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The situation has since turned into a protracted conflict with disturbing humanitarian implications. Tigrayan defense forces are fighting against the Ethiopian National Defense Force, who have partnered with troops from neighboring Eritrea and other militias within Ethiopia, specifically Amhara forces.

Telecommunications blackouts and limited access to parts of Tigray have made it difficult to fully assess what is unfolding there. But in recent months, credible reports of war crimes and crimes against humanity have started to trickle out, including evidence of ethnic cleansing against Tigrayans.

An internal United States government report, which the New York Times reviewed in February, assessed that the Ethiopian military and their allies were “deliberately and efficiently rendering Western Tigray ethnically homogeneous through the organized use of force and intimidation.”

There have been massacres and mass executions. Jan Nyssen, a geography professor at the University of Ghent, and a team of researchers have compiled a list of 1,900 Tigrayans killed in approximately 150 mass killings since the fighting began.

“This is ongoing,” Nyssen told me earlier this month. “In the last month, we recorded 20 massacres, and it continues almost at the same speed.” There is a common pattern, he said: When the Eritrean or Ethiopian forces lose a battle, “they take revenge on civilians in the surrounding areas.”

Rape has been used as a weapon of war; a USAID report includes testimony from a woman who recalled her rapist saying he was “cleansing the blood lines” of Tigrayan women. Eritrean forces have been accused of mass looting, pillaging, and wanton destruction of everything from banks to crops to hospitals.

AFP via Getty Images
Mourners at a mass grave containing the bodies of 81 people killed in clashes between Eritrean and Ethiopian forces in the city of Wukro, Ethiopia, in February.
AFP via Getty Images
A view through a broken window of a bus station in Wukro, Ethiopia, in March. The recent conflict in Tigray has impacted this hub once best known for its religious and archaeological sites.

Most of the alleged atrocities point to Eritrean, Ethiopian, and Amhara forces, though Tigray People’s Liberation Front-linked groups have also been linked to at least one mass killing. The Eritrean government has denied involvement, and only just last week admitted to its presence in Tigray.

In March, Ethiopian Prime Minister Abiy Ahmed acknowledged that reports “indicate that atrocities have been committed in Tigray region.” He said those responsible should be held accountable, though he also blamed the “propaganda of exaggeration.”

The security situation is fueling other crises. More than 60,000 refugees have fled to neighboring Sudan since the fighting began in November, and humanitarian groups — many of which remain cut off from parts of Tigray — say the security situation has likely displaced thousands of people internally.

The United Nations estimates that of Tigray’s 6 million people, 4.5 million are in need of food aid. A recent report from the World Peace Foundation warns of the risk of famine and mass starvation as people are displaced and crops, livestock, and the tools needed to make and collect food are destroyed.

One witness in Tigray, who spoke on condition of anonymity because he fears for his safety, told me that Eritrean soldiers will kill an ox and eat just one leg, leaving the rest of the carcass to rot. “The people are either dying by blood or by hunger,” he said by phone from Mekele, Tigray’s capital, earlier this month.

Prime Minister Abiy, a Nobel Peace Prize recipient who was once seen as the country’s peacemaker and a democratic liberalizer, is now leading a country that is beginning to turn on itself.

Violence and ethnic tensions are flaring up in other parts of Ethiopia. Sudanese and Ethiopian troops have clashed in a disputed border territory, a sign of how Tigray’s unrest is spilling over into an already volatile neighborhood where Ethiopia had been viewed, at least by some international partners, as a stabilizing force.

The war in Tigray has no clear end, and the reports of killing and rape and looting are still happening. “Everybody is just waiting, just waiting — not to live, but waiting for what will happen tomorrow, or in the night,” the man in Mekele said.

“We never know what will happen,” he added. “You never know what will happen to anybody.”

A conflict that had been brewing finally breaks out

Tensions between Abiy’s government and the Tigray People’s Liberation Front had been coursing for some time, and experts say anyone paying attention was warning of the possibility of war before it happened.

In 2018, Ethiopia’s government got a major shake-up. The Ethio­pian People’s Revolutionary Democratic Front (EPRDF), a Marxist-Leninist party, had ruled the country for nearly three decades, having emerged victorious from a brutal civil war in 1991.

The party was a coalition representing four different regions or nationalities: the TPLF (made up of Tigrayans); the Amhara Democratic Party (representing the Amhara ethnic group); the Oromo Democratic Party (representing the Oromo ethnic group); and the Southern Ethiopian People’s Democratic Movement, which represented a few ethnic groups.

A map in shades of blue shows the regions of Ethiopia. Olga Turkas/Getty Images/iStockphoto
A simplified administrative map of Ethiopia.

But the Tigrayan wing of the party dominated.

The Tigrayan-led government presided over rapid economic growth, but not all of it was equal, and many Ethiopians felt left behind. In 2015 and 2016, after decades in power, the government faced popular protests over human rights abuses, corruption, and inequality.

Some, including members of the Amhara and Oromo ethnic groups, were particularly angry about the TPLF’s control of the most important positions in politics and the military, despite representing just 6 percent of the country’s population.

In 2018, Ethiopia’s prime minister resigned, and other members of the ruling EPRDF coalition united against the Tigrayan wing. They elected Abiy Ahmed, a relative newcomer from the Oromo, as the leader.

Abiy began to establish himself as a democratizer, releasing political prisoners and promising free and fair elections. He also pursued peace with neighboring Eritrea. The two countries had gone to war in 1998 over a disputed border in Badme (also in the Tigray region), and though they signed a peace deal in 2000, it had basically become a stalemate, with occasional skirmishes erupting for 20 years.

All of this made Abiy a star in Africa and around the world. In 2019, he won the Nobel Peace Prize for resolving the border war and “for his efforts to achieve peace and international cooperation.”

Minasse Wondimu Hailu/Anadolu Agency via Getty Images
Ethiopian Prime Minister Abiy Ahmed (second from right) and Executive Secretary of the UN Economic Commission for Africa Vera Songwe (right) attend the 53rd session of the Economic Commission for Africa on March 22.

At home, things were a bit more complicated. Abiy had promised to reform the EPRDF, but in late 2019 he created a new Prosperity Party (PP) meant to deemphasize the role of ethnic groups in the name of unity.

The Tigray People’s Liberation Front opposed this move and what it saw as Abiy’s attempt to consolidate federal power at the expense of regional and ethnic autonomy. The TPLF declined to join the PP, and though the party still retained control of Tigray’s regional government, members generally saw Abiy as taking steps detrimental to their interests and their region — and to the vision of Ethiopia that the TPLF had championed since the 1990s.

“At the root of the war in Tigray is this ideological difference between TPLF and Prime Minister Abiy Ahmed for the future of the country,” Tsega Etefa, an associate professor of history and Africana and Latin American studies at Colgate University, wrote in an email.

Experts said Abiy rode the wave of anti-TPLF grievance to try to consolidate his own power, especially as it became a lot harder to deliver on some of the political promises he’d made when he took over.

“In a bid to deflect the growing criticism of him, now that he was formally in charge, he began increasingly confronting Tigrayans and blaming them for everything that had gone wrong,” Harry Verhoeven, of the Oxford University China-Africa Network, told me.

Abiy portrayed Tigrayans as “the Ethiopian equivalent of the ‘deep state,’ if you like,” Verhoeven added.

AFP via Getty Images
A looted office in a school that was allegedly shelled by Eritrean forces, in Wukro, Ethiopia, on March 1.

Experts noted this kind of rhetoric had the effect of blurring the lines between the TPLF leadership — which had earned legitimate criticisms after decades in power — and the Tigrayan people themselves.

Tensions persisted into 2020, which was supposed to be an election year, until Abiy (with Parliament’s approval) postponed elections, citing the coronavirus pandemic. Abiy’s critics, including those in the TPLF, accused him of an anti-democratic power grab.

The Tigray region held elections anyway in September in an act of defiance. Abiy’s government deemed those elections illegal.

Ethiopia’s Parliament then voted to cut funds from the regional Tigrayan government, a move the TPLF said violated the law and was “tantamount to a declaration of war.” In late October, the TPLF blocked an Ethiopian general from taking up a post in Tigray. The International Crisis Group warned that this standoff “could trigger a damaging conflict that may even rip the Ethiopian state asunder.”

Just a few days later, Abiy accused the TPLF of attacking its military base. “The last red line had been crossed,” he said, as Ethiopian troops entered Tigray and he declared a six-month state of emergency. Reports of airstrikes accompanied the federal government’s push into the region.

The federal government’s communications blackout, combined with competing accounts from both the government and Tigray officials, made it hard to fully account for the situation.

By the end of the month, Abiy had declared the Ethiopian government “fully in control” of the region’s capital, Mekele.

Six months later, the war grinds on.

Why Eritrea is embroiled in Ethiopia’s war

Tigrayan defense forces have since regrouped and are now fighting a guerrilla insurgency against Ethiopian federal troops and those backing them up — namely, Eritrean troops and Amhara militia fighters from the region south of Tigray.

The Eritrean government — led by President Isaias Afwerki, the country’s longtime brutal dictator — and Abiy repeatedly denied the presence of Eritrean troops in Tigray, despite mounting evidence of their involvement.

It took until the end of March 2021 for Abiy to publicly acknowledge that Eritrean troops were present in Tigray. Shortly after, the Ethiopian government said Eritrean troops were withdrawing, though the TPLF had said there were no signs of any exit.

A top United Nations officials also said last week that there was no sign Eritrea was leaving. In response, Eritrea did, officially, confirm its presence in Tigray in an April 16 letter to the UN Security Council. In it, Eritrea said it had “agreed — at the highest levels — to embark on the withdrawal of the Eritrean forces and the simultaneous redeployment of Ethiopian contingents along the international boundary.”

But both advocates and experts are skeptical that Eritrea will exit quietly, or quickly.

Handout/Anadolu Agency via Getty Images
Eritrean President Isaias Afwerki (ceter) is welcomed by Sudanese Lt. Gen. Abdel Fattah al-Burhan (right) in Khartoum, Sudan, on June 25, 2020.

“There is no sign that the Eritrean forces are withdrawing,” Alex de Waal, a research professor and executive director of the World Peace Foundation at Tufts University, told me earlier this month. “If anything, they are inserting themselves more deeply into the Ethiopian military and intelligence structure.”

But Abiy’s pact with Eritrea is forged from a common goal: the desire to crush the Tigray People’s Liberation Front.

Ethiopia and Eritrea have a long and tangled history, but to understand it, it helps to start after World War II, when world powers decided the fate of Eritrea after its previous colonizer, Italy, lost control of its territory in East Africa.

In 1952, the UN General Assembly voted to make Eritrea a federal component of Ethiopia. Ten years later, Ethiopia annexed Eritrea, leading to a protracted battle for independence that culminated in an Eritrean independence referendum in the early 1990s.

During that struggle, Ethiopia’s TPLF cooperated with members of the Eritrean People’s Liberation Front (EPLF), the latter of whom were fighting for Eritrean independence from Ethiopia. They were both opposed to rule in Addis Ababa and had cultural and linguistic ties, but the two movements had ideological differences. It was, in some ways, a relationship of necessity, and tensions simmered — and sometimes spilled out into the open — even when they were partners.

After Eritrea gained independence in 1993, relations between the country and the TPLF-dominated Ethio­pian People’s Revolutionary Democratic Front began to deteriorate.

At first, the disputes were minor. But in 1998, Eritrea and Ethiopia went to war over a disputed border town. The two signed a peace agreement in 2000, allowing an independent commission would settle the status of the area. That commission, however, ruled in favor of Eritrea, and the TPLF-led government in Ethiopia objected to the ruling. That led to two decades of tension and sporadic fighting.

When Abiy took over, he moved to make peace with Eritrea, agreeing to accept the commission’s decision. Meanwhile, the TPLF continued to try to thwart Abiy’s overtures to Eritrea.

Still, President Isaias of Eritrea accepted those Abiy’s olive branch. But in doing so, he didn’t exactly bury old grudges, and continued to criticize the TPLF as “vultures” for undermining Eritrea’s and Ethiopia’s normalization of relations.

“Today is payback time for a number of deeply felt historical injustices, real or perceived — but certainly deeply felt,” Verhoeven said of Eritrea’s involvement.

Nariman El-Mofty/AP
More than 60,000 refugees have fled to neighboring Sudan since fighting began in November 2020.

Isaias rules a repressive state on a constant war footing, and he sees an opportunity to finally vanquish his political rival and settle political scores. It’s also a chance to assert himself as the Horn of Africa’s most consequential leader, which Verhoeven said “is very much something he’s always aspired to.” And he may believe he can’t achieve that as long as a politically influential TPLF still resides on his border.

Isaias wanted freedom from the TPLF. So did Abiy, who saw the TPLF as a challenge to his agenda. Abiy fed that animosity by attacking the TPLF and blaming it for trying to destabilize Ethiopia.

Experts told me the TPLF also made miscalculations, such as trying to frustrate Abiy’s ability to implement the peace deal on the ground, which may have helped to push Abiy closer to Isaias. The Tigray elections provoked even more acrimony with Abiy, though the momentum toward conflict had already been set in motion.

“All the sides really wanted to go to war, and all the sides were making the wrong moves that made war possible,” Awet Weldemichael, a Horn of Africa expert at Queen’s University in Ontario, said.

Ethiopia’s civil war is exacerbating deep-seated ethnic tensions

Just as Abiy forged a political pact with an outsider, Eritrea, his reliance on ethnic Amhara militias to help fight his war in Tigray is accelerating Ethiopia’s internal strife.

Amhara militias have reportedly taken control of parts of western Tigray. Amhara officials say the TPLF annexed this territory when it came to power in 1991, and say it rightfully belongs to them and they are re-seizing it.

But Tigrayan civilians and officials claim that the militias are now forcibly driving out the Tigrayan civilians who live there through a campaign of threats and violence. Amharan officials have denied this, despite growing evidence of a campaign of ethnic cleansing. Abiy has also defended the militias, saying in March that “portraying this force as a looter and conqueror is very wrong.”

This piece of land has been a longstanding source of tension between Amhara leaders and the TPLF, which fits into a broader history of grievances between the two.

Each held power at some point — Amhara’s elites before the rise of the EPRDF, the TPLF after that. The Tigray People’s Liberation Front considered the Amhara to be “oppressors” during their revolutionary campaign, and Amhara elites were marginalized during the TPLF’s reign.

Amhara’s elites also tend to interpret the TPLF’s vision of a federal Ethiopia — where each nationality has a degree of autonomy and power — as antithetical to their own. Theirs is one of a more unified Ethiopia with one national identity, albeit with them in control.

Abiy, too, has adopted that more unified vision, so the Amhara and Abiy found a politically beneficial partnership. But in aligning with the Amhara, just as with the Eritreans, Abiy is also putting his political survival in their hands.

Asafa Jalata, a professor of Africana studies at the University of Tennessee, said that Abiy didn’t care what the consequences were; he was focused on the TPLF and hadn’t planned beyond that. He, as other experts I spoke to did, thought Abiy showed his ineptitude and inexperience.

All of this has put Abiy in a very perilous position. “It makes very little sense,” Verhoeven said. “But it’s the course that he’s chosen to pursue, and Ethiopia is paying its price.”

“The hallmarks of ethnic cleansing are there”

The bullet that killed the 14-year-old boy brought his father down with it. The father stayed still beneath his boy’s bleeding body until the soldiers departed, leaving him and 19 others rounded up from their homes for dead.

The father escaped. “They saw him from afar,” the source from Tigray told me, recounting what the man, a farmer from the Gulomakeda district of Tigray, had told him about an incident at the end of November.

“When the soldiers saw that some were escaping, they came back to the bodies to check whether they’d died or not.” The soldiers, whom the farmer believed were Eritrean, went one by one, cutting the throats of the bodies that remained to make sure they were dead.

Researchers and human rights groups have slowly begun to compile accounts like this, piecing together a troubling picture of cruelty and violence happening inside Tigray.

Communications and electricity blackouts, especially outside the major cities, have made it difficult to get information. Witnesses and victims also fear speaking out will provoke reprisal; their attackers are still lurking, still a threat.

“We never know who is there, who’s listening to what,” Fissuh, of the Irob Advocacy Association, said.

Eritrean, Ethiopian, and Amhara forces have been linked to most of the attacks on Tigrayan civilians, though the Tigrayan People’s Liberation Front are also implicated in mass killings during the conflict. The United Nations High Commissioner for Human Rights said in March that “credible information also continues to emerge about serious violations of international human rights law and humanitarian law by all parties to the conflict in Tigray in November last year.”

Among those violations are extrajudicial killings, sexual violence, and widespread destruction of property. The UN and the Ethiopian Human Rights Council, an NGO affiliated with the government, have agreed to launch an investigation.

Nariman El-Mofty/AP
A Tigrayan woman, who says she was gang-raped by Amhara fighters, speaks to a doctor at the Sudanese Red Crescent clinic near the Sudan-Ethiopia border in March.
Nariman El-Mofty/AP
Orthodox Christian Tigrayans pray in front of a church at Hamdeyat Transition Center near the Sudan-Ethiopia border.
Nariman El-Mofty/AP
Tigrayan survivor Abrahaley Minasbo, from Mai-Kadra, Ethiopia, shows his wounds from machetes, inside a shelter near the Sudan-Ethiopia border in December.

“There is active looting and destruction of public infrastructure and private businesses, there is weaponized rape, there is weaponized hunger happening everywhere,” Meaza Gebremedhin, a US-based international researcher with Omna Tigray, a Tigrayan advocacy group, told me. “And there are massacres happening in different pockets of Tigray.”

Those with connections on the ground have reported Eritrean soldiers rampaging through houses and destroying food sources. “They take everything from your house,” the witness from Tigray told me. “What they can’t carry, they burn.”

At least 500 women have self-reported rape to five clinics in Tigray, which the United Nations says is likely a low-range estimate given the stigma and general lack of functioning health services.

“Women say they have been raped by armed actors, they also told stories of gang rape, rape in front of family members, and men being forced to rape their own family members under the threat of violence,” Wafaa Said, deputy UN aid coordinator, said last month.

A USAID report included testimony from one woman who said she and five others were gang-raped by 30 Eritrean troops, as the soldiers laughed and took pictures.

There is also evidence of ethnic cleansing against Tigrayans. A recent report from the Associated Press spoke to Tigrayans who were issued new identity cards that erased their Tigrayan heritage. “This is genocide … Their aim is to erase Tigray,” Seid Mussa Omar, a Tigrayan refugee who twice fled to Sudan, told the Associated Press.

It coincides with reports of Tigrayans being driven from their homes in western Tigray by Amhara forces. “They said, ‘You guys don’t belong here,’” Ababu Negash, a 70-year-old woman fleeing Tigray, told Reuters in March. “They said if we stay, they will kill us.”

“The hallmarks of ethnic cleansing are there,” said Queen’s University’s Weldemichael, “and they’re not just allegations. They are a serious smoking gun to that charge.”

A top United Nations humanitarian official, Mark Lowcock, said in a closed-door meeting last week that the humanitarian situation continues to deteriorate and that “the conflict is not over and things are not improving.”

More than 1 million people are believed to be internally displaced in Tigray, in addition to the 60,000 who have fled across the border to Sudan.

People are often fleeing from one place to another as violence erupts, taking shelter in schools and other overcrowded facilities — creating conditions that are especially worrisome amid the pandemic. In Tigray, just 13 out of 38 hospitals are functioning, and 41 out of 224 primary health facilities, according to Michele Servadei, UNICEF’s deputy representative in Ethiopia.

The region was already in a precarious position to begin with because of climate change and locusts. Ethiopia is approaching its rainy season — the traditional time for planting, to harvest food for the following year — but the destruction of property and the displacement of people from their lands may make this nearly impossible. Aid groups are trying to do what they can but are still unable to reach all parts of the region.

All of this has increased the very real possibility of famine in Tigray.

What happens now?

Ethiopian federal troops and their partners handed the Tigrayan Defense Forces early defeats. But the Tigrayan forces are now waging a war of attrition, and they have popular support. No one side really has the edge, so the prospects of a ceasefire look grim.

The longer the conflict goes on, the more dire the humanitarian consequences will become — and the more unpredictable Ethiopia’s future will be. As Ethiopian forces are bogged down in Tigray, long-simmering unrest is brewing in other regions of Ethiopia. Tigray is “unfortunately serving as a bit of a domino effect throughout the country,” Sarah Miller, a senior fellow at Refugees International covering the Great Lakes and the Horn of Africa, said. These multiple frontiers of conflict put Abiy in an even more uncertain position, both at home and abroad.

The international community has also started to be more vocal about what’s happening.

Earlier this month, foreign ministers from the G7 group of nations (Canada, France, Germany, Italy, Japan, the United Kingdom, and the United States) issued a joint statement demanding the “swift, unconditional and verifiable” withdrawal of Eritrean troops.

Themba Hadebe/AP
Members of the Tigrayan-Ethiopian community protest the conflict in the Ethiopia’s Tigray region, outside the European Union offices in Pretoria, South Africa, on March 25.

US National Security Adviser Jake Sullivan has also called on foreign forces to withdraw from Tigray and asked for an investigation into potential human rights abuses — which US Secretary of State Antony Blinken referred to as “acts of ethnic cleansing.” Sullivan also said USAID would be providing another $152 million to address humanitarian needs in the country. The United Nations Security Council this week finally expressed “deep concern” about the humanitarian situation in Tigray.

International pressure is critical, experts told me, especially as Abiy’s sheen as a peacemaker wears off. “He’s playing for time and trying to deal with the international community, which has become slowly but surely ever more critical, and salvaging what remains of his influence in international affairs,” Verhoeven said.

Indeed, Sen. Chris Coons (D-DE) met with Abiy in March. But after the visit, Abiy confirmed the presence of Eritrean troops, admitted to possible violations, and said Eritrean troops were withdrawing. Again, there’s reason to be skeptical about these statements, but experts said it certainly is a sign that Abiy is sensitive to how the rest of the world, particularly the West, sees him.

Which is why experts told me they think the US and allies in Europe may be able to use this leverage and influence with Abiy. Economic pressure, many said, was particularly important, including the possibility of sanctions.

Stopping the carnage is the immediate concern, but finding a political solution looks precarious, as the status quo was already untenable. The war has pushed Tigray to embrace the possibility of independence, for example.

“Ethiopia may not survive as a country,” Verhoeven said.

Nariman El-Mofty/AP
Tigrayan refugees who fled the conflict in the Ethiopia’s Tigray at a transition center near the Sudan-Ethiopia border in March.

All of this has troubling implications for the wider region as well. Ethiopia was seen as the steadying force in the Horn of Africa, something that Weldemichael said perhaps was a bit of wishful thinking — a reputation gained mostly because of the chaos around it.

“Think of a ship exploding, right? And you find yourself on a flat plank or a piece of wood that’s sailing smoothly in this messy water. That’s Ethiopia,” Weldemichael said.

But an Ethiopia in a protracted civil war could drag even more neighbors into the conflict — and generate even deeper humanitarian and refugee crises.

Another poll on April 15 of 1,000 adults found that 36 percent of respondents saw no change in their likelihood of getting a vaccine and 40 percent said they were more likely to get a Covid-19 shot after the pause was announced. And a poll of 1,033 adults between April 16 and 19 found that 88 percent of respondents thought that the FDA and CDC were being responsible in pausing the Johnson & Johnson shot.

So it seems that most Americans were not fazed by the pause to review the vaccine, which was a relief for some observers.

“When I woke up that day, I was really depressed that they had paused the J&J vaccine rollout … I thought that it would increase vaccine hesitancy,” said Monica Gandhi, an infectious disease doctor and a professor of medicine at the University of California San Francisco. “However, I actually changed my mind over the ensuing week.”

She noted that the polls aligned with the attitudes she saw in patients, who appreciated that regulators were taking safety issues seriously. Another factor that changed her mind is that with so many vaccines already administered in the US, the challenge now is convincing the remaining people who are more reluctant to get immunized.

“Anything that we can do to assure people who are still concerned about the safety of these vaccines, that everything is going to be closely looked at, I think will hopefully increase vaccine uptake,” Gandhi said.

But the pause had an opportunity cost. People who were in line to get the Johnson & Johnson vaccine had to scramble to find alternatives. And now more than a week has passed where people who otherwise would have had some degree of protection against Covid-19 may not have any.

This is the right call now, just as the pause was also initially the right call. Safety signals need to be investigated rapidly, especially when tied to severe outcomes, even if rare.

And for anyone wondering, would I get the J&J vaccine again?

Hell yes. It’s a great vaccine. https://t.co/PN3jRB0ktl

— Dr. Angela Rasmussen (@angie_rasmussen) April 23, 2021

Though pausing the distribution of the vaccine was warranted, waiting more than a week to make a decision about it was likely excessive, according to Eric Topol, director of the Scripps Research Translational Institute. “There was enough data to make the call last Wednesday,” he said.

Topol added that while vaccine confidence remains high in the US, it’s also important to keep the international context in mind with respect to Covid-19. People in the US also have multiple effective vaccines in circulation while other countries barely have any, and hesitancy on other continents is already on the rise. How the US manages rare complications will ripple into other countries. “The US is in the fishbowl of the world,” he said.

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