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<h1 data-aos="fade-down" id="daily-dose">Daily-Dose</h1>
<h1 data-aos="fade-right" data-aos-anchor-placement="top-bottom" id="contents">Contents</h1>
<ul>
<li><a href="#from-new-yorker">From New Yorker</a></li>
<li><a href="#from-vox">From Vox</a></li>
<li><a href="#from-the-hindu-sports">From The Hindu: Sports</a></li>
<li><a href="#from-the-hindu-national-news">From The Hindu: National News</a></li>
<li><a href="#from-bbc-europe">From BBC: Europe</a></li>
<li><a href="#from-ars-technica">From Ars Technica</a></li>
<li><a href="#from-jokes-subreddit">From Jokes Subreddit</a></li>
</ul>
<h1 data-aos="fade-right" id="from-new-yorker">From New Yorker</h1>
<ul>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The Significance of the Derek Chauvin Verdict</strong> - The New Yorker’s Jelani Cobb discusses the trial’s outcome. - <a href="https://www.newyorker.com/news/our-columnists/the-significance-of-the-derek-chauvin-verdict">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The Forgotten History of the Purging of Chinese from America</strong> - The surge in violence against Asian-Americans is a reminder that America’s present reality reflects its exclusionary past. - <a href="https://www.newyorker.com/news/daily-comment/the-forgotten-history-of-the-purging-of-chinese-from-america">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>How 1.5 Degrees Became the Key to Climate Progress</strong> - The number has dramatically reorganized global thinking around the climate. - <a href="https://www.newyorker.com/news/annals-of-a-warming-planet/how-15-degrees-became-the-key-to-climate-progress">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The Lessons of the Johnson &amp; Johnson Vaccine Saga</strong> - There were complaints that the pause would undermine confidence in vaccines. But it would have been more disastrous for the F.D.A. to be seen as ignoring or covering up the issue. - <a href="https://www.newyorker.com/news/daily-comment/the-lessons-of-the-johnson-and-johnson-vaccine-saga">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>The Killing of Adam Toledo and the Colliding Cycles of Violence in Chicago</strong> - With shootings in the city on the rise, trust in the police has nearly bottomed out. - <a href="https://www.newyorker.com/news/dispatch/the-killing-of-adam-toledo-and-the-colliding-cycles-of-violence-in-chicago">link</a></p></li>
</ul>
<h1 data-aos="fade-right" id="from-vox">From Vox</h1>
<ul>
<li><strong>Biden is using his economic plan to challenge China</strong> -
<figure>
<img alt="" src="https://cdn.vox-cdn.com/thumbor/HOhhFCa6u7-EvxA8_rrbUEGirMs=/0x0:7339x5504/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/69186215/968768936.0.jpg"/>
<figcaption>
Lonnie Harris loads steel parts into an end finishing machine at Stripmatic Products Inc. in Cleveland, Ohio, on June 4, 2018. | Angelo Merendino for The Washington Post via Getty Images
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Biden’s domestic policy is also foreign policy.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="it4F52">
The dire warning implicit in President Joe Biden’s more than <a href="https://www.vox.com/2021/4/2/22364100/biden-human-infrastructure-jobs-plan">$2 trillion American Jobs Plan</a> — which promises to rebuild American infrastructure, create union jobs, and jump-start manufacturing — is that if it fails to become law, China will outcompete the United States for decades to come.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="0j13Av">
Biden has been saying that China is <a href="https://apnews.com/article/joe-biden-politics-xi-jinping-china-united-states-4a76b0f360906ab21020a0e308943ade">“eating our lunch”</a> for months, promising his plan would “put us in a position to win the global competition with China in the upcoming years.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="8kfD5T">
“This is not part of my speech,” he said during <a href="https://www.whitehouse.gov/briefing-room/speeches-remarks/2021/04/07/remarks-by-president-biden-on-the-american-jobs-plan-2/">April 7 remarks</a> to sell his plan, “but I promise you, you’re all going to be reporting over the next six to eight months how China and the rest of the world is racing ahead of us in the investments they have in the future, attempting to own the future.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="J1xVsz">
Mentioning China so often when talking about a domestic infrastructure plan might seem odd. But it makes sense if you realize that Biden’s signature domestic economic policy plan is also<strong> </strong>a critical element of a broader foreign policy strategy to thwart China’s growing power and global influence.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="237ROm">
“When [Biden’s] thinking about the infrastructure investments necessary, a lot of it is in contraposition to what he is seeing China doing in terms of strategic investments,” National Economic Council director Brian Deese <a href="https://www.nytimes.com/2021/04/09/opinion/ezra-klein-podcast-brian-deese.html">recently told the New York Times’s Ezra Klein</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Ct4KwI">
The idea is that making America more economically competitive by improving domestic infrastructure and investing in new and emerging technologies, especially clean energy technology, is the best way the US can challenge China for supremacy on the world stage — even more so than through military might or by trying to win the “war of ideas” against China’s authoritarianism.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="QXK3iO">
Competing with China is fundamental to Biden’s presidency and goes hand in hand with his promise to bring middle-class jobs back to the United States. Biden envisions those jobs in<strong> </strong>manufacturing electric vehicles in Detroit, and long-duration energy storage that can store the clean energy generated from wind and solar,<strong> </strong>among other jobs in the clean energy economy.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="IaZ5nP">
Yet the constant framing of China as America’s greatest competitor, if not outright foe, is not without its hazards.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="KqEOFC">
Anti-China sentiment and hate crimes against Asian Americans <a href="https://www.vox.com/identities/2020/4/21/21221007/anti-asian-racism-coronavirus-xenophobia">are on the rise</a> in the United States, in large part due to former President Donald Trump’s aggressive anti-China rhetoric and posture, and in particular his insistence on using <a href="https://www.theguardian.com/us-news/2020/jun/20/trump-covid-19-kung-flu-racist-language">racist and xenophobic language</a> to blame China for the Covid-19 pandemic.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="3YjiBP">
Though Biden and Trump may agree on the goal of making America more competitive with — and stronger than — China, Biden seems to recognize the need to be more careful in his messaging.<strong> </strong>The president has strongly condemned hate crimes against Asian Americans, calling such violence <a href="https://www.whitehouse.gov/briefing-room/statements-releases/2021/03/30/fact-sheet-president-biden-announces-additional-actions-to-respond-to-anti-asian-violence-xenophobia-and-bias/">“un-American.”</a>
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="T31gb6">
Asian Americans have “been attacked, blamed, scapegoated, and harassed,” Biden <a href="https://www.nytimes.com/2021/03/11/us/biden-asian-americans-hate-crimes.html">said</a> in a White House address on the one-year anniversary of the coronavirus being declared a pandemic by the World Health Organization. “They’ve been verbally assaulted, physically assaulted, killed. … It’s wrong. It’s un-American, and it must stop.”
</p>
<figure class="e-image">
<img alt=" " src="https://cdn.vox-cdn.com/thumbor/96hZXnTNrcfzVtqWWYrEf67J29o=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22457697/1232397238.jpg"/> <cite>Xinhua/Li Jianguo via Getty Images</cite>
<figcaption>
People protest anti-Asian hate crimes in Millbrae, California, on April 17.
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Z7pgny">
Still, hammering home the critical importance of competing against China without painting the country as a threat could be a tricky line for him to walk.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="YyjCtJ">
The coming weeks will determine whether Biden’s big domestic and foreign policy gamble pays off. If it doesn’t, Biden will have suffered a loss on two fronts.
</p>
<h3 id="QjfpVI">
China’s infrastructure spending vastly outmatches that of the United States
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="hAwnSO">
Biden’s refrain about China “eating America’s lunch” has a lot to do with just how much China has spent in recent years to improve its domestic infrastructure to become more competitive in the world economy.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="IJ8NNg">
China’s years-long investment in domestic infrastructure has produced a <a href="https://www.travelchinaguide.com/china-trains/railway-map.htm">sprawling network</a> of high-speed train lines, at least <a href="https://www.wsj.com/articles/what-the-u-s-can-learn-from-chinas-infatuation-with-infrastructure-11617442201">1 million bridges</a>, and entire cities springing up — sometimes <a href="https://www.youtube.com/watch?v=Ie6zd3Rwu4c">without enough people to fill them</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="E1W3r0">
China spends more than three times what the US does on infrastructure: about 8 percent of its gross domestic product (GDP), versus just 2.4 percent of GDP in the US, according to a <a href="https://www2.deloitte.com/content/dam/Deloitte/at/Documents/real-estate/2017-global-powers-of-construction.pdf">2017 report</a> by the consulting firm Deloitte.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="xdPUqa">
In 2020, China’s dollar investment in infrastructure, buildings, and other projects<strong> </strong>was about $8 trillion US, according to <a href="http://www.xinhuanet.com/english/2021-01/18/c_139677391.htm#:~:text=Investment%20by%20the%20private%20sector,industry%20edged%20up%200.1%20percent.">China’s National Bureau of Statistics</a>. Meanwhile, the <a href="https://usafacts.org/state-of-the-union/transportation-infrastructure/">US federal government spent</a> $63 billion directly on infrastructure projects in 2020, granting an additional $83 billion in infrastructure funding to states — a total of $146 billion. In other words, the US invested a small fraction of China’s total spending for the year.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="EjJbKV">
Biden’s $2.25 trillion American Jobs Plan will amount to about 1 percent of America’s GDP per year over about eight years, according to a Biden administration official. But even with that factored in, US spending pales in comparison to China’s.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="DhEgrq">
“Right now, China doesn’t need to invest that much more; it has a brand new infrastructure that’s already been built,”<strong> </strong>Kelly Sims Gallagher, a professor of energy and environmental policy at Tufts University, who served as a senior China adviser in the Obama administration’s Special Envoy for Climate Change office, told Vox.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="6hlsPz">
In comparison, she said, “we need to rebuild the original infrastructure, which is old and outdated, we need to climate-proof that infrastructure, and we need to be competing with China internationally for those global markets.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="6Iibp1">
Biden’s plan is a lot more than the $621 billion in spending dedicated to rebuilding what is traditionally considered “infrastructure”: the nation’s roads, bridges, ports, and rail systems. It also contains $300 billion to bolster manufacturing, $213 billion for affordable housing, and a collective $380 billion for research and development, modernizing America’s electricity grid, and installing high-speed broadband around the country. The plan also includes $400 billion for home- and community-based health and elder care.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="nZQfYU">
Biden administration officials have been explicit that they see this plan as a major driver of job growth in the United States across multiple sectors, including construction, manufacturing, and energy. They frequently tout the sheer size of the plan, with Biden calling it the “single largest investment in American jobs since World War II.” And with a $2 trillion federal investment, the Biden administration is betting the private sector will spur even more job growth.
</p>
<figure class="e-image">
<img alt=" " src="https://cdn.vox-cdn.com/thumbor/r0P6BP5dmgonPTFrwWc7OXgxgGg=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22457701/1307561082.jpg"/> <cite>Zhang Bin/China News Service via Getty Images</cite>
<figcaption>
Workers at the construction site of Quanzhou Bay cross-sea bridge of the Fuzhou-Xiamen high-speed railway on March 17 Quanzhou, Fujian province of China.
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="4WZhZS">
“Part of the economic logic of this plan is that this is not just about infrastructure, but it’s about creating more jobs and more industrial strength in the United States,” a Biden administration official told reporters. “When you make these infrastructure investments and couple it with the president’s commitment to buy American, you’re pulling forward and creating demand that will help accelerate new industries in the US.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="pwlb0X">
What the US lacks in manufacturing capacity, it can make up for in cutting edge research and development, experts told Vox. Especially when it comes to clean energy technologies that will power the world for years to come, the Biden administration sees an opening.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="u78vsF">
“The US needs to think strategically about what is our role in developing … essentially the next generation of these technologies, because we’re never going to compete with China on pure manufacturing scale,” Joanna Lewis, director of the science, technology and international affairs program at Georgetown University and an expert on US-China relations, told Vox.
</p>
<h3 id="yDA9yp">
Biden’s China push differs from Obama’s and Trump’s
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="34pEyo">
Engagement with China, meaning consistent and significant dialogue on areas of mutual interest, has defined Washington-Beijing relations since the <a href="https://www.nixonfoundation.org/exhibit/the-opening-of-china/">Nixon era</a>. Presidents from both parties wanted China to become a <a href="https://2001-2009.state.gov/s/d/former/zoellick/rem/53682.htm">“responsible stakeholder,”</a> a wonderfully wonky Washington term that mostly means they hoped Beijing would abide by global, cooperative rules even as it gained immense power. In effect, they wanted to <a href="https://journals.openedition.org/ejas/9157">make China act more like America</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="1mSEUb">
That bipartisan consensus started to fall apart in President Barack Obama’s second term as China relentlessly began <a href="https://www.wired.com/2016/10/inside-cyberattack-shocked-us-government/">cyber espionage and hacks of the US government</a>. But more importantly, Obama used beating China economically as his main selling point for the <a href="https://ustr.gov/tpp/overview-of-the-TPP">Trans-Pacific Partnership</a>, a 12-nation free trade deal representing roughly 40 percent of the world’s GDP.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="0boLtf">
The objective of the deal was to partner with other countries in the region to reduce China’s influence. But that deal became mired in domestic politics: Unions, some progressives, and some on the right opposed it. The deal eventually collapsed under congressional pressure. Neither Democratic presidential challenger Hillary Clinton nor Republican nominee Donald Trump engaged with it during the campaign.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="rrhXpc">
As president, Trump took it up a notch and pushed an approach that viewed China more as an enemy than a competitor.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="efn3DA">
Instead of working with allies to box China in, the US would make a series of moves to <a href="https://www.vox.com/world/2018/9/18/17790600/us-china-trade-war-trump-tariffs-taiwan">derail Beijing’s economic future</a>. “Trump looked to reduce China’s ability to compete, whether it was in cyber, tech, or economics,” said John Costello, who served as a top Commerce Department official for intelligence and security in the Trump administration.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="bXeUNS">
He launched a multibillion-dollar trade war; aimed to downgrade China’s prevalence in the supply chains of many industries, like putting pressure on Apple to move its products from factories in China to factories in Vietnam; and restricted the access of Chinese telecommunications companies such as <a href="https://www.vox.com/recode/2019/5/30/18642877/5g-huawei-china-rural-mobile-broadband-ookla-politics">Huawei and ZTE</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="1VVmpL">
Trump’s plan was to wield America’s might to stymie China’s economic influence in the world. Only then, really, would the US have a shot at competing. However, studies showed that the trade war he launched hurt America’s ability to get protective equipment during the coronavirus pandemic, the <a href="http://www.bu.edu/articles/2021/trump-trade-wars-worsened-covid-19-racial-inequity-bu-study-reveals/">manufacturing job losses hurt primarily people of color</a>, and the virus’s origination in Wuhan, China, fueled anti-Asian sentiment that persists to this day.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="78pKRS">
For Biden, neither the Obama nor the Trump approach was quite right, and both failed in important ways. Obama’s international play fell flat but barely addressed economic needs at home. Trump aimed to revamp the domestic economy but did little to rally the world to counter Beijing comprehensively.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="yp1BiF">
The new president’s approach, then, picks up where the last two strategies failed. “What the Biden administration is doing by broadening the way we discuss infrastructure is painting a picture of the future in which some of the constraints on our current infrastructure go away and new possibilities are realized,” said Anthony Foxx, the secretary of transportation from 2013 to 2017.
</p>
<figure class="e-image">
<img alt=" " src="https://cdn.vox-cdn.com/thumbor/Cqny9h2g6j6S3d25Pu1Z6LCk6jc=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22457705/1227942388.jpg"/> <cite>Kyle Mazza/Anadolu Agency via Getty Images</cite>
<figcaption>
President Donald Trump delivers remarks at Whirlpool Corporation Manufacturing Plant in Clyde, Ohio, on August 6, 2020.
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="pc9T00">
Biden’s is essentially a two-pronged approach. The first is the domestic piece, which experts explain is about essentially beating China in a domestic race for new technologies. “It’s all about running faster,” said Costello, now a senior fellow at the Center for a New American Security think tank in Washington.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ntFKRt">
That’s going to be tough, as China remains determined to fund domestic projects and critical technologies, like artificial intelligence, that will keep the race with America close for years.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="41qeaV">
“China is ramping up AI investment, research, and entrepreneurship on a historic scale,” wrote Kai-Fu Lee, chair and CEO of the China-based technology firm Sinovation Ventures, in his 2018 book <a href="https://www.aisuperpowers.com/"><em>AI Superpowers: China, Silicon Valley, and the New World Order</em></a>. Beijing “projected that by 2030, China would become the center of global innovation in artificial intelligence, leading in theory, technology, and application.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ygHq1j">
But there’s a larger point to this domestic-focused plan. <a href="https://asia.nikkei.com/Opinion/Facing-up-to-China-s-state-led-tech-revolution2">China’s government says</a> that only an authoritarian nation can move at the speed required to “win the future.” Simply put, a strongman like Xi Jinping can dictate where and how much to invest in key industries faster than Biden can get Congress to approve proposals. With this infrastructure bill, Biden wants to prove democracies can still make big moves to outcompete the Chinas of the world.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="hJWo1I">
“The autocrats are betting on democracy not being able to generate the kind of unity needed to make decisions to get in that race,” Biden said during an <a href="https://www.whitehouse.gov/briefing-room/speeches-remarks/2021/04/07/remarks-by-president-biden-on-the-american-jobs-plan-2/">April 7 press conference</a>. “We can’t afford to prove them right. We have to show the world — and, much more importantly, we have to show ourselves — that democracy works; that we can come together on the big things. It’s the United States of America for God’s sake.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="fi05l7">
The second part is the global one plucked from the Obama playbook. But instead of an economic super-deal, Biden wants nations to work together to counter China’s aggressive behavior. That means banning Beijing’s telecommunications companies from their critical infrastructure, speaking out against China’s human rights abuses against Uyghur Muslims or Hong Kong, and pushing Xi to agree to bold climate change standards.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="jMH5PL">
Despite its immense power, Biden’s thinking goes, the US can’t compel China to change in these areas unless and until America’s allies also stand against it. That, too, will be a difficult task. For example, the European Union and China are still finalizing a <a href="https://www.voanews.com/east-asia-pacific/voa-news-china/critics-raise-alarm-over-eu-china-deal">trade deal</a> that would give Beijing preferential access to the EU’s market.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="r0oIFA">
The Biden administration is against such a pact because, they argue, it sends China a signal that it can still make lucrative deals with democracies even as it erodes democracy back home.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="TScnhH">
The agreement, however, <a href="https://www.cnn.com/2021/03/24/economy/china-eu-investment-deal-sanctions-intl-hnk/index.html">may not go through</a> after sanctions the US and the EU placed on Chinese officials over mistreatment of the Uyghurs led Beijing to retaliate with sanctions of its own on EU officials. The continent’s leaders are still steaming over that move. “The prospects for … ratification will depend on how the situation evolves,” <a href="https://www.ft.com/content/6b236a71-512e-4561-a73c-b1d69b7f486b">Valdis Dombrovskis</a>, the EU’s trade commissioner, told the Financial Times in March.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="uuha3C">
Still, the key part of Biden’s China strategy is the domestic part, and the American Jobs Plan is the centerpiece of it. Now the president just has to convince Congress that it’s the right play.
</p>
<h3 id="wRprSI">
Framing infrastructure as competing with China could get more GOP support
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="rqcO8X">
It’s still an open question whether there’s enough political will to pass Biden’s $2.25 trillion infrastructure and jobs plan. With Republicans wanting a smaller bill, some Democrats think the best way to get Biden’s plan through Congress is to hammer at the China competition angle with Republicans.
</p>
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“The best way to enact a progressive agenda is to use China [as a] threat,” a Democratic congressional aide told Vox.
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The theory that America is at its best when it’s united against a common adversary can motivate members of both parties, especially using the idea that the US will lose its competitive edge or cede ground to another country. Indeed, one of the few things both parties can agree on is the need to compete with China.
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The Senate Foreign Relations Committee will soon formally introduce a bipartisan bill called the Strategic Competition Act, which focuses on countering China’s human rights abuses, prioritizing security assistance for the Indo-Pacific region, and combating intellectual property theft. And Senate Majority Leader Chuck Schumer has called on committees to work on the bipartisan Endless Frontiers Act, which focuses especially on strengthening the US semiconductor industry.
</p>
<figure class="e-image">
<img alt=" " src="https://cdn.vox-cdn.com/thumbor/FUi3tfQKgmGXeDIKc_VdOxYGeXE=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22457714/1232422273.jpg"/> <cite>Sarah Silbiger/Getty Images</cite>
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Senate Majority Leader Chuck Schumer speaks during a news conference following the weekly Democrat policy luncheon on Capitol Hill on April 20 in Washington, DC.
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“It seems to have some rhetorical benefit that other people have this great thing that we don’t have,” said Deborah Seligsohn, assistant professor of political science at Villanova University. “We somehow need to create a Sputnik era to have nice things,” she added, referring to <a href="https://history.nasa.gov/sputnik.html">decades of competition</a> between the US and Soviet Russia over the countries’ dueling space programs.
</p>
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At the same time, calling China a threat or adversary could have damaging — even dangerous — consequences in the United States. Amid a spike of hateful rhetoric and violence against Asian Americans across the country, Democrats say they recognize the need to make a big distinction between competing with the Chinese government to not cede economic ground, and portraying the Chinese people as enemies.
</p>
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The US Senate is deliberating on a bill aimed at combating Asian American hate crimes that has bipartisan support, and Biden is ramping up his own outreach to the Congressional Asian Pacific American Caucus (CAPAC), meeting with them in mid-April.
</p>
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“We need to stand by<strong> </strong>the AAPI [Asian American and Pacific Islander]<strong> </strong>community as a whole-of-government response with what we have to get done,” Biden told Asian American lawmakers at the CAPAC meeting.
</p></li>
<li><strong>How thrifting became problematic</strong> -
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<img alt="Clothing racks are on display inside a brightly lit Goodwill store in Florida." src="https://cdn.vox-cdn.com/thumbor/9K0t7p8JjmlWn6WnTUwqxYPImxY=/212x0:3589x2533/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/69186103/GettyImages_1084721160.0.jpg"/>
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The debate in the secondhand fashion world has largely been directed at excessive thrift shoppers and independent Depop sellers who hawk thrifted garments. | Jeffrey Greenberg/Universal Images Group via Getty Images
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</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Thrift shopping is popular online, but some are worried about the effects of overconsumption.
</p>
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Alli Vera has sold more than 2,600 articles of clothing on Depop since 2016. Her shop, <a href="https://www.depop.com/colorclub/">Color Club</a>, specializes in vintage styles from the 1970s through the early 2000s, and most of the garments are sourced from local thrift stores in Virginia, where she lives. In March, Vera decided to permanently close Color Club and leave behind her 83,000 Depop followers.
</p>
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In a <a href="https://www.youtube.com/watch?v=4m-t6Va0fQI">28-minute video</a>, Vera explained that she wanted to focus on growing her YouTube channel, since reselling had become “crazy time-consuming.” But nearly half the video addressed an ongoing debate in the secondhand fashion world, one of the pillars of the sustainable fashion movement. The concern is over how upper- and middle-class “haulers” — people who purchase massive amounts of secondhand clothing for resale purposes or personal wear — are contributing to the gentrification of thrift stores.
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The popularity and proliferation of thrift haul videos on YouTube and TikTok have introduced thrift shopping to a generation of teenagers, even those who can afford to buy new items. In a digital world where style is constantly on display, thrifted garments are unique, and fast fashion has significantly lowered expectations around price. Regular people can build a substantial social media following based on their proclivity for thrifting. These vloggers, most of whom are young women, film themselves perusing through racks at Goodwill or showcasing and styling the garments they’ve found. Platforms like Depop, Poshmark, and Mercari have also made secondhand buying and reselling more accessible, especially with the pandemic’s impact on in-person shopping.
</p>
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<blockquote class="twitter-tweet">
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thrifting becomes a trend -&gt; prices rise due to demand -&gt; people who rely on thrift stores not being able to get the things they need to survive ‍♀️ <a href="https://t.co/PZVr7EAdEb">https://t.co/PZVr7EAdEb</a>
</p>
— ً (<span class="citation" data-cites="NEGR0SWAN">@NEGR0SWAN</span>) <a href="https://twitter.com/NEGR0SWAN/status/1382070795451633668?ref_src=twsrc%5Etfw">April 13, 2021</a>
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</ul>
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The secondhand apparel market was worth about $28 billion in 2019 and is expected to reach $64 billion in 2024, according to the <a href="https://go.redirectingat.com?id=66960X1516588&amp;xs=1&amp;url=https%3A%2F%2Fwww.thredup.com%2Fresale%2F&amp;referrer=vox.com&amp;sref=https%3A%2F%2Fwww.vox.com%2Fthe-goods%2F22396051%2Fthrift-store-hauls-ethics-depop" rel="sponsored nofollow noopener" target="_blank">2020 Resale Report</a> by ThredUp and GlobalData. Within this market, traditional thrift and donation stores (not-for-profit organizations such as Goodwill and the Salvation Army, for example) currently account for the bulk of secondhand sales, but the ThredUp report anticipates that resale (through independently owned consignment stores and Depop shops) will grow significantly. Secondhand buying is growing — and likely contributing to the <a href="https://apnews.com/press-release/business-wire/495034faade64103b7e2c1ee4bb84cca">decline of fast fashion</a>. That should be a good thing, especially for environmental reasons. So why has buying and selling used clothes become, to use internet parlance, so problematic?
</p>
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The criticism surrounding the so-called gentrification of thrift stores has zeroed in on excessive shoppers: Depop resellers, like Vera, who mark up items found at their local Goodwill to turn a profit; thrift shop YouTubers who frequently buy more than they could reasonably wear; and thrift “flippers’’ who buy oversized garments to transform into smaller, fitted items. The general argument is that resellers and bulk buyers are inadvertently raising the prices of thrifted goods by purchasing items they don’t personally need. As a result, low-income shoppers might be priced out of thrift stores in their area, and plus-sized consumers, who already struggle to find clothing in the firsthand market, could be left with fewer options.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="7tZkIY">
At the heart of this online discourse, which is being driven primarily by young women shoppers, is a broad critique of overconsumption and resellers’ profit motivations. The argument has pervaded the fashion worlds on YouTube and TikTok over the past year, coinciding with the pandemic and its toll on the retail industry. In a world that produces too many clothes, who gets to sell and who gets to buy, even when the items are all secondhand?
</p>
<hr class="p-entry-hr" id="0WYhBK"/>
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There is perhaps no better embodiment of free market capitalism than resale marketplaces. Prices are dictated by sellers, which means items’ value can range from the reasonable to the outlandish. On Depop, where <a href="https://techcrunch.com/2019/06/06/depop-a-social-app-targeting-millennial-and-gen-z-shoppers-bags-62m-passes-13m-users/">90 percent</a> of active users are under 26, shop owners are often young adults or teenagers selling their thrifted garments to buyers in their age cohort. These young consumers might have minimal knowledge to help <a href="https://www.reddit.com/r/Depop/comments/biiuqj/stop_labeling_and_tagging_nonvintage_stuff_vintage/">discern true vintage items</a> from the mounds of thrifted clothes on Depop, and as a result could be paying well-above-average prices for items that aren’t really that special. For resellers, though, so long as there is at least one buyer willing to pay the listed amount, the price must not be that outrageous. In a competitive market, so the thinking goes, it’s simply supply and demand.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="thpkWw">
Currently, the hottest genre of clothing on Depop, as <a href="https://www.vox.com/the-goods/22364404/low-rise-jeans-trend-y2k-fashion">Vox’s Rebecca Jennings</a> has reported, is Y2K and ’90s styles: satin bustiers, low-rise jeans, baguette bags, halter tops, and cropped tees. Unsurprisingly, resellers have thrown screen-printed baby tees and children’s clothing into the mix — pieces that are often advertised for double or triple their thrifted price and which tend to generate the most social media outrage for absurd markups. It doesn’t help that most garments on Depop are tagged as “vintage” to drive search traffic to sellers’ stores, even if the term technically only applies to items that are <a href="http://nacvalue.com/vintage-retro-or-antique/">at least 20 years old</a>.
</p>
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Ridiculous Depop listings are screenshotted and reposted on TikTok or Twitter for users to mock, with commentary verging on the cusp of <a href="https://www.tiktok.com/@elenahaz3l/video/6851371157409565958">disbelief and derision</a>. In December, after <a href="https://twitter.com/v4mpgrI/status/1343436420954742786">screenshots</a> of TikTok user <span class="citation" data-cites="dullgerm">@dullgerm</span>’s thrift haul went viral on Twitter, people pointed out how she was upselling thrifted garments on Depop for more than double their original prices. “$40 for a skirt you bought for what $7 max?” one TikTok user commented. It was “<a href="https://twitter.com/v4mpgrI/status/1343752505990103040">market value</a>,” the seller responded, pointing out that the skirt sold for the listed price.
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<div id="3LyLaA">
<blockquote cite="https://www.tiktok.com/@goodfair/video/6879096504724868358" class="tiktok-embed">
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<a href="https://www.tiktok.com/@goodfair" target="_blank" title="@goodfair"><span class="citation" data-cites="goodfair">@goodfair</span></a>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
This sound was made for us <span class="citation" data-cites="curli_fries">@curli_fries</span> say it louder <a href="https://www.tiktok.com/tag/dilemma" target="_blank" title="dilemma">#dilemma</a> <a href="https://www.tiktok.com/tag/thriftedfashion" target="_blank" title="thriftedfashion">#thriftedfashion</a> <a href="https://www.tiktok.com/tag/thriftshopping" target="_blank" title="thriftshopping">#thriftshopping</a> <a href="https://www.tiktok.com/tag/sustainablefashion" target="_blank" title="sustainablefashion">#sustainablefashion</a> <a href="https://www.tiktok.com/tag/nonewthings" target="_blank" title="nonewthings">#Nonewthings</a> <a href="https://www.tiktok.com/tag/goodfair" target="_blank" title="goodfair">#goodfair</a>
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<a href="https://www.tiktok.com/music/Thrift-Shopping-Guilt-6863986897656597253" target="_blank" title="♬ Thrift Shopping Guilt - Curli_fries">♬ Thrift Shopping Guilt - Curli_fries</a>
</section>
</blockquote>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="xXHM0J">
As more of these callout posts go viral, some resellers, particularly those who publicly document their haul process on TikTok, have been branded as scammers, grifters, and gentrifiers. On the <a href="https://www.reddit.com/r/Depop/">Depop subreddit</a>, shop owners have advised others to stop promoting themselves on TikTok or to remain mum about where they source from, in case their profit margins get scrutinized.
</p>
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“I can’t speak to the motivations of every seller, but before I list a price, I factor in the 10 percent fee Depop takes, shipping costs, and the time [it] takes to clean, style, and package the garment,” said Sora, a teenage Depop seller who asked that their last name be withheld out of concern for their business. “I care about quality, and I’m not the type of person who upsells every trendy item I come across at the thrift store just to make a quick buck.”
</p>
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Sellers like Sora worry the overwhelming focus on the ethics of selling and buying secondhand detracts from other issues in the fashion world, specifically fast fashion and the <a href="https://www.shopify.com/blog/what-is-dropshipping">growth of dropshipping</a>. Dropshippers on Etsy and Depop don’t manufacture garments or items directly; instead, they place bulk orders from factories (sometimes overseas) and ship the product to buyers themselves, usually under the guise that the items are unique or handmade. When major clothing brands barely understand their supply chain, it’s nearly impossible for consumers to determine whether small sellers’ wares are from reputable sources. Thrifting, at least, avoids this concern.
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“My shop is a one-person operation, and I love thrifting, photographing the clothes, and selling them as a hobby,” Sora said. “I wish there were more constructive conversations about buying from Amazon or fast-fashion retailers like H&amp;M and Shein, so it’s frustrating to see all this anger directed at resellers, who are mostly young women trying to start a business.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Tfk9F2">
The concern over the gentrification of thrift stores is not a new phenomenon, although the internet’s cycle of discourse has certainly accelerated it. Jennifer Le Zotte, an assistant professor at the University of North Carolina Wilmington, said the history of thrift and secondhand shopping is rooted in stylistic and economic appropriation by well-off consumers dating to the 19th century.
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“It has been a process of appropriating not just the styles associated with secondhand dress but the actual venues: the sales of items, the economic process, and availability,” Le Zotte told me. “Secondhand buying and selling has never wholly been for the altruistic reasons that are often championed, whether it be environmental or to aid people who can’t afford to buy firsthand clothing. This isn’t a new conversation at all.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="CRrz5b">
In her book <a href="https://uncpress.org/book/9781469631905/from-goodwill-to-grunge/"><em>From Goodwill to Grunge: A History of Secondhand Styles and Alternative Economies</em></a>, Le Zotte writes that thrift stores, the organizations that run them, and consumer interest all reveal “an increasingly intricate relationship between industrial capitalism, social welfare, and mass culture” that was “responsive to changes in the meaning of public appearance.” Early in their history, thrift stores gave more people access to newer fashions, benefiting immigrants, minorities, and low-income shoppers who existed on the margins of the consumer world. But as clothing production sped up in the 20th century, thrift stores became places where Americans discarded used clothing for newer items. “What this accomplished, even back a century ago, was to constantly accelerate the demand for new clothing,” Le Zotte told me. “The impetus to get rid of clothing is often charitable, but the more clothing that is contributed and viable, the more fashion cycles speed up.”
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<aside id="QXxXYf">
<q>“The more clothing that is contributed and viable, the more fashion cycles speed up”</q>
</aside>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="1JSpMw">
This is currently reflected in the availability and pricing of new clothing, namely at fast-fashion and <a href="https://www.vox.com/the-goods/2020/2/3/21080364/fast-fashion-h-and-m-zara">“ultra-fast-fashion” brands</a> like Shein and Fashion Nova, which release hundreds of new styles every week. Americans are buying more clothes than ever, and even avid thrifters have felt the need to accumulate new styles and garments to keep up appearances on social media. Still, the discourse combined with the pandemic has led some resellers to reevaluate their purchasing pace and their definition of “sustainable” consumption.
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Thrift-oriented YouTuber Alexa Hollander — aka Alexa Sunshine — grew her channel by consistently uploading “Thrift With Me” hauls but told subscribers in January that haul content would no longer be a main part of her YouTube channel. “My favorite part about thrifting is showing all the gems you can find and not having the pressure to buy it,” she said in <a href="https://www.youtube.com/watch?v=Td9rHaEQsQA&amp;t=288s">a video</a>, explaining why she felt stressed about the sustainable fashion movement. Hollander’s decluttering videos have received comments criticizing her overconsumption habits, and over the past year, she was moved to reassess how frequently she bought or thrifted clothes.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="RraSXa">
According to Le Zotte, this wide-scale reflection on individualized consumption habits is generally positive. Social media platforms, through ads and the streamlining of the purchasing process, have only eased people into buying more. Still, Le Zotte said she is skeptical that excessive shoppers are to blame for rising thrift store prices, or for buying up items intended for low-income people. Thrift haulers are not outpacing the production of new clothes. During Covid-19, <a href="https://www.reuters.com/article/us-health-coronavirus-textiles-recycling/height-of-fashion-clothes-mountains-build-up-as-recycling-breaks-down-idUSKBN26L0QQ">thrift and charity shops</a> across the US received more donations than they could handle. Tons of pre-owned garments still go to landfills or get sold by the ton for very cheap amounts overseas. These misconceptions, Le Zotte said, are wrapped up in the prevailing myth that donating clothes offers a net positive for society, an idea that has existed for decades.
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“The idea is that you’re giving it to someone who otherwise wouldn’t be able to buy, and that has expanded to such a degree that there’s so much secondhand clothing waste, [the] equation doesn’t work out anymore,” said Le Zotte. And thrift stores have historically distinguished high-quality goods from regular garments by charging more, upcycling, or selling it in higher-priced shops. “This blame shouldn’t be directed specifically at the haulers or buyers,” she added. “Maybe we should look at the corporate facilities, even as they’re classed as nonprofit organizations. That is a dubious delineation when it comes to major secondhand clothing corporations.”
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A common refrain online is that wealthy white teenagers have ruined things: Depop, the Y2K trend, even the premise of thrifting itself. It’s a tale as old as time, but the internet has a tendency to make things seem new. When a trend enters the mainstream, it’s inevitable that retailers and people (namely, influencers) will try to profit off of it. The markup on Y2K-styled clothing is just the latest example of how easily retro aesthetics are co-opted once enough consumers think it looks cool.
</p>
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Mainstream retailers such as Urban Outfitters initially drove this aesthetic reappropriation. Through its Urban Renewal program, UO notoriously sells <a href="https://click.linksynergy.com/deeplink?id=nOD%2FrLJHOac&amp;mid=43176&amp;u1=vox&amp;murl=https%3A%2F%2Fwww.urbanoutfitters.com%2Fcurated-vintage-clothing" rel="sponsored nofollow noopener" target="_blank">pre-owned clothing</a> in its shops, labeling it vintage to appeal to customers (sound familiar?) interested in dressing “trendy” without putting in the effort to source such clothing secondhand. In some ways, the program was a corporate precursor to how independent Depop sellers operate. But as illustrated by Macklemore and Ryan Lewis’s hit 2012 single “Thrift Shop,” going to a thrift store soon became a teenage rite of passage and a normalized part of American consumer culture.
</p>
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rich white girls will criticise poor people from buying at shein instead of ethical companies or thrifting and then go to second hand shops themselves to buy all the affordable stuff and sell it on depop for 10x the price so they can call themselves small business owners
</p>
— Inés (<span class="citation" data-cites="vnbrkl">@vnbrkl</span>) <a href="https://twitter.com/vnbrkl/status/1375756459674378240?ref_src=twsrc%5Etfw">March 27, 2021</a>
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="1yMr0m">
Some teenagers and young adults, though, are dropping hundreds of dollars at thrift stores — not just 20 bucks. TikTok’s format, which helps cement the narrative of each user as the main character in their own lives, makes it easy for a certain type of thrifter to be villainized. Over the past year, some of this finger-pointing has been lobbed at individual resellers who feel they’ve received the brunt of backlash that should be directed toward fast-fashion corporations, thrift stores that are purposefully raising prices, and Depop, for its largely unregulated structure.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="6Nbv01">
There’s a lot of rage directed at individuals rather than institutions, one seller remarked on a Depop subreddit. Members of Gen Z know shopping is a political act, and they’re well aware of the nuances of race and class that separate “privileged” individuals from the underprivileged. Still, the psychic burden laid upon shoppers and sellers to operate ethically under a flawed system can be overwhelming. It’s easier to point fingers at visible, seemingly well-off people — who have the means to go to thrift stores and buy up heaps of clothes without batting an eye — and ignore the mechanism that makes this a desirable act.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="S1vi58">
While thrift shopping, on its surface, might seem like an anti-capitalist alternative to capitalism, the secondhand market is closely linked to the firsthand retail market. “There’s a lot of rhetoric that makes it seem like thrift shopping exists ethically outside the negative ramifications of capitalism,” Le Zotte said. Sadly, thrift shopping exists in the same messy reality as everything else.
</p>
<ul>
<li><strong>How the UK found the first effective Covid-19 treatment — and saved a million lives</strong> -
<figure>
<img alt="" src="https://cdn.vox-cdn.com/thumbor/-CpuQqCjVaN4ouOQnkaxPeTB-ZQ=/197x0:2864x2000/1310x983/cdn.vox-cdn.com/uploads/chorus_image/image/69185901/MartinLandray_PeterHorby_045.0.jpg"/>
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Oxford researchers Martin Landray (left) and Peter Horby helped save an estimated 1 million lives worldwide in their study on an effective treatment for Covid-19.
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The United Kingdom is not a pandemic success story. But its massive Covid-19 trials program is.
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Peter Horby couldn’t believe his eyes.
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He’d just gotten his first glimpse of new data from the United Kingdom’s Recovery Trial, an experiment enrolling tens of thousands of patients at dozens of hospitals for clinical trials investigating <a href="https://www.vox.com/covid-19-coronavirus-treatment-prevention-cure-vaccines">Covid-19 therapies</a>.
</p>
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Horby and his Oxford University colleague Martin Landray had dreamed up the trial program in March 2020. Nearly three months later, more than 35,000 people <a href="https://ourworldindata.org/covid-deaths#what-is-the-cumulative-number-of-confirmed-deaths">were dead</a> in the UK (and more than 100,000 in the US), and Horby and Landray were still hunting for the world’s first lifesaving treatment for the novel coronavirus.
</p>
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Now Horby was looking at the results of a Recovery Trial project testing dexamethasone, a cheap, widely available steroid. It found dexamethasone had lowered the likelihood of death for Covid-19 patients who required oxygen or a ventilator while in the hospital.
</p>
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He called Landray. His summary was pithy.
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<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="aDptR3">
“Holy shit, it works.”
</p>
<figure class="e-image">
<img alt=" " src="https://cdn.vox-cdn.com/thumbor/fIsnLsflPd1BZgriRlwRyeeKZA4=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22465979/MartinLandray_PeterHorby_038.jpg"/>
<figcaption>
Landray and Horby designed the Recovery Trial and discovered that dexamethasone helped severely ill patients recover from Covid-19.
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="v5sZGX">
On June 16, after verifying the data, the Recovery Trial <a href="https://www.recoverytrial.net/news/low-cost-dexamethasone-reduces-death-by-up-to-one-third-in-hospitalised-patients-with-severe-respiratory-complications-of-covid-19">announced</a> the news: A drug had finally been shown to reduce Covid-19’s mortality. Dexamethasone became part of the standard of care across the world. A UK government estimate published in March 2021 <a href="https://www.england.nhs.uk/2021/03/covid-treatment-developed-in-the-nhs-saves-a-million-lives/">concluded</a> that the drug’s use had so far saved 22,000 lives in the UK and an estimated 1 million lives worldwide.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="lXQUSq">
As the <a href="https://www.vox.com/coronavirus-covid19">coronavirus pandemic</a> exploded across the world, medical science was starting from scratch. While the long-range goal was an effective vaccine, millions could — and would — die before a shot was approved and widely distributed. The best bet for preventing as many deaths as possible was to find existing drugs that could treat Covid-19.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="GBzW5N">
But doing this would require enormous capacity: Researchers had to test a lot of different therapies simultaneously, which would mean recruiting thousands of patients to participate. In the US, the New York Times’s Carl Zimmer <a href="https://www.nytimes.com/2021/01/30/health/covid-drugs-antivirals.html">wrote</a> in January 2021: “many trials for Covid antivirals were doomed from the start — too small and poorly designed to provide useful data.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="EAzEUe">
The United Kingdom’s Recovery Trial was the opposite: massive and simple. It has proven to be the most effective program in the world for delivering desperately needed research results. Pharmaceutical companies sought out partnerships with the Recovery Trial because they see it as the most reliable way to determine whether their drugs can help stop the global outbreak. Since June 2020, when Horby and Landray saw the first results on dexamethasone, the trial has since identified another drug, <a href="https://www.recoverytrial.net/files/recovery-press-release-tocilizumab_final.pdf">tocilizumab</a>, that improves mortality rates. It has also done the valuable service of demonstrating that some once-promising treatment candidates don’t work.
</p>
<div class="c-wide-block">
<figure class="e-image">
<img alt=" " src="https://cdn.vox-cdn.com/thumbor/DskAWl9eGE_JIzwYjbJxNosLtQs=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22466025/GettyImages_1230834553.jpg"/> <cite>Kirsty Wigglesworth/AFP/Getty Images</cite>
<figcaption>
Felicia Kwaku, associate director of nursing (left), and Anna Castellano help Justin Fleming out of bed in his recovery from Covid-19 at King’s College Hospital in London in January 2021.
</figcaption>
</figure>
</div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Uk4FwV">
In this series, the <a href="https://www.vox.com/22381700/pandemic-playbook">Pandemic Playbook</a>, Vox is exploring the successes — and setbacks — of countries around the world in combating Covid-19. In many important ways, Britain struggled; it has, per capita, <a href="https://www.nytimes.com/interactive/2020/world/coronavirus-maps.html">suffered</a> among the most cases and deaths of any country in the world. But the Recovery Trial is a notable exception. It’s made vital contributions to medicine’s understanding of Covid-19 that saved lives not just in the United Kingdom but around the world.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ytKIft">
The US health care system, for all its flaws, is often touted for encouraging innovation. But the Recovery Trial was made possible by the UK’s unified, government-run health care system. The National Health Service runs most hospitals in the country, and their staff, including the research staff, are all government employees. British patients’ medical records are all shared in one data system.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="C3zTGZ">
This made setting up the world’s biggest clinical trial in the middle of a pandemic straightforward. To hear the doctors involved tell it, it was as simple as the country’s chief medical officer sending a letter to the head of every hospital, asking them to take part. The grand experiment was soon underway.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="xW8Xic">
“We were able to get up and going within days. That was because of the NHS,” says Duncan Browne, who is running the Recovery Trial program at a hospital in Cornwall. “Whereas if we had a fragmented approach, I think we’d still be arguing about it.”
</p>
<h3 id="gCgnW8">
The ideas behind the Recovery Trial can be traced back to a very different program in the 1980s
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="W4NHzW">
The road to the Recovery Trial started in the 1980s, when a group of Oxford scholars was dissatisfied with the lack of treatments for heart attacks. They imagined a trial that could test different interventions — a massive trial, perhaps as many as 10,000 to 15,000 patients. For such a big trial to work, it had to be simple: Nurses and doctors would need to be able to try out the treatments the researchers were testing as part of their normal care routine.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Hxfgv8">
The system they set up began when a patient was admitted to the hospital. The research team would tell the medical staff which treatment pack to use for the patient, a pack containing either a placebo or a treatment. (Nobody, including the researchers, knew which.) The hospital staff had to report whether the patient lived or died, plus any notable events, like a blood clot or a stroke.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ThqeEW">
Ultimately, that research, the International Studies of Infarct Survival, <a href="https://www.google.com/search?q=isis+trials+140%2C000&amp;oq=isis+trials+140%2C000&amp;aqs=chrome..69i57j33i299l3.3627j0j4&amp;sourceid=chrome&amp;ie=UTF-8">enrolled</a> more than 140,000 patients and identified several treatments that significantly cut the number of heart attack deaths, including a combination of an anti-clotting enzyme and aspirin — a groundbreaking finding, and a treatment regimen still in use today. They became famous in the medical field, attracting younger medical researchers like Landray, who came to Oxford in 2000 to work with the team.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="g3yVFP">
But nobody had set up a very large clinical trial program in the middle of an emergency before. Previous efforts had failed.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="LF6I2K">
Horby, who was already studying infectious diseases before the pandemic, had given lectures about the missed opportunities for research during the SARS crisis: “all the studies they could have done but didn’t.” He had tried to get some clinical trials started during the H1N1 flu pandemic in 2009, but he says it had taken researchers three weeks to draft the proposals, which then spent two more weeks in front of an ethics review board before getting a green light. The trials that made it through the process enrolled just a few hundred patients, not nearly enough to yield robust results.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="JKj2Oa">
“It was appalling. Hardly any trials started,” Horby says. “It just was a failed model for epidemic infections.”
</p>
<div class="c-wide-block">
<figure class="e-image">
<img alt=" " src="https://cdn.vox-cdn.com/thumbor/WJ_ZSnvQ6Or_TkPT3ZBjDeEkGHk=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22466038/GettyImages_1303391820.jpg"/> <cite>Lynsey Addario/Getty Images</cite>
<figcaption>
Foysal Ahma is helped to his feet to take his first steps after spending over two months in a Covid-19 critical care unit in Cambridge, in June 2020.
</figcaption>
</figure>
</div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ymnFTb">
Landray, meanwhile, had spent his life before Covid-19 trying to figure out how to best run big — really big — clinical trials. But he’d never given infectious disease outbreaks much thought until the coronavirus pandemic began.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="vgMfg6">
On February 28, when there were still just 20 confirmed Covid-19 cases in the UK, Landray emailed Jeremy Farrar, who leads the Wellcome Trust, one of the top medical research charities in the country. It seemed clear to Landray that the SARS-CoV-2 virus would spread fast, and clinical trials for possible treatments would be needed. Vaccine research had barely begun, and in the short term, doctors would need to find something else to save lives — likely a treatment for an existing condition that could also work against Covid-19.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="HPjlJl">
Farrar suggested that he contact Peter Horby, who had secured financial support for a multi-drug trial in China. But by the time the financing was approved, the Chinese outbreak had slowed down — while cases were taking off in the UK.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="CQj5kp">
When Horby and Landray sat down for their first face-to-face meeting in Oxford on March 5, they realized they each had one half of the equation. Horby had the protocols to set up a multi-drug investigation during the pandemic; Landray had been thinking about how to establish such a massive trial in the UK.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="d0uDHh">
“He’d never done a clinical trial over about 200 patients,” Landray says. “I’d never, ever worked on infectious diseases.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="OENQWj">
They had a proposal drawn up by March 10. With Farrar’s support, they pitched it to England’s chief medical officer, Chris Whitty. Whitty bought it.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="cdwHUE">
He and his peers in Scotland, Wales, and Northern Ireland sent out <a href="https://www.recoverytrial.net/files/professional-downloads/the-importance-of-covid-19-clinical-trials.pdf">a missive</a> to the NHS hospitals, urging them to take part in this public project. More than 175 hospitals across the country eventually agreed to participate.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Mlpy0Z">
“Back in March, we didn’t really know what was going on. It was more scary than it is now,” Browne says. “To feel that you were doing something was, I think, a really positive thing.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="lunkEi">
Within two weeks of Horby and Landray’s first meeting, more than 1,000 patients had already enrolled in the Recovery Trial. Now all they had to do was wait.
</p>
<div class="c-float-right c-float-hang">
<div id="UNNZUA">
<div>
</div>
</div>
</div>
<h3 id="rQMU2H">
Once it got started, the Recovery Trial successfully found effective Covid-19 treatments
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="AaUj3w">
Browne, the lead investigator at the Cornwall hospital, and Fiona Hammonds, who serves as the lead research nurse there, had been studying diabetes before the Covid-19 pandemic. Neither of them had worked on infectious diseases before.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ZqY37a">
But that lack of experience didn’t matter, Browne says. “It’s really more about the process of doing research.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="NqliKE">
Horby and Landray had designed the Recovery Trial, like the heart attack trials before it, to be as easy to administer as possible.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="pXLM1q">
Recruitment started as soon as a patient walked through the hospital doors. UK emergency rooms were stocked with pamphlets and posters advertising the Recovery Trial. Within three or four hours of testing positive for Covid-19 and being admitted, an eligible patient would be approached by a member of the research team and asked if they would like to take part in the trial. Many of them wanted to enroll, Browne and Hammonds found. More than 35,000 patients have been enrolled in the Recovery Trial over the past year.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="g4qNt5">
Once a patient agreed to participate, they signed a simplified consent form — one page instead the more typical five or six — shorn of a lot of the fine print. The research team would then enter the patient into the Recovery Trial’s computer algorithm, which randomly assigned them to one of the trials. The NHS’s electronic system then generated a prescription for the experimental drug for half the patients; the other half served as the control group. Dexamethasone, or one of the other drugs tested in the trial, became just another name on a patient’s drug chart, given by the nurses in the normal course of care.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="k3pSZ5">
“It became no more time for the nurses and doctors in the ward than if it had been a conventional part of their treatment,” Browne says. The patients who were given the treatment in the trial were then compared to the patients who received the regular standard of care.
</p>
<figure class="e-image">
<img alt=" " src="https://cdn.vox-cdn.com/thumbor/UNfaKRu52qC3_-gIYNVTEZca5mE=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22466056/DuncanBrown_FionaHammonds_042.jpg"/>
<figcaption>
Fiona Hammonds, a senior research nurse, and Duncan Browne, an endocrinologist, ran the Recovery Trial program at the Royal Cornwall Hospital in Cornwall.
</figcaption>
</figure>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="M8JjgU">
Nurses could be trained to run the trial in about 20 minutes. They logged the patient’s discharge date as well as side effects or adverse events. The information was automatically uploaded to an online NHS database, where an independent panel monitored the data.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="7S9zIt">
A group of experts formally recommended which treatments should be included in the trial. Some of Recovery’s candidates were obvious because they were already being used for Covid-19 care; hydroxychloroquine, hyped by then-US President Donald Trump as a possible cure for Covid-19, was one such candidate.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="My0r1B">
Others, like dexamethasone, were more educated guesses. There was limited research available on dexamethasone and viral infections. Some of it showed the drug could be helpful, but there were also indications it could be dangerous at high doses. Nobody knew for sure if it would work. Prominent experts warned against testing dexamethasone, Horby and Landray say, because the potential adverse effects made it unethical.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="heZOPz">
The investigators saw it differently. There was already an existing proposal to set up a steroid trial whenever the next flu pandemic happened. They thought the uncertainty was a good reason to conduct a trial.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="7g2uip">
“There was a lot of controversy about it, which probably tells you it’s a good drug to test,” Horby says. “Opinion was very divided, and this was the only way to un-divide the opinion.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="0hgh3w">
In one year, the trial has examined nine repurposed drugs, a convalescent plasma, and a newly developed antibody cocktail.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="3pzLAl">
And it has found that two of those drugs reduce mortality for seriously ill Covid-19 patients: dexamethasone and, more recently, tocilizumab.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="1MAQyo">
Paul Buckler, 46, was one of the 4,000-some patients enrolled in the tocilizumab trial. He lives near Southampton, almost two hours southwest of London. He says he’d been careful during the pandemic — his dad has chronic obstructive pulmonary disease — but he still found himself infected with Covid-19 in early November.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="IdzMBL">
He first noticed he couldn’t smell his hand sanitizer. Tipped off that something was wrong, Buckler got a coronavirus test — and it was positive. At first, he didn’t feel particularly bad, but after a few days, he started coughing and lost his appetite. He checked his blood oxygen levels with a home monitor and his numbers looked low. He called his primary care doctor, who told him to get himself to a hospital.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="o88kZ8">
“I knew I wasn’t right,” he says.
</p>
<div class="c-wide-block">
<figure class="e-image">
<img alt=" " src="https://cdn.vox-cdn.com/thumbor/iE3_neW-TszQEekrBixN2CU-38g=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22466070/PaulBuckler_071.jpg"/>
<figcaption>
Paul Buckler was diagnosed with Covid-19 last fall. After being admitted to a hospital for treatment, he was enrolled in the Recovery Trial’s test of tocilizumab.
</figcaption>
</figure>
<div class="c-image-grid">
<div class="c-image-grid__item">
<figure class="e-image">
<img alt=" " src="https://cdn.vox-cdn.com/thumbor/IGLZzU2fPbCQ386lM6yFMVK7oLU=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22466076/PaulBuckler_065.jpg"/>
<figcaption>
Buckler’s parents also contracted the coronavirus, though they did not end up needing to be hospitalized.
</figcaption>
</figure>
</div>
<div class="c-image-grid__item">
<figure class="e-image">
<img alt=" " src="https://cdn.vox-cdn.com/thumbor/77pUSEbf9o1q3h5-kp94fUNxauo=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22466083/PaulBuckler_002.jpg"/>
<figcaption>
Buckler says he didn’t think twice about participating in the Recovery Trial. “Everybody’s doing a bit. That’s what Covid has really shown: If everybody does their bit, it does help,” he says.
</figcaption>
</figure>
</div>
</div>
</div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="UCMJLw">
The morning after his first night in the hospital, a nurse and a Recovery staff member came to Buckler’s room and pitched him on participating in the trial. They reassured him they knew these drugs well, including what side effects to expect. They gave him some material to read, though he admits he didn’t examine the fine print. He said he’d do it, and by that afternoon, the hospital staff told him he had been selected for the tocilizumab trial.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="ILlh2f">
He never knew if he got the placebo or not. But he did start feeling better in a matter of days.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="E9b5LE">
“I didn’t even think about it. When you feel ill, if someone says, ‘We’ve got these drugs that might help you get better,’ you think, ‘Okay,’” Buckler says. “I did do my bit a little bit, I guess. Everybody’s doing a bit. That’s what Covid has really shown: If everybody does their bit, it does help.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="qD8K83">
In February 2021, the results were <a href="https://www.recoverytrial.net/news/tocilizumab-reduces-deaths-in-patients-hospitalised-with-covid-19">published</a>: Tocilizumab, largely when taken in tandem with dexamethasone, reduced mortality for patients who were receiving oxygen (like Buckler) or placed on a mechanical ventilator. It also helped patients who developed severe symptoms be discharged from the hospital more quickly.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="fsKsze">
The finding was another victory for the Recovery Trial’s premise of going big. Earlier, smaller trials had <a href="https://www.biospace.com/article/actemra-reduces-deaths-mechanical-ventilation-for-covid-19-in-early-data/">failed</a> to show any benefit in using tocilizumab. Now doctors could put it in their care regimen with confidence, right away.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="it2cuL">
“We publish the results at lunchtime,” Landray says, “and it’s practiced by tea time.”
</p>
<h3 id="S50hgM">
Critics say the Recovery Trial is an imperfect program — but maybe still the best option in a crisis
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="hlMyiJ">
The UK’s research achievements during the pandemic extend beyond the Recovery Trial.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="enWBEH">
Two other trial programs — one for patients in primary care, another for only the critically ill — ran alongside it. Browne’s hospital participated in the Siren study, which tracked antibodies in hospital workers. British scientists also <a href="https://www.wsj.com/articles/how-the-u-k-became-world-leader-in-sequencing-the-coronavirusgenome-11612011601#:~:text=Half%20of%20the%20genome%20sequences,large%20laboratories%20around%20the%20U.K.">lead</a> the world in sequencing coronavirus genomes, work that was critical in identifying new variants. And while the US has played an important role in developing and producing Covid-19 vaccines, the UK hasn’t been too shabby, either: The country has vaccinated <a href="https://www.bloomberg.com/graphics/covid-vaccine-tracker-global-distribution/">about the same share of its population </a>as the US, with <a href="https://www.reuters.com/world/uk/british-regulator-says-astrazeneca-covid-shot-clots-rise-168-2021-04-22/">almost half of those doses</a> being the AstraZeneca vaccine <a href="https://www.bloomberg.com/news/features/2020-07-15/oxford-s-covid-19-vaccine-is-the-coronavirus-front-runner">designed by Oxford scientists</a>.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="gQs0Pm">
But the Recovery Trial especially helped set British science apart during the pandemic. Even its critics preface their critiques with praise for its scope and extraordinary efficiency amid a public health emergency, deploying descriptors like “brilliant” and “absolutely stellar.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="7X22Ym">
“Covid was new and we had no idea how to treat it,” says Tobias Kurth, a Berlin-based epidemiologist who focuses on study design. “The approach was really good.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Alog8l">
But precision is sacrificed when you design a study as simple as the Recovery Trial. Big numbers are good at answering basic questions — did the patient live or die? — but they don’t provide the same level of detail or certainty that researchers are accustomed to.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="tyWH0a">
The investigators know they are making a trade-off by keeping it simple. Horby spoke at the WHO about the tocilizumab results, and he remembers somebody asking him whether the drug would be clinically appropriate for a diabetic in their 70s.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="l5aRnw">
“I can’t answer the question,” he says. “We didn’t look at that specific subgroup.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="5JgLFE">
And the Recovery Trial has at times been labeled with the four words that have stained other scientific findings during the Covid-19 pandemic: “science by press release.” Announcing initial study results without a full data set to support them could erode the trust among experts whose acceptance the researchers need to achieve widespread adoption of their proven treatments.
</p>
<div class="c-wide-block">
<figure class="e-image">
<img alt=" " src="https://cdn.vox-cdn.com/thumbor/zEnHbjREIf8AmHAPHfo3Qnn7Iv4=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22466131/AP_20179597438639.jpg"/> <cite>Mulugeta Ayene/AP</cite>
<figcaption>
Centenarian Tilahun Woldemichael prays in his home after spending weeks in a hospital recovering from the coronavirus in Addis Ababa, Ethiopia, in June 2020. He was discharged after receiving oxygen and dexamethasone.
</figcaption>
</figure>
<div class="c-image-grid">
<div class="c-image-grid__item">
<figure class="e-image">
<img alt=" " src="https://cdn.vox-cdn.com/thumbor/Xzr94NibOKNX5eLZJdQeBknpNoE=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22466126/AP_20238854232278.jpg"/> <cite>Ariana Cubillos/AP</cite>
<figcaption>
A Covid-19 patient receives a treatment package containing chloroquine, azithromycin, and dexamethasone in Caracas, Venezuela, in August.
</figcaption>
</figure>
</div>
<div class="c-image-grid__item">
<figure class="e-image">
<img alt=" " src="https://cdn.vox-cdn.com/thumbor/EP6T2EgdYgPgzl9bLCUdGWJseEk=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22466127/AP_20239019567264.jpg"/> <cite>Ariana Cubillos/AP</cite>
<figcaption>
A medical worker holds bags containing chloroquine, azithromycin, and dexamethasone to treat Covid-19 patients in Caracas.
</figcaption>
</figure>
</div>
</div>
</div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="vZYPw1">
For Kurth, from a methodological perspective, the Recovery Trial’s core challenge is how it conveys certainty. To give an overwrought example: Does dexamethasone really “work,” as Horby said in disbelief during his phone call with Landray? Or are there “indications that it works”? For people who think hard about how to design scientifically viable studies, there is a big difference between a signal — some kind of association that may indicate, but does not prove, a cause and effect — and a real result, a demonstrable causal link. Kurth says it’s still hard to know which one we’re getting from the Recovery Trial.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="3XvpUS">
The push for speed might have another downside, Kurth said. Recovery Trial data is published when an independent panel of experts, which monitors the incoming data, decides it has seen enough.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="KUfScY">
Kurth’s concern is that they might be making the call too soon. What if data collection had continued, and the effect that the study appeared to detect when it was stopped actually disappeared? Tocilizumab, for example, saves one person who otherwise would have died for every 25 patients who take it. It’s at least conceivable that, with even more data, that link could evaporate.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="lW0ueh">
This was another methodological risk Horby and Landray knew they were taking. But they feel a responsibility to publish clinically relevant information they believe could save lives. Even a small effect means thousands of deaths averted, given the number of people who ended up in the hospital with severe Covid-19.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="x5Fr4C">
“My own view has been: We had confidence in our data,” Horby says. “Are we going to sit on it when there are hundreds of thousands of people in the hospital and we know the drug is going to work?”
</p>
<h3 id="F57dyj">
The UK outpaced the US in researching Covid-19 therapies because it has a unified health system
</h3>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="p7CGOY">
The United Kingdom had one big advantage for researchers looking to set up a massive clinical trial in no time flat: the National Health Service.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="qi3c0c">
The NHS made it easier for the Recovery Trial to launch with the urgency required by the moment. Derek Lowe, who writes about drug discovery, told me last summer that the US could have conceivably set up a similar program.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="vWeXdc">
But it didn’t. Instead, clinical trials in the US were forced to try to coordinate among disconnected hospital systems. The NHS is a single system of <a href="https://www.interweavetextiles.com/how-many-hospitals-uk/#:~:text=The%20actual%20number%2C%20correct%20as,that%20are%20currently%20in%20use.">roughly</a> 1,250 hospitals; the largest hospital system in the US <a href="https://www.beckershospitalreview.com/largest-hospitals-and-health-systems-in-america-2019.html">includes</a> fewer than 200 facilities and most are much smaller than that. They struggled to achieve the same scale as the Recovery Trial — and therefore were slow to deliver results. As a result, even American companies developing new therapies in the US ended up looking to the Recovery Trial when it was time for large-scale tests.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="zRsO8B">
One was Regeneron, a US-based biotech firm that developed a cocktail of Covid-19 antibodies. They initially ran a small clinical trial in cooperation with America’s biodefense research agency, BARDA, but the company realized it would need a much bigger sample size to get reliable results on whether their drugs reduced deaths.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="eYs0dR">
So when they were ready to start wider testing in September, they decided to partner with the Recovery Trial. The US trial had enrolled just a few hundred patients; the UK trial would eventually include data from more than 9,000 people.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="qaFp6G">
“In order to see really meaningful results, you really needed a very large sample size,” Leah Lipsich, vice president at Regeneron, says. “Working with Recovery, a big-basket trial, was the way to go.”
</p>
<div class="c-wide-block">
<figure class="e-image">
<img alt="A woman wearing a face mask as a precaution against the spread of Covid-19 walks past a Superman graffiti tribute to the NHS in Waterloo." src="https://cdn.vox-cdn.com/thumbor/ezB0pcgO1YU-cWqr1OVHJJuOHto=/800x0/filters:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/22466138/GettyImages_1232063652.jpg"/> <cite>Thomas Krych/LightRocket/Getty Images</cite>
<figcaption>
The UK’s National Health Service was the key in implementing the massive Recovery Trial with its 1,250-hospital system.
</figcaption>
</figure>
</div>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="SDTCDA">
A reduction in Covid-19 hospitalizations in the UK, likely driven by the country’s successful vaccine rollout, have slowed down enrollment in the trial. But Regeneron expects results in the next few months.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="irf3ri">
Lowe and Lipsich both thought the NHS had probably helped the UK succeed in this difficult task.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="vbhwpl">
“The NHS is an enormous network, and all of those hospitals are linked together,” Lipsich said, describing a single system that was seeing, in effect, every Covid-19 patient in the country. “I don’t think you can say that about any place in the US.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="u6eY6k">
The UK pulled together in a moment of crisis, when the prognosis felt grim. Hammonds, the nurse in Cornwall, found comfort in the first dexamethasone result. She knew she could now tell patients when recruiting them to join the Recovery Trial: We’ve already found one thing that worked, and it will help you.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="Khf3iH">
“We know what the best treatment is, and you’re receiving it,” she says. “Would you like to receive one or two more?”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="gfxBwd">
<a href="https://www.aliciacanter.com/"><em>Alicia Canter</em></a> <em>is an independent photographer based in London.</em>
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="MJKHg1">
<em>This project was supported by the Commonwealth Fund, a national private foundation based in New York City that supports independent research on health care issues and makes grants to improve health care practice and policy.</em>
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom" id="oI8h54">
</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>2022 Commonwealth Games | India, Australia and Pakistan among eight countries to compete in women’s T20</strong> - New Zealand, South Africa, hosts England, a country from the Caribbean region and a qualifier are the other teams</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>IPL 2021 | I told Rishabh that I too can bowl the Super Over, reveals Axar</strong> - The team trusted the left-arm spinner when he said he was ready to play after recovering from 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>IPL 2021 | Hit hard by foreign pull-outs, Royals seek to loan players from other teams</strong> - Ben Stokes and Jofra Archer are out of the IPL due to injuries while Liam Livingstone had gone back home citing bubble fatigue.</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>IPL 2021 | Pat Cummins donates USD 50,000 to India’s fight against COVID-19 pandemic</strong> - The fast bowler urged other top players to do the same, and backed the IPL to continue</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>IPL 2021 | Delhi Capitals, Royal Challengers Bangalore look to outsmart each other in ‘battle of equals’</strong> - Up against Delhi Capitals, RCB will need to address their middle-order woes, to return to winning ways, in what could be touted as a battle of equals</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>Man ‘kills’ mother, two siblings in Kadapa</strong> - He surrenders before the police after committing the crime</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>35 tigers identified in Parambikulam</strong> - Two cubs spotted during the estimation using camera traps, says official</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>Curtail election victory celebrations to contain COVID-19 spread: Ex-PM Deve Gowda in letter to PM Modi</strong> - During this period, Mr. Gowda said, the EC can evolve new rules for conduct of safe elections, and simultaneously, the vaccination programme has to be accelerated</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Covid-19 | Supreme Court advances summer vacation by a week due to surge in cases</strong> - The summer vacation will now begin on May 8 and end on June 27.</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>Two containers for carrying oxygen being brought from Dubai: Home Ministry</strong> - India is struggling with a second wave of the coronavirus infection and hospitals in several States are reeling under a shortage of medical oxygen and beds</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>Covid-19: EU hints at summer return for US travellers</strong> - Fully vaccinated Americans might be able to visit, but the bloc has not given an exact timetable.</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>Navalny support network ordered to stop Russia-wide activities</strong> - A prosecutor moves to label the network of jailed Putin critic Alexei Navalny as “extremist”.</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>Man living alone on Italian island to leave after 32 years</strong> - Mauro Morandi, 81, moved to Budelli in 1989 but has faced pressure from the island’s owners to leave.</p></li>
<li data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Covid-19: Sport and parks reopen as restrictions ease in Ireland</strong> - Some outdoor attractions as well as sports training are resuming in the Republic of Ireland.</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>Chernobyl nuclear disaster: ‘Three-day evacuation lasted 35 years’</strong> - Lyudmila Honchar was four when she had to leave her home in Pripyat, Ukraine after the Chernobyl nuclear disaster. Now she’s going home.</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>Review: The Falcon and the Winter Soldier aims high but falls a bit short</strong> - It tries to do too many things at once, and thus doesn’t do them as well as it could. - <a href="https://arstechnica.com/?p=1759651">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Children of Chernobyl cleanup crew don’t have excess mutations</strong> - A deep look into the genetic damage left by the disaster. - <a href="https://arstechnica.com/?p=1759928">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Why lawmakers are so interested in Apple’s and Google’s “rents”</strong> - You can’t understand the app store debate without some grasp of antitrust jargon. - <a href="https://arstechnica.com/?p=1759817">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Apple’s AirDrop leaks users’ PII, and there’s not much they can do about it</strong> - Apple has known of the flaw since 2019 but has yet to acknowledge or fix it. - <a href="https://arstechnica.com/?p=1759947">link</a></p></li>
<li><p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"><strong>Republicans and Democrats increasingly agree: Big Tech is too powerful</strong> - Biden chose a Big Tech critic for the FTC—GOP senators seem happy about it. - <a href="https://arstechnica.com/?p=1759536">link</a></p></li>
</ul>
<h1 data-aos="fade-right" id="from-jokes-subreddit">From Jokes Subreddit</h1>
<ul>
<li><strong>I’ve decided to quit my job as a personal trainer because the weights are too heavy.</strong> - <!-- SC_OFF -->
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
I just handed in my too weak notice.
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/jparkeriv"> /u/jparkeriv </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/mym1yb/ive_decided_to_quit_my_job_as_a_personal_trainer/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/mym1yb/ive_decided_to_quit_my_job_as_a_personal_trainer/">[comments]</a></span></p></li>
<li><strong>Are you Blonde?</strong> - <!-- SC_OFF -->
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
A blond cop pulls over a blond and asks for her drivers license. The blond starts looking through her car then asks, “Uhh, what are they again?”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The blond cop replies, “Ugh. It’s the thing in your purse with your picture on it.” “Oh yeah,” says the blond who reaches in her purse, pulls out a compact mirror, and hands it over. The blond cop opens it, takes a look inside, hands it back, and says, “I’m sorry ma’am. If I knew you were a cop, I wouldn’t have pulled you over.”
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/Tugger_Case"> /u/Tugger_Case </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/my90qa/are_you_blonde/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/my90qa/are_you_blonde/">[comments]</a></span></p></li>
<li><strong>A US Navy cruiser anchored in Mississippi for a week’s shore leave. The first evening, the ship’s Captain received the following note from the wife of a very wealthy and influential plantation owner:</strong> - <!-- SC_OFF -->
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“Dear Captain, Thursday will be my daughter’s Debutante Ball. I would like you to send four well-mannered, handsome, unmarried officers in their formal dress uniforms to attend the dance. They should arrive promptly at 8:00 PM prepared for an evening of polite Southern conversation. They should be excellent dancers, as they will be the escorts of lovely refined young ladies. One last point: No Jews please.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Sending a written message by his own yeoman, the captain replied: “Madam, thank you for your invitation. In order to present the widest possible knowledge base for polite conversation, I am sending four of my best and most prized officers. One is a lieutenant commander, and a graduate of Annapolis with an additional Masters degree from MIT in fluid technologies and ship design. The second is a lieutenant, one of our helicopter pilots, and a graduate of Northwestern University in Chicago, with a BS in Aeronautical Engineering. His Masters Degree and PhD. in Aeronautical and Mechanical Engineering are from Texas Tech University and he is also an astronaut candidate. The third officer is also a lieutenant, with degrees in both computer systems and information technology from SMU and he is awaiting notification on his Doctoral Dissertation from Cal Tech. Finally, the fourth officer, also a lieutenant commander, is our ship’s doctor, with an undergraduate degree from the University of Georgia and his medical degree is from the University of North Carolina . We are very proud of him, as he is also a senior fellow in Trauma Surgery at Bethesda.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Upon receiving this letter, Melinda’s mother was quite excited and looked forward to Thursday with pleasure. Her daughter would be escorted by four handsome naval officers without peer (and the other women in her social circle would be insanely jealous). At precisely 8:00 PM on Thursday, Melinda’s mother heard a polite rap at the door which she opened to find, in full dress uniform, four very handsome, smiling black officers.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
Her mouth fell open, but pulling herself together, she stammered, “There must be some mistake.”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“No, Ma’am,” said the first officer. “Captain Goldberg never makes mistakes.”
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/OyVeyzMeir"> /u/OyVeyzMeir </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/mybr3x/a_us_navy_cruiser_anchored_in_mississippi_for_a/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/mybr3x/a_us_navy_cruiser_anchored_in_mississippi_for_a/">[comments]</a></span></p></li>
<li><strong>Three men crash in a plane over the Amazon rainforest and are immediately captured by cannibals</strong> - <!-- SC_OFF -->
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
To their surprise, the cannibals don’t immediately kill them. Instead, they show the men (through pictures and such) the beginning of an ancient ritual which, upon successful completion by the men, will result in their freedom.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
For the first step, they are instructed to go off into the jungle and collect ten pieces of a single kind of fruit.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The first man comes back triumphantly holding ten oranges. He is overcome with dismay when the second part of the ritual is revealed to him: he must now put all ten of the fruits up his ass without making the slightest noise, or he will be killed.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
He fits an entire orange up there but when he starts to put the second in, he whimpers in pain. The cannibals kill him on the spot, roast him, and eat him.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The second man returns with a handful of ten grapes. The second part of the ritual is also explained to him, and he feels confident he can succeed. Sure enough, he starts popping them in his rectum one by one, and eventually is left with only one grape to go. However, as he is about to insert it, he suddenly bursts out laughing. The cannibals murder him and eat him.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
The two men meet each other up at the Pearly Gates. The first man can’t believe it.
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“You were almost there!” He says to the second man. “You could’ve lived! Why did you laugh?”
</p>
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
“Because,” says the second man, “I saw the third guy coming back with pineapples.”
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/br34kf4s7"> /u/br34kf4s7 </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/mymvgx/three_men_crash_in_a_plane_over_the_amazon/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/mymvgx/three_men_crash_in_a_plane_over_the_amazon/">[comments]</a></span></p></li>
<li><strong>A company owner was asked a question,</strong> - <!-- SC_OFF -->
<div class="md">
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom">
How do you motivate your employees to be so punctual?" He smiled &amp; replied, “It’s simple. I have 30 employees and 29 free parking spaces. One is paid parking.”
</p>
</div>
<!-- SC_ON -->
<p data-aos="fade-left" data-aos-anchor-placement="bottom-bottom"> submitted by <a href="https://www.reddit.com/user/crazyfortaco"> /u/crazyfortaco </a> <br/> <span><a href="https://www.reddit.com/r/Jokes/comments/mxzuu5/a_company_owner_was_asked_a_question/">[link]</a></span> <span><a href="https://www.reddit.com/r/Jokes/comments/mxzuu5/a_company_owner_was_asked_a_question/">[comments]</a></span></p></li>
</ul>
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