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<h1 data-aos="fade-down" id="covid-19-sentry">Covid-19 Sentry</h1>
<h1 data-aos="fade-right" data-aos-anchor-placement="top-bottom" id="contents">Contents</h1>
<ul>
<li><a href="#from-preprints">From Preprints</a></li>
<li><a href="#from-clinical-trials">From Clinical Trials</a></li>
<li><a href="#from-pubmed">From PubMed</a></li>
<li><a href="#from-patent-search">From Patent Search</a></li>
</ul>
<h1 data-aos="fade-right" id="from-preprints">From Preprints</h1>
<ul>
<li><strong>Efficient SARS-CoV-2 detection utilizing chitin-immobilized nanobodies synthesized in Ustilago maydis</strong> -
<div>
The COVID-19 pandemic has greatly impacted the global economy and health care systems, illustrating the urgent need for timely and inexpensive responses to a pandemic threat in the form of vaccines and antigen tests. The causative agent of COVID-19 is SARS-CoV-2. The spike protein on the virus surface interacts with the human angiotensin-converting enzyme (ACE2) via the so-called receptor binding domain (RBD), facilitating virus entry. The RBD thus represents a prime target for vaccines, therapeutic antibodies, and antigen test systems. Currently, antigen testing is mostly conducted by qualitative flow chromatography or via quantitative ELISA-type assays. The latter mostly utilize materials like protein-adhesive polymers and gold or latex particles. Here we present an alternative ELISA approach using inexpensive materials and permitting quick detection based on components produced in the microbial model Ustilago maydis. In this fungus, heterologous proteins like biopharmaceuticals can be exported by fusion to unconventionally secreted chitinase Cts1. As a unique feature, the carrier chitinase binds to chitin allowing its additional use as a purification or immobilization tag. In this study, we produced different mono- and bivalent SARS-CoV-2 nanobodies directed against the viral RBD as Cts1 fusions and screened their RBD binding affinity in vitro and in vivo. Functional nanobody-Cts1 fusions were immobilized on chitin forming an RBD tethering surface. This provides a solid base for future development of an inexpensive antigen test utilizing unconventionally secreted nanobodies as RBD trap and a matching ubiquitous and biogenic surface for immobilization.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2022.11.11.516239v1" target="_blank">Efficient SARS-CoV-2 detection utilizing chitin-immobilized nanobodies synthesized in Ustilago maydis</a>
</div></li>
<li><strong>Age and gender differences in loneliness during the COVID-19: Analyses on large cross-sectional surveys and emotion diaries</strong> -
<div>
Loneliness level was shown to vary by age and gender. Considering the recent COVID-19 outbreak had more impact on the susceptible groups’ mental health, this study scrutinized the joint influence of age and gender on loneliness during the COVID-19 pandemic in South Korea. We utilized large, government-funded public data that contains self-reported measures and emotion diaries collected from October 2020 to March 2021 (N=4,017, age 20-79, 76% female). Hierarchical regression, t-test, and analysis of variance examined the effect of age as a continuous or categorical variable and gender on loneliness. N-gram frequency analyses and topic modeling helped analyze the differences in expressions used by the age-gender groups in the diaries. Loneliness increased with age (p=0.043), and women were lonelier than men (p&lt;0.001). However, age and gender interacted to predict loneliness (p=0.004), showing that younger women and older men experienced higher levels of loneliness. Age (p&lt;0.001) and age-gender (p=0.030) interaction remained significant even with the presence of demographic and personality risk factors. When parceled by the age groups and gender, gender differences in loneliness level were significant within 20s (95% CI: Female [2.196, 2.264], Male [1.986, 2.133]) and 30s (95% CI: Female [2.390, 2.499], Male [2.071, 2.251]). In emotion diaries, all age-gender groups except women in their 60s-70s frequently expressed anxiety and depression. Women in their 20s talked more about work experiences and difficulties in job search, and women in their 30s wrote more about difficulties in childcare and lack of social connections. Spirituality was one of the major topics mentioned by women in their 50s and 60s-70s, but not by the other groups. The effects of age and gender on loneliness reflect social and psychological challenges in Korea during the COVID-19 pandemic. It is important to establish valid interventions targeted at younger women and older men.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://psyarxiv.com/2bdek/" target="_blank">Age and gender differences in loneliness during the COVID-19: Analyses on large cross-sectional surveys and emotion diaries</a>
</div></li>
<li><strong>Using Genome Sequence Data to Predict SARS-CoV-2 Detection Cycle Threshold Values</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The continuing emergence of SARS-CoV-2 variants of concern (VOCs) presents a serious public health threat, exacerbating the effects of the COVID19 pandemic. Although millions of genomes have been deposited in public archives since the start of the pandemic, predicting SARS-CoV-2 clinical characteristics from the genome sequence remains challenging. In this study, we used a collection of over 29,000 high quality SARS-CoV-2 genomes to build machine learning models for predicting clinical detection cycle threshold (Ct) values, which correspond with viral load. After evaluating several machine learning methods and parameters, our best model was a random forest regressor that used 10-mer oligonucleotides as features and achieved an R2 score of 0.521 +/- 0.010 (95% confidence interval over 5 folds) and an RMSE of 5.7 +/- 0.034, demonstrating the ability of the models to detect the presence of a signal in the genomic data. In an attempt to predict Ct values for newly emerging variants, we predicted Ct values for Omicron variants using models trained on previous variants. We found that approximately 5% of the data in the model needed to be from the new variant in order to learn its Ct values. Finally, to understand how the model is working, we evaluated the top features and found that the model is using a multitude of k-mers from across the genome to make the predictions. However, when we looked at the top k-mers that occurred most frequently across the set of genomes, we observed a clustering of k-mers that span spike protein regions corresponding with key variations that are hallmarks of the VOCs including G339, K417, L452, N501, and P681, indicating that these sites are informative in the model and may impact the Ct values that are observed in clinical samples.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2022.11.14.22282297v1" target="_blank">Using Genome Sequence Data to Predict SARS-CoV-2 Detection Cycle Threshold Values</a>
</div></li>
<li><strong>Detection of infectious SARS-CoV-2 in frozen aerosol samples collected from hospital rooms of patients with COVID-19</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
We isolated infectious SARS-CoV-2 from aerosol samples collected from hospital rooms of COVID19 patients. Isolated virus successfully replicated in cell cultures 14 months after collection, opening up prospects for retrospective analyses of samples stored during the previous waves of COVID-19.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2022.11.14.22282295v1" target="_blank">Detection of infectious SARS-CoV-2 in frozen aerosol samples collected from hospital rooms of patients with COVID-19</a>
</div></li>
<li><strong>Assessment of level of depression and associated factors among COVID-19 recovered patients: a cross sectional study</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Objectives: The Corona Virus Disease-2019 (COVID-19) pandemic has psychological consequences such as increased risk of depression, anxiety, and stress problems, exacerbating human health disparities. This study aimed to analyze depression and its causes in COVID-19-recovered patients in Bangladesh. Method: A cross-sectional study was conducted on COVID-19 recovered patients, who attended for follow-up after 14 days to 3 months at Dhaka Medical College Hospital (DMCH) and Dhaka North City Corporation Hospital (DNCCH), Dhaka, Bangladesh from 1st January to 31st December, 2021. Respondents were face-to-face interviewed with a semi-structured questionnaire after written agreement. The Patient Health Questionnaire (PHQ-9) was used to assess respondents9 depression, and data were analyzed using SPSS version-23, with p &lt; 0.05 indicating statistical significance. Results: A total of 325 COVID-19 recovered patients aged from 15 to 65 years (mean 44.34 ±13.87 years) of age were included in this study, highest 23.1% of them belonged to 46-55 years, and majority (61.5%) of them were male. There were 69.5% of respondents had no signs of depression while 31% of them had with 26.7% being mildly depressed, 2.5% being extremely depressed, and 1.2% being severely depressed. Diabetes mellitus, hospitalization duration, social distancing, the social media post on COVID-19, loss of employment, family damage, and fear of re-infection were significantly associated with depression level of respondents. Conclusion: This study gives us a glimpse into the psychological health of COVID-19 recovered patients, and its findings highlight the imperative of alleviating their psychological anguish in Bangladesh.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2022.11.14.22282128v1" target="_blank">Assessment of level of depression and associated factors among COVID-19 recovered patients: a cross sectional study</a>
</div></li>
<li><strong>Probing different paradigms of morphine withdrawal on sleep behavior in male and female C57BL/6J mice</strong> -
<div>
Opioid misuse has dramatically increased over the last few decades resulting in many people suffering from opioid use disorder (OUD). The prevalence of opioid overdose has been driven by the development of new synthetic opioids, increased availability of prescription opioids, and more recently, the COVID-19 pandemic. Coinciding with increases in exposure to opioids, the United States has also observed increases in multiple Narcan (naloxone) administrations as life-saving measures for respiratory depression, and, thus, consequently, naloxone-precipitated withdrawal. Sleep dysregulation is a main symptom of OUD and opioid withdrawal syndrome, and therefore, should be a key facet of animal models of OUD. Here we examine the effect of precipitated and spontaneous morphine withdrawal on sleep behaviors in C57BL/6J mice. We find that morphine administration and withdrawal dysregulate sleep, but not equally across morphine exposure paradigms. Furthermore, many environmental triggers promote relapse to drug-seeking/taking behavior, and the stress of disrupted sleep may fall into that category. We find that sleep deprivation dysregulates sleep in mice that had previous opioid withdrawal experience. Our data suggest that the 3-day precipitated withdrawal paradigm has the most profound effects on opioid-induced sleep dysregulation and further validates the construct of this model for opioid dependence and OUD.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2022.04.06.487380v2" target="_blank">Probing different paradigms of morphine withdrawal on sleep behavior in male and female C57BL/6J mice</a>
</div></li>
<li><strong>Moral decision making in healthcare and medical professions during the COVID-19 pandemic</strong> -
<div>
With coronavirus disease 2019 (COVID-19) outbreak, healthcare and medical professions face challenging situations. High number of infected patients, scarce resources, and being vulnerable to the infection are among the reasons that may influence clinicians’ decision making and puts them in a moral situation. Furthermore, they may be carriers of coronavirus, resulting their social interactions to involve moral decision making. The aim of this study was to examine the moral decision making in clinicians during the COVID-19 pandemic and to find its relation to psychological, cognitive, and behavioral correlates. 193 clinicians who worked in hospitals allocated to coronavirus disease patients, participated in our study. We designed an online survey containing 8 dilemmas to test moral decision making in clinicians. Information on clinicians’ behavior, cognition and psychological state during the COVID-19 pandemic, including the degree of respect to social distancing, sources of stress, and dead cases of COVID-19 they confronted with were collected. The relation between these measures and moral decision making was assessed. Based on our results, clinicians’ most important source of stress was the infection of their families. There was a positive correlation between utilitarian responses and clinicians’ stress level, and number of dead cases they confronted with. Moreover, degree of utilitarian behavior was positively correlated to social distancing. Both age and sex contributed to individual differences in respecting social distancing, stress and utilitarian behavior. With increasing stress and encountering more deaths, clinicians tended to decide based on the outcome. Our results have critical implications in implementing policies for healthcare principals.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://psyarxiv.com/5c769/" target="_blank">Moral decision making in healthcare and medical professions during the COVID-19 pandemic</a>
</div></li>
<li><strong>Pandemic modelling for regions implementing an elimination strategy</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
During the COVID-19 pandemic, some countries, such as Australia, China, Iceland, New Zealand, Thailand, and Vietnam successfully implemented an elimination strategy, enacting strict border control and periods of lockdowns to end community transmission. Atlantic Canada and Canada9s territories implemented similar policies, and reported long periods with no community cases. In Newfoundland and Labrador (NL), Nova Scotia, and Prince Edward Island a median of 80% or more of daily reported cases were travel-related from July 1, 2020 to May 31, 2021. With increasing vaccination coverage, it may be appropriate to exit an elimination strategy, but most existing epidemiological frameworks are applicable only to situations where most cases occur in the community, and are not appropriate for regions that have implemented an elimination strategy. To inform the pandemic response in regions that are implementing an elimination strategy, we extend importation modelling to consider post-arrival travel restrictions, and pharmaceutical and non-pharmaceutical interventions in the local community. We find that shortly after the Omicron variant had begun spreading in Canada, the expected daily number of spillovers, infections spread to NL community members from travelers and their close contacts, was higher than any time previously in the pandemic. By December 24, 2021, the expected number of spillovers was 44% higher than the previous high, which occurred in late July 2021 shortly after travel restrictions were first relaxed. We develop a method to assess the characteristics of potential future community outbreaks in regions that are implementing an elimination strategy. We apply this method to predict the effect of variant and vaccination coverage on the size of hypothetical community outbreaks in Mount Pearl, a suburb of the St. John9s metropolitan area in NL. Our methodology can be used to evaluate alternative plans to relax public health restrictions when vaccine coverage is high in regions that have implemented an elimination strategy. This manuscript was submitted as part of a theme issue on “Modelling COVID-19 and Preparedness for Future Pandemics”.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2022.07.18.22277695v2" target="_blank">Pandemic modelling for regions implementing an elimination strategy</a>
</div></li>
<li><strong>The SARS-CoV-2 protein ORF3c is a mitochondrial modulator of innate immunity</strong> -
<div>
The SARS-CoV-2 genome encodes a multitude of accessory proteins. Using comparative genomic approaches, an additional accessory protein, ORF3c, has been predicted to be encoded within the ORF3a sgmRNA. Expression of ORF3c during infection has been confirmed independently by ribosome profiling. Despite ORF3c also being present in the 2002-2003 SARS-CoV, its function has remained unexplored. Here we show that ORF3c localises to mitochondria during infection, where it inhibits innate immunity by restricting IFN-{beta} production, but not NF-{kappa}B activation or JAK-STAT signalling downstream of type I IFN stimulation. We find that ORF3c acts after stimulation with cytoplasmic RNA helicases RIG-I or MDA5 or adaptor protein MAVS, but not after TRIF, TBK1 or phospho-IRF3 stimulation. ORF3c co-immunoprecipitates with the antiviral proteins MAVS and PGAM5 and induces MAVS cleavage by caspase-3. Together, these data provide insight into an uncharacterised mechanism of innate immune evasion by this important human pathogen.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2022.11.15.516323v1" target="_blank">The SARS-CoV-2 protein ORF3c is a mitochondrial modulator of innate immunity</a>
</div></li>
<li><strong>Use of substances to cope predicts PTSD symptom persistence: Investigating patterns of interactions between complex PTSD symptoms and its maintaining mechanisms</strong> -
<div>
Post-traumatic stress disorder (PTSD), and a novel related condition, complex PTSD, remain a growing public health challenge across the globe and are associated with negative and persistent long-term consequences. The last decades of research revealed different processes and mechanisms associated with the development and persistence of PTSD and complex PTSD symptoms, including different maladaptive coping strategies, cognitive and experiential avoidance, positive, and negative metacognitions. Despite these advances, little is known about how these different processes interact with specific (C)PTSD symptoms, and how they influence each other over time at the within-person level. Leveraging a large (N &gt; 1,800) longitudinal dataset representative of the Norwegian population during the COVID-19 pandemic, this pre-registered study investigated these symptom-process interactions over an eight-month period. Our panel graphical vector autoregressive (GVAR) network model revealed the dominating role of substance use to cope in predicting higher levels of all different PTSD symptoms over time and being associated with increases in CPTSD symptomatology within more proximal time-windows (i.e., within six weeks). Threat monitoring was associated with increased suicidal ideation, while threat monitoring itself was increasing upon decreased avoidance behavior, greater presence of negative metacognitions, and higher use of substances to cope. In addition, our analyses revealed several, particularly strongly co-occurring PTSD symptoms and processes within the same time window (six weeks, contemporaneous associations). Our findings speak to the importance of attending to different coping strategies, particularly the use of substances as a coping behavior in efforts to prevent PTSD chronicity upon symptom onset. We outline future directions for research efforts to better understand the complex interactions and temporal pathways leading up to the development and maintenance of (C)PTSD symptomatology.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://psyarxiv.com/7r9e6/" target="_blank">Use of substances to cope predicts PTSD symptom persistence: Investigating patterns of interactions between complex PTSD symptoms and its maintaining mechanisms</a>
</div></li>
<li><strong>A call for immediate action to increase COVID-19 vaccination uptake to prepare for the third pandemic winter</strong> -
<div>
This Comment piece summarises current challenges regarding routine vaccine uptake in the context of the COVID-19 pandemic and provides recommendations on how to increase uptake. To implement these recommendations, the article points to evidence-based resources that can support health care workers, policy makers and communicators.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://psyarxiv.com/q4pk6/" target="_blank">A call for immediate action to increase COVID-19 vaccination uptake to prepare for the third pandemic winter</a>
</div></li>
<li><strong>The COVID-19 marathon: demands and resources of crises managers in continuous operation</strong> -
<div>
The COVID-19 pandemic required the deployment of crisis management teams (CMTs) on an unprecedented scale. Due to their high level of responsibility and wide-ranging decision-making authority, the enduring resilience and health of CMT members is essential – yet, during pandemics they are permanently challenged. We tested six hypotheses based on the Job Demands-Resources model with 219 CMT members. In our preregistered analyses, we found most of the expected associations: Between demands and strain, moderated by leisure time resources, between resources and work engagement, as well as between strain and engagement and outcome measures such as evaluations of CMT members’ performance and quitting intention. Furthermore, we explore how the pandemic has changed from experts’ perspectives, describe lessons learned, and derive practical recommendations and suggestions for future research. Particularly, promoting specific resources should allow CMTs to buffer negative effects of unavoidable demands, and promote the long-term viability of these key crisis management entities.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://psyarxiv.com/7vke5/" target="_blank">The COVID-19 marathon: demands and resources of crises managers in continuous operation</a>
</div></li>
<li><strong>To read or not to read? Motives for reading negative COVID-19 news.</strong> -
<div>
People were confronted with a barrage of negative news during the COVID-19 crisis. This study investigated how anticipated psychological impact predicted decisions to read personalized and factual COVID-19 news. First, participants chose, based on headlines, whether they wanted to read news articles (or not). Then, all headlines were rated on a set of motivational dimensions. In order to test confirmatory hypotheses, the data was divided into an exploration (n = 398) and validation dataset (n = 399). Using multilevel modelling, we found robust support for four preregistered hypotheses: choice for negative COVID-19 news was positively predicted by 1) personal vs. factual news; 2) the anticipated amount of knowledge acquisition; 3) the anticipated relevance to one’s own personal situation; and 4) participant’s sense of moral duty. Moreover, exploratory findings suggested a positive relationship between headline choice and anticipated compassion, a negative relationship with anticipated inappropriateness and gratitude, and a quadratic relationship with anticipated strength of feelings. These results support the idea that negative content offers informational value, both in terms of understanding negative events, and in terms of preparing for these events. Furthermore, engagement with negative content can be motivated by moral values.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://psyarxiv.com/df6ye/" target="_blank">To read or not to read? Motives for reading negative COVID-19 news.</a>
</div></li>
<li><strong>Fear and Trembling While Working in a Pandemic: An Exploratory Meta-Analysis of Workers’ COVID-19 Distress</strong> -
<div>
The global COVID-19 pandemic has disrupted the lives of workers and taken its toll on health and well-being. In line with recent calls for more inductive and abductive occupational health science research, we exploratorily meta-analyzed workers’ COVID-19 distress, defined as psychological and psychosomatic strain contextualized to experiencing the virus and pandemic broadly. We identified many existing COVID-19 distress measures (e.g., Fear of COVID-19 Scale by Ahorsu et al., 2020; Coronavirus Anxiety Scale by Lee, 2020a) and correlates, including demographic variables (viz., gender, marital status, whether worker has children), positive well-being (e.g., quality of life, perceived social support, resilience), negative well-being (e.g., anxiety, depression, sleep problems), and work-related variables (e.g., job satisfaction, burnout, task performance). Additionally, we found preliminary evidence of subgroup differences by COVID-19 distress measure and country-level moderation moderators (viz., cultural values, pandemic-related government response) as well as COVID-19 distress’s incremental validity over and above anxiety and depression. The findings—based on k = 135 independent samples totaling N = 61,470 workers—were abductively contextualized with existing theories and previous research. We also call for future research to address the grand challenge of working during the COVID-19 pandemic and ultimately develop a cumulative occupational health psychology of pandemics.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://psyarxiv.com/5zfrv/" target="_blank">Fear and Trembling While Working in a Pandemic: An Exploratory Meta-Analysis of Workers’ COVID-19 Distress</a>
</div></li>
<li><strong>Long-term COVID-19 booster effectiveness by infection history and clinical vulnerability and immune imprinting</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Background: Long-term effectiveness of COVID-19 mRNA boosters in populations with different prior infection histories and clinical vulnerability profiles is inadequately understood. Methods: A national, matched, retrospective, target trial cohort study was conducted in Qatar to investigate effectiveness of a third mRNA (booster) dose, relative to a primary series of two doses, against SARS-CoV-2 omicron infection and against severe COVID-19. Associations were estimated using Cox proportional-hazards regression models. Results: Booster effectiveness relative to primary series was 41.1% (95% CI: 40.0-42.1%) against infection and 80.5% (95% CI: 55.7-91.4%) against severe, critical, or fatal COVID-19, over one-year follow-up after the booster. Among persons clinically vulnerable to severe COVID-19, effectiveness was 49.7% (95% CI: 47.8-51.6%) against infection and 84.2% (95% CI: 58.8-93.9%) against severe, critical, or fatal COVID-19. Effectiveness against infection was highest at 57.1% (95% CI: 55.9-58.3%) in the first month after the booster but waned thereafter and was modest at only 14.4% (95% CI: 7.3-20.9%) by the sixth month. In the seventh month and thereafter, coincident with BA.4/BA.5 and BA.2.75* subvariant incidence, effectiveness was progressively negative reaching -20.3% (95% CI: -55.0-29.0%) after one year of follow-up. Similar levels and patterns of protection were observed irrespective of prior infection status, clinical vulnerability, or type of vaccine (BNT162b2 versus mRNA-1273). Conclusions: Boosters reduced infection and severe COVID-19, particularly among those clinically vulnerable to severe COVID-19. However, protection against infection waned after the booster, and eventually suggested an imprinting effect of compromised protection relative to the primary series. However, imprinting effects are unlikely to negate the overall public health value of booster vaccinations.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2022.11.14.22282103v1" target="_blank">Long-term COVID-19 booster effectiveness by infection history and clinical vulnerability and immune imprinting</a>
</div></li>
</ul>
<h1 data-aos="fade-right" id="from-clinical-trials">From Clinical Trials</h1>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>COVID-19 Bivalent Booster Megastudy</strong> - <b>Condition</b>:   COVID-19<br/><b>Intervention</b>:   Behavioral: COVID Booster text messages<br/><b>Sponsor</b>:   University of Pennsylvania<br/><b>Enrolling by invitation</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A Study on Utilization, Adherence, and Acceptability of Voluntary Routine COVID-19 Self-testing Among Students, Staff and Health Workers at Two Institutions in Mizoram, India.</strong> - <b>Condition</b>:   COVID-19 Pandemic<br/><b>Intervention</b>:   Diagnostic Test: COVID-19 Self testing and related messaging<br/><b>Sponsors</b>:   PATH;   UNITAID;   Zoram Medical College;   Pacchunga University College;   ALERT India;   Government of Mizoram<br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Using a Community-level Just-in-Time Adaptive Intervention to Address COVID-19 Testing Disparities</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Behavioral: Multi-Level Multi-Component Intervention (MLI);   Behavioral: Community Just-In-Time Adaptive Intervention (Community JITAI)<br/><b>Sponsors</b>:   The University of Texas Health Science Center, Houston;   National Center for Advancing Translational Sciences (NCATS)<br/><b>Active, not recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Examining How a Facilitated Self-Sampling Intervention and Testing Navigation Intervention Influences COVID-19 Testing</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Behavioral: Facilitated Self-Sampling Intervention (FSSI);   Behavioral: Testing Navigation Intervention (TNI).;   Behavioral: Control<br/><b>Sponsors</b>:   The University of Texas Health Science Center, Houston;   National Center for Advancing Translational Sciences (NCATS)<br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Assessing Performance of the Testing Done Simple Covid 19 Antigen Test</strong> - <b>Condition</b>:   COVID-19<br/><b>Intervention</b>:   Diagnostic Test: Testing Done Simple SARS CoV-2 Antigen Test<br/><b>Sponsors</b>:   Testing Done Simple;   Nao Medical Urgent Care<br/><b>Recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A Study to Evaluate EDP-235 in Non-hospitalized Adults With COVID-19</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Drug: EDP-235;   Drug: Placebo<br/><b>Sponsor</b>:   Enanta Pharmaceuticals, Inc<br/><b>Recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A Phase III of COVID-19 Vaccine EuCorVac-19 in Healthy Adults Aged 18 Years and Older</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Biological: EuCorVac-19;   Biological: ChAdOx1<br/><b>Sponsor</b>:   EuBiologics Co.,Ltd<br/><b>Recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Study Evaluating GS-5245 in Participants With COVID-19 Who Have a High Risk of Developing Serious or Severe Illness</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Drug: GS-5245;   Drug: GS-5245 Placebo<br/><b>Sponsor</b>:   Gilead Sciences<br/><b>Recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The LAVA (Lateral Flow Antigen Validation and Applicability) 2 Study for COVID-19</strong> - <b>Condition</b>:   SARS-CoV-2 Infection<br/><b>Intervention</b>:   Diagnostic Test: Innova Lateral Flow Test<br/><b>Sponsor</b>:   Alder Hey Children’s NHS Foundation Trust<br/><b>Completed</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Q-POC COVID-19 Clinical Evaluation</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Diagnostic Test: RT-PCR Test;   Diagnostic Test: Real-time PCR Test<br/><b>Sponsors</b>:   QuantuMDx Group Ltd;   EDP Biotech;   Paragon Rx Clinical;   PathAI;   PRX Research and Development<br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A Phase I/II Study of GLB-COV2-043 as a COVID-19 Vaccine Booster</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Drug: GLB-COV2-043;   Drug: BNT162b2/COMIRNATY®<br/><b>Sponsor</b>:   GreenLight Biosciences, Inc.<br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Enhancing Protection Against Influenza and COVID-19 for Pregnant Women and Medically at Risk Children</strong> - <b>Conditions</b>:   Influenza;   COVID-19<br/><b>Intervention</b>:   Behavioral: Nudge<br/><b>Sponsor</b>:   University of Adelaide<br/><b>Recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Safety and Efficacy of Intranasal Administration of Avacc 10 Vaccine Against COVID-19 in Healthy Volunteers</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Biological: Avacc 10;   Combination Product: Outer Membrane Vesicles (OMV) : OMV alone in vehicle;   Other: Placebo<br/><b>Sponsors</b>:   Intravacc B.V.;   Novotech (Australia) Pty Limited<br/><b>Not yet recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A Trial Evaluate the Immunogenicity and Safety of Recombinant COVID-19 Omicron-Delta Variant Vaccine (CHO Cell)</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Biological: Omicron-Delta Recombinant Novel Coronavirus Protein Vaccine (CHO cells);   Biological: Recombinant Novel Coronavirus Protein Vaccine (CHO cells)<br/><b>Sponsor</b>:   Anhui Zhifei Longcom Biologic Pharmacy Co., Ltd.<br/><b>Recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>COVID-19 Antibody Responses in Cystic Fibrosis</strong> - <b>Conditions</b>:   COVID-19;   Cystic Fibrosis<br/><b>Intervention</b>:   Biological: Blood sample<br/><b>Sponsors</b>:   Hospices Civils de Lyon;   Queen’s University, Belfast<br/><b>Recruiting</b></p></li>
</ul>
<h1 data-aos="fade-right" id="from-pubmed">From PubMed</h1>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Evaluation of the anti-diabetic drug sitagliptin as a novel attenuate to SARS-CoV-2 evidence-based in silico: molecular docking and molecular dynamics</strong> - The current outbreak of COVID-19 cases worldwide has been responsible for a significant number of deaths, especially in hospitalized patients suffering from comorbidities, such as obesity, diabetes, hypertension. The disease not only has prompted an interest in the pathophysiology, but also it has propelled a massive race to find new anti-SARS-CoV-2 drugs. In this scenario, known drugs commonly used to treat other diseases have been suggested as alternative or complementary therapeutics. Herein…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong><em>In Silico</em> and <em>In Vitro</em> studies of taiwan chingguan yihau (NRICM101) on TNF-α/IL-1β-induced human lung cells</strong> - COVID-19 pandemic has been a global outbreak of coronavirus (SARS-CoV-2 virus) since 2019. Taiwan Chingguan Yihau (NRICM101) is the first traditional Chinese medicine (TCM) classic herbal formula and is widely used for COVID-19 patients in Taiwan and more than 50 nations. This study is to investigate in silico target fishing for the components of NRICM101 and to explore whether NRICM101 inhibits cytokines-induced normal human lung cell injury in vitro. Our results showed that network prediction…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Comparison of RT-qPCR and RT-dPCR Platforms for the Trace Detection of SARS-CoV-2 RNA in Wastewater</strong> - We compared reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and RT digital PCR (RT-dPCR) platforms for the trace detection of SARS-CoV-2 RNA in low-prevalence COVID-19 locations in Queensland, Australia, using CDC N1 and CDC N2 assays. The assay limit of detection (ALOD), PCR inhibition rates, and performance characteristics of each assay, along with the positivity rates with the RT-qPCR and RT-dPCR platforms, were evaluated by seeding known concentrations of exogenous…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>GLUCOSE AND MANNOSE ANALOGS INHIBIT KSHV REPLICATION BY BLOCKING N-GLYCOSYLATION AND INDUCING THE UNFOLDED PROTEIN RESPONSE</strong> - Kaposi’s sarcoma-associated herpesvirus (KSHV) is the etiological agent for Kaposi’s sarcoma (KS), an HIV/AIDS-associated malignancy. Effective treatments against KS remain to be developed. The sugar analog 2-deoxy-d-glucose (2-DG) is an anti-cancer agent that is well-tolerated and safe in patients and was recently demonstrated to be a potent antiviral, including KSHV and SARS-Cov-2. Because 2-DG inhibits glycolysis and N-glycosylation, identifying its molecular targets is challenging. Here we…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Differential upregulation of AU-rich element-containing mRNAs in COVID-19</strong> - CONCLUSIONS: Compared to the rest of the transcriptome, ARE-containing mRNAs are preferentially upregulated in response to viral infections at a global level. In the context of COVID-19, they are most upregulated in mild disease. Due to their large number, their levels measured by RNA-seq may provide a reliable indication of COVID-19 severity.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>SARS-CoV-2 Spike protein suppresses CTL-mediated killing by inhibiting immune synapse assembly</strong> - CTL-mediated killing of virally infected or malignant cells is orchestrated at the immune synapse (IS). We hypothesized that SARS-CoV-2 may target lytic IS assembly to escape elimination. We show that human CD8+ T cells upregulate the expression of ACE2, the Spike receptor, during differentiation to CTLs. CTL preincubation with the Wuhan or Omicron Spike variants inhibits IS assembly and function, as shown by defective synaptic accumulation of TCRs and tyrosine phosphoproteins as well as…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Charge-Dependent Signal Changes for Label-Free Electrochemiluminescence Immunoassays</strong> - Label-free electrochemiluminescence (ECL) immunoassays (lf-ECLIA), based on biomarker-induced ECL signal changes, have attracted increasing attention due to the simple, rapid, and low-cost detection of biomarkers without secondary antibodies and complicated labeling procedures. However, the interaction rule and mechanism between analytical interfaces and biomarkers have rarely been explored. Herein, the interactions between biomarkers and analytical interfaces constructed by assembly of a…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Rational Development of Hypervalent Glycan Shield-Binding Nanoparticles with Broad-Spectrum Inhibition against Fatal Viruses Including SARS-CoV-2 Variants</strong> - Infectious virus diseases, particularly coronavirus disease 2019, have posed a severe threat to public health, whereas the developed therapeutic and prophylactic strategies are seriously challenged by viral evolution and mutation. Therefore, broad-spectrum inhibitors of viruses are highly demanded. Herein, an unprecedented antiviral strategy is reported, targeting the viral glycan shields with hypervalent mannose-binding nanoparticles. The nanoparticles exhibit a unique double-punch mechanism,…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>DNA virus oncoprotein HPV18 E7 selectively antagonizes cGAS-STING-triggered innate immune activation</strong> - Cellular infections by DNA viruses trigger innate immune responses mediated by DNA sensors. The cyclic GMP-AMP synthase (cGAS)-stimulator of interferon gene (STING) signaling pathway has been identified as a DNA-sensing pathway that activates interferons in response to viral infection and, thus, mediates host defense against viruses. Previous studies have identified oncogenes E7 and E1A of the DNA tumor viruses, human papillomavirus 18 (HPV18) and adenovirus, respectively, as inhibitors of the…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Favipiravir Efficacy And Safety For The Treatment Of Severe Coronavirus Disease 2019: A Retrospective Study</strong> - CONCLUSIONS: In this study, Favipiravir showed better therapeutic responses in patients with severe COVID-19 infection, in terms of average duration of stay in the intensive care unit and was well tolerated in the younger age, but showed no mortality benefit. However, elevated levels of inflammatory markers, including increased ALT, AST, BUN, bilirubin, and creatinine, needs to be carefully examined.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Characteristics and source apportionment of PM<sub>2.5</sub> under the dual influence of the Spring Festival and the COVID-19 pandemic in Yuncheng city</strong> - Based on the online and membrane sampling data of Yuncheng from January 1st to February 12th, 2020, the formation mechanism of haze under the dual influence of Spring Festival and COVID-19 (Corona Virus Disease) was analyzed. Atmospheric capacity, chemical composition, secondary transformation, source apportionment, backward trajectory, pollution space and enterprise distribution were studied. Low wind speed, high humidity and small atmospheric capacity inhibited the diffusion of air pollutants….</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Active Ingredients of Reduning Injections Maintain High Potency against SARS-CoV-2 Variants</strong> - CONCLUSIONS: The mechanisms were revealed of quercetin and luteolin inhibiting the infection of SARS-CoV-2 and its variants. Reduning Injection is a promising drug for COVID-19.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Why Molnupiravir Fails in Hospitalized Patients</strong> - Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease 2019 (COVID-19), has radically altered daily life. Effective antiviral therapies to combat COVID-19, especially severe disease, remain scarce. Molnupiravir is an antiviral that has shown clinical efficacy against mild-to-moderate COVID-19 but failed to provide benefit to hospitalized patients with severe disease. Here, we explained the mechanism behind the failure of molnupiravir in…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong><em>Ganoderma lucidum</em> polysaccharides ameliorate lipopolysaccharide-induced acute pneumonia via inhibiting NRP1-mediated inflammation</strong> - CONTEXT: Ganoderma lucidum polysaccharides (GLP), from Ganoderma lucidum (Leyss. ex Fr.) Karst. (Ganodermataceae), are reported to have anti-inflammatory effects, including anti-neuroinflammation and anti-colitis. Nevertheless, the role of GLP in acute pneumonia is unknown.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The numerical solution of a mathematical model of the Covid-19 pandemic utilizing a meshless local discrete Galerkin method</strong> - It was in early December 2019 that the terrible news of the outbreak of new coronavirus disease (Covid-19) was reported by the world media, which appeared in Wuhan, China, and is rapidly spreading to other parts of China and several overseas countries. In the field of infectious diseases, modeling, evaluating, and predicting the rate of disease transmission are very important for epidemic prevention and control. Several preliminary mathematical models for Covid-19 are formulated by various…</p></li>
</ul>
<h1 data-aos="fade-right" id="from-patent-search">From Patent Search</h1>
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<h1 data-aos="fade-down" id="daily-dose">Daily-Dose</h1>
<h1 data-aos="fade-right" data-aos-anchor-placement="top-bottom" id="contents">Contents</h1>
<ul>
<li><a href="#from-new-yorker">From New Yorker</a></li>
<li><a href="#from-vox">From Vox</a></li>
<li><a href="#from-the-hindu-sports">From The Hindu: Sports</a></li>
<li><a href="#from-the-hindu-national-news">From The Hindu: National News</a></li>
<li><a href="#from-bbc-europe">From BBC: Europe</a></li>
<li><a href="#from-ars-technica">From Ars Technica</a></li>
<li><a href="#from-jokes-subreddit">From Jokes Subreddit</a></li>
</ul>
<h1 data-aos="fade-right" id="from-new-yorker">From New Yorker</h1>
<ul>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The Future of the Amazon, and Maybe the Planet, Depends on Brazil’s President-Elect Lula</strong> - Luiz Inácio Lula da Silva speaks out about deforestation and the weakness of global institutions before his speech at the COP27 climate summit. - <a href="https://www.newyorker.com/news/daily-comment/the-future-of-the-amazon-and-maybe-the-planet-depends-on-brazils-president-elect-lula">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>How Math Became an Object of the Culture Wars</strong> - As was true in the nineties, today’s fights about math are not entirely about what kids actually learn in their classrooms. - <a href="https://www.newyorker.com/news/our-columnists/how-math-became-an-object-of-the-culture-wars">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Don Bolduc Explains His Defeat in the Midterms</strong> - The Republican candidate for Senate in New Hampshire campaigned on election denialism, and lost by nine points. Is he ready to renounce Donald Trump? - <a href="https://www.newyorker.com/news/q-and-a/don-bolduc-explains-his-defeat">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The End of Donald Trump?</strong> - Murdoch may have pulled the plug on him for 2024, but it’s not clear yet if the rest of the G.O.P. will follow. - <a href="https://www.newyorker.com/news/letter-from-bidens-washington/the-end-of-trump">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>How Catherine Cortez Masto Won Nevada and Secured Democratic Control of the Senate</strong> - She positioned herself as a champion of working-class voters, courting organized labor and the Latino community. - <a href="https://www.newyorker.com/news/the-political-scene/how-catherine-cortez-masto-won-nevada-and-secured-democratic-control-of-the-senate">link</a></p></li>
</ul>
<h1 data-aos="fade-right" id="from-vox">From Vox</h1>
<ul>
<li><strong>Where Trump and DeSantis actually disagree</strong> -
<figure>
<img alt="Governor DeSantis sits at a table pointing to his left at Donald Trump. Behind them in an American flag and a sign reading “We’re in this together.”" src="https://cdn.vox-cdn.com/thumbor/3U_LIggIryLID8G6-4odBtQRdUY=/256x0:3723x2600/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/71634762/GettyImages_1227861583a.0.jpg"/>
<figcaption>
Florida Gov. Ron DeSantis and then-President Donald Trump participate in a roundtable in Belleair, Florida, in 2020. | Saul Loeb/AFP via Getty Images
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The murky policy differences between Donald Trump and Ron DeSantis, explained.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="XO0ysl">
<a href="https://www.vox.com/donald-trump">Donald Trump</a>, who announced Tuesday night that he will seek the White House for another term in 2024, has never made policy central to his political career. So conservative policy experts do not necessarily expect the Republican primary electorate to be swayed by the intricacies of his or any other candidate’s agenda.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="iZZFti">
Nevertheless, Republicans who are dubious of Trump’s return are uncomfortable with not only his bigotry and authoritarian streak but also his disinterest in governance itself.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ZRxL3F">
And so with <a href="https://www.vox.com/policy-and-politics/23450428/donald-trump-midterm-elections-republican-red-wave">Trump and his movement taking much of the blame for the GOP’s disappointing midterms</a>, Trump-skeptical Republicans see new weakness in the former president. High-profile conservative commentators are touting <a href="https://www.vox.com/policy-and-politics/2022/11/13/23454213/desantis-trump-2024-president-primary-republican-gop">Florida Gov. Ron DeSantis</a>, who easily won reelection in what was once a swing state, as <a href="https://www.washingtonpost.com/opinions/2022/11/14/desantis-normal-republican/">the preferred Trump alternative</a> if he decides to run for the presidency in 2024.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Ty4nXf">
As the governor of one of the largest states who has spent years building up his conservative bona fides, DeSantis has long been eyed as a possible successor to Trump. But with Trump now in the running, the governor will have to give voters a reason to vote for him instead of the former president.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="BMgUMj">
“As far as I can tell, there are no serious policy differences between Trump and DeSantis at the moment. The biggest divergence between the two is competence and execution,” Matthew Continetti, a senior fellow at the American Enterprise Institute who studies the conservative movement, told me. “I wouldn’t expect a Trump-DeSantis presidential primary to swing on policy. Such a contest, if it happens, will be a test of Republican primary voters’ willingness for new leadership and a chance at victory.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="l8HeMX">
But that still requires drawing a meaningful contrast with Trump — not something that, to date, DeSantis nor many other elected Republicans have been willing to do since Trump won the 2016 GOP primary. So I asked a group of conservative policy wonks where they saw or expected to see a distinction being made between Trump and DeSantis, who seem for the time being to be the strongest contenders for the 2024 Republican nomination.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="7zgizr">
There was not an obvious answer. Trump has not stuck with a consistent policy platform and DeSantis has largely governed as a conventional Republican for the past four years (and voted as one in the US House before that). There may be little space between them on typically important subjects like taxes or regulation. Trump has, when he has paid much mind to policy, focused primarily on immigration and trade. DeSantis, perhaps with future national ambitions in mind, has picked hawkish fights on both of those issues, while also stoking the culture-war flames in a way that can feel reminiscent of Trumpism (without the Trump).
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="RSRf71">
Ultimately, that may be the terrain on which the 2024 GOP primary is fought: less over specific policy differences and more over whether DeSantis can convince the Trumpist base that he can also be trusted on the issues where they place absolute faith in the former president.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="yVhtTo">
“It’s not so much going to be about policy differences, but who do you trust to fight the woke left?” Avik Roy, who leads the Foundation for Research on Equal Opportunity, told me. “That will be the ground on which the campaign is fought.”
</p>
<h3 id="lmCq7Y">
Where Trump and DeSantis might actually disagree on policy
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="E4nuSe">
There are early indications of where DeSantis might put his policy record or plans up against Trump’s, to loosen the former president’s hold on the Republican base. Ironically, it starts with the issue that helped topple Trump’s presidency while also turning DeSantis into a national hero for many conservatives and a loathsome villain for Democrats: <a href="https://www.vox.com/coronavirus-covid19">Covid-19</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="6dgiaQ">
Roy said he thought the pandemic response would be a point of emphasis for DeSantis. While Trump often <a href="https://www.vox.com/2020-presidential-election/2020/11/3/21547973/trump-election-day-covid-coronavirus-pandemic">confused and undermined his own administration’s plans</a> with his off-the-cuff rhetoric, he was still the president who put Anthony Fauci and Deborah Birx — who became avatars for an overbearing response in the eyes of many GOP voters — in charge. It was his administration that recommended a two-week partial shutdown of the economy in order to try to stop the spread of the novel coronavirus in the spring of 2020.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="0GKq6b">
DeSantis charted a deliberately different path. He resisted calls to close schools and businesses. Roy described the governor’s approach as one of conviction, driven by data. Florida’s record on Covid-19 is more mixed than DeSantis’s fans might have you believe — the state’s economy did recover more quickly, but it also ranks <a href="https://www.nytimes.com/interactive/2021/us/covid-cases.html">12th out of the 50 states</a> in coronavirus deaths per capita.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="6pnSJg">
But for Republican voters who are more skeptical of government intervention, and saw much of the pandemic response as an overreaction, DeSantis could criticize Trump for those unpopular measures while offering the Florida experience as an example of the alternative approach — the crux of his argument against Trump, no matter the specific issue.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="hiH3kU">
Roy described DeSantis’s potential argument on Covid-19 like this: “During the pandemic, when Trump was out to lunch, drifting from policy and policy, we were really consistent and Floridians benefited a lot from that.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="vQBZSp">
<a href="https://www.nationalreview.com/2022/09/the-question-for-desantis/">It’s a case DeSantis himself has started to make,</a> if obliquely, in national appearances that are helping to lay the groundwork for his expected presidential candidacy.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="C24r9H">
“Stack up their records on that issue,” Roy said. “In a Republican primary, that’s a case DeSantis can make very convincingly.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="eFXXuf">
Beyond that issue, though, the policy experts I spoke with did not see many obvious differences between Trump and DeSantis. On taxes, for example, “I am not sure Trump or DeSantis has or will articulate a position on tax policy that is different than the bread-and-butter Republican position of lower taxes being better,” said Kyle Pomerleau, senior fellow at AEI.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="C2AAby">
Part of the problem is that, as governor, “the set of policy issues [DeSantis] focuses on is actually quite different than the ones that would be front and center in a national GOP primary,” Oren Cass, executive director of the conservative policy think tank American Compass, said. “I would expect him to start establishing a profile on that set of economic and foreign policy issues in the coming months.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="nKvc7w">
Foreign policy will be one issue area to watch. Trump brought an end to expansionist neoconservative dominance of Republican politics, reintroducing an isolationist streak that had been mostly dormant for decades. DeSantis generally took a hawkish stance as a member of the US House of Representatives, criticizing the Obama administration for making overtures to Cuba and Iran and ridiculing the nascent BDS movement that sought to penalize Israel for its treatment of Palestinians. He has also as governor signed executive orders meant to limit his state’s trade relationship with China and Russia.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ah666j">
At the same time, DeSantis has glommed onto some of Trump’s more heterodox foreign policy positions: In <a href="https://justfacts.votesmart.org/public-statement/1270204/fox-news-the-ingraham-angle-transcript-interview-with-rep-ron-desantis">one interview during his first run for governor</a>, DeSantis said that he does support the NATO alliance but credited Trump with drawing attention to some of its problems.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="zQuWjO">
Then there is DeSantis’s economic agenda, still a bit of a black box. As Michael Brendan Doughtery <a href="https://www.nationalreview.com/2022/09/the-question-for-desantis/">wrote in the National Review this fall</a>, DeSantis’s “isn’t Florida grand?” message may have limited appeal in the Rust Belt. States that voted for Obama and then Trump are looking for an economic plan to revitalize their industries. New tax cuts and infrastructure projects, two hallmarks of his time as governor, aren’t going to draw a meaningful contrast with Trump. The 2017 tax bill remains Trump’s signature achievement and he obsesses over infrastructure (though he failed to close the deal on a major bill as president).
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="4JPzPe">
“What is the DeSantis message about the American economic model?” Doughtery wrote, implying the answer was not yet obvious.
</p>
<h3 id="AzNB5y">
What is DeSantis going to do for the next two years?
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="dZI65C">
So the particulars of the disagreements between Trump and DeSantis will be hashed out in the coming months, as the 2024 campaign heats up in earnest. But the stakes of that debate are already clear: In order to topple the current leader of the Republican Party, DeSantis needs to persuade some of Trump’s supporters.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="bJTidQ">
On that front, as Roy described it, it becomes a matter of trust. Who will fight the left? Trump’s entire personal brand is tied up in the idea of him as a fighter. So it’s telling that DeSantis has spent much of his time as governor picking fights meant to agitate the left and win plaudits on the right.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="epDRpL">
Two particular episodes come to mind. First there was <a href="https://www.vox.com/23036009/disney-culture-war-desantis-florida-dont-say-gay">DeSantis’s standoff with Disney over his state’s “don’t say gay” education bill</a>. After some deliberation, the company announced its support for repealing the law and said it would stop donating money to politicians who supported the policy. DeSantis went on the offensive, ginning up legislation that would roll back Disney’s privileged tax status within the state.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="XGyjXV">
“It’s not that he’s deviating from free market philosophy, but the fights he’s fighting are blending traditional free market values with concerns of social conservatives,” Roy told me.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="VNm0BX">
Then there was <a href="https://www.vox.com/policy-and-politics/2022/9/17/23357832/desantis-marthas-vineyard-flights-gop-immigration-stunts">DeSantis’s plot to transfer migrants from the southern US border to Massachusetts</a>. The maneuver was derided by many for being inhumane and dishonest toward the people who were most directly affected. But for the Republican primary audience, it was a chance for DeSantis to show his willingness to fight, to stick it in the eyes of progressives, on an issue that the conservative base cares deeply about.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="vqWFGp">
More stunts may follow. DeSantis’s office has already made plans to transfer even more migrants out of Florida to Illinois and Delaware and they may follow through in the next few weeks based on the contracts <a href="https://www.theguardian.com/us-news/2022/oct/15/florida-governor-ron-desantis-fly-migrants-illinois-delaware">underlying the plan</a>. He may look for more opportunities to antagonize progressives on education curriculum (he is a big anti-critical race theory guy) and on LGBTQ rights.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="XOYLgK">
But after the election results, one issue looms in particular: abortion. The Supreme Court’s decision to overturn <em>Roe v. Wade</em> animated many swing voters in 2022 and Democrats are likely going to continue to emphasize reproductive rights in campaign seasons to come so long as Republicans continue to roll back those rights at the state level.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="iIYwzH">
DeSantis has been methodical in the wake of the <em>Dobbs</em> decision, at least so far. He did succeed in passing new abortion restrictions this year, but they were not as extreme as the near-total bans seen elsewhere, prohibiting the procedure after 15 weeks.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="rSwdaQ">
As the Tallahassee Democrat <a href="https://www.tallahassee.com/story/news/politics/elections/2022/10/20/ron-desantis-republican-abortion-strategy-say-nothing-florida-midterm-elections-charlie-crist/10495668002/">reported before the 2022 election</a>, DeSantis was decidedly noncommittal about further abortion restrictions during his reelection campaign. Though he is thought to support a six-week ban, he and his office refused to say what policies they would try to pass during a second term.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="FcBc2R">
It remains to be seen whether DeSantis sees the results of the 2022 midterms and decides to pull back. On the other hand, he may decide to plow ahead to continue building support for his presidential run within the Republican base. Whatever he decides to do, it will have major implications for a potential presidential campaign. Democrats would surely hammer the governor over a six-week ban.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="4XoeZt">
But what would Trump do?
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="LAWUXN">
On the one hand, the former president can claim ownership of the conservative Supreme Court that overturned <em>Roe</em>, after appointing three justices in just four years in office. But he has also <a href="https://www.nytimes.com/2022/06/24/us/politics/abortion-ruling-trump.html">privately expressed concerns</a> that the issue could hurt the GOP with swing voters.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="fOhyTQ">
Would he use a new stringent DeSantis bill as an opportunity to separate the two of them on a pivotal issue, another chance for him to flout conservative orthodoxy? Or would alienating the base over something as foundational as abortion be too big a risk?
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="I7K3Wq">
Either way, DeSantis will have the opportunity to make a move to which Trump must react.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="oULGNR">
Trump has shown a remarkable ability to bend the Republican Party to his will in his six years of dominance. But his forthcoming battle with DeSantis will test the strength of his hold, particularly if the up-and-coming challenger seizes on (small) areas of daylight between the two of them.
</p></li>
<li><strong>The lame-duck Congress can avoid the next debt ceiling crisis. They just need to act.</strong> -
<figure>
<img alt="A photo shows the US Capitol’s dome with trees and a bridge in front of it, as street lights turn on and the sky darkens." src="https://cdn.vox-cdn.com/thumbor/RfcdIjvwpkYhNFVKSuX9Xi8w_Uw=/280x0:3900x2715/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/71634693/GettyImages_1375394955a.0.jpg"/>
<figcaption>
Congress returns to a lame-duck session Monday after an election where Republicans are expected to narrowly retake the House. | Justin Sullivan/Getty Images
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Why Democrats have to head off another debt ceiling standoff while they still can.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="5GX6At">
Tell me if this sounds familiar: A first-term Democratic president, after spending two years managing a precarious majority in Congress, loses control of the House. The new majority, brought to power by the election of highly ideological and conservative first-term members skeptical of the Republican “establishment,” tries to extract concessions from the president by declining to raise the <a href="https://www.vox.com/policy-and-politics/2019/2/21/18233169/debt-ceiling-explained">debt ceiling</a>, a federal law limiting how much the government is allowed to borrow. If the ceiling is not raised, the result could be a large-scale recession or even a global financial crisis.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="HmUjby">
Fearing the worst outcome, the White House agrees to the second worst: over a trillion dollars in spending cuts to placate the new Republican House. Those cuts have major negative consequences for the country over the next decade.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="LcZutp">
The above all happened in 2011, as President Barack Obama dealt with new Republican House Speaker John Boehner and the hardline Tea Party-backed members of Congress brought to power in the 2010 midterm elections — largely driven by the continuing pain and outrage caused by the 2007-2009 recession.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="NGTwEl">
But it could happen again in 2023. Republicans have retaken the House, albeit narrowly in a weaker than expected performance, and the next likely House speaker, current House Minority Leader Kevin McCarthy, <a href="https://punchbowl.news/archive/101822-punchbowl-news-am/">has already signaled</a> that he wants concessions from President Joe Biden in exchange for raising the debt ceiling. McCarthy was heavily involved in the 2011 crisis as House majority whip, and this time around he has even more radical, Trump-loyal members to manage. Denouncing the “<a href="https://www.northjersey.com/story/news/2022/11/04/nj-midterm-elections-2022-comparing-party-plans-for-inflation/69615709007/">out</a> <a href="https://patch.com/pennsylvania/pittsburgh/lee-versus-doyle-pa-12th-congressional-district-results">of</a> <a href="https://www.kimt.com/news/iowa-republicans-blast-democrats-defend-biden-plan-to-forgive-some-student-loan-debt/article_e14cee12-23d7-11ed-b31b-97d52e2b6942.html">control</a> spending” of the Biden administration and <a href="https://www.nbcboston.com/news/local/high-costs-economy-abortion-top-last-pappas-leavitt-debate/2883860/">pledging to hold the debt limit hostage</a> were popular talking points <a href="https://www.nytimes.com/2022/10/26/us/politics/midterms-gop-republican-inflation-plans.html">among Republican candidates</a> this cycle.
</p>
<aside id="nPqGA4">
<div>
</div>
</aside>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ubtnrK">
We cannot be certain how this showdown will end. Outgoing House Speaker Nancy Pelosi and reelected Senate Majority Leader Chuck Schumer have said they will try to nip the problem in the bud and <a href="https://www.reuters.com/world/us/us-house-speaker-pelosi-backs-debt-limit-action-soon-2022-11-13/">raise the debt ceiling before January</a>; Senate Finance Committee chair Ron Wyden (D-OR) has said he’d be <a href="https://www.nytimes.com/2022/11/03/business/biden-debt-limit-shutdown.html">open to using budget reconciliation rules</a>, which would not require any Republican support. Some Democrats, like Sens. <a href="https://www.politico.com/minutes/congress/10-24-2022/shaheens-debt-limit-push/">Jeanne Shaheen</a> (D-NH) and <a href="https://www.axios.com/2022/11/13/elizabeth-warren-congress-debt-ceiling-republicans">Elizabeth Warren</a> (D-MA), have called for eliminating the ceiling altogether, which would prevent any repeat of the 2011 standoff in the future.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Y6CyHf">
President Biden could also <a href="https://www.vox.com/policy-and-politics/22684328/us-debt-ceiling-government-shutdown-biden-democrats">use executive power to subvert the ceiling</a>, either by asserting that ignoring the limit is <a href="https://scholarship.law.cornell.edu/facpub/591/">the “least unconstitutional” option he can take</a> (compared to ignoring tax and spending laws passed by Congress), or by <a href="https://www.vox.com/22711346/trillion-dollar-coin-mintthecoin-debt-ceiling-beowulf">minting a platinum coin</a> worth trillions of dollars, which is totally a real option.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="aRBSah">
But despite those options,<strong> </strong>a full-on repeat of the 2011 standoff looks unnervingly possible. That ended with the Budget Control Act, which the <a href="https://www.cbo.gov/sites/default/files/112th-congress-2011-2012/costestimate/budgetcontrolactaug1.pdf">Congressional Budget Office estimated</a> would reduce the deficit by $2.1 trillion over a decade through massive, obligatory spending cuts. Congress later undid some of the cuts included in the BCA, but Marc Goldwein, senior vice president of the Committee for a Responsible Federal Budget and a leading budget analyst in DC, tells me that total wound up being around $1.3 trillion. All of those savings were achieved not through raising taxes, but reducing spending. And almost all that reduced spending came from a relatively narrow slice of the federal budget, known as “discretionary spending.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="qHQrad">
Large programs like Social Security and Medicaid were excluded entirely, and Medicare only saw modest cuts. But defense spending, <a href="https://www.cbpp.org/research/federal-budget/boosts-in-non-defense-appropriations-needed-due-to-decade-of-cuts-unmet">federal support for K-12 schools</a>, <a href="https://www.cbpp.org/research/housing/budget-caps-not-rent-aid-forcing-hud-budget-cuts">rental assistance vouchers</a>, <a href="https://www.cbpp.org/research/federal-budget/new-budget-deal-needed-to-avert-cuts-invest-in-national-priorities">environmental protection</a>, and various <a href="https://www.aaas.org/news/budget-control-act-may-have-cost-over-200-billion-federal-rd">research and development programs</a> all suffered.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ufX7vG">
The dynamics that led the Budget Control Act of 2011 to take the form it did have not suddenly disappeared. They reflect longstanding political pressures on both parties in Congress that persist to this day,<strong> </strong>and could easily lead to a similar deal if the debt ceiling is not raised in the lame-duck period. The 2011 deal cut billions in funding to priorities like clean air and water, education, housing, and more. A 2023 deal could do the same, or worse.
</p>
<h3 id="Z7wzc5">
The US federal government is an insurance company with an army
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="h0coiL">
There’s an old saying in DC that the federal government is basically an <a href="https://economistsview.typepad.com/economistsview/2013/01/who-first-said-the-us-is-an-insurance-company-with-an-army.html">insurance company with an army</a>. That’s not exactly true, but it’s close. Defense spending, Social Security, Medicare, and Medicaid combined made up about 62 percent of the federal budget in 2019 (see <a href="https://www.cbo.gov/publication/56324">this CBO infographic</a>). During the pandemic, huge stimulus and unemployment payments pushed that percentage down, but in normal times about three out of every five federal dollars go to those programs. If you add in other “mandatory” programs like federal employee pensions and food stamps, and interest payments on old debt, the share grows to over 85 percent.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="3KvnT9">
Outside of defense, which Republicans are loath to cut, Social Security, Medicare, and Medicaid are where the money is. More ideologically committed (see the <a href="https://banks.house.gov/uploadedfiles/rsc_2023_budget_final_version.pdf">Republican Study Committee</a>, to which 156 members of Congress belong) and/or gaffe-prone (see <a href="https://www.washingtonpost.com/national-security/2022/08/03/ron-johnson-medicare-social-security/">Ron Johnson</a>) Republicans tend to call for big cuts to these three. <a href="https://about.bgov.com/news/entitlement-spending-cap-plans-linked-by-gop-to-debt-limit-deal/">Some RSC members</a> have explicitly demanded that a debt ceiling increase in 2023 be tied to reforms to these programs.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="aMzwmu">
But those programs are also <a href="https://www.dataforprogress.org/blog/2022/10/6/democrats-and-voters-support-expanding-social-security">wildly</a> <a href="https://press.aarp.org/2021-5-26-AARP-Survey-Overwhelming-Bipartisan-Majority-Oppose-Social-Security-and-Medicare-Cuts-to-Reduce-Deficit">popular</a>, they’re the last things Democrats are likely to agree to cut, and they have a potent defender in Donald Trump, who <a href="https://archive.ph/I166q">repeatedly</a> <a href="https://www.youtube.com/watch?v=sbiX1asmi04">promised</a> to <a href="https://www.cnn.com/2016/03/10/politics/republican-debate-transcript-full-text/">protect</a> <a href="https://web.archive.org/web/20200210000609/https://twitter.com/realdonaldtrump/status/1226219499847811072">them</a> from cuts as president. That didn’t stop his administration from <a href="https://www.cbpp.org/blog/medicare-in-the-2021-trump-budget">proposing</a> <a href="https://www.cbpp.org/blog/trump-budget-cuts-medicaid-even-more-than-house-health-bill-showing-danger-of-per-capita-cap">budgets</a> <a href="https://www.cbpp.org/research/federal-budget/trump-budget-deeply-cuts-health-housing-other-assistance-for-low-and">full</a> of <a href="https://www.cbpp.org/research/federal-budget/cuts-to-low-income-assistance-programs-in-president-trumps-2020-budget-are">cuts</a> to <a href="https://www.cbpp.org/research/federal-budget/trumps-2021-budget-would-cut-16-trillion-from-low-income-programs">these</a> <a href="https://www.cbpp.org/research/federal-budget/trump-budget-gets-two-thirds-of-its-cuts-from-programs-for-low-and-moderate">programs</a>, or from <a href="https://www.vox.com/policy-and-politics/2017/7/31/16055960/why-obamacare-repeal-failed">pushing for a health reform package</a> that would gut Medicaid — but none of those policies actually passed, and the Republican in the White House being openly skeptical of entitlement cuts probably hurt their odds of passage.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="IVOwlB">
Tellingly, Republican leaders spent 2022 running away from their past calls for entitlement cuts. Sen. Rick Scott (R-FL), who months earlier proposed <a href="https://rescueamerica.com/wp-content/uploads/2022/02/RickScott-11-Point-Policy-Book.pdf#page=19">sunsetting every federal law</a> (including Social Security and Medicare) every five years, <a href="https://www.cnn.com/videos/politics/2022/10/30/scott-on-economic-plan.cnn">told CNN</a> in October, “I don’t know one Republican” who wants to reduce Medicare or Social Security benefits, and that he would oppose raising the retirement age for either. (He has apparently not met any of the 156 House members of the Republican Study Committee.) But after the election, <a href="https://www.washingtonpost.com/us-policy/2022/11/14/congress-lame-duck-spending-debt/">Scott told the Washington Post</a>, “We’re not going to just keep raising the debt ceiling without structural reform.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="EI29rI">
Likely incoming speaker McCarthy disputed the idea that he’d use the debt ceiling to force cuts to Social Security and Medicare, <a href="https://thehill.com/blogs/blog-briefing-room/news/3695720-mccarthy-tamps-down-concerns-over-linking-social-security-medicare-reforms-to-debt-ceiling/">telling CNBC</a>, “The debt ceiling needs to be raised, but I also know I’m going to strengthen Social Security, Medicare. I never brought them up.”
</p>
<h3 id="9JIxCl">
The making of the 2011 debt ceiling deal
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ldNW7S">
None of these dynamics are new. During the 2011 debt ceiling fight, the Obama White House took a firm line against any deal that cut Social Security or Medicare without increasing taxes. For a brief time, House Speaker John Boehner seemed to be playing ball, <a href="https://www.nytimes.com/2012/04/01/magazine/obama-vs-boehner-who-killed-the-debt-deal.html">agreeing to as much as $800 billion in revenue increases</a>, but it soon became clear that he could not get his caucus to support major tax increases. Without the tax hikes, the Social Security and Medicare cuts that Obama was open to — like <a href="https://www.latimes.com/politics/la-xpm-2011-jul-07-la-na-debt-ceiling-20110708-story.html">slowing cost-of-living adjustments for the former</a> and <a href="https://www.politico.com/story/2011/07/medicare-at-67-the-next-big-change-060141">raising the age for the latter to 67</a> — went off the table.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="AWoUvS">
Ultimately, the two sides agreed to <a href="https://www.pgpf.org/analysis/peter-g-peterson-foundation-analysis-of-the-budget-control-act-of-2011">$917 billion in spending cuts</a>, mostly by capping discretionary spending (both defense and non-defense), but for the other $1.2 trillion in deficit reduction, they punted negotiations to a congressional committee (colloquially called “the supercommittee”). If the supercommittee failed to put together a package slashing $1.2 trillion through tax hikes or spending cuts, indiscriminate spending cuts would ensue through forced decreases in the caps on defense and non-defense discretionary spending. Unless Congress passed spending bills with totals below these new, even lower caps, a “sequestration” process forcing across-the-board cuts to every affected program would ensue.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="bLX1bZ">
The <a href="https://www.washingtonpost.com/business/economy/debt-committee-failure-will-become-official-with-written-joint-statement/2011/11/21/gIQAfRmCiN_story.html">supercommittee failed</a>, shocking no one. The across-the-board cuts included as a backup were never meant to take effect. They were an enforcement mechanism meant to pressure Congress into making a deal, the equivalent of paying a guy from Craigslist to punch you if you don’t get your work done on deadline.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="M3uxbN">
But Congress rarely gets its work done on deadline, so it got punched in the face. Which means, of course, Americans who relied on this spending got punched in the face. Because the deal took cuts to Social Security, Medicaid, and the beneficiary side of Medicare off the table, the punch was lighter than it could have been. (Medicare payments to providers were cut, though, which <a href="https://www.jstor.org/stable/42568845">some</a> <a href="https://www.nber.org/system/files/working_papers/w16859/w16859.pdf">studies</a> have found reduces quality of care received.) Further, Congress agreed in another deal at the end of 2012 to delay the sequestration cuts for two months, so they began on March 1, 2013. But they took effect then, as planned.
</p>
<h3 id="xI031A">
The consequences of the 2013 sequestration
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="MbqwvB">
As I <a href="https://www.washingtonpost.com/news/wonk/wp/2013/02/20/the-sequester-absolutely-everything-you-could-possibly-need-to-know-in-one-faq/">wrote at the time</a>, the sequestration led to 7.7 percent across-the-board cuts to defense and 5.1 percent across-the-board cuts to domestic discretionary spending. Military operations funding fell by $17.1 billion, the National Institutes of Health by $1.6 billion, nuclear weapons security by $903 million, border security and immigration enforcement by a combined $890 million, and on and on.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Ev9Pce">
Agency heads had little to no flexibility in distributing these cuts; every “program, project, and activity” had to be cut equally, and “activity” was defined to include things <a href="https://www.washingtonpost.com/news/wonk/wp/2013/02/22/heres-how-you-run-a-sequester-scrape-five-percent-less-poop/">as small as a single buoy the government floated in the Chesapeake Bay</a>. That buoy, somehow, had to be cut by 5 percent (in practice, that meant scraping 5 percent less bird poop off the buoy).
</p>
<figure class="e-image">
<img alt="A pie chart illustrating the numerous categories of non-defense discretionary spending; no category comprises more than 18 percent of the spending." src="https://cdn.vox-cdn.com/thumbor/SpkTjV2VpF83wASylDOXZ8-lZKw=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/24198845/3_25_21bud_f1.png"/> <cite><a class="ql-link" href="https://www.cbpp.org/research/federal-budget/boosts-in-non-defense-appropriations-needed-due-to-decade-of-cuts-unmet" target="_blank">Center on Budget and Policy Priorities</a></cite>
<figcaption>
The composition of non-defense discretionary spending in 2021.
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="bu2xqj">
These across-the-board cuts, though, only came because Congress approved spending bills totaling more than the caps they set for themselves (again, assuming the cuts wouldn’t actually take effect). After 2013, Congress was free to pass spending bills that did abide by the caps, after which no across-the-board cuts would ensue. It simply had to make decisions about what spending it wanted to prioritize, subject to those limits. It also could, and occasionally did, change the caps, as in the <a href="https://www.crfb.org/blogs/updated-summarizing-ryan-murray-deal">2013</a> and <a href="https://www.crfb.org/blogs/budget-deal-truly-offsets-only-half-its-cost">2015</a> budget deals, which raised both defense and non-defense spending caps in the short term, partially offsetting that with lower spending later on. The <a href="https://www.crfb.org/blogs/bipartisan-budget-act-means-return-trillion-dollar-deficits">2018</a> and <a href="https://www.crfb.org/blogs/policymakers-added-22-trillion-debt-2019">2019</a> budget deals under Trump increased the caps still further and barely included any offsets, driven largely by a Republican desire to restore defense spending.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="2krS7c">
Taking all these changes together, the Committee on a Responsible Federal Budget’s Goldwein told me, the Budget Control Act of 2011, the fruit of the debt ceiling crisis, resulted in $1.2 trillion or so in overall deficit reduction, less than the $2.1 trillion originally promised (due to the repeated deals which raised the budget caps) but still sizable. Overall spending was substantially lower from 2011 until the Covid-19 pandemic hit (and threw the federal budget into general chaos) than previously planned.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="duuKcY">
So, what did this all mean for actual users of government services? For some, the impact was temporary. Head Start, the pre-K program for low-income children, <a href="https://www.acf.hhs.gov/archive/blog/2013/08/numbers-are">kicked 57,000 kids off its rolls</a> when the sequestration hit. But <a href="https://eclkc.ohs.acf.hhs.gov/policy/pi/acf-pi-hs-14-01">the next year</a>, funding was restored and stayed roughly on track for the rest of the decade. Some affected spending categories actually rose dramatically over this period, most notably health care for veterans, which members of Congress prioritized in appropriations bills.
</p>
<figure class="e-image">
<img alt="A chart showing which categories of non-defense discretionary spending grew and fell between 2010 and 2021. An accessible table with the same data is available at the Center on Budget and Policy Priorities’s website." src="https://cdn.vox-cdn.com/thumbor/y3bTDc5xae8Y9wcSFX6of1_gOSk=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/24198849/3_25_21bud_f3.png"/> <cite><a class="ql-link" href="https://www.cbpp.org/research/federal-budget/boosts-in-non-defense-appropriations-needed-due-to-decade-of-cuts-unmet" target="_blank">Center on Budget and Policy Priorities</a></cite>
<figcaption>
Veterans’ health care funding grew dramatically, but every other category of non-defense discretionary spending fell after adjusting for inflation and population growth.
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="KJkkEA">
So what <em>did</em> suffer? The <a href="https://www.cbpp.org/research/federal-budget/boosts-in-non-defense-appropriations-needed-due-to-decade-of-cuts-unmet">Center on Budget and Policy Priorities’ David Reich</a> co-authored a category-by-category report and found that between 2010 and 2021, every single category of non-defense discretionary spending besides veterans’ programs saw declines after adjusting for inflation and population growth. Economic security, health care, and scientific research programs were close to stagnant, falling by 4 percent or less. But funding for environmental protection and parks fell by 15 percent; general government operations by 26 percent; education and job training by 14 percent; diplomacy and foreign aid by 19 percent; agriculture, energy, and commerce by 19 percent.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="28K5VZ">
Housing vouchers through the Section 8 program could not keep up with rents; the <a href="https://www.cbpp.org/research/housing/budget-caps-not-rent-aid-forcing-hud-budget-cuts">Center estimated</a> that between 2010 and 2017, voucher funding fell by 9 percent after adjusting for rent inflation. “We saw significant decreases in the number of families that were being served over that time,” Peggy Bailey, the Center’s vice president for housing and income security and a former senior adviser to HUD Secretary Marcia Fudge, told me.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="XAwRnE">
A <a href="https://www.aaas.org/news/budget-control-act-may-have-cost-over-200-billion-federal-rd">study from the American Association for the Advancement of Science</a> found that aggregate research and development spending from the federal government was $200 billion lower due to the Budget Control Act; health research from the National Institutes of Health and the VA fell by over $7 billion a year relative to previous historical trends, while the National Science Foundation got almost $2 billion a year less.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="WxFmki">
That was bad news for people interacting with government programs. The two biggest social assistance agencies in the US are the Social Security Administration (which administers old-age and disability payments) and the Internal Revenue Service, which administers tax credits that are crucial for reducing poverty. Adjusted for inflation, funding for the agencies <a href="https://www.cbpp.org/research/federal-budget/boosts-in-non-defense-appropriations-needed-due-to-decade-of-cuts-unmet#:~:text=Many%20Shortfalls%20and%20Unmet%20Needs%20Exist">fell by 13 and 19 percent</a> between 2010 and 2021, respectively.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="BRgrKq">
The IRS lost a third of its enforcement staff, rendering it incapable of going after many high-income tax cheats. The Inflation Reduction Act included a historic infusion of funds to fix this problem, but <a href="https://apnews.com/article/2022-midterm-elections-biden-kevin-mccarthy-newt-gingrich-border-security-97f04b6997ea980a868b8d7628378824">McCarthy has said the very first bill a GOP House passes</a> will be a measure to repeal those funds.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="RqZrHC">
The federal government isn’t the main source of funding for K-12 schools, but what grants it does make <a href="https://www.cbpp.org/research/federal-budget/boosts-in-non-defense-appropriations-needed-due-to-decade-of-cuts-unmet#:~:text=Many%20Shortfalls%20and%20Unmet%20Needs%20Exist">fell by 11 percent</a> from 2010 to 2021, adjusting for inflation.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="hCYqf3">
Perhaps the single worst category of cuts that took effect — given what followed — were to programs related to pandemic preparedness and effectiveness. As <a href="https://www.cbpp.org/research/federal-budget/boosts-in-non-defense-appropriations-needed-due-to-decade-of-cuts-unmet">Reich and Katie Windham note</a>, the Centers for Disease Control and Prevention’s budget fell by 7 percent from 2010 and 2021, and its grants to state and local public health agencies fell by 20 percent. That <a href="https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30182-1/fulltext">almost certainly hampered</a> America’s ability to anticipate and respond to pandemics like Covid-19, and almost certainly cost lives.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="i62SAq">
Some of these funding gaps were made up in 2020 and 2021 through the CARES Act and the American Rescue Plan. Those bills provided emergency rental assistance and supplemental funding to state governments that helped make up for years of declines in federal support for things like K-12 education. But those were emergency measures meant to assist states during an extraordinary historical moment. They didn’t guarantee adequate funding over the next decade.
</p>
<h3 id="ETdqXA">
What will a 2023 deal look like?
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="FOZkz3">
We do not know exactly how the new House majority will approach the debt ceiling. Maybe they’ll quietly approve increases and shrink away from a fight. Maybe Democrats will use <a href="https://www.vox.com/policy-and-politics/2022/11/15/23458878/lame-duck-congress-same-sex-marriage-protections">the lame-duck session</a> or a trillion-dollar coin to make the issue moot for good, or at least until 2025. Maybe Congress will suddenly decide that cutting Social Security and Medicare benefits while raising taxes on the middle class is a great idea.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="y4fWSK">
Anything’s possible! But personally, I’m steeling myself for a repeat of the 2011 budget deal, precisely because the dynamics that led to it narrowly focusing on a small sliver of the budget are still there. Republicans are still vehemently opposed to tax increases, and Democrats are equally vehemently opposed to tax hikes affecting all but the richest 1 percent or so of Americans. Social Security and Medicare are still hot potatoes, and while other “mandatory” programs like food stamps are less popular, Democrats have historically held firm against any cuts to them.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="9Nu3US">
That leaves discretionary programs, both defense and non-defense, covering everything from the FBI to medical research to our embassies abroad. Those programs took a severe battering during the 2010s under the Budget Control Act, and there’s every reason to expect them to take a battering in whatever deal emerges in 2023. The consequences are not straightforward to predict, but could weaken important parts of the government that have already been underfunded for a decade.
</p></li>
<li><strong>Republicans’ “candidate quality” problem sank their Senate chances</strong> -
<figure>
<img alt="A black-and-white photograph of Mitch McConnell walking through a door away from the camera." src="https://cdn.vox-cdn.com/thumbor/DaDCaqwx8OQhvf3C_KapKPwQMl4=/511x0:4606x3071/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/71634648/GettyImages_1423425982t.0.jpg"/>
<figcaption>
Senate Minority Leader Sen. Mitch McConnell (R-KY) returns to his office after a weekly Republican policy luncheon at the US Capitol on September 13, 2022. | Alex Wong/Getty Images
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Mitch McConnell was right.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="SOS6Df">
Back in August, Senate Minority Leader Mitch McConnell said Republicans would have a bit of a problem in their effort to retake the Senate: their candidates.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="RNFujd">
“I think there’s probably a greater likelihood the House flips than the Senate,” <a href="https://www.nbcnews.com/politics/2022-election/mcconnell-says-republicans-may-not-win-senate-control-citing-candidate-rcna43777">McConnell said</a>. “Senate races are just different — they’re statewide, candidate quality has a lot to do with the outcome.” The comment was widely interpreted as disparaging Trump-endorsed candidates with non-traditional political profiles or extreme views, who had won several GOP Senate primaries.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ETOhoN">
So, now that Republicans have indeed failed to retake the Senate, was McConnell right? Were they sunk by their poor-quality candidates?
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ZVh8vp">
The answer seems to be yes. In a more Republican year than 2020, five of eight GOP Senate candidates in competitive contests did not improve on Donald Trump’s 2020 margins — instead, they did even worse than he did.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="nKbdQ7">
Those worse-performing candidates were exactly who you might expect — Peter Thiel employee Blake Masters (AZ), celebrity doctor Mehmet Oz (PA), <a href="https://www.nytimes.com/2022/08/28/us/politics/don-buldoc-new-hampshire.html">election denier</a> Don Bolduc (NH), author J.D. Vance (OH), and scandal-plagued football star Herschel Walker.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="64mmKR">
Their poor performances contrast with the more “ordinary” GOP nominees — former Nevada attorney general Adam Laxalt, two-term incumbent Sen. Ron Johnson (WI), and Rep. Ted Budd (NC), who each outperformed Trump — though in Laxalt’s case, not by enough to win.
</p>
<figure class="e-image">
<img alt="Chart showing that 2022 GOP Senate candidates in AZ, PA, NH, OH, and GA did worse than Trump in 2020, while GOP candidates in WI, NV, and NC did better than him" src="https://cdn.vox-cdn.com/thumbor/G6e5n6N37yvcRjQWnUxQpCM5_fI=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/24199567/Screen_Shot_2022_11_15_at_3.01.33_PM.png"/> <cite>Andrew Prokop / Vox</cite>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="5CgzIE">
Devastatingly for Republicans, if they had run candidates who improved on Trump’s margin as much as Laxalt and Johnson did (1.6 percentage points) in Pennsylvania, Arizona, and Georgia, they would have won all three of those contests, averting a Georgia runoff and grabbing the Senate majority.
</p>
<h3 id="Nmw2hv">
Senate candidate quality, as compared to Trump’s performance
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="7CVVx5">
The intuitive way of assessing who’s a strong or a weak candidate is to just look at who won or lost, and at the size of their win or loss. But every candidate is running in a state or national political context, and a more sophisticated analysis should take into account these contexts.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="50Ri9z">
For instance, a Democrat who comes close to winning in a deep-red state but fall short should probably be thought of as a strong candidate — they did well considering how challenging their state is.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="DhYZGU">
So it’s useful to have a baseline for comparison, and the one I used for the above chart is Trump’s margin of victory or defeat in the same state in 2020. To be more specific:
</p>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="NzS7Uz">
Trump lost Arizona by 0.3 percentage points, Masters lost it by about 5.
</li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="SNoOHP">
Trump lost Pennsylvania by 1.2 percentage points, Oz lost it by 4.4
</li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="7AMlmy">
Trump lost New Hampshire by 7.4 percentage points, Bolduc lost it by 9.2
</li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="hqWjue">
Trump lost Georgia by 0.2 percentage points, Walker trailed Raphael Warnock in the first round by 1 point
</li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="5ZVElZ">
Even Vance, who won Ohio’s Senate race by 6.6 percentage points, underperformed Trump, who won the state by 8.
</li>
</ul>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="xUaFfp">
Then there are the candidates who improved on Trump:
</p>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="x2Fyo8">
Trump lost Nevada by 2.4 percentage points, and Laxalt lost it by 0.8 percentage points. So he did better than Trump, but not by enough to flip the seat.
</li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Jn7LVU">
Trump lost Wisconsin by 0.6 percentage points, and Johnson won it by 1 point.
</li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ILgSI9">
Trump won North Carolina by 1.3 percentage points, and Budd won it by 3.5.
</li>
</ul>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Fh8voz">
So by that baseline, Laxalt, Johnson, and Budd were decent candidates while the others were not. But that’s not the only baseline we could use.
</p>
<h3 id="x6nJc7">
Senate candidate quality, as compared to the national environment
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="yrl8dr">
Another context worth keeping in mind is the national one — that all these candidates were running in a year when the national popular vote appears to have shifted from favoring Democrats to favoring Republicans.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="APHwvB">
In 2020, Democrats won the House of Representatives popular vote by 3 percentage points. This year, Republicans are <a href="http://www.thegreenpapers.com/G22/HouseVoteByParty.phtml">currently leading it by 4.5 points</a>, though that margin will shrink as California tallies more votes. We don’t know what the final number will be, but let’s be conservative and assume the national environment shifted four points in favor of Republicans, as compared to 2020.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="RsOcOs">
With that baseline, every Republican in a competitive Senate race underperformed because no one managed to improve on Trump’s margin by four points. (Budd in North Carolina, who improved the most, only did so by 2.2 percentage points.)
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="0H41Pt">
Yet that doesn’t necessarily mean all the GOP nominees were bad candidates. Perhaps it points to a broader problem with the party’s brand that made voters in all these states hesitant to grant that party control of the Senate. Then, perhaps, some candidates did better than others in dealing with that constraint.
</p>
<h3 id="SglRL0">
Senate candidate quality, as compared to GOP governor nominees
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="pG0cHr">
Still, a national popular vote shift might be a misleading baseline because there were some very different trends in different states. In particular, Republicans sharply improved in New York and Florida, two populous states that affect the nationwide vote count significantly, but the GOP made more limited gains elsewhere.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="9j6hZZ">
So another potentially useful comparison is to check how Republican Senate candidates in competitive races did compared to their own party’s governor nominees in 2022.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="WiyHVT">
Here we see that in five of these seven contests with a governor’s race on the ballot (there was none in North Carolina), the GOP’s Senate candidates did worse.
</p>
<figure class="e-image">
<img alt="Chart showing GOP Senate nominees underperformed GOP governor nominees in NH, OH, GA, AZ, and NV while overperforming them in WI and PA" src="https://cdn.vox-cdn.com/thumbor/RLnr2JGTh4waoXztFgfrwRy_VBA=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/24199629/Screen_Shot_2022_11_15_at_3.23.04_PM.png"/> <cite>Andrew Prokop/Vox</cite>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="s4Zftw">
More specifically:
</p>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="y26nRp">
Bolduc, Vance, and Walker did dramatically worse than Govs. Chris Sununu, Mike DeWine, and Brian Kemp. Those governors were all helped by incumbency, but still, they managed to become broadly popular and win handily, and there were a lot of ticket-splitting voters in these states who backed them and Democratic Senate nominees.
</li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="GSKkGj">
In Arizona, Masters ran behind GOP gubernatorial nominee Kari Lake, and they both lost.
</li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="R4Wl3S">
In Nevada, both Laxalt and GOP governor nominee Joe Lombardo were challenging Democratic incumbents — but Lombardo won and Laxalt lost.
</li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="utqoXv">
Only in Wisconsin and Pennsylvania did the GOP Senate candidate do better than their governor candidate, though in Pennsylvania that is likely because Doug Mastriano was a disastrous governor nominee, not because Oz did particularly well.
</li>
</ul>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="4fZPef">
Again, this could be interpreted as meaning Republican Senate candidates were lower quality than their governor nominees — or that there was a general trend of voters being relatively more reluctant to hand the GOP control in competitive states.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="lqKoWD">
But notably, the best-performing Republican governors on this list — Sununu and DeWine, who each won by 15 percentage points — have appealed to centrists, at times battling with their party’s right flank. And Kemp is conservative, but he earned Trump’s ire by failing to interfere with Biden’s 2020 election win — which could have helped him appeal to centrists.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="1kTOIH">
Senate nominees in those states, by contrast, did nothing in particular to distance themselves from their party’s right, and merely hoped a Republican wave and disenchantment with Biden over the economy and crime would carry them to victory.
</p>
<h3 id="Z04J6s">
What about the Democrats’ candidate quality?
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="faR2l4">
Finally, this article has mainly discussed how well the Republican candidates did. But of course, those Republican candidates all had different opponents. Any instance of a Republican underperforming could also be read as one of a Democrat overperforming, and vice versa.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="bhuY0C">
By all of the above metrics, Blake Masters performed poorly in Arizona. He had never run for office before being propelled to the GOP nomination with billionaire Peter Thiel’s money and <a href="https://www.axios.com/2022/06/03/trump-endorsement-blake-masters-arizona-senate-primary">Trump’s endorsement</a>, and there were always questions about his general election appeal. The <a href="https://www.nytimes.com/2022/11/12/us/politics/midterm-elections-officials.html">New York Times’s Shane Goldmacher reported</a> that one Republican operative claimed Masters “had scored the worst focus group results of any candidate he had ever seen.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="DZKBXR">
Still, his opponent Mark Kelly likely deserves credit too. Kelly was also on the ballot in Arizona in 2020, and he outperformed Biden then too — suggesting some intrinsic strength as a candidate (he’s a former astronaut!).
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="EqcThn">
In Pennsylvania, John Fetterman and Tim Ryan both branded themselves as different types of Democrats with more populist appeal, and they outperformed Biden. However, Maggie Hassan, a pretty traditional Democrat, also outperformed Biden’s margin, as did Raphael Warnock.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="OJrLnX">
Meanwhile, Mandela Barnes in Wisconsin faced attacks for being too far left and underperformed both Biden and his party’s incumbent governor, Tony Evers (who won). Catherine Cortez Masto in Nevada ran mainly as a generic Democrat, but she also underperformed Biden — though she won and outperformed her party’s incumbent governor, Steve Sisolak (who lost). Overall it’s a mixed picture, and it’s difficult to draw clear generalizable lessons about which sorts of Democrats did better or worse.
</p>
<h3 id="TW2w5A">
The big picture
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="5qKyj0">
Zeroing in on the contests that truly determined Senate control: In 2020, Biden won Georgia by 0.2 percentage points, Arizona by 0.3 percentage points, and Pennsylvania by 1.2 percentage points. These were close states that one would think would be ripe for Republican Senate candidate victories in a more Republican-leaning year, as 2022 was. Yet Walker, Masters, and Oz, Trump’s endorsed candidates, performed notably worse than Trump had two years earlier.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="aGRVoh">
Meanwhile, in Nevada, Adam Laxalt (also Trump-endorsed but a more traditionally qualified Republican) improved on Trump’s margin by 1.6 percentage points. Though he still lost, that might suggest a Laxalt-like nominee could have flipped Georgia (averting a runoff), Arizona, and Pennsylvania. If Republicans had flipped all three, the Senate would be theirs.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Zbyfnp">
Still, we can’t say for sure that a more ordinary Republican would have defeated the actual candidates in these races — Warnock, Kelly, and Fetterman — because those Democrats have their own strengths as candidates too.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="wrtfui">
And even Laxalt underperformed the national environment, which shifted right by more than his race did. He also underperformed his own party’s governor nominee on the same ballot, and so did several other GOP Senate candidates elsewhere. This could suggest that, for Republicans to win more Senate races in competitive states like this, their candidates should distance themselves more from the party’s right — that, except in a red wave year, being a generic Republican challenger isn’t enough.
</p></li>
</ul>
<h1 data-aos="fade-right" id="from-the-hindu-sports">From The Hindu: Sports</h1>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>FIFA World Cup 2022 | Full Brazil squad and schedule</strong> - Here is the official Brazil national football team squad and their group G stage schedule for the FIFA World Cup 2022</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>FIFA World Cup 2022 | Costa Rica full squad and schedule</strong> - Here is the official Costa Rica national football team squad and their group E stage schedule for the FIFA World Cup 2022</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>They have the talent, but will the Dutch finally achieve the ultimate glory?</strong> - Senegal, the Africa Cup of Nations winner, has a strong reason to believe in its strength and ability; Ecuador will look to carry on its form from the qualifiers; host Qatar’s aim will be to cause a few upsets in its first appearance at the global extravaganza</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Synthesis, Knight In Hooves, Priceless Gold and Touch Of Grey shine</strong> -</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Emrys pleases</strong> -</p></li>
</ul>
<h1 data-aos="fade-right" id="from-the-hindu-national-news">From The Hindu: National News</h1>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>3 tiger cubs whose mother was snared tracked in Nagarahole</strong> - All are safe and found to be hunting on their own</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>PM Modi is no longer appealing to people of Gujarat: Jignesh Mevani</strong> - Congress leader Jignesh Mevani pitches for a Congress surge in the 2022 Gujarat Assembly elections</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Governor draws a monthly salary of ₹3.50 lakh</strong> - Raj Bhavan employs 165 staff, as revealed by two Right to Information applications</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Excise Policy case: Delhi court allows businessman Dinesh Arora to turn approver</strong> - The court had earlier granted anticipatory bail to Mr. Arora after the CBI didn't opposed his petition.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Govt says masks no more compulsory during air travel</strong> - The latest decision has been taken in line with the government's policy of a graded approach to COVID-19 management response.</p></li>
</ul>
<h1 data-aos="fade-right" id="from-bbc-europe">From BBC: Europe</h1>
<ul>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Ukraine war: Poland says missile deaths an unfortunate incident</strong> - Nato ambassadors meet in Brussels after two people are killed in a strike inside Poland’s borders.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Russian anger as UN calls for reparations over invasion of Ukraine</strong> - In a largely symbolic move, the UN found that Russia should be held accountable for its conduct.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Ukraine: Zelensky snubs Russia as he addresses ‘G19’ at G20</strong> - Ukraine’s president called on world leaders to end the war, and extend a crucial grain deal.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Netherlands to ban laughing gas from January</strong> - Authorities hope to reduce the number of accidents on Dutch roads involving people using the drug.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Mondrian painting sells for record $51m at auction</strong> - A 1930s painting by the Dutch artist has sold for $51m (£43m) in New York - a record for his work.</p></li>
</ul>
<h1 data-aos="fade-right" id="from-ars-technica">From Ars Technica</h1>
<ul>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>NASA gets its mojo back with a stunning nighttime launch of the SLS rocket</strong> - The US space agency had not launched an orbital rocket since 2011. - <a href="https://arstechnica.com/?p=1898017">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The Snapdragon 8 Gen 2 brings Wi-Fi 7, sticks with some 32-bit support</strong> - Features 32-bit support, Wi-Fi 7, the AV1 codec, and hardware ray tracing. - <a href="https://arstechnica.com/?p=1897640">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Hobbyist adds a hinge to the Game Boy Pocket, delighting everyone</strong> - No, it’s not a Game Boy Advance SP. This is the monochrome Pocket with hinge. - <a href="https://arstechnica.com/?p=1898074">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Study: Ötzi the Iceman probably thawed and refroze several times</strong> - This would increase the odds of finding another prehistoric human body in melting ice. - <a href="https://arstechnica.com/?p=1897727">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Right-wing doctor group led by anti-vaccine insurrectionist implodes in scandal</strong> - Simone Gold used charity funds to buy $3.6M house, group leaders claim. - <a href="https://arstechnica.com/?p=1898062">link</a></p></li>
</ul>
<h1 data-aos="fade-right" id="from-jokes-subreddit">From Jokes Subreddit</h1>
<ul>
<li><strong>If all dogs go to heaven, where do cats go?</strong> - <!-- SC_OFF -->
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Purrrgatory
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/spatialflow"> /u/spatialflow </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/ywgm2d/if_all_dogs_go_to_heaven_where_do_cats_go/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/ywgm2d/if_all_dogs_go_to_heaven_where_do_cats_go/">[comments]</a></span></p></li>
<li><strong>A guy driving a Kia.</strong> - <!-- SC_OFF -->
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
A guy driving a Kia pulls up at a stoplight next to a Rolls-Royce…
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The driver of the Kia rolls down his window and shouts to the driver of the Rolls, “Hey, buddy, that’s a nice car. You got Wi-Fi in your Rolls? I’ve got Wi-Fi in my Kia!”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The driver of the Rolls looks over and says simply, “Yes I have Wi-Fi.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The driver of the Kia says, “Cool! Hey, you got a fridge in there too? I’ve got a fridge in the back seat of my Kia!”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The driver of the Rolls, looking annoyed, says, “Yes, I have a refrigerator.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The driver of the Kia says, “That’s great, man! Hey, you got a TV in there, too? You know, I got a TV in the back seat of my Kia!”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The driver of the Rolls, looking very annoyed by now, says, “Yes, I have a television, a Rolls-Royce is the finest luxury car in the world!”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The driver of the Kia says, “That’s a very cool car! Hey, you got a bed in there, too? I got a bed in the back of my Kia!”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Upset that he did not have a bed, the driver of the Rolls-Royce sped away. He went straight to the dealer, where he promptly ordered that a bed be installed in the back of the Rolls. The next morning, the driver of the Rolls picked up his car. The bed looked superb, complete with silk sheets and brass trim. It was clearly a bed fit for a Rolls Royce.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
So, the driver of the Rolls drove around all day looking for the Kia…
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Finally, late that night, he finds the Kia parked, with all the windows fogged up from the inside. The driver of the Rolls gets out of his car and knocks on the Kia’s window. At first there is no answer, then the owner sticks his head out, soaking wet.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“I now have a bed in the back of my Rolls-Royce,” the driver of the Rolls said arrogantly.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The driver of the Kia says… “You got me out of the shower to tell me that?!”
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/harrygatto"> /u/harrygatto </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/yvy1gt/a_guy_driving_a_kia/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/yvy1gt/a_guy_driving_a_kia/">[comments]</a></span></p></li>
<li><strong>I quit my position as a scuba diving instructor the first day at my job.</strong> - <!-- SC_OFF -->
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Deep down, I realized it wasn’t for me.
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/porichoygupto"> /u/porichoygupto </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/ywjols/i_quit_my_position_as_a_scuba_diving_instructor/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/ywjols/i_quit_my_position_as_a_scuba_diving_instructor/">[comments]</a></span></p></li>
<li><strong>A genie grants three wishes to an old lady.</strong> - <!-- SC_OFF -->
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
She says, “I want to be young again.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
<em>poof</em>
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
She’s young again.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“I want my little house to be turned into a beautiful mansion.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
<em>poof</em>
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
She’s now living in a beautiful mansion.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“I want my cat to be turned into a handsome young man!”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
<em>poof</em>
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Her cat is now a handsome young man.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“Oh cat, all my fantasies have come true! Take me in your arms, take me upstairs and make mad, passionate love to me!”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The cat says, “Oh darlin’, you should’ve thought about that a long time ago, before you had me fixed.”
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/LadeeAlana"> /u/LadeeAlana </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/ywpn70/a_genie_grants_three_wishes_to_an_old_lady/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/ywpn70/a_genie_grants_three_wishes_to_an_old_lady/">[comments]</a></span></p></li>
<li><strong>In a small town, a doctor is about to retire and a young colleague comes to replace him.</strong> - <!-- SC_OFF -->
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
They visit all the patients together, and the old doctor introduces the young one everywhere.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“Doctor, I’ve been having a constant stomach ache lately.” cries one of the patients.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The old doctor answers,
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“Didn’t you eat too much fruit? I think you should eat less, that’ll make you okay.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
As the two doctors leave the house, the young man wonders,
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“How could you make a diagnosis so quickly? You didn’t even examine the lady.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“Simple. I dropped my stethoscope, and as picking it up, I saw that the trash can under the table was full of banana peels. I immediately realized what was wrong.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
They move on to the next house, where they are greeted by another lady.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
It’s the young doctor’s turn.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“Doctor, I’ve been feeling exhausted and weak lately.” says the lady.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“Well, ma’am, maybe you should do less volunteering for the church and get more rest.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
As they leave, the surprised old doctor asks his colleague,
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“How did you know that? After all, you didn’t even examine the lady, and you don’t even know her.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“Simple. I dropped my stethoscope, and as picking it up, I saw the priest under the bed.”
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/joke_channel"> /u/joke_channel </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/yw76wh/in_a_small_town_a_doctor_is_about_to_retire_and_a/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/yw76wh/in_a_small_town_a_doctor_is_about_to_retire_and_a/">[comments]</a></span></p></li>
</ul>
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