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<title>09 November, 2023</title>
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<title>Covid-19 Sentry</title><meta content="width=device-width, initial-scale=1.0" name="viewport"/><link href="styles/simple.css" rel="stylesheet"/><link href="../styles/simple.css" rel="stylesheet"/><link href="https://unpkg.com/aos@2.3.1/dist/aos.css" rel="stylesheet"/><script src="https://unpkg.com/aos@2.3.1/dist/aos.js"></script></head>
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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>Nanoscale cellular organization of viral RNA and proteins in SARS-CoV-2 replication organelles</strong> -
<div>
The SARS-CoV-2 viral infection transforms host cells and produces special organelles in many ways, and we focus on the replication organelle where the replication of viral genomic RNA (vgRNA) occurs. To date, the precise cellular localization of key RNA molecules and replication intermediates has been elusive in electron microscopy studies. We use super-resolution fluorescence microscopy and specific labeling to reveal the nanoscopic organization of replication organelles that contain vgRNA clusters along with viral double-stranded RNA (dsRNA) clusters and the replication enzyme, encapsulated by membranes derived from the host endoplasmic reticulum (ER). We show that the replication organelles are organized differently at early and late stages of infection. Surprisingly, vgRNA accumulates into distinct globular clusters in the cytoplasmic perinuclear region, which grow and accommodate more vgRNA molecules as infection time increases. The localization of ER labels and nsp3 (a component of the double-membrane vesicle, DMV) at the periphery of the vgRNA clusters suggests that replication organelles are enclosed by DMVs at early infection stages which then merge into vesicle packets as infection progresses. Precise co-imaging of the nanoscale cellular organization of vgRNA, dsRNA, and viral proteins in replication organelles of SARS-CoV-2 may inform therapeutic approaches that target viral replication and associated processes.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.11.07.566110v1" target="_blank">Nanoscale cellular organization of viral RNA and proteins in SARS-CoV-2 replication organelles</a>
</div></li>
<li><strong>Standardization and Comparison of Emergency Use Authorized COVID-19 Assays and Testing Laboratories</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
SARS-CoV-2, the causal agent of the global COVID-19 pandemic, made its appearance at the end of 2019 and is still circulating in the population. The pandemic led to an urgent need for fast, reliable, and widely available testing. After December 2020, the emergence of new variants of SARS-CoV-2 led to additional challenges since new and existing tests had to detect variants to the same extent as the original Wuhan strain. When an antigen-based test is submitted to the Food and Drug Administration (FDA) for Emergency Use Authorization (EUA) consideration it is benchmarked against PCR comparator assays, which yield cycle threshold (CT) data as an indirect indicator of viral load—the lower the CT, the higher the viral load of the sample and the higher the CT, the lower the viral load. The FDA mandates that 10-20% of clinical samples used to evaluate the antigen test have to be low positive. Low positive, as defined by the FDA, are clinical samples in which the CT of the SARS-CoV-2 target gene is within 3 CT of the mean CT value of the approved comparator test9s Limit of Detection (LOD). While all comparator tests are PCR-based, the results from different PCR assays used are not uniform. Results vary depending on assay platform, target gene, LOD and laboratory methodology. The emergence and dominance of the Omicron variant further challenged this approach as the fraction of low positive clinical samples dramatically increased as compared to earlier SARS-CoV-2 variants. This led to 20-40% of clinical samples having high CT values and therefore assays vying for an EUA were failing to achieve the 80% Percent Positive Agreement (PPA) threshold required. Here we describe the methods and statistical analyses used to establish a predefined cutoff, based on genome copies per ml (GE/ml) to classify samples as low positive (less than the cutoff GE/ml) or high positive (greater than the cutoff GE/mL). CT 30 for the E gene target using Cobas® SARS-CoV-2-FluA/B platform performed at TriCore Reference Laboratories, and this low positive cutoff value was used for two EUA authorizations. Using droplet digital PCR and methods described here, a value 49,447.72 was determined as the GE/ml equivalent for the low positive cutoff. The CT cutoff corresponding to 49447.72 GE/ml was determined across other platforms and laboratories. The methodology and statistical analysis described here can now be used for standardization of all comparators used for FDA submissions with a goal towards establishing uniform criteria for EUA authorization.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.11.08.23297633v1" target="_blank">Standardization and Comparison of Emergency Use Authorized COVID-19 Assays and Testing Laboratories</a>
</div></li>
<li><strong>Small Fiber Neuropathy after COVID-19: A Key to Long COVID</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Objectives: Report a case series of new onset small fiber neuropathy (SFN) after COVID-19 treated with intravenous immunoglobulin (IVIG). SFN is a critical objective finding in long COVID and amenable to treatment. Methods: A retrospective chart review was conducted on patients seen in the NeuroCOVID Clinic at Yale who developed new-onset SFN after a documented COVID-19 illness. We documented demographics, symptoms, treatments, diagnostics, and clinical response to treatment. Results: Sixteen patients were diagnosed with length dependent or independent SFN on skin biopsy (median age 47, 75% female, 75% Caucasian). Among the nine patients tested for autoantibodies, six were positive for either trisulfated heparin disaccharide (TS-HDS) or fibroblast growth factor receptor 3 (FGFR3). Eight patients underwent treatment with IVIG and experience significant clinical improvement in their neuropathic symptoms. 92% of patients reported post-exertional malaise characteristic of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and six patients underwent invasive cardiopulmonary exercise testing (iCPET), which demonstrated neurovascular dysregulation and dysautonomia consistent with ME/CFS. Discussion: Here we present preliminary evidence that SFN is responsive to treatment with IVIG and linked with neurovascular dysregulation and dysautonomia. A larger clinical trial is indicated to further demonstrate the clinical utility of IVIG in treating post-infectious small fiber neuropathy.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.11.07.23297764v1" target="_blank">Small Fiber Neuropathy after COVID-19: A Key to Long COVID</a>
</div></li>
<li><strong>The impact of SARS-CoV-2 variants on the likelihood of children identified as sources of infection in the NIH workforce: a cohort study</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Abstract Background: Children (&lt;18 years old) were not initially considered significant sources of infection (SOIs) for SARS-CoV-2. Risk mitigation strategies were thus prioritized for adults, and vaccination was inaccessible for children until mid-2021. Emergence of novel variants led to significant increases in COVID-19 cases in both children and adults. Whether these emergence events and increased vulnerability of unvaccinated children had a synergistic effect resulting in increased caseloads in adults requires further exploration. Methods: A retrospective cohort study was conducted among 3,545 workers diagnosed with COVID-19. Case details were compiled during contact investigations. Variants of concern were identified following sequencing of biological samples collected through employer-based testing programs. Logistic regression was performed to compare the odds of having a child SOI based on the dominant variant in the workforce. Results: One-fourth (24.5%) of the cohort reported having a child in-residence; 11.2% identified a child as their SOI. In Alpha-dominant months, the odds of having a child SOI were 0.3, and the child SOI was likely older (5-17 years old). The odds of having a child SOI increased to 1.3 and 2.2 in Delta- and Omicron-dominant months, respectively. The odds of having younger child SOIs (&lt;5 years old) were significantly higher in Omicron-dominant months. Conclusions: Children were highly likely to acquire the virus and posed a significant risk of transmission to their adult caretakers during Delta- and Omicron-dominant months. Without proper mitigation strategies in both the home and the workplace, child-associated transmission can threaten operations in the forms of staff shortages.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.11.07.23297422v1" target="_blank">The impact of SARS-CoV-2 variants on the likelihood of children identified as sources of infection in the NIH workforce: a cohort study</a>
</div></li>
<li><strong>Combining genomic data and infection estimates to characterize the complex dynamics of SARS-CoV-2 Omicron variants in the United States</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
SARS-CoV-2 Omicron surged as a variant of concern (VOC) in late 2021. Subsequently, several distinct Omicron variants have appeared and overtaken each other. We combined variant frequencies from GISAID and infection estimates from a nowcasting model for each US state to estimate variant-specific infections, attack rates, and effective reproduction numbers (Rt). BA.1 rapidly emerged, and we estimate that it infected 47.7% of the US population between late 2021 and early 2022 before it was replaced by BA.2. We estimate that BA.5, despite a slower takeoff than BA.1, also infected 35.7% of the US population, persisting in circulation for nearly 6 months. Other Omicron variants - BA.2, BA.4, or XBB - infected 30.7% of the US population. We found a positive correlation between the state-level BA.1 attack rate and social vulnerability. Our findings reveal the complex interplay between viral evolution, population susceptibility, and social factors since Omicron emerged in the US.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.11.07.23298178v1" target="_blank">Combining genomic data and infection estimates to characterize the complex dynamics of SARS-CoV-2 Omicron variants in the United States</a>
</div></li>
<li><strong>Overview of the 8th Social Media Mining for Health Applications (#SMM4H) Shared Tasks at the AMIA 2023 Annual Symposium</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The aim of the Social Media Mining for Health Applications (#SMM4H) shared tasks is to take a community-driven approach to address the natural language processing and machine learning challenges inherent to utilizing social media data for health informatics. The eighth iteration of the #SMM4H shared tasks was hosted at the AMIA 2023 Annual Symposium and consisted of five tasks that represented various social media platforms (Twitter and Reddit), languages (English and Spanish), methods (binary classification, multi-class classification, extraction, and normalization), and topics (COVID-19, therapies, social anxiety disorder, and adverse drug events). In total, 29 teams registered, representing 18 countries. In this paper, we present the annotated corpora, a technical summary of the systems, and the performance results. In general, the top-performing systems used deep neural network architectures based on pre-trained transformer models. In particular, the top-performing systems for the classification tasks were based on single models that were pre-trained on social media corpora. To facilitate future work, the datasets, totaling 61,353 posts, will remain available by request, and the CodaLab sites will remain active for a post-evaluation phase.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.11.06.23298168v1" target="_blank">Overview of the 8th Social Media Mining for Health Applications (#SMM4H) Shared Tasks at the AMIA 2023 Annual Symposium</a>
</div></li>
<li><strong>Universal protection against SARS-CoV-2 viruses by multivalent mRNA vaccine in mice</strong> -
<div>
The ongoing emergence of new strains of Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants challenges available SARS-CoV-2 vaccines for adequate control of outbreaks. Currently, there is a lack of universal vaccines for SARS-CoV-2 variants that do not necessitate strain matching between mRNA vaccines and the viruses. In this study, a nucleoside-modified twenty-valent lipid nanoparticle mRNA vaccine was designed and manufactured. The primary objective is to provide protection against various recent variants via the twenty-valent mRNA vaccine after efficacy assessment. Furthermore, the protection efficiency of bivalent and quadrivalent mRNA vaccines was compared with the universal vaccine. The neutralizing antibody activity against BA.4/5, XBB.1.5, BQ.1.1, and EG.5.1 was evaluated using enzyme-linked immunosorbent assay, pseudovirus neutralization test, and a rapid fiber-optic biolayer interferometry-based biosensor. Our universal multivalent vaccine provided robust protection against both prevailing and emerging, previously unidentified SARS-CoV-2 strains.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.11.05.565350v1" target="_blank">Universal protection against SARS-CoV-2 viruses by multivalent mRNA vaccine in mice</a>
</div></li>
<li><strong>Predicting human and viral protein variants affecting COVID-19 susceptibility and repurposing therapeutics</strong> -
<div>
The COVID-19 disease is an ongoing global health concern. Although vaccination provides some protection, people are still susceptible to re-infection. Ostensibly, certain populations or clinical groups may be more vulnerable. Factors causing these differences are unclear and whilst socioeconomic and cultural differences are likely to be important, human genetic factors could influence susceptibility. Experimental studies indicate SARS-CoV-2 uses innate immune suppression as a strategy to speed-up entry and replication into the host cell. Therefore, it is necessary to understand the impact of variants in immunity-associated human proteins on susceptibility to COVID-19. In this work, we analysed missense coding variants in several SARS-CoV-2 proteins and its human protein interactors that could enhance binding affinity to SARS-CoV-2. We curated a dataset of 19 SARS-CoV-2: human protein 3D-complexes, from the experimentally determined structures in the Protein Data Bank and models built using AlphaFold2-multimer, and analysed impact of missense variants occurring in the protein-protein interface region. We analysed 468 missense variants from human proteins and 212 variants from SARS-CoV-2 proteins and computationally predicted their impacts on binding affinities to SARS-CoV-2 proteins, using 3D-complexes. We predicted a total of 26 affinity-enhancing variants from 14 human proteins implicated in increased binding affinity to SARS-CoV-2. These include key-immunity associated genes (TOMM70, ISG15, IFIH1, IFIT2, RPS3, PALS1, NUP98, RAE1, AXL, ARF6, TRIMM, TRIM25) as well as important spike receptors (KREMEN1, AXL and ACE2). We report both common (e.g., Y13N in IFIH1) and rare variants in these proteins and discuss their likely structural and functional impact, using information on known and predicted functional sites. Potential mechanisms associated with immune suppression implicated by these variants are discussed. Occurrence of certain predicted affinity-enhancing variants should be monitored as they could lead to increased susceptibility and reduced immune response to SARS-CoV-2 infection in individuals/populations carrying them. Our analyses aid in understanding the potential impact of genetic variation in immunity-associated proteins on COVID-19 susceptibility and help guide drug-repurposing strategies.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.11.07.566012v1" target="_blank">Predicting human and viral protein variants affecting COVID-19 susceptibility and repurposing therapeutics</a>
</div></li>
<li><strong>Allosteric modulation by the fatty acid site in the glycosylated SARS-CoV-2 spike</strong> -
<div>
The trimeric spike protein plays an essential role in the SARS-CoV-2 virus lifecycle, facilitating virus entry through binding to the cellular receptor angiotensin-converting enzyme 2 (ACE2) and mediating viral and host membrane fusion. The SARS-CoV-2 spike contains an allosteric fatty acid (FA) binding site at the interface between two neighbouring receptor-binding domains. This site, also found in some other coronaviruses, binds free fatty acids such as linoleic and oleic acid, and other small molecules. Understanding allostery and how this site modulates the behaviour of different regions in this protein could potentiate the development of promising alternative strategies for new coronavirus therapies. Here, we apply dynamical nonequilibrium molecular dynamics (D-NEMD) simulations to investigate allosteric effects and identify the communication pathways in the fully glycosylated spike in the original SARS-CoV-2 ancestral variant. The results reveal the allosteric networks that connect the FA site to important functional regions of the protein, including some more than 40 Angstroms away. These regions include the receptor binding motif, an antigenic supersite in the N-terminal domain, the furin cleavage site, the regions surrounding the fusion peptide and a second allosteric site known to bind heme and biliverdin. The networks identified here highlight the complexity of the allosteric modulation in this protein and reveal a striking and unexpected connection between different allosteric sites. Notably, 65% of amino acid substitutions, deletions and insertions in the Alpha, Beta, Delta, Gamma and Omicron variants map onto or close to the identified allosteric pathways.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.11.06.565757v1" target="_blank">Allosteric modulation by the fatty acid site in the glycosylated SARS-CoV-2 spike</a>
</div></li>
<li><strong>Mucosal Adenoviral-vectored Vaccine Boosting Durably Prevents XBB.1.16 Infection in Nonhuman Primates</strong> -
<div>
Waning immunity and continued virus evolution have limited the durability of protection from symptomatic infection mediated by intramuscularly (IM)-delivered mRNA vaccines against COVID-19 although protection from severe disease remains high. Mucosal vaccination has been proposed as a strategy to increase protection at the site of SARS-CoV-2 infection by enhancing airway immunity, potentially reducing rates of infection and transmission. Here, we compared protection against XBB.1.16 virus challenge 5 months following IM or mucosal boosting in non-human primates (NHP) that had previously received a two-dose mRNA-1273 primary vaccine regimen. The mucosal boost was composed of a bivalent chimpanzee adenoviral-vectored vaccine encoding for both SARS-CoV-2 WA1 and BA.5 spike proteins (ChAd-SARS-CoV-2-S) and delivered either by an intranasal mist or an inhaled aerosol. An additional group of animals was boosted by the IM route with bivalent WA1/BA.5 spike-matched mRNA (mRNA-1273.222) as a benchmark control. NHP were challenged in the upper and lower airways 18 weeks after boosting with XBB.1.16, a heterologous Omicron lineage strain. Cohorts boosted with ChAd-SARS-CoV-2-S by an aerosolized or intranasal route had low to undetectable virus replication as assessed by levels of subgenomic SARS-CoV-2 RNA in the lungs and nose, respectively. In contrast, animals that received the mRNA-1273.222 boost by the IM route showed minimal protection against virus replication in the upper airway but substantial reduction of virus RNA levels in the lower airway. Immune analysis showed that the mucosal vaccines elicited more durable antibody and T cell responses than the IM vaccine. Protection elicited by the aerosolized vaccine was associated with mucosal IgG and IgA responses, whereas protection elicited by intranasal delivery was mediated primarily by mucosal IgA. Thus, durable immunity and effective protection against a highly transmissible heterologous variant in both the upper and lower airways can be achieved by mucosal delivery of a virus-vectored vaccine. Our study provides a template for the development of mucosal vaccines that limit infection and transmission against respiratory pathogens.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.11.06.565765v1" target="_blank">Mucosal Adenoviral-vectored Vaccine Boosting Durably Prevents XBB.1.16 Infection in Nonhuman Primates</a>
</div></li>
<li><strong>The α-dystroglycan N-terminus is a broad-spectrum antiviral agent against SARS-CoV-2 and enveloped viruses</strong> -
<div>
The COVID-19 pandemic has shown the need to develop effective therapeutics in preparedness for further epidemics of virus infections that pose a significant threat to human health. As a natural compound antiviral candidate, we focused on -dystroglycan, a highly glycosylated basement membrane protein that links the extracellular matrix to the intracellular cytoskeleton. Here we show that the N-terminal fragment of -dystroglycan (-DGN), as produced in E. coli in the absence of post-translational modifications, blocks infection of SARS-CoV-2 in cell culture, human primary gut organoids and the lungs of transgenic mice expressing the human receptor angiotensin I-converting enzyme 2 (hACE2). Prophylactic and therapeutic administration of -DGN reduced SARS-CoV-2 lung titres and protected the mice from respiratory symptoms and death. Recombinant -DGN also blocked infection of a wide range of enveloped viruses including the four Dengue virus serotypes, influenza A virus, respiratory syncytial virus, tick-borne encephalitis virus, but not human adenovirus, a non-enveloped virus in vitro. This study establishes soluble recombinant -DGN as a broad-band, natural compound candidate therapeutic against enveloped viruses.
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.biorxiv.org/content/10.1101/2023.11.06.565781v1" target="_blank">The α-dystroglycan N-terminus is a broad-spectrum antiviral agent against SARS-CoV-2 and enveloped viruses</a>
</div></li>
<li><strong>Combining models to generate a consensus effective reproduction number R for the COVID-19 epidemic status in England</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The effective reproduction number R was widely accepted as a key indicator during the early stages of the COVID-19 pandemic. In the UK, the R value published on the UK Government Dashboard has been generated as a combined value from an ensemble of fourteen epidemiological models via a collaborative initiative between academia and government. In this paper we outline this collaborative modelling approach and illustrate how, by using an established combination method, a combined R estimate can be generated from an ensemble of epidemiological models. We show that this R is robust to different model weighting methods and ensemble size and that using heterogeneous data sources for validation increases its robustness and reduces the biases and limitations associated with a single source of data. We discuss how R can be generated from different data sources and is therefore a good summary indicator of the current dynamics in an epidemic.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.02.27.23286501v2" target="_blank">Combining models to generate a consensus effective reproduction number R for the COVID-19 epidemic status in England</a>
</div></li>
<li><strong>Combining models to generate consensus medium-term projections of hospital admissions, occupancy and deaths relating to COVID-19 in England</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Mathematical modelling has played an important role in offering informed advice during the COVID-19 pandemic. In England, a cross government and academia collaboration generated Medium-Term Projections (MTPs) of possible epidemic trajectories over the future 4-6 weeks from a collection of epidemiological models. In this paper we outline this collaborative modelling approach and evaluate the accuracy of the combined and individual model projections against the data over the period November 2021-December 2022 when various Omicron subvariants were spreading across England. Using a number of statistical methods, we quantify the predictive performance of the model projections for both the combined and individual MTPs, by evaluating the point and probabilistic accuracy. Our results illustrate that the combined MTPs, produced from an ensemble of heterogeneous epidemiological models, were a closer fit to the data than the individual models during the periods of epidemic growth or decline, with the 90% confidence intervals widest around the epidemic peaks. We also show that the combined MTPs increase the robustness and reduce the biases associated with a single model projection. Learning from our experience of ensemble modelling during the COVID-19 epidemic, our findings highlight the importance of developing cross-institutional multi-model infectious disease hubs for future outbreak control.
</p>
</div>
<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.11.06.23298026v1" target="_blank">Combining models to generate consensus medium-term projections of hospital admissions, occupancy and deaths relating to COVID-19 in England</a>
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<li><strong>ASSESSMENT AND CHARACTERIZATION OF COVID-19 RELATED COGNITIVE DECLINE: RESULTS FROM A NATURAL EXPERIMENT</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Background: Cognitive impairment is the most common and disabling manifestation of post-acute sequelae of SARS-CoV-2. There is an urgent need for the application of more stringent methods for evaluating cognitive outcomes in research studies. Objective: To determine whether cognitive decline emerges with the onset of COVID-19 and whether it is more pronounced in patients with Post-Acute Sequelae of SARS-CoV-2 or severe COVID-19. Methods: This longitudinal cohort study compared the cognitive performance of 276 patients with COVID-19 to that of 217 controls across four neuroinflammation or vascular disease-sensitive domains of cognition using data collected both before and after the pandemic starting in 2015. Results: The mean age of the COVID-19 group was 56.04 (SD=6.6) years, while that of the control group was 58.1 (SD=7.3) years. Longitudinal models indicated a significant decline in cognitive throughput ((B=-0.168, P=.001) following COVID-19, after adjustment for pre-COVID-19 functioning, demographics, and medical factors. The effect sizes were large; the observed changes in throughput were equivalent to 10.6 years of normal aging and a 59.8% increase in the burden of mild cognitive impairment. Cognitive decline worsened with coronavirus disease 2019 severity and was concentrated in participants reporting post-acute sequelae of SARS-CoV-2. Conclusion: COVID-19 was most likely associated with the observed cognitive decline, which was worse among patients with PASC or severe COVID-19. Monitoring patients with post-acute sequelae of SARS-CoV-2 for declines in the domains of processing speed and visual working memory and determining the long-term prognosis of this decline are therefore warranted.
</p>
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<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.11.06.23298101v1" target="_blank">ASSESSMENT AND CHARACTERIZATION OF COVID-19 RELATED COGNITIVE DECLINE: RESULTS FROM A NATURAL EXPERIMENT</a>
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<li><strong>Text Augmentations with R-drop for Classification of Tweets Self-Reporting Covid-19</strong> -
<div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
This paper presents models created for the Social Media Mining for Health 2023 shared task. Our team addressed the first task, which involves automatically distinguishing tweets that self-report a Covid-19 diagnosis, for example, a positive test, clinical diagnosis, or hospitalization from tweets that merely state that the user has experienced Covid-19 without presenting any evidence and thus would not be considered a diagnosis. Our approach involves a classification model that incorporates diverse textual augmentations and utilizes R-drop to augment data and mitigate overfitting, boosting model efficacy. Our leading model, enhanced with R-drop and augmentations like synonym substitution, reserved words, and back translations, outperforms the task mean and median scores. Our system achieves an impressive F1 score of 0.877 on the test set.
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<div class="article-link article-html-link">
🖺 Full Text HTML: <a href="https://www.medrxiv.org/content/10.1101/2023.11.06.23298151v1" target="_blank">Text Augmentations with R-drop for Classification of Tweets Self-Reporting Covid-19</a>
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<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>Child and Adolescent Mental Health Literacy for Primary Schools Teachers. A Multicomponent Intervention</strong> - <b>Conditions</b>: Child Mental Health <br/><b>Interventions</b>: Behavioral: Child Mental Health Literacy Program <br/><b>Sponsors</b>: Universidad de Valparaiso <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>Brief Digital Intervention to Increase COVID-19 Vaccination Among Individuals With Anxiety or Depression</strong> - <b>Conditions</b>: Misinformation; Vaccine Hesitancy; Anxiety; Depression; COVID-19 <br/><b>Interventions</b>: Behavioral: Attitudinal inoculation; Behavioral: Cognitive-behavioral therapy-informed intervention; Behavioral: Conventional public health messaging <br/><b>Sponsors</b>: City University of New York, School of Public Health; University of North Carolina, Chapel Hill <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 PhaseⅡ Study to Evaluate the Safety and Immunogenicity of COVID-19 Vaccine</strong> - <b>Conditions</b>: SARS-CoV-2 Infection <br/><b>Interventions</b>: Biological: COVID-19 mRNA Vaccine (ZSVG-02-O); Biological: COVID-19 mRNA Vaccine (ZSVG-02-O); Biological: COVID-19 Vaccine (Vero Cell) ,Inactivated <br/><b>Sponsors</b>: CNBG-Virogin Biotech (Shanghai) Ltd. <br/><b>Recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Pilot Randomized Study of RD-X19 Tx Device in Subjects With PCC (Long Covid) in the Outpatient Setting</strong> - <b>Conditions</b>: Post COVID-19 Condition (PCC) <br/><b>Interventions</b>: Device: RDX-19 <br/><b>Sponsors</b>: KNOWBio Inc.; NAMSA <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>CPAP Therapy Through a Helmet or a Full Face Mask in Patients With Acute Hypoxemic Respiratory Failure: Cross-over Study</strong> - <b>Conditions</b>: Pneumonia, Bacterial; Respiratory Failure; COVID-19 Pneumonia <br/><b>Interventions</b>: Diagnostic Test: Arterial blood gases; Diagnostic Test: Respiratory rate (RR); Diagnostic Test: Pulseoximeter; Diagnostic Test: Assessment of accessory respiratory muscles work; Diagnostic Test: Esophageal pressure measurement; Diagnostic Test: Discomfort Visual Analog Scale (VAS); Diagnostic Test: Noninvasive blood pressure; Diagnostic Test: Heart rate <br/><b>Sponsors</b>: I.M. Sechenov First Moscow State Medical University <br/><b>Recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>A Phase 1 Study to Evaluate the Safety and Immunogenicity of COVID-19 Vaccine</strong> - <b>Conditions</b>: SARS-CoV-2 Infection <br/><b>Interventions</b>: Biological: Placebo; Biological: COVID-19 Vaccine (Vero Cell) ,Inactivated; Biological: COVID-19 mRNA Vaccine (ZSVG-02-O) 10 μg; Biological: COVID-19 mRNA Vaccine (ZSVG-02-O) 30 μg; Biological: COVID-19 mRNA Vaccine (ZSVG-02-O) 60 μg <br/><b>Sponsors</b>: CNBG-Virogin Biotech (Shanghai) Ltd.; Shulan (Hangzhou) Hospital <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>Investigation of Efficacy and Safety of Electrical Signal Therapy Provided by Dr Biolyse® Device in COVID-19 Disease</strong> - <b>Conditions</b>: COVID-19 Pneumonia; Virus Diseases; COVID-19 <br/><b>Interventions</b>: Device: Signal Therapy provided by Dr.Biolyse device; Other: Liquid Support Treatment <br/><b>Sponsors</b>: AVB Biotechnology <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>SAFE Workplace Intervention for People With IDD</strong> - <b>Conditions</b>: Developement of Infectious Airborne Disease Prevention Workplace Curriclulm <br/><b>Interventions</b>: Behavioral: SAFE Employment Training <br/><b>Sponsors</b>: Temple University; National Institute on Disability, Independent Living, and Rehabilitation Research <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>Effects of an EMDR Intervention on Traumatic and Obsessive Symptoms</strong> - <b>Conditions</b>: Adult ALL; Post-traumatic Stress Disorder; Obsessive-Compulsive Disorder; Disgust; Guilt; Shame <br/><b>Interventions</b>: Behavioral: EMDR <br/><b>Sponsors</b>: University of Pisa <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>Lithium Long COVID Dose-finding Study</strong> - <b>Conditions</b>: Long COVID <br/><b>Interventions</b>: Dietary Supplement: Lithium <br/><b>Sponsors</b>: State University of New York at Buffalo <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>Pharmacokinetics and Safety of GST-HG171 Tablets in Subjects With Impaired and Normal Renal Function</strong> - <b>Conditions</b>: COVID-19 Pneumonia <br/><b>Interventions</b>: Drug: GST-HG171 Tablets <br/><b>Sponsors</b>: Fujian Akeylink Biotechnology Co., Ltd. <br/><b>Recruiting</b></p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Preoperative Educational Videos on Maternal Stress Whose Children Received Congenital Heart Disease Surgery: During COVID-19 Panic</strong> - <b>Conditions</b>: COVID-19; Educational Videos; Maternal; Uncertainty; Anxiety; Depression; Congenital Heart Disease; Children <br/><b>Interventions</b>: Other: Preoperative educational videos plus routine education; Other: Preoperative routine education <br/><b>Sponsors</b>: Chung Shan Medical University <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>Pharmacokinetics and Safety of GST-HG171 Tablets in Subjects With Impaired and Normal Liver Function</strong> - <b>Conditions</b>: COVID-19 Pneumonia <br/><b>Interventions</b>: Drug: GST-HG171 Tablets <br/><b>Sponsors</b>: Fujian Akeylink Biotechnology Co., Ltd. <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>Enhancing Employee Job Satisfaction Responding to COVID-19: The Role of Organizational Adaptive Practices and Psychological Resilience</strong> - CONCLUSION: The study provides a new perspective on increasing JS during the COVID-19 pandemic, thereby expanding the scope of the antecedents of employee JS in crisis situations. It also reveals the mediating role of EE and deepens the research on the mechanism by which OAP and PR affect individuals, providing practical guidance for organizations to improve employee satisfaction in sudden public crisis situations.</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>Dexamethasone impairs the expression of antimicrobial mediators in lipopolysaccharide-activated primary macrophages by inhibiting both expression and function of interferon β</strong> - Glucocorticoids potently inhibit expression of many inflammatory mediators, and have been widely used to treat both acute and chronic inflammatory diseases for more than seventy years. However, they can have several unwanted effects, amongst which immunosuppression is one of the most common. Here we used microarrays and proteomic approaches to characterise the effect of dexamethasone (a synthetic glucocorticoid) on the responses of primary mouse macrophages to a potent pro-inflammatory agonist,…</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>Designing Cell Delivery Peptides and SARS-CoV-2-Targeting Small Interfering RNAs: A Comprehensive Bioinformatics Study with Generative Adversarial Network-Based Peptide Design and <em>In Vitro</em> Assays</strong> - Nucleic acid technologies with designed intracellular delivery systems are some of the most promising therapies of the future. Small interfering (si)RNAs inhibit gene expression and protein synthesis and may complement current vaccines with faster design and production. Although successful delivery remains an issue, delivery peptides may help to fill this gap. Here, we address this issue by applying bioinformatic approaches to design new putative cell delivery peptides and siRNAs for COVID-19…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The SLC6A15-SLC6A20 neutral amino acid transporter subfamily: functions, diseases, and their therapeutic relevance</strong> - The neutral amino acid transporter subfamily that consists of six members; consecutively SLC6A15-SLC620, also called orphan transporters, represents membrane, sodium-dependent symporter proteins that belong to the family of solute carrier 6 (SLC6). Primarily, they mediate the transport of neutral amino acids from the extracellular milieu toward cell or storage vesicles utilizing an electric membrane potential as the driving force. Orphan transporters are widely distributed throughout the body,…</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>Drug repurposing for the treatment of COVID-19: Targeting nafamostat to the lungs by a liposomal delivery system</strong> - Despite tremendous global efforts since the beginning of the COVID-19 pandemic, still only a limited number of prophylactic and therapeutic options are available. Although vaccination is the most effective measure in preventing morbidity and mortality, there is a need for safe and effective post-infection treatment medication. In this study, we explored a pipeline of 21 potential candidates, examined in the Calu-3 cell line for their antiviral efficacy, for drug repurposing. Ralimetinib 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>Inhibitory effects of SARS-CoV-2 Spike protein and BNT162b2 vaccine on erythropoietin-induced globin gene expression in erythroid precursor cells (ErPCs) from β-thalassemia patients</strong> - During the recent COVID-19 pandemic several β-thalassemia patients have been infected by SARS-CoV-2 and most patients were vaccinated against SARS-CoV-2. Recent studies demonstrate an impact of SARS-CoV-2 infection on the hematopoietic system. The main objective of this study was to verify the effects of exposure of erythroid precursor cells (ErPCs) from β-thalassemia patients to SARS-CoV-2 Spike protein (S-protein) and the BNT162b2 vaccine. Erythropoietin (EPO)-cultured ErPCs have been either…</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>Physiological responses and molecular mechanism of Chlorella sorokiniana to surgical mask exudates in wastewater</strong> - Microalgae-based bioremediation is likely to be challenged by the microplastics (MPs) in wastewater induced by the widely use of surgical masks (SMs) during COVID-19. However, such toxic impact was generally evaluated under high exposure concentrations of MPs, which was not in agreement with the actual wastewater environments. Therefore, this study investigated the microalgal cellular responses to the surgical mask exudates (SMEs) in wastewater and explored the underlying inhibitory mechanism…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Molecular dynamic simulation reveals spider antimicrobial peptide Latarcin-1 and human eosinophil cationic protein as peptide inhibitors of SARS-CoV-2 variants</strong> - COVID-19 has rapidly proliferated around 180 countries, and new cases are reported frequently. No peptide medication has been developed that can reliably block SARS-CoV-2 infection. The investigation focuses on the crucial host receptors angiotensin-converting enzyme 2 (ACE2) , which can bind receptor-binding domain (RBD) on the SARS-CoV-2 spike protein (S). To investigate the inhibitory effects of human Eosinophil Cationic Protein (hECP) and Latarcin-1 (L1)on SARS-CoV-2 infection, we have…</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 Enhancing Aerobic Capacity in Countering COVID-19-induced Liver Injury in Elderlies</strong> - COVID-19 is still a world disaster; however, its vaccination is globally available. Liver and gastrointestinal disturbances occur in patients infected with COVID-19 at varying incidences. Aging decreases the functions of the liver. Thus, the elderly have a weaker response to the COVID-19 virus. The COVID-19 virus affects the liver directly through direct and indirect mechanisms. It directly affects the renin-angiotensin system or indirectly causes sepsis, uncontrolled immune reactions,…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The prediction of main protease SARS-CoV-2 inhibition based on models of enzyme-inhibitor complexes</strong> - A set of linear regression equations predicting the IC50 values for SARS-CoV-2 main protease inhibitors was analyzed. For 180 competitive inhibitors, we have simulated the molecular dynamics of enzyme-inhibitor complexes with known structures or modeled using molecular docking. In the docking procedure, the selection of final poses was restricted by similarity to known structural analogs. The values of the energy contributions obtained by means of calculation of the free energy change of the…</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Rituximab, but not other biologics, impairs humoral immunity in patients with rheumatoid arthritis-a study using CoVariant protein arrays</strong> - CONCLUSION: After receiving three doses of SARS-CoV-2 vaccination, RA patients who underwent rituximab treatment generated sufficient antibodies but exhibited lower neutralizing activities against wild-type and multiple variants, including current Omicron. Other biological DMARDs, e.g. TNF inhibitor, IL-6 inhibitor and CTLA4-Ig, did not show obvious inhibition.</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>Inhibition of SARS-CoV-2 infection in human airway epithelium with a xeno-nucleic acid aptamer</strong> - CONCLUSIONS: Together, these results suggest that FANA-R8-9 effectively prevents infection by specific SARS-CoV-2 variants and indicate that aptamer technology could be utilized to target other clinically-relevant viruses in the respiratory mucosa.</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>Broad spectrum post-entry inhibitors of coronavirus replication: Cardiotonic steroids and monensin</strong> - A small molecule screen identified several cardiotonic steroids (digitoxin and ouabain) and the ionophore monensin as potent inhibitors of HCoV-229E, HCoV-OC43, and SARS-CoV-2 replication with EC(50)s in the low nM range. Subsequent tests confirmed antiviral activity in primary cell models including human nasal epithelial cells and lung organoids. Addition of digitoxin, ouabain, or monensin strongly reduced viral gene expression as measured by both viral protein and RNA accumulation….</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>Lipin-2 regulates the antiviral and anti-inflammatory responses to interferon</strong> - Interferons (IFN) are crucial antiviral and immunomodulatory cytokines that exert their function through the regulation of a myriad of genes, many of which are not yet characterized. Here, we reveal that lipin-2, a phosphatidic acid phosphatase whose mutations produce an autoinflammatory syndrome known as Majeed syndrome in humans, is regulated by IFN in a STAT-1-dependent manner. Lipin-2 inhibits viral replication both in vitro and in vivo. Moreover, lipin-2 also acts as a regulator of…</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>Saying no to SARS-CoV-2: the potential of nitric oxide in the treatment of COVID-19 pneumonia</strong> - Nitric oxide (NO), a gaseous free radical produced from L-arginine catalyzed by NO synthase, functions as an important signaling molecule in the human body. Its antiviral activity was confirmed in the 1990s, and has been studied more extensively since the outbreak of the SARS pandemic in 2003. In the fight against the ongoing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, some recent studies have revealed the potential of NO in the treatment of coronavirus disease 2019…</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>Inside the Israeli Crackdown on Speech</strong> - Since the October 7th attack, Palestinians and peace activists in Israel have increasingly been targeted by employers, universities, government authorities, and right-wing mobs. - <a href="https://www.newyorker.com/news/annals-of-human-rights/inside-the-israeli-crackdown-on-speech">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Women Played an Unprecedented Role at the Popes Synod. Will It Make Any Difference?</strong> - What was clear going in was that the event could have been a capstone to Franciss first decade as Pope. - <a href="https://www.newyorker.com/news/daily-comment/women-played-an-unprecedented-role-at-the-popes-synod-will-it-make-any-difference">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>How Would a Humanitarian Pause Work in Gaza?</strong> - The vague, technocratic term was apparently chosen to avoid “ceasefire.” - <a href="https://www.newyorker.com/news/daily-comment/how-would-a-humanitarian-pause-work-in-gaza">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Nikki Haley Takes On the Scum at the Third Republican Debate</strong> - Donald Trump has dominated the primary season, but his former U.N. Ambassador is the best debater in the field—and she would probably be the G.O.P.s most effective candidate against Joe Biden. - <a href="https://www.newyorker.com/news/our-columnists/nikki-haley-takes-on-the-scum-at-the-third-republican-debate">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Where Does Antisemitism Come From?</strong> - Amid a dramatic increase in attacks on Jewish people and institutions, a historian traces the cultural and political forces at work. - <a href="https://www.newyorker.com/news/q-and-a/where-does-antisemitism-come-from">link</a></p></li>
</ul>
<h1 data-aos="fade-right" id="from-vox">From Vox</h1>
<ul>
<li><strong>Its getting increasingly dangerous to be a newborn in the US</strong> -
<figure>
<img alt="Newborn baby lying on a digital scale and crying." src="https://cdn.vox-cdn.com/thumbor/JzwRUNuBzZIFPsPea8RI_HQ0Hjc=/213x0:3486x2455/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/72846472/629993186.0.jpg"/>
<figcaption>
A newborn being weighed in Fridley, Minnesota. | Education Images/Universal Images Group via Getty Images
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
How maternity care deserts are leading to a spike in infant syphilis and mortality rates.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="VrKleS">
For two weeks in a row, the Centers for Disease Control and Prevention (CDC) has released data with a clear and dismal message: Its getting increasingly dangerous to be a newborn in the United States.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="a09p0t">
First, last week, the agency published statistics showing that in 2022, the <a href="https://www.cdc.gov/nchs/data/vsrr/vsrr033.pdf">death rate for American infants increased</a> for the first time in 20 years. Then, on Tuesday, the agency released a report showing rates of congenital syphilis — that is, syphilis infections acquired in the womb — have <a href="https://www.cdc.gov/media/releases/2023/s1107-newborn-syphilis.html">risen tenfold</a> over the past decade.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="xvWG8o">
Although a lot of different risk factors drive each of these trends, theres an important one they have in common: bad — and worsening — <a href="https://www.vox.com/health-care">health care</a> access for mothers and babies.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="IFzd5y">
In the US, the obstacles mothers face in accessing health care are too often insurmountable — and as this latest data shows, the consequences to American children are dire. Things might only get worse, some experts fear, as financial, political, and social pressures drive providers further from many of the places where theyre needed most.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="aCBYsB">
“We only are hearing about more [obstetricians] leaving and more maternity wards closing,” said <a href="https://medicine.iu.edu/faculty/23603/wilkinson-tracey">Tracey Wilkinson</a>, a pediatrician who specializes in reproductive health issues at Indiana Universitys medical school. “I am terrified about what the data is going to look like next year.”
</p>
<h3 id="1TQ8Or">
Congenital syphilis and infant mortality are on the rise
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="FXsz83">
Both the syphilis data and the infant mortality data represent stunning setbacks after years of progress.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="WExCja">
Syphilis is a sexually transmitted infection caused by a spiral-shaped bacterium that leads to skin rashes in its early stages and, in its later stages, complications ranging from neurologic problems to cardiovascular disease. It can be lethal if untreated, but in its early stages, syphilis has been curable with penicillin since the 1940s.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="g597Fk">
Babies can catch syphilis from their parents while in the womb, and the infection has high rates of complication: In different studies, anywhere from <a href="https://www.cdc.gov/mmwr/volumes/72/wr/mm7246e1.htm?s_cid=mm7246e1_w#T1_down">7</a> to 31 percent of babies with congenital infection <a href="https://www.jpeds.com/article/S0022-3476(23)00513-9/fulltext#back-bib10">die as a result</a>, and another third develop <a href="https://www.ajog.org/article/S0002-9378(15)01270-3/pdf">health problems</a> that can include liver disease and bone and neurologic abnormalities.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="9170xo">
For decades, congenital syphilis was a rarity in the US. An intensive syphilis eradication campaign in the late 1990s and high rates of condom use due to concerns about HIV transmission led to a syphilis low at the turn of the millennium. Over the next decade, the CDC identified <a href="https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5914a1.htm">300 to 400 cases</a> of congenital infection every year.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ePGyji">
As HIV treatment became more widely available and condom use dropped over that period, syphilis transmission increased, with the highest rates of transmission among gay men and people in their sexual networks. But around <a href="https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6444a3.htm">2014</a>, syphilis cases began rising in women, too, and as they did, rates of syphilis infections in babies also began to rise.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="TUjPJb">
Yesterday, scientists in the CDCs STD (sexually transmitted disease) branch reported that in 2022, more than 3,700 cases of congenital syphilis were reported across the US — a <a href="https://www.cdc.gov/media/releases/2023/s1107-newborn-syphilis.html">1,000 percent increase</a> from 2012.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="PgCGIN">
As with syphilis, the story on infant mortality in the US had been largely a positive one, with rates decreasing steadily for at least <a href="https://www.cdc.gov/nchs/data/nvsr/nvsr72/nvsr72-11.pdf">30 years</a>. But in 2022, there were 600 more infant deaths than in 2021 — a 3 percent increase in the age groups death rate.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="bOqE1T">
A <a href="https://www.cdc.gov/reproductivehealth/maternalinfanthealth/infantmortality.htm">range of factors</a> can contribute to infant mortality, such as congenital abnormalities and sudden infant death syndrome, or <a href="https://www.cdc.gov/sids/index.htm">SIDS</a>. But in last weeks report, CDC authors singled out bacterial bloodstream infections and maternal complications of pregnancy as particularly notable rising threats.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="lE0hAl">
Neither congenital syphilis nor infant mortality is evenly distributed across the US. In 2021, babies born to Black, Hispanic, or American Indian/Alaska Native mothers were up to <a href="https://www.cdc.gov/media/releases/2023/s1107-newborn-syphilis.html">8 times</a> more likely to have congenital syphilis (the same analysis has not yet been performed on the 2022 numbers).
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="1g27EP">
And when it comes to <a href="https://www.cdc.gov/nchs/data/vsrr/vsrr033.pdf">infant mortality</a>, Black newborns had the highest death rate, with nearly 11 deaths per 1,000 live births — about twice the average rate. American Indian babies had the most dramatic rise in deaths — a 20 percent increase, from 7.5 to 9 deaths per 1,000 births. And the uptick in deaths was particularly pronounced in four states: Georgia, Iowa, Texas, and Missouri.
</p>
<h3 id="X1dnCL">
How pregnancy care deserts amplify threats to babies
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="KWvZne">
The risks for both infant mortality and syphilis are directly related to what happens during pregnancy.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="yhdzA7">
Because the stakes are so high for maternal syphilis infection, all but eight states <a href="https://www.cdc.gov/std/treatment/syphilis-screenings.htm">require syphilis testing during pregnancy</a>. That means prenatal care is a key opportunity for preventing congenital syphilis for babies born in the US.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="zQIYSJ">
But that system only works if people are reliably getting prenatal care and if everyone who tests positive during pregnancy gets treated. According to the newborn health nonprofit organization March of Dimes, about <a href="https://www.marchofdimes.org/peristats/data?reg=99&amp;top=5&amp;stop=34&amp;lev=1&amp;slev=4&amp;obj=1">15 percent</a> of American women get inadequate care during pregnancy.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="CraKks">
And thats contributing to the syphilis trend. According to the CDCs latest data, nine out of every 10 congenital syphilis cases in 2022 were born to women who didnt get adequate syphilis care during pregnancy. Four out of 10 were born to women who didnt get prenatal care at all, and an additional five out of 10 were born to women tested while pregnant but not treated. (Confirming a current syphilis infection usually requires two tests done several days apart. Its possible some of these women who initiated testing never followed up.)
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="fPIlXC">
Lapses in maternal care are likely contributing to the infant mortality trends, too. Although the CDCs report on infant mortality did not explore how maternal care access is related to risk, other research suggests they are closely linked.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="kfS95E">
Many of the leading causes of infant death are related to <a href="https://www.ncbi.nlm.nih.gov/books/NBK11385/">premature birth</a>, i.e. birth before 36 weeks of gestation, which is more likely to happen when a pregnant person doesnt get <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3877457/#:~:text=There%20was%20a%20significant%20relationship,in%20adequate%20and%20intensive%20care.">adequate prenatal care</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="wgt36K">
And pregnant people are increasingly finding themselves facing barriers to adequate prenatal care: Nearly 11 percent of American women of childbearing age live in counties with <a href="https://www.marchofdimes.org/maternity-care-deserts-report">inadequate maternity care</a><strong> </strong>— meaning they lack the<strong> </strong>obstetric providers and labor wards necessary to meet peoples needs.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="UE2btB">
So, just as maternal care deserts are on the rise, <a href="https://www.marchofdimes.org/peristats/reports/united-states/prematurity-profile">so are premature births</a> and the risks associated with them.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="XM0hgQ">
To make things worse, at the same time peoples access to premature birth prevention care is falling, many of the <a href="https://www.marchofdimes.org/peristats/reports/united-states/prematurity-profile">social and health risk factors for prematurity</a> are rising, like obesity and lack of health insurance.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ysvqcL">
The big picture: Better access to maternal care could reduce premature birth rates and, potentially, infant mortality. But so long as prenatal care remains scarce for many Americans, theyll be more likely to have their baby early, without the advantage of managing any risk factors they have that might affect their babys health.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="m8JWw9">
Notably, congenital syphilis transmission<strong> </strong>is probably itself contributing to rising infant mortality rates. In 2022, there were 610 more total<strong> </strong>infant deaths and 62 more syphilis-related infant deaths than in 2021.<strong> </strong>
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="VgyvCZ">
Although these numbers come from different sources, this suggests that congenital syphilis, and the prenatal care failures that are fueling its rise, may have<strong> </strong>accounted for about 10 percent<strong> </strong>of the increase in infant deaths.
</p>
<h3 id="86WT9z">
A broken insurance system, abortion restrictions, and punitive policies on pregnancy are driving a wedge between maternal care providers and the patients who need them
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="IQu0yz">
Why are so many American women not getting the maternal care they need?
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="urxgfH">
A big part of the problem is related to the hollowing out of rural health care. As <a href="https://www.cdc.gov/nchs/data/databriefs/db323-h.pdf">rural fertility declines</a> and rural areas lose <a href="https://apnews.com/article/birthing-rural-hospitals-maternity-care-births-e67a91d927eb545459e83bc7b2b95a0d">maternity wards</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8923823/">hospitals</a> — largely because of the <a href="https://www.healthsystemtracker.org/brief/health-costs-associated-with-pregnancy-childbirth-and-postpartum-care/">high cost</a> of maternity care, the difficulty of <a href="https://www.gao.gov/assets/gao-23-105515.pdf">recruiting and retaining staff</a>, and several states <a href="https://www.kff.org/health-costs/issue-brief/rural-hospitals-face-renewed-financial-challenges-especially-in-states-that-have-not-expanded-medicaid/">refusal to expand Medicaid</a> — pregnant people in rural areas are finding it increasingly hard to find care. According to the <a href="https://www.marchofdimes.org/maternity-care-deserts-report">March of Dimes 2022 report</a>, two-thirds of maternity care deserts are rural.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="yVaYNH">
But urban hospitals with labor and delivery wards are also <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8923823/">shutting down</a> or cutting services, especially <a href="https://www.cnn.com/2022/11/12/us/hospital-closures-race-deconstructed-newsletter-reaj/index.html">safety-net hospitals</a> that care for cities most vulnerable populations. These closures, which are also generally <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8923823/">blamed on financial reasons</a>, mean parents in urban areas also have less access and lower-quality pregnancy care than they once did.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="I92PU8">
Theres another important reason some states may soon see their maternal care capacity further hollowed out. In the wake of the <a href="https://www.vox.com/scotus">Supreme Court</a> decision eliminating the constitutional right to <a href="https://www.vox.com/abortion">abortion</a>, maternal care providers are <a href="https://www.nytimes.com/2023/09/06/us/politics/abortion-obstetricians-maternity-care.html">leaving red states that have chosen to tighten abortion restrictions</a> due to concern they wont safely be able to provide the full spectrum of maternity care. Additionally, <a href="https://www.washingtonpost.com/education/2023/10/13/obgyn-training-abortion-restrictions/">medical trainees</a> are <a href="https://www.axios.com/2023/04/18/abortion-ban-states-drop-student-residents">avoiding these states</a> because they know that in a state that does not permit abortion, they wont get training in a key part of pregnancy care.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="FrOeeP">
“Maternity care deserts are widening,” said Wilkinson, the Indiana pediatric reproductive health specialist. “We are seeing the experts in maternity care, such as OB-GYN and maternal-fetal medicine doctors, leave — theyre just leaving states. And were seeing hospitals close because of the costs of that. Its almost like a double hit.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="GUJsBz">
“We knew there was a train crash coming, and <em>Dobbs</em> actually just took the train off the rails completely,” she said.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="6dC25Y">
Even when they can access prenatal care, women who live on the margins of society — in particular, women who use drugs — may <a href="https://www.vox.com/health/23688319/syphilis-rates-women-rising-substance-use-health-care">avoid contact with health care providers</a> out of concern that punitive <a href="https://www.vox.com/policy">policies</a> around drug use in pregnancy could lead to bad consequences for themselves or their kids. Unfortunately, these women are among those whose babies are at <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6915834/">highest risk</a> for congenital syphilis infection and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3349286/">other conditions</a> that could lead to death in infancy.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="5q7WMq">
Authors of the infant mortality report did not suggest solutions in their publication. But on syphilis, CDC representatives articulated a strategy centered on broadening testing to more people and places and treating people who test positive during their first office visit.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="aldaKx">
Problems with multiple causes require multiple solutions, said Laura Bachmann, the chief medical officer of the <a href="https://www.cdc.gov/nchhstp/eis/DSTDP.html">CDCs Division of STD Prevention</a>, in an interview. “Theres a lot of work to be done,” she said.
</p></li>
<li><strong>Why stop at the four-day workweek?</strong> -
<figure>
<img alt="A figure sits, working at a desk in the middle of a Japanese dry garden. Four giant keys from a keyboard sit amongst the sand with lines in the sand emanating around them. " src="https://cdn.vox-cdn.com/thumbor/QEynFhx5bQ979wT4O9nIJMgulto=/111x0:1551x1080/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/72739902/HoiChan_4dayworkweek_final.0.png"/>
<figcaption>
Hoi Chan for Vox
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Companies are opting for shorter weeks. But without worker power, theyre just another employer perk.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="VnmDKF">
A widely shared definition of “freedom” is tough to agree upon, but until the 1930s, <a href="https://tupress.temple.edu/books/free-time">a broad group of Americans</a>, from poets and architects to business owners and conservative politicians, shared a vision that capitalism would deliver on the hazy idea in a very concrete way: more and more leisure time for all.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="oKGCuO">
In their view, economic progress would carve a path from the grueling factories of the Industrial Revolution to a not-so-distant future largely free from work. As the British economist John Maynard Keynes <a href="http://www.econ.yale.edu/smith/econ116a/keynes1.pdf">put it</a> in 1930, “for the first time since his creation man will be faced with his real, his permanent problem — how to use his freedom from pressing economic cares, how to occupy the leisure which science and compound interest will have won for him.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="98fyLE">
For many decades, things seemed to be on track. New technologies helped <a href="https://ourworldindata.org/grapher/gdp-per-capita-maddison?tab=chart&amp;time=1775..latest&amp;country=~USA">drive up productivity</a>, while the labor movement <a href="https://archive.nytimes.com/www.nytimes.com/books/business/9806schor-overworked.html">helped steer that growth to shift</a> the balance of life for ordinary citizens from employment to leisure. Americans began shifting from agriculture to manufacturing <a href="https://www.vox.com/labor-jobs">jobs</a>, where the average working week dropped from <a href="https://academic.oup.com/book/36392/chapter-abstract/320016496?redirectedFrom=fulltext">over 70 hours</a> in 1830 to <a href="https://www.nber.org/system/files/working_papers/w18816/w18816.pdf">roughly 40 hours</a> in 1930. In 1933, <a href="https://www.washingtonpost.com/history/2021/09/06/40-hour-work-week-fdr/">a bill passed the Senate</a> — with initial support from then-President Franklin Roosevelt — that would have created a 30-hour workweek. But following significant industry opposition, Roosevelt shifted toward focusing on <a href="https://www.nytimes.com/2006/02/12/business/yourmoney/chasing-full-employment.html#:~:text=Roosevelt%20put%20full%20employment%20on,every%20adult%20who%20wanted%20work.">40-hour workweeks for all</a> rather than shortening them. The aim of progress followed the same shift — <a href="https://www.musingmind.org/podcasts/ben-hunnicutt">away from gathering more leisure time</a> and toward securing full-time employment.
</p>
<figure class="e-image">
<img alt="Weekly working hours from 1870 to 2000 in the US. They declined until around 1940, after which they began flatlining." src="https://cdn.vox-cdn.com/thumbor/u8ed21yWmeUglR7ddiZIEGMjmSQ=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/24962289/work_hours_per_week__1_.png"/> <cite>Our World in Data</cite>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="HiXsOc">
Now, the lingering disruptions of the pandemic and rapid progress in AI and automation are helping to revive the dream that economic progress could lead to more leisure time. Nowhere is that clearer than in the rising <a href="https://time.com/6248369/4-day-work-week-2023/">interest in four-day workweeks</a>. Results from international trials of the idea across wealthy countries are <a href="https://www.cnbc.com/2023/04/14/countries-that-are-embracing-or-experimenting-with-a-4-day-workweek.html">beginning to roll in</a>. The word is good — employees are <a href="https://www.latimes.com/world-nation/story/2023-02-21/4-day-workweek-shorter-hours-happier-employees">happier</a>, and employers seem to exhibit the <a href="https://www.wsj.com/articles/after-testing-four-day-week-companies-say-they-dont-want-to-stop-a06089cc">same amount of productivity</a> they do with five-day weeks.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="R9ISqV">
Four-day weeks would make for an excellent perk wherever they fit — like free lunches at the office, but way better. I hope they spread. That said, convincing some companies to offer four-day weeks falls well short of designing an <a href="https://www.vox.com/economy">economy</a> that translates economic growth into the option of more leisure time for all. Leisure isnt just an extra vacation day here or there. As the German philosopher <a href="https://www.google.com/books/edition/Leisure_the_Basis_of_Culture/45DWAAAAMAAJ?hl=en">Josef Pieper wrote</a>, its the basis of culture, a “condition of the soul,” a way of living where people arent forced to sacrifice most of their waking lives for a paycheck.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="RjWFU5">
The deeper issue is that convincing companies to adopt four-day weeks does little to change the balance of power between workers and employers. Left unchanged, the negotiation over how many hours should constitute “full-time” would continue being held in the boardroom, where workers and their interests are largely without representation, and given todays <a href="https://www.vox.com/future-perfect/2023/6/10/23754360/labor-union-resurgence-boom-starbucks-amazon-sectoral-bargaining">hampered labor movement</a>, without much influence. That would significantly reduce the scope of our potential leisure time by leaving employers — rather than workers or an empowered labor movement — in virtually sole control of deciding when economic growth translates to more time off.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="835x2D">
In the glory days of the American labor movement, when <a href="https://www.vox.com/unions">unions</a> were strong and wages rose alongside productivity, “organized workers could cash that out as more free time,” said <a href="https://www.maxwell.syr.edu/directory/aaron-benanav">Aaron Benanav</a>, a professor of sociology at Syracuse University and author of <a href="https://www.versobooks.com/products/2682-automation-and-the-future-of-work"><em>Automation and the Future of Work</em></a><em>. </em>
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="9K2ry2">
“But for decades, workers havent even been getting that choice because, for the most part, productivity growth has ended up as higher profits and more inequality,” he said. “It takes a political movement to cash that out in terms of a reduced workweek.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="nkdsxp">
A renewed politics of leisure time should return that choice to workers by focusing on the old program of <a href="https://rooseveltinstitute.org/publications/we-need-a-whole-of-government-approach-to-increasing-worker-power">raising labors bargaining power</a>. Familiar ideas like unions and <a href="https://www.vox.com/policy-and-politics/2019/9/2/20838782/unions-for-all-seiu-sectoral-bargaining-labor-unions">sectoral bargaining</a> are good starting places. But beyond institutions that give workers an organized voice, other avenues that provide unconditional resources to all citizens — like <a href="https://racepowerpolicy.org/wp-content/uploads/2023/05/Guaranteed-Income-for-the-21st-Century.pdf">guaranteed income</a>, <a href="https://www.nytimes.com/2023/06/23/opinion/ezra-klein-podcast-darrick-hamilton.html">baby bonds</a>, or <a href="https://www.nytimes.com/2023/07/18/opinion/universal-health-care.html">universal health care</a> — can also help give workers more of a say in what they do with their time by making their basic needs less dependent on having a paycheck.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="LBeAE5">
Without these pieces, the working week, and through it, the shape of most Americans lives, will continue being set by the clock of business. But the old ideal of leisure, what the <a href="https://pubs.lib.uiowa.edu/wwqr/article/25637/galley/134005/view/">poet Walt Whitman called</a> both “higher progress” and “the task of America,” held that human potential goes far beyond the scope of whats good for business. “The world of work,” Pieper cautioned, “threatens to become our only world … grasping ever more completely the whole of human existence.” Leisure expands the world beyond work, adding a richness and depth that exceeds the logic of business.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="7JSkKm">
Alone, four-day weeks will probably not bring on a leisurely transformation of the soul toward Whitmans vistas of higher progress. But combined with empowered workers who wield more of a say in the shape of their lives, we could recover the sense that economic progress expands the horizons of human life, even if that means leaving economic logic behind.
</p>
<h3 id="mVhNG2">
<strong>Four-day workweek experiments bring good news</strong>
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ptvk4K">
Societies can approach a four-day workweek from two directions: above or below. From above, the government could lower the overtime-pay threshold of weekly hours — the limit at which employees are contracted to work without additional pay — from 40 to 32. The threat of extra pay creates enough incentive for most employers to set what counts as “full-time” at the overtime threshold. This is how the <a href="https://www.epi.org/blog/celebrating-75-years-fair-labor-standards/">Fair Labor Standards Act</a>, signed into law in 1938, codified the 40-hour workweek in 1940.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="NOsN0V">
From below, individual companies can choose to offer shorter hours on their own. Before the 40-hour week was law, Henry Ford <a href="https://timesmachine.nytimes.com/timesmachine/1926/09/26/100002542.html?pageNumber=1">implemented one</a> in his factories in the 1920s to prevent exhaustion among his assembly line workers and open up more time for consumption and travel, while still paying enough to <a href="https://content.time.com/time/specials/packages/article/0,28804,1977881_1977883_1977922,00.html">help grow the middle class</a> he needed to purchase his cars. It worked so well that it was eventually adopted across much of the economy, helping create the pressure that led to federal legislation.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="WpChXZ">
Its one thing to imagine shorter weeks working on an assembly line in 1920, where the work is so repetitive that it nearly automates itself by turning the humans carrying it out into robots. But todays four-day experiments have seen success across a range of industries, from <a href="https://www.nytimes.com/2023/08/08/dining/restaurant-four-day-workweek.html">restaurants</a> to <a href="https://www.theguardian.com/world/2017/jan/04/sweden-sees-benefits-six-hour-working-day-trial-care-workers">healthcare</a> to preschool education. Iceland <a href="https://www.bbc.com/news/business-57724779">experimented</a> with four-day weeks across public sector jobs, including hospitals, preschools, and social service providers. Large companies like <a href="https://www.npr.org/2019/11/04/776163853/microsoft-japan-says-4-day-workweek-boosted-workers-productivity-by-40">Microsoft</a> and <a href="https://www.nytimes.com/2020/12/03/business/unilever-work-week.html">Unilever</a> tried it at their Japan and New Zealand locations, respectively. And if companies cant afford (or refuse) to pay the same amount for less work, <a href="https://www.reuters.com/world/europe/spain-offers-pay-companies-testing-4-day-work-week-2023-04-13/">Spain tried an approach</a> where the government steps in to make up the difference in pay.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="5DLi88">
Across these experiments, the results tell a similar story: Paying people the same amount for less time leaves them feeling happier and healthier and often boosts business, too. “I used to be exhausted all the time,” Lise-Lotte Pettersson, an assistant nurse at a retirement home that dropped down to six-hour workdays for two years, <a href="https://www.theguardian.com/world/2017/jan/04/sweden-sees-benefits-six-hour-working-day-trial-care-workers">told the Guardian</a>. “But not now … I have much more energy for my work, and also for family life.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="WVtxX5">
One analysis made the case that reducing working hours <a href="https://6a142ff6-85bd-4a7b-bb3b-476b07b8f08d.usrfiles.com/ugd/6a142f_5061c06b240e4776bf31dfac2543746b.pdf">could also help lower carbon emissions</a> by cutting electricity use, commutes, and household consumption in the UK, a connection <a href="https://www.washingtonpost.com/climate-solutions/2022/08/08/4-day-workweek-environment/">growing in popularity</a> among advocates.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="WKzZtX">
The <a href="https://autonomy.work/portfolio/uk4dwpilotresults/">worlds largest four-day experiment</a> to date — a six-month trial with 61 participating companies and about 2,900 workers across the UK — wrapped up at the end of 2022 with another batch of extremely positive results. The average life satisfaction across all workers spiked from 6.69 to 7.56 on a scale from zero to 10. Thats nearly a 10 percent jump in overall life satisfaction, a pretty massive well-being gain. When asked about the amount of time they had to “do the things they like doing,” employee satisfaction went up over two points, or more than 20 percent.
</p>
<figure class="e-image">
<img alt="A table visualizing the worlds largest four-day workweek experiment demonstrates a marked increase in life satisfaction and employee retention and decreases in stress and burnout. " src="https://cdn.vox-cdn.com/thumbor/0Gb2I8piQPfdwnT46nkcI9i0fvU=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/24962786/Resized_4DWW_final.png"/>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="9QDnnf">
<br/>Companies did well, too. Resignations fell by 57 percent compared to the same period the year before. Employers rated the experiment an 8.3 out of 10. Months after the trial ended, 56 of 61 participating companies still had the four-day week in place, 18 of which had already made it a permanent change.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="MyHnqH">
Even if the results from trials are positive on balance, there are already a few potential issues in view. First, especially if employers are dictating the terms, four-day weeks could simply come to mean cramming the same amount of work time into fewer calendar days, like working four 10-hour days. That might suit some peoples preferences. But for others, its <a href="https://www.wired.com/story/four-day-week-burnout/">a road to more burnout</a>, not less.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="HBsfYx">
To keep the idea of four-day weeks from pointing toward burnout, <a href="https://www.4dayweek.com/">4 Day Week Global</a>, an organization behind many of the pilot experiments, <a href="https://www.4dayweek.com/about-us">advocates</a> for the 100-80-100 model: 100 percent of the pay for 80 percent of the time, with 100 percent of the productivity.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="HdHSKZ">
But keeping productivity up despite less time creates a need to cut fluff out of the workday. That can mean unnecessary meetings. It can also mean those leisurely moments of communion with a colleague, spending an extra five minutes chatting while the tea steeps, or roaming the halls just to see what folks are up to. Some leisure at the workplace can be good, too.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="qRpQFg">
More broadly, <a href="https://link.springer.com/article/10.1007/s11301-023-00347-3">a review of the academic literature</a> on four-day weeks found that while, yes, the balance of results looks good, negatives include an intensification of both employee surveillance and performance measures, while some employees positive reactions may fade over time. If shorter weeks drive employers to squeeze as much productivity as they can out of the remaining time their employees are on the clock, and technologies for employee surveillance continue their <a href="https://equitablegrowth.org/research-paper/workplace-surveillance-is-becoming-the-new-normal-for-u-s-workers/">Orwellian development</a>, more leisure time could paradoxically come at the cost of less freedom at work.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="9josCc">
Its incredibly convenient, then, that theres a solution that could bring todays four-day efforts back in line with the older, grander vision for a more emancipatory politics of leisure time, while also guarding against the downsides were seeing today: a focus on significantly raising workers bargaining power.
</p>
<h3 id="tIpcV5">
<strong>A politics of leisure time needs power, not perks</strong>
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="FyssWG">
To design an economy that both sustains and spreads the option of more free time to all, well need a political movement that gathers power. But for the moment, four-day weeks are more of a perk. The <a href="https://www.nytimes.com/2022/09/22/business/four-day-work-week-uk.html">focus</a> on pro-business merits like stable productivity levels and lower employee turnover makes the power dynamics clear: Even if workers want more leisure, unless their bosses sign off, they cant have it.
</p>
<figure class="e-image">
<img alt="A black-and-white photograph depicts a line of marching protesters holding signs. One sign reads: We want a six-day week. Another reads: We are asking a 48 hour week. " src="https://cdn.vox-cdn.com/thumbor/Sw5ohzk1rEoSBFmiV3PcgkuB_o0=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/24962682/GettyImages_515162514.jpg"/> <cite>Bettmann</cite>
<figcaption>
Workers from the De Vries dairy plant in Norwalk, Ohio, picket for shorter hours and more pay in 1937.
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="masiGB">
“That framing was really important for getting employers to sign on,” said Benanav. “My sense from talking to the researchers is that it was a very strategic way of presenting things to get the pilots off the ground.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="SygoWK">
When leisure time was understood <a href="https://www.bostonreview.net/articles/mike-konczal-tk/">as the measure of freedom through the early 20th century</a>, it wasnt primarily because more leisure time would be good for business. It was that human life could be about more than business. The struggle for subsistence, the “economic problem” as <a href="http://www.econ.yale.edu/smith/econ116a/keynes1.pdf">Keynes called it</a>, is not the “permanent problem of the human race.” Selling the four-day week as a productivity boon <a href="https://www.theatlantic.com/ideas/archive/2021/07/stop-treating-leisure-as-a-productivity-hack/619467/">belies the point</a>: As it was historically understood by many, the point of raising productivity was to expand human leisure, not the other way around. Justifying leisure in terms of productivity is like justifying a vacation in terms of how much work you could get done once youre back and well-rested.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="OB4x8R">
But designing a world where economic logic doesnt always have the final say over human life means workers need the power to make different choices or demand different structures of work, even — or especially — when businesses arent on board.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="DAUrGy">
A politics of leisure led by boosting worker power is also far more flexible. Plenty of Americans really do love their jobs and would not want to work any less than they do. Particularly in the US, work can be <a href="https://www.theatlantic.com/ideas/archive/2019/02/religion-workism-making-americans-miserable/583441/">an anchor of identity</a> and a real source of meaning, community, and fulfillment. If Americans choose to work 40-hour weeks on the grounds of freedom rather than necessity — because they love the work and not because they cant otherwise afford decent lives — then why not?
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="BeXEHw">
But plenty of Americans have no choice but to labor in full-time jobs that suffocate rather than nourish their identities. Here, access to more leisure can help people forge meaningful lives through activities outside the labor market.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="8HxtSX">
“People talk about the decay of civil society,” said <a href="https://rooseveltinstitute.org/authors/mike-konczal/">Michael Konczal</a>, director of the <a href="https://rooseveltinstitute.org/">Roosevelt Institute</a>, a progressive think tank. “Control over time is such an essential part of whether or not youre able to participate in your community. If you have very low control over your time, that really does cut against civil society.” Religious affiliation, for example, has been <a href="https://www.pewresearch.org/religion/2021/12/14/about-three-in-ten-u-s-adults-are-now-religiously-unaffiliated/">on the decline</a>. Maybe more leisure time could afford people the space to build new institutions that help fill the gap and <a href="https://www.sciencedirect.com/science/article/pii/S2352250X20301780">reclaim the prosocial effects</a> that noneconomic activities can generate.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="7fWO48">
None of this works, though, if we stray from the 100-80-100 model and more leisure means less pay. Thats why a focus on worker power is so important — it can help spread the option of leisure to waged workers <a href="https://nymag.com/intelligencer/2023/03/four-day-week-workweek-studies-white-collar.html">outside of the white-collar industries</a> where employers might be willing to offer four-day weeks out of self-interest.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="VdLKwY">
But the future of worker power in the US is deeply unclear. The last 50 or so years have seen <a href="https://www.epi.org/unequalpower/publications/wage-suppression-inequality/">one of the largest declines in worker power</a> in American history. Wages <a href="https://www.epi.org/publication/charting-wage-stagnation/">stagnated while productivity and inequality</a> rose. Union coverage declined to historic lows, where it<a href="https://www.vox.com/future-perfect/2023/6/10/23754360/labor-union-resurgence-boom-starbucks-amazon-sectoral-bargaining"> remains today</a>. The reclassification of some <a href="https://www.vox.com/policy-and-politics/2019/3/20/18272918/conde-nast-epicurious-employee-freelancer-contractor">workers as independent contractors</a> means a whole new group now misses out on traditional benefits like health care and sick days.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="SXbKj5">
And yet, there are<a href="https://www.politico.com/news/2023/05/29/low-income-wages-employment-00097135"> reasons for cautious optimism</a> beginning to enter the frame. Wage growth is<a href="https://www.theatlantic.com/ideas/archive/2023/03/wage-growth-income-inequality-labor-market/673277/"> now outpacing inflation</a> at the low end of the income distribution. The White House <a href="https://www.dol.gov/general/labortaskforce">established a task force</a> on worker power, signaling the much-needed return of federal support. Unemployment has <a href="https://commonwealthmagazine.org/economy/unemployment-rate-hits-lowest-monthly-level-since-1976/">remained remarkably low</a>, leaving a tight labor market that can drive up wages. Workers have been flexing their muscles in a <a href="https://www.vox.com/technology/2023/8/2/23815980/hot-strike-summer-labor-union-actors-writers-drivers">summer of strikes</a>.
</p>
<figure class="e-image">
<img alt="A crowd of people hold protest signs and raise their hands in the air. " src="https://cdn.vox-cdn.com/thumbor/xo6MDLK41J64u15JRKAG9ipBYTs=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/24962709/GettyImages_1532794702.jpg"/> <cite>David McNew</cite>
<figcaption>
SAG-AFTRA union members walk a picket line outside Paramount Studios on day two of the Hollywood actors strike on July 14th, 2023.
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="TT5DCu">
Like the four-day week, this is all good news. Also like the four-day week, it falls short of what may be required to put more worker control over their time on the bargaining table. To gain that sort of leverage, workers will likely need <em>a lot</em> more power, not just a tight labor market and slightly higher wages. So how do we get from here to there?
</p>
<h3 id="sJFAkZ">
<strong>Bargaining for leisure</strong>
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ToQv8J">
Empowering workers to bargain for more leisure means giving them enough leverage to make demands while conveying a real threat of walking away from the job if their demands arent met. Empty threats wont change the economy, but credible ones could.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Fhx4TJ">
While its a long road to that kind of worker power, its pretty well mapped out. “The formula has more or less been there for a century,” said Konczal. First, make sure everyone in the economy has money to buy stuff. That drives up profits, leads to more hiring, lowers unemployment, and ultimately gives labor more leverage since employers are competing for fewer available workers. Second, let workers unionize and collectively bargain <a href="https://www.washingtonpost.com/business/2022/12/13/unions-nlrb-firings-unions/">rather than firing them</a> for it.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Eyc2LN">
The road, though, doesnt end there. “One thing you need,” said Benanav, “is something that was never really achieved in the US: actual <a href="https://www.vox.com/policy-and-politics/2019/9/2/20838782/unions-for-all-seiu-sectoral-bargaining-labor-unions">sectoral bargaining</a>. Not just collective bargaining at the firm level, but at the industry level.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Jqlqyi">
Sectoral bargaining means unions would negotiate standards that apply to all workers in an industry, not just those who work in unionized firms. To complement that greater representation, workers would also benefit from <a href="https://www.vox.com/social-programs">social programs</a> like unconditional cash transfers, universal healthcare, or as the pandemic showed, stronger <a href="https://uiworkerbenefit.niskanencenter.org/">unemployment insurance</a>. We already saw early tremors of the power such reforms can hold as part of the <a href="https://www.vox.com/22348364/united-states-stimulus-covid-coronavirus">surprisingly generous US policy response</a> to the Covid-19 pandemic, particularly the <a href="https://www.vox.com/the-highlight/21358814/coronavirus-covid-19-pandemic-unemployment-600">boosted unemployment insurance</a>. “A lot of that was giving people resources to just make their own decisions,” said Konczal.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="YR5m9v">
Having enough resources to make ones own decisions is a key point. One particularly loopy assumption in economic theory is that workers are free to choose the precise <a href="https://scholar.harvard.edu/files/gborjas/files/lechapter2.pdf">balance between labor and leisure</a> that reflects their preferences and values. In practice, most workers cannot just tune down their work by one and a half hours if theyd prefer that much more leisure — employment hours arent that flexible, and doing away with that much pay is often untenable.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="evzxOM">
Critics will <a href="https://www.independent.co.uk/news/world/americas/us-politics/anger-at-marco-rubio-as-he-calls-child-tax-credit-socialism-while-he-pockets-174-000-a-year-b1942183.html">often deride programs</a> that deliver unconditional benefits as “socialist,” but the irony is that such reforms can actually help <a href="https://www.researchgate.net/publication/225409663_The_Physical_Basis_of_Voluntary_Trade">shore up capitalisms broken foundations</a>. Market economies are based on the promotion of freedom through voluntary trade. But how voluntary is accepting an undesirable job when the alternative is eviction or food insecurity?
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="gAfBtK">
By providing a baseline of resources unconditionally — that is, to all citizens, whether or not theyre employed — people gain what the economist <a href="https://www.hup.harvard.edu/catalog.php?isbn=9780674276604">Albert Hirschman called an “exit option</a>.” Not just the freedom to choose their flavor of misery, but the real possibility of saying no.
</p>
<h3 id="pO85U9">
<strong>Putting a real leisure agenda on the table</strong>
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="VtFvat">
There are other ways of <a href="https://www.peoplespolicyproject.org/projects/the-leisure-agenda/">promoting leisure time</a> — more federal holidays, mandatory vacations, <a href="https://www.jec.senate.gov/public/_cache/files/98e919eb-87e6-4a5a-b286-ccb9283bd40b/retirement-insecurity-2020-final.pdf">pumping up social security</a> so people can actually retire. <a href="https://groups.csail.mit.edu/mac/users/rauch/worktime/hours_workweek.html">Some scholars believe</a> that peasants of the late medieval period enjoyed more leisure time than todays average American worker, largely because about half of the calendar year was occupied with festivals and celebrations.
</p>
<figure class="e-image">
<img alt="A black-and-white photograph shows a line of men wearing suits and top hats standing beneath a large banner that reads: 8 hours labor / 8 hours recreation / 8 hours rest. " src="https://cdn.vox-cdn.com/thumbor/0S439ObVQ7gV0-j1pkKDMVpoINA=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/24962730/GettyImages_86260586.jpg"/> <cite>Hulton Archive/Stringer</cite>
<figcaption>
A labor organization in Australia celebrates the third anniversary of securing the eight-hour day for stonemason workers in 1858.
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="bdJ9dD">
But no leisure agenda is complete without significantly boosting worker power. This helps ensure not only the possibility of more leisure, but a more dynamic and adaptable economy that accommodates a variety of people with different values and different visions of what makes for a good life.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="MR02FR">
A useful way to orient the leisure agenda is to ask what its for. If the point is just to keep workers refreshed and happy enough to continue their productive contributions to economic growth, then maybe things are already on track. Results from the four-day experiments suggest its the kind of balm for workers that would sustain them as happier, better employees.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="IOKO8p">
If the politics of leisure time is about raising the amount of control all people have over the kinds of time that fill their lives, then the present trajectory needs to angle toward power. Without more bargaining power, leisure will always have to justify itself in terms of productivity, placing a cap on how far the leisure agenda might go. With more power, leisure could break free from the hold of economic logic, expanding peoples freedom to lead a wider variety of lives.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="JkNN1W">
The possibility of leisure is something that society — the collective action of all members — produces. But seizing it requires empowering those who would be its champions. And there are plenty. Anyone who endures the gnawing feeling that work is <a href="https://strikemag.org/bullshit-jobs/">bending their life in service of a job they do not particularly enjoy</a> is the potential beneficiary of a real leisure agenda.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ZDhyqa">
The opportunity to spread the power of choosing more leisure is closer than ever before. Alongside the governments and businesses making decisions about the working week, we should equip workers with the tools to rein in the freedom of leisure, one of the oldest — and today, neglected — frontiers of progress.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="4jnmy4">
“In terms of technological and economic conditions, we could do this,” said Benanav. “We have all the technical capacities. We just arent organized enough.”
</p></li>
<li><strong>In the West Bank, Israeli settlers are on an anti-Palestinian rampage</strong> -
<figure>
<img alt="Three men stack pieces of wood and metal on a large farm wagon, with tents and pieces of canvas collapsed nearby." src="https://cdn.vox-cdn.com/thumbor/k53bZyXQq7X9mpdjOSJuF9tumWk=/38x0:1745x1280/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/72846362/GettyImages_1758010490.0.jpg"/>
<figcaption>
Palestinian families pack up their belongings, dismantle their homes, and uproot their lives after a decision was made as a community to leave due to repeated reports of Israeli settler violence and harassment, in the village of Khirbet Zanuta in the West Bank, on October 30. | Marcus Yam/Los Angeles Times via Getty Images
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Since October 7, settler radicals have been attacking Palestinians at an unprecedented rate — uprooting entire communities and threatening a wider war.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="nTCSQd">
On Friday afternoon, I sat at home and waited to find out if Tariq Hathaleen was alive.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="TOS0Us">
Tariq is an activist and English teacher in the <a href="https://www.vox.com/palestine">Palestinian</a> village of Umm al-Khair located in the <a href="https://www.vox.com/2018/11/20/18080034/west-bank-israel-palestinians">West Bank</a>, the land to the east of <a href="https://www.vox.com/israel">Israel</a> thats home to nearly 3 million Palestinians and would make up the heart of any future Palestinian state. He and I had just been connected by a mutual acquaintance, who suggested that Tariq would be a good person to talk to about the wave of violence unleashed against <a href="https://www.vox.com/2018/11/20/18080034/west-bank-israel-palestinians">West Bank</a> Palestinians while the worlds eyes were <a href="https://www.vox.com/2023/10/7/23907683/israel-hamas-war-news-updates-october-2023">focused on Gaza</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="irJ72U">
Radical Israeli settlers, who intentionally build communities in the West Bank, routinely harass and assault their Palestinian neighbors. The settlers attack their herds, burn their property, beat them, and even kill them. This violence, paired with many more subtle techniques to pressure Palestinians to give up their land, has reached unprecedented levels in the month since the terrorist group <a href="https://www.vox.com/politics/2023/10/10/23911661/hamas-israel-war-gaza-palestine-explainer">Hamas</a>s massacre in southern Israel on October 7. <a href="https://www.btselem.org/settler_violence/20231019_forcible_transfer_of_isolated_communities_and_families_in_area_c_under_the_cover_of_gaza_fighting">At least 15 Palestinian communities have been fully displaced</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="X1KYPD">
<a href="https://twitter.com/nabothVin/status/1719315874941710803">Many of these forcible transfers</a> have happened to Palestinian communities in the South Hebron Hills, the West Bank region where Tariq lives. I was supposed to talk to him about what it was like to live through this at 4 pm on Friday, 11 pm his time. But when I texted, he didnt answer. When I called, he didnt answer again. Soon after, he sent me an ominous voice memo.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="X0pTBx">
“I was about to answer and call you back, but now theres military inside the community. Well see what happens,” he said.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="1inphG">
The Israeli military, far from enforcing order, is a major part of the problem: Soldiers frequently abuse Palestinians, nearly always getting away with it. Data from the Israeli human rights group Yesh Din shows over <a href="https://www.yesh-din.org/en/law-enforcement-against-israeli-soldiers-suspected-of-harming-palestinians-and-their-property-summary-of-figures-for-2017-2021/">99 percent of official Palestinian allegations against soldiers</a> between 2017 and 2021 did not yield an indictment, let alone a conviction. Since the war in <a href="https://www.vox.com/2018/11/20/18080046/gaza-palestine-israel">Gaza</a> began, sources on the ground have reported soldiers becoming even more hostile toward the Palestinians. While some Israeli military activity in the West Bank serves legitimate counterterrorism needs, the day-to-day reality is the Israeli government <a href="https://www.newyorker.com/news/q-and-a/the-gaza-ification-of-the-west-bank">working hand-in-glove</a> with the settlement movement to seize Palestinian land.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Aqb6lT">
The most radical faction in Israel is, in effect, stepping up a longstanding campaign of dispossession: acting, both opportunistically and out of anger, to remove West Bank Palestinians from their homes. This escalation could lead to a deeper entrenchment of Israels occupation and, quite possibly, a violent Palestinian response that brings outright war to the West Bank. These developments threaten to further weaken the already-slim prospects of a negotiated solution to the Israeli-Palestinian conflict in the foreseeable future.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="jbo94N">
But most immediately, the consequences are being felt by the Palestinians under attack — like Tariq. When he told me that soldiers were in his village late at night, it meant something bad could happen — bad enough that I might never talk to him again.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="rzgXKW">
I waited past sundown, the beginning of the Jewish Sabbath. I try not to work or use social media on Shabbat, but I had to know if Tariq was okay. Around 7 pm, he called me back: He was safe. This time around, the soldiers hadnt bothered him — searching only outside Umm al-Khairs homes rather than inside of them.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="A7767H">
But the threat was real, based on both his recent experiences and those of other Palestinians. <a href="https://www.ohchr.org/en/press-briefing-notes/2023/11/israelopt-update">According to the United Nations</a>, over 130 West Bank Palestinians have been killed in the weeks since October 7 — already nearing the entire total of Palestinians killed in the West Bank last year, itself <a href="https://www.washingtonpost.com/world/2022/12/29/palestinians-killed-west-bank-israel/">the deadliest in nearly 20 years</a>. Almost all were killed by the Israeli military, while “eight of them, including one child, were gunned down by settler militias, sometimes in army uniform,” per Mairav Zonszein, a senior analyst at the <a href="https://www.crisisgroup.org/middle-east-north-africa/east-mediterranean-mena/israelpalestine/settler-violence-rises-west-bank-gaza-war">International Crisis Group</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="nEOyG0">
“[In our village] you think about how to live that day, how to stay safe that day, how to stay alive that day,” Tariq told me. “You dont think about the future.”
</p>
<figure class="e-image">
<img alt="A person walks on rubble past small homes that have been graffitied in Arabic and English. The English reads, “Where will I sleep?” and “Families not firing zones.”" src="https://cdn.vox-cdn.com/thumbor/9aEp2xfLSy8NDku8dbmJ6bTQ6WY=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/25068952/GettyImages_1763959649.jpg"/> <cite>Thomas Coex/AFP via Getty Images</cite>
<figcaption>
A Palestinian walks in the village of Khallet al-Daba, in the occupied West Bank on October 26, 2023, after it was attacked by Israeli settlers.
</figcaption>
</figure>
<h3 id="ZZSr9Q">
Fanaticism, security, and the settlements
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="RhHaRj">
Israeli settlement in the West Bank, which started after Israel took the territory from Jordan <a href="https://www.vox.com/world-politics/23921529/israel-palestine-timeline-gaza-hamas-war-conflict">during the 1967 Six-Day War</a>, grew for <a href="https://www.jewishbookcouncil.org/book/the-accidental-empire-israel-and-the-birth-of-the-settlements-1967-1977">two distinct reasons</a>. Understanding their interconnections is crucial to understanding the violence plaguing the West Bank today.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="OIatPQ">
In those early days, the settlers themselves tended to be religious radicals, firmly committed to the idea that all of the land from the Jordan River to the Mediterranean Sea had been biblically granted to Jews and (by extension) to the state of Israel. Israels government encouraged settlement for more pragmatic reasons. A few settlements, established in key places alongside military bases, could serve to protect Israeli control over Jerusalem and provide “<a href="https://apps.dtic.mil/sti/tr/pdf/ADA326679.pdf">strategic depth</a>” in the event of a Jordanian invasion from the east, which was then a real possibility.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="mwH3Qh">
Today, the security situation is completely different. Israel has had a formal peace treaty with Jordan for nearly 30 years and, bolstered by its close relationship with the US, is so militarily powerful that neither Jordan nor any other neighboring Arab state would dream of trying to conquer it. Its greatest security threat comes from <a href="https://www.vox.com/iran">Iran</a> and its non-state terrorist proxies, including both Hamas and Hezbollah in Lebanon.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="VxcqxC">
But the settler movement has long taken on a life of its own. Religious nationalists streamed into the West Bank; quite a few less fanatical Israelis, lured by <a href="https://www.haaretz.com/israel-news/2023-02-15/ty-article-magazine/.premium/go-west-bank-israels-housing-crisis-plan-turns-even-more-israelis-into-settlers/00000186-545c-de95-a1fe-f65f212f0000">relatively cheap housing prices in the settlements</a>, followed suit. While many of these settlers live close to the “Green Line” — the border between Israel proper and the West Bank — many others live farther out. Settlers established these far-flung communities, sometimes legally and other times illegally, with an eye toward cutting Palestinian communities off from each other.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="0p1pBl">
The radical religious settlers make up <a href="https://www.haaretz.com/opinion/2023-07-02/ty-article-opinion/.premium/a-far-right-radical-minority-is-forcing-israel-into-a-disastrous-annexation/00000189-136a-dae1-afa9-1bff8fb20000">a small percentage</a> of the overall Israeli population, but they have allies on the mainstream right, including Prime Minister <a href="https://www.vox.com/23910085/netanyahu-israel-right-hamas-gaza-war-history">Benjamin Netanyahu</a>. Netanyahu and many in his Likud Party oppose a Palestinian state on security grounds, worrying it would become a launching pad for rocket fire and terrorist incursions. Together, the settlers and their allies employ a laundry list of legalistic tools — ranging from housing subsidies to the national parks service — to assist in settler land grabs.
</p>
<figure class="e-image">
<img alt="A large orange metal gate blocks a road, and behind it stand soldiers in camouflage uniforms." src="https://cdn.vox-cdn.com/thumbor/vbmR52DsiSkVnniCam1oyVthGdw=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/25069132/GettyImages_1761215299.jpg"/> <cite>Nasser Ishtayeh/SOPA Images/LightRocket via Getty Images</cite>
<figcaption>
Israeli soldiers guarding Israeli settlers who launched an attack on the Palestinian town of Deir Sharaf in the northern West Bank, on November 2.
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="1RFtrZ">
And all Israeli governments, not just Netanyahus, have felt obligated to ensure their citizens security, settlers included. To protect them from Palestinian militants, Israel uses troops to block Palestinians from going near settlements, builds settler-only roads leading to and from Israel, and <a href="https://reliefweb.int/report/occupied-palestinian-territory/fact-sheet-movement-and-access-west-bank-august-2023#:~:text=These%20include%2049%20checkpoints%20constantly,walls%2C%20road%20barriers%20and%20trenches.">places hundreds of checkpoints and roadblocks</a> impeding Palestinian movement around the West Bank.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="2hA4tF">
Settlement, in short, is not merely isolated acts from individual radicals; it is <a href="https://www.newyorker.com/news/q-and-a/the-gaza-ification-of-the-west-bank">a wholly owned project of the Israeli state</a>. It is no surprise that Israeli soldiers have long turned a blind eye to settler violence against Palestinians; theyre there to protect the settlers, and sometimes even align with the settler agenda. The interplay of religious fanaticism and Israeli security concerns has created an ever-deepening colonial project in the West Bank.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="wKzxGM">
“The relationship of military and settlers is so symbiotic that the system cannot go against itself,” says Yehuda Shaul, director of the left-wing Israeli Center for Public Affairs.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="L6TkDJ">
Over the past two years, things have gotten much worse — especially since Netanyahu returned to power in the very last days of 2022, <a href="https://www.vox.com/world/2023/1/20/23561464/israel-new-right-wing-government-extreme-protests-netanyahu-biden-ben-gvir">helming one of the countrys most extreme right-wing coalitions</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="j7RJrN">
According to <a href="https://www.ochaopt.org/content/displacement-palestinian-herders-amid-increasing-settler-violence#:~:text=A%20total%20of%201%2C105%20people,settlers%20as%20the%20primary%20reason">a September UN report</a>, there had been roughly two settler attacks on Palestinians per day in 2022, a doubling of the previous years average. In the first eight months of 2023, the daily average went up to three — the highest figure since the UN began recording data on the topic in 2006. The violence between 2022 and August 2023 displaced roughly 1,100 Palestinians and emptied four communities, with scant accountability. The UN found that while 81 percent of Palestinian communities reported incidents to Israeli authorities, only 6 percent said they were aware of Israel acting on the provided information.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="kZ61oW">
In the current government, the minister <a href="https://apnews.com/article/israel-palestinians-west-bank-settlements-smotrich-1f16401de915559965e906f70269908b">in charge of settlement policy</a> is Bezalel Smotrich, the leader of the far-right Religious Zionist party who is himself a settler extremist. After settlers attacked <a href="https://www.vox.com/world-politics/2023/2/28/23617766/israeli-settler-rampage-palestine-violence-government">the Palestinian town of Huwara</a> in February, Smotrich said, “<a href="https://www.reuters.com/world/middle-east/one-palestinian-killed-three-arrested-over-killing-israeli-american-2023-03-01/">I think that Huwara needs to be erased</a>.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ihIxWy">
So when the October 7 attacks happened, things were already getting worse. Since then, the dire situation has become a true crisis.
</p>
<figure class="e-image">
<img alt="A cloud of black smoke rises above two multi-story tan buildings with trees in front of them. " src="https://cdn.vox-cdn.com/thumbor/hKHFgYK4at3wEoSQxAAbcj_3zLA=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/25069088/GettyImages_1761218084.jpg"/> <cite>Nasser Ishtayeh/SOPA Images/LightRocket via Getty Images</cite>
<figcaption>
Smoke seen rising from Palestinian shops and homes after an attack by Israeli settlers on the town of Deir Sharaf, in the northern West Bank, on November 2.
</figcaption>
</figure>
<h3 id="DfTKRv">
How October 7 set the West Bank on fire
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="0QqwnL">
Since the Hamas attack, the pace of settler violence has more than doubled — reaching<a href="https://www.cbc.ca/news/world/west-bank-settlers-violence-israel-palestinians-1.7019263#:~:text=According%20to%20the%20United%20Nations%2C%20in%202023%20there%20were%2C%20on,third%20of%20them%20involving%20firearms."> an average pace of seven attacks a day</a>. The scale of displacement has escalated accordingly, with nearly four times as many communities depopulated in the past month <a href="https://www.ochaopt.org/content/displacement-palestinian-herders-amid-increasing-settler-violence">as in the preceding year and eight months</a>. Of the 29 Palestinians killed by settlers in 2023, <a href="https://www.cbc.ca/news/world/west-bank-settlers-violence-israel-palestinians-1.7019263#:~:text=According%20to%20the%20United%20Nations%2C%20in%202023%20there%20were%2C%20on,third%20of%20them%20involving%20firearms.">eight have died in the past month alone</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="0yOYF4">
Part of the reason is very simple: The settlers thrive on impunity. When fewer people are paying attention to them, they feel like they have a greater ability to act without pushback from their opponents inside Israel and around the world. Like all Israelis, they were infuriated by the attacks of October 7; unlike almost all other Israelis, they have both the motive and the opportunity to take out their anger on Palestinian neighbors.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Sq5EOj">
“The focus on Gaza has created a fog that allows … settlers to create facts on the ground that they believe to be irreversible,” says Omar Shakir, the Israel and Palestine director at Human Rights Watch.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="10g0fJ">
The government has condemned the violence but done little to stop it. If anything, some elements of the current Israeli leadership have encouraged their rampage.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="IZXQ6W">
During the war, <a href="https://www.timesofisrael.com/ultranationalist-mk-tzvi-succot-appointed-head-of-knesset-west-bank-subcommittee/">a far-right parliamentarian named Zvi Sukkot</a> became the new chair of the legislative subcommittee on West Bank affairs. Sukkot is an extremist settler who has been arrested at least four times on suspicion of radical activity, including lighting a mosque on fire. While he will have limited concrete powers, his appointment sends a signal that settler violence will be tolerated.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="XeYkKU">
Theres another factor at work here, too, one that has to do with the nature of wartime mobilization.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="1BBUnU">
Typically, the foot soldiers deployed to the West Bank are conscripts — young Israelis just out of high school fulfilling their mandatory military service. But during wartime, these conscripts are needed elsewhere. Currently, theyre deployed either in and around Gaza or else on the northern border with Lebanon, positioned in anticipation of potential escalation with Hezbollah.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="TB4dzR">
To supplement its wartime forces, Israel has <a href="https://www.washingtonpost.com/world/2023/10/10/israel-military-draft-reservists/">called up at least 360,000 reservists</a> — roughly 4 percent of its entire population. Many of these reservists are directly involved in the war effort. But in at least some parts of the West Bank, the reservists are being drawn from local communities — which is to say, the settlements. As a result, some settlers who were assailing Palestinians as private citizens are now formally in charge of their security.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="HzDPJJ">
“Its not that the military accompanies the settlers. Now the military <em>is</em> the settlers,” Shaul says.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="bEhvvZ">
These three factors — the focus on Gaza, the governments indifference, and the settler penetration of the military — have created a kind of perfect storm leading to a spike in settler violence.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="MZAcZ2">
And now, Palestinians like Tariq Hathaleen are paying the price.
</p>
<figure class="e-image">
<img alt=" " src="https://cdn.vox-cdn.com/thumbor/fWECT9MqQSRiDgGSUFG8CixnkI0=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/25068980/GettyImages_1707541950.jpg"/> <cite>Zain Jaafar/AFP via Getty Images</cite>
<figcaption>
People gather around a bloodstain surrounded with leaves near the occupied West Bank city of Tulkarm, where two Palestinians were reportedly killed during clashes with Israeli forces on October 5.
</figcaption>
</figure>
<h3 id="vjdDco">
How settler violence could ignite a wider war
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="M7rJTj">
There are a number of armed Palestinian militants in the West Bank, including both a smallish Hamas presence and the newly formed <a href="https://www.nytimes.com/2023/03/04/world/middleeast/west-bank-lions-den.html">“Lions Den” faction</a>. These groups activities are both a cause and consequence of settler violence; their attacks lead to settler retaliation, but their own incentives to violence arise in the wake of land grabs.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="4qlw4i">
The more egregious the settlers actions become, the more likely Palestinian militants are to respond with brutal violence of their own. The more violent they get, the more settlers and the Israeli military will retaliate. And the more Israel inflicts violence on Palestinians, the <a href="https://www.haaretz.com/opinion/editorial/2023-10-15/ty-article-opinion/.premium/settlers-are-trying-to-drag-israel-into-war-in-the-west-bank/0000018b-2fda-d450-a3af-6fdebe030000">more likely it is</a> that violence erupts into a full-fledged uprising across the West Bank.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="AqSj1R">
“I smell blood in the West Bank,” <a href="https://www.economist.com/middle-east-and-africa/2023/11/06/settlers-are-causing-mayhem-in-the-west-bank">an unnamed Palestinian official</a> told the Economist. “I dont know where it will be, but it is coming: the settlers are going to do something terrible.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="879DY4">
The settler attacks on Palestinians, while occurring under the aegis of Israels military, are thus actually endangering the countrys security while it focuses on the tough task of fighting Hamas in Gaza.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="nxY041">
“Hamas has a crucial ally in the West Bank: the settlers,” says <a href="https://agsiw.org/associates/hussein-ibish/">Hussein Ibish</a>, a senior resident scholar at the Arab Gulf States Institute.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="JGQhWd">
Israel is aware of the risk here. The US government has become increasingly vocal about its fears of West Bank escalation; <a href="https://www.vox.com/joe-biden">President Joe Biden</a> has <a href="https://www.aljazeera.com/news/2023/10/25/biden-condemns-israeli-settler-attacks-in-occupied-west-bank">publicly</a> and <a href="https://www.cnn.com/2023/11/02/politics/biden-administration-warning-israel-gaza-civilians/index.html">privately</a> demanded that Israel do more to put a stop to the settler violence.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="oSzYMK">
This is definitely within Israels power, but theres a question of will. Netanyahu is on <a href="https://www.vox.com/world-politics/2023/10/31/23938474/netanyahu-benjamin-israel-palestine-gaza-hamas-war-remove-prime-minister-hostage-crisis">incredibly shaky political ground</a> as resentment over October 7 and his response to it simmers; he remains in office by the grace of far-right settler parties, who care primarily about seizing West Bank land. If Netanyahu crosses them by ordering a crackdown on settler violence, theres a real chance theyll punish him by leaving the governing coalition — collapsing his government and costing him the position he seems to value above all else.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="wGPumW">
Israel today is in the exact opposite position it was in 1967. The interests of the state and settlers are no longer aligned; the settlers religious quest for land is increasingly jeopardizing Israeli security. The question is whether the settlers have become influential enough to override what is, in theory, the number one obligation of the Israeli state: keeping its citizens safe.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="BlaiPn">
But security is not the only reason that some Israelis oppose the settlers. A minority, but a meaningfully sized one, care deeply about Palestinian rights and are willing to do something about it.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="py0b22">
At the end of my conversation with Tariq, it was deep into the night in the West Bank. He told me something extraordinary: that, as we spoke, there were two Israelis still sleeping in his home, part of a contingent that voluntarily offers their bodies as protection from settler violence. They are not only his friends, but representatives of a different Israel than that of the settlers.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="8ajwPM">
If there is to be a solution to both settler violence and the broader Israeli-Palestinian conflict, it will involve gestures like this: Israelis and Arabs working together against the extremists to build a common future. As dark as things look in the West Bank and Gaza today, we can at least take some comfort in the idea that this spirit isnt entirely dead.
</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>Victoria Punch, Stravinsky, Champions Way and Michigan Melody excel</strong> -</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>SL vs NZ | New Zealand opt to bowl against Sri Lanka in World Cup game</strong> - New Zealand made one change, bringing in fit-again seamer Lockie Ferguson for spinner Ish Sodhi. Sri Lanka brought in all-rounder Chamika Karunaratne for Kasun Rajitha</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>Jos Buttler keen to continue as white-ball skipper</strong> - Buttler has been woefully out of form in the ongoing tournament with many believing the England captaincy is weighing him down. He has admitted that it has been frustrating not to score runs</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>We want to target Gen Zs and 10-year-olds: ICCs big digital push for global events</strong> - As part of its global growth strategy, the ICC wants to directly reach 300 million fans by 2032 and a chunk of that will come from India</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>Manchester United falls again in wild Champions League loss; impressive Real Madrid advances</strong> - Uniteds 4-3 loss at Copenhagen — the same result as its opening game at Bayern — after twice letting leads slip leaves coach Erik ten Hags team last in Group A</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>Here are the big stories from Karnataka today</strong> - Welcome to the Karnataka Today newsletter, your guide from The Hindu on the major news stories to follow today. Curated and written by Nalme Nachiyar.</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>Fishermen concerned over Tamil Nadus ports development policy</strong> - Former Fisheries Minister D. Jayakumar says the sea and the coastal area belongs to fishermen and that they should not be used for other purposes</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>Manam Theatre Festival in Hyderabad to celebrate diversity in cultures and communities</strong> - The inaugural edition of the Manam Theatre Festival, to be held from November 24 to December 17, 2023, is an ensemble of performances and various art forms</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>100 billion uses on, Aadhaar authentication down for over 54 hours this year</strong> - Even though Aadhaar is used tens of millions of times a day, authentication failures amount to over two dozen hours this year, RTI data obtained by The Hindu show.</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>Kerala Tourisms pavilion adjudged best at World Travel Market</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>Transgender people can be baptised and be godparents, Vatican says</strong> - The Roman Catholic Church says priests can baptise trans people so long as it does not cause “scandal”.</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>Belarus musicians behind bars in Lukashenkos crackdown on dissent</strong> - The members of Tor Band have been given long jail terms after their songs became a symbol for dissent.</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>Apple should pay €13bn Irish tax, argues EU lawyer</strong> - The opinion is the latest twist in a long-running saga between the EU, Apple and the Irish government.</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>UK government orders probe into Channel mass drowning</strong> - A pregnant woman and three children were among at least 27 people who died when a boat sank in 2021.</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>Russia strikes civilian ship in Black Sea port of Odesa - Ukraine</strong> - At least one person is said to have been killed when a missile hit a ship entering the port of Odesa.</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>In a surprise move, the militarys spaceplane will launch on Falcon Heavy</strong> - SpaceXs Falcon Heavy could send the X-37B into a higher orbit than before. - <a href="https://arstechnica.com/?p=1982469">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>First planned small nuclear reactor plant in the US has been canceled</strong> - NuScale and its primary partner give up on its first installation. - <a href="https://arstechnica.com/?p=1982466">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Dealmaster: Herman Miller chairs, AirPods, and more</strong> - Sales on Herman Miller chairs, OLED TVs, and all sorts of tech gear. - <a href="https://arstechnica.com/?p=1982280">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>AirTags are the new go-to tool for cops after spike in car thefts</strong> - TikTok car theft trend led cops to give out free AirTags, police chief said. - <a href="https://arstechnica.com/?p=1982442">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Funeral home of horrors: Owners arrested after 190 rotting corpses found</strong> - Owners charged with abuse of a corpse, theft, money laundering, and forgery. - <a href="https://arstechnica.com/?p=1982446">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>Interviewer: How much amount of milk does your cow produce?</strong> - <!-- SC_OFF --></p>
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Farmer: which one, black one or white one?
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Interviewer: Black one
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Farmer: 2 litres per day.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Interviewer: And the white one?
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Farmer: 2 litres per day.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Interviewer : Where do they sleep?
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Farmer: The Black one or the. White one?
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Interviewer: The black one
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Farmer : In the Barn
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Interviewer: And the White one?
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Farmer: In the Barn also
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Interviewer: Your cows look healthy… What do you feed them?
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Farmer: which one..black one or white one?
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Interviewer: Black one
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Farmer: Grass
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Interviewer: And the white one?
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Farmer: Grass
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Interviewer: (Annoyed) but why do you keep on asking if black one or white one when answers are just the same??
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Farmer: Because the black one is mine.
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Interviewer: And the white one?
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Farmer: Its also mine.
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/Tall_Acadia8838"> /u/Tall_Acadia8838 </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/17r81uw/interviewer_how_much_amount_of_milk_does_your_cow/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/17r81uw/interviewer_how_much_amount_of_milk_does_your_cow/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>This blonde decides one day that she is sick and tired of all these blonde jokes and how all blondes are perceived as stupid, so she decides to show her husband that blondes really are smart.</strong> - <!-- SC_OFF --></p>
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While her husband is off at work, she decides that she is going to paint a couple of rooms in the house. The next day, right after her husband leaves for work, she gets down to the task at hand. Her husband arrives home at 5:30 and smells the distinctive smell of paint. He walks into the living room and finds his wife lying on the floor in a pool of sweat. He notices that she is wearing a ski jacket and a fur coat at the same time. He goes over and asks her if she is OK. She replies yes. He asks what she is doing. She replies that she wanted to prove to him that not all blonde women are dumb and she wanted to do it by painting the house. He then asks her why she has a ski jacket over her fur coat. She replies that she was reading the directions on the paint can and they said… FOR BEST RESULTS, PUT ON TWO COATS.
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/YZXFILE"> /u/YZXFILE </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/17qldnr/this_blonde_decides_one_day_that_she_is_sick_and/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/17qldnr/this_blonde_decides_one_day_that_she_is_sick_and/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>My wife wanted to go on vacation, but I wanted a staycation…</strong> - <!-- SC_OFF --></p>
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In the end, we settled it with an altercation.
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/Fuzzie8"> /u/Fuzzie8 </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/17r68xs/my_wife_wanted_to_go_on_vacation_but_i_wanted_a/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/17r68xs/my_wife_wanted_to_go_on_vacation_but_i_wanted_a/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Irish daughter had not been home for over 5 years. Upon her return her Father cursed her heavily.</strong> - <!-- SC_OFF --></p>
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“Where have ye been all this time, child? Why did ye not write to us, not even a line? Why didnt ye call? Can ye not understand what ye put yer old Mother through?‌‌” The girl, crying, replied, “Dad... I became a prostitute.‌‌” “Ye what!? Get out a here, ye shameless harlot! Sinner! Youre a disgrace to this Catholic family.‌‌” “OK, Dad... as ye wish. I only came back to give mum this luxurious fur coat, title deed to a ten bedroom mansion, plus a 5 million savings certificate. For me little brother, this gold Rolex. And for ye Daddy, the sparkling new Mercedes limited edition convertible thats parked outside plus a membership to the country club ... (takes a breath) ... and an invitation for ye all to spend New Years Eve on board my new yacht in the Riviera.‌‌” “What was it ye said ye had become?”‌‌, says Dad. Girl, crying again, “A prostitute, Daddy!‌‌” “Oh! My Goodness! Ye scared me half to death, girl! I thought ye said a Protestant! Come here and give yer old Dad a hug!‌‌”
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/arztnur"> /u/arztnur </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/17qpoh9/irish_daughter_had_not_been_home_for_over_5_years/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/17qpoh9/irish_daughter_had_not_been_home_for_over_5_years/">[comments]</a></span></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>I bought a pair of shoes off a drug dealer, dunno what hes laced them with,</strong> - <!-- SC_OFF --></p>
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but Ive been trippin all day.
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/tbonesteakbigone"> /u/tbonesteakbigone </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/17ra4un/i_bought_a_pair_of_shoes_off_a_drug_dealer_dunno/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/17ra4un/i_bought_a_pair_of_shoes_off_a_drug_dealer_dunno/">[comments]</a></span></p></li>
</ul>
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