Gun Violence

Most Gun Laws Aren't Backed Up By Evidence. Here's Why.

By Maggie Koerth

Feb. 6, 2023, at 6:00 AM

In the first month of 2023, 25 people lost their lives in four mass shootings in California over just eight days. It’s a grim statistic, made all the more distressing when you consider the fact that California has one of the lowest gun death rates in the entire country. This is what a safe state looks like. 

California also has some of the strictest gun control laws in the country. And in the aftermath of those four mass shootings, new House Speaker Kevin McCarthy — who represents a district in southern California — took the opportunity to poke at the state’s firearms restrictions, saying in a press conference that federal gun control legislation would not be an automatic response to these tragedies because such laws “apparently … did not work in this situation.” 

Watch: https://abcnews.go.com/fivethirtyeight/video/tyre-nicholss-murder-finally-make-congress-police-reform-96801092

So, did California’s gun laws succeed at making it one of the safest states … or did they fail to stop a string of mass shootings? Questions about the efficacy of gun laws have gotten easier to answer in recent years as changes to federal policy have helped to bring money and people back to the field of gun violence research. But decades of neglect mean there are still lots of blank spaces — policies that don’t yet have good quality data backing them up. A recent report from the Rand Corporation that reviewed the evidence behind a variety of gun policies found just three that were supported by evidence that met the report’s quality standards.¹ 

That fact, however, doesn’t mean other gun laws don’t work — just that the research proving it doesn’t yet exist. Scientists I spoke to saw it as an “absence of evidence” problem, stemming from long-standing, intentional roadblocks in the path of gun violence research. Even the authors of the Rand report say lawmakers should still be putting policies aimed at preventing gun violence into practice now — regardless of what the science does or doesn’t say.

“I think that the goal of the lawmaker is to pick laws that they have a reasonable hope will be better than the status quo,” said Andrew Morral, a senior behavioral scientist at the Rand Corporation. “And there’s lots of ways of persuading oneself that that may be true, that don’t have to do with appealing to strict scientific evidence.”

California doesn’t just have some of the nation’s strictest gun laws and lowest gun death rates, it’s also maybe the best state to study gun laws in, said Dr. Garen Wintemute, director of the Violence Prevention Research Program at University of California, Davis Medical Center. That’s because of both the way the state makes data available to researchers and its willingness to work with researchers to further the science. Wintemute is currently part of a team that is working on a randomized controlled trial of one particular California gun law — an initiative that tracks legal gun owners over time and dispatches authorities to remove their weapons if those people later break a law or develop a condition that would make them ineligible to own guns in the state. 

It’s hard to oversell what a big deal this is. Frequently referred to as the “gold standard” of evidence-based medicine, randomized controlled trials split participants randomly (natch) into groups of people who get the treatment and groups that don’t. Because of that, it’s easier for researchers to figure out if a medication is actually working — or if it just appears to be working because of some other factor the people in the study happen to share. These kinds of studies are crucial, but almost impossible to do with public policy because, after all, how often can you randomly apply a law? 

But California has been willing to try. It took cooperation from many different levels of state leadership, Wintemute said. The government was always going to slowly expand this particular program statewide, but in this case legislators were willing to work with scientists and randomize that expansion across more than 1,000 communities, so that some randomly became part of the program earlier and some later. When the study finally concludes, researchers will be able to compare these two groups and see how joining the program affected gun violence in those places with a high level of confidence. 

Most of the time, however, the scientists who study gun laws aren’t working with the kind of research methodology like this that produces strong results. Morral, along with his Rand colleague, economist Rosanna Smart, have reviewed the vast majority of the research on gun control policies done between 1995 and 2020. Their research synthesis found that a lot of what is out there are cross-sectional studies — observational research that basically just compares gun violence statistics at one point in time in a state that has a specific law to those in a state that doesn’t. That type of study is prone to mixing up correlation and causation, Smart said. There could be lots of reasons why California has lower rates of gun violence than Alabama, but studies like this don’t try to tease apart what’s going on. They end up being interpreted by the public as proof a law works when all they’ve really done is identified differences between states. 

The Rand analysis threw out these kinds of studies and only looks at research that is, at least, quasi-experimental — studies that tracked changes in outcomes over time between comparison groups. Even then, the analysis ranked some studies as lower quality than others, based on factors such as how broadly the results could be applied. For instance, a study that only looked at the effects of minimum age requirements for gun ownership in one state would be ranked lower than a study that looked at those effects in every state where a law like that existed.

Watch: https://abcnews.go.com/fivethirtyeight/video/americans-view-crime-gun-violence-issues-fivethirtyeight-88152853

Following these rules, the Rand team found just three policies that have strong evidence supporting outcomes — and two of these are about the negative outcomes of policies that increase gun access. Stand-your-ground laws, which allow gun owners to use deadly force without trying to leave or deescalate a situation, appear to increase firearm homicides. Meanwhile, conceal-carry laws, which allow gun owners to carry a gun in public places, appear to increase the number of all homicides and increase the number of firearm homicides, specifically. The only laws restricting gun ownership that have this level of evidence behind them are child-access prevention laws, which have been shown to reduce firearm suicide, unintentional self-injuries and death, and homicides among young people. 

That makes gun control laws seem flimsy, but it shouldn’t, Morral said. Instead, the lack of evidence ought to be understood as a product of political decisions that have taken the already challenging job of social science and made it even harder. The Dickey Amendment, first attached to the 1996 omnibus spending bill, for example, famously prevented the Centers for Disease Control and Prevention from funding gun violence studies for decades. A new interpretation of that amendment in 2018 changed that, but Dickey wasn’t the only thing making it hard to study gun violence. 

Instead, the researchers told me, the biggest impediment to demonstrating whether gun control policies work is the way politicians have intentionally blocked access to the data that would be necessary to do that research. 

“So for instance, the federal government has this massive, great survey of behavioral risk indicators that they do every year in every state,” Morral said. “And you can get fantastic information on Americans’ fruit juice consumption as a risk factor for diabetes. But you can’t get whether or not they own guns.” Not knowing gun ownership rates at the state level makes it hard to evaluate causality of some gun control policies, he explained. “And it’s not because anyone thinks [gun ownership] is not a risk factor for various outcomes. It’s because it’s guns.”

The missing data problem also includes the 2003 Tiahrt Amendment that prevents the sharing of data tracing the origins of guns used in crimes with researchers, said Cassandra Crifasi, co-director of the Center for Gun Violence Solutions at Johns Hopkins University. “So now all we can see are these sort of aggregate-level state statistics,” she said. “We can no longer look at things like, when a gun is recovered in a crime, was the purchaser the same person who was in possession of the gun at the time of the crime?” 

Recently, researchers have even been missing basic crime data that used to be reported by the FBI’s Uniform Crime Reporting program. Law enforcement agencies and states were supposed to be shifting to the relatively new, much more detailed National Incident-Based Reporting System, but the transition has been a catastrophe, with some of the biggest law enforcement agencies in the country not yet making the switch because of financial and logistical complications, Smart said. “The FBI has not been able to report for the last eight quarters whether homicide rates are up or down,” Morral added. 

But much of the data that’s not available at a national level is available in California, Wintemute said. “Unlike researchers in any other state, we have access to individual firearm purchaser records,” he told me — the very data the Tiahrt Amendment blocks at the national level. “We do studies involving 100,000 gun purchasers, individually known to us, and we follow them forward in time to look for evidence of criminal activity or death or whatever the outcome might be that we’re studying,” Wintemute said. 

Unfortunately, because the data is only available in California, the results of those studies would only be applicable to California — making it data that wouldn’t be considered high-quality in the Rand report. Wintemute can demonstrate if a policy is working in his home state, but not whether it works in a big, broad, existential sense. It wouldn’t count towards expanding the number of policies Rand has found evidence to support. This is something researchers like Crifasi see as a flaw in the Rand analysis, but it’s also a reason why Morral and Smart don’t think evidence-based policy is a good standard to apply to gun control to begin with. 

It’s useful to know what there is evidence to support, Morral said. “But we don’t at all believe that legislation should rest on strong scientific evidence,” he said. Instead, the researchers from Rand described scientific evidence as a luxury that legislators don’t yet have. 

“There’s always gonna be somebody who’s the first person to implement the law,” said Smart. “And they’re going to have to derive their decision based on theory and other considerations that are not empirical scientific evidence.”

Watch: https://abcnews.go.com/fivethirtyeight/video/supreme-courts-gun-ruling-remakes-gun-control-americans-85660014

Education

Teaching In The Age Of AI Means Getting Creative

By Zoha Qamar

Jan. 23, 2023, at 6:00 AM

Alarm bells seemed to sound in teachers’ lounges across America late last year with the debut of ChatGPT — an AI chatbot that was both easy to use and capable of producing dialogue-like responses, including longer-form writing and essays. Some writers and educators went so far as to even forecast the death of student papers. However, not everyone was convinced it was time to panic. Plenty of naysayers pointed to the bot’s unreliable results, factual inaccuracies and dull tone, and insisted that the technology wouldn’t replace real writing.  

Indeed, ChatGPT and similar AI systems are being used in realms beyond education, but classrooms seem to be where fears about the bot’s misuse — and ideas to adapt alongside evolving technology — are playing out first. The realities of ChatGPT are forcing professors to take a long look at today’s teaching methods and what they actually offer to students. Current types of assessment, including the basic essays ChatGPT can mimic, may become obsolete. But instead of branding the AI as a gimmick or threat, some educators say this chatbot could end up recalibrating the way they teach, what they teach and why they teach it. 

At Santa Clara University this month, 32 students began a course called “Artificial Intelligence and Ethics” where the usual method of assessment — writing — would no be longer in use. The course is taught by Brian Green, who also serves as director of the university’s Markkula Center for Applied Ethics, and in lieu of essays, he’ll be setting up one-on-one sessions with each student to hold ten-minute conversations. He said it doesn’t take any more time to evaluate that than to grade an essay.

“In that context, you really remove any possibility of text-generating software. And in talking to them, it really becomes all about whether they understand the material,” he said.

Watch: https://abcnews.go.com/fivethirtyeight/video/epa-finally-addressing-4-dangerous-forever-chemicals-4000-95750270

But such an approach may not be realistic in all educational contexts, especially in schools where resources are scarcer and teacher-to-student ratios are worse. 

On some campuses, the response to such technology has simply been to restrict access. Earlier this month, the New York City Department of Education announced that ChatGPT would be banned on networks and devices throughout its public schools. “While the tool may be able to provide quick and easy answers to questions, it does not build critical-thinking and problem-solving skills, which are essential for academic and lifelong success,” a department spokesperson said in a statement. 

And the country’s largest public-school system isn’t alone: Educators at different levels across the world have aired their concerns, and other districts in the U.S., like the Seattle public-school system, have also restricted the technology.

But such bans are hardly a solution. Anyone with access to a smartphone — such as 95 percent of Americans between the ages of 13 and 17, according to Pew Research Center polling conducted last spring — can easily bypass these restrictions without needing a school computer or campus Wi-Fi. 

And some teachers told FiveThirtyEight they see bans on ChatGPT as misguided responses that misunderstand what the tool can and cannot provide. 

“ChatGPT may have better syntax than humans, but it’s shallow on research and critical thinking,” said Lauren Goodlad, a professor of English and comparative literature at Rutgers University and the chair of its Critical Artificial Intelligence initiative. She said she understands where concern about the tool is coming from but that — at least at the college level — the type and caliber of written tasks that ChatGPT can offer does not replace critical thinking and human creativity. “These are statistical models,” she said. “And so they favor probability, as in they are trained on data, and the only reason they work as well as they do is that they are looking for probable responses to a prompt.”

These point to limitations that stifle chatbots’ originality, such as how statistical models favor using more common words at the expense of rarer ones that human authors might use. Goodlad also pointed out that, for now, the tool is not always accurate. For example, ChatGPT is prone to “hallucinations” — or providing false sources and quotations. 

It’s those kinds of markers that may also currently help teachers not only catch students attempting to pass ChatGPT-generated text off as their own writing, but also institute measures that encourage students to do the work themselves. Some suggestions that she and her colleagues have outlined include asking students to reference class discussions in their work, to attach a reflection video or blurb of why they chose the writing points they did and to require that specific rhetorical skills appear in the piece.

But it’s most important that schools evolve by changing what they emphasize in their syllabi, Goodlad said, suggesting that educators instead lean into teaching methods and written assessments that underscore critical thinking. Otherwise, these approaches could quickly become outdated. 

“The entire space has essentially become an arms race,” Green said, adding that anti-cheating technology remains in perpetual competition with the technology to circumvent it, as has been the case for years with plagiarism detectors like TurnItIn. The dynamic with ChatGPT will likely follow the same pattern. For example, earlier this month, Princeton student Edward Tian revealed that he’d developed software to detect ChatGPT-written work. And while the news did enjoy some praise, many also see it as merely a stopgap measure. 

“These tools are only going to get more advanced,” said Hod Lipson, a professor of mechanical engineering and Data Science at Columbia University. “This is not unlike the beginning of the internet or Wikipedia. And it would have been a mistake to prohibit students from using Wikipedia or Google search, right?” The question is not whether to ban the technology but how to evolve alongside it, he said.

Lipson is trying to integrate ChatGPT and similar technologies in his teaching. For example, in his introductory robotics course this semester, he’ll be asking his students to use DALL-E — an image-generating software developed by ChatGPT’s parent company, OpenAI, and underpinned by similar tech — to help ideate their initial sketches for the robotics project they’ll work on throughout the term. “With just a few keywords,” he said, “it takes the machine about 25 seconds to generate maybe 25 designs or concepts — something that would have otherwise taken students a week to produce.” 

In lieu of bans, then, the future of teaching may be some combination of new methods utilizing tools like ChatGPT and older approaches — like pen-and-paper exams, as some Australian universities are bringing back — that help regulate students’ reliance on technology. 

And many educators, no matter their current approaches to ChatGPT, continue to lean into the optimism that such technology will ultimately push us to get at the heart and soul of what it means to educate, with a focus on deeper comprehension rather than simply developing a skill. 

“We know calculators exist,” said Green. “But we still teach math.”

Watch: https://abcnews.go.com/fivethirtyeight/video/californias-senate-primary-doozy-fivethirtyeight-politics-podcast-96493536

2022 In Review

The Numbers That Defined 2022

By Anna Rothschild

Dec. 30, 2022, at 6:00 AM

What a year 2022 has been. There was so … much … news. We saw record-high inflation, war in Ukraine, a landmark Supreme Court session, continuing effects of the pandemic, the Winter Olympics, the death of Queen Elizabeth II, the World Cup and, of course, the midterms. In typical FiveThirtyEight fashion, we’ve been reflecting on 2022 the way we do best: through numbers. Here, seven of our reporters share some of the most important stats of the year, highlighting big political decisions, feelings of the electorate and hints at what’s to come in 2023.

Poverty

In September, the U.S. Census Bureau released its annual supplemental poverty rate for the previous year. That’s the poverty rate after accounting for the impact of key government programs targeted at low-income families, among other things. For reporter and editor Santul Nerkar, the defining number of the year was 7.8 percent, the supplemental poverty rate for 2021 and lowest rate on record. It was the first concrete measure of how COVID-19 stimulus money affected poverty in America.

Watch: https://abcnews.go.com/fivethirtyeight/video/us-poverty-rate-hit-record-low-expect-stay-95391465

Abortion

In June, the Supreme Court released its decision in Dobbs v. Jackson Women’s Health Organization, overturning Roe v. Wade as the law of the land. In short order, many states enacted abortion bans, including total bans without exceptions for rape or incest. For senior writer Amelia Thomson-DeVeaux, the defining number of the year was 10,000 — that’s how many fewer legal abortions there were in just the first two months after Roe v. Wade was overturned.

Watch: https://abcnews.go.com/fivethirtyeight/video/number-captures-impact-dobbs-decision-fivethirtyeight-95627922

Forever chemicals

Per- and polyfluorinated chemicals, or PFAS, are used in all sorts of household products, from nonstick pans to dental floss. These pervasive chemicals are dangerous to human health, and the government and industry are finally starting to crack down on them. That brings us to senior science reporter Maggie Koerth’s numbers of the year: four, the number of PFAS the Environmental Protection Agency released new guidelines for, and 4,700, the rough number of different PFAS chemicals out there.

Watch: https://abcnews.go.com/fivethirtyeight/video/epa-finally-addressing-4-dangerous-forever-chemicals-4000-95750270

Election deniers

Denying the results of the 2020 presidential election was the cornerstone of many Republican campaigns this election cycle. Election denial is hardly a new thing, but it reached unprecedented levels in the 2022 midterms. That’s why 47 is the defining number of the year for politics and tech reporter Kaleigh Rogers. It’s the percentage of Republican candidates who ran for House, Senate, governor, secretary of state and attorney general this year and didn’t accept the legitimacy of the 2020 election.

Watch: https://abcnews.go.com/fivethirtyeight/video/number-election-denying-republicans-defined-2022-midterms-fivethirtyeight-95710927

Inflation

Heading into the midterm elections, Americans told pollsters that one issue was their top priority: the economy and inflation. For senior writer Monica Potts, the 9.1 percent inflation rate in June topped her list of most important stats of the year. Here she explores the ways — big and small — that historic levels of inflation affected American lives in 2022.

Watch: https://abcnews.go.com/fivethirtyeight/video/inflations-41-year-high-impacted-american-life-fivethirtyeight-95850805

The Republican margin in the House

The results of the 2022 election were worse for Republicans than one might expect, given that the president’s party usually loses ground in the midterms. In the U.S. House, Republicans gained a majority but only a slim one. They won by only nine seats, which for editor Maya Sweedler is one of the most important numbers of the year. What Republicans will — and won’t — be able to do with that majority will define American politics for at least the next two years.

Watch: https://abcnews.go.com/fivethirtyeight/video/number-shape-republicans-politics-2023-fivethirtyeight-95905408

Democratic trifectas

With Congress divided between Democrats and Republicans after the 2022 midterms, some of the most important political shifts of the next few years could be coming at the state level. Those new policies might lean liberal because, for the first time in 12 years, more Americans will live in states totally controlled by Democrats than by Republicans. That’s why senior elections analyst Nathaniel Rakich picked 140 million as his defining stat of the year. It’s the number of Americans who will soon be living in a state where Democrats will have total control over state government.

Watch: https://abcnews.go.com/fivethirtyeight/video/140-million-americans-live-states-controlled-democrats-fivethirtyeight-95547189

Thanks for watching, reading and listening to FiveThirtyEight this year. We’ll see you in 2023!

That — plus the fact that the majority of Americans dislike changing clocks to begin with — has led to efforts to eliminate standard time … and counterefforts to eliminate daylight saving time. Can either option squeeze more day out of the light we do have? Try your hand at optimizing daylight all year long:

Unfortunately, no solution will make every American happy. Even if you’ve found a combination that satisfies your personal preferences, you may have noticed that those preferences could negatively impact other parts of the country. And advocates for changing the system we currently have — whether pro-DST or anti — feel strongly that their personal preference is the best.

Those who want to permanently stay on standard time (the time we’re on from November to March) say it’s preferential to permanent daylight saving time because standard time more closely aligns the clocks with our natural circadian rhythm, which is dictated by light exposure. Such a change would be better for our health. For instance, daylight saving time has been associated with a host of negative health effects including worse sleep and cardiovascular disease, and permanent daylight saving time could lead to higher rates of depression — prompting groups like the American Academy of Sleep Medicine to endorse permanent standard time instead. “The problem is that we don’t adapt. Our bodies align to the sun,” said Dr. Karin Johnson, a sleep medicine specialist and a professor of neurology at the University of Massachusetts Chan Medical School.

Advocates for permanent daylight saving time, however, argue that Americans live by the clock, not the sun, and that brighter evenings fit with how we live in the real world. Perhaps that’s why in the past five years 19 states have passed a bill or resolution that would implement year-round daylight saving time. A bill that passed the Senate in March would also have made it permanent, but the measure has virtually no chance of being taken up by the House before the next Congress is seated.

There’s some evidence that people are more likely to shop or be active after work if it’s still light out. But the arguments aren’t just economic, said Steve Calandrillo, a professor at the University of Washington School of Law. With more people out and about in the evening hours, the chances for traffic accidents go up when the sun sets earlier. He pointed to a study from 2004, which found that switching to permanent daylight savings time could reduce pedestrian fatalities by 13 percent and motor-vehicle fatalities by 3 percent during morning and evening hours.² Other studies suggest more evening daylight could help prevent street crime.

The problem is that both standard time and daylight saving time are fictions. Daylight saving time, which was introduced as a temporary measure for maximizing usable daylight during World War I, tends to get a bad rap for its artificiality, but standard time isn’t exactly natural either. According to Michael O’Malley, a professor of history at George Mason University and the author of “Keeping Watch: A History of American Time,” standard time was introduced in the late 19th century by railroad companies who wanted to standardize their timetables. Not everyone was happy about it. The city of Cincinnati, for example, initially continued to set its clocks to “Cincinnati time,” which was twenty-two minutes different from standard time. “Their argument was, ‘Noon is when the sun is overhead, not when the Pennsylvania Railroad says it’s noon,’” O’Malley said. Our current system of springing forward and falling back is a kludge designed to make everyone happy — which, of course, it fails at.

That’s the fundamental problem with trying to restructure time to fit our schedules. Whether it’s permanent standard time or daylight saving time, any attempt to standardize the clocks will be dislocating for someone. O’Malley’s dream is that the country could somehow return to solutions from before the 20th century, when local communities still responded to changes in daylight by shifting their own schedules to fit the season. That could mean schools might open or close earlier or later depending on when the sun rose and set in a specific place, he said. Adapting to seasonal darkness — and even finding joy in the coziness of the depths of winter — could mean living our lives differently depending on the local hours of light in the day. Slowing down, maximizing activity in sunlight hours and seeking warmth and comfort are ways that people have been coping with the long, dark, cold nights for centuries.

But the promise of daylight saving time — that we can somehow wring more productive hours of brightness out of the day — has always been a false one. No matter how we manipulate the clocks, this will always be a dark time of year. By trying to escape that reality, we may just end up making ourselves more unhappy.

2022 In Review

33 Cool Charts We Made In 2022

In 2022, FiveThirtyEight’s visual journalists covered the midterm elections, the end of Roe v. Wade and sports stories ranging from the World Cup to changes in Major League Baseball’s pitch timing rules. Here are some of the most interesting — and weird and colorful and complicated — charts we made in the last 12 months.

Charts are grouped by topic but are not in any particular order beyond that. Click any of them to read the story featuring that chart.

Politics

Sports

Science

Conservation

The Butterfly Effect

How do scientists keep going when extinction feels inevitable?

It used to be, if you wanted to see a Poweshiek skipperling butterfly, the thing to do was go out on the prairie and stare into the middle distance, like you were trying to see a sailboat buried in a Magic Eye painting. Just watch, and wait, and they’d appear. 

Back then, more than 20 years ago, there were Poweshieks seemingly everywhere you looked in the Upper Midwest and Canada. Little, erratic, flapping things, Poweshieks are all rust and brown fuzz, no bigger than a quarter. They thrived on the endless golden zen gardens of protected tallgrass, but you could also spot the metallic sheen of their wings dancing among the black-eyed Susans in an overgrown railroad siding, or bounding through grassy ditches pinned between the state highway and a soybean field. “All of a sudden, you’d just see this little sparkle shoot across,” said Cale Nordmeyer, a butterfly conservation specialist at the Minnesota Zoo. “Nothing else on the prairie does that.”

Now, mostly, nothing at all does that. The Poweshieks are all but gone, confined to a patchy mange of small, isolated habitats in Michigan and Manitoba. Even there, survival is precarious, and humans have become a part of the species’ life cycle. Researchers collect the white butterfly eggs — each tiny and round like the period on the end of a sentence — and hatch them in captivity, where the caterpillars are supplied with their favorite foods and conditions replicating a perfect Northern winter. In spring, the scientists carry cocoons back to the prairie and release the adult butterflies — guests now on grasslands that once belonged to them.

Our hands are all over these butterflies, yet still they slip through our grasp. This July, in 16 days of searching through the marshy prairie fens of central Michigan, a team of researchers were able to collect four wild females, perhaps some of the last wild members of the species in the whole United States. By the time you’re reading this, these Poweshieks will have died — the average adult only lives for a couple weeks. Some of their offspring are growing on a zoo backlot, slivers of green clinging to stalks of grass in plastic pots. But it’s anyone’s guess whether other caterpillars are out there under the Michigan sky. 

The Poweshiek skipperling is just one threatened species in a world where a thousand tiny things are dying every day, an era of mass extinctions that’s been creeping up on us for decades. If humans stop trying to keep the Poweshieks alive, even for a year, the species could disappear. If humans don’t stop, it might well go extinct anyway. Even successfully staving off the species’ demise would likely mean these butterflies limp into the future changed in fundamental ways — living in different places, under different conditions than they did before Western civilization staked a claim to the prairie. 

We are skirting tragedy in a time of certain uncertainty. Nobody knows whether the Poweshiek skipperlings have reached their end, or whether they’re starting on a new beginning. Probably it’s both, at once. But either way, these butterflies represent a moment of reckoning and wrestling, as environmental scientists struggle to find hope in a world where losing battles are the ones most likely to be fought. 

GHOST TOWN

The last known U.S. habitat of wild Poweshieks is a series of small prairies, the biggest maybe the size of a city block, clustered around a lake in Michigan. The specific location is kept a secret in order to protect the butterflies from both collectors and well-meaning lookiloos who might otherwise come out to photograph the Poweshieks and, inadvertently, grind the caterpillars into the damp soil. It’s a wet place, full of matted paths that twine through clots of muddy grasses and waving wildflowers. The only noises are grasshoppers, massasauga rattlesnakes and the wind. 

The conditions there weren’t perfect for Poweshieks on the warm afternoon in July 2022, when Nordmeyer took me along on his hunt. Clouds were passing overhead, blotting out the sunshine butterflies love, and the breeze was up, maybe enough to make a small, winged creature cling to a flower as if it were a port in a storm. But there were other butterflies about. Movement in the grass stirred mulberry wing skippers and dorcas coppers. They flew into the air, where a hopeful journalist repeatedly mistook them for Poweshieks. 

In mud-caked boots, we walked through areas Nordemeyer and his team called Poweshiek Country and Poweshiek City — named less than a decade ago to reflect their relative skipperling populations. But now both felt like ghost towns. Nordmeyer, who has been deeply involved in efforts to boost wild Poweshiek populations in Michigan, wasn’t worried at first. He’d come to this place regularly since 2012 and he figured that maybe it was just a little early in the season. It had been a cold spring. Maybe the wild butterflies were delayed in emerging from their cocoons. Or maybe the day was just bad. It seemed hard to believe they were gone entirely.

But that’s the same hope researchers have been clinging to since the species started vanishing, more than 20 years ago. Back then, Robert Dana couldn’t believe it, either, when he first started hearing that Poweshieks were going missing on the Minnesota prairies. It was the scientific equivalent of rumors. A small survey here. A set of anecdotal reports from hobbyist bug lovers there. Dana, then an entomologist with the Minnesota Department of Natural Resources, didn’t buy it. It was like somebody saying the grass was gone. From the first time he’d ever seen a prairie as a graduate student, Poweshieks had been there. It wasn’t the biggest butterfly, or the showiest. It was humble but distinct. Beautiful in its own quiet way. A real Upper Midwesterner of an insect. 

Dana believed the Poweshieks must be OK in the early 2000s for the same reasons Nordmeyer hoped they’re going to be now: It’s hard to imagine a world without them. The Poweshieks once defined the Northern prairies, with a range that stretched down from Manitoba, across both Dakotas, Minnesota, Wisconsin, Michigan, and even south into Iowa, Illinois and Indiana. The butterfly’s name even comes from a county in Iowa and, by extension, from an early 19th century chief of the Meskwaki people. 

And while the years between Dana’s search and Nordmeyer’s have seen a massive retreat of Poweshiek territory, it remains difficult to know if any single bad year for the species is truly a step on the road to extinction. Poweshieks are small butterflies, compact and fast — they don’t really fly so much as manically hop across the landscape from flower to flower, a dark blur just above the top of the grass. They do not travel long distances in the single year that makes up an individual’s lifetime. The tiny caterpillars, nearly invisible on a bending stem, stay within a few centimeters of where they hatch, waiting out the winter beneath the snow. A typical flight for an adult is only a few meters at a time, and it may not leave an area bigger than a square mile before it dies. 

Their short lives and small individual home ranges mean that local populations have always fluctuated a lot from year to year, and it’s easy to lose a population in one small, specific location while a different population flourishes nearby. This is what Dana assumed was actually going on in Minnesota back in the early 2000s. People who were only looking in one place, one year, were just mistaking these local fluctuations for actual disappearances, he told himself. 

Yet Dana found a hollow stillness everywhere he went, like a room grown suddenly too silent. Across more than 50 locations, his 2006 search turned up exactly one butterfly. As the horror of what he was witnessing began to truly set in, he clung to that butterfly as a beacon. “I guess I felt some kind of relief that maybe it was still hanging on, maybe it was going to recover,” Dana said. It was the last Poweshiek he’d ever see in the wild. 

Nearly 20 years later in Michigan, Nordmeyer would come up with similarly grim statistics. There were no Poweshieks in Poweshiek City. There were almost no Poweshieks anywhere. After I left the prairie patches, Nordmeyer stayed on, and it became clear the absence wasn’t just a product of bad timing. But, like Dana before him, Nordmeyer wasn’t ready to give up. Instead, he contacted the federal officials in charge of endangered species management and came to an agreement — whatever few wild Poweshieks he found would be taken into captivity and mated with the butterflies he had raised by hand.

“Fish and Wildlife [Service] pretty much decided, ‘No, we think these things are safer with you guys than they are in the wild,’” Nordmeyer said.

PLAYING GOD

Today, Poweshiek skipperlings are ferried to adulthood in the backseat of a Subaru Outback. The ride from the Minnesota Zoo to Michigan is the culmination of their new, human-directed life cycle. They make the journey still wrapped in their cocoons, no longer caterpillars but not quite yet butterflies, each one attached to a small tuft of prairie dropseed growing from a plastic pot and wrapped in a protective tower of pantyhose-covered metal framing. Nordmeyer drives the Poweshieks to Michigan, where he sets up the pots like a miniature city of beige condominiums inside a collapsible picnic shelter on site. He calls it the “Poweshiek Party Tent.” 

As each cocoon opens, the butterfly that emerges is released into the wild. Two or three at a time, Nordmeyer marks their wings with an identifying dot from a colored Sharpie, loads them into test tubes and carries them out onto the prairie in a messenger bag. He lowers them carefully by the bristly end of a paintbrush onto the waiting petals of a black-eyed Susan, their favorite flower. Over the course of a couple of weeks in 2022, Nordmeyer and his colleagues released 102 butterflies and searched the grasses for pregnant females and already laid eggs to carry back to the zoo. The caterpillars that later hatched from those eggs went on to eat their way through their own potted prairie dropseeds. In the summer, they were loaded into special cooling boxes that can mimic the overnight temperature drops that no longer happen reliably in this part of the country. As the seasons turned, humans plucked the fat babies from the plants and packed them into plastic cups filled with clay. The cups are covered with paper towels and stored in a freezer, the analogue of a caterpillar buried beneath a thick snowpack. In the spring, they’ll go back on a dropseed, spin a cocoon and wait for their cross-country road trip in that Subaru — the new year’s butterfly crop.

Nordmeyer isn’t the only one working to save the Poweshiek. At the John Ball Zoo in Michigan, scientists have figured out how to breed Poweshieks right there in captivity, no need to drop them off in a field so they can find dates. In Manitoba, researchers are monitoring Poweshiek numbers and working to both figure out what kinds of habitats the butterflies prefer, and how to keep those habitats healthy and safe. 

Twenty years ago, when Dana first called Richard Westwood, a professor of biology at the University of Winnipeg, and asked him if he’d noticed anything odd about the Poweshieks in his area, Westwood’s response was “I don’t know. They’re always around right? We don’t really pay attention.” Today, they are a species Westwood and dozens of other scientists have spent years paying intense attention to. 

The Poweshieks’ transition from a species humans neglected to one whose life is now literally in our hands is a reflection of how we’ve approached insects, as a whole. For every charismatic megafauna gracing the cover of a magazine, there are literal armfuls of smaller creatures fading quietly into the night. Insects are threatened at a rate far exceeding that of mammals, birds and reptiles, with as much as 40 percent of all insect species potentially facing extinction in the next few decades. Butterflies are one of the most affected groups, but they weren’t a major focus of conservation science until recently. The International Union for the Conservation of Nature, the agency that evaluates the conservation status of species and helps determine which are threatened, has assessed the risks posed to 67 percent of vertebrate species but only 2 percent of invertebrates, as of 2019. 

Saving those species is an exercise in just how much control we can take over nature before we’re not only preserving it, but molding it. The people working to save the Poweshiek know they’re walking that tightrope. And they also know it’s not something that we have enough resources to do for every species that’s in danger of extinction. Choices will have to be made. 

That reality represents a big shift in the way both science and policy have thought about animal conservation, said Daniel Rohlf, a professor of wildlife law at Lewis & Clark Law School. There’s a can-do attitude that’s embedded into the law and regulations that govern how species are managed. The Endangered Species Act defines the very concept of “conservation” as doing whatever is necessary to ensure every listed species no longer needs the ESA. “The overwhelming attitude was, ‘Humans have kind of messed this up but we can fix it,’” Rohlf said. Species become endangered, but then humans come in, identify what went wrong, correct the problem, and help the species rebuild until eventually it stops needing our intervention.

There have definitely been some species for which that understanding of the world has worked. Melinda Morgan, director of the sustainability studies program at the University of New Mexico, pointed to the success we’ve had in saving the peregrine falcon. “Ban DDT and you’re great. Done,” she said, referring to the once-common, bird-killing pesticide. But the reality is that most endangered animals will not be large and iconic, with an easily identified threat that can be quickly eliminated with one weird trick, like in a clickbait ad. Most are insects, small and hard to find, easier to accidentally kill without thinking about it than to find and rescue. Most are suffering from a tangle of intertwined problems. For the Poweshiek, there are pesticides we won’t stop using, land we won’t stop developing and climate that won’t stop changing. If you resuscitate the species in a zoo, it may or may not have a wild habitat to return to. Most endangered animals are not the peregrine falcon. Most endangered animals are a mess. 

“There’s a level of overwhelm that comes with that,” Morgan said. “There’s a level of despair.” What do you do when a species you thought was fine turns out to be actually teetering on the brink of death? What do you do when you have to decide which species you’ll focus your grants and labs and manpower on, knowing there are others in just as dire straits? What do you do when you have basically become a minor deity to a species of butterfly that relies on you to guide its life across generations — and the damn thing won’t be fruitful and multiply?

This is the point where Morgan suggested I speak to a Buddhist philosopher.

UNCERTAIN HOPE

Three years ago, researchers from the Minnesota Zoo took one of the Poweshieks they’d painstakingly raised from birth, released it onto the Michigan prairie, and watched in frustration as a mint-green dragonfly, the size of a human palm, dropped out of the sky … and ate it. 

There are no guarantees in nature. Not even when everything is working the way it’s supposed to — maybe especially not then. The dragonfly, a common pondhawk, was also native to those swampy grasslands. “It sort of forced us to stop and think,” Nordmeyer said. “That's also a natural species, right? This is part of the natural order of things then, too.” 

This Far Side cartoon of a moment is where the hard science of keeping a species alive runs smack into philosophy. That’s where Joanna Macy comes in. Macy is a 93-year-old environmental activist and Buddhist scholar whose work focuses specifically on the kinds of challenges scientists face when they have to decide how far they’re willing to go to conserve a species like the Poweshiek skipperling. Her writing is dedicated to staring straight down the barrel of environmental failure and coming away with a heart that’s larger, rather than one that’s been blasted to bits. 

How do you do that? Well, consider the idea that the world is a bit like a tomato. In “Active Hope,” a 2012 book Macy wrote with psychologist Dr. Chris Johnstone, the tomato helps illustrate what human intervention in nature can often look like. If you squeeze a tomato too much, too hard — when humans alter our environment in unsustainable ways — we destroy it. You can’t unsqueeze a tomato, just like you can’t unmush the world we’ve damaged. If the chances of fixing the problem aren’t very high, then why not just stop trying to help altogether?

But the analogy doesn’t end with the world destroyed in a pasta-sauce apocalypse. Instead, Johnstone told me, every collapse carries the seeds of a future renewal. What grows will be a different tomato. You can’t get the old one back. But something can grow — if we take the seeds and plant them. 

And that’s … it. That’s the message. Somehow, that’s supposed to be uplifting? Buck up, little buttercup, and keep trying? It’s okay if that’s not enough for you. It wasn’t enough for me. But then I realized that, whether the scientists I was interviewing knew about Macy and Johnstone’s work or not, they had already come to rely on this perspective for their own sanity. They weren’t giving up because hope, for them, wasn’t dependent on the Poweshieks’ odds of survival. Instead, hope was an action to take. They wanted something good to happen, so they tried to make it so.

That’s why they could accept the risk of Poweshieks being eaten by natural predators — their efforts don’t need to be successful to be worthwhile. If the Michigan summer truly ended without any Poweshiek caterpillars clinging to the drying grasses — if the species is truly gone in the U.S. outside of captivity — it’s all still been worth it, said Anna Monfils, a professor of biology at Central Michigan University. That’s in part because the struggle is bigger than those prairie fens, and bigger than the Poweshieks. If the skipperlings died there this year, but live on in zoos and in Canada, maybe that can teach us something about what’s happening in this specific ecosystem and how it might affect the other animals that live there — the other butterflies, the dragonflies that eat them, or even the rattlesnakes hidden under the grass. “No loss is good,” she said. “But learning from that process is a better outcome than not learning.”

It matters that researchers can breed Poweshieks in captivity now, for example — not just for the Poweshieks, but for butterflies on the other side of the world who might benefit from the same techniques. And, as multiple scientists pointed out, the only way to really guarantee failure is to stop. 

Macy and Johnstone describe this as radical uncertainty, the realization that “we don’t know if this will work” goes both ways. It could mean a world where the only Poweshieks are stiff and pinned to cardboard, under glass, a memorial to themselves. But uncertainty can also mean scientists’ intervention works, putting the species in a good position to be successfully reintroduced somewhere else. It could mean a young scientist comes along who figures out how to ensure the prairies the Poweshieks once loved are safe for them again. It could mean, as Nordmeyer hoped, that we find “a new pocket of these butterflies that we didn't even know was in someone's backyard.” It isn’t naive to think things might not be as bad as they seem. And that interpretation provides a reason to do the work.

This winter, the community of scientists who have taken on that work will talk about the next steps to take with the Poweshiek now that the Michigan prairie fens are no longer a place the butterfly seems to thrive. Something will change. What that is, nobody knows yet. It’s possible they’ll stop trying to release Poweshieks in Michigan at all, and instead focus on breeding for a few years, working up the captive population so it’s large enough to try reintroduction at a different site. But it’s unlikely this is the end. There’s still too much to hope for. 

“When you get us all together in the room we can be extremely positive,” Westwood said. “It’s depressing. But I don’t see anybody here giving up. We won’t give up until it’s give-up time.” 

Because that’s the other thing that seemed truly important to these scientists: the fact that others were there, seeing the things they saw, carrying the burden with them. The ecologist Aldo Leopold once wrote that "one of the penalties of an ecological education is that one lives alone in a world of wounds." But that’s not how these researchers live. They’re part of a community that crosses borders and has spent years helping a tiny creature rebuild its own community. They may not succeed. But they won’t have been alone. And maybe that, by itself, can heal some wounds.  

2022 Election

Can Focusing On Climate Change Help Win Elections?

By Maggie Koerth

Oct. 17, 2022, at 6:00 AM

“Our generation grew up watching as the climate crisis got worse and worse and politicians did nothing.” That might sound like a quote from teen climate activist Greta Thunberg, but it’s actually the opening line for a new series of political ads appearing in multiple states in the lead-up to the 2022 midterms — ads that the advocacy groups Climate Power Action and the League of Conservation Voters are hoping will tip the scales towards climate-focused Democrats.

Historically, however, climate change has not been much of a political kingmaker. Even when candidates trusted that their constituents did care deeply about the environment, it hasn’t been something that reliably changed votes. In the 2020 presidential election, for example, two-thirds of voters told exit pollster Edison Research that climate change was a “serious problem” — but 29 percent of that same group voted for then-President Donald Trump, a candidate whose position on climate change was … inconsistent … at best. 

So a $12 million ad campaign aimed specifically at promoting Democratic candidates’ climate change bona fides seems, at first glance, like a fool’s errand. But even though the content of these ads makes it clear they’re meant for a narrow audience — young voters, who see themselves as part of a generation bearing the consequences of inaction on climate change — the ads aren’t even for all of them. Instead, the groups funding these ads are trying to reach a specific sliver of a slice of a subset of young voters. And yet there’s reason to think that, on those slender margins, climate change could be becoming an issue that really sways elections.

One thing definitely working in favor of climate change as a voting issue this year is the existence of actual legislative change on climate, said Anthony Leiserowitz, director of the Yale Program on Climate Change Communication. Attempts to reach out to voters on climate issues are happening in context with the passage of the Inflation Reduction Act, President Biden’s spending bill that includes a number of tax breaks, new regulations, financing and incentives focused on reducing the country’s carbon emissions over the long term.

Watch: https://abcnews.go.com/fivethirtyeight/video/oregon-elect-republican-governor-fivethirtyeight-91521213

The passage of that bill is genuinely a big deal, Leiserowitz said. Outside of that, “there has been little to no major national action on climate change. And I’ve been doing this for 30 years,” he told me. 

The passage of the IRA is in keeping with what voters say they want. A large majority of Democratic voters think the Biden administration and Congress need to be doing more to deal with climate change — 82 percent according to a Pew Research Center survey from May. And that same report found that 58 percent of all Americans felt that the federal government wasn’t doing enough to combat climate change. Given results like that, it would be easy to assume that the passage of a federal bill finally addressing climate would be something that could really motivate voters — at least the liberal-leaning ones.

But the relationship between voters and climate policy has long fallen under the label of “it’s complicated.” There is an established gap between what voters say they want — action on climate change — and what they’re willing to do to achieve that. In 2019, for example, polling by Reuters and Ipsos found that while 69 percent of Americans wanted the government to take “aggressive” action on climate change, only 42 percent were likely to install solar panels on their own home; 38 percent were likely to begin carpooling to reduce emissions; and just 34 percent were likely to pay an extra $100 a year in taxes to support climate policies. And in 13 years of YouGov polls tracking which issues registered voters see as the most important, climate change has consistently taken a back seat to economic issues like jobs and inflation. As of Oct. 10, 12 percent of voters listed climate change and the environment as their No. 1 concern, while 22 percent cited inflation and high prices. It’s not that emphasizing climate change is a turn-off for voters — President Biden got a solid B+ on Greenpeace’s 2020 election Climate Scorecard. But neither is climate an issue that seems to attract voters on its own. Having the highest score on the Greenpeace scorecard during his candidacy was not enough to catapult Washington’s Democratic governor, Jay Inslee, to the White House.

That history is probably why ads touting climate change policy have been relatively rare this campaign cycle. Of the nearly 350 ad campaigns the University of Virginia’s Center for Politics is tracking in this midterm election, abortion and crime have been the primary issues at play, to the point that the center’s most recent analysis doesn’t even mention climate. Even in the month of September, after the passage of the IRA, ads focused on energy and the environment were still playing third fiddle to other issues like crime and inflation, according to data from the Wesleyan Media Project, which documents details of political advertising. The project found that 15 percent of nationwide political ads in September were focused on energy and environmental issues (which could include climate change), compared to 26 percent of ads focused on public safety and 19 percent on inflation. Even among the ads created by the LCV, some aren’t about climate change or the IRA, specifically — instead talking more broadly about how a specific candidate fits with the Democratic platform. 

But the main goal of the LCV’s ad campaign appears to be persuading people to vote for a candidate because that person has gotten climate policy done — something that’s presented in the ads as a bit of a surprise, a “can you believe they actually did it?” moment. Years of research have shown that the persuasion effects created by advertising — whether political or otherwise — do not last very long, and they are very small, capable of maybe creating a percentage-point difference in swing, said Lynn Vavreck, a professor of politics and public policy at the University of California, Los Angeles. “But don’t confuse small in size with not being pivotal,” she said. 

That’s because while the voting public as a whole has this messy situationship with climate change, there’s a segment of Democratic-leaning voters for whom it is increasingly the real deal. Young and left-leaning voters were most likely to rank climate change as their No. 1 issue in the most recent YouGov poll from Oct. 10. Eighteen percent of voters under 30 and 19 percent of Democrats said it’s the most important issue facing the U.S., compared to 11 percent of voters 65 and older, and just 2 percent of Republicans. And in the ongoing FiveThirtyEight/Ipsos panel survey conducted between April and September using Ipsos’s KnowledgePanel, as much as 36 percent of Democrats named climate change as one of the country’s top issues.³

Watch: https://abcnews.go.com/fivethirtyeight/video/races-bringing-democrats-odds-holding-senate-fivethirtyeight-91476350

Young people have the strongest beliefs about the reality of climate change and the need to take action on it, said Charlotte Hill, a professor of political science at the University of California, Berkeley. That trend is so strong that it even crosses party lines: Forty-seven percent of voting-age Republicans under 30 told Pew in May that the government was doing too little to combat climate change, compared to just 18 percent of Republicans 65 and older. But young (and particularly young, left-leaning) voters are such good targets for these ads because they are also the age group least likely to turn out for a midterm election. And “it’s also pretty consistent that the top reason that young people cite for not voting is not liking the candidates or the issues,” Hill said.

Targeting the people who care the most about climate change, and are the least likely to just go out and vote on their own, with ads that tell them politicians are actually acting on their desires can produce the kind of small differences that tip the scales in some elections, Hill and Vavreck said. 

But the LCV campaign took this one step further, by targeting ads at 2 million specific voters who live in the districts where that tiny margin of change will matter the most, including seven states where the statewide Senate race is a tight one — Arizona, Colorado, Georgia, New Hampshire, Nevada, Pennsylvania and Wisconsin. The model is based off of similar microtargeting work from the 2020 presidential election, when the goal was to persuade undecided voters who cared a lot about climate issues to cast their ballot in favor of Biden, said Pete Maysmith, senior vice president of campaigns at LCV. Those voters approved of Trump more than Biden, but the targeted ads seem to have convinced at least a portion of them to vote Democrat. Based on post-election surveys and a controlled experiment, LCV believes they increased Biden’s vote margin by 5.6 percentage points, relative to the control population. 

Nobody knows yet how big a difference the group will be able to make with this latest round of micro-targeted ads. But evidence suggests that small can be big, and that fact changes the stakes on climate change advertising. 

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Hurricanes

How Natural Disasters Can Change A Politician

By Maggie Koerth

Sep. 30, 2022, at 2:36 PM

In September 2017, Hurricane Irma swept across the southern tip of Florida, swamping what was then the state’s 26th Congressional District. The following July, that district’s Republican representative, Carlos Curbelo, introduced a bill that would tax greenhouse-gas emissions to help reduce the impact of climate change on his hurricane-prone constituency. Curbelo’s party affiliation raised eyebrows at the time, but for him, the threat of recurrent disasters sent political partisanship out the window. “This is not an academic discussion for those of us who live in South Florida. This is a local issue,” he told Audubon magazine in 2018.

And he’s not alone. Today, although some one-quarter of elected officials walking the halls of Congress don’t believe human-caused climate change is even real, research suggests that politicians can be persuaded to take action on climate change and other environmental issues. Unfortunately, it might take a headline-grabbing hurricane to do it. In the past decade, several studies have suggested that lawmakers are more likely to take action on climate change when they — and their constituents — have had to deal with the disastrous consequences of previously doing nothing. 

From the 1969 Cuyahoga River fire that led to the creation of the Environmental Protection Agency to the 1990 Oil Pollution Act that was born out of a series of oil spills, most notably from the Exxon Valdez, a long history of environmental disasters have inspired improvements in environmental policy, said M. Daniele Paserman, an economist at Boston University. 

“Disasters make environmental problems more salient,” he said. Paserman’s research has found that, between 1989 and 2014, congresspeople from districts hit by a hurricane were more likely to sponsor or co-sponsor environmental regulatory bills in the following year. And he’s not the only one who has noticed similar correlations. According to another study, which looked at abnormal temperature and precipitation trends between 2004 and 2011, members of Congress whose home states were experiencing weird weather were more likely to vote for all kinds of environmental legislation. More broadly, international research from 34 countries found that nuclear disasters increased the number of renewable-energy policies implemented for as long as seven years after the event. 

This line of research is relatively new and the number of studies relatively thin. But all of this builds on a larger question that has been studied more in depth: how personally experiencing the effects of climate change shape belief and behavior in the general public. 

A 2021 review of existing literature discovered ample evidence that living through a natural disaster is associated with higher levels of self-reported belief that climate change is a problem and a greater concern about what this might do to you and your family. Our own polling with Ipsos earlier this month showed something similar. Even among Republicans, nearly half of those who had experienced an extreme weather event in the past five years told us they were worried about climate change, compared with only 17 percent who hadn’t experienced a natural disaster.

But there are limits to the ability of a disaster to prevent future calamities. For one thing, the same review paper that showed increased belief in climate change didn’t find a corresponding increase in behaviors that would deal with that issue. And changes in belief are still heavily moderated by what people already think. For example, in a 2019 survey of people who experienced severe flooding in the United Kingdom during the winter of 2013-14, the ones who walked away with the highest levels of concern about climate change were those who had already attributed floods to global warming. 

So, it probably shouldn’t be a shock that the much smaller number of papers looking at how politicians might change their behavior in the face of climate change comes with its own set of caveats and complications. Studies have indicated that only countries with strong democracies see an increase in climate policy following climate disasters. And Paserman’s study found that the effects were tightly linked to proximity to the disaster. Even lawmakers who served in the same state where a hurricane occurred but whose districts were unaffected weren’t as likely to step up for political change. 

And while that paper found that politicians who experienced climate disasters were more likely to push for climate policies regardless of party, a different study — the one that showed abnormal temperature and precipitation trends were correlated with representatives’ environmental votes — found that party did matter. Moderate Democrats made the biggest shift toward more environmental-policy support, said Erich Muehlegger, an economist at the University of California, Davis, and an author on that paper. “We didn’t find much of a result for Republicans, nor did we find much of a result for the more strident Democrats, though that might be due to the fact that they were always voting for environmental regulations,” he said. “You can’t become more pro-environment if you were already on top of all those issues.” 

It’s going to take a lot more research to fully understand why politicians sometimes change their policy in the face of climate disaster and sometimes don’t. Meanwhile, just because lawmakers are responding to natural disasters with environmental votes doesn’t mean they aren’t seeing other, seedier kinds of legislative opportunities from the same event. Ethan Kaplan, an economist at University of Maryland, College Park, and his colleagues found that politicians are likely to use the immediate aftermath of a natural disaster to push through votes favoring the concerns of special-interest donors when nobody is paying attention. That’s not a contradiction to the idea that disaster could prompt politicians to take action on climate change. Instead, Kaplan said, the two things can run parallel. A disaster can create a distraction for donors’ goals in the short term, even as it prompts greater environmental policies in the long run. 

Hurricanes

How Waffle House Helps Us Respond To Hurricanes

After a hurricane, the 24/7 restaurant provides one measure of how infrastructure and supply chains are holding up.

By Maryn McKenna

Sep. 29, 2022, at 1:36 PM

This 2016 story followed a team of Waffle House operations analysts as they decided whether to close any of the chain’s locations in preparation for Hurricane Matthew, a Category 5 storm that ended up affecting the Florida coast as a Category 2 storm. This week, as at least 21 Waffle House locations in Florida closed due to Hurricane Ian, we thought we should revisit what happens when the famously resilient restaurant shuts its doors for a storm — and why even the federal government pays attention when it does. 

On a warm, cloudy morning in the first week of October, in an anonymous office park just outside Atlanta, operations analyst Matt Stark opened a computer program, ran through some data and looked thoughtfully at the results.

Out in the Atlantic Ocean, Hurricane Matthew was hurling winds of 115 miles an hour toward the coast of Florida. Hundreds of miles inland, in the headquarters of Waffle House Inc., Stark’s software predicted that 477 of the chain’s almost 1,900 restaurants might be affected by the onrushing storm.

This meant two things. First, as the storm made landfall, some locations of Waffle House — which boasts that every restaurant stays open 24 hours a day, 365 days a year — would probably have to close because of power loss or concerns for workers’ safety. And second, sometime after they did, someone would invoke the “Waffle House Index,” the slightly flippant measure of how bad a storm can get.

And Matthew brought on both those expected scenarios. Waffle House announced Oct. 6 that it was pre-emptively closing some restaurants on a 90-mile stretch of Interstate 95 between Fort Pierce and Titusville in Florida. (In the next few days, as the storm churned up the coast and flooded North Carolina, it would close 98 all told.) And as soon as the announcement went out, media tracking the storm, and customers on social media, invoked the closings as a sign of the apocalypse.

The Miami Herald: “When Waffle House surrenders to a hurricane, you know it’s bad.” The Washington Post: “Hurricane Matthew is so scary even the always-open eatery is evacuating.” A faithful customer on Twitter: “GOD IN HEAVEN THIS IS THE END!”

In those areas, the Waffle House Index had just gone to red.

Disaster responders pay attention to that index, which was created — in the midst of 2004’s devastating Hurricane Charley — by W. Craig Fugate, administrator of the Federal Emergency Management Agency since 2009. Fugate was director of emergency management for Florida when Charley slammed the state with unexpected force: Its winds strengthened abruptly and it went from a Category 2 to a Category 4, and the storm suddenly changed direction and struck the state’s Gulf Coast at Sanibel, 150 miles south of its predicted landfall. Tens of thousands of people were reportedly left homeless.

Fugate was in his office with state meteorologist Ben Nelson and members of the Florida National Guard, color-coding infrastructure loss on a map — green for operating, yellow for affected, and red for destroyed — and the group decided to take a look at some of the damage, and try to find a meal.

“They went to a Waffle House and noticed they had a limited menu, with nonperishable items,” Alexa Lopez, FEMA’s press secretary, told me. “The next day, they were driving around and they went to a different Waffle House, and the same thing happened, a limited menu.”

So, she said, the group was inspired first to rank Waffle Houses in the same way: green for fully operational, yellow for a limited menu and red for closed. “Which is pretty bad, because Waffle House is always open,” Lopez added. And, second, to use those observations as a proxy for how much a disaster disrupts a community. Fugate has since been quoted as saying: “If you get there and the Waffle House is closed? That’s really bad. That’s where you go to work.”

The concept of restaurant operations as an indicator of storm impact percolated slowly into emergency-management culture — the magazine Environment Health Safety Today wrote about it in July 2011 — and broke out into the open around the time of Hurricane Irene in August 2011 (when, according to The Wall Street Journal, 22 Waffle Houses lost power but only one stayed closed longer than a day).

But the so-called index isn’t actually an official metric. FEMA doesn’t publish it anywhere; no one, except for Waffle House itself, counts how many restaurants are running lean or forced to close. But the company does give that count to the agency, and FEMA uses it — along with wind speeds and power outages and other objective measures — to judge a storm’s impact, and to figure out where its own crews and other emergency responders can get fed.

So far, so obvious: If a storm is bad enough to close restaurants that “never close,” we can agree that storm is bad. Hurricane Matthew was the strongest storm of the 2016 Atlantic hurricane season, which ended Nov. 30.

But the Waffle House Index also stands for something less obvious. It is an indicator of how complex and long supply chains are — for food, for fuel, for power — and of what it takes to plan around infrastructure that can be fragile in unexpected ways.

“The essence of the index is not just that the situation is bad,” Panos Kouvelis, director of the Boeing Center for Supply Chain Innovation at Washington University in St. Louis, told me. “Companies like Waffle House, and Wal-Mart and Home Depot, operate in areas that are frequently hit by disasters, where their operations may go down at the same time the demand for their services go up. So they have had to develop very well-defined playbooks for being prepared.”

But preparation is a complicated endeavor in an economy where few things are sold in the places where they were made. Vanilla comes from Madagascar. The United States imports most of its salt. The plywood needed to protect windows from storm debris might have been manufactured in China, and a storm in the Gulf of Mexico can force enough interruption on petroleum refining to choke off supply on the other side of the country.

“When I talk to companies about whether they understand their supply chains, they generally know one step up and back: who they buy from and who they sell to,” said Amy Kircher, director of the Food Protection and Defense Institute at the University of Minnesota. “They don’t understand that there are five or 10 steps in the chain before the product reaches them. Or that the alternate suppliers they consider their contingency plan are all buying from the same place.”

At Waffle House headquarters in November, Stark and his colleagues on the chain’s storm team — Vice Presidents Pat Warner and Will Mizell and Communications Director Kelly Thrasher-Bruner, who handles social media in disasters — walked me through how they prepare. As we talked, Stark pulled up an updated post-Matthew map. Of 200 restaurants that ended up in the storm’s path, just one, in inland North Carolina, gleamed red, for “still affected”; it had been flooded and needed cleaning out.

“It’s a big deal for us to shut down, because we’re not used to turning everything off and turning the lights off and closing the door,” said Warner, who estimates that he has worked “more than 10” hurricane responses in 17 years. “So our goal is to open up as quickly as possible afterward. The operations team works with the distributor to get food ready to go in. The construction team lines up generators. If you have generators you have to have fuel, so we line up that.”

On the edge of the predicted storm zone — which Stark monitors from a temporary “war room” assembled by putting mobile giant screens in a conference room — the company positions personnel who can swoop in: carpenters, electricians, IT specialists, a food-safety expert and someone to talk to local governments and law enforcement and soothe concerns about curfews. A little farther out, restaurants in other markets line up “jump teams”: spare personnel who volunteer to work in place of locals who might have evacuated or might need to repair their homes or care for family. In Hurricane Matthew, the company sent in an extra 250 people.

“We say we throw chaos at chaos,” Mizell said. “We just throw a lot of resources down there to get restaurants open. Our CEO will be there. In Matthew, our chairman was there, too.”

Before the carpenters and computer specialists or the replacement cooks and servers arrive, the company assesses how long it has been since supplies were delivered and — just as crucial — how long since the local trash removal company last emptied the dumpster. “Most restaurants get a delivery once a week,” Stark said. “If it got there Wednesday and the storm hits Thursday, they should have enough food, but if the storm hits Tuesday, we may have to hurry up and get some food there.”

Waffle House uses one main distributor, Illinois-based US Foods, which has depots scattered across the Southeast, where most Waffle Houses are concentrated, and where many hurricanes that strike the U.S. make landfall. So supplies don’t need to travel far in advance of a storm and are close by once roads are clear.

That model of staging supplies and personnel in layers outside an emergency, in order to swoop in quickly once it abates, isn’t unique to Waffle House. It’s also followed by the military and by the Centers for Disease Control and Prevention, which oversees the Strategic National Stockpile of emergency medications, vaccines and antidotes for natural disasters and biological attacks.

“We think about, What are the timelines in which people have to be provided medications?” Greg Burel, the stockpile’s director, told me. “Our primary stock is laid down in undisclosed locations around the country that give us access to large swaths of the population and that are accessible” by more than one type of transportation.

But the CDC also puts smaller, lighter assets — the equivalent of a temporary field hospital or a stash of medications that could be deployed immediately — “as far forward as we can if we have advance notice, but not so far forward that it becomes victim to that event,” Burel said.

The first rule of operating in a disaster, though, is keeping personnel safe. Every Waffle House employee gets a key fob with lists of relevant phone numbers. Local managers keep track of who has challenging home situations — disabled parents, children with special needs, single heads of household — and might need extra help. Every location has a wall-mounted “crisis response” flier that includes detachable wallet cards listing personal-preparedness steps for hurricanes, tornadoes and ice storms.

The cards also remind employees how needed they will be at work. “We will be very busy,” the current hurricane-preparedness card says, “and you will make lots of money!”

Once employees arrive or return and a location can open, they work through the storm manual: a giant binder, a kind of choose-your-own-adventure game composed in eggs and grits. “Here’s how you run the restaurant if you’re without power, without gas for the grills, without water,” Mizell said. “We can cook on the grills even if we don’t have electricity. We can bring in bottled water and canned Coke products and serve on to-go plates. We can get porta-potties.”

The storm team examines what worked and didn’t after every disaster, each time learning new lessons. In Hurricane Katrina — when they closed 107 locations in Mississippi and on the north shore of Lake Ponchartrain — roads were so bad they stashed supplies in a refrigerated semi-trailer with armed guards, and fuel so scarce they brought in their own tank trucks. When Katrina struck in 2005, Twitter had not yet launched; now Bruner uses it not just to alert customers to closings, but to crowdsource whether roads are open and where the power is on.

Waffle House began working on storm response before Katrina — Warner said he thinks the first organized attempt was Hurricane Hugo, which hit Charleston, South Carolina, in September 1989 — but from then to now, the company’s biggest need in disasters hasn’t changed.

“People,” Warner said. “We can get the food there, by hook or by crook. It costs more, but we’re willing to spend it. But if we don’t have people, we can’t open up.”

Monkeypox

Why Monkeypox Wasn’t Another COVID-19

Thanks to public health and a little luck, this disease didn’t become a pandemic.

By Maggie Koerth

Sep. 14, 2022, at 6:00 AM

When you’ve lived through two-plus years of a pandemic, it can feel weird to see “disease” and “good news” in the same sentence. But here we are, watching a disease decline, with cautious optimism. Two weeks ago, the World Health Organization announced that monkeypox cases in Europe had fallen so fast, the outbreak could be eliminated there. And while the U.S. recently experienced its first monkeypox death, cases here have fallen by 40 percent between the middle and end of August. In other words, it’s too early to declare victory and dust off our hands, but the situation is generally improving.

This news shows that public health officials — and the public itself — got some important stuff right in combating this serious illness. But monkeypox is also a reminder that humans will encounter many potentially dangerous new diseases. COVID wasn’t the first, or the last. What stops most diseases from becoming pandemics is as much about luck as it is about human intervention.

This spring, many of us braced ourselves for the worst. Monkeypox seemed mysterious, and cases of it were soaring. But a positive outcome was not surprising to the scientists who study the disease. “One of the difficulties I’ve faced in public communication is trying to get people to understand that none of us who work in public health thought the sky was going to be falling from monkeypox,” said Jay Varma, a professor of population health sciences at Weill Cornell Medical College. “We were just concerned that a lot of people were going to suffer needlessly … because we had a diagnostic test, a drug to treat this and a vaccine to prevent it all stockpiled.” Monkeypox was, in other words, a serious disease that needed attention to make sure vulnerable groups were protected, but it was never likely to become the same kind of massive problem as COVID-19. 

In August, scientists surveyed more than 800 men who have sex with men, trying to find out how monkeypox — and the education campaigns surrounding it — had affected their lives. According to results published by the Centers for Disease Control and Prevention, about half of the men made some important changes to their behavior. Of the 824 surveyed, 48 percent reported reducing their overall number of sex partners, 50 percent said they had reduced their one-time sexual encounters and 50 percent said they had reduced sex with people they met on dating apps and in sex clubs. Those voluntary behavioral changes as well as the public health campaigns that inspired them have been particularly crucial to curbing monkeypox, said Varma and Rodney Rohde, a professor of clinical laboratory science at Texas State University. 

That’s because other studies have shown that while one-night stands account for only a fraction of sex happening daily among men who have sex with men — about 3 percent of daily sexual relationships — those interactions are responsible for about half of daily monkeypox transmissions. 

Vaccination campaigns have also been important, but the behavioral changes seem to be more widespread in the high-risk community than vaccination has been, Varma said. “The original guidance from the CDC has been refreshingly frank and honest and transparent about what are the behaviors that put people at highest risk and what are the ways in which you can minimize your risk, without questioning whether sex is an essential activity to life,” he said.

But had the monkeypox outbreak happened just a few years ago, it might not have been on the radar of anyone outside the most affected communities. Dr. Sonja Rasmussen, a Johns Hopkins University professor of genetic medicine who worked at the CDC for 20 years, remembers a former director at the agency often saying that when public health did its job well, we never heard about it.

New diseases are popping up and entering the U.S. all the time, according to Rasmussen and the other experts I spoke with. But SARS-CoV-2 aside, most of them are swiftly and effectively shut down by the hard work of public health. “Remember that MERS outbreak … when there were two cases in the U.S.?” she asked, referring to the time in May 2014 when a particularly deadly cousin of COVID cropped up in unlinked cases in Indiana and Florida. “People would say, ‘I don’t even remember that.’ And … that’s because we dealt with it.” 

We’re more likely to hear about these diseases now because everyone is much more primed to pay attention after a couple of years of COVID. But the reality is that thousands of people nationwide are working to ensure those diseases don’t spread unnoticed, that the highest-risk populations are treated, and that we don’t end up constantly marinating in preventable pandemics. That’s the good news. 

The bad news: Not every pandemic is a preventable one. “We did get a little lucky [with monkeypox],” Rohde said. Yes, there’s pain involved and some risk of death, but if and when this disease is nipped in the bud, that will be in part because the virus makes itself relatively easy to prune. It’s not a respiratory virus that people can easily spread to strangers at the bus stop. The mode of transmission, primarily through sex, limits who can spread to whom. The transmission rate is also different from that of COVID, he said. And the mode of transmission means the virus affects primarily a high-risk group rather than all of society, so it’s easier to change behavior and administer pharmaceutical treatments. Monkeypox is also a DNA virus, not an RNA virus like SARS-CoV-2, so it mutates less than COVID and can be prevented with older, existing vaccines. Those are the kinds of outbreaks humans can stop from turning into pandemics. Of course, both scientists and the public have to take action when they pop up, but it’s relatively easy to manage. 

Most new or new-to-us diseases that appear will have more in common with monkeypox than with COVID. They’ll be dealt with. And you’ll forget you ever saw them on the news. But, eventually, another pathogen will come along that’s more challenging just by its nature – another fast-spreading, fast-mutating respiratory virus that hits everybody all at once. “I am concerned as we move away from COVID that we’re going to say, ‘That’s our pandemic. We don’t need to fund [public health infrastructure] anymore,’” Rasmussen said. 

Unfortunately, one of the biggest takeaways from this monkeypox outbreak and how it was handled is a paradox. You don’t need to assume that every new disease you hear about will be another uncontrollable pandemic, so you can let that tension go. But, at the same time, that doesn’t mean another pandemic won’t happen in your lifetime. Somebody needs to be on the job, paying attention. 

“It doesn’t matter if you’re tired, if you’re fatigued, if you’re done with it,” Rohde said. “Those [infectious diseases] don’t care. They never get tired.” 

Monkeypox

Who Should Get Tested For A New Disease?

Monkeypox shows how hard it is to answer that question.

By Maggie Koerth

Aug. 24, 2022, at 6:00 AM

Between May 6 and July 20, doctors in the United Kingdom confirmed 2,162 cases of monkeypox. Ninety-nine percent of those cases were men.⁴ That could be most reflective of who is contracting the virus. But it could also be partly because 80 percent of the people tested were men.

Public health officials have emphasized that the monkeypox outbreak is largely affecting men who have sex with men. That’s not incorrect. But there’s a side effect of that kind of framing: People who don’t fit into that category may think they can’t get monkeypox, might be afraid of what others will think of them if they contract it, or may even have trouble convincing a doctor to test them — even if they have symptoms of the disease. “You’ll never find [a disease] in a population you don’t test,” said Thomas Holland, a professor of infectious diseases at Duke University, who also sees patients at the University’s hospital.

This problem hampered U.S. public health officials during the initial stages of the COVID-19 pandemic, when tests for the illness were unavailable unless you’d recently traveled abroad, and the virus spread unchecked through communities believed to be uninfected. We know how that turned out.

Deciding who to test for a new — or newly ascendant — illness is a challenging paradox. Limiting testing isn’t always a bad idea and can even be necessary because of a lack of resources. But, sometimes, it is a bad idea. And it’s not always clear which side of that line you’re on until it’s too late. 

When medical experts are faced with deciding which patients should be tested for a new, scary illness, they have to ask themselves, “Is this gonna be more like Ebola, or more like COVID-19?” 

In 2014, when Ebola made a brief landfall in North America, and in the first months of 2020, when COVID-19 was brand new in the U.S., tests for either disease were a limited resource. In both cases, the public health community kept a tight rein on who could get tested. It took more than a fever and chills, said Brittany Kmush, a professor of public health at Syracuse University, since the symptoms of both diseases overlapped with other more benign illnesses. To be tested for either, patients needed an epidemiological connection to them — in particular, having recently visited countries where they were already known to exist.

“That worked pretty well for the Ebola outbreak,” Kmush told me. The protocol kept hospitals from being overwhelmed, caught the cases that truly needed isolating, and no significant spread went undetected. But the same wasn’t true with COVID-19. “I think with COVID, we really learned a lesson that we don’t always know what is going on,” she said.

But broad, open testing isn’t always the right choice. That did turn out to be necessary with COVID-19, Holland said, but early on there were a number of factors that made the strategy unworkable. Infamously, both tests and processing equipment were in short supply at the time, and getting results could take a week. In the meantime, he said, people waiting for results were kept at the hospital in isolation units visited only by staff wearing protective coverings and masks, which were themselves a limited resource.

Lots of hospital patients had symptoms that could have been COVID-19, he said. But, at that early stage, statistically speaking, Holland knew most of them didn’t have it. There was real danger in treating all those people as potential COVID-19 cases, not just the stress of unnecessary isolation and using up limited hospital space, but also from failing to diagnose what, if not COVID-19, was actually wrong with them.

“It was how I spent my days,” he said, deciding who got a COVID-19 test and who did not. “Those were some of the hardest conversations I’ve ever had professionally.”

But Holland and other experts I spoke also with see problems with how access to monkeypox testing has been restricted. Testing capacity for this new disease was limited early in the spring and summer, but it isn’t now, said Sandra Kemmerly, an infectious disease specialist in the New Orleans-based Ochsner Health System. And while monkeypox occurs primarily in men who have sex with men right now, it’s perfectly capable of infecting people outside that demographic.

The Centers for Disease Control and Prevention’s criteria for a probable monkeypox case includes having known contact with other monkeypox cases, being in contact with a community where it’s spreading (like men who have sex with men), or having recently traveled to a country where monkeypox is spreading. However, Kemmerly said the Ochsner Health System is encouraging doctors to expand their idea of who might be a potential case — to test based on symptoms rather than on contact with a high-risk community.

“One thing that’s been taught to us through HIV and repeated in COVID is if you have very narrow criteria for testing you’ll miss cases,” Kemmerly said. On the other hand, Holland said, wider testing needs to be balanced with the potential for false positives and the risk of informing someone that they have a disease that’s been heavily stigmatized when they actually don’t. 

The good news is that doctors say they’ve learned some lessons from past pandemics. For example, the experience of COVID-19 seems to have taught the public health community the importance of producing more tests and quickly enabling more places to process them. Kemmerly was impressed with how quickly the CDC made partnerships with commercial labs and increased testing capacity on monkeypox. 

Holland also found it important that testing for monkeypox has been expanded to a wider variety of medical facilities people are likely to already frequent — like dermatologists and sexual health clinics. 

And the COVID-19 experience has also made wastewater testing for communicable diseases something more local public health systems have familiarity with and infrastructure for, Kmush said. (Some areas of California are already using it to test for monkeypox.) That would really help because even if men continue to make up the bulk of individual test-takers, wastewater can help determine whether the virus has spread further.

But maybe the most important lesson for the future, Kemmerly said, is that you can’t just pick one position — test broadly or test narrowly — and expect to stick with that for the long haul. “As new diseases emerge and different modes of transmission become more common, we have to be ready to more rapidly reevaluate our criteria for testing,” she said. When all the options are imperfect, the worst thing you can do is refuse to change. 

Climate Change

Why The Same Temperature Can Feel Different Somewhere Else

By Maggie Koerth

Aug. 5, 2022, at 9:56 AM

In much of the United States, the high 80s in Fahrenheit is hot, but it’s not hot-hot. It could even be a day of sweet relief in the South, maybe time for a family picnic. But last month, across the United Kingdom, headlines warned of temperatures that could hit 31 degrees Celsius. When Americans found out that translated to 88 degrees Fahrenheit, they quickly concluded: “Europeans are weak.” And while temperatures in Europe kept going up, eventually hitting levels even Texans would find daunting and killing thousands of people across the continent, the question of how a temperature could mean serious danger in one place while being an average summer Saturday in another remained. 

The temperature may be an objective number, but how we experience it is not. Culture influences the biology and psychology of thermal comfort, shaping what our bodies are used to dealing with and how our homes and businesses are set up to adapt. In fact, the very numbers of thermal comfort aren’t even universal. There are dozens of ways to measure what a hot summer day actually feels like; different countries do it differently, and how you measure affects how we communicate and understand risk.

What’s more, the climate is changing faster than our cultural and subjective experience of it. So if you’re ever tempted to flex on people in other parts of the world for not being able to take the heat, maybe it’s time to recognize that you and they are living in very different kitchens. 

Most of the time, when you check the daily weather report, you’re looking at the air temperature — a measurement of heat in the air around you. But that measurement doesn’t tell the whole story of human experience. What you feel like when you open the door — and how the situation you find outside affects your body — depends on more than temperature, said Margaret Sugg, a professor of geography and planning at Appalachian State University. Humidity, air speed and direction, how hot it usually is compared to right now, and even how much the air cooled during the previous night: These factors all play a role in determining whether 88 degrees Fahrenheit feels comfortable or crushing. How we talk about our thermal comfort is both cultural and scientific. 

For example, we use the heat index in the United States to measure the difference between real and perceived temperature. This is a formula that combines air temperature and humidity to give people a better indication of when they might be at risk of heat stroke. The heat index tells us that 88 degrees with 40 percent humidity feels like 88 degrees, and while there is risk there if you’re out in the sun being active for a long time, it’s not a huge deal. In contrast, 88 degrees with 90 percent humidity feels like 113 degrees — cramps and exhaustion are likely, and activity could put you on the path to heat stroke. 

But “there’s a ton of metrics out there, you could spend forever researching them,” Sugg said. Another researcher, Salman Shooshtarian, a design and social context lecturer at Australia’s Royal Melbourne Institute of Technology, told me more than 116 different indices are used in different contexts. Heat index just happens to be one for which you can gather data cheaply, Sugg said. These indices can vary by country. Canada uses one called Humidex, which also combines temperature and humidity but uses a different formula and categorizes its results based on degree of comfort rather than risk of heat sickness. Another system, called the wet bulb globe temperature, takes many more factors into account, including cloud cover, wind speed and sun angle, and frames its results around how long you can work in direct sunlight before feeling ill and how long a break you need each hour. (The Occupational Safety and Health Administration is a big fan of that one.) There are even proprietary versions with secret math formulas, like AccuWeather’s “RealFeel.”

These different indices matter because they’re all telling you something slightly different and presenting their results in ways that leave you with different understandings of what’s at risk and what you should do about it. And studies have shown that they have to be recalibrated to correctly define “normal” and “safe” in different countries. The dangers of heat, in other words, are at least partially determined by culture. And that’s not the only way temperature — a thing that seems so basic, so absolute — can be pretty subjective.

“I’m from Wisconsin, and I live in Tennessee,” said Alisa Hass, a professor of geography at Middle Tennessee State University. “Moving south is a huge shock to the body.” That’s because your body acclimatizes to the temperature range it’s used to — literally, your physiology changes. People accustomed to spending time outside in higher temperatures sweat more and have increased blood flow to the skin, two changes that can help the body offload excess heat. These are short-term effects and can go away if the person gets de-acclimatized,  a process that helps explain why lower high temperatures in spring can produce the same levels of heat sickness as higher highs later in the summer, Sugg said. 

But there’s long-term acclimatization, as well, with people used to living in hotter climates feeling more comfortable at higher temperatures — even if their health risks are actually larger. For example, in a comparison of outdoor workers in Mississippi and North Carolina, Sugg found that the Mississippi workers believed their jobs had lower heat risks but were also the ones experiencing more heat-strain events. Another study that compared the temperature and local perception of temperature across a bunch of European cities found that what people considered “neutral” in comfort corresponded pretty well with local temperature ranges and was, in fact, closer to the local maximum temperatures than the local mean. 

There’s a whole host of studies showing that where you grew up and what you’re used to affects what temperatures you perceive as comfortable and safe. The reasons seem to range from physiological acclimatization to behavioral adaptations chosen based on the normal climate — like the fact that more than 80 percent of Tennessee households have central air conditioning, compared to 60 percent of Wisconsin households and less than 5 percent of homes in the U.K. Even sex and gender can affect whether you feel comfortable at a certain temperature. There are decades of literature showing women are more comfortable at warmer temperatures indoors (where office air conditioning is often calibrated by a metric designed with male bodies and male clothing in mind) and out. The same study that found differences in local perception of temperature across Europe found that women in the study consistently reported a higher neutrally comfortable temperature than men, no matter where they lived. 

And the subjective nature of temperature only gets messier as climates change. Quite quickly, the climates people have acclimatized to over their whole lives have become much hotter and wetter. So what happens to a place with the cultural infrastructure adaptations of the U.K. when it starts to have the comfort index of Wisconsin or Tennessee? Well, that’s what we saw last month. The good news, Shooshtarian said, is that acclimatizing to heat seems to take less time than acclimating to cold. But climate change also complicates our efforts to adapt. After all, Shooshtarian pointed out, people in the U.K. could install more central air, but that energy use will make climate change worse. To survive and thrive, the future might need a new culture all its own — one that adapts to rising temperatures and to the causes of them.

COVID-19

No President Is Safe From His Own COVID-19 Policy

By Maggie Koerth

Jul. 22, 2022, at 12:56 PM

The French philosopher Joseph de Maistre once said that every country gets the government it deserves. Likewise, perhaps every American president gets the COVID-19 infection he deserves.

OK, “deserves” might be a strong word. While de Maistre, a counter-Enlightenment intellectual who believed in the divine right of kings as the most stable form of government, probably would endorse the concept of pathogen as karmic comeuppance, we here at FiveThirtyEight believe a case of COVID isn’t anyone’s punishment for anything.

But, mayyyybe that’s a little less true if you’re the guy deciding what choices are available to everyone else. The news this week that President Biden had been diagnosed with COVID started me thinking about the ways an American president can set the stage for his own infection through his decisions about pandemic policy. If anyone in this country ever got a case of COVID because of their own mistakes, it’s Biden and Donald Trump. It’s almost as if each man’s illness was a microcosm of the larger way he chose to approach the virus — and of how those choices affected everyone else in the country he led.

Trump likely got his infection via a famously cavalier approach to party planning — throwing a largely unmasked gathering at a point in the pandemic when vaccines weren’t yet available. On Sept. 26, 2020, the then-president held a Rose Garden event to celebrate the nomination of Amy Coney Barrett to the Supreme Court. Case numbers in Washington, D.C., were low at the time, but this was a party full of hugging and handshakes — and it launched a superspreader event that likely infected not just the president and first lady but also multiple members of Congress, White House staffers, members of the media and a whole litany of government and campaign workers.

Trump ended up in the hospital with a case so severe, he came close to being put on a ventilator and was given basically every drug doctors could think of to treat COVID — a mixture of dexamethasone, remdesivir and monoclonal antibodies. Throughout the ordeal, Trump’s large-scale public policy choices — mocking and dismissing masks and other ways of preventing transmission, downplaying the severity of COVID risks, promising a miracle would come along and make the virus disappear, etc. — were reflected in his own experience.

But while President Biden has approached the pandemic in a very different way than President Trump, he, too, has made a series of choices that set the stage for his own infection. If the overarching theme of Trump’s approach to COVID was to shut his eyes and hope the pandemic couldn’t see him if he couldn’t see it, the overarching theme of Biden’s approach has been to frame a collective disaster as just another matter of personal responsibility.

The administration thought it had a silver bullet, going so far as to declare that July 4, 2021, would be a celebration of freedom from COVID. They were so certain that individual vaccinations would be enough that they rolled back federal mask mandates in May 2021 under the assumption that if you did the right thing and got vaccinated, then you’d be fine. Even as delta, omicron, and multiple omicronlets proved this theory wrong, Biden’s policy has continued to focus mainly on getting more Americans vaccinated and boosted. Other policy options that could prevent spread — ventilation requirements, reliable data collection on case numbers, masking during periods of high transmission, getting vaccines to other countries where the virus still spreads unchecked — have largely been left to wither.

The result is an America where COVID keeps mutating, waves of disease keep coming and the populations of the most vulnerable remain isolated, trapped and dying. We have an America where we take COVID seriously but not literally. We have an America where even the most responsible and well-protected of Americans is almost guaranteed to get COVID eventually.

Even a president who trusts the science. 

Abortion

Even Exceptions To Abortion Bans Pit A Mother’s Life Against Doctors’ Fears

By Maggie Koerth and Amelia Thomson-DeVeaux and Maggie Koerth and Amelia Thomson-DeVeaux

Jun. 30, 2022, at 6:00 AM

Layla Houshmand was eight weeks pregnant in the spring of 2021 when she woke up to find her field of vision smeared with a hazy sheen, like Vaseline rubbed on the lens of a camera. She was already worried about her own health. She’d spent the day before nursing herself through the pain of a migraine. But now the headache was worse and her vision was blurring and Houshmand was even more scared. Then the vomiting began. Nothing would stay down. During one 90-minute appointment with an ophthalmologist, she remembered vomiting 20 times. 

Something was clearly going horribly wrong with Houshmand’s body. Her ophthalmologist suspected a stroke in her optic nerve and told her the condition can be caused by pregnancy, but Houshmand was stuck in a Catch-22: The pregnancy was now also preventing treatment. Doctors told her that she needed steroids and blood thinners and a specific type of MRI that could make sure there wasn’t something even more serious happening. But she couldn’t get any of those things because they could endanger her fetus. 

Houshmand decided she wanted an abortion. She wasn’t willing to risk losing eyesight and continuing to be in pain, vomiting over and over, with no solution … not for an eight-week pregnancy. But her doctors couldn’t help her — abortion wasn’t even an option they brought up. Houshmand had to find a private clinic that could treat her on her own. After the abortion she found out the truth: She had a life-threatening infection in her optic nerve. 

As long as she was pregnant, none of the doctors Houshmand encountered would do the things that needed to happen to diagnose her — or treat her. Without an abortion, she was just a sick pregnant woman, rather than a woman who needed an abortion to save her life. 

Watch: https://abcnews.go.com/fivethirtyeight/video/overturning-roe-means-abortion-access-us-fivethirtyeight-85676655

With the end of Roe v. Wade’s abortion protections, there are now millions of Americans who won’t be able to get an abortion if they want one. Some, like Houshmand, will be people who are seeking abortion because of the way a pregnancy is affecting their health. In theory, this shouldn’t be a problem, thanks to exceptions for the life of the mother that are common, even in the strictest abortion bans. But the medical professionals, legal experts and researchers we spoke to said those exceptions are usually vague, creating an environment where patients have to meet some unspoken and arbitrary criteria to get treatment. 

When it’s not clear what is legal, patients are often treated as though nothing is. It can be hard to prove your medical emergency is enough of an emergency to get an abortion in a doctor’s office or hospital, or to get Medicaid and other insurers to pay for it. Uncertainty breeds fear and stigma for doctors, who might delay treatment so they can evaluate just how close a person is to dying. In some situations, patients are simply shuttled from one facility to the next like a hot potato until they find a place willing to offer care.

There are a lot of unknowns about what will happen in the wake of the Dobbs decision. But doctors say they do know at least one thing: Overturning Roe v. Wade will lead to more situations where the health and safety of a pregnant person comes second to doctors’ own risks and fears. They know this because it’s already been happening for years. 

As she sat in the ophthalmologist’s office, it was obvious to Houshmand that her symptoms were freaking out the eye doctor. And what that doctor had to say was freaking out Houshmand. Her vision loss might be permanent, and she could also end up losing vision in her other eye. But, Houshmand remembers the ophthalmologist saying, “You’re pregnant so there’s nothing I can do for you.” 

No one ever said the word “abortion” out loud or even suggested it as an option — and this was in Maryland, a state that has very few restrictions on abortion. The doctors just told her what she needed and why she couldn’t have it. When Houshmand tried to call her OB-GYN’s office to ask what kind of abortion would be safe for someone who might have had an optic nerve stroke, the flustered medical assistant who answered the phone didn’t answer her questions and tried to talk her out of making any quick decisions. And the OB-GYN couldn’t even help Houshmand — she worked at a religiously affiliated hospital and Houshmand’s condition didn’t meet its standard for when abortions could be performed. 

Houshmand felt trapped between the parts of the medical system that were ideologically opposed to her choice, and the parts that were too afraid of controversy to help her. 

And it is pretty common for sick pregnant people to end up squeezed in that vise, said Dr. Lisa Harris, a professor of obstetrics and gynecology at the University of Michigan who specializes in treating pregnant patients with complex medical problems. While she can remember cases where death was certain if an abortion couldn’t be performed — a patient with heart and lung failure, for example — they only come up maybe once a year in her work. But patients like Houshmand happen all the time, she said. “Maybe it’s a 30 or 50 percent chance that someone might die. And they might not die immediately. Maybe it would be in the next week or month, or even year or beyond.” 

Abortion bans and abortion restrictions nearly all contain exceptions that allow abortion to save the life of the mother, and, in some cases, preserve her health as well. But every law and statute that contains this exception is written a little differently, and most of them are ambiguous about what constitutes “life-threatening” and how that should be determined. Maryland’s “life of the mother” exception to its ban on post-viability abortions specifically allows doctors to use their best medical judgment. But that kind of detail isn’t common, said Joanne Rosen, a senior lecturer on public health and law at Johns Hopkins University. What’s more, she said, “the states that are the most hostile to abortion are the states least likely to provide really helpful specificity.” Take Tennessee’s abortion ban, which requires doctors who perform an abortion to prove that “the abortion was necessary to prevent the death of the pregnant woman or to prevent serious risk of substantial and irreversible impairment of a major bodily function of the pregnant woman.”

Legislators in these states may worry that if the laws give doctors too much leeway, some will take advantage and use that as an excuse to perform any abortion they want, said David Cohen, a law professor at Drexel University’s Kline School of Law who has studied abortion restrictions. Rosen agreed, saying the ambiguity is part of how states make abortion — even doctor-recommended abortion — hard to get. Even if doctors’ actual liability is kind of nebulous, the fear that they could go to jail, incur legal costs or lose their medical license is acutely clear. “It will massively change the risk calculus,” Cohen said. “People will have to think, ‘Will I spend 10 to 20 years in jail for performing this abortion?’”

There’s no clear answer to that question under an ambiguous law. After Texas passed Senate Bill 8, which banned abortion after fetal cardiac activity is detected, as early as six weeks, and opened the door for expensive civil lawsuits against doctors, a group of researchers interviewed 25 clinicians in the state and found a huge amount of variation in how those people were interpreting exceptions in the law. Some were still providing abortion counseling and referrals. Others felt they weren’t allowed to even mention the treatment. Some thought the health of the mother exception in the law allowed them to perform abortions for patients whose water broke before the point of fetal viability. Others were sending those patients home to wait until infection set in and the patient could be admitted to an intensive care unit. 

Meanwhile, hospitals often err on the side of caution even in states without bans. “It’s common when I talk with friends who work at hospitals, where, even though abortion is legal in their state, their hospital or clinic has chosen not to allow them to do abortion, because they don’t want controversy,” said Jonas Swartz, a professor of obstetrics and gynecology at Duke University Medical School. Several other medical professionals we spoke with also said that secular hospitals often had policies on abortion that were more strict than state law. Jen Moore Conrow, former director of the Pregnancy Early Access Center at the University of Pennsylvania, described setting up the hospital’s new internal clinic for handling miscarriage and medically necessary abortion in 2015, and then not being allowed to publicly talk about that clinic in the media for two years. A Penn Medicine spokesperson said the system is committed to providing information to the public, including frequently addressing reproductive health issues in the press. “The chair of our department was like, ‘We don’t ever want to be an abortion clinic.’ And I’m like well, we are an abortion clinic,” Conrow said.

“When you’re pregnant, you’re a second-class citizen inside your own body,” Houshmand said. “It was just abundantly clear to me that everyone was prioritizing this eight-week embryo over me.” Houshmand wrestled with those feelings while she argued with her doctor’s office on the phone, while she called abortion clinics on her own, and while she waited overnight for the appointment she’d managed to get. She felt like she was going crazy. The pain was so intense that she’d barely slept in two days. She passed out in her shower. And, seemingly out of nowhere, Houshmand began to have thoughts of suicide. 

She would later find out that was caused by the infection in her brain. But in some ways she was lucky. Her emergency happened at the right place, at the right time. If she’d gone through this experience now, she might not have been able to get that appointment since wait times are rising as remaining clinics struggle to meet a demand for abortions that doesn’t go away just because national abortion rights have.

Delayed treatment has real impacts on the health and welfare of pregnant people. A condition that wasn’t immediately dangerous two weeks ago might be life and death today. And with every week that passes, the fetus gets bigger and abortion becomes more complicated and riskier, as well. Maternal mortality rates are higher in states that have more abortion restrictions, even after scientists account for demographic factors. Suzanne Baird, an obstetric nursing and health care consultant and a member of the board of the Association of Women’s Health, Obstetric and Neonatal Nurses, said delays could be one reason why. She pointed to a 2018 report by nine state committees that review individual cases of maternal mortality in the United States. This report found that delayed diagnosis and treatment had been a major factor in those deaths. 

In North Carolina, for example, Swartz has had to follow state restrictions, including a 72-hour waiting period and reading mandatory scripts meant to dissuade a patient from an abortion — even when the patient is sick. It’s common, he told us, to find himself debating whether a patient who isn’t in an emergency situation yet, will be by the time the waiting period is up. 

Likewise, Medicaid and many other state-funded insurance providers can’t use federal funds to pay for abortions unless the life of the mother is at risk. And doctors we spoke to say those exceptions are approved in arbitrary, haphazard ways that vary widely by state as well as the reviewer of that particular case. If the case is denied, the patient has little means to pay out of pocket. Conrow described having to delay the care of a patient with sickle cell anemia, waiting to see if Medicaid would cover the patient’s abortion, knowing that sometimes Medicaid will cover abortions for people with the disorder … and sometimes it won’t. In 2019, a report from the Government Accountability Office found that some states weren’t following federal requirements for Medicaid abortion funding — such as paying for abortion pills, or covering abortions in the cases of rape or incest. 

Even when patients aren’t going to die, they can still be left with lifelong complications that abortion could have helped them avoid, Harris said. One of her first cases at the University of Michigan involved a patient who wanted an abortion because of a fetal anomaly, but who also had placenta previa — a condition where the placenta grows across the part of the uterus that would normally open during childbirth. Instead of giving her a second-trimester abortion, dilating the cervix and removing the fetus through the birth canal, doctors had decided to induce labor with drugs. Days of contractions later, when the patient still hadn’t given birth, her doctors planned a hysterotomy. That procedure is like a C-section, surgery that cuts through the abdominal wall and uterus, but because the uterus is still so small in the second trimester, the scarring resulting from the hysterotomy would have meant the patient would never be able to give birth vaginally — and might have had trouble maintaining a future pregnancy at all. Instead, Harris performed an abortion, leaving the patient’s uterus intact. 

Being pregnant can make you sick, and it can exacerbate existing illnesses you never knew you had. The needs of pregnant people sometimes end up at odds with the needs of a fetus. And in that way, abortion restrictions — and vague life of the mother exceptions — are a thumb on the scale. The end of Roe v. Wade will obviously throw that balance even more out of whack, but the asymmetry was already there. The risks to pregnant people just get bigger as their choices shrink. “Hospitals want to get out of making these decisions but they won’t be able to,” said Greer Donley, a law professor at the University of Pittsburgh who has studied the law surrounding abortion and medical emergencies. “They will see pregnant people who have life-threatening complications and no other options, and they’ll have to make the call.”

A year after the abortion that saved her life — and allowed her to know her life needed saving — Houshmand has vowed to never get pregnant again. After her abortion, when she met with doctors from the Wills Eye Hospital in Philadelphia, they told her the immunosuppression that happens during pregnancy had allowed a normally harmless virus that causes cold sores to run rampant, attacking her optic nerves and, possibly, her brain. 

Houshmand has had antiviral medications injected into her eye, and she’s gone through three surgeries. She is still legally blind in her right eye, and she suffers from PTSD. “I never want to live through the experience of not being in charge of my own body ever again,” she said. The risk just isn’t worth it.

When we spoke with her, Houshmand had a fourth eye surgery scheduled. It took place less than a week after the Supreme Court overturned Roe v. Wade. 

COVID-19

Partly Cloudy With A 75 Percent Chance Of COVID Exposure

The CDC wants to make COVID forecasts a thing. The only problem: COVID data is becoming less reliable.

By Betsy Ladyzhets

Jun. 9, 2022, at 11:36 AM

It’s 6:30 a.m. and your third alarm is blaring. Another 10 minutes and you’ll have to miss breakfast before going to work. You get up, brush your teeth, shower and start a pot of coffee while watching the morning news. After the station’s meteorologist tells you it’s sunny with a high of 70 degrees, a health reporter follows up with the COVID-19 forecast: red-alert level today, with a 75 percent chance of exposure in spaces with at least 50 people.

You respond to the risk by taking a rapid test before leaving the house — snapping a picture of the negative result for your colleagues — and grabbing your N95 mask.

This is a hypothetical future, but one that a new team at the Centers for Disease Control and Prevention is working on. The Center for Forecasting and Outbreak Analytics got an initial $200 million in funding from the American Rescue Plan to recruit data scientists, epidemiologists and science communicators who will come up with forecasts for the public and promote data-based decision-making. CFA aims to operate “like the National Weather Service, but for infectious diseases,” said epidemiologist Caitlin Rivers, the new center’s associate director for science, in an April article in The Washington Post.

Which would be great — except that the forecasts have less data to work with now than they’ve had in years. COVID-19 case data is less and less reliable thanks to rapid testing, for one. In addition, hospitalization data can lag behind trends in transmission and may become unavailable in the coming months. And new sources like wastewater surveillance aren’t yet ready to replace clinical data. Imagine producing a weather forecast without reliable temperature or humidity measurements.

Two converging trends are causing case data to become less useful. First, more Americans are using at-home rapid tests, and second, fewer Americans are using lab-based PCR tests.

About six times as many at-home tests as PCR tests are being taken in the U.S., according to Mara Aspinall, a diagnostic-testing expert and health-care industry consultant. Using data from test manufacturers and retailers, Aspinall has kept a close eye on test capacity in the U.S. throughout the pandemic, and at this time last year, Americans were taking considerably more PCR tests than at-home tests.

Unlike PCR test results, which are automatically reported by the labs that process the tests, the vast majority of at-home test results are not reported to public-health authorities. In recent months, PCR tests have also become less available. States such as Vermont and Colorado are shutting down free public-testing sites and directing patients to at-home tests and private health-care providers instead — even as government funding to cover tests for uninsured people has run out.

“The official numbers we hear about on a daily basis, in terms of official COVID-19 cases, is becoming an increased undercount of the true number of infections that are circulating,” said Jason Salemi, an epidemiologist at the University of South Florida College of Public Health.

This increasing undercount leads to more uncertainty in COVID-19 forecasting, said Marc Lipsitch, an infectious-disease expert at Harvard and the temporary director of science at CFA. As the quality of case data gets worse, “we’re more reliant on the delayed indicators, like hospitalizations and deaths,” he said. 

CFA scientists are currently focused on hospitalization data, which U.S. modelers find more reliable than case numbers: Lipsitch described it as the best source that is “routinely and uniformly reported.”

Hospital admissions — the number of COVID-19 patients newly admitted for treatment — can be particularly useful, said Lauren Ancel Meyers, director of the University of Texas at Austin’s COVID-19 Modeling Consortium. This metric provides “a stabler signal” than case counts, even though it doesn’t typically show an increase until a week or two after a surge.

But when health agencies rely on hospitalization data as their main source for policy decisions, they “lose valuable time to prevent morbidity and mortality,” Salemi said. Essentially, by the time hospital admissions show a meaningful uptick, it’s already too late to prevent a surge that will cause more people to get seriously ill — and it will drive similar increases in long COVID that aren’t visible in hospitalization data at all.

Lipsitch agreed that this delay is a problem. Hospitalization data reflects COVID-19 spread in the recent past; when using data about the past to identify trends in the present, “the present becomes more ambiguous, because the most timely signal was also the lowest quality.”

In addition, Salemi said, hospitalization metrics face a problem of geography. While people living in every U.S. county may get infected with SARS-CoV-2, not every county has a hospital. For example, Alachua County, Florida, has a major health-care system where Floridians from several smaller, nearby counties go for treatment. Most of the hospitalizations from this region show up in Alachua County, not in the surrounding areas.

Even the imperfect hospitalization data may not always be available. When the Biden administration ends the national public-health emergency for COVID-19, hospitals and local health departments may no longer be required to report their data to federal agencies. The emergency declaration will continue beyond at least July 15, but it’s unclear how long the administration will keep extending it.

And if the data does become even less reliable, then what? CFA is looking into alternatives, and wastewater monitoring is a top priority. Our sewers can provide more timely data than hospitalizations, and less biased data than cases. But wastewater is far from a national surveillance system: COVID-19 levels aren’t being tracked in water systems for much of the country, it takes time and resources to set up this tracking, and health agencies aren’t yet sure how to use the data once they do have it.

Lipsitch also wants to find a way to pinpoint who in a community is infected, with data that’s individual-level, not population-level like wastewater. Ideally, he would like to see the CDC perform population surveys, sampling a representative subset of Americans to estimate who has COVID-19. Such surveys could contribute to precise estimates of how many people in a given state or county are currently infected, driving forecasts of an individual’s chance at exposure if they go to work or school. British modelers consider similar surveys conducted by the U.K.’s Office for National Statistics much more reliable than case counts, Lipsitch said. But there’s no comparison for these surveys in the U.S.

CFA’s conversations about potential data sources and public-health actions are largely theoretical at this point, as the center is still a team of only four people — three of whom are “on loan” from their academic positions, as Lipsitch described it. Posting job descriptions for the center’s eventual 100 scientists and communicators is “taking longer than we had hoped,” he said. As of early June, only one job posting is open for applications.

As it works on scaling up, CFA faces a broader challenge: the CDC’s lack of authority over state and local health agencies. “Outside of a public-health emergency, CDC has no authority to require states to share data,” Lipsitch said. And even during the COVID-19 emergency, the agency has been unable to require sharing some key metrics, such as breakthrough cases and deaths.

The CDC also has limited authority over Americans overall, and trust in the public-health system is waning. One recent poll showed that nearly one-third of the country thinks the pandemic is already over, while Congress consistently fails to deliver new funding for COVID-safety measures. These may be concerning signals for the new forecasting center’s future: Even if the CFA is able to provide timely, accurate infectious-disease forecasts like what we have for the weather, how many people will actually act on the information?

UPDATE (June 10, 2022, 6:09 p.m.): The CFA says its team has expanded to 14 people now. Five of them are splitting their time between the center and academic institutions or other CDC offices.

Gun Violence

Suicide Prevention Could Prevent Mass Shootings

By Maggie Koerth

Jun. 6, 2022, at 1:32 PM

The following is an updated version of this article, published in 2019.

Imagine a doctor who wanted to treat a broken leg with chemotherapy. Or treat cancer with a cast.

Just because cancer and broken legs are both things that happen to the body doesn’t mean they call for the same treatment. These are the kinds of issues policymakers face every day. Take gun violence. It feels like one big problem, but it’s actually a bunch of different problems that don’t necessarily have a single cause. But it’s also easy to get so focused on the differences between types of gun violence that we miss the unexpected connections. Just like a fragile, cracked bone could be a symptom of certain kinds of cancers, researchers are finding evidence that suicides and mass shootings can often be different expressions of the same problem.

I first reported on this connection back in 2019, as part of trying to explain why a suicide prevention tool — “red flag laws” that enable family members and law enforcement to determine that a person is a threat to themselves or others and temporarily remove guns from their home — was being proposed as a way to prevent mass shootings. 

Today, 19 states have enacted red flag laws and they’ve had mixed results in violence prevention. But the connections between suicidality and mass shootings have just gotten stronger. “Many of these mass shootings are angry suicides,”  James Densley, professor of criminal justice at Minnesota’s Metropolitan State University, told me four years ago. And now there’s even more evidence to suggest that’s true. 

It isn’t news that a lot of mass shooters suffer from suicidal ideation, said James Lankford, a professor of criminology at the University of Alabama. But it wasn’t until he published a 2021 study comparing mass shooters to other demographic groups that he truly realized just how much more mass shooters had in common with people who die by suicide than they did with other kinds of homicide offenders.

“Homicides are rarely premeditated but public mass shootings almost always are,” Lankford said. So are suicides. While mass shootings were 3.8 times more likely to be premeditated than standard homicides, they were only 1.2 times more likely to premeditated compared to suicide. Mass shooters were more likely than other homicide offenders to act alone. They were more likely to be killed by law enforcement. And while standard homicide offenders aren’t particularly likely to experience suicidal tendencies, in Lankford’s study anyway, mass shooters were a bit more likely to have a history of suicidal ideation than even people who actually died by suicide. 

Lankford is not the first person to find connections between suicide and mass shootings. In a database of more than 150 mass shootings that took place between 1966 and 2018, Densley found that about half the attackers in his sample had demonstrated signs of feeling suicidal before they hurt others. A different set of researchers who analyzed 41 school shooters for the Secret Service and Department of Education found that 78 percent had a history of thinking about or attempting suicide.

“We’ve even talked to a couple of people who tried to kill themselves but failed and then launched an attack because they were hoping police would kill them,” said Marisa Randazzo, a former chief psychologist for the Secret Service who now consults on active threat assessment with schools and other organizations, told me.

A third set of researchers, who compiled the details of 119 lone-actor terrorists, did not specifically track whether the people in their data set had thought about or attempted suicide, but the researchers told me they also found significant overlap between mass shootings and choices that suggested suicidal tendencies. “A fairly sizeable subset only planned this to be a one-off event” — that is, something they didn’t return from — said Paul Gill, a professor of security and crime science at University College London and the researcher in charge of that data set. “They were taking preparations to maximize the chances of death by cop or their own hand.”

In other words, acts of mass violence are functioning as a method of suicide. “These are individuals who are planning in advance to commit a crime for which there’s almost no chance they’ll avoid life imprisonment or death as a direct result of the crime,” Lankford said. “It’s very reasonable to say that they’re not very invested in their current lives, or their future lives.” 

That fact has implications for policy and prevention. 

A connection to suicide means armed guards are unlikely to be a deterrent to mass shooters, Densley said. In 2021, he published a paper that analyzed 133 cases of school shootings between 1980 and 2018 and found that the ones where armed guards were present had a death rate 2.8 times higher than those with no armed guards on scene. Densley thinks this could partly be because in the eyes of a shooter exhibiting suicidal ideation, good guys with guns are a feature, not a bug. They may see a higher chance of death for themselves and they may go in more heavily armed — and more innocent people could be caught in the ensuing shootouts. And even if that’s not the case, Lankford said, a shooter having armed guards to fight creates a story that increases the killer’s chances of achieving notoriety and fame.

The connection to suicide also means potential mass shooters can easily slip under the radar of law enforcement, who are trained to deal with crime, not crisis, Lankford said. It’s not uncommon for future mass shooters to come to the attention of law enforcement before their major attack, but those interactions often go nowhere because that person has no connection to violent crime or gangs, and they have no previous criminal record. “Those questions aren’t useful in assessing the threat of a mass shooter,” he told me. 

And these kinds of shooters remain difficult to profile. Even knowing the connection to suicidality doesn’t particularly help because most suicidal people aren’t a danger to others, just themselves. 

But there is some good news here. Mass shootings are very often preceded by what experts describe as cries for help — shooters tell other people about their plans, they make threats, they describe their desire to kill and be killed. In a 2021 study of 170 perpetrators of mass shootings, researchers found that 44 percent had leaked specific details of their own plans beforehand. Multiple studies have found that family and friends of a mass shooter are often aware that something is wrong long before the violence happens. That happened one-third of the time in Densley’s database, 64 percent in Gill’s, and 81 percent in the cases Randazzo logged.

And this is why many experts who study the epidemiology of mass shooters like the idea of red flag laws as a preventative. Even once you identify some details that many of the attackers have in common, such a large swath of the population shares these traits that the “profile” is fairly useless for prevention. Red flag laws circumvent that problem by focusing less on a type of person and more on a type of emotional and situational crisis — where the people involved aren’t necessarily “bad guys” but troubled individuals in need of help. Gill thinks of it as a public health approach, analogous to the way we treat physical health problems that are hard to profile.

“We know that raised cholesterol leads to heart problems. We don’t have the ability to predict who in the general population who already has raised cholesterol will go on to have a heart attack. So we put in place prevention policies to try to decrease cholesterol in the whole ‘at risk’ community,” he said.

For the researchers who study mass violence, what’s appealing about red flag laws is that these rules have the potential to shift the emphasis from a cut-and-dried checklist of dangerous traits to a more nuanced system that accounts for a person’s big-picture emotional state. 

Right now, experts said, even when friends, family and teachers know something is wrong with a potential shooter, they may not be able to actually do much about it. Sometimes people don’t know who to tell. Sometimes they choose not to tell in order to avoid sending a loved one to prison for crimes they haven’t yet committed. Sometimes the authorities can’t do anything because the nature of the threat doesn’t include illegal behavior.

All these researchers supported red flag laws because they could create a clear plan of action for friends and family concerned about a loved one’s combination of emotional crisis and violent threats. It creates a place to take concerns, a system to evaluate those concerns and a means of mitigating them. That’s particularly true, researchers said, if national red flag laws are set up so that the system isn’t punitive. Ideally, the process would focus on helping a person get through to the other side of an emotional crisis rather than putting them in jail. It’s also important, the researchers said, to make sure the laws are focused on professional evaluations of overall behavior, not checklists.

And there’s some evidence this could work. An analysis of records from California, where one of the first red flag laws was enacted in 2016, found at least 21 cases where the laws had been used specifically because people around a person were worried about their potential to commit a mass shooting. As of 2019, none of those people had followed through on that potential. It’s impossible to know, however, how those risks would have played out if the red flag hadn’t been there. 

But if those parts work together the way they should, then red flag laws really could be a useful tool for combating the segment of mass shootings that function like very public, violent suicides. “There’s an important piece when we interviewed school shooters and active threat cases,” Randazzo said. “They feel very strongly about two things: They have to carry out the violence, they have no options left, but they also don’t want to do it and hope someone will stop them.”

FiveThirtyEight is seeking a temporary Video Producer to join our team full-time from mid-July through mid-November. This person will pitch, storyboard and edit videos about U.S. politics, filling an important role in our coverage of the 2022 midterm elections.

The Video Producer will report to and work with the Senior Video Producer to direct and edit a short-form video series that gives our audience a deeper, data-informed understanding of American politics. They will also be responsible for editing the video version of the FiveThirtyEight Politics podcast, which comes out twice a week. During the primaries, the second weekly episode is often filmed on Tuesday nights after election results come in, so the video producer must be open to working a shifted schedule at times, which will include some late nights.

The Video Producer will work closely with the rest of FiveThirtyEight’s video team; FiveThirtyEight reporters, visual journalists and copy editors; and the graphics team from ABC News Digital. This is a U.S.-based position, and work can be conducted remotely or out of our New York City office. Candidates should be able to work 40 hours a week on an Eastern time zone schedule. To apply, please send a résumé and two clips by Sunday, June 19 to anna.rothschild@abc.com with the subject line “Temporary Video Producer.”

Basic Qualifications:

• Proficiency in Adobe Premiere Pro
• Ability to script and storyboard
• Experience working in a fast-paced environment on a tight deadline
• Experience with multi-cam editing
• Ability to communicate about visual style and provide thoughtful, constructive feedback to animators and other collaborators
• Solid news judgment
• General knowledge of and interest in U.S. electoral politics
• An interest in data journalism

Preferred Qualifications:

• Experience working in a newsroom 
• Proficiency in Adobe After Effects and Illustrator
• Ability to light a studio shoot
• Experience filming with a Canon C300
• Experience directing a remote film crew
• Experience editing a multi-guest podcast video

Abortion

What The History Of Back-Alley Abortions Can Teach Us About A Future Without Roe

By Maggie Koerth

Jun. 2, 2022, at 6:00 AM

UPDATE (June 24, 2022, 12:33 p.m.): On Friday, the Supreme Court overturned Roe v. Wade, which established the constitutional right to abortion in 1973, with five of the six Republican-appointed justices arguing that there was no basis for the constitutional right to abortion.

In an article we published earlier this month, we looked at the history of back-alley abortions in the U.S. with an eye to what they can tell us about a post-Roe future. A lot has changed since abortion was not legal in the U.S. in the 1970s, but a post-Roe future will still mean unequal access for women seeking abortion. You can read more about what we found below.

A metal coat hanger can’t speak, but it can send a message. Long a symbol of the dangers faced by people seeking to end pregnancies in the years before Roe v. Wade, coat hangers stand in for a whole inventory of physical horrors, most of which never involved coat hangers, specifically. Over the past few weeks, protesters have mailed hangers to the Supreme Court in an effort to evoke that past era — from the so-called back-alley butchers who botched surgical procedures and sexually harassed patients, to the terrible lengths individuals went through to give themselves an abortion at home. The message is simple and brutal: Without safe and legal abortion, the protesters believe, people will die.

In the years since Roe became the law of the land, the medical landscape of abortion has changed drastically. Today, abortion is extremely safe — safer than birth. So safe, in fact, that it’s not always obvious what made illegal abortions unsafe. Or, for that matter, what the coat hangers were for.

And this is why those objects still have important stories to tell us, historians told me. Because while the most physically violent abortion methods of the past have become medically obsolete, the march of scientific progress hasn’t eliminated the shame, fear and hopelessness experienced by people who are pregnant, don’t want to be, and live in a society where there is no simple, legal access to abortion. Coat hangers don’t just tell us about the dangers of bad medicine, practiced shoddily, these historians said. Instead, the hangers also speak volumes about the desperation that can lead people to those dangerous procedures in the first place.

“The whole phrase ‘back-alley butcher’ is an exaggeration because there were lots of good practitioners who were perfectly safe,” said Leslie J. Reagan, professor of history at the University of Illinois at Urbana-Champaign and author of “When Abortion Was a Crime.”

Even in the past, the dangers of illegal abortion weren’t about the abortion itself. No one knows how many illegal abortions were being performed annually, pre-Roe, but researchers in the early 1990s estimated it was on par with annual numbers of legal abortions at the time, so more than 1 million. People with money and connections could always get safe ones and plenty of people survived, the historians I spoke with said. Illegal abortions were primarily unsafe for the people who were blocked out of better options.

Legal abortions in hospitals, for example, happened with some regularity. These records were kept hospital by hospital, so it’s rare to have even city-wide data, but University of Vermont historian Felicia Kornbluh pointed me towards a 1965 paper that found hospital review boards in New York City had approved 4,703 so-called therapeutic abortions between 1951 and 1962.  In those cases, the technique actually being used was something called a dilation and curettage, or D&C. Also often referred to as a “surgical abortion” the D&C is still used today as a treatment for both abortion and miscarriage. Doctors dilate the cervix — making the opening between the vagina and uterus wider — and use a sharp tool to scrape out the contents of the uterus.

Before Roe, in the 1950s and 60s, getting a legal hospital abortion was not easy. A patient could get a D&C if they were already experiencing a natural miscarriage. Otherwise, patients who requested one would have to make a case to their doctors, who would then have to bring the situation before a hospital review board. The patient would likely be examined by other doctors and might have to answer questions — basically, they needed to prove the abortion was medically or psychologically necessary. But necessity wasn’t the only factor at play. “There are studies that show that almost all of them were done on people with private insurance,” Reagan said. Patients without insurance, as well as black and brown patients regardless of insurance status, had a much harder time getting approved. In her upcoming book, “A Woman’s Life is a Human Life,” Kornbluh records that Metropolitan Hospital in East Harlem approved five white women’s requests for every one Black woman’s. The hospital was even less likely to approve Puerto Rican women’s requests. And Reagan has documented instances of Black women being denied abortions even though they had rubella infections during pregnancy — something that can kill a fetus, or leave it with lifelong complications, including deafness, heart defects and intellectual disabilities. (Others were lied to and told they didn’t have it.)

People who were denied — or who never had a hope of getting — a hospital abortion were left with only illegal options. Both trained doctors and untrained practitioners offered D&C’s, but that procedure was considerably more dangerous in illegal settings. Without sterilized equipment and ready access to antibiotics and painkillers, doctors used furtive practices that optimized for speed and offered no room for follow-up care, and practitioners sometimes had no idea what they were doing. Carole Joffe, professor of obstetrics and gynecology at the University of California, San Francisco, interviewed trained doctors who practiced illegal abortion during this time and has written about their experiences. One doctor told her that he used to explain the challenges of performing a D&C by telling his residents that it was like being blindfolded and trying to scrape the inside of a wet paper bag without cutting through the paper. Possible, but not easy. “D&C’s in competent hands are safe, but in incompetent hands it’s very easy to perforate the uterus,” Joffe said. 

To avoid trying to perform the tricky D&C under clandestine circumstances, illegal abortionists sometimes opted instead to simply induce enough of a miscarriage that their patient could go to a hospital and get one without a problem. They did this often by inserting a foreign object — like a hollow tube catheter — through the cervix. In some cases, they might use a type of catheter with a balloon on one end. Filled with saline, it would put pressure on the cervix, like a fetus’s head would towards the end of pregnancy, causing it to fully dilate. Just sticking any catheter in could prompt a miscarriage as the body tried to expel the object. These methods didn’t work all the time, though. They could cause hemorrhages and embolisms. And catheters had to be left in for a while, along with gauze packed into the patient’s vagina to staunch the blood. This could cause infection and with patients trying to hide from authorities, they often didn’t seek treatment until near death.

People who couldn’t find or afford an illegal abortion often tried to give one to themselves. It’s impossible to say how many of these happened every year, but there are records showing thousands of people coming into emergency rooms with septic infections of the uterus and reproductive organs in the 1960s, Reagan said. This is where the coat hangers come in, Joffe said, as one of many objects people would try to insert through their own cervical openings. The goal was not necessarily to complete an abortion at home but rather to induce enough bleeding and symptoms of miscarriage that the person could go to a hospital, say they were having a miscarriage naturally, and get a hospital D&C. But perforation, hemorrhage, and infection were all risks. 

Even less reliable, and more dangerous, were an array of suppositories, tinctures, herbs and home remedies that plenty of people tried. One doctor told Joffe about treating a patient who had gotten a catheter into her cervix and poured turpentine through it, literally cooking the inside of her uterus, which had to be removed. Others told stories about potassium permanganate tablets, sold over the counter, which people would put in their vaginas to induce bleeding and get their hospital D&C. But the tablets could easily eat through the vaginal lining, causing hemorrhage and destroying the cervix. 

It’s very unlikely that anyone will go back to performing back-alley D&Cs or catheter abortions, Reagan and Joffe said. Even if Roe is overturned, doctors and other people who want to defy it are much more likely to offer patients abortion pills. While abortion via pill can be a physically painful and psychologically intense experience for some people, the existence of these pills drastically changes the calculus when it comes to the risks of illegal abortion. They’re much easier to get and conceal, much safer to use, and if a patient is worried about side effects they can seek treatment knowing no one will be able to tell the difference between the effects of a pill and a natural miscarriage.

But both Reagan and Joffe said the existence of abortion pills won’t eliminate risk if abortion becomes illegal. Just as there were some people who could get abortions more easily than others before Roe, there will be those who can do so after, as well. Meanwhile, some of the most vulnerable people — poor people, people living in very rural areas, people who can’t take time off to drive to another state in search of pills — will still end up with only desperate options left. Reagan was particularly worried that websites selling fake abortion pills will deceive people who have no idea they aren’t getting the real thing. And both she and Joffe worried about how illegality and increased stigma could drive more people towards dangerous at-home methods, with social media becoming the new back alley. Even with abortion still legal, there are occasional instances of people — usually young — trying to abort on their own, Reagan said. 

The methodology of abortion has improved, Reagan and Joffee told me. But as long as desperation for an abortion exists — and easy access does not — some people will still be in danger. 

Abortion

Better Birth Control Hasn’t Made Abortion Obsolete

By Maggie Koerth and Amelia Thomson-DeVeaux and Maggie Koerth and Amelia Thomson-DeVeaux

May 19, 2022, at 6:00 AM

Has modern birth control made abortion a thing of the past? That’s what lawyers for the state of Mississippi want the U.S. Supreme Court to think. In a brief in the the pending case that could overturn abortion rights nationwide, Mississippi’s lawyers wrote, “[E]ven if abortion may once have been thought critical as an alternative to contraception, changed circumstances undermine that view.” Access to birth control has improved, they noted, and some methods’ failure rates are “now approaching zero.” According to Mississippi’s lawyers, effective birth control means people don’t need abortions anymore.

But Sarah, a professional living in the suburbs of Washington, D.C., did.⁵ She had always wanted four children, but four was it. So after her fourth child was born, she and her husband researched birth-control options and landed on the one that seemed foolproof: a vasectomy. “We’re very thorough people, very by the book,” she said. “We wanted to make very, very sure we didn’t have an accident.”

Then, on Mother’s Day, Sarah found herself in her bathroom looking at two lines on a pregnancy test. She knew almost immediately that she was going to have an abortion.

Statistically, Sarah’s experience was very unlikely. There’s a reason why vasectomies are touted as one of the most reliable forms of birth control: They have a failure rate of less than 1 percent,⁶ as opposed to something like condoms, which has a failure rate closer to 13 percent. But because a 1 percent chance isn’t zero, some vasectomies fail every year, just like every other form of birth control. As a result, thousands of Americans who took steps to avoid getting pregnant will seek an abortion anyway. A report from the Guttmacher Institute found that about half of abortion patients used contraception in the month they became pregnant. Framing abortion as a procedure that can be avoided through personal responsibility doesn’t prevent abortions from happening, experts told us. Instead, it just places more blame on women.

Americans need better access to contraception. In countries where birth control is cheap or free and more easily available to more people, there are much lower rates of unintended pregnancy, said Dr. Emily Godfrey, a professor of family medicine, obstetrics and gynecology at the University of Washington. The unintended pregnancy rate in the United States is about 21 percent higher than in the average Western country,⁷ where national insurance or other universal health care programs are common. Likewise, a large drop in unintended pregnancy rates in the U.S. between 2008 and 2011 was correlated to an increase in the use of long-term, reversible methods of birth control, such as IUDs or implants, which have low failure rates. And that large drop in unintended pregnancy rates has led to fewer abortions.

But that’s not the same as saying that using birth control eliminates the need for abortion, Godfrey said. Yes, Americans can choose from 16 forms of birth control, two types of emergency contraception or “morning-after pills,” and three methods of sterilization. But there are many reasons why she says access to abortion remains necessary.

The simplest and most inescapable reason is that birth control can — and does — fail. That’s true even of the most reliable methods of preventing pregnancy, such as IUDs, implants and sterilization. 

According to the Guttmacher Institute study cited in the chart above, about 51 percent of abortion patients in 2014 reported using some type of birth control in the month they got pregnant. The shares of patients in that study who reported using a long-lasting, high-efficacy birth-control method were low — far more respondents said they had used a condom in the month they got pregnant, which doesn’t necessarily mean, of course, that they were using one at the time they got pregnant. But small percentages still represent thousands of individuals. Just 0.8 percent of respondents said they’d been using an IUD in the month they got pregnant, but that 0.8 percent translated to an estimated 7,700 abortion patients that year. Even the 0.2 percent who said they’d used either sterilization or implants represented an estimated 1,600 and 1,800 people, respectively, who ended up needing access to abortion. 

But the political rhetoric of abortion doesn’t reckon with that fact, said Dr. Christine Dehlendorf, a professor of family community medicine at the University of California, San Francisco. “The mantra of ‘safe, legal and rare’ is stigmatizing,” she said. “It’s saying [abortion is] a bad outcome you should be able to avoid, as opposed to a health care service you should be able to access.”

And as a result, people are getting the message that abortion is a purely preventable problem — something a person can avoid if they are responsible enough. Sarah’s story comes from a collection of experiences with abortion that readers shared with FiveThirtyEight. Our database contains hundreds of entries, and a common, recurring theme is that people reported getting pregnant while using birth control — and then felt like they were the ones who had failed. Contributors said they had done everything right, yet they still felt responsible. 

User error does contribute to unintended pregnancy, Godfrey said. That’s especially relevant when you’re talking about methods like the birth-control pill, which has to be taken correctly every day, or physical methods like condoms, which rely on proper usage in the moment. But user error can’t be dismissed as sexual irresponsibility either, she added. It’s just normal human behavior. “There’s research showing, on average, people miss a pill or two each month. That’s not just birth control, it’s all long-term pills … depression, diabetes, everyone,” she said. “Nobody uses any medication perfectly for 25 years. It’s not possible.” 

Over and over, contributors described struggling with the feeling that abortion should be something they needed only if they were victimized, young and uninformed, too poor to get birth control, or just too irresponsible to take it properly. The stigma wrapped up in that stereotype made Sarah feel uneasy about her decision, even though she knew it was the right choice for her. “Society tells you to feel bad, so therefore I felt bad,” she said. “But, ultimately, I realized that if you can’t control when you have an abortion, then you can’t control when you’re going to have children,” she added. “Because I did literally everything I could not to get pregnant.” 

And any attempt to frame abortion as preventable by birth control has to take into account the many reasons why people might not be able to get contraception — and even reasons why some might not want it. Not all sex is consensual, after all. And even for people who can plan ahead, birth control can be expensive — an IUD can run upward of $2,000 by the time you include both the device and doctor’s fees, Godfrey said. Then there’s the fact that the forms of birth control least likely to fail are also the ones patients have the least control over. Some doctors have refused to give patients IUDs they requested and, in other cases, refused to take out IUDs patients no longer wanted. “Black and Latino women are more likely to be counseled to use IUDs and encouraged to limit family size, and more likely to be encouraged to use a [birth-control] method they don’t want,” Dehlendorf said. 

The reality is, birth control might reduce the need for abortions — but it can’t make abortions go away. That’s because the need for abortion goes beyond the capabilities of birth control, Godfrey said. People can be trying to get pregnant and still end up in situations where they want an abortion. There will always be people who couldn’t get reliable birth control. There will always be people who can’t or don’t want to use specific kinds of birth control. And there will always be people whose birth control simply didn’t work.

CORRECTION (May 19, 2022, 10:04 a.m.): An earlier version of this article misstated the failure rate of condoms. It is about 13 percent, not 24 percent — which is the percentage of nonhospital abortion patients in 2014 who reported using a condom in the month they got pregnant.