
The Power of a Good Suit
Why the COVID Deniers Won
In the March issue, David Frum considered lessons from the pandemic and its aftermath.
David Frum asks why so many Americans resisted vaccines, and finds his answer in political strife, misinformation, and irrational responses. But rational mistrust of the health-care system also lay behind that resistance.
COVID came on the heels of the opioid crisis. Many people, especially in red states, were suffering from an addiction to a class of medicines once promoted as cutting-edge science. The opioid crisis is but one example of ethical failings in American health care. The essence of the Hippocratic oath—to place patient welfare over every other motive—has been assailed by incentives to both over- and undertreat, costing citizens time, blood, and money. Although I hope, with Frum, that the future belongs to those who help their country, we need to first agree that it is dead wrong for anyone, in any way, to profit from hurting people.
Sarah M. Brownsberger
Bellingham, Wash.
I really appreciate David Frum's writing, but I think this article brushed over valid skepticism of the government in a moment of crisis. The official advice was always presented as an edict. I didn't appreciate being told not to ask questions. Similarly, I understood why some were nervous about receiving rushed vaccines with brand-new mRNA technology. I would love to see both sides of this debate conduct an open postmortem. That would be good for all of us.
Mike Bergman
Minneapolis, Minn.
Thank you to David Frum for his analysis of why the COVID deniers won. But as a physician, I believe Frum missed one of the major reasons denying COVID paid off for Donald Trump. This factor is medical, not social, and if we are to avoid an even bigger disaster during the next pandemic, it's crucial that we understand it.
Trump lucked out in part because of the nature of the coronavirus, which was relatively less lethal than other viral species. Most deaths occurred in patients who were old, chronically ill, or suffering from other preexisting conditions. As a result, the pandemic, tragic as it was, lacked the element of horror that might accompany one caused by more inherently lethal viruses. No wonder people ended up sneering at masks and school closures. Right-wing media could spin COVID denial into a sensible response to what they presented as an epidemiological nonevent.
Unfortunately, Trump may not be so lucky next time. And a potential killer virus may be lurking just beyond the horizon: avian influenza, commonly known as bird flu. The World Health Organization views this virus with great alarm, because, having slashed through the poultry industry and many dairy herds, it is only a few mutations away from being able to pass from human to human. The death rate for bird flu is about 50 percent. Young people are not spared.
Any risks to the U.S. population would be magnified dramatically by President Trump's appointments and policies. The chances of quickly developing a vaccine, should bird flu begin infecting significant numbers of humans, appear small. It's not just the anti-vaxxers who will paralyze us: Our biomedical-research capabilities have been devastated by cuts to the National Institutes of Health's budget.
If an avian-influenza pandemic does hit, Trump could pull out the old COVID‑19 playbook. Why not? It worked the last time. But the viral character of the next pandemic could make it difficult for him to evade responsibility for the nightmare that may follow.
Brad Stuart, M.D.
Forestville, Calif.
David Frum replies:
In the first weeks after the coronavirus struck, many decisions had to be made quickly based on imperfect information. Unsurprisingly, many of those decisions now look wrong.
But the most lethal of all the bad decisions was the effort to discourage conservative-leaning Americans from receiving COVID vaccines. Tens of thousands of people died unnecessarily because they followed advice from leaders they trusted.
Lockdowns were too draconian. Masking was mostly useless. Blue-state schools should have reopened faster. But those mistakes all shrink in gravity compared with the malicious effort to disparage vaccination. So, yes, let's criticize the errors of the overzealous. But right now, the people who hold government power in the United States are those with the deadliest record—and no conscience.
Behold My Suit!
In the March issue, Gary Shteyngart wrote about his quest to end a lifetime of fashion misery.
Gary Shteyngart looks indescribably cool and writerly in his new suit! I'd offer to marry Gary based solely on how he looks in that suit, walking those New York streets like he owns them. Boston ladies love a man in a good suit.
Ruth Morss
Cambridge, Mass.
Reading 'Behold My Suit!' was gratifying on many levels. I wholly agree that women should not have all the fun with clothes. Some people dress to impress others, and some people dress to please themselves; perfection is reached when you can do both at once. I envy Shteyngart for hitting the bull's-eye.
Not that I would ever dream of claiming greater shoe expertise than Yohei Fukuda—but brown suede shoes with a blue suit? Brown shoes with a dark-blue suit are acceptable, but not preferred. Plus, the world's most elegant suede shoes are still informal. I'd never drop $3,000 on a pair of suede shoes, even if they had diamonds on their soles. And one final tip to the young men out there considering upping their fashion game: You can make even a $10,000 suit irrelevant if you don't bother to get a shave.
Austin, Texas
The Last Great Yiddish Novel
In the April issue, Judith Shulevitz considered how Chaim Grade's Sons and Daughters rescues a destroyed world.
I translated four of Chaim Grade's books and placed them with U.S. publishers in the 1970s. I had a wonderful personal relationship with Grade, a kind of uncle-nephew bond. I'm proud to have helped put him on the map: When I finished translating Grade's two-volume masterwork, The Yeshiva, I found a home for it with the venerable Bobbs-Merrill, a more famous publisher than those that had issued my earlier translations. It also published my first novel, The Yemenite Girl.
Many ultra-Orthodox Jews read Grade's work, including Rabbi Menachem Mendel Schneerson, the leader of the worldwide Chabad organization. Grade told me that Schneerson once called him to ask how he was feeling, somehow sensing that he was ill.
'Rebbe, how did you know I was not well?' Grade asked.
'Because for two weeks I did not see your weekly chapter of The Yeshiva in the Morgn-Journal,' the Rebbe answered. 'So I thought something must be the matter.' The Morgn-Journal was a Yiddish daily to which Grade contributed fiction.
Shulevitz is right to note that, aside from his Holocaust memoir, The Seven Little Lanes, Grade did not mention the Holocaust in his work. But if you read carefully the last page of The Yeshiva, where the two protagonists stand on a platform full of people awaiting the arrival of a train, one cannot help but feel in Grade's elegiac tone a recognition that other trains will soon be coming.
Behind the Cover
In this month's cover story, ' Donald Trump Is Enjoying This,' Ashley Parker and Michael Scherer offer a definitive account of the president's political comeback. They discussed with Trump how he is using his power, and drawing on the lessons of his first term, to run the country (and, in his words, 'the world'). For our cover image, the illustrator Dale Stephanos rendered in pencil a photograph of Trump taken in North Las Vegas last fall.
— Paul Spella, Senior Art Director
Corrections
'Growing Up Murdoch' (April) originally stated that a line in King Lear was directed at Cordelia. In fact, it was directed at Goneril. 'Turtleboy Will Not Be Stopped' (April) misstated the number of nights Karen Read has spent in jail. She has spent two nights in jail, not one. 'The Cranky Visionary' (April) originally stated that the Barnes Foundation was effectively America's first museum of modern art. In fact, it was among the first.

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Time Magazine
13 minutes ago
- Time Magazine
Big Data Can Make America Healthier. Here's How to Do It Right
Big data can help make Americans healthier, and the Trump Administration has stated—in its recently released Make America Healthy Again report and elsewhere—that building a national big-data platform is one of its primary goals. As scientists who use large data sets to study health, we're excited about its potential and the willingness of the federal government to invest in it, particularly since big data has been underutilized in the U.S. compared with other developed countries—and since the number of ways it can be used grows nearly daily. It's a huge opportunity. But there are lots of concerns when assembling sensitive health data and combining it with other sensitive data, like credit scores, tax records, employment, educational records, and more. Some of those concerns with the Administration's plans have already surfaced. The Administration's first goal of assembling big data to studying autism has left some worried that if used inappropriately, such data could lead to harm, rather than help, for those with autism. Others worry that big data could be used to perform and justify shoddy research that supports predetermined conclusions without adhering to rigorous scientific methods—a concern reinforced by the discovery that the Make America Healthy Again report cited non-existent sources to support its claims. So how can we reap the benefits of big data while minimizing its risks? Here are some guiding principles: 1. Link the highly siloed health care and government data we already have The health care system already possesses health data on millions of Americans. Medical records are now almost always digitized, permitting doctors' notes, medical imaging, laboratory tests, insurance claims, and more to be linked (in theory) across doctors' offices, hospitals, nursing homes, and any other place people receive care. However, data collected about a patient in one setting often doesn't get connected to data from other settings—making it hard for researchers to get a full picture of what, exactly, is happening to each of us within the larger health care system. The federal government also has data on us that can be connected to health care data to answer important questions. For example, comprehensive and detailed data on Americans' occupations linked with health, insurance, and other data could help shed more light on relationships between our work and our health—helping to better answer curious questions like why taxi drivers are less likely to die from Alzheimer's disease or why female physicians don't outlive their male colleagues. The first step of making big data more helpful is to simply link the data—which, while possible, is difficult to accomplish without centralized effort. Once linkages have been made, data can be anonymized so that those studying sensitive questions aren't privy to confidential information about specific individuals. 2. Create capacity for researchers to securely link to other valuable data In addition to governmental data, many other sources of data can provide insights into our health. For example, smartwatches not only have data on how our hearts are beating (e.g., they can identify abnormal heart rhythms like atrial fibrillation), but they can also identify subtle changes in mobility that might be predictive of early neuromuscular diseases like Parkinson's disease. Meanwhile, grocery stores have data on the foods we eat, and with increasing interest in how diet affects our lives, these data could be linked to detailed measures of health. Similarly, social-media platforms possess data that can offer insights into changes in our mental health, and through large-scale analysis of online photos could even identify, in real time, early visible markers of disease. These are moonshots, of course, and whether we want to use data in this way is an open question. But the potential to improve health could be large. Creating a way for scientists to link outside data to existing government and health data—while responsibly maintaining individual anonymity after the linkage—could open many novel research opportunities. 3. Invest in data-research infrastructure Keeping all of these data sources organized, secure, and accessible to scientists is a tall order. Researchers who use big data often dedicate substantial resources to finding the data they need, organizing it, and ensuring its accuracy; the better the database is maintained, the easier it is for researchers to actually perform their analyses. The secure online platform where Medicare and other government health care data are currently accessed has been described by researchers as 'tedious and prone to system errors' and in need of major improvements. Meanwhile, security concerns have led the government to stop letting researchers store the data on their own secure servers, the easiest and most cost-effective way to actually work with the data. Access to Medicare data by researchers has become prohibitively expensive, costing about $30,000 a year or more for a single user to work on one project using the online platform. Proposals to drastically cut medical research funding have been reported, and if passed, these research funding cuts will come at the cost of discoveries to improve health that will never be made. High-quality research of any kind requires investment, whether it's in a biology lab under a microscope or working with data on powerful computers. A new data platform is only as valuable as researchers' ability to access it in a functional and cost-effective way. Any roadmap to designing a national data platform that links together health care and other sensitive data must consider the many valid concerns about collecting data in the U.S., including privacy concerns and how data will be used. The Pew Research Center finds that large majorities of Americans say they are concerned about how the government uses data collected about them (71%), while also admitting that they have little to no understanding of what the government even does with such data (77%). Here are some strategies—in addition to many of the cybersecurity and privacy safeguards already in place—to both protect the data and help earn the public trust: 1. Strictly limit data access to vetted researchers Mistrust and unease with government data collection is readily traceable to historical abuse of Americans' data (as well as recent allegations of improper access), so it's not surprising that many are wary of the Trump Administration's plans. Ensuring data cannot be weaponized by the government against individuals is perhaps the single biggest barrier to creating a useful database, but it can be done. Those currently using federal health care data must already undergo training and comply with very high data-security standards. Misuse of the data—such as even attempting to figure out the identity of an anonymous individual in the data—or failure to protect patient privacy can lead to criminal penalties. A platform of sensitive data without well-delineated restrictions on who can use it and what they can use it for is a recipe for problems. Other ongoing efforts by the Administration to compile data under the vague goal of 'increasing government efficiency' have been met with pushback and lawsuits from organizations concerned about data being used against members of the public. 2. Require analytical plans and ethics-board approval up front Current use of federal health data also requires researchers to provide the government detailed plans to justify the use of specific data. This allows the government to ensure that no more data than is needed to answer the specific question is provided to researchers. Researchers must also obtain ethical approval from an Institutional Review Board prior to accessing and analyzing data, a second checkpoint. These boards, which exist in light of egregious failures of medical research ethics in the 20 th century, help ensure that analyses are designed to minimize risk to patients—even if it is only their data, and not their bodies, at risk. 3. Emphasize true transparency Transparency into who is using this sensitive data and what exactly they are doing with it can engender trust between researchers and the American public. Just like researchers already do for clinical trials, those accessing the data platform should specify their plans in advance, and those plans should be easily and publicly available. Transparency around which data were accessed and what computer code was used to analyze it not only promotes trust, but such data- and code-sharing practices among researchers make it easier to appraise the quality of the work, identify mistakes, and root out misconduct. We can only assume that Americans' unease with governmental data use stems from knowledge that, as with all powerful tools, linked data has the potential to be used in potentially harmful ways. But when in the hands of qualified scientists using rigorous scientific methods and privacy safeguards, a robust real-world data platform like this could lead to new discoveries about how all of us can lead healthier lives.


San Francisco Chronicle
26 minutes ago
- San Francisco Chronicle
Where you live may affect your risk of dementia, UCSF study finds
In a major national study led by UCSF researchers, dementia rates among older Americans were found to vary sharply by region, with the Southeast facing the greatest burden and the Bay Area's broader region faring somewhat better. Published Monday in JAMA Neurology, the study drew on health records from more than 1.2 million veterans age 65 and older, served by the Veterans Health Administration, the largest integrated health system in the U.S. It is one of the largest efforts to date to chart geographic patterns in dementia, and its findings could guide how public health officials respond to one of the most pressing challenges of an aging population. Using the Mid-Atlantic region — including states such as Pennsylvania and Virginia — as the baseline, UCSF researchers found that dementia incidence was 25% higher in the Southeast, which includes Kentucky, Tennessee, Alabama and Mississippi. Rates in the Northwest and Rocky Mountains were 23% higher, and in the South, including Texas and New Mexico, 18% higher. California was part of the Southwest region, which showed a 13% higher rate of dementia compared to the Mid-Atlantic. The Northeast, including New York and New England states, was 7% higher. 'The study underscores the need to understand regional differences in dementia and the importance of region-specific prevention and intervention efforts,' said senior author Dr. Kristine Yaffe, a professor at UCSF and the San Francisco VA Health Care System. 'Quality of education, early life conditions, and environmental exposures may be among those factors,' she said. The authors noted some limitations in the study, including that veterans 'may not be entirely representative of the general U.S. population, particularly regarding sex and gender distribution,' and have a higher prevalence of dementia risk factors, including traumatic brain injury, post-traumatic stress and depression. However, despite adjusting for race, age, cardiovascular disease and rurality, the regional patterns remained, highlighting the importance of local context in both risk and response, the authors added.
Yahoo
41 minutes ago
- Yahoo
An Uproar at the NIH
The Atlantic Daily, a newsletter that guides you through the biggest stories of the day, helps you discover new ideas, and recommends the best in culture. Sign up for it here. Updated at 10:26 a.m. on June 9, 2025 Since winning President Donald Trump's nomination to serve as the director of the National Institutes of Health, Jay Bhattacharya—a health economist and prominent COVID contrarian who advocated for reopening society in the early months of the pandemic—has pledged himself to a culture of dissent. 'Dissent is the very essence of science,' Bhattacharya said at his confirmation hearing in March. 'I'll foster a culture where NIH leadership will actively encourage different perspectives and create an environment where scientists, including early-career scientists and scientists that disagree with me, can express disagreement, respectfully.' Two months into his tenure at the agency, hundreds of NIH officials are taking Bhattacharya at his word. More than 300 officials, from across all of the NIH's 27 institutes and centers, have signed and sent a letter to Bhattacharya that condemns the changes that have thrown the agency into chaos in recent months—and calls on their director to reverse some of the most damaging shifts. Since January, the agency has been forced by Trump officials to fire thousands of its workers and rescind or withhold funding from thousands of research projects. Tomorrow, Bhattacharya is set to appear before a Senate appropriations subcommittee to discuss a proposed $18 billion slash to the NIH budget—about 40 percent of the agency's current allocation. The letter, titled the Bethesda Declaration (a reference to the NIH's location in Bethesda, Maryland), is modeled after the Great Barrington Declaration, an open letter published by Bhattacharya and two of his colleagues in October 2020 that criticized 'the prevailing COVID-19 policies' and argued that it was safe—even beneficial—for most people to resume life as normal. The approach that the Great Barrington Declaration laid out was, at the time, widely denounced by public-health experts, including the World Health Organization and then–NIH director Francis Collins, as dangerous and scientifically unsound. The allusion in the NIH letter, officials told me, isn't meant glibly: 'We hoped he might see himself in us as we were putting those concerns forward,' Jenna Norton, a program director at the National Institute of Diabetes and Digestive and Kidney Diseases, and one of the letter's organizers, told me. None of the NIH officials I spoke with for this story could recall another time in their agency's history when staff have spoken out so publicly against a director. But none of them could recall, either, ever seeing the NIH so aggressively jolted away from its core mission. 'It was time enough for us to speak out,' Sarah Kobrin, a branch chief at the National Cancer Institute, who has signed her name to the letter, told me. To preserve American research, government scientists—typically focused on scrutinizing and funding the projects most likely to advance the public's health—are now instead trying to persuade their agency's director to help them win a political fight with the White House. In an emailed statement, Bhattacharya said, 'The Bethesda Declaration has some fundamental misconceptions about the policy directions the NIH has taken in recent months, including the continuing support of the NIH for international collaboration. Nevertheless, respectful dissent in science is productive. We all want the NIH to succeed.' A spokesperson for HHS also defended the policies the letter critiqued, arguing that the NIH is 'working to remove ideological influence from the scientific process' and 'enhancing the transparency, rigor, and reproducibility of NIH-funded research.' The agency spends most of its nearly $48 billion budget powering science: It is the world's single-largest public funder of biomedical research. But since January, the NIH has canceled thousands of grants—originally awarded on the basis of merit—for political reasons: supporting DEI programming, having ties to universities that the administration has accused of anti-Semitism, sending resources to research initiatives in other countries, advancing scientific fields that Trump officials have deemed wasteful. Prior to 2025, grant cancellations were virtually unheard-of. But one official at the agency, who asked to remain anonymous out of fear of professional repercussions, told me that staff there now spend nearly as much time terminating grants as awarding them. And the few prominent projects that the agency has since been directed to fund appear either to be geared toward confirming the administration's biases on specific health conditions, or to benefit NIH leaders. 'We're just becoming a weapon of the state,' another official, who signed their name anonymously to the letter, told me. 'They're using grants as a lever to punish institutions and academia, and to censor and stifle science.' NIH officials have tried to voice their concerns in other ways. At internal meetings, leaders of the agency's institutes and centers have questioned major grant-making policy shifts. Some prominent officials have resigned. Current and former NIH staffers have been holding weekly vigils in Bethesda, commemorating, in the words of the organizers, 'the lives and knowledge lost through NIH cuts.' (Attendees are encouraged to wear black.) But these efforts have done little to slow the torrent of changes at the agency. Ian Morgan, a postdoctoral fellow at the NIH and one of the letter's signers, told me that the NIH fellows union, which he is part of, has sent Bhattacharya repeated requests to engage in discussion since his first week at the NIH. 'All of those have been ignored,' Morgan said. By formalizing their objections and signing their names to them, officials told me, they hope that Bhattacharya will finally feel compelled to respond. (To add to the public pressure, Jeremy Berg, who led the NIH's National Institute of General Medical Sciences until 2011, is also organizing a public letter of support for the Bethesda Declaration, in partnership with Stand Up for Science, which has organized rallies in support of research.) Scientists elsewhere at HHS, which oversees the NIH, have become unusually public in defying political leadership, too. Last month, after Health Secretary Robert F. Kennedy Jr.—in a bizarre departure from precedent—announced on social media that he was sidestepping his own agency, the CDC, and purging COVID shots from the childhood-immunization schedule, CDC officials chose to retain the vaccines in their recommendations, under the condition of shared decision making with a health-care provider. Many signers of the Bethesda letter are hopeful that Bhattacharya, 'as a scientist, has some of the same values as us,' Benjamin Feldman, a staff scientist at the National Institute of Child Health and Human Development, told me. Perhaps, with his academic credentials and commitment to evidence, he'll be willing to aid in the pushback against the administration's overall attacks on science, and defend the agency's ability to power research. But other officials I spoke with weren't so optimistic. Many at the NIH now feel they work in a 'culture of fear,' Norton said. Since January, NIH officials have told me that they have been screamed at and bullied by HHS personnel pushing for policy changes; some of the NIH leaders who have been most outspoken against leadership have also been forcibly reassigned to irrelevant positions. At one point, Norton said, after she fought for a program focused on researcher diversity, some members of NIH leadership came to her office and cautioned her that they didn't want to see her on the next list of mass firings. (In conversations with me, all of the named officials I spoke with emphasized that they were speaking in their personal capacity, and not for the NIH.) Bhattacharya, who took over only two months ago, hasn't been the Trump appointee driving most of the decisions affecting the NIH—and therefore might not have the power to reverse or overrule them. HHS officials have pressured agency leadership to defy court orders, as I've reported; mass cullings of grants have been overseen by DOGE. And as much as Bhattacharya might welcome dissent, he so far seems unmoved by it. In early May, Berg emailed Bhattacharya to express alarm over the NIH's severe slowdown in grant making, and to remind him of his responsibilities as director to responsibly shepherd the funds Congress had appropriated to the agency. The next morning, according to the exchange shared with me by Berg, Bhattacharya replied saying that, 'contrary to the assertion you make in the letter,' his job was to ensure that the NIH's money would be spent on projects that advance American health, rather than 'on ideological boondoggles and on dangerous research.' And at a recent NIH town hall, Bhattacharya dismissed one staffer's concerns that the Trump administration was purging the identifying variable of gender from scientific research. (Years of evidence back its use.) He echoed, instead, the Trump talking point that 'sex is a very cleanly defined variable,' and argued that gender shouldn't be included as 'a routine question in order to make an ideological point.' The officials I spoke with had few clear plans for what to do if their letter goes unheeded by leadership. Inside the agency, most see few levers left to pull. At the town hall, Bhattacharya also endorsed the highly contentious notion that human research started the pandemic—and noted that NIH-funded science, specifically, might have been to blame. When dozens of staffers stood and left the auditorium in protest, prompting applause that interrupted Bhattacharya, he simply smiled. 'It's nice to have free speech,' he said, before carrying right on. Article originally published at The Atlantic