Oregonians have made their state the first in the United States to decriminalize use of all drugs, including cocaine and heroin, after voting to approve Measure 110, according to the New York Times and the Associated Press.

The approval of the measure, one of several drug-related initiatives on the ballot November 3, doesn’t mean that the state has legalized the drugs.

Instead, Oregon will remove criminal penalties — including prison time — for possessing small amounts of currently illegal drugs, and will give those caught with drugs the option of either paying a $100 fine or getting a “completed health assessment” at an addiction recovery center. The sale of drugs will still be illegal, so don’t expect stores or pharmacies selling cocaine or heroin to pop up (at least legally).

The state will also now redirect existing marijuana sales tax revenues and savings from the measure — for example, savings from reduced prison time — toward setting up a more expansive drug addiction treatment and recovery program.

Advocates say Measure 110 replaces a criminal justice-centered approach to drugs with a public health one

Supporters of decriminalization argue that drug misuse and addiction are public health issues, not problems for the criminal justice system. They claim that criminal prohibition leads to hundreds of thousands of unneeded, racially disparate arrests each year in the US. And that this is a costly endeavor, straining police and contributing to mass incarceration, that does little to actually help people struggling with drug use.

It would be better, these advocates say, to put all that money toward education, treatment, and harm reduction services. And to the extent that drug use does contribute to crime and violence, there are other laws in place, including for drug trafficking, that can cover those issues without making possession itself a criminal offense.

Opponents argue that decriminalization removes a powerful deterrent to trying and using drugs, potentially fueling more drug use and addiction. They claim criminal penalties attached to drug possession can also be leveraged — through, say, drug courts — to push people into addiction treatment they otherwise wouldn’t accept. And they argue that to the extent there are real racial disparities in such arrests, that’s a problem with bias in law enforcement and systemic racism across American society in general, not necessarily a result of drug prohibition itself.

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Some critics also questioned if the ballot initiative’s reallocation strategy will really direct sufficient funding to addiction treatment. The campaign in support of the measure claimed, citing state analyses, that it would at least quadruple state funding to recovery services.

Oregonians previously legalized marijuana. Although some states have ended felony charges for use of all illegal drugs, Oregon is the first in the US to take the more aggressive step to decriminalize them.

But Oregon isn’t the first place in the world to decriminalize drugs. Portugal did it in 2001, earning a lot of continued media coverage (including at Vox). The effects seemed, on net, positive: Coupled with boosts to drug addiction treatment and harm reduction services, drug decriminalization seemed to lead to more drug use overall but less problematic use.

Citing Portugal’s model, critics of the war on drugs have long clamored to bring the model to the US. With Oregon’s vote, they now have a launching pad — one to not just prove that the idea can work in the US, but also to maybe inspire other states to take more aggressive steps toward ending their drug wars.

For more on Oregon’s Measure 110, read Vox’s explainer.

TYRONE’S FIRST WIN of the Division 1 campaign arrived against Kildare on Sunday despite the absence of a number of established players. 

There were minus the services of the four (Peter Harte, Kieran McGeary, Padraig Hampsey and Michael McKernan) that shipped red cards in round 2 against Armagh plus injured pair Ronan McNamee and Mattie Donnelly.

The nature of their second-half fightback against the Lilywhites was even more impressive given the five players that departed the Red Hand panel during the off-season.

Mark Bradley, Tiernan McCann, Ronan O’Neill, Hugh Pat McGeary and Michael Cassidy all walked away after winning their All-Ireland medals last season. Their exits left question marks over Tyrone’s bench strength as they face into the defence of their Ulster and All-Ireland crowns in 2022. 

The Red Hand infused the panel with talent from the vibrant club championship over the winter. 

“We had a lot of changes, a lot of changes in general this year with men returning and things like that,” said joint manager Feargal Logan after the game. 

“That’s what a panel is for. That’s the value from today, the take-home message, those boys there.”

Nathan Donnelly was a new call-up after his consistent performances for Killyclogher in recent club campaigns and he’s started all three league games so far.

Padraig McNulty, who made his debut under Mickey Harte in 2015, rejoined the panel, having last featured in 2018. He was recalled after showing strong form for Dungannon Clarkes, who he skippered to the Tyrone SFC title in 2020. 

McNulty became the 25th player to see game-time for Tyrone in the Allianz Football League.

Perhaps it’s unsurprising given they are the reigning All-Ireland champions with a panel of players mainly in their mid-to-late 20s, but Tyrone have not been one of the counties who’ve cast the net wide in search of talent in Division 1 so far. 

Only two sides have experimented less than the Red Hand: Monaghan and Kerry.

As a county with a small playing pool, the Farney have regularly been the team who’ve used the least amount of players over league campaigns in recent years.

Seamus McEnaney has tended to put out his strongest available team since returning to the job, and he required just 23 players in their first three outings. Veteran marksman Conor McManus arrived off the bench in the opening two rounds before he started against Armagh last weekend, in a game where Kieran Hughes made his seasonal bow. 

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Jack O’Connor lifted the Division 1 crown on three occasions in the 2000s as Kingdom boss and consistency of selection, with 24 players fielded so far, indicates he’s looking to challenge for spring honours again in 2022. 

Dan O’Donoghue has been a welcome addition to Kerry in defence.

Source: Ben Brady/INPHO

Dan O’Donoghue, Greg Horan and Dylan Casey were Kerry’s three debutants so far in the league, while injured players such as David Moran, Stefan Okunbor and new captain Joe O’Connor will come into the mix down the line. 

With survival in the top flight all but assured, O’Connor did promise greater experimentation across the remaining fixtures. Jack Savage and Tony Brosnan, for instance, should be afforded a couple of starts after making substitute appearances in all three games. 

For some teams, the short gap between league and championship has increased the necessity to get key men up to speed in the spring but for others, such as Dublin, there remains a need to explore their panel for potential championship starters.

Dublin have handed game-time to 29 players inside the first three weekends of action, more than any other team in the division bar Mayo. 

In Dessie Farrell’s first league campaign in 2020, Dublin used 38 players and heavy experimentation remains a feature two years later.

The Sky Blues, who introduced 14 new squad members this year, are rooted to the bottom of the table after shipping three straight defeats but the manager has insisted their focus remains on the championship. 

Lee Gannon, Cameron McCormack, Ross McGarry, Lorcan O’Dell, Darragh Conlon, Killian McGinnis, CJ Smith, Alex Wright and Harry Ladd all made their league debuts over the past few weeks – by far the most of any county.

Emmet O Conghaile and Cian Murphy, who’ve been on the fringes of squads in the past, have logged minutes and 29-year-old Ryan Basquel started two games and came off the bench in a third. 

Considering James McCarthy, Con O’Callaghan, Robbie McDaid, Paddy Small have yet to come into contention, Dublin’s figure by the end of the league could well extend to the high 30s once again. 

Mayo are level with Dublin on 29 players used as they examine their options ahead of the summer.

Seven members of James Horan’s squad made their first appearances of the season against Dublin on Saturday night. 34-year-old Kevin McLoughlin was eased back into action after his extended club campaign with Knockmore, as established stars Oisin Mullin, Matthew Ruane and Enda Hession also returned. 

Aidan Orme grabbed a goal on his second appearance in Division 1.

Source: James Crombie/INPHO

Donnacha McHugh,  Jack Carney and Sam Callinan, the latest athletic wing-back to emerge from the county, were their only league debutants to date as Aidan Orme made his Division 1 bow, having appeared in the second tier last year.

Other familiar names such as James Carr and Cillian O’Connor will return from injury in the coming weeks.

Shane O’Donnell was Donegal’s most impressive rookie blooded under Declan Bonner, scoring two points as they struggled for long spells away to Kerry. Donegal are third in the table on 28 players tested, with Charles McGuinness, Mark Curran and Rory O’Donnell their other notable newcomers.

Donegal have been badly hampered by injury to date. Caolan McGonigle, Michael Murphy and Michael Langan all appeared in the first round but were forced to miss recent games.

However, Oisin Gallen and Daire Ó Baoill made their seasonal debuts in Killarney after recovering from problems and will add depth to Bonner’s panel. Jamie Brennan hasn’t seen a minute yet as he recovers from injury.

In fourth place on the players fielded table is Division 1 newcomers Kildare, who’ve mixed battling for points with getting a look at 27 players.

11 of those have started their encounters with Kerry, Donegal and Tyrone. In the third game, Glenn Ryan welcomed back Alex Beirne, Fergal Conway and Darragh Kirwan from injury off the bench. That trio are likely to come into contention for starting places in the weeks ahead, adding to Kildare’s depth.

Despite their strong start to the year, Armagh have spread minutes around the panel. Kieran McGeeney has used 26 players across their three games, leaving them ahead of Tyrone, Kerry and Monaghan.

Conor Turbitt and Oisin O’Neill became the latest two to make league appearances after their arrived off the bench against Monaghan. 

But McGeeney’s first XV has been remarkably consistent, with 13 players starting all three ties against Dublin, Tyrone and Monaghan.

Players used in Division 1 after 3 games

• Dublin – 29
• Mayo – 29
• Donegal – 28
• Kildare – 27
• Armagh – 26
• Tyrone – 25
• Kerry – 24
• Monaghan – 23

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President-elect Joe Biden has nominated Michael Regan, secretary of the North Carolina Department of Environmental Quality, to head the Environmental Protection Agency, according to the transition team. Regan has two decades of experience in environmental policy and positions at the Environmental Defense Fund as well as the EPA, and would be the first Black man to run the agency in its 50-year history if confirmed.

Regan and the Biden administration will need to not only restore our nation’s premier environmental regulator but also remake it, adapting it to tackle mounting environmental problems against which it has long faltered, from climate change to rampant environmental injustice to toxic pollutants old and new.

It might seem like an impossible task, given that climate-linked disasters keep multiplying, many curbs on greenhouse gas emissions have vanished, and environmental enforcement has plummeted. But our new leaders and all Americans can take inspiration from how we have done it before.

Fifty years ago, our rivers were on fire, smog choked our urban centers, and state and local governments struggled to respond. In the single month of December 1970, President Nixon opened the EPA, its new head William Ruckelshaus came out swinging against water polluters and industry-dominated state pollution boards, and Congress finalized the Clean Air Act, which Nixon then signed into law.

Since then, the EPA has brought substantial improvements in our air, water, and dealings with hazardous waste, benefiting not just our health but also our economy. Over the past four years, however, EPA political appointees tied to industries regulated by the agency have set about stripping this vital agency of its power to act. Tragically, they’ve done so even as environmental pollution still contributes substantially to premature mortality, cancer, and heart disease, as its effects still weigh most heavily on our society’s most vulnerable and exploited, and as climate disasters impose ever more unmistakable impacts on Americans’ health and well-being.

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What can be done to reverse the EPA’s systematic weakening under Trump, while retooling it to meet today’s challenges? The wisdom of staffers as gathered from the Environmental Data and Governance Initiative’s EPA oral history project and interwoven with our own analysis suggests there’s much that a Biden administration and the EPA itself can do.

Here are 10 things the new leadership should do to fix the EPA.

1) Take quick climate action

As the world’s largest historical emitter of greenhouse gases and still the second-largest annual contributor, the US has for too long shirked its global duty in helping alleviate the climate crisis.

The first step to rectifying this will be rejoining the Paris climate agreement and then translating our Paris commitments into policies that speed emissions reductions, a job that the Clean Air Act and the courts have placed largely in EPA’s hands. To make up for four years of EPA inaction under Trump, the Biden EPA must reverse the Trump administration’s rollback of Obama-era policies for curbing greenhouse gases and strengthen them in durable ways including possible legislation, and improve emissions reporting so that everyone can easily follow policies’ impacts.

2) Restore the budget and staff

The EPA’s staff has declined 22 percent since 1999, and its inflation-adjusted budget is now less than in 1979. Its budget has shrunk despite added responsibilities, limiting its ability to carry out longstanding work such as enforcing the Clean Air and Water acts and ensuring clean drinking water nationwide, while impeding its response to newer challenges, from tracking and lowering greenhouse gas emissions to preparing for and responding to the heat waves, wildfires, superstorms, and other threats posed by climate change.

To start fixing that, President-elect Biden should propose — and Congress should approve — a 10 percent or more increase to the agency’s funding. This would allow the EPA to hire adequate staff to meet its current responsibilities and decisively tackle climate change.

3) Keep industry out

In the Trump EPA, political appointees — as well as scientific advisers — have had extensive ties to industries regulated by the agency (such as the fossil fuel and chemical industries). But the agency’s decisions must be based on science and the public’s health, rather than an industry’s bottom line. The federal government needs to create better ways to prevent these sorts of conflicts of interest that undermine sound science and public confidence.

4) Make environmental justice a priority

The EPA has long struggled with how much more people of color are exposed to pollution. To better rectify this, the Biden administration should prioritize environmental justice not just through agency-wide administrative actions (which can be backpedaled later), but by advocating for greater legislative authority in this arena.

Among the promising recent legislative proposals, a proposed Public Health Air Quality Act mandating more fenceline monitoring would greatly aid the agency’s ability to recognize and respond to these communities’ dilemmas. An environmental justice bill passed in New Jersey as well as a similar federal bill introduced by Sen. Cory Booker (D-NJ) would also give the agency stronger legal tools to limit pollution in overburdened communities.

5) Tackle toxic chemicals

The EPA has had limited success ensuring the safety of chemicals used in everyday products, guarding against lead contamination of drinking water, and banning chemicals like asbestos that cause deadly diseases.

To tackle these toxics, the agency should improve implementation of the 2016 Frank R. Lautenberg Chemical Safety for the 21st Century Act. It should also strengthen air quality and other standards to prioritize protection of pregnant women, infants, and children from hazardous chemicals. And it should do more to protect children from lead — one way to do this is to dedicate funding to rapidly replace the millions of lead service lines that still carry drinking water in many parts of the country.

6) Reinvigorate science

The EPA’s ability to protect human health and enforce environmental laws hinges on science and scientists. But during the Trump administration, scientists were sidelined from top-level decision-making, and hundreds left the agency, weakening its expertise. To make the EPA a place where top scientists want to work means improving the hiring system, providing them with sufficient resources for their work, and heeding their knowledge and recommendations. The EPA must reinvigorate its scientific workforce, advisory system, and research to ensure that environmental decision-making is grounded in science.

7) Enforce the law

The EPA’s power and willingness to enforce environmental laws has undergone long-term erosion but dropped off precipitously under Trump — even as noncompliance remains frequent. To increase pressure on polluters on behalf of the public, the EPA needs to step up enforcement, especially when and where the states do not. To do so, its enforcement capacity needs rebuilding (environmental and compliance staff fell 23 percent under Trump), and from the outset, the new administrator and his team need to announce and pursue a serious commitment to taking on violators.

8) Upgrade data

Much of the federal government’s existing environmental data infrastructure remains fragmented, partial, and outmoded. The EPA should update technology for measuring and monitoring pollution and better integrate its data systems across programs. This promises to improve the agency’s work by, for one, enabling more prompt targeting of violators. It should also strive to help people and advocacy groups better understand what is going on.

Even the EPA’s best current digital interfaces pose challenges for ordinary citizens seeking to learn about nearby facilities, from unfamiliar acronyms to unexplained numbers. EPA data on polluters as well as the agency’s own actions or inaction need to be made more transparent, accessible, and interpretable to the public, so as to better inform communities about the environmental risks surrounding them. Making it easier to analyze environmental justice impacts at the community level should be an agency priority.

9) Be a better steward of information

The EPA should be a national force for educating the public about the science that grounds our environmental laws. Under Trump, this agency slid in the opposite direction, removing not just references to climate change but much other scientific information from its websites, abandoning many environmental education efforts, and even turning its press office into a megaphone for conservative op-eds by its political appointees. The incoming leadership should ensure not just that the agency provides factual, technically accurate, and user-friendly information, but that it actively promotes environmental science literacy.

10) Partner with the American public

To accomplish many of these goals, the agency needs support from advocacy groups, educators, and other environmentally concerned citizens. These partnerships will provide new avenues for communicating accurate information about environmental problems, including more “citizen science” to enhance the agency’s work. They will also fortify efforts to push for local, state, and federal actions to improve environmental health and address climate change, and to further strengthen the EPA’s abilities.

For 50 years, the EPA has played a critical role in making our air cleaner, providing safe drinking water, and ensuring that rivers no longer spontaneously catch fire. Let’s rebuild and strengthen the agency so that it is equipped to prevent the fires, both literal and figurative, of our present and future.

Marianne Sullivan is a professor of public health at the William Paterson University of New Jersey and a member of the Environmental Data and Governance Initiative (EDGI).

Christopher Sellers is a professor of history at Stony Brook University, a research fellow at the Institute for Historical Studies at the University of Texas at Austin, and on the coordinating committee of EDGI. He is the author of Crabgrass Crucible: Suburban Nature and the Rise of Environmentalism in 20th-Century America, and forthcoming books on the history of environmental politics in Atlanta, Texas, and Mexico.

In the United States, there have been 17 million reported cases of Covid-19 — about 5 percent of the population. Millions more have been infected and either did not get tested or didn’t have symptoms to begin with.

Vaccines are slowly rolling out — first to front-line health care and high-risk people, and next, likely to other essential workers, followed by people ages 65 and older and those with preexisting conditions.

But it’s reasonable to ask, given that there are well over 100 million people in these groups and not nearly enough vaccine supply for them right away: Should people who’ve already had Covid-19 be vaccinated too?

After all, the body mounts an immune response to the virus during an infection. In lab studies, scientists find that most people who contract the virus develop neutralizing antibodies to it. These antibodies are the immune system proteins that bind to viruses and render them harmless.

So a person who has had the virus likely has developed some level of immunity. Still, immunologists and vaccine experts say these people can — and perhaps should — get vaccinated anyway, should a vaccine become available to them.

“If I, personally, had Covid, I would still like to be vaccinated,” Alexander Sette, an immunologist at the La Jolla Institute for Immunology, says.

He and other immunology and vaccine experts can explain why.

Why people who have had Covid-19 should still be vaccinated

The biggest reason everyone — whether or not they had Covid-19 in the past — should be vaccinated is because different immune systems have responded very differently to the virus.

In general, Sette says, a body will mount a durable immune response. “In fact, we’ve seen it persist up to eight months,” he says. But this is only the case for 90 percent of people. “For 10 percent of people, they don’t seem to have a good immune response eight months out.”

There have been some documented cases of reinfection, which suggests that in some people, the immunity that comes from a first infection is either weak or wanes over time (scientists still don’t know how common reinfection is). Generally, scientists have told us, the worse the first infection, the stronger the immune response will be.

The thing is, “we have no way to tell,” he says, at least easily and feasibly, if a formerly infected person is in the 90 percent or in the 10 percent. Not taking precautions like masking and social distancing, or avoiding a vaccine after an infection, he says, is like “driving a car where you’re 90 percent sure the car has brakes.”

This has been the story of the whole pandemic: The human body’s response to the SARS-CoV-2 virus that causes Covid-19 has been extremely variable. Some people don’t get symptoms at all. Some people end up dying of the infection. “Some develop very high levels of neutralizing antibodies and are likely in no need of vaccines, while others develop undetectable levels of neutralizing antibodies,” Yale immunobiology researcher Akiko Iwasaki explains in an email.

So, quite simply: A vaccine helps level out that variability. People whose immune systems didn’t produce a robust response can catch up to those who did. According to Sette, there’s less variability in people’s immune responses to the Covid-19 vaccines than there is to natural infection.

And, again, individuals who have had Covid-19 can’t really gauge their own levels of immunity. Yes, a person could potentially get an antibody test, to see if there are any in their bloodstream.

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But the immune system has many, many other components, from memory B cells that can be activated to produce antibodies in the future, to T cells, which kill and destroy infected cells. These are not commonly tested for. And even if an individual could be tested for all the components of an immune response to SARS-CoV-2, it’s still hard to know what it all means for a second infection. Scientists still don’t understand the “correlate of protection” for Covid-19. That is: What is the precise right mix of immune system cells for a particular person that would prevent them from getting infected again?

Sette says it’s a “reasonable argument” to suggest that maybe people who have had Covid-19 shouldn’t be prioritized to get the vaccine, should the stock of it remain limited over the long term. But in practice, that argument could become problematic.

For one: “It’s too difficult to operationalize pre-vaccination testing,” Peter Hotez, vaccine expert and the dean of the National School of Tropical Medicine at Baylor College, says in an email. It would be tedious work to determine who might be immune to SARS-CoV-2 before vaccination. It could be tedious work to determine who has been infected prior to vaccination as well.

Plus, again, the information resulting from such tests may not be all that useful in determining a person’s lasting immunity.

The vaccines are safe — regardless of whether you have been infected

To sum up: “To be safe, I recommend getting the vaccine, even after you recover from COVID, when the vaccines become sufficiently available,” Iwasaki says.

It’s still a little unclear what the vaccine would add on top of a person’s natural immune response to the infection. Would a person who made a weak immune response to a natural infection make a stronger immune response to a vaccine? It’s possible.

“During a natural exposure to SARS-CoV-2, there are multiple factors that interfere with a robust immune response,” Iwasaki says. “The exposure dose may be too little. The virus interferes with our immune system (both innate and adaptive) to block proper antibody induction.”

On the other hand, she says, “vaccines are formulated to provide just the right dose” of the viral protein, and there’s no live virus to interfere with out immune systems. “There appears to be a much more uniform and higher level of antibodies generated with a vaccine,” she says.

For now, the Centers for Disease Control and Prevention isn’t making an official recommendation on whether people who have had Covid-19 should be vaccinated; it’s waiting on the input of the Advisory Committee on Immunization Practices, a group of medical and public health advisers who make recommendations on how to vaccinate the public. Though we know from clinical trial data, and the Food and Drug Administration’s review of it, that the Pfizer/BioNTech and Moderna vaccines appear to be very safe for the general public.

But have they been proven safe, in particular, for people who have already been infected? There may not yet be enough data to say that definitively. “I think the answer is probably yes, but we won’t know for sure until the numbers are larger,” University of Washington immunologist and physician Helen Y. Chu writes in an email. “For most of the phase 3 trials, there was no screening for pre-existing antibody.”

Keep in mind that lack of safety data for this particular group doesn’t mean it’s unsafe. As Chu explained, there just needs to be more data.

Both the Moderna and Pfizer/BioNTech trials did include a small number of people who had already been infected, though. On Thursday, Moderna vaccine scientist Jacqueline Miller told an FDA advisory committee that the company is “anticipating data in the coming weeks” on how and whether the company’s vaccine boosts the immune systems of people who had been previously infected.

Also unclear from the current data: whether the vaccine truly does give people who mounted a weak immune response to a natural infection — that is, people who either did not produce a lot of immune system cells to fight the virus or whose immune system cells to fight the virus have declined over time — an immunological boost.

“This is not answered yet, but I would say that it probably does not hurt,” Chu says. “Antibody wanes over time, and it is likely that the vaccine will boost your pre-existing antibody titers.”

That said, per the current trial data, both vaccines are around 95 percent effective at preventing Covid-19. Sette says that high a level of efficacy is probably indicative that the vaccine can produce a robust immune response in a broad majority of people.

The language of vaccine science is really tricky. To say a vaccine protects against disease is not the same as saying the vaccine makes a person completely immune (or unable to spread the virus). Perhaps some people still get infected but clear the infection before symptoms show up. Scientists will need more data on this fine distinction. That said, “it would be hard to fathom that the vaccine gives you a 95 percent protection without inducing an immune response,” Sette says.

There’s a lot about decision-making during the pandemic that’s been very difficult. Deciding whether, and how, to visit friends and loved ones leads to a tedious risk-benefit analysis. Luckily, with the vaccines, this decision matrix is a lot simpler: Even if you have had Covid-19 in the past, a vaccine may help prevent future infections. Yes, more data is needed to be absolutely definitive on this. But for now, this is all pretty encouraging.

Americans have spent much of the Covid-19 pandemic blaming one another for the coronavirus’s spread.

Don’t go to that beach or park. Don’t go to that bar or restaurant. Don’t do anything for Thanksgiving or Christmas. Wear a mask! You don’t want to kill Grandma, do you?

Public officials have joined in. Increasingly, they are blaming private gatherings, not the restaurants and bars they insist on keeping open, for the spread of the disease. In some places, such as the Dakotas, framing Covid-19 prevention as an individual responsibility became the core of the strategy to fight Covid-19. As cases and deaths climbed to among the highest rates in the world, South Dakota’s leaders preached “personal responsibility” and refused to require masks, much less stricter measures. Ian Fury, a spokesperson for Gov. Kristi Noem (R), told me his boss gave citizens “up-to-date science, facts, and data, and then trusted them to make the best decisions for themselves and their loved ones.”

It’s true that individuals have an important role in fighting Covid-19. Everyone should wear a mask, and, unfortunately, everyone should reconsider big family gatherings this holiday season. But relying on individual action to fight a deadly virus — an approach that the US has leveraged for problems ranging from the opioid crisis to global warming — simply hasn’t worked.

Today, America is among the worst performers at fighting Covid-19. Despite recent surges in Europe and Israel, the US remains within the top 20 percent for most coronavirus deaths per person among developed nations, with more than twice the death rate as the median developed country. If the US managed the same Covid-19 death rate as Canada, more than 190,000 Americans would likely be alive today.

There are many reasons for that, not least President Donald Trump’s awful leadership. But part of it, experts say, is America’s inability to address structural problems, instead relying on demanding more from individuals. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, highlighted this problem when he remarked that the “independent spirit in the United States of people not wanting to comply with public health measures has certainly hurt us a bit.”

That was clear in much of the public’s response to lockdowns starting in the spring. With “Don’t Tread on Me” flags hoisted in the background, protesters often took to statehouses to demand the end of government-mandated closures. At the demonstrations, attendees claimed they could take care of themselves and didn’t need the government to tell them what to do.

It’s also been apparent in the government responses. The emphasis on individualism helps explain why Trump and his conservative allies, like Noem, have resisted more government mandates on masks and stay-at-home orders in lieu of letting people deal with the virus for themselves.

But it’s not just Trump and friends. Every state in the country, Democratic or Republican, has at some point reopened restaurants or bars, allowing people to congregate in indoor areas that experts widely agree are breeding grounds for Covid-19. While resisting shutting down such places, local and state officials have argued that it’s on people to wear masks, cancel private gatherings for the holidays, and avoid nonessential activities — while leaving room for people to not follow at least some of those guidelines. Every state in the country has also, subsequently, seen surges in the coronavirus this fall.

New York Gov. Andrew Cuomo exemplified the failure of this approach. In the lead-up to Thanksgiving, he said, “My personal advice is you don’t have family gatherings — even for Thanksgiving.” Days later, it came out that Cuomo was planning to host a family gathering with his 89-year-old mother and two of his three adult daughters. He only canceled after a public backlash. Even Cuomo wasn’t planning on following his own advice. (Cuomo’s office argued his comments were misinterpreted.)

Meanwhile, much less attention has gone to addressing Covid-19 from a truly structural perspective. The coronavirus has revealed America’s pathetic public health infrastructure — there’s still no national testing-and-tracing program, and no state has an adequate contact tracing program, if they have such a program at all. Businesses and workers have been left to fend for themselves, as Congress failed to pass an economic relief bill before the last one started to expire. For all the talk about outdoor activities being safer during the coronavirus pandemic, there’s been next to no action in most of the country on getting people outside — at times, governments have even eliminated outdoor venues by closing parks or beaches.

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“It’s a structural issue,” Jen Kates, director of global health and HIV policy at the Kaiser Family Foundation, told me. “Systemic challenges in the United States — that predate the pandemic but have gotten worse [during the pandemic] — lead to the situation we’re in.”

It’s easy to yell at people over their Covid-19 failures — simply log on to Twitter and blast away. It’s costless for a governor to tell people that it’s on them to stop the spread of the coronavirus by voluntarily giving up things they love, especially if the same governor doesn’t even plan on following his own advice.

So rather than do anything about it, Americans are stuck blaming each other for Covid-19. But until we truly realize this is a collective failure, not an individual one, the problems will linger.

Structural problems are really to blame here

Since the start of America’s epidemic, experts have warned that indoor dining and bars are among the worst places for the spread of Covid-19: People are in poorly ventilated indoor areas where the virus spreads more easily sit close for possibly hours, can’t wear masks as they eat or drink, and spew germs at each other as they shout, sing, and laugh.

So many experts have called on governments to close bars and restaurants. Acknowledging the economic toll of this, economists and public health experts have also asked for a bailout of the industry to make employers and their workers whole until the pandemic resides.

None of that happened. Instead, America started to reopen before Covid-19 cases were under control — at the US’s best point in the spring and summer, it still had more than 60 times the daily new cases of Australia, New Zealand, and South Korea — with bars and restaurants reopening in every state by the fall. Public officials acknowledged the risks but merely moved to limit capacity and called on everyone to be responsible by physical distancing, wearing a mask, and limiting contact with people from other households.

This has not gone well. Coronavirus cases have shot up across much of the country, with the US in the middle of its third and biggest surge of Covid-19 yet. At the same time, we’ve gotten more data showing how dangerous bars and restaurants can be for the spread of Covid-19: A study published in the Journal of Korean Medical Science found that a person in South Korea may have been infected with Covid-19 in a restaurant in as little as five minutes. Another study in Nature found, “Reopening full-service restaurants was associated with a particularly high risk.”

Despite that, officials across the country have by and large resisted shutting down again. Many of them, instead, have cited another culprit for Covid-19 spread: private gatherings. New York, for example, put out a PSA to stop “living room spread,” and the state published data suggesting households and private gatherings are driving 74 percent of coronavirus spread.

It’s true private gatherings and households are driving some transmission. Most experts agree Thanksgiving dinners likely led to a surge on top of a surge, and similar Christmas and New Year’s events likely will too.

But that’s why at least some experts believe there’s a need for more focus on systemic action, not the individualistic approach. “People, in general, are horrendous risk assessors — we’re awful at assessing risk,” Daniel Goldberg, a medical historian and public health ethicist at the University of Colorado, told me. “I hate to say people can’t be trusted, but.”

There are other problems with this framing. For one, the New York data doesn’t separate within-household transmissions from social gatherings — so the 74 percent figure includes someone spreading Covid-19 to the husband he lives with (not as avoidable) and someone spreading the virus to someone he invited over for drinks one night (very avoidable). This also only includes the cases that New York could actually contact trace, and it’s much easier to trace transmission between family and friends in a household than strangers in a bar.

The big problem, though, is that there’s nothing unusual about Covid-19 spreading among people who live together. It’s typical for the bulk, even the majority, of the transmission of any disease to happen within households. If you’re infected, the people you live with or come into close contact with at home are simply likely to get it too. That’s how pathogens work. What matters most, though, is where that virus originated from in the first place.

To put it another way: People couldn’t infect others in their homes if they hadn’t picked up the coronavirus in bars, restaurants, or other public spaces. So if these places weren’t open, individual choices to gather — including over Thanksgiving and Christmas — would be of far less concern. There would simply be much less virus out there jumping from person to person.

So it largely comes down to the lack of systemic action, not solely the individual choice.

It’s not just bars and restaurants. If officials want people to wear masks, they can mandate masks and actually enforce those mandates. If they want more adults to stay home, they can replace any income individuals might lose by not going into work, or take steps to make work-from-home life more bearable, like deeming schools “essential” or subsidizing day care. If they want people to stay outdoors and not indoors, they can do things that can encourage people to go outside instead of congregating inside — like offering free outdoor activities like ice skating or art installations, or even just places to eat (with some heating during the winter) — rather than shutting down parks. If they want to address racial disparities for Covid-19, they need to address systemic racial disparities across society and health care.

Otherwise, we’re going to be stuck with relying on people to make decisions — almost always against their own social, cultural, and economic interests — to do the right thing. So far, that just isn’t working.

It’s easier to blame individuals than fix big problems

Public leaders and government officials face their own structural forces too.

Brown University School of Public Health dean Ashish Jha told me of a recent conversation with a governor. Jha argued that risky indoor spaces like bars and restaurants should be closed, or hospitals will soon overflow. The governor responded that such closures would require money to support affected businesses and their employees, and the state simply doesn’t have that money. The governor added, “Maybe I should spend a little bit of money and try to campaign for people to be more careful” — a pivot to an individualistic approach.

“I came to appreciate that, ultimately, the problem wasn’t this governor,” Jha said. He later added, “The right answer is not we need better governors — the right answer is we need a different structure and a better federal government.”

Structural issues are, almost by definition, much harder to fix than simply asking people to do the right thing. It’s easy and cheap to yell at people for getting together for Christmas — especially when they really shouldn’t be doing it. Closing down bars and supporting them economically, in turn, requires both political and financial capital.

In some cases, governments legitimately can’t do what they would prefer. Local and state officials, unlike the federal government, can’t print money and usually have to balance their budgets. Given that reality, a governor might decide that she has to keep bars open simply because she can’t bail them out — the economic cost is so high, and, who knows, maybe the state might get lucky and avoid an outbreak anyway. States, counties, and cities face a structural barrier in the federal government’s inaction.

There’s a cultural component, too. Americans pride themselves on their individualistic and libertarian qualities — what Fauci described as an “independent spirit in the United States.” That creates an innate resistance, among the public and its leaders, to look at problems in a collective over an individual manner. So with Covid-19, we yell at people for not distancing or wearing masks in bars, but not as much at public officials for allowing that bar to open in the first place.

The truth, as Covid-19 has shown us, is this individualistic approach doesn’t work well for public health (even if it does serve us well in other areas). The alternative to not taking collective action is more death. The countries that have done the best against Covid-19 — including Australia, New Zealand, South Korea, and, to a now lesser degree, Germany — all approached the issue collectively, leveraging government aid and public health systems to let people stay home without losing as much income or health insurance, to test and trace infections, and, when necessary, to close down to stop the spread.

In fact, America’s best — and perhaps only — success against Covid-19 so far came about with the power of collective action. The vaccines that are now being shot into the arms of health care workers and people in nursing homes came about with the strong support of various governments, which funded research or, at the very least, paid for tens of millions of doses before the vaccines were even proven to work. Crucially, this came about by acknowledging the structural risks involved in developing a vaccine, particularly that drug companies might be reluctant to gamble on the medications if they may not pan out, and mitigated those risks.

The problem runs deeper than what America did and can do about Covid-19 alone. One advantage that other countries had as the pandemic began is stronger social safety nets, which guaranteed people would retain some income and health care even if a lockdown was needed. The US has no such guarantees — the programs that do exist are notoriously underfunded (hence Congress needing to boost unemployment insurance in its economic relief bills), and far from universal. So while British and German workers could rely on some significant government support even if they lost their jobs, Americans could claim no such certainty.

We see that today. Even as Congress nears a deal on economic relief, the truth is it’s already too late for many Americans. With much of the previous stimulus measure expiring, people who lost their jobs have languished for months with little to no support. And even if the new deal passes Congress (which is still uncertain), there will likely be a lag in actually rolling out those benefits to the people who need them, leading to more prolonged suffering. It could have been avoided if these kinds of benefits were permanent, or kicked in automatically if the economy begins to weaken, as government programs in other developed countries do.

That’s just one example. From building up the social safety net to actually funding public health infrastructure to reforming government so it’s more responsive, there’s a lot of work America could do to make sure it’s better equipped to handle crises as they come up. That won’t completely end the need for leadership in troubled times — European countries with large social safety nets have still passed additional economic relief measures — but it would put the US in a much better place.

It won’t be easy. It means committing to a more hands-on governing structure, costing us more in dollars and cents and forcing many Americans to rethink how they view the role of government.

But if Covid-19 has taught us anything, those changes are worth the cost. It begins with taking a structural, rather than individualistic, view of the problems facing the US today.

The Food and Drug Administration on Friday issued an emergency use authorization for Moderna’s Covid-19 vaccine, clearing the way for it to be the second vaccine distributed in the United States. The decision follows a vote on Thursday by an advisory committee to the FDA which found that the benefits of the vaccine outweigh its harms for people ages 18 years old and older.

“With the availability of two vaccines now for the prevention of COVID-19, the FDA has taken another crucial step in the fight against this global pandemic that is causing vast numbers of hospitalizations and deaths in the United States each day,” said FDA Commissioner Stephen Hahn, in a statement.

Between the Pfizer/BioNTech vaccine that received a green light last week and the Moderna vaccine, US officials were expecting to have enough doses to vaccinate 20 million Americans by the end of the month. However, some states reported Thursday that they had received fewer doses than they were promised of the Pfizer/BioNTech vaccine.

Both of these vaccines use an mRNA platform to get human cells to make a component of SARS-CoV-2, the virus that causes Covid-19. That component, the spike protein of the virus, is then used by the immune system to build up protection against the pathogen. It’s an approach that is seeing widespread use in humans for the first time. Both vaccines are also administered as two doses; the doses of the Moderna vaccine are spaced 28 days apart, while the Pfizer/BioNTech vaccine doses are spread 21 days apart.

Moderna’s vaccine can be stored long-term at minus 20 degrees Celsius (minus 4 degrees Fahrenheit) and is stable for 30 days between 2° and 8°C (36° to 46°F). In contrast, the Pfizer/BioNTech vaccine needs temperatures of minus 70°C (minus 94°F). The less stringent storage requirements of Moderna’s product may ease some of the logistical challenges of distributing a vaccine.

The task of getting delicate vaccines from manufacturers to hospitals and into the hands of patients is complicated, something that will have to be scaled up to immunize millions of people across the United States.

Already, the distribution of the Pfizer/BioNTech vaccine has hit some bumps. State officials are reporting that their allocations of the vaccine have been suddenly downscaled, while Pfizer said that there are millions of doses of its vaccine that have gone unclaimed.

Though having a second vaccine on the market increases the number of people who can get immunized, it could also complicate the distribution process further, with more doses to track, transport, and administer.

Health officials are also warning recipients about potential side effects of these vaccines. At least four people who received the Pfizer/BioNTech vaccine under an EUA experienced severe allergic reactions. While effects this severe are very rare, some doctors are pointing out that reactions to these vaccines can be more intense than responses to other inoculations, as Vox’s Julia Belluz explained:

What’s now clear: An injection with either vaccine, both of which use mRNA technology, can feel more intense than other routine vaccinations (such as the flu shot) — with side effects for some recipients such as pain, headache, and fatigue. And this may be especially true for Moderna’s vaccine: About 16 percent of people who got the shot in clinical trials experienced a “severe” systemic adverse reaction, a classification the FDA uses to refer to side effects, like fever or fatigue, that require medical attention and prevent people from going about their daily activities.

Per guidelines set by an advisory group for the Centers for Disease Control and Prevention, the first people slated to receive the Moderna vaccine will be the same as those for the Pfizer/BioNTech vaccine — health workers and residents and staff at long-term care facilities. The US government has purchased 100 million doses of each of these vaccines to be delivered through the end of March.

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An EUA, however, is still short of a full approval, and there are still some outstanding concerns that need to be addressed. Moderna noted in its briefing document that the company is still trying to find out how long the vaccine’s protection lasts, how well it prevents transmission, and its long-term impacts. The company says it will monitor its trial pool for two years and will conduct additional studies among the people who receive the vaccine under an EUA to get answers to these questions.

Jupiter and Saturn are due to converge in their orbits on Monday, appearing as a double planet in the night sky — the first such occurrence in almost 800 years.

The two planets have been near one another throughout the year, according to Rice University astronomer Patrick Hartigan. They will reach their closest approach, passing within 0.1 degrees of each other during the winter solstice on December 21, the longest night of the year.

The two celestial bodies pass one another about every 20 years, according to the Mount Wilson Observatory, in Los Angeles County, in what is referred to as a “great conjunction,” because they are the two largest planets.

But a passage as close as the one expected Monday has happened only a handful of times in the last two millennia. And two of those occurrences, one in 769 and one in 1623, happened too close to the sun to be seen with the unaided eye.

The last time a person could clearly see this event was on March 4, 1226.

Although the night of the solstice will be the planets’ closest convergence, the conjunction is ongoing. Their close approach will continue through Christmas, with the double planet appearing low in the western sky for about an hour after sunset, depending on conditions.

Because of the timing of the event, some early scientists — including noted astronomer Johannes Kepler — attempted to link the convergence to the so-called “Christmas star” or “star of Bethlehem,” which, according to the New Testament, guided the Magi to the birth of Jesus. But modern astronomers have established that, timing-wise, it seems unlikely that a similar great conjunction was at play around the time linked to the historical Jesus’s birth.

How to see Jupiter and Saturn’s great convergence

Although the path of these planets will be far enough from the sun to be observable this year, the planets may be so close that it will be difficult to separate them unaided by a telescope, Hartigan writes.

Visibility is best by the equator, and becomes increasingly fleeting the farther north a person is. This will make viewing conditions less than ideal for residents of the United States, Canada, and Europe, for example.

Depending on weather conditions, however, those in the Northern Hemisphere should be able to glimpse the planets at twilight, for about an hour after sunset, by looking to the southwest.

Binoculars or a small telescope will make it easier to witness the event, and to separate the two planets. Jupiter will be the clearer planet of the two, since it is far closer to Earth, with Saturn just next to it.

For those in less ideal locales, who don’t have access to binoculars, or just don’t want to miss the action, several planetariums have set up options to see the event up close.

Three California institutions — the Mount Wilson Observatory, Carnegie Observatories, and Glendale Community College — will host a virtual viewing party on Monday, beginning at 8 pm ET. Viewers can sign up on Zoom or watch on YouTube to see the event through a Mount Wilson Observatory telescope.

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Many of us dread being alone. We find isolation uncomfortable or downright scary. If you want to know just how eager we are to avoid it, consider a scientific study that offered people a choice between giving themselves electric shocks or being alone with their thoughts for 15 minutes. Believe it or not, many chose the electric shocks.

But here’s the good news: Being alone is a skill. And, just like any other skill, you can get better at it with practice. I want to suggest that honing this skill now can help you get through this pandemic winter. Instead of dreading being alone, you can lean into it.

Whether you’re skipping holidays with your family in an effort to contain the current coronavirus surge, or quarantined in your room because you have Covid-19, you’ve probably felt at least a momentary surge of panic at the idea of being physically cut off from your loved ones for days or weeks or months.

That’s a reasonable feeling: Social distancing is brutal. Full stop. Human beings have evolved over thousands of years to take comfort in one another’s presence, so when we’re isolated, it hurts us on a physiological level.

At the same time, we can probably recognize that some of our fear about being alone is not unique to the current pandemic. It’s a fear that has lurked in us for years, as we’ve forgotten — or perhaps never really learned — how to sit with ourselves, including with our uncomfortable thoughts and emotions.

“I think most of us are afraid to be alone with ourselves because getting to know ourselves is a very fearsome process,” Jack Fong, a sociologist who researches solitude at California State Polytechnic University, Pomona, told me. To keep this fear at bay, lots of us have a podcast or TV show constantly playing in the background, or a rotation of friends we call one after another.

Many factors have conspired to make us bad at solitude. They’re mostly not our fault. As Jenny Odell lays out in her book How to Do Nothing, we live in a culture where sociability and constant connectivity are rewarded, and where choosing to be by yourself marks you out as a loser, crazy, possibly immoral.

And when we do find ourselves alone, we’re increasingly at the mercy of an attention economy that bombards us with ever-present, ever-pleasant distractions. With external stimulation always just a click away, it’s never been so easy to avoid our inner worlds. Why would you sit with a feeling like boredom or sadness if you can distract yourself from it by texting a friend, or bingeing a Netflix show, or launching a Zoom call?

And indeed, these technologies are the salves everyone seems to be proposing for pandemic-induced loneliness. Don’t get me wrong: They can be genuinely useful. Like I said, loneliness hurts us physically as well as mentally. I live alone, so to stay sane, I’ve engaged in my fair share of Zoom dance parties.

Nevertheless, these fixes feel unsatisfying because they’re all about how to avoid being alone instead of just, well, being alone. And that avoidance stands to make us even more scared of our solitude. Decades of psychology research have taught us that trying to escape a distressing emotion is a bad long-term strategy; it teaches our brain that we can’t handle that emotion, and our distress actually grows more intense.

So how can we use this opportunity not to escape solitude but to lean into it? We can learn from people who figured out how to do this long before the coronavirus came knocking.

What we can learn from survivors of solitary confinement

For starters, we need to distinguish between voluntary solitude and enforced solitude. Plenty of people who’ve experimented with the former — hermits and monks, philosophers and artists — have worthwhile lessons to teach us about being alone. But it’s people in the latter category whose experience is most instructive for us now.

Consider what Keith LaMar, who’s been in solitary confinement in a supermax prison for 27 years, recently told Mother Jones. I want to be clear that I think solitary confinement is a form of torture that should be abolished, and it makes our self-enforced, tech-enabled isolation look like a walk in the park. There is simply no comparing the two.

Yet LaMar — as well as Jason Rezaian, a journalist who survived solitary confinement in an Iranian prison — have discussed their experiences in the context of the wide-scale quarantining going on now, in an effort to help us through this period. So let’s consider LaMar’s insights:

Being in solitary confinement is really just being thrown upon yourself: You’re running around, just like people do in your regular life, and now all of a sudden you’re confronted with yourself, and find that in a lot of cases you haven’t really put anything into yourself to occupy yourself. Everything is outward directed. That’s what happened to me 27 years ago, and what happens to a lot of guys who are initially thrown into this situation — it’s like being thrown into the ocean. You have to learn how to swim. You have to learn how to deal with yourself.

I’ve been lucky in a lot of ways. My cell has a bookshelf with three shelves, and there’s a table to sit and write. I have a lot of music, books to read. Not to distract myself from myself, but to take me deeper into myself. I paint, I work out, I do yoga, I meditate.

I’ve watched quite a few people fall apart, lose their minds. But I went in another direction. So 27 years later I’m still sound in mind and body and spirit. I attribute that to just reading and cultivating myself. That’s the thing, when you’re thrown upon yourself, you realize you are more equipped than you realized. A lot of the system keeps us from realizing our own power. It’s a good opportunity for people to tap into that. … Hopefully young people being forced to stay home outside of the mainstream curriculum are able to get a glimpse of themselves and start pulling on that thread.

There’s a lot of wisdom in this perspective. In fact, it echoes many of the key observations scholars have made over the years about solitude.

First, there’s the idea that to succeed at solitude, you have to accept that you’re being “thrown upon yourself” — to confront your reality rather than opting for distraction. Then you have to “put something into yourself” — to make solitude a generative practice that takes you deeper into who you are and develops you further.

Matthew Bowker, a Medaille College researcher who studies solitude, says something very similar in The Handbook of Solitude. He notes that being adept at being alone “implies the capacity to generate meaningful and valuable experiences in the internal world, for if one wishes to be when alone and not merely to wither or starve, one must be able to generate and possess some of the vital stuff of being.”

In other words, you’ve got to quit seeing solitude as an experiment in subtraction, and start seeing it as an experiment in addition. What you’re adding is your self — a true self, because at last it’s you who’s building it, not anyone else. You’re no longer looking to other people for their attention or approval.

The psychologist D.W. Winnicott often drew a distinction between the “authentic self” and the “false self.” Without realizing it, he said, we look to other people to scaffold our sense of who we are. It’s they who perform the construction of our identity. When we’re alone — when their judgments and preferences are no longer there to shape our self-concept — it tends to break down. That can be terrifying. But it can also be a gift. Because when the false self falls away, it leaves space for you to build a more authentic self.

What we can learn from people who pretend to live on Mars

Another key ingredient to successful solitude, psychologists have found, is having a clear sense of purpose.

Steve Cole, a researcher at the University of California Los Angeles, studies interventions designed to help people cope with loneliness. He’s found that the ones that work tend to focus not on decreasing loneliness but on increasing people’s sense of purpose. Recalling one pilot program that paired isolated older people with elementary school kids whom they’re asked to tutor and look out for, Cole told Vox, “Secretly, this is an intervention for the older people.”

Philosophers have also noted the fortifying effects of a clear sense of purpose. “Nietzsche said if you find purpose in your suffering, you can tolerate all the pain that comes with it,” Fong, the sociologist, told me. “It’s when people don’t see a purpose in their suffering that they freak out.”

In 2003, Kate Greene moved into a geodesic dome on top of a Hawaiian volcano, where she spent four months pretending to be an astronaut on Mars. NASA funded the experiment because it needs to know how human beings deal with isolation, so that real missions won’t go kaput just because someone gets lonely. In a recent essay, Greene confesses that she had a hard time living in the dome. Separated from her loved ones and troubled by confusing information from mission support, it was hard to remember her sense of purpose. But when she did, it made all the difference, she writes:

Remembering that we were doing something that might be good for the future of human exploration and maybe even humanity kept me grounded when I wanted to be flying and let me fly when I felt heavy and stuck. To be part of something historic, to do something potentially grand for others — it was remarkable how focusing on that was often enough.

Billy Barr, who’s been living alone in an abandoned mining shack high up in the Rocky Mountains for almost 50 years, has very similar advice. He says we should all keep track of something.

In his case, it’s the environment. How high is the snow today? What animals appeared this month? For decades, he’s been keeping track of the answers to these questions, and his records have actually had a serious influence on climate change science.

Now, he suggests that people in isolation get through the coronavirus pandemic by participating in a citizen science project such as CoCoRaHS, which tracks rainfall.

“I would definitely recommend people doing that,” he told WAMU. “You get a little rain gauge, put it outside and you’re part of a network where there’s thousands of other people doing the same thing as you, the same time of the day as you’re doing it.”

He and Greene both also emphasize the importance of routines — the little daily rituals that anchor us in time and give shape to a day.

The rewards — and risks — of solitude

Isolation has many virtues. But, harnessed incorrectly, it can also harbor danger.

First, the virtues. A long line of nature writers — from William Wordsworth and Henry David Thoreau to Annie Dillard and Mary Oliver — have described how solitude allows them to reconnect with nature, and through nature, a deep bliss. Many artists insist that isolation is necessary for creative work. “I paint with my back to the world,” said the painter Agnes Martin, because “the best things in life happen to you when you’re alone.”

Most world religions, even if they’re ambivalent about solitude as a long-term path, acknowledge that it’s useful for fostering spiritual insight. The Hebrew Bible says Moses spent 40 days alone on Mount Sinai before receiving the Torah. In the Roman Empire, Symeon the Stylite lived on top of a 60-foot pillar — for 37 years! Hinduism and Buddhism both have rich traditions of solitary forest dwellers. And Christianity has countless recluses; my favorite is Julian of Norwich, who at age 30 asked to be permanently shut into a cell so she could have visions of God and write about them.

The Trappist monk Thomas Merton and the psychologist Carl Jung both pointed out that dissociating from society allows us to perceive and call out its illusions. “I am a solitary,” Jung wrote, “because I know things and must hint at things which other people do not know, and usually do not even want to know.”

Nietzsche, in Thus Spoke Zarathustra, suggested that solitude can heal us from an overstimulating culture (“Flee, my friend, into your solitude! I see you dazed by the noise of men”) and reconnect us to ourselves (“go into isolation … seek the way to yourself”).

But isolation also comes with its fair share of danger. The problem is that, as Nietzche’s Zarathustra puts it, “whatever one brings into solitude grows in it, even the inner beast.” That can mean anxiety, or melancholy, or some other kind of distress. For this reason, the philosopher said “solitude is ill-advised” for many people.

“Nietzche was prescient enough to know that solitude is a dangerous project,” Fong told me. “If you are not ready for it, the cave you enter can be a very scary place. For those who have unresolved issues that may not have been attended to by a mental health expert, this may not be a good place to go.”

That’s why psychologists typically recommend gradual exposure. If being alone is scary to you, ideally you want to seek it out in small doses first, and then — once you’ve proven to your brain that it can in fact tolerate the distress — slowly increase the dose. If you’re in the midst of a full-blown panic attack, that’s not a good time to practice honing a new skill; you may need to first soothe the distress a bit. Engaging the senses to bring yourself back into your body is one commonly recommended way to do that (it’s no coincidence that everyone on social media is now baking sourdough bread and planting fragrant herbs).

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Unfortunately, a pandemic doesn’t allow us to take the stepladder of solitude as gradually as we might like. It’s not ideal, but even under these circumstances, we can build up to the skill of being alone.

How to practice “distress tolerance skills” for being alone: A practical guide

The best step-by-step guide I’ve read for this purpose comes from the Centre for Clinical Interventions, supported by the Australian government’s department of health. Psychologists there have published a comprehensive guide to developing “distress tolerance skills.” It’s free, it’s online, and it uses an evidence-based approach rooted in cognitive-behavioral therapy and mindfulness-based therapy. It’s worth checking out the whole guide, but I’ll give a capsule summary of the process it recommends.

First, accept the distress you’re feeling. Instead of engaging in your usual escape methods for avoiding uncomfortable emotions (whether it’s bingeing TV, numbing out with alcohol, or whatever), commit to doing the opposite: Stay with the emotion.

Second, watch the emotion. Noting how it’s manifesting in your clenched muscles or using imagery to describe it (“this feeling is not me, it’s just like a cloud floating past in the sky”) may help you detach from it a bit. Keep observing it until it naturally subsides.

Third, turn your attention back to a task you want to do in the present moment. It can be a simple inward task like focusing on your breath, or an outward task like volunteering to help people in need during the pandemic.

Expect that the distressing feelings will come back. But know, too, that by actually facing them rather than running away from them, you’re teaching yourself that you’re strong enough to handle them.

If this is sounding a bit familiar, that’s because it echoes the strategies laid out by the experienced solitaries we met above, like the survivor of solitary confinement and the woman on the ersatz Mars mission. Accepting your isolation, letting it take you deeper into yourself, remembering your purpose — these are tried-and-true strategies for successful solitude. You will find the same strategies echoed in other sources, from contemporary Western psychologists and mindfulness teachers to ancient Buddhist texts.

And perhaps there’s some comfort in that. As alone as you might feel right now, remember that many human beings have experienced isolation before you, and they’ve left you their best tips for how to make the most of it. In a sense, you’re in community with them right now.

You’re also in community with the friends and family you have access to through your phone, Zoom, and so on. We should absolutely keep using these distance-collapsing technologies.

But there’s a difference between using them from a place of desperation, where we’re scrambling to generate a constant stream of chatter to distract us from our aloneness, and using them from a place of mindfulness, where we’ve already faced the distress of being alone and experienced it naturally subside. When we do the latter, psychologists say, that Zoom dance party becomes a reward for approaching rather than avoiding our solitude.

Reporting for this article was supported by Public Theologies of Technology and Presence, a journalism and research initiative based at the Institute of Buddhist Studies and funded by the Henry Luce Foundation.

“I am seeing tons of hair loss,” Mona Gohara says.

Patients come to Gohara, a dermatologist and professor at the Yale School of Medicine, for all kinds of reasons from skin cancer screenings to cosmetic procedures. But this year more than ever, they’re worried about their hair.

It’s not a coincidence. Stress — like, say, that brought on by living through a deadly pandemic — is known to cause hair loss. Ordinarily, “90 percent of the hairs on our head are in the growing cycle; 10 percent are in the shedding cycle,” Gohara explained. “But when we’re subject to some type of physiologic or emotional stress, that cycle shifts to where the shed outweighs the grow.” The result: “people notice a massive, massive shed.”

And those stray hairs are part of a bigger trend. At this point, millions of Americans have spent nine months living through a public health nightmare and an unprecedented economic crisis at the same time. They have also had to cope with all this while avoiding gatherings, limiting physical contact, and, when possible, staying inside their homes. Put together, the isolation and anxiety of life in 2020 have brought with them numerous side effects. For one, they might be doing weird things to our bodies.

If you’ve noticed your menstrual cycle is more irregular this year, for example, you’re not alone: More patients are reporting irregular periods since the pandemic began, Mary Jane Minkin, an OB-GYN who teaches at the Yale School of Medicine, told Vox. The likely culprit, as with hair loss, is the anxiety of living in such a difficult and uncertain time. “When stressors come into play,” Minkin said, “we end up with screwy periods.”

If you’ve spotted more gray hairs on Zoom calls, there may be a pandemic-related explanation for that too. And according to some, life in lockdown may even be changing people’s body odor.

Those are just some of the smaller effects. Some experts are also concerned because isolation has documented effects on health, increasing the risk of cardiovascular disease and even death. “Humans are considered a social species,” Julianne Holt-Lunstad, a professor of psychology and neuroscience at Brigham Young University who studies the impact of social relationships on health, told Vox. “When we lack proximity to others, and particularly trusted others, this creates a heightened state of alert or stress” — which, over time, can have harmful effects on our bodies.

To be clear, none of this is an argument for getting rid of pandemic-related restrictions — after all, the effects of Covid-19 on the body can be far more severe than the effects of isolation.

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But the rise of pandemic periods, weird smells, and other bodily indignities are a reminder that Americans are going through something right now that most of us have never experienced before. And that takes its toll in a lot of ways — some of them stranger than others.

2020 is messing with people’s periods

Let’s talk about periods first. Trend pieces about menstrual changes — either irregularity or worsened symptoms like cramps — began popping up in the spring. “A couple of weeks into the stay-at-home order in Washington State, where I live, I woke up in the middle of the night with the worst cramps I’ve ever had,” Colleen Stinchcombe wrote at Self in May.

And while it’s likely too soon for any published research on the impact of the pandemic on menstruation, Minkin isn’t the only one to see increased reports of irregularity among her patients. “It’s common for us to see patients with changes in their menstrual cycle, but anecdotally, it seems like it’s been happening more over the last six months,” Beth Schwartz, an OB-GYN at Thomas Jefferson University Hospital in Philadelphia, told the Washington Post in August.

These changes aren’t necessarily surprising, Minkin told Vox. “Most people think that the ovaries and the uterus regulate periods,” she said. But actually, “the boss is sitting in our brain.”

Specifically, it’s the hypothalamus and the pituitary gland that control the ovaries, regulating their hormone production, which in turn regulates the menstrual cycle. “It’s our nice, regular hormonal activity from the hypothalamus and the pituitary which stimulate the ovaries to do their thing appropriately and get us nice, regular periods,” Minkin said.

And when we’re under stress, that can disrupt the functioning of the hypothalamus and pituitary, leading to irregularity. Researchers have noticed a similar effect among young people who go away to college — and often experience irregular periods as they adjust to a new environment and a new set of worries and pressures.

The good news, Minkin said, is having an irregular period generally isn’t dangerous. When her patients report irregularity, she’ll typically test their thyroid function and levels of certain hormones to rule out conditions like polycystic ovary syndrome, but as long as everything’s normal, no treatment is needed. If the irregularity is especially bothersome, people can take hormonal contraception to regulate their periods, Minkin said. “Once we get through things and people’s lives get back toward normal, most folks are probably going to regulate themselves just fine.”

The pandemic could also be changing people’s body odor

But irregular periods aren’t the only strange symptom people are reporting after months of reduced contact with others. Another is body odor — some say they’ve started to smell worse, or just different, since the pandemic began.

“I am a man who prides himself on smelling fresh and fancy free at all times,” Joseph Lamour wrote at Mic in July. But during the pandemic summer, he became “so limburger-esque that my own odor woke me up in the middle of the night.”

As with periods, there’s not yet published research on changes in body odor during the pandemic. But anecdotal reports of the issue have gotten back to Julie Horvath, head of the Genomics and Microbiology Research Lab at the North Carolina Museum of Natural Sciences and a professor at North Carolina Central University. An expert in primate genetics who expanded into studying microbes and odor (“I never thought I would be the armpit researcher,” she says), Horvath explains that a big factor in the way we smell is our skin microbiome, or the mix of bacteria, fungi, and viruses that live on our skin.

“When you’re in your home, you’re now coming into contact more with maybe your pets and your family, who you didn’t see as many hours a day,” she told Vox. This means we’re exchanging microbes with a different group of people (and animals) than usual, which could affect our smell. Spending more time indoors can also affect the microbiome, as can wearing different types of clothes — synthetic fabrics can host different kinds of microbes than cotton, for example. And a lot of people have changed their style (if you can call it that anymore) during the pandemic. “When I talk to people, maybe they’re wearing a nice shirt, but now they have jeans or sweatpants on,” Horvath said.

Stress can also affect the microbiome, Horvath said. A specific set of glands, the apocrine glands, release sweat when you’re nervous. That sweat contains different compounds from sweat that comes from the ecrine glands, which get to work when you’re too hot. And if your apocrine glands — found in the armpit and a few other places on the body — are highly active, then they are providing a “different food source to some of those microbes there, and maybe you’re promoting the growth of some that smell different than what they would’ve before,” Horvath said.

But the microbiome doesn’t just affect the way we smell. Beneficial bacteria on our skin create a “protective barrier,” Horvath explained. “If you have these good, beneficial microorganisms that are on your skin, eating oil or sweat and living there happily, they’re taking up residence,” she said. Then, if something lands on your skin that can make you sick — a staph bacterium, for example — “then it can’t take hold very quickly, because your beneficial organisms are going to outcompete it for resources.”

Washing your hands with soap and water just washes away the lop layer of microbes, potentially allowing some of the good ones to stick around. But hand sanitizer kills the microorganisms on your skin, the good along with the bad, Horvath said. Thus, using too much hand sanitizer during the pandemic could leave us more vulnerable to staph, acne, or other infections down the road.

Airborne spread of the coronavirus in close contact is the main danger in the pandemic, but we still need to wash our hands, too. Horvath recommends using soap and water when possible to help maintain a healthy microbiome. Beyond that, habits like eating a healthy diet could be good for your microbial balance, though they may or may not help you smell better. Spending time outside if you can is also a good idea, Horvath said. “Certain organisms that are outside in the soil are actually beneficial for your overall body.”

Stress is affecting our hair and skin

Beyond weird smells and irregular periods, the isolation of this year has brought with it other physical changes for many. In addition to hair loss, a proliferation of gray hair is a common complaint — one that can also likely be pinned on stress, as Deanna Pai reports at Medium. While the mechanism by which stress causes graying isn’t fully understood, one recent study in mice found that stress led to the death of stem cells that produce melanocytes, the cells in hair follicles that produce pigment.

Gray hair isn’t reversible (except with dye), Pai points out, but managing stress — as much as anyone can during a pandemic — can help slow the process.

Stress could also be making our skin look worse, Gohara, the dermatologist, said. It causes an increase in the hormone cortisol, which “wreaks cosmetic havoc on your skin” and can lead to anything from dryness to puffy eyes, she explained. “Everything just looks worse with a surge in cortisol.”

An increase in stress can also lead to more acne, something also exacerbated by the friction of wearing a mask (hence the 2020 neologism “maskne,” or breakouts on the lower part of the face linked to mask-wearing). Luckily, unlike gray hair, much of this is reversible — you can combat maskne by washing masks in the same gentle cleanser you use for your face, Gohara said, and using a product with salicylic acid or benzoyl peroxide. For hair loss, meanwhile, she sometimes prescribes supplements, but also reassures patients that when it comes to shedding, “eventually the cycle is going to re-equilibrate itself and your hair will be back on track.”

Loneliness could cause more severe physical effects

While things like hair loss are typically harmless, if annoying, the way we live in 2020 could be causing more serious issues too.

Researchers have long known that isolation — the condition of having little or no contact with other people — and loneliness — the subjective feeling of being alone, regardless of how much contact with people one has — can be harmful, Holt-Lunstad, the psychologist, said. For example, in one 2015 analysis, she and her coauthors found that isolation was associated with a 29 percent increased likelihood of mortality, while loneliness was associated with a 26 percent increase.

There are a couple of ways that loneliness can potentially hurt our health. For one, friends and loved ones can influence us to take better care of ourselves — “having someone who encourages you to get to bed,” or eat fruits and vegetables, or quit smoking, is good for our health, Holt-Lunstad said.

But many studies actually control for lifestyle factors like smoking and diet, and still find that loneliness and isolation have a negative effect. One reason, some researchers believe, is that “our brains have adapted to expect proximity to others, and particularly trusted others,” Holt-Lunstad said. When they aren’t around, the brain signals other parts of the body to go into a heightened state of alert. That can lead to changes in heart rate and blood pressure that could increase our risk of cardiovascular disease. But it could also lead to systemic inflammation in the body, which in turn has been linked to a host of mental and physical problems, Holt-Lunstad said, from Alzheimer’s disease to, troublingly, increased susceptibility to viruses.

These impacts are especially concerning because some early research has found high rates of loneliness and isolation during the pandemic. In an August survey, for example, two-thirds of adults reported social isolation, and more than 7 in 10 said the pandemic had made it harder to connect with friends.

Luckily, there are ways to reduce isolation, even during a time of social distancing. In a study this summer sponsored by the neighborhood-focused social network Nextdoor, Holt-Lunstad and her colleagues found that performing small acts of kindness for neighbors, such as bringing them groceries or checking in on them over the phone, was associated with a significant drop in loneliness — 1 in 10 participants felt lonely at the beginning of the study, while just 1 in 20 felt the same at the end.

But it can’t all be on individuals to fix their isolation during this very lonely time. Instead, Holt-Lunstad has advocated for policymakers to pay more attention to people’s social needs throughout the pandemic and recovery, including increased funding to help students and older people, who may be especially vulnerable to loneliness right now. And while funding for anything remains a fraught subject in Congress, Holt-Lunstad writes at Health Affairs that decisions “should be based on scientific evidence of benefits and drawbacks to our well-being, not solely on economic costs and convenience.”

Some of the smaller effects of pandemic living may dissipate naturally when this time in our lives is over. When it comes to issues like irregular periods, for example, the biggest takeaway is “don’t panic,” Minkin says. “We will get back to normal.”

But for other, larger problems, like isolation and its serious effects on the body, the pandemic could be a wake-up call. “My hope is now that we have all experienced, in some degree or another, this feeling of isolation and loneliness, that there may be greater awareness and less stigma,” Holt-Lunstad said.

Winter and the holidays can be hard even in typical years: short days, cold winds, and family stress, to name a few. But the ongoing US Covid-19 surge, with more than 200,000 new virus cases reported every day since December 7 (about double what they were a month before), is putting the hallmark activities that help sustain us — holiday gatherings, meals with friends, volunteering, or a visit to see Santa — in more dire limbo.

Despite being more than nine months into the pandemic, figuring out whether and how to approach a previously routine event is still complicated. And the calculus seems to change with new case rates and evolving guidelines — and with our own fluctuating pandemic burnout.

Experts are still parsing the data on what role Thanksgiving played in the increase in Covid-19 cases and deaths. But the hard fact remains that, with case rates so high, “all activities are going to have some risk of being impinged upon by the virus,” says Amesh Adalja, a physician and faculty member of the Johns Hopkins University Bloomberg School of Public Health’s department of environmental health and engineering.

And doing things with people you know — but aren’t living with — can heighten that risk. Just because you love them, a family member or old acquaintance doesn’t have any lower risk of carrying or catching the virus than a stranger does. And it will likely make you less careful than if you were interacting with a stranger.

So this winter is going to be different, but it doesn’t have to be all bad unless we are determined to think of it that way. “Usually people find the holidays stressful, so this could potentially be the year with less stress — just see what it feels like not to go to or host all those parties,” Krysia Lindan, an epidemiologist at the University of California San Francisco, notes in an email to Vox. She calls it a year for “some experimentation.” For example, she had a picnic on the beach for Thanksgiving this year. Other experts suggest trying different activities, like a distanced hike instead of gathering around a meal or at a party.

A big part of the challenge is that Covid-19 spreads before people start showing symptoms. So anybody can show up feeling the picture of health only to unwittingly spread the virus to those they come into close contact with.

We talked with epidemiologists and other health experts about the safest — and riskiest — ways to see others, keep kids busy, help out, and travel this winter during the pandemic. (Note: Activities are ranked relatively within each category, so a “moderate” risk in one category does not carry the same relative risk as “moderate” in another category.) Here is what they said.

As a result of the pandemic, millions of people in the US are struggling to put enough food on the table for themselves and their families. More people need help this winter than perhaps at any other time in the past 80-plus years. So there has been no better time to find ways to help others.

Helping out not only benefits others, it also has a knock-on positive effect for you. For example, thinking about and helping others is a really important way to combat anxiety and stress and a feeling of helplessness — all of which are currently pervasive.

“It’s always good to volunteer, and doing so might lighten the sadness of not being able to see family and friends as in years past,” Lindan writes.

Other experts agree: “I do think people are hungry for ways to help each other right now,” says Jodie Guest, vice-chair of the department of epidemiology at Emory University’s Rollins School of Public Health.

Safest: Give money

Charitable organizations can often stretch donated money further than donated goods. So financial contributions are especially helpful, in addition to being Covid-19 transmission-free. Established charity-rating sites, such as GuideStar or Charity Navigator, can tell you how much of your contribution will go directly to the cause.

Next safest: No-contact help

The next safest way to help out this season is through contact-free volunteering or donations. This could be a formal, organized effort, like contributing food to a local pantry, or it could be personal efforts, like arranging grocery or meal deliveries for higher-risk community members.

Guest notes that these kinds of efforts can also safely be turned into a shared experience of sorts — such as organizing a coat or blanket drive with friends, family, or neighbors. (She suggests quarantining the donated goods for three days before you touch them.)

Moderate: Helping out in person with a few others

There are many organizations that rely heavily on behind-the-scenes volunteers. Food pantries or clothing and household goods distribution centers might offer opportunities to donate time and help in a slightly safer environment than, say, serving meals. Before you go, find out how many other people you will be working with, if they require masks, and how long you will be expected to work (shorter shifts are better for limiting exposure).

You shouldn’t have to look far for opportunities to contribute this way in your area, says Guest: Since the start of the pandemic, “the need for volunteers has only gotten bigger.”

Riskier: Volunteering in person with larger numbers of people

If you want to do more personal work, first check in with places where you might want to volunteer and ask if they are accepting in-person help and what precautions they are taking. For instance, if you want to serve meals, ask how many people they allow in at any time, if people are required to have masks, how often the organization cleans the area, and whether you will be the only one touching serving utensils, Guest notes.

“You should continue to use the same precautions as always when in a group setting — masks, even face shields, hand-washing, and distancing to the extent possible,” Lindan writes.

Riskiest: Volunteering in congregate living settings

The highest-risk ways to give back this year are those where you volunteer in person in a place where lots of people live, whether that’s a homeless shelter or an assisted living facility. Each carries different risks in terms of acquiring the virus or passing it along. But, as Guest notes, most of these places are being quite careful in terms of their protocol around any outside people (and whether they allow them at all). Even so, it’s still good to check on their practices first. You can also ask if there are other ways your time or money could be even more valuable to them than serving in person.

Whether you usually celebrate Christmas, Festivus, New Year’s, or a birthday this time of year, it’s likely that plans for a get-together will need to be adapted — if not scuttled altogether.

For one, having people from different households together is risky. Before the pandemic, more than 85 percent of Americans planned to attend a gathering with extended family or friends for the holidays. And the average holiday meal included about 11 people.

Now, in many states, that exceeds the limit allowed for private gatherings. (The maximum is 10 or fewer — sometimes as few as five — in many places, including Connecticut, Delaware, Idaho, Illinois, Kentucky, Massachusetts, Mississippi, Nevada, New Mexico, New York, North Carolina, Ohio, Oregon, Pennsylvania, Texas, Virginia, Washington, and Washington, DC. And in some states — including California, Colorado, Illinois, Minnesota, Rhode Island, Vermont, and Washington, gatherings cannot include people from other households at all.)

Even if your state allows gatherings (decisions that are often made based on a variety of reasons including transmission rates and also political and economic interests), there are good reasons to reconsider get-togethers.

In many places, for example, “you shouldn’t do anything with people you aren’t actively living with [because] there’s so much virus spreading out in the community,” says Lisa Gralinski, an epidemiologist at the University of North Carolina Gillings School of Global Public Health. For example, an area with more than 5 percent of tests coming back positive indicates that there is undocumented community spread. Just two states as of mid-December have test positivity rates below that. Even in those places, she says, “I would encourage people to be incredibly cautious.”

As Lindan notes, it is especially important to “avoid multi-generational gatherings that include older adults and those with pre-disposing health conditions.”

Expected family time might need to be skipped this year. “This may be the year not to invite your young adult children to come home or, conversely, to visit your parents or grandparents,” Lindan writes.

The final Covid-19 caution to remind others of is that this particular virus frequently spreads just before someone develops symptoms (as well as from people who never develop symptoms at all). So feeling fine provides little to no measure of safety.

With these things in mind, here are considerations for different formats of gatherings this season.

Safest: Virtual

It’s hard to pass the dessert when you’re celebrating on Zoom. But it’s also impossible to pass Covid-19.

Althoff said that although she loves visiting her “ginormous” family in Iowa, she won’t be seeing them in person this year. Instead, she is planning to partake in video toasts and virtual game nights with family and friends.

Other ideas include having everyone make the same food or drink to enjoy during the call or playing a game of charades — or even enlisting kids to provide entertainment.

Next safest: Small, short, outdoors, distanced, and masked — hold the food and drink

For some, seeing others in person is not something they are willing to hold off on until there is widespread vaccination. So the safest way to do this is by keeping gatherings small, brief, outdoors, distanced, and continuously masked — which means no food and drink.

“Outside is where we want to be if we want to be together,” Guest says. She also recommends keeping it under a total of 10 people — with only one or (if your area permits it) two other households — and keeping everyone separated by household pod.

One caution this time of year is to be mindful of outdoor heaters. They can help extend the outdoor season, but if too many people are crowded around them, that could increase the risk of disease spread. As Guest notes, she bought two heaters for her porch: one for her household and the other, spaced far away, for one couple they see regularly, outdoors.

Moderate risk: Outdoor meal

If eating and/or drinking are non-negotiable, “Consider having tables spaced around outside and people within bubbles or family units seated together,” Lindan writes.

Guest adds that everyone should be masked when they’re not eating or drinking. People should also be mindful of alcohol consumption, she says, as it reduces inhibitions, making people less likely to stick with safety protocols and more likely to revert to pre-pandemic socializing behaviors.

Riskier: Indoors, distanced, and masked — or testing and quarantining

If you decide having people together indoors is the only option, there are several things you can do to decrease the risk of turning your event into a Covid-19 outbreak. Most of the usual advice applies: Ensure people keep their masks on at all times and remain physically distant. Keeping households in different areas “is not perfect,” says Gralinski, “but it’s better than completely intermingling and being right next to each other.”

Keep the event short, and limit the number of people attending. And increase air circulation by opening windows, turning on fans, and cranking on the central AC or heat, Althoff said.

But be forewarned that although a gathering might be set up with the best of plans — distanced seats, open windows, masks — indoor risk is higher than outdoor risk, says Adalja. “Especially if it’s a social gathering with friends or family that [people] feel comfortable around.”

If strict distancing seems like it will be challenging, one option is to have everyone test and quarantine beforehand. It’s not a perfect strategy, but it can decrease risks a bit. Here’s how:

• Test: Have everyone get a Covid-19 test before the gathering — and if anyone is traveling, they should test before they make the trip.
• Quarantine after testing and before seeing others: This means households should avoid contact with others, including not going to the grocery store, work, or school in person. “Once you test, you need to quarantine as much as possible,” Guest says, so that you don’t then contract the virus in the interim. The CDC is recommending that people traveling should quarantine for at least a week upon arrival — as well as testing again three to five days after traveling.

Now, if everyone is negative, the gathering could proceed with slightly less worry about spreading Covid-19.

Adalja recommends doing some research on testing first. Many places are facing delays returning results, and the American Clinical Laboratory Association has warned of increased stress on testing capacity and shortages of testing equipment ahead of the holidays.

Also, as Adalja points out, “Test results are not ironclad — just look at the White House,” where top-level officials are tested regularly but there have still been numerous outbreaks. And tests are only a snapshot of one point in time and can even return negative results if someone is early on in their infection.

If someone is unable to effectively quarantine upon arrival (say, a young adult who comes home to their parents’ house and cannot remain entirely separate from other household members), the next best option is to at least get everyone tested and attempt as much of a quarantine as possible while awaiting results, says Lindan.

Riskiest: Indoors with few or no precautions

A standard, sit-down indoor meal with anyone outside of your household presents a substantially increased risk of transmitting the virus. Other things that further increase the risk include a large number of people, multiple households, a lengthy gathering, physical closeness — whether that’s people packed into a kitchen cooking together or around a table — limited mask-wearing, and shouting (it was an election year, after all) or singing (hold the holiday songs).

“I would just avoid large gatherings indoors at all costs,” Lindan says. “I know it’s really hard.”

Traveling during the holidays is usually a little hellish: crowded planes, overheated trains, and gridlocked automobiles. But this year, the specter of Covid-19 makes it that much more daunting.

“Given the rise in cases throughout many parts of the US, the best advice is to avoid travel at this time,” Lindan writes. The CDC has, in fact, asked people to avoid travel.

Travel right now can also get pretty complicated pretty quickly, and not just because you need to pack extra masks and hand sanitizer.

Some 24 states and the District of Columbia have travel advisories or orders — carrying fines of up to $10,000 for violating them — for some or all people to test, quarantine, and/or submit official paperwork if they will be visiting the state for more than 24 hours (i.e., not just traveling through). So that usual week-long visit to see family in California, New York, or Chicago, for example, isn’t going to be as feasible. (Specific guidance is also available through the CDC’s travel planner.) “It might be a logistical nightmare to make sure you’re in compliance,” Adalja said in a November press briefing.

In addition to state or city guidelines for travel, many employers, schools, and day cares are issuing rules about travel, so Althoff advised reviewing those as well. “Be ready to accept abrupt changes to your travel plans.”

If you must travel this winter, there are ways to reduce your risk of catching or spreading the virus. Much of it depends on how you travel.

Safer: Self-contained car trip with your household

In this case, while you’re in the car, you’re just with your pod. But the key is to make it household members only. Expanding the roster to other people vastly increases the risk of this mode of travel, especially since, “If you’re taking a road trip with a bunch of your friends, you’re more likely to be unmasked, and you’re less likely to distance,” Adalja says.

Things to consider along the way: where you’ll eat, where you’ll sleep, and where you’ll make pit stops.

Short pit stops to use a public bathroom should be okay, says Guest — wear your mask and wash and/or sanitize your hands. Some travelers are choosing to bring their own open-air facilities on car trips these days.

“The safest is going to be being self-contained as much as possible,” Gralinski says. For sleeping, that might mean renting a dwelling that you have entirely to yourself to stay in “and bringing as many supplies as you possibly can.” The idea is to minimize contact with others, which includes limiting trips to a local grocery store. For additional food, curbside pickup and drive-through are safest.

What about hotels? A November study in Nature, based on cellphone data of 98 million people in large cities, found that this spring, hotels and motels were fairly large drivers of Covid-19 spread — just below restaurants, gyms, and cafes. (Their data, though, is from March 1 to May 2, a period during which mask mandates and other Covid-19-prevention protocols were just starting.)

Adalja says these days hotels are taking many more precautions and should be fairly safe so long as you’re careful. “It’s not the hotel itself, it’s what you do in the hotel,” he says. So wear a face covering, wash your hands, and avoid other people (for example, skip the elevator, restaurant, bar, and lobby common areas).

For her part, Gralinski said she still avoids hotels. For a fall vacation she and her husband took, they rented a camper to travel in. “We had our own bedroom, our own bathroom, got curbside takeout; we were pretty self-sufficient,” she says. They would park in the driveways of friends’ houses and see them safely from a distance outdoors. Even though it was cold, it worked. “We got to see friends, and it was amazing.”

Moderate risk: Airplane

We still don’t have definitive data on the safety of air travel right now. Many of the studies that looked at airplane risk — which did show cases of transmission — were carried out before masks were required.

Increasing the safety is the fact that masks are now mandated, and planes have very high rates of air circulation — replacing the full air of the cabin with clean air about 20 to 30 times per hour, thus hopefully removing more virus from the air. “The data does show that airline travel is fairly safe right now if people are wearing face coverings,” Adalja says.

But there are other downsides to flying, and they mostly have to do with other people. Namely, you’re in close proximity to a lot of them — even with middle seats empty, as they remain on some, but not all, airlines — and you’re largely at the mercy of their choices. Do they keep their mask on for the entire flight or have it off for long stretches?

Another thing to be mindful of in air travel is that it involves a lot more than just sitting on a plane. ”It’s the whole experience,” Althoff says, including airport shuttles, lines, lots of high-touch surfaces, and people mingling from all over the country, including areas with very high rates of transmission. If you’re going to be in an airport, she advises to “practice your statement about how you will remind a stranger to maintain a distance.”

Also, be prepared to remind people about masks. In airports and even in airplanes, “insouciant mask-wearing — by having them dangle from earlobes or positioned under the nose — still seems to happen,” Lindan says. “Don’t be afraid to ask people to put on their masks when in the airport.”

How can you lower your risk if you do decide to fly? Wear not only a good mask but also eye protection, such as sunglasses, safety glasses, goggles, or a face shield (with a mask), says Guest. Also, you can check to see if a flight will serve snacks or beverages. This used to be a perk, but these things now up the odds of virus transmission as people remove their masks to eat or drink, so if possible you might want to avoid a flight with food and drink services. “If you need to eat or drink something on a plane, do so when other people are not eating,” Lindan writes. “Keep your mask on, and only lift it up to insert food or drink into your mouth.”

Slightly riskier: Train

There has been even less research on train travel than on plane travel. A study from passenger trains in China relatively early in the pandemic — mid-December 2019 through early March 2020 — found Covid-19 spread fairly easily to nearby passengers on these trips, especially if people were in close proximity for more than three hours. Based on these findings, which were published over the summer, the authors suggested physical distancing, mask-wearing, and improved air filtration would lower the rate of spread on trains.

These are all steps Amtrak has instituted, along with enhanced cleaning and other measures. Trains also have the advantage of generally having fewer passengers per square foot than planes, and you might be more able to get away from someone who is not following the rules or appears ill. (Amtrak also offers private rooms on some trains.)

However, experts we spoke with suggested it might still be slightly riskier than air travel. This is in part because distance train trips are more likely to be longer than a typical domestic flight, increasing your exposure time to others. Train cars also don’t quite have the same rate of air replacement as an airplane cabin — Amtrak is promising clean air exchange 12 to 15 times an hour.

Like airports, there are also train stations to contend with — and there might be even less enforcement of rules, as they are typically more open to the public (rather than the majority of airport space being behind TSA checkpoint screening).

Riskiest: Long-haul bus

We also don’t have a lot of solid scientific information about the risk of Covid-19 transmission on long-haul buses. But early research suggests this mode of travel could be riskier than planes or trains, especially when people aren’t taking proper precautions. One case study showed how a single sick passenger on a bus in China infected 23 of 67 others on a drive that was less than an hour. Of note, though, is that in this superspreading event, which occurred in January 2020, none of the passengers were wearing masks, and the bus was recirculating air.

Bus companies in the US have updated safety protocols to help reduce spread of the virus. Greyhound, for example, requires face masks, has upped cleaning and sanitizing of its buses, replaces the bus air about 12 times per hour, and is “encouraging” passengers to physically distance.

Epidemiologists, however, are still warier of bus travel over other modes of transport right now. “It might be harder on a longer ride to keep your mask on, and it’s probably not as enforced as it is on an airplane,” Adalja says.

Outside, outside, and mostly outside is what experts say as a general rule for kid activities this winter. To that end, if you live in a colder climate, it’s an important year to make sure you have warm outdoor gear that fits your kids well.

That said, there are some caveats to this guidance. Not all outdoor activities are created equal, and there could be some indoor ones that, if done responsibly, could carry slightly less risk. It’s also important to remember that “the virus survives longer in the winter due to the lower temperature and lower humidity, resulting in increased risk of transmission in winter compared to summer,” Dean Blumberg, chief of pediatric infectious disease at the UC Davis Children’s Hospital, writes in an email to Vox.

Safest: Activity with only household members

The activities that carry the lowest risk of Covid-19 for kids are the same as adults: avoiding exposure to anyone outside the household, whether it’s indoors or out.

This could mean there’s more screen time this winter — including those video calls with family and friends. Or time offline doing crafts (particularly to give to people you cannot see in person) or house projects, such as cleaning out old toys and clothing to donate. Or bundling up for outdoor activities away from other households, such as exploring quiet parks, hiking, biking, or sledding.

Moderate: Quiet indoor activity with masks and distancing

What about all of those museums and movie theaters that were key — especially during long school breaks — in the Before Times? “If you’re going to a kids museum where you’re restricting the number of people, and everybody’s wearing a mask and hand-washing, and they have good air filtration, that’s probably okay,” Lindan says.

Adalja agrees. Even though a museum is indoors, “if they’re distanced and wearing masks, that becomes an obstacle that’s harder for the virus to overcome.”

That said, some experts caution that other indoor activities — even though they might seem to have similar precautions — carry higher risk, especially if local case numbers are high. “If there is increased transmission in your community, then an indoor activity like a movie theater is risky,” noted Blumberg. “There may be compromising of social distancing in common areas, such as corridors and bathrooms, and people may not be masking at all times as they sip their soda or snack.”

Riskier: Busy outdoor activity with intermittent distancing and masking

According to the experts we spoke with, a busy playground might bring higher risk of Covid-19 transmission than a quiet indoor activity in which all of the best protocols are being followed.

For example, “playgrounds — those are not ever going to be without risk,” Adalja says. Not all kids are diligent about wearing their masks, surfaces are very high-touch, and it’s essentially impossible to keep children physically distanced. “That’s a risk where you have to make an individual risk calculation,” he says.

Also, outdoor sports in which kids come into contact with one another increase the risk of transmission, as could crowded outdoor events or activities, especially those where people do not always have their masks on (such as for eating or drinking).

Riskiest: Close activities indoors with others

Families are all having to make the best decisions for themselves. And keeping kids isolated from others, especially on school breaks or when schools are remote, is not always feasible.

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Adalja suggests some things families can do to lower the risk in these situations. Continue to avoid any crowded indoor spaces where you will come into contact with other households. Instead, work with another family or two (if permitted in your locality) to establish a small, closed group of children for in-person visits, ensuring everyone is comfortable with each household’s risks and behavior, and insist on hand-washing.

“The whole thing is about weighing risks and benefits,” he says. “Children playing is crucial for psychosocial development. It is a balancing act.” But high levels of community transmission can tip those scales and make in-person activities with friends too risky for many. And any time group visits can be outdoors, that will help lower the risk.

We have an opportunity, through our actions, to make a real impact on the spread of the pandemic — not just among our own circles but in the broader community. This has important implications for health justice and equity because when the virus spreads, it is more likely to hit and cause greater harm to essential workers, their families, and people of color.

“Our epidemic is only going to recede if people take the appropriate precautions,” Lindan writes to Vox. “The problem is that we just do not want to do what we have to do.”

So this winter will take some acceptance, perseverance, and perspective.

How are epidemiologists putting this difficult season into perspective for themselves? For one, by “acknowledging that this is hard and that the holidays of 2020 are going to look much different,” Guest says. “We need to be cautious and protect each other now so that when we do get together [in the future] everyone we care about is there. It’s important to keep that in mind so that these sacrifices now feel like they’re worth it.”

Lindan agrees. “It’s really difficult over the holidays. We want to see our family and friends, and it’s a really difficult task not to after living this way for so long. But it’s a small price to pay for the long-term benefit.”

And as Althoff reminds us, “We will be telling stories from these holidays for generations to come.” It’s largely in our control to make them the right ones.

Katherine Harmon Courage is a freelance science journalist and author of Cultured and and Octopus! Find her on Twitter at @KHCourage.