Thursday, March 31, 2022

The Morning: Dollars and knowledge

The U.S. may soon run out of Covid money.

Good morning. The U.S. may soon run out of Covid money. But that's not the only problem.

A vaccination clinic in Hagerstown, Md.Kenny Holston for The New York Times

Dollars and knowledge

The short-term and long-term flaws with the country's current Covid-19 policy are quite different.

In the short term, the main problem is a lack of demand for Covid vaccines and treatments: Not enough people are trying to get them. In the longer term — by the second half of this year — the bigger problem may end up being a lack of supply, especially if cases surge again.

I think this distinction has gotten lost in some of the public discussion. Yesterday, President Biden called for additional Covid funding, after Congress had left out such money from its most recent spending bill because of a disagreement over how to pay for it.

"We need to secure additional supply now," Biden said in a brief speech, shortly before receiving his second booster shot onstage. "We can't wait until we find ourselves in the midst of another surge to act. It'll be too late."

Biden is right that the lack of funding creates problems. To ensure an adequate supply of vaccines and treatments later this year, the government probably needs to take action soon. Democrats and Republicans have been negotiating over a possible deal this week.

But the potential funding shortfall is nowhere near the entire problem. A lack of money is not preventing many Americans from getting vaccinated or getting valuable treatments right now. Even if Congress does pass more Covid funding, the country will still face a problem that is more about information and persuasion than dollars.

Shots in arms

For months, the United States has been awash in Covid vaccine shots, and many Americans would benefit from getting one. About one-quarter of adults remain unvaccinated, while roughly another quarter are vaccinated but not boosted, according to the Kaiser Family Foundation. A booster shot sharply reduces the chances of severe Covid illness, especially for vulnerable people like the elderly and immunocompromised.

I know that last point may sound counterintuitive. The elderly and immunocompromised, even if boosted, face a higher risk of severe illness than a healthy, younger person. But a booster shot still reduces the risk more for a vulnerable person than for an average person. It's a common dynamic in medicine: Treatments tend to be most valuable for the most vulnerable even if they do not eliminate risk.

Despite the huge value of additional vaccine shots, many Americans simply aren't getting one. The number of shots given per day, including both initial doses and boosters, has fallen to the lowest level since the beginning of the mass vaccination campaign, in early 2021.

Source: Centers for Disease Control and Prevention

What might help?

Employer and customer mandates would probably nudge more people to get initial shots. Previous employer mandates have generally caused more people to get vaccinated and only a tiny share to quit or be fired. But mandates have fallen out of fashion. Even some politically liberal places, like New York City and Washington, D.C., have been dropping theirs recently.

Boosting more people seems as if it should be more feasible, because it involves people who have already received a shot. Still, boosters are lagging. Many Americans seem confused about how much a booster shot matters.

The scientific evidence suggests that everybody who is eligible should get a first booster shot. A second booster shot — now available to people 50 and older, among others — may also make sense, although the benefits appear smaller. And if you are boosted and have already had Omicron, you probably don't need another booster yet, Dr. Eric Topol of Scripps Research notes (as part of his helpful overview of the evidence).

Treatments

The story is similar with both Evusheld (a drug that appears to boost immunity among the immunocompromised) and post-infection treatments that reduce the chance of severe illness. They are widely available, yet many people remain unaware of them.

Many doctors also seem uncertain how and when to prescribe them. "Doctors are beginning to use this," a Biden administration official told me, "but it takes a while for things to get absorbed in medical practice."

Biden yesterday announced a new federal website — Covid.gov — where people can search for pharmacies near them that have both Evusheld and the treatments. I found most parts of it simple to use. But I also thought that Rob Relyea, a Microsoft engineer who has become an advocate for the immunocompromised, made a good critique on Twitter: The Evusheld information is too hard to find.

The bottom line is that Americans would benefit from hearing a series of clear, repeated messages:

  • Getting a booster shot may save your life.
  • Many immunocompromised people would probably be helped by Evusheld, and it's available.
  • Vulnerable people — like the elderly — should talk with a doctor as soon as they test positive for Covid and seek treatments that can reduce its severity, like Paxlovid or molnupiravir.

As Biden said yesterday, "America has the tools to protect people."

What's next

If more people become aware of the treatments, however, some of them are likely to run low later this year. And if the federal government waits until then to act, it may discover that other countries have bought the available supply. "You can't snap your fingers and buy the stuff," the Biden administration official told me.

Already, the administration has reduced shipments of one kind of treatment — monoclonal antibodies — that it is sending to states. It has also said it would cut back on new orders of Evusheld in the next several days.

A Covid bill would likely cost $10 billion to $15 billion, or less than 0.25 percent of the annual federal budget. Congressional Republicans have said that the money should be diverted from another area, rather than add to the deficit. My colleague Sheryl Gay Stolberg, who covers the pandemic from Washington, said Congress was likely to agree on a funding source soon, perhaps before lawmakers leave for their April recess. But nobody knows for sure.

Related:

THE LATEST NEWS

State of the War
Ukrainian fighters surveying a damaged Russian tank outside Kyiv.Daniel Berehulak for The New York Times
More on Ukraine
Politics
Other Big Stories
Opinions

Covid has made us angry and distrustful. We need to learn to live with one another again, Miranda Featherstone says.

Jair Bolsonaro's plan to loosen environmental rules threatens the planet, Vanessa Barbara writes.

Your support makes our journalism possible.

Help The Times continue to provide essential reporting. Become a subscriber today.

MORNING READS

Olivier Martinez and Diane Lane in the 2002 movie "Unfaithful."Courtesy of Everett Collection

Steamy: From "9 1/2 Weeks" to "Fatal Attraction," a look at the golden age of the erotic thriller.

Keep getting lost? Maybe you grew up on a grid.

Wormhole: Want to see the weirdest Wikipedia pages?

Nature: Cameras captured a bobcat's risky quest for python eggs.

A Times classic: Tips for modern parenting.

Advice from Wirecutter: This alarm clock will change your life.

Lives Lived: Ashton Hawkins was the Metropolitan Museum of Art's executive vice president, but he could be more aptly described as its chief curator of powerful donors. He died at 84.

ARTS AND IDEAS

Sales of queer romance novels have surged.

L.G.B.T.Q. romance is booming

For decades, most L.G.B.T.Q. romance novels were self-published or put out by niche presses. That has changed, The Times's Elizabeth Harris writes. Now, queer romance novels are coming from the biggest publishers and are prominently displayed in stores.

Some of them become best sellers, like "Red, White & Royal Blue" by Casey McQuiston, a 2019 love story about a British prince and the American president's son. Experts see its success as a turning point for the genre. Publishers long assumed that only L.G.B.T.Q. readers were interested in queer romance novels. But readers regularly tell McQuiston, "Oh, my mom and her book club are reading that."

The new novels also break from the longstanding trope of queer characters meeting tragic ends. An L.G.B.T.Q. romance novel promises the opposite. "Customers will come in and say, 'I just want something that's gay and happy,'" Laynie Rose Rizer, a bookshop manager in Washington, D.C., said. "And I'm like, 'I have 10 different options for you.'"

PLAY, WATCH, EAT

What to Cook
Lisa Corson for The New York Times

Egg salad that's gorgeous and delicious.

What to Watch

Starring Oscar Isaac and Ethan Hawke, the new Marvel series "Moon Knight" follows a troubled, crime-fighting caped crusader.

Profiles

"I'm not a bad girl," Joan Collins tells The Times. "But I had dark hair and green eyes, and I suppose they said that I smoldered."

Late Night

Stephen Colbert condemned Trump.

Now Time to Play

The pangrams from yesterday's Spelling Bee were drooping, dropping and prodding. Here is today's puzzle — or you can play online.

Here's today's Wordle. Here's today's Mini Crossword, and a clue: Good news for an employee (five letters).

If you're in the mood to play more, find all our games here.

Thanks for spending part of your morning with The Times. See you tomorrow. — David

P.S. A hidden haiku from The Times: "But in the midst of / it all, Will Smith's victory / became a defeat."

"The Daily" is about gerrymandering.

Claire Moses, Ian Prasad Philbrick, Tom Wright-Piersanti, Ashley Wu and Sanam Yar contributed to The Morning. You can reach the team at themorning@nytimes.com.

Need help? Review our newsletter help page or contact us for assistance.

You received this email because you signed up for the Morning newsletter from The New York Times, or as part of your New York Times account.

To stop receiving these emails, unsubscribe or manage your email preferences.

Subscribe to The Times

Connect with us on:

facebooktwitterinstagram

Change Your EmailPrivacy PolicyContact UsCalifornia Notices

The New York Times Company. 620 Eighth Avenue New York, NY 10018

Wednesday, March 30, 2022

The Morning: The battle for Donbas

And why it's a risky moment for Ukraine.

Good morning. Russia appears to be focusing more on eastern Ukraine. That's both good and bad for Ukraine's military.

Yulia Beley, center, with her daughter at a shelter in Lviv, western Ukraine.Mauricio Lima for The New York Times

'Significant danger'

When Russia began its invasion of Ukraine on Feb. 24, Vladimir Putin and his inner circle were not the only people who expected a rapid Russian march to victory. Many independent observers did, too.

Instead, Ukraine has held firm.

Ukrainian civilians have shown resilience amid terrible suffering. Its military has kept Russia from taking over Kyiv and even regained some ground in the northeast. And the Russian military has suffered heavy losses, partly because of an overly ambitious strategy — evidently reflecting Putin's wishes more than military reality — that left its forces stretched thin and vulnerable to counterattacks.

Russia's early failures explain its new willingness to hold peace negotiations and its promised pullback from Kyiv. U.S. officials understandably expressed skepticism yesterday about whether Putin is genuinely open to ending the war. But Russia really does appear to have narrowed its goals, in response to its battlefield struggles. That's good news for Ukraine.

At the same time, Russia's new strategy creates a potential challenge: Increasingly, Russia appears to be concentrating its effort in fewer areas — particularly the Donbas region, in eastern Ukraine.

"We've seen a major shift toward one specific front in this war," Michael Kofman of the Russia studies program at CNA told me. "For Russia, it's much more rational."

Today's newsletter examines the battle for Donbas, which is likely to be an increasing focus of the war in coming weeks.

Why Donbas matters

The Donbas region, on the border with Russia, makes up about 9 percent of Ukraine's landmass. Many of its residents have long felt at least as much of a connection to Russia as to the rest of Ukraine.

The New York Times

After Russia invaded a nearby region of Ukraine in 2014 and annexed it — Crimea — Moscow-backed separatists in Donbas started their own civil war against Ukraine's government. The separatists proclaimed the formation of two breakaway republics, and fighting has continued sporadically over the past eight years. Last month, Putin recognized both republics.

Focusing on Donbas has multiple advantages for Russia. In recent weeks, it has already made progress in taking over territory there. It can hold that territory without the long, exposed supply lines that Ukraine has successfully attacked elsewhere. A battle over Donbas also gives Russia an opportunity to encircle and destroy a large chunk of Ukraine's military. More than a third of all Ukrainian troops may be in the region, fighting both the separatists and the Russian military.

Russia appears to be on the verge of being able to create such a pincer around these Ukrainian troops, coming from both the east and the south. Experts refer to this Russian progress as a "land bridge" from Crimea to the Donbas.

The city of Mariupol, in southern Donbas, is a part of this story. Putin and his military planners have attacked Mariupol so brutally because it is the largest city in the potential land bridge that they do not yet control. It also has a major port.

(This Times story examines Russia's attempts to starve the people of Mariupol, including the physical and psychological toll of hunger. "The fire was gone from their eyes," one mother said about her children, describing her futile attempts to distract them by reading fairy tales.)

Damaged houses in Mariupol.Alexander Ermochenko/Reuters

Some analysts, like Kofman, believe that Russia would struggle to maintain the land bridge for an extended period. Its military would face many of the same challenges — a dedicated opposition, dispersed over a large territory — that have bedeviled it elsewhere in Ukraine.

Others think a sustained land bridge is more likely. "With its long history of starting wars disastrously but then winning them by piling in more men and matériel to overwhelm the defender through sheer brute force, Russia has time on its side," said Keir Giles of the Conflict Studies Research Center in Britain. "It can keep up the pressure on Ukraine longer than Ukraine can keep up Western interest in supporting it in its fight for freedom."

A new risk

Either way, Putin may try to use the cease-fire negotiations as a way to lock in the territory Russia now controls or soon may, including the land bridge. That prospect worries some experts who want to see Putin defeated. "We're at the next moment of significant danger around this conflict," Frederick Kagan, a military expert at the American Enterprise Institute, told me.

If the West pressures Ukraine to accept a cease-fire that leaves the land bridge intact, Ukraine would be a broken country, Kagan argues. It would be cut off from a large number of its citizens and from economically important coal and natural gas resources in the east. Many parts of central Ukraine would be vulnerable to Russian attacks and disruption.

"If we allow the Russians under the facade of a cease-fire to control that line, that's exactly what I'm worried about," Kagan added.

The war has gone surprisingly well for Ukraine so far, but it still faces major risks. "I think a lot of folks in the West are more starry-eyed than Ukrainians are," Kofman said. "I'm skeptical that either side is ready for peace, because both sides in this war still have opportunities in the battlefield."

Related: "It's always wiser to treat your adversary as a canny fox, not a crazy fool," Bret Stephens writes, asking whether Putin's goal was always to take over the east, rather than to conquer the whole country.

State of the War

More on Ukraine

A MESSAGE FROM Facebook

Our tools help you connect safely

Tools like Privacy Checkup, Access Your Information and Security Checkup help keep you safer online.

Learn More

Facebook Logo

THE LATEST NEWS

The Virus
Other Big Stories
The scene of an attack near Tel Aviv yesterday.Nir Elias/Reuters
Opinions

Parts of the American right are aiding Putin's culture war, Michelle Goldberg says.

To defeat Putin and save the planet, transition to clean energy, Thomas Friedman argues.

The pandemic left doctors traumatized and exhausted. They need to be able to access mental health treatments without stigma, Seema Jilani writes.

Your support makes our journalism possible.

Help The Times continue to provide essential reporting. Become a subscriber today.

MORNING READS

Strawberry Park Hot Springs in Colorado.Caine Delacy for The New York Times

Relaxing: The magic of a dip in a hot spring.

Hollywood: Will Smith's slap hangs over a historic Oscars for Black men, Wesley Morris writes. (Times Opinion writers mulled the meaning of the slap.)

Ask Well: Why am I bloated all the time?

A Times classic: Why scientists think fiber is good for you.

Advice from Wirecutter: Find the cheapest gas.

Lives Lived: Joan Joyce's softball pitching feats and achievements in basketball, volleyball and golf made her one of the greatest female athletes of her generation. She died at 81.

ARTS AND IDEAS

The year of the wedding

After two years of pandemic postponements, roughly 2.5 million couples are planning to get married in 2022, up from two million in 2019.

The glut of weddings has made it harder to pull together a dream ceremony. Caterers, venues and even calligraphers are booked solid, forcing some couples to enlist friends to help with food and photos (or bribe vendors to bump others off the list).

But neither logistical problems nor Covid uncertainty is stopping many people. "I think we're at a point where it feels like it needs to happen no matter what," Leslie Krivo-Kaufman told The Times before her wedding this month.

For those who have their plans in order, though, an extra two years of savings has allowed some couples to go over the top, with weddings that look like a throwback to the 1980s. This story, by Ivy Manners, explores this year's trends — including ornate cakes, elaborate floral arrangements and lacy gowns.

A MESSAGE FROM Facebook

Our tools help you connect safely

Tools like Privacy Checkup, Access Your Information and Security Checkup help keep you safer online.

Learn More

Facebook Logo

PLAY, WATCH, EAT

What to Cook
Sang An for The New York Times. Food Stylist; Simon Andrews.
What to Watch

Looking for a soapy tearjerker? Try "Pachinko," a historical family saga adapted from Min Jin Lee's best-selling novel.

What to Listen to

Daddy Yankee, the reggaeton forefather, made "Legendaddy," an album billed as his last.

Late Night
Now Time to Play

The pangram from yesterday's Spelling Bee was axiomatic. Here is today's puzzle — or you can play online.

Here's today's Wordle. Here's today's Mini Crossword, and a clue: "Same for me" (five letters).

If you're in the mood to play more, find all our games here.

Thanks for spending part of your morning with The Times. See you tomorrow. — David

P.S. William Seward, the U.S. secretary of state, agreed to buy Alaska from Russia for $7.2 million 155 years ago today.

"The Daily" is about Clarence and Ginni Thomas. On "The Argument," Big Tech's response to the Russian invasion.

Claire Moses, Ian Prasad Philbrick, Tom Wright-Piersanti, Ashley Wu and Sanam Yar contributed to The Morning. You can reach the team at themorning@nytimes.com.

Need help? Review our newsletter help page or contact us for assistance.

You received this email because you signed up for the Morning newsletter from The New York Times, or as part of your New York Times account.

To stop receiving these emails, unsubscribe or manage your email preferences.

Subscribe to The Times

Connect with us on:

facebooktwitterinstagram

Change Your EmailPrivacy PolicyContact UsCalifornia Notices

The New York Times Company. 620 Eighth Avenue New York, NY 10018