#health and economic implications

[coochiequeens]

Can there be an ethical way to exploit a woman for a womb and treat a baby like a commodity?

The global surrogacy industry is experiencing an unprecedented boom, raising ethical concerns across borders. As more couples turn to surrogacy as a path to parenthood, this assisted reproductive technology has evolved into a multi-billion dollar market.

According to recent research, the global surrogacy industry is projected to grow from $21.85 billion in 2024, to $196 billion by 2034. This explosive growth is primarily concentrated in Europe and North America, where surrogacy is legal and regulated. 

However, the legal landscape of surrogacy remains a complex patchwork across nations, with some countries embracing it while others maintain strict prohibitions. This inconsistency in regulations has created gray areas.

Scientific research highlights the possibility of abuse arising from gaps in legal frameworks and disputes, whether surrogacy is legal or not. It points to unethical practices such as trafficking of women, coercion of both surrogates and prospective parents by agencies, lack of respect for bodily autonomy or informed consent, ‘sham’ procedures and multiple embryo exchanges.

Cross-Border Exploitation: A Dark Web of Surrogacy

Surrogacy-related abuse often happens in a region formed by three countries: Turkey, Georgia and Northern Cyprus.

While surrogacy remains illegal in Turkey, it’s perfectly legal in its northeastern neighbor Georgia and southern neighbor Northern Cyprus, creating a dangerous legal vacuum that enables exploitation.

The Hope for the Future Association, based in Tbilisi, Georgia, is one of the organizations reporting cases of abuse and illegal surrogacy in the country. 

“Our organization has evidence of both Georgian and Turkish citizens being used as surrogate mothers, along with cases of children being transported across borders with falsified documents,” said Tamar Khachapuridze, the association’s director. “We’ve reported these to the prosecutor’s office. Despite a decade-long investigation by Georgian prosecutors, these cases remain collecting dust. It appears someone is working to keep these dark dealings under wraps.” 

While surrogacy remains illegal in Turkey, it’s perfectly legal in its northeastern neighbor Georgia and southern neighbor Northern Cyprus, creating a dangerous legal vacuum that enables exploitation.

The Hope for the Future Association, based in Tbilisi, Georgia, is one of the organizations reporting cases of abuse and illegal surrogacy in the country. 

“Our organization has evidence of both Georgian and Turkish citizens being used as surrogate mothers, along with cases of children being transported across borders with falsified documents,” said Tamar Khachapuridze, the association’s director. “We’ve reported these to the prosecutor’s office. Despite a decade-long investigation by Georgian prosecutors, these cases remain collecting dust. It appears someone is working to keep these dark dealings under wraps.” 

Khachapuridze cited a particularly alarming case involving a Turkish surrogate mother. After undergoing embryo transfer in Georgia, she was reportedly transported to Thailand three months before giving birth, where she delivered a baby intended for a single Chinese man.

This case directly violates Georgian law, which explicitly prohibits embryo transfer or any surrogacy procedures for women from foreign countries.

When we obtained the case number from Khachapuridze’s files and approached the Georgian Prosecutor’s Office with written questions about the existence and content of the investigation, our written inquiries and follow-up calls went unanswered.

Rusudan Nanava, a Tbilisi-based lawyer handling surrogacy cases, explained the wall of silence: “I doubt you’ll get any information from the prosecutor’s office. Criminal cases, especially those involving surrogacy, are treated with the highest level of confidentiality.”

Georgia’s Legislative Tug of War: Balancing Ethics and Economics

In a significant policy shift, the Georgian government is grappling with proposed legislation that could fundamentally reshape the country’s surrogacy landscape. The move comes amid growing concerns over human trafficking and exploitation in the industry.

“We’re seeing cases of law abuse, including human trafficking,” said independent member of parliament  Tamar Kordzaia. “While the government pushes for change through surrogacy laws, I believe we could address these issues through other regulatory measures.”

The controversial bill, introduced in June 2023, would effectively end commercial surrogacy in Georgia, permitting only altruistic arrangements. This shift would bar foreign couples—who currently make up 95 percent of intended parents—from accessing Georgian surrogacy services, restricting the practice to Georgian citizens only.

However, Kordzaia remains skeptical about the bill’s future, which has yet to take effect.  

“This is moving at a glacial pace, despite the government’s ability to fast-track legislation when it wants to,” she said. “The economic implications are severe—both for medical facilities and the women who rely on surrogacy income. I suspect the bill will ultimately be withdrawn.”

In a country where 11.5 percent of women aged 18-65 live below the absolute poverty line, surrogacy has become a lifeline for many Georgian women struggling to make ends meet. Their stories paint a stark picture of economic desperation intersecting with the global fertility market.

Take Teona, a 42-year-old teacher and domestic violence survivor, who turned to surrogacy twice a decade ago. “As a woman, I wanted to help another woman who couldn’t have children,” she said, her voice tinged with both pride and pragmatism. “Of course, there was financial motivation. My main goal was to buy my own apartment, and I did it—for my child’s future.”

Dr. Keti Gotsiridze, director of the Reproductive Health Center of the Chachava clinic, one of Georgia’s well-established health institutions, said according to the data research of her clinic, surrogacy practice contributes $300 million a year to health tourism. Gotsiridze said 90 percent of their clients are foreigners. Surrogate mothers are paid 25-30 thousand Euros; Chachava works with an average of 300-400 surrogate mothers a year. 

For the time being, it seems that the new legislation to change the practice of surrogacy in Georgia has been shelved due to economic concerns. However, the question of how to prevent human trafficking, which has also emerged with the abuse of the existing law, remains unanswered. 

Cross-Border Surrogacy Investigation Closes With No Charges Filed

A prosecutorial investigation has revealed an alleged surrogacy trafficking network spanning Turkey, Georgia and Northern Cyprus, highlighting the devastating human cost of unregulated fertility treatments.

The case began on Sept. 3, 2021, when Turkey’s Health Ministry received an anonymous tip about “F. IVF (In Vitro Fertilization) Center,” a fertility clinic in Istanbul’s affluent Beşiktaş district. According to the whistleblower, the clinic was targeting vulnerable young women, including minors, from the working-class neighborhood of Ümraniye with promises of financial gain through surrogacy.

The scheme was elaborate: Women were provided with fertility drugs to use at home for durations  ranging from two to 12 days. They were then allegedly trafficked to Georgia and Northern Cyprus using forged documents, with all expenses covered by the network. The fertility medications were reportedly sourced from pharmaceutical warehouses and distributed through a café in Üsküdar, serving as a front for the operation.

Despite the gravity of these allegations, the investigation faced significant hurdles. After a year-long probe, authorities could only identify one suspect, known as A.A., who allegedly recruited the women. The café implicated in the scheme closed its doors just one month before police surveillance began.

When we reached out to M.K., the lawyer who owned the café, he confirmed his ownership but denied any knowledge of the fertility drug distribution, claiming he was also a victim in the scheme.

Another crucial lead emerged regarding Dr. S.T., who allegedly treated the women at “F. IVF (In Vitro Fertilization) Center” and later deleted their medical records. However, police terminated the investigation, citing lack of evidence and the doctor’s clean criminal record.

When reached for comment, Dr. S.T. denied all allegations, dismissing the claims made in the investigation as baseless.

The case took another turn when the Istanbul Public Prosecutor’s Office dismissed the case in January 2023. The Provincial Health Directorate appealed, arguing that “the investigation was inadequate” and “the material and moral elements of the crime have not been fully established.” Nevertheless, on May 31, 2023, the Istanbul 7th Criminal Court of Peace rejected the appeal without explanation.

The case remains closed, leaving crucial questions unanswered about the fate of these young Turkish women, the conditions they endured, and the clinics involved in Georgia and Northern Cyprus. The Ministry of Health has remained silent on queries about similar reported cases, raising concerns about the scale of this cross-border surrogacy trade. 

A Cross-Border Underground Surrogacy Network

A police raid in Istanbul in 2019 exposed a sophisticated trafficking network spanning Turkey, Georgia and Northern Cyprus. The operation revealed a complex web involving a Northern Cypriot ringleader and two Moldovan accomplices who coordinated the trafficking of Turkish women for surrogacy purposes.

During the raid, police discovered large quantities of fertility drugs. According to detained suspects’ testimonies, these hormones were supplied by the Northern Cypriot kingpin and administered to potential surrogate mothers recruited from Turkey. The women were then trafficked to clinics in both Northern Cyprus and Georgia, with one prominent facility identified as “IVF Tours Georgia” in Tbilisi.

To verify whether this clinic continues to engage with Turkish women five years after the raid, we conducted an undercover investigation. Posing as potential surrogates from Turkey, we contacted “IVF Tours Georgia” via email. The response was swift and telling: Not only did they accept our inquiry, but they immediately began discussing financial arrangements and medical screenings. This exchange revealed a striking fact: Despite Georgian law restricting surrogacy to Georgian citizens, the clinic openly offered services to Turkish nationals, highlighting the persistent nature of this illegal cross-border trade.

Lack of Oversight Fuels Surrogacy Concerns in Northern Cyprus

In Northern Cyprus, a growing surrogacy industry operates within a complex web of legal ambiguity and insufficient oversight, despite having well-crafted regulations. Former health minister (2018-2019) and Republican Turkish Party MP Filiz Besim warns that human trafficking cases persist due to inadequate supervision.

“While we have meticulously drafted laws permitting surrogacy, the lack of oversight remains a critical issue,” Besim said. “Our unique position outside international law, due to our unrecognized status, has created vulnerabilities that are being extensively exploited. This has led to the emergence of illicit international networks involved in human, women, and child trafficking.”

Deputy Besim emphasizes that women—particularly from Caucasian countries—are being brought from abroad as surrogate mothers in violation of laws. He notes that due to insufficient oversight, questions remain about the agreements, facilitators, and conditions under which these women are transported.

Our anonymous field interviews and observations reveal serious concerns about surrogacy practices stemming from the country’s lack of oversight. A troubling gray area has emerged where low-income women face potential exploitation. Women may be pressured into surrogacy due to financial hardship, raising ethical concerns about the commodification of women’s bodies and children’s rights.

International organizations like U.N. Women have voiced similar concerns about surrogacy practices in regions like Northern Cyprus, citing these risks and inadequate oversight. They stress the importance of protecting surrogate mothers through proper safeguards: ensuring they are fully informed, free from coercion, and fairly compensated for the risks they undertake

Surrogacy became legal in Northern Cyprus in August 2016 under the Law Regulating Human Cell, Tissue, and Organ Transplantation Rules. A new, more robust bill was drafted in April 2023, though Parliament has yet to convene to discuss these changes.

Northern Cyprus has emerged as Europe’s leading destination for reproductive treatments. The industry’s prominence is evident in everyday encounters in the capital, Lefkoşa, where stories of successful surrogacy arrangements—including a recent case involving a European couple—are commonplace.

While official statistics remain undisclosed, artificial intelligence analysis estimates approximately 500 surrogacy arrangements occur annually in Northern Cyprus. According to LaingBuisson, a London-based healthcare market research firm, the country handles about 11 percent of all egg donation treatments in Europe.

Social Media’s Underground Surrogacy Market

Despite legal bans and restrictions, a thriving underground surrogacy market in Turkey continues to operate in plain sight. There are numerous advertisements openly seeking surrogate mothers on social media platforms such as Instagram and Facebook. 

In one of these advertisements, we wrote  to a woman who said  she could  be a surrogate mother, with a request to have a child. Ten years ago in Turkey, the woman said she had been a surrogate mother once and explained how the process would work and offered us two methods to help her conceive:

“The child could be from my egg and your husband’s sperm. Would you be okay with that after birth? We’d never need to know each other. We wouldn’t even need a transfer. We could handle it ourselves – inject your husband’s sperm directly into my uterus. Or, we could select healthy eggs and have your and your husband’s eggs transferred to me.”

Most alarmingly, she assured us that certain private clinics would perform these procedures clandestinely, promising there would be “no issues” with birth certificates—a clear indication of document fraud.

The desperation of infertile couples seeking parenthood through these illegal channels may be understandable, but the risks are severe. These back-alley procedures not only endanger the health of all parties involved but also expose them to serious legal consequences. The combination of medical risks and criminal liability creates a potential storm of challenges for vulnerable individuals. 

The Delicate Balance: Finding a Legal Middle Ground

Is there a way to craft ideal legislation that prevents exploitation while acknowledging the deep human desire for parenthood? Attorney and professor Dr. Özlem Yenerer Çakmut believes the answer lies in nuanced regulation rather than absolute prohibition.

“We can’t simply ignore the profound yearning of those who dream of experiencing not just parenthood, but the entire journey—from pregnancy to birth,” Yenerer explained. “These are couples who want more than adoption; they want to be part of every moment, every milestone.”

“The challenge lies in striking a delicate balance between regulation and prohibition,” she continued. “A blanket ban isn’t the answer, especially in societies where having children carries immense social and cultural weight. While we can’t legitimize illegal practices, we can work toward meaningful legislation that protects all parties involved while acknowledging these deeply human desires.”

There is also a section of the world strongly opposed to surrogacy. At its forefront stands the Casablanca Declaration, a document signed by 100 experts from 75 countries in March 2023, calling for a universal ban on surrogacy practices.

Leading this charge is Olivia Maurel, herself born through surrogacy in 1991, who has emerged as one of the movement’s most compelling voices. 

“Standing against surrogacy means advocating for its universal abolition,” Maurel declared with conviction born of personal experience. “This isn’t just about abstract principles—it’s about defending the fundamental rights of women and children, about protecting human dignity in its most basic form. Surrogacy, by its very nature, undermines these essential values.”

For some, surrogacy represents a last resort in their journey to parenthood. A 46-year-old woman living in Georgia, who chose to remain anonymous, shared the challenging aspects of this process. After having her uterus and ovaries removed due to health issues, she and her husband decided to pursue surrogacy six years ago.

The woman described maintaining close contact with the surrogate mother both before the transfer and throughout the pregnancy. “I monitored her doctor visits, tests and medications regularly. I ensured she maintained a healthy diet, and I was present during the birth. I was with my baby from the moment of delivery.”

Despite being a challenging and costly process, she pursued surrogacy to fulfill her dream of motherhood. “If surrogacy is the only path to becoming a mother, you must give it your all, learn to manage your emotions, and stay focused on your goal. The difficulties and pain are temporary; the love for a child is permanent,” she said.

E.U. Redefines Surrogacy Regulations

Recent legal scholarship challenges the traditional binary approach of outright bans versus complete legalization. Instead, experts advocate for a nuanced international framework that transcends cultural and moral absolutes while protecting fundamental human rights. This perspective emphasizes the critical need for comprehensive national legislation in countries where surrogacy exists, whether legal or not, to safeguard the rights of both women and children.

Amid this contentious landscape, the European Parliament Council took decisive action on Jan. 23, 2024, reaching a provisional agreement to classify exploitative surrogacy practices as human trafficking. The measure was formally adopted on May 27, 2024.

The new framework imposes strict penalties on those who exploit women through forced surrogacy or deceptive practices, while establishing comprehensive support systems for victims. E.U. member states must implement these protections into their national legislation within two years.

The production of this investigation is supported by a grant from the IJ4EU fund. The International Press Institute (IPI), the European Journalism Centre (EJC) and any other partners in the lJ4EU fund are not responsible for the content published and any use made out of it.

This reporting was supported by the International Women’s Media Foundation’s Howard G. Buffett Fund for Women Journalist

About Seda Karatabanoğlu and Zeynep Yüncüler

Seda Karatabanoğlu graduated with a bachelor's degree from Istanbul University's Faculty of Communication in Turkey and a master's degree in European studies and international relations at l'Université Paul-Valéry in France. She worked at Cumhuriyet Newspaper. Her articles have been published on many online platforms such as Euronews Turkish and DW Turkish. Currently residing in France, she continues her work as an independent journalist.

Zeynep Yüncüler is a graduate of Izmir University of Economics, where she studied in the Media and Communication Department. She worked at Milliyet Daily, 'Artı 1' TV, BirGün Daily, ‘Artı Tv’ and Punto24, an independent journalism platform in Turkey. She also served as the secretary for the Journalists’ Union of Turkey's Istanbul branch. She was honored with the best interview award (2016) by the Progressive Journalists’ Association (ÇGD). Currently, she is a freelancer.

[reasonsforhope]

"In an unprecedented transformation of China’s arid landscapes, large-scale solar installations are turning barren deserts into unexpected havens of biodiversity, according to groundbreaking research from the Chinese Academy of Sciences. The study reveals that solar farms are not only generating clean energy but also catalyzing remarkable ecological restoration in some of the country’s most inhospitable regions.

The research, examining 40 photovoltaic (PV) plants across northern China’s deserts, found that vegetation cover increased by up to 74% in areas with solar installations, even in locations using only natural restoration measures. This unexpected environmental dividend comes as China cements its position as the global leader in solar energy, having added 106 gigawatts of new installations in 2022 alone.

“Artificial ecological measures in the PV plants can reduce environmental damage and promote the condition of fragile desert ecosystems,” says Dr. Benli Liu, lead researcher from the Chinese Academy of Sciences. “This yields both ecological and economic benefits.”

The economic implications are substantial. “We’re witnessing a paradigm shift in how we view desert solar installations,” says Professor Zhang Wei, environmental economist at Beijing Normal University. “Our cost-benefit analysis shows that while initial ecological construction costs average $1.5 million per square kilometer, the long-term environmental benefits outweigh these investments by a factor of six within just a decade.” ...

“Soil organic carbon content increased by 37.2% in areas under solar panels, and nitrogen levels rose by 24.8%,” reports Dr. Sarah Chen, soil scientist involved in the project. “These improvements are crucial indicators of ecosystem health and sustainability.”

...Climate data from the study sites reveals significant microclimate modifications:

Average wind speeds reduced by 41.3% under panel arrays

Soil moisture retention increased by 32.7%

Ground surface temperature fluctuations decreased by 85%

Dust storm frequency reduced by 52% in solar farm areas...

The scale of China’s desert solar initiative is staggering. As of 2023, the country has installed over 350 gigawatts of solar capacity, with 30% located in desert regions. These installations cover approximately 6,000 square kilometers of desert terrain, an area larger than Delaware.

“The most surprising finding,” notes Dr. Wang Liu of the Desert Research Institute, “is the exponential increase in insect and bird species. We’ve documented a 312% increase in arthropod diversity and identified 27 new bird species nesting within the solar farms between 2020 and 2023.”

Dr. Yimeng Wang, the study’s lead author, emphasizes the broader implications: “This study provides evidence for evaluating the ecological benefit and planning of large-scale PV farms in deserts.”

The solar installations’ positive impact stems from several factors. The panels act as windbreaks, reducing erosion and creating microhabitats with lower evaporation rates. Perhaps most surprisingly, the routine maintenance of these facilities plays a crucial role in the ecosystem’s revival.

“The periodic cleaning of solar panels, occurring 7-8 times annually, creates consistent water drip lines beneath the panels,” explains Wang. “This inadvertent irrigation system promotes vegetation growth and the development of biological soil crusts, essential for soil stability.” ...

Recent economic analysis reveals broader benefits:

Job creation: 4.7 local jobs per megawatt of installed capacity

Tourism potential: 12 desert solar sites now offer educational tours

Agricultural integration: 23% of sites successfully pilot desert agriculture beneath panels

Carbon reduction: 1.2 million tons CO2 equivalent avoided per gigawatt annually

Dr. Maya Patel, visiting researcher from the International Renewable Energy Agency, emphasizes the global implications: “China’s desert solar model could be replicated in similar environments worldwide. The Sahara alone could theoretically host enough solar capacity to meet global electricity demand four times over while potentially greening up to 20% of the desert.”

The Chinese government has responded by implementing policies promoting “solar energy + sand control” and “solar energy + ecological restoration” initiatives. These efforts have shown promising results, with over 92% of PV plants constructed since 2017 incorporating at least one ecological construction mode.

Studies at facilities like the Qinghai Gonghe Photovoltaic Park demonstrate that areas under solar panels score significantly better in environmental assessments compared to surrounding regions, indicating positive effects on local microclimates.

As the world grapples with dual climate and biodiversity crises, China’s desert solar experiment offers a compelling model for sustainable development. The findings suggest that renewable energy infrastructure, when thoughtfully implemented, can serve as a catalyst for environmental regeneration, potentially transforming the world’s deserts from barren wastelands into productive, life-supporting ecosystems.

“This is no longer just about energy production,” concludes Dr. Liu. “We’re witnessing the birth of a new approach to ecosystem rehabilitation that could transform how we think about desert landscapes globally. The next decade will be crucial as we scale these solutions to meet both our climate and biodiversity goals.”"

-via Green Fingers, January 13, 2025

[investoropia]

Federal Reserve Stress Test Sends Shock waves through Stock Market! JP MORGAN JUMPED 3.49%

Federal Reserve stress test results on U.S. bank stocks and their influence on the overall market. Gain insights into investor sentiment, regulatory concerns, and the future outlook.

U.S. bank stocks surged in response to the results of the Federal Reserve’s annual stress tests, instilling renewed confidence among investors and traders. The comprehensive health checks provided insights into the resilience of major lenders, addressing concerns stemming from recent failures, including Silicon Valley Bank and other institutions. The impressive performance of bank stocks highlights their ability to weather an economic slump and underscores the importance of stress testing in ensuring a stable financial system.

While the stress test results boosted market sentiment, skeptics remain cautious regarding dividends and share buybacks. Heightened regulatory oversight and uncertainties surrounding the economic outlook contribute to concerns about the feasibility of larger payouts. Analysts at RBC Capital Markets caution that the recent banking crisis has driven banks to adopt a more conservative approach, potentially limiting share buyback activities for the remainder of 2023.

Continue Reading the Complete Article : Click Here

OTHER TOPIC:

Market Corrections: 5 Factors Every Investor and Trader Must Understand

Mastering the Stochastic Oscillator

THE POWER OF BOLLINGER BANDS

GDP Data: Economic Growth and Stable Inflation

Strong Economy: Understanding and Impact

How to Safeguard your Investments During a Market Decline?

[nardacci-does-art]

I only had 10 panels but here's some more fun exciting delightful articles about how republicans think public schools should make kids say christian prayers & teach students that slavery had no longterm affect on black communities, how trump makes fun of disabled people, & just a big categorized list of both republican & democrats' stances on various issues. Oh right the republicans are also lying & saying that the democrats gave all of FEMA's money to illegal immigrants even tho they're the ones who voted against FEMA funding. Not to mention that one time trump refused to fund California's wildfire relief until he was told there's people there who vote for him. Did all the anti-voters just conveniently forget how fucking bad it was when he was president last time.

Either you vote Harris-Wals or you let a bunch of hateful bigots run the US again. Stop using the horrible plight of the Palestinians to justify your voter apathy. It's really hard to help other people when you're fighting to survive. Put on your own oxygen mask first.

Any anti-voter morons will be blocked.

Articles referenced in screenshots under the cut:

https://www.nbcnews.com/politics/donald-trump/trump-israel-gaza-finish-problem-rcna141905

https://www.reuters.com/world/us/project-2025-what-is-it-who-is-behind-it-how-is-it-connected-trump-2024-07-12/

https://www.newsweek.com/hate-crimes-under-trump-surged-nearly-20-percent-says-fbi-report-1547870

https://www.nytimes.com/interactive/2020/climate/trump-environment-rollbacks-list.html

https://www.cnbc.com/2022/06/24/roe-v-wade-overturned-by-supreme-court-ending-federal-abortion-rights.html

https://www.huffpost.com/entry/donald-trump-anti-immigrant-rant-rally-response_n_66de9a43e4b01b464f3dee5e

https://abcnews.go.com/Health/trumps-chinese-virus-tweet-helped-lead-rise-racist/story?id=76530148

https://thehill.com/homenews/campaign/4892401-trump-proposes-sanctuary-cities-legislation/

https://ballotpedia.org/2024_presidential_candidates_on_transgender_healthcare

https://www.piie.com/publications/working-papers/2024/international-economic-implications-second-trump-presidency

https://apnews.com/article/gaza-israel-refugee-crisis-gop-ban-terrorism-85afcf677743b8f8c82fe814ffe61161

https://www.washingtonpost.com/business/2023/11/11/unrwa-gaza-humanitarian-aid-congress/

[ecomehdi]

Some Dangers From Pandemic Fatigue: Understanding the Risks

The COVID-19 pandemic has significantly impacted the lives of people across the globe. With the prolonged duration and the extensive measures put in place to control the spread of the virus, individuals have been experiencing what is commonly referred to as “pandemic fatigue.” Pandemic fatigue refers to the physical, mental, and emotional exhaustion resulting from the ongoing crisis. While the…

[mariacallous]

It is often assumed that far-right parties do well in areas with many new immigrants. This is supposedly because housing prices rise, traffic jams get worse, crime and employment can become an issue, and the arrival of newcomers with different habits and religions creates friction with local residents—who then proceed to vote for anti-immigrant parties. The implication of this presumed link between immigration and the rise of the far right is that far-right parties listen better to the frustrations and complaints of “ordinary people” and that other parties have somehow “lost touch with reality.”

But what if this link does not really exist? What if far-right parties aren’t so much listening to the wishes and demands of ordinary citizens in immigrant areas, and then translating them into policy proposals, as they are scaring them and pitting them against newcomers in their neighborhood so they end up voting in their favor?

That is exactly the conclusion of a recent study conducted by four researchers from Bocconi University in Milan and the ETH in Zurich: The Free Movement of People and the Success of Far-Right Parties: Evidence from Switzerland’s Border Liberalization, just published in American Political Science Review. In light of the current hysterical anti-immigration discourse in Europe, it is a compelling read. It provides a convincing explanation for at least part of the political turbulence in France, Romania, the Netherlands, and other countries.

The success of anti-immigration parties, the authors argue, cannot be explained by cultural, economic, or political problems that citizens experience with immigration. Instead, they found it is rather the other way around: It is “political elites” in far-right parties who are responsible for such votes. They decide to focus their election campaigns in areas with immigrants. These campaigns are often hard-hitting and confrontational, using slogans like “full is full” or “stop migration” and cartoons depicting immigrants as black sheep or thieves who do harm and need to be expelled. Instead of citizens complaining of immigrants of their own accord, they are often incited by far-right political entrepreneurs—whereafter they start complaining about immigration and voting for the far right.

The Swiss and Italian researchers studied the correlation between immigration and the success of the far right in an unusual place: the mostly well-off border towns and villages of Ticino, Switzerland’s Italian-language canton. They focused on the period after 2000, when Switzerland and its EU neighbors first opened their borders to enable citizens to live and work freely in each other’s countries. In the period studied, immigration in Ticino rose by 14 percent, and support for the far right increased by 32 percent.

While the link looks strong at first glance, the researchers could not prove it. “We find limited evidence that the standard economic, cultural and security explanations are driving this rising anti-immigrant sentiment,” they write. What their report does show is this: From the moment the borders with France, Germany, Austria, and Italy were opened, Swiss political elites on the far right began campaigning aggressively in those areas, advancing narratives of overcrowding, crime, and “density stress,” meaning increasing pressure on public transportation, housing, parking, health care, and other collective facilities.

The researchers consistently use the term “political elite” in their article to emphasize that the success of the far right is orchestrated from above (top-down), rather than coming from citizens themselves (bottom-up). Far-right politicians often claim they speak on behalf of “the people,” who are fed up with “the elite.” But these politicians, the researchers argue, are themselves part of the elite.

The cultural disruptions caused by immigration in Tricine are minimal. Nearly all immigrants in Tricine come from Italy, oftentimes from just across the border. Most are white, Catholic, and educated. They speak Italian and eat pasta. Culturally and socially, they do not cause much friction.

Economically, too, problems are rare. On the contrary: According to the study, Ticino’s economy has grown since the borders opened for immigrant workers. Employment picked up and salaries rose slightly. Traffic jams did get worse, the researchers observed. But that also happened in parts of Ticino a little further from the border—areas that were used as the control areas in the study—where immigration increased but the support for the far right did not.

The explanation for this, they found, is simple: In these control areas, far-right politicians did not run anti-immigrant campaigns as they did in the areas closer to the border. “Our analysis suggests that political elites target their hostile rhetoric at border regions, and that it resonates more strongly with persuadable voters exposed to immigration.” The voters were “persuadable” because they were in a new situation that they had to adapt to; the far right recognized the potential to give that situation a negative spin by portraying immigrants as troublemakers, freeloaders, or criminals. In the control areas, where voters found themselves in a similar situation, there was no such spin. There, the vote for the far right did not increase.

Politicians in Ticino’s parliament coming from border areas were also found to be more likely to propose anti-immigrant legislation than their colleagues from control areas a little further from the border. Those politicians tabling anti-immigrant legislation mostly came from the far right, and in a few instances also from center-right parties trying to curry favour with voters who were supposedly fed up with immigrants.

This study is important. It confirms findings from internationally renowned political scientists such as Larry Bartels, whose book Democracy Erodes From the Top makes the same point, and Nancy Bermeo, whose study Ordinary People in Extraordinary Times analyzes breakdowns of European and Latin American democracies in the 20th century. Both argue that it is not voters who determine the political direction of a country and, ultimately, the fate of democracy, but the political elites who make calculated decisions to offer voters only certain options.

It would be good if centrist politicians, who all too often ape what their far-right colleagues (or rather rivals) do, finally understood this crucial point. The future of our democracies depends on it.

[covid-safer-hotties]

Also preserved on our archive

SARS-CoV-2 is now circulating out of control worldwide. The only major limitation on transmission is the immune environment the virus faces. The disease it causes, COVID-19, is now a risk faced by most people as part of daily life.

While some are better than others, no national or regional government is making serious efforts towards infection prevention and control, and it seems likely this laissez-faire policy will continue for the foreseeable future. The social, political, and economic movements that worked to achieve this mass infection environment can rejoice at their success.

Those schooled in public health, immunology or working on the front line of healthcare provision know we face an uncertain future, and are aware the implications of recent events stretch far beyond SARS-CoV-2. The shifts that have taken place in attitudes and public health policy will likely damage a key pillar that forms the basis of modern civilized society, one that was built over the last two centuries; the expectation of a largely uninterrupted upwards trajectory of ever-improving health and quality of life, largely driven by the reduction and elimination of infectious diseases that plagued humankind for thousands of years. In the last three years, that trajectory has reversed.

The upward trajectory of public health in the last two centuries Control of infectious disease has historically been a priority for all societies. Quarantine has been in common use since at least the Bronze Age and has been the key method for preventing the spread of infectious diseases ever since. The word “quarantine” itself derives from the 40-day isolation period for ships and crews that was implemented in Europe during the late Middle Ages to prevent the introduction of bubonic plague epidemics into cities.

Modern public health traces its roots to the middle of the 19th century thanks to converging scientific developments in early industrial societies:

The germ theory of diseases was firmly established in the mid-19th century, in particular after Louis Pasteur disproved the spontaneous generation hypothesis. If diseases spread through transmission chains between individual humans or from the environment/animals to humans, then it follows that those transmission chains can be interrupted, and the spread stopped. The science of epidemiology appeared, its birth usually associated with the 1854 Broad Street cholera outbreak in London during which the British physician John Snow identified contaminated water as the source of cholera, pointing to improved sanitation as the way to stop cholera epidemics. Vaccination technology began to develop, initially against smallpox, and the first mandatory smallpox vaccination campaigns began, starting in England in the 1850s.

The early industrial era generated horrendous workplace and living conditions for working class populations living in large industrial cities, dramatically reducing life expectancy and quality of life (life expectancy at birth in key industrial cities in the middle of the 19th century was often in the low 30s or even lower). This in turn resulted in a recognition that such environmental factors affect human health and life spans. The long and bitter struggle for workers’ rights in subsequent decades resulted in much improved working conditions, workplace safety regulations, and general sanitation, and brought sharp increases in life expectancy and quality of life, which in turn had positive impacts on productivity and wealth.

Florence Nightingale reemphasized the role of ventilation in healing and preventing illness, ‘The very first canon of nursing… : keep the air he breathes as pure as the external air, without chilling him,’ a maxim that influenced building design at the time.

These trends continued in the 20th century, greatly helped by further technological and scientific advances. Many diseases – diphtheria, pertussis, hepatitis B, polio, measles, mumps, rubella, etc. – became things of the past thanks to near-universal highly effective vaccinations, while others that used to be common are no longer of such concern for highly developed countries in temperate climates – malaria, typhus, typhoid, leprosy, cholera, tuberculosis, and many others – primarily thanks to improvements in hygiene and the implementation of non-pharmaceutical measures for their containment.

Furthermore, the idea that infectious diseases should not just be reduced, but permanently eliminated altogether began to be put into practice in the second half of the 20th century on a global level, and much earlier locally. These programs were based on the obvious consideration that if an infectious agent is driven to extinction, the incalculable damage to people’s health and the overall economy by a persisting and indefinite disease burden will also be eliminated.

The ambition of local elimination grew into one of global eradication for smallpox, which was successfully eliminated from the human population in the 1970s (this had already been achieved locally in the late 19th century by some countries), after a heroic effort to find and contain the last remaining infectious individuals. The other complete success was rinderpest in cattle9,10, globally eradicated in the early 21st century.

When the COVID-19 pandemic started, global eradication programs were very close to succeeding for two other diseases – polio and dracunculiasis. Eradication is also globally pursued for other diseases, such as yaws, and regionally for many others, e.g. lymphatic filariasis, onchocerciasis, measles and rubella. The most challenging diseases are those that have an external reservoir outside the human population, especially if they are insect borne, and in particular those carried by mosquitos. Malaria is the primary example, but despite these difficulties, eradication of malaria has been a long-standing global public health goal and elimination has been achieved in temperate regions of the globe, even though it involved the ecologically destructive widespread application of polluting chemical pesticides to reduce the populations of the vectors. Elimination is also a public goal for other insect borne diseases such as trypanosomiasis.

In parallel with pursuing maximal reduction and eventual eradication of the burden of existing endemic infectious diseases, humanity has also had to battle novel infectious diseases40, which have been appearing at an increased rate over recent decades. Most of these diseases are of zoonotic origin, and the rate at which they are making the jump from wildlife to humans is accelerating, because of the increased encroachment on wildlife due to expanding human populations and physical infrastructure associated with human activity, the continued destruction of wild ecosystems that forces wild animals towards closer human contact, the booming wildlife trade, and other such trends.

Because it is much easier to stop an outbreak when it is still in its early stages of spreading through the population than to eradicate an endemic pathogen, the governing principle has been that no emerging infectious disease should be allowed to become endemic. This goal has been pursued reasonably successfully and without controversy for many decades.

The most famous newly emerging pathogens were the filoviruses (Ebola, Marburg), the SARS and MERS coronaviruses, and paramyxoviruses like Nipah. These gained fame because of their high lethality and potential for human-to-human spread, but they were merely the most notable of many examples.

Such epidemics were almost always aggressively suppressed. Usually, these were small outbreaks, and because highly pathogenic viruses such as Ebola cause very serious sickness in practically all infected people, finding and isolating the contagious individuals is a manageable task. The largest such epidemic was the 2013-16 Ebola outbreak in West Africa, when a filovirus spread widely in major urban centers for the first time. Containment required a wartime-level mobilization, but that was nevertheless achieved, even though there were nearly 30,000 infections and more than 11,000 deaths.

SARS was also contained and eradicated from the human population back in 2003-04, and the same happened every time MERS made the jump from camels to humans, as well as when there were Nipah outbreaks in Asia.

The major counterexample of a successful establishment in the human population of a novel highly pathogenic virus is HIV. HIV is a retrovirus, and as such it integrates into the host genome and is thus nearly impossible to eliminate from the body and to eradicate from the population (unless all infected individuals are identified and prevented from infecting others for the rest of their lives). However, HIV is not an example of the containment principle being voluntarily abandoned as the virus had made its zoonotic jump and established itself many decades before its eventual discovery and recognition, and long before the molecular tools that could have detected and potentially fully contained it existed.

Still, despite all these containment success stories, the emergence of a new pathogen with pandemic potential was a well understood and frequently discussed threat, although influenza viruses rather than coronaviruses were often seen as the most likely culprit. The eventual appearance of SARS-CoV-2 should therefore not have been a huge surprise, and should have been met with a full mobilization of the technical tools and fundamental public health principles developed over the previous decades.

The ecological context One striking property of many emerging pathogens is how many of them come from bats. While the question of whether bats truly harbor more viruses than other mammals in proportion to their own species diversity (which is the second highest within mammals after rodents) is not fully settled yet, many novel viruses do indeed originate from bats, and the ecological and physiological characteristics of bats are highly relevant for understanding the situation that Homo sapiens finds itself in right now.

Another startling property of bats and their viruses is how highly pathogenic to humans (and other mammals) many bat viruses are, while bats themselves are not much affected (only rabies is well established to cause serious harm to bats). Why bats seem to carry so many such pathogens, and how they have adapted so well to coexisting with them, has been a long-standing puzzle and although we do not have a definitive answer, some general trends have become clear.

Bats are the only truly flying mammals and have been so for many millions of years. Flying has resulted in a number of specific adaptations, one of them being the tolerance towards a very high body temperature (often on the order of 42-43ºC). Bats often live in huge colonies, literally touching each other, and, again, have lived in conditions of very high density for millions of years. Such densities are rare among mammals and are certainly not the native condition of humans (human civilization and our large dense cities are a very recent phenomenon on evolutionary time scales). Bats are also quite long-lived for such small mammals – some fruit bats can live more than 35 years and even small cave dwelling species can live about a decade.

These are characteristics that might have on one hand facilitated the evolution of a considerable set of viruses associated with bat populations. In order for a non-latent respiratory virus to maintain itself, a minimal population size is necessary. For example, it is hypothesized that measles requires a minimum population size of 250-300,000 individuals. And bats have existed in a state of high population densities for a very long time, which might explain the high diversity of viruses that they carry. In addition, the long lifespan of many bat species means that their viruses may have to evolve strategies to overcome adaptive immunity and frequently reinfect previously infected individuals as opposed to the situation in short-lived species in which populations turn over quickly (with immunologically naive individuals replacing the ones that die out).

On the other hand, the selective pressure that these viruses have exerted on bats may have resulted in the evolution of various resistance and/or tolerance mechanisms in bats themselves, which in turn have driven the evolution of counter strategies in their viruses, leading them to be highly virulent for other species. Bats certainly appear to be physiologically more tolerant towards viruses that are otherwise highly virulent to other mammals. Several explanations for this adaptation have been proposed, chief among them a much more powerful innate immunity and a tolerance towards infections that does not lead to the development of the kind of hyperinflammatory reactions observed in humans, the high body temperature of bats in flight, and others.

The notable strength of bat innate immunity is often explained by the constitutively active interferon response that has been reported for some bat species. It is possible that this is not a universal characteristic of all bats – only a few species have been studied – but it provides a very attractive mechanism for explaining both how bats prevent the development of severe systemic viral infections in their bodies and how their viruses in turn would have evolved powerful mechanisms to silence the interferon response, making them highly pathogenic for other mammals.

The tolerance towards infection is possibly rooted in the absence of some components of the signaling cascades leading to hyperinflammatory reactions and the dampened activity of others.

An obvious ecological parallel can be drawn between bats and humans – just as bats live in dense colonies, so now do modern humans. And we may now be at a critical point in the history of our species, in which our ever-increasing ecological footprint has brought us in close contact with bats in a way that was much rarer in the past. Our population is connected in ways that were previously unimaginable. A novel virus can make the zoonotic jump somewhere in Southeast Asia and a carrier of it can then be on the other side of the globe a mere 24-hours later, having encountered thousands of people in airports and other mass transit systems. As a result, bat pathogens are now being transferred from bat populations to the human population in what might prove to be the second major zoonotic spillover event after the one associated with domestication of livestock and pets a few thousand years ago.

Unfortunately for us, our physiology is not suited to tolerate these new viruses. Bats have adapted to live with them over many millions of years. Humans have not undergone the same kind of adaptation and cannot do so on any timescale that will be of use to those living now, nor to our immediate descendants.

Simply put, humans are not bats, and the continuous existence and improvement of what we now call “civilization” depends on the same basic public health and infectious disease control that saw life expectancy in high-income countries more than double to 85 years. This is a challenge that will only increase in the coming years, because the trends that are accelerating the rate of zoonotic transfer of pathogens are certain to persist.

Given this context, it is as important now to maintain the public health principle that no new dangerous pathogens should be allowed to become endemic and that all novel infectious disease outbreaks must be suppressed as it ever was.

The death of public health and the end of epidemiological comfort It is also in this context that the real gravity of what has happened in the last three years emerges.

After HIV, SARS-CoV-2 is now the second most dangerous infectious disease agent that is 'endemic' to the human population on a global scale. And yet not only was it allowed to become endemic, but mass infection was outright encouraged, including by official public health bodies in numerous countries.

The implications of what has just happened have been missed by most, so let’s spell them out explicitly.

We need to be clear why containment of SARS-CoV-2 was actively sabotaged and eventually abandoned. It has absolutely nothing to do with the “impossibility” of achieving it. In fact, the technical problem of containing even a stealthily spreading virus such as SARS-CoV-2 is fully solved, and that solution was successfully applied in practice for years during the pandemic.

The list of countries that completely snuffed out outbreaks, often multiple times, includes Australia, New Zealand, Singapore, Taiwan, Vietnam, Thailand, Bhutan, Cuba, China, and a few others, with China having successfully contained hundreds of separate outbreaks, before finally giving up in late 2022.

The algorithm for containment is well established – passively break transmission chains through the implementation of nonpharmaceutical interventions (NPIs) such as limiting human contacts, high quality respirator masks, indoor air filtration and ventilation, and others, while aggressively hunting down active remaining transmission chains through traditional contact tracing and isolation methods combined with the powerful new tool of population-scale testing.

Understanding of airborne transmission and institution of mitigation measures, which have heretofore not been utilized in any country, will facilitate elimination, even with the newer, more transmissible variants. Any country that has the necessary resources (or is provided with them) can achieve full containment within a few months. In fact, currently this would be easier than ever before because of the accumulated widespread multiple recent exposures to the virus in the population suppressing the effective reproduction number (Re). For the last 18 months or so we have been seeing a constant high plateau of cases with undulating waves, but not the major explosions of infections with Re reaching 3-4 that were associated with the original introduction of the virus in 2020 and with the appearance of the first Omicron variants in late 2021.

It would be much easier to use NPIs to drive Re to much below 1 and keep it there until elimination when starting from Re around 1.2-1.3 than when it was over 3, and this moment should be used, before another radically new serotype appears and takes us back to those even more unpleasant situations. This is not a technical problem, but one of political and social will. As long as leadership misunderstands or pretends to misunderstand the link between increased mortality, morbidity and poorer economic performance and the free transmission of SARS-CoV-2, the impetus will be lacking to take the necessary steps to contain this damaging virus.

Political will is in short supply because powerful economic and corporate interests have been pushing policymakers to let the virus spread largely unchecked through the population since the very beginning of the pandemic. The reasons are simple. First, NPIs hurt general economic activity, even if only in the short term, resulting in losses on balance sheets. Second, large-scale containment efforts of the kind we only saw briefly in the first few months of the pandemic require substantial governmental support for all the people who need to pause their economic activity for the duration of effort. Such an effort also requires large-scale financial investment in, for example, contact tracing and mass testing infrastructure and providing high-quality masks. In an era dominated by laissez-faire economic dogma, this level of state investment and organization would have set too many unacceptable precedents, so in many jurisdictions it was fiercely resisted, regardless of the consequences for humanity and the economy.

None of these social and economic predicaments have been resolved. The unofficial alliance between big business and dangerous pathogens that was forged in early 2020 has emerged victorious and greatly strengthened from its battle against public health, and is poised to steamroll whatever meager opposition remains for the remainder of this, and future pandemics.

The long-established principles governing how we respond to new infectious diseases have now completely changed – the precedent has been established that dangerous emerging pathogens will no longer be contained, but instead permitted to ‘ease’ into widespread circulation. The intent to “let it rip” in the future is now being openly communicated. With this change in policy comes uncertainty about acceptable lethality. Just how bad will an infectious disease have to be to convince any government to mobilize a meaningful global public health response?

We have some clues regarding that issue from what happened during the initial appearance of the Omicron “variant” (which was really a new serotype) of SARS-CoV-2. Despite some experts warning that a vaccine-only approach would be doomed to fail, governments gambled everything on it. They were then faced with the brute fact of viral evolution destroying their strategy when a new serotype emerged against which existing vaccines had little effect in terms of blocking transmission. The reaction was not to bring back NPIs but to give up, seemingly regardless of the consequences.

Critically, those consequences were unknown when the policy of no intervention was adopted within days of the appearance of Omicron. All previous new SARS-CoV-2 variants had been deadlier than the original Wuhan strain, with the eventually globally dominant Delta variant perhaps as much as 4× as deadly. Omicron turned out to be the exception, but again, that was not known with any certainty when it was allowed to run wild through populations. What would have happened if it had followed the same pattern as Delta?

In the USA, for example, the worst COVID-19 wave was the one in the winter of 2020-21, at the peak of which at least 3,500 people were dying daily (the real number was certainly higher because of undercounting due to lack of testing and improper reporting). The first Omicron BA.1 wave saw the second-highest death tolls, with at least 2,800 dying per day at its peak. Had Omicron been as intrinsically lethal as Delta, we could have easily seen a 4-5× higher peak than January 2021, i.e. as many as 12–15,000 people dying a day. Given that we only had real data on Omicron’s intrinsic lethality after the gigantic wave of infections was unleashed onto the population, we have to conclude that 12–15,000 dead a day is now a threshold that will not force the implementation of serious NPIs for the next problematic COVID-19 serotype.

Logically, it follows that it is also a threshold that will not result in the implementation of NPIs for any other emerging pathogens either. Because why should SARS-CoV-2 be special?

We can only hope that we will never see the day when such an epidemic hits us but experience tells us such optimism is unfounded. The current level of suffering caused by COVID-19 has been completely normalized even though such a thing was unthinkable back in 2019. Populations are largely unaware of the long-term harms the virus is causing to those infected, of the burden on healthcare, increased disability, mortality and reduced life expectancy. Once a few even deadlier outbreaks have been shrugged off by governments worldwide, the baseline of what is considered “acceptable” will just gradually move up and even more unimaginable losses will eventually enter the “acceptable” category. There can be no doubt, from a public health perspective, we are regressing.

We had a second, even more worrying real-life example of what the future holds with the global spread of the MPX virus (formerly known as “monkeypox” and now called “Mpox”) in 2022. MPX is a close relative to the smallpox VARV virus and is endemic to Central and Western Africa, where its natural hosts are mostly various rodent species, but on occasions it infects humans too, with the rate of zoonotic transfer increasing over recent decades. It has usually been characterized by fairly high mortality – the CFR (Case Fatality Rate) has been ∼3.6% for the strain that circulates in Nigeria and ∼10% for the one in the Congo region, i.e. much worse than SARS-CoV-2. In 2022, an unexpected global MPX outbreak developed, with tens of thousands of confirmed cases in dozens of countries. Normally, this would be a huge cause for alarm, for several reasons.

First, MPX itself is a very dangerous disease. Second, universal smallpox vaccination ended many decades ago with the success of the eradication program, leaving the population born after that completely unprotected. Third, lethality in orthopoxviruses is, in fact, highly variable – VARV itself had a variola major strain, with as much as ∼30% CFR, and a less deadly variola minor variety with CFR ∼1%, and there was considerable variation within variola major too. It also appears that high pathogenicity often evolves from less pathogenic strains through reductive evolution - the loss of certain genes something that can happen fairly easily, may well have happened repeatedly in the past, and may happen again in the future, a scenario that has been repeatedly warned about for decades. For these reasons, it was unthinkable that anyone would just shrug off a massive MPX outbreak – it is already bad enough as it is, but allowing it to become endemic means it can one day evolve towards something functionally equivalent to smallpox in its impact.

And yet that is exactly what happened in 2022 – barely any measures were taken to contain the outbreak, and countries simply reclassified MPX out of the “high consequence infectious disease” category in order to push the problem away, out of sight and out of mind. By chance, it turned out that this particular outbreak did not spark a global pandemic, and it was also characterized, for poorly understood reasons, by an unusually low CFR, with very few people dying. But again, that is not the information that was available at the start of the outbreak, when in a previous, interventionist age of public health, resources would have been mobilized to stamp it out in its infancy, but, in the age of laissez-faire, were not. MPX is now circulating around the world and represents a future threat of uncontrolled transmission resulting in viral adaptation to highly efficient human-to-human spread combined with much greater disease severity.

While some are better than others, no national or regional government is making serious efforts towards infection prevention and control, and it seems likely this laissez-faire policy will continue for the foreseeable future. The social, political, and economic movements that worked to achieve this mass infection environment can rejoice at their success.

Those schooled in public health, immunology or working on the front line of healthcare provision know we face an uncertain future, and are aware the implications of recent events stretch far beyond SARS-CoV-2. The shifts that have taken place in attitudes and public health policy will likely damage a key pillar that forms the basis of modern civilized society, one that was built over the last two centuries; the expectation of a largely uninterrupted upwards trajectory of ever-improving health and quality of life, largely driven by the reduction and elimination of infectious diseases that plagued humankind for thousands of years. In the last three years, that trajectory has reversed.

The upward trajectory of public health in the last two centuries Control of infectious disease has historically been a priority for all societies. Quarantine has been in common use since at least the Bronze Age and has been the key method for preventing the spread of infectious diseases ever since. The word “quarantine” itself derives from the 40-day isolation period for ships and crews that was implemented in Europe during the late Middle Ages to prevent the introduction of bubonic plague epidemics into cities1.

Rat climbing a ship's rigging. Modern public health traces its roots to the middle of the 19th century thanks to converging scientific developments in early industrial societies:

The germ theory of diseases was firmly established in the mid-19th century, in particular after Louis Pasteur disproved the spontaneous generation hypothesis. If diseases spread through transmission chains between individual humans or from the environment/animals to humans, then it follows that those transmission chains can be interrupted, and the spread stopped. The science of epidemiology appeared, its birth usually associated with the 1854 Broad Street cholera outbreak in London during which the British physician John Snow identified contaminated water as the source of cholera, pointing to improved sanitation as the way to stop cholera epidemics. Vaccination technology began to develop, initially against smallpox, and the first mandatory smallpox vaccination campaigns began, starting in England in the 1850s. The early industrial era generated horrendous workplace and living conditions for working class populations living in large industrial cities, dramatically reducing life expectancy and quality of life (life expectancy at birth in key industrial cities in the middle of the 19th century was often in the low 30s or even lower2). This in turn resulted in a recognition that such environmental factors affect human health and life spans. The long and bitter struggle for workers’ rights in subsequent decades resulted in much improved working conditions, workplace safety regulations, and general sanitation, and brought sharp increases in life expectancy and quality of life, which in turn had positive impacts on productivity and wealth. Florence Nightingale reemphasized the role of ventilation in healing and preventing illness, ‘The very first canon of nursing… : keep the air he breathes as pure as the external air, without chilling him,’ a maxim that influenced building design at the time. These trends continued in the 20th century, greatly helped by further technological and scientific advances. Many diseases – diphtheria, pertussis, hepatitis B, polio, measles, mumps, rubella, etc. – became things of the past thanks to near-universal highly effective vaccinations, while others that used to be common are no longer of such concern for highly developed countries in temperate climates – malaria, typhus, typhoid, leprosy, cholera, tuberculosis, and many others – primarily thanks to improvements in hygiene and the implementation of non-pharmaceutical measures for their containment.

Furthermore, the idea that infectious diseases should not just be reduced, but permanently eliminated altogether began to be put into practice in the second half of the 20th century3-5 on a global level, and much earlier locally. These programs were based on the obvious consideration that if an infectious agent is driven to extinction, the incalculable damage to people’s health and the overall economy by a persisting and indefinite disease burden will also be eliminated.

The ambition of local elimination grew into one of global eradication for smallpox, which was successfully eliminated from the human population in the 1970s6 (this had already been achieved locally in the late 19th century by some countries), after a heroic effort to find and contain the last remaining infectious individuals7,8. The other complete success was rinderpest in cattle9,10, globally eradicated in the early 21st century.

When the COVID-19 pandemic started, global eradication programs were very close to succeeding for two other diseases – polio11,12 and dracunculiasis13. Eradication is also globally pursued for other diseases, such as yaws14,15, and regionally for many others, e.g. lymphatic filariasis16,17, onchocerciasis18,19, measles and rubella20-30. The most challenging diseases are those that have an external reservoir outside the human population, especially if they are insect borne, and in particular those carried by mosquitos. Malaria is the primary example, but despite these difficulties, eradication of malaria has been a long-standing global public health goal31-33 and elimination has been achieved in temperate regions of the globe34,35, even though it involved the ecologically destructive widespread application of polluting chemical pesticides36,37 to reduce the populations of the vectors. Elimination is also a public goal for other insect borne diseases such as trypanosomiasis38,39.

In parallel with pursuing maximal reduction and eventual eradication of the burden of existing endemic infectious diseases, humanity has also had to battle novel infectious diseases40, which have been appearing at an increased rate over recent decades41-43. Most of these diseases are of zoonotic origin, and the rate at which they are making the jump from wildlife to humans is accelerating, because of the increased encroachment on wildlife due to expanding human populations and physical infrastructure associated with human activity, the continued destruction of wild ecosystems that forces wild animals towards closer human contact, the booming wildlife trade, and other such trends.

Because it is much easier to stop an outbreak when it is still in its early stages of spreading through the population than to eradicate an endemic pathogen, the governing principle has been that no emerging infectious disease should be allowed to become endemic. This goal has been pursued reasonably successfully and without controversy for many decades.

The most famous newly emerging pathogens were the filoviruses (Ebola44-46, Marburg47,48), the SARS and MERS coronaviruses, and paramyxoviruses like Nipah49,50. These gained fame because of their high lethality and potential for human-to-human spread, but they were merely the most notable of many examples.

Pigs in close proximity to humans. Such epidemics were almost always aggressively suppressed. Usually, these were small outbreaks, and because highly pathogenic viruses such as Ebola cause very serious sickness in practically all infected people, finding and isolating the contagious individuals is a manageable task. The largest such epidemic was the 2013-16 Ebola outbreak in West Africa, when a filovirus spread widely in major urban centers for the first time. Containment required a wartime-level mobilization, but that was nevertheless achieved, even though there were nearly 30,000 infections and more than 11,000 deaths51.

SARS was also contained and eradicated from the human population back in 2003-04, and the same happened every time MERS made the jump from camels to humans, as well as when there were Nipah outbreaks in Asia.

The major counterexample of a successful establishment in the human population of a novel highly pathogenic virus is HIV. HIV is a retrovirus, and as such it integrates into the host genome and is thus nearly impossible to eliminate from the body and to eradicate from the population52 (unless all infected individuals are identified and prevented from infecting others for the rest of their lives). However, HIV is not an example of the containment principle being voluntarily abandoned as the virus had made its zoonotic jump and established itself many decades before its eventual discovery53 and recognition54-56, and long before the molecular tools that could have detected and potentially fully contained it existed.

Still, despite all these containment success stories, the emergence of a new pathogen with pandemic potential was a well understood and frequently discussed threat57-60, although influenza viruses rather than coronaviruses were often seen as the most likely culprit61-65. The eventual appearance of SARS-CoV-2 should therefore not have been a huge surprise, and should have been met with a full mobilization of the technical tools and fundamental public health principles developed over the previous decades.

The ecological context One striking property of many emerging pathogens is how many of them come from bats. While the question of whether bats truly harbor more viruses than other mammals in proportion to their own species diversity (which is the second highest within mammals after rodents) is not fully settled yet66-69, many novel viruses do indeed originate from bats, and the ecological and physiological characteristics of bats are highly relevant for understanding the situation that Homo sapiens finds itself in right now.

Group of bats roosting in a cave. Another startling property of bats and their viruses is how highly pathogenic to humans (and other mammals) many bat viruses are, while bats themselves are not much affected (only rabies is well established to cause serious harm to bats68). Why bats seem to carry so many such pathogens, and how they have adapted so well to coexisting with them, has been a long-standing puzzle and although we do not have a definitive answer, some general trends have become clear.

Bats are the only truly flying mammals and have been so for many millions of years. Flying has resulted in a number of specific adaptations, one of them being the tolerance towards a very high body temperature (often on the order of 42-43ºC). Bats often live in huge colonies, literally touching each other, and, again, have lived in conditions of very high density for millions of years. Such densities are rare among mammals and are certainly not the native condition of humans (human civilization and our large dense cities are a very recent phenomenon on evolutionary time scales). Bats are also quite long-lived for such small mammals70-71 – some fruit bats can live more than 35 years and even small cave dwelling species can live about a decade. These are characteristics that might have on one hand facilitated the evolution of a considerable set of viruses associated with bat populations. In order for a non-latent respiratory virus to maintain itself, a minimal population size is necessary. For example, it is hypothesized that measles requires a minimum population size of 250-300,000 individuals72. And bats have existed in a state of high population densities for a very long time, which might explain the high diversity of viruses that they carry. In addition, the long lifespan of many bat species means that their viruses may have to evolve strategies to overcome adaptive immunity and frequently reinfect previously infected individuals as opposed to the situation in short-lived species in which populations turn over quickly (with immunologically naive individuals replacing the ones that die out).

On the other hand, the selective pressure that these viruses have exerted on bats may have resulted in the evolution of various resistance and/or tolerance mechanisms in bats themselves, which in turn have driven the evolution of counter strategies in their viruses, leading them to be highly virulent for other species. Bats certainly appear to be physiologically more tolerant towards viruses that are otherwise highly virulent to other mammals. Several explanations for this adaptation have been proposed, chief among them a much more powerful innate immunity and a tolerance towards infections that does not lead to the development of the kind of hyperinflammatory reactions observed in humans73-75, the high body temperature of bats in flight, and others.

The notable strength of bat innate immunity is often explained by the constitutively active interferon response that has been reported for some bat species76-78. It is possible that this is not a universal characteristic of all bats79 – only a few species have been studied – but it provides a very attractive mechanism for explaining both how bats prevent the development of severe systemic viral infections in their bodies and how their viruses in turn would have evolved powerful mechanisms to silence the interferon response, making them highly pathogenic for other mammals.

The tolerance towards infection is possibly rooted in the absence of some components of the signaling cascades leading to hyperinflammatory reactions and the dampened activity of others80.

Map of scheduled airline traffic around the world, circa June 2009 Map of scheduled airline traffic around the world. Credit: Jpatokal An obvious ecological parallel can be drawn between bats and humans – just as bats live in dense colonies, so now do modern humans. And we may now be at a critical point in the history of our species, in which our ever-increasing ecological footprint has brought us in close contact with bats in a way that was much rarer in the past. Our population is connected in ways that were previously unimaginable. A novel virus can make the zoonotic jump somewhere in Southeast Asia and a carrier of it can then be on the other side of the globe a mere 24-hours later, having encountered thousands of people in airports and other mass transit systems. As a result, bat pathogens are now being transferred from bat populations to the human population in what might prove to be the second major zoonotic spillover event after the one associated with domestication of livestock and pets a few thousand years ago.

Unfortunately for us, our physiology is not suited to tolerate these new viruses. Bats have adapted to live with them over many millions of years. Humans have not undergone the same kind of adaptation and cannot do so on any timescale that will be of use to those living now, nor to our immediate descendants.

Simply put, humans are not bats, and the continuous existence and improvement of what we now call “civilization” depends on the same basic public health and infectious disease control that saw life expectancy in high-income countries more than double to 85 years. This is a challenge that will only increase in the coming years, because the trends that are accelerating the rate of zoonotic transfer of pathogens are certain to persist.

Given this context, it is as important now to maintain the public health principle that no new dangerous pathogens should be allowed to become endemic and that all novel infectious disease outbreaks must be suppressed as it ever was.

The death of public health and the end of epidemiological comfort It is also in this context that the real gravity of what has happened in the last three years emerges.

After HIV, SARS-CoV-2 is now the second most dangerous infectious disease agent that is 'endemic' to the human population on a global scale. And yet not only was it allowed to become endemic, but mass infection was outright encouraged, including by official public health bodies in numerous countries81-83.

The implications of what has just happened have been missed by most, so let’s spell them out explicitly.

We need to be clear why containment of SARS-CoV-2 was actively sabotaged and eventually abandoned. It has absolutely nothing to do with the “impossibility” of achieving it. In fact, the technical problem of containing even a stealthily spreading virus such as SARS-CoV-2 is fully solved, and that solution was successfully applied in practice for years during the pandemic.

The list of countries that completely snuffed out outbreaks, often multiple times, includes Australia, New Zealand, Singapore, Taiwan, Vietnam, Thailand, Bhutan, Cuba, China, and a few others, with China having successfully contained hundreds of separate outbreaks, before finally giving up in late 2022.

The algorithm for containment is well established – passively break transmission chains through the implementation of nonpharmaceutical interventions (NPIs) such as limiting human contacts, high quality respirator masks, indoor air filtration and ventilation, and others, while aggressively hunting down active remaining transmission chains through traditional contact tracing and isolation methods combined with the powerful new tool of population-scale testing.

Oklahoma’s Strategic National Stockpile. Credit: DVIDS Understanding of airborne transmission and institution of mitigation measures, which have heretofore not been utilized in any country, will facilitate elimination, even with the newer, more transmissible variants. Any country that has the necessary resources (or is provided with them) can achieve full containment within a few months. In fact, currently this would be easier than ever before because of the accumulated widespread multiple recent exposures to the virus in the population suppressing the effective reproduction number (Re). For the last 18 months or so we have been seeing a constant high plateau of cases with undulating waves, but not the major explosions of infections with Re reaching 3-4 that were associated with the original introduction of the virus in 2020 and with the appearance of the first Omicron variants in late 2021.

It would be much easier to use NPIs to drive Re to much below 1 and keep it there until elimination when starting from Re around 1.2-1.3 than when it was over 3, and this moment should be used, before another radically new serotype appears and takes us back to those even more unpleasant situations. This is not a technical problem, but one of political and social will. As long as leadership misunderstands or pretends to misunderstand the link between increased mortality, morbidity and poorer economic performance and the free transmission of SARS-CoV-2, the impetus will be lacking to take the necessary steps to contain this damaging virus.

Political will is in short supply because powerful economic and corporate interests have been pushing policymakers to let the virus spread largely unchecked through the population since the very beginning of the pandemic. The reasons are simple. First, NPIs hurt general economic activity, even if only in the short term, resulting in losses on balance sheets. Second, large-scale containment efforts of the kind we only saw briefly in the first few months of the pandemic require substantial governmental support for all the people who need to pause their economic activity for the duration of effort. Such an effort also requires large-scale financial investment in, for example, contact tracing and mass testing infrastructure and providing high-quality masks. In an era dominated by laissez-faire economic dogma, this level of state investment and organization would have set too many unacceptable precedents, so in many jurisdictions it was fiercely resisted, regardless of the consequences for humanity and the economy.

None of these social and economic predicaments have been resolved. The unofficial alliance between big business and dangerous pathogens that was forged in early 2020 has emerged victorious and greatly strengthened from its battle against public health, and is poised to steamroll whatever meager opposition remains for the remainder of this, and future pandemics.

The long-established principles governing how we respond to new infectious diseases have now completely changed – the precedent has been established that dangerous emerging pathogens will no longer be contained, but instead permitted to ‘ease’ into widespread circulation. The intent to “let it rip” in the future is now being openly communicated84. With this change in policy comes uncertainty about acceptable lethality. Just how bad will an infectious disease have to be to convince any government to mobilize a meaningful global public health response?

We have some clues regarding that issue from what happened during the initial appearance of the Omicron “variant” (which was really a new serotype85,86) of SARS-CoV-2. Despite some experts warning that a vaccine-only approach would be doomed to fail, governments gambled everything on it. They were then faced with the brute fact of viral evolution destroying their strategy when a new serotype emerged against which existing vaccines had little effect in terms of blocking transmission. The reaction was not to bring back NPIs but to give up, seemingly regardless of the consequences.

Critically, those consequences were unknown when the policy of no intervention was adopted within days of the appearance of Omicron. All previous new SARS-CoV-2 variants had been deadlier than the original Wuhan strain, with the eventually globally dominant Delta variant perhaps as much as 4× as deadly87. Omicron turned out to be the exception, but again, that was not known with any certainty when it was allowed to run wild through populations. What would have happened if it had followed the same pattern as Delta?

In the USA, for example, the worst COVID-19 wave was the one in the winter of 2020-21, at the peak of which at least 3,500 people were dying daily (the real number was certainly higher because of undercounting due to lack of testing and improper reporting). The first Omicron BA.1 wave saw the second-highest death tolls, with at least 2,800 dying per day at its peak. Had Omicron been as intrinsically lethal as Delta, we could have easily seen a 4-5× higher peak than January 2021, i.e. as many as 12–15,000 people dying a day. Given that we only had real data on Omicron’s intrinsic lethality after the gigantic wave of infections was unleashed onto the population, we have to conclude that 12–15,000 dead a day is now a threshold that will not force the implementation of serious NPIs for the next problematic COVID-19 serotype.

UK National Covid Memorial Wall. Credit: Dominic Alves Logically, it follows that it is also a threshold that will not result in the implementation of NPIs for any other emerging pathogens either. Because why should SARS-CoV-2 be special?

We can only hope that we will never see the day when such an epidemic hits us but experience tells us such optimism is unfounded. The current level of suffering caused by COVID-19 has been completely normalized even though such a thing was unthinkable back in 2019. Populations are largely unaware of the long-term harms the virus is causing to those infected, of the burden on healthcare, increased disability, mortality and reduced life expectancy. Once a few even deadlier outbreaks have been shrugged off by governments worldwide, the baseline of what is considered “acceptable” will just gradually move up and even more unimaginable losses will eventually enter the “acceptable” category. There can be no doubt, from a public health perspective, we are regressing.

We had a second, even more worrying real-life example of what the future holds with the global spread of the MPX virus (formerly known as “monkeypox” and now called “Mpox”) in 2022. MPX is a close relative to the smallpox VARV virus and is endemic to Central and Western Africa, where its natural hosts are mostly various rodent species, but on occasions it infects humans too, with the rate of zoonotic transfer increasing over recent decades88. It has usually been characterized by fairly high mortality – the CFR (Case Fatality Rate) has been ∼3.6% for the strain that circulates in Nigeria and ∼10% for the one in the Congo region, i.e. much worse than SARS-CoV-2. In 2022, an unexpected global MPX outbreak developed, with tens of thousands of confirmed cases in dozens of countries89,90. Normally, this would be a huge cause for alarm, for several reasons.

First, MPX itself is a very dangerous disease. Second, universal smallpox vaccination ended many decades ago with the success of the eradication program, leaving the population born after that completely unprotected. Third, lethality in orthopoxviruses is, in fact, highly variable – VARV itself had a variola major strain, with as much as ∼30% CFR, and a less deadly variola minor variety with CFR ∼1%, and there was considerable variation within variola major too. It also appears that high pathogenicity often evolves from less pathogenic strains through reductive evolution - the loss of certain genes something that can happen fairly easily, may well have happened repeatedly in the past, and may happen again in the future, a scenario that has been repeatedly warned about for decades91,92. For these reasons, it was unthinkable that anyone would just shrug off a massive MPX outbreak – it is already bad enough as it is, but allowing it to become endemic means it can one day evolve towards something functionally equivalent to smallpox in its impact.

Colorized transmission electron micrograph of Mpox virus particles. Credit: NIAID And yet that is exactly what happened in 2022 – barely any measures were taken to contain the outbreak, and countries simply reclassified MPX out of the “high consequence infectious disease” category93 in order to push the problem away, out of sight and out of mind. By chance, it turned out that this particular outbreak did not spark a global pandemic, and it was also characterized, for poorly understood reasons, by an unusually low CFR, with very few people dying94,95. But again, that is not the information that was available at the start of the outbreak, when in a previous, interventionist age of public health, resources would have been mobilized to stamp it out in its infancy, but, in the age of laissez-faire, were not. MPX is now circulating around the world and represents a future threat of uncontrolled transmission resulting in viral adaptation to highly efficient human-to-human spread combined with much greater disease severity.

This is the previously unthinkable future we will live in from now on in terms of our approach to infectious disease.

What may be controlled instead is information. Another lesson of the pandemic is that if there is no testing and reporting of cases and deaths, a huge amount of real human suffering can be very successfully swept under the rug. Early in 2020, such practices – blatant denial that there was any virus in certain territories, outright faking of COVID-19 statistics, and even resorting to NPIs out of sheer desperation but under false pretense that it is not because of COVID-19 – were the domain of failed states and less developed dictatorships. But in 2023 most of the world has adopted such practices – testing is limited, reporting is infrequent, or even abandoned altogether – and there is no reason to expect this to change. Information control has replaced infection control.

After a while it will not even be possible to assess the impact of what is happening by evaluating excess mortality, which has been the one true measure not susceptible to various data manipulation tricks. As we get increasingly removed from the pre-COVID-19 baselines and the initial pandemic years are subsumed into the baseline for calculating excess mortality, excess deaths will simply disappear by the power of statistical magic. Interestingly, countries such as the UK, which has already incorporated two pandemic years in its five-year average, are still seeing excess deaths, which suggests the virus is an ongoing and growing problem.

It should also be stressed that this radical shift in our approach to emerging infectious diseases is probably only the beginning of wiping out the hard-fought public health gains of the last 150+ years. This should be gravely concerning to any individuals and institutions concerned with workers and citizens rights.

This shift is likely to impact existing eradication and elimination efforts. Will the final pushes be made to complete the various global eradication campaigns listed above? That may necessitate some serious effort involving NPIs and active public health measures, but how much appetite is there for such things after they have been now taken out of the toolkit for SARS-CoV-2?

We can also expect previously forgotten diseases to return where they have successfully been locally eradicated. We have to always remember that the diseases that we now control with universal childhood vaccinations have not been globally eradicated – they have disappeared from our lives because vaccination rates are high enough to maintain society as a whole above the disease elimination threshold, but were vaccination rates to slip, those diseases, such as measles, will return with a vengeance.

The anti-vaccine movement was already a serious problem prior to COVID-19, but it was given a gigantic boost with the ill-advised vaccine-only COVID-19 strategy. Governments and their nominal expert advisers oversold the effectiveness of imperfect first generation COVID-vaccines, and simultaneously minimized the harms of SARS-CoV-2, creating a reality gap which gave anti-vaccine rhetoric space to thrive. This is a huge topic to be explored separately. Here it will suffice to say that while anti-vaxxers were a fringe movement prior to the pandemic, “vaccination” in general is now a toxic idea in the minds of truly significant portions of the population. A logical consequence of that shift has been a significant decrease in vaccination coverage for other diseases as well as for COVID-19.

This is even more likely given the shift in attitudes towards children. Child labour, lack of education and large families were the hallmarks of earlier eras of poor public health, which were characterized by high birth-rates and high infant mortality. Attitudes changed dramatically over the course of the 20th century and wherever health and wealth increased, child mortality fell, and the transition was made to small families. Rarity increased perceived value and children’s wellbeing became a central concern for parents and carers. The arrival of COVID-19 changed that, with some governments, advisers, advocacy groups and parents insisting that children should be exposed freely to a Severe Acute Respiratory Syndrome virus to ‘train’ their immune systems.

Infection, rather than vaccination, was the preferred route for many in public health in 2020, and still is in 2023, despite all that is known about this virus’s propensity to cause damage to all internal organs, the immune system, and the brain, and the unknowns of postinfectious sequelae. This is especially egregious in infants, whose naive immune status may be one of the reasons they have a relatively high hospitalization rate. Some commentators seek to justify the lack of protection for the elderly and vulnerable on a cost basis. We wonder what rationale can justify a lack of protection for newborns and infants, particularly in a healthcare setting, when experience of other viruses tells us children have better outcomes the later they are exposed to disease? If we are not prepared to protect children against a highly virulent SARS virus, why should we protect against others? We should expect a shift in public health attitudes, since ‘endemicity’ means there is no reason to see SARS-CoV-2 as something unique and exceptional.

We can also expect a general degradation of workplace safety protocols and standards, again reversing many decades of hard-fought gains. During COVID-19, aside from a few privileged groups who worked from home, people were herded back into their workplaces without minimal safety precautions such as providing respirators, and improving ventilation and indoor air quality, when a dangerous airborne pathogen was spreading.

Can we realistically expect existing safety precautions and regulations to survive after that precedent has been set? Can we expect public health bodies and regulatory agencies, whose job it is to enforce these standards, to fight for workplace safety given what they did during the pandemic? It is highly doubtful. After all, they stubbornly refused to admit that SARS-CoV-2 is airborne (even to this very day in fact – the World Health Organization’s infamous “FACT: #COVID19 is NOT airborne” Tweet from March 28 2020 is still up in its original form), and it is not hard to see why – implementing airborne precautions in workplaces, schools, and other public spaces would have resulted in a cost to employers and governments; a cost they could avoid if they simply denied they needed to take such precautions. But short-term thinking has resulted in long-term costs to those same organizations, through the staffing crisis, and the still-rising disability tsunami. The same principle applies to all other existing safety measures.

Worse, we have now entered the phase of abandoning respiratory precautions even in hospitals. The natural consequence of unmasked staff and patients, even those known to be SARS-CoV-2 positive, freely mixing in overcrowded hospitals is the rampant spread of hospital-acquired infections, often among some of the most vulnerable demographics. This was previously thought to be a bad thing. And what of the future? If nobody is taking any measures to stop one particular highly dangerous nosocomial infection, why would anyone care about all the others, which are often no easier to prevent? And if standards of care have slipped to such a low point with respect to COVID-19, why would anyone bother providing the best care possible for other conditions? This is a one-way feed-forward healthcare system degradation that will only continue.

Finally, the very intellectual foundations of the achievements of the last century and a half are eroding. Chief among these is the germ theory of infectious disease, by which transmission chains can be isolated and broken. The alternative theory, of spontaneous generation of pathogens, means there are no chains to be broken. Today, we are told that it is impossible to contain SARS-CoV-2 and we have to "just live with it,” as if germ theory no longer holds. The argument that the spread of SARS-CoV-2 to wildlife means that containment is impossible illustrates these contradictions further – SARS-CoV-2 came from wildlife, as did all other zoonotic infections, so how does the virus spilling back to wildlife change anything in terms of public health protocol? But if one has decided that from here on there will be no effort to break transmission chains because it is too costly for the privileged few in society, then excuses for that laissez-faire attitude will always be found.

And that does not bode well for the near- and medium-term future of the human species on planet Earth.

(Follow the link for more than 100 references and sources)

[justinspoliticalcorner]

Derek Thompson at The Atlantic:

For decades, America’s young voters have been deeply—and famously—progressive. In 2008, a youthquake sent Barack Obama to the White House. In 2016, voters ages 18 to 29 broke for Hillary Clinton by 18 points. In 2020, they voted for Joe Biden by 24 points. In 2024, Donald Trump closed most of the gap, losing voters under 30 by a 51–47 margin. In one recent CBS poll, Americans under 30 weren’t just evenly split between the parties. They were even more pro-Trump than Boomers over 65. Precisely polling teens and 20-somethings is a fraught business; some surveys suggest that Trump’s advantage among young people might already be fading. But young people’s apparent lurch right is not an American-only trend.

[...]

There is another potential driver of the global right turn: the pandemic.

Pandemics might not initially seem to cash out in any particular political direction. After all, in the spring of 2020, one possible implication of the pandemic seemed to be that it would unite people behind a vision of collective sacrifice—or, at least, collective appreciation for health professionals, or for the effect of vaccines to reduce severe illness among adults. But political science suggests that pandemics are more likely to reduce rather than build trust in scientific authorities. One cross-country analysis published by the Systemic Risk Center at the London School of Economics found that people who experience epidemics between the ages of 18 and 25 have less confidence in their scientific and political leadership. This loss of trust persists for years, even decades, in part because political ideology tends to solidify in a person’s 20s.

The paper certainly matches the survey evidence of young Americans. Young people who cast their first ballot in 2024 were “more jaded than ever about the state of American leadership,” according to the Harvard Political Review. A 2024 analysis of Americans under 30 found the “lowest levels of confidence in most public institutions since the survey began.” In the past decade alone, young Americans’ trust in the president has declined by 60 percent, while their trust in the Supreme Court, Wall Street, and Congress has declined by more than 30 percent.

[...]

These changes may not be durable. But many people’s political preferences solidify when they’re in their teens and 20s; so do other tastes and behaviors, such as musical preferences and even spending habits.

[...]

New ideologies are messy to describe and messier still to name. But in a few years, what we’ve grown accustomed to calling Generation Z may reveal itself to contain a subgroup: Generation C, COVID-affected and, for now, strikingly conservative. For this micro-generation of young people in the United States and throughout the West, social media has served as a crucible where several trends have fused together: declining trust in political and scientific authorities, anger about the excesses of feminism and social justice, and a preference for rightward politics.

The Atlantic had a story on why a portion of Gen Z went rightwards, and COVID played a large role in that.

[olderthannetfic]

I still think the people responding to the abortion thing with "well you wouldn't want them to raise that kid" are missing the point a bit, though. Even if someone has ample resources to take care of a kid, and they're fully prepared to be the best parent ever, they still have an inherent right to abort a pregnancy they don't want. Like focusing on "an ableist parent wouldn't be the best to raise that kid!" or "what if they don't have the resources for the health care they need!' opens up the "adoption" argument - and I'm sure many people would counter it with all the problems of the adoption system particularly for disabled kids. But even if adoption were a surefire way to ensure every child finds the perfect loving home, it is still wrong to force the pregnant person to use their body for 9 months to carry a pregnancy when they would rather not. The problems with relying overmuch on this argument is it has a kind of ugly implication that if a woman has no economic or emotional reason to struggle to raise a kid, it's mean and selfish for her not to be a mother. We saw some of that with the overturning of Roe in the U.S. - a lot of rhetoric of how this was bad just because of how it would affect poor or minority women. And I just wanted to be like, okay, but a wealthy white woman with ample resources who just doesn't want to have a kid, shouldn't have to have a kid. And it's still a massive violation of her human rights to force her to carry an unwanted pregnancy for 9 months. Like I thought one of the anons made this clear, but people keep saying this so maybe they're not getting it: but think of the burden that pregnancy puts on a body? Think about all the little things you have to do differently if you're pregnant. You can't drink, you can't take certain medications, including some that a lot of people's mental and physical health relies on the rest of the time. It literally moves around your organs to accommodate the growing fetus. It's just painful and nauseating a lot of time. That's not even going into how it's often enough of a medical emergency that it regularly killed pregnant people before we had access to modern medicine and hospitals, and still does in other parts of the world, or with people who refuse that treatment. Isn't that enough to convince you that it's horrifying to inflict that on someone unwillingly? I understand focusing on financial burdens and so on because it helps convince people who maybe aren't all there with respecting bodily autonomy. But also, I'm a cis woman who has no desire to be pregnant and have kids, and sure the fact that I haven't got a lot of money right now helps, but I know that if I was a billionaire and had tons of people at the ready to help raise my kids for me, I still wouldn't want to be a mother. And it's bizarre how radical that is to say even in ostensibly feminist, progressive spaces. A lot of people are just still so deeply uncomfortable with women (or anyone they see as a woman) deciding to choose life paths that don't include motherhood, in a way they simply are not with men eschewing fatherhood. And we can't really talk about gender equality until that starts to change. There's no reason that being born as a particular gender should limit the kind of life that people let you live or even imagine. There's nothing about being a woman that makes you more nurturing or parental, and so no reason that you shouldn't be able to decide that's not for you.

--

[redistrictgirl]

RFK Jr.’s Autism Rhetoric Makes No One Healthy

Many terrible things have happened over the past 87 days (and counting). The global economy has been kneecapped, healthcare has been stripped away from vulnerable populations domestically and abroad, dissenters have been kidnapped and disappeared, and massive security breaches in our national infrastructure are now commonplace. Yet somehow, nothing has pushed my buttons quite like Health Secretary Robert F. Kennedy Jr.’s claims on Wednesday that autism is an epidemic that “destroys families and more importantly… destroys our greatest resource, our children.” Of course, this fearmongering is primarily intended for use as a cudgel in the Trump administration’s campaign to discredit vaccines, but the pure inhumanity of the remarks on autism itself should not be lost and could easily spiral into discriminatory or genocidal activity in the context of a reactionary and authoritarian government.

I would be remiss to approach this topic without discussing my own perspective on it. As you may have guessed if you followed my election coverage last year, I am autistic myself. Doctors in the early 2000s told my parents to expect that I would never live an independent lifestyle. However, thanks to rapid and strong interventions as well as sacrifice from my entire support network (not least of all myself as a young child!), I was in fact able to develop healthy speech, social skills, and general life skills. I maintain a full-time job and livelihood that most of my neurotypical peers find challenging to achieve while remaining unabashedly myself. I inspired my mother to become a behavior analyst, for crying out loud.

With all this in mind, my resentment towards antivaxxer depictions of autism should be fairly clear - they fail to depict my experience and erase the work I and others put in throughout my life as a pipe dream. I’m not trying to be a feel-good inspiration, but my experience is real and my remaining needs shouldn’t be ignored because my life isn’t as bad as it “should be.” Of course, the picture here is broader than my own experience, and that’s where Mr. Kennedy’s epidemic claims frighten me most.

It is true that most autistic people struggle to hold jobs and “go out on a date”, as the Secretary claims. Profoundly autistic people also may not engage in most everyday activities the same way neurotypical people do. But in the context of the Trump administration as a whole, these talking points are chilling. One of the most frightening statements was slipped in alongside these cherry-picked observations: “These are kids who will never pay taxes.”

Let’s ignore the infantilization in the choice of words for a moment. The implication of “never pay taxes” is that autistic people take up more economic resources more than they contribute. The Republican Party has laser-focused its economic messaging over the past 45 years on personal responsibility and self-sufficiency. We now have a GOP official in an administration that regularly introduces new barriers to healthcare and withdraws health-related foreign aid complaining that autistic people don’t help the national budget. If this rhetoric continues, discrimination against the neurodivergent community in healthcare could very well be emboldened as a “cost-saving” measure. Profoundly autistic people could lose their lifelines as they are regarded as dead weight on the budget. More fortunate individuals might simply be viewed as lazy “welfare monarchs” who should never be provided aid to overcome their disability, a common intersectional attack on marginalized groups.

And here’s the kicker - regardless of whether or not an autistic person pays taxes, has a job, or “writes a poem” (another bizarre point from Mr. Kennedy), they have worth by virtue of being a person. If life is worth living (and I think most people without depression would agree on that front), we should encourage life itself no matter how it touches the government’s budget or whether it checks all the boxes we expect a life to have. And I’m sorry, Secretary - your dramatic griping about autism on Wednesday doesn’t make any lives healthy, and not just because of the malaria and measles you inexplicably support. It will “destroy” more than autism ever could.

[reasonsforhope]

"In short: Thailand's Senate has approved a bill legalising same sex marriage in the South-East Asian country.

It will afford same-sex couples practical benefits such as being able to have children through IVF and make emergency medical decisions for their spouse.

What's next? The first weddings may take place later this year, 120 days after the law is announced in the Royal Gazette.

Thailand has become the first nation in South-East Asia to legalise same sex marriage, with the country's Senate approving the landmark bill this afternoon.

The legislation was expected to pass after it cleared the country's House of Representatives in a near-unanimous vote in March.

Despite Thailand's bustling gay bars and prominent transgender community making it a mecca for LGBTQ+ tourists, until now local same-sex couples there have been unable to marry.

The law will take effect 120 days after its announcement in the Royal Gazette, so the first same sex weddings may take place later this year.

Couples who have been waiting years have hailed the move as a historic moment that will afford them rights only reserved for spouses.

A Lifechanging Law

Photos of Anticha and Worawan [including the article picture], dressed in floor-length white gowns and trailed by rainbow flags, getting married at Bangkok's first Pride Festival two years ago went viral, but they are still not legally married.

Now they will be able to change that, and Anticha Sangchai is elated.

"This will change my life and change many Thai people's lives, especially in the LGBT community," she said.

"It is a historical moment and I really want to join with my community to celebrate this moment.

"I want to send a message to the world that Thailand has changed. Even though there are still many issues, this is a big step for us." ...

There were an estimated 3.7 million LGBT people in Thailand in 2022, according to LGBT Capital, a private company which models economic data pertaining to the community around the world.

For the young couple from Bangkok, being able to marry also has very real practical implications.

If they want to have children through IVF, Ms Sangchai says they will need a marriage certificate first.

"I am quite concerned about the time because we are getting older every day, and the older you get the more difficult it is to have a healthy pregnancy," she said.

"So we've been really wanting this law to pass as soon as possible."

Cabaret performer Jena is excited Thailand's laws are finally catching up with the nation's image...

She too had worried about the practical implications of being unable to marry.

"For example, if myself or my partner had to go to hospital or there was an accident that needs consent for an emergency operation, without a marriage certificate we couldn't sign it," she said.

She now wants the government to move forward with a law to allow transgender people to amend their gender on official documents." ...

An Economic Boost?

Thailand has long been famous for LGBTQ tourism and there are now hopes this new law could allow the country to cash in on the aging members of the community.

Chaiwat Songsiriphan, who runs a health clinic for people in the LGBTQ community, said laws preventing same sex marriage were the last barrier holding the country back from becoming a gay retirement hub.

[Note: They do not just mean for rich westerners; Thailand as a gay retirement hub would probably appeal most to and definitely benefit LGBTQ people from throughout Asia.]

"Thailand has an LGBTQ-friendly environment since Thai culture is quite flexible," he said.

"One of my foreigner friends, a gay friend, told me that when he's in his country he has to pretend to be straight … but when he comes to Bangkok he said you can be as gay as you want.

"When we talk about retirement or a long-term stay for the rest of their lives, what people need is … food, good healthcare services, transportation, homes.

"I think Thailand has it all at a very affordable price."

He said it could help give the country a desperately needed economic boost.

"This will have a lot of benefits for Thailand's economy because when we talk about retirement it's people literally bringing all the money they have earned for the rest of their working lives to spend and invest here," he said.

He said he, like the rest of the community, was thrilled by the news.

"It's not about a privilege, it's just equality," he said.

"We are we also humans, so we should be able to marry the one we love.""

-via ABC Australia, June 18, 2024

[sunnycanvas]

As Life Fades, Sibylla remembers Baldwin IV

Warning: Implication of sexual violence and strong implications of internalised misogyny

Note: Although inspired by heavily historical events the fiction is still historically inaccurate. So please take everything here as a grain of salt

From former queen of Jerusalem

Sibylla

Sibylla signed the letter with a heavy heart, her hand trembling as she sealed it. She ordered her servants to deliver it to Conrad de Montferrat, though she knew deep down that it was likely in vain. Already stricken with illness, Sibylla mourned in the camp alongside her relatives, where the epidemic had ravaged their lives. The loss of her daughters, Alix and Maria, who had succumbed to the epidemic just days earlier, weighed heavily on her soul. As she lay in her tent, waiting for Conrad's reply, a sense of foreboding settled over her. Death was closing in, and though the thought of reuniting with her children in the afterlife brought her some solace, she couldn’t shake the sorrow for her kingdom. Why had God been so cruel to her? Had she not been the obedient wife she was required to be? Had she not remained silent when it was demanded of her? What had she done to deserve this fate? Why would God allow the kingdom to fall into Saracen hands? Her troubled thoughts were interrupted by the arrival of a servant, holding a letter from Conrad. Sibylla’s heart raced as she demanded impatiently, "What does it say?" Despite her worries for the kingdom, her desire to reunite with her children in the afterlife was overwhelming. She wondered what her sons and daughters would be like in heaven, confident that she had earned her place there. The servant hesitated, nervously clutching the letter as he fidgeted with his fingers. "Well...?" Sibylla pressed, her voice sharp with anticipation. Finally, the servant unfolded the letter and began to read aloud, "I shall maintain the succession rule established by the former King of Jerusalem, King Baldwin IV." Sibylla's eyes widened as memories of her late brother flooded back. The atmosphere in the tent grew tense, as the other servants and maids fell silent at the mention of Baldwin’s name. She could see the grief in their eyes, a reflection of the loss they still felt for their king. Sibylla, too, missed her brother, but after the death of her son, she had scarcely had time to think of him. A maid, her voice filled with nostalgia, remarked, "Our kingdom flourished both spiritually and economically under his rule." Sibylla’s cheeks flushed with shame at the reminder of her own failures. Before she could dwell on it, her health took a sudden turn for the worse, and she collapsed to the floor. To her shock, none of the servant neither the maids nor the male messenger standing by the tent’s entrance moved to help her. One maid, her voice dripping with venom, spat out, "We were wrong to think our kingdom was cursed because of our leprous king. No, it was cursed because of you. You are the reason why our women are being violated, why we lost Ascalon to save your husband. We lost our lives and dignity because of you, and I pray God gives you the judgment you deserve for your sins." Sibylla wanted to protest, to defend herself, but she was too weak. Her life was slipping away, and the last thing she heard was another maid scolding the one who had spoken so harshly. As darkness closed in, her final thoughts were of her brother Baldwin, wondering how he would have reacted if he were alive to see the fall of Jerusalem.

Sibylla awoke, feeling groggy and disoriented. As she looked around, she found herself in a dark, desolate place. The only things visible were trees, their branches bare and charred as if they had been burned. The oppressive darkness weighed heavily on her, and she struggled to recall anything her name, her family, or where she had come from but her mind was blank. With no memory and no sense of direction, Sibylla began to walk, her feet sinking into the wet, murky ground. She wandered aimlessly, unsure of where she was headed, until she noticed a faint glimmer of light in the distance. Desperate for a sign of hope, she pressed on toward it. As she drew closer, the ground beneath her feet became warm and dry, and she found herself surrounded by clouds, a stark contrast to the darkness she had just left behind. Sibylla sighed in relief and continued walking, hoping to find someone who could help her make sense of her situation. Soon, she spotted a blonde, bearded man crouched down, playfully interacting with two little girls. He looked cheerful, chuckling as he gently pulled the girls' cheeks, his eyes filled with warmth. Sibylla felt a surge of hope and hurried toward them, eager to ask for help."Excuse me, Sir," she called out. "I find myself in a strange situation where I can't remember my name or where I come from. Do you happen to know how to help me?"

The man's smile vanished the moment he heard her voice. He stood up slowly, his demeanor shifting from warmth to a stern, almost detached expression. "Sibylla," he said confidently, addressing her by name.Sibylla stared at him in confusion, the name sounding familiar yet distant. The two little girls turned toward her, their innocent voices calling out, "Mommy?" Her confusion deepened as she looked at them, unable to comprehend what was happening. The man's gaze remained fixed on her, his expression now tinged with frustration and disappointment. He closed his eyes halfway, his tone sharp as he spoke."You seem as lost as we were when we first arrived here," he said. "But it's okay, you’ll remember soon enough... 'Dear Sister'."

Sibylla’s confusion quickly turned to frustration. Unable to contain herself, she yelled at the blonde man, "I came here looking for answers, but you've only made things worse! Help me if you can, or leave me alone! Why do you insist on complicating my life?" As the words left her mouth, a sudden wave of déjà vu washed over her. Baldwin, hearing her outburst, chuckled bitterly and shook his head. "Still the same," he muttered, his voice tinged with a resigned bitterness. Sibylla noticed how tired he looked, as though her reaction was something he had seen too many times before. It was clear he knew her far too well for a stranger, and that only deepened her frustration. "You look like you were expecting me to say that," she protested. With a weary sigh, the man replied, "This time, yes. I only wish I’d expected it back when I was alive." He paused, then added in a strained voice, "Sister." The word struck Sibylla, silencing her. The déjà vu grew stronger, and suddenly, flashes of memory began to surface, fragments of a past she had forgotten starting to come back to her.

"Annul your marriage. It’s what's best for our kingdom," the king insisted. Sibylla clicked her tongue in annoyance. "Don't you see that what I’m doing is for the best?" The king looked at her, shocked, as if she had just grown a second head. "No, you can’t rule not that you’ve ever shown any interest in ruling, anyway." Sibylla hummed, a slight smirk on her lips. "You’re right, brother. As a woman, I’m supposed to have no voice, only to be a devoted wife and mother." Frustrated, the king snapped back, "And yet you disrespect your king by disobeying his orders in front of everyone! What about your duty to me and our kingdom? You and your husband humiliated me before the entire court and the common people by refusing to appear when summoned, and by questioning my authority when I personally came to see him." He paused, the weight of his position evident in his voice as he continued, "I’m trying to stabilize the kingdom, but you and your husband seem determined to tear it apart. People are already questioning my authority because I chose Guy de Lusignan as my successor. It’s hard enough to stay on the throne as a leper, especially after our parents' marriage was annulled. They see Guy as a weakness, one that can be exploited against me." His tone softened, now vulnerable, as he added, "Can’t you show the same love and devotion to me, your brother?" Sibylla smiled, her tone almost patronizing. "Brother, God cursed you because of our parents’ annulment. I’m doing everything right, fulfilling what’s expected of me as a woman. You should be here helping me, not arguing against me. Why do you have to make everything so complicated?" The king, exhausted, sighed deeply. "There’s no point in arguing any further. I’ve made my decision—I am disinheriting you."

Sibylla blinked as tears welled up in her eyes. "Baldwin?" she whispered. Baldwin nodded, confirming her suspicions. Sibylla looked down, her voice trembling as she asked, "Alix and Maria?". The two girls beamed with joy. "Mommy!" they exclaimed, rushing forward to embrace her. Sibylla felt a surge of joy as she held her daughters, overwhelmed to finally be reunited with them. As she looked up, she noticed Baldwin’s attention had shifted to his nieces. His expression was warm and affectionate as he gazed at them, a tenderness that pierced Sibylla’s heart. She realized, with a pang of sorrow, that Baldwin had never shown her the same love since she arrived here.

Baldwin knelt down and gently called to his nieces, "Do you remember your promise? Now that you’ve seen your mommy, it’s time for you to go to the place where you truly belong."

The girls giggled and replied, "Okay," before hugging their uncle one last time. Baldwin welcomed their affection with open arms, ruffling their hair and kissing each of them on the forehead. "Go," he said, though his voice wavered, betraying his vulnerability. Fortunately, the girls didn’t notice and left .

Sibylla’s heart shattered as she watched her daughters walk away. Driven by an instinct to follow them, she started to move, but Baldwin gently caught her hand, stopping her in her tracks. She turned to him, about to question his actions, but Baldwin spoke first. “They had to go; they’d stayed longer than they should have,” he explained softly. “Children aren’t meant to linger in the afterlife like we adults are. Besides, I wanted some time alone with you.”

Sibylla composed herself, knowing she couldn’t question the workings of the afterlife. Yet, she couldn’t resist asking, “How are my son and mother?” Baldwin’s response was sharp and filled with anger. “Do you think anyone would want to see you after what you’ve done?” His sudden outburst made Sibylla flinch; Baldwin had never spoken to her like that before. Her eyes welled up with tears as she struggled to hold back her emotions. Sensing her distress, Baldwin pressed on, his voice cold and demanding. “I can’t help but wonder… Why did you do all of it? Why did you betray me and our kingdom like that? Was it because I was a leper?” Tears streamed down Sibylla’s face as she protested, “How could you say that? You’re my brother; I could never hate you.” But Baldwin shook his head, refusing to listen. “You said you didn’t wish to rule, and I accepted that,” he continued. “All I asked in return was respect, but you undermined my authority by refusing to come to court. Your husband publicly insulted me in front of both commoners and nobles when he refused to answer me, even when I was carried on my litter to ask why he disobeyed his king. I was already blind, my limbs barely functioning, yet I got up from that litter and knocked on his door. He ignored me ignored his king in front of everyone, showing them all how weak I was in controlling my own vassal.” Sibylla shook her head, now openly weeping. “That’s not true, brother. I thought I shouldn’t meddle in men’s affairs. Besides, my husband said you would separate us.” Baldwin, however, was unmoved by her tears. “If it were that easy, I could have eliminated my brother-in-law and forced you to marry someone else. Sister, you’re not naive or submissive, because if you were, you wouldn’t have tricked the council into making Guy de Lusignan king.” Sibylla’s eyes widened in shock as she stared at her brother. Baldwin met her gaze and continued, “Yes, I saw everything from above. I saw how you abdicated the throne in your husband’s name. You knew exactly what was happening; otherwise, you wouldn’t have been able to deceive the council. I watched as you dismantled my kingdom so easily after my death, as if my words and choices meant nothing to you. You knew how much I despised him, yet you went ahead and did everything I expressly didn’t want. Did I do something so terrible to deserve such disrespect from you?”

Sibylla tried to justify herself, but Baldwin had no interest in her excuses. “I tried to understand your actions, but no matter how hard I tried, I couldn’t. How could I, a leper cursed by God, earn the respect of both my enemies and allies, yet fail to earn my own sister’s respect? You never stood up for me against your husband, not even when it came to my health. Back when my condition wasn’t as severe, I needed Tyre for medical reasons.” Baldwin paused, a bitter smirk crossing his lips. “Remember?”

Sibylla swallowed hard as the memory came rushing back.

Baldwin dismounted from his horse and approached the residence of Guy de Lusignan. He signaled the guards to come closer. "Tell your lord I wish to exchange Jerusalem for Tyre," he instructed. The guard bowed and departed. It wasn’t long before the guard returned, his expression clearly indicating that the news was unfavorable. Bowing again, he reported, "The Lord refuses to exchange the city, stating that it is of no benefit to grant such a favor to yourself." Baldwin was deeply offended by Guy’s dismissive response but decided to try once more. "Tell him that Tyre is essential for my health and that I am willing to trade it for the holy city of Jerusalem," he said firmly. The guard, visibly anxious, left to deliver the message again. When the guard returned, he brought another scathing reply from Guy. The people around Baldwin were astonished by the continued rudeness. The guard, fearful of Baldwin’s reaction, attempted to excuse Guy’s behavior by saying, "The Lord is not very skilled at communication," but it was too late. The insult had already been delivered, and the damage was done. In the twelfth century, such disrespect was intolerable for any king, and Baldwin left the encounter in evident displeasure.

Sibylla smiled as she reminisced, saying, "You could still walk back then." Baldwin was uncertain whether Sibylla was being nostalgic or attempting to humor him. His frustration flared as he replied, "The coastal climate of Tyre was beneficial for my condition, which is why I was willing to exchange the holy city of Jerusalem for it. Yet, despite how Guy treated me, you repeatedly took his side. Why did you persist in supporting him after everything he did to me?" Sibylla, trembling with pain, responded, "I didn’t understand back then. I loved him too much to question him." Baldwin raised an eyebrow and pressed, "Love? Or was it something else? Did you harbor a personal grudge against me?" "I am sure the man who you loved, for whom you fought against your family and gave up MY kingdom wouldn't even personally mourn your death but mourn the claim he lost through you" In her fearful state, Sibylla defended herself, "Please brother, don't talk to me like that, it hurts" "I listened to you when you advised me to marry William Longsword, and I also obeyed when you instructed me to marry Guy de Lusignan, despite not knowing him well. Just as I obeyed you, I obeyed my husband." Baldwin sneered, "Imagine if Father had refused to annul his marriage out of love. He would have been seen as a fool. You, however, have the advantage of being a woman here. Nobody would have questioned you, but they would have questioned me if I choose my decisions emotionally" "They had already questioned me when I failed to appoint a proper successor. I could have been ruthless, but I loved you too much to do anything that would deeply hurt you and therefore now I look ike a fool in front of everyone" He paused, his laughter fading into a sigh of exhaustion. "Honestly, I find it hard to believe you were so naive. If you were truly that submissive, you would have married someone else when I asked. Jerusalem might have survived longer." Sibylla looked horrified. "How could I annul my marriage with a living husband and marry someone else while he was still alive? I couldn't jeopardize the kingdom by angering God. I cared for the kingdom enough to call for the Third Crusade."

Baldwin retorted, "Our kingdom wouldn’t have suffered so if you hadn't crowned Guy as king again. Your husband surrendered the birthplace of our Lord because he lacked both the skills of a king and a general. Jerusalem wouldn't have fallen so quickly if it weren’t for Guy. Your husband’s incompetence led to the city's fall and the suffering of its people. We had our enemies boasting about their atrocities especially r**pe committed against women. Everyone knew Jerusalem would fall if Guy continued to rule. I publicly dismissed him while I was alive, yet you disregarded my authority as king by not appearing in court when summoned. You crowned Guy again despite the pleas of the entire nobility. Even our enemies were baffled by your choice. You went to Ascalon with your daughters to defend the city, only to surrender it to Saladin in exchange for Guy's release, but the sultan kept him imprisoned anyway."

Baldwin's voice grew weary as he expressed his frustrations. Baldwin walked away from Sibylla, standing at the edge of the clouds, his posture reflecting a profound sense of brokenness. Sibylla felt a surge of fear as she saw him like this, a sight that reminded her of the last time she had witnessed him so shattered after Guy's massacre of the Bedouin.Just when Sibylla thought things couldn’t get worse, she heard Baldwin whisper words she wished she had never heard: "At the cost of my life." The whisper brought back painful memories she struggled to forget.

Bedouin were a nomadic tribe under royal family's protection. They provided information about the Egyptians' movements. Guy's massacre of the Bedouin of the royal fief of Darum, who were under royal protection of Baldwin shocked him. She had first time seen him so broken and suffering from severe anxiety from at that time. He shortly suffered from fever and died. Sometimes Sibylla wondered if Guy's action indirectly caused his death. Sibylla felt immense guilt feeling in her bones now that her suspicion in proved to be true. Baldwin generally keeps falling ill all the time with new diseases. Sibylla believed that she was overthinking when she felt somehow her husband was related to it. Alas, her suspicion has been proved true. She really never wished to know about it."Jerusalem, the place for which I sacrificed my body and soul," Baldwin said with a wistful smile, reminiscing about his past. "I remember when I was a child, surrounded by physicians who rubbed oils on my body and performed bloodletting. I could sense something was terribly wrong, which led to my isolation. I lost all my childhood friends, and I came to realize that my condition was the reason for this separation. When I finally understood my disease, I accepted it, believing I was cursed. Defending Jerusalem was not just a duty but a way to escape the torment of my condition." Baldwin paused, looking at his hands. "I loved being a king and not just a helpless leper. Jerusalem reminded me that I could still be a king despite my curse." He continued, smiling once more, "I did everything for Jerusalem, the designated birthplace of our Lord, even at the cost of my health. Despite being advised to rest and relinquish my office, I refused." The smile faded from his face as he spoke sadly. "To have those very places taken away, as if my sacrifices meant nothing," he said, turning to Sibylla with a face full of pain. "I waited for you to seek answers so that I could finally move on peacefully. Everyone I met in the afterlife told me to let go. They advised me to accept that I had earned my place in heaven and it was time to leave. I could go if I wanted, but I truly needed an answer: Why did you do all that?" Sibylla began to beg, tears streaming down her face. "Please, brother, no more. I can't bear to hear any more. I was blinded by love. I thought I was making things right by following my husband's commands. I believed he was the best choice to rule the kingdom. Please forgive me. It hurts so much." Baldwin pinched the bridge of his nose in frustration. "Is love the only justification for everything? Even at the expense of my health? I endured more anxiety from your husband's actions than I did in the Battle of Montgisard. How could you be so naive? You could have ruled alone, with no one threatening your power, unlike our grandmother, Queen Melisende." Baldwin’s expression grew calm as he faced his sister. "If you truly loved me, you would never have given up Jerusalem the place I protected with my life. I had hoped for a different answer, Sibylla, but I must accept that you loved your husband more than you loved me."

With that, Baldwin turned away from Sibylla, his back turned to her. Desperate to end their conversation on a more positive note, Sibylla ran after him. "Brother, please wait," she pleaded as she chased him. Baldwin began to slowly fade into the clouds, and Sibylla felt herself slipping away as well. As her final moments flickered before her eyes, tears streamed down her face until, with one last, anguished cry, she too vanished.

Meanwhile in Acre:

"So the queen is dead". Muttered an elderly knight. Another knight complimented the queen "She was a good devoted wife who shed tears when her husband was held hostage". All the others nodded their head in agreement.

"So what happens to Jerusalem then" questioned another knight. The question laid heavy in the air. Which was answered by solem reply

"I don't know"

[gatheringbones]

[“Like every profession, psychiatry has a degree of autonomy in their research and practices, yet they are ultimately shaped by current power relations. The priorities of the profession, therefore, tend to mirror the priorities of capitalism. To illustrate this point with another example, Lane (2007) has profiled how shyness became the new mental disorder of social phobia (since relabelled as social anxiety disorder) in the DSM-III (Chap. 4). With no validity for such a diagnosis, a number of parties are implicated in this case of medicalisation including the Pfizer pharmaceutical corporation (who funded a number of task force meetings at the time) and Robert Spitzer’s fight with the psychoanalysts for control of diagnostic constructions. However, these issues are predated by the profession’s own research focus on shyness which can be traced back to the mid-1960s, with a small number of patients showing symptoms of anxiety around social situations such as visiting the office canteen, attending parties, or being involved in public speaking (Lane 2007: 71).

As would progress further under the neoliberalist doctrine, the development of new classifications such as social phobia would appear to the profession to originate in some sort of “evidence base” (which are actually people’s problems in adjusting to changing arrangements of capital in arenas such as work, home, and the school). Psychiatry then does in fact maintain a key role in setting the agenda for what potentially ends up in the DSM; however, the origins of that agenda are external to the profession, dictated by wider social and economic forces. By the time of the DSM-5, psychiatric diagnoses are blatantly mirroring neoliberal ideology in relating mental illness to underperformance. With the diagnostic criteria for premenstrual dysphoric disorder (PMDD), for example, the manual (American Psychiatric Association 2013: 172, emphasis added) states that “[t]he symptoms are associated with clinically significant distress or interference with work, school, usual social activities, or relationships with others (e.g., avoidance of social activities; decreased productivity and efficiency at work, school, or home).” Thus, the prevailing ideological values of our time—for instance, to be productive and efficient in all aspects of our lives—is conceived through psychiatric discourse as a common sense mental health message. Are you failing within neoliberal society? Then you might have a mental illness.

As Conrad and Potter (2000: 561–562) have summated of psychiatry’s diagnostic project here, the process is necessarily historically and culturally contingent: “[c]ertain diagnostic categories appear and disappear over time, reflecting and reinforcing particular ideologies within the ‘diagnostic project’ (the professional legitimization of diagnoses), as well as within the larger social order.”]

bruce m.z. cohen, from psychiatric hegemony: a marxist theory of mental illness, 2016

[political-us]

The recent shutdown of the U.S. Agency for International Development (USAID) has significant implications for Americans:

1. Job Losses and Economic Impact

Domestic Employment: Thousands of USAID staff and contractors have been placed on leave or terminated, leading to immediate job losses. Economic Ripple Effect: The cessation of USAID-funded projects affects American businesses and non-profits involved in international development, potentially leading to further economic downturns.

2. National Security Concerns

Global Stability: USAID's programs contribute to global stability by addressing issues like poverty, disease, and conflict. Their absence may lead to increased global instability, indirectly affecting U.S. national security.

Health Threats: The halt of health programs, such as those combating HIV/AIDS and malaria, could lead to the resurgence of diseases, which may cross borders and pose health risks to Americans.

3. Diplomatic and Global Standing

International Relations: The abrupt withdrawal from international commitments may strain relationships with allied nations and diminish U.S. influence in global affairs.

Moral Leadership: The U.S. has long been seen as a leader in humanitarian aid; stepping back from this role could damage its reputation and moral authority on the world stage.

4. Domestic Program Impacts

Educational and Research Initiatives: USAID funds various educational and research programs within the U.S. The shutdown may lead to reduced funding for these initiatives, affecting students and researchers.

Community Support Programs: Some domestic programs, especially those in agriculture and health that receive USAID support, may face cutbacks, impacting local communities.

In summary, while the shutdown of USAID primarily affects international aid, the repercussions for Americans are substantial, spanning economic, security, diplomatic, and domestic spheres.

[dreaminginthedeepsouth]

An upwelling of outrage spreads across America

January 29, 2025

Robert B. Hubbell

Trump plunged America into chaos on Tuesday as the implications of his unconstitutional “freeze” on federal grants and loans began to sink in. In a gigantic miscalculation, Trump risked driving the US economy into a tailspin that would take years to overcome.

Or not.

Trump has the opportunity to blink (voluntarily or involuntarily)—but that window is closing rapidly. There are three offramps to this crisis caused by his illegal “freeze” on all federal grants and loans:

Public outrage will force Trump to retreat. A massive upwelling of public outrage is spreading across America. It may take a day or two for MAGA members of Congress to absorb the outrage from their constituents who suddenly realize Trump's thoughtless action has threatened their constituent’s economic security. Millions of Americans have been plunged into uncertainty over government benefits, loans, grants, and payments. They are letting their representatives know how they feel. See Politico, Trump's spending freeze spreads chaos across US. Indivisible has called on congressional Democrats to oppose all nominees until Trump repeals the unconstitutional freeze, saying, “Shut down the Senate.”

The markets may tell Trump to retreat. In a day or two, the money managers on Wall Street will realize that freezing government benefits to seniors, students, veterans, families, government contractors, and people in general will cause a sudden, massive contraction in consumer spending. A shrinking economy will instill fear in the most bullish fund managers. If the markets drop over worries of recession, Trump will hear from the only constituency he fears: Megadonors upset over losses in their portfolios.

Private litigants should be able to obtain an injunction. It is also possible that a judge will pick up a copy of the Constitution and read it. If they do so, they will grant a permanent injunction against Trump's unconstitutional order. On Tuesday, a federal judge granted an “administrative stay,” but that stay was ambiguous and limited. The stay was designed to allow the parties to submit briefing for a hearing next Monday. Moreover, the stay appeared to allow some portions of the “freeze” to remain in effect. See CNN, Judge temporarily blocks part of Trump administration’s plans to freeze federal aid.

Trump attempted to quiet the growing sense of panic by claiming that the freeze would not affect individuals receiving “direct assistance” from the federal government. That assurance is illusory because most federal grants and loans are not paid directly to individuals but rather, are paid through states, federal agencies, and third-party programs that manage federal grants and loans—e.g., Head Start, scientific research grants, federal infrastructure projects, educational subsidies to state schools, programs to support and house veterans.

And despite the assurances from the White House that “direct assistance” to individuals would not be affected, the facts proved otherwise. The Medicaid portal was closed to states (who administer Medicaid funds) for much of the day. See Quartz, Trump Medicaid freeze locks 72 million Americans out of their health insurance. The administration claimed that the shutdown of the Medicaid portal was a “fluke” unrelated to the freeze—a lie so transparent it hurts to repeat it.

Here is the (semi) good news: The Trump administration has already begun to walk-back the reach of the ill-considered freeze, claiming that the following grants and loans are not affected by the freeze: Medicaid, student loans, small business loans, and SNAP food assistance. It is likely that as the media and constituents identify more crucial programs—like food inspection, air traffic control improvements, law enforcement subsidies, veterans’ programs--the administration will make case-by-case exceptions that will swallow the rule.

Although millions of Americans may suffer economic hardship and extreme anxiety in the short term, the financial crisis of withholding hundreds of billions of dollars with no notice may be averted. But the constitutional crisis remains front and center. We cannot allow the constitutional questions to be lost in the understandable focus on the financial implications of Trump's order.

Trump's order is unconstitutional—and it is important that we not lose sight of that fact

Many in the media are downplaying the illegality and unconstitutionality of Trump's “freeze” order. Andrea Mitchell of MSNBC described the illegal order as “controversial.” The New York Times covered the freeze order as a political kerfuffle: “Trump’s ‘Flood the Zone’ Strategy Leaves Opponents Gasping in Outrage.” The NYTimes Editorial Board had nothing to say about Trump's blatant effort to rewrite the Constitution by demoting Congress to an advisory body subject to being overridden on presidential whim.

Congressional Republicans defended the order’s legality. The few Republicans who criticized the order did so only on the ground that it “went too far” in affecting their constituents. Susan Collins said,

I think the administration needs to be more selective and look at it one department at a time, for example. But make sure important direct service programs are not affected.

Here’s the problem with Susan Collins’s analysis: The order is unconstitutional not because it is overbroad but because the president has no authority to freeze funds appropriated by Congress. Period. See ABC News, Trump funding freeze a blatant violation of Constitution, federal law: Legal experts.

As I wrote yesterday, we need to set aside euphemisms and niceties in raising the alarm. Rebecca Solnit (of The Guardian) rose to the challenge with a post on BlueSky:

[T]hat was a coup last night in case no one mentioned that to you. The executive branch seized the power of the purse the Constitution gave to Congress, which is a pretty authoritarian / illegal consolidation of powers move. Time to go yell at your reps, the media, etc.

Senator Angus King of Maine said,

This is a profound constitutional issue. What happened last night is the most direct assault on the authority of Congress, I believe, in the history of the United States.

See Charles P. Pierce, Esquire, Trump’s Federal Grant Freeze Looks Like an Assault on the Authority of Congress.

The grassroots organization Indivisible likewise pulled no punches with a special alert to its members, headlined: Trump’s Dictatorial Power Grab: Chaos, Cruelty, and Constitutional Collapse.

Indivisible wrote:

Congress Controls Federal Spending. The Constitution explicitly gives Congress—not the president—the power to allocate and control federal funds. By freezing funds Congress appropriated, Trump is undermining a foundational principle of democracy. The Impoundment Control Act (ICA). Enacted after Nixon’s abuses, the ICA explicitly prohibits the president from withholding funds appropriated by Congress without following a strict process. Trump has not followed this process, and in many cases, the ICA outright bars the impoundment of these funds.

Indivisible suggests a “no holds barred” response (with which I wholeheartedly agree):

Refuse to Negotiate. Trump is using federal programs as hostages in a power grab. Democrats must refuse to engage in any funding or debt ceiling negotiations while this freeze remains in place. No compromises with dictatorship. Sound the Alarm. Every senator must become a megaphone for what’s at stake. Go on TV, hold town halls, and flood social media with the stories of families who will lose food, homes, and healthcare because of Trump’s chaos. Back Legal Challenges. Support every lawsuit challenging this freeze. File amicus briefs, amplify cases, and make it clear this isn’t just morally wrong—it’s illegal.

All good suggestions. And the point about backing legal challenges may be the best way to fight this power grab. US District Judge Loren L. AliKhan issued a short-term administrative stay to allow further briefing on an application for an injunction. See CNN, Judge temporarily blocks part of Trump administration’s plans to freeze federal aid.

The lawsuit before Judge AliKhan makes an important point: The memo was issued by the Acting Director of the OMB. Per the lawsuit, the OMB has no authority to direct agencies to freeze funds appropriated by Congress. Per the plaintiffs in the lawsuit:

The [OMB] Memo fails to explain the source of (the Office of Management and Budget’s) purported legal authority to gut every program in the federal government.

Good point. While the OMB is integral to the preparation and monitoring of congressional appropriations, OMB has no authority to override a congressional appropriation. See, generally, Congressional Research Service, Office of Management and Budget (OMB): An Overview.

Here are the takeaways:

First, the freeze threatens the separation of powers specified in the Constitution. We must not allow that point to be lost in the chaos and pain that the illegal order will cause.

Second, the upwelling of public outrage spreading across America is already having an impact! This is the path forward! We must do more of it consistently over the long term. We are off to a good start!

[Robert B. Hubbell Newsletter]