials this spring. Moderna, meanwhile, built on earlier work on the Mers virus conducted at the US National Institute of Allergy and Infectious Diseases in Bethesda, Maryland.

Sars-CoV-2 shares between 80% and 90% of its genetic material with the virus that caused Sars – hence its name. Both consist of a strip of ribonucleic acid (RNA) inside a spherical protein capsule that is covered in spikes. The spikes lock on to receptors on the surface of cells lining the human lung – the same type of receptor in both cases – allowing the virus to break into the cell. Once inside, it hijacks the cell’s reproductive machinery to produce more copies of itself, before breaking out of the cell again and killing it in the process.

All vaccines work according to the same basic principle. They present part or all of the pathogen to the human immune system, usually in the form of an injection and at a low dose, to prompt the system to produce antibodies to the pathogen. Antibodies are a kind of immune memory which, having been elicited once, can be quickly mobilised again if the person is exposed to the virus in its natural form.

Traditionally, immunisation has been achieved using live, weakened forms of the virus, or part or whole of the virus once it has been inactivated by heat or chemicals. These methods have drawbacks. The live form can continue to evolve in the host, for example, potentially recapturing some of its virulence and making the recipient sick, while higher or repeat doses of the inactivated virus are required to achieve the necessary degree of protection. Some of the Covid-19 vaccine projects are using these tried-and-tested approaches, but others are using newer technology. One more recent strategy – the one that Novavax is using, for example – constructs a “recombinant” vaccine. This involves extracting the genetic code for the protein spike on the surface of Sars-CoV-2, which is the part of the virus most likely to provoke an immune reaction in humans, and pasting it into the genome of a bacterium or yeast – forcing these microorganisms to churn out large quantities of the protein. Other approaches, even newer, bypass the protein and build vaccines from the genetic instruction itself. This is the case for Moderna and another Boston company, CureVac, both of which are building Covid-19 vaccines out of messenger RNA.

Cepi’s original portfolio of four funded Covid-19 vaccine projects was heavily skewed towards these more innovative technologies, and last week it announced $4.4m (£3.4m) of partnership funding with Novavax and with a University of Oxford vectored vaccine project. “Our experience with vaccine development is that you can’t anticipate where you’re going to stumble,” says Hatchett, meaning that diversity is key. And the stage where any approach is most likely to stumble is clinical or human trials, which, for some of the candidates, are about to get under way.

Clinical trials, an essential precursor to regulatory approval, usually take place in three phases. The first, involving a few dozen healthy volunteers, tests the vaccine for safety, monitoring for adverse effects. The second, involving several hundred people, usually in a part of the world affected by the disease, looks at how effective the vaccine is, and the third does the same in several thousand people. But there’s a high level of attrition as experimental vaccines pass through these phases. “Not all horses that leave the starting gate will finish the race,” says Bruce Gellin, who runs the global immunisation programme for the Washington DC-based nonprofit, the Sabin Vaccine Institute.

There are good reasons for that. Either the candidates are unsafe, or they’re ineffective, or both. Screening out duds is essential, which is why clinical trials can’t be skipped or hurried. Approval can be accelerated if regulators have approved similar products before. The annual flu vaccine, for example, is the product of a well-honed assembly line in which only one or a few modules have to be updated each year. In contrast, Sars-CoV-2 is a novel pathogen in humans, and many of the technologies being used to build vaccines are relatively untested too. No vaccine made from genetic material – RNA or DNA – has been approved to date, for example. So the Covid-19 vaccine candidates have to be treated as brand new vaccines, and as Gellin says: “While there is a push to do things as fast as possible, it’s really important not to take shortcuts.”

An illustration of that is a vaccine that was produced in the 1960s against respiratory syncytial virus, a common virus that causes cold-like symptoms in children. In clinical trials, this vaccine was found to aggravate those symptoms in infants who went on to catch the virus. A similar effect was observed in animals given an early experimental Sars vaccine. It was later modified to eliminate that problem but, now that it has been repurposed for Sars-CoV-2, it will need to be put through especially stringent safety testing to rule out the risk of enhanced disease.


What Social Distancing Looked Like in 1666

What Social Distancing Looked Like in 1666
Humanity has been surviving plagues for thousands of years, and we have managed to learn a lot along the way.
By Annalee Newitz
Mar 29 2020

A lot of English people believed 1666 would be the year of the apocalypse. You can’t really blame them. In late spring 1665, bubonic plague began to eat away at London’s population. By fall, roughly 7,000 people were dying every week in the city. The plague lasted through most of 1666, ultimately killing about 100,000 people in London alone — and possibly as many as three-quarters of a million in England as a whole.

Perhaps the greatest chronicler of the Great Plague was Samuel Pepys, a well-connected English administrator and politician who kept a detailed personal diary during London’s darkest years. He reported stumbling across corpses in the street, and anxiously reading the weekly death tolls posted in public squares.

In August of 1665, Pepys described walking to Greenwich, “in my way seeing a coffin with a dead body therein, dead of the plague, lying in [a field] belonging to Coome farme, which was carried out last night, and the parish have not appointed any body to bury it, but only set a watch there day and night, that nobody should go thither or come thence, which is a most cruel thing.” To ensure that no one — not even the family of the dead person — would go near the corpse or bury it, the parish had stationed a guard. “This disease making us more cruel to one another than if we are doggs.”

It felt like Armageddon. And yet it was also the beginning of a scientific renaissance in England, when doctors experimented with quarantines, sterilization and social distancing. For those of us living through these stay-at-home days of Covid-19, it’s useful to look back and see how much has changed — and how much hasn’t. Humanity has been guarding against plagues and surviving them for thousands of years, and we have managed to learn a lot along the way.

When a plague hit England during the summer of 1665, it was a time of tremendous political turmoil. The nation was deep into the Second Anglo-Dutch War, a nasty naval conflict that had torpedoed the British economy. But there were deeper sources of internal political conflict. Just five years earlier in 1660, King Charles II had wrested back control of the government from the Puritan members of Parliament led by Oliver Cromwell.

Though Cromwell had died in 1658, the king had him exhumed, his corpse put in chains and tried for treason. After the inevitable guilty verdict, the King’s henchmen mounted Cromwell’s severed head on a 20-foot spike over Westminster Hall, along with the heads of two co-conspirators. Cromwell’s rotting head stayed there, gazing at London, throughout the plague and for many years after.

War and social upheaval hastened the spread of the plague, which had broken out several years earlier in Holland. But when he wasn’t displaying the severed heads of his enemies, the king was invested in scientific progress. He sanctioned the founding of the Royal Society of London for Improving Natural Knowledge, a venerable scientific institution known today as The Royal Society.

It was most likely thanks to his interest in science that government representatives and doctors quickly used social distancing methods for containing the spread of bubonic plague. Charles II issued a formal order in 1666 that ordered a halt to all public gatherings, including funerals. Already, theaters had been shut down in London, and licensing curtailed for new pubs. Oxford and Cambridge closed.

Isaac Newton was one of the students sent home, and his family was among the wealthy who fled the cities so they could shelter in place at their country homes. He spent the plague year at his family estate, teasing out the foundational ideas for calculus.

Things were less cozy in London. Quarantining was invented during the first wave of bubonic plague in the 14th century, but it was deployed more systematically during the Great Plague. Public servants called searchers ferreted out new cases of plague, and quarantined sick people along with everyone who shared their homes. People called warders painted a red cross on the doors of quarantined homes, alongside a paper notice that read “LORD HAVE MERCY UPON US.” (Yes, the all-caps was mandatory).

The government supplied food to the housebound. After 40 days, warders painted over the red crosses with white crosses, ordering residents to sterilize their homes with lime. Doctors believed that the bubonic plague was caused by “smells” in the air, so cleaning was always recommended. They had no idea that it was also a good way to get rid of the ticks and fleas that actually spread the contagion.

Of course, not everyone was compliant. Legal documents at the U.K. National Archives show that in April 1665, Charles II ordered severe punishment for a group of people who took the cross and paper off their door “in a riotious manner,” so they could “goe abroad into the street promiscuously, with others.” It’s reminiscent of all those modern Americans who went to the beaches in Florida over spring break, despite what public health experts told them.

Pepys was a believer in science, and he tried to follow the most cutting-edge advice from his doctor friends. This included smoking tobacco as a precautionary measure, because smoke and fire would purify the “bad air.” In June of 1665, as the plague began, Pepys described seeing red crosses on doors for the first time. “It put me into an ill conception of myself and my smell,” he writes, “so that I was forced to buy some roll-tobacco to smell and chaw, which took away the apprehension.”

Quack medicine will always be with us. But there was some good advice, too. During the Great Plague, shopkeepers asked customers to drop their coins in dishes of vinegar to sterilize them, using the 1600s version of hand sanitizer.

Just as some American politicians blame the Chinese for the coronavirus, there were 17th century Brits who blamed the Dutch for spreading the plague. Others blamed Londoners. Mr. Pepys had relocated his family to a country home in Woolwich, and writes in his diary that the locals “are afeard of London, being doubtfull of anything that comes from thence, or that hath lately been there … I was forced to say that I lived wholly at Woolwich.”

By late 1666, the plague had begun its retreat from England, but one disaster led to another. In autumn, the Great Fire of London destroyed the city’s downtown in a weeklong conflagration. The damage was so extensive in part because city officials were slow to respond, having already spent over a year dealing with plague. The fire left 70,000 Londoners homeless and angry, threatening to riot.


The last global crisis didn’t change the world. But this one could

The last global crisis didn’t change the world. But this one could
The financial meltdown of 2008 failed to provoke a fundamental shift in capitalism. Will this moment be different?
By William Davies
Mar 24 2020

The term “crisis” derives from the Greek “krisis”, meaning decision or judgment. From this, we also get terms such as critic (someone who judges) and critical condition (a medical state that could go either way). A crisis can conclude well or badly, but the point is that its outcome is fundamentally uncertain. To experience a crisis is to inhabit a world that is temporarily up for grabs.

The severity of our current crisis is indicated by the extreme uncertainty as to how or when it will end. The modellers at Imperial College – whose calculations have belatedly shifted the government’s comparatively relaxed approach to coronavirus – suggest that our only guaranteed exit route from enforced “social distancing” is a vaccine, which may not be widely available until the summer of next year. It is hard to imagine a set of policies that could successfully navigate such a lengthy hiatus, and it would be harder still to implement them.

It is now inevitable that we will experience deep global recession, a breakdown of labour markets and the evaporation of consumer spending. The terror that drove government action in the autumn of 2008 was that money would stop coming out of the cash machines, unless the banking system was propped up. It turns out that if people stop coming out of their homes, then the circulation of money grinds to a halt as well. Small businesses are shedding employees at a frightening speed, while Amazon has advertised for an additional 100,000 workers in the US. (One of the few, and far from welcome, continuities from the world we’re leaving behind is the relentless growth of the platform giants.)

The decade that shapes our contemporary imagination of crises is the 1970s, which exemplified the way a historic rupture can set an economy and a society on a new path. This period marked the collapse of the postwar system of fixed exchange rates, capital controls and wage policies, which were perceived to have led to uncontrollable inflation. It also created the conditions in which the new right of Margaret Thatcher and Ronald Reagan could ride to the rescue, offering a novel medicine of tax cuts, interest rate hikes and attacks on organised labour.

The 1970s inspired a vision of crisis as a wide-ranging shift in ideology, which has retained its hold over much of the left ever since. The crisis involved a contradiction that was largely internal to the Keynesian model of capitalism (wages were being pushed up faster than productivity growth, and destroying profits), and an overhaul in the dominant style of business: out with rigid heavy manufacturing, in with flexible production that could respond more nimbly to consumer tastes.

There was also an important spatial dimension to the 1970s crisis. Capital abandoned its iconic industrial strongholds in northern England and the American midwest, and (with help from the state) headed towards the financial and business districts of slick global cities, such as London and New York.

For over 40 years after Thatcher first took office, many people on the left have waited impatiently for a successor to the 1970s, in the hope that a similar ideological transition might occur in reverse. But despite considerable upheaval and social pain, the global financial crisis of 2008 failed to provoke a fundamental shift in policy orthodoxy. In fact, after the initial burst of public spending that rescued the banks, the free-market Thatcherite worldview became even more dominant in Britain and the eurozone. The political upheavals of 2016 took aim at the status quo, but with little sense of a coherent alternative to it. But both these crises now appear as mere forerunners to the big one that emerged in Wuhan at the close of last year.

We can already identify a few ways that 2020 and its aftermath will differ from the crisis of the 1970s. First, while its transmission has followed the flightpaths of global capitalism – business travel, tourism, trade – its root cause is external to the economy. The degree of devastation it will spread is due to very basic features of global capitalism that almost no economist questions – high levels of international connectivity and the reliance of most people on the labour market. These are not features of a particular economic policy paradigm, in the way that fixed exchange rates and collective bargaining were fundamental to Keynesianism. They are features of capitalism as such.

Second, the spatial aspect of this crisis is unlike a typical crisis of capitalism. Save for whichever bunkers and islands the super-rich are hiding in, this pandemic does not discriminate on the basis of economic geography. It may end up devaluing urban centres, as it becomes clear how much “knowledge-based work” can be done online after all. But while the virus has arrived at different times in different places, a striking feature of the last few weeks has been the universality of human behaviours, concerns and fears.

In fact, the spread of smartphones and the internet has generated a new global public of a sort we have never witnessed before. Events such as September 11 provided a glimpse of this, with Nokias around the world vibrating with instructions to get to a television immediately. But coronavirus is not a spectacle happening somewhere else: it’s going on outside your window, right now, and in that sense it meshes perfectly with the age of ubiquitous social media, where every experience is captured and shared.

The intensity of this common experience is one grim reason that the present crisis feels closer to a war than a recession. In the end, government policymakers will ultimately be judged in terms of how many thousands of people die. Before that reckoning is reached, there will be horrifying glimpses beneath the surface of modern civilisation, as health services are overwhelmed and saveable lives go unsaved. The immediacy of this visceral, mortal threat makes this moment feel less like 2008 or the 1970s and more like the other iconic crisis in our collective imagination – 1945. Matters of life and death occasion more drastic shifts in policy than economic indicators ever can, as witnessed in Rishi Sunak’s astonishing announcement that the government would cover up to 80% of the salaries of workers if companies kept them on their payroll. Such unthinkable measures are suddenly possible – and that sense of possibility may not be easily foreclosed again.