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COVID

Work Requirements Just Won’t Die

The Atlantic

www.theatlantic.com › ideas › archive › 2023 › 05 › work-requirements-snap-debt-ceiling › 674246

Republicans and Democrats have reached a debt-ceiling deal. Republicans will agree not to blow up the global economy if Democrats trim federal spending over the next two years, claw back money from the Internal Revenue Service, speed up the country’s energy-permitting process, and impose new work requirements on the food-stamp and welfare programs, among other changes.

Perhaps this is the best deal the two sides could have reached. Perhaps it is not that big a deal at all. But Congress got the deal by selling out some of America’s poorest and most vulnerable families. And it did so by expanding the use of a policy mechanism so janky, ineffective, and cruel that it should not exist. No work requirements in any program, for anyone, for any reason: This should be the policy goal going forward.

The deal, which is pending a vote in the House later today, requires “able-bodied” people ages 18 to 54 without dependents in the home to work at least 20 hours a week in order to get food stamps for more than three months every three years; previously, people only had to do so up to the age of 50. (The deal does expand access to the program for veterans and kids leaving foster care.) It also hinders states’ ability to exempt families on welfare from the program’s onerous work requirements.

Work requirements have a decent-enough theory behind them: If you are on the dole and you are an able-bodied adult, you should be working or trying to find a job. It’s good for people to work, and the government should not send citizens the message that it is fine not to.

The theory runs into problems in theory long before it runs into problems in practice. The point of Temporary Aid to Needy Families, the cash-welfare program, is to eliminate deep poverty among children. The point of the Supplemental Nutrition Assistance Program is to end hunger. The point of Medicaid—to which Republicans are desperate to add work requirements, which thank goodness failed in these talks—is to ensure that everyone has health coverage.

[James Surowiecki: The GOP’s unworkable work requirements]

Should infants and kids remain in poverty because their parents can’t hold down a job? Should people go hungry if they can’t work? Should they lose their health insurance if they won’t? The answer is no—of course not, no.

Then, there are the problems in practice. Work requirements impose grievous costs for limited (or possibly nonexistent) benefits. For one, determining who is “able-bodied” is difficult and invasive. Having a disability or a disabling condition is not enough. A person needs to have a specific kind of disability, certified in a Kafkaesque, months-long process. “It is notoriously difficult,” Pamela Herd, a Georgetown professor and an expert on administrative burdens, wrote in a blog post this week. “Not only does it require reams of paperwork and documentation, it requires effectively navigating a complex medical diagnostic process to verify one’s eligibility.” Each year, she noted, about 10,000 people die while waiting for their application to be processed.

It is worth pausing here for a moment to appreciate the cruelty. Imagine you have long COVID. Or incontinence due to pelvic-floor trauma from childbirth. Or an undiagnosed psychiatric condition. You’re having trouble coming up with enough money for groceries, so you decide to apply for SNAP. But you realize you need a disability exemption from the work requirement. You wait months to offer up intimate details about your body to a civil servant, and face a one-in-three chance of getting denied.

Then comes getting SNAP itself. Applying is quick and easy in some states, for some people. It is long and arduous for other people in other places. Half of the New Yorkers applying for SNAP in December failed to get their benefits within a month, as required by federal law; pervasive delays have spurred a class-action lawsuit against the state. If and when people do get approved, they must comply with their state’s work requirements, really two interlocking sets of work requirements. (Don’t get confused!) Folks have to document their hours and log them on buggy online systems. If they’re looking for work, they have to search in certain ways in certain locations. It’s annoying. It’s finicky.

Again, it is worth appreciating the cruelty of it all. Years ago, I spoke with a Texan on food stamps. She had been exempted from her state’s work requirement because she was pregnant. But she suffered a late miscarriage. Did she have to call her caseworker to tell them she had lost her baby? Would the state come after her for not informing them, clawing her food stamps back? Was there some kind of bereavement policy? Did she need to start complying with the work requirement there and then? Another person I spoke with, in Maine, struggled to use a computer or phone and did not have reliable transportation to bring her paperwork to her caseworker in person. What was she supposed to do?

You might argue that such policies are worth it, if they get people to work. But they don’t. Most adults using safety-net programs who are capable of working are working. They just earn too little. And many adults who aren’t working can’t work, because of illness, a lack of transportation, or some other reason. As a result, work requirements at best lead to modest increases in employment, ones that fade over time. In some cases, they do nothing to bolster it. Yet work requirements have a catastrophic impact on the people who will not or cannot comply with them. Those people become more likely to live in poverty, get evicted, and end up incarcerated or homeless.

[Derek Thompson: Why Americans care about work so much]

At a more philosophical level, work requirements cement the narrative that poverty is the fault of the poor rather than the fault of a society with inadequate social services, unchecked corporate concentration, an overgrown carceral system, low wages, and massive discrimination against Black and Latino workers. They bolster the theory that a lack of personal responsibility and cultural rot are the reasons that deprivation persists. They are a way for the state to bully the poor.

Perhaps the best argument for work requirements is that they make safety-net programs palatable to higher-income folks. But the truth is that few people have any kind of granular understanding of these policies; not a lot of people vote on the basis of the fine print in the TANF program.

Republicans worried about poor people working should start supporting policies proven to boost employment, like universal child care and effective job training. Democrats should feel ashamed for ever having supported work requirements. They should feel even more ashamed for offering them as a policy concession to Republicans now, when we have so much evidence of how little they help and how much they hurt.

Now Is the Perfect Time to Role-Play a Pandemic

The Atlantic

www.theatlantic.com › health › archive › 2023 › 05 › pandemic-war-games-predictions-covid-lessons › 674213

In October 2019, just a few months before a novel coronavirus sparked a deadly pandemic, a group of government officials, business leaders, and academics convened in New York City to role-play a scenario in which a novel coronavirus sparked a deadly pandemic. Their imagined virus leaped from livestock to farmers in Brazil, then spread to Portugal, the United States, and China. Soon, it was everywhere. Eighteen months later, 65 million people were dead.

This simulation, known as Event 201, was one of dozens of so-called pandemic war games run in the two decades leading up to the outbreak of COVID-19. In mid-2020, as the world came to terms with its new pandemic reality, media outlets published a flood of articles about these simulations. Some highlighted their prescience, others their blind spots. But the real-world crisis that occasioned this review was only a few months old. Whatever hindsight it provided wasn’t yet in focus, because many of the greatest challenges of the pandemic—new variants, vaccine hesitancy, the hyper-politicization of public health—were still to come.

Almost three years later, we know that the war-gamers whiffed on many of these longer-term outcomes. Pre-pandemic role-plays successfully predicted early events like the overwhelming of the nation’s hospitals, ineffective travel bans, and a lack of coordination across levels of government. But they underestimated the significance of masking policies, the speed at which vaccines would be developed, and the politicized backlash to those interventions. They also failed to account for cascading viral evolution, and did not grasp how long such a crisis could last. “The scenario ends at the 18-month point,” the makers of Event 201 wrote. “The pandemic is beginning to slow due to the decreasing number of susceptible people. The pandemic will continue at some rate until there is an effective vaccine or until 80–90% of the global population has been exposed.” If only.

[Read: The next plague is coming. Is America ready?]

War-gamers are trying to learn from their mistakes. Long before any public-health authority had declared the acute phase of the pandemic over, officials were already playing out fresh scenarios that better fit the facts. At the Munich Security Conference in February 2022, for example, the Johns Hopkins Center for Health Security helped run an exercise focused on rapid development and equitable distribution of vaccines for an imagined future virus, Tom Inglesby, the center’s director, told me. Later that year, at an annual meeting convened in Brussels by the WHO and the Bill & Melinda Gates Foundation, the same group ran a simulation in which current and former foreign ministers had to grapple with the threats of misinformation and resistance to non-pharmaceutical interventions. Unlike pre-pandemic war games, this one also took into account governments’ attitudes toward expert public-health advice.

Accounting for the specific facts of the coronavirus pandemic could make future war games more realistic, experts told me, but it won’t ensure that they have substantive value. These exercises are not meant to predict what will happen in the next pandemic, so much as to prepare for what might happen. Bringing games into alignment with recent experience matters only insofar as it conduces to the latter.

War-gamers often draw a distinction between tabletop exercises and functional exercises. In the former, participants sit around discussing what they would do in a given scenario; in the latter, participants actually do it. They might transport stockpiled resources, distribute personal protective equipment, or care for pretend patients at a hospital. The Pentagon moves real forces around the world as part of its simulations. This real-world practice is sorely needed for pandemic scenarios, too, says Jennifer Nuzzo, the director of Brown University’s Pandemic Center. “When I look back at COVID, many of the failings stemmed from the fact that we didn't functionally exercise enough of the capacities that we supposedly had.”

Pandemic exercises could also be made more challenging, Inglesby said. Too many are set up to prevent participants from feeling demoralized, he said, as opposed to “exercising to the point of failure.” This principle can be taken too far, though, Nuzzo told me. If the exercise is too intense, people get overwhelmed and disengage. Real pandemics, of course, are highly overwhelming, but if you’re trying to train someone to bench-press their weight, you can’t just drop a 200-pound barbell on their chest and shout “Go!” They have to build up strength over time.

[Read: The boardgames that ask you to reenact colonialism]

Coming through an actual pandemic is a form of training, too, but that experience doesn’t make war games useless. In fact, they may be more important now than ever, experts told me. Before COVID, pandemic role-plays were meant in part to raise awareness—to show participants and the public alike that a pandemic could really happen. Now, obviously, few people need to be persuaded of the risk. Post-COVID, the exercises serve a very different function: They remind us that the next pandemic might look nothing like the one we’ve just experienced. It could have a far higher case-fatality rate. It could disproportionately sicken children rather than the elderly. Its symptoms could be neurological instead of respiratory. “Just having lived through COVID doesn’t prepare us for all future events,” Inglesby said. Experience is an infinitesimal sliver of possibility.

We try, through war games, to internalize this. It is not always easy. Event 201 notwithstanding, pandemic simulations have traditionally focused too much on influenza and not enough on other pathogens, perhaps because of how many outbreaks the former has caused in the past. It would be just as wrong to focus only on coronaviruses now, and leave influenza behind. At the simulation in Brussels, Eric Toner, a senior scholar at the Johns Hopkins Center for Health Security, told me, some participants struggled not to default to recent memory: “They kept coming back to, ‘Well, in COVID we did this,’ or ‘In COVID we did that.’” It’s a delicate balance to strike: to learn from experience without being constrained by it.

What Happens if Russia Stashes Nukes in Belarus

The Atlantic

www.theatlantic.com › newsletters › archive › 2023 › 05 › what-happens-if-russia-stashes-nukes-in-belarus › 674221

This is an edition of 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.

The dictator of Belarus, Alexander Lukashenko, has signed an agreement with Russia to base Russian nuclear weapons in his country. The strategic impact of such a move is negligible, but a lot can go wrong with this foolish plan.

First, here are four new stories from The Atlantic:

The play that explains Succession (and everything else) The Russian red line Washington won’t cross—yet. COVID shots are still one giant experiment. AI is unlocking the human brain’s secrets. A Tense Summer

Russia has taken another step toward nuclearizing its satrapy in neighboring Belarus. This is bad news but not a crisis (yet). But first, I want to add a note to what I wrote a few weeks ago about the drone attack on the Kremlin.

I suggested that the weird strike on a Kremlin building was unlikely to be an act sanctioned or carried out by the Ukrainian government. My best guess at the time was that the Russians might be pulling some kind of false-flag stunt to justify more repression and violence against Ukraine as well as internal dissent in Russia. I didn’t think the Ukrainians would attack an empty building in the middle of the night.
The U.S. intelligence community, however, now thinks the strike could have been some kind of Ukrainian special operation. Those same American analysts, according to The New York Times, are not exactly sure who authorized action against the Russian capital:

U.S. intelligence agencies do not know which unit carried out the attack and it was unclear whether President Volodymyr Zelensky of Ukraine or his top officials were aware of the operation, though some officials believe Mr. Zelensky was not.

That’s not much to go on, especially because the intelligence community’s confidence in this view is “low,” meaning there is at least some general, but not specific, evidence for it. The Americans suggest the attack may have been “orchestrated” by the Ukrainian security services, but that could mean any number of possibilities, including civilians, a small militia, a few people loosely affiliated with the Ukrainians, or even a commando team.

The best evidence, however, that this was not a false flag is that with the exception of firing a wave of missiles, the Russian government has said and done almost nothing in response either in Ukraine or in Russia. If Vladimir Putin’s security forces had engineered the incident, they’d almost certainly be taking advantage of it, but they’re not. Instead, the Kremlin seems paralyzed and has clamped down on any further reporting about the whole business; if the Ukrainian goal was to rattle Russian leaders, mission accomplished. So my theory has gone up in smoke—a hazard of trying to piece together an explanation while waiting for better evidence—but I thought it important to update you here.

Now, about those Belarus nukes.

Putin announced back in March that he intended to station nuclear arms in Belarus, a move that had Belarusian President Alexander Lukashenko doing a bit of uneasy throat-clearing as he tried to stay in Putin’s good graces while being understandably nervous about hosting weapons of mass destruction in his fiefdom. The hesitation is over: Belarusian Defense Minister Victor Khrenin and Russian Defense Minister Sergey Shoigu yesterday signed a formal agreement allowing the deployment of Russian nuclear weapons in Belarus.

This would be the first time post-Soviet Russia has stationed nuclear weapons outside its own territory, but the bombs aren’t in Belarus yet. Lukashenko was in Moscow yesterday to attend a summit of the Eurasian Economic Forum, and although he claimed that the complicated process of relocating Russian nuclear bombs has already begun, I don’t believe him. (There I go again, theorizing in the absence of evidence. But Western intelligence agencies watch the movement of Russian nuclear weapons pretty closely, and so far, none of them has indicated that they see anything happening.) Besides, Lukashenko’s assertion wasn’t exactly definitive; when asked in Moscow if the weapons had already arrived, he said, “Maybe. I will go and take a look.”

Now, without getting too far over my skis, I will say that the leaders of countries with nuclear weapons in their territory know without exception whether they have them or not, and don’t need to “go and take a look.” Lukashenko’s flip comment suggests to me that he knows that nothing has been moved yet, and that he understands that his role in this dangerous sideshow is to play along with the Kremlin’s attempt to jangle Western nerves about nuclear war.

Putin, for his part, has said that storage facilities for Russian nuclear arms will be complete by July 1. Nuclear weapons, of course, require highly secure military installations and personnel trained in dealing with such systems, such as how to load them onto their delivery vehicles, and the unique safety precautions that surround them. Even in the best of times, nuclear weapons are a high-maintenance proposition, and accidents do happen: In 2007, an American B-52 flew across the United States with six nuclear bombs that the crew didn’t realize were mounted on the wings.

It’s also possible that Putin is squeezing political impact of a nuclear agreement while he still can, given recent questions about Lukashenko’s health. The Belarus strongman has looked weak lately. It would be very much Putin’s gangland style to make sure he gets Belarus as a stage for his nuclear threats as soon as possible, if he thinks the grim reaper is about to step in.

Putin’s July deadline is also important because it means the Russians will be moving nuclear weapons in the middle of what looks to be a summer of intense fighting. Such a timetable is probably intentional. The Kremlin boss believes that the West is deeply afraid of nuclear war, and he intends to play on that fear. Western leaders, of course, are deeply afraid of nuclear war, because they are not utter psychopaths. Putin and his generals, although brutal and vicious men, are afraid of it, too, no matter what they might say, because they are not suicidal. (So were Soviet leaders and their generals, as we learned after the Cold War.)

What Putin fails to understand, however, is that years of struggling with the Soviet Union taught the United States and its allies how to contend with an aggressive Kremlin and the dangers of escalation at the same time. Putin, as I often note, is a Soviet nostalgist who longs for the old Soviet empire and who still seems to believe that a weak and decadent West will not continue to oppose him.

As ever, I worry not about Putin’s deliberate move to start World War III, but about some kind of error or accident when transferring nuclear weapons from one paranoid authoritarian country to another. Putin may well place nuclear weapons close to Ukraine and then claim that NATO is threatening Russia’s nuclear deterrent, thus provoking a crisis he thinks will induce the West to back away from supporting Kyiv. This would be yet another harebrained blunder in a series of poor moves, but Putin, as we know, is not exactly a master strategist. It’s going to be a tense summer.

Related:

“Lukashenko is easier to unseat than Putin.” The irreversible change in Belarus Today’s News A South Carolina circuit-court judge has temporarily blocked the state’s six-week abortion ban, one day after Governor Henry McMaster signed it into law. A House committee led by Texas Republicans recommended the impeachment of State Attorney General Ken Paxton yesterday, citing years of alleged lawbreaking and misconduct. The Mississippi police officer who shot Aderrien Murry, an unarmed 11-year-old Black boy, has been suspended with pay as the shooting is investigated. Dispatches Work in Progress: The hottest trend in investing is mostly a sham, James Surowiecki writes.

The Books Briefing: Books editor Gal Beckerman breaks down what you should be reading this summer—just in time for the season’s unofficial start.

Explore all of our newsletters here.

Evening Read Carlos Lopez-Calleja / Disney

A Chinese American Show That Doesn’t Bother to Explain Itself

By Shirley Li

Growing up in suburban New Jersey, I dreaded having new visitors over. I wasn’t asocial; I just feared that anyone who wasn’t Chinese—as in, the majority of my classmates—wouldn’t understand my family home and all of its inevitable differences from their own. Even if they didn’t ask me about the cultural objects they might stumble upon around the house, I felt the need to explain what they were seeing, in order to make them comfortable. We have this taped to the wall because it’s the Chinese character for fortune! These hard-boiled eggs are brown because they’ve been soaked in tea! In an attempt to prove that my surroundings were perfectly normal, I turned myself into a tour guide, and my own home into a sideshow.

American Born Chinese doesn’t bother with such disclaimers. The Disney+ show, now streaming, is exuberant and unabashed about its hyper-specific focus on the Chinese American experience.

Read the full article.

More From The Atlantic

Jennifer Egan: Martin Amis taught me how to be funny.

How America can avoid the next debt-ceiling showdown

Ozempic in teens is a mess.

Culture Break Kailey Schwerman / Showtime

Watch. Yellowjackets’ Season 2 finale (streaming on Showtime) made a terrible mistake.

Listen. To the first episode of the newly launched Radio Atlantic podcast with host Hanna Rosin, on whether the war in Ukraine can recapture the world’s attention at a crucial moment.

Play our daily crossword.

P.S.

This is my last Daily for the next week or so, as I am headed off for some sunshine and downtime, but senior editor Isabel Fattal and our colleagues at The Atlantic will keep things as lively here as ever. (This newsletter will be off on Monday for Memorial Day, so look for the next edition on Tuesday.)

With vacation on my mind, I want to recommend a gem of a movie about Las Vegas that has lived in the shadow of Martin Scorsese’s Casino (an undeniable masterpiece) for too long. Twenty years ago, William H. Macy, Maria Bello, and Alec Baldwin starred in The Cooler, one of the bleakest movies about Sin City since Leaving Las Vegas. Macy plays a “cooler,” a guy whose bad luck is so contagious that the casinos hire him to stand near people who win too much money at the tables.

It’s a love story and a crime story, but it’s also about old Vegas becoming a new (and sillier) Vegas. Back then, developers were making an inane attempt to transform an industry mostly devoted to gambling, booze, and sex into a theme park for families. Alec Baldwin—who was nominated for Best Supporting Actor—rails against it all in a rant about the Strip circa 2002: “You mean that Disneyland mook fest out there? Huh? That’s a fucking violation is what that is. Something that used to be beautiful, used to have class, like a gorgeous high-priced hooker with an exclusive clientele … It makes me want to cry, because I remember the way she used to be.”

I cheer him on every time. See you in a few weeks.

— Tom

Katherine Hu contributed to this newsletter.

What Should Go Into This Year’s COVID Vaccine?

The Atlantic

www.theatlantic.com › science › archive › 2023 › 05 › covid-vaccine-strain-xbb1 › 674208

This fall, millions of Americans might be lining up for yet another kind of COVID vaccine:  their first-ever dose that lacks the strain that ignited the pandemic more than three and a half years ago. Unlike the current, bivalent vaccine, which guards against two variants at once, the next one could, like the first version of the shot, have only one main ingredient—the spike protein of the XBB.1 lineage of the Omicron variant, the globe’s current dominant clade.

That plan isn’t yet set. The FDA still has to convene a panel of experts, then is expected to make a final call on autumn’s recipe next month. But several experts told me they hope the agency follows the recent recommendation of a World Health Organization advisory group and focuses the next vaccine only on the strains now circulating.

The switch in strategy—from two variants to one, from original SARS-CoV-2 plus Omicron to XBB.1 alone—would be momentous but wise, experts told me, reflecting the world’s updated understanding of the virus’s evolution and the immune system’s quirks. “It just makes a lot of sense,” said Melanie Ott, the director of the Gladstone Institute of Virology, in San Francisco. XBB.1 is the main coronavirus group circulating today; neither the original variant nor BA.5, the two coronavirus flavors in the bivalent shot, is meaningfully around anymore. And an XBB.1-focused vaccine may give the global population a particularly good shot at broadening immunity.

At the same time, COVID vaccines are still in a sort of beta-testing stage. In the past three-plus years, the virus has spawned countless iterations, many of which have been extremely good at outsmarting us; we humans, meanwhile, are only on our third-ish attempt at designing a vaccine that can keep pace with the pathogen’s evolutionary sprints. And we’re very much still learning about the coronavirus’s capacity for flexibility and change, says Rafi Ahmed, an immunologist at Emory University. By now, it’s long been clear that vaccines are essential for preventing severe disease and death, and that some cadence of boosting is probably necessary to keep the shots’ effectiveness high. But when the virus alters its evolutionary tactics, our vaccination strategy must follow—and experts are still puzzling out how to account for those changes as they select the shots for each year.

In the spring and summer of 2022, the last time the U.S. was mulling on a new vaccine formula, Omicron was still relatively new, and the coronavirus’s evolution seemed very much in flux. The pathogen had spent more than two years erratically slingshotting out Greek-letter variants without an obvious succession plan. Instead of accumulating genetic changes within a single lineage—a more iterative form of evolution, roughly akin to what flu strains do—the coronavirus produced a bunch of distantly related variants that jockeyed for control. Delta was not a direct descendant of Alpha; Omicron was not a Delta offshoot; no one could say with any certainty what would arise next, or when. “We didn’t understand the trajectory,” says Kanta Subbarao, the head of the WHO advisory group convened to make recommendations on COVID vaccines.

And so the experts played it safe. Including an Omicron variant in the shot felt essential, because of how much the virus had changed. But going all in on Omicron seemed too risky—some experts worried that “the virus would flip back,” Subbarao told me, to a variant more similar to Alpha or Delta or something else. As a compromise, several countries, including the United States, went with a combination: half original, half Omicron, in an attempt to reinvigorate OG immunity while laying down new defenses against the circulating strains du jour.

And those shots did bolster preexisting immunity, as boosters should. But they didn’t rouse a fresh set of responses against Omicron to the degree that some experts had hoped they would, Ott told me. Already trained on the ancestral version of the virus, people’s bodies seemed to have gotten a bit myopic—repeatedly reawakening defenses against past variants, at the expense of new ones that might have more potently attacked Omicron. The outcome was never thought to be damaging, Subbarao told me: The bivalent, for instance, still broadened people’s immune responses against SARS-CoV-2 compared with, say, another dose of the original-recipe shot, and was effective at tamping down hospitalization rates. But Ahmed told me that, in retrospect, he thinks an Omicron-only boost might have further revved that already powerful effect.

Going full bore on XBB.1 now could keep the world from falling into that same trap twice. People who get an updated shot with that strain alone would receive only the new, unfamiliar ingredient, allowing the immune system to focus on the fresh material and potentially break out of an ancestral-strain rut. XBB.1’s spike protein also would not be diluted with one from an older variant—a concern Ahmed has with the current bivalent shot. When researchers added Omicron to their vaccine recipes, they didn’t double the total amount of spike protein; they subbed out half of what was there before. That left vaccine recipients with just half the Omicron-focused mRNA they might have gotten had the shot been monovalent, and probably a more lackluster antibody response.

Recent work from the lab of Vineet Menachery, a virologist at the University of Texas Medical Branch, suggests another reason the Omicron half of the shot didn’t pack enough of an immunizing punch. Subvariants from this lineage, including BA.5 and XBB.1, carry at least one mutation that makes their spike protein unstable—to the point where it seems less likely than other versions of the spike protein to stick around for long enough to sufficiently school immune cells. In a bivalent vaccine, in particular, the immune response could end up biased toward non-Omicron ingredients, exacerbating the tendencies of already immunized people to focus their energy on the ancestral strain. For the same reason, a monovalent XBB.1, too, might not deliver the anticipated immunizing dose, Menachery told me. But if people take it (still a big if), and hospitalizations remain low among those up-to-date on their shots, a once-a-year total-strain switch-out might be the choice for next year’s vaccine too.

Dropping the ancestral strain from the vaccine isn’t without risk. The virus could still produce a variant totally different from XBB.1, though that does, at this point, seem unlikely. For a year and a half now, Omicron has endured, and it now has the longest tenure of a single Greek-letter variant since the pandemic’s start. Even the subvariants within the Omicron family seem to be sprouting off each other more predictably; after a long stint of inconsistency, the virus’s shape-shifting now seems “less jumpy,” says Leo Poon, a virologist at the University of Hong Kong. It may be a sign that humans and the virus have reached a détente now that the population is blanketed in a relatively stable layer of immunity. Plus, even if a stray Alpha or Delta descendant were to rise up, the world wouldn’t be caught entirely off guard: So many people have banked protection against those and other past variants that they’d probably still be well buffered against COVID’s worst acute outcomes. (That reassurance doesn’t hold, though, for people who still need primary-series shots, including the kids being born into the world every day. An XBB.1 boost might be a great option for people with preexisting immunity. But a bivalent that can offer more breadth might still be the more risk-averse choice for someone whose immunological slate is blank.)

More vaccination-strategy shifts will undoubtedly come. SARS-CoV-2 is still new to us; so are our shots. But the virus’s evolution, as of late, has been getting a shade more flu-like, and its transmission patterns a touch more seasonal. Regulators in the U.S. have already announced that COVID vaccines will probably be offered each year in the fall—as annual flu shots are. The viruses aren’t at all the same. But as the years progress, the comparison between COVID and flu shots could get more apt still—if, say, the coronavirus also starts to produce multiple, genetically distinct strains that simultaneously circulate. In that case, vaccinating against multiple versions of the virus at once might be the most effective defense.


Flu shots could be a useful template in another way: Although those shots have followed roughly the same guidelines for many years, with experts meeting twice a year to decide whether and how to update each autumn’s vaccine ingredients, they, too, have needed some flexibility. Until 2012, the vaccines were trivalent, containing ingredients that would immunize people against three separate strains at once; now many, including all of the U.S.’s, are quadrivalent—and soon, based on new evidence, researchers may push for those to return to a three-strain recipe. At the same time, flu and COVID vaccines share a major drawback. Our shots’ ingredients are still selected months ahead of when the injections actually reach us—leaving immune systems lagging behind a virus that has, in the interim, sprinted ahead. Until the world has something more universal, our vaccination strategies will have to be reactive, scrambling to play catch-up with these pathogens’ evolutionary whims.