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<title>27 March, 2023</title>
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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>Novel emm4 lineage associated with an upsurge in invasive group A streptococcal disease in the Netherlands, 2022</strong> -
<div>
Invasive group A streptococcal (iGAS) disease cases increased in the first half year of 2022 in the Netherlands with a remarkably high proportion of emm4 isolates. Whole-genome sequence analysis of 66 emm4 isolates, 40 isolates from the pre-COVID-19-pandemic period 2009-2019 and 26 contemporary isolates from 2022, identified a novel Streptococcus pyogenes lineage (M4NL22), which accounted for 85% emm4 iGAS cases in 2022. Surprisingly, we detected few isolates of the emm4 hypervirulent clone, which has replaced nearly all other emm4 in the USA and the UK. M4NL22 displayed genetic differences compared to other emm4 strains, although these were of unclear biological significance. In publicly available data, we identified a single Norwegian isolate belonging to M4NL22, which was sampled after the isolates from this study, possibly suggesting export of M4NL22 to Norway. In conclusion, our study identified a novel S. pyogenes emm4 lineage underlying an increase of iGAS disease in early 2022 in the Netherlands and results have been promptly communicated with public health officials.
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<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2022.12.31.522331v3" target="_blank">Novel emm4 lineage associated with an upsurge in invasive group A streptococcal disease in the Netherlands, 2022</a>
</div></li>
<li><strong>Disruptiveness of COVID-19: Differences in Course Engagement, Self-appraisal, and Learning</strong> -
<div>
We investigated how the transition to remote instruction amidst the COVID-19 pandemic affected students’ engagement, self-appraisals, and learning in advanced placement (AP) Statistics courses. Participants included 681 (Mage=16.7 years, SDage=.90; %female=55.4) students enrolled in the course during 2017-2018 (N=266), 2018-2019 (N=200), and the pandemic-affected 2019-2020 (N=215) year. Students enrolled during the pandemic-affected year reported a greater improvement in affective engagement but a decrease in cognitive engagement in the spring semester relative to a previous year. Females enrolled in the pandemic-affected year experienced a greater negative change in affective and behavioral engagement. Students enrolled during the pandemic-affected year reported a greater decrease in their anticipated AP exam scores and received lower scores on a practice exam aligned with the AP exam compared to a prior year. Though resilient in some respects, students’ self-appraisal and learning appeared negatively affected by pandemic circumstances.
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<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://psyarxiv.com/b2pxd/" target="_blank">Disruptiveness of COVID-19: Differences in Course Engagement, Self-appraisal, and Learning</a>
</div></li>
<li><strong>The potential contribution of vaccination uptake to occupational differences in risk of SARS-CoV-2: Analysis of the ONS COVID-19 Infection Survey</strong> -
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Objectives To assess variation in vaccination uptake across occupational groups as a potential explanation for variation in risk of SARS-CoV-2 infection. Design We analysed data from the UK Office of National Statistics COVID-19 Infection Survey linked to vaccination data from the National Immunisation Management System in England from December 1st 2020 to 11th May 2022. We analysed vaccination uptake and SARS-CoV-2 infection risk by occupational group and assessed whether adjustment for vaccination reduced the variation in risk between occupational groups. Setting Results Estimated rates of triple-vaccination were high across all occupational groups (80% or above), but were lowest for food processing (80%), personal care (82%), hospitality (83%), manual occupations (84%), and retail (85%). High rates were observed for individuals working in health (95% for office-based, 92% for those in patient-facing roles) and education (91%) and office-based workers not included in other categories (90%). The impact of adjusting for vaccination when estimating relative risks of infection was generally modest (ratio of hazard ratios reduced from 1.38 to 1.32), but was consistent with the hypothesis that low vaccination rates contribute to elevated risk in some groups. Conversely, estimated relative risk for some occupational groups, such as people working in education, remained high despite high vaccine coverage. Conclusions Variation in vaccination coverage might account for a modest proportion of occupational differences in infection risk. Vaccination rates were uniformly very high in this cohort, which may suggest that the participants are not representative of the general population. Accordingly, these results should be considered tentative pending the accumulation of additional evidence.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.03.24.23287700v1" target="_blank">The potential contribution of vaccination uptake to occupational differences in risk of SARS-CoV-2: Analysis of the ONS COVID-19 Infection Survey</a>
</div></li>
<li><strong>Clinical Evaluation of Post-Surgical Scar Hyperesthesia; an Exploratory Longitudinal Study</strong> -
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Introduction: Evidence for the objective clinical evaluation of scar hyperesthesia is lacking. This exploratory study investigated the clinical relevance and responsiveness of objective scar evaluation measures in adults following hand surgery. Methods: With ethical approval and consent, participants were enrolled from one NHS hospital. Patient reported and investigator completed scar morphology, cosmesis, pain and function were evaluated at 1- and 4-months post-surgery. Statistical analysis investigated the responsiveness of outcome measures and association of physical measures with the Palmar Pain Severity Scale (PPS). Results: 21 participants enrolled prior to premature study closure due to the COVID-19 pandemic; 13 completed follow up. Scar pain (p=.002); scar interference (PPI [p=.009]) and Brief Pain Inventory (BPI) scores (p=.03) improved. Neuropathic Pain Symptom Inventory (NPSI) scores demonstrated heterogeneity in scar pain; evoked pain predominated. Patient Scar Assessment Questionnaire (PSAQ) indicated improvement in cosmetic dissatisfaction and consciousness (p=.03; p=.003), respectively. Baseline psychological screening scores correlated with scar pain (p=.04), and interference (p&lt; .001). Scar morphology, pliability and inflammation were not associated with scar pain. Significant differences in scar mechanical pain sensitivity (p=.04) and cold pain threshold (p=.05) were identified. Discussion: PPS and PPI scores were responsive in a heterogeneous hand surgery sample. BPI worst pain identified severe pain, suggesting composite scar pain scores are required. The PSAQ robustly measured scar appearance and consciousness. Psychophysical tests of mechanical and thermal sensitivity are potential candidate objective measures of scar hyperesthesia. The NPSI demonstrates clinical utility for exploring scar pain symptoms and may support the elucidation of the drivers of persistent scar pain.
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<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.03.25.23287735v1" target="_blank">Clinical Evaluation of Post-Surgical Scar Hyperesthesia; an Exploratory Longitudinal Study</a>
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<li><strong>Used paper tissues for pathogen identification in acute respiratory infection.</strong> -
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We investigated the potential of used paper tissues as a non-invasive sampling method for the diagnosis of acute respiratory infections. The method allowed the identification and typing of respiratory pathogens in symptomatic individuals, as well as in collective samples taken at a community level. The collection of used paper tissues could therefore be useful in epidemiological surveillance for SARS-CoV-2 and other respiratory pathogens such as influenzavirus, respiratory syncytial virus, entero/rhinoviruses and Streptococcus pneumoniae.
</p>
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.03.24.23287683v1" target="_blank">Used paper tissues for pathogen identification in acute respiratory infection.</a>
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<li><strong>An appraisal of the scope of domestic tourism in Dooars foothills tourist circuit in the post-pandemic scenario</strong> -
<div>
COVID-19 has wreaked havoc on world economy including tourism and hospitality industry. While international tourism has been on a slump for most of the last three years, people and organisations involved in the sector need to focus on domestic tourism for a slow but steady turn around. India with a huge share of annual domestic tourists is better positioned to cope up with this scenario. Tourism Department, Govt. of West Bengal has been promoting and developing different tourist circuits in the state for the last two decades. Dooars circuit, located in a comparatively backward region in the northern foothills of the state deserves more attention. With various kinds of tourist spots and events, it attracts visitors throughout the year. Impact of the pandemic and subsequent lockdown has been felt here too. The tourism sector has suffered a setback and most of the people associated with it, have lost their earning and livelihood. Thus promoting domestic tourism in Dooars is the only feasible way to protect the industry and its workers. The present paper attempts to make an appraisal of the tourism infrastructure and services available at different tourist attractions spread over the region. It aims to suggest some policies for improvement of the tourism scenario in general and domestic tourism in particular.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://osf.io/preprints/socarxiv/r7vgk/" target="_blank">An appraisal of the scope of domestic tourism in Dooars foothills tourist circuit in the post-pandemic scenario</a>
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<li><strong>Longitudinal wastewater surveillance addressed public health priorities during the transition from “dynamic COVID-zero” to “opening up” in China: a population-based study</strong> -
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Background Wastewater surveillance provides real-time, cost-effective monitoring of SARS-CoV-2 transmission. We developed the first city-level wastewater warning system in mainland China, located in Shenzhen. Our study aimed to reveal cryptic transmissions under the “dynamic COVID-zero” policy and characterize the dynamics of the infected population and variant prevalence, and then guide the allocation of medical resources during the transition to “opening up” in China. Methods In this population-based study, a total of 1,204 COVID-19 cases were enrolled to evaluate the contribution of Omicron variant-specific faecal shedding rates in wastewater. After that, wastewater samples from up to 334 sites distributed in communities and port areas in two districts of Shenzhen covering 1.74 million people were tested daily to evaluate the sensitivity and specificity of this approach and were validated against daily SARS-CoV-2 screening. After the public health policy was switched to “opening up” in December 7, 2022, we conducted wastewater surveillance at wastewater treatment plants and pump stations covering 3.55 million people to estimate infected populations using model prediction and detect the relative abundance of SARS-CoV-2 lineages using wastewater sequencing. Findings In total, 82.4% of SARS-CoV-2 Omicron cases tested positive for faecal viral RNA within the first four days after the diagnosis, which was far more than the proportion of the ancestral variant. A total of 27,759 wastewater samples were detected from July 26 to November 30 in 2022, showing a sensitivity of 73.8% and a specificity of 99.8%. We further found that wastewater surveillance played roles in providing early warnings and revealing cryptic transmissions in two communities. Based on the above results, we employed a prediction model to monitor the daily number of infected individuals in Shenzhen during the transition to “opening up” in China, with over 80% of the population infected in both Futian District and Nanshan District. Notably, the prediction of the daily number of hospital admission was consistent with the actual number. Further sequencing revealed that the Omicron subvariant BA.5.2.48 accounted for the most abundant SARS-CoV-2 RNA in wastewater, and BF.7.14 and BA.5.2.49 ranked second and third, respectively, which was consistent with the clinical sequencing. Interpretation This study provides a scalable solution for wastewater surveillance of SARS-CoV-2 to provide real-time monitoring of the new variants, infected populations and facilitate the precise prediction of hospital admission. This novel framework could be a One Health system for the surveillance of other infectious and emerging pathogens with faecal shedding and antibiotic resistance genes in the future. Funding Sanming Project of Medicine in Shenzhen, Shenzhen Key Medical Discipline Construction Fund.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.03.25.23287563v1" target="_blank">Longitudinal wastewater surveillance addressed public health priorities during the transition from “dynamic COVID-zero” to “opening up” in China: a population-based study</a>
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<li><strong>Seventy Years of Mortality Transition in India 1950-2021</strong> -
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Mortality in India remains high by international standards. This paper analyses mortality transition in India during the 70 years since 1950 based on the annual estimates of age-specific probabilities of death prepared by the United Nations Population Division for the period 1950-2021. The analysis reveals that characterisation of mortality transition is sensitive to the summary index of mortality used. Mortality transition in India based on the geometric mean of the age-specific probabilities of death is found to be different from that based on the life expectancy at birth. The transition in mortality based on the geometric mean of age-specific probabilities of death accelerated during 2008-2019 but decelerated when based on the life expectancy at birth. The reason is that mortality transition in younger ages has been faster than mortality transition in older ages. The analysis also reveals that there were around 4.3 excess deaths associated with the COVID-19 epidemic in the country leading to a loss of around 3.7 years in the life expectancy at birth between 2019 and 2021.
</p>
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<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.03.24.23287189v1" target="_blank">Seventy Years of Mortality Transition in India 1950-2021</a>
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<li><strong>The impact of the Covid-19 pandemic on young people from black and mixed-ethnic groups’ mental health: A qualitative study</strong> -
<div>
Author Notes <strong>This manuscript has been submitted for publication and is likely to be edited as part of the peer-review process. Correspondence regarding this paper should be addressed to Dr Keri Ka-Yee Wong, keri.wong@ucl.ac.uk</strong> Abstract Objectives The Covid-19 pandemic has disproportionately impacted vulnerable groups’ physical and mental health, especially young people and minority ethnic groups, yet little is known about how this is taking place and what support they would like. To address this gap, this qualitative study aims to uncover the effect of the Covid-19 outbreak on young people with ethnic minority backgrounds’ mental health, how this changed since the end of lockdown and what support they need to cope with these issues. Setting and Participants Ten 20-minute in-person semi-structured interviews were conducted with young people aged 12 to 17 years old from black and mixed-ethnic groups who regularly attend a community centre in West London. Results Through Interpretative Phenomenological Analysis, results indicated that the participants’ mental health was negatively impacted by the Covid-19 pandemic, with feelings of loneliness being the most common experience. However, positive effects were concurrently observed including improved well-being and better coping strategies post-lockdown, which is a testament to the young people’s resilience. That said, it is clear that young people from minority ethnic backgrounds lacked support during the Covid-19 pandemic and would now need psychological, practical and relational assistance to cope with these challenges. Conclusions Whilst future studies would benefit from a larger ethnically-diverse sample, this is a start. Study findings have the potential to inform future government policies around mental health support and access for young people from ethnic minorities, notably prioritising support for grassroots initiatives during times of crisis. Strengths and limitations • This qualitative interview study during Covid-19 gives voice to the experiences of young people from black and mixed-ethnic backgrounds in the UK • The in-person quality of the interviews helped build rapport between the researcher and the young people and sharing of sensitive issues around mental health access and support, increasing the results’ validity • This is a convenient sample, with girls and those aged 15 years and above being disproportionately represented in our data as they provided most of the answers. • The small sample size and lack of ethnic diversity limits the generalisability of the study to individuals from other ethnic minority groups.
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<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://osf.io/fe36p/" target="_blank">The impact of the Covid-19 pandemic on young people from black and mixed-ethnic groups’ mental health: A qualitative study</a>
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<li><strong>Intra-Host Mutation Rate of Acute SARS-CoV-2 Infection During the Initial Pandemic Wave</strong> -
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Background: Our understanding of SARS-CoV-2 evolution and mutation rate is limited. The rate of SARS-CoV-2 evolution is minimized through a proofreading function encoded by NSP-14 and may be affected by patient comorbidity. Current understanding of SARS-CoV-2 mutational rate is through population based analysis while intra-host mutation rate remains poorly studied. Methods: Viral genome analysis was performed between paired samples and mutations quantified at allele frequencies (AF) [≥]0.25, [≥]0.5 and [≥]0.75. Mutation rate was determined employing F81 and JC69 evolution models and compared between isolates with ({Delta}NSP-14) and without (wtNSP-14) non-synonymous mutations in NSP-14 and by patient comorbidity. Results: Forty paired samples with median interval of 13 days [IQR 8.5-20] were analyzed. The estimated mutation rate by F81 modeling was 93.6 (95%CI:90.8-96.4], 40.7 (95%CI:38.9-42.6) and 34.7 (95%CI:33.0-36.4) substitutions/genome/year at AF [≥]0.25, [≥]0.5, [≥]0.75 respectively. Mutation rate in {Delta}NSP-14 were significantly elevated at AF&gt;0.25 vs wtNSP-14. Patients with immune comorbidities had higher mutation rate at all allele frequencies. Discussion: Intra-host SARS-CoV-2 mutation rates are substantially higher than those reported through population analysis. Virus strains with altered NSP-14 have accelerated mutation rate at low AF. Immunosuppressed patients have elevated mutation rate at all AF. Understanding intra-host virus evolution will aid in current and future pandemic modeling.
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<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.03.24.534062v1" target="_blank">Intra-Host Mutation Rate of Acute SARS-CoV-2 Infection During the Initial Pandemic Wave</a>
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<li><strong>Concerns about data integrity of 30 randomized clinical trials from one author.</strong> -
<div>
Introduction In 2021, we learnt about the problems in studies on ivermectin and hydrocholoroquine in COVID-19. We noticed an appreciable number of unfunded randomised clinical trials (RCTs) on the treatment of COVID-19 conducted across three centres in Egypt (Tanta University, Assiut University, Ain-shams University) on COVID-19 patients with similar inclusion criteria and overlapping time frames. Dr Sherief M Abd-Elsalam ran seven such RCTs across these three centres; four of these RCTs have since been retracted. We therefore set out to systematically analyse the integrity of all RCTs (co-)authored by Dr Abd-Elsalam, in particular 23 RCTs on Gastroenterology and Hepatology. Methods We searched PubMed, Google Scholar, Scopus and clinical trial registries for RCTs published by Dr Sherief M Abd-Elsalam, affiliated with the Department of Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta University, Tanta, Egypt. We assessed trial registration, tables for identical data values, statistical errors, and improbable data trends. We assessed the probability of true randomization by assessing baseline characteristics through a Monte Carlo Analysis. Results We report on 30 published randomized control trials (RCTs) of Dr. Sherief Abd-Elsalam, in particular 23 RCTs on Gastroenterology and Hepatology. We found important issues in all RCTs examined. Of these 23 RCTs, 10 RCTs had substantial trial registration inconsistencies. Only one of these 10 RCTs has been retracted to date. We found nine RCTs with substantial statistical mistakes, five RCTs with similarities between tables unlikely to happen by chance, four RCTs with implausible Gaussian distributions, three RCTs in which almost all dichotomous variables had even values, while part of at least one study was plagiarized. Monte Carlo analysis indicated that the probability that distribution of baseline characteristics due to randomisation was 0.0000228. According to the trial registration, Dr. Abd-Elsalam is coordinating 76 clinical trials with 45 trials currently marked as ‘Recruiting’ and 17 trials marked as ‘Unknown Status’ as of November 2022. Interpretation We strongly recommend a thorough investigation of the data integrity of all RCTs by Dr Sherief M Abd-Elsalam by journal editors. Until the completion of such an investigation, we suggest that none of these studies are used to inform clinical practice.
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🖺 Full Text HTML: <a href="https://osf.io/vjcnp/" target="_blank">Concerns about data integrity of 30 randomized clinical trials from one author.</a>
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<li><strong>False Information Literacy During the Covid-19 Pandemic</strong> -
<div>
The COVID-19 pandemic is a confusing time. Because COVID-19 was a new evolution of a virus, much of the information surrounding it was ever-evolving. Although a vaccine was quickly developed, and it was approved by the FDA for emergency use, people were still skeptical of its efficacy and safety. Malicious internet users chose to spread mis- and disinformation about the vaccine. An explosion of information literacy has accompanied the spread of misinformation. Specifically, people used the internet to combat misinformation and spread true information about both the virus and its corresponding vaccine. By using a case study of an article, I choose to explore the methods in which malicious users spread misinformation and specifically the language used to spread this misinformation. While doctors and other public health experts have used the internet to argue against misinformation, malicious users have also used their medical qualifications, applicable or otherwise, to demonstrate credibility. Similarly, arguments such as “believe science” or “trust the evidence” have been twisted to spread misinformation. Finally, visualizations showing a false relationship between otherwise-unrelated topics spread quickly. While information literacy is an important tool, malicious users have co-opted the language used to obtain credibility. Identifying the forms that this false information literacy takes is one step in understanding how to combat it.
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🖺 Full Text HTML: <a href="https://osf.io/mdwrx/" target="_blank">False Information Literacy During the Covid-19 Pandemic</a>
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<li><strong>The COVID-19 impact on tuberculosis incidence notification in India- A comparative study (2017-2022)</strong> -
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Abstract - Despite modern drugs treatment with 60 years of chemotherapy and 90 years of vaccination with various strategies to prevent and control tuberculosis (TB), globally TB ranks 13th in leading causes of mortality. In recent year 2021 Worldwide, TB ranks 2nd after COVID-19, in leading causes of infectious killer, killing about 1.6 million people in 2021 (including 187 000 people infected with HIV). During COVID-19 era 2020, very significant global reduction in TB incidence was detected, which suddenly reduced from 7.1 million in 2019, to 5.8 million in 2020 (–18 percent). Globally, India is listed among the top three countries accounting for 67percent of this global reduction in TB incidence, besides Indonesia and the Philippines. As per data of The World Bank, India’s annual TB incidence was falling continuously since 2000, rose again and reached 210/100,000 in 2021 from 204/100,000 in 2020. A modelling analysis study found that lockdown has induced 80 percent reduction in TB notification rates in India. India ranks fourth in infection and death from COVID-19; hence there is a possibility that slowing down of COVID-19 will unmask the TB cases and deaths leading to increase in the count of TB in future years. In spite of several similarities in manifestation and differences in aetiology, there is still lack of full knowledge about the epidemiological relationship between TB and COVID-19 .To know the real situation and scenario of TB cases this study was started with aim to alert policy maker for needful action to control TB effectively in time. This study aimed to know the impact of COVID-19 on annual TB notifications incidence in India. This is a cross-sectional, quantitative, retrospective, deductive study. This research study included all the 36 states and UTs of India. We performed a linear regression study of the existing data of pre pandemic years included in this study for calculating a counterfactual analysis in order to find out the possible real incidence of TB cases notifications, which may have been notified if the current natural intervention of COVID-19 had not taken place. The annual number of new (TB) cases detected during the pre-COVID-19 period as well as COVID-19 period of this study has shown similar trends separately. During both periods the number of new (TB) cases increased in consecutive years. Another significant finding of this study is that the number of new (TB) cases detected during the first two COVID-19 years i.e. 2020 and 2021 decreased in comparison to last pre-COVID-19 year i.e. 2019. The base year of this study i.e. 2017 are having least whereas the last year of this study i.e. 2022 are having the largest number of new (TB) cases detected in one individual year. There is an increase of 7.79 percent in TB case detection during the COVID-19 period of this study. This study revealed that during first COVID-19 year i.e. 2020 there is significant reduction in number of new (TB) cases detected by 580869 numbers or 24.29 percent in comparison to last pre-COVID-19 year i.e. 2019. The number of new (TB) cases detected increased continuously during pre-COVID-19 years by 29.59 percent in 2018 and 18.49 percent in 2019. The question arises from this study is that, is it possible to achieve the goal of NTEP by year 2025 in current scenario reality?
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🖺 Full Text HTML: <a href="https://osf.io/wucgb/" target="_blank">The COVID-19 impact on tuberculosis incidence notification in India- A comparative study (2017-2022)</a>
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<li><strong>Obesity and Smoking: A Tale of 2 Risk Factors with Implications for the Next Pandemic</strong> -
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Background: In 1990, two risk factors that would figure prominently in the COVID-19 pandemic were on divergent paths in the US. The smoking rate was 23.5% and dropped to 13.5% in 2021, while the obesity rate was 11.5% and increased 186% to 33.0%. Objective: The study objective was to compare the global impact of those risk factors on COVID deaths to help prepare the US for future pandemics. Methods: Stata and Excel were used to regress global COVID deaths on obesity and smoking before and after vaccines were available, and US deaths/day were compared pre-and post-vaccines. Results: Obesity was associated with global COVID deaths, with R2 as high as 0.87 for cumulative data with slightly lower R2 and coefficients for post-vaccines. For 9 regressions of deaths on obesity, all P values (overall and coefficients) were &lt;0.05 while for regressions on smoking, no P values were &lt; 0.05. Of the 1.1 million US deaths, the death rate/day post-vaccines was 59% of that pre-vaccines. If the US obesity rate had remained 11.5%, estimates suggest 800,000+ lives could have been saved. US smoking rate was reduced 42% by multiple strategies using support from a 1998 multi-billion-dollar settlement between states and tobacco companies. Conclusion: Vaccines have limited ability to reduce total COVID deaths, with obesity remaining a key factor in death rates. Results suggest that lower obesity rates are needed to further reduce US COVID deaths, potentially saving thousands of lives in future pandemics. Lessons from reducing smoking rates might prove useful.
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🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.03.23.23287630v1" target="_blank">Obesity and Smoking: A Tale of 2 Risk Factors with Implications for the Next Pandemic</a>
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<li><strong>Morbidity and mortality burden of COVID-19 in rural Madagascar: results from a longitudinal cohort and nested seroprevalence study</strong> -
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Introduction: Three years into the pandemic, there remains significant uncertainty about the true infection and mortality burden of COVID-19 in the WHO-Africa region. High quality, population-representative studies in Africa are rare and tend to be conducted in national capitals or large cities, leaving a substantial gap in our understanding of the impact of COVID-19 in rural, low-resource settings. Here, we estimated the spatio-temporal morbidity and mortality burden associated with COVID-19 in a rural health district of Madagascar until the first half of 2021. Methods: We integrated a nested seroprevalence study within a pre-existing longitudinal cohort conducted in a representative sample of 1600 households in Ifanadiana District, Madagascar. Socio-demographic and health information was collected in combination with dried blood spots for about 6500 individuals of all ages, which were analysed to detect IgG and IgM antibodies against four specific proteins of SARS-CoV2 in bead-based multiplex immunoassay. We evaluated spatio-temporal patterns in COVID-19 infection history and its associations with several geographic, socio-economic and demographic factors via logistic regressions. Results: Eighteen percent of people had been infected by April-June 2021, with seroprevalence increasing with individuals age. COVID-19 primarily spread along the only paved road and in major towns during the first epidemic wave, subsequently spreading along secondary roads during the second wave to more remote areas. Wealthier individuals and those with occupations such as commerce and formal employment were at higher risk of being infected in the first wave. Adult mortality increased in 2020, particularly for older men for whom it nearly doubled up to nearly 40 deaths per 1000. Less than 10% of mortality in this period could be directly attributed to COVID-19 deaths given known infection fatality ratios and observed seroprevalence in the district. Conclusion: Our study provides a very granular understanding on COVID-19 transmission and mortality in a rural population of sub-Saharan Africa and suggests that the disease burden in these areas may have been substantially underestimated.
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<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.03.24.23287674v1" target="_blank">Morbidity and mortality burden of COVID-19 in rural Madagascar: results from a longitudinal cohort and nested seroprevalence study</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>Clinical Performance Evaluation of the CareSuperb™ COVID-19 Antigen Home Test</strong> - <b>Condition</b>:   COVID-19<br/><b>Intervention</b>:   Device: CareSuperb COVID-19 Antigen Home Test Kit<br/><b>Sponsor</b>:   AccessBio, 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>Evaluation of Safety &amp; Efficacy of MIR 19 ® Inhalation Solution in Patients With Mild COVID-19</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Drug: MIR 19 ®;   Combination Product: Standart therapy<br/><b>Sponsor</b>:   National Research Center - Institute of Immunology Federal Medical-Biological Agency of Russia<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>LACTYFERRIN™ Forte and ZINC Defense™ and Standard of Care (SOC) vs SOC in the Treatment of Non-hospitalized Patients With COVID-19</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Drug: Sesderma LACTYFERRIN™ Forte and Sesderma ZINC Defense™;   Drug: Placebo<br/><b>Sponsors</b>:   Jose David Suarez, MD;   Sesderma S.L.;   Westchester General Hospital Inc. DBA Keralty Hospital Miami;   MGM Technology Corp<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>MP0420 for Inpatients With COVID-19 (An ACTIV-3/TICO Treatment Trial)</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Drug: MP0420;   Drug: Placebo;   Biological: Remdesivir<br/><b>Sponsors</b>:   National Institute of Allergy and Infectious Diseases (NIAID);   International Network for Strategic Initiatives in Global HIV Trials (INSIGHT);   University of Copenhagen;   Medical Research Council;   Kirby Institute;   Washington D.C. Veterans Affairs Medical Center;   AIDS Clinical Trials Group;   National Heart, Lung, and Blood Institute (NHLBI);   US Department of Veterans Affairs;   Prevention and Early Treatment of Acute Lung Injury (PETAL);   Cardiothoracic Surgical Trials Network (CTSN);   Molecular Partners AG;   University of Minnesota<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>AZD7442 for Inpatients With COVID-19 (An ACTIV-3/TICO Treatment Trial)</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Biological: AZD7442;   Biological: Placebo;   Biological: Remdesivir<br/><b>Sponsors</b>:   National Institute of Allergy and Infectious Diseases (NIAID);   International Network for Strategic Initiatives in Global HIV Trials (INSIGHT);   University of Copenhagen;   Medical Research Council;   Kirby Institute;   Washington D.C. Veterans Affairs Medical Center;   AIDS Clinical Trials Group;   National Heart, Lung, and Blood Institute (NHLBI);   US Department of Veterans Affairs;   Prevention and Early Treatment of Acute Lung Injury (PETAL);   Cardiothoracic Surgical Trials Network (CTSN);   AstraZeneca;   University of Minnesota<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>PF-07304814 for Inpatients With COVID-19 (An ACTIV-3/TICO Treatment Trial)</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Drug: PF-07304814;   Drug: Placebo;   Biological: Remdesivir<br/><b>Sponsors</b>:   National Institute of Allergy and Infectious Diseases (NIAID);   International Network for Strategic Initiatives in Global HIV Trials (INSIGHT);   University of Copenhagen;   Medical Research Council;   Kirby Institute;   Washington D.C. Veterans Affairs Medical Center;   AIDS Clinical Trials Group;   National Heart, Lung, and Blood Institute (NHLBI);   US Department of Veterans Affairs;   Prevention and Early Treatment of Acute Lung Injury (PETAL);   Cardiothoracic Surgical Trials Network (CTSN);   Pfizer;   University of Minnesota<br/><b>Suspended</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>VIR-7831 for Inpatients With COVID-19 (An ACTIV-3/TICO Treatment Trial)</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Biological: VIR-7831;   Biological: Placebo;   Biological: Remdesivir<br/><b>Sponsors</b>:   National Institute of Allergy and Infectious Diseases (NIAID);   International Network for Strategic Initiatives in Global HIV Trials (INSIGHT);   University of Copenhagen;   Medical Research Council;   Kirby Institute;   Washington D.C. Veterans Affairs Medical Center;   AIDS Clinical Trials Group;   National Heart, Lung, and Blood Institute (NHLBI);   US Department of Veterans Affairs;   Prevention and Early Treatment of Acute Lung Injury (PETAL);   Cardiothoracic Surgical Trials Network (CTSN);   Vir Biotechnology, Inc.;   GlaxoSmithKline;   University of Minnesota<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>BRII-196/BRII-198 for Inpatients With COVID-19 (An ACTIV-3/TICO Treatment Trial)</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Biological: BRII-196;   Biological: BRII-198;   Biological: Placebo;   Biological: Remdesivir<br/><b>Sponsors</b>:   National Institute of Allergy and Infectious Diseases (NIAID);   International Network for Strategic Initiatives in Global HIV Trials (INSIGHT);   University of Copenhagen;   Medical Research Council;   Kirby Institute;   Washington D.C. Veterans Affairs Medical Center;   AIDS Clinical Trials Group;   National Heart, Lung, and Blood Institute (NHLBI);   US Department of Veterans Affairs;   Prevention and Early Treatment of Acute Lung Injury (PETAL);   Cardiothoracic Surgical Trials Network (CTSN);   Brii Biosciences Limited;   University of Minnesota<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>LY3819253 (LY-CoV555) for Inpatients With COVID-19 (An ACTIV-3/TICO Treatment Trial)</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Biological: LY3819253;   Biological: Placebo;   Biological: Remdesivir<br/><b>Sponsors</b>:   National Institute of Allergy and Infectious Diseases (NIAID);   International Network for Strategic Initiatives in Global HIV Trials (INSIGHT);   University of Copenhagen;   Medical Research Council;   Kirby Institute;   Washington D.C. Veterans Affairs Medical Center;   AIDS Clinical Trials Group;   National Heart, Lung, and Blood Institute (NHLBI);   US Department of Veterans Affairs;   Prevention and Early Treatment of Acute Lung Injury (PETAL);   Cardiothoracic Surgical Trials Network (CTSN);   Eli Lilly and Company;   University of Minnesota<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>Use of E-health Based Exercise Intervention After COVID-19</strong> - <b>Condition</b>:   COVID-19<br/><b>Intervention</b>:   Behavioral: Exercise training using an e-health tool<br/><b>Sponsors</b>:   Norwegian University of Science and Technology;   University of Oslo<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>Effect Of Calcitriol On Neutrophil To Lymphocytes Ratio And High Sensitivity C-Reactive Protein Covid-19 Patients</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Drug: Calcitriol;   Other: Placebo<br/><b>Sponsor</b>:   Universitas Sebelas Maret<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>Clinical Study for the Efficacy and Safety of Ropeginterferon Alfa-2b in Moderate COVID19.</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Drug: P1101 (Ropeginterferon alfa-2b);   Procedure: SOC<br/><b>Sponsor</b>:   National Taiwan University Hospital<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>Phase I Clinical Trial of Recombinant Variant COVID-19 Vaccine (Sf9 Cell) (WSK-V102)</strong> - <b>Condition</b>:   COVID-19<br/><b>Intervention</b>:   Biological: Recombinant variant COVID-19 vaccine(Sf9 cell)<br/><b>Sponsor</b>:   WestVac Biopharma Co., Ltd.<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 II Clinical Trial of Recombinant Variant COVID-19 Vaccine (Sf9 Cell) (WSK-V102)</strong> - <b>Condition</b>:   COVID-19<br/><b>Interventions</b>:   Biological: Recombinant variant COVID-19 vaccine (Sf9 cell);   Biological: Recombinant COVID-19 vaccine (CHO cell);   Biological: Recombinant COVID-19 vaccine (Sf9 cell)<br/><b>Sponsor</b>:   WestVac Biopharma Co., Ltd.<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>Short-term Effects of Transdermal Estradiol on Female COVID-19 Patients</strong> - <b>Conditions</b>:   COVID-19;   Hormone Replacement Therapy<br/><b>Interventions</b>:   Drug: Climara 0.1Mg/24Hr Transdermal System;   Other: Hydrogel patch<br/><b>Sponsors</b>:   Istanbul University - Cerrahpasa (IUC);   Turkish Menopause and Osteoporosis Society;   Karakoy Rotary Club;   Rebul Pharmacy<br/><b>Completed</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>Qingfei Jiedu Granules fight influenza by regulating inflammation, immunity, metabolism, and gut microbiota</strong> - BACKGROUND AND AIM: Qingfei Jiedu Granules (QFJD) are a new Traditional Chinese Medicine (TCM) which has been clinically used against coronavirus pneumonia in China. In this study, the therapeutic effect and the underlying mechanisms of QFJD against influenza were investigated.</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 pan-variant mRNA-LNP T cell vaccine protects HLA transgenic mice from mortality after infection with SARS-CoV-2 Beta</strong> - Licensed COVID-19 vaccines ameliorate viral infection by inducing production of neutralizing antibodies that bind the SARS-CoV-2 Spike protein and inhibit viral cellular entry. However, the clinical effectiveness of these vaccines is transitory as viral variants escape antibody neutralization. Effective vaccines that solely rely upon a T cell response to combat SARS-CoV-2 infection could be transformational because they can utilize highly conserved short pan-variant peptide epitopes, but 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>Discovery of therapeutic targets of quercetin for endometrial carcinoma patients infected with COVID-19 through network pharmacology</strong> - CONCLUSIONS: Taken together, this study provides new treatment option for UCEC patients infected with COVID-19. Quercetin may work by reducing the expression of ISG15 and participating in ubiquitination-related pathways.</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>Effects of diarylbutane lignans from <em>Schisandra chinensis</em> fruit on SARS-CoV-2 3CL<sup>pro</sup> and PL<sup>pro</sup> and their <em>in vitro</em> anti-inflammatory properties</strong> - CONCLUSION: Our results suggest that compounds 63, 64, and 65 may be promising SARS-CoV-2 3CL^(pro) and PL^(pro) inhibitors and anti-inflammatory.</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>Adamantanes for the treatment of neurodegenerative diseases in the presence of SARS-CoV-2</strong> - Advent of the acute respiratory coronavirus SARS-CoV-2 has resulted in the search for novel antiviral agents and in the repurposing of existing agents with demonstrated efficacy against other known coronaviruses in the search for an agent with antiviral activity for use during the COVID-19 pandemic. Adamantanes including amantadine, rimantadine, and memantine have well-established benefit in the treatment of neurodegenerative diseases including Parkinson’s disease (PD), Alzheimer’s disease (AD)…</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>Endogenous IFITMs boost SARS-coronavirus 1 and 2 replication whereas overexpression inhibits infection by relocalizing ACE2</strong> - Opposing effects of interferon-induced transmembrane proteins (IFITMs 1, 2 and 3) on SARS-CoV-2 infection have been reported. The reasons for this are unclear and the role of IFITMs in infection of other human coronaviruses (hCoVs) remains poorly understood. Here, we demonstrate that endogenous expression of IFITM2 and/or IFITM3 is critical for efficient replication of SARS-CoV-1, SARS-CoV-2 and hCoV-OC43 but has little effect on MERS-, NL63-and 229E-hCoVs. In contrast, overexpression of IFITMs…</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>Repurposing 1,2,4-oxadiazoles as SARS-CoV-2 PLpro inhibitors and investigation of their possible viral entry blockade potential</strong> - Although vaccines are obviously mitigating the COVID-19 pandemic diffusion, efficient complementary antiviral agents are urgently needed to combat SARS-CoV-2. The viral papain-like protease (PLpro) is a promising therapeutic target being one of only two essential proteases crucial for viral replication. Nevertheless, it dysregulates the host immune sensing response. Here we report repositioning of the privileged 1,2,4-oxadiazole scaffold as promising SARS-CoV-2 PLpro inhibitor with potential…</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>Thalidomide interaction with inflammation in idiopathic pulmonary fibrosis</strong> - The “Thalidomide tragedy” is a landmark in the history of the pharmaceutical industry. Despite limited clinical trials, there is a continuous effort to investigate thalidomide as a drug for cancer and inflammatory diseases such as rheumatoid arthritis, lepromatous leprosy, and COVID-19. This review focuses on the possibilities of targeting inflammation by repurposing thalidomide for the treatment of idiopathic pulmonary fibrosis (IPF). Articles were searched from the Scopus database, sorted, and…</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>Antiviral drugs block replication of highly immune-evasive Omicron subvariants ex vivo, but fail to reduce tissue inflammation</strong> - The identification of the SARS-CoV-2 Omicron variants BA.4/BA.5, BF.7 and BQ.1.1 immediately raised concerns regarding the efficacy of currently used monoclonal antibody therapies. Here we examined the activity of monoclonal antibody therapies and antiviral drugs against clinical specimens for SARS-CoV-2 Omicron BA.4/BA.5, BF.7 and BQ.1.1 employing an immunofluorescence neutralization assay. Further we explored treatment of BA.4/BA.5 infections with efficient antiviral drugs and monoclonal…</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>Structural basis of main proteases of HCoV-229E bound to inhibitor PF-07304814 and PF-07321332</strong> - PF-07321332 and PF-07304814, inhibitors against SARS-CoV-2 developed by Pfizer, exhibit broad-spectrum inhibitory activity against the main protease (M^(pro)) from various coronaviruses. Structures of PF-07321332 or PF-07304814 in complex with M^(pro)s of various coronaviruses reveal their inhibitory mechanisms against different M^(pro)s. However, the structural information on the lower pathogenic coronavirus M^(pro) with PF-07321332 or PF-07304814 is currently scarce, which hinders our…</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>Intranasal trimeric sherpabody inhibits SARS-CoV-2 including recent immunoevasive Omicron subvariants</strong> - The emergence of increasingly immunoevasive SARS-CoV-2 variants emphasizes the need for prophylactic strategies to complement vaccination in fighting the COVID-19 pandemic. Intranasal administration of neutralizing antibodies has shown encouraging protective potential but there remains a need for SARS-CoV-2 blocking agents that are less vulnerable to mutational viral variation and more economical to produce in large scale. Here we describe TriSb92, a highly manufacturable and stable trimeric…</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>Role of heat shock protein 90 as an antiviral target for swine enteric coronaviruses</strong> - A variety of swine enteric coronaviruses (SECoVs) have emerged and are prevalent in pig populations, including porcine epidemic diarrhea virus (PEDV), transmissible gastroenteritis virus (TGEV), porcine deltacoronavirus (PDCoV), and swine acute diarrhea syndrome (SADS)-CoV, a newly identified bat-origin CoV with zoonotic potential. Unfortunately, available traditional, inactivated and attenuated SECoV vaccines are of limited efficacy against the variants currently circulating in most pig…</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>Potent NKT cell ligands overcome SARS-CoV-2 immune evasion to mitigate viral pathogenesis in mouse models</strong> - One of the major pathogenesis mechanisms of SARS-CoV-2 is its potent suppression of innate immunity, including blocking the production of type I interferons. However, it is unknown whether and how the virus interacts with different innate-like T cells, including NKT, MAIT and γδ T cells. Here we reported that upon SARS-CoV-2 infection, invariant NKT (iNKT) cells rapidly trafficked to infected lung tissues from the periphery. We discovered that the envelope (E) protein of SARS-CoV-2 efficiently…</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>Protocol for an Implementation Science Evaluation of Roots of Hope: A Community Suicide Prevention Project</strong> - CONCLUSIONS: The evaluation results, including the identification of factors that facilitate and inhibit the implementation of RoH and adaptations to challenges, should be of use to the MHCC, current RoH communities and those who are considering adopting the RoH model.</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>Levels of Complement Components in Children With Acute COVID-19 or Multisystem Inflammatory Syndrome</strong> - CONCLUSIONS AND RELEVANCE: In this cross-sectional study, the complement system was associated with the pathogenesis of MIS-C and COVID-19 in children; complement inhibition could be further explored as a potential treatment option.</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>Trolled by Trump, Again</strong> - Thoughts after a week of waiting and waiting for the indictment that the former President promised. - <a href="https://www.newyorker.com/news/letter-from-bidens-washington/trolled-by-trump-again">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The Secret Joke at the Heart of the Harvard Affirmative-Action Case</strong> - A federal official wrote a parody of Harvard’s attitude toward Asian Americans and shared it with the dean of admissions. Why did a judge try to hide that from the public? - <a href="https://www.newyorker.com/news/our-columnists/the-secret-joke-at-the-heart-of-the-harvard-affirmative-action-case">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Advice for Alvin Bragg from Former Trump Prosecutors</strong> - The Manhattan District Attorney faces huge legal and political challenges, but the former President’s antics could help the prosecution’s case. - <a href="https://www.newyorker.com/news/daily-comment/advice-for-alvin-bragg-from-former-trump-prosecutors">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Should Latinos Be Considered a Race?</strong> - A proposed change to the census faces opposition from Afro-Latino groups, and exposes conflicts among Latino communities. - <a href="https://www.newyorker.com/news/daily-comment/should-latinos-be-considered-a-race">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Jia Tolentino on the Ozempic Weight-Loss Craze</strong> - A drug designed to treat diabetes is changing how celebrities—and maybe the rest of us—will look. Plus, D. T. Max on the Latino author who fabricated his very identity. - <a href="https://www.newyorker.com/podcast/the-new-yorker-radio-hour/jia-tolentino-on-the-ozempic-weight-loss-craze">link</a></p></li>
</ul>
<h1 data-aos="fade-right" id="from-vox">From Vox</h1>
<ul>
<li><strong>How to save America’s public transit systems from a doom spiral</strong> -
<figure>
<img alt="In an underground subway station, riders are seen inside an open subway train, and others are seen on the platform in the foreground waiting for their train." src="https://cdn.vox-cdn.com/thumbor/A2WXp4c-r-aYxGHGuOtRigMS2XE=/234x0:4407x3130/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/72118259/GettyImages_1460624449.0.jpg"/>
<figcaption>
Riders board an F-line subway train in New York City in January 2023. | Gary Hershorn/Getty Images
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Don’t let buses and subways become another casualty of the pandemic.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="uzzMeu">
America’s largest public transportation systems are facing their greatest challenge in generations — a crisis with the potential to decimate their service, cripple local economies, and diminish quality of life.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="NIeAiu">
When Covid-19 arrived three years ago, most transit passengers <a href="https://www.sciencedirect.com/science/article/pii/S204604302100085X">stopped riding</a>, <a href="https://www.enotrans.org/article/the-mass-transit-fiscal-cliff-estimating-the-size-and-scope-of-the-problem/">shrinking transportation agencies’ fare revenues</a>. Today, ridership remains <a href="https://transitapp.com/apta">far below</a> pre-pandemic levels. Unless they can quickly find new sources of funding, big transit systems will be forced to <a href="https://www.smartcitiesdive.com/news/public-transit-agencies-2023-budget-gaps-ridership-zero-fare/641116/">drastically curtail service,</a> which would drive away still more passengers and place those systems in an even deeper financial hole.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="fBQc5o">
Such a scenario would directly affect current riders, but it would also devastate cities whose post-pandemic priorities — such as revitalizing downtowns, reducing greenhouse gas emissions, and boosting equity — rely on the ready availability of mass transportation.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="VQvIri">
But a death spiral is not inevitable. To escape it, transit leaders must offer a full-throated defense of their essential role in American life. They must then secure new and reliable revenue streams from state and regional sources, which will require convincing residents and legislators that transit is worthy of subsidy — not an easy thing to do in a country where the <a href="https://www.census.gov/newsroom/press-releases/2021/public-transportation-commuters.html">vast majority of people</a> don’t ride the bus or train. “Do you know how many times the median American rides transportation each year?” Brian Taylor, a professor of urban planning and policy at UCLA, asked me.“<a href="https://nhts.ornl.gov/">Zero</a>.”
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</div></div></li>
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<figure class="e-image">
<img alt="A chart showing total number of US transit riders per week. Total weekly national public transit ridership hovered around 180 million in early March 2020, plummeted down to 40 million by April 2020, and has slowly increased since then but now hovers at 140 million, significantly below the pre-pandemic baseline." src="https://cdn.vox-cdn.com/thumbor/A7u3p7zvYjMtvvAWY9MJi9j5_8k=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/24534161/K0rcR_in_march_2020_public_transit_ridership_plummeted_br_it_still_hasn_t_recovered_.png"/>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="fh9CuQ">
The only realistic way for transit officials to garner public support for the funding they desperately need is to demonstrate an ability to replace car trips, not just serve economically disadvantaged people who lack other means to get around their city. Otherwise, they forfeit the pro-transit arguments that resonate most with the public: curtailing congestion, reducing auto emissions, and boosting economic growth.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="UjOcXH">
And to replace cars, transit agencies must offer fast, frequent, and reliable trips. This should be the core mission of any functional public transportation system, but increasingly, transit leaders are being pushed to focus on distracting priorities like <a href="https://ww2.arb.ca.gov/news/california-transitioning-all-electric-public-bus-fleet-2040">electrifying buses</a>, <a href="https://www.cnbc.com/2023/01/30/dc-free-bus-bill-becomes-law-zero-fare-transit.html">eliminating fares</a>, and <a href="https://wtop.com/tracking-metro-24-7/2023/02/in-partnership-with-metro-dc-police-to-start-patrols-at-several-stations/">fighting crime</a>. The biggest US transit agencies must be allowed to simply focus on delivering high-quality service. There is no Plan B.
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<h3 id="YfxfDG">
20th-century suburbanization triggered a fiscal crisis for transit
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="swqhAq">
To appreciate the urgency of transit’s current predicament, one must first understand its turbulent past. “The cycle I’m worried about now is one we saw from 1945 to 1970,” said Nicholas Bloom, a professor of urban policy and planning at Hunter College and the author of the forthcoming book <a href="https://press.uchicago.edu/ucp/books/book/chicago/G/bo191431990.html"><em>The Great American Transit Disaster: A Century of Austerity, Auto-Centric Planning, and White Flight</em></a>.
</p>
<div class="c-float-left">
<figure class="e-image">
<img alt="A black-and-white photo of a dense residential street with a streetcar running down the center." src="https://cdn.vox-cdn.com/thumbor/4yNe3Qh0fMPdTUQ-EylYds8yYbk=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/24534213/GettyImages_1371426808.jpg"/> <cite>Hum Images/Universal Images Group</cite>
<figcaption>
A Washington, DC streetcar circa 1921-1923.
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="JSVrc2">
Mass transportation’s heyday came in the early 20th century, when privately run <a href="https://americanhistory.si.edu/america-on-the-move/streetcar-city">streetcars</a> were ubiquitous throughout urban America, and residents of cities like <a href="https://historyofmassachusetts.org/boston-first-subway-america/">Boston</a> and <a href="https://www.ascemetsection.org/committees/history-and-heritage/landmarks/first-new-york-city-subway">New York City</a> flocked to new subway lines. But the rapid ascent of the automobile prompted many regular passengers to decamp for car-oriented suburbs, with employers following. Declining ridership eroded transit companies’ finances, leading to <a href="https://www.vox.com/2015/5/7/8562007/streetcar-history-demise">deteriorating service</a> that drove away still more riders.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="48hEq1">
With transit companies teetering on the brink of collapse after World War II, local and state governments intervened to prevent service from disappearing altogether. A wave of public takeovers included the creation of Chicago’s CTA (1947), Boston’s MBTA (1964), Philadelphia’s SEPTA (1964), and New York City’s MTA (1968).
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="2HSb85">
Adding to transit’s postwar woes was a federal government focused on cars, not buses and trains. The landmark <a href="https://highways.dot.gov/public-roads/summer-1996/federal-aid-highway-act-1956-creating-interstate-system">1956 Federal-Aid Highway Act,</a> for instance, launched the modern interstate system that catalyzed suburbanization while destroying many dense urban neighborhoods. Only with the <a href="https://www.transit.dot.gov/about/brief-history-mass-transit">1964 Urban Mass Transportation Act</a> did Congress start to provide a modicum of financial support for transit.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="HQv6d1">
But it came with a big catch: The feds would subsidize capital expenditures, such as purchasing new buses or building a new rail line, rather than the ongoing provision of service, which was mostly paid from a combination of fare revenues and contributions from state and local governments.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="q7BNKn">
In 1960, just over <a href="https://library.cqpress.com/cqresearcher/document.php?id=cqresrre1963042400">12 percent</a> of commutes to work occurred on transit, but by 2019 that figure had <a href="https://t.co/zRsYNJZdEr">fallen to 5 percent</a>. It was even lower in most of the country; the national average was propped up by a few populous metro regions that developed before the automobile’s arrival, where residents had more reason to use the bus or train because of limited downtown parking.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="6lcLHs">
In New York City, for instance, <a href="https://data.census.gov/table?q=means+of+travel+to+work&amp;g=310XX00US14460,35620&amp;y=2019&amp;d=ACS+5-Year+Estimates+Subject+Tables&amp;tid=ACSST5Y2019.S0802&amp;moe=false">32 percent</a> of commuters in 2019 traveled to work via transit; the figure in Boston was 13 percent and in Chicago 12 percent. Those three regions plus San Francisco, Washington, DC, and Philadelphia <a href="https://www.transit.dot.gov/ntd/data-product/ts22-service-data-and-operating-expenses-time-series-system-0">accounted for</a> around 65 percent of total transit trips nationwide.
</p>
<h3 id="S133vl">
In major metros, transit has been indispensable
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Gfsv6K">
Unlike in the rest of the United States, transit agencies in these big, dense cities have long derived much of their operating revenues from passenger fares. In 2019 New York City’s MTA recovered <a href="https://www.transit.dot.gov/ntd/data-product/ts22-service-data-and-operating-expenses-time-series-system-0">more than half</a> of its operating expenses through farebox revenue, while Chicago’s CTA drew 41 percent and Philadelphia’s SEPTA 35 percent. By comparison, the comparable figure for Phoenix’s Valley Metro was 14 percent, and for Dallas’s DART 12 percent.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="kSItXu">
Fare revenues allowed the biggest transit systems to provide more service, which made taking the bus or train more appealing for those who could otherwise use a car. Research has consistently found that transit’s regularity and reliability — more than its price — exert a powerful influence over mode choice. “The two most important factors driving satisfaction with transit are service frequency and travel time,” observed the nonprofit TransitCenter in a <a href="https://transitcenter.org/wp-content/uploads/2016/07/Whos-On-Board-2016-7_12_2016.pdf">2016 report</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="uoxKMG">
Big transit systems’ singular ability to replace driving has brought them powerful allies. Their regional business groups often see transit as <a href="https://t4america.org/portfolio/la-transit-strike/">a means to avoid the crippling congestion</a> that would hinder economic growth and depress real estate values. In Washington, DC, an alliance of corporate executives called the Federal City Council played a <a href="https://www.federalcitycouncil.org/about-us/history/">key role</a> rallying the region to create Metrorail, which opened in 1976.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="xPR1Sv">
Such agencies have also found support in regional referendums and state budgets. According to the American Public Transportation Association, state and local governments <a href="https://www.apta.com/wp-content/uploads/APTA-2021-Fact-Book.pdf">contributed more than $500 billion</a> toward transit systems between 1975 and 2019, with the largest systems getting a disproportionate share of those funds. Although suburban and rural residents may never ride the bus or train themselves, many still appreciate transit’s ability to mitigate congestion, grow local economies, and reduce greenhouse gasses and air pollution.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="2wmVC2">
“It’s essential that transit lead people to drive less in order to win a statewide coalition,” said Monica Tibbits-Nutt, the undersecretary for the Massachusetts Department of Transportation. “When talking to people who don’t use the T [Boston’s rail system], I’ve always said, ‘The more people who ride the T, the more people who get off the road.’” The same argument was lampooned by The Onion in a 23-year-old <a href="https://www.theonion.com/report-98-percent-of-u-s-commuters-favor-public-trans-1819565837">headline</a>, “98 Percent of US Commuters Favor Public Transportation for Others,” but it’s true — <a href="https://link.springer.com/article/10.1007/s11116-014-9545-2#page-1">subsequent research</a> found that many people really do support transit subsidies in the hopes that others will drive less.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="09uwPz">
Although pre-Covid transit was <a href="https://www.nytimes.com/interactive/2019/07/08/upshot/nyc-subway-variability-calculator.html">far from perfect</a> in megalopolises like Chicago, New York, and Washington, DC, agencies’ ability to offer service competitive with car travel set them apart from peers in the rest of the country, which primarily serve low-income riders with limited (if any) access to a car.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="4xLbGS">
Then came the pandemic.
</p>
<h3 id="JYDs2h">
After Covid, big transit systems’ finances fell off a cliff
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="CKw2kl">
Few parts of the American economy were upended by Covid as much as public transportation. Ridership nationwide plummeted <a href="https://transitapp.com/apta">around 80 percent</a> in March 2020, shrinking farebox revenues as it fell.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="pUSJeJ">
That decline was less crippling for smaller transit agencies than those of major metros. A system that collects only <a href="https://www.marc.org/sites/default/files/2022-04/Peer-Cities-Transit-Report-summary.pdf">11 percent</a> of its operating budget from fares (like Austin’s Metro did pre-pandemic, for example) could endure a massive drop in riders without incurring a significant budget deficit. But similar ridership declines would — and did — devastate bigger agencies that were far more reliant on fares. Adding to their pain, the largest systems often endured the steepest drops in ridership because their relatively more affluent passengers were more likely to work from home or have access to a car. By April 2020, transit trips in metro areas with over 2 million residents were <a href="https://transitapp.com/apta">down 83</a> percent, compared to 66 percent for smaller regions.
</p>
<div class="c-float-right">
<figure class="e-image">
<img alt="A woman sits alone in an otherwise empty train car" src="https://cdn.vox-cdn.com/thumbor/58h7ev2rgqgT-lqrLymhnguoNNE=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/24534229/GettyImages_1209095517.jpg"/> <cite>Boston Globe via Getty Images</cite>
<figcaption>
A virtually empty Boston transit train in April 2020.
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="oycrog">
Seeking to avoid a repeat of transit’s near-death experience in the mid-20th century, Congress threw agencies a lifeline in 2020 by approving the first of several Covid relief packages, ultimately totaling <a href="https://www.enotrans.org/article/covid-aid-is-slowing-regular-mass-transit-spending/">$69 billion</a>. That aid broke with federal precedent by directly funding big agencies’ operating costs, which allowed them to minimize service cuts even with far fewer riders.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="cu9FyY">
But now the federal money is running out, while fare revenues remain low as ridership in big metros like Boston is <a href="https://recovery.transitmatters.org/">barely half its pre-pandemic level</a> and downtowns are still suffering from the remote work trend. “We’re calling it the ‘big red,’” said Randy Clarke, general manager of WMATA, the transit system of the DC region, which is projecting a deficit of <a href="https://www.washingtonpost.com/opinions/2022/10/28/anthony-williams-metro-must-fix-itself-before-it-gets-more-funding/">over half a billion dollars</a> by fiscal year 2025. New York City’s MTA faces an even larger gap, estimated at <a href="https://www.osc.state.ny.us/press/releases/2022/10/dinapoli-mta-outlook-shows-growing-need-new-funding-budget-gaps-widen#:~:text=Budget%20Gaps,-Entering%20July%202022&amp;text=Gaps%20are%20forecast%20at%20%242.5,costs%20and%20weaken%20tax%20revenues.">$2.5 billion</a> in 2025 and increasing thereafter.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="HqhzCw">
At the same time, ridership patterns have been scrambled, requiring agencies to navigate a fast-changing environment. Downtown lines have generally seen ridership fall the furthest and recover the slowest, but demand for routes connecting neighborhoods has been more resilient, especially during off-peak hours.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="EVLich">
Facing a financial cliff, transit agencies are raising the alarm. In a <a href="https://www.rtachicago.org/blog/2022/12/15/what-is-the-fiscal-cliff-and-what-can-be-done-about-it">blog post</a> last December, Chicago’s Regional Transportation Authority, a financial oversight body, warned, “If no action is taken, the CTA, Metra, and Pace [Chicagoland’s three major transit systems] will be faced with difficult choices to cut service, raise fares, or both.” The Bay Area’s BART recently created a <a href="https://www.bart.gov/about/financials/crisis">public website</a> titled “Financial Crisis” to draw attention to its plight. “We can’t afford to lose transit,” it proclaims. “Don’t let BART go broke!”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="0jAeBY">
To keep BART running, the agency says it needs more financial support from California — not, notably, the federal government. David Bragdon, the executive director of the nonprofit TransitCenter, doesn’t expect Congress to ride to the rescue again. “I don’t think there’s ever been — or will be — a point in time when federal funds are transit’s primary source of revenue,” he said. “Politically, that’s not how this country works with regard to its urban areas. Even in the most flush times, the vast majority of mass transportation funds are generated regionally and at the state level.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="fjTqzR">
To avoid a downward spiral of falling revenue, curtailed service, and lower ridership, transit agencies will need to convince governments and voters to give them more money. To do that, they need to focus on transit’s competitiveness with driving — and not be distracted by other priorities.
</p>
<h3 id="yhZtOg">
Eliminating fares sends transit in the wrong direction
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Rx9V6E">
During the pandemic, popular discourse about public transportation’s societal value underwent a shift. With so many people staying home, transit’s ability to mitigate traffic by replacing car trips seemed less urgent. Instead, public discussions focused on its role providing mobility for low-income “essential workers” who would otherwise be unable to reach jobs that housebound residents relied on them to perform.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="9GJRkp">
“The people using transit now are working in hospitals that are saving lives,” wrote transit consultant and author Jarrett Walker in <a href="https://www.bloomberg.com/news/articles/2020-04-07/in-a-pandemic-we-re-all-transit-dependent">Bloomberg CityLab</a> in April 2020. “They are creating, shipping, and selling urgently needed supplies. They are keeping grocery stores functioning, so we can eat.” A few months later, anti-racism protests in the wake of George Floyd’s murder also contributed to <a href="https://www.bloomberg.com/news/articles/2020-07-20/the-powerful-role-transit-plays-in-racial-justice">discussion</a> of access to public transportation as an equity and justice issue.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="rGbqO3">
With transit users increasingly perceived as an economically vulnerable group, a <a href="https://www.washingtonpost.com/transportation/interactive/2021/public-transportation-free-fare-future/">rising chorus</a> of activists, along with influential urban officials like <a href="https://www.bostonglobe.com/2022/03/01/metro/first-day-fare-free-bus-pilot-wu-boards-29-bus-celebratory-ride/">Boston Mayor Michelle Wu</a> and <a href="https://www.politico.com/newsletters/the-long-game/2023/02/08/the-councilmember-making-d-c-buses-free-00081792">Washington, DC, Councilmember Charles Allen</a>, spearheaded policies to eliminate fares entirely, rejecting the more targeted approach of providing discounts only for low-income riders, which was adopted in places like <a href="https://www.nyc.gov/site/fairfares/index.page#:~:text=Fair%20Fares%20NYC%20is%20a,unlimited%20options%20are%20all%20available.">New York</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="RGkMtX">
Transit riders are more likely to be poor than the general public, so dropping fares is a progressive policy move, although most low-income riders still <a href="https://transitcenter.org/transit-be-free/">say</a> they would rather see agencies prioritize faster and more reliable trips. But eliminating fares requires transit systems to find even more outside funding to be able to function, making it harder to provide high-quality service. And it’s not clear that equity-based appeals will resonate in the suburbs and rural areas. There is <a href="https://www.bloomberg.com/news/articles/2022-04-22/the-green-case-against-free-public-transit">no evidence</a> that fare-free transit can meet the key goal of reducing driving, because those with car access typically care more about trip times and reliability than the cost of a transit trip.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="lJeOYI">
“The fare-free dialogue can make it more difficult to win statewide support” for funding transit, said Tibbits-Nutt, the Massachusetts undersecretary of transportation. “It continues to focus the conversation on the city of Boston” rather than the interests of those living outside the city.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="6fvGnA">
Forgoing state and regional funds wouldn’t be a problem if big cities, whose elected leaders are often the most bullish on fare-free transit, could themselves provide the additional money that their transit systems need. Joshua Schank, a research associate at San Jose State University’s Mineta Transportation Institute, said he would welcome a new emphasis on equity, even if it upends transit’s historical alliance of corporate, suburban, and state interests. “Maybe transit would function better if you blow up that old coalition,” he said. “You’d lose some funding in the short term, but it’s not as though transit was thriving before the pandemic. That coalition wasn’t working.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ozV7xp">
But Bloom, the Hunter College professor, thinks it would be a catastrophic mistake to focus funding appeals on inequality. “There’s this idea of having a social equity awakening about transit,” he said. “As someone who spent the last 20 years studying public housing, social equity has not impressed me as a way of getting consistent, high funding for important and crucial public services. I just don’t see it.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="sDbha3">
Taylor, the UCLA professor, agreed. “When framed as a social service, transit hasn’t done well securing funding,” he said. “But when it’s framed as an environmental benefit or as getting people off the road, that can work.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Fy7Ey1">
Jeffrey Tumlin, the leader of San Francisco’s transit system, is already building his case for aid around the beneficial effects of replacing car trips. “Part of the argument is about climate,” he said. “Here in California, transportation is 47 percent of emissions, and of that, 72 percent is private cars and trucks. Transit is absolutely essential.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="vlG5Ua">
Compared to climate change, transit’s ability to mitigate congestion and strengthen downtowns seems even easier to grasp. But the credibility of both appeals rests on transit’s ability to reduce driving. And that requires providing trips that are reliable and rapid, with the next bus or train only a few minutes away.
</p>
<h3 id="m85kYv">
Let transit agencies focus on providing good service
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="VJccgX">
Despite acute <a href="https://www.americancityandcounty.com/2022/11/28/report-acute-workforce-shortages-challenge-public-transit-agencies/">staffing challenges</a> during the last year, thanks in part to an <a href="https://www.bloomberg.com/news/articles/2022-07-20/america-s-bus-driver-shortage-has-left-transit-systems-in-crisis">uptick in retirements</a>, many transit agencies have found ways to improve service, enhancing its appeal to those who could otherwise travel by car. In the Washington, DC region, for instance, WMATA in February managed to <a href="https://www.wusa9.com/article/news/local/dc/metro-more-blue-orange-line-trains-during-rush-hour-starting-feb-7/65-8b0d2718-34cd-46d1-b4f2-663130912936">deploy additional weekday rush hour trains</a> in response to rebounding demand.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="opEbaw">
San Francisco’s Muni, meanwhile, revamped its schedule to drop peripheral routes and boost frequency on core lines like the 22 and 49 that serve neighborhoods including the Marina District, the Castro District, and the Mission District, which have always had relatively high ridership and, Tumlin said, are now seeing more passengers than before the pandemic. Neither route serves San Francisco’s Financial District, suggesting that agencies could grow ridership (and reduce driving) by adding service in areas that are within central cities but outside of downtowns.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="t0W7R5">
Service improvements like these are indispensable, but some of the other priorities transit agencies are currently balancing are not. For instance, with ridership still depressed, now seems like a good time to <a href="https://www.masstransitmag.com/rail/infrastructure/article/21259603/capital-programs-strike-steady-pace">deprioritize expensive capital projects</a> like vehicle purchases and rail expansions, and reallocate the money toward maintenance that makes service more reliable and frequent. Or better yet, agencies could find ways to transfer money from their capital budgets to their operating budgets, where it can help them hire desperately needed operators. (President Biden’s <a href="https://twitter.com/eli_kamisher/status/1634230310316670978?s=20">new budget proposal</a> would give agencies temporary authority to make such transfers with federal funds.)
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="i0ArB0">
With ridership still recovering and dollars scarce, it’s also unclear why transit agencies should be spending money on pricey service expansions. Massachusetts residents, for instance, might question why MBTA is planning an <a href="https://www.wbur.org/news/2022/11/28/silver-line-expansion-royal-visit-deer-collisions-newsletter">extension of its Silver Line</a> at a time when ridership is still so far <a href="https://www.wgbh.org/news/local-news/2022/10/24/spill-the-t-riders-are-back-but-the-ts-rebound-has-been-uneven">below pre-Covid levels</a> that the system faces a 2024 budget deficit of up <a href="https://www.nbcboston.com/news/local/mbta-could-face-a-deficit-up-to-421-million-by-2024/2836492/">to $421 million</a>, and when wait times between Red Line trains have <a href="https://www.cambridgeday.com/2022/06/20/causes-of-mbta-service-cuts-reach-back-decades-and-the-solution-isnt-necessarily-more-funding/">increased</a> from 90 seconds in the 1940s to 4.5 to 11 minutes today.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="07UD9f">
Another dubious move: prioritizing bus electrification, as California has done by <a href="https://ww2.arb.ca.gov/news/california-transitioning-all-electric-public-bus-fleet-2040">demanding</a> that all buses within the state emit zero emissions by 2040. Although their adoption makes for <a href="https://www.northjersey.com/story/news/transportation/2022/10/04/nj-transit-first-electric-bus-unveiled/69538554007/">good headlines</a> (and is eligible for <a href="https://www.utilitydive.com/news/electric-transit-buses-boom-fta-delivery-shortage/637161/">generous federal subsidies</a>), electric buses force already stretched transit staff to navigate a thicket of <a href="https://www.alxnow.com/2021/11/08/dash-electric-buses-face-challenges-from-hills-and-cold-weather/">operational challenges</a>, such as figuring out where to place charging stations and how to handle extreme weather. “Mandatory fleet and facility conversions should not come at the expense of the survival of transit operations,” Tumlin said.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="93u5LN">
To meet climate goals, state and local officials would be better off focusing on nudging people out of cars and into buses instead of electrifying their bus fleets. The OECD has <a href="https://t.co/XvYNN8y7KQ">found</a> that diesel buses produce fewer emissions per passenger mile than even electric cars. “Getting someone on the bus is already green,” said WMATA’s Clarke. Creating Bus Rapid Transit (BRT) lines with dedicated lanes and priority for buses at traffic signals can cost far less than purchasing new vehicles, and unlike electric buses, it measurably improves transit service in ways that win over new riders.
</p>
<figure class="e-image">
<img alt="A bus rides down a red-painted bus lane alongside lanes of car traffic" src="https://cdn.vox-cdn.com/thumbor/ogfP_bfNjlJRyBShxkEOr5ybtwY=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/24534248/GettyImages_1220866183.jpg"/> <cite>John Lamparski/Getty Images</cite>
<figcaption>
A bus cruises down a New York City bus-exclusive lane.
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="1eik65">
BRT is just one of the smart, low-cost ways that cities and states could strengthen transit service. Another is the adoption of onboard bus cameras that automatically photograph and ticket car drivers who illegally block bus lanes, slowing down service and making schedules less reliable. New York City was the first big US city to use such cameras at scale, and <a href="https://www.bloomberg.com/news/articles/2022-01-10/bus-lane-blocked-enforcement-cameras-can-fight-back">initial evidence</a> suggests it has substantially sped up bus trips.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="8Rc1IG">
States and cities could also give transit a lift by assuming responsibility for managing rising concerns over public safety on buses and subways, which <a href="https://www.cnn.com/2022/10/23/us/new-york-subway-crime-adams-miller/index.html">can suppress</a> ridership. Agencies are increasingly being forced to reallocate precious dollars away from operations and toward public safety, which is the core competence of mental health and law enforcement departments. Such departments, not transit agencies, should be handling transit’s growing safety and social services needs.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="2Ug1Ky">
“I can either hire operators or hire security staff,” said Tumlin, noting that in the last year, his agency created 50 new security positions. “That’s a few bus lines’ worth of people.” In fact, high-frequency transit service is itself a powerful <a href="https://twitter.com/RidersAlliance/status/1575878918707597312?s=20&amp;t=qG2CP5iM5CYY_ky1sJN4Ew">countermeasure</a> against crime because it allows riders to exit uncomfortable situations without enduring a lengthy wait for the next vehicle.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="9xlwEi">
“If we had a more functioning society, we would be focused more on being a transit operator,” said Clarke of WMATA, which recently <a href="https://dcist.com/story/23/02/08/metro-staff-five-stations-after-shootings/">paid</a> for DC police to patrol Metrorail stations following the shooting death of an employee. “If you go to Singapore, the agency’s staff are not doing these things. They’re running transit.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="8t5ECs">
Inequality, global warming, and crime are obviously critical societal challenges. But transit agencies can help solve all three simply by providing the fast, frequent, reliable service that lies at the core of their mission. New mandates risk distracting transit officials, undermining their ability to deliver on the very goals that advocates most want.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="k0pgio">
“MBTA staff are not only being asked to address our crisis with congestion; they’re being asked to address asthma rates in low-income communities,” said Tibbits-Nutt. “They’re being asked to electrify their entire system, to open up to those who can’t afford a car, to modernize stations. There is so much being asked of them right now that it’s making it hard for the system to operate.”
</p>
<h3 id="8dgAXA">
Cities can’t function without robust transit
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="TcCOwr">
As transit’s perceived responsibilities multiply, federal dollars are dwindling. The most immediate and obvious way for state and regional governments to help is by establishing recurring sources of funding. For that reason, implementing New York City’s congestion pricing plan, which will charge motorists up to $23 to enter Manhattan’s central business district and <a href="https://www.bloomberg.com/news/articles/2022-08-17/new-york-s-congestion-pricing-plan-is-politically-explosive#:~:text=Officials%20anticipate%20congestion%20pricing%20will,%2451.5%20billion%20multiyear%20capital%20plan.">add around $1 billion annually</a> to MTA’s capital budget — funding that could improve maintenance and service quality — can’t happen soon enough.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="lT7ol5">
New York is an exception; for most large transit agencies, obtaining necessary funds will require months if not years of negotiation and advocacy. The stakes could not be higher — not only for transit riders, but for everyone who benefits from mass transportation. We can’t have vibrant cities without it.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="QbLOTR">
Those who want to see transit not just survive but thrive, including public officials as well as everyday citizens, can improve agencies’ chances for success by doing two things. First, support staff who are working to provide maximally useful service, so that residents are more likely to leave their car at home (or maybe even <a href="https://www.vox.com/future-perfect/23578481/how-to-live-without-a-car">get rid of it</a>). Bus Rapid Transit, bus lane enforcement, and prioritizing maintenance over service expansions are all consistent with that goal.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="y7Gshi">
Second, they can resist the temptation to complicate agencies’ challenges with well-intentioned but counterproductive mandates to go fare-free, electrify buses, or spend their own money on public safety.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="y5ICKd">
The focus must be on providing the high-quality service that reinforces transit systems as assets worthy of investment. The alternative — widening budget deficits and deteriorating service — would be a tragedy for some of America’s greatest cities.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="s4Zru5">
“Right now we are still in a crisis,” said Bloom. “But if you want to make today’s low the permanent low, cut the transit service.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Sz6PE2">
“You won’t get it back.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="AYoKlL">
<em>Lucas Peilert contributed research assistance.</em>
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="5uCdVu">
<em>David Zipper is a visiting fellow at the Harvard Kennedy School’s Taubman Center for State and Local Government, where he examines the interplay between cities, transportation, and technology.</em>
</p>
<ul>
<li><strong>There are valid critiques of Kamala Harris. They also don’t tell the full story.</strong> -
<figure>
<img alt="A black-and-white photo illustration of Kamala Harris surrounded by multicolored dots and bubbles." src="https://cdn.vox-cdn.com/thumbor/PI_xydVFQ4XE3KTAspMXlMHWPdA=/425x0:2972x1910/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/72118221/02_Kamala_2_21__1_.0.jpg"/>
<figcaption>
Vice President Kamala Harris | Paige Vickers for Vox
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
What’s fair — and unfair — about the intense scrutiny she’s received as vice president.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="tIrS4w">
<a href="https://www.vox.com/21547999/kamala-harris-first-woman-vice-president-black">Ever since she became vice president</a>, critiques — both fair and unfair — have plagued Kamala Harris.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="yAF7S6">
There have been questions about how she’s represented the administration <a href="https://www.washingtonpost.com/politics/2023/01/30/harris-democrats-worry/">as a spokesperson</a>, <a href="https://www.washingtonpost.com/politics/2021/12/04/kamala-harris-staff-departures/">concerns about staff turnover</a>, and most recently, worries about whether <a href="https://www.washingtonpost.com/politics/2023/01/30/harris-democrats-worry/">she’s been effective as a VP</a>, and what that could mean for her future as a leader of the party.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="cUXBUP">
The latest wave of criticism featured a number of unnamed Democrats disparaging her and worrying that she wouldn’t be able to win an election at the top of the ticket. As a particularly stinging line in a February <a href="https://www.nytimes.com/2023/02/06/us/politics/kamala-harris-vice-presidenct-legacy.html">New York Times piece put it</a>: “Even some Democrats whom her own advisers referred reporters to for supportive quotes confided privately that they had lost hope in her.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="pD5G7K">
Such intense scrutiny has been driven, in part, by a heightened focus on Harris as President Joe Biden’s successor. Given the president’s age, and the possibility that Harris may actually have to step into the presidency, there’s been a much bigger spotlight on her record than there otherwise might be. Harris’s identity — she’s the first woman, first Black person and first South Asian person to hold the VP’s office — has also contributed to an unprecedented level of attention relative to her predecessors, historians told Vox.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Cj6ODx">
To better understand Harris’s performance as vice president, and what to make of these critiques, Vox spoke to more than two dozen sources, including White House officials, top Democratic strategists, activists, and academic experts. The White House did not respond to a request for comment and the vice president’s office pointed to a public statement from press secretary Kirsten Allen, who highlighted what Harris has done so far in a <a href="https://twitter.com/KirstenAllen46/status/1622654344855277568?s=20">Twitter thread</a>.
</p>
<div id="6UKC6V">
<blockquote class="twitter-tweet">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" dir="ltr" lang="en">
As we’ve seen over the past week there is no shortage of people willing to anonymously or publicly tear down the vice president. So since no one seems to know what she has done or is doing I’ll put in all in one place:
</p>
— Kirsten Allen (<span class="citation" data-cites="KirstenAllen46">@KirstenAllen46</span>) <a href="https://twitter.com/KirstenAllen46/status/1622654344855277568?ref_src=twsrc%5Etfw">February 6, 2023</a>
</blockquote></div></li>
</ul>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="QSaYGO">
The conversations revealed four things fueling the criticisms against Harris. First, she’s had a few early public missteps and gaffes. Second, there are lingering questions about how she’s defined her role as vice president. Third, Harris has been held to a higher standard than other VPs, given both her identity and the expectation she may succeed Biden (either imminently or in 2028.) And fourth, some of the criticisms against Harris have overlooked the inherent limitations of the vice presidency.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="1vPqvI">
In response to her detractors, Harris’s supporters note that she’s had several big accomplishments — including serving as the administration’s lead on reproductive rights — that have been overlooked, and they raise another issue: that there’s <a href="https://www.diverseeducation.com/leadership-policy/article/15288078/women-in-academia-examine-criticisms-of-kamala-harris-after-a-year-in-office">an outsize focus</a> on her <a href="https://thehill.com/homenews/administration/3809504-harris-navigates-double-standard-in-unscripted-moments-as-vp/">due to racism and sexism</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="I2sM45">
Ultimately, there are valid critiques of Harris that speak directly to how she would lead as president, and how responsive a Democratic Party led by her could be. At the same time, the discourse on her record doesn’t always capture <a href="https://time.com/6249434/kamala-harris-abortion-powerful-asset/">the full scope of what she’s achieved in the role</a>, or the nuances of the job itself.
</p>
<h3 id="oCFSCB">
The critiques of Harris, briefly explained
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="qq0RTE">
Questions about Harris’s effectiveness as a spokesperson reached their peak early during a <a href="https://www.forbes.com/sites/markjoyella/2021/06/08/kamala-harris-tells-nbcs-lester-holt-weve-been-to-the-border-he-responds-you-havent/">June 2021 interview with NBC News’s Lester Holt</a>, when she was repeatedly pressed about going to the southern US border during a visit to Guatemala, and offered a confusing response.
</p>
<div id="7oXaI0">
<div style="width: 100%; height: 0; padding-bottom: 56.25%;">
</div>
</div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="hX95Iw">
“At some point, you know, we are going to the border. We’ve been to the border. So this whole thing about the border, we’ve been to the border. We’ve been to the border,” <a href="https://www.forbes.com/sites/markjoyella/2021/06/08/kamala-harris-tells-nbcs-lester-holt-weve-been-to-the-border-he-responds-you-havent/?sh=4e9d49647cc6">Harris said when asked about the issue</a>. At the time, Harris had not yet visited as vice president, prompting Holt to note, “You haven’t.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="lAyxDw">
Since then, other Harris statements have been pilloried. In October 2022, the Daily Show mocked her as serving up a <a href="https://www.sfgate.com/politics/article/Daily-Show-brutally-roasts-Kamala-Harris-17486309.php">“word salad”</a> when discussing climate change or talking about broadband access.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="EK5ZIJ">
Harris’s stronger rhetorical performances, like an address about the urgent need for police reform at the funeral for Tyre Nichols, or a <a href="https://www.whitehouse.gov/briefing-room/speeches-remarks/2023/01/22/remarks-by-vice-president-harris-on-the-50th-anniversary-of-roe-v-wade/">fiery speech</a> that marked the 50th anniversary of <em>Roe v. Wade</em>, haven’t received as much attention. This has helped calcify some Democrats’ perception that she’s a poor public speaker. “It doesn’t help that she’s not [that] adept as a communicator,” Jacquelyn Bettadapur, a former head of Georgia’s Cobb County Democrats, <a href="https://www.washingtonpost.com/politics/2023/01/30/harris-democrats-worry/">told the Washington Post</a> in January, for example.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ffs6n8">
Beyond questions about these public appearances, critics claim that they don’t know what Harris has done — and that she needs to carve out a niche. “She has to find an issue she owns,” <a href="https://thehill.com/homenews/administration/3786584-vice-president-harris-reaches-2023-at-a-crossroads/">a Democratic strategist told the Hill in January</a>. “She’s not the Recovery Act person or the COVID person or the voting rights person. She could be the champion of women’s rights. But she and her team have to be dogged in approaching that.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="xWriUB">
White House officials note that Harris has led both publicly and privately on reproductive rights and voting rights, pointing to the 40 public events she’s held on the former and the 60 engagements she’s had on the latter. And that <a href="https://www.whitehouse.gov/briefing-room/statements-releases/2023/02/06/fact-sheet-vice-president-harris-launches-next-phase-of-public-private-partnership-for-northern-central-america/">she’s launched a new effort to address</a> the root causes of <a href="https://www.latimes.com/politics/story/2022-06-07/harris-new-private-investment-central-america-deter-migration">migration from Central America</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="FyhzK2">
Still, for some, confusion about Harris’s contributions seems to be driving disenchantment with her vice presidency. “I think some Democrats are disappointed. There was a lot of excitement around her candidacy and the historic nature of her candidacy. And since she’s taken office, that excitement has fallen flat,” says Carly Cooperman, a Democratic strategist.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="LfJCso">
Staff departures and statements from anonymous sources have also fueled longstanding concerns about Harris’s management skills. In July 2021, former staffers, <a href="https://www.businessinsider.com/kamala-harris-staffers-toxic-office-culture-dysfunction-2021-7">including some from her time as California’s attorney general</a>, anonymously complained to Business Insider about what they described as a difficult work environment. And amid a presidential campaign that reportedly had <a href="https://www.politico.com/news/2019/11/15/kamala-harris-campaign-2020-071105">some top-level management issues</a>, Harris’s state operations director <a href="https://www.nytimes.com/2019/11/29/us/politics/kamala-harris-2020.html">cited poor staff treatment</a> as a reason for her decision to resign in late 2019.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="LpTo6v">
<a href="https://www.politico.com/news/2021/06/30/kamala-harris-office-dissent-497290">In June 2021,</a> roughly six months after inauguration, a person with direct knowledge of the office told Politico that it was “not a healthy environment and people often feel mistreated.” This included a culture of blame that stemmed from the top, the person said.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="S5oPRM">
<a href="https://www.washingtonpost.com/politics/2021/12/04/kamala-harris-staff-departures/?pml=1">In December 2021</a>, chief spokesperson Symone Sanders, and three other staffers left their roles. And since then, <a href="https://thehill.com/homenews/administration/3572304-revolving-door-creates-questions-and-complications-for-kamala-harris/">any personnel changes</a> that have occurred have been put under a microscope.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="qpMxwU">
The White House has <a href="https://www.usatoday.com/story/news/politics/2021/12/02/kamala-harris-top-aide-symone-sanders-leave-white-house/8835084002/">argued</a> that these departures are standard for roles that are fast-paced and susceptible to burnout. Former staffers who immediately transitioned from the campaign to the administration, for example, said that they needed a break from the constant grind or wanted to spend more time with their families. Multiple former staffers also told Vox that Harris held staffers to a high standard, but was a fair boss.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="VKGpfC">
Harris’s office also isn’t the only one to have senior staff depart after one or two years. The Biden White House overall has seen 8 percent of senior staff leave in the first year and 32 percent leave in the second year, <a href="https://www.axios.com/2023/01/26/biden-white-house-turnover-senior-staff">according to an analysis by Brookings Institution</a> fellow Kathryn Dunn Tenpas, a turnover rate on par with that of President George W. Bush’s and President Bill Clinton’s. <a href="https://www.independent.co.uk/news/world/americas/us-politics/mike-pence-aides-leave-trump-white-house-a8144481.html">Vice President Mike Pence’s team</a> also saw several high-level departures in his first year including the exodus of his chief counsel, chief of staff, domestic policy adviser, and press secretary.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="q13ZdZ">
Kelly Dittmar, a political science professor at Rutgers, said it was vital to hold elected officials and lawmakers accountable for how they treat their staff. But she added that women, particularly women of color, faced outsize attention for issues related to management. “We see women who are managers in these roles, who get scrutiny of treatment of staff and turnover,” says Dittmar. “That’s a fair critique, but are we making the same critique of Mike Pence, of Joe Biden, of anyone who’s holding these roles?”
</p>
<h3 id="3gjCid">
There’s a looming question posed by Biden’s age
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="YpMN4r">
Harris isn’t the first vice president to make public missteps. During his time as vice president, Biden, <a href="https://www.theguardian.com/us-news/2019/apr/25/joe-biden-2020-public-gaffes-mistakes-history">a self-proclaimed “gaffe machine,”</a> was constantly making life difficult for his administration.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="eGNAii">
She is, however, different from other vice presidents in that she’s serving alongside the oldest president ever. Biden will turn 81 this November. Trump was 72 at this point in his presidency; Obama was 49. Biden’s advanced age puts pressure on Harris: perhaps more so than any vice president in recent history, there’s a real chance she’ll need to step into the role of president.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="GppYCG">
That’s led to her being evaluated not just as a vice president, but as a potential president. But the vice presidency isn’t set up to spotlight presidential skills — it’s a support role, at best.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="0KW7lH">
“I think it’s nearly impossible as a vice president to use the position to your political advantage in a calculated way,” says Kate Andersen Brower, a journalist and author of <a href="https://www.katebrower.com/first-in-line/"><em>First in Line</em></a>, a book on the vice presidency. “The most successful modern vice presidents, Dick Cheney and Joe Biden, were devoted to the presidents they served.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="3Eu8hz">
Despite the Biden administration’s attempts to elevate Harris by referring to the executive branch as the “Biden-Harris administration,” achievements like the Inflation Reduction Act tend to be solely attributed to Biden. That doesn’t mean Harris had nothing to do with those successes, as White House officials repeatedly pointed out in interviews.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="OsDmFV">
Biden’s outgoing Labor Secretary Marty Walsh, for instance, told Vox, “When you think about all these legislative pieces that were passed in Congress, the vice president was part of the conversations with the president, with the Cabinet, whether it was the infrastructure bill, or the IRA, or the CHIPS bill.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ZIeKmP">
Other officials stressed that Harris pushed people internally to consider the full range of responses to issues that had no hope of legislative solutions, like the end of <em>Roe</em>. “She’s been the one who is always asking the question, ‘Have we thought of everything? Are we doing everything we can, you know, running down every policy?’” one official said, adding that she was deeply involved in discussions about executive actions on reproductive rights.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="eDsVjn">
Outside groups that work on voting rights and reproductive rights offered similar thoughts: “What I don’t think she gets enough credit for is all the work she’s doing behind the scenes. And in some ways that’s the role of the VP,” says LaTosha Brown, a cofounder of Black Voters Matter, who pointed to Harris wielding her influence to make sure voting rights stayed a priority inside the White House and on Capitol Hill.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="WcA3k3">
But because she is a second-in-command, doing much of her work “behind the scenes,” some of these contributions have been less visible. Needing to serve as the tie-breaking vote in the Senate, until recently, also meant that she’s been tied to DC and unable to travel more widely.
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ZFxyJh">
There have been some vice presidents who have stepped out of the traditional support role and taken more obvious control of an issue. Vice President Dick Cheney, a former secretary of defense, for instance, had so much influence on the war on terror and national security that he was seen <a href="https://www.thedailybeast.com/cheneys-shadow-government">as running a shadow government at times.</a>
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For a VP to take on such a prominent position is uncommon, however. Biden was perhaps more typical, serving as a key congressional liaison during the Obama administration. Harris, experts say, is an important envoy on the issue of reproductive rights, including rallying voters ahead of the midterms. However, that role doesn’t give her the sort of concrete legislative victories Biden’s work on the Hill gave him during the Obama era, like the passage and implementation of the administration’s Recovery Act stimulus package.
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="IfngPV">
As a woman, and a woman of color, Harris also faces standards that other vice presidents have not. “There were a lot of expectations heaped on her as the first woman, the first Black person, the first Asian person in this job,” says University of Maryland public policy professor Niambi Carter.
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="uvHKD0">
Those expectations have been evident in the volume of negative stories she’s faced, the response to her gaffes, as well as <a href="https://www.nytimes.com/2020/08/12/us/politics/kamala-harris-gop-attacks.html">gendered</a> and <a href="https://www.cbsnews.com/news/twitter-slow-to-remove-racist-sexist-tweets-targeting-vice-president-kamala-harris-report-finds/">racist attacks</a> against her. Republicans, for instance, have <a href="https://www.youtube.com/watch?v=mH5nUme6oEw">repeatedly tried to paint her as the cause of problems</a> along the border, even though she’s not singularly responsible for these policies. Both the attacks and the heightened scrutiny Harris has encountered are classic examples of misogynoir, a compounded form of misogyny and racism that Black women face, <a href="https://www.vox.com/2020/8/21/21366337/kamala-harris-racism-sexism-misogynoir">as Vox’s Fabiola Cineas has previously reported</a>.
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“I just can’t recall a single story that’s been written about her predecessors at the volume and persistent basis that she’s seen,” said Laphonza Butler, the president of Emily’s List and an adviser for Harris’s 2019 presidential campaign.
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Dgh8j1">
When it comes to Harris’s approach to the role itself, there’s a constant catch-22, former staffers say. If she is too vocal and visible, coverage would suggest that she’s trying to control the presidency, something her <a href="https://www.vox.com/2015/4/27/8502493/obama-white-house-correspondents-dinner">predecessor Cheney was accused of</a>. If she’s not visible enough, coverage focuses on what she’s not doing, as is her problem now. If she picked a single policy lane, they say, she’d be perceived as unable to handle issues outside that subject.
</p>
<h3 id="MpkVMt">
The vice presidency comes with its own limitations
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="MR1LSY">
Harris’s supporters have one consistent rebuttal to her critics: stop treating the vice presidency as something that it’s not. “I actually think they’re kind of funny,” said Walsh. “Anyone who’s being critical of this vice president could be critical of any vice president for what their role is.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="oi8vTW">
Modern vice presidents typically follow the approach to the job pioneered by Vice President Walter Mondale, who worked under President Jimmy Carter in the 1970s, according to Joel Goldstein, a law professor at Saint Louis University who’s written a book on the vice presidency. Goldstein said Mondale created “a vision of the vice president as an across-the-board adviser and troubleshooter.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="jbZhbe">
Those who’ve worked in the White House say that’s what Harris is for Biden. “I think that the president, in my experience, sort of recognizes the comparative advantages that the two of them have, and has in the past sought out and taken to heart the vice president’s counsel on a wide range of different issues,” says one former White House official.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="91u6ij">
Stepping into such a role, however, creates an awkward tension between being vice president and bolstering your own political prospects down the line. There’s a reason only three former vice presidents have been elected president in modern times, despite more than a few attempts. In some ways, a VP job is the ideal springboard for future political ambitions given both the experience and exposure; Biden and Vice President Al Gore are among those who’ve tried to use it in this way. In others, it’s a very limiting job, because it’s a role with little opportunity to tout your own accomplishments.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Gv4rPp">
Harris does have accomplishments under her belt, like launching and overseeing a program known as <a href="https://www.state.gov/central-america-forward/">Central America Forward</a>, which includes helping secure over $4 billion in investment commitments from businesses in hopes of improving living conditions in the “Northern Triangle” countries, and reducing the number of US-bound migrants from the region. She’s also been engaging in high-profile diplomacy abroad, and has been credited with mobilizing women, voters of color, and young voters over the last two cycles.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="uVRBJ2">
Barring any major changes, and based on comments Democrats have made to the press, as well as the general perception of her — according to the FiveThirtyEight polling aggregator, <a href="https://projects.fivethirtyeight.com/polls/approval/kamala-harris/">her approval rating is at 38 percent</a> as of March 24 — those accomplishments seem unlikely to clear the way for her to clinch the presidential nomination unchallenged in the future, however.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="4y0tnj">
“Look, for the nomination, there is absolutely no way that the ambitious Democrats who ran in 2020, or those who want to run for the first time, will stand by and say, ‘Well, it’s her turn,’” says University of Virginia political scientist Larry Sabato. “She will have to work for it, no question about it.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="prWUzI">
As of now, though, two things can be true. Like any public official, Harris can and should be held accountable for her record and how she operates her office. But she’s also getting judged more harshly than her predecessors, and facing unreasonable expectations that the limitations of her role prevent her from meeting.
</p>
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<ul>
<li><strong>What Logan Roy’s sad birthday party tells you about the new season of Succession</strong> -
<figure>
<img alt="Brian Cox as Logan Roy in HBO’s Succession, wearing an all-black outfit with a black baseball cap and white beard." src="https://cdn.vox-cdn.com/thumbor/zhhPOCmZru_JeLO6FZlAgx_qTmY=/0x0:1707x1280/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/72117723/brian_cox.0.jpg"/>
<figcaption>
Brian Cox as Logan Roy in HBO’s <em>Succession</em>. | David Russell/HBO
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
It’s Logan Roy’s birthday party and he’ll further alienate his kids if he wants to.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="HzpRQA">
<em><strong>Note: This article contains spoilers for several </strong></em><strong>Succession</strong><em><strong> episodes, particularly season four, episode one, “The Munsters.”</strong></em>
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Gz1cl8">
The first episode of the fourth and final season of HBO’s <em>Succession</em> finds us — not for the first time — at the birthday celebration of Logan Roy (Brian Cox). This year, it’s not clear who organized it. Not his wife, Marcia (Hiam Abbass), who left him in season two and is now “in Milan shopping, forever.” Maybe it’s Kerry (Zoe Winters) — the new girlfriend who introduces herself as Logan’s “friend, assistant, and advisor.” Or perhaps Connor (Alan Ruck), the only one of his children that he’s currently on speaking terms with, planned it. The party looks more like a work function or a political fundraiser than a birthday celebration — adult kids Kendall (Jeremy Strong), Roman (Kieran Culkin), and Shiv (Sarah Snook) are conspicuously absent, and we don’t recognize most of the people in attendance. And Logan is miserable. “Munsters,” he grumbles, eyeballing the guests. “Meet the fucking Munsters.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="J8fBdk">
It’s a not-so-subtle callback to the very first episode, which began at Logan’s 80th birthday. Marcia has planned a “surprise” party for him. He’s surrounded by his family. Even Kendall, who’s trying to close a media acquisition deal that he hopes will please his father, takes a breather from the touch-and-go negotiations to join the festivities. Of course, it’s not all sunshine and cake — when is it ever where Logan’s involved? At the party, Logan tries to steamroll his kids into accepting a change to the trust that will give his wife Marcia more power — but there’s no doubt that the billionaire CEO of Waystar Royco is enveloped by people who care about him and know him intimately.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="nszaoK">
If Logan is having a bad birthday in the season four premiere, however, that’s of his own making. In last season’s finale, Kendall, Shiv, and Roman tried to stop him from selling Waystar to the streaming video company GoJo. First, they tried to force his hand. When that didn’t work, Roman pleaded with him, invoking love as a reason why a parent who has all the power in the world might still stand down, show compassion, and not crush his children. “You come for me with love?” Logan scoffed ferociously. “You bust in here, guns in hand, and now you found they’ve turned to fucking sausages. You talk about love?”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="9gR1Bx">
In denying the possibility of his kids ever taking over the family business, Logan crossed the Rubicon. This time, the Roy children don’t even deign to show up for their beloved father’s birthday. On what looks like the opposite side of the country, Kendall and his siblings are strategizing for the launch of their own venture, a brand-spanking new digital media outlet called The Hundred that promises to be “Substack meets MasterClass meets The Economist meets The New Yorker.” A lot has changed since Italy and the end of season three, where the kids were left sick to their stomachs at the thought that their own father would lock up Waystar forever and throw away the key. They’ve all written resignation letters for Waystar and seem (somewhat) excited about starting their own company as they prepare to meet with potential investors.
</p>
<figure class="e-image">
<img alt="Logan and Tom at Logan’s birthday party." src="https://cdn.vox-cdn.com/thumbor/eOjIxBvxVt-7_tgg702G8h7enrQ=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/24533604/brian_cox_matthew_macfadyen.jpg"/> <cite>Macall B. Polay/HBO</cite>
<figcaption>
Logan and Tom at Logan’s birthday party.
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="fdlQRy">
<em>Succession</em> has always been largely about the ruthless competition between the Roy siblings — scions of a powerful media mogul inspired by real-life media families such as the Murdochs — to inherit the top position at Waystar from their aging father. Kendall, Shiv, and Roman have each suffered a litany of betrayals, manipulations, and cruelties from Logan; trauma that would be worth it in the end, the children told themselves, if Logan chose one of them to follow in his footsteps. That all seems to have changed, perhaps irrevocably, in season four. (For a more complete backstory on the Roys, check out Vox’s <a href="https://www.vox.com/culture/23650636/succession-season-four-hbo-roy-family">pre-season preview</a>.)
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="fHghr7">
The trio, who are usually at each other’s throats, are suspiciously in sync. Throughout the episode they’re affectionate; they still rib each other, but it doesn’t have quite the same bite. They actually listen to what the others have to say, instead of waiting for the perfect moment to inject a devastating insult. “Let a thousand sunflowers bloom, Romie,” Kendall says early on — meaning, let’s throw all our ideas at the wall. It’s not clear if he recognizes that this phrase (attributed to <a href="https://www.britannica.com/event/Hundred-Flowers-Campaign">Mao Zedong</a>) is an echo of something his father said in season three, egging on his terrified advisors to suggest someone to replace him temporarily: “Let a hundred flowers bloom,” Logan tells them, though it underscores how little Logan actually listens to other people. The kids, on the other hand, might earnestly be equals in this new partnership and already look lighter now that they’re no longer under Logan’s thumb. It’s jarring to see and also a little sad — a glimpse of who these people might have been if they hadn’t grown up the way they had.
</p>
<h3 id="t5WMI6">
The kids bag a minor victory against their father
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ijv6Hy">
Then Shiv gets a call from Tom (Matthew Macfadyen) that sets off the drama of episode one. He gives his estranged wife a heads-up that he’s just had a drink with Naomi Pierce (Annabelle Dexter-Jones), who is not only a cousin of Pierce Global Media owner Nan Pierce (Cherry Jones) — the Roys tried to buy PGM in season two — but also Kendall’s ex. Tom makes it sound like it was a date, all while claiming it was not a date. He’s toying with her a bit, which is understandable considering how much of a head start Shiv has had in the “play mind games with my spouse” department. It works, momentarily, until Shiv realizes what “a drink” actually means: Logan is trying to buy PGM again.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="J2n27M">
As a reminder, here’s the latest on the business side of things in <em>Succession</em>-world: Logan is, pending a shareholder vote, selling Waystar to tech company GoJo, but retaining control of ATN, their broadcast news network. In season two, the Roys spent a lot of energy trying to buy PGM, a rival, but it fell through as the Pierces realized the Roys (and especially Logan) were toxic and about to be embroiled in scandal.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Z1BC1u">
Back at the birthday party, Tom and Logan confirm that they’re once again close to a deal with PGM. This time around, things aren’t going well at PGM, apparently. Nan seems to have lost interest in running the business, according to whispers from her own family members. “Savages,” Logan says without a hint of irony. “They eat their own.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="0uJcFU">
Logan, ever the doting father, asks after his children. “Have you heard from the rats?” he asks Tom. Tom lies that he hasn’t, and then in his typical unsubtle way probes Logan about whether their relationship might change if he and Shiv divorce. “Whatever happens, we’ll always be good, right?” he asks, making the mistake of so many Roy children in seeking reassurance from a family patriarch who purposely ensures they’re never on sure footing.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="7wMNxz">
Just a whisper of what their father is up to, and the kids are back in his orbit, ready to abandon The Hundred to make a rival bid for PGM. They’re all addicts of the family feud and can’t seem to resist scoring on their dad. Roman worries about his siblings’ vengeful motivations: Kendall wants to get back at Logan. Shiv wants to get back at Tom. Roman, as usual, is the only one who “doesn’t want to fuck anyone.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="42lqof">
Kendall leans on Roman’s penchant for mischief. “Just think about how fucking funny it would be if we screwed Dad over his decadeslong obsession,” he points out. Unbeknownst to them, they actually do have the upper hand for once. Logan is downright despondent over his absentee children and also angry that he misses their presence.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="gAILLP">
Back at the party, Kerry calls Roman, and the kids are absolutely vicious to her, but she suffers the humiliation of asking them to give their father a call. They want their father to call them, but that’s unlikely. Kerry says she could maybe get him to text a request for a call. It’s just one more business-like negotiation to the Roys, yet another game of one-upmanship.
</p>
<figure class="e-image">
<img alt="Shiv, Roman, and Kendall finally get on the phone with their father." src="https://cdn.vox-cdn.com/thumbor/OUrpFM9BarrrplAIpX2H8cfmbEQ=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/24533632/sarah_snook_kieran_culkin_jeremy_strong.jpg"/> <cite>Claudette Barius/HBO</cite>
<figcaption>
Shiv, Roman, and Kendall finally get on the phone with their father.
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="zy8lGQ">
After Logan is informed there’s a rival bid for PGM, some of his verve returns — there’s work to do. Logan’s war council — Gerri (J. Smith-Cameron), Karl (David Rasche), and Frank (Peter Friedman) — soon suss out that it’s the kids, but how did they find out about the PGM bid? Tom tries to cast off any suspicion, but his tip to Shiv is probably going to come back and bite him in the ass.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="FNbwRv">
Kendall, Shiv, and Roman travel to Nan Pierce’s home. Naomi, who is now rocking a wolf cut, tells them Nan needs five minutes because she has a headache. In other words, she’s spotted that the Roys will pay any price to destroy one another and plans on milking every cent out of it. Nan also worries that one of the new owners of PGM might be married to Tom, who heads its rival, ATN. Without missing a beat, Shiv says, “I’m getting a divorce.” It doesn’t seem like she’s announced it to anyone else. Kendall looks surprised.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="V5Yzuf">
The bidding war for PGM begins, with each side trying to figure out how high the other has gone. Logan low-balls. The kids go much higher, offering a conversation-ending number: $10 billion. (“Eight, nine,” Nan hints earlier in the episode, “who knows what someone will say next?” “9b?” Roman guesses.) Logan is told that Nan is not accepting any more bids. “Tell them I’ll go up,” Logan says. “She says they’re content,” replies Tom. Logan can’t fathom how someone could be content when there’s an offer for a bigger number.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="boEqMC">
Logan finally gets on the phone with his kids. “Congratulations on saying the biggest number, you fucking morons,” he tells them. The kids know that this is a concession, of sorts. Shiv and Kendall actually do a fist bump, while Roman looks relieved.
</p>
<h3 id="nLWPKu">
Shiv and Tom call it quits
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="rMEane">
At night, Shiv returns to a dark New York apartment. Her dog barely recognizes her. We learn that Shiv and Tom aren’t living together anymore. Shiv is full of rancor, needling Tom with crass questions regarding his love life. She’s jealous, and has been all day, of the other women Tom may or may not be sleeping with. She may also be on a mission to push forward the divorce she promises Nan earlier, which Tom doesn’t know about. But Tom is in a rare moment of blunt honesty. “Do you really want to get into a full accounting of all the pain in our marriage?” he asks gently. Shiv has no comeback to that.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="2khY7b">
Tom has mostly been a buffoon on <em>Succession</em>; he’s a social climber who has weaseled his way into one of the most powerful families in America, and his usual obsequiousness is often played off as comic relief. But his hurt here is palpable, and his sincerity is clear. No one can doubt that Tom really loves Shiv, even if part of what he loves is her power and status — and maybe Shiv realizes now, when it could be too late, that what she feels is love, too. Why else would his betrayal still hurt so much that she can’t even talk about it? Tom wants to discuss things, but she shuts it down. She doesn’t want to probe through her feelings. “I think it might be time for you and I to move on,” she says, holding back tears. Tom doesn’t beg and plead. They both lie to each other, claiming they gave it their best try.
</p>
<h3 id="hFavVn">
Logan doesn’t find life funny anymore
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="QiTAV6">
At the end of a very long, strange day, Logan is still up watching TV. He calls Cyd Peach (Jeannie Berlin), an executive at ATN, to complain about the channel’s late-night coverage. “Are you losing it, Cyd?” he asks.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="5623va">
It’s a question Logan would be better off posing to himself. During his party, he escapes the apartment for a lonely evening walk in the park, his bodyguard Colin (Scott Nicholson) trailing behind him. At a diner, Logan tells Colin that he’s his best pal. He’s suddenly an old man bitter about the turning of seasons. “Everything I try to do, people turn against me,” he says. “Nothing tastes like it used to, does it? Nothing’s the same as it was.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="JIz6OZ">
It’s his birthday, and the man normally allergic to existential waxing asks his employee, “You think there’s anything after all this?”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="hdcTul">
“I don’t know,” replies Colin.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="CSL0Qr">
“We don’t know. We can’t know,” says Logan. “But I’ve got my suspicions.” It’s the first time we’ve seen Logan meditate on the reality of nearing the end of his life, and what his legacy might be. He’s shown before that he doesn’t like to think of the past, but in this episode, he’s full of nostalgia for the way things were before. In an interlude during the PGM bidding war, Logan abruptly says to the room, “Nobody tells jokes anymore, do they?” Karl, Frank, Tom, Gerri — a room full of sycophants — look at him like deer caught in headlights.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ZhbFtF">
“Come on, roast me!” he orders. The king wants a jester. He turns to Greg.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="xFgoma">
“You’re mean,” Greg offers feebly. “You’re a mean old man, you’re a mean old bastard. And you scare the life out of folks, that’s your thing — you’re scaring me right now, and that’s why I don’t even know what to do.” Logan mocks Greg, pushing him to go further.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="dlyxIB">
“Where are your kids?” Greg asks. “Where’s all your kids, Uncle Logan, on your big birthday?”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="soAWJR">
It’s a direct hit, but Logan knows how to hit harder. He throws Greg’s absent father right at his grand-nephew’s face. It’s just too easy. No one can wound Logan the way he can wound his peons, no one can beat him at a game he invented: When they go low, he goes to the ninth circle of hell. It’s a place reserved for very few people — and he wonders why he feels so alone.
</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>Women’s cricket has finally arrived in India in its full glory!</strong> - The performances and high-intensity contests justify demands for an IPL-like league for women</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>Nikhat Zareen eager to use World Championship experience to win Olympic quota</strong> - The Asian Games, scheduled later this year, are the first qualifying event for the Paris Olympics for the boxers of the continent.</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>Winning crucial moments key to Mumbai Indians’ success in WPL, says captain Harmanpreet Kaur</strong> - MI chased down the target of 132 with three balls to spare in the low-scoring but tense summit clash at the Brabourne Stadium</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>SC agrees to hear plea related to All India Football Federation</strong> - On February 9, the top court had said it must bring the curtain down on issues plaguing the AIFF, including those pertaining to approval of its draft constitution</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>Morning Digest | EPFO subscribers are captive investors of two Adani stocks; Centre notifies revised MGNREGS wage rates, and more</strong> - Here’s a select list of stories to read before you start your day</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>Stone-throwing at Chandy: court finds three guilty</strong> - One is a CPI(M) member, while two are former members of the party. Court acquits 110 persons in the 2017 incident</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>Sigh of relief for residents near former US consulate in Begumpet</strong> - A month earlier, the place used to look like a slice of Green Zone with gun-toting guards, and people were stopped from photographing</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>BJP has to pay price in public court: K. Narayana</strong> - Congress observes ‘Satyagraha Deeksha’ in support of Rahul</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>Union Minister defends State govt. decision to scrap Muslim 2B quota, saying facility was unconstitutional</strong> - Chief Minister Basavaraj Bommai’s bold decision has helped rectify Congress mistake, says Pralhad Joshi</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>Soil testing commences for Airport Metro</strong> -</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>Nato condemns ‘dangerous’ Russian nuclear rhetoric</strong> - President Putin says Russia will station tactical nuclear weapons in Belarus.</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>Germany ‘mega strike’: Public transport network halted over pay</strong> - The 24-hour walkout is one of the largest the country has experienced in decades.</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>No Ukraine offensive without more weapons – Zelensky</strong> - There has been talk for some weeks of Ukraine launching a spring offensive against Russian forces.</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>French police clash with water reservoir protesters</strong> - The unrest follows weeks of protests against President Emmanuel Macron’s pension reforms.</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>Finland election: Sanna Marin fights for survival</strong> - Polls suggest she is in a tight race with centre-right Petteri Orpo and right-wing populist Riikka Purra.</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>Android app from China executed 0-day exploit on millions of devices</strong> - Fast-growing e-commerce app Pinduoduo had an EvilParcel stow-away. - <a href="https://arstechnica.com/?p=1926914">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Would building a Dyson sphere be worth it? We ran the numbers.</strong> - Here’s the math behind making a star-encompassing megastructure. - <a href="https://arstechnica.com/?p=1925649">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Your grocery bag might not have been recycled</strong> - Laws encourage recycling plastics, but verifying recycled content relies on tricky math. - <a href="https://arstechnica.com/?p=1926872">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The fight to expose corporations’ real impact on the climate</strong> - Most carbon emissions caused by businesses are hidden from sight. - <a href="https://arstechnica.com/?p=1926799">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Garmin’s Forerunner 955 review: Still king for runners and cyclists</strong> - Garmin proves once again that it’s the only choice for serious athletes. - <a href="https://arstechnica.com/?p=1872046">link</a></p></li>
</ul>
<h1 data-aos="fade-right" id="from-jokes-subreddit">From Jokes Subreddit</h1>
<ul>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>At the bar last night, a woman got her nipple pierced right in front of me</strong> - <!-- SC_OFF --></p>
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
On a related note, I suck at darts
</p>
</div>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/faithless_serene"> /u/faithless_serene </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/123ed0e/at_the_bar_last_night_a_woman_got_her_nipple/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/123ed0e/at_the_bar_last_night_a_woman_got_her_nipple/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A police officer pulls over a speeding car.</strong> - <!-- SC_OFF --></p>
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The officer says, “I clocked you at 80 miles per hour, sir.” The driver replies, “Gee, officer, I had it on cruise control at 60; perhaps your radar gun needs calibrating.” Not looking up from her knitting, the driver’s wife says, “Now don’t be silly, dear. You know that this car doesn’t have cruise control.” As the officer writes out the ticket, the driver looks over at his wife and growls, “Can’t you please keep your mouth shut for once?” The wife smiles demurely and says, “Well, dear, you should be thankful your radar detector went off when it did or your speed would have been higher.” As the officer makes out the second ticket for the illegal radar detector, the man glowers at his wife and says through clenched teeth, “Woman, can’t you keep your mouth shut?” The officer frowns and says, “And I notice that you’re not wearing your seat belt, sir. That’s an automatic $75 fine.” The driver says, “Yeah, well, you see, officer, I had it on, but I took it off when you pulled me over so that I could get my license out of my back pocket.” The wife says, “Now, dear, you know very well that you didn’t have your seat belt on. You never wear your seat belt when you’re driving.” And as the police officer is writing out the third ticket, the driver turns to his wife and barks, “Will you please be quiet?” The officer looks over at the woman and asks, “Does your husband always talk to you this way, ma’am?” She replies, “Only when he’s been drinking.”
</p>
</div>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/bmaltais"> /u/bmaltais </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/1235q37/a_police_officer_pulls_over_a_speeding_car/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/1235q37/a_police_officer_pulls_over_a_speeding_car/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>I love “technically true” jokes, like:</strong> - <!-- SC_OFF --></p>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
If everybody in the world held hands around the equator, most of them would drown.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Or
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Did you know that after all these years, the swimming pool on Titanic is still filled with water?
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Or
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
There are more airplanes in the ocean than submarines in the sky.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
What else you got? (It doesn’t <em>have</em> to be water-related…)
</p>
</div>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/quotidian_nightmare"> /u/quotidian_nightmare </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/122m8hh/i_love_technically_true_jokes_like/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/122m8hh/i_love_technically_true_jokes_like/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The cop asked, “Whose car is this? Where are you headed? What do you do?”</strong> - <!-- SC_OFF --></p>
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The miner replied, “Mine.”
</p>
</div>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/madazzahatter"> /u/madazzahatter </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/123iokl/the_cop_asked_whose_car_is_this_where_are_you/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/123iokl/the_cop_asked_whose_car_is_this_where_are_you/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Beauty</strong> - <!-- SC_OFF --></p>
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
A husband and wife were having dinner at a very fine restaurant when this absolutely stunning young woman comes over to their table, gives the husband a big kiss, says she’ll see him later and walks away.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
His wife glares at him and says, “Who the hell was that?”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“Oh,” replies the husband, “she’s my mistress.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“Well, that’s the last straw,” says the wife. “I’ve had enough, I want a divorce.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“ I can understand that," replies her husband, “but remember, if we get a divorce it will mean no more shopping trips to Paris, no more wintering in Barbados, no more summers in Tuscany, no more Infinities and Lexus in the garage and no more yacht club. But the decision is yours.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Just then, a mutual friend enters the restaurant with a gorgeous babe on his arm. "
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“Who’s that woman with Jim?” asks the wife. "
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“That’s his mistress,” says her husband. "
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“Ours is prettier,” she replies.
</p>
</div>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/gary6043"> /u/gary6043 </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/123if8v/beauty/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/123if8v/beauty/">[comments]</a></span></p></li>
</ul>
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