SU E THE PERILS OF A BOOM IN SOCIAL MOVEMENTS

LI S LONG COVID DIAGNOSTICS AND BACKLASH

CI A
S PE

SCIENTIFICAMERICAN.COM MARCH 2022

HOW
COVID
CHANGED
THE
WORLD
Lessons from two years
of emergency science,
upheaval and loss

DE
INSI
• A
 virus showed the dangers of rugged individualism
• G
 lobal health institutions lost trust
• M
 essenger RNA vaccines opened the door to new therapies
• C
 onspiracy theories made everything harder
• A
 nd more
 March 202 2

VO LU M E 3 2 6 , N U M B E R 3

28
SPECIAL REPORT

2 8 How COVID
Changed the World
By Jen Schwartz
32 A Microbe Proved That
Individualism Is a Myth
By Robin G. Nelson
34 A High-Speed Scientific
Hive Mind Emerged 
By Joseph Bak-Coleman and
Carl T. Bergstrom
38 Science Journalism Shifted
with New Realities By Tanya Lewis
40 COVID Set Off a Boom
in Diagnostics By Roxanne Khamsi
43 American Public Health
Revealed Its Fragility
By Wendy E. Parmet
46 Global Health Institutions
Reached Their Limits
By Lawrence O. Gostin
50 We Didn’t Get Serious about
the Climate Crisis
By Samantha Montano
51 Lockdowns Showed the Promise
of Cities with Fewer Cars
By Andrea Thompson
52 Inequality Got Much Worse
By Joseph E. Stiglitz
54 Messenger RNA Therapies
Finally Arrived By Drew Weissman 66 Fault Lines in American Society
55 Billionaire Space Tourists Got Deeper By Aldon Morris 
Became Insufferable 70 Vaccine Inequality Shut
By Clara Moskowitz Vulnerable People Out of
56 Long Haulers Called Attention Plans to Save the Planet
to Chronic Illnesses By Nnimmo Bassey
By Meghan O’Rourke 71 Oxygen Shortages Delayed
58 Data Captured COVID’s Rocket Launches By Tory Bruno
Uneven Toll 72 Conspiracy Theories Made It
By Amanda Montañez and Harder for Scientists to Seek
Jen Christiansen  the Truth By Stephan Lewandowsky,
64 Work Changed Forever ­Peter Jacobs and Stuart Neil
ON THE C OVE R
By Christina Maslach and 75 Pandemic-Era Research Two years into the pandemic,
Michael P. Leiter Paid Off—and Will for Years experts reflect on what the virus
By Britt Glaunsinger has done to science and society—
65 Nasal Spray Preventives what we’ve learned, what can’t be
Went into Development 78 COVID Is Here to Stay undone and how to move forward.
By Megha Satyanarayana By Christine Crudo Blackburn Illustration by Olena Shmahalo.

Illustration by James Olstein March 2022, ScientificAmerican.com  1

 4 From the Editor
6 Letters
8 Science Agenda
Neglect of global public health cannot continue. 
By the Editors

10 Forum
A patent-free vaccine could finally inoculate the world.
By Peter J. Hotez and Maria Elena Bottazzi

12 Advances
Pulling DNA from thin air to track biodiversity.
8 A mathematical law for sea-life mass. Gooey liquids’
coun­terintuitive flow. A giant flower’s adversarial host.

24 Meter
Planetary scientists report their findings in haiku.
By Attendees of the 52nd Lunar
and Planetary Science Conference

26 The Science of Health

Abortion pills are safe and effective—
and access is still restricted. By Claudia Wallis

80 Recommended
Earth’s sonic diversity is threatened by humans.
Secret scents of birds. Imagining animals in revolt.
12 Revised take on consciousness. Leaving COVID-
stricken New York for another planet.
By Amy Brady

82 Observatory
Claims about a fertility “biological clock”
are wildly overblown.
By Naomi Oreskes

83 50, 100 & 150 Years Ago

By Mark Fischetti

84 Graphic Science
The incredible south-north journey
of monarch butterflies.
82 By Katie Peek

Scientific American (ISSN 0036-8733), Volume 326, Number 3, March 2022, published monthly by Scientific American, a division of Springer Nature America, Inc., 1 New York Plaza, Suite 4600, New York, N.Y. 10004-1562.
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2  Scientific American, March 2022

FROM
THE EDITOR Laura Helmuth is editor in chief of Scientific American. 
Follow her on Twitter @laurahelmuth

How Has fied the need for science and humanity. Most of the staff contrib-
uted to this report, beginning with the early brainstorming ses-

COVID Changed sions (we do a lot of brainstorming), to make sure that we were
representing many fields of research and segments of society. Our
creative director, Michael Mrak, designed the section with clev-

Your World? er illustrations and memorable images, thanks to photo editor

Monica Bradley. Words are powerful, but graphics can be even
more gripping. If you’re reading this issue in print, turn the pag-
It’s been a tough two years. I hope you and yours are as safe es sideways to see a stunning collection of data visualizations, cre-
and healthy as possible at this stage of the C­ OVID pandemic. Like ated by graphics editors Amanda Montañez and Jen Christian-
everyone, we at S  cientific American h
 ave been thinking about sen, that show the profound ways ­COVID has shortened life span,
this terrible disease constantly and trying to make sense of it. transformed research, and changed education and the economy.
We’ve published hundreds of articles about the coronavirus itself, We’d like to hear from you: How has ­COVID changed your
the immune system response, the astonishingly protective vac- world? Please share your observations about the pandemic’s
cines, the psychological toll on society, the trauma of health-care impact on your community, profession, hobbies, schools, or oth-
workers, deadly misinformation and the best ways to stop the er aspects of life. We’ll publish your reports in our Letters to the
spread of SARS-CoV-2. We meet weekly to brainstorm about the Editor column, which you can reach at [email protected].
most important stories we should pursue to inform, engage and The ­COVID pandemic isn’t over, of course, and we’re antici-
protect people, and even two years in we come up with dozens pating years of important research findings. We’ll keep covering
of ideas in every discussion. new insights on the immune system, long-term effects of viral
In this issue, we look at how C
­ OVID has changed the world. We infections, psychological resilience, children’s cognitive develop-
have 24 articles (don’t worry, some are quite short) that cover ment, science-informed policies (we hope), and how to prevent
endeavors that have been directly and dramatically transformed, or control the next pandemic. Some of this research will be con-
such as disease testing (page 40) and vaccine development (page ducted by people who were inspired by this disaster to pursue
75), as well as some of the more unexpected impacts, such as on careers in science and health.
climate conferences (page 70) and rocket launches (page 71). The 1918 flu pandemic killed an estimated 50 million to 100 mil-
The main package of articles starts on page 28, with an intro- lion people around the world and raged for years. Afterward, his-
duction by senior editor Jen Schwartz, who did brilliant work torians have found, the catastrophe slid out of collective memory
pulling these pieces together and making sense of the many ways surprisingly quickly. We hope the dangers and disruption of ­COVID
that ­COVID disrupted society, accelerated research, and ampli- will ease soon, but we hope the lessons of ­COVID will last. 

BOARD OF ADVISERS
Robin E. Bell Jonathan Foley John Maeda
Research Professor, Lamont-Doherty Earth Observatory, Executive Director, Project Drawdown Global Head, Computational Design + Inclusion, Automattic, Inc.
Columbia University Jennifer A. Francis Satyajit Mayor
Emery N. Brown Senior Scientist and Acting Deputy Director, Senior Professor, National Center for Biological Sciences,
Edward Hood Taplin Professor of Medical Engineering Woodwell Climate Research Center Tata Institute of Fundamental Research

and of Computational Neuro­science, M.I.T., Carlos Gershenson John P. Moore

and Warren M. Zapol Prof­essor of Anesthesia, Harvard Medical School Research Professor, National Autonomous University of Mexico Professor of Microbiology and Immunology,
Alison Gopnik Weill Medical College of Cornell University
Vinton G. Cerf
Professor of Psychology and Affiliate Professor Priyamvada Natarajan
Chief Internet Evangelist, Google
of Philosophy, University of California, Berkeley Professor of Astronomy and Physics, Yale University
Emmanuelle Charpentier
Lene Vestergaard Hau Donna J. Nelson
Scientific Director, Max Planck Institute for Infection Biology,
Mallinckrodt Professor of Physics and of Applied Physics, Professor of Chemistry, University of Oklahoma
and Founding and Acting Director, Max Planck Unit for the
Harvard University Lisa Randall
Science of Pathogens
Hopi E. Hoekstra Professor of Physics, Harvard University
Rita Colwell
Alexander Agassiz Professor of Zoology, Harvard University Martin Rees
Distinguished University Professor, University of Maryland College Park
Ayana Elizabeth Johnson Astronomer Royal and Professor of Cosmology and Astrophysics,
and Johns Hopkins Bloomberg School of Public Health Institute of Astronomy, University of Cambridge
Co-founder, Urban Ocean Lab, and
Kate Crawford Co-founder, The All We Can Save Project Daniela Rus
Director of Research and Co-founder, AI Now Institute, Christof Koch Andrew (1956) and Erna Viterbi Professor of Electrical Engineering
and Distinguished Research Professor, New York University, Chief Scientist, MindScope Program, Allen Institute for Brain Science and Computer Science and Director, CSAIL, M.I.T.
and Principal Researcher, Microsoft Research New York City Meg Urry
Meg Lowman
Nita A. Farahany Director and Founder, TREE Foundation, Rachel Carson Fellow, Israel Munson Professor of Physics and Astronomy, Yale University
Professor of Law and Philosophy, Director, Ludwig Maximilian University Munich, and Research Professor, Amie Wilkinson
Duke Initiative for Science & Society, Duke University University of Science Malaysia Professor of Mathematics, University of Chicago

4  Scientific American, March 2022 Illustration by Nick Higgins

LETTERS
[email protected]

“When state legis­ ments, including more than 200 published

scientific works and a period as leader of
latures pass laws the provincial Green Party here in British
Columbia. But most pertinent to his com-
that take control ment is that he was a lead author in sev-
of public health and eral of the IPCC’s past assessment reports.
I was thus somewhat surprised that he
safety measures away was publicly rebuked by those offended by
his assertion.
from local agencies, I happened to hear Weaver interviewed
the entire population on the CBC, and he clarified that his inten-
tion was not to advocate abandonment of
is at risk of COVID.” the goal of limiting warming as much as
emmanuel padin c lermont, fla. possible. Rather it was to recognize that
we have passed a point where, if we were
to fix levels of greenhouse gases today, we
of politics in this essential and life-threat- would still see average global temperatures
ening matter. rise by more than 1.5 degrees C.
November 2021 Emmanuel Padin C  lermont, Fla. My observation is that, so far, the pub-
lic has been somewhat lulled by the nature
STORM WATCH of scientific statements. That is, science is
STATES OF DISEASE “Vapor Storms,” by Jennifer A. Francis, de- cautious; science does not practice hyper-
“States vs. Health,” by the Editors [Science scribes how increased moisture in a warm- bole even when it may be necessary from
Agenda], explains how politicians in sev- er atmosphere is fueling intense hurri- a social perspective. All the projections of
eral states are trying to prevent the lifesav- canes and flooding rains. Reading the ar- climate change I have seen appear to be
ing work that public health officials are ex- ticle reminded me of an experience I had underestimates of the severity of this ac-
ecuting to protect the population by re- camping on the eastern edge of Lake Su- celerating crisis. It may be more in the in-
quiring masking and physical distancing. perior, probably 35 years ago. terest of the greater good to speak plainly.
I agree with the presentation of the That October I was sitting on the shore This dovetails with Oreskes’s sugges-
article and the position that the Editors late in the afternoon. The sky was cloud- tion that the IPCC’s working group on cli-
take on the importance of letting science less several hundred meters offshore, with mate change’s physical science basis
and good medical practice lead the way to a breeze blowing in from the lake. The sky should be wrapped up and that the orga-
deal with the devastating effects that the above the shore was overcast, tending to- nization’s focus should be directed to its
­COVID pandemic is having in the U.S. and ward drizzle. working groups devoted to impacts and
throughout the world. When state legisla- This pattern stayed constant for the mitigation. I would add that the urgency
tures pass laws that take control of public hour or so I watched; the clouds were be emphasized by all possible means.
health and safety measures away from forming over that short distance. Watch- Richard “Dick” Fahlman
local agencies, as the article exposes, the ing weather change over such a small area Tla’amin Nation, British Columbia
entire population is at risk of contamina- gave me some appreciation for how diffi-
tion and the spread of the virus that cult climate modeling has to be. THE PROBLEM
causes ­COVID. Erick Erickson S outh Orange, N.J. WITH PAINKILLERS
In the piece, Georges Benjamin, execu- In “Painkiller Risks” [The Science of Health],
tive director of the American Public Health DIRE WARMING Claudia Wallis discusses the downsides of
Association, is eloquent in describing how “IPCC, Your Job Is Partly Done,” by Naomi high doses of analgesics, including kidney
the health strategies being applied by the Oreskes [Observatory], argues that the In- damage from nonsteroidal anti-inflamma-
public health agencies have been proved tergovernmental Panel on Climate Change tory drugs (NSAIDs). I find it lacking,
to be effective for hundreds of years and (IPCC) has fully established the “physical though, that she does not expand on the
how what some state legislatures are do- science basis” of climate change and should connection between over-the-counter
ing is “equivalent to taking away the abil- now focus entirely on analyzing its im- painkillers and kidney issues other than a
ity of doctors to write prescriptions.” pacts and potential ways to stop it. brief mention of potential adverse use of
I congratulate Scientific American for I wonder if Oreskes has heard of the NSAIDs during pregnancy.
publishing this article and invite the read- University of Victoria professor Andrew Long before the current opioid crisis,
ers to reflect on and support the science Weaver’s recent comment that limiting the scientific community and literature
and public health strategies that have pro- warming to 1.5 degrees Celsius is now im- knew of the dangers of NSAIDs and acet-
tected lives from many viruses, including possible. Weaver, whose Ph.D. is in applied aminophen (Tylenol). NSAIDS have been
the present one, and to avoid the intrusion mathematics, has numerous accomplish- clearly associated with damage to kidneys,

6  Scientific American, March 2022

 ESTABLISHED 1845

EDITOR IN CHIEF
Laura Helmuth
MANAGING EDITOR  Curtis Brainard COPY DIRECTOR  Maria-Christina Keller CREATIVE DIRECTOR  Michael Mrak
and there is evidence that high doses of ac-
EDITORIAL
etaminophen can harm them as well. In CHIEF FEATURES EDITOR  Seth Fletcher CHIEF NEWS EDITOR  Dean Visser CHIEF OPINION EDITOR  Megha Satyanarayana
1994 the New England Journal of Medicine FEATURES
SENIOR EDITOR, SUSTAINABILITY  Mark Fischetti SENIOR EDITOR, SCIENCE AND SOCIETY  Madhusree Mukerjee
published a study entitled “Risk of Kidney SENIOR EDITOR, MEDICINE / SCIENCE POLICY  Josh Fischman SENIOR EDITOR, TECHNOLOGY / MIND  Jen Schwartz
SENIOR EDITOR, SPACE / PHYSICS  Clara Moskowitz SENIOR EDITOR, EVOLUTION / ECOLOGY  Kate Wong
Failure Associated with the Use of Acet-
NEWS
aminophen, Aspirin, and Nonsteroidal SENIOR EDITOR, MIND / BRAIN  Gary Stix ASSOCIATE EDITOR, TECHNOLOGY  Sophie Bushwick
SENIOR EDITOR, SPACE / PHYSICS  Lee Billings ASSOCIATE EDITOR, SUSTAINABILITY  Andrea Thompson
Anti­inflammatory Drugs.” This 27-year-old SENIOR EDITOR, HEALTH AND MEDICINE  Tanya Lewis ASSISTANT NEWS EDITOR  Sarah Lewin Frasier
paper estimated that up to approximately MULTIMEDIA
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10 percent of the incidence of end-stage re- SENIOR EDITOR, AUDIENCE ENGAGEMENT  Sunya Bhutta SENIOR EDITOR, COLLECTIONS  Andrea Gawrylewski
nal disease (ESRD), or kidney failure, ART
SENIOR GRAPHICS EDITOR  Jen Christiansen Monica Bradley Ryan Reid
could be the result of long-term acetamin- ASSOCIATE GRAPHICS EDITOR 
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Amanda Montañez
ART DIRECTOR, ONLINE 
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ophen use and that such use of the drug COPY AND PRODUC TION
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lion (in 1994 dollars) in annual ESRD-­
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related medical costs. EDITORS EMERITI  Mariette DiChristina, John Rennie

I applaud Wallis for highlighting the Amy Brady, Katherine Harmon Courage, Lydia Denworth, Ferris Jabr,

EDITORIAL 
Anna Kuchment, Michael D. Lemonick, Robin Lloyd,
overall risk of acetaminophen toward the Steve Mirsky, Melinda Wenner Moyer, George Musser, Ricki L. Rusting,
Dava Sobel, Claudia Wallis, Daisy Yuhas
end of her article: She quotes pain research- ART  Edward Bell, Zoë Christie, Lawrence R. Gendron, Nick Higgins, Katie Peek, Beatrix Mahd Soltani

er and professor of medicine Erin Krebs as EXECUTIVE ASSISTANT SUPERVISOR  Maya Harty

noting the drug “is very safe up to a certain
threshold, and above that line it is very haz- SCIENTIFIC A MERIC AN CUS TOM MEDIA
ardous.” Wallis then adds that the same re- MANAGING EDITOR  Cliff Ransom CREATIVE DIRECTOR  Wojtek Urbanek
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searcher “says it’s ‘crazy’ that the drug is ENGAGEMENT EDITOR  Dharmesh Patel ACCOUNT MANAGER  Samantha Lubey
present in more than 600 products,” which
“makes it all too easy to go overboard.” PRESIDENT
I believe all products that contain acet- Kimberly Lau
aminophen or NSAIDs should require EXECUTIVE VICE PRESIDENT  Michael Florek VICE PRESIDENT, COMMERCIAL  Andrew Douglas
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CLARIFICATION
CONSUMER MARKETING & PRODUC T
“Overcoming Gene Therapy’s Long Shad- DEVELOPMENT TEAM LEAD  Raja Abdulhaq
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ow,” by Tanya Lewis [Innovations In: Gene SENIOR PRODUCT MANAGER  Ian Kelly
Therapy], did not give Mark Batshaw’s cur- SENIOR WEB PRODUCER  Jessica Ramirez
SENIOR COMMERCIAL OPERATIONS COORDINATOR  Christine Kaelin
rent affiliation. He is now a developmen- MARKETING & CUSTOMER SERVICE ASSISTANT  Justin Camera

tal pediatrician at Children’s National Hos- ANCILL ARY PRODUC TS

ASSOCIATE VICE PRESIDENT, BUSINESS DEVELOPMENT  Diane McGarvey
pital in Washington, D.C. CUSTOM PUBLISHING EDITOR  Lisa Pallatroni

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March 2022, ScientificAmerican.com 7

SCIENCE AGENDA
O PINI O N A N D A N A LYS I S FR OM
S C IENTIFIC A MERIC AN ’ S B OA R D O F E D ITO R S

Get Ready for

the Next One
Contagions worse than COVID will prevail
if neglect of global public health continues
By the Editors

After Omicron c omes pi i n the Greek alphabet. And then rho,
sigma, tau.... B  efore SARS-CoV-2 finishes its grand tour through
the Greek alphabet, the global public health establishment
should do what it should have done long before this coronavi-
rus emerged. It must put in place the basic health systems need-
ed to detect new outbreaks and deploy technologies that allow
for vaccines and medicines to be manufactured and adminis-
tered in low- and middle-income countries.
Because they have often refused to treat COVID as a common
threat that demands a unified response, policy makers have yet to
thwart the predations of a virus that, to channel the Greeks again, that public health is as essential to national security as a standing
affects all (pan) people (demos). This myopia means that these mis- army. And the cost of health security is minimal. In 2016 the Com-
takes could be repeated when a new pandemic arrives. mission on a Global Health Risk Framework for the Future esti-
The next time could be worse. The National Academy of Med- mated that for 65 cents a year for every person on the planet, we
icine predicted in November 2021 that a flu epidemic akin to the could upgrade national pandemic preparedness programs world-
one in 1918 and 1919 could prove more catastrophic than COVID-19. wide. An investment of $4.5 billion—far less than the price of a sin-
The preconditions for such a disaster are in place. A warming plan- gle new ballistic missile submarine—might prevent the global loss
et, mega­cities, mass migration, intercontinental travel and habi- of millions of lives and an economic hit in the trillions of dollars.
tat loss are among the reasons that infectious diseases, like inten- The basics entail not only building new systems to prepare for
sifying typhoons and hurricanes, have become part of our lives. pandemics but a major strengthening of institutions already in
Fast-tracked development of diagnostics, vaccines, monoclo- place. Public health legal expert Lawrence O. Gostin notes in this
nal antibodies and antiviral drugs marks an undisputed medical issue (page  46) that the World Health Organization has a 2022–
triumph of the COVID era. Also notable, however, is the failure of 2023 budget of $6.12 billion, which is less than those of some major
governments and international organizations to use our current U.S. teaching hospitals. The WHO needs not just money but
predicament to rectify glaring public health deficiencies. reforms that give it the authority to better monitor and intervene
The Global Health Security Index for 2021 rated the world’s when new infectious diseases emerge. At the country level, the
195 countries as “dangerously unprepared” to deal with future epi- most basic of basics consist of functioning national systems that
demic and pandemic threats. The average score for individual furnish medical care for all and financial help, as needed, for child
countries came in at 38.9 out of 100, about the same as the 2019 care, food and housing and other measures to waylay the poverty-
rating—before the pandemic began. Many countries failed to grasp related chronic diseases capable of sending even a relatively young
that the pandemic presented an unparalleled opportunity to lay adult onto a ventilator during a future pandemic.
the groundwork for coping with not only this public health crisis After repeated outbreaks of horrific diseases such as SARS, Ebo-
but also future ones. la and Zika, perhaps this calamity will prove traumatic enough to
Readiness for a COVID-30 or a new pandemic flu strain—or, allow for a coherent remake of the current system. Deaths from
for that matter, an out-of-control bioweapon—will require new COVID worldwide by mid-January about equaled the population
generations of surveillance tools, diagnostics and drugs, as well as, of Norway—and the pandemic is still with us. Only when global
say, a “universal” coronavirus vaccine that can counter any strain. public health commands the attention of policy makers in the same
Having sufficient available vaccine formulations with long shelf way as a new contract for nuclear submarines will Greek letters
lives would also help alleviate the inequities that have accompa- return to their more familiar role in American life as naming con-
nied distribution of shots. Underscoring the absence of “global” in ventions for student groups on college campuses. 
“global public health,” Portugal had fully vaccinated 89 percent of
its population by mid-January but Mali only 2.8 percent.
J O I N T H E C O N V E R S AT I O N O N L I N E
The most pressing priority should be a return to basics, both Visit Scientific American on Facebook and Twitter
globally and locally. COVID has served as a painful demonstration or send a letter to the editor: [email protected]

8  Scientific American, March 2022 Illustration by Martin Gee

FORUM Peter J. Hotez and Maria Elena Bottazzi 
are professors of pediatrics and molecular
C OMM E N TA RY O N S C IE N C E IN
T H E N E W S FR OM T H E E X PE R T S virology at the Baylor College of Medicine.
They also serve as co-directors of the
Texas Chil­dren’s Hospital Center for
Vaccine Develop­ment.

A COVID
Vaccine for All
This patent-free technology could
finally inoculate the world
By Peter J. Hotez and Maria Elena Bottazzi

As the pandemic entered its third year, the Texas Children’s

Hospital Center for Vaccine Development and the Baylor Col-
lege of Medicine gifted the world the first COVID vaccine
designed specifically for global health. This patent-free vaccine,
called ­CORBEVAX, is a milestone for global health equity. Based
on an older and more widely used technology than the now well-
known COVID mRNA vaccines, it could help end vaccine hesi-
tancy in some parts of the world. It also serves as a blueprint for
developing a potent vaccine for pandemic use in the absence of
substantial public funding.
We are part of the team that developed the vaccine, and our
institution licensed the vaccine prototype and transferred its tech-
nology in 2021—with no strings attached—to Biological E. Limit-
ed, a company based in Hyderabad, India. The Indian government duced more lasting protection and more neutralizing antibodies
has authorized the vaccine, and Biological E. plans to deliver more against the Delta and Beta variants of SARS-CoV-2. It neutralized
than a billion additional doses to other countries. This means that variants of concern in laboratory studies and was highly protective
if it is widely authorized, ­CORBEVAX could soon vaccinate more in two primate trials in which the animals were infected with SARS-
people than have the vaccine doses donated thus far by the U.S. CoV-2 to see how well the vaccine defended them against infection.
government or any other G7 country. The human trial results are being submitted to a peer-reviewed
This COVID vaccine has several distinct features that make it journal. Clinical trials in children are underway in India.
suitable for use in resource-poor settings: it is safe, effective, inex- Based on the use of the hepatitis B vaccine, we anticipate peo-
pensive and easy to store and can be produced locally at high quan- ple will readily accept ­CORBEVAX and similar recombinant pro-
tities. We expect it will be used in low- and middle-income coun- tein C
­ OVID vaccines. If there was ever a COVID vaccine that might
tries where vaccine availability has basically been abysmal. triumph over vaccine hesitancy and refusal, this could be the one.
­CORBEVAX uses the SARS-CoV-2 spike protein to stimulate an Texas Children’s Hospital developed this vaccine with no major
immune reaction, but the technology used to develop it resembles federal or G7 support, instead relying almost exclusively on private
that of the recombinant hepatitis B vaccine used in many resource- philanthropy based in Texas, New York and elsewhere. Is it possi-
poor countries. Manufacturing processes for such vaccines are gen- ble that had we enjoyed even a small fraction of the support afford-
erally well understood and will not require a steep learning curve, ed to the biotech or multinational companies producing new-tech-
like those needed for vaccines based on new technologies such as nology vaccines, the world might have been vaccinated by now?
mRNA (used by Moderna and Pfizer-BioNTech) or adenovirus Could the emergence of the Delta and Omicron varieties, which
(AstraZeneca and Sputnik). likely arose from unvaccinated people, have been prevented? It is
Companies in Indonesia and Bangladesh have also licensed the not too late. We continue to ask the U.S. and other G7 nations for
technology, as has California-based ImmunityBio, which is build- assistance in co-developing our re­­­combinant protein vaccine with
ing manufacturing capacity in South Africa and other countries new partners in other low-re­­source countries and advancing them
in Africa. Such technology-transfer agreements with suitable part- to the ­COVAX sharing facility for global distribution.
ners represent the ideal for how ­COVID vaccines can and should During 2022, we hope to partner with the World Health Orga-
be produced locally and widely in resource-poor countries. nization and other United Nations agencies to vaccinate the world.
Our analysis of available data suggests that, like the hepatitis B We believe that global vaccine equity is finally at hand and that it
vaccine, C ­ ORBEVAX has an excellent safety profile. In a phase  3 is the only thing that can bring the C­ OVID pandemic to an end. 
trial conducted in India, C ­ ORBEVAX produced no serious adverse
events, making it one of the safest ­COVID vaccines in use. When
J O I N T H E C O N V E R S AT I O N O N L I N E
compared with the Astra­Zeneca–University of Oxford vaccine man- Visit Scientific American on Facebook and Twitter
ufactured by the Serum Institute of India, C ­ ORBEVAX also pro- or send a letter to the editor: [email protected]

10  Scientific American, March 2022 Illustration by James Olstein

ADVANCES

DNA found in the air may be especially

useful to document insects such as moths.

12  Scientific American, March 2022

D I S PATC H E S FR OM T H E FR O N TIE R S O F S C IE N C E , T E C H N O LO GY A N D M E D I C IN E IN S ID E

• Pigeons remember routes years later

• Experiment makes subjects feel an
illusory sixth finger—and alters its length
• Bull runs offer a chance to study
dangerous crowds
• Tiny parasite uses its prodigious grip
to journey across a flying bee

GENETIC S

From Thin Air

Airborne genetic material holds
clues to Earth’s biodiversity

Two decades ago b  iologists and natural his-

torians around the world launched ambitious
projects to create inventories of our planet’s
biodiversity. After all, they said, you can’t
work to save what you don’t know exists.
Even the most optimistic estimates suggest
only a quarter of Earth’s species are currently
known to science, raising concerns about
the big picture amid rising extinction rates.
These projects have crept along because
of the painstaking work of identifying and
describing species—as well as, in many
cases, collecting samples of the organisms
for DNA sequencing. Now a new approach
to cataloguing the world’s animals has
emerged: vacuuming DNA out of thin air.
The technique is a variation on one previ-
ously used in water, soil and elsewhere,
in which scientists collect and sequence
environmental DNA (eDNA), the genetic
material in cells shed by local species. Pulling
eDNA from the air could provide an exten-
sive picture of a location’s inhabitants. It may
also prove particularly useful with organisms
such as insects, which are notoriously hard
to monitor (and are often killed in traditional
DNA-sequencing practices). Analyzing
eDNA is faster and less costly than collect-
ing and sequencing individual animals, and
it can capture data from many species at
once—even in hard-to-reach environments.
Two new papers published in C  urrent
Biology put airborne eDNA to the test. One
group of researchers worked at the Copen-
hagen Zoo and one in Hamerton Zoo Park
vmenshov/Getty Images

in the U.K.—perfect locations to evaluate

such sampling because the scientists knew
exactly what species were present and how
many individuals there were.

J O I N T H E C O N V E R S AT I O N O N L I N E Visit Scientific American on Facebook and Twitter

ADVANCES

The teams used different methods Researchers estimate that scientists

to vacuum or blow air through a filter have described only one million of the
to extract DNA. Once the DNA was world’s 5.5 million insect species, so
amplified and sequenced, both teams looking to the air to monitor biodiver-
detected many of the species present in sity is an exciting development that
the zoo—even those inside buildings or might speed up conservation efforts.
hundreds of meters from the col- “The time is ready for environmental ANIMAL COGNITION
lection sites. DNA to take on this new substrate,”
The eDNA sampling also picked up
genetic signatures of species outside the
says Kristine Bohmann, an ecologist at
the University of Copenhagen, who co-
Bird Memory
zoos’ walls. The U.K. group identified authored the Denmark study. She adds Pigeons remember specific routes
Eurasian hedgehogs, which are vulnera- that she has worked on eDNA from home after years away
ble to extinction in the country, and the fecal samples, and others have looked
Denmark group found genetic traces at soil and water—and even flowers to Homing pigeons combine p  recise internal
from squirrels and cats. discover which pollinating species have compasses and memorized landmarks to re­­
The researchers say eDNA is a game landed on them. trace a path back to their lofts—even four years
changer for monitoring biodiversity: There are still questions about air- after the previous time they made the trip, a
other techniques require the animal to borne eDNA: for one, it is unclear how new study shows.
be physically present when scientists are long genetic material persists in the air. Testing nonhuman memory retention is
looking. “If you have a camera trap, they Are researchers detecting a recent pres- challenging; in research studies, “it’s rare that
have to walk in front of your camera— ence or one from months earlier? Studies there is a gap of several years between when an
because if they walk behind it, you’ll have found intact DNA in permafrost up animal stores the information and when it is
never know,” says Elizabeth Clare, a to 10,000 years after its source organ- next required to retrieve it,” says University of
molecular ecologist at York University isms perished. But in other conditions, Oxford zoologist Dora Biro. For a recent study
and a co-author on the U.K. study. “If such as exposure to ultraviolet radiation in the Proceedings of the Royal Society B, B iro and
you’re acoustically recording or [con- from the sun, DNA may degrade quickly. her colleagues compared domestic homing
ducting] visual surveys, the animal has Another big question involves abun- pigeons’ paths three or four years after the birds
to be there. But environmental DNA is dance. Does a larger signal of a species’ established routes back to their loft from a farm
more like a footprint. It’s a really funda- DNA indicate the presence of many 8.6 kilometers away. The study built on data
mentally different type of data. The ani- individuals or just one that happens to from a 2016 experiment in which pigeons
mal doesn’t physically have to be pres- be closer to the sampling station? This learned routes in different social contexts during
ent, and so you’re much more likely to is one of the hottest topics in eDNA several flights—on their own or with peers that
catch rare stuff.” research circles, Clare says. “The sim- did or did not know the way.
A recent proof-of-concept airborne ple answer is no,” she adds. “You can’t Using data from GPS devices temporarily
eDNA project, presented at the confer- know the abundance unless you have attached to the birds’ backs, the researchers
ence Ecology Across Borders, took sim- extremely controlled conditions.” compared the flight paths a cohort of pigeons
ilar techniques into the wild to identify Still, the implications of using eDNA took in 2016 with many of the same birds’
insects based on air samples from three from the air to remotely monitor biodi- routes in 2019 or 2020, without the birds visiting
locations in southern Sweden. Conser- versity are enormous. A global network the release site in between. Some birds missed
vation scientist Fabian Roger and his of air-collecting stations could let farm- a handful of landmarks along the way, but many
colleagues at Lund University found ers know about invasive creatures enter- others took “strikingly similar” routes to those
DNA traces and matched them with ing their areas or inform conservation they used in 2016, says Oxford zoologist and
85 species, including butterflies, beetles, scientists if an endangered bird still lives study co-author Julien Collet: “It was ... as if the
ants and flies, as well as nine noninsect in a specific area, the researchers say. It last time they flew there was just the day before,
species such as frogs and birds. When would also provide a snapshot of what not four years ago.”
compared with results from a conven- is out there, faster and cheaper, without The team found that the pigeons remem-
tional survey, the eDNA process missed people having to do laborious sample bered a route just as well if they first flew it
some species but found others the sur- collection in hard-to-reach locations. alone or with others and fared much better than
vey had overlooked. Bohmann once trudged through Mada- those that had not made the journey in 2016.
Roger, now at ETH in Zurich, says he gascar to deliberately attract leeches— The result is not surprising, says Verner Bing-
was inspired to try sampling airborne and later analyzed the DNA inside the man, who studies animal navigation at Bowling
Todor Dinchev/Alamy Stock Photo

eDNA after monitoring aquatic ecosys- bloodsuckers’ stomachs to learn about Green State University and was not involved
tems for new species. “It hit me how dif- the forest’s inhabitants. “If I could avoid with the study. But it provides new confirmation
ficult it was to get good data on popula- being human bait and get the results of homing pigeons’ remarkable memory, he
tions,” he says. “And with recent research beamed to me at my computer,” she says: “It closes the distance a little bit between
showing a 70 percent reduction in insect says, “that would be amazing.” our egocentric sense of human cognitive abilities
biomass, we have a crucial lack of data.”  —Katharine Gammon and what animals can do.”  —Robin Donovan

14  Scientific American, March 2022

NEUROSCIENCE
NEUROSCIENCE centimeters shorter or
centimeters shorter or
Phantom Finger about three centimeters
about three centimeters
longer than their real-life
longer than their real-life
An
An unusual
unusual illusion
illusion points
points to
to philosophy
philosophy and
and robotics
robotics pinky, respectively. These
pinky, respectively. These
differences suggest that
differences suggest that
Brains contain maps of the bodies they ing the right and left hand the extra finger was per-
Brains contain maps o  f the bodies they ing the right and left hand the extra finger was per-
inhabit, with neurons dedicated to the per- simultaneously. When they got ceived not merely as a duplicate
inhabit, with neurons dedicated to the per- simultaneously. When they got ceived not merely as a duplicate
ception or control of particular parts—and to the pinky, the experimenters stroked pinky but as its own entity.
ception or control of particular parts—and to the pinky, the experimenters stroked pinky but as its own entity.
research suggests there may be quite a bit of the top of the right pinky and the inner side Cadete says that beyond its intriguing
research suggests there may be quite a bit of the top of the right pinky and the inner side Cadete says that beyond its intriguing
wiggle room in that representation. In 2016 of the left pinky. Finally, they made 20 double philosophical implications about humans’
wiggle room in that representation. In 2016 of the left pinky. Finally, they made 20 double philosophical implications about humans’
scientists set up an experiment that made strokes on the table next to the right pinky sense of self, this research could also be
scientists set up an experiment that made strokes on the table next to the right pinky sense of self, this research could also be
subjects fleetingly feel like they had a sixth while stroking the outer side of the left pinky, useful for people with robotic limbs. She
subjects fleetingly feel like they had a sixth while stroking the outer side of the left pinky, useful for people with robotic limbs. She
finger on one hand (one subject yelled, creating a self-reported feeling of an invisible says a mechanical appendage might trans-
finger on one hand (one subject yelled, creating a self-reported feeling of an invisible says a mechanical appendage might trans-
“Witchcraft!”), and in 2020 another research sixth finger on the left hand. fer sensation to a nearby body part via
“Witchcraft!”), and in 2020 another research sixth finger on the left hand. fer sensation to a nearby body part via
group extended that sensation indefinitely. “It’s quite honestly scary,” says Denise these brain illusions, even for limbs with
group extended that sensation indefinitely. “It’s quite honestly scary,” says Denise these brain illusions, even for limbs with
The second group went further in its latest Cadete, a neuroscience graduate student at complex, “Swiss Army–like” features.
The second group went further in its latest Cadete, a neuroscience graduate student at complex, “Swiss Army–like” features.
work, published in Cognition, to make partici- Birkbeck, University of London, and lead The experiment is well done, says Eti-
work, published in Cognition, t o make partici- Birkbeck, University of London, and lead The experiment is well done, says Eti-
pants feel as if they had a sixth finger—and to author on the new paper. “Even if we under- enne Burdet, a roboticist at Imperial College
pants feel as if they had a sixth finger—and to author on the new paper. “Even if we under- enne Burdet, a roboticist at Imperial College
control the invisible digit’s perceived length. stand all that’s happening, the illusion London who has studied the one-handed
control the invisible digit’s perceived length. stand all that’s happening, the illusion London who has studied the one-handed
To experience the mental illusion, the doesn’t go away—it’s a very striking feeling.” capabilities of people born with six fingers
To experience the mental illusion, the doesn’t go away—it’s a very striking feeling.” capabilities of people born with six fingers
participants placed their hands on a table In her group’s latest study, the strokes on and was not involved in the research. Future
participants placed their hands on a table In her group’s latest study, the strokes on and was not involved in the research. Future
with a vertical mirror between them, posi- the table were sometimes half or double the studies could explore whether the phenom-
with a vertical mirror between them, posi- the table were sometimes half or double the studies could explore whether the phenom-
tioned to show the reflection of the right length of a typical pinkie. Twenty right- enon applies beyond an extra pinky; if he
tioned to show the reflection of the right length of a typical pinkie. Twenty right- enon applies beyond an extra pinky; if he
hand where the left hand should be. Starting handed participants then used a mechanical wanted
hand where the left hand should be. Starting handed participants then used a mechanical wanted toto start
start aa company
company to to make
make robotic
robotic
with the thumb, experimenters stroked the slider to indicate how long the new finger body
with the thumb, experimenters stroked the slider to indicate how long the new finger body parts, Burdet says, “I would start
parts, Burdet says, “I would start with
with
top of each finger up and down twice, strok- felt—reporting it felt on average about 1.5
top of each finger up and down twice, strok- felt—reporting it felt on average about 1.5 an
an arm.”
arm.” —Matthew
— Matthew Hutson
Hutson
© 2022 Scientific American

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ADVANCES
Major Groups
BIODIVERSIT Y
Body Mass Order Heterotrophic
Weight of Life
Phytoplankton Zooplankton Fish Mammals
of Magnitude bacteria
(grams)
Humans may have altered the Smallest 10-14–10-13
mass distribution of sea life organisms
Circle sizes show total
Weigh all the creatures t hat roam the sea, 10-13–10-12 biomass in gigatons
and a striking balance emerges. Researchers
have found that the total mass of this life, 10-12–10-11
when grouped in size classes, roughly follows 1.5 Gt 0.02 Gt
a regular mathematical distribution—
although humans may have disrupted part 10-11–10-10
of the pattern. Outlines show estimated
biomass before 1850
For a study in Science Advances, r esearch- 10-10–10-9
ers combined satellite images, water samples,
Filled circles
commercial fishing catch data and computer show current
10-9–10-8
simulations to estimate the combined weight biomass
of all the organisms that move through the
open ocean. Next they visualized biomass dis- 10-8–10-7
tribution by placing species on a size spec-
trum segmented into 23 weight classes. To 10-7–10-6
accommodate the vast size differences, the
researchers divided classes using a mathe-
10-6–10-5
matical function called a logarithm: the aver-
age weight of organisms in one class differed
by a factor of 10 from adjacent classes. One 10-5–10-4
class contained organisms weighing between
0.01 and 0.1 gram, another between 0.1 gram For organisms with a
10-4–0.001 body mass of less than
and 1 gram, and so on. 10 grams, human
The scientists found that most of the activities have not
weight classes contain roughly one gigaton 0.001–0.01 affected total biomass

Source: “The Global Ocean Size Spectrum from Bacteria to Whales,” by Ian A. Hatton et al., in S cience Advances, Vol. 7; November 10, 2021
of life each. “This could be one of the largest- since 1850
scale regularities among life on Earth,” says 0.01–0.1
the study’s lead author Ian Hatton, a biologist
at the Max Planck Institute for Mathematics
0.1–1
in the Sciences in Leipzig, Germany.
Exceptions included a few classes contain-
ing bacteria, which were overweight because 1–10
of microbes’ domination of deep waters,
and classes containing animals bigger than 10–100
10 grams, which had disproportionately little
mass. Wondering if humans had contributed
to this divergence, Hatton’s team used previ- 100–1,000
ously published computer simulations and
animal population estimates to reconstruct 1,000–10,000
the ocean size spectrum of the 1850s, before For most organisms with
modern industrial fishing. The researchers a body mass of more
10,000–105
found that the combined weight of organisms than 10 grams, fishing
above 10 grams, including whales and many and other human
activities have
fishes, has decreased by 60 percent since then. 105–106
significantly decreased
Overfishing is a well-known problem, but total biomass since 1850
this work helps illuminate its extent, says 106–107
Andrea Bryndum-Buchholz, a marine ecolo-
gist at Memorial University in Newfoundland,
107–108
who was not involved in the study. “It visual-
izes how we’ve actually changed the ocean Largest
fundamentally,” she says.  —Nikk Ogasa organisms 108–109

16  Scientific American, March 2022 Graphic by Amanda Montañez

 A 2019
A 2019 “running
“running of
of the
the bulls”
bulls” in
in Pamplona,
Pamplona, Spain
Spain

CRROW
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crowd
density increases.
density increases. Like Like cars
cars crawling
crawling the world a shot
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through
redduce
re­
traffic, pedestrians
speed to
uce speed
pedestrians typically
to avoid
avoid bumping
typically
bumping into into others.
others. in the arm.
Bull runners show how panicked AA charging
charging 1,300-pound
1,300-pound bull, bull, however,
however, flips flips
crowds move that relationship
that relationship on
ners sped
ners sped up up as
on its
as they
its head.
head. Pamplona
they jostled
jostled to
Pamplona run­
to keep
keep pace
pace
run­
JOIN NOW!
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last things
things aa pedestrian
pedestrian wants wants with the
with the animals—and
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charging bull.bull. Yet
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every JulyJuly Even with
Even with other
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by, Parisi
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Join the nation’s largest
thousands of
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people voluntarily
voluntarily jam jam thethe says, “when
says, “when aa bull bull isis near,
near, they
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narrow streets
streets of of Pamplona,
Pamplona, Spain, Spain, to to run
run at maximum
maximum speed speed no no matter
matter what.”
what.”
association of freethinkers
narrow at
alongside six
alongside six agitated
agitated fighting
fighting bulls.
bulls. But these
But these runners
runners can can movemove only only soso (atheists and agnostics) working to
Although the
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entire course
course is is just
just half
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mile, fast. The
fast. The researchers
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the keep religion out of government,
most runners
most runners do do not
not complete
complete itit because
because bulls caused
bulls caused speedspeed and and density
density to to simulta­
simulta­ and social policy.
of the dense
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animals’ break­
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neously increase, fasterfaster runners
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neck speed.
neck speed. TheseThese blistering
blistering bovines
bovines cover
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become tangledtangled with with others
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nearly 20
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average. and fall.
and fall. In
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been criticized
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pileups that that cause
cause injuries
injuries
reckless and
reckless and cruel,
cruel, and
and itit is
is increasingly
increasingly and occasionally
and occasionally turn turn deadly.
deadly.
controversial. But
controversial. But for
for some
some researchers
researchers itit Bulls rarely
Bulls rarely stampede
stampede through through con­ con­ Call 1-800-335-4021
presents aa fascinating
presents fascinating case case study
study of of how
how gested business
gested business districts,
districts, but but Parisi
Parisi hopes
hopes
crowds respond
crowds respond to to danger—a
danger—a difficult difficult sce­
sce­ lessons learned
lessons learned from from thisthis study
study willwill pro­
pro­ ffrf.us/science
nario to
nario to replicate
replicate in in scientific
scientific study.
study. “You
“You vide insights
vide insights into into howhow crowds
crowds respond
respond to to
cannot make
cannot make experiments
experiments putting putting people people other kinds
other kinds of of dangerous
dangerous situations.
situations. Ale­ Ale­ Join now or get a FREE trial
in real
in real danger
danger to to see
see what
what happens,”
happens,” thea Barbaro, a researcher
thea Barbaro, a researcher at the Delft at the Delft membership & bonus issues
notes Daniel
notes Daniel Parisi,
Parisi, who
who studies
studies pedestrian
pedestrian University of
University of Technology
Technology in in the
the Nether­
Nether­ of Freethought Today,
dynamics at
dynamics at the
the Buenos
Buenos Aires Aires Institute
Institute of of lands who
lands who was was not not involved
involved in in the
the study,
study, FFRF’s newspaper.
Technology. But
Technology. But in
in Pamplona,
Pamplona, he he says,
says, peo­
peo­ agrees the
agrees the findings
findings havehave real-world
real-world impli­impli­
ple eagerly
ple eagerly put put themselves
themselves in in harm’s
harm’s way.way. cations. Barbaro,
cations. Barbaro, who who has has modeled
modeled phe­ phe­
To gauge
To gauge runners’
runners’ collective
collective response
response nomena ranging
nomena ranging from from fish
fish migrations
migrations to to
to rampaging
to rampaging bulls, bulls, Parisi
Parisi and
and his his col­
col­ gang territorial
gang territorial disputes,
disputes, says says the
the Pam­
Pam­
leagues monitored
leagues monitored two two 2019
2019 bull bull runs.
runs. plona data
plona data could
could helphelp calibrate
calibrate modelsmodels for for
They perched
They perched cameras cameras along along the the famed
famed stressed crowds
stressed crowds to to aid
aid architectural
architectural design design
Estafeta Street,
Estafeta Street, where
where the the course
course narrowsnarrows and evacuation
and evacuation planning.
planning. Plus, Plus, she
she says,
says,

ffrf.org
Photo
Stock Photo

like aa funnel,
like funnel, and and tracked
tracked runners’
runners’ and and “such models
“such models would would allow
allow emergency
emergency
Reuters/Alamy Stock

bulls’ movements
bulls’ movements through through each each re­ re­­ response personnel
response personnel to to have
have insights
insights intointo
Reuters/Alamy

corded frame.
corded frame. potentially averting
potentially averting the the crowd-based
crowd­based trag­ trag­
FFRF is a 501(c)(3) educational charity.
Their findings,
Their findings, published
published in in the
the P Proceed-
roceed- edies that
edies that we we regularly
regularly see see in
in the
the news.”
news.”
ings of
ings of the
the National
National Academy
Academy of of Sciences
Sciences — —JJack Tamisiea
ack Tamisiea
Deductible for income tax purposes.

March 2022, ScientificAmerican.com 17

ADVANCES

MEDICINE MRI machines are particularly

useful for scanning brains.
Portable View
Compact MRIs could
bring down the cost of 
powerful medical scanning

Magnetic resonance imaging (MRI)

scanners are crucial tools in modern medi-
cine. But these behemoths typically cost
$1 million to $3 million; they require pur-
pose-built rooms to contain their powerful
magnetic fields and block outside signals,
plus elaborate liquid-helium cooling sys-
tems. About two thirds of the world’s
people lack access to such devices,
90 percent of which are located in high-
income countries.
Now, however, lower-cost alternatives
are coming closer. In N  ature Communica-
tions, r esearchers at the University of Hong
Kong, led by biomedical engineer Ed Wu,
describe an MRI scanner that is compact
enough to move on wheels, needs no
shielding and draws power from a stan-
dard wall socket. This approach—­­­a new
entry in a category known as ultralow-field
(ULF) MRI—lacks the resolution needed
for some precision diagnostics, but its
material costs are estimated at under
$20,000. And its design and algorithms are
open source, inviting researchers every-
where to help develop the technology. them from the measured signals. “That’s The new design joins a growing list
MRI exploits the fact that we are one very useful innovation here,” says of ULF MRI scanners being developed.
mostly made of water. The protons in biomedical engineer Sairam Geethanath A U.S. company called Hyperfine re­­
water’s hydrogen atoms have magnetically of Columbia University, who was not ceived fda approval last year for a porta-
charged “spins,” which can be temporarily involved in the new research. “It’s similar ble scanner, but details of the design are
aligned by a scanner’s magnetic field and to noise-cancellation headphones, where proprietary; Wu and his colleagues have
then probed by radio-frequency pulses. you’re trying to learn the noise pattern in made their data, designs and code avail-
Different tissues have distinct water con- real time and suppress it.” able online, which could speed improve-
centrations and magnetic properties, The team demonstrated the device ments to ULF.
which generate light and dark contrasts by scanning 25 patients and comparing Ultimately ULF devices are not
in reconstructed images. the images with those from a standard intended to completely replace high-field
Instead of the standard superconduct- high-powered MRI machine. The scanners. Instead they hold promise in tri-
ing electromagnets, this ULF design uses researchers could identify most of the age settings, where patients cannot be
permanent magnets that do not require same pathologies, including tumors and moved or time is critical, Geethanath says.
cooling. It also generates far less magne- stroke. “The images appear to be of suffi- Wu says he believes the range of appli-
tism than a standard MRI scanner, elimi- cient quality to be clinically useful in a cations will likely grow as performance
nating the need for shields. The main number of scenarios,” says neuroscientist improves. “Right now MRI systems are
trade-off is that the signals are weaker, Tom Johnstone of Swinburne University of built as if we don’t know anything about
resulting in lower image resolution. Technology in Melbourne, Australia, who what we’re scanning,” he says, “but often
To enable portability, the new design was also not involved in the study. “Rapid the information we need is very subtle”—
yumiyum/Getty Images

eschews physical shielding against exter- assessment of stroke, which has a large namely, to identify what is different from
nal radio-frequency noise. Instead a “deep-­ impact on success of interventions, could the expected. “That’s going to be a huge
learning” algorithm recognizes and pre- be facilitated by ULF MRI being located in revolution, driven by cheap computing.”
dicts interference signals, then subtracts more towns or even mobile units.”  —Simon Makin

18  Scientific American, March 2022

FFLU
LUIID
D DY
DYNNA
AMMIIC
CSS
solutions, are
solutions, are dissolved
dissolved roscale slowing
roscale slowing had had its
its

Unusual Flow versions of

versions of large
molecule chains
molecule
large stretchy
stretchy
chains common
common
microscopic origins
microscopic
researchers had
researchers
origins where
where
had suspected:
suspected:
fluid effect
effect revealed in biology
in biology as as well
well as
as the
the polymer chains
polymer chains stretching
stretching
A strange fluid
cosmetics and
cosmetics and energy
energy indus-
indus- out and
out and then
then coiling
coiling back
back asas
For most
For most fluids,
fluids, aan increase in
n increase in pressure
pressure tries. Theoretical
tries. Theoretical studies
studies have
have they passed
they passed through
through pores.pores. The
The
should lead
should lead to
to aa burst
burst of of speed,
speed, likelike squeez-
squeez- suggested that
suggested that when
when the the chains
chains findings appeared
findings appeared in in SScience Advances.
cience Advances.
ing ketchup
ing ketchup from
from aa tube.
tube. But
But when
when flowing
flowing stretch through
stretch through aa nearly
nearly flat
flat channel
channel and
and “Visualizing flow
“Visualizing flow inside
inside aa 3-D3-D porous
porous
through porous
through porous materials
materials suchsuch as as soil
soil or
or then recoil,
then recoil, they
they generate
generate forcesforces that
that stir
stir up
up media literally
media literally gives
gives aa window
window into into some-
some-
sedimentary rock,
sedimentary rock, certain
certain liquids
liquids slowslow down
down eddies. But
eddies. But whether
whether thatthat turbulence
turbulence “arises
“arises thing that
thing that was
was impossible
impossible to to see,”
see,” says
says Uni-
Uni-
under pressure.
under pressure. Pinpointing
Pinpointing the the cause
cause of of this
this in realistic
in realistic 3-D3-D soils,
soils, sediments
sediments and and porous
porous versity of
versity of Pennsylvania
Pennsylvania biochemical
biochemical engineerengineer
slowing would
slowing would benefit
benefit industries
industries suchsuch as as rocks has
rocks has been
been hotly
hotly debated,”
debated,” Datta Datta says.
says. Paulo Arratia,
Paulo Arratia, who
who was was notnot involved
involved in in the
the
environmental clean-up
environmental clean-up and and oiloil extraction,
extraction, To resolve
To resolve thethe controversy,
controversy, the the research-
research- study. As
study. As aa next
next step,
step, “if
“if you
you could
could actually
actually
where pumping
where pumping one one liquid
liquid into
into the
the ground
ground ers pumped
ers pumped aa synthetic
synthetic polymer
polymer solution
solution see the
see the molecules
molecules stretching
stretching and and recoiling,
recoiling,
forces another
forces another out;
out; however,
however, such such move-
move- into aa simulated
into simulated “sedimentary
“sedimentary rock” rock” built
built that would
that would be be wonderful
wonderful [to] [to] connect
connect the the
ment isis challenging
ment challenging to to observe
observe directly.
directly. from aa box
from box filled
filled with
with tiny
tiny glass
glass beads.
beads. They
They molecular point
molecular point ofof view
view to to the
the microscopic.”
microscopic.”
Princeton University
Princeton University chemical
chemical engineer
engineer tweaked the
tweaked the polymer
polymer solution’s
solution’s precise
precise Industrial applications
Industrial applications require require knowing
knowing
Christopher Browne
Christopher Browne and and physicist
physicist SujitSujit chemistry by
chemistry by diluting
diluting itit slightly
slightly to to change
change which specific
which specific pressures
pressures are are needed
needed to to push
push
Datta offer
Datta offer aa solution
solution to to this
this puzzle.
puzzle. By By how light
how light refracts,
refracts, rendering
rendering the the “rock”
“rock” fully
fully aa polymer
polymer solution
solution through
through aa porous
porous mate-
mate-
tweaking aa special
tweaking special liquid
liquid toto be
be transparent
transparent transparent even
transparent even when
when saturated.
saturated. rial at
rial at aa given
given flow
flow rate.
rate. The
The study
study provides
provides
and pumping
and pumping itit through
through the the pores
pores of of an
an The scientists
The scientists laced
laced thethe polymer
polymer with
with flu-
flu- a physical model
a physical model describing
describing that that relation
relation and
and
equally transparent
equally transparent artificial
artificial rock,
rock, they
they doc-
doc- orescent chips
orescent chips and
and tracked
tracked its its movement
movement could predict,
could predict, for
for example,
example, how how much
much con-con-
umented how
umented how thethe liquid’s
liquid’s movement
movement through the
through the pores
pores under
under aa microscope,
microscope, taminant can
taminant can be
be retrieved
retrieved from from aa chemical
chemical
becomes chaotic,
becomes chaotic, causing
causing swirling
swirling eddies
eddies recording patchy
recording patchy regions
regions of of eddies
eddies and
and mea-
mea- site by
site by injecting
injecting aa solution.
solution. “Without
“Without predict-
predict-
that gum
that gum up up the
the pores
pores andand slow
slow thethe flow.
flow. suring how
suring how thethe solution
solution flowed
flowed underunder differ-
differ- ability,” Datta
ability,” Datta says,
says, “injection
“injection operations
operations are are
The fluids
The fluids of
of interest,
interest, called
called polymer
polymer ing pressure.
ing pressure. This This confirmed
confirmed that that the
the mac-
mac- trial and
trial and error.”
error.”  —RRachel
— Berkowitz
achel Berkowitz
© 2022 Scientific American

March 2022, ScientificAmerican.com 19

ADVANCES

BIOMECHANIC S

Science
in Images
By Gary Hartley

To wrangle a ride o  n their honeybee hosts, wing-

less parasitic flies need a truly phenomenal grasp.
Now a new study reveals how B  raula coeca m
 anages
to walk around on a flying bee while exhibiting what
researchers say is the highest attachment force per
body weight of any land-based insect ever measured.
This force relies on the parasite’s highly adapted
feet, called tarsi, which are equipped with toothed
claws. Each foot has a total of 28 teeth, or claw tips,
which let the parasite lock onto sparse honeybee
hairs during flight.
“The claws are unique, from what we know so
far. Usually insects have claws with one tip only.
A few species have two to three tips. But this species
possesses comblike claws with several tips and deep
interstices [gaps],” says Thies Büscher, a zoologist
at Germany’s Kiel University and co-lead author
of a recent study in Physiological Entomology.
The claws are complemented by soft lateral
ridges and “stoppers” along the foot, letting the fly
swiftly break its rigid grip with a simple twisting
motion and detach from the hairs as it moves—
a trait likely to be intriguing to researchers working
in biology-influenced design, or biomimetics. The
parasite’s feet also feature pads that firmly cling to
smooth surfaces, such as the wax in beehives.
“Other strongly attaching animals either secrete
strong glues or anchor with structures that damage
the surface,” Büscher says. “Both solutions are more
or less permanent and do not allow for fast detach-
ment and locomotion.” But because B. coeca’s
grasping mechanisms are purely mechanical, they
could prove useful for both terrestrial and under-
water robots.
“Attachment technology is a prominent domain
within biomimetic research,” says Shoshanah Jacobs,
an integrative biologist at the University of Guelph in
Ontario, who was not involved in the research.
Jacobs agrees with Büscher on the finding’s potential
value but notes that designers working on attach-
ment problems might not readily become aware
of such discoveries in insect physiology.
“Biomimetic researchers grapple with the chal-
lenges of knowledge mobilization across disciplin-
ary silos,” Jacobs says. “When we’ve figured out
how to do this better, we may very well be opening
a floodgate of innovation.”

To see more, visit ScientificAmerican.com/science-in-images

20  Scientific American, March 2022

 Source:
Source:“The
“TheExceptional
ExceptionalAttachment
AttachmentAbility
Abilityofofthe
theEctoparasitic
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Phenotype;November
November29,
29,2021
2021(https://doi.org/10.1111/phen.12378)
(https://doi.org/10.1111/phen.12378)

March
March 2022,
treatments.
Program

2022, ScientificAmerican.com 21
ScientificAmerican.com 21
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 afflesia bloom­
R
ing in Sumatra

E VO L U T I O N

Slow and Steady

Snakes and lizards played it safe in early
evolution—outcompeting ancient cousins
Earth is crawling w  ith lizards and snakes. More than
10,000 species of these reptiles, called squamates, have
adapted to thrive across almost every continent. But this
vast assortment took a surprisingly long time to develop,
according to University of Bristol paleontologist Jorge
Herrera-Flores and his colleagues. Instead of trying new
adaptations as quickly as possible, squamates succeeded
by evolving with a relatively slow and steady pace, the
researchers say—an idea counter to many biologists’
assumptions about how and why life generates diversity.
B I O LO G Y
The researchers charted squamates’ evolution in a

Parasite Challenge new study published in Palaeontology, c ontrasting them

with elusive reptilian relatives called rhynchocephalians.
A giant, meaty flower has a fraught relationship Today the latter are represented by just one living spe-
cies—New Zealand’s tuatara—but there were far more
with its host plant
in the deep past. “For many decades,” Herrera-Flores
Little is known a bout how the parasitic Rafflesia—a genus that produces says, “it has been questioned what was the real cause
the world’s largest and stinkiest flower—infects its host plants. Rafflesia of the decline of the rhynchocephalians.”
spends most of its life span as a tangle of strandlike cells lurking inconspic- The researchers observed a strange pattern: the two
uously underneath the bark of a woody vine called Tetrastigma, b  efore groups’ evolutionary trajectories were flipped. Squa-
emerging as drab, golf ball–sized buds. These eventually burst into fleshy mates evolved differences in body size slowly during
blooms that smell like rotting meat and can reach 20 pounds and three the first two thirds of the group’s existence, from about
feet across. Since 2017, Long Island University plant biologist Jeanmaire 240 million to 80 million years ago. At the same time,
Molina has been trying to infect Tetrastigma seedlings with Rafflesia seeds rhynchocephalians were rapidly splitting into a profusion
in the laboratory, so far without success; her latest work delves further of different sizes—until their diversity collapsed.
into how some potential hosts manage to thwart this spectacular parasite. Until now, it had seemed that quick bursts of evolu-
For a new study in Planta, M  olina and her colleagues extracted and tionary experimentation built long-term staying power.
screened over 10,000 chemicals produced by infected and noninfected Tet- Previous studies of two other reptile groups, dinosaurs
rastigma cuttings from rain forests in the Philippines. The re­­searchers found and crocodiles, proposed that fast early evolution helped
that noninfected cuttings contained elevated levels of benzylisoquinoline these animals shoulder out competitors and quickly dom-
alkaloids, a group of compounds that includes morphine and codeine. inate the landscape. By that logic, rhynchocephalians’
Such substances have never been reported before in T  etrastigma o r speedy variations should have presaged greater success.
other creepers in the same family (which includes the common grape). Instead, Herrera-Flores and his colleagues suggest, fast
Molina says she is intrigued that T  etrastigma c an produce such biologically evolution might create a kind of volatility that leads more
potent substances, and the precise reasons it does so are not yet known. readily to extinction. Squamates’ slower pace resulted in
She suspects T  etrastigma m  ay brandish these alkaloids preemptively to a more stable history, followed by a later burst of diversity
stave off infection. Perhaps, she adds, R  afflesia’s opening gambit is to sup- when tuatara relatives were already on their downturn.
press this secretion and besiege its host. Reptiles are not alone in this apparent “slow and
In any case, the finding is “pretty surprising,” says Harvard University steady” strategy. Even though modern bony fishes are
evolutionary biologist Charles Davis, who was not involved in the study. much more diverse today, a previous study found that in
“Plants are incredible chemists.” He adds that the work is an important the past they were not as numerous or varied as holoste-
step toward demystifying interactions between parasite and host. ans—the prehistoric relatives of today’s gar and paddle-
Next, Molina hopes to learn how to tip the balance toward R  afflesia. fish. Such studies suggest that quickly diversifying to fill
Her long-term goal is to bring some of these endangered flowers out of more niches is not always a route to long-term success.
their Southeast Asian habitats and make them more accessible to the out- And unlike its cousins, the specific rhynchocephalian
side world. Learning how T  etrastigma’s defenses work—and how to sub- lineage that led to today’s tuatara had “exceptionally low
vert them—is a place to start. rates of evolution,” notes Harvard University herpetolo-
mazzzur/Getty Images

Molina keeps a potted Tetrastigma in her university office, regularly sprin- gist Tiago Simões, who was not involved in the new
kling the plant with R afflesia s eeds in the hope they will miraculously catch. study. This is what makes the tuatara stand out as a “liv-
So far, nothing. But she still maintains the routine. “I think there is a way. We ing fossil,” an echo of an ancient evolutionary boom that
just don’t know it yet,” she says. “We’ll get there somehow.”  —Shi En Kim eventually went bust.  —Riley Black

22  Scientific American, March 2022

 ADVANCES
CANADA
 CANADA  GREENLAND
 GREENLAND 
IIN
N TTH
HEE N
NEEW
WSS Scientistsfound
Scientists foundevidence
evidenceofofbacteria
bacteria“mining”
“mining”silver
silver in
in Computer simulations
Computer simulations suggest
suggest climate
climate change
change waswas among
among

Quick ancient underwater

ancient
of
underwater worm
of fossilized
fossilized feces
worm poo.
feces revealed
poo. AA microscopic
revealed specks
microscopic analysis
specks of
of the
the metal,
analysis
metal, which
which
thereasons
the reasonsVikings
An expanding
An
Vikingsabandoned
expanding ice
abandonedGreenland
ice sheet
sheet would
Greenlandin
would have
inthe
have depressed
the15th
15thcentury.
depressed the
century.
the land
land and
and

Hits likely accumulated

likely accumulated about
dung-dwelling bacteria
dung-dwelling
about 500
500 million
million years
bacteria extracted
years ago
extracted itit from
from the
ago as
as
the sur-
sur-
pulled seawater
pulled
with up
with
seawater onshore,
up to
to five
onshore, flooding
five meters
meters of
flooding coastal
of water.
water.
coastal settlements
settlements

BBy Nikk Ogasa

y Nikk Ogasa rounding water.
rounding water.
U.K.
 U.K. 
MEXICO
 MEXICO  Researchers in
Researchers in northeastern
northeastern
Small freshwater
Small freshwater fishfish called
called England unearthed
England unearthed an an exo-
exo-
sulfur mollies
sulfur mollies synchronously
synchronously skeleton fragment
skeleton fragment from
fromthe
the
splash their
splash their tails
tails to
to create
create largest arthropod
largest arthropod everever discov-
discov-
waves, and
waves, and scientists
scientists have
have now
now ered, in
ered, in aa genus
genus called
called
demonstrated that
demonstrated that this
this strat-
strat- AArthropleura.
rthropleura. B By referencing
y referencing
egy can
egy can deter
deter hungry
hungry birds.
birds. related fossils’
related fossils’ body
body propor-
propor-
Researchers triggered
Researchers triggered the
the tions, the
tions, the team
team estimates
estimates this
this
wave-making process
wave-making process using
using sling-
sling- millipede would
millipede would have
have weighed
weighed
shots and
shots and found
found that
that birds
birds waited
waited 50 kilograms
50 kilograms andand measured
measured
twice as
twice as long
long between
between attacks.
attacks. 2.6meters
2.6 meterslong.
long.

CHILE
 CHILE 
An investigation
An investigation of
of sedimentary
sedimentary rock
rock cores
cores revealed
revealed that
that TANZANIA
 TANZANIA 
aa large,
large, previously
previously undocumented
undocumented tsunami
tsunami slammed
slammed intointo Chile’s
Chile’s New work
New work suggests
suggests 3.66-million-year-old
3.66-million-year-old footprints
footprints might
might come
come fromfrom aa hominin
hominin
coast in
coast in 1737.
1737. The
The finding
finding suggests
suggests that
that tsunamis
tsunamis hit
hit the
the country’s
country’s that walked
that walked with
with aa strange
strange gait,
gait, strutting
strutting by
by crossing
crossing one
one foot
foot in
in front
front of
of another.
another.
coastline more
coastline more often
often than
than previously
previously thought
thought and
and that
that hazard
hazard The tracks
The tracks are
are distinct
distinct from
from AAustralopithecus afarensis—
ustralopithecus afarensis —the area’s known
the area’s known hominid
hominid
assessments should
assessments should consider
consider both
both geologic
geologic and
and historical
historical records.
records. species—suggesting early
species—suggesting early humans
humans with
with very
very different
different strides
strides may
may have
have coexisted.
coexisted.
© 2022 Scientific American For more
For more details,
details, visit
visit www.ScientificAmerican.com/mar2022/advances
www.ScientificAmerican.com/mar2022/advances

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March 2022, ScientificAmerican.com 23

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METER
Edited by Dava Sobel

OTHER WORLDS
IN FEW WORDS
The following haiku, written in the traditional three-line,
17-syllable format by teams of planetary scientists, summarize
research results reported at the 52nd Lunar and Planetary
Science Conference, which was held virtually March 15–19, 2021.

“Detailed Chloride Mapping in Terra Sirenum, Mars”

Oceans long since past
Dry, cracked ground, no trace remains
But the taste of salt.
—E. M. Harrington, B. B. Bultel, A. M. Krzesin�ska and S. Werner

“Identifying Landing and Sample Tube Depot Sites and

Characterizing Traverse Terrains for Mars Sample Return”
Three summer interns
Helping a little rover
Return rocks from Mars.
—M. C. Deahn, M. M. Morris, C. L. Brooks, N. R. Williams, M. P. Golombek, F. J. Calef III, S. Do and A. K. Nicholas

“Are Maryland and Other Craters on CCKBO Arrokoth

Compaction Craters, and Does it Matter?”
Compaction craters
Explains Arrokoth’s surface
Saves its neck from harm.
—W. B. McKinnon, X. Mao, K. N. Singer, J. T. Keane, P. M. Schenk, O. L. White, R. A. Beyer, S. B. Porter, D. T. Britt,
J. R. Spencer, W. M. Grundy, J. M. Moore, S. A. Stern, H. A. Weaver, C. B. Olkin and New Horizons Science Team

24  Scientific American, March 2022

“Investigating Icequakes on Enceladus Using an Antarctic Analog:
Application of Seismic and Machine-Learning Techniques
to Characterize Tidally Induced Seismicity along Icy Rifts”
Antarctic ice quakes
Can this then tell us how does
Enceladus shake?
—K. G. Olsen, N. C. Schmerr, M.-H. Huang, T. A. Hurford and K. M. Brunt

PANORAMA: This view of Mars’s Teal Ridge

was captured by nasa’s Curiosity rover in 2019.

“Seasonal Variability of Titan’s Global Wind Field”

The gales of Titan
Oh, how they blow! What fury!
And how they do change!
—S. L. Light, M. A. Gurwell, C. A. Nixon and A. E. Thelen

“Habitability of Cloudy Worlds:

Intersecting Constraints and Unknowns”
Why clouds are not green:
NASA/JPL-Caltech/MSSS

Where there’s water, there is life*

*Exceptions apply.
—D. M. Gentry, L. Iraci, E. Barth, K. McGouldrick and K.-L. Jessup

March 2022, ScientificAmerican.com 25

THE SCIENCE Claudia Wallis is an award-winning science journalist
OF HEALTH whose work has appeared in the New York Times, Time, Fortune
and the New Republic. S he was science editor at Time a nd
managing editor of S cientific American Mind.

edged as much by permanently scrapping the in-person rule.

The agency did not, however, remove the other regulations.
And although patients will be able to get their prescription at
a drugstore or by mail, the fda is requiring a new certification
for pharmacies that dispense the drug. Such measures “contin-
ue to be necessary to ensure the benefits of mifepristone outweigh
the risks,” according to the fda. Researchers who study medical
abortion see this split decision as both a step forward and a
missed opportunity at a time when abortion rights are in peril.
Mifepristone works by blocking progesterone, a hormone that
maintains pregnancy. In a standard protocol, the drug is followed
by a dose of misoprostol, which triggers contractions and expul-
sion of the embryo. “It is identical to how we often treat early
miscarriage,” notes Lesley Regan, who chairs the abortion task
force of England’s Royal College of Obstetricians and Gynecolo-
gists. In the U.S., the pills may be used during the first 10 weeks
of gestation, although the World Health Organization considers
them safe up to 12 weeks. Research confirms that medication
abortion is about 95 percent effective in ending pregnancy. The
risk of complications that require further medical attention—
such as hemorrhage or infection—is less than 1 percent.
During the COVID era, at least three studies showed that the
efficacy and safety hold up without in-person clinical visits. In

Abortion Pill fact, a large study done in the U.K.—where the government also
provisionally allowed telehealth care—identified distinct advan-

Barriers
tages. It compared outcomes in more than 52,000 medication
abortions during the two months before and after the government
decision. Researchers found no increase in complications.
Politics, not science, restrict access Moreover, the average wait time for treatment dropped from
10.7 days to 6.5 days, and 40  percent of abortions were complet-
to a safe, effective drug ed at six weeks or earlier; only 25 percent met that mark with in-
person drug treatment. Patient satisfaction was also higher with
By Claudia Wallis
telemedicine, says the study’s lead author, Abigail Aiken, an expert
Ever since it was approved i n 2000 as an abortion pill, mifepris- in reproductive health policy at the University of Texas at Austin.
tone has been regulated as if it were a dangerous substance. The One reason is that people can be treated sooner: “When someone
U.S. Food and Drug Administration required doctors to be spe- is facing a pregnancy that they didn’t want, the mental stress and
cially certified to prescribe it. Patients had to sign an agreement anxiety take a toll.” Telemedicine is also more convenient and less
confirming that they had been counseled on its risks. Most oner- expensive. Regan notes that it takes fewer health-care resources
ously, the pill had to be given in person in an approved clinical and better serves people who live far from an abortion clinic.
setting—even though a second drug used to complete the abor- The U.K. study, along with two done in the U.S., also showed
tion, misoprostol, could be taken at home. In addition, 17 U.S. that an ultrasound scan is unnecessary except when patients
states have passed laws requiring an ultrasound scan before report issues that warrant it, such as symptoms of an ectopic
mifepristone can be prescribed. Yet decades of study have shown pregnancy (one outside the uterus), or if they cannot recall the
that the medication is safe and that those restrictions are need- date of their last menstrual period. Research shows that the date
less, according to the American College of Obstetricians and suffices to determine gestational age before abortion.
Gynecologists and other medical groups. The rules have more Ironically the fda’s sensible move on telemedicine is likely to
to do with politics and ideology than with science. widen state-by-state inequities in access to abortion. In most
It took the ­COVID pandemic to strip away the fig leaf of sci- states access will improve. But 19 have laws mandating in-per-
entific justification from one regulation. The U.S. and several son abortion care, and “six specifically ban mailing the pills,”
other countries that restrict mifepristone suspended the require- notes Elizabeth Nash of the Guttmacher Institute. Further restric-
ment of in-person distribution. Patients could access care via tions are probable in abortion-hostile states if the U.S. Supreme
telemedicine and get the pills by mail rather than risk catching Court fails to protect abortion rights later this year, as is widely
­COVID at a clinic. A natural experiment unfolded that highlight- expected. Aiken predicts that “we’re going to see this picture of
ed the safety of this approach. Last December the fda acknowl- uneven access—this zip code lottery—diverge even further.” 

26  Scientific American, March 2022 Illustration by Fatinha Ramos

28  Scientific American, March 2022
 HOW

­COVID
CHANGED
THE
WORLD
Illustration by Olena Shmahalo

March 2022, ScientificAmerican.com 29

I
n the spring of 2020 a cartoon was making the rounds on social media. It showed
a city perched on a tiny island, surrounded by ocean. A speech bubble emerged from
the skyline: “Be sure to wash your hands and all will be well.” Not far out at sea, a
giant wave labeled “­COVID-19” was about to crash over the city. Behind it was an
even bigger wave marked “recession.” And beyond that one was a tower of water that
threatened to swallow it all: “climate change.”
I’ve often thought of that statement, by Canadian cartoonist Graeme MacKay, in
moments that seem to define our pandemic disorientation: the botched messaging,
willful unpreparedness and exhausted confusion. In ple, delayed rocket launches (page 71). It also worsened
America, though, the cartoon didn’t play out exactly as inequality (page 66), increased the prevalence of
drawn. The economy actually g rew in 2021. Does that depressive disorders, added “moral injury” to the com-
mean the damage wasn’t as bad as many predicted? That mon lexicon and set back students’ learning trajecto-
question can only be an­­swer­ed in the context of another ries for years to come.
superlative: the U.S. claims the highest reported number Amid the noise of an ongoing emergency, it can be
of ­COVID cases—as well as COVID deaths—in the world. hard to notice troubling new trends (page 58). We
The past two years have been full of incongruities, should be far more concerned about the shadow of
paradoxes and absurdities. Consider the mRNA vac- long COVID. If millions of people end up developing
cines (page 54). Scientists formed a global hive mind persistent health issues after the acute disease stage,
(page 34) and delivered a supereffective vaccine faster they will likely encounter a medical system unable to
than anyone thought possible. But more than a year do much more than shrug. As with the climate crisis
after the shots became available, the U.S. has one of (page 50), many of us avert our eyes from the specter
the lowest vaccination rates among wealthy coun- of long COVID because its effects tend to be more
tries. Some Americans think the vaccine represents a insidious than dramatic, and the fixes aren’t quick or
weapon of oppression, if not a literal weapon. easy. Dealing with the problem requires acknowledg-
The politicization of our best tool for ending the ing what was already broken. Yet for every bleak
pandemic surprised everyone. Except for the behav- future there’s a hope­ful one. Propelled by the force of
ioral scientists, misinformation researchers, sociolo- pa­­­tient advocates, research into long COVID could
gists, historians and speculative fiction writers who lead to new understanding of other postinfection ill-
spent 2020 waving their arms (sometimes in the nesses and autoimmune disorders (page 56).
pages of this magazine), calling attention to cognitive When we planned this issue, Omicron had not
bias, influence operations, accessibility issues (page yet emerged. I wondered if people would be interested
70) and barriers to trust. ­COVID was never going to be in stories about a pandemic that wasn’t over, even if they
the “common enemy” that finally united Americans. were over the pandemic. Would we be fear­mongering to
As Alondra Nelson, who is now deputy director for sci- suggest that the pandemic hasn’t ended (page 78)
ence and society at the White House Office of Science because we haven’t vaccinated the world, leaving us
and Technology Policy, ex­­plained it to me in December susceptible to variants that are more transmissible?
2020: “This idyllic idea of solidarity, especially in a We’re all o
 ver ­COVID. But we can’t give up and
wartime modality, is created by making an enemy of leave our collective fate to the machinations of a virus,
someone else.” Indeed, former president Donald sighing in relief when one peak crests (for those of us
Trump tried to make an enemy by blaming the virus still unharmed) and leaning on wishful thinking that
on China. His xenophobic rhetoric has spread, feeding only the best-case scenarios will come to pass. Avoid-
dangerous conspiracy theories (page 72), threatening ing adaptation isn’t the key to reaching the endemic
scientific research and leading to a rise in hate crimes. stage, nor will it help us prepare for the even bigger
The virus provoked other reckonings and pivots— waves of climate crises. We assembled this collection of
not all of them bad. Many of us who could do our jobs stories to reflect on how ­COVID has already changed
remotely discovered the power of owning our time our world, as well as how our world has been resistant
(page 64). ­COVID concerns made it easier for Euro- to change—even when a virus disrupts everything,
pean cities to install miles and miles of bike lanes, giv- even when it shows us what we need to change the most.
ing us a glimpse of a car-free urban future (page 51).
The pandemic revealed strange hidden interdepen- Jen Schwartz is a senior editor of features at S cientific American
dencies; hospital demand for liquid oxygen, for exam- who covers how people are adapting, or not, to a rapidly changing world.

30  Scientific American, March 2022

Illustration by Hanna Barczyk March 2022, ScientificAmerican.com 31
 degree that is commensurate with the size

A Microbe
and complexity of today’s globalized societies.
In a sense, the entanglement of our every-
day lives made us all the more vulnerable to
an airborne virus that demanded social isola-

Proved That tion, blowing up the facade of normalcy in

the spring of 2020. The new ­COVID normal,
with its mask wearing, social distancing,

Individual­ism
lockdowns and closed schools, compelled us
to abandon our most basic instincts and turn
away from our closest friends and family. It

Is a Myth
rent the social fabric on which we all rely.
Infectious diseases present an unusual
challenge: to combat them effectively, we
must render aid appropriately and consistent-
Humans evolved to be ly at scale. This pandemic exposed the fragili-
ty and faults in each layer of our lives—from
inter­dependent, not self-sufficient our innermost circle of family and friends to
By Robin G. Nelson the nation state at the periphery—and the dif-
ferential risk experienced by any individual’s

F
or countless Americans, there was core community. Communities that were al-
a dull but persistent pain to prepan- ready heavily invested in social safety nets
demic life: high-priced housing, nearly with measures such as paid sick leave were
inaccessible health care, underresourced able to lower ­COVID rates. Those invested in
schools, wage stagnation and systemic in- the ideology of self-sufficiency and individual-
equality. It was a familiar ache, a kind of ism prolonged suffering and loss of life.
chronic hurt that people learned to live with New Zealand (Aotearoa in Māori), a coun-
simply because they had no other choice. try with a long history of reckoning with its
Faced with threadbare safety nets and a cul- colonial past and building community, has
tural ethos championing nationalist myths been a standout success story in the pandem-
of self-sufficiency, many people did what ic. The government there countered ­COVID
humans have always done in times of need: with nationwide stay-at-home orders, border
they sought emotional comfort and material controls, hygiene campaigns, accessible test-
aid from their family and friends. But when ing and contact tracing. The results were
­COVID-19 hit, relying on our immediate net- dramatic: 18 months into the pandemic, the
works was not sufficient. Americans are gas­ country had seen only 27 COVID deaths. By
lit into thinking that they are immeasurably late 2021, 90 percent of eligible citizens were
strong, impervious to the challenges people fully vaccinated. Although new variants have
in other countries face. In reality, our social been challenging these successes, the govern-
and economic support systems are weak, ment remains deeply committed to care.
and many people are made vulnerable by Similarly, Taiwan defied predictions that
nearly any change in their capacity to earn a it would struggle with ­COVID infections like
living. The fallout from the pandemic is an its neighbors in China by instituting a 14-
urgent call to strengthen our aid systems. day isolation policy for travelers entering
Anthropologists have long recognized that the country, stepping up mask production,
exceptionally high degrees of sociality, coop- increasing border controls and deputizing
eration and communal care are hallmarks of quarantine officers who could help isolated
humankind, traits that separate us from our citizens. By March 2021 there had been only
closest living relatives, the chimpanzees and 10 COVID deaths in a country of nearly 24
bonobos. This interdependence has been key million people. Taiwan has fought each new
to our success as a species. Viewed this way, wave of the pandemic with these tactics. Al-
we humans have an evolutionary mandate to though we may call on our inner circle most
be generous and take care of one another. But frequently during our times of need, ulti-
unlike early humans, who lived in compara- mately we must rely on local and national
tively small groups, we cannot just rely on officials on the periphery of our lives to be
our immediate family and friends for support. exquisitely human—as the leaders of New
We must invest in national policies of com- Zealand and Taiwan have been—when they
munal care—policies that facilitate access to develop and enact health policies.
resources for people who need help—to a In the U.S., government support was

32  Scientific American, March 2022

 inconsistent, and citizens struggled to work
together to keep the virus at bay. The roots of
these problems run deep. Since this country’s
inception, the dominant ideologies here have
encouraged not only individualism but also
the dehumanization of certain groups, as evi-
denced by the enslavement of Black people
and the displacement of Indigenous commu-
nities from their ancestral lands. This dehu-
manization continues today in the form of the
bootstrap narrative—the myth that anyone
can prosper if only they work hard enough—
and in efforts to weaken relief programs for
people who need help. As a result, even
though we now know how the virus spreads
and causes disease and we have effective vac-
cines against it, the death toll from ­COVID is
higher in the U.S. than anywhere else.
There have been some success stories in
the U.S.—they can be found in groups that
have a fundamentally different ideological
relationship to community interdependence.
The Navajo Nation, which early on saw some
of the highest rates of ­COVID-related illness
and death, ran its own vaccine education
campaigns and implemented in-house vac-
cine-distribution policies. It achieved far
higher vaccination rates on its reservations
than surrounding areas did. Tribal values
that prioritize the group over the individual
helped motivate members to get their shots.
Unfortunately, in late 2021 the virus surged
among the Navajo again, perhaps because of
low vaccination rates in neighboring areas.
A microbe revealed the lie of rugged indi-
vidualism. We are not self-sufficient and in-
dependent; we never have been. Our fates
are bound together. Taking care of others is
taking care of ourselves. With the arrival of
the highly infectious Omicron variant, we
are paying the price for not having devel-
oped strong policies early on and stuck to
them. But that does not mean we should just
give up the fight. Instead we need to redou-
ble our efforts to provide care and resources
to vulnerable community members. The
emergence of each new ­COVID variant is an
opportunity to reflect on what worked and
what did not with the last one, whether local-
ly or on the other side of the world. Commit-
ting ourselves to upholding our evolutionary
mandate to help one another—not just the
people we see every day but everyone, every-
where—is the only thing that will save us.

Robin G. Nelson is a biological anthropologist at Arizona

State University. She studies human sociality and health
outcomes through the lens of evolutionary theory.

Illustration by Ellen Weinstein March 2022, ScientificAmerican.com 33

A High-Speed what to expect next and what peo-
ple could do to keep themselves
safe. The scale of cooperation and
pers are posted prior to peer re-
view or consideration at a scientif-
ic journal. The number of papers

Scientific
collaboration is staggering. Large- submitted to medRxiv, a key re-
scale surveys of scientists done in pository of biomedical preprints,
2020 and 2021 show that roughly a increased 10-fold in the first few

Hive Mind
third of researchers in the U.S. and months of the pandemic.
Europe contributed to the effort. These changes also shifted early-
This vast collaboration moved stage science from a private activity

Emerged
quickly and effectively in several to part of the public discourse. In-
areas. On December 30, 2019, an stead of presenting the world with
epidemiological surveillance net- polished scientific articles, investi-
work published the first English- gators worked in open view, think-
Researchers found new forms language note about a cluster ing aloud, offering preliminary
of pneumonia cases of unknown speculations, arguing, making
of rapid communication and cause in Wuhan, China. Eight days wrong turns, following dead ends
collaboration later Chinese scientists identified and pursuing some hypotheses that
the pathogen as a novel corona­ would ultimately be refuted.
 y Joseph Bak-Coleman and
B virus. The full genome sequence This approach to communica-
Carl T. Bergstrom was published just two days after tion does have a downside. Previ-
that. Then on January 13, 2020, ously private communications

M
ost of the time s cience is a the World Health Organization were now open to exploitation and
slow and tedious business. published instructions for a PCR- distortion by politicians and pun-
Researchers toil away for based diagnostic test based on dits. For instance, flawed blood-
decades at obscure limits of human that genome. sample research reported in an
knowledge, collecting and analyz- The genome sequence also April 2020 medRxiv paper purport-
ing data, refining theories, writing, opened the door for vaccine devel- ed to show that COVID was a mild
debating, and advancing our un- opment. Scientists used it to de- disease with a very low fatality
derstanding of the world in tiny in- termine the 3-D structure of the rate. Although the scientific com-
crements. Working in small teams SARS-CoV-2 spike protein, and by munity quickly pointed out a host
on highly specialized projects far the end of January they had fig- of problems with the work, people
from the public eye—that is what ured out how to stabilize the pro- seeking to avoid business restric-
most of us are accustomed to doing. tein to make it an effective vaccine tions, school closures and mask
But a calamity upends every- component, leading to mRNA- mandates ignored the criticism
thing. In early 2020 COVID spread based and other vaccines, which and used the paper to undermine
around the globe. Millions of lives were developed, tested and dis- public health interventions.
were at stake. Yet we knew next to tributed in less than a year. Rapid and unorthodox chan-
nothing about the nature of the The urgency of COVID drove nels of communication also could
threat. Just a few months earlier scientists to adapt. Discussions not solve all the problems scien-
no one had ever seen the SARS- that previously took place at con- tists encountered. We took too
CoV-2 virus. ferences, on the telephone or in long to recognize the importance
For researchers, the emergence revision notes on manuscripts of airborne transmission of the vi-
of the disease was an all-hands-on- moved to social media platforms rus. We spent early 2020 washing
deck moment. Biologists such as such as Twitter, review sites such our groceries but not wearing
the two of us, along with virologists as PubPeer and all-hours Zoom masks. Most critically, we have
and immunologists, all pivoted to rooms. Researchers and clinicians been largely unsuccessful at antic-
focus on the new pathogen. And spontaneously organized into fo- ipating and managing the human
other researchers from across the cused teams and working groups. element of the pandemic. By not
scientific ecosystem—economists, By rapidly sharing information on accounting for ways that behavior
physicists, engineers, statisticians, their patients, physicians figured would change in response to infor-
psychologists, sociologists, and out that people with severe mation—and misinformation—we
more—dropped everything to learn COVID were at high risk for dan- have struggled to predict the size
about COVID and figure out how gerous blood clots in their lungs, and timing of successive disease
they could contribute. Public inter- so anticoagulants became a stan- waves and virus variants. A collec-
est exploded. Scientists with scant dard of care and saved lives. tive failure to stop misinformation
experience in public communica- In general, traditional modes of from spreading on social and tra-
tion learned to work closely with publication were far too slow. We ditional media platforms has left
journalists, informing a worried embraced a rapid alternative mod- large segments of the population
public about what was happening, el: preprint archives, where pa- unvaccinated, vulnerable and un-

34  Scientific American, March 2022

willing to embrace measures such laborations, submitted papers and ly funded scientific ecosystem,
as masks and social distancing. new projects started during the which has millions of researchers
By some measures COVID has pandemic. Lockdowns, school clo- effectively on retainer. When glob-
also hampered scientific produc- sures and other changes took a al crises arise, they organize, learn
tivity overall, researchers suggest- disproportionate toll on women and coordinate. And that, ulti-
ed in a paper in Nature Communi- scientists juggling work and child mately, leads to solutions.
cations l ate last year. Some of the care—a major problem that re-
2020 survey data revealed that sci- quires urgent redress. Joseph Bak-Coleman is a postdoctoral
entists were spending an average But a publication dip is precisely fellow at the University of Washington Center
for an Informed Public. He studies how
of seven fewer hours per week what we would expect when scien- communications technology affects collective
working on research. The group, tists shift from day-to-day research decision-making.
led by Dashun Wang of North- to an emergency response. Placing
Carl T. Bergstrom is a professor of biology
western University, wrote that the papers in journals becomes second-
at the University of Washington. He studies
decrease in productivity will likely ary to fixing problems. Dealing how evolution encodes information within
have lasting effects, with scientists with urgent issues is one of the genomes and how institutions and behavioral
reporting fewer publications, col- most important roles of the public- norms influence scientific communication.

Illustration by James Yang March 2022, ScientificAmerican.com 35

36  Scientific American, March 2022
 SCALING UP
VACCINES:
The Pfizer-
BioNTech
mRNA vaccine
became a major
protective
shield against
COVID. This
time-lapse
image shows
technicians at
BioNTech’s
facility in Mar-
burg, Germany,
filtering batches
Luca Locatelli/INSTITUTE

of the vaccine,
in one of the
final stages
before shipping
it out.

March 2022, ScientificAmerican.com 37

 often exhaled by a person showing no symptoms at all.
At the heart of science journalism is a focus on evi-
dence. But one of the hardest lessons many other jour-
nalists and I learned while reporting on C ­ OVID is that
absence of evidence is not evidence of absence—and
that even advice from renowned public health author-
ities should sometimes be questioned. Take face masks,

Science
for example: in the pandemic’s first crucial weeks, the
Centers for Disease Control and Prevention and the
World Health Organization said the public did not need

Journalism
to wear masks (despite the fact that medical workers
and many people in Asia use them routinely to protect
against respiratory diseases). At the same time, cdc and
WHO officials specifically told people not to buy high-

Shifted with quality respirator masks because health-care workers

needed them—breeding confusion and mistrust.
At the time, I debated with my editor over whether

New Realities to recommend that people wear masks, against the

guidance of these esteemed health agencies. I resisted
doing so, in part out of deference to these authorities
It is no longer possible to separate and in part because of a lack of published studies that
masks—especially nonmedical ones—were protective
science and politics for the wearer. In retrospect, I should have followed the
precautionary principle; in the absence of direct evi-
By Tanya Lewis dence, masks were a reasonable precaution to protect
against a respiratory virus. That episode highlighted for

W
hen I first heard the reports of a “myste- me just how challenging it can be when the evidence is
rious pneumonia” spreading in Wuhan, shifting in real time and even the experts can’t keep up.
China, in January 2020, I thought I would It wasn’t until two years into the pandemic that the cdc
write a story or two about it and move on to the and others finally started to emphasize the importance
next big medical news development. As a health of high-filtration masks, which had been abundantly
journalist, disease outbreaks are not a rare occur- available in the U.S. for many months.
rence on my beat, and most do not rise to the level It didn’t take long for bad actors to weaponize the
of an international emergency. But the story of confusion to spread misinformation. Patient zero in this
­COVID-19 would turn out to be unlike anything I “infodemic” was Donald Trump. The former president
had covered before or am likely—I hope—to ever routinely downplayed the virus’s severity, calling it “no
cover again. worse than the flu.” He blamed China, stoking xenopho-
Reporting on the pandemic was like building a bia rather than urging people to protect themselves and
plane while flying it—at warp speed in a hurricane. others. He mocked people who wore masks, politiciz-
The underlying science was evolving daily, so there ing a basic public health measure, while promoting
was no expert consensus or body of established baseless ­COVID treatments. It wasn’t just Trump—Fox
research to draw on. And there were plenty of peo- News personalities and celebrities such as Joe Rogan
ple willing to exploit this information vacuum, cre- and Aaron Rodgers have used their platforms to spread
ating a secondary epidemic of misinformation. falsehoods about the virus and the vaccines. As a health
Early on Chinese authorities suppressed informa- journalist, my job was no longer purely about explain-
tion about the virus, and the Trump administration ing the science—I now had to contend with politics and
downplayed its threat to the U.S. Testing blunders human behavior. Actions as seemingly innocuous as
and shortages prevented this country from recogniz- wearing a mask or getting a vaccine to avoid getting a
ing the number of ­COVID cases circulating within its disease had become political statements.
borders in the critical early phase when we could There has perhaps been no more consequential or
have slowed its spread. And for months health bitter battleground in the U.S. epidemic than vaccines.
authorities said SARS-CoV-2 was spread primarily by The anti-vax movement—a small faction but already a
symptomatic people through large respiratory drop- potent force before C ­ OVID—took advantage of people’s
lets from a cough or a sneeze or by contaminated sur- hesitancy about the speed with which the new vaccines
faces (remember the now ridiculous-seeming grocery- were developed to spread lies and misinformation about
disinfecting ritual?). That guidance was based on their effects. ­COVID anti-vaxxers promoted their dan-
how some other respiratory diseases circulate, but of gerous claims under the guise of “freedom,” never
course we now know this novel coronavirus com- acknowledging that it comes at the cost of people’s lives
monly spreads through aerosols that linger in the air, and the freedom to live without threat of a deadly virus.

38  Scientific American, March 2022

As science journalists, it was not enough just to report tals because it is so transmissible. As journalists, all we
the facts and debunk misinformation—we had to can do is try to make sense of the evidence as it develops,
engage with the reasons people believe such falsehoods. hope in hindsight we made the right call, and remind
We learned to use the latest research on how misinfor- readers it’s normal, not bad, to update our knowledge as
mation spreads to try to expose lies without amplifying the virus—and our understanding of it—evolves.
them and replace conspiracy theories with truth. Reporting on C ­ OVID has fundamentally changed the
All of this has played out against the backdrop of way I approach science journalism. I have gained a
vast inequities in access to vaccines and health care, deeper appreciation for scientific knowledge as a process,
both nationwide and globally. One of the biggest les- not merely an end result. I have seen that it is not enough
sons of the pandemic for many of us has been that rac- to simply follow the science—that skepticism of author-
ism, not race, explains why C ­ OVID has been even more ity is warranted even when that authority comes from
devastating for people of color. respected public health experts. And I have learned that
The arrival of new viral variants further complicated science is a
 lways political—despite what many scientists
messaging. The mRNA vaccines achieved an effective- like to think. These lessons have been won at a terrible
ness beyond any expert’s wildest dreams. But their pro- expense. But failing to heed them could doom us to
tection waned over time, and they have been less effec- repeat this tragedy when the next pandemic comes.
tive against the highly contagious Delta and Omicron
variants, prompting a return to mask wearing and a hast- Tanya Lewis is a senior health and medicine editor at Scientific American.
ily implemented booster shot campaign. As I write this, She co-hosts a biweekly podcast, ­COVID Quickly, with fellow senior
Omicron is spreading rapidly and overwhelming hospi- medicine editor Josh Fischman.

Illustration by Thomas Fuchs March 2022, ScientificAmerican.com 39

WILLY SSENGOOBA, shown
here in Kampala, Uganda, in
January 2022, set up COVID
testing at Uganda’s borders.
­COVID Set
Off a Boom
in Diagnostics

A
The pandemic accelerated the development of cutting-edge
PCR tests—and made the need for them urgent By Roxanne Khamsi

decade ago Willy Ssengooba began crisscrossing Uganda, training health-care

workers on how to use a new machine to detect tuberculosis. The deadly lung
disease infects around 90,000 people in the East African nation annually, but
it can sometimes take months to diagnose using traditional methods such as
culturing samples of coughed-up sputum. These new machines used rapid
molecular testing to yield results within a couple of hours, meaning patients
who tested positive could immediately be referred for lifesaving treatment. Ssen-
gooba, who is scientific director of the mycobacteriology research unit at the Makerere Univer-
sity College of Health Sciences in Kampala, helped to set up 265 of the devices in clinics around
the country. By increasing the number of early diagnoses—especially among vulnerable groups
such as children and people living with HIV—deaths associated with tuberculosis dropped, too.
Ssengooba saw this as a major success and wanted to deploy more machines. But it was hard to
make politicians aware of the technology’s power.
Then COVID arrived. Not long after the first case was reported samples—sometimes more than 1,000 a day—then needed to be
in Uganda on March 21, 2020, Ssengooba received a message from shuttled 150 miles to Kampala. The capital city was the nearest
a commissioner under the Ministry of Health. It had quickly place with laboratory technology set up to run a process known as
become apparent that most of the new cases were coming through polymerase chain reaction—or PCR. Using fluorescent probes that
the border crossings, so screening people there would be a prior- latch onto portions of the coronavirus genetic sequence, these mas-
ity. Could Ssengooba make it possible to test everyone who wanted sive machines could determine whether a sample was positive for
to enter Uganda? His entire country was counting on him. the genetic material of SARS-CoV-2.
Ssengooba and his team began facilitating the collection of Ssengooba’s team had to shuttle the samples themselves. A crew
nasal swabs taken from truckers at popular entry points, where of about 50 workers collected the samples in pickup trucks and
imported goods are brought into the landlocked country. Those delivered them to the lab, then turned around to go back for the

Photographs by Esther Ruth Mbabazi March 2022, ScientificAmerican.com 41

next batch, spending long, exhausting nights on the road. As the created demand from pretty much everyone; it has also spurred
pandemic intensified, they couldn’t keep up. Truckers awaiting the adoption of more advanced versions of the tests themselves.
their test results were stalled at the border for days, in part because Hospital systems have begun purchasing PCR machines that are
the sample analysis in Kampala would sometimes take up to 72 small enough to install at a doctor’s office so that samples do not
hours to return a result. A queue of trucks formed, stretching for have to be sent offsite to a huge, centralized lab. That means
kilometers, holding up the import of everything from home appli- patients can get a diagnosis on the spot and isolate immediately, if
ances to construction materials to replacement parts for cars. Mak- needed—and take whatever antiviral or antibiotic is most appro-
ing matters worse, authorities had closed the airport. priate. Companies and university researchers around the globe
The government was desperate to alleviate the backlog. Ssen- who are working on PCR technologies say there is escalating inter-
gooba considered the 265 machines he had set up throughout est in their innovations, such as handheld versions that would
Uganda over the years to test for tuberculosis. He realized he could make testing anywhere—from supermarket parking lots to remote
repurpose some of those small PCR machines to test for the coro- villages—more feasible.
navirus by using a different sample-processing cartridge. He relo- All of this may benefit more than just individual patients. As the
cated that equipment directly to the border entry points and engi- emergence of the quick-spreading Omicron variant demonstrated
neered some basic infrastructure (electrical power; benchtop safety in late 2021, ramping up testing at the population level is crucial to
spaces) to support their use. Unlike the lab setup in Kampala, keep tabs on how ­COVID might morph and push hospital systems
which requires multiple machines spread across different rooms (among other sectors of society) to a breaking point. The sweeping
and experienced technicians to prepare and process the samples, uptake of PCR for ­COVID could also pave the way for stronger pub-
these so-called GeneXpert modules were automated and about the lic health surveillance systems that can spot future pandemics by
size of a printer. They still used PCR technology but could return scanning for dozens of pathogens at once. According to Jeffrey
results on the spot in around half an hour. Townsend, a biostatistician at the Yale School of Public Health, PCR
By May the first ­COVID testing systems were working at the is a powerful tool to use for disease surveillance, and “there’s a lot
crossing point in the Kenya-Uganda border town of Malaba, reduc- of people who say we need to be doing it even more.”
ing the waiting time for truck drivers from days to around half an
hour. Within a week the equipment was set up at two other major A STRANGE TRIP
border points. Many countries, even wealthy ones, struggled to get In 1983 Kary Mullis was driving up to his cabin on the northern coast
­COVID screenings off the ground in the early months of the pan- of California with his girlfriend, a chemist at the biotechnology
demic. But Ssengooba understood how to balance the needs of pub- company where they had been hired to synthesize genetic frag-
lic health and the economy. By cobbling together testing infrastruc- ments. Mullis had spent earlier years completing a Ph.D. at the
ture where it was most needed, he was preventing disease while University of California, Berkeley, where he would trip on LSD
keeping critical goods flowing into the country. while making new chemicals. His girlfriend had fallen asleep, and
Ssengooba’s creative repurposing of Uganda’s limited testing as he drove he had a vision of molecules dancing on the mountain
resources was “tremendous,” says Wilber Sabiiti, an expert at the road. It was then that the idea for polymerase chain reaction came
University of St. Andrews in Scotland in the development of diag- to him. He pulled over the car and scribbled down his thoughts. It
nostics tests. After Ssengooba had worked tirelessly for years to try won him a Nobel Prize a decade later.
to make PCR testing more accessible for tuberculosis, his efforts At its heart, PCR is a method of making copies of genetic
finally seemed to be getting validated. The pandemic, he says, has sequences. There are now many dozens of different kinds of PCR,
clarified the urgency of deploying PCR technology more widely for but the most basic form that Mullis devised started with a tiny bit
all kinds of infectious diseases, especially to politicians, who are of DNA and then used various cycles of heating and cooling to rep-
now allocating more money to the technology. “The SARS-CoV-2 licate it. First, the process would heat the DNA to break its double
outbreak has been like a blessing in disguise for the scale-up of helix structure into two strands. Next, it would cycle to a cooler
molecular assays,” he says. temperature that would allow specially tailored primers to bind to
Ssengooba is hardly alone in his thinking. Alex Greninger, assis- specific target sequences within the strands. The samples would
tant director of the clinical virology labs at the University of Wash- be warmed up again, and enzymes would get to work building off
ington Medical Center, says that in the past, the facility where he those primers to finish replicating the complementary DNA
works typically ran 50,000 PCR tests a year for diseases such as sequences. The cycle would then repeat. Ultimately it yielded a lot
influenza and HIV. Between early 2020 and the end of 2021, it had of copies of the target strands. Special fluorescent tags were later
done four million PCR tests, mainly for ­COVID. Unlike in the past, added to the process to flag the presence of those amplified short
however, the results have been vital to informing immediate behav- sequences of interest.
iors: those who test positive self-isolate or are kept in a special ward It became possible to use this method to detect the presence or
of a hospital. This has created a massive new reliance on testing to absence of pathogens: if a virus was present in a person’s blood
guide such decisions. “We [did] 81 years’ worth of molecular test- sample, for example, the PCR machine would make a lot of copies
ing in the virology lab in the first 22 months” of the pandemic, of its sequence, and the fluorescent tags would shine brightly. If
Greninger says. He expects the demand for PCR testing to stick there was no virus, there would be only darkness.
around even after ­COVID ebbs. The general public is much more The incorporation of fluorescent tags meant that the PCR
aware of virology now, he says, and as rapid antigen tests become machines could also indicate how m  uch v irus was in a person’s sys-
a more routine part of living amid ­COVID and its potential future tem. If the fluorescent light shined more strongly and sooner in
surges, people will seek out PCR tests to confirm positive results. the replication cycling, it meant more virus was present. A PCR
­COVID has not just increased the scale of disease testing and could not only detect DNA, it could also detect genetic material

42  Scientific American, March 2022

known as RNA. This opened up a whole new world of
diagnostics because many viruses, such as HIV, are RNA- American Public Health
based organisms. As the AIDS pandemic tore through
the globe, doctors wanted to know how much HIV was Revealed Its Fragility
circulating in their patients’ bodies and whether the anti-
EPIDEMICS EXPOSE a society’s vulnerabilities. And we
viral drugs they prescribed were working to keep the lev-
els low. PCR could finally give them an answer. were already an unhealthy population before ­COVID
The machines that did the analyses, though, required emerged. Compared with some other developed coun-
lab technicians with highly specialized expertise to prep tries, the U.S. has extra­ordinary rates of c­ hronic obstruc-
samples and took half a day or more to return results. tive pulmonary disease, diabetes and other afflictions
That changed after the U.S. Postal Service launched a that leave people more susceptible to severe ­COVID.
competition for technology that could quickly screen These vulnerabilities were influenced strongly by social
mail for deadly anthrax spores, which a bioterrorist sent factors—not purely genetics.
in letters to the offices of U.S. senators and journalists How did we get here? Partially it was because our
after 9/11. The winner, announced in 2002, was a Gene­ public health system had been depleted and eroded.
Xpert prototype from Cepheid, a Silicon Valley diagnos- Public health has long been the second-class cousin of
tics company founded in the late 1990s. The system auto- the individual health-care system, even though they are
mated many of the previously laborious sample prepa- closely related. In recent history, we spent lots of money
ration steps by using cartridges and valves that pull on individual treatment
liquids through tiny channels and mix them together. and invested far less in
And it returned results in minutes rather than hours. In population health. Public
the decades since, the GeneXpert platform has received health systems lacked
approval to test for pathogens such as norovirus, chla- adequate personnel, data
mydia, tuberculosis and SARS-CoV-2. systems for analysis, the
Cepheid says there are now more than 40,000 Gene­ latest technology and gov-
Xpert machines around the world, up from 23,000 in ernment support.
2020. (The diagnostics branch of the major biomedical Adding to an already
company Roche also has a PCR machine for clinics that perilous situation, the pan-
is about the size of a coffee machine.) Increasingly, they demic exposed and accel-
are found at doctors’ offices and at locations such as the erated preexisting trends
border crossings in Uganda—rather than just at central- in our society, such as
ized labs. In September 2020 Cepheid received fda autho- growing distrust of institu-
rization for a GeneX­pert test that looks simultaneously tions, including of science.
for influenza A and B, SARS-CoV-2 and a pathogen that In the past 20 years or
is particularly dangerous in young kids called respiratory more American conserva-
syncytial virus. The test results, which can come back in tism transformed to anti-
about half an hour, help clinicians know what specific science populism. Even
antiviral to give if a patient is sick—Tamiflu for influenza, in the legal sphere, there
for example, and Paxlovid for ­COVID. That is all the more has been a dramatic
crucial during a pandemic when your infection deter- change in the past year in how many courts, including
mines your isolation behavior. the U.S. Supreme Court, look at public health—a shift
from perhaps being excessively def­erential to public
REAL-TIME WARNING SYSTEMS health policies to becoming hostile to public health,
It was not until t he past decade or so that scientists embracing an antiregulatory approach that spans various
established global surveillance systems that rapidly doctrinal categories.
tracked outbreaks of viruses. Testing for pathogens fell With such a great push toward individualism, popu-
to individual labs, and molecular diagnostics approaches lism and a judicial review that is skeptical of public health,
such as PCR were expensive or unavailable. Furthermore, how do we keep the gains we’ve made against childhood
to do PCR testing for viruses of interest, scientists needed diseases such as polio and measles, chronic illnesses such
specific probes that would recognize a genetic sequence as those caused by smoking, and motor vehicle accidents?
in the pathogens. But they lacked easy tools to create Life expectancy climbed in the 20th century not only
these probes. The barriers to conducting PCR and the because of tremendous scientific advancements and
dearth of repositories to upload such data made track- increasing wealth but also because public health cam-
ing the ebb and flow of viruses in populations spotty. paigns and public health laws accomplished a lot. In the
In 2012 the California Department of Public Health backlash against ­COVID restrictions and policy, we risk
received several reports of a mysterious poliolike disease undoing all that.
striking children. It manifested as a sudden onset of mus-
Wendy E. Parmet is Matthews University Distinguished
cle weakness in the limbs, sometimes also leading to Professor of Law and a professor of public policy and urban affairs
slurred speech and difficulty moving the eyes. The sick at Northeastern University.

Illustration by James Olstein

children did not have poliovirus, and health authorities ruled out teins unique to a particular pathogen—cannot do. The emergence
other possible culprits, including West Nile virus, stroke and bot- of the Omicron variant has shown how vital it is to track variants.
ulism. What the children did have was an obscure virus called The data pouring in from PCR tests revealed that Omicron was
enterovirus D68, or EV-D68, which had first been identified spreading like wildfire compared with the Delta variant that pre-
decades ago. It had recently been linked with acute flaccid myeli- ceded it. As a result, some governments began updating their
tis. Although some children make a full recovery from this condi- guidelines and pushing for more booster shots, and some people
tion, it can cause permanent paralysis and even death. took the data as a cue to reconsider their social interactions and
Around the same time that acute flaccid myelitis became asso- upgrade the efficacy of their masks.
ciated with EV-D68, BioFire Diagnostics, a Utah-based molecular Some experts worry that even if PCR testing capacity expands
biology company that is now a subsidiary of the global diagnostics to make more of this kind of surveillance possible, it will be ham-
giant bioMérieux, began offering a comprehensive PCR-based pered by insurance companies that might be unwilling to pay for
respiratory test. It looked for 17 viruses and three bacteria in a sin- asymptomatic testing or that hesitate to reimburse tests for patho-
gle deep nasal swab taken from a patient. gens for which no drugs or treatment are yet available. In most
Although the respiratory panel does not test specifically for cases, insurance companies “pay for vaccines and diagnostics based
EV-D68, it tests for the presence of the general family of viruses to on individual benefit,” says Dan Wattendorf, the Innovative Tech-
which it belongs. BioFire wanted to find a way to catch EV-D68 out- nology Solutions team director at the Bill & Melinda Gates Foun-
breaks so that doctors and public health officials could know to dation. “But we don’t really have payment schemes or reimburse-
keep patients from infecting others. Along with its academic part- ment and coverage to find transmission in the community.” The
ners, the company developed and tested an algorithm that was problem with coverage for PCR testing has already been a sticking
trained on past data to predict hotspots of EV-D68. The real proof point in the coronavirus pandemic. The U.S. government set up
of the approach came in 2018, when the algorithm alerted research- requirements for health insurers to cover PCR testing for ­COVID,
ers to the emergence of EV-D68 that summer. Nationwide Chil- but consumers both with and without coverage have still been left
dren’s Hospital in Columbus, Ohio, was one of the first places the with surprise bills in the thousands of dollars. Whereas PCR tech-
algorithm identified with a possible uptick in cases of the virus; nology itself is undoubtedly powerful for disease surveillance, the
the team there confirmed the algorithm was right. As a result, the question of who will foot the bill remains largely unanswered.
hospital implemented EV-D68 testing to catch cases early and pre-
vent it from spreading. HOW COVID IS SHAPING THE FUTURE OF DIAGNOSTICS
A related surveillance platform that uses BioFire’s PCR test col- As ­COVID created demand for more PCR testing everywhere, it also
lates data from different sites across the U.S. and other countries exposed how most of the technology relies on costly enzymes and
around the world on respiratory viruses such as influenza, rhino- single-use plastic parts for sample processing. After successfully
virus and now coronavirus, as well as more than a dozen gastroin- setting up the fast-turnaround GeneXpert machines on Uganda’s
testinal pathogens. Unlike the cumbersome data-collection proto- border in the spring of 2020, Ssengooba soon ran out of the car-
cols of the past, surveillance systems that continuously collect data tridges and reagents the machines rely on. In those early months
directly from connected PCR machines have the potential to be of the pandemic, Uganda requested 500,000 such cartridges from
used to detect outbreaks, including those of foodborne disease. Cepheid, but Ssengooba says the company sent only 30,000. The
In many ways, this approach—combination PCR tests that cast test maker, he recalls, said that it was barred from sending more
a wider net to look for more possible pathogens in a given sample— cartridges out of the U.S. “We spent the rest of 2020 without access
signals the future of PCR. “Their instruments are phoning home, to additional cartridges,” Ssengooba says.
which is totally cool,” Greninger says of the BioFire disease-track- Modern PCR machines use plastic trays that traditionally have
ing platform, explaining that the broad net it casts could help show each contained 96 or 384 small wells to hold samples. To circum-
where unexpected outbreaks are occurring. The C ­ OVID pandemic vent the need for expensive plastic “consumables” such as tubes
has made it clear that testing people for viruses even if they are and caps, U.K.-based company LGC replaces the tray with a long,
asymptomatic can help identify those who would not otherwise flexible polymer tape. Only 0.3 millimeter thick, it can stretch up
know they are infected, prompting them to isolate before they pass to 40 meters and has room for 106,368 reaction wells. “That allows
the pathogen unknowingly to others in their community. you to do 100,000 to 150,000 tests per machine per day, which is
Viral evolution can sometimes create a challenge for PCR. 10 times more than any machine in the world at 10 times less cost,”
Because the primers and probes used in the tests are tailored to Wattendorf says, adding that the Gates foundation has partnered
look for specific, telltale sequences within a virus, sometimes a new with LGC and Northwell Health, the largest health system in New
viral variant can evade detection because its sequence has evolved York State, to try the tape-based method for ­COVID testing.
beyond what the test is looking for. Test developers have to con- Another bottleneck with PCR is that “you have to get the sam-
stantly ensure the primers and probes are up-to-date. “You need ple very, very purified” before running the test, says biomedical engi-
to have a very good understanding of emerging genomes in popu- neer Nicholas Adams. PCR machines are calibrated to run reactions
lations throughout the globe if you’re going to have a globally appli- at specific temperatures, and impurities such as salts and proteins
cable and accurate diagnostic PCR-based test,” explains Alexandra from patient samples and added preservatives can throw that off.
Valsamakis, head of clinical development and medical affairs at Removing impurities is tough. To avoid that step, Adams and Fred-
Roche Diagnostics Solutions. erick Haselton, both at Vanderbilt University, had the idea of add-
Yet once scientists have identified new viral variants, they can ing DNA that is a mirror version of the target genetic sequence the
use PCR testing to track the spread of those variants. This is a capa- PCR test is trying to detect. These mirror sequences are “left-
bility that the antigen-based testing methods—which look for pro- handed”—meaning that they twist in the opposite direction of nat-

44  Scientific American, March 2022

urally occurring DNA, which is right- UNASSUMING MACHINES: G  eneXpert mod- make the tests more efficient at detect-
handed—so they do not interfere with ules use PCR technology to test for all kinds of ing specific pathogen genes.
the detection process. By adding a spe- infectious diseases, including COVID. At Uganda’s border crossings, Ssen-
cific amount of the left-handed DNA gooba says that testing, at this moment,
and tracking how much of it is copied, anyway, is “very smooth.” But nearly
Adams can use it as a benchmark to calibrate and confirm that the 40 years after the idea of PCR was born, the technology is evolving
PCR machine is running without worrying about many impurities. rapidly as a result of the pandemic, and Ssengooba is dreaming big.
Adams says that by reducing the need for purification with the left- He is eager to try the handheld disease diagnostics because tradi-
handed DNA—which costs about 11 cents per test—labs could save tional PCR—including the printer-size machines at the border—
significant labor and material costs. still require hookups to the electricity grid and various sample-pro-
Now that ­COVID has shown how important it is for testing to cessing rooms. A portable version, akin to the one in development
be accessible, there is more enthusiasm for portable PCR devices. by Indian company Molbio, could bypass some of these require-
Avleo Technologies has designed a handheld molecular testing ments and open up fast-testing access to remote areas for the first
machine that gives results in 30 minutes. Another device, from time. “This is something that is incredible,” he says.
Visby Medical, was initially developed to look for sexually trans- Public health has always been stymied by the hours or days
mitted infections such as chlamydia and gonorrhea (and received between collecting a sample and delivering the results to the
fda clearance for those applications) and has since added testing patient; in the meantime, an infected person has left the clinic and
for SARS-CoV-2. Anavasi Diagnostics’ AscencioDx platform, orig- gone back to the routines of their life, unwittingly exposing others
inally developed to detect HIV and flu before the pandemic hit, is and delaying treatments that are often more effective if started ear-
being used in trials as a rapid molecular COVID test. In November lier. ­COVID, and the stunning transmissibility of Omicron in par-
2021 the National Institutes of Health awarded $14.9 million to ticular, has laid bare the consequences of that gap—for individual
Anavasi to support that initiative. health, community transmission, overburdened hospitals, labor
Diagnostics developers are continuing to tinker with PCR. Ger- shortages, and so much more. Ssengooba is hopeful that the
man engineering company Solarkiosk Solutions is developing a urgency for closing that gap will persist. When imagining a future
version that runs on solar power, which it is piloting for ­COVID where portable PCR tests with on-site results are commonplace,
testing in a remote part of Sumatra where many residents lack “all of these challenges,” he says, “are going to be left behind.”
access to electricity and diagnostics. Academic labs and start-ups
such as Mammoth Biosciences in San Francisco are combining tra- Roxanne Khamsi is a science journalist and radio contributor based in Montreal.
ditional PCR methods with CRISPR gene-editing technology to She has reported extensively on the ­COVID pandemic.

March 2022, ScientificAmerican.com 45

 Global
rey­es­us has been the world’s conscience throughout
the ­COVID crisis by urging global cooperation. But his
pleas have largely been ignored by nationalistic lead­

Health
ers taking a stance of “my country first.” Global dys­
function reached a pinnacle when President Donald
Trump formally announced the U.S.’s intent to with­

Institutions
draw from the WHO. (President Joe Biden reversed
this decision on his first day in office.) Yet Trump’s was
only one of many dysfunctional nationalistic respons­
es, which ranged from near-total border closures to

Reached the hoarding by rich countries of personal protective

equipment, oxygen and vaccines. The WHO was pow­
erless to stop any of it. Even the agency’s vaunted sci­

Their Limits entific expertise came into question, as it was embar­

rassingly late in recommending masks or acknowledg­
ing asymptomatic and aerosolized spread of the virus.
It is tempting to simply create an entirely new in­
The need to reinvent the ternational health organization, but that would be a
World Health Organization serious mistake. It took a world war to build political
has become abundantly clear consensus to establish a global health agency with
vast constitutional powers. Every country on Earth is
By Lawrence O. Gostin a member except Liechtenstein and Taiwan (the latter
left out because of the U.N.’s “One China” policy). The

M
oments of existential crisis c an turn into WHO helped to lead the efforts that brought about
opportunities for bold reform. World the eradication of smallpox and the near eradication
War II led to the creation of trans­form­a­ of polio, among other crowning achievements. In­
tive institutions—the United Nations in 1945 and stead of giving up on the agency, we should use this
the World Health Organization in 1948. The birth moment, and what political consensus we have, to
of the WHO came the same year that the U.N. ad­ prepare the organization for future pandemics—and
opted the Universal Declaration of Human Rights. what remains of the current one. This goal can be ac­
The COVID pandemic marks just such a mo­ complished with robust funding and a bold new in­
ment of crisis. But instead of ushering in signifi­ ternational agreement.
cant change, it has fractured global solidarity. That, It has become painfully obvious that there is a ma­
in turn, has revealed deep-seated fragility in the jor disconnect between what the world expects of the
WHO, the planet’s health leader. The WHO’s bind­ WHO and its capacities and powers. Consider its fund­
ing, governing framework for pandemic response— ing: The WHO’s next Biennium Budget (for 2022 and
the International Health Regulations—has failed to 2023) is $6.12 billion, less than those of some large U.S.
serve its purpose in the face of widespread failures teaching hospitals and one fifth of the budget of the
by national governments to comply. Centers for Disease Control and Prevention. As long
But it is not too late to turn the corner. In fact, ago as 2011, the WHO’s report on the H1N1 influenza
this is just the moment to ask what a bold new pandemic concluded that the agency’s budget is “whol­
global public health architecture might look like. ly incommensurate” with its global responsibilities. Yet
As the U.N.’s first specialized agency, the WHO the money it receives has remained roughly constant in
has a constitutional mandate to direct and coordi­ inflation-adjusted dollars for the past three decades.
nate international health, which includes advanc­ What is worse is that the WHO has control of less
ing work to eradicate epidemic disease. No state than 20 percent of its overall finances. That is the per­
acting alone can prevent the worldwide spread centage of its budget that comes from so-called man­
of infectious diseases. Only robust international datory assessed contributions. The rest consists of
institutions can set global norms, promote cooper­ voluntary contributions, which are mostly earmarked
ation and share scientific information needed to for donors’ pet projects. The WHO cannot set global
respond to disease outbreaks. As a result, the priorities or even hire for the long term, as voluntary
WHO’s role remains indispensable. With vast and funds disappear after a year. A donor then may just
growing global interdependency, intercontinental shift to another cause. Sustainable funding requires,
travel and mass migration, the realities of global­ at minimum, doubling the WHO’s total budget over
ization and climate change have fueled a modern five years, with mandatory assessments making up at
era of new diseases. The list includes three novel least 50 percent of its overall budget. Yet even these
coronaviruses—SARS-CoV, MERS-CoV and SARS- modest proposals might not pass muster, because
CoV-2—and, of course, Ebola and Zika. member states insist on calling the shots as to how
WHO director general Tedros Adhanom Gheb­ their contributions are used.

46  Scientific American, March 2022

 ITALIAN ARMY
nurse helps a
COVID patient
at a camp hospi-
tal in Perugia
that was opened
to relieve the
burden on
nearby Santa
Maria della
Misericordia
hospital.
In December
of 2020, the
world continued
to struggle with
the pandemic’s
successive waves.

Tommaso Ausili/Contrasto/Redux Pictures

March 2022, ScientificAmerican.com 47

 Beyond funding, the WHO must have enhanced
powers to ensure governments work cooperatively in
responding to global health emergencies. Yet the goal
of enhancing the agency’s powers involves several chal­
lenges. Most countries frowned on Trump’s withdrawal
from the WHO, but many agreed that he had a legiti­
mate grievance. China’s early reporting of ­COVID cases
was disingenuous, causing a delay of weeks before the
world was alerted, and the country later blocked an in­
dependent investigation of SARS-CoV-2’s proximal ori­
gins. But what national leaders did not realize is that
the WHO has no power to verify a nation’s reports or
gain entry to a state’s territory for scientific investiga­
tions. These two structural weaknesses—and many
more—are the subject of intense global negotiations to
create a bold new pandemic treaty, perhaps taking ad­
vantage of the WHO’s power to adopt broad-based, le­
gally defined commitments such as the Framework
Convention on Tobacco Control.
With crisis comes opportunity, and the new pan­
demic treaty has the potential to be transformative.
It should introduce momentous reforms even beyond
giving the WHO power to conduct independent inves­
tigations. These provisions should include adopting
a “One Health” strategy (a collaborative and transdisci­
plinary approach to achieving optimal health out­
comes) that recognizes the interconnection among
people, animals, plants and their shared environments.
The most likely origin of SARS-CoV-2 is a natural zoo­
notic spillover, the source of more than 60 percent of
emerging diseases. Separating animal and human pop­
ulations could prevent spillovers—a step that could be
achieved through land management, reforestation and
regulation of wild animal trade and markets.
Although SARS-CoV-2 most likely reached humans
through natural means, a laboratory leak at the Wuhan
Institute of Virology has been posed as an alternative
theory for ­COVID’s origins. Rigorous regulation and
inspection of lab safety, as well as gain-of-function re­
search, could help prevent the unintentional or delib­
erate release of novel pathogens. and its partners designed the Access to ­COVID-19 Tools
Undoubtedly the rapid development of vaccines (ACT) Accelerator to hasten the development and pro­
and therapeutics, including innovative messenger duction of, and equitable access to, ­COVID resources.
RNA technologies, was the greatest technological suc­ Yet ­COVAX (the ACT Accelerator’s vaccine pillar) has
cess in responding to the pandemic. But open access badly underperformed. About 10 percent of Africa was
and sharing of data and tools, such as real-time virus fully vaccinated as of mid-January, compared with
samples, genomic sequencing, and results from clini­ roughly 63 percent of the U.S. (the European Union
cal trials and other research, were often lacking. A had achieved even better coverage). ­COVAX could be
new legal instrument negotiated under the auspices transformative if it were properly funded and re­
of the WHO’s constitution could provide a pipeline for sourced and if its distribution channels were strength­
channeling significant research funding to where it is ened so that vaccines could be stored, transported and
needed while promoting public-private partnerships administered with speed and without waste.
and scientific cooperation. President Biden has announced the investment of
Michael Nagle/Redux Pictures

Perhaps most important, the ­COVID pandemic re­ billions of dollars to expand mRNA-vaccine manufac­
vealed massive divides based on race, ethnicity, sex, turing, aiming for 100 million doses a month for
disability and socioeconomic status at both interna­ domestic and global use. Yet this charitable-donation
tional and national levels. High-income countries dom­ model is deeply flawed because donations always
inated global markets in diagnostics, protective equip­ seem to come too little, too late. Any new internation­
ment, therapeutics and, especially, vaccines. The WHO al agreement must go beyond donations to plan for

48  Scientific American, March 2022

adequate and equitably distributed supplies of medi­ ics ranging from asymptomatic and aerosolized spread REFRIGERATED
cal resources, including by securing supply chains, in­ to guidance on masks, vaccines and isolation. Its vac­ TRAILERS
tellectual-property waivers, knowledge sharing and cine and mask recommendations, for example, served as make-
technology transfers. changed three times in a matter of six weeks. shift morgues
I have delved into remaking global institutions, but We are at a crucial junction in the ­COVID pandemic. during New
it is obvious that we also must consider domestic pub­ We could simply return to the unvirtuous cycle of panic York City’s first
lic health capacities. The Global Health Security Index to neglect and back again. All too often, rather than COVID wave
ranked the U.S. as most prepared for a pandemic, but building resilience during the pandemic response, we in May 2020.
the country was among the world’s worst performers. have blamed “the other,” engaging in stereotyping of
There are many reasons for this lack of success, includ­ racial minorities and immersing ourselves in geostrate­
ing a collapse of public trust and deep political polar­ gic battles. But we could transform this crisis into a
ization. But the cdc’s guidance and actions—as well as historic opportunity for once-in-a-lifetime reforms
those of state, local and tribal health departments— of our national and global health systems based on sci­
were, by any measure, weak. That agency and health ence, equity and solidarity.
departments at both state and local levels have lost
considerable capacities (surveillance, labs and re­ Lawrence O. Gostin is University Professor in Global Health Law at
Georgetown University, faculty director of the O’Neill Institute for National
sponse) since the post-9/11 anthrax attacks. Buttressing
and Global Health Law, and director of the World Health Organization
domestic health system capacities is vital. But the cdc Collaborating Center on National and Global Health Law. His latest book is
also erred badly in its health communications on top­ Global Health Security ( Harvard University Press, 2021).

March 2022, ScientificAmerican.com 49

We Didn’t D
isaster researchers a re the scenarios narrowed until it was
used to seeing train wrecks inevitable that hundreds of thou-
coming. We study the worst sands of people in the U.S., if not

Get Serious
moments in human history—their more, would die. We have become
warning signs, failures, destruc- haunted by the knowledge that the
tion, pain, corruption and injus- worst could have been prevented.
tice—so that we can lessen the For decades the U.S. has built

about the hurt. But the scale of the pandem-

ic, and the response to it, shook
even the most practiced among us.
a network for responding to acute
crises, with the Federal Emergency
Management Agency at the top.

Climate In the beginning, I spent hours

gaming out scenarios with other
researchers, trying to answer the
Each state and territory has a
matching agency. The real heart
of the system, though, is the patch-

Crisis
question everyone was asking us: work of local agencies. Our ap-
How bad is this going to be? O ur de- proach to disaster response de-
bates (“if this happens, then that pends on sharing resources: When
could happen”) were frequently re- one community is in crisis, help ar-
Emergency managers are appraised as we learned more rives from other parts of the coun-
stuck reacting to a constant about the how the virus was trans- try to back them up. But when the
mitted—and watched politicians pandemic began, ­every part of this
march of disasters mishandle the response. With ev- system activated for a response si-
ery wrong or delayed decision multaneously for the first time ever.
By Samantha Montano made by the Trump administration, I held my breath. There was no

Tayfun Coskun/Anadolu Agency via Getty Images

RECORD RAINFALL a  nd deadly floods

hit New Jersey in September 2021.

50  Scientific American, March 2022

plan for what happens when every-
one is in crisis at once.
that one global crisis inspired ac-
tion on the other. Perhaps the U.S. Lockdowns Showed
I witnessed so many local emer-
gency managers move mountains
Congress would finally admit the
need to reform—and massively ex- the Promise of Cities
with Fewer Cars
to get their communities what they pand—our emergency management
needed—ventilators, PPE, testing system to one that prioritizes risk
sites, vaccines—while navigating reduction rather than reactionary
DURING COVID’S FIRST WAVE, the streets of New
virulent political conditions that measures. One that meets the needs
York and other major cities became eerily empty.
made their jobs harder. As the pan- of frontline and marginalized com-
Mournful sirens replaced the usual bustle and din.
demic response dragged on, new munities who experience dispro-
But urban dwellers also heard something new: an
disasters fueled by climate change portionate disaster impacts and are
abundance of birdsong. During walks outside—the
piled up: From suburban wildfires kept from accessing adequate aid.
only safe respite beyond their apartments—they
in Colorado to back-to-back hurri- None of this has happened. Not
breathed cleaner air. Lockdowns had meant fewer
canes in Louisiana to deadly rain- only is the government not apply-
cars on the roads, and the effects were unmissable.
storms in the Northeast to heat ing the lessons of the pandemic re-
Levels of nitrogen dioxide—a by-product of fossil
waves that led to hundreds of sponse to other disasters, but even
fuels burned in cars and in electricity generation—
deaths in the Pacific Northwest, the within the pandemic itself, many
were 30 percent lower along the I-95 corridor from
extraordinary has become ordinary. elected officials have failed to apply
Washington, D.C., to Boston in March 2020 com-
This constant march of disaster the lessons learned at the begin-
pared with previous
has pushed emergency manage- ning. Inadequate COVID testing,
years. Come summer,
ment to the brink and exhausted for instance, was a significant prob-
people sat at outdoor
the people who make it run. Elect- lem early on; when the Omicron
extensions of restau-
ed officials expect them not only to variant emerged, we saw a lack of
rants built in parking
respond to increasingly severe di- access to testing yet again. Month
zones and moved
sasters but to help lead multiyear after month officials have debated
around on newly added
recoveries—while preparing for to- mask mandates and the need for
bike lanes. These inci-
morrow’s crises at the same time. hazard pay despite clear evidence
dental adaptations to
This is an insurmountable task for that these types of public health
the pandemic allowed
local agencies, many of which are policies minimize spread. For all its
residents to experience
staffed with a single, part-time upheaval, the pandemic has not be-
the benefits of shifting
emergency manager. Like health- come a focusing event. Instead it is
away from the “car is
care workers, emergency managers the latest in a long line of disasters
king” status quo in a
are battling burnout as they fight for which the U.S. is unprepared.
way that policy propos-
to protect their communities with- For my entire career, I have ar-
als for climate-friendly infrastructure never could,
out proper resources and support. gued that it does not have to be like
explains Christian Brand, an environmental scientist
When you are surrounded by ca- this. We have the research and re-
with the Transport Studies Unit at the University of
lamity, there is an impulse to look sources to manage disasters more
Oxford. Now, he says, “they know what’s possible.”
for the silver lining. We like to be- effectively, efficiently and justly, if
Some fought to keep it that way. Paris has been
lieve there are windows of opportu- only policy makers would make
a leader of this sustainability shift nudged along by
nity that open in the aftermath of that choice. I have always believed
the pandemic. The French capital already had
disasters, periods of reckoning dur- that at some point there will be a
plans to tamp down car use and encourage cycling
ing which time changes can be disaster so bad it will drive them to
before COVID emerged, but in late spring 2020
made to make people and places strengthen our emergency manage-
some 50 kilometers of pop-up bike lanes, called
safer. Although most disasters do ment system. Watching the pro-
coronapistes, w
 ere added literally overnight. They
not lead to major policy updates, tracted bungling of the pandemic
are now a permanent part of Paris’s cycling net-
some—like 9/11 and the levee fail- response, however, has made me
work, with more in the works.
ure after Hurricane Katrina—do. doubt there will ever be enough po-
These strides, Brand says, came in no small part
Disaster researchers call these “fo- litical will to do so—and that is
because of political will. Paris Mayor Anne Hidalgo
cusing events,” and while the ques- what has scared me the most. If the
made climate change a focus of her reelection
tion of whether the policy outcomes government cannot effectively
campaign. Besides providing subsidies for purchas-
are “good” or “enough” is a second manage a single acute surge, I am
ing and repairing bicycles, she emphasized the
matter, they rattle the status quo. at a loss for how the U.S. will be
health benefits of reducing car emissions, calling
In early 2020 some thought the able to respond to the all-consum-
pollutants and a contagious respiratory virus “a
pandemic would be just the sort of ing effects of the climate crisis.
dangerous cocktail.” In other cities, like New York,
focusing event that wakes up world
Samantha Montano is author of D  isasterology: changes were more modest or temporary. Shut-
leaders to the risks of sleeping on
Dispatches from the Frontlines of the Climate downs may have revealed the possibility of safer,
the climate crisis. Maybe they Crisis ( 2021) and an assistant professor of healthier streets—but it was often a fleeting vision.
would use this “window of opportu- emergency management at Massachusetts
nity” to draw obvious parallels, so Maritime Academy.
Andrea Thompson is an associate editor at Scientific American
 ho covers climate and sustainability.
w

Illustration by James Olstein

 2021 by more than a third, demonstrating that the country’s high
level of poverty has always been a matter of choice. But the mea-
sures taken so far are temporary palliatives. The Build Back Bet-
ter plan was designed to make these achievements more perma-
nent and to reduce inequality in all its dimensions. If it fails to

Inequality pass, we can expect an enduring increase in poverty. Matters will

almost surely get even worse if the pandemic continues.
It was a triumph of scientific, political and economic organi-

Got zation that we were able to so quickly develop, produce and

distribute billions of vaccine doses. But matching these enor-
mous successes are colossal failures. Despite having the tech-

Much Worse
nology and the resources, we have failed to ramp up vaccine
supply and distribute enough doses in poor countries.
Markets can solve most economic problems—a shortage
of glass vials, for example. They cannot, however, overcome the
The poor, no matter legal barriers presented by intellectual-property rights that
where they live, will suffer have given the current producers of vaccines monopoly power.
Those pharmaceutical companies have an incentive to restrict
the greatest lasting toll manufacturing, allowing them to charge prices that are a mul-
By Joseph E. Stiglitz tiple of the cost of production—although most of the original
R&D, and even much of the initial productive capacity, was

T
he coronavirus exposed and exacerbated the fragility publicly financed.
and inequity of the global economic system. Many The failure to bring the disease under control and the
countries, including the U.S., proved unable to man- unequal burden of the disease are thus largely a failure of our
ufacture simple products such as face masks, let alone economic and political systems. Had the vaccine intellectual-
more complicated ones such as ventilators. Multiple supply property waiver, which would allow any firm in the world to
chains broke. The resulting ordeal will almost surely lead produce the vaccines after paying a fair royalty, been adopted
to the creation of more onshore production facilities. when it was first proposed more than a year ago, we would
An ugly nationalism displayed by countries that have almost surely have far greater supplies today. Hope may have
hoarded vaccines and put profits over lives shows no sign arrived in the form of CORBEVAX, a vaccine that has no patent
of abating, despite its po­­ten­tial­ly devastating consequenc- restrictions and is easy to make, circumventing national selfish-
es for the world. ness and corporate greed. If it proves sufficiently safe and effec-
The pandemic’s most significant outcome will be a wors- tive, it could get the world inoculated, reducing the likelihood
ening of inequality, both within the U.S. and between devel- of a more deadly, more contagious or vaccine-resistant mutation.
oped and developing countries. Global billionaire wealth The global inequities in vaccine distribution are matched
grew by $4.4 trillion between 2020 and 2021, and at the by glaring inequities in responses to the economic downturn.
same time more than 100 million people fell below the pov- Whereas the U.S. has spent a quarter of its gross domestic prod-
erty line. Just how bad the situation will become depends uct (GDP) to keep the economy going, poor countries could
on how long the disease rages and what policy makers do spend but a mere fraction of that amount. Some countries
to control it and its consequences. have seen a drop in GDP of 10 percent or more, with especially
In part because of its huge income and wealth inequali- adverse effects on the poorest. And although the U.S. can
ties, the U.S. suffered the most COVID-attributed deaths manage the large increase in debt, poor countries will find it
of any country. SARS-CoV-2 went after those with poverty- difficult to do so.
related health conditions and with jobs that cannot be done Unfortunately, then, the economic shock of the pandemic
in isolation. Surviving from paycheck to paycheck and not most likely will linger. It will be those at the bottom—poorer
having even the most basic rights of health care and paid Americans and most people in poorer countries—who will
sick leave, many Americans lacked testing to know if they still suffer the consequences years from now. Not doing every-
were infected and either went to work, spreading the virus, thing we can to control the disease and its economic aftermath
or sought help too late. everywhere i s shortsighted. Dithering and dawdling will allow
The poorest will also suffer the most from the pandem- COVID to rage on, with further supply chain disruptions con-
ic’s economic aftermath—in particular, from the loss of jobs, tributing to shortages, postponing a robust global recovery and
disproportionately concentrated in low-wage service sec- entrenching unconscionable levels of inequality.
tors. Just as worrisome, poorer children have experienced
terrible educational setbacks as schools moved online, pre- Joseph E. Stiglitz is a University Professor at Columbia University and chief
saging a potentially long-term aggravation of inequality economist at the Roosevelt Institute. He received the Nobel Prize in economics
in 2001. Stiglitz chaired President Bill Clinton’s Council of Economic Advisers from
and deprivation.
1995 to 1997 and served as the chief economist and senior vice president of the
Still, a strong policy response in the U.S. has created a World Bank from 1997 to 2000. He chaired the Sarkozy Commission (2008–2009)
shallower economic downturn than elsewhere. President Joe and an expert group (2013–2019) at the OECD for devising measures for well-being
Biden’s American Rescue Plan r educed childhood poverty in and sustainability.

52  Scientific American, March 2022

Illustration by Samantha Mash March 2022, ScientificAmerican.com 53
Messenger RNA
Therapies
Finally Arrived
Instructing our cells to make specific
proteins could control influenza,
autoimmune diseases, even cancer
By Drew Weissman

I
n just 17 years, messenger RNA
t herapies have gone from proof
of concept to global salvation.
The Pfizer-BioNTech and Moderna
vaccines for ­COVID-19 have been
given to hundreds of millions of
people, saving countless lives.
In 2005 Katalin Karikó and I
created a way to make mRNA mol-
ecules that would not cause dan-
gerous inflammation when inject-
ed into an animal’s tissue. In 2017
Norbert Pardi and I demonstrated
that modified mRNA, carried into
human cells by a fatlike nanoparti-
cle, protected the mRNA from be-
ing broken down by the body and
prompted the immune system to
generate antibodies that neutralize
an invading virus more effectively
than the immune system could do
on its own. The Pfizer-BioNTech
and Moderna vaccines both use
this mRNA-liquid-nanoparticle
“platform”—known as mRNA-LNP.
In large clinical trials, it prevented
more than 90 percent of the people now familiar with the technology, manufacturing facility is built, it can
who received the vaccines from Drew Weissman assessment of new therapeutics quickly switch to a new mRNA vac-
becoming ill. is a professor of vac- should come readily. cine or drug—unlike protein or
cine research at
These extremely promising trials, Messenger RNA vaccines in- mono­clonal facilities, which must
the University of
and massive studies of people who Pennsylvania. The struct cells to create proteins that re­engineer production from the
have since received the vaccines, nucleoside-modified induce an immune response to an ground up for each new therapy.
have finally given us suf ­­­fi cient in- mRNA-lipid-nano­ invader such as the SARS-CoV-2 vi- Success has inspired research-
formation about the safety and effi- particle vaccine plat- rus, training the immune system to ers, companies and government
cacy of mRNA vaccines in humans. form his laboratory attack future infections of the actual labs to pursue mRNA therapies for
created is used in
The platform outperformed more pathogen. They are easier to pro- many infectious diseases, including
­COVID-19 vaccines
conventional ap­proaches, in which made by Pfizer- duce in large quantities than con- influenza, cytomegalovirus, herpes
vaccines are grown in laboratory BioNTech and ventional protein therapies (geneti- simplex virus 2, norovirus, rabies,
cell cultures or chicken eggs. The Moderna. Weissman cally engineered versions of natural malaria, tuberculosis, dengue, Zika,
rapid development also accelerated receives royalties human or pathogen proteins) and HIV, hepatitis C and the entire fam-
from a patent for
investment in further research that monoclonal antibody therapies (lab- ily of coronaviruses. In each case,
nucleoside-modified
is now underway. And because the mRNA that is produced molecules that attack vi- researchers are determining exact-
U.S. Food and Drug Administration licensed by those ruses in the same way that human ly how mRNA-LNP vaccines induce
and similar regulatory agencies are two companies. antibodies do). And once a reliable potent antibody responses.

54  Scientific American, March 2022 Illustration by Thomas Fuchs

 The Defense Advanced Research
Projects Agency is even experiment- Billionaire Space
ing with mRNA delivery of mono-
clonal antibodies that could be tai- Tourists Became
Insufferable
lored for previously unidentified in-
fectious diseases, with the goal of
supplying reliable manufacturing
LAST SUMMER, a
 t a time when the pandemic had
of such remedies within 60 days.
strained many people’s finances, inflation was rising
The concentrated ­COVID-19
and unemployment was still high, the sight of the
work has also helped make mRNA a
richest man in the world joyriding in space hit
leader in nucleic acid therapeutics—
a nerve. On July 20 Amazon founder Jeff Bezos
approaches that can produce nearly
rode to the edge of space onboard a rocket built by
any protein made by a specific cell.
his company Blue Origin. A few weeks earlier Pro-
The technique is starting to be ap-
Publica had revealed that he did not pay any
plied, and it could fight diseases in
income taxes for two years, and in other years
more convenient, less invasive and
he paid a tax rate of just 0.98 percent. To many
less expensive ways. For example,
watching, it rang hollow when Bezos thanked
the fda has approved gene therapy
Amazon’s workers, whose low-paid labor had
for sickle cell anemia, and it is work-
enriched him enough to start his own rocket com-
ing in the U.S., although it requires
pany, even though
marrow to be extracted from a per-
Amazon had
son’s bone, treated and reinserted;
quashed workers’
mRNA therapy could be delivered
efforts to unionize
to marrow with a straightforward
several months
injection into a person’s arm. If that
before. The fact that
works, sickle cell treatment could
another billionaire,
be greatly expanded in countries
Richard Branson,
where the condition is widespread.
had also launched
In similar fashion, mRNA thera-
himself onboard his
peutics could revolutionize treat-
own company’s
ment of many infectious diseases
rocket just a week
in developing countries, greatly im-
earlier did not help.
proving health-care equity. I am
COVID changed
collaborating with labs around the
many people’s will-
world. Thai investigators at the vac-
ingness to shrug off
cine center at Chulalongkorn in
the excesses of the rich. The pandemic drew an
Bangkok and I have made a Thai
impossible-to-ignore distinction between those
­COVID vaccine and established a
who can literally escape our world and the rest of
quality manufacturing center to
us stuck on the ground confronting the ills of Earth:
produce it for Thailand and seven
racism, climate change, global diseases. Even sev-
surrounding low- and middle-in-
eral members of Congress expressed their disap-
Work on mRNA vaccines is also come countries. I am doing similar
proval of Bezos. “Space travel isn’t a tax-free holi-
expanding to certain cancers, food work in Africa and eastern Europe;
day for the wealthy,” said Representative Earl
and environmental allergies, and au- South America will be next.
Blumenauer of Oregon. Bezos and Branson putting
toimmune diseases. Positive results Plenty of hurdles remain, in-
the spotlight on themselves as passengers served
against ATTR amyloidosis, a fatal cluding the creation of a better sup-
to downplay the work that hundreds of scientists
condition that involves the liver, ply chain for delivering raw mRNA
and engineers at Blue Origin and Virgin Galactic
have already been produced in a vaccine and materials needed for its
had put into designing, building and testing their
phase 1 clinical trial. Although pro- production worldwide, as well as
spacecraft. It also masked the reality that advances
tein-based medications for certain improvements that could reduce
in private spaceflight really could eventually pay off
illnesses are expanding quickly, the dosage a person needs to re-
in greater access to space for all and more oppor-
large doses are typically required, ceive. Yet the ease of mRNA pro-
tunities for scientific research that could benefit
and production is often difficult duction should enable most coun-
everyone. All their flights did was give the impression
and expensive; mRNA delivery of tries to make their own medica-
that space—historically seen as a brave pursuit
therapeutic proteins could help. tions, as long as they can attract
for the good of all humankind—has just become
The approach has already worked and retain researchers who can de-
another playground for the 0.0000001 percent.
in animals for issues as disparate as velop subsequent therapeutics that
bone repair and asthma, and hu- in turn keep domestic, high-quality
Clara Moskowitz is a senior editor at Scientific American who
man clinical trials are underway. manufacturing sites operating. covers space and physics.

Illustration by James Olstein

Long Haulers
ing long ­COVID visible in ways
that ME/CFS had struggled for
decades to become. In a matter

Called
of months centers dedicated to
treating long ­COVID sprang up
at respected research hospitals,

Attention to
such as the Center for Post-­COVID
Care at Mount Sinai in New York
City. In itself, this is a hopeful de-
velopment: when I got sick with

Chronic a similar condition a decade ago,

I longed for such a place.
The effects on research, too,

Illnesses have been dramatic, with scien-

tists at numerous academic medi-
cal centers working to understand
what long ­COVID is, how to mea-
But society is not prepared sure it and how best to treat or
for the growing crisis of long manage it. Akiko Iwasaki, an im-
munologist and head of a labora-
COVID  By Meghan O’Rourke tory at the Yale School of Medicine,
is one of them. “I used to focus

W
hen the first wave o  f coro- mainly on acute infectious diseas-
navirus infections hit the es, but with long ­COVID on the
U.S. in March 2020, what rise, a big chunk of my lab now
kept me up at night was not only focuses on long ­COVID and other
the tragedy of the acute crisis but postacute infection syndromes,”
also the idea that we might soon she says. David Putrino, director
be facing a second crisis—a pan- of rehabilitation innovation for
demic of chronic illness triggered the Mount Sinai Health System,
by the virus. I had just finished re- says he is “seeing a sharp increase
porting and writing a book about in interested researchers,” in part
infection-associated syndromes because funding agencies such as
and contested chronic illnesses, the National Institutes of Health
long an underresearched and dis- “have begun allocating increased
missed area of medicine. Medical resources to long ­COVID.”
science has increasingly under- Two years into the pandemic,
stood that infections can trigger long ­COVID remains one of the
ongoing physical symptoms in biggest threats it poses. Early esti-
a subset of people, yet the medical mates suggest that anywhere from
establishment has typically ignored 10 to 50 percent of unvaccinated
the experiences of those people. people infected with the virus de-
Such conditions include myalgic velop long-term symptoms. Vac-
encephalomyelitis/chronic fatigue cines may reduce the risk by as
syndrome (ME/CFS), so-called much as 50 percent, but according
chronic Lyme disease, and more. to ­Putrino, they do not eliminate it.
Sure enough, later that spring a Yet long ­COVID was rarely dis-
cohort of patients who had caught cussed in public health messaging
the coronavirus in March began during the Delta and Omicron This lack of concern is even
reporting that they were still not waves; officials focused on acute se- more surprising considering that
better. In online message boards, vere disease and death and largely we still understand little about the
patients began sharing stories ignored the debilitating—and life- condition, including what causes
of what they called long ­COVID. altering—long-term effects that the it. Some theories suggest that the
Groups of “long haulers” banded virus has on so many people. We’ve virus triggers rampant inflamma-
together to call for more attention had even fewer conversations tion or autoimmune disease, oth-
and research into their plight. about the societal responsibilities ers that the virus itself may persist
The clamor, combined with the we have toward a growing genera- in tissues in the body. What we do
scope of the problem, had a clear tion of sick people, many of whom know is that millions of people are
impact on medical attitudes, mak- are between the ages of 30 and 50. seeking care for a staggering array

56  Scientific American, March 2022

 to offer. These patients are often
dismissed as malingerers or as
suffering from a psychosomatic
condition—and so it still is with
long ­COVID.
Some patients have reported
seeing doctors who want to help
but lack the skills and bandwidth
to do so. Early in the pandemic,
staff at the Center for Post-­COVID
Care at Mount Sinai would spend
hours with patients during their in-
take sessions. Compare that with
the silo-based U.S. health-care sys-
tem, which is designed to maximize
efficiency: its basic building block is
a 15-minute visit with a clinician. To
treat long ­COVID effectively, then,
Putrino thinks medicine needs
more than just an infusion of inter-
est and money. Additional funding,
he says, will not “lead to a meaning-
ful cultural change in the research
and clinical world” until research
centers start “actively involving
people with these conditions” in the
decision-making process.
The potential for transforma-
tion goes far beyond long ­COVID.
Under­standing what causes this
condition might illuminate treat-
ments for ME/CFS, tick-borne
illness and other diseases that
involve dysfunction of the im-
mune system, many of which are
on the rise. “I believe understand-
ing the pathogenesis of long
­COVID not only will help reveal
parallel mechanisms for ME/CFS
but also may hold a key to under-
standing auto­immune diseases, as
many auto­immune diseases occur
post­infection,” Iwasaki says.
It is time for medical research-
ers to investigate these long-
contested illnesses with the full
force of science’s power and for
medical educators to train doctors
of symptoms that include fatigue, as Harvard University researcher in how to effectively c are for
brain fog, racing hearts, breath- ­Susan D. Block put it to me. Medi- chronically ill patients. If they do
lessness, pain, and more. The task cine has a long history of stigma- not, they will be failing not only
of treating all these patients is ex- tizing diseases it does not under- this generation of patients but
posing some of medicine’s endur- stand and cannot yet readily mea- many millions more to come.
ing weaknesses. sure. Clinicians like to be able to
Modern medicine is based on treat diseases that resolve. When Meghan O’Rourke is editor of the Yale Review.
 er essays, criticism and poetry have ap­­pear­
H
replicability. Since the advent of patients present with chronic con-
ed in the Atlantic, t he New Yorker a nd many
germ theory in the 19th century, ditions or an array of systemic other publications. Her latest book is T he In­­vis­
the field has taken an “if you can’t symptoms that are hard to quanti- ible Kingdom: Reimagining Chronic Illness
measure it, it doesn’t exist” view, fy, doctors do not have quick fixes (Riverhead Books, 2022).

Illustration by Thomas Fuchs March 2022, ScientificAmerican.com 57

 Reported Lives Lost from COVID per Week
100,000
Nearly
5,412,000
COVID deaths
reported to the World
Data Captured LIVES LOST Health Organization
as of Dec. 29, 2021
COVID’s The most obvious change is
perhaps the most staggering:
the pandemic has caused an
enormous loss of life. The
numbers portrayed here only
Uneven Toll reflect COVID-related deaths that
Visualizing ongoing stories were reported to the WHO. As

58  Scientific American, March 2022

a result, they are very likely under­
of loss, adaptation and inequality counted, particularly in regions
where data-collection methods
are less reliable or reporting
 y Amanda Montañez and Jen Christiansen,
B mechanisms are less robust.
Source: WHO COVID-19 Dashboard.
with research by Sabine Devins, World Health Organization, 2020.
Available online: h ttps://covid19.who.int/ 
Mariana Surillo and Ashley P. Taylor (d ata downloaded on December 31, 2021)

y telling the story of ­COVID-19 in real time, data 50,000

visualization has taken on new importance in our
B daily lives. Early in the pandemic, we watched
circles multiply and swell on a map as the virus spread
around the globe. We saw lines on time-series charts turn
nearly vertical during surges in cases. These numbers and
their pictorial signifiers have been critical for informing
our behaviors over the past two years, but they hardly
capture the full significance of the crisis and its many
snowball effects. Much of the fallout—from personal and
collective traumas to profound economic disruption— Americas
can also be measured to help us tell a fuller story of how
­COVID has changed the world. The visualizations that March 11, Europe
follow focus on the emergence of potential trends,
sudden pivots and troubling setbacks; we also explore
2020
the consequences of some dramatic, if temporary, blips. Global pandemic
Because no story can be captured by data alone, context declared by the
and caveats are provided throughout. World Health
Organization
Southeast
SouthEast Asia Africa

Eastern Mediterranean
Western Pacific
Week starting: Dec. 30, 2019 Sept. 7, 2020 Mar. 8, 2021 Sept. 6, 2021
 Life Expectancy 2015* 2019 2020 Superlatives (2019–2020) ­ verall life expectancy in the U.S. has plummeted, but some
O
HEALTH at Birth for 29 populations suffered more than others. The pan­demic’s
Spain (F) big drop
Countries (years) disproportionate impact on communities
Norway (F) rise
Globally, COVID has changed people’s health in ways that go far beyond the 84 Finland (F) rise of color underscores the serious
acute impact of the disease. Efforts to limit the virus’s spread, as well as Denmark (F) rise health effects of racial and
the death toll itself, have generated widespread fear, isolation and economic Female (F) ethnic inequality.
hardship, the effects of which will be felt for generations. Male (M) Norway (M) rise Source: “Reductions in 2020
U.S. (F) big drop U.S. Life Expectancy Due to Latino
80 ­COVID-19 and the Dispropor­
80
Denmark (M) rise tionate Impact on the Black Non-Latino
Life Expectancy and Latino Populations,” Life
Information by Theresa Andrasfay and
white
Bulgaria (F) big drop Expectancy
A useful measure of population health and longevity, the on nonbinary Noreen Goldman, in PNAS, Total
categories 76 Vol. 118; February 2, 2021 (data) at Birth, 76
indicator known as “life expectancy at birth” has been on the U.S. population
was not
rise in most places for the past century. In a recent study of published
U.S. (M) big drop (years,
29 countries, ­COVID single-handedly reversed that trend in Non-Latino
all sexes) Black
27 of them. Life expectancy is typically measured separately *Data for 72 72
for males and females; overall, the pandemic’s toll was Chile, Germany,
and Greece Bulgaria (M) big drop No-COVID-19 COVID-19
greater among males.
from 2016 Lithuania (M) big drop scenario scenario
Source: “Quantifying Impacts of the ­C OVID-19 Pandemic through Life-
Expectancy Losses: A Population-Level Study of 29 Countries,” by José Manuel
Aburto et al., in I nternational Journal of Epidemiology; S eptember 26, 2021 (d ata)
Number of Undernourished
768.0
Individuals (millions)
656.8
World
Food Insecurity 600 624.1
Factors such as climate change and pervasive inequality Projections for the COVID-19 scenario 299.5
were already contributing to high rates of food insecurity. 418.0 Projections for the no-COVID-19 scenario (Africa)
400 Asia
A recent report found that the pandemic caused an immediate 299.3
spike in undernourishment both globally and regionally 281.6 290.8
Africa
in 2020, primarily related to people losing their jobs or 200 283.0
experiencing a reduction in work hours amid lockdowns. (Africa)
It also compared projected numbers of undernourished Latin America and the Caribbean 59.7
52.2
people over the next decade with what those values would be 0
45.4
without ­COVID. The data suggest that these seemingly acute 2016 2019 2020 2030
disruptions will have a long tail: ­COVID scenario projections
largely exceed no-­COVID ones as far out as 2030. Estimated Childhood
Vaccine Disruption Birth Rates • Globally, COVID’s impact on
Source: The State of Food Security and Nutrition in the World 2021. “Transforming 1.4
Food Systems for Food Security Improved Nutrition and Affordable Healthy Patterns birth rates has been mixed. In many high-income
Diets for All,” by FAO, IFAD, UNICEF, WFP and WHO, 2021 (diphtheria- nations, people had fewer babies than expected in
Nepal
tetanus-pertussis 2020, perhaps because of high levels of stress and
or measles) 1.2 financial uncertainty. But in low- and middle-income
Childhood Vaccinations Australia Nigeria countries, pandemic restrictions disrupted access
Despite ubiquitous talk of vaccines, rates of immunization to contraceptives for an estimated 12 million women,
against diseases other than C­ OVID have recently fallen. Baseline 1.0 resulting in nearly 1.4 million unintended pregnancies.
A study tracking children due for their third dose of the (no-COVID-19
diphtheria-tetanus-pertussis vaccine and their first dose scenario)
of the measles vaccine estimated that between eight Index values over 0.8
1.0 indicate more India
million and nine million more doses of each vaccine were Loss of Caregivers • In October 2021
doses than baseline
missed globally compared with what was expected, with were administered the CDC reported that one in four COVID deaths in
coverage dipping lowest in April 2020. Numbers have U.S.
during that month. 0.6 the U.S. deprived a child of a primary or secondary
improved since then, but in some countries, coverage An index value of Tinted panels caregiver. From April 2020 to June 2021, this
remains lower than it would be without ­COVID. zero would indicate represent ranges amounted to 140,000 children affected, a dispro­
complete disruption of uncertainty
Source: “Estimating Global and Regional Disruptions to Routine Childhood portionate number of whom were kids of color.
Vaccine Coverage during the COVID-19 Pandemic in 2020: A Modelling Study,” of vaccine delivery 0.4

March 2022, ScientificAmerican.com 59

by Kate Causey et al., in L ancet, Vol. 398; July 14, 2021 (d ata) during that month. Mar. 2020 Jul. 2020 Nov. 2020
 Changes in mental health disorders do not capture
the full picture of loss, stress and isolation
Mental Health Estimated Prepandemic Pandemic Age “The mental health consequences of C­ OVID could lead to
Prevalence of
The global prevalence of depressive disorders grew by long-term losses in well-being, diminished economic
Anxiety Disorders 25
nearly 28 percent in 2020, and anxiety disorders rose productivity and increasing health-care costs. Unfortunately,
(per 100,000 50
by almost 26 percent, according to a study in the Lancet. individuals: Female
75 the existing U.S. mental health system is sorely lacking
This explosion of cases was linked to pandemic-related data from 204 6,000
factors such as high infection rates and decreased 15 a public focus: it engages largely with those who
countries and
mobility during lockdowns. territories)
are already mentally ill and often only those
Source: “Global Prevalence and Burden of Depressive and Anxiety Disorders who are able to pay for treatment.”
in 204 Countries and Territories in 2020 Due to the ­COVID-19 Pandemic,” 25
by Damian Santomauro et al., in Lancet, Vol. 398; October 8, 2021 (data) 50 —Psychiatry residents Sofia Noori and Isobel
Information on Male
15 Rosenthal, in Scientific American,
nonbinary categories
One study in N
 ature evaluated mental health effects was not published 75 June 2020

60  Scientific American, March 2022

by tracking calls to helplines in 19 countries. Call volume
was up 35 percent compared with prepandemic levels, 2,000
with more callers than usual expressing feelings of fear COVID caused new types of stress
and loneliness. Percent Change 40 A CDC survey conducted in April and May of 2020 evaluated
Source: “Mental Health Concerns during the ­C OVID-19 Pandemic as
in Daily Helpline prevalence of depression, suicidal ideation and the initiation
Revealed by Helpline Calls,” by Marius Brülhart et al., in N ature, V
 ol. 600; Calls (data from 20 of substance abuse, along with specific pandemic-associated
November 17, 2021 (d ata) 398.3 19 countries and
0 stressors and social determinants of health. Rates of these
(2001) territories) issues varied across racial and ethnic groups. For example,
–20 Hispanics reported outsize rates of both housing instability
Substance Use –4 4 8 12
Billions Weeks from Outbreak and suicidal ideation. Meanwhile those identifying as Native
of Cigarettes American/Alaska Native, Asian, multiracial, or another race
Cigarette Sales • In 2020 cigarette sales in the Sold (U.S.)
U.S. increased for the first time in nearly 20 years. or ethnicity not listed separately in the survey reported the
Source: Federal Trade Commission Cigarette Report for 2020,
highest rates of stigma around viral spread, job or income
published October 2021 (d ata) loss and lack of access to health services.
Source: “Racial and Ethnic Disparities in the Prevalence of Stress and Worry, Mental
Health Conditions, and Increased Substance Use among Adults during the COVID-19
Pandemic—United States, April and May 2020,” by Lela R. McKnight-Eily et al.,
in Morbidity and Mortality Weekly Report, Vol. 70; February 5, 2021 (data)
Alcohol Sales • From March to September 2020,
retail sales of alcoholic beverages in the U.S. jumped
203.7 Prevalence of Self-Reported Stress
by 20.4 percent compared with the same period in 2019.
This change was accompanied by a decrease in sales Alcohol Retail Sales (millions of dollars, U.S.) (2020) 0% 20% 40%
Psychosocial Stressors
at restaurants and bars, so it is hard to say whether
6,000 Stigma or discrimination Native American/Alaska Native,
the pandemic prompted people to consume more Restaurants and bars
for spreading COVID Asian, multiracial,
alcohol overall. But drinking at home certainly became
or another
more prevalent. Beer, wine, and liquor stores Death of loved one race/ethnicity
Source: “The Concerning Increasing Trend of Alcohol Beverage Sales in White (non-Hispanic)
the U.S. during the COVID-19 Pandemic,” by João M. Castaldelli-Maia et al., 3,000 Feeling isolated
in Alcohol, Vol. 96; November 2021 (data) Hispanic/Latino
June 2019 Sept. 2020 Workplace exposure
Mar. 2020
to COVID

Drug Overdose Deaths • People in Nearly 100,000 Health of family Black (non-Hispanic)
the U.S. died from drug overdoses in unprecedented (2021) and loved ones
numbers following the onset of the pandemic, according
Getting ill from COVID
to CDC data. The period from April 2020 to April 2021
represented the first time over 100,000 overdose deaths Social Determinants of Health
were reported in a single year. Many of these deaths Drug Overdose Deaths
per Year (U.S.) Housing instability
were attributed to fentanyl, the powerful synthetic
opioid that has flooded the illegal drug market following 19,394 Not enough food
a surge in prescription opioid addiction in recent years. (2001) Access to health services
Source: National Center for Health Statistics, Centers for Disease Control Provisional data for 2020 and
and Prevention (d ata) 12 months ending in May 2021 Loss of job or income
 Number of 600 Between Jan. 2020 and
SCIENTIFIC RESEARCH Clinical Trials Oct. 2020, 1,625 clinical
Halted* trials cited COVID as
Beginning in March 2020, some research projects screeched to a halt, whereas (Citing COVID) 400 Halted a reason for people
others suddenly ramped up. An urgency to understand C­ OVID—and the under­ and Later halting their work
lying public health issues it has revealed—may have prompted a reevaluation Restarted†
per Month Only 56.4% of those
of priorities in scientific research. 200 Restarted trials had restarted
as of Oct. 2021
* Through
Clinical Trials Dec. 2020
† As of
0
During the period of December 2019 through January 2021, Oct. 2021 Mar. 2020 Jul. 2020 Nov. 2020 Mar. 2021 Jul. 2021
2,043 clinical trials globally were suspended or paused
because of ­COVID-19. Some of those have subsequently Behavioral
restarted, but many have not. Estimated NIH Funding (millions of dollars)
Infectious diseases science research
Source: Data from ClinicalTrials.gov, processed by Benjamin Gregory 8,000
Carlisle (u npublished analysis) Applied behavioral and social science is on the rise
Reflecting on how misinformation
exacerbated ­COVID’s impacts in the U.S.,
6,000 Emerging infectious diseases outgoing nih director Francis Collins told PBS
Funding by the National Health disparities NewsHour: “I wish we had more insights from
Mental health behavioral social science research into how this has
Institutes of Health come to pass and why it could have gotten so
Out of a total of 200 broad research areas, certain Social determinants of health
4,000 completely widespread. I want to call this out as one
categories of nih funding experienced especially large Basic behavioral and social science of my most major concerns as I stepped down
increases from 2019 to 2022 (which is a pro­jected budget). Health services from the nih, of looking at the situation in our
Some seem clearly linked to the pandemic: social Immunization nation.” The nih’s increased investment
determinants of health, for example, are related to 2,000 Vaccine-related in the field in 2022 reflects
­COVID’s dis­pro­por­­­tionate impact on certain populations. Coronaviruses Collins’s concerns.
Other areas, such as influenza and vector-borne disease,
Vector-borne diseases
received relatively little investment.
Source: National Institutes of Health, June 25, 2021 0 Influenza
(d ata downloaded from https://report.nih.gov) 2011 2013 2015 2017 2019 2020 2022 Burden of illness CO2 • According to CarbonMonitor.org, global emissions
of carbon dioxide, the greenhouse gas responsible for the
majority of global warming, fell by a considerable 5.4 percent
Global Fossil Carbon Dioxide in 2020 but have since rebounded to levels approximating
EMISSIONS Emissions (billion those of 2019.
tonnes, Gt) Projected: Source: Global Carbon Project
36.4 Gt
When governments issued lockdowns and other restrictions in response to (2021) NO2 • Nitrogen dioxide is emitted through the burning of
­COVID, transportation and commercial energy consumption dropped suddenly. fossil fuels and is associated with human respiratory problems.
The result was a striking decrease in air pollution. But studies tracking 20 In the first several weeks of pandemic lockdowns in the U.S.,
changes in carbon dioxide, nitrogen dioxide and fine particulates Mean Nitrogen levels of this gas dropped by more than 25 percent relative to
also show a rebound toward prepandemic levels. Dioxide the same period in the previous three years.
10
Concentration
Source: “Changes in U.S. Air Pollution during the COVID-19 Pandemic,”
across 122 U.S. by Jesse D. Berman and Keita Ebisu, in Science of the Total Environment, Vol. 739;
Reducing 25.3 Gt Counties (parts 0 October 2020 (d ata)
emissions is possible— (2001) per billion) Jan. 9, 2020 Mar. 11 Apr. 21
Fine Particulates • Following lockdowns in the U.S.,
but how we get there matters fine particulate matter (PM2.5) stayed relatively close to
The pandemic’s immediate impact on Daily Mean Prepandemic Pandemic County Characteristic prepandemic levels overall. Researchers did find, however,
emissions proves that collective behavioral changes Concentration of Urban significant decreases in urban areas and those where
can produce swift results. But there is little about Fine Particulate 6 Late/no business closures nonessential businesses closed early.
the painful conditions of the pandemic that anyone Matter (micro- Mean for all 122 counties
Source: “Changes in U.S. Air Pollution during the ­C OVID-19 Pandemic,”
desires to replicate. One exception is the shift grams per cubic Early business closures by Jesse D. Berman and Keita Ebisu, in S cience of the Total Environment, V
 ol. 739;

March 2022, ScientificAmerican.com 61

to remote work for millions of people who meter of air) 4 Rural October 2020 (data)

formerly commuted by car. Policies that

support telecommuting could help sustain
a decrease in emissions.
 Mar. 2020

Global Labor Force The burden of job loss Unions are on the rise
ECONOMY Participation Rate is not shared evenly People who were put in the category
(percent of total population, In mid-2021 the International Labor of “essential worker” in 2020 found
C­ OVID’s economic impacts are as varied as they are significant. From a distance, ages 15 and up) that their roles had become both
Organization reported that although
it is easy to identify clear winners and losers: air travel and hospitality industries men’s global employment had returned newly dangerous and indispensable.
64.4%
suffered, for example, whereas video calling and online shopping skyrocketed. to prepandemic levels, there were still Yet many did not feel their employers
(2001)
But a closer look at the data reveals a more granular picture because different 13 million fewer women in the work­force responded adequately to keep them
people experienced these changes in varying ways. than in 2019. People in low-paying jobs safe and fairly compensated. Perhaps
were also affected disproportionately, in response to these developments,
in part because their roles may not be the U.S. has seen a recent uptick
compatible with remote work. The in unionized workers as a percent
Labor Force Participation of its total workforce.

62  Scientific American, March 2022

U.S.-based Brookings Institution
The worldwide share of people in the labor force—defined reported that “before C­ OVID-19, nearly Source: Bureau of Labor Statistics
by the World Bank as those aged 15 or older who supply labor half of all working women . . . worked
for the production of goods and services—has been gradu­ally in jobs paying low wages, with median
falling in recent decades (although trends have varied earnings of only $10.93 per hour.”
by country). Since 1990 the typical annual fluctu­a­tions Hispanic and Latina women represent
were around 0.1 percent. From 2019 to 2020 the global rate
an outsize share of these workers,
fell from around 61 percent of the population to less than 59— 58.7%
(2020)
compared with white women.
a sudden, steep drop. Percent of U.S. Employees
Source: International Labor Organization, ILOSTAT database; Who Are Members of a Labor Union
data retrieved on June 15, 2021, and presented by the World Bank
Deviation in Google Search Intensity Higher than baseline
Historic baseline (dotted) Lower than baseline 20.1%
(1983)
Zoom
10.8%
Skype (2020)
Industry Ups and Downs
A look at worldwide trends of Google search terms reveals Delivery
clear industry winners and losers. When lockdowns put an
abrupt stop to nonessential travel, searches including words Flight
like “hotel” and “airport” became scarce. Meanwhile remote
workers sent “Zoom” sky­­rocketing, and people avoiding the Shopping
grocery store performed abundant searches for “delivery.” Restaurant
Source: “Winners and Losers from COVID-19: Global Evidence from Google
Search,” by Kibrom A. Abay at al. Policy Research Working Paper 9268, World Museum
Bank Group, Development Economics Development Research Group, June 2020

–6 –4 –2 2 4 6
Weeks from Outbreak

$14.6 Telehealth-Related Bills Passed

Telehealth Policy
Large-Scale* Annual
Digital Health Funding, (2020) In the U.S., federal and state laws
Telehealth Investments 0 60
U.S. (billions of dollars) control the type and extent of
Telehealth uses certain technologies to provide health care telehealth services available to
*Includes deals more Regulatory requirements
at a distance. Examples range from sensors that allow for 2020 patients. During the C­ OVID public
than $2 million Private payer reimbursement
remote tracking of vital signs to consultations with a medical health emergency, regulations shifted
professional by phone or computer. It is not a new concept, 2021
Online prescribing quickly, making the option of remote
but global investments—in terms of number of investors and
Medicaid reimbursement care more accessible to more people.
scale of contributions—jumped up in 2020 and continued $4.6
to break records in 2021. The chart here shows one measure: (2016) Studies and reports Advocates are pushing for continued—
cumulative investments in digital health companies. and expanded—access, even as the
Cross state licensing acute need wanes.
Source: Rock Health Funding Database, as published on July 6, 2021,
by rockhealth.org (data) Broadband Source: Center for Connected Health Policy (data)
 Interrupted Learning Alternative COVID trajectory
EDUCATION Trajectories
Accelerated learning to get
back to pre-COVID benchmark.
A report from the World Bank, UNESCO and UNICEF warns that ­COVID-related
disruptions caused “the worst education crisis on record.” Children in low- and
middle-income countries have suffered the biggest losses because of school
closures and will likely experience longer-lasting effects than those in high- Pre-COVID learning trajectory
income nations. “Affected cohorts of children end up with lower educational

Learning Progression
attainment, as well as lower earnings and higher unemployment in adulthood.” COVID trajectory

Disrupted Learning Trajectories School closures

According to the World Bank, some evidence shows that a
portion of the long-term losses “are attributable to slower Loss of previously acquired learning If students do not get
learning once children return to school.” If educators and and expected learning that does not back on track, learning
administrators are given the resources and support to respond take place because of school disruptions. losses will accumulate.
to pandemic-related setbacks with an “accelerated learning Time
trajectory,” students may still catch up. But that would require
immediate, sweeping changes to education systems, including
consolidating the curriculum, increasing instructional time
and tutoring students in small groups. Perceived Corruption Index Lines are colorized
Source: T he State of the Global Education Crisis: A Path to Recovery,  according to the New rules
World Bank, UNESCO and UNICEF (2021) 2019 2020 require interpersonal trust
Pandemic Violations of
Less corrupt 100 Democratic Standards “The problem is that for the
Index, which represents
the extent to which
recommendations or regulations to work,
TRUST 90 2020 pandemic we need to trust our fellow citizens as well as
New Zealand, responses have violated the government institutions that are issuing
The success of any democracy depends largely on the degree to which the Denmark democratic standards. them. If people do not believe that most others
public trusts its institutions to act in its best interest. In many countries, political 80
Violations are going to play by these novel and
responses to COVID appear to have shifted public perceptions of corruption
in government—some for better, others for worse. None restrictive rules, they are unlikely to adhere
70 Minor to them themselves.”
Moderate
Perceived Corruption (Global) Major —Political scientist Bo Rothstein,
in S cientific American,
According to the organization Transparency International, the 60 March 2020
corrosive effects of corruption are amplified during emergencies,
which can in turn exacerbate the emergency. Some of the key U.S.
factors in this spiral of harm are di­­version of funds from 50 Armenia
essential services, opaque government
spending, and breaches of human
In general, countries MOVING FORWARD
rights in the management of Successes 40 with lower levels of
the crisis. All these issues and failures perceived corruption The story of COVID and its myriad impacts is far
arose during the pan­ In New Zealand, which famously (top of chart) have from over. As we enter year three of the pandemic,
demic, and people all handled COVID quite well, levels of public 30 exhibited a more
over the world suf­ data will continue to play a key role in quantify-
trust started out high in 2019 and improved democratic handling of
fered and died as the pandemic (yellow ing the waves of change that ripple through soci-
in 2020 as the government maintained
a result. 20 and orange). ety. Some of these data will help us make personal
democratic standards throughout its response.
Sources: Transparency risk assessments in our daily lives, whereas oth-
International (Corruption In the U.S., however, violations of democratic
Perception Index values), standards seem to have worsened Somalia ers might inform policy decisions. Charts and
and Pandemic Backsliding 10
Project, Varieties of Demo­ perceptions of corruption at the same graphics can also highlight emerging trends that
cracy Institute (Pandemic Vio­ time the country has suffered might otherwise get lost as we navigate the daily
lations of Democratic Standards

March 2022, ScientificAmerican.com 63

Index values) devastating losses during More corrupt 0 noise of an ongoing crisis.
the pandemic.
Work
Changed
Forever
People realized their jobs
don’t have to be that way
 y Christina Maslach and
B
Michael P. Leiter

H
ardly anyone h as made it
through the pandemic
with their work life un-
changed. Millions of people have
lost jobs, been placed on furlough
or switched to working from home.
Essential workers have continued
in place but often with major
changes to their workloads, includ-
ing additional safety procedures
and an awareness of infectious dis-
ease as a new workplace hazard.
According to the Bureau of Labor
Statistics, employment dropped
by 20.5 million people in the U.S.
alone in April 2020. Service pro-
viders were hit most intensely:
7.7 million jobs were lost in the lei-
sure and hospitality sector, with
5.5 million of them in food service
or drinking establishments.
The shift to remote work led to
the complete collapse of the work-
home boundary, especially for
parents juggling child care and
homeschooling with job demands.
Poorly timed or endless Zoom
meetings interfered with people’s
ability to get work done and some-
times harmed relationships with
colleagues. Essential workers often difficult for everyone to relax and At the same time, other peo-
discovered that their employers’ recover from their ongoing ex­­ ple—especially those with
only strategy to bridge the gap cre- haustion as entertainment and fit- comfortable home offices and
ated by increased demand was for ness facilities closed. Because of few parental responsibilities—
them to work harder—reinforce- these changes, workers experi- found benefits in working re­­­­-
ments were not on the way. Many enced more stressful ex­­haustion, motely. Being on their own gave
employees had to deal with inade- became more negative and cynical them greater control with fewer
quate personal protective equip- about the workplace and felt distractions. The absence of com-
ment while feeling unfairly an erosion of self-confidence— muting gave people more time
treated. And it be­­came more the triple markers of burnout. and energy while saving them

64  Scientific American, March 2022 Illustration by James Yang

 provider and hospitality sectors
were facing major challenges in
enticing people back to these low-
paid, heavy-demand jobs, with
many positions remaining empty.
At the same time, 4.5 million Amer-
icans (3 percent of the workforce)
voluntarily quit their jobs in
November, reflecting both discon-
tent with their current positions
and the desire to find better
ones. But solving the burnout
problem cannot fall to individual
workers. The workplace must
change. People burn out because
their employers have not success-
fully managed chronic job stressors.
We must place a stronger focus
on modifying or redesigning work- Nasal Spray Preventives
place conditions. How can job
environments be places that help Went into Development
people thrive rather than wear­ing COVID IS CREDITED WITH p  ropelling clinical inno-
them down? vation. But for a disease that seems to start in peo-
People whose work lives got ple’s noses, none of the available drugs or vaccines
better over the past two years are delivered intranasally. Killing the virus before it
can generally thank personal travels into our lower airways could prevent serious
re­­sources—a comfortable room illness. An intranasal vaccine could do this by stimu-
of one’s own—rather than fore- lating the immune system in the mucus of our noses.
sight from their employers. But And intranasal treatments, such as antibodies or
em­­ployers can learn a lot from small-molecule antivirals, could stop the virus
at­­tending to what helped people before it infects enough cells to cause disease. Vac-
be more productive and satisfied cinated health-care workers, for instance, could
during this time. For example, take a puff of a virus-killing nasal spray after expo-
workers were less distracted by sure to protect against breakthrough infection.
pointless meetings and open office So why aren’t intranasal pharmaceuticals here
settings and were able to focus yet? Drugmakers default to injectable vaccines and
on meaningful tasks rather than treatments for a few reasons. Our muscles have lots
being burdened by busywork. of blood vessels, so injections in arms are perhaps
Some companies are trying to the fastest way to get immune-stimulating vaccines
entice workers with higher pay and therapeutic antibodies into the bloodstream.
or time off. Im­­proving job condi- From there these molecules can work their way to
tions has even more potential for the respiratory system (and other systems), where
enduring impact. the C ­ OVID virus is doing its dirty work. Similarly,
Work takes up a lot of people’s pills get absorbed into our circulation quickly. To
time, talent and potential— make existing drugs or vaccines work intranasally
and workers are increasingly may require reformulation and retesting. But a nasal
demanding that it offer a sustain- spray might have benefits that injectables and pills
able and rewarding quality do not: direct delivery to the earliest site of infection.
of  life in return. Several nasal vaccines are now in clinical trials.
money. People who had been Intranasals for prevention and treatment ­are also in
working in unpleasant or hostile Christina Maslach is a professor of psychology
development. A scientist at the University of Hous-
workplaces were now free from at the University of California, Berkeley, and
creator of the Maslach Burnout Inventory, ton, for example, has shown in animal models of
disrespectful encounters. a widely used psychological instrument. ­COVID that an intranasal antibody spray seems to
The pandemic has taught many She and Leiter co-authored the forthcoming reduce viral load; the biotech company he co-
people that the job does not have book The Burnout Challenge (Harvard founded is working toward clinical trials. Depending
to be the way it was. This realiza- University Press, 2022).
on how these methods perform, we may get new
tion may be one reason that many Michael P. Leiter is an orga­nizational tools for living amid this pervasive disease.
are not going back to their old jobs. psychologist and president of Michael Leiter &
At the end of 2021, the service Associates, a consulting firm in Nova Scotia. Megha Satyanarayana is chief opinion editor at Scientific American
and has reported on COVID-related technologies.

Illustration by James Olstein

 suffering there is, oppression,
inequality and injustice can be
thought of as natural. The Bible
says, for example, that the poor
will always be among us. Some
people see it that way—it is just
fate. Or defective genes or culture.

Fault Lines
A real diagnosis was finally on the
table, being discussed not only by
a few scholars and activists but

in American
by Americans at large.
Understanding the depth of the
injustice made people angry, and
they came out in the streets in

Society unprecedented numbers. In this

manner, the pandemic dovetailed
with police oppression and tech-

Got Deeper nology to energize the Black Lives

Matter (BLM) movement. In addi-
tion, the pandemic nearly shut
The pandemic energized the Black down the economy, giving many
more people opportunities to pro-
Lives Matter movement—and test. During the Civil Rights Move-
provoked a dangerous backlash ment (CRM), college students were
especially available for sit-ins and
By Aldon Morris other protests on so-called T-days—
Tuesdays and Thursdays—when

I
n 2020, as the bodies piled up, they had no classes. But at the
it became clear that people of height of the pandemic, far more
color were dying at far higher people had the time to join the
rates than white people. They BLM and other protests. And there
had the jobs that exposed them was another breakthrough: for
to infections, the comorbidities the first time in American history,
that made them more likely to people of diverse classes, races
get very sick, and less ability to and ethnicities joined a movement
access quality health care than against racial oppression.
white Americans. The toll revealed These protests led to important
in very stark ways that racial gains. For the first time, there is
disparities and racism were alive serious public deliberation on the
and well in the U.S. disparities in health, schooling,
At the same time, police were access to universities and wealth
attacking Black people, and those that persist along racial lines. The
attacks were being disseminated police are more aware of the possi-
far and wide via new visual tech- bility of be­­ing held accountable.
nologies. Just as ­COVID laid bare And a debate over reparations for
the racial disparities, the murder slavery has sprung up—something
of George Floyd unfolded in front hitherto un­­thinkable. More broadly,
of millions of eyes in a way that the intersection of the pandemic,
made racial oppression undeni- police brutality and modern tech-
able. Not only was the structural nology has spurred a very vibrant
racism in American society dis- progressive movement in the
played in all its hideousness, country and the world.
but people were dissecting and How lasting the gains will be
debating it across social media is far from clear. Worryingly, the
in a way that had never been pos- massive social justice movements
sible before. energized countermovements
For social justice movements that are determined to halt any
to erupt, you need a diagnosis of progressive changes to American
the problem. No matter how much society. The political right has

66  Scientific American, March 2022

 CELEBRATING
JUNETEENTH,
a day that
marks the end
of U.S. slavery,
residents of
Richmond, Va.,
gathered on
June 21, 2020,
at a Confeder-
ate monument
that they have
reclaimed. The
memorial now
honors victims
of police brutal-
ity and is called
Marcus-David
Carlos Bernate/Redux Pictures

Peters Circle,
after a man
who was
shot dead by
Richmond
police in 2018.

March 2022, ScientificAmerican.com 67

FAR-RIGHT
PROTESTERS,
including mem-
bers of the
Proud Boys,
a neofascist
group, marched
against COVID
vaccine man-
dates in Man-
hattan last
November.
More than two
dozen Proud
Boys members
have been
in­dict­ed in con-
nection with the
attack on the
U.S. Capitol on
January 6, 2021.

68  Scientific American, March 2022

 gathered new strength, to the
extent that it threatens to set us
back to an era before the Civil
Rights Movement. Among the
great achievements of the CRM
were the 1964 Civil Rights Act and
the 1965 Voting Rights Act. What
is under attack now? It is precisely
the right to vote. Multiple states
now have laws restricting the
rights of what they call “minority
voters,” by which they mean
voters of color.
The recent Kyle Rittenhouse
case, in which a vigilante who
shot white people participating
in largely Black protests was com-
pletely exonerated, is also alarming.
In the 1960s segregationists at­­
tack­ed white participants in the
CRM, de­­scribing them as race trai-
tors. Rittenhouse’s as­­sault has sim-
ilar overtones. Now white people
know that not only can conserva-
tives at­­tack them if they partici-
pate in protests, but the courts
may also side with the attackers.
Going forward, will they be willing
to risk their lives for a cause that
is not directly theirs? And how can
we ignore the insurrection of Jan-
uary 6, 2021, when a predomi-
nantly white armed mob sought
to annul the outcome of the presi-
dential election?
As I see it, a very serious clash
is taking place be­­tween progres-
sive and conservative forces,
be­­tween people who are fighting
for equality and people who are
fighting to maintain the status
quo. It is not clear who will tri-
umph. What is clear is that
America is at its highest level
of polarization in modern history.
I can imagine it must have looked
something like this prior to the
Civil War. We are at a cusp, and
we could fall on either side—into
the chasm of fascism or into a
more hopeful, democratic world.

Aldon Morris is Leon Forrest Professor

Mark Peterson/Redux Pictures

of Sociology and African American Studies

at Northwestern University and a previous
president of the American Sociological
Association. His landmark books include 
The Origins of the Civil Rights Movement ( 1986)
and The Scholar Denied: W.E.B. Du Bois and
the Birth of Modern Sociology ( 2015).

March 2022, ScientificAmerican.com 69

Vaccine
society groups representing scien-
tists, farmers and Indigenous peo-
ples for being at best indifferent,

Inequality Shut and at worst hostile, to their views.

As the Alliance for Food Sover-
eignty in Africa (AFSA), which rep-

Vulnerable resents more than 200 million Af-

rican food producers and others,
observed, the summit had been

People Out structured to give undue influence

over global agricultural systems to
multinational corporations and

of Plans to their allies. As such, the summit

was bound to “echo the busi-

Save the Planet

ness-as-usual, quick-technofix pol-
icy prescriptions of the agribusi-
ness agenda,” AFSA argued. The
boycott, along with an alternative
Those with the most at stake summit that focused on food sov-
were heard the least ereignty, may have fended off what
many observers feared was an at-
By Nnimmo Bassey tempt by global capital to control
the future of agriculture.

F
or decades a global econom- But ­COVID constraints en-
ic system based on the con- sured that civil society was barely
version of nature into profit represented at the U.N. Biodiversi-
has been accelerating inequality, ty Conference last October, where
environmental destruction and delegates from 195 nation-states
climate change. Hundreds of mil- and the European Union met to
lions of people are vulnerable to discuss a plan to protect 30 per-
(seemingly) natural disasters, in- cent of the planet by 2030. Many
cluding pandemics caused by the Indigenous groups, who have am-
emergence of novel pathogens. By ple reason to fear violent eviction
exacerbating xenophobic national- from and dispossession of the eco-
ism and precipitating vaccine systems they protect as nation-­
apartheid, ­COVID-19 has intensi- states use “30 by 30” as an excuse
fied these dangerous trends. to seize their territories, opposed
People from the Global South the plan. But with their partici­
have always been underrepresented pation limited to brief online
at international conferences where appearances, they were unable
road maps for the future are etched. to explain their concerns or pro-
Now the barriers to participation vide their alternative visions for
are prohibitive. With the voices of biodiversity conservation. sands of delegates it represented
those worst impacted by biodiver- Most disastrously impacted by had given up on attending it.
sity loss and climate change being the pandemic was COP26, the It was double trouble for dele-
muffled by ­COVID-related con- 26th Conference of Parties to the gates from nations red-listed for
straints, corporate and other win- U.N. Framework Convention on ­COVID, who had to quarantine in
ners of the neoliberal order are Climate Change, held in Glasgow, hotels for days on arrival in the
seizing decision-making processes Scotland, last October–November. U.K. After passing the hurdles of
on these crucial and urgent issues, Climate activists condemned the obtaining visas and covering ex-
Nnimmo Bassey
to the detriment of people and conference as the most exclusion- pensive travel costs, many negotia-
is director of the
the biosphere. Health of Mother ary COP ever, with delegates fac- tors were excluded from the con-
The one major event since the Earth Foundation, ing severe ­COVID-related restric- ference halls and had to watch the
pandemic began that was not im- based in Nigeria. tions for entering the U.K. and ac- proceedings from screens in their
pacted by ­COVID-related restric- His books include  cessing the venue. The COP26 rooms—which they could just as
To Cook a Continent:
tions was the United Nations Food Coalition, representing grassroots well have done from their home
Destruct­ive Extraction
Systems Summit, held on Septem- and the Climate Crisis activists from around the world, countries. ­COVID protocols re-
ber 23, 2021. That is because it was in Africa ( Pambazuka announced as the conference be- quired some side events to have
shunned by more than 300 civil-­ Press, 2012). gan that two thirds of the thou- only panelists speaking before

70  Scientific American, March 2022 Illustration by Hanna Barczyk

 Oxygen Shortages
Delayed
Rocket Launches
WHEN FLORIDA had a C
­ OVID surge, it caused a
shortage of liquid oxygen for people in intensive
care. Part of the supply chain for liquid oxygen was
moved over to compensate for it, and that impacted
about half a dozen rocket launches. Florida was the
source of the need for oxygen, but it pulled
resources from the entire country.
We [United Launch Alliance] had a planned
launch going off the West Coast, out of Vandenberg
Space Force Base in California. We had seen the
issue starting in Florida, and we stocked up on liquid
oxygen ahead of time.
But we were sur-
prised when we could
not get liquid nitro-
gen. By then all the
trucks that could
move cryogenic liq-
uids, and the people
who could drive them,
had gone to Florida.
It was kind of a
funny opportunity
for SpaceX and us
to almost help each
other. I did not have
any nitrogen on the
West Coast, and they
had a shortage of liq-
uid oxygen on the
East Coast. I think Gwynne Shotwell [president and
chief operating officer of SpaceX] and I had a con-
ference somewhere together, and I said, “Hey, I’ve
got this giant tank of liquid oxygen that was for a
launch several months away. I’d be happy to make
that available to you.” She replied, “Well, I’ve got a
cameras, excluding the possibility those living in sacrifice zones and
bunch of nitrogen out on the West Coast that I
of discussion. And with only two demanding real climate action—
could loan you.” We were arranging to trade this
seats assigned for national dele- keeping fossil fuels in the ground—
material when our respective teams solved the
gates in each negotiating room, of- were shut out. The outcome was a
problems locally, so we ended up not having to
ficials were denied access to need- lot of hot air, which did not even
do it. I was actually a little disappointed because
ed technical backup. include a pledge to phase out coal.
it would have been fun.
All told, the fossil-fuels sector Disproportionately impacting
I doubt we will face a crisis quite that acute
had an outsize influence on a con- those who already suffer the most
again, but it did reveal the weak links in that
ference that should have been and will continue to suffer the
supply chain. We had a shortage of drivers with
about curtailing its damaging ac- most, pandemic-era exclusions
the special training and certification to drive liquid
tivities. There were a whopping mean that multilateral events can
cryogenics around. Now that we understand
503 representatives of fossil-fuel no longer be counted on to solve
that this is a vulnerability, we have more people
companies, more than any nation’s the existential challenges con-
certified than are needed at any time.
delegation, and no participants at fronting the world. Instead ­COVID
all from 11 out of 14 Pacific Island is enabling the entrenchment of Tory Bruno is an aerospace engineer and chief executive officer
states, which are the worst affect- exploitative and false solutions to of United Launch Alliance, one of the world’s largest space
ed by climate change. The voices of impending catastrophes. launch companies.

Illustration by James Olstein

 missed. But some theories came
with a patina of plausibility. Specu-
lation that the SARS-CoV-2 virus
was engineered in the Wuhan Insti-
tute of Virology (WIV) in China was

Conspiracy Theories facilitated by the physical location

of the institute: it is right across the
Yangtze River from the Huanan

Made It Harder
market where many of the earliest
cases of ­COVID were detected. The
Chinese government’s denial that

for Scientists to
markets sold live wild animals also
roused suspicion, even though such
wares were always suspected and

Seek the Truth

have since been confirmed.
The so-called lab-leak hypothe-
sis gained sufficient rhetorical and
political force that President Joe

W
Virus-origin stories have always been prone to disinformation, Biden instructed the U.S. intelli-
gence services to investigate it. Al-
and the “lab-leak hypothesis” threatens research—and lives  though the interagency intelligence
report update, declassified in Octo-
By Stephan Lewandowsky, Peter Jacobs and Stuart Neil ber 2021, dismissed several popular
laboratory-origin claims—including
henever scientific findings that the virus was a bioweapon and
that the Chinese government knew
threaten people’s sense of control about the virus before the pandem-
over their lives, conspiracy theo- ic—it was unable to unequivocally
ries are never far behind. The resolve the origin question.
Does this mean that proponents
emergence of novel viruses is no of the lab-leak hypothesis uncov-
exception. New pathogens have ered a genuine conspiracy that will
always been accompanied by con- be revealed by persistent examina-
tion? Or is the lab-leak rhetoric
spiracy theories about their origin. These claims are rooted in conspiracy theories fue-
often exploited and amplified—and sometimes even led by anxiety over China’s increas-
created—by political actors. In the 1980s the Soviet ing prominence on the world stage
or in preexisting hostility to bio-
KGB mounted a massive disinformation campaign technology and fear over biosecuri-
about AIDS, claimitng that the U.S. when the Zika virus was spreading ty? And what is it about the condi-
Central Intelligence Agency had in 2016 and 2017, social media was tions of the past two years that
created HIV as part of a biological awash in claims that it had been made it so difficult to know?
weapons research program. This designed as a bioweapon.
campaign benefited from a “scien- From the beginning, the genom- ZOONOTIC ORIGINS
tific” article written by two East ic evidence led most virologists The ostensible lab-leak hypothesis
German scientists that ostensibly who were investigating SARS- is not a single identifiable theory
ruled out a natural, African origin CoV-2 to favor a zoonotic origin in- but a loose constellation of diverse
of the virus, an explanation favored volving a jump of the virus from possibilities held together by the
by Western scientists that has since bats to humans, possibly with the common theme that Chinese sci-
been unambiguously established. help of an intermediate host ani- ence institutions—be it the WIV or
In African countries, where many mal. But considering the anxie- some other arm of the Chinese gov-
scientists and politicians consid- ty-provoking upheavals of the pan- ernment—are to blame for the pan-
ered the hypothesis of an African demic, it came as no surprise that demic. At one end is the straightfor-
origin of AIDS to be racist, the dis- the virus inspired conspiratorial ward possibility of WIV lab person-
information campaign fell on fer- thinking. Some of these theories— nel being infected during fieldwork
tile ground. Ultimately the conspir- such as the idea that 5G broadband or while culturing viruses in the lab.
acy theory was picked up by West- rather than a virus causes ­COVID Scientifically, this possibility is chal-
ern media and became firmly or that the pandemic is a hoax—are lenging to disentangle from a zoo-
entrenched in the U.S. Similarly, so absurd that they are easily dis- notic origin that followed other

72  Scientific American, March 2022

 GREATER HORSESHOE BAT (Rhinolophus ferrumequinum). Research
shows a clear zoonotic path between bats and the SARS-CoV-2 virus.
Stephen Dalton/Minden Pictures

March 2022, ScientificAmerican.com 73

 FEAR AND pathways and is therefore difficult ly swapped at a rate that implies fected cell, priming the virus to
BLAME: to rule out or confirm. At the other a vast ecosystem of these viruses is spread to new cells more efficiently.
A table of extreme are the assertions that circulating, most of which have not The RBD and FCS are central to
T-shirts with SARS-CoV-2 was designed and en- been discovered. The area of the ge- initial virological arguments by ex-
antimask slo- gineered by the WIV, perhaps as a nome that is most likely to recom- pert proponents of the lab-leak hy-
gans accompa- bioweapon, and was released either bine is also the area that encodes pothesis. Such arguments are based
nied a protest accidentally or as a biological at- the “spike” proteins—the very pro- on the supposition that neither the
outside the Jet tack. This possibility necessarily en- teins that play a crucial role in initi- RBD nor the FCS “appears natural”
Blue headquar- tails a conspiracy among WIV sci- ating an infection. Many sarbecovi- and therefore that they can only
ters in Queens, entists—and potentially many oth- ruses encode spike proteins that be the product of lab-based engi-
N.Y., on October ers—to first engineer a virus and can bind to a wide range of mam- neering or selection. Nobel laureate
27, 2021. Pro- then cover up its release. Scientific malian cells, suggesting that these David Baltimore, an early propo-
testers were investigation of the genomic and viruses can easily move back and nent of the lab-leak hypothesis,
pushing back phylogenetic evidence c an h
 elp us forth between different species referred to the FCS as a “smoking
against the air- determine whether SARS-CoV-2 of mammals, including humans. gun” that points to a lab origin.
line’s COVID was genetically engineered. SARS-CoV-2 is not as virulent Although an unusual feature
vaccine man- SARS-CoV-2 is a member of a as SARS-CoV-1, but it is transmitted of a virus can legitimately stimu-
date and mask subgenus of the betacoronaviruses far more easily between people. late further inquiry, this argument
policies. The called the sarbecoviruses, named Two of the most prominent features is reminiscent of the creationist
instability cre- after their prototype member, of the SARS-CoV-2 spike are its claim that humans must have been
ated by the pan- SARS-CoV-1, which caused the receptor-binding domain (RBD), “intelligently designed” because we
demic is fertile SARS epidemic in 2002 and 2003. which binds very tightly to human are seemingly too complex to have
ground for con-
The zoonotic origin of SARS-CoV-1 ACE2, the protein that allows it to evolved by natural selection alone.
spiracy theories.
has been firmly established by re- enter lung cells, and the so-called This logic is fundamentally flawed
search that also showed that the furin cleavage site (FCS). This site because complexity does not li-
bat sarbecoviruses pose a clear and divides the spike protein into sub- cense dismissal of the overwhelm-
Mark Peterson/Redux Pictures

present danger of pandemic over- units. The FCS is present in many ing evidence for natural selection
spill from bats to humans. other corona­viruses, but so far and, by itself, does not mandate
One key feature of sarbecovirus- SARS-CoV-2 is the only sarbecovi- any design, intelligent or otherwise.
es is that they undergo extensive rus known to include it. It allows Likewise, labeling the RBD or the
amounts of recombination. Parts the viral spike protein to be cut in FCS “unnatural” does not mandate
of their genomes are being regular- half during its release from an in- lab-based engineering, and, critical-

74  Scientific American, March 2022

ly, it does not license the dismissal more. Baltimore, for instance, with-
of the growing evidence for a zoo- drew his “smoking gun” comment
notic origin. when challenged by additional evi-
Recently, for example, bat colo- dence, conceding that a natural ori-
nies on the border between Laos gin was also possible. Revising or
and China were discovered to carry rejecting failed hypotheses in light
sarbecoviruses that have RBDs al- of refuting evidence is central to
most identical to those of SARS- the scientific process. Not so with
CoV-2 in both sequence and ability conspiracy theories and pseudosci-
to enter human cells. This finding ence. One of their hallmarks is that
refutes the claim that SARS-CoV-2’s they are self-sealing: as more evi-
binding affinity in humans is un- dence against the conspiracy
likely to have a natural origin. emerges, adherents keep the theory
Similarly, although some lab- alive by dismissing contrary evi-
leak proponents contend that the dence as further proof of the con-
lack of an FCS in the closest rela- spiracy, creating an ever more elab-
tives of SARS-CoV-2 is indicative orate and complicated theory.
of its manual insertion in a lab, very There is perhaps no better exam-
recent evidence from SARS-CoV-2 ple of self-sealing cognition than
population sequencing suggests the contortions of climate change
that the insertion of new sequences
from human genes next to the FCS
denial that erupted after the 2009
“Climategate” controversy. At that
Pandemic-Era Research
can be detected. Moreover, the clos-
est relative of the SARS-CoV-2 spike
time thousands of documents and
e-mails were stolen from the Cli-
Paid Off—and Will
in the Laotian bat viruses would re-
quire the addition of only a single
matic Research Unit of the Univer-
sity of East Anglia in England and
for Years
amino acid to generate a putative made public right before the United ­ OVID APPEARED, a huge number of virolo-
AFTER C
FCS. Thus, in a species where it Nations climate conference in Co- gists, biochemists, cell biologists and immunologists
would have a major selective ad- penhagen. The e-mails were cherry- shifted their work to the coronavirus, and because
vantage, it would probably be very picked by deniers for sound bites of that, the world got what it was desperately hop-
easy for some of these bat coronavi- that, when taken out of context, ing for: a vaccine, in record time. Everything worked
ruses to rapidly evolve an FCS. seemed to point to malfeasance by out better than we could have dreamed—several
This research sketches a clear scientists. Ultimately nine indepen- parallel vaccines, all with high efficacy. We are see-
zoonotic path to the emergence dent inquiries around the world ing antiviral treatments roll out, too.
of the RBD and FCS. Although cleared the scientists of misconduct, Scientists can leverage all this effort to better
some evolutionary gaps along this and nine of the warmest years ever understand other viruses and diseases. Never before
path persist, their number and measured have occurred in the have we been able to simultaneously test multiple
size have been dwindling. A de- 11 years since Climategate. vaccine platforms, head-to-head, in massive global
tailed analysis in late 2021 further Undeterred by the exonerations, clinical trials. Usually you are lucky if you get one
strengthened the link to the Huan- climate deniers—including at least vaccine to trial, and if it fails, you will not really know
an markets as the point of origin one U.S. congressperson—branded whether the concept or just the one platform failed.
of the virus and the initial source the inquiries as a “whitewash.” The I anticipate that scientists will use all the C ­ OVID
of community transmission. This volume of activity on skeptics’ Web research infrastructure to build more vaccines
rapidly growing body of evidence sites relating to the hacked e-mails against other pathogens, such as cytomegalovirus
for a zoonotic origin of SARS-CoV-2 continued to increase for at least and respiratory syncytial virus, and to create mRNA
creates increasing difficulties for four years, long after the public had vaccines for flu. Furthermore, most of the coronavi-
the lab-engineering hypothesis. lost all interest in the confected rus research has been collaborative. That will stick
scandal. It was only in late 2021 with people. It will make future work pay off more
CONSPIRATORIAL that one of the principals making than if all those individuals went back to just their
COGNITION unfounded accusations against the own niches.
In normal scientific inquiry, a s evi- scientists apologized for his role. This is not going to be the last spillover pandemic
dence emerges, the remaining space The e-mails were publicly mis- we see. It is not going to be the last public health cri-
for plausible hypotheses narrows. represented as a result of an un- sis. I hope that C­ OVID has given the public a sense
Some facets continue to be support- solved hack, but top scientists and of how important it is to have sustained investment
ed, and others are contradicted and health officials also have seen their in science. We don’t know what discovery we will
eventually precluded altogether. correspondence become public stumble on that will be the lifesaver the next time.
Some of the strongest advocates through Freedom of Information
for a lab origin for SARS-CoV-2 Act (FOIA) requests by groups with Britt Glaunsinger is a molecular virologist at the University of
changed their views as they learned long histories of attacking scien- California, Berkeley, and the Howard Hughes Medical Institute.

Illustration by James Olstein

 tists. The anti-GMO organization lection of bat swab samples. RaTG13 mune to further evidence. Just as
U.S. Right to Know honed its FOIA is more than 96 percent identical there are effectively unlimited
tactics against food scientists be- to SARS-CoV-2. It is likely that this “gaps” between transitional fossils
fore turning its sights on virolo- virus genome was sequenced from that are exploited by creationists,
gists. Despite e-mails clearly show- a swab taken in 2013 from bats in so, too, are there effectively unlim-
ing virologists considering but ulti- an abandoned mine shaft in Moji- ited potential natural viruses from
mately rejecting various claims ang, a county in China’s Yunnan which SARS-CoV-2 must have been
about SARS-CoV-2 being engi- province. RaTG13’s centrality to engineered that have been kept
neered, lab-leak proponents tend many lab-leak claims stemmed hidden by the WIV. Or else unnatu-
to selectively quote messages. They from its putative role as the “back- ral viruses the WIV might have
cast virologists as either never hav- bone” from which SARS-CoV-2 engineered to make SARS-CoV-2’s
ing given lab scenarios fair consid- was allegedly engineered. features seem naturally evolved.
eration or—on the other extreme— Being closely related to SARS- More and more relatives and
believing in a lab origin all along CoV-2 and being present in the lab antecedents of SARS-CoV-2 are
and deliberately lying about it. Peo- at the WIV made RaTG13 a perfect bound to be discovered, and adher-
ple who push conspiracy theories candidate for a precursor that was ents of the lab-leak hypothesis will
often toggle between opposing engineered into SARS-CoV-2. In the face a stark choice. They can aban-
claims as the rhetorical need arises. short time since the pandemic took don, or at least qualify, their belief
Another e-mail-centered theory hold, however, several related virus- in genetic engineering, or they
turned on the idea that the WIV es have been discovered that are must generate an ever increasing
had originally housed viruses close- closer in sequence to SARS-CoV-2 number of claims that these rela-
ly related to SARS-CoV-2, presum- over much of the genome. More- tives and antecedents, too, have
ably including the natural virus over, despite being related to SARS- been fabricated or engineered. It is
from which it had been engineered. CoV-2, RaTG13 has been found to likely that at least some people will
The theory further held that the occupy a separate phylogenetic follow the latter path of motivated
WIV suspiciously delayed publica- branch. SARS-CoV-2 is not descend- reasoning, insisting that secretive
tion of a paper that had been sub- ed from RaTG13; rather the viruses Chinese machinations or an unnat-
mitted in October 2019 until 2020. share a common ancestor from ural manipulation of biology is
Stephan
Lewandowsky At some point after the paper’s sub- which they diverged an estimated responsible for the virus’s origin.
is a professor mission with the “true” sequences, 40 to 70 years ago, meaning it could Motivated reasoning based on
of cognitive science the argument went, the WIV halted not have served as a backbone for blaming an “other” is a powerful
at the University its publication and altered the se- an engineered SARS-CoV-2. force against scientific evidence.
of Bristol in England. quence information in furtherance Rather than accepting this con- Some politicians—most notably
His research focuses
on disinformation of the cover-up. trary evidence, some lab-leak advo- former President Donald Trump
and people’s attitudes Another FOIA effort was mar- cates resorted to self-sealing rea- and his entourage—still push the
toward science. shaled to reveal the discrepancy soning that deviates from standard lab-leak hypothesis and blame Chi-
between the “real” sequences sub- scientific practice: They began to na in broad daylight. When Trump
Peter Jacobs
is a climate scientist mitted to the journal and those argue that RaTG13 was not a natu- baldly pointed the finger at China
and a strategic that were pawned off on the unsus- ral virus itself but rather had been in the earliest days of the pandemic,
science adviser pecting public. Unfortunately for edited or in some way fabricated unfortunate consequences fol-
in the Office of this conspiracy claim, the FOIA re- in an effort to hide the “true” back- lowed. The proliferation of xeno-
Communications at
sults revealed that the submitted bone of SARS-CoV-2 and thus its phobic rhetoric has been linked
the nasa Goddard
Space Flight Center. paper’s sequences were exactly engineered nature. The virus from to a striking increase in anti-Asian
The views expressed what the scientists publicly said Laos showing that SARS-CoV-2’s hate crimes. It has also led to a vili-
are his own and they were. The self-sealing nature RBD and the efficiency of its bind- fication of the WIV and some of its
do not necessarily of conspiratorial reasoning being ing to human receptors are not Western collaborators, as well as
represent those what it is, however, some propo- unique—providing strong support partisan attempts to defund certain
of nasa or the
United States.
nents of the lab-leak hypothesis for a zoonotic origin—is thus rein- types of research (such as “gain of
remain undeterred and believe the terpreted to mean that the WIV function” research) that are linked
Stuart Neil is a “real” sequences must exist in some obtained and used a similar but so with the presumed engineering
professor of virology
as yet undocumented draft created far secret virus from Laos to design of SARS-CoV-2. There are legiti-
and head of the
department of before the submitted version. SARS-CoV-2. This ad hoc hypothe- mate arguments about the regula-
infectious disease at The self-sealing dynamic can sis is accompanied by the expecta- tion, acceptability and safety of do-
King’s College London. produce even more elaborate epi- tion that the burden is on the WIV ing gain-of-function research with
His research group cycles to resist falsification. Until to prove it did not have that secret pathogens. But conflating these
studies the interaction
earlier this year, the closest known virus—a reversal of the expected concerns with the fevered discus-
between the human
immune system and relative of SARS-CoV-2 was a virus burden of proof that runs counter sion of the origins of SARS-CoV-2
pathogenic viruses, called RaTG13, which is known to to conventional scientific reasoning. is unhelpful. These examples show
including SARS-CoV-2. have been held by the WIV in a col- Such pivots are potentially im- how a relatively narrow conspiracy

76  Scientific American, March 2022

 theory can expand to endanger en- tirely unsurprising: It took 10 years out from conspiratorial rhetoric. IN THE LAB:
tire groups of people and categories to pin down the zoonotic source of Lessons from climate science  he Wuhan Insti-
T
of scientific research—jeopardizing SARS-CoV-1. The Zaire Ebola virus show that failure to demarcate con- tute of Virology
both lives and lifesaving science. has never been isolated from bats, spiratorial reasoning from scientif- in China, shown
despite strong serological evidence ic investigation results in public here in a 2017
A LONG TAIL that they are the likely reservoir. confusion, insufficient action from photograph, has
Scientists no longer debate t he Plausible routes for a lab origin leadership, and the harassment of been a leader
fact that greenhouse gas emissions do e xist—but they differ from the scientists. It even has the potential in infectious dis-
from the burning of fossil fuels are engineering-based hypotheses that to impact research itself, as scien- ease research
changing Earth’s climate. Although most lab-leak rhetoric relies on. tists are diverted into knocking for many years.
this scientific consensus on climate The lab in Wuhan could be a relay back incorrect claims and, in the Some scientists
change was established 20 years point in a zoonotic chain in which process, potentially ceding them identified with
ago, it has never stopped influen- a worker became infected while more legitimacy than warranted. COVID research
tial politicians from calling climate sampling in the field or being acci- We must anticipate that this have been
change a hoax. Climate denial is dentally contaminated during an type of dangerous distraction will harassed by
a well-organized disinformation attempt to isolate the virus from continue. Scientists identified proponents
campaign to confuse the public a sample. Evidence for these possi- with ­COVID research are suffering of SARS-
CoV-2 conspir-
in pursuit of a clear policy goal— bilities may yet emerge and repre- abuse, including death threats.
acy theories.
namely, to delay climate mitigation. sents a legitimate line of inquiry When the Omicron variant emerged,
The markers of conspiratorial that proponents of a natural origin so did nonsensical conspiracy
cognition are universal, whether and lab-leak theorists should be theories that it, too, was an escaped,
the subject is climate denial, anti- able to agree on. But support for human-altered virus, originating
vaccination propaganda or conspir- those claims will not be found in from the lab in South Africa that
Feature China/Barcroft Media via Getty Images

acies surrounding the origin of self-sealing reasoning, quote min- first reported it. One can only
SARS-CoV-2. It is critical to help ing of ­e-mails or baseless sugges- assume that further variants may
the media and the public identify tions. Ironically the xenophobic likewise be blamed on whichever
those markers. Unlike the over- instrumentalization of the lab-leak research lab is closest to the loca-
whelming evidence for climate hypothesis may have made it hard- tion of discovery. We are not
change, however, a zoonotic origin er for reasonable scientific voices doomed to keep repeating the mis-
of SARS-CoV-2 is likely but not yet to suggest and explore theories takes of past intersections of sci-
conclusive. This is not a sign of ne- because so much time and effort ence and conspiracy should we
farious activity and is, in fact, en- has gone into containing the fall- choose to learn from them instead.

March 2022, ScientificAmerican.com 77

FINDING HAPPINESS in the after times.

78  Scientific American, March 2022 Photograph by Peter Turnley

COVID Is
Here to Stay
How do we live with it?
By Christine Crudo Blackburn

C
OVID-19 will continue in pandemic form, surging in one or more
regions and disrupting daily life, until the world reaches herd
immunity. With that, most scientists say, the SARS-CoV-2 virus
will become endemic—always present but transmitted among people
at modest, predictable rates. After several years the infamous 1918 influ­
enza pandemic made that transition, and the virus is still circulating,
104 years later, in mutated strains. Almost all influenza A infections
since 1918 have descended from that strain.
As the endemic stage arrives, people of all ages will be eligible for the
COVID vaccine, and hospitals and pharmacies will be well supplied with
effective treatments for infection. At that point, it might be wise for pub-
lic health officials to treat COVID as a respiratory disease that is more
dangerous than a cold, similar to how we handle influenza and cytomeg-
alovirus (CMV)—by evaluating distribution of a seasonal vaccine, track-
ing hospitalization rates and educating the public about current risk. We
don’t yet know if COVID will lead to higher rates of long-term complica-
tions than those diseases do, so other precautions may be necessary.
In this future, routine testing might become part of everyday life.
People with imperceptible symptoms who test positive would know to
wear masks and isolate from others. If we could develop similar tests for
influenza and CMV and make them cheaply available to everyone, every-
where, society could end up even safer against infectious respiratory
diseases than it was before COVID arrived.
Even if COVID cases declined significantly, it’s unlikely the virus
would burn out. As long as it was still spreading in animals, it could
spill over into humans at another time. Nature is always surprising us.
A future, reemergent SARS-CoV-2 could be either less or more transmis-
sible, less or more lethal. The Omicron variant that spread this winter
taught us to expect the unexpected. Our world still has much to do to
become better prepared for new variants—as well as whatever novel
virus emerges next.

Christine Crudo Blackburn is an assistant professor of security studies at Sam Houston
State University.

March 2022, ScientificAmerican.com 79

RECOMMENDED
Edited by Amy Brady

NONFIC TION tive, complexity and beauty emerge from

Tending Our
the interacting voices of Earth and its
creatures. Here, in the bittern’s croak,
in the turtle’s cluck and whine, in Miles

Musical Planet ­Davis’s trumpet, is “evolution drunk on its

own aesthetic energies.” Music returns us
to direct experience—a time before lan-
What do we lose when the diversity of Earth’s noise guage, before tools, before humans began
is drowned out by humans? to imagine themselves as separate from
Earth’s community and outside its limits.
By Kathleen Dean Moore We are enticed by beauty to listen to the
sounds that remind us of our membership
In the beginning was silence. The big pitches higher than those of their country in the intricate, interactive orchestras.
bang made not a whimper, let alone a cousins, choosing frequencies less masked As the book develops, it becomes
bang. That is because the universe was by the city’s dull roar. Humans’ teeth, clear that all this sonic science is not
born in a sea of nothingness without the which once met in a predator’s vise, slid merely reporting. It is bearing witness
space and time where sound can exist. into an overbite as people turned to the to a terrible moral and ecological crisis.
In the end, the universe will be reduced softer foods that agriculture provided, With lives powered by sequential explo-
again to silence, either collapsed into a shaping sounds such as “farm,” “vivid,” sions of gas and oil, humans make deafen-
singularity or expanded into cold, flat uni- “fulvous” and “favorite.” We hear Earth’s ing noise. In our industrial empires, we
formity. But now, suspended between the Sounds Wild sounds with ears that evolved from repur- are constantly assaulted by whirring tires,
beginning and the end, Earth sings and and Broken: posed fish gill bone, sometimes in theaters booming woofers, pounding engines and
rings and warbles: a musical planet, Sonic Marvels, designed to match the acoustic properties “a smeared canopy of airline noise.” The
maybe the only one in the universe. As Evolution’s of forests. But why don’t worms sing? burden of noise pollution in cities is un-
David George Haskell tells it in his capti- Creativity, “Predation is a powerful silencer,” Haskell justly distributed, reinforcing race, class
vating new book, S ounds Wild and Broken, and the Crisis explains. “Animals whose lives are seden- and gender inequities. The cacophonies
it is astonishing good fortune—and a fear- of Sensory tary or slow and whose bodies lack weap- indirectly and directly harm animals, of
some responsibility—to be given this Extinction onry are voiceless.” course, interfering with their reproductive
music and the ears to hear it with. by David Earth’s musical variety show testifies patterns, reducing their habitats, frag-
At first stone, water, lightning and George Haskell. to the boundless creativity of evolution. menting their communities and some-
wind sang alone. After 3.5 billion years Viking, 2022 ($29) As with improvisational jazz, order, narra- times killing them outright. Haskell cites
came the tremolo of cilia on the earliest the U.S. Navy’s high-intensity sonar
cells. Eventually insects joined the swell- blasts, which panic whales: “Sound bleeds
ing chorus, with “rasping mouthparts, them to death from within.”
wheezing air tubes, drumming abdomens, Reckless human enterprise is killing
and wings shaped to crackle and snap as Earth’s wild songmakers at alarming
they fly.” Lacking a syrinx, dinosaurs could rates, using poisons, bulldozers, forest-
not exactly sing, but they still shook the clearing fires and industrial-scale pillage
Cretaceous forests with rubbing scales, of prey species. Readers who are at least
snapping jaws, whip-cracking tails and 50 years old live in a world that is less
a sound like the “strangled belch of ruddy than half as song-graced as when they
ducks.” The asteroid that brought that ca- were born. In that half a century, a third
cophony to a cataclysmic end made room of North American songbirds have disap-
for the expansion of fluting birds. “In bird- peared. Ninety percent of large fish are
song,” Haskell writes, “we hear the evolu- gone. Sixty percent of bellowing, squeak-
tionary legacy of renewal after great loss.” ing mammals are extinct. All lost, in our
And what a renewal it was: roaring lifetimes, on our watch.
whales, bellowing elephants, tootling What do we lose when we lose their
children and moaning freight trains. The songs? Listening to the song stories of
whole Earth shimmered with sound. other species can make us better mem-
The science stories in Sounds Wild and bers of life’s community, Haskell argues.
Broken offer one delight after another. They signal interdependence and resil-
What a joy to know that elephants can ience, deep kinship, shared beginnings
“hear” with special sensory pads on their and likely a shared fate. So they are the
feet, picking up the rumbling voices in the “foundations not only of delight,” he
ground, and that birds in cities sing at writes, “but of wise ethical discernment.”

80  Scientific American, March 2022 Illustration by London Ladd

 NONFIC TION

Secrets of
Bird Scent
A delightfully mean-
dering account of
a scientist’s curiosities
By Ryan Mandelbaum

Vultures and albatrosses fi nd food using

scent cues. Scent influences the mating
behaviors of dark-eyed juncos. But when a
scientist offhandedly told Danielle J. Whit- expects them to, at times making her worn T-shirts. Most of these experiments,
taker that “birds can’t smell,” she discov- question everything she already knows. in Whittaker’s view, have yielded as many
ered that most ornithology textbooks rarely After all, the study of avian olfaction questions as answers.
mention avian olfaction and that this mis- is not straightforward. Birds daily cover Though not a birder herself, Whittaker
conception was a common one. The real- their feathers in a substance called preen presents a new lens for bird lovers to view
ization changed the course of her life. oil taken from a gland at the base of their common species, and she had me wonder-
Unexpected changes are a regular tail. This oil contains odorous compounds— ing what some of my favorite birds smell
occurrence for Whittaker, who has The Secret in the case of the dark-eyed junco, it like. But the book’s greatest success is
“never been particularly good at long- Perfume smells like leaf litter and soil. Studying how it depicts the reality of doing science.
term planning.” In T he Secret Perfume of Birds: how this odor arises and its purpose in Experiments are difficult and do not always
of Birds, W
 hittaker humorously recounts Uncovering bird behavior combines the chemistry return clean answers. Scientists carry
her own journey from office worker to the Science of smelly compounds, the biology of bac- biases that can influence their results; for
primatology Ph.D. student to postdoc of Avian Scent teria and even the genetics of human im- example, focusing on the stereotypically
studying bird behavior to Roller-Derby- by Danielle J. mune systems. In turn, scientists study flashier male birds instead of the females
ing managing director of a National Sci- Whittaker. this topic with a funhouse of experiments can lead researchers to overlook impor-
ence Foundation Science and Technology Johns Hopkins that involve capturing juncos in the Appa- tant details. It takes a diverse group of per-
Center. One constant throughout the University Press, lachians, sequencing DNA and surveying spectives—and the humility to reconsider
book is that things rarely happen as she 2022 ($27.95) human women after they smell men’s our biases—to truly understand our world.

I N B R I E F 

Animal Revolution Journey of the Mind:  The Kaiju Preservation Society

by Ron Broglio. How Thinking Emerged from Chaos by John Scalzi. Tor, 2022 ($26.99)
University of Minnesota Press, 2022 ($88) by Ogi Ogas and Sai Gaddam.
W. W. Norton, 2022 ($30) John Scalzi’s stand-alone adventure
In a chapter appropriately entitled novel is a fun throwback to Michael
“Manifesto,” English professor Ron Questions o f consciousness often Crichton’s 1990s sci-fi thrillers. When
Broglio begins his book of speculative veer into philosophical territory the first COVID wave hits New York
nonfiction by proclaiming that the that cannot be resolved, let alone City, a food-delivery driver named
animal revolution, while it “will not be approached by science. Journey of Jamie Gray joins a team of scientists at a secret facil-
televised, mediated, or co-opted by our representa- the Mind is a more unusual take. The ity in Greenland, where they travel to an alternative
tion systems,” is nonetheless afoot. The following co-authors’ backgrounds in computational neuro- version of Earth populated by mountain-sized crea-
chapters present a compelling argument that pairs science and machine learning inform their premise tures called Kaiju, like those familiar from Japanese
“untold incidents of animals in revolt” with theoreti- that behaviors can be broken down into modules films. But other people with less scientific goals have
cal frameworks that reveal their revolutionary of sensors and doers in the same way proteins are found their way there as well. In an author’s note,
mwalker973/Getty Images

power: Kantian subjectivism explicates the hordes made of peptides and amino acids. The stars of the Scal­­zi describes the book as a “pop song,” and he’s
of jellyfish that choke nuclear reactors, Derridean book are its illustrated diagrams of minds, begin- right—there are no cerebral messages about animal
radical hospitality unpacks the sheep that com- ning with “Archie” the haloarcheon and progressing rights or nuclear proliferation. Written with the brisk
mando roll over cattle grates. Broglio calls for all to “Captain Buzz” the fruit fly and eventually to pace of a screenplay, it’s as quippy as a Marvel movie
comrades to join the revolution.  —Dana Dunham frogs, monkeys and humans.  —Maggie Brenner and as awe-inspiring as Jurassic Park. —
 Adam Morgan

March 2022, ScientificAmerican.com  81

OBSERVATORY Naomi Oreskes i s a professor of the history of science
K E E PIN G A N E Y E O N S C IE N C E
at Harvard University. She is author of Why Trust Science?
(Princeton University Press, 2019) and co-author
of D
 iscerning Experts (University of Chicago, 2019).

Healthy that a claim stems from outdated and poorly applied evidence.
The latter is what happened with a famous and specious claim

Skepticism about female fertility.

For decades women have heard distressing warnings about
their “biological clocks.” We have been repeatedly told that fer-
Popular notions, such as a woman’s tility drops dramatically after age 30, so people who want chil-
fertility dropping at age 30, are overblown dren either need to get moving or else freeze their eggs. Embryo
freezing is now a big business, and discussions of it are common-
By Naomi Oreskes
place among young professional women. Pregnancy, and age-
Why do fitness device makers c laim you need to take 10,000 linked anxiety about it, also occurs among transgender and non-
steps every day? Do you also really need to drink eight glasses binary people.
of water daily? The scientific basis for popular health claims is But, as Jean  M. Twenge reported in 2013 in the Atlantic, t he
often thin. A piece in the New York Times, f or example, notes claim is based on very sparse data, much of them of dubious qual-
that the idea of 10,000 steps was based more on marketing—it ity or relevance. The notion stems largely from a 2004 paper based
was the name of an early pedometer—than science. Data point on records from 1670 through 1830. Many things have changed
to clear benefits from moderate exercise—perhaps 7,000 steps since then, including medical care and nutrition. In wealthier
or so but not necessarily more. nations, people are now healthier overall and likely to be more fer-
Often popular wisdom turns out to be only sort of true. The tile for longer periods of their lives. Systematic data collected by
emphasis on so many steps is one instance. Glasses of water is the National Center for Health Statistics demonstrate that from
another. If you let yourself get too thirsty, you may be tempted to 1980 to 2002 fertility rates for women aged 30 and older were going
reach for sodas or sugary coffee drinks, and that’s not good. But up. It is also worth noting that when infertility treatments started
a scientific review in 2002 found “no scientific studies” that sup- to become more common and more clinics began opening in the
port the eight-glass claim for healthy adults in a temperate cli- 1980s and 1990s, alarms over biological clocks were being sound-
mate. That doesn’t mean it’s wrong, but it does mean we proba- ed by this growing industry with a self-interest in the matter.
bly shouldn’t worry if we drink only six. Despite the importance of childbearing to so many people—
It’s worthwhile to dig a bit into often heard health maxims and although infertility treatments are costly, have only modest
before accepting them literally. You can sometimes find a nugget success rates and are not risk-free—the sad fact is that robust stud-
of truth that has become seriously exaggerated, or you discover ies of age-dependent infertility are scant. The data we do have
tend to show that although fertility does decline slightly at older
ages, most women continue to be fertile well into their 30s, and
for many people that is a good time to have children. There’s a
long-standing cultural tendency to blame infertility on women,
but when a couple is infertile it is equally likely that the cause can
be traced to the man. Male infertility also declines with age, but
how often do you hear warnings about the male biological clock?
Like the female clock or the 10,000 steps, many health beliefs
have shallow and flimsy roots. But sometimes the wisdom of the
crowd is supported by facts: most of us do need around eight
hours of sleep a night, for instance. So where does this leave some-
one trying to make sense of what they hear or read?
Well, for one thing, people should be skeptical of any large
claim based on one study. Good science requires building a mul-
tifaceted and detailed case, which takes time and is almost nev-
er achieved in a single piece of research. The online medical
library PubMed.gov enables people to find out if a subject is well
studied or not. And the National Institutes of Health has a med-
ical consensus program that has published more than 160 state-
ments on various diseases and their treatments. Some of them
are actually readable, and none relies solely on data from more
than a century ago. 

J O I N T H E C O N V E R S AT I O N O N L I N E
Visit Scientific American on Facebook and Twitter
or send a letter to the editor: [email protected]

82  Scientific American, March 2022 Illustration by Jay Bendt

 S cienti f ic A m erican O N L I N E
FIND ORIGINAL ARTICLES AND IMAGES
50, 100 & 150 YEARS AGO
IN THE Scientific American ARCHIVES AT IN N OVATI O N A N D D I S C OV E RY A S C H R O NI C L E D IN S c ientific A meric an
scientificamerican.com/magazine/sa Compiled by Mark Fischetti

M ar c h

1972 Surprise:
Mars Volcano
“Mars continues to surprise the
of Walter J. Kilner, electrical expert
of St. Thomas’ Hospital, London,
as given in his book, The Human
past summer seem to indicate that
a delicious drink can be produced.
The tea as now being concocted in
investigators associated with Mar- Atmosphere, should at once set the bureau’s laboratory is of two
iner 9, which has been in orbit aside any belief that this is a colors, one being dark and the
around the planet since Novem- byproduct of occultism or charla- other of a greenish hue.”
ber 13. Perhaps the most spectacu- tanism. Professor Kilner says,
lar feature is a volcanic cone at
least 300 miles in diameter at the
base, making it larger than any
1972 “Although at present it is impossi-
ble to say exactly of what the aura
consists, I feel positive that we
1872 Is Dead
Lead Head

“With but few exceptions, all the

comparable feature on the earth. are dealing with an ultra-violet concoctions sold for the purpose
Close-ups of the sides of the vol- phenomenon. The physical aura of ‘restoring’ the color of the hair,
cano show a lineated texture [also] can be influenced by exter- or for dyeing the hair, contain the
almost certainly produced by the nal forces such as electricity and salts of lead, a deadly poison, highly
flow of lava. The volcano coincides chemical action.” injurious to the health when
with a circular feature identified applied to the scalp or other por-
on maps since 1879 as Nix Olym- 1922 Holly Tea tions of the body, even in minute
pica. In pictures returned by Mari- “A species of holly, growing riot- quantities. Professor Charles F.
ner 6 and Mariner 7 it appeared to ously over 40,000 square miles in Chandler of Columbia College has
be a giant crater about 300 miles the South Atlantic and Gulf States, examined a variety of these prepa-
in diameter; now it is seen to be may in the not remote future be rations and, in each fluid ounce of
a cone at least four miles high.” converted into a beverage in quan- many popular articles, finds lead.”
tity production. George F. Mitchell,
Computer Logic tea specialist of the Bureau of Nature Enchants
“In a major effort to build a com- Chemistry, has correctly appraised “Everything in nature indulges
puter that is easier to work with, 1872 the value of this native plant, in amusement of some kind. The
the Fairchild Camera and Instru- sometimes called cassina, as a lightnings play, the winds whistle,
ment Corporation has designed stimulating drink similar to the thunders roll, the snow flies,
a new computer system in which imported teas and coffees. This the rills and cascades sing and
a large fraction of the program- shrubbery has wide appeal for dec- dance, the waves leap, the fields
ming tasks normally assigned to orative purposes and as Christmas smile, the vines creep and run, the
software are handled by hardware, trees during the festive season. buds shoot, and the hills have tops
that is, by logic incorporated Samples of the leaves analyzed by to play with. But some of them
directly into the computer. Fair- chemists evidenced as high as 1.65 have their seasons of melancholy.
child calls the new system ­SYMBOL, percent of caffeine. Laboratory The tempests moan, the zephyrs
which signifies direct hardware experiments and reinforced obser- sigh, the brooks murmur, and
symbolic addressing. The system vations in the South during the the mountains look blue.”
will handle many critical areas
of memory management from
10 to 100 times more efficiently
than it is now handled by software.
The first prototype of the new 1972: “Paleo-
lithic portraits
Fairchild system, ­SYMBOL IIR,
of bears include
is undergoing tests at Iowa the engraved
State University.” image of a cave
bear, character-

1922 Is Ultraviolet
Human Aura
S cientific American, Vol. 226, No. 3; March 1972

ized by its
domed fore­head.
“Each person is enveloped by a The 20-inch-
haze invisible under ordinary cir- long likeness is
one of the many
cumstances. This halo, shown in
Ice Age animal
old pictures, has for a long time images at
been manifest to certain ‘clairvoy- La Combarelle,
ants’ possessing a specially gifted near Les Eyzies
sight. The unquestionable evi­­dence in France.”

March 2022, ScientificAmerican.com  83

 GRAPHIC SCIENCE
Text and Graphic by Katie Peek

The Old Guard First Generation Second Generation Third and Fourth Generations
In March the mon­ The spring eggs In late May and early In late summer the last generations
archs that wintered in gestate for a month June the second gen­er­a­ emerge in the northern part of the

The Great Mexico move north. In

northern Mexico and
the southern U.S., they
or so. By late April
first-generation
monarchs emerge
tion hatches. The South
will soon be too hot for
monarchs, so those
monarch range. These are the butter­
flies that will make the trek south
again, starting in September. They

Monarch lay the eggs that will

be the first generation
of the next life cycle.
and begin to fly
north, laying eggs
as they go.
born there move north.
Their objective:
make more butterflies.
will spend November through March
in the mountains of Michoacán,
then begin the cycle anew.

Odyssey
Citizen science data March April May June July
reveal where and when 1–15 16–31 1–15 16–30 1–15 16–31 1–15 16–30 1–15 16–31
Latitude
the famously itinerant

2,266

4,482

5,229

4,164

4,031

9,218

11,893 observations
7,776

5,524

9,050
60°
butterflies travel
It’s spring, and monarchs are on the HOW TO READ
move. Every year the butterflies leave THIS GRAPHIC
their dense winter clusters near Mexi- Each shape represents
sightings of eastern
co City and head for northern latitudes. Edmonton, monarchs—eggs,
It will take four months and three gen- Alta. larvae and adult
erations to get there. Once they arrive, butter ­flies—logged
the butterflies will get busy boosting Calgary, Alta. in the Journey North
their company enough to survive next Winnipeg, database between 50°
Man. 2012 and 2021 (more
year’s winter. It’s a Si­syphean task—
Thunder than 66,000 data
eastern monarch numbers have dropped Bay, Ont. points). For each shape,
80 percent in the past 20 years because Quebec City width represents the
of habitat degradation (in­­clud­ing few- number of sightings
Montreal during that half
er flowers)—throughout their range,
Minneapolis month, corrected by
says Iman Momeni-De­hag­hi, a biologist
Toronto the human population
at Carleton University in Ottawa. Enter
at that latitude.
citizen scientists, who have been build-
Chicago
ing databases such as Journey North,
New York
which Momeni-Dehaghi re­­cent­ly used 40°
to identify where the overwintering Washington
generation hatches. The data could help St. Louis
re­­search­ers devise more targeted in­­­ter­

Population Data from Columbia University’s Socioeconomic Data and Applications Center (SEDAC)
ventions for a species Nashville
in rapid decline.

S ources: M onarch Sightings from Journey North Citizen Science Data (journeynorth.org);
Area Included Atlanta
Monarchs from wintering Dallas
grounds in Mexico (orange star)
spread through North America east
of the Rockies. Florida is excluded because
its monarchs over­winter Houston 30°
there rather than
in Mexico. Corpus
Christi, Tex.
60°
45° Monterrey, N.L.

30°

15°
Monarch
wintering
grounds 20°
Mexico City

84  Scientific American, March 2022