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Persuasive Essay Guide

Persuasive Essay About Covid19

How to Write a Persuasive Essay About Covid19 | Examples & Tips

11 min read

Steps to Write a Persuasive Essay About Covid-19

Here are the steps to help you write a persuasive essay on this topic, along with an example essay:

Step 1: Choose a Specific Thesis Statement

Your thesis statement should clearly state your position on a specific aspect of COVID-19. It should be debatable and clear. For example:

Step 2: Research and Gather Information

Collect reliable and up-to-date information from reputable sources to support your thesis statement. This may include statistics, expert opinions, and scientific studies. For instance:

COVID-19 vaccination effectiveness data
Information on vaccine mandates in different countries
Expert statements from health organizations like the WHO or CDC

Step 3: Outline Your Essay

Create a clear and organized outline to structure your essay. A persuasive essay typically follows this structure:

Introduction
Background Information
Body Paragraphs (with supporting evidence)
Counterarguments (addressing opposing views)

Step 4: Write the Introduction

In the introduction, grab your reader's attention and present your thesis statement. For example:

Step 5: Provide Background Information

Offer context and background information to help your readers understand the issue better. For instance:

Step 6: Develop Body Paragraphs

Each body paragraph should present a single point or piece of evidence that supports your thesis statement. Use clear topic sentences, evidence, and analysis. Here's an example:

Step 7: Address Counterarguments

Acknowledge opposing viewpoints and refute them with strong counterarguments. This demonstrates that you've considered different perspectives. For example:

Step 8: Write the Conclusion

Summarize your main points and restate your thesis statement in the conclusion. End with a strong call to action or thought-provoking statement. For instance:

Step 9: Revise and Proofread

Edit your essay for clarity, coherence, grammar, and spelling errors. Ensure that your argument flows logically.

Step 10: Cite Your Sources

Include proper citations and a bibliography page to give credit to your sources.

Remember to adjust your approach and arguments based on your target audience and the specific angle you want to take in your persuasive essay about COVID-19.

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Examples of Persuasive Essay About Covid19

When writing a persuasive essay about the Covid-19 pandemic, it’s important to consider how you want to present your argument. To help you get started, here are some example essays for you to read:

Check out some more PDF examples below:

Persuasive Essay About Covid-19 Pandemic

Sample Of Persuasive Essay About Covid-19

Persuasive Essay About Covid-19 In The Philippines - Example

If you're in search of a compelling persuasive essay on business, don't miss out on our “ persuasive essay about business ” blog!

Examples of Persuasive Essay About Covid-19 Vaccine

Covid19 vaccines are one of the ways to prevent the spread of Covid-19, but they have been a source of controversy. Different sides argue about the benefits or dangers of the new vaccines. Whatever your point of view is, writing a persuasive essay about it is a good way of organizing your thoughts and persuading others.

A persuasive essay about the Covid-19 vaccine could consider the benefits of getting vaccinated as well as the potential side effects.

Below are some examples of persuasive essays on getting vaccinated for Covid-19.

Covid19 Vaccine Persuasive Essay

Persuasive Essay on Covid Vaccines

Interested in thought-provoking discussions on abortion? Read our persuasive essay about abortion blog to eplore arguments!

Examples of Persuasive Essay About Covid-19 Integration

Covid19 has drastically changed the way people interact in schools, markets, and workplaces. In short, it has affected all aspects of life. However, people have started to learn to live with Covid19.

Writing a persuasive essay about it shouldn't be stressful. Read the sample essay below to get idea for your own essay about Covid19 integration.

Persuasive Essay About Working From Home During Covid19

Searching for the topic of Online Education? Our persuasive essay about online education is a must-read.

Examples of Argumentative Essay About Covid 19

Covid-19 has been an ever-evolving issue, with new developments and discoveries being made on a daily basis.

Writing an argumentative essay about such an issue is both interesting and challenging. It allows you to evaluate different aspects of the pandemic, as well as consider potential solutions.

Here are some examples of argumentative essays on Covid19.

Argumentative Essay About Covid19 Sample

Argumentative Essay About Covid19 With Introduction Body and Conclusion

Looking for a persuasive take on the topic of smoking? You'll find it all related arguments in out Persuasive Essay About Smoking blog!

Examples of Persuasive Speeches About Covid-19

Do you need to prepare a speech about Covid19 and need examples? We have them for you!

Persuasive speeches about Covid-19 can provide the audience with valuable insights on how to best handle the pandemic. They can be used to advocate for specific changes in policies or simply raise awareness about the virus.

Check out some examples of persuasive speeches on Covid-19:

Persuasive Speech About Covid-19 Example

Persuasive Speech About Vaccine For Covid-19

You can also read persuasive essay examples on other topics to master your persuasive techniques!

Tips to Write a Persuasive Essay About Covid-19

Writing a persuasive essay about COVID-19 requires a thoughtful approach to present your arguments effectively.

Here are some tips to help you craft a compelling persuasive essay on this topic:

Choose a Specific Angle

Start by narrowing down your focus. COVID-19 is a broad topic, so selecting a specific aspect or issue related to it will make your essay more persuasive and manageable. For example, you could focus on vaccination, public health measures, the economic impact, or misinformation.

Provide Credible Sources

Support your arguments with credible sources such as scientific studies, government reports, and reputable news outlets. Reliable sources enhance the credibility of your essay.

Use Persuasive Language

Employ persuasive techniques, such as ethos (establishing credibility), pathos (appealing to emotions), and logos (using logic and evidence). Use vivid examples and anecdotes to make your points relatable.

Organize Your Essay

Structure your essay involves creating a persuasive essay outline and establishing a logical flow from one point to the next. Each paragraph should focus on a single point, and transitions between paragraphs should be smooth and logical.

Emphasize Benefits

Highlight the benefits of your proposed actions or viewpoints. Explain how your suggestions can improve public health, safety, or well-being. Make it clear why your audience should support your position.

Use Visuals -H3

Incorporate graphs, charts, and statistics when applicable. Visual aids can reinforce your arguments and make complex data more accessible to your readers.

Call to Action

End your essay with a strong call to action. Encourage your readers to take a specific step or consider your viewpoint. Make it clear what you want them to do or think after reading your essay.

Revise and Edit

Proofread your essay for grammar, spelling, and clarity. Make sure your arguments are well-structured and that your writing flows smoothly.

Seek Feedback

Have someone else read your essay to get feedback. They may offer valuable insights and help you identify areas where your persuasive techniques can be improved.

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Common Topics for a Persuasive Essay on COVID-19

Here are some persuasive essay topics on COVID-19:

The Importance of Vaccination Mandates for COVID-19 Control
Balancing Public Health and Personal Freedom During a Pandemic
The Economic Impact of Lockdowns vs. Public Health Benefits
The Role of Misinformation in Fueling Vaccine Hesitancy
Remote Learning vs. In-Person Education: What's Best for Students?
The Ethics of Vaccine Distribution: Prioritizing Vulnerable Populations
The Mental Health Crisis Amidst the COVID-19 Pandemic
The Long-Term Effects of COVID-19 on Healthcare Systems
Global Cooperation vs. Vaccine Nationalism in Fighting the Pandemic
The Future of Telemedicine: Expanding Healthcare Access Post-COVID-19

In search of more inspiring topics for your next persuasive essay? Our persuasive essay topics blog has plenty of ideas!

To sum it up,

You have read good sample essays and got some helpful tips. You now have the tools you needed to write a persuasive essay about Covid-19. So don't let the doubts stop you, start writing!

If you need professional writing help, don't worry! We've got that for you as well.

MyPerfectWords.com is a professional persuasive essay writing service that can help you craft an excellent persuasive essay on Covid-19. Our experienced essay writer will create a well-structured, insightful paper in no time!

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Frequently Asked Questions

Are there any ethical considerations when writing a persuasive essay about covid-19.

Yes, there are ethical considerations when writing a persuasive essay about COVID-19. It's essential to ensure the information is accurate, not contribute to misinformation, and be sensitive to the pandemic's impact on individuals and communities. Additionally, respecting diverse viewpoints and emphasizing public health benefits can promote ethical communication.

What impact does COVID-19 have on society?

The impact of COVID-19 on society is far-reaching. It has led to job and economic losses, an increase in stress and mental health disorders, and changes in education systems. It has also had a negative effect on social interactions, as people have been asked to limit their contact with others.

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Arguments in the debate over responses to the coronavirus (covid-19) pandemic, 2020.

State and local government responses to the coronavirus (COVID-19) pandemic have varied widely. Those responses have generated a similar variety of responses from pundits, policy makers, lawmakers, and more. This article highlights the arguments over government responses in several areas:

Universal or mass testing

Mask requirements

School closures, travel restrictions, lockdown/stay-at-home orders.

Expansion of absentee or mail-in voting

Religious service restrictions

This article is a hub for our coverage of arguments within each area of debate. It includes links to policy-specific pages that provide an overview of the arguments within each topic. It also includes links to state-specific pages that dive into the debate that's happening in each state about a variety of policies.

These arguments come from a variety of sources, including public officials, journalists, think tanks, economists, scientists, and other stakeholders. We encourage you to share the debates happening in your local community to [email protected] .

For an overview of federal, state, and local responses around the country, click here .

1.1 Testing
1.2 Mask requirements
1.3 School closures
1.4 Travel restrictions
1.5 Lockdown/stay-at-home orders
1.6 Expansion of absentee/mail-in voting
1.7 Religious service restrictions
2 General resources
4 External links
5 Footnotes

Topics and arguments

The main areas of disagreement about universal or mass testing for COVID-19 before the economy can reopen are:

Universal testing is necessary
Universal testing is effective
Universal testing is possible
Universal testing is not necessary
Universal testing is not possible
Universal testing would divert and waste resources
Universal testing might be dangerous
Massive testing is too expensive
Universal testing results are unreliable
Universal testing is too slow to protect public health

The main areas of disagreement about mask requirements during the coronavirus pandemic are:

Masks reduce airborne spread of coronavirus
Mask requirements are good for the economy
Mask laws are justified to promote public health
Mask mandates should apply statewide
Masks reduce the intensity of COVID-19 infection and sickness
Mask requirements are not necessary to stop the spread of coronavirus
Mask requirements give a false sense of security
Mask requirements restrict freedom
Masks present other health risks
Mask requirements have harmful social consequences
Mask requirements are unenforceable

The main areas of disagreement about school closures during the coronavirus pandemic are:

School closures are necessary to prevent the spread of the virus
Evidence from past pandemics supports the efficacy of school closures
Reopening Universities will increase COVID-19 spread
Reopening schools puts people of color at higher risk
Keep schools closed because COVID-19 outbreaks are inevitable
School closures are ineffective in preventing the spread of the virus
School closures pose significant unintended consequences
School closures and reopening plans have disparate economic effects
School closures and distance learning exacerbate digital divide
Reopen schools to protect the economy
School-aged children have reduced COVID-19 risk

The main areas of disagreement about travel restrictions are:

Travel restrictions prevent the spread of the virus
Travel restrictions promote the state's safety image
Travel restrictions are constitutional
Travel restrictions protect tourism workers
Certain travel restrictions are unconstitutional
Travel restrictions are unfair to tourism businesses
Travel restrictions are difficult to enforce
Travel restrictions are ineffective
Travel restrictions damage local economies

The main areas of disagreement about lockdown/stay-at-home orders are:

Lockdown/stay-at-home orders are necessary
Lockdown/stay-at-home orders are better for the economy long-term
Lockdown/stay-at-home orders are legal
Lockdown/stay-at-home orders are limited
Lockdown/stay-at-home orders are unnecessary
Lockdown/stay-at-home orders are worse than the coronavirus pandemic itself
Lockdown/stay-at-home orders are illegal
Lockdown/stay-at-home orders are unpopular
Lockdown/stay-at-home orders are unenforceable
Lockdown/stay-at-home orders go too far
Lockdown/stay-at-home orders create COVID-19 risks

Expansion of absentee/mail-in voting

The main areas of disagreement about the expansion of absentee/mail-in voting are:

Absentee/mail-in voting reduces the spread of COVID-19
Absentee/mail-in voting expansion is necessary to facilitate access to voting
Expanding absentee/mail-in voting is unlikely to increase fraud
Expanding vote-by-mail is fair to both major parties
States have the capacity and experience to expand absentee/mail-in voting
Absentee/mail-in voting is less reliable than in-person voting
Absentee/mail-in voting systems can fail
Absentee/mail-in voting poses a higher risk for fraud and manipulation
It is unnecessary to change voting systems in response to COVID-19
The expansion of absentee/mail-in voting systems open the door to flawed election policies
Expansion of absentee/mail-in voting systems creates election controversies (“blue shift”)

The main areas of disagreement about religious service restrictions are:

Public safety priorities take precedence over religious interests
Religious services present a higher risk than other social and business activities
Restrictions on physical gatherings do not preclude religious practices
Limiting religious gatherings during a pandemic aligns with most religious values
Skepticism of religious restrictions has harmed religious communities during COVID-19
In-person religious gatherings are not essential services
Religious gathering restrictions do not discriminate against faiths
Religious service restrictions violate the First Amendment and religious freedom
Religious services are essential
Religious service restrictions put church viability at risk
There is insufficient evidence that religious services pose a higher risk than other social and business activities
COVID-19 religious restrictions unfair to some faiths

General resources

Click the links below to explore official resources related to the coronavirus outbreak.

Centers for Disease Control and Prevention (CDC), U.S. Department of Health & Human Services
National Institutes of Health, U.S. Department of Health & Human Services
Occupational Safety and Health Administration, U.S. Department of Labor
U.S. Department of Education
World Health Organization
Trends in Number of COVID-19 Cases and Deaths in the US Reported to CDC, by State/Territory
Coronavirus (COVID-19) Vaccinations, Our World in Data (Number of vaccines administered)
Coronavirus Vaccine Tracker, New York Times (Progress of vaccine trials)
Ballotpedia: Political responses to the coronavirus (COVID-19) pandemic, 2020
State government responses to the coronavirus (COVID-19) pandemic, 2020
Government official, politician, and candidate deaths, diagnoses, and quarantines due to the coronavirus (COVID-19) pandemic, 2020-2021
Changes to ballot measure campaigns, procedures, and policies in response to the coronavirus (COVID-19) pandemic, 2020-2022
Ballotpedia's elections calendar

External links

The external resources listed below are related to the coronavirus pandemic.

Centers for Disease Control and Prevention (CDC), U.S. Department of Health and Human Services
National Institutes of Health, U.S. Department of Health and Human Services
Coronavirus arguments by topic
One-off pages, evergreen

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How to Write About Coronavirus in a College Essay

Students can share how they navigated life during the coronavirus pandemic in a full-length essay or an optional supplement.

Writing About COVID-19 in College Essays

Serious disabled woman concentrating on her work she sitting at her workplace and working on computer at office

Getty Images

Experts say students should be honest and not limit themselves to merely their experiences with the pandemic.

The global impact of COVID-19, the disease caused by the novel coronavirus, means colleges and prospective students alike are in for an admissions cycle like no other. Both face unprecedented challenges and questions as they grapple with their respective futures amid the ongoing fallout of the pandemic.

Colleges must examine applicants without the aid of standardized test scores for many – a factor that prompted many schools to go test-optional for now . Even grades, a significant component of a college application, may be hard to interpret with some high schools adopting pass-fail classes last spring due to the pandemic. Major college admissions factors are suddenly skewed.

"I can't help but think other (admissions) factors are going to matter more," says Ethan Sawyer, founder of the College Essay Guy, a website that offers free and paid essay-writing resources.

College essays and letters of recommendation , Sawyer says, are likely to carry more weight than ever in this admissions cycle. And many essays will likely focus on how the pandemic shaped students' lives throughout an often tumultuous 2020.

But before writing a college essay focused on the coronavirus, students should explore whether it's the best topic for them.

Writing About COVID-19 for a College Application

Much of daily life has been colored by the coronavirus. Virtual learning is the norm at many colleges and high schools, many extracurriculars have vanished and social lives have stalled for students complying with measures to stop the spread of COVID-19.

"For some young people, the pandemic took away what they envisioned as their senior year," says Robert Alexander, dean of admissions, financial aid and enrollment management at the University of Rochester in New York. "Maybe that's a spot on a varsity athletic team or the lead role in the fall play. And it's OK for them to mourn what should have been and what they feel like they lost, but more important is how are they making the most of the opportunities they do have?"

That question, Alexander says, is what colleges want answered if students choose to address COVID-19 in their college essay.

But the question of whether a student should write about the coronavirus is tricky. The answer depends largely on the student.

"In general, I don't think students should write about COVID-19 in their main personal statement for their application," Robin Miller, master college admissions counselor at IvyWise, a college counseling company, wrote in an email.

"Certainly, there may be exceptions to this based on a student's individual experience, but since the personal essay is the main place in the application where the student can really allow their voice to be heard and share insight into who they are as an individual, there are likely many other topics they can choose to write about that are more distinctive and unique than COVID-19," Miller says.

Opinions among admissions experts vary on whether to write about the likely popular topic of the pandemic.

"If your essay communicates something positive, unique, and compelling about you in an interesting and eloquent way, go for it," Carolyn Pippen, principal college admissions counselor at IvyWise, wrote in an email. She adds that students shouldn't be dissuaded from writing about a topic merely because it's common, noting that "topics are bound to repeat, no matter how hard we try to avoid it."

Above all, she urges honesty.

"If your experience within the context of the pandemic has been truly unique, then write about that experience, and the standing out will take care of itself," Pippen says. "If your experience has been generally the same as most other students in your context, then trying to find a unique angle can easily cross the line into exploiting a tragedy, or at least appearing as though you have."

But focusing entirely on the pandemic can limit a student to a single story and narrow who they are in an application, Sawyer says. "There are so many wonderful possibilities for what you can say about yourself outside of your experience within the pandemic."

He notes that passions, strengths, career interests and personal identity are among the multitude of essay topic options available to applicants and encourages them to probe their values to help determine the topic that matters most to them – and write about it.

That doesn't mean the pandemic experience has to be ignored if applicants feel the need to write about it.

Writing About Coronavirus in Main and Supplemental Essays

Students can choose to write a full-length college essay on the coronavirus or summarize their experience in a shorter form.

To help students explain how the pandemic affected them, The Common App has added an optional section to address this topic. Applicants have 250 words to describe their pandemic experience and the personal and academic impact of COVID-19.

"That's not a trick question, and there's no right or wrong answer," Alexander says. Colleges want to know, he adds, how students navigated the pandemic, how they prioritized their time, what responsibilities they took on and what they learned along the way.

If students can distill all of the above information into 250 words, there's likely no need to write about it in a full-length college essay, experts say. And applicants whose lives were not heavily altered by the pandemic may even choose to skip the optional COVID-19 question.

"This space is best used to discuss hardship and/or significant challenges that the student and/or the student's family experienced as a result of COVID-19 and how they have responded to those difficulties," Miller notes. Using the section to acknowledge a lack of impact, she adds, "could be perceived as trite and lacking insight, despite the good intentions of the applicant."

To guard against this lack of awareness, Sawyer encourages students to tap someone they trust to review their writing , whether it's the 250-word Common App response or the full-length essay.

Experts tend to agree that the short-form approach to this as an essay topic works better, but there are exceptions. And if a student does have a coronavirus story that he or she feels must be told, Alexander encourages the writer to be authentic in the essay.

"My advice for an essay about COVID-19 is the same as my advice about an essay for any topic – and that is, don't write what you think we want to read or hear," Alexander says. "Write what really changed you and that story that now is yours and yours alone to tell."

Sawyer urges students to ask themselves, "What's the sentence that only I can write?" He also encourages students to remember that the pandemic is only a chapter of their lives and not the whole book.

Miller, who cautions against writing a full-length essay on the coronavirus, says that if students choose to do so they should have a conversation with their high school counselor about whether that's the right move. And if students choose to proceed with COVID-19 as a topic, she says they need to be clear, detailed and insightful about what they learned and how they adapted along the way.

"Approaching the essay in this manner will provide important balance while demonstrating personal growth and vulnerability," Miller says.

Pippen encourages students to remember that they are in an unprecedented time for college admissions.

"It is important to keep in mind with all of these (admission) factors that no colleges have ever had to consider them this way in the selection process, if at all," Pippen says. "They have had very little time to calibrate their evaluations of different application components within their offices, let alone across institutions. This means that colleges will all be handling the admissions process a little bit differently, and their approaches may even evolve over the course of the admissions cycle."

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Read these 12 moving essays about life during coronavirus

Artists, novelists, critics, and essayists are writing the first draft of history.

by Alissa Wilkinson

The world is grappling with an invisible, deadly enemy, trying to understand how to live with the threat posed by a virus . For some writers, the only way forward is to put pen to paper, trying to conceptualize and document what it feels like to continue living as countries are under lockdown and regular life seems to have ground to a halt.

So as the coronavirus pandemic has stretched around the world, it’s sparked a crop of diary entries and essays that describe how life has changed. Novelists, critics, artists, and journalists have put words to the feelings many are experiencing. The result is a first draft of how we’ll someday remember this time, filled with uncertainty and pain and fear as well as small moments of hope and humanity.

The Vox guide to navigating the coronavirus crisis

At the New York Review of Books, Ali Bhutto writes that in Karachi, Pakistan, the government-imposed curfew due to the virus is “eerily reminiscent of past military clampdowns”:

Beneath the quiet calm lies a sense that society has been unhinged and that the usual rules no longer apply. Small groups of pedestrians look on from the shadows, like an audience watching a spectacle slowly unfolding. People pause on street corners and in the shade of trees, under the watchful gaze of the paramilitary forces and the police.

His essay concludes with the sobering note that “in the minds of many, Covid-19 is just another life-threatening hazard in a city that stumbles from one crisis to another.”

Writing from Chattanooga, novelist Jamie Quatro documents the mixed ways her neighbors have been responding to the threat, and the frustration of conflicting direction, or no direction at all, from local, state, and federal leaders:

Whiplash, trying to keep up with who’s ordering what. We’re already experiencing enough chaos without this back-and-forth. Why didn’t the federal government issue a nationwide shelter-in-place at the get-go, the way other countries did? What happens when one state’s shelter-in-place ends, while others continue? Do states still under quarantine close their borders? We are still one nation, not fifty individual countries. Right?

A syllabus for the end of the world

Award-winning photojournalist Alessio Mamo, quarantined with his partner Marta in Sicily after she tested positive for the virus, accompanies his photographs in the Guardian of their confinement with a reflection on being confined :

The doctors asked me to take a second test, but again I tested negative. Perhaps I’m immune? The days dragged on in my apartment, in black and white, like my photos. Sometimes we tried to smile, imagining that I was asymptomatic, because I was the virus. Our smiles seemed to bring good news. My mother left hospital, but I won’t be able to see her for weeks. Marta started breathing well again, and so did I. I would have liked to photograph my country in the midst of this emergency, the battles that the doctors wage on the frontline, the hospitals pushed to their limits, Italy on its knees fighting an invisible enemy. That enemy, a day in March, knocked on my door instead.

In the New York Times Magazine, deputy editor Jessica Lustig writes with devastating clarity about her family’s life in Brooklyn while her husband battled the virus, weeks before most people began taking the threat seriously:

At the door of the clinic, we stand looking out at two older women chatting outside the doorway, oblivious. Do I wave them away? Call out that they should get far away, go home, wash their hands, stay inside? Instead we just stand there, awkwardly, until they move on. Only then do we step outside to begin the long three-block walk home. I point out the early magnolia, the forsythia. T says he is cold. The untrimmed hairs on his neck, under his beard, are white. The few people walking past us on the sidewalk don’t know that we are visitors from the future. A vision, a premonition, a walking visitation. This will be them: Either T, in the mask, or — if they’re lucky — me, tending to him.

Essayist Leslie Jamison writes in the New York Review of Books about being shut away alone in her New York City apartment with her 2-year-old daughter since she became sick:

The virus. Its sinewy, intimate name. What does it feel like in my body today? Shivering under blankets. A hot itch behind the eyes. Three sweatshirts in the middle of the day. My daughter trying to pull another blanket over my body with her tiny arms. An ache in the muscles that somehow makes it hard to lie still. This loss of taste has become a kind of sensory quarantine. It’s as if the quarantine keeps inching closer and closer to my insides. First I lost the touch of other bodies; then I lost the air; now I’ve lost the taste of bananas. Nothing about any of these losses is particularly unique. I’ve made a schedule so I won’t go insane with the toddler. Five days ago, I wrote Walk/Adventure! on it, next to a cut-out illustration of a tiger—as if we’d see tigers on our walks. It was good to keep possibility alive.

At Literary Hub, novelist Heidi Pitlor writes about the elastic nature of time during her family’s quarantine in Massachusetts:

During a shutdown, the things that mark our days—commuting to work, sending our kids to school, having a drink with friends—vanish and time takes on a flat, seamless quality. Without some self-imposed structure, it’s easy to feel a little untethered. A friend recently posted on Facebook: “For those who have lost track, today is Blursday the fortyteenth of Maprilay.” ... Giving shape to time is especially important now, when the future is so shapeless. We do not know whether the virus will continue to rage for weeks or months or, lord help us, on and off for years. We do not know when we will feel safe again. And so many of us, minus those who are gifted at compartmentalization or denial, remain largely captive to fear. We may stay this way if we do not create at least the illusion of movement in our lives, our long days spent with ourselves or partners or families.

What day is it today?

Novelist Lauren Groff writes at the New York Review of Books about trying to escape the prison of her fears while sequestered at home in Gainesville, Florida:

Some people have imaginations sparked only by what they can see; I blame this blinkered empiricism for the parks overwhelmed with people, the bars, until a few nights ago, thickly thronged. My imagination is the opposite. I fear everything invisible to me. From the enclosure of my house, I am afraid of the suffering that isn’t present before me, the people running out of money and food or drowning in the fluid in their lungs, the deaths of health-care workers now growing ill while performing their duties. I fear the federal government, which the right wing has so—intentionally—weakened that not only is it insufficient to help its people, it is actively standing in help’s way. I fear we won’t sufficiently punish the right. I fear leaving the house and spreading the disease. I fear what this time of fear is doing to my children, their imaginations, and their souls.

At ArtForum , Berlin-based critic and writer Kristian Vistrup Madsen reflects on martinis, melancholia, and Finnish artist Jaakko Pallasvuo’s 2018 graphic novel Retreat , in which three young people exile themselves in the woods:

In melancholia, the shape of what is ending, and its temporality, is sprawling and incomprehensible. The ambivalence makes it hard to bear. The world of Retreat is rendered in lush pink and purple watercolors, which dissolve into wild and messy abstractions. In apocalypse, the divisions established in genesis bleed back out. My own Corona-retreat is similarly soft, color-field like, each day a blurred succession of quarantinis, YouTube–yoga, and televized press conferences. As restrictions mount, so does abstraction. For now, I’m still rooting for love to save the world.

At the Paris Review , Matt Levin writes about reading Virginia Woolf’s novel The Waves during quarantine:

A retreat, a quarantine, a sickness—they simultaneously distort and clarify, curtail and expand. It is an ideal state in which to read literature with a reputation for difficulty and inaccessibility, those hermetic books shorn of the handholds of conventional plot or characterization or description. A novel like Virginia Woolf’s The Waves is perfect for the state of interiority induced by quarantine—a story of three men and three women, meeting after the death of a mutual friend, told entirely in the overlapping internal monologues of the six, interspersed only with sections of pure, achingly beautiful descriptions of the natural world, a day’s procession and recession of light and waves. The novel is, in my mind’s eye, a perfectly spherical object. It is translucent and shimmering and infinitely fragile, prone to shatter at the slightest disturbance. It is not a book that can be read in snatches on the subway—it demands total absorption. Though it revels in a stark emotional nakedness, the book remains aloof, remote in its own deep self-absorption.

Vox is starting a book club. Come read with us!

In an essay for the Financial Times, novelist Arundhati Roy writes with anger about Indian Prime Minister Narendra Modi’s anemic response to the threat, but also offers a glimmer of hope for the future:

Historically, pandemics have forced humans to break with the past and imagine their world anew. This one is no different. It is a portal, a gateway between one world and the next. We can choose to walk through it, dragging the carcasses of our prejudice and hatred, our avarice, our data banks and dead ideas, our dead rivers and smoky skies behind us. Or we can walk through lightly, with little luggage, ready to imagine another world. And ready to fight for it.

From Boston, Nora Caplan-Bricker writes in The Point about the strange contraction of space under quarantine, in which a friend in Beirut is as close as the one around the corner in the same city:

It’s a nice illusion—nice to feel like we’re in it together, even if my real world has shrunk to one person, my husband, who sits with his laptop in the other room. It’s nice in the same way as reading those essays that reframe social distancing as solidarity. “We must begin to see the negative space as clearly as the positive, to know what we don’t do is also brilliant and full of love,” the poet Anne Boyer wrote on March 10th, the day that Massachusetts declared a state of emergency. If you squint, you could almost make sense of this quarantine as an effort to flatten, along with the curve, the distinctions we make between our bonds with others. Right now, I care for my neighbor in the same way I demonstrate love for my mother: in all instances, I stay away. And in moments this month, I have loved strangers with an intensity that is new to me. On March 14th, the Saturday night after the end of life as we knew it, I went out with my dog and found the street silent: no lines for restaurants, no children on bicycles, no couples strolling with little cups of ice cream. It had taken the combined will of thousands of people to deliver such a sudden and complete emptiness. I felt so grateful, and so bereft.

And on his own website, musician and artist David Byrne writes about rediscovering the value of working for collective good , saying that “what is happening now is an opportunity to learn how to change our behavior”:

In emergencies, citizens can suddenly cooperate and collaborate. Change can happen. We’re going to need to work together as the effects of climate change ramp up. In order for capitalism to survive in any form, we will have to be a little more socialist. Here is an opportunity for us to see things differently — to see that we really are all connected — and adjust our behavior accordingly. Are we willing to do this? Is this moment an opportunity to see how truly interdependent we all are? To live in a world that is different and better than the one we live in now? We might be too far down the road to test every asymptomatic person, but a change in our mindsets, in how we view our neighbors, could lay the groundwork for the collective action we’ll need to deal with other global crises. The time to see how connected we all are is now.

The portrait these writers paint of a world under quarantine is multifaceted. Our worlds have contracted to the confines of our homes, and yet in some ways we’re more connected than ever to one another. We feel fear and boredom, anger and gratitude, frustration and strange peace. Uncertainty drives us to find metaphors and images that will let us wrap our minds around what is happening.

Yet there’s no single “what” that is happening. Everyone is contending with the pandemic and its effects from different places and in different ways. Reading others’ experiences — even the most frightening ones — can help alleviate the loneliness and dread, a little, and remind us that what we’re going through is both unique and shared by all.

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The complexity of managing COVID-19: How important is good governance?

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Alaka m. basu , amb alaka m. basu professor, department of global development - cornell university, senior fellow - united nations foundation kaushik basu , and kaushik basu nonresident senior fellow - global economy and development @kaushikcbasu jose maria u. tapia jmut jose maria u. tapia student - cornell university.

November 17, 2020

13 min read

This essay is part of “ Reimagining the global economy: Building back better in a post-COVID-19 world ,” a collection of 12 essays presenting new ideas to guide policies and shape debates in a post-COVID-19 world.

The COVID-19 pandemic has exposed the inadequacy of public health systems worldwide, casting a shadow that we could not have imagined even a year ago. As the fog of confusion lifts and we begin to understand the rudiments of how the virus behaves, the end of the pandemic is nowhere in sight. The number of cases and the deaths continue to rise. The latter breached the 1 million mark a few weeks ago and it looks likely now that, in terms of severity, this pandemic will surpass the Asian Flu of 1957-58 and the Hong Kong Flu of 1968-69.

Moreover, a parallel problem may well exceed the direct death toll from the virus. We are referring to the growing economic crises globally, and the prospect that these may hit emerging economies especially hard.

The economic fall-out is not entirely the direct outcome of the COVID-19 pandemic but a result of how we have responded to it—what measures governments took and how ordinary people, workers, and firms reacted to the crisis. The government activism to contain the virus that we saw this time exceeds that in previous such crises, which may have dampened the spread of the COVID-19 but has extracted a toll from the economy.

This essay takes stock of the policies adopted by governments in emerging economies, and what effect these governance strategies may have had, and then speculates about what the future is likely to look like and what we may do here on.

Nations that build walls to keep out goods, people and talent will get out-competed by other nations in the product market.

It is becoming clear that the scramble among several emerging economies to imitate and outdo European and North American countries was a mistake. We get a glimpse of this by considering two nations continents apart, the economies of which have been among the hardest hit in the world, namely, Peru and India. During the second quarter of 2020, Peru saw an annual growth of -30.2 percent and India -23.9 percent. From the global Q2 data that have emerged thus far, Peru and India are among the four slowest growing economies in the world. Along with U.K and Tunisia these are the only nations that lost more than 20 percent of their GDP. 1

COVID-19-related mortality statistics, and, in particular, the Crude Mortality Rate (CMR), however imperfect, are the most telling indicator of the comparative scale of the pandemic in different countries. At first glance, from the end of October 2020, Peru, with 1039 COVID-19 deaths per million population looks bad by any standard and much worse than India with 88. Peru’s CMR is currently among the highest reported globally.

However, both Peru and India need to be placed in regional perspective. For reasons that are likely to do with the history of past diseases, there are striking regional differences in the lethality of the virus (Figure 11.1). South America is worse hit than any other world region, and Asia and Africa seem to have got it relatively lightly, in contrast to Europe and America. The stark regional difference cries out for more epidemiological analysis. But even as we await that, these are differences that cannot be ignored.

To understand the effect of policy interventions, it is therefore important to look at how these countries fare within their own regions, which have had similar histories of illnesses and viruses (Figure 11.2). Both Peru and India do much worse than the neighbors with whom they largely share their social, economic, ecological and demographic features. Peru’s COVID-19 mortality rate per million population, or CMR, of 1039 is ahead of the second highest, Brazil at 749, and almost twice that of Argentina at 679.

Similarly, India at 88 compares well with Europe and the U.S., as does virtually all of Asia and Africa, but is doing much worse than its neighbors, with the second worst country in the region, Afghanistan, experiencing less than half the death rate of India.

The official Indian statement that up to 78,000 deaths 2 were averted by the lockdown has been criticized 3 for its assumptions. A more reasonable exercise is to estimate the excess deaths experienced by a country that breaks away from the pattern of its regional neighbors. So, for example, if India had experienced Afghanistan’s COVID-19 mortality rate, it would by now have had 54,112 deaths. And if it had the rate reported by Bangladesh, it would have had 49,950 deaths from COVID-19 today. In other words, more than half its current toll of some 122,099 COVID-19 deaths would have been avoided if it had experienced the same virus hit as its neighbors.

What might explain this outlier experience of COVID-19 CMRs and economic downslide in India and Peru? If the regional background conditions are broadly similar, one is left to ask if it is in fact the policy response that differed markedly and might account for these relatively poor outcomes.

Peru and India have performed poorly in terms of GDP growth rate in Q2 2020 among the countries displayed in Table 2, and given that both these countries are often treated as case studies of strong governance, this draws attention to the fact that there may be a dissonance between strong governance and good governance.

The turnaround for India has been especially surprising, given that until a few years ago it was among the three fastest growing economies in the world. The slowdown began in 2016, though the sharp downturn, sharper than virtually all other countries, occurred after the lockdown.

On the COVID-19 policy front, both India and Peru have become known for what the Oxford University’s COVID Policy Tracker 4 calls the “stringency” of the government’s response to the epidemic. At 8 pm on March 24, 2020, the Indian government announced, with four hours’ notice, a complete nationwide shutdown. Virtually all movement outside the perimeter of one’s home was officially sought to be brought to a standstill. Naturally, as described in several papers, such as that of Ray and Subramanian, 5 this meant that most economic life also came to a sudden standstill, which in turn meant that hundreds of millions of workers in the informal, as well as more marginally formal sectors, lost their livelihoods.

In addition, tens of millions of these workers, being migrant workers in places far-flung from their original homes, also lost their temporary homes and their savings with these lost livelihoods, so that the only safe space that beckoned them was their place of origin in small towns and villages often hundreds of miles away from their places of work.

After a few weeks of precarious living in their migrant destinations, they set off, on foot since trains and buses had been stopped, for these towns and villages, creating a “lockdown and scatter” that spread the virus from the city to the town and the town to the village. Indeed, “lockdown” is a bit of a misnomer for what happened in India, since over 20 million people did exactly the opposite of what one does in a lockdown. Thus India had a strange combination of lockdown some and scatter the rest, like in no other country. They spilled out and scattered in ways they would otherwise not do. It is not surprising that the infection, which was marginally present in rural areas (23 percent in April), now makes up some 54 percent of all cases in India. 6

In Peru too, the lockdown was sudden, nationwide, long drawn out and stringent. 7 Jobs were lost, financial aid was difficult to disburse, migrant workers were forced to return home, and the virus has now spread to all parts of the country with death rates from it surpassing almost every other part of the world.

As an aside, to think about ways of implementing lockdowns that are less stringent and geographically as well as functionally less total, an example from yet another continent is instructive. Ethiopia, with a COVID-19 death rate of 13 per million population seems to have bettered the already relatively low African rate of 31 in Table 1. 8

We hope that human beings will emerge from this crisis more aware of the problems of sustainability.

The way forward

We next move from the immediate crisis to the medium term. Where is the world headed and how should we deal with the new world? Arguably, that two sectors that will emerge larger and stronger in the post-pandemic world are: digital technology and outsourcing, and healthcare and pharmaceuticals.

The last 9 months of the pandemic have been a huge training ground for people in the use of digital technology—Zoom, WebEx, digital finance, and many others. This learning-by-doing exercise is likely to give a big boost to outsourcing, which has the potential to help countries like India, the Philippines, and South Africa.

Globalization may see a short-run retreat but, we believe, it will come back with a vengeance. Nations that build walls to keep out goods, people and talent will get out-competed by other nations in the product market. This realization will make most countries reverse their knee-jerk anti-globalization; and the ones that do not will cease to be important global players. Either way, globalization will be back on track and with a much greater amount of outsourcing.

To return, more critically this time, to our earlier aside on Ethiopia, its historical and contemporary record on tampering with internet connectivity 9 in an attempt to muzzle inter-ethnic tensions and political dissent will not serve it well in such a post-pandemic scenario. This is a useful reminder for all emerging market economies.

We hope that human beings will emerge from this crisis more aware of the problems of sustainability. This could divert some demand from luxury goods to better health, and what is best described as “creative consumption”: art, music, and culture. 10 The former will mean much larger healthcare and pharmaceutical sectors.

But to take advantage of these new opportunities, nations will need to navigate the current predicament so that they have a viable economy once the pandemic passes. Thus it is important to be able to control the pandemic while keeping the economy open. There is some emerging literature 11 on this, but much more is needed. This is a governance challenge of a kind rarely faced, because the pandemic has disrupted normal markets and there is need, at least in the short run, for governments to step in to fill the caveat.

Emerging economies will have to devise novel governance strategies for doing this double duty of tamping down on new infections without strident controls on economic behavior and without blindly imitating Europe and America.

Here is an example. One interesting opportunity amidst this chaos is to tap into the “resource” of those who have already had COVID-19 and are immune, even if only in the short-term—we still have no definitive evidence on the length of acquired immunity. These people can be offered a high salary to work in sectors that require physical interaction with others. This will help keep supply chains unbroken. Normally, the market would have on its own caused such a salary increase but in this case, the main benefit of marshaling this labor force is on the aggregate economy and GDP and therefore is a classic case of positive externality, which the free market does not adequately reward. It is more a challenge of governance. As with most economic policy, this will need careful research and design before being implemented. We have to be aware that a policy like this will come with its risk of bribery and corruption. There is also the moral hazard challenge of poor people choosing to get COVID-19 in order to qualify for these special jobs. Safeguards will be needed against these risks. But we believe that any government that succeeds in implementing an intelligently-designed intervention to draw on this huge, under-utilized resource can have a big, positive impact on the economy 12 .

This is just one idea. We must innovate in different ways to survive the crisis and then have the ability to navigate the new world that will emerge, hopefully in the not too distant future.

Writing about COVID-19 in a college admission essay

by: Venkates Swaminathan | Updated: September 14, 2020

Print article

Writing about COVID-19 in your college admission essay

For students applying to college using the CommonApp, there are several different places where students and counselors can address the pandemic’s impact. The different sections have differing goals. You must understand how to use each section for its appropriate use.

The CommonApp COVID-19 question

First, the CommonApp this year has an additional question specifically about COVID-19 :

Community disruptions such as COVID-19 and natural disasters can have deep and long-lasting impacts. If you need it, this space is yours to describe those impacts. Colleges care about the effects on your health and well-being, safety, family circumstances, future plans, and education, including access to reliable technology and quiet study spaces. Please use this space to describe how these events have impacted you.

This question seeks to understand the adversity that students may have had to face due to the pandemic, the move to online education, or the shelter-in-place rules. You don’t have to answer this question if the impact on you wasn’t particularly severe. Some examples of things students should discuss include:

The student or a family member had COVID-19 or suffered other illnesses due to confinement during the pandemic.
The candidate had to deal with personal or family issues, such as abusive living situations or other safety concerns
The student suffered from a lack of internet access and other online learning challenges.
Students who dealt with problems registering for or taking standardized tests and AP exams.

Jeff Schiffman of the Tulane University admissions office has a blog about this section. He recommends students ask themselves several questions as they go about answering this section:

Are my experiences different from others’?
Are there noticeable changes on my transcript?
Am I aware of my privilege?
Am I specific? Am I explaining rather than complaining?
Is this information being included elsewhere on my application?

If you do answer this section, be brief and to-the-point.

Counselor recommendations and school profiles

Second, counselors will, in their counselor forms and school profiles on the CommonApp, address how the school handled the pandemic and how it might have affected students, specifically as it relates to:

Grading scales and policies
Graduation requirements
Instructional methods
Schedules and course offerings
Testing requirements
Your academic calendar
Other extenuating circumstances

Students don’t have to mention these matters in their application unless something unusual happened.

Writing about COVID-19 in your main essay

Write about your experiences during the pandemic in your main college essay if your experience is personal, relevant, and the most important thing to discuss in your college admission essay. That you had to stay home and study online isn’t sufficient, as millions of other students faced the same situation. But sometimes, it can be appropriate and helpful to write about something related to the pandemic in your essay. For example:

One student developed a website for a local comic book store. The store might not have survived without the ability for people to order comic books online. The student had a long-standing relationship with the store, and it was an institution that created a community for students who otherwise felt left out.
One student started a YouTube channel to help other students with academic subjects he was very familiar with and began tutoring others.
Some students used their extra time that was the result of the stay-at-home orders to take online courses pursuing topics they are genuinely interested in or developing new interests, like a foreign language or music.

Experiences like this can be good topics for the CommonApp essay as long as they reflect something genuinely important about the student. For many students whose lives have been shaped by this pandemic, it can be a critical part of their college application.

Want more? Read 6 ways to improve a college essay , What the &%$! should I write about in my college essay , and Just how important is a college admissions essay? .

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Covid 19 Essay in English

Essay on Covid -19: In a very short amount of time, coronavirus has spread globally. It has had an enormous impact on people's lives, economy, and societies all around the world, affecting every country. Governments have had to take severe measures to try and contain the pandemic. The virus has altered our way of life in many ways, including its effects on our health and our economy. Here are a few sample essays on ‘CoronaVirus’.

100 Words Essay on Covid 19

200 words essay on covid 19, 500 words essay on covid 19.

COVID-19 or Corona Virus is a novel coronavirus that was first identified in 2019. It is similar to other coronaviruses, such as SARS-CoV and MERS-CoV, but it is more contagious and has caused more severe respiratory illness in people who have been infected. The novel coronavirus became a global pandemic in a very short period of time. It has affected lives, economies and societies across the world, leaving no country untouched. The virus has caused governments to take drastic measures to try and contain it. From health implications to economic and social ramifications, COVID-19 impacted every part of our lives. It has been more than 2 years since the pandemic hit and the world is still recovering from its effects.

Since the outbreak of COVID-19, the world has been impacted in a number of ways. For one, the global economy has taken a hit as businesses have been forced to close their doors. This has led to widespread job losses and an increase in poverty levels around the world. Additionally, countries have had to impose strict travel restrictions in an attempt to contain the virus, which has resulted in a decrease in tourism and international trade. Furthermore, the pandemic has put immense pressure on healthcare systems globally, as hospitals have been overwhelmed with patients suffering from the virus. Lastly, the outbreak has led to a general feeling of anxiety and uncertainty, as people are fearful of contracting the disease.

My Experience of COVID-19

I still remember how abruptly colleges and schools shut down in March 2020. I was a college student at that time and I was under the impression that everything would go back to normal in a few weeks. I could not have been more wrong. The situation only got worse every week and the government had to impose a lockdown. There were so many restrictions in place. For example, we had to wear face masks whenever we left the house, and we could only go out for essential errands. Restaurants and shops were only allowed to operate at take-out capacity, and many businesses were shut down.

In the current scenario, coronavirus is dominating all aspects of our lives. The coronavirus pandemic has wreaked havoc upon people’s lives, altering the way we live and work in a very short amount of time. It has revolutionised how we think about health care, education, and even social interaction. This virus has had long-term implications on our society, including its impact on mental health, economic stability, and global politics. But we as individuals can help to mitigate these effects by taking personal responsibility to protect themselves and those around them from infection.

Effects of CoronaVirus on Education

The outbreak of coronavirus has had a significant impact on education systems around the world. In China, where the virus originated, all schools and universities were closed for several weeks in an effort to contain the spread of the disease. Many other countries have followed suit, either closing schools altogether or suspending classes for a period of time.

This has resulted in a major disruption to the education of millions of students. Some have been able to continue their studies online, but many have not had access to the internet or have not been able to afford the costs associated with it. This has led to a widening of the digital divide between those who can afford to continue their education online and those who cannot.

The closure of schools has also had a negative impact on the mental health of many students. With no face-to-face contact with friends and teachers, some students have felt isolated and anxious. This has been compounded by the worry and uncertainty surrounding the virus itself.

The situation with coronavirus has improved and schools have been reopened but students are still catching up with the gap of 2 years that the pandemic created. In the meantime, governments and educational institutions are working together to find ways to support students and ensure that they are able to continue their education despite these difficult circumstances.

Effects of CoronaVirus on Economy

The outbreak of the coronavirus has had a significant impact on the global economy. The virus, which originated in China, has spread to over two hundred countries, resulting in widespread panic and a decrease in global trade. As a result of the outbreak, many businesses have been forced to close their doors, leading to a rise in unemployment. In addition, the stock market has taken a severe hit.

Effects of CoronaVirus on Health

The effects that coronavirus has on one's health are still being studied and researched as the virus continues to spread throughout the world. However, some of the potential effects on health that have been observed thus far include respiratory problems, fever, and coughing. In severe cases, pneumonia, kidney failure, and death can occur. It is important for people who think they may have been exposed to the virus to seek medical attention immediately so that they can be treated properly and avoid any serious complications. There is no specific cure or treatment for coronavirus at this time, but there are ways to help ease symptoms and prevent the virus from spreading.

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Original research article, covid-19: scientific arguments, denialism, eugenics, and the construction of the antisocial distancing discourse in brazil.

1 Faculty of Public Health's Audioteca Collection, University of São Paulo, São Paulo, Brazil
2 School of Arts Science and Humanities, University of São Paulo, São Paulo, Brazil

Since March 11, the world has been experiencing a pandemic of Sars-Cov-2, the new coronavirus, which emerged in China in late December 2019 and causes the COVID-19 disease. Pandemics are characterized by pathogen's ability of emerging or re-emerging across geographical boundaries, simultaneously affecting a large number of people around the world, due to the sustained transmission in humans. In the case of the COVID-19 pandemic, we have witnessed in real time the dissemination of different types of information about it and strategies used to contain the rate of virus contamination. Our main goal in this study is to analyze the discursive production of the Brazilian journalistic media about vertical isolation as a supposed scientific strategy, and to demonstrate how that has been used in the denialist approach adopted by the Brazilian President Jair Bolsonaro. The research was carried out on the Google platform, using the following descriptors: coronavirus and herd immunity; coronavirus and the Imperial College herd immunity strategy; vertical isolation; Bolsonaro and vertical isolation. Thirty-six articles were selected for a qualitative analysis besides the original article by David L. Katz (published in The New York Times), where he claims the creation of the vertical confinement strategy. All documents of the analytical corpus are open and free of charge. The articles were submitted to discursive analysis and the main results shows that Brazilian media highlighted Bolsonaro's proposal of vertical isolation and amplified his pandemic denial and eugenics policies The mass media vehicles play a central role in the dissemination of information and should commit to the publication of reliable and trustworthy information, as well as to objectively situate the areas of knowledge of the specialists whose opinions are being published.

Introduction

The COVID-19 pandemic presents itself as concerning for the majority of people across the planet. This concern is guided by a number of characteristics of Sars-Cov-2 and by the contemporary lifestyle. The virus has a high potential for dissemination in the globalized world—by mid-August 2020, more than 20.7 million people had been contaminated; part of this contingent became seriously ill, requiring hospitalization, and nearly 780 thousand people had died 1 . There is still no treatment available for this disease, nor vaccines that might prevent infection. These factors, together with the lack of knowledge and the uncertainties on the evolution of the infection/disease, as well as the post-infection immunological responses, have led to great investments in scientific research in the several fields of science, while at the same time the population searches incessantly for information in order to make sense of their own experiences.

Within this context of a pandemic, mass media holds a key social role; as a source of information that is historically recognized and trustworthy, the media has been disseminating and modeling the ways in which ordinary people think about and deal with everyday events. It is important to remember that the conditions of truth and of social justification are the pillars that support the belief in journalistic discourse, which becomes trustworthy and credible as long as it manages to prove the veracity of its testimony, by means of the detailing of facts and the citation of specialized sources ( Lisboa and Benetti, 2015 ).

It is important to note, however, that this “proof of veracity” does not make news stories “mirrors” of reality, but instead, simply one of the possible narratives about social occurrences. Transformed into information, these occurrences are shared between members of society and journalists, who in turn claim a monopoly on this knowledge (defining what is news), meaning that, more than passive observers, they are active participants in the construction of reality ( Traquina, 2007 ). Although creative, journalistic activity is submitted to a number of “tyrannies”: of the deadlines and formats of journalistic production; of superior hierarchies (editors-in-chief, news editors, and, frequently, the owners of the platforms); the imperatives of journalism as a business; the extreme competition; and the action/pressure of different social actors searching to highlight their own matters ( Traquina, 2007 ). Thus, newsmaking results in journalism's capacity for producing social facts, in other words, for instituting realities, according to the repertories and contexts that the journalist chooses to use.

We have, in addition, used journalistic discursive practices within the perspective offered by Van Der Haak et al. (2012) , who state that journalism, as a public asset, should produce information and analyses that are useful for democratic societies, based on transparency, independence, the use of reliable sources, and the detailed analysis of events.

In this text we took the journalistic coverage of COVID-19 as a producer of meanings and social facts ( Spink, 2004 ). We also used the perspective of Thompson (2014) , for whom the process of news production, whichever it may be, always occurs within a socio-historical context that allows media outlets to capture and transform a certain number of everyday events into messages (symbolic forms) in detriment of an infinity of others.

We considered the context of exceptionality of the pandemic, where researchers and scientists are being obliged to accelerate their production to a rhythm never seen before, in order to provide clinical responses to the disease and guide public policies and State actions for managing public health around the world. This implies that most of the knowledge produced about Sars-CoV-2 and the disease it causes is being permanently revised, refuted, and discarded.

The problem is that, with this frenetic production, the refuted suppositions have often already reached a level of dissemination and absorption by common sense and even by public authorities which, due to a variety of interests, makes it impossible to revert their use, remaining as valid points of view. In other words, even when these suppositions have been invalidated by science, they continue as a social fact, affecting the lives of people and the manners in which they make their decisions when faced with the epidemic. Thus, it is important for journalists and mass media companies to be vigilant regarding the possible consequences of the content they relay.

We are referring, therefore, to the decisive role played by mass media in structuring the public space. This is a sensitive debate around the world, as it involves controlling the access to the production and circulation of the information that is transformed into messages (symbolic content) by a restricted number of actors, according to private interests or that of the groups that the media represents ( Thompson, 2014 ). This aspect is especially problematic in Brazil. The country has a historical asymmetry in the relationship between mass media and society, establishing what Kucinski (2006) call the “principle of exclusion,” violating the human right to information.

In Brazil, different from that which occurred for the most part in the liberal democracies of the global North, the mediatic market is marked by an ideological, economic, and political homogeneity that is usually pro-establishment. From the start, the media—and particularly the press—has historically reproduced with great fidelity the oligarchic model of land ownership, with a predominance in newspaper management of the “favoritism typical of the command culture of large rural properties” ( Kucinski, 2006 , p. 20).

The business model for national media is amplified by Brazil's complexity. Companies are configurated as oligopolies, with properties that are horizontal, vertical, and crisscrossed by different mediums (newspapers, magazines, AM and FM radio, open access and pay TV, internet provider) within the same market, whether local, regional, or national. This process was accentuated by the privatization of telecommunications during the 1990s ( de Lima, 2001 , 2011 ; Malinverni, 2016 ). Currently, according to the Brazilian section of the MOM (Media Ownership Monitor)/Reporters Sans Frontiéres, eight economic family groups control 26 of the 50 largest media vehicles in the country, according to audience and to scheduling capacity; in other words, in terms of potential to influence public opinion.

Divided into four large sectors (print, radio, TV, and online), the study, which resulted in the report “Who controls the media in Brazil,” released in late 2017, indicates a red alert for the Brazilian mediatic system due to the high concentration of audience and properties, the high geographic concentration, and the lack of transparency, besides economic, political, and religious interference in the production of information 2 . Seven of the twelve vehicles that published the news stories analyzed in this work integrate the control group describe above. The most paradigmatic of these is the Globo group, the largest oligopoly in this sector in Brazil and Latin America, and one of the largest in the world, with more than half of the audience among the first four (36.9%). The concentration of media outlets by a small number of private groups restricts competition and, consequently, the diversity to represent the distinct interests of society. Without the possibility of contradiction, there is a predominance in the mediatic market of what many studies and analysts call “penseé unique” ( de Lima, 2011 ).

Faced with such a complex dynamic—taken here in the sense proposed by Law and Mol (2002) , according to whom innumerable actors, materialities, and sociabilities perform the several facets of a phenomenon—and with the up-to-the-minute scope of the pandemic, which takes place in real time, journalistic coverage is up against enormous difficulties. These range from the immediacy of translating the technical-scientific knowledge of several fields to critical evaluations on what to publish and the possible effects.

Historically, at moments of public health emergency, the population and journalists wait to receive trustworthy information from governmental organizations and political leaderships, whose actions are based on the guidance of health authorities. In Brazil, however, besides this complexity that is inherent to the pandemic, mass media must deal with other challenges. The first, as we will see in the analyses, lies in reporting two distinct official discourses on controlling COVID-19: that of the president of the Republic and his supporters; and that of the scientists in the field of health, technicians from the Ministry of Health (in the first months), and governors and mayors who are favorable to social distancing. This resulted in a politicization of the actions for disease control.

Brazil has a Unified Health System (Sistema Único de Saúde—SUS) that guarantees universal health access to all within the national territory; the System is well-structured and organized in a decentralized manner. Since the promulgation of the 1988 Constitution, it is up to the federal government to establish guidelines and coordinate healthcare actions, allocating a budget for the states and municipalities, who manage resources and actions according to local/regional needs. This system counts on a structure of sanitary surveillance and consolidated data registration that allows the monitoring of healthcare actions throughout the country. The pandemic, however, hit Brazil at a point when SUS has been weakened, since, as stated by Menezes et al. (2019) , from 2016 a policy of defunding healthcare has been implemented, by means of the approval of a constitutional amendment that froze the federal budget in this sector for the next 20 years, with readjustment calculations based only on inflation. This policy of deconstructing SUS has intensified during the Bolsonaro government, with already-perceptible effects upon the population's health: “For example, the loss of 8.5 thousand Cuban doctors from the More Doctors Program, who were treating around 30 million Brazilians, in 2.9 thousand municipalities and indigenous villages” ( Menezes et al., 2019 , p. 67).

Despite this process of scrapping, from January to May the technical team of the Ministry of Health, responsible for managing SUS, carried out assertive actions relating to the pandemic, creating decrees, establishing benchmarks for action, and guiding the population. The president of the Republic, however, who refuses to acknowledge the severity of the pandemic, has been producing and divulging, from the start, counterinformation that contradicts the ministerial discourse. Within this context, on April 16, Bolsonaro dismissed the minister of Health, doctor and politician, and nominated a new leader for the department, an oncologist and business entrepreneur who works in the private sector. With a more technical profile, he remained only 28 days in office, and resigned due to disagreeing with the president's position regarding use of chloroquine to combat COVID-19. Therefore, since May 15, the position of minister of Health has been occupied in an interim manner by a general without any health background, who nominated other members of the military, equally without specialized training, to key roles in the Ministry of Health, furthering the dismantling of SUS 3 .

Brazilian journalism gave plenty of space for this polarization between the president and his supporters and the Ministry of Health, during the first months of the pandemic, as well as to the national and international scientific community on the subject of measures of social distancing. The analysis of articles indicated that the journalistic coverage often considered both discourses as equivalent, even knowing that the president and his supporters had no scientific backing—on the contrary, they often based themselves on false news and unfounded calculations.

For Gelbspan (1998 , p. 57–58), in discussing journalistic coverage of global warning:

The professional canon of journalistic fairness requires reporters who write about a controversy to present competing points of view. When the issue is of a political or social nature, fairness – presenting the most compelling arguments of both sides with equal weight – is a fundamental check on biased reporting. But this canon causes problems when it is applied to issues of science. It seems to demand that journalists present competing points of views on a scientific question as though they had equal scientific weight, when actually they do not.

In this sense, it is crucial that journalists covering themes that involve science know how to translate the concepts and recognize strong evidence so as not to fall into the mistake that Pitts (2018) designates “ both-sideism.” Rosen (2010) , discussing this journalistic strategy, states that it is often adopted in order to seek an “objectivity,” by means of which the journalist would speak from a supposed position of neutrality (a view from nowhere), and could not therefore be accused of favoring one position. For Sousa (2002) , this position is a tributary of two ideological forces that modulate news: that of objectivity and that of professionalism. The first explains the descriptive and factual orientation of news, with its mimetic ambition regarding reality that becomes explicit, and the systematic identification of sources of information in news statements; the second is based on the belief that the production routine and professional experience are sufficient tools for journalistic exemption. Supported by deontological codes constructed throughout history, the journalist acts as a “professional authority,” imbued with the right and the obligation to mediate and simplify information on daily happenings ( Traquina, 2007 ). In other words, under the jargon “interests of society,” the press acts within a discursive safe conduct that “authorizes” the prescription of standards and practices, while at the same time serving as an “argumentative shield” that protects and exempts journalists and owners of communication vehicles from the consequences of their discursive practices ( Malinverni et al., 2012 ). This strategy, however, impedes a deeper analysis and the production of precise information based on the truth.

Another challenge that journalists face is the increasingly precarious nature of work in newsrooms, and a lack of specialization in the area of health ( Malinverni and Cuenca, 2017 ), both of which have become more of an issue over the past decade with the financial crisis that has impacted media companies, especially print journalism, due to the rise of virtual media ( Castilho, 2015 ), affecting directly the quality of the news. Vukasovich and Vukasovich (2016) indicate, additionally, that globalization and the incessant pressures of newsmaking are two more elements that greatly impact the quality of journalistic coverage.

Methodology

In this work we carried out the discursive analysis of journalistic coverage following two key thematic lines: herd immunity and vertical isolation. Using Google search, we researched news articles on the Sars-CoV-2 epidemic in Brazil using four descriptors: 1—Herd immunity and coronavirus; 2—Herd immunity and Imperial College; 3—Vertical isolation; and 4—Bolsonaro and vertical isolation. Criteria for inclusion: the first three pages of results presented by Google; articles published by print media and mass news sites with high visitation numbers and open access links. Criteria for exclusion: blogs with no connection to mass media or governmental and non-governmental organizations; low repercussion media, videos and links that can be exclusively accessed by subscribers; texts reproduced ipsis litteris on other sites.

The time period set for article selection was March 16 to April 30, 2020, starting 5 days before the date on which the Ministry of Health confirmed community transmission of the disease in the country (March 20) and a public health emergency was declared by most state and municipal governments.

In the first phase of systemization, 101 texts were located; of these, after application of the above criteria, 36 were selected for analysis: 8 articles under descriptor 1; 8 under descriptor 2; 11 under descriptor 3; and 9 under descriptor 4. All texts were copied into Word to be later read in full and analyzed. The texts were published on 12 websites, linked to nine media groups: UOL, Folha de S.Paulo and Bol/UOL (Grupo Folha); O Globo (Organizações Globo); Saúde Estadão (Grupo Estado); Saúde Abril and Veja (Grupo Abril); Gazeta do Acre (independent); IstoÉ Dinheiro (Editora Três); BBC News Brasil (a subsidiary of BBC, controlled by the British government); El País Brasil (from the Spanish group PRISA); and CNN Brasil (a subsidiary of the American CNN). The four first, as already mentioned, are among the organizations that control almost 60% of the national audience. Historically, they operate under the establishment logic, with episodic demonstrations of divergences that lend an appearance of plurality. Rarely do they explicitly support a candidate or political party, although the journalistic coverage is always more favorable to agendas that adopt a center or right-wing positioning within the political spectrum. This perspective, shared by IstoÉ Dinheiro and CNN Brasil, has been in effect in the country since mid-March of 2020. The Gazeta do Acre is the only independent vehicle; in other words, that is not connected to a multimedia conglomerate. It was founded by two reporters who worked at an alternative newspaper which, in the 1970s, challenged the censorship imposed by the military regime and reported the daily violence committed by the large landowners against the small-scale rubber tree tappers—among them Acre environmentalist Chico Mendes, murdered by local ranchers in 1988. El País Brasil and BBC News Brasil follow the more liberal line of journalistic coverage set by their parent companies. These characteristics may explain why these three vehicles were the only ones to adopt a more critical approach to Bolsonaro's discourse, as will be discussed.

We adopted the theoretical perspective of discursive practices ( Spink, 2004 ), focusing on the language in use, a social practice analyzed in the intersection between performative aspects of language (when, in which conditions, with what intention, in which manner) and the conditions of production (understood in this case both as social and interactional context, and in the Foucauldian sense of historical constructions).

In this approach, the notion of interpretative repertories of Wetherell and Potter (1988 , p. 172) is central:

Repertoires could be seen as building blocks speakers use for constructing versions of actions, cognitive processes, and other phenomena. Any particular repertoire is constructed out of a restricted range of terms used in a specific stylistic and grammatical fashion. Commonly these terms are derived from one or more key metaphors and the presence of a repertoire will often be signaled by certain tropes or figures of speech.

The circulation dynamic of the interpretative repertories, within the flow of production of meanings, updates contents and processes present in the history of a society.

In this analysis we looked for these standards in the journalistic coverage of the two studied themes, making clear the content of the discussions and marking out the meanings they produce, as well as situating the contexts for production of the articles. Therefore, throughout the text, we introduce episodes and events that contextualize the analysis and help us to understand the scenario for news production, since, as stated by Rosen et al. (1997 , p.3), “[…] the journalism itself, the art of telling our collective story, is never independent of the country and culture in which the story is told.”

Strategies of Social Distancing and Herd Immunity in Brazil

The strategies of social distancing and of herd immunity were already circulating in Brazilian media before the official declaration of sustained transmission of Sars-CoV-2 in the country. We carried out this study associating the descriptor “Herd immunity” to coronavirus and to Imperial College. Next, we introduce the main results of the discursive analysis, discussing the meanings produced by the articles found with these descriptors.

The first article with the descriptor herd immunity (“What is ‘group immunity,' the polemical strategy of the United Kingdom to combat coronavirus” 4 ) dates from March 16, and was published by two large Brazilian news sites; its central theme is the debate surrounding the measures adopted by the United Kingdom. The article discusses the criticism suffered by the British government that, contrary to countries such as Italy, Spain, and France, had decided not to adopt a strategy of social suppression, betting on the free circulation of the virus in order to consequently lead the population toward herd immunity (a mitigation strategy). According to this text, the mitigation measure would help preserve the economy, since all activities would remain operational. The key criticism stemmed from the scientific community, for whom mitigation would lead to an uncontrolled growth in the number of people contaminated by Sars-CoV-2, with an inevitable rise in infections and the overburdening of the National Health Service (NHS) due to hospitalization demands for severe cases. This debate permeated the 16 articles analyzed under the descriptor “Herd immunity,” progressively incorporating references to reports from the Imperial College.

All the articles analyzed, when discussing herd immunity, made reference at some point to the United Kingdom and/or its prime minister and team. The United States and its president were also cited in six articles. Thus, we can say that the debate on social distancing, in Brazil, was closely connected to the measures and pronouncements of British and North American political authorities. Despite herd immunity having been considered and discussed in other cities/countries in Europe, the perspective that dominated the Brazilian news was that of the UK and the USA.

In addition to the positioning of political authorities, the scientific reports of the Imperial College were also widely commented on by the Brazilian media, and for this reason it was included as a descriptor. This institution appears often as being responsible for publishing studies that made the UK and the USA give up on the mitigation strategy. The majority of articles published between March 17 and April 24 refer directly to a specific report by the Imperial College, made public on March 16, which presents calculations regarding the lethality of the disease and the number of sick people according to each behavioral strategy adopted by the two countries. Only one article, from March 26, cites the report that makes estimates regarding the possible effects of the different non-pharmacological strategies in Brazil.

It is interesting to observe that, among the group of articles discussing herd immunity there are explanations on what this strategy entails. But most of these (5 articles) promote a simplification of this strategy, which can be explained by observing the authorship of the analyzed texts: only in three were the authors specialists. The first of these, mentioned above and produced by BBC News Brasil, is signed by a foreign journalist, a specialist in scientific communication. The second—““Coronavirus: must almost everyone catch it to end the pandemic?” 5 , from March 25, published in the health section of the website of Veja magazine—was written by two Brazilian researchers from the field of microbiology who acted as scientific disseminators. In this article there is a clear effort to translate expert knowledge for ordinary non-specialized readers, in a clear and simple manner, focusing on the reasons that herd immunity could not be legitimized by science to guide public policies against Sars-CoV-2. The third article—“Who is immune to coronavirus?” 6 , published on April 14 by the newspaper Folha de S.Paulo and available on the UOL website—was written by Marc Lipsitch, a professor of Epidemiology at Harvard University's School of Public Health. Published originally in the New York Times , it is a direct translation. In these three articles, there is a greater care in explaining herd immunity, based on scientific knowledge.

Another factor that could explain the simplifications and superficial approaches adopted by the Brazilian media for the theme of herd immunity relates to the sources consulted and used in the articles. Historically, the production of news articles in the field of health includes consultation with known specialists who can expound on the theme with authority, productivity, and credibility, conferring legitimacy and reliability to the information presented ( Tuchman, 1983 ; Traquina, 2007 ). However, with regard to the debate on herd immunity, the analyzed articles make little use of consulting epidemiologists, the most appropriate specialists when it comes to this theme. Among the medical sources, the articles prioritized the opinions of virologists, infectious disease specialists, and immunologists; only four epidemiologists were consulted—two Brazilians, one from North America, and one from India. This may have contributed toward the polarization of measures of social distancing, as the guidelines suggested by epidemiology would explain with more clarity the catastrophic effects of the epidemic on the healthcare system and, consequently, on people's lives, if natural herd immunity were to be adopted in the country.

The articles that cite the reports of the Imperial College approach the theme in a manner that presents, together with projections of mathematical models that favor suppression, the arguments contrary to this measure, as well as the “harmful” effects of broad and unrestricted social distancing on the economy.

The concept of herd immunity has a longstanding and legitimate scientific basis, which postulates that the infection of a percentage of the population is enough to block transmission of a virus, and therefore can contain or even eradicate it within a certain territory. Since this debate began, the World Health Organization (WHO) and scientists all over the world have explained that this concept applies to immunization by means of vaccinations, and that investing in natural herd immunity against COVID-19 would overburden the healthcare systems, causing hundreds of thousands of avoidable deaths.

The positioning of some government leaders in favor of this strategy appears to be oriented by Malthusian theories, according to which some populations, such as the elderly, can be considered as weak and surplus ( Mezzadra, 2020 ). In this manner, they could become “naturally” extinct by pandemics, such as the case of COVID-19. Hannah et al. (2020) observe that, by defending herd immunity, governors assume that the biopolitical interests of capital take precedence over the biopolitical interests of life. One of the articles of the corpus emphasizes that matters of economy were decisive in the debate on herd immunity. The text “Specialists recommend herd immunity for poor countries 7 ”—produced by Bloomberg, a news agency of the financial sector, and published in the finance section of UOL on April 22—, presents herd immunity as the only alternative for poor, young countries such as India. The journalist presents arguments from an Indian epidemiologist as well as researchers from the Center for Disease Dynamics, Economics & Policy and Princeton University in defense of this strategy:

[…] allow the virus to circulate in a controlled manner throughout the next seven months would provide immunity to 60% of the country's population by November, and thus, contain the disease. Mortality could be limited while the virus propagates, in comparison to European countries, such as Italy, since 93.5% of the Indian population is under 65 years, it is said, although they have not divulged projections on the number of dead .

The article is overly brief, but points out that this is a risky strategy, concluding that at the moment not much was known regarding immunity to coronavirus.

The possibility of using the strategy of herd immunity to minimize the effects of the pandemic on the economy was discussed hypothetically in many of the articles analyzed, but not indicated as a viable solution. For instance, the texts that mention this discussion in the United Kingdom clarify that the British government refuted that they were seeking herd immunity. This proposal would be morally unacceptable, since the known lethality data indicates that this strategy would imply acceptance and recognition that at least 1% of the population could die, in addition to a high number of hospitalizations, leading to a collapse of the healthcare services.

In the 16 articles analyzed with descriptors 1 and 2, only one has a critical approach and presents the Imperial College projections for Brazil. The article is “Coronavirus pandemic: the best scenario is disastrous 8 ,” published on March 30 on the website of the Gazeta do Acre , a local newspaper of the state of Acre, at the extreme north of the country. The text presents the calculations for the newspaper's hometown, the state capital Rio Branco, informing the amount of people who would get sick and die if suppression were not adopted. The other articles touched generically upon the theme, without taking the trouble to inform about the effects of different measures within the local contexts of Brazilian cities with their inequalities.

Among the articles of this corpus , the only argument in favor of herd immunity that had no economic framing was that of a supposed prevention of a second wave of the disease, since in the countries that adopted restrictive measures only a small portion of the population would have had contact with the virus, and thus the virus would once again strike these populations.

Before we continue the discussion, it is important to present the facts for the Brazilian context. From March 11, some state governors and mayors began to declare non-pharmacological measures to deal with the pandemic, following recommendations from the Ministry of Health and creating scientific committees. Throughout that entire month, several states and municipalities suspended classes at all educational levels, prohibiting events and religious services, and closing commerce and non-essential services, maintaining only healthcare, pharmacies, and grocery stores, in addition to bars, restaurants, and bakeries, although these last could only serve customers by delivery. These measures met with strong resistance from entrepreneurs and politicians, especially the president of the Republic and his social and political support base.

In this manner, from mid-March and throughout the month of April, the media began to include in discussions of the pandemic the financial damage that social distancing measures could provoke, and the effects on people's daily lives. In this context, the news began to construct a narrative around the concept of “two sides”; one favorable to the strategy of seeking herd immunity, and the other, to social distancing. As previously discussed, his false equivalency between scientifically based arguments and fragile arguments supported by hypotheses is damaging to the coverage of scientific themes ( Gelbspan, 1998 ).

With regard to herd immunity, this approach was present in many of the articles analyzed, with only two of the news stories breaking this logic. The first, titled “Epidemiologist opposes Osmar Terra and sees Brazil as far from the end of the epidemic 9 ,” from April 14, published on the UOL website, the journalist presents the arguments of an epidemiologist to deconstruct the reasoning presented by congressman Osmar Terra 10 , an advisor to Bolsonaro and part of his support base. As the central character in the text, and in opposition to Osmar Terra, the epidemiologist, who is also the rector of a federal university, demonstrates with data and scientific evidence that the country was far from reaching herd immunity, and points out the political polarization of the debate on social distancing:

The discussion about social distancing in all the media is based on ideology and not science. There is a group of people who think we must relax and who voted on the same candidate [Bolsonaro], and the other people, who voted against, are in favor of distancing .

The epidemiologist's perception on the role of the media in this polarization is precise. Osmar Terra is a member of Congress who, despite a degree in medicine and an appointment as Health Secretary, is not a specialist in this theme. It is worth noting that, according to the evaluation carried out by the website Radar aos Fatos, which checks and verifies fake news , he was the parliamentary member who most divulged false news on COVID-19 11 . More than that, the fact that there was a link to the video in which the congressman reproduces false news signals that the news site UOL itself contributed toward disseminating an opinion that, based on antiscientific visions, not only encourages the political polarization of the epidemic scenario, but also confuses the population. This polarization indicates a narrative framing typical of political coverage, in which reality is taken as “[…] a field in conflict, a bipolar world of successive hostilities” ( Motta, 2007 , p. 10), feeding the confrontation with successive affirmations that belie the sources, in a dramatic game based on the notion of contradiction. In the case of this coverage, the narrative option for the “two opposite sides” of the phenomenon makes no sense, as by giving equal weight and space to the scientific evidence and positioning of the majority of national and international scientists, and the opinions of a small group of denialist politicians with an anti-science agenda, the media breaks their social commitment of informing the population correctly about phenomena and events that impact daily life, such as the case of the COVID-19 epidemic.

The second article for the descriptor “herd immunity”—the previously mentioned “Coronavirus pandemic: the best scenario is disastrous” of the Gazeta do Acre —was the only one among the 16 news stories analyzed to critically situate the attacks of Bolsonaro and his supporters upon suppression measures. The text, with authorship stated simply as “Newsroom,” classifies Bolsonaro's statements as unfounded and absurd:

At this moment, the majority of countries, the Ministry of Health of Brazil, governors and mayors from all around the country, based on directives given by the WHO, are trying to adopt the measure of suppression to control the epidemic in Brazil .

However, president Bolsonaro and a small group of his counselors and advisors (which includes his children) are the only dissonant voices and are actively advocating the adoption of the mitigation strategy to control dissemination of the virus in Brazil .

This is a noisy minority, incidentally. Thanks to the control that the president and his children have over their thousands of fanatic followers, the social networks are inundated with the most absurd campaigns in favor of this option of control .

From “Vertical Interdiction” to “Vertical Isolation,” The Use of Scientists' Opinions for Denialism

The analysis demonstrated that the use of the terminology “vertical isolation” was imposed by President Bolsonaro himself and naturalized by the media. On March 24, in a pronouncement on the radio and TV network 12 , he urged the population to abandon the social distancing measures that had been recommended by the Ministry of Health and which, as previously mentioned, had been adopted by several governors and mayors. His proposal: keep in confinement only the so-called risk groups. In Brazil, this would be the elderly population over 60 years of age and those with chronic diseases, besides symptomatic cases. In his speech, which shocked the national and international scientific community and those Brazilians who had adhered to social distancing—at least 50% of the population, in several regions, at the start of community transmission—, Bolsonaro stated that COVID-19 was just “a little flu,” a “little cold” that was inoffensive to the majority of the young and the healthy who, like him, had an “athletic history” 13 . The following morning (25), when asked by a reporter how the country would protect these vulnerable groups, he answered: “[…] there is horizontal isolation, that they're doing here, and there's the vertical. It's the vertical [for groups at risk]” 14 .

The term vertical isolation resonated intensely in newspapers and news sites, and, after March 25, it was in the title of the 20 articles analyzed for descriptors 3 and 4 (“Vertical” isolation” and “Bolsonaro and vertical isolation”). When explaining the concept proposed by Bolsonaro, three texts cited the hypotheses of David L. Katz, a doctor who specialized in diet and nutrition 15 , which were published in an article in The New York Times , on March 20, 2020, with one text also bringing up an article by epidemiologist John Ioannidis, statistician, and co-director of the Stanford Prevention Research Center, published on March 17, on the StatNews website. Both were critics of the social suppression measures proposed and adopted in some Asian and European countries.

The analysis also suggested that the terminology “vertical isolation” which circulated in the national media was a translation of the arguments proposed by Katz, which were in turn anchored on the debate about herd immunity and the initial mitigation strategies adopted by the UK and USA to deal with the pandemic. Although quickly rejected by the scientific community, “isolation” as a synonym to distancing continued to resonate in Brazilian newspapers and news sites and is still used today in this sense.

Katz's article (“Is our fight against coronavirus worse than the disease?”) was published 5 days before Bolsonaro's interview. In it, Katz employs classic concepts of epidemiology to make a misleading analysis, based on a still-fragile foundation of data about the pandemic, as we will see in the following analysis. Centered on repertories from epidemiology, he frames social distancing as a potentially harmful “war” strategy, with socioeconomic consequences and effects upon the healthcare systems that could be worse than the disease. From the very start, with the title, Katz makes use of militaristic metaphors—a longstanding and recurring discursive strategy in all dimensions of the dissemination of science and medicine ( Wenner, 2007 )—in order to build his thesis for reducing the costs of the “war” against the new coronavirus.

He supports his arguments by interpreting data from South Korea, which indicated that 99% of COVID-19 cases were light, while the lethality of the disease basically affected those who were more vulnerable. Still employing war metaphors, Katz concludes that the most advisable approach would be a “surgical strike,” naming this a “vertical interdiction,” which would consist in forbidding circulation only for those who are most vulnerable and exposing the majority of the population to the virus, thus attaining herd immunity. In the text, even though the social impact of distancing is mentioned, it is clear that the specialist is preoccupied with the financial aspect:

I am deeply concerned that the social, economic and public health consequences of this near total meltdown of normal life — schools and businesses closed, gatherings banned — will be long lasting and calamitous, possibly more severe than the direct toll of the virus itself. The stock market will bounce back in time, but many businesses never will. The unemployment, impoverishment and despair likely to result will be public health scourges of the first order ( Katz, 2020 ).

Likewise, the arguments made by Ioannidis—in the article “We know enough now to act decisively against COVID-19. Social distancing is a good place to start”—focused on the economic effects of distancing measures:

If that is the true rate, locking down the world with potentially tremendous social and financial consequences may be totally irrational. It's like an elephant being attacked by a house cat. Frustrated and trying to avoid the cat, the elephant accidentally jumps off a cliff and dies ( Ioannidis, 2020 ).

The hypotheses of Ioannidis and, mainly, Katz gather elements that are of great use to the interests of the denialists, in the sense used by Hoofnagle and Hoofnagle (2007) and referenced by Diethelm and McKee (2009) , for whom the denialist discourse is constructed around rhetorical arguments,

[…] to give the appearance of argument or legitimate debate, when in actuality there is none. These false arguments are used when one has few or no facts to support one's viewpoint against a scientific consensus or against overwhelming evidence to the contrary. They are effective in distracting from actual useful debate using emotionally appealing, but ultimately empty and illogical assertions ( Hoofnagle and Hoofnagle, 2007 ).

The denial is constructed with basis on five discursive tactics which, together or separately, produce pseudoscientific discourse ( Hoofnagle and Hoofnagle, 2007 ; Diethelm and McKee, 2009 ). Three of these bring to light the manner in which the arguments of the two American specialists help sustain the denialism of President Bolsonaro and his supporters: (1) selectivity in choosing out-of-context scientific data in order to suggest error; (2) the use of specialists whose opinions are inconsistent with the knowledge established by scientific canon; and (3) resorting to isolated articles that challenge the dominant consensus as a means of discrediting the entire field.

In Brazil, the hypotheses of Ioannidis and, above all, Katz were presented by the media as an explanation for the vertical isolation proposed by Bolsonaro. The news stories also included criticism of this strategy by Brazilian and international specialists. This is what can be surmised from the article “What is the vertical isolation that Bolsonaro wants and why do specialists fear it will cause more deaths 16 ” published on the BBC News Brasil website, on March 25. In this news piece, the arguments of the two American specialists are rejected by the scientific community, due to their hypothetical nature, based on fragile data and a partial analysis that does not include the response capacity of the healthcare system; in this case, American healthcare. One of the opposing sources presented in the article is Harry Crane, a statistics professor from Rutgers University, who considered that their mistake was:

[…] to allow themselves to be affected by the desire to negate a situation that can cause despair. “Under severe uncertainty, it's natural instinct and common sense to hope for the best, but prepare for the worst”, wrote Crane, in response to the article by Ioannidis. This is because the mortality rate does not depend only on the clinical picture that the virus itself can produce, but also the capacity for response of societies for treating the sick .

The text makes it clear that, while the hypotheses of the two specialists were refuted by their peers, they were rapidly embraced by neoliberal politicians and economists, becoming “[…] music for the ears of the governmental economy teams who were trying to finish public accounting in midst of the perspective of recession” (BBC News Brasil, 2020). The journalist who authored the text supports this statement by citing part of an editorial from The Wall Street Journal , published in the wake of the Ioannidis article:

“ America urgently needs a pandemic strategy that is more economically and socially sustainable than the current national lockdown”, summarized the editorial from The Wall Street Journal, known for expressing the thoughts of the American economic elite, a week ago .

In the same article, the journalist affirms that the conclusions of Katz and Ioannidis acquired a following in the team of the Brazilian minister of Economy, “[…] in search of a gentler solution for the public health crisis.”

But it was, above all, the political support base of denialist leaders that took on the hypotheses of the two specialists and began using them to contest social distancing measures. In the news piece “Why is vertical isolation seen with skepticism 17 ?” produced by the agency Conteúdo Estadão and published on five news sites, on March 30, there is a clear use of these specialist arguments in the discourse against distancing:

Defended by President Jair Bolsonaro, the so-called “vertical isolation” of the population is a minority theory among scientists and is viewed with skepticism by the medical community. It consists on separating those who are in the risk group from being exposed to the virus, such as those older than 60 and those with chronic diseases (UOL, March 30).

Although the title of the article points to skepticism, the body of text brings a plurality of opinions, under the dichotomy of pros-cons and advantages-disadvantages of this strategy, including the discussion on herd immunity as a strategy and the reasons it was discarded in the United Kingdom. The most interesting point brought up in the article is a comparison of the supporters of Bolsonaro and Donald Trump. After informing that the American president had recommended extreme distancing, following the publication of the Imperial College study on March 16, the article adds that Trump went back to defending a quick return to activities in the United States, projecting a flexibilization in 10 days, which did not end up taking place but still had repercussions among Bolsonaro supporters:

Excerpts of the video with this speech from the American [Trump] were disseminated by supporters of Bolsonaro in Brazil, as a supposed sign that the Americans would relax their measures. After being criticized, Trump pulled back and said that the date to reopen the country was just a suggestion, but that the end of social isolation would not take place without backing from scientists. The day before yesterday, Trump affirmed that he is thinking of establishing an official quarantine for states such as New York (which has the majority of cases), New Jersey and Connecticut .

This text makes it clear how the denialist discourse of Trump and Bolsonaro align and, at the same time, how the largely connected environments of the social networks serve as feedback for both of their support bases. However, by indicating a new retreat by Trump, the text also demonstrates that his denialism was more vulnerable to scientific and medical arguments in favor of social distancing. The impression that we get is that Trump oscillates, either denying the scientific reading of the severity of the pandemic in his discourse and actions, or accepting information from scientists, different in this way from Bolsonaro, who has been unwavering in his denialist positioning from the start of the epidemic in Brazil.

Media Adhesion and Naturalization of “Vertical Isolation”

In the 20 articles analyzed for descriptor 3 (Vertical isolation), vertical isolation appears as a specific type of social distancing, allowing us to infer the media's unrestricted adhesion to the terminology, central to the sum of information circulated in both corpora . Instrumental, 10 of the 11 titles for descriptor 3 were constructed around the notions of functioning/operation of this model, seeking to explain vertical isolation with its advantages, disadvantages, and risks 18 .

We raised several hypotheses on what may have contributed to this: the generalist nature and increasingly precarious state of Brazilian mass journalism and the absence of epidemiologists as sources for news stories, already discussed in this work; the didacticism employed in the framing of texts, announced even in the titles.

This pedagogic concern brings to light the efforts made by journalists to translate to readers, who are always assumed to be laypeople, the technical-scientific jargon employed in the news. This didacticism—which legitimizes journalists as “[…] the place of ‘being able to show', of ‘being able to say' and ‘being able to analyze' (…) as a place of mediation and of revelation of truth” ( Vizeu, 2009 , p. 77)—may have contributed in particular toward the production of the meaning of “vertical isolation” as a scientifically validated consensus strategy that “mirrors” a supposed epidemiological reality, aseptic and neutral.

It is necessary, therefore, to problematize the media's naturalization of “vertical isolation” to express measures of social distancing (quarantine, cordon sanitaire , lockdown). In first place, the terminology confuses two distinct models of attention to epidemics. In the field of health, including Brazil, the established scientific consensus uses the term isolation to designate the care given to an infected and symptomatic patient, and is therefore a model for individual attention, belonging to the field of clinical medicine; distancing, on the other hand, implies collective/populational care, affiliated to epidemiology.

The use of “social isolation” in the place of social distancing is also a sematic error as it is based on a false synonymy. In the Portuguese language, “isolate” means to separate, segregate, and confine a person from all others in their social circle—in Brazilian dictionaries, among examples of isolate, we find medical activity aimed at treating patients with contagious diseases. On the other hand, distancing is the act or effect of separating people/groups, centered on a notion of physical space and not segregation.

By using one term in place of another, naturalizing a theoretical hypothesis that is still under discussion and therefore not validated by the scientific community, the media legitimized the term social isolation as common sense. And this may have contributed to the construction of a derogatory meaning for the strategy of social distancing, amplifying the resistance of the Brazilian population toward this measure.

Vertical Isolation, Denialism, and Eugenics

The denialist discourse throughout the world is not just aligned to anti-science, but also resonates as a more or less homogeneous mark of eugenics. In Brazil, this is no different. The social and scientific movement for improving the human race that emerged at the end of the nineteenth century and was widely experimented with by the German Nazi regime during World War II (1939–1945), arrived in the country in 1918, with the creation of the Eugenics Society of São Paulo. Intellectuals from several areas notably from medicine and the public health services, gathered around this movement, and the triad of sanitation, hygiene, and eugenics supported a broad and generalized project for civilizational progress ( Maciel, 1999 ), with medical knowledge playing a central role.

Racial regeneration would occur by means of three types of eugenics: positive, negative, and preventive. This last, also called prophylactic hygiene by Brazilian eugenists, was mixed with principles of rural and urban sanitation, the suppression of social vices such as alcoholism, control of immigration and of matrimony, and the compulsory sterilization of “degenerates.” In the 1930s, the main activist in Brazilian eugenics, Renato Kehl, openly assumed his favorable position to some of the measures adopted by the German eugenics movement ( Kobayashi et al., 2009 ).

Thus, the world eugenics ideology met the Brazilian positivist-hygienist movement, forming a new and active field, of hygienist-physicians, the protagonists and disseminators of the eugenics elements that would mark the actions of Brazilian public health for the next decades, and which still linger today in many practices, especially in the field of social care. This scientific rationality led to the implementation of “[…] projects of eugenic nature that intended to eliminate disease, separate madness and poverty” ( Schwarcz, 1993 , p. 34), focusing mainly on immigrants, Black people, and the poor ( Diwan, 2007 ). Acting in an intensive manner, the hygienist doctors undertook “[…] what they imagined to be a national regenerative mission, exerting functions, carrying out tasks, occupying positions that were strange to medicine,” and disseminating the certainty “[…] of being able to end the blemishes of the nation, collaborating with Brazil's administrative and social entirety” ( Mota, 2003 , p. 21).

From the start of the community transmission of Sars-CoV-2 in Brazil it is possible to observe this memory of eugenics in Bolsonaro's denialism, especially in his defense of vertical isolation. As governors and mayors began to officially order social distancing, the president's position became more and more radical. This is what can be surmised from the article “Bolsonaro once again minimizes COVID-19 and says that Health is studying vertical isolation 19 ,” published on the financial news site IstoÉ Dinheiro on March 26. In this piece, the president once again says that “ some governors and mayors erred in the dose” of containment measures, demanding the reopening of all sectors of the economy:

“ And do a stay-at-home campaign. Don't let grandpa leave the house, leave him in a corner. When you get home have a shower, wash your hands, wipe your ears with sanitizer gel. That's it”, he declared .

In the excerpt, Bolsonaro dehumanizes the elderly, the main target for his strategy of vertical isolation, turning their existence into objects in face of the epidemic. In his ambition to maintain the capitalist order, the president treats this subject (the elderly) as objects without free will who must be segregated in a “corner,” removing “their individual, malleable, unique characteristics” and transforming them “into empty husks, representations of themselves who, apparently, are no longer covered by the State of right” ( Souza, 2017 , p. 70).

In the same article, when commenting on the critical situations in other countries and on the perspectives of how the disease would manifest in Brazil, Bolsonaro yet again invests in a rhetoric of dehumanization:

“ I don't think it's going to reach that point, even because Brazilians should be studied, they don't catch anything. You see the guy leaping into sewage, coming out, diving in and nothing happens” .

This speech speaks directly of the more vulnerable social classes in Brazil that, due to conditions of extreme poverty, are subject to extremely precarious production relations. In this manner, it is possible to identify in the president's discourse a correlation between men and rats, who are immune to sewers. This perspective, in turn, bears a resemblance to the metaphor of the crab man, created by doctor and geographer Josué de Castro to designate a new species of Brazilians: those excluded from the production processes and who took their subsistence from the mangrove swamps of Recife, mixing them up with the crabs they fed upon 20 . Later, in the 1990s, following on the heels of the crab men, the gabiru men emerged. This hyperbole was used to designate country folk who lost their lands to large-scale farming and ended up in urban shantytowns, carrying with them an old acquaintance, hunger ( Portella et al., 1992 ; de Melo Filho, 2003 ). From the Tupi wa'wiru , gabiru means that which devours supplies, lives off trash, begs for hand-outs, causes repugnance, attacks and steals ( Portella et al., 1992 ).

Besides touching upon this social imaginary of the excluded Brazilian, the speech is evidence of a reading in which the population can be left to their own luck, without needing the actions of a protective State since they are, by their animalistic nature, survivors.

In addition to the theoretical fragility of Bolsonaro's proposal, the news stories analyzed also demonstrate that the strategy was unfeasible due to Brazil's socioeconomic inequalities. In the article “Vertical isolation proposed by Bolsonaro may accelerate contagion by coronavirus and compromise health systems 21 ,” published on March 25 on the El País Brasil website, health specialists and medical authorities alert to the risks of accelerated contagion in Brazil and a rapidly compromised healthcare system:

“ The theoretical idea of vertical isolation is that you can allow young people to circulate. They would become infected and could become immune. But we don't know how this works with COVID-19 and we can't guarantee the exclusive isolation of a specific group”, alerts the doctor Valdes Bollela, professor at the School of Medicine of USP Ribeirão Preto [São Paulo University of Ribeiro Preto] . (…) You think you can separate all the people [in the risk groups] who are young from those who are over 60? (…) People with HIV, diabetes and the elderly who count on their families? I can't imagine that in real life. In a theoretical idea, it's possible. In practice, it's a trap (…) In Brazil, a lot of people depend exactly on the care of their children” .

On the isolation of the elderly, in an article published on March 25 on the CNN Brasil website, along with the previously mentioned press conference video, titled “Bolsonaro vai propor isolamento vertical para conter coronavírus 22 ,” other related opinions are mentioned:

[…] each family must be responsible for their relatives. “The people need to stop pushing things onto the public powers”, he stated. (…) He stressed that the president of the United States, Donald Trump, follows a “similar line” as to measures to contain the disease, referencing yesterday's speech by the North-American in which he intends to end quarantine in the USA “by Easter” .

In these excerpts, it is possible to observe Bolsonaro's contempt for the excluding social characteristics in Brazil, where extreme social inequality would make it impossible to completely isolate the elderly and those with comorbidities from their relatives. Additionally, this also indicates his positioning on two aspects: the first, in prioritizing the economy—what really matters is to keep people working and generating income and taxes; the second, in making the State exempt from the consequences of its omission regarding the risks that the elderly face, in other words, that their life or death is not a problem of the public powers but of their families. Bolsonaro also uses the reference to the president of the United States in order to legitimize and strengthen his arguments and transmit the idea that there is a consensus between them regarding the pandemic, reinforcing the thesis that vertical isolation would be a viable strategy, since it was adopted by a developed country.

The article is short and uses a neutral tone, but it refers to a number of links, informing us, among other things, that Bolsonaro was the target of protests by Brazilians who were maintaining social distancing and of criticism by politicians:

The speech [referring to the press conference video posted at the start of the article and already mentioned in this analysis] — during which there were records of pot-banging protests in several of the country's capitals — gave rise to criticism by health secretaries, authorities and politicians (CNN Brasil, March 25).

The website brings visibility to the president's speeches without the concern of reflecting upon them or of pointing out their damaging effects upon the population's health.

In the article “Bolsonaro defende isolamento vertical e sugere que país pode 'sair da normalidade democrática 23 ,”' produced by international news agency Ansa and published on the website of the O Globo newspaper (March 25), the president also makes what can be considered his first threat of democratic rupture, using the argument that measures of social distancing would provoke an economic crisis of enormous proportions, which could lead to social convulsions.

“ […] what happened in Chile [street movement that left its mark upon the Chilean scenario for months] will be small change next to what could happen in Brazil. We will all pay a price that will take years to pay, that is, if Brazil might not yet leave the democratic normality that you all defend so much, no one knows what can happen in Brazil” (…) “The chaos makes it so the left can seize the moment to come to power.”

By treating a scientifically legitimized event—the existence of an epidemic with planetary proportions—as an “excuse” of the Brazilian left to take his power, Bolsonaro brings up a fourth element that is characteristic of denialism: the identification of conspiracies among the consensuses of science. For conspiracy theorists, the validation of science is not a result of an evidence-based consensus among scientists, but of the involvement of these scientists in a complex and secret conspiracy ( Hoofnagle and Hoofnagle, 2007 ). In this sense, the process of peer revision “[…] is seen as a tool by which the conspirators suppress dissent, rather than as a means of weeding out papers and grant applications unsupported by evidence or lacking logical thought” ( Diethelm and McKee, 2009 ).

“So What?”: Considerations on a Eugenics Discourse

Denialism has different motivations—economic, political, personal, ideological, or religious—, but has as a common point the rejection of any thesis incompatible with the fundamental beliefs of those who hold them. As the analyses demonstrate, a first dimension of the denialism of Jair Bolsonaro on the Sars-Cov-2 epidemic is based on the idea that the effects of an economic crisis would be worse than the severe consequences of the disease itself on people's lives. As seen in this work, this discourse aligns with that of other denialist world leaders, such as President Donald Trump and Prime Minister Boris Johnson —although, different from the Brazilian president, these leaders have oscillated throughout the pandemic between accepting scientific arguments in favor of the population's health and prioritizing the economy.

In terms of the economic argument, however, a second dimension emerges in Bolsonaro's discourse: that of eugenics. Under the terminology of vertical isolation, naturalized and legitimized by the media, the Brazilian president turns the most vulnerable segment of the population into objects, establishing a moral compass according to which, faced with the needs of maintaining the relations of capitalist production, some lives are worth less than others, and that this would be enough to justify the sacrifice.

It is important to point out that this discursive posture is not casual or chaotic. There is a method here that, moreover, helped to elect Bolsonaro 24 , known for his racist, misogynistic, sexist, and xenophobic statements. In 2017, during the electoral campaign for presidency, the then parliamentary member promised to end all demarcation of land for Indigenous Peoples 25 : “You can be certain that, if I get there (…) There will not be a centimeter marked off for indigenous reservations or for quilombola 26 lands.”

At the same event, he made disparaging and fat-shaming comments: “I went to a quilombo. The lightest Afro-descendent there weighed seven arrobas (arroba is a measurement used to weigh cattle; one arroba is equivalent to 15 kg). They do nothing. I think he was of no use even to serve for breeding.” Ironically, this speech, which drew laughter from the audience, was given at Hebraica in Rio de Janeiro, one of the most traditional Jewish associations in the country.

In the wake of the rise of right-wing populism that, in the last years, has benefitted other leaders around the world, Bolsonaro was elected for his antisystem rhetoric, exploiting the fears and prejudices of ordinary voters, undermining the credibility of traditional political parties and democratic institutions, and normalizing discriminatory discourse, thanks to the reach of his social media, which he and his group manage with mastery, and with advisory help from Steve Bannon, former vice-president of Cambridge Analytica ( Ricard and Medeiros, 2020 ). When he took over the presidency of the Republic, in January 2019, he not only radicalized this rhetoric but also, in many cases, transformed it into State policy—in the first days of his government, he ended social and environmental protection structures and programs; under Bolsonaro, for example, the recognition of quilombos fell to the lowest levels in history 27 .

On March 18, in an interview to Fox News 28 during an official visit to the United States, Bolsonaro attacked immigrants by defending Trump's plans to build a wall on the border between the USA and Mexico: “The majority of immigrants do not have good intentions and do not want to do good for Americans.” It is worth remembering that there are over a million Brazilians living in the USA. In this manner, the alignment of Bolsonaro's migratory policies with those of the American president—who in December 2019 called Haiti, El Salvador, and African countries “shitholes”—indicates “a racist slant, since not by chance most immigrants are Black or Indigenous people, from countries with a non-white populational majority. There is a logic that is eugenic, racist, and ethnic in nature,” states Dennis Oliveira in the same article—a journalism professor from the University of São Paulo (USP) and an activist in the Rede Quilombação network.

As the Brazilian health crisis grew in severity, Bolsonaro's eugenics slant became more explicit, until it reached an emblematic declaration: “So what? I'm sorry. What do you want me to do? I'm a Messiah, but I don't do miracles 29 .” Spoken to a group of reporters and supporters in front of the Alvorada Palace, the presidential residence in Brasília, on the night of April 28, when Brazil hit 5,017 official deaths, the phrase was followed by a disturbing statement on the severity of COVID-19 among the elderly: “I regret the situation we are going through with the virus. We sympathize with the families who have lost their loved ones, who were mostly elderly. But such is life. Tomorrow it will be me [to die].”

The numbers for the epidemic in Brazil indicate that the eugenics project is succeeding, since on June 5, CNN informed that 40% more Black than white people die from COVID-19 in Brazil 30 . Although the country did not officially adopt the vertical isolation policy proposed by Bolsonaro, because the Supreme Court decreed that states and municipalities had the autonomy to adopt social distancing measures, Bolsonaro's government continued to boycott the actions of governors and mayors to contain dissemination of the virus. This boycott could be observed in the presidential decrees that increased the list of activities considered essential, in the delays and inefficiency in implementing financial aid to those who were left without income, in the absence of effective programs to subsidize small businesses, and, of course, in Bolsonaro's speeches, which resonated throughout the country both by means of mass media and social networks 31 .

Up until the conclusion of this article, the Ministry of Health was still under the interim command of a general who, like Bolsonaro, also adopted a denialist stance. On May 20, under this administration, the ministry published a protocol 32 with guidelines for prescribing chloroquine and hydroxychloroquine for light, moderate, and severe cases of COVID-19. Although there is no strong scientific evidence on the effectiveness of this medication, the Bolsonaro administration maintains its use as a standard for care in SUS. Since the start of June 33 , the government has been changing the manner and time for divulging the epidemiological reports that update infection cases and deaths by the disease, while also announcing the adoption of a new methodology for sharing the data which will invalidate comparisons with the previous numbers and, consequently, affect monitoring of the evolution of COVID-19 in the country. One of the aims of this strategy is to reduce the visibility of the number of deaths and misinform the population. Following the same direction, the Department of Social Communication created a “life scoreboard,” a report disseminated exclusively on the presidency's social networks that highlights the number of recovery cases while omitting the deaths.

In addition to these actions, the president's denialist speeches that are spread both by mass media and social networks have a direct effect upon the behavior of the population regarding social distancing, as demonstrated by Ajzenman et al. (2020) .

In this scenario, our study demonstrates that the Brazilian mass media is still fixed upon the notion that it is necessary to present both sides of an event, giving each equal weight, even when one has assumed a denialist position toward the science. This positioning, justified normally by the pursuit of neutrality in news coverage, allows for the spreading of false premises posing as science and strengthens the denialist and eugenist project of Bolsonaro. This occurs because, as stated by Happer and Philo (2013) , the media holds a central role in spreading information and in the process of focusing attention on a specific subject, as well as in defining a public agenda.

Another aspect identified in the study relates to the characteristics of the method adopted by Bolsonaro since the elections, which have endured during this past year-and-a-half of his mandate: the discursive verbiage, often grotesque and always of populist appeal, which the Brazilian media appears to have become a hostage of. And, by amplifying the president's speeches, the media symbolically places him at the center of the coordination of control measures for the epidemic in Brazil, a role he has never undertaken. In this sense, we agree with Rosen (2020) and Smith (2020) , who identified the same phenomenon in the media coverage of coronavirus in the United States, pointing to the need of removing President Trump as a protagonist in news about the theme.

Under the guise of conclusion, it is important to highlight an action which indicates that the Brazilian press has gradually taken on a more critical posture. In June, faced with the proposal from the Ministry of Health for presenting incomplete data on COVID-19, the six largest newspapers and news sites in the country united in order to compile and systematize daily the data from the State Departments of Health 34 , ensuring a higher reliability and transparency of the numbers, thus acting as overseers for the public powers and guaranteeing the dissemination of correct information. However, in a health crisis with the magnitude of the present one, much more is necessary than merely making numbers visible. Newspapers and news sites have a key role, since the information they produce and circulate guide collective and individual behaviors ( Stevens and Hornik, 2014 ). Therefore, it is crucial that journalists take on a critical posture, knowing how to identify the multiple faces of denialism and making clear the damaging effects of eugenics policies upon the health of the population.

Data Availability Statement

Publicly available datasets were analyzed in this study. All the articles/data used in the research are listed in the footnotes and are open access.

Author Contributions

CM and JB contributed to the design and implementation of the research, to the analysis of the results, and to the writing of the manuscript. All authors contributed to the article and approved the submitted version.

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

1. ^ Daily map of Johns Hopkins University and Medicine. Available at https://coronavirus.jhu.edu/map.html .

2. ^ Carried out in partnership between the RSF and the Intervozes collective, MOM-Brasil was the 11th study throughout the world and also the largest—up until 2017, the number of vehicles investigated had reached at the most 40. Available at: http://brazil.mom-rsf.org/br/ .

3. ^ Available at: https://brasil.elpais.com/brasil/2020-06-25/nem-o-pior-ministro-da-saude-fez-o-que-exercito-esta-fazendo-desmontando-a-engrenagem-do-sus.html .

4. ^ “What is ‘group immunity,' the polemical strategy of the United Kingdom to combat coronavirus.” Available at: https://noticias.uol.com.br/saude/ultimas-noticias/bbc/2020/03/16/o-que-e-a-imunidade-de-grupo-a-polemica-estrategia-do-reino-unido-para-combater-coronavirus.htm .

5. ^ “Coronavirus: must almost everyone catch it to end the pandemic?” Available at: https://saude.abril.com.br/blog/cientistas-explicam/coronavirus-quase-todo-mundo-tem-que-pegar-para-a-pandemia-passar/ .

6. ^ “Who is immune to coronavirus?” Available at: https://www1.folha.uol.com.br/equilibrioesaude/2020/04/quem-e-imune-ao-coronavirus.shtml .

7. ^ “Specialists recommend herd immunity for poor countries.” Available at: https://economia.uol.com.br/noticias/bloomberg/2020/04/22/especialistas-recomendam-imunidade-de-rebanho-para-paises-pobres.htm .

8. ^ “Coronavirus pandemic: the best scenario is disastrous.” Available at: https://agazetadoacre.com/2020/03/pandemia-de-coronavirus-o-melhor-cenario-e-desastroso/ .

9. ^ “Epidemiologist opposes Osmar Terra and sees Brazil as far from the end of the epidemic.” Available at: https://www.bol.uol.com.br/noticias/2020/04/14/brasil-esta-longe-do-final-da-epidemia-e-de-imunizacao-diz-epidemiologista.htm .

10. ^ Doctor, former Health Secretary of Rio Grande do Sul and former minister for presidents Michel Temer (who took over the presidency of the Republic in 2016, after the parliamentary coup against president Dilma Rousseff) and for Bolsonaro himself, Terra had participated, the day before, in a debate on the epidemic promoted by UOL, one of the largest news sites in the country. Available at: https://noticias.uol.com.br/politica/ultimas-noticias/2020/04/13/governistas-criticam-isolamento-e-minimizam-briga-bolsonaro-x-mandetta.htm .

11. ^ Available at: https://www1.folha.uol.com.br/poder/2020/05/deputados-divulgam-fake-news-sobre-coronavirus-para-ecoar-discurso-de-bolsonaro.shtml .

12. ^ Available at: https://www.youtube.com/watch?v=Fy9dqEsjkVk .

13. ^ Link to the pronouncement.

14. ^ After 7m14s. Available at: https://www.youtube.com/watch?reload=9&v=vp3A_8vywC0 .

15. ^ The president of the True Health Initiative and director-founder of the Yale-Griffin Prevention Research Center.

16. ^ “What is the vertical isolation that Bolsonaro wants and why do specialists fear it will cause more deaths?” Available at: https://www.bbc.com/portuguese/internacional-52043112 .

17. ^ “Why is vertical isolation seen with skepticism?” Available at: https://saude.estadao.com.br/noticias/geral,por-que-isolamento-vertical-e-visto-com-ceticismo,70003252797 .

18. ^ The titles of the articles (descriptor 3): What is vertical isolation against coronavirus; What is the vertical isolation that Bolsonaro wants and why do specialists fear it will cause more deaths?; Does vertical isolation work? Reality has already answered that question, says doctor; What is vertical isolation and why it may not work; What is vertical isolation [and why this may not be a good idea)?]; What is vertical isolation (and why this is not a good idea)? Horizontal vs. vertical isolation: know the pros and cons of the strategies to contain coronavirus; Health alerts to rash transition, but sees vertical isolation as possible in little-affected locations; and, What are the risks of adopting only vertical isolation, proposed by Bolsonaro; What is the vertical isolation that Bolsonaro wants and why do specialists fear it will cause more deaths?; Specialists: Brazil's characteristics do not permit vertical isolation; Health alerts to rash transition, but sees vertical isolation as possible in little-affected locations; Turkey endures drastic consequences of vertical isolation.

19. ^ Bolsonaro once again minimizes COVID-19 and says that Health is studying vertical isolation. Available at: https://www.istoedinheiro.com.br/bolsonaro-volta-a-minimizar-COVID-19-e-diz-que-saude-estuda-isolamento-vertical/ .

20. ^ The notion of the crab men emerged from the main works of Josué de Castro: Geografia da fome (1948), Geopol í tica da fome (1951), Documentário do Nordeste (1957), Fatores de localização da cidade do Recife (1957), and Homens e caranguejos (1967), the last an autobiographical romance.

21. ^ “Vertical isolation proposed by Bolsonaro may accelerate contagion by coronavirus and compromise health systems.” Available at: https://brasil.elpais.com/brasil/2020-03-25/isolamento-vertical-proposto-por-bolsonaro-pode-acelerar-contagios-por-coronavirus-e-comprometer-sistema-de-saude.html .

22. ^ “Bolsonaro will propose vertical isolation to contain coronavirus.” Available at: https://www.cnnbrasil.com.br/politica/2020/03/25/bolsonaro-nao-estou-preocupado-com-a-minha-popularidade .

23. ^ “Bolsonaro defends vertical isolation and suggests the country may ‘depart from democratic normality.”' Available at: https://oglobo.globo.com/brasil/bolsonaro-defende-isolamento-vertical-sugere-que-pais-pode-sair-da-normalidade-democratica-24327038 .

24. ^ After retiring as a captain of the Brazilian Army at the age of 33, Bolsonaro has been a professional politician for over 30 years. Before becoming president, he was on the Rio de Janeiro city council and, later, was a federal congressman for 27 years. During that period, he presented only two draft bills.

25. ^ Available at: https://veja.abril.com.br/brasil/bolsonaro-e-acusado-de-racismo-por-frase-em-palestra-na-hebraica/ .

26. ^ Quilombo are settlements first established by escaped slaves in Brazil. Quilombolas are the descendants of Afro-Brazilian slaves who escaped from slave plantations that existed in Brazil until abolition in 1888. Since 2003 the Decreto 4.887/2003,recognized Quilombo communities and their claims to the land they inhabited, but only 219 of the 2,926 Quilombos have land titles.

27. ^ Available at: https://www.bol.uol.com.br/noticias/2020/06/23/sob-bolsonaro-reconhecimento-de-quilombolas-cai-ao-menor-patamar-da-historia.htm .

28. ^ Available at: https://ponte.org/eugenia-2-0-a-politica-migratoria-de-bolsonaro/ .

29. ^ Available at: https://veja.abril.com.br/politica/e-dai-nao-faco-milagres-diz-bolsonaro-sobre-mortes-por-COVID-19/ .

30. ^ Available at: https://www.cnnbrasil.com.br/saude/2020/06/05/negros-morrem-40-mais-que-brancos-por-coronavirus-no-brasil .

31. ^ Available at: https://www.huffpostbrasil.com/entry/mortes-COVID-19-25-junho_br_5ef4b64cc5b66c3126832ef9 .

32. ^ Available at: https://www.saude.gov.br/images/pdf/2020/May/20/orientacoes-manuseio-medicamentoso-covid19.pdf .

33. ^ To read further, see: “ https://www.huffpostbrasil.com/entry/mortes-COVID-19-25-junho_br_5ef4b64cc5b66c3126832ef9 .

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Keywords: novel SARS-coronavirus-2/SARS-CoV-2/COVID-19, digital media, eugenics, denialism, public health communication, journalism

Citation: Malinverni C and Brigagão JIM (2020) COVID-19: Scientific Arguments, Denialism, Eugenics, and the Construction of the Antisocial Distancing Discourse in Brazil. Front. Commun. 5:582963. doi: 10.3389/fcomm.2020.582963

Received: 13 July 2020; Accepted: 30 September 2020; Published: 04 November 2020.

Reviewed by:

Copyright © 2020 Malinverni and Brigagão. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Claudia Malinverni, claudia.malinverni@usp.br ; Jacqueline Isaac Machado Brigagão, jac@usp.br

This article is part of the Research Topic

Strategic Narratives in Political and Crisis Communication: Responses to COVID-19

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Iran J Med Sci
v.45(4); 2020 Jul

A Narrative Review of COVID-19: The New Pandemic Disease

Kiana shirani, md.

1 Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

Erfan Sheikhbahaei, MD

2 Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Zahra Torkpour, MD

Mazyar ghadiri nejad, phd.

3 Industrial Engineering Department, Girne American University, Kyrenia, TRNC, Turkey

Bahareh Kamyab Moghadas, PhD

4 Department of Chemical Engineering, Shiraz Branch, Islamic Azad University, Shiraz, Iran

Matina Ghasemi, PhD

5 Faculty of Business and Economics, Business Department, Girne American University, Kyrenia, TRNC, Turkey

Hossein Akbari Aghdam, MD

6 Department of Orthopedic Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Athena Ehsani, PhD

7 Department of Biomedical Engineering, Science and Research Branch, Islamic Azad University, Tehran, Iran

Saeed Saber-Samandari, PhD

8 New Technologies Research Center, Amirkabir University of Technology, Tehran, Iran

Amirsalar Khandan, PhD

9 Department of Electrical Engineering, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran

10 0Technology Incubator Center, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran

Nearly every 100 years, humans collectively face a pandemic crisis. After the Spanish flu, now the world is in the grip of coronavirus disease 2019 (COVID-19). First detected in 2019 in the Chinese city of Wuhan, COVID-19 causes severe acute respiratory distress syndrome. Despite the initial evidence indicating a zoonotic origin, the contagion is now known to primarily spread from person to person through respiratory droplets. The precautionary measures recommended by the scientific community to halt the fast transmission of the disease failed to prevent this contagious disease from becoming a pandemic for a whole host of reasons. After an incubation period of about two days to two weeks, a spectrum of clinical manifestations can be seen in individuals afflicted by COVID-19: from an asymptomatic condition that can spread the virus in the environment, to a mild/moderate disease with cold/flu-like symptoms, to deteriorated conditions that need hospitalization and intensive care unit management, and then a fatal respiratory distress syndrome that becomes refractory to oxygenation. Several diagnostic modalities have been advocated and evaluated; however, in some cases, diagnosis is made on the clinical picture in order not to lose time. A consensus on what constitutes special treatment for COVID-19 has yet to emerge. Alongside conservative and supportive care, some potential drugs have been recommended and a considerable number of investigations are ongoing in this regard

What’s Known

Substantial numbers of articles on COVID-19 have been published, yet there is controversy among clinicians and confusion among the general population in this regard. Furthermore, it is unreasonable to expect physicians to read all the available literature on this subject.

What’s New

This article reviews high-quality articles on COVID-19 and effectively summarizes them for healthcare providers and the general population.

Introduction

A pathogen from a human-animal virus family, the coronavirus (CoV), which was identified as the main cause of respiratory tract infections, evolved to a novel and wild kind in Wuhan, a city in Hubei Province of China, and spread throughout the world, such that it created a pandemic crisis according to the World Health Organization (WHO). CoV is a large family of viruses that were first discovered in 1960. These viruses cause such diseases as common colds in humans and animals. Sometimes they attack the respiratory system, and sometimes their signs appear in the gastrointestinal tract. There have been different types of human CoV including CoV-229E, CoV-OC43, CoV-NL63, and CoV-HKU1, with the latter two having been discovered in 2004 and 2005, respectively. These types of CoV regularly cause respiratory infections in children and adults. 1 There are also other types of these viruses that are associated with more severe symptoms. The new CoV, scientifically known as “SARS-CoV-2”, causes severe acute respiratory syndrome (SARS). 2 A newer type of the virus was discovered in September 2012 in a 60-year-old man in Saudi Arabia who died of the disease; the man had traveled to Dubai a few days earlier. The second case was a 49-year-old man in Qatar who also passed away. The discovery was first confirmed at the Health Protection Agency’s Laboratory in Colindale, London. The outbreak of this CoV is known as the Middle East Respiratory Syndrome (MERS), commonly referred to as “MERS-CoV”. The virus has infected 2260 people and has killed 912, most of them in the Middle East. 3 - 5 Finally, in December 2019, for the first time in Wuhan, in Hubei Province of China, a new type of CoV was identified that caused pneumonia in humans. 6 SARS-CoV-2 has affected 5404512 people and killed more than 343514 around the world according to the WHO situation report-127 (May 26, 2020). 3 , 7 - 10 The WHO has officially termed the disease “COVID-19”, which refers to corona, the virus, the disease, the year 2019, and its etiology (SARS-CoV-2). This type of CoV had never been seen in humans before. The initial estimates showed a mortality rate ranging from between 1% and 3% in most countries to 5% in the worst-hit areas ( Figure 1 ). 9 Some Chinese researchers succeeded in determining how SARS-CoV-2 affects human cells, which could help to develop techniques of viral detection and had antiviral therapy potential. Via a process termed “cryogenic electron microscopy (cryo-EM)”, these scientists discovered that CoV enters human cells utilizing a kind of cell membrane glycoprotein: angiotensin-converting enzyme 2 (ACE2). Then, the S protein is split into two sub-units: S1 and S2. S1 keeps a receptor-binding domain (RBD); accordingly, SARS-CoV-2 can bind to the peptidase domain of ACE2 directly. It appears that S2 subsequently plays a role in cellular fusion. Chinese researchers used the cryo-EM technique to provide ACE2 when it is linked to an amino acid transporter called “B0AT1”. They also discovered how to connect SARS-CoV-2 to ACE2-B0AT1, which is another complex structure. Given that none of these molecular structures was previously known, the researchers hoped that these studies would lead to the development of an antiviral or vaccine that would help to prevent CoV. Along the way, scientists found that ACE2 has to undergo a molecular process in which it binds to another molecule to be activated. The resulting molecule can bind two SARS-CoV-2 protein molecules simultaneously. The scientists also studied different SARS-CoV-2 RBD binding methods compared with other SARS-CoV-RBDs, which showed how subtle changes in the molecular binding sequence make the coronal structure of the virus stronger.

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Most cases with SARS-CoV-2 are asymptomatic or have mild clinical pictures such as influenza and colds. This group of patients should be detected and isolated in their homes to break the transmission chain of the disease and adhere to the precautionary recommendations in order not to infect other people. The screening process will help this group and suppress the outbreak in the community. Patients with the confirmed disease who are admitted to hospitals can contaminate this environment, which should be borne in mind by healthcare providers and policymakers.

Transmission

While the first mode of the transmission of COVID-19 to humans is still unknown, a seafood market where live animals were sold was identified as a potential source at the beginning of the outbreak in the epidemiologic investigations that found some infected patients who had visited or worked in that place. The other viruses in this family, namely MERS and SARS, were both confirmed to be zoonotic viruses. Afterward, the person-to-person spread was established as the main mode of transmission and the reason for the progression of the outbreak. 11 Similar to the influenza virus, SARS-CoV-2 spreads through the population via respiratory droplets. When an infected person coughs, sneezes, or talks, the respiratory secretions, which contain the virus, enter the environment as droplets. These droplets can reach the mucous membranes of individuals directly or indirectly when they touch an infected surface or any other source; the virus, thereafter, finds its ways to the eyes, nose, or mouth as the first incubation places. 11 - 15 It has been reported that droplets cannot travel more than two meters in the air, nor can they remain in the air owing to their high density. Nonetheless, given the other hitherto unknown modes of transmission, routine airborne transmission precautions should be considered in high-risk countries and during high-risk procedures such as manual ventilation with bags and masks, endotracheal intubation, open endotracheal suctioning, bronchoscopy, cardiopulmonary resuscitation, sputum induction, lung surgery, nebulizer therapy, noninvasive positive pressure ventilation (eg, bilevel positive airway pressure and continuous positive airway pressure ), and lung autopsy. In the early stages of the disease, the chances of the spread of the virus to other persons are high because the viral load in the body may be high despite the absence of any symptoms ( Figure 2 ). 11 - 13 The person-to-person transmission rates can be different depending on the location and the infection control intervention; still, according to the latest reports, the secondary COVID-19 infection rate ranges from 1% to 5%. 13 - 23 Although the RNA of the virus has been detected in blood and stool, fecal-oral and blood-borne transmissions are not regarded as significant modes of transmission yet. 19 - 26 There have been no reports of mother-to-fetus transmission in pregnant women. 27

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SARS-CoV-2 mode of transmission and clinical manifestations are illustrated in this figure. The potential source of this outbreak was identified to be from animals, similar to MERS and SARS, in epidemiologic studies; nonetheless, person-to-person transmission through droplets is currently the important mode. After reaching mucous membranes by direct or indirect close contact, the virus replicates in the cells and the immune system attacks the body due to its nature. Afterward, the clinical pictures appear, which are much more similar to influenza. However, different patients will have a spectrum of signs and symptoms.

Source Investigation

Recently, the appearance of SARS-CoV-2 in society shocked the healthcare system. 28 - 32 Veterinary corona virologists reported that COVID-19 was isolated from wildlife. Several studies have shown that bats are receptors of the CoV new version in 2019 with variants and changes in the environment featuring various biological characteristics. 33 - 36 The aforementioned mammals are a major source of CoV, which causes mild-to-severe respiratory illness and can even be deadly. In recent years, the virus has killed several thousands of people of all ages. 37 - 39 The mutated alternative of the virus can be transmitted to humans and cause acute respiratory distress. 40 , 41 One of the main causes of the spread of the virus is the exotic and unusual Chinese food in Wuhan: CoV is a direct result of the Chinese food cycle. The virus is found in the body of animals such as bats, 42 and snake or bat soup is a favorite Chinese food. Therefore, this sequence is replicated continuously. Almost everyone who was infected for the first time was directly in the local Wuhan market or had indirectly tried snake or bat soup in a Chinese restaurant. An investigation stated that the Malayan pangolin (Manis javanica) was a possible host for SARS-CoV-2 and recommended that it be removed from the wet market to prevent zoonotic transmissions in the future. 43 , 44

Pathogenesis

The important mechanisms of the severe pathogenesis of SARS-CoV-2 are not fully understood. Extensive lung injury in SARS-CoV-2 has been related to increased virus titers; monocyte, macrophage, and neutrophil infiltrations into the lungs; and elevated levels of pro-inflammatory cytokines and chemokines. Thus, the clinical exacerbation of SARS-CoV-2 infection may be in consequence of a combination of direct virus-induced cytopathic and immunopathological effects due to excessive cytokinesis. Changes in the cytokine/chemokine profile during SARS infection showed increased levels of circulating cytokines such as tumor necrosis factor-α (TNF-α), C–X–C motif chemokine 10 (CXCL10), interleukin (IL)-6, and IL-8 levels, in conjunction with elevated levels of serum pro-inflammatory cytokines such as IL-1, IL-6, IL-12, interferon-gamma (IFN-γ), and transforming growth factor-β (TGF-β). Nevertheless, constant stimulation by the virus creates a cytokine storm that has been related to acute respiratory distress syndrome (ARDS) and multiple organ dysfunction syndromes (MODS) in patients with COVID-19, which may ultimately lead to diminished immunity by lowering the number of CD4+ and CD8+ T cells and natural killer cells (crucial in antiviral immunity) and decreasing cytokine production and functional ability (exhaustion). It has been shown that IL-10, an inhibitory cytokine, is a major player and a potential target for therapeutic aims. 45 - 51 Severe cases of COVID-19 have respiratory distress and failure, which has been linked to the altered metabolism of heme by SARS-CoV-2. Some virus proteins can dissociate iron from porphyrins by attacking the 1-β chain of hemoglobin, which decreases the oxygen-transferring ability of hemoglobin. Research has also indicated that chloroquine and favipiravir might inhibit this process. 52

Clinical Manifestations

SARS-CoV-2, which attacks the respiratory system, has a spectrum of manifestations; nonetheless, it has three main primary symptoms after an incubation period of about two days to two weeks: fever and its associated symptoms such as malaise/fatigue/weakness; cough, which is nonproductive in most of the cases but can be productive indeed; and shortness of breath (dyspnea) due to low blood oxygenation. Although these symptoms appear in the body of the affected person over two to 14 days, patients may refer to the clinic with gastrointestinal symptoms (nausea/vomiting-diarrhea) or decreased sense of smell and/or taste. More devastatingly, however, patients may refer to the emergency room with such coagulopathies as pulmonary thromboembolism, cerebral venous thrombosis, and other related manifestations. The WHO has stated that dry throat and dry cough are other symptoms detected in the early stages of the infection. 53 , 54 The estimations of the severity of the disease are as follows: mild (no or mild pneumonia) in 81%, severe (eg, with dyspnea, hypoxia, or >50% lung involvement on imaging within 24 to 48 hours) in 14%, and critical (eg, with respiratory failure, shock, or multiorgan dysfunction) in 5%. In the early stages, the overall mortality rate was 2.3% and no deaths were observed in non-severe patients. Patients with advanced age or underlying medical comorbidities have more mortality and morbidity. 55 Although adults of middle age and older are most commonly affected by SARS-CoV-2, individuals at any age can be infected. A few studies have reported symptomatic infection in children; still, when it occurs, it has mild symptoms. The vast majority of cases have the infection with no signs and symptoms or mild clinical pictures; they are called “the asymptomatic group”. These patients do not seek medical care and if they come into close contact with others, they can spread the virus. Therefore, quarantine in their home is the best option for the population to break the transmission of the virus. It should be considered that some of these asymptomatic patients have clinical signs such as chest computed tomography scan (CT-Scan) infiltrations. Similar to bacterial pneumonia, lower respiratory signs and symptoms are the most frequent manifestations in serious cases of COVID-19, characterized by fever, cough, dyspnea, and bilateral infiltrates on chest imaging. In a study describing pneumonia in Wuhan, the most common clinical signs and symptoms at the onset of the illness were fever in 99% (although fever might not be a universal finding), fatigue in 70%, dry cough in 59%, anorexia in 40%, myalgia in 35%, dyspnea in 31%, and sputum production in 27%. Headache, sore throat, and rhinorrhea are less common, and gastrointestinal symptoms (eg, nausea and diarrhea) are relatively rare. 7 , 42 , 43 , 45 - 48 , 56 , 57 According to our clinical experience in Iran, anosmia, atypical chest pain, diarrhea, nausea/vomiting, and hemoptysis are other presenting symptoms in the clinic. It should be noted that COVID-19 has some unexplained potential complications such as secondary bacterial infections, myocarditis, central nervous system injury, cerebral edema, MODS, acute demyelinating encephalomyelitis (ADEM), kidney injury, liver injury, new-onset seizure, coagulopathy, and arrhythmias.

Laboratory data : Complete blood counts, which constitute a routine laboratory test, have shown different results in terms of the white blood cell count: from leukopenia and lymphopenia to leukocytosis, although lymphopenia appears to be the most common. Fatal cases have exhibited severe lymphopenia accompanied by an increased level of D-dimer. Liver function enzymes can be increased; however, it is not sufficient to diagnose a disease. The serum procalcitonin level is a marker of infection, especially in bacterial diseases. Patients with COVID-19 who require intensive care unit (ICU) management may have elevated procalcitonin. Increased urea and creatinine, creatinine-phosphokinase, lactate dehydrogenase, and C-reactive protein are other findings in some cases. 7 , 56 , 57

Imaging studies : Routine chest X-ray (CXR) is widely deemed the first-step management to evaluate any respiratory involvement. Although negative findings in CXR do not rule out the viral disease, patients without common findings do not have severe disease and can, consequently, be managed in the outpatient setting. 58 , 59 Another modality is chest CT-Scan. It can be ordered in suspected cases with typical symptoms at the first step, or it can be performed after the detection of any abnormalities in CXR. The most common demonstrations in CT-Scan images are ground-glass opacification, round opacities, and crazy paving with or without bilateral consolidative abnormalities (multilobar involvement) in contrast to most cases of bacterial pneumonia, which have locally limited involvement. Pleural thickening, pleural effusion, and lymphadenopathy are less common. 58 - 61 Tree-in-bud, peribronchial distribution, nodules, and cavity are not in favor of common COVID-19 findings. Although reverse transcriptase-polymerase chain reaction (RT-PCR) is used to confirm the diagnosis, it is a time-consuming procedure and has high false-negative/false-positive findings; hence, in the emergency clinical setting, CT-Scan findings can be a good approach to make the diagnosis. It is deserving of note, however, that false-positive/false-negative cases were reported by one study to be high and other differential diagnoses should be in mind in order not to miss any other cases such as acute pulmonary edema in patients with heart disease.

Suspected cases should be diagnosed as soon as possible to isolate and control the infection immediately. COVID-19 should be considered in any patient with fever and/or lower respiratory tract symptoms with any of the following risk factors in the previous 2 weeks: close contact with confirmed or suspected cases in any environment, especially at work in healthcare places without sufficient protective equipment or long-time standing in those places, and living in or traveling from well-known places where the disease is an epidemic. 61 - 66 Patients with severe lower respiratory tract disease without alternative etiologies and a clear history of exposure should be considered having COVID-19 unless confirmed otherwise. According to the Centers for Disease Control and Prevention (CDC), sending tests to check SARS-CoV-2 in suspected cases is based on physicians’ clinical judgment. Although there are some positive cases without clinical manifestations (ie, fever and/or symptoms of acute respiratory illness such as cough and dyspnea), infectious disease and control centers should take action in society to limit the exposure of such patients to other healthy individuals. The CDC prioritizes the use of the specific test for hospitalized patients, symptomatic patients who are at risk of fatal conditions (eg, age ≥65 y, chronic medical conditions, and immunocompromising conditions) and those who have exposure risks (recent travel, contact with patients with COVID-19, and healthcare workers). 61 - 66 Although treatment should be started after the confirmation of the disease, RT-PCR for highly suspected cases is a time-consuming test; accordingly, a considerable number of clinicians favor the use of a combination of clinical manifestations with imaging modalities (eg, CT-Scan findings) and their clinical judgment regarding the probability of the disease in order not to lose more time. 61 - 66

Treatment of COVID-19

There is no confirmed recommended treatment or vaccine for SARS-CoV-2; prevention is, therefore, better than treatment. Nevertheless, the high contagiousness of COVID-19, combined with the fact that some individuals fail to adhere to precautionary measures or they have significant risk factors, means that this infectious disease is inevitable in some people. Beside supportive treatments, many types of medications have been introduced. These medications come from previous experimental studies on SARS, MERS, influenza, or human immunodeficiency virus (HIV); hence, their efficacy needs further experimental and clinical approval. Patients with mild symptoms who do not have significant risk factors should be managed in their home like a self-made quarantine (in an isolated room); still, prompt hospital admission is required if patients exhibit signs of disease deterioration. 25 , 67 , 68 Isolation from other family members is an important prevention tip. Patients should wear face masks, eat healthy and warm foods similar to when struggling with influenza or colds, do the handwashing process, dispose of the contaminated materials cautiously, and disinfect suspicious surfaces with standard disinfectants. 69 Patients with severe symptoms or admission criteria should be hospitalized with other patients who have the same disease in an isolated department. When the disease is progressed, ICU care is mandatory. 25 , 67 , 68 SARS-CoV-2 attacks the respiratory system, diminishing the oxygenation process and forcing patients with low blood oxygen saturation to take extra oxygen from different modalities. Nasal cannulae, face masks with or without a reservoir, intubation in severe cases, and then extracorporeal membrane oxygenation in refractory hypoxia have been used; however, the safety and efficacy of these measures should be evaluated. As was mentioned above, impaired coagulation is one of the major complications of the disease; consequently, alongside all recommended supportive care and drugs, anticoagulants such as heparin should be administered prophylactically ( Table 1 ). Although it is said that all the clinical signs and symptoms of COVID-19 are induced by the immune system, as other research on influenza and MERS has revealed, glucocorticoids are not recommended in COVID-19 pneumonia unless other indications are present (eg, exacerbation of chronic obstructive pulmonary disease and refractory septic shock) due to the high risk of mortality and delayed viral clearance. Earlier in the national and international guidelines, nonsteroidal anti-inflammatory drugs such as naproxen were recommended on the strength of their antipyretic and anti-inflammatory components; however, the guideline has been revised recently and acetaminophen with or without codeine is currently the favored drug in patients with COVID-19. 25 , 67 , 68 According to the pathogenesis of the disease, whereby cytokine storm and immune-cell exhaustion can be seen in severe cases, selective antibodies against harmful interleukins such as IL-6 and IL-10 or other possible agents can be therapeutic for fatal complications. Tocilizumab, an IL-6 inhibitor, albeit with limited clinical efficacy, has been introduced in China’s National Health Commission treatment guideline for severe infection with profound pulmonary involvement (ie, white lung). 70 , 87

Summary of possible anti-COVID-19 drugs

mg, Milligrams; BD, Every 12 hours; RdRP, RNA-dependent RNA polymerase; TDS, Every 8 hours; IV, Intravenous; IL, Interleukin; μg, Micrograms

RNA synthesis inhibitors (eg, tenofovir disoproxil fumarate and 2’-deoxy-3’-thiacytidine [3TC]), neuraminidase inhibitors (NAIs), nucleoside analogs, lopinavir/ritonavir, atazanavir, remdesivir, favipiravir, INF-β, and Chinese traditional medicine (eg, Shufeng Jiedu and Lianhuaqingwen capsules) are the major candidates for COVID-19. 26 , 70 , 85 , 88 - 96 Antiviral drugs have been investigated for various diseases, but their efficacy in the treatment of COVID-19 is under investigation and several randomized clinical trials are ongoing to release a consensus result on the treatment of this infectious disease. Moderate-to-severe SARS-CoV-2 disease needs drug therapy. Favipiravir, a previously validated drug for influenza, is a drug that has shown promising results for COVID-19 in experimental and clinical studies, but it is under further evaluation. 70 , 79 , 80 Remdesivir, which was developed for Ebola, is an antiviral drug that is under evaluation for moderate-to-severe COVID-19 owing to its promising results in in vitro investigations. 70 , 73 - 75 , 81 Remdesivir was shown to have reduced the virus titer in infected mice with MERS-CoV and improved lung tissue damage with more efficiency compared with a group treated with lopinavir/ritonavir/INF-β. 67 , 70 Another investigation studied the potential efficacy of INF-β-1 in the early stages of COVID-19 as a potential antiviral drug. 86 Although there is some hope, an evidence-based consensus requires further clinical trials. 70 , 77 A combined protease inhibitor, lopinavir/ritonavir, is used for HIV infection and has shown interesting results for SARS and MERS in in vitro studies. 73 - 75 The clinical effectiveness of lopinavir/ritonavir for SARS-CoV-2 was also reported in a case report. 70 , 71 , 74 , 76 Atazanavir, another protease inhibitor, with or without ritonavir is another possible anti-COVID-19 treatment. 77 , 78 NAIs, including oseltamivir, zanamivir, and peramivir, are recommended as antiviral treatment in influenza. 68 Oral oseltamivir was tried for COVID-19 in China and was first recommended in the Iranian guideline for COVID-19 treatment; nevertheless, because of the absence of strong evidence indicating its efficacy for SARS-CoV-2, it was eliminated from the subsequent updates of the guideline. 85 RNA-dependent RNA polymerase inhibitors with anti-hepatitis C effects such as ribavirin have shown satisfactory results against SARS-CoV-2 RNA polymerase; however, they have limited clinical approval. 82 - 84 The well-known drugs for rheumatoid arthritis, systemic lupus erythematosus, and an antimalarial drug, chloroquine 71 and hydroxychloroquine 21 are other potential drugs for moderate-to-severe COVID-19 but with limited or no clinical appraisal. Hydroxychloroquine has exhibited better safety and fewer side effects than chloroquine, which makes it the preferred choice. 70 Furthermore, the immunomodulatory effects of hydroxychloroquine can be used to control the cytokine precipitation in the late phases of SARS-CoV-2 infections. There are numerous mechanisms for the antiviral activity of hydroxychloroquine. A weak base drug, hydroxychloroquine concentrates on such intracellular sections as endosomes and lysosomes, thereby halting viral replication in the phase of fusion and uncoating. Additionally, this immunosuppressive and antiparasitic drug is capable of altering the glycosylation of ACE2 and inhibiting both S-protein binding and phagocytosis. 72 A recent multicenter study showed that regarding the risks of cardiovascular adverse effects and mortality rates, hydroxychloroquine or chloroquine with or without a macrolide (eg, azithromycin) was not beneficial for hospitalized patients, although further research is needed to end such controversies. 97

Disease Duration

It is not easy to quarantine the patients who have fully recovered because there is evidence that they are highly infectious. 81 The recovery time for confirmed cases based on the National Health Commission reports of China’s government was estimated to range between 18 and 22 days. 73 As indicated by the WHO, the healing time seems to be around two weeks for moderate infections and 3 to 6 weeks for the severe/ serious disease. 75 Pan Feng and others studied 21 confirmed cases with COVID-19 pneumonia with about 82 CT-Scan images with a mean interval of four days. Lung abnormalities on chest CT showed the highest severity approximately 10 days after the initial onset of symptoms. All patients became clear after 11 to 26 days of hospitalization. From day zero to day 26, four stages of lung CT were defined as follows: Stage 1 (first 4 days): ground-glass opacities; Stage 2 (second 4 days): crazy-paving patterns; Stage 3 (days 9–13): maximum total CT scores in the consolidations; and Stage 4 (≥14 d): steady improvements in the consolidations with a reduction in the total CT score without any crazy-paving pattern. 74 Nevertheless, there are also rare cases reported from some studies that show the recurrence of COVID-19 after negative preliminary RT-PCR results. For example, Lan and othersstudied one hospitalized and three home-quarantined patients with COVID-19 and evaluated them with RT-PCR tests of the nucleic acid. All the patients with positive RT-PCR test results had CT imaging with ground-glass opacification or mixed ground-glass opacification and consolidation with mild-to-moderate disease. After antiviral treatments, all four patients had two consecutive negative RT-PCR test results within 12 to 32 days. Five to 13 days after hospital discharge or the discontinuation of the quarantine, RT-PCR tests were repeated, and all were positive. An additional RT-PCR test was performed using a kit from a different manufacturer, and the results were also positive. Their findings propose that a minimum percentage of recovered patients may still be infection carriers. 76

Supplements for COVID-19

Since the appearance of SARS-CoV-2 in Wuhan, China, there have been reports of the unreliable and unpredictable use of mysterious therapies. Some recommendations such as the use of certain herbs and extracts including oregano oil, mulberry leaf, garlic, and black sesame may be safe as long as people do not utilize their hands for instance. 98 According to data released by the CDC, vitamin C (VitC) supplements can decrease the risk of colds in people besides preventing CoV from spreading. The aforementioned organization states that frequent consumption of VitC supplements can also decrease the duration of the cold; however, if used only after the cold has risen, its consumption does not influence the disease course. VitC also plays an important role in the body. One of the main reasons for taking VitC is to strengthen the immune system because this vitamin plays a significant part in the immune system. Firstly, VitC can increase the production of white blood cells (lymphocytes and phagocytes) in the bone marrow, which can support and protect the body against infections. Secondly, VitC helps immune cells to function better while preserving white blood cells from damaging molecules such as free oxidative radicals and ions. Thirdly, VitC is an essential part of the skin’s immune system. This vitamin is actively transported to the skin surface, where it serves as an antioxidant and helps to strengthen the skin barrier by optimizing the collagen synthesis process. Patients with pneumonia have lower levels of VitC and have been revealed to have a longer recovery time. 69 , 99 In a randomized investigation, 200 mg/d of VitC was applied to older patients and resulted in improvements in the respiratory symptoms. Another investigation reported 80% fewer mortalities in a controlled group of VitC takers. 73 However, for effective immune system improvement, VitC should be consumed alongside adequate doses of several other supplements. Although VitC plays an important role in the body, often a balanced diet and the consumption of fresh fruits and vegetables can quickly fill the blanks. While taking high amounts of VitC is less risky because it is water-soluble and its waste is eliminated in the urine, it can induce diarrhea, nausea, and abdominal spasms at higher concentrations. Too much VitC may cause calcium-oxalate kidney stones. People with genetic hemochromatosis, an iron deficiency disorder, should consult a physician before taking any VitC supplements as high levels of VitC can lead to tissue damage. Some studies have evaluated the different doses of oral or intravenous VitC for patients admitted to the hospital for COVID-19. Although they used different regimens, all of them demonstrated satisfactory results regarding the resolution of the compilations of the disease, decreased mortality, and shortened lengths of stay in the ICU and/or the hospital. 100 , 101 Immunologists have also recommended 6 000 units of vitamin A (VitA) per day for two weeks, more than twice the recommended limit for VitA, which can create a poisoning environment over time. According to the guidance of the National Institutes of Health (NIH), middle-aged men and women should take 1 and 2 mg of VitA every day, respectively. The safe upper limit of this vitamin is 6000 mg or 5000 units, and overdose can have serious outcomes such as dizziness, nausea, headache, coma, and even death. Extreme consumption of VitA throughout pregnancy can lead to birth anomalies.

Similar to VitC, vitamin D (VitD) has antioxidant, anti-inflammatory, and immune-modulatory effects in our body such as reducing pro-inflammatory cytokines and inhibiting viral replication according to experimental studies. 83 The VitD state of our body is checked through 25 (OH) VitD in the serum. VitD deficiency is pandemic around the world due to multifactorial reasons. It has been shown that VitD deficient patients are prone to SARS-CoV-2 and, accordingly, treating VitD deficiency is not without benefits. Grant and others recommended 10 000 units per day for two weeks and then 5 000 units per day as the maintenance dose to keep the level between 40 and 100 ng/mL. 102 VitD toxicity causes gastrointestinal discomfort (dyspepsia), congestion, hypercalcemia, confusion, positional disorders, dysrhythmia, and kidney dysfunction.

James Robb, 103 a researcher who detected CoV for the first time as a consultant pathologist with the National Cancer Institute of America, suggested the influence of zinc consumption. Oral zinc supplements can be dissolved in the nback of the throat. Short-term therapy with oral zinc can decrease the duration of viral colds in adults. Zinc intake is also associated with the faster resolution of nasal congestion, nasal drainage, sore throats, and coughs. Researchers 104 , 105 have warned that the consumption of more than 1 mg of zinc a day can lead to zinc poisoning and have side effects such as lowered immune function. Children and old people with zinc insufficiency in developing nations are extremely vulnerable to pneumonia and other viral infections. It has also been determined that zinc has a major role in the production and activation of T-cell lymphocytes. 106 , 107

And finally, for high-risk people or those who work in high-risk places such as healthcare providers, hydroxychloroquine has been mentioned to be effective as a prophylactic regimen ( Table 2 ). Although different doses have been investigated so far, Pourdowlat and others recommended 200 mg daily before exposure, and for the post-exposure scenario, a loading dose of 600-800 mg followed by a maintenance dose of 200 mg daily. 74

Possible prophylactic regimens against SARS-CoV-2 infection

IU, International unit; mg, Milligrams; kg, Kilograms; ICU, Intensive care unit; g, Grams; IV, Intravenous; Vit, Vitamin; ng, Nanograms; mL, Milliliter

COVID-19 Kits and Deep Learning

COVID-19 has threatened public health, and its fast global spread has caught the scientific community by surprise. 108 Hence, developing a technique capable of swiftly and reliably detecting the virus in patients is vital to prevent the spreading of the virus. 109 , 110 One of the ways to diagnose this new virus is through RT-PCR, a test that has previously demonstrated its efficacy in detecting such CoV infections as MERS-CoV and SARS-CoV. Consequently, increasing the availability of RT-PCR kits is a worldwide concern. The timing of the RT-PCR test and the type of strain collected are of vital importance in the diagnosis of COVID-19. One of the characteristics of this new virus is that the serum is negative in the early stage, while respiratory specimens are positive. The level of the virus at the early stage of the illness is also high, even though the infected individual experiences mild symptoms. 111 For the management of the emerging situation of COVID-19 in Wuhan, various effective diagnostic kits were urgently made available to markets. While a few different diagnostics kits are used merely for research endeavors, only a single kit developed by the Beijing Genome Institute (BGI) called “Real-Time Fluorescent PCR” has been authenticated for clinical diagnostics. Fluorescent RT-PCR is reliable and able to offer fast results probably within a few hours (usually within two hours). Besides RT-PCR, China has successfully developed a metagenomic-sequencing kit based on combinatorial probe-anchor synthesis that can identify virus-related bacteria, allowing observation and evaluation during the transmission of the virus. Furthermore, the metagenomic-sequencing kit based on combinatorial probe-anchor synthesis is far faster than the abovementioned fluorescent RT-PCR kit. Apart from China, a Singapore-based laboratory, Veredus, developed a virus detection kit (Vere-CoV) in late January. It is a portable Lab-On-Chip used to detect MERS-CoV, SARS-CoV, and SARS-CoV-2, in a single examination. This kit works based on the VereChip™ technology, the lines of code (LOC) program incorporating two different influential molecular biological functions (microarray and PCR) precisely. Several studies have focused on SARS-CoV diagnostic testing. These papers have presented investigative approaches to the identification of the virus using molecular testing (ie, RT-PCR). Researchers probed into the use of a nested PCR technique that contains a pre-amplification step or integrating the N gene as an extra subtle molecular marker to improve on the sensitivity. 112 - 115 CT-Scan is very useful for diagnosing, evaluating, and screening infections caused by COVID-19. One recommendation for scanning the disease is to take a scan every three to five days. According to researchers, most CT-Scan images from patients with COVID-19 are bilateral or peripheral ground-glass opacification, with or without stabilization. Nowadays, because of a paucity of computerized quantification tools, only qualitative reports and sometimes inaccurate analyses of contaminated areas are drawn upon in radiology reports. A categorization system based on the deep learning approach was proposed by a study to automatically measure infected parts and their volumetric ratios in the lung. The functionality of this system was evaluated by making some comparisons between the infected portions and the manually-delineated ones on the CT-Scan images of 300 patients with COVID-19. To increase the manual drawing of training samples and the non-interference in the automated results, researchers adopted a human-based approach in collaboration with radiologists so as to segment the infected region. This approach shortens the time to about four minutes after 3-time updating. The mean Dice similarity coefficient illustrated that the automatically detected infected parts were 91.6% similar to the manually detected ones, and the average of the percentage estimated error was 0.3% for the whole lung. 116 , 117

Prevention Considerations

In the healthcare setting, any individual with the manifestations of COVID-19 (eg, fever, cough, and dyspnea) should wear a face mask, have a separate waiting area, and keep the distance of at least two meters. Symptomatic patients should be asked about recent travel or close contact with a patient in the preceding two weeks to find other possible infected patients. The CDC and WHO have announced special precautions for healthcare providers in the hospital and during different procedures. Wearing tight-fitting face masks with special filters and impermeable face shields is necessary for all of them. 11 , 18 , 65 , 66 , 76 , 118 - 124 Other people should pay attention to the CDC and WHO preventive strategies, which recommend that individuals not touch their eyes, mouth, and nose before washing or disinfecting their hands; wash their hands regularly according to the standard protocol; use effective disinfection solutions (ie, containing at least 60% ethylic alcohol) for contaminated surfaces; cover their mouth when coughing and sneezing; avoid waiting or walking in crowded areas, and observe isolation protocols in their home. Postponing elective work and decreasing non-urgent visits and traveling to areas in the grip of COVID-19 may be useful to lessen the risk of exposure. If suspected individuals with mild symptoms are managed in outpatient settings, an isolated room with minimal exposure to others should be designed. Patients and their caregivers should wear tight-fitting face masks. 11 , 18 , 65 , 66 , 76 , 118 - 124 Substantial numbers of individuals with COVID-19 are asymptomatic with potential exposure; accordingly, a screening tool should be employed to evaluate these cases. In addition to passport checks, corona checks have been incorporated into the protocols in airports and other crowded places. The use of a remote thermometer to measure body temperature leads to an increase in the number of false-negative cases. It is, thus, essential that everyone pay sufficient heed to the WHO and CDC recommendations in their daily life. Traveling is not prohibited, but it should be restricted and passengers from any country should be monitored. 11 , 18 , 65 , 66 , 76 , 118 - 124

SARS-CoV-2 is the new highly contagious CoV, which was first reported in China. While it had a zoonotic origin in the beginning, it subsequently spread throughout the world by human contact. COVID-19 has a spectrum of manifestations, which is not lethal most of the time. To diagnose this condition, physicians can avail themselves of laboratory and imaging findings besides signs and symptoms. RT-PCR is the gold standard, but it lacks sufficient sensitivity and specificity. Although there are some potential drugs for COVID-19 and some vitamins or minerals for prophylaxis, the best preventive strategies are quarantine (staying at home) and the use of personal protective equipment and disinfectants.

Acknowledgement

The authors express their gratitude toward the Supporting Organizations for Foreign Iranian Students, Islamic Azad University Isfahan (Khorasgan) Branch, and Isfahan University of Medical Sciences.

Conflict of Interest: None declared.

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What you need to know about covid-19 vaccines, answers to the most common questions about coronavirus vaccines..

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Vaccines save millions of lives each year. The development of safe and effective COVID-19 vaccines are a crucial step in helping us get back to doing more of the things we enjoy with the people we love.

We’ve gathered the latest expert information to answer some of the most common questions about COVID-19 vaccines. Keep checking back as we will update this article as more information becomes available.

What are the benefits of getting vaccinated?

Vaccines save millions of lives each year and a COVID-19 vaccine could save yours. The COVID-19 vaccines are safe and effective, providing strong protection against serious illness and death. WHO reports that unvaccinated people have at least 10 times higher risk of death from COVID-19 than someone who has been vaccinated.

It is important to be vaccinated as soon as it’s your turn, even if you already had COVID-19. Getting vaccinated is a safer way for you to develop immunity from COVID-19 than getting infected.

The COVID-19 vaccines are highly effective, but no vaccine provides 100 per cent protection. Some people will still get ill from COVID-19 after vaccination or pass the virus onto someone else.

Therefore, it is important to continue practicing safety precautions to protect yourself and others, including avoiding crowded spaces, physical distancing, hand washing and wearing a mask.

Who should be vaccinated first?

Each country must identify priority populations, which WHO recommends are frontline health workers (to protect health systems) and those at highest risk of death due to COVID-19, such as older adults and people with certain medical conditions. Other essential workers, such as teachers and social workers, should then be prioritized, followed by additional groups as more vaccine doses become available.

The risk of severe illness from COVID-19 is very low amongst healthy children and adolescents, so unless they are part of a group at higher risk of severe COVID-19, it is less urgent to vaccinate them than these priority groups.

Children and adolescents who are at higher risk of developing severe illness from COVID-19, such as those with underlying illnesses, should be prioritized for COVID-19 vaccines.

When shouldn’t you be vaccinated against COVID-19?

If you have any questions about whether you should receive a COVID-19 vaccine, speak to your healthcare provider. At present, people with the following health conditions should not receive a COVID-19 vaccine to avoid any possible adverse effects:

If you have a history of severe allergic reactions to any ingredients of a COVID-19 vaccine.
If you are currently sick or experiencing symptoms of COVID-19 (although you can get vaccinated once you have recovered and your doctor has approved).

Should I get vaccinated if I already had COVID-19?

Yes, you should get vaccinated even if you’ve previously had COVID-19. While people who recover from COVID-19 may develop natural immunity to the virus, it is still not certain how long that immunity lasts or how well it protects you against COVID-19 reinfection. Vaccines offer more reliable protection, especially against severe illness and death. Vaccination policies after COVID-19 infection vary by country. Check with your health care provider on the recommendation where you live.

Which COVID-19 vaccine is best for me?

All WHO-approved vaccines have been shown to be highly effective at protecting you against severe illness and death from COVID-19. The best vaccine to get is the one most readily available to you.

You can find a list of those approved vaccines on WHO’s site . 

Remember, if your vaccination involves two doses, it’s important to receive both to have the maximum protection.

How do COVID-19 vaccines work?

Vaccines work by mimicking an infectious agent – viruses, bacteria or other microorganisms that can cause a disease. This ‘teaches’ our immune system to rapidly and effectively respond against it.

Traditionally, vaccines have done this by introducing a weakened form of an infectious agent that allows our immune system to build a memory of it. This way, our immune system can quickly recognize and fight it before it makes us ill. That’s how some of the COVID-19 vaccines have been designed.

Other COVID-19 vaccines have been developed using new approaches, which are called messenger RNA, or mRNA, vaccines. Instead of introducing antigens (a substance that causes your immune system to produce antibodies), mRNA vaccines give our body the genetic code it needs to allow our immune system to produce the antigen itself. mRNA vaccine technology has been studied for several decades. They contain no live virus and do not interfere with human DNA.

For more information on how vaccines work, please visit WHO .

Are COVID-19 vaccines safe?

Yes, COVID-19 vaccines have been safely used to vaccinate billions of people. The COVID-19 vaccines were developed as rapidly as possible, but they had to go through rigorous testing in clinical trials to prove that they meet internationally agreed benchmarks for safety and effectiveness. Only if they meet these standards can a vaccine receive validation from WHO and national regulatory agencies.

UNICEF only procures and supplies COVID-19 vaccines that meet WHO’s established safety and efficacy criteria and that have received the required regulatory approval.

How were COVID-19 vaccines developed so quickly?

Scientists were able to develop safe effective vaccines in a relatively short amount of time due to a combination of factors that allowed them to scale up research and production without compromising safety:

Because of the global pandemic, there was a larger sample size to study and tens of thousands of volunteers stepped forward
Advancements in technology (like mRNA vaccines) that were years in the making
Governments and other bodies came together to remove the obstacle of funding research and development
Manufacturing of the vaccines occurred in parallel to the clinical trials to speed up production

Though they were developed quickly, all COVID-19 vaccines approved for use by the WHO are safe and effective.

What are the side effects of COVID-19 vaccines?

Vaccines are designed to give you immunity without the dangers of getting the disease. Not everyone does, but it’s common to experience some mild-to-moderate side effects that go away within a few days on their own.

Some of the mild-to-moderate side effects you may experience after vaccination include:

Arm soreness at the injection site
Muscle or joint aches

You can manage any side effects with rest, staying hydrated and taking medication to manage pain and fever, if needed.

If any symptoms continue for more than a few days then contact your healthcare provider for advice. More serious side effects are extremely rare, but if you experience a more severe reaction, then contact your healthcare provider immediately.

>> Read: What you need to know before, during and after receiving a COVID-19 vaccine

How do I find out more about a particular COVID-19 vaccine?

You can find out more about COVID-19 vaccines on WHO’s website .

Can I stop taking precautions after being vaccinated?

Keep taking precautions to protect yourself, family and friends if there is still COVID-19 in your area, even after getting vaccinated. The COVID-19 vaccines are highly effective against serious illness and death, but no vaccine is 100% effective.  

The vaccines offer less protection against infection from the Omicron variant, which is now the dominant variant globally, but remain highly effective in preventing hospitalization, severe disease, and death. In addition to vaccination, it remains important to continue practicing safety precautions to protect yourself and others. These precautions include avoiding crowded spaces, physical distancing, hand washing, and wearing a mask (as per local policies). 

Can I still get COVID-19 after I have been vaccinated? What are ‘breakthrough cases’?

A number of vaccinated people may get infected with COVID-19, which is called a breakthrough infection. In such cases, people are much more likely to only have milder symptoms. Vaccine protection against serious illness and death remains strong.

With more infectious virus variants such as Omicron, there have been more breakthrough infections. That’s why it's recommended to continue taking precautions such as avoiding crowded spaces, wearing a mask and washing your hands regularly, even if you are vaccinated.

And remember, it’s important to receive all of the recommended doses of vaccines to have the maximum protection.

How long does protection from COVID-19 vaccines last?

According to WHO, the effectiveness of COVID-19 vaccines wanes around 4-6 months after the primary series of vaccination has been completed. Taking a booster to strengthen your protection against serious disease is recommended if it is available to you.

Do the COVID-19 vaccines protect against variants?

The WHO-approved COVID-19 vaccines continue to be highly effective at preventing severe illness and death.

However, the vaccines offer less protection against infection from Omicron, which is the dominant variant globally. That's why it's important to get vaccinated and continue measures to reduce the spread of the virus – which helps to reduce the chances for the virus to mutate – including physical distancing, mask wearing, good ventilation, regular handwashing and seeking care early if you have symptoms.

Do I need to get a booster shot?  

Booster doses play an important role in protecting against severe disease, hospitalization and death.

WHO recommends that you take all COVID-19 vaccine doses recommended to you by your health authority as soon as it is your turn, including a booster dose if recommended.

Booster shots should be given first to high priority groups. Data shows that a booster shot plays a significant role in boosting waning immunity and protecting against severe disease from highly transmissible variants like Omicron.

If available, an additional second booster shot is also recommended for some groups of people, 4-6 months after the first booster. That includes older people, those who have weakened immune systems, pregnant women and healthcare workers.

Check with your local health authorities for guidance and the availability of booster shots where you live. 

What do we know about the bivalent COVID-19 booster doses that have been developed to target Omicron?

Bivalent COVID-19 booster shots have now been developed with both the original strain of the coronavirus and a strain of Omicron. These have been designed to better match the Omicron subvariants that have proven to be particularly transmissible. Lab studies have shown that these doses help you to mount a higher antibody response against Omicron. Both Moderna and Pfizer have developed these bivalent vaccines, and some countries have now approved their use.

Check with your local health authorities for information about the availability of these doses and who can get them where you live. And it’s important to note that the original COVID-19 vaccines continue to work very well and provide strong protection against severe illness from Omicron.

Can I receive different types of COVID-19 vaccines?  

Yes, however, policies on mixing vaccines vary by country. Some countries have used different vaccines for the primary vaccine series and the booster. Check with your local health authorities for guidance where you live and speak with your healthcare provider if you have any questions on what is best for you.

I’m pregnant. Can I get vaccinated against COVID-19?

Yes, you can get vaccinated if you are pregnant. COVID-19 during pregnancy puts you at higher risk of becoming severely ill and of giving birth prematurely.

Many people around the world have been vaccinated against COVID-19 while pregnant or breastfeeding. No safety concerns have been identified for them or their babies. Getting vaccinated while pregnant helps to protect your baby. For more information about receiving a COVID-19 vaccination while pregnant, speak to your healthcare provider.

>> Read: Navigating pregnancy during the COVID-19 pandemic

I’m breastfeeding. Should I get vaccinated against COVID-19?

Yes, if you are breastfeeding you should take the vaccine as soon as it is available to you. It is very safe and there is no risk to the mother or baby. None of the current COVID-19 vaccines have live virus in them, so there is no risk of you transmitting COVID-19 to your baby through your breastmilk from the vaccine. In fact, the antibodies that you have after vaccination may go through the breast milk and help protect your baby. >> Read: Breastfeeding safely during the COVID-19 pandemic

Can COVID-19 vaccines affect fertility?

No, you may have seen false claims on social media, but there is no evidence that any vaccine, including COVID-19 vaccines, can affect fertility in women or men. You should get vaccinated if you are currently trying to become pregnant.

Could a COVID-19 vaccine disrupt my menstrual cycle?

Some people have reported experiencing a disruption to their menstrual cycle after getting vaccinated against COVID-19. Although data is still limited, research is ongoing into the impact of vaccines on menstrual cycles.

Speak to your healthcare provider if you have concerns or questions about your periods.

Should my child or teen get a COVID-19 vaccine?

An increasing number of vaccines have been approved for use in children. They’ve been made available after examining the data on the safety and efficacy of these vaccines, and millions of children have been safely vaccinated around the world. Some COVID-19 vaccines have been approved for children from the age of 6 months old. Check with your local health authorities on what vaccines are authorized and available for children and adolescents where you live.

Children and adolescents tend to have milder disease compared to adults, so unless they are part of a group at higher risk of severe COVID-19, it is less urgent to vaccinate them than older people, those with chronic health conditions and health workers.

Remind your children of the importance of us all taking precautions to protect each other, such as avoiding crowded spaces, physical distancing, hand washing and wearing a mask.

It is critical that children continue to receive the recommended childhood vaccines.

How do I talk to my kids about COVID-19 vaccines?

News about COVID-19 vaccines is flooding our daily lives and it is only natural that curious young minds will have questions – lots of them. Read our explainer article for help explaining what can be a complicated topic in simple and reassuring terms.

It’s important to note that from the millions of children that have so far been vaccinated against COVID-19 globally, we know that side effects are very rare. Just like adults, children and adolescents might experience mild symptoms after receiving a dose, such as a slight fever and body aches. But these symptoms typically last for just a day or two. The authorized vaccines for adolescents and children are very safe.

My friend or family member is against COVID-19 vaccines. How do I talk to them?

The development of safe and effective COVID-19 vaccines is a huge step forward in our global effort to end the pandemic. This is exciting news, but there are still some people who are skeptical or hesitant about COVID-19 vaccines. Chances are you know a person who falls into this category.

We spoke to Dr. Saad Omer, Director at the Yale Institute for Global Health, to get his tips on how to navigate these challenging conversations. >> Read the interview

How can I protect my family until we are all vaccinated?

Safe and effective vaccines are a game changer, but even once vaccinated we need to continue taking precautions for the time being to protect ourselves and others. Variants like Omicron have proven that although COVID-19 vaccines are very effective at preventing severe disease, they’re not enough to stop the spread of the virus alone. The most important thing you can do is reduce your risk of exposure to the virus. To protect yourself and your loved ones, make sure to:

Wear a mask where physical distancing from others is not possible.
Keep a physical distance from others in public places.
Avoid poorly ventilated or crowded spaces.
Open windows to improve ventilation indoors.
Try and focus on outdoor activities if possible.
Wash your hands regularly with soap and water or an alcohol-based hand rub.

If you or a family member has a fever, cough or difficulty breathing, seek medical care early and avoid mixing with other children and adults.

Can COVID-19 vaccines affect your DNA?

No, none of the COVID-19 vaccines affect or interact with your DNA in any way. Messenger RNA, or mRNA, vaccines teach the cells how to make a protein that triggers an immune response inside the body. This response produces antibodies which keep you protected against the virus. mRNA is different from DNA and only stays inside the cell for about 72 hours before degrading. However, it never enters the nucleus of the cell, where DNA is kept.

Do the COVID-19 vaccines contain any animal products in them?

No, none of the WHO-approved COVID-19 vaccines contain animal products.

I’ve seen inaccurate information online about COVID-19 vaccines. What should I do?

Sadly, there is a lot of inaccurate information online about the COVID-19 virus and vaccines. A lot of what we’re experiencing is new to all of us, so there may be some occasions where information is shared, in a non-malicious way, that turns out to be inaccurate.

Misinformation in a health crisis can spread paranoia, fear and stigmatization. It can also result in people being left unprotected or more vulnerable to the virus. Get verified facts and advice from trusted sources like your local health authority, the UN, UNICEF, WHO.

If you see content online that you believe to be false or misleading, you can help stop it spreading by reporting it to the social media platform.

What is COVAX?

COVAX is a global effort committed to the development, production and equitable distribution of vaccines around the world. No country will be safe from COVID-19 until all countries are protected.

There are 190 countries and territories engaged in the COVAX Facility, which account for over 90 per cent of the world’s population. Working with CEPI, GAVI, WHO and other partners, UNICEF is leading efforts to procure and supply COVID-19 vaccines on behalf of COVAX.

Learn more about COVAX .

This article was last updated on 25 October 2022. It will continue to be updated to reflect the latest information.

How to talk to your children about COVID-19 vaccines

Tips for navigating the conversation

How to talk to friends and family about vaccines

Tips for handling tough conversations with your loved ones

COVAX information centre

UNICEF and partners led the largest vaccine procurement and supply operation in history

Examining the Case for Universal Healthcare Access

This essay about the debate surrounding universal healthcare presents a balanced exploration of its ethical, economic, and social dimensions. Advocates argue for healthcare as a human right, citing equity and societal benefits, while critics raise concerns about feasibility and individual autonomy. Despite reservations, empirical evidence supports the effectiveness of universal healthcare in improving accessibility and cost-efficiency. The COVID-19 pandemic underscores the importance of robust healthcare systems. Overall, the essay advocates for universal healthcare as a pragmatic solution to healthcare challenges, promoting dignity and equity in societies worldwide.

How it works

In the vast landscape of healthcare discussions, there exists a perennial dialogue that spans across borders, ideologies, and socioeconomic spectra: the argument for universal access to healthcare. This discourse delves into the core question of whether healthcare should be a privilege reserved for the affluent or a basic human entitlement extended to all. Within this intricate tapestry of perspectives lies a rich mosaic, weaving together ethical considerations, economic analyses, and social imperatives.

Proponents of universal healthcare fervently advocate for it as a moral necessity grounded in principles of equity.

They assert that in a just society, every individual should enjoy equal access to essential healthcare services, irrespective of financial status. From routine check-ups to critical treatments, healthcare transcends being merely a commodity; it embodies a fundamental human need. Denying access based on economic prowess perpetuates inequality and undermines the very essence of societal fairness.

Moreover, advocates highlight the broader societal advantages of universal healthcare beyond individual well-being. By ensuring everyone has access to preventative care and timely treatments, public health is enhanced, leading to a reduction in disease spread and long-term healthcare cost containment. Additionally, a healthier populace fosters greater productivity, thereby contributing to economic prosperity and stability.

Economically, proponents argue that universal healthcare can prove more cost-effective than the current fragmented private insurance systems. Through consolidation under a single-payer or government-run framework, administrative overheads can be slashed, while negotiating power with pharmaceutical firms and healthcare providers is bolstered. Examples from countries like Canada, the United Kingdom, and Scandinavia showcase how universal healthcare not only offers comprehensive coverage but also manages costs more efficiently compared to privatized models.

Nevertheless, critics of universal healthcare raise pertinent concerns regarding its feasibility and potential drawbacks. One prevalent argument is the strain it might exert on government finances, potentially leading to increased taxes or burgeoning deficits. Skeptics point to instances in countries with struggling healthcare systems, highlighting prolonged wait times for procedures, restricted access to innovative treatments, and bureaucratic inefficiencies.

Moreover, opponents caution against the loss of individual autonomy and market competition under a universal healthcare system. They contend that private insurance allows for tailored options and flexibility, catering to diverse needs and preferences. Conversely, a government-run system could lead to standardized approaches, stifling innovation and progress in medical care.

Despite these reservations, empirical evidence suggests that universal healthcare systems can yield superior outcomes in terms of accessibility and cost-effectiveness. Studies, such as those published in The Lancet, demonstrate that countries with universal healthcare exhibit lower mortality rates and higher life expectancies compared to those lacking such systems. Similarly, analyses of healthcare expenditures reveal that per capita spending is often lower in nations with universal coverage, dispelling the myth that it inevitably leads to fiscal instability.

Furthermore, the COVID-19 pandemic laid bare the vulnerabilities of fragmented healthcare systems, emphasizing the necessity for comprehensive and coordinated responses to public health crises. Countries with robust universal healthcare infrastructures, like Germany and South Korea, were better poised to contain the virus’s spread and mitigate its impact on healthcare systems and economies.

In conclusion, while the case for universal healthcare access is intricate and multifaceted, the evidence overwhelmingly favors its merits. Beyond moral imperatives, it offers pragmatic solutions to pressing healthcare challenges, from escalating costs to health disparities. By embracing universal healthcare, societies can uphold the intrinsic dignity of every individual and cultivate healthier, more equitable communities. As the world navigates the aftermath of a global pandemic, the call for universal healthcare access rings clearer and more urgent than ever before.

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Serge Schmemann

Editorial Board Member

Suddenly, a Real Chance to Halt the Fighting in Gaza

The “comprehensive new proposal” made by Israel for the Gaza war, announced by President Biden on Friday, is essentially a six-week cease-fire that would include the withdrawal of Israeli troops from populated areas of Gaza, the release of most Israeli hostages and a massive relief effort for two million battered, hungry Gazans. The stages beyond that — a permanent end to hostilities, release of all remaining hostages, the reconstruction of Gaza — are left to future negotiations.

That leaves a lot of open questions down the road, all heavily laden with polarized politics, animosities and unknowns. Yet if the plan Biden described on Friday is accepted by Hamas, which looks likely, the cease-fire alone would be a huge achievement for the United States and its mediating partners, Egypt and Qatar — and a desperately needed dollop of food, medicine, shelter and hope for Gazans.

Despite a deafening international outcry against the vast carnage and destruction in Gaza, including heated protests on American campuses and arrest warrants (albeit largely demonstrative) for top Israeli and Hamas leaders from the International Criminal Court, along with considerable pressure from the Biden administration, a cease-fire seemed always just beyond reach.

The reasons are many and varied: The Hamas terrorist attack of Oct. 7 left many Israelis hungry for the eradication of Hamas, cost be damned; Prime Minister Benjamin Netanyahu and his far-right nationalist government showed little interest in ending the fight, especially as that would most likely lead to the end of his fragile government and leave him facing criminal charges; the Hamas leader, Yahya Sinwar, insisted that the fighting must end before any hostage release or deal with Israel.

At the same time, the war put growing political pressures on Biden. There was always a threat of the conflict spreading to northern Israel and beyond, and the use of American ordnance against civilians in Gaza was feeding a swelling fury among American liberals, Biden’s constituency in a critical election year.

The president acknowledged some of the opposition the full proposal would confront in Israel. Responding to the longing for the destruction of Hamas, he claimed that the organization was no longer capable of an attack like the one on Oct. 7. Aware that some on the Israeli right wanted total victory, he argued that this would not bring hostages home, not bring an “enduring defeat” of Hamas and “not bring Israel lasting security.”

That is the message the president will have to relentlessly drive home over the six weeks the cease-fire is meant to last, if it starts and holds. All the obstacles to peace will still be in place as negotiations turn to a permanent end to hostilities. And Biden admitted that six weeks may not be enough. But for now, any respite is welcome.

Jesse Wegman

Fantasies Aside, Sentencing Trump Poses a Very Tough Choice

Donald Trump is not your average felon. That creates a devil of a dilemma for Juan Merchan, the New York trial judge who by July 11 must decide on an appropriate sentence for Trump after his conviction on 34 counts of falsifying business records. Send him to prison? Fine him, put him on probation, order him to perform 300 hours of community service?

It’s not a straightforward question. Unlike the federal system, New York has no formal sentencing guidelines, but decades of case law help judges weigh several familiar factors — including age, criminal record, and the severity of the offense — in determining the right punishment.

“So much depends on the individual,” Michael J. Obus, who sat on the New York State Supreme Court bench for 28 years, and alongside Merchan for more than a decade, told me. “There’s just no precedent for this particular individual that makes this an easy decision. Everything pulls you in different directions. On the one hand, you’ve got a man who’s 77 years old and is convicted of the lowest-level, Class E felony. On the other hand, he’s been held in contempt 10 times and is not showing any remorse.”

As I followed the trial over the last several weeks, and then absorbed the jury’s verdict on Thursday evening, I found myself torn. Trump is a uniquely malign, and uniquely powerful, figure in American life. He mocks the notion of equal justice even as he squeals endlessly about his own mistreatment. He considers himself above the law even as he threatens to wield it against his enemies if given the chance. He poses an extreme danger to the rule of law and the future of democracy that no workaday carjacker could dream of.

And yet if no one is above the law, no one is below it either. Trump can’t be given an unusually strong sentence simply for being a bad president, or an immoral lout, or for any other reason not directly related to the specific crimes in this case and the usual factors judges consider.

Orange-jump-suited liberal fantasies aside, most people convicted of low-level, nonviolent felonies in New York are not sentenced to prison . At the same time, Obus pointed out, several of Trump’s crimes “took place while the defendant was in the White House. You can’t say that about most defendants.” (Trump may yet talk his way into the lockup if he keeps testing the limits of Merchan’s gag order.)

I don’t know the right answer and can’t predict Merchan’s decision. What I do know is that in a healthy country, a nominee for president would not come anywhere near the line of criminality — certainly not so close that reasonable people can debate whether he should spend time behind bars.

This is the situation we are faced with. That this candidate may yet prevail in November is the biggest predicament of all.

Jonathan Alter

Contributing Opinion Writer

Six of Trump’s Dumbest Trial Mistakes

In the avalanche of post-conviction coverage, we’ve all heard that if Donald Trump had just copped to a misdemeanor, or admitted to having sex with Stormy Daniels, or been allowed to have his expert witness testify fully, he wouldn’t be a felon.

Maybe so, but that’s beside the point. Trump could still have been Trumpy and possibly won the case if he and his lawyers had not made six critical mistakes:

Trump disrespected the judge. The last thing any defendant should do is tick off the judge. Trump and his team did so repeatedly. His 10 citations for contempt of court, which almost got him thrown in jail, were just the start of it. Trump’s lawyers made a series of frivolous and repetitive motions that did their case — and their own reputations — no good. The only explanation is that their volcanic client must have insisted on it.

Trump dozed for much of the trial. Jurors might have been fine with him falling asleep occasionally. But inside the courtroom we noticed on the monitors (which showed Trump from the front) that his eyes were closed every day and for large portions of the testimony. That’s a bad look for any defendant trying to win favor with the jury.

The defense blew its cross-examination of Stormy Daniels. Susan Necheles, one of the defense lawyers, had a tough assignment: Prove Stormy Daniels was lying about her sexual encounter with Trump when she clearly was not. But Necheles made it worse by seeming to shame Daniels for her career choices, falsely hinting she had records to disprove the account, and by failing to object more when Daniels got prurient, as the judge later pointed out.

The defense dropped its best anti-Michael Cohen argument. The lead defense attorney, Todd Blanche, elicited on cross-examination that Cohen thought William H. Pauley, a former federal judge, was in on some kind of crazy conspiracy with Cohen’s enemies to hurt him. But Blanche was so eager to catalog all of Cohen’s lies that he failed to focus on Cohen’s wildest charge later.

The defense insisted on putting on a case. If the defense had rested without calling witnesses, Trump’s refusal to testify would have made a certain sense, suggesting the prosecution’s case was so weak there was no need to rebut it. Instead, the defense called the thuggish Robert Costello, who was by far the worst, least credible witness in the entire trial and was destroyed on cross-examination. This ended the trial on a down note for the defense.

The defense lied about the “Access Hollywood” tape. “You heard that politicians reacted negatively to the ‘Access Hollywood’ tape,” Blanche said, in one of the biggest lies during his closing. “None of that is true.” Oh, yeah? So why was Trump nearly dumped from the 2016 ticket over it? This jury wasn’t born yesterday, and they had heard lots of testimony about the effect of that explosive tape.

Trump still doesn’t get that a court of law is not the same as the court of public opinion. Politicizing the trial might be good for donations and even polling but it will hurt him on July 11, when he will have to answer for his antics at sentencing.

Zeynep Tufekci

Opinion Columnist

Bird Flu Doesn’t Have to Become History’s Most Avoidable Disaster

The Michigan Department of Health and Human Services reported on Thursday that another farmworker has been infected with H5N1, an avian flu virus. Alarmingly, unlike earlier cases, he has respiratory symptoms. This means the virus is in his lungs, where it has a better chance to evolve into an airborne form that could easily infect others.

Viruses often hit a dead end when they cross from one species to another, getting stuck at their first victim. For example, H5N1 has been around since the 1990s, but most patients have had extensive, direct contact with sick poultry and almost never pass it on to other humans.

The pathogens that have the greatest potential to set off a pandemic often have a deadly combination of airborne transmission and frequent mild cases, allowing them to spread widely and stealthily. That’s a key reason there hasn’t yet been an Ebola pandemic. The disease causes severe illness and kills most victims, and it mainly spreads through close contact with infected bodily fluids. It has fewer chances to spread widely than another disease might.

The United States is certainly giving H5N1 many, many chances to adapt to spreading easily and quietly among humans.

Cows started getting sick with H5N1 last winter, but unlike birds with H5N1, they weren’t dying. It took dogged investigation by Dr. Barb Petersen, a veterinarian in Texas, to determine that they were afflicted with a form of avian influenza. When we spoke, she told me that whenever cows fell sick on farms she monitored, an unusual number of people also became ill.

In April, the Centers for Disease Control and Prevention reported a farmworker in Texas had been infected with H5N1 . This month, state health officials in Michigan found two more human cases (including the one reported on Thursday). Even so, public health officials have largely been slow to establish the sort of widespread testing and data sharing that would give Americans the best chance at stopping an H5N1 pandemic.

This month, Dr. Mandy Cohen, the director of the C.D.C., told The New York Times there were no immediate plans to make testing mandatory. But if we don’t test for H5N1, we won’t find it.

As Rick Bright, an expert on the H5N1 virus who served on President Biden’s coronavirus advisory board, told me : “We are missing additional cases by not testing. We are missing evolutionary patterns of the virus by not sequencing more. We are also losing the trust of people by not being completely timely and transparent with data and information as it becomes available.”

This virus may never evolve to spread dangerously among humans, but if it does, this particular avian flu pandemic will go down as one of the most avoidable slow-motion disasters in history.

David Firestone

Deputy Editor, the Editorial Board

Trump Is ‘Honored’ by a Verdict That Should Shame Him

Donald Trump could have gone any number of directions on Friday morning in his first speech after becoming a felon. A better human being might have expressed some remorse or a modicum of respect for the jury’s verdict, but that’s not who he is. He might have at least acknowledged that the historic conviction was a significant defeat and urged his supporters to help him rise above it in pursuit of some larger goal. But he didn’t even do that.

In fact, what was remarkable about the speech at Trump Tower was how little effect the conviction seems to have had on his permanent vocabulary of grievance. To hear him tell it, it’s just another speed bump erected by what he called the “fascists” in the Democratic Party, no different from his two impeachments, or the devastating Jan. 6 investigation, or the judgments against his business, or the civil finding that he is a sexual abuser. To acknowledge that this moment is spectacularly different would be to give the verdict real power, and he was determined to rob the legal system of any ability to get in his way.

And so, even though he must have known that the audience for this speech would be unusually large, he tossed out the same jumbled shards of anger, lies and hyperbole that he dispenses every day on the trail. The usual journalistic cliché for speeches like this one is “rambling,” but at least on a ramble you actually go someplace, if slowly. Trump, on the other hand, had no apparent destination.

He insulted the district attorney, Alvin Bragg, and said Justice Juan Merchan “looks like an angel but he’s really a devil.” But those attacks were blended with fevered denunciations of President Biden for imaginary policies like banning cars, letting vast mobs of terrorists march unimpeded into the country and ruining the country with a politicized system of justice. “We are living in a fascist state,” he said.

Regarding the trial itself, he bashed Michael Cohen as a “sleazebag,” denied having a sexual affair and dismissed the crime of falsifying business records as some kind of bookkeeping hiccup. The jury didn’t believe any of this for a minute, of course, but Trump will never stop trying to litigate it, and he was even less effective than his inept lawyers.

The only real acknowledgment that something unusual had happened was when he called the conviction “a great, great honor” that he was willing to bear, as if he were Saint Sebastian, pierced by Democratic arrows for the country’s greater good. His wounds, however, are entirely self-inflicted.

Kathleen Kingsbury

Opinion Editor

What the Nation Needs to Hear From Trump (but Won’t)

Donald Trump has announced he plans to speak to the nation from Trump Tower on Friday morning. It made me pause and consider what I — and I suspect many voters, especially swing voters, and maybe even some of Trump’s supporters — want to hear less than 24 hours after the first conviction on felony charges of a former president.

What I want to hear — from a sober, humbled presidential candidate — is this: “Yesterday a jury of my peers rendered a verdict against me and my actions in 2016. I have believed, from the get-go, that this prosecution was politically motivated, and there is evidence that the district attorney always intended to bring it, despite a lack of any good evidence that I committed a crime. I continue to think the case rested on a bogus legal theory, and we will appeal. But until that appeal is ruled on, I will respect this verdict, as much as I disagree with it.”

In other words, I would like the former, and potentially future, president to rise to the seriousness of the occasion.

Of course, Trump will say no such words, and he will express no remorse in a way that might lighten his eventual sentence. He will declare the trial rigged, and he will rail against the judge, the court and the jury, despite the responsible and somber ways in which all parties conducted themselves. He will ask his supporters to join him in his outrage, and he will continue — as he has done time and time again — to undermine the law and democratic norms.

He will not rise to the occasion. And our country will be worse off for it.

‘Is That Your Verdict?’ As Trump Seethes, a Jury Says ‘Yes.’

The verdict might not have been a total surprise, but the timing sure was.

All Thursday afternoon, those of us in the courtroom watching the Donald Trump trial had been expecting a Friday verdict. This was validated when, a little before 4 p.m., Justice Juan Merchan came into the courtroom and told us that the jury would be excused at 4:30 and would resume deliberations on Friday.

Then crickets. For more than half an hour, we heard nothing — certainly not the buzzy bell we expected if the jury had a note to send or a verdict.

The judge had left the bench to tell jurors he was excusing them and hadn’t come back.

I had a nice whispered chat with Andrew Giuliani, a fervent Trump supporter who was sitting behind me. I told him I expected a conviction and asked him if he would blame his fellow New Yorkers who had spent many hours painstakingly examining the evidence. He said yes and took a shot at Matthew Colangelo, the federal prosecutor who came in from the Justice Department to help the D.A.’s office.

“That’s totally unprecedented!” Giuliani said, previewing some of the team’s damage-control spin. I reminded him that this had been done countless times in civil rights cases in the South and complex local prosecutions.

Around 4:30 p.m., Merchan mounted the bench and announced that he had received a note from the jury. I first thought it was another request for more evidence to be read back. This was a conscientious jury that had been deliberating since midday on Wednesday. But the note said that a verdict had been reached and jurors needed another half-hour before announcing it.

You could hear a collective gasp in the courtroom.

At 5:03 p.m., the jury entered. After the foreman, an Irish-born former waiter clad in a blue pullover, stood and confirmed that the jury had reached a verdict, he was asked about each count and said “guilty” 34 times.

The defense was asked if it wanted to waive its right to poll the jurors and, of course, said no. When asked, “Is that your verdict?” each of the other 11 jurors — their poker faces intact — calmly answered, “Yes.”

Trump had become a felon.

Merchan thanked the jurors for their service in a “very stressful and difficult task” and told them they are “free to discuss the case, but you are also free not to. The choice is yours.”

Then came what I have always viewed as the most moving part of the trial, a ritual of democracy performed eight times a day, as the jury moves back and forth for breaks and lunch and exits when court adjourns:

The jurors marched past Donald Trump without looking at him, soldiers for justice.

Trump’s lead attorney, Todd Blanche, moved for a “judgment of acquittal” because there’s “no way this jury could have reached a verdict without accepting the testimony of Michael Cohen.”

Merchan thought he heard Blanche say that even the judge knew Cohen had perjured himself on the stand. Blanche backtracked, and the motion was denied with dispatch.

At the request of Blanche, who has other Trump legal proceedings to deal with in June, Merchan set sentencing for July 11. It struck me that since Trump is guilty of 34 felonies in the first degree, he is unlikely to get off with a slap on the wrist. First he will have to undergo a probation interview, followed by a probation report.

This summer, will we be discussing ankle bracelets in the White House? Quite possibly.

Merchan asked for Trump’s current bail status.

In what may have been my favorite line of the day after “guilty,” the prosecution lawyer Joshua Steinglass said, “No bail, judge.”

In another trial, that might mean the felon had been denied bail. Here it was a simple recognition of the stark reality that a jury had just convicted a former president of the United States, who would not be sent to a holding cell.

As usual, Trump walked up the center aisle, swinging his right arm out in an exaggerated handshake with his son Eric. He looked more hunched than usual, with pain on his face.

In the elevator a photographer who has been shooting him for years said, “I have never seen him looking so tired.”

Trump’s Trial and Lincoln’s Example Make 2024 a Character Test

History hangs heavily over the Manhattan Criminal Courthouse this week. Everyone inside feels its weight. After the jury was sent to deliberate, things loosened up a bit and I chatted with a court police officer from Brooklyn who for weeks has been one of our hall monitors. She spoke of being able to someday tell her grandchildren that she witnessed a historic trial.

There has been other presidential history made in Lower Manhattan, of course. In 1860, little more than three months before Abraham Lincoln became the Republican nominee for president, he came to New York, where he bought a new suit at Brooks Brothers and a stovepipe hat. He also stopped by a home for desperately poor children, just two blocks south of where the courthouse now stands. The children’s faces, a witness reported, “would brighten into sunshine as he spoke cheerful words of promise.” When told he had inspired the children, Lincoln responded, “No, they inspired me.”

Lincoln’s address during that New York trip at the Cooper Union, a mile north of the current courthouse, would help catapult him to the presidency. He wrote the ending in all capital letters:

LET US HAVE FAITH THAT RIGHT MAKES MIGHT, AND IN THAT FAITH LET US, TO THE END, DARE TO DO OUR DUTY AS WE UNDERSTAND IT.

Donald Trump often compares himself to Lincoln, noting that they are both honest and Republicans. But he has inverted Lincoln’s motto of right making might, believing the opposite. He also castigated Lincoln for nearly losing to a bigger hero, the Confederate general Robert E. Lee. And the ultimate un-Lincoln constantly celebrates Jan. 6 insurrectionists who threatened to kill his vice president and flew a Confederate flag under the Capitol dome built by Lincoln.

The liar and cheat we’ve heard the most about in the courtroom for the past six weeks is not Michael Cohen but Trump, whose basic values deviate not only from Lincoln’s but also from those of any man who has ever held the office of president.

I understand why many voters might favor Trump under the mistaken impression that he has their back. But for any leaders or well-educated people in any realm — from Nikki Haley to the billionaire Stephen Schwarzman to your otherwise intelligent uncle — to support Trump now out of narrow self-interest raises deeper questions about their patriotism.

They know better, and as the evidence presented in this trial has shown, they are failing the character test of their generation.

Now we are engaged in our own cold civil war, and American voters must think harder about whether this nation — or any nation — can long endure the consequences of another Trump presidency.

Adam Sternbergh

Opinion Culture Editor

Ángel Hernández Made Baseball Great

The retirement of Ángel Hernández, long reputed to be the worst umpire in baseball, was greeted by many baseball fans with unfettered glee . In an age when the strike zone is constantly displayed on TV and each pitch can be instantly measured for speed, movement and location, the notion of a human consistently misjudging balls and strikes can seem not just outdated but absurd. The outsize antics of certain umpires — presumably intoxicated by their own power — has long been a subject of fan exasperation, inspiring the derisive phrase “ump show.”

I admit I reacted to the Hernández news by watching a series of his most questionable calls, many of which made me laugh out loud. I’m not here to debate whether he was a good umpire; the data clearly indicates he was one of the least accurate.

But Major League Baseball needs fallible humans like Ángel Hernández. The ump show is as much an essential part of baseball as bone-headed errors , egregious showmanship or players angrily tossing a glove into the stands . The alternative scenario — in which baseball is adjudicated, flawlessly and bloodlessly, by machines — would make the sport less meaningful.

The Automated Balls and Strikes system, or A.B.S., is already in use in Triple-A, and the argument for embracing so-called robo-umps boils down to their accuracy. Yet the element of human judgment, as displayed by human umps, is as intrinsic to baseball as is the element of human skill, as displayed by the players. Players drop balls. They lose fly balls in the lights. They overrun bases or run through stop signals. All of this is part of the game. Blown strike calls, idiosyncratic strike zones and even flamboyantly performative umps are, and should be, a part of the game as well.

You might counter: But bad officiating adversely affects the outcome of the game. Yes, but so does bad playing. Also, it’s a game. The argument that technological proficiency should supersede human fallibility in all arenas is pernicious enough elsewhere in society, but it seems especially wrongheaded when it comes to sports, an entertaining but meaningless forum for human excellence and human foibles. There is a reason the most enduring examination of baseball’s allure ends with a mythically talented player striking out .

Infallible robot brain surgeon? Honestly, I can see the argument. Infallible robot umpires? No, thanks — I’ll take the ump show .

Paul Krugman

Inflation and the Problem of McMisinformation

The United States, like many other countries, experienced a burst of inflation in 2021-22, which has since largely subsided. But prices haven’t gone down, so almost everything costs more than it did a few years ago.

Wages, however, have risen even more, so most Americans’ purchasing power is higher than before the pandemic. But anyone who points this out gets a huge amount of pushback from people saying “Get out of your office into the real world! The price of food (it’s usually food, although it’s sometimes other stuff) has doubled!”

As it turns out, such claims about the “real world” are almost always false. A few months ago I looked at some independent estimates of grocery prices and found that they closely match the official data. No, inflation isn’t much higher than the deep state wants you to know.

Well, I now have an unexpected ally in this argument. Management at McDonald’s is apparently irked by constant claims that its prices have doubled since before the pandemic. So the company has issued a special news release about what has really happened to its prices, which are up, but not by nearly as much as the inflation truthers claim:

The price of a Big Mac, in particular, is up 21 percent since 2019, not the 100 percent some are claiming. Over the same period average wages of nonsupervisory employees — that is, most workers — rose 28 percent:

So no, McDonald’s hasn’t become unaffordable, whatever your vibes may say.

The Best Move for the Trump Jury: A Split Decision

With the jury still deliberating, it’s time for those of us who have heard every minute of this trial to place our bets. My prediction is this: Donald Trump will be convicted on nine of 34 counts of falsifying business records. He’ll go down for the nine fraudulent checks he signed in the White House in 2017 — each a piece of a broader effort to falsify business records and, ultimately, to interfere unlawfully in the 2016 election.

I could easily be wrong, of course, but here’s my reasoning. To resolve differences with a split-the-baby approach, the jury might decide that Trump’s fingerprints are literally on those checks, while the 11 false invoices, 12 false ledger entries and two false checks signed by Donald Jr. and Eric are not as closely connected to Trump, though he was the one who caused the falsification of all of them.

Jurors are showing commendable signs of diligence. It would have hurt the credibility of their verdict had they returned with one too soon on Wednesday, the day they began deliberating. On Thursday morning they reheard portions of the judge’s instructions and many pages of important trial testimony. No one has any idea if they will ask to hear more.

I think Trump deserves to be convicted on all 34 counts. But reasonable jurors could legitimately conclude that they are more comfortable with nine.

And if they reach that outcome, it could have a political effect. A conviction on fewer counts would be the best possible outcome for the country, demonstrating that the jury was unbiased and carefully considered each count, dismissing most of them.

If convicted, Trump is unlikely to win on appeal. Justice Juan Merchan has dotted his i’s and crossed his t’s, making an immediate reversal a long shot. Federal courts, including the Supreme Court, probably won’t want to get involved, and if they did, it wouldn’t be until months or years after the election.

So Trump will spend the rest of his life attacking the verdict, the judge, the prosecutors and the fair-minded residents of his hometown who determined his fate.

But at least it will be a little harder for him to spew his venom if the jury thoughtfully studies the evidence and clears him on 25 counts. His base won’t care, but I have faith that at least some swing voters who respect our jury system will conclude that this man is a criminal who should not be returned to power. Will that be enough at the margins to tip the election? No one knows for sure.

But we do know that this would probably be the only conviction of Trump before November. A careful jury verdict could help build a constituency to keep a felon out of the White House.

Time to Examine Why New York Fared Poorly Early in the Pandemic

In the coming days, House Republicans in Washington will hammer Andrew Cuomo, New York’s former governor, over his botched pandemic response, after issuing him a subpoena to appear.

That may be a political stunt, but it’s more than the Democrats who run New York State’s government have done to examine the deaths of approximately 23,000 New York City residents from Covid-19 in the first three months of the pandemic. According to an analysis by the Empire Center, a nonpartisan think tank, New York City had a higher population-adjusted Covid death rate than any state in 2020, and a rate that was 132 percent higher than the national death rate from the coronavirus.

But New York State has yet to conduct a thorough review of the actions by state, city and local officials that may have contributed to the deaths. An important bill under consideration in Albany would finally change this by creating a commission to study New York’s pandemic response. The legislation is sponsored by State Senator Julia Salazar of Brooklyn and Assemblywoman Jessica González-Rojas of Queens, whose districts were hard hit by the virus.

The commission they propose would have the authority to hold public hearings, review confidential state records and correspondence related to the pandemic, and, importantly, issue subpoenas. A review ordered by Gov. Kathy Hochul in 2022 is being conducted by a private firm, is delayed and has no such powers.

In the years since 2020, the disastrous handling of the pandemic by former President Donald Trump has been the dominant story on the issue. But New York’s early response to the virus is also worthy of scrutiny. Most widely known is a directive issued by the Cuomo administration in March 2020 ordering nursing homes to accept residents who had tested positive for the virus, leading the virus to spread even more rapidly among a vulnerable population. In 2022, a report from State Comptroller Thomas DiNapoli found that Cuomo’s administration had underreported deaths in nursing homes related to Covid-19 by more than 4,000 people. Cuomo also directed state health officials that March to give his family members special access to Covid-19 tests.

New York officials made other critical missteps. The Metropolitan Transportation Authority, which is run by the state, barred workers until early March from wearing face coverings. Former Mayor Bill de Blasio waited too long to close the city’s school system, as cities such as San Francisco had lower case counts but shuttered their schools earlier. On March 5, de Blasio discouraged the use of masks among the general public, language that was similar to guidance then from the Centers for Disease Control and Prevention and downplayed the threat posed by the virus.

New Yorkers deserve as full an accounting as possible of how and why these decisions were made.

Michelle Cottle

Opinion Writer

Team Biden’s Urgent Pitch to Black Voters in Philadelphia

At the rollout of the Black Voters for Biden-Harris effort in Philadelphia on Wednesday, Team Biden’s basic message — what it desperately needed to convey — was summed up by Vice President Kamala Harris near the end of her brief remarks: “Who sits in the White House matters. It matters!”

This may seem obvious. But as Democratic strategists and officials will tell you, a lack of urgency about, or even interest in, the outcome of this year’s presidential election — especially among younger Black voters — is one of the scariest threats the party is facing.

At this rare joint appearance, in a city where they desperately need to do well in November, both Harris and President Biden spotlighted numerous “promises made, promises kept” that they figured would be of particular interest to Black Americans.

Harris ticked through specifics, such as capping the price of insulin, forgiving billions in student loan debt, making it so medical debt doesn’t affect a person’s credit score and strengthening background checks for gun purchases.

Biden ran through even more wins — pardoning people incarcerated on charges of marijuana possession, investing in historically Black colleges, appointing the first Black woman to the Supreme Court — along with some promises about what he would do with a second term.

And both leaders brought up some of the darker moments of the Trump years, from Donald Trump’s efforts to kill Obamacare to his musings about injecting bleach as a way to cure Covid-19.

The president was not playing around. He asserted that, after Trump lost in 2020, “something snapped” in the guy, who is now “clearly unhinged.” Noting the former president’s vow to pardon the Jan. 6 rioters, Biden asked: “What do you think would have happened if Black Americans had stormed the Capitol?”

Wrapping things up, the president urged the crowd to go forth and spread the word about the urgency of this race. “Talk to your families,” he pleaded.

Biden and his team are well aware of how hard it is to break through to people who have decided to tune out an election. All of us had best hope they find a way.

Is Trump Starting to Worry About a Conviction?

Donald Trump dozed on Wednesday through a good chunk of the judge’s all-important instructions to the jury, rousing himself once to ask one of his attorneys for a bottle of Poland Spring. (His favorite drink, Diet Coke, is not allowed in the courtroom.) After Justice Juan Merchan sent the jury to deliberate, Trump chatted with Don Jr. and Alina Habba, an incompetent lawyer from an earlier trial. Then he did a quick, lip-pursed intake of breath that indicated some anxiety.

In the hallway outside, he told reporters that “Mother Teresa could not beat the charges” because of the way the judge, whom he called “corrupt,” instructed the jury. He seemed to be hinting that he believes a conviction is likely.

In fact, Merchan’s hourlong charge to the jury was standard issue in New York State and incorporated unsurprising rulings that went back to pretrial motions in March. One difference is that he read the more complicated parts twice.

The judge sided with the defense by telling the jury that if it focuses on tax offenses, it must find that Trump “willfully” intended to commit unlawful acts. But if it finds that campaign finance violations are the underlying crime, he twice mentioned that corporate contributions are banned altogether and the maximum allowable individual donation is $2,700 — a lot less than the $130,000 in hush-money that Michael Cohen paid to Stormy Daniels with Trump’s approval.

Merchan essentially instructed the jury that it can think Cohen lied about many things but find him credible on other things. And he told the jurors, “You need not be unanimous on whether the defendant committed crimes personally, by acting in concert with another, or both.” Unanimity is required only for overall conviction on each of the 34 counts.

The state law on falsifying business records requires intent to commit other crimes, so the judge spent lots of time defining that term.

In the afternoon, after nearly five hours of deliberation, the jury sent notes to the judge asking to rehear at least some of the judge’s complex instructions, which is likely to happen on Thursday. Jurors would also like another look at testimony from five weeks ago by David Pecker, the former publisher of The National Enquirer, about one particular 2016 phone call with Trump (highlighted Tuesday by a prosecution lawyer, Joshua Steinglass, in his closing argument). And jurors want to hear again why Pecker backed out of the Karen McDougal deal and how Pecker and Cohen depicted the Trump Tower meeting in August of 2015 that prosecutors argue was the birth of the conspiracy.

Trump’s defense team also focused on that meeting, insisting that it was commonplace for candidates to “work with the media” to squelch sex stories, as Pecker said he did with Arnold Schwarzenegger and Rahm Emanuel. (It is not commonplace.)

Because the jurors are now practiced at poker faces, we aren’t learning which way they are moving, only that they are diligently examining the evidence.

Nikki Haley’s Valentine to Civilian Death

It was a sweet little heart, the kind you might draw on a Valentine’s Day card. “America 💜 Israel Always,” the author wrote, above her handwritten signature: “Nikki Haley.” How lovely.

Except it wasn’t written on a greeting card. Haley drew the heart in purple ink on a 155-millimeter artillery shell, the kind that the Israeli Army has routinely loaded into howitzers and fired on Gaza in the hopes of eradicating Hamas but resulting in the mass deaths of civilians. Tens of thousands of these shells have rained down on Gaza since the Oct. 7 massacre, and when they explode they send countless metal fragments in every direction, with a casualty range of between 100 and 300 meters . A coalition of human rights groups say that this particular artillery weapon is so indiscriminate that its use in heavily populated areas like Gaza violates international humanitarian law.

But that wasn’t all that Haley wrote. Above the little heart was a message of savage revenge: “Finish them!”

“Finish Them, America ♥️ Israel Always!” Message from @NikkiHaley , written on an Israeli missile intended for Hamas. pic.twitter.com/DgPQYNvkWM — Team Nikki Haley (@NikkiHaleyHQ) May 28, 2024

Haley, the former governor of South Carolina, made it clear on social media that both the inscription and the shells were intended for Hamas. But her scrawled fondness for bloodshed — with little apparent concern for whose blood will actually be shed — sends a more important message to American voters.

A huge number of progressive voters are furious at President Biden for not doing more to stop Israel’s assault on Gaza. And it’s true that many of those artillery shells were supplied by the United States. But if those voters think that the situation in Gaza will change if they sit out the election and allow Donald Trump and other Republicans to be elected, they don’t really understand what’s coming. Because it would be a lot worse.

Haley lost her bid to become the Republican nominee for president because she was seen as too moderate for a party that still prefers Trump’s recklessness. When it comes to issues like Israel, most of the party is further to the right than the author of “Finish them!”

Biden should have done much more to use American leverage on Israel to reduce the civilian toll in Gaza. But Republicans pound him every day for withholding an arms shipment to Israel to prevent it from being used to attack Rafah, in the Gaza Strip. He has never signed his name on a lethal explosive device and expressed a hope that it would kill. There’s a big difference.

Neel V. Patel

Opinion Staff Editor

The Stalled Pandemic Accords Offer an Opportunity for Vaccine Equity

For more than two years, the member states of the World Health Organization have been meeting to iron out an agreement on how to prevent and respond to future pandemics. The text of the accord was supposed to be finalized last Friday, for nations to formally approve it this week during the World Health Assembly in Geneva.

That deadline came and went, and negotiations on the accord have stalled because of disagreements about global vaccine availability. Countries cannot agree on whether to prioritize making new treatments more available to poor countries or certain intellectual property rights of vaccine manufacturers in wealthy countries instead. There’s a stark division between the haves and the have-nots of the global stage.

On the surface, the breakdown in talks is a familiar story of international diplomacy. But it also presents an opportunity. Wealthier nations could use this moment to reverse course on the agreement’s more rushed, toothless measures and turn it into something consequential and lifesaving.

Not even three years ago, richer countries like the United States bought enough Covid-19 vaccine stock for twice its population ; Canada, for five times its population. Poorer countries came last , relying on donated vaccines and Covax, the global vaccine-sharing scheme. Vaccine hoarding among wealthy nations probably led to more than a million deaths in 2021 alone . Many countries on the African continent suffered an especially slow rollout, causing their economic recoveries to lag those of the rest of the world .

Besides the moral argument that developed countries should do more to help developing ones, there’s a practical argument to make: Pandemics don’t care about national borders. If an infectious disease is allowed to thrive in one region, travel and migration ensure that it will inevitably threaten surrounding regions as well, putting the globe at further risk.

If our leaders want to avoid a fate similar to 2020, they need to guarantee that essential vaccines and treatments are available wherever they are needed.

Prosecutors Leave the Jury With a Mountain of Evidence Against Trump

Humor helps, especially if you are delivering a five-hour speech.

Joshua Steinglass of the prosecution team knew he was taking a risk by “trading brevity for thoroughness” in his closing argument in the Donald Trump felony trial in Manhattan; besides being exhausted after an 11-hour day, jurors might conclude “the people” (the formal name for the prosecution) were not sure enough about their case to avoid piling on.

So Steinglass copped to “beating a dead horse” and helped neutralize the defense’s best point with a little playacting.

In the morning Trump’s lead attorney, Todd Blanche, again called Michael Cohen a liar for claiming he phoned Trump on Oct. 24, 2016, to talk to him about hush money for Stormy Daniels when text chains showed he wanted to ask Keith Schiller, Trump’s bodyguard, about a 14-year-old prank caller who was harassing him.

To explain that Cohen could have talked about both , Steinglass assumed Cohen’s voice and cradled an imaginary phone:

“Hey, Keith, how’s it going?” he asked, imitating Cohen. “Hey, is the boss near you? Can you pass him the phone for a minute?”

Then Steinglass turned self-effacing — “Sorry if I didn’t do a good job” — before proving that was only one of about 20 times in October alone that Cohen updated Trump about his progress in hushing Daniels, thereby helping to save Trump’s sagging campaign.

Steinglass went to great lengths to show that his case did not rely entirely on Cohen. Steinglass returned again and again to the first-week testimony of David Pecker, a former publisher of The National Enquirer, who implicated Trump directly in a conspiracy to interfere in the 2016 election. And Steinglass assembled, disassembled and all but cleaned what he called “the smoking gun” — the handwritten notes detailing Trump’s scheme to disguise his reimbursement of Cohen as legal expenses.

The long faces in the Trump guest section reflected the sense in the courtroom that Trump’s story that the $420,000 he paid to Cohen was really a legal retainer will not fly. Steinglass showed that Trump himself admitted in court documents and other records that it was a reimbursement.

Steinglass also proved that “Michael Cohen is no rogue actor” and that in 2018 Trump, Rudy Giuliani and the lawyer Robert Costello treated Cohen like a mob rat as part of the cover-up. This was La Casa Blanca meets La Cosa Nostra.

The defense has a better shot at creating doubt that Trump intended to commit a crime, but even here, Steinglass had a heap of evidence to shovel in the jury’s direction.

The judge allowed most of it until the prosecutor overreached by urging jurors not to let Trump get away with shooting someone on Fifth Avenue, evoking his famous line about what he could get away with.

Just after the objection to that was sustained by the judge, Steinglass finally stood down, and we all dragged off to bed. The case finally goes to the jury on Wednesday.

Farah Stockman

Netanyahu Is Sorry/Not Sorry for the Killings in Rafah

I often tell my 8-year-old daughter that saying “sorry” doesn’t cut it if she continues the behavior that she’s apologizing for. It’s a basic lesson that kids learn. World leaders need to learn it, too, apparently.

After facing international blowback for the Israeli military strike that burned dozens of people alive in their tents in a refugee camp in Rafah on Sunday, the Israeli prime minister, Benjamin Netanyahu, called the civilian deaths a “tragic mishap.” He also said that his government was making “utmost efforts not to harm innocent civilians” and that mistakes would be investigated.

It reminded me of the awfully similar statement he gave in April, after the Israeli military attacked a convoy of World Central Kitchen staff members who had just unloaded food aid at a warehouse in Gaza. Those deadly airstrikes took place even though the World Central Kitchen workers drove in a clearly marked convoy and had meticulously coordinated their movements with the Israeli military. After an international outcry, Netanyahu issued a statement calling the deaths “a tragic accident” that “happens in war.”

“We are conducting a thorough inquiry and are in contact with the governments,” the statement read. “We will do everything to prevent a recurrence.”

But by that time, the sheer number of attacks on aid workers and on Gaza civilians seeking aid raised real questions about whether we have been witnessing intentional killings or “reckless incompetence,” as Christopher Lockyear, an official with Doctors Without Borders, noted .

On the side of reckless incompetence, there was that time in December when Israeli soldiers fired on three unarmed men waving white flags — only to discover that they were Israeli hostages who had managed to break free of their captors. At that time, Netanyahu’s office released a statement that called the killings “an unbearable tragedy.” The statement pledged to “learn the lessons” to ensure that it wouldn’t happen again.

How many apologies will be issued and investigations pledged before this God-forsaken war ends? Netanyahu’s list of international apologies keeps growing. But the attacks on Rafah — and the unspeakable suffering of Palestinian civilians — continue .

Frank Bruni

Pope Francis’ Remarkable Act of Contrition

I’m not accustomed to apologies from popes. Aren’t they infallible?

Yes, I know, that term doesn’t have practical, colloquial application — it doesn’t mean that they never bungle math problems or lose track of where they hung their robes. But the general notion or mythology of infallibility reflects a kind of papal authority and aloofness that discourages any real-time revisiting of false steps, any open regret for errant syllables.

“I’m sorry” belongs to the political realm (or at least did until Donald Trump came along). Popes inhabit a higher plane.

So a Vatican statement on Tuesday that Pope Francis “extends his apologies” to anyone offended by something he recently said is a big and surprising deal. It’s all the bigger and more surprising because Francis was apologizing for insulting gay people, and for most of my 59 years, Roman Catholic leaders were more concerned with condemning or converting or chiding or hiding us than with making sure our feelings weren’t hurt.

In a closed-door meeting with Italian bishops last week, Francis reportedly responded to a question about whether openly gay men should be admitted to seminaries by saying that those training grounds for future priests were already too crowded with “frociaggine,” a crude Italian slur.

I’m disappointed that he used it, contradicting past statements of his that urged respect for gay people and his decision last year to allow priests to bless same-sex couples . I don’t know whether he was disclosing his own lingering bigotry or trying to curry favor with the conservatives around him.

But I know this: Another pope in a prior era wouldn’t have been so quick to do damage control. Another pope in a prior era mightn’t have felt that any damage was done.

And even Francis could have decided simply to ignore the media attention to his offensive language until it died down. Popes are expected to worry not about the news cycle but about eternity. What’s more, he would have pleased some of his sternest critics by moving on. They complain that he has done too much outreach to L.G.B.T.Q. people and been too indulgent of them.

His apology speaks to the kind of pope that he, at his best, has been: one who means to heal wounds. But it says even more about an altered church in a changed world, where gay people still endure taunts aplenty but also encounter unexpected moments of grace.

The Trump Team’s Inept Closing Argument Blew Up

If Donald Trump becomes a felon in the coming days, he and his defense team can partly blame themselves. Throughout the trial they offered implausible arguments against the prosecution’s case, and on Tuesday Trump’s lead attorney, Todd Blanche, slipped an I.E.D. into the end of his closing argument that blew up in his face.

“You cannot send someone to prison based on the words of Michael Cohen,” Blanche said, in a bid to make jurors think it was their role to decide if a president should be incarcerated.

“Saying that was outrageous,” Justice Juan Merchan told Blanche after the jury left for lunch. Mentioning sentencing to gain sympathy with jurors who have no say in punishment “is simply not allowed,” he said, and that it was “hard for me to imagine how that was not intentional.”

The defense got more than a tongue-lashing. After lunch, Merchan turned to the jurors and told them why they had to ignore this sneaky move — not a good final look for the defense.

In his three-hour closing argument, Blanche gave jurors a few places to explore reasonable doubt but mostly swung wildly and set up the prosecution for better arguments in the afternoon.

My favorite dumb moment: “Guess who else you did not hear from in this trial?” Blanche asked. “Don and Eric. Is there some allegation that they are part of a conspiracy?” No, counselor, but the jury will likely wonder why the defense called Robert Costello, who was destroyed on cross-examination, instead of Trump’s own sons.

Blanche huffed and puffed to discredit the two possible “smoking guns” offered by the prosecution. The first consists of the scrawled notes of Allen Weisselberg, former financial head of the Trump Organization, breaking down the $420,000 that Trump paid Cohen in 2017. Weisselberg wrote “gross it up” in reference to doubling the $130,000 in hush money for tax purposes. That “is a lie,” Blanche said, using a word he would employ more than 30 times in his closing argument, to diminishing effect.

But it wasn’t a lie. The former controller of the Trump Organization had confirmed on the stand that the numbers and “gross it up” were in Weisselberg’s own hand.

The other smoking gun involves a call Cohen taped, during which Trump said “150” in reference to the hush money for Karen McDougal. While trying and — to my mind — failing to establish that Cohen’s phone was tampered with, Blanche played the tape and challenged the idea that Trump even said “150” and that Trump saying “cash” on the tape had anything to do with hush money. Jurors will presumably listen to the tape and decide for themselves. Believe me, you can hear “150.”

Blanche ended his closing argument by telling jurors that if they focus on the evidence, “this is a very easy and quick not-guilty.” Insulting the jury’s intelligence? Not smart.

Michelle Goldberg

The Trump Team’s Big Lie About the ‘Access Hollywood’ Tape

In his closing argument on Tuesday, Donald Trump’s lead defense attorney, Todd Blanche, repeatedly tried to sell a revisionist history of the infamous “Access Hollywood” tape, in which Trump was recorded boasting of his penchant for sexual assault. In the felony case against Trump, the “Access Hollywood” tape is important because, in the story the prosecution is telling, it’s the reason Trump was desperate to quash Stormy Daniels’s story.

“The government wants you to believe that the release of that tape from 2005 was so catastrophic to that campaign that it provided a motive for President Trump to do something criminal,” he said.

Attempting to undercut that narrative, Blanche insisted that it really wasn’t that big of a deal. It caused, he said, a “couple days of frustration and consternation, but that happens all the time during campaigns.” He added: “The ‘Access Hollywood’ tape is being set up in this trial to be something that it is not.”

This is insultingly and obviously untrue. As the longtime Trump aide Hope Hicks testified about that moment in the 2016 campaign, “I think there was consensus among us all that the tape was damaging, and this was a crisis.”

We now know that a critical mass of voters doesn’t care about Trump’s misogyny and predation, but we didn’t know that then. One job of the prosecution, which begins closing arguments Tuesday afternoon, will be to take the jury back to a more innocent time before Trump’s election, when people still imagined there were Republicans with a capacity for shame.

There’s Nothing Simple or Obvious About Trump’s Trial Defense

During closing arguments in Donald Trump’s felony trial on Tuesday morning, his lawyer Todd Blanche said, “There’s a reason why, in life, usually the simplest answer is the right one.”

I found this an odd approach, because to believe his theory of the case requires accepting several improbable things. First, although it’s not legally germane, Blanche reiterated, perhaps at the insistence of his client, that Trump “has unequivocally and repeatedly denied” any encounter with Stormy Daniels. And rather than simply arguing that Trump didn’t know about the scheme to reimburse Michael Cohen for the payoff to Daniels, he appears to be arguing that no such scheme existed.

Cohen, said Blanche, had a verbal retainer agreement in 2017 to serve as Trump’s personal attorney, and that’s why he was paid $420,000. If that’s the case, it’s hard to imagine why Cohen pleaded guilty and served prison time in connection with the hush-money payment.

Blanche’s argument has been internally inconsistent. First, he insisted that Trump, being busy as president, didn’t always look at the checks he signed. Then, trying to discredit the idea that Trump would reimburse Cohen $420,000 for a $130,000 payment — which Cohen has claimed was grossed up to include taxes and a bonus — Blanche pointed to “all the evidence you heard about how closely President Trump watches his finances.”

During a long digression about the National Enquirer’s practice of “catching and killing” stories, he insisted that there had never been a “catch and kill” plot involving the Playboy model Karen McDougal, implying, I think, that her deal with the publication was on the level. “She wanted to be on the cover of magazines, she wanted to write articles,” Blanche, said and that’s what she did.

Obviously, I have no idea what the jury is thinking. But given the implausibility of the narrative that Trump’s defense is spinning, it just seems weird that Blanche is invoking Occam’s razor.

Patrick Healy

Deputy Opinion Editor

How Quickly Would a Trump Verdict Sink In for Voters?

Each week on The Point, we kick things off with a tipsheet on the latest in the presidential campaign. Here’s what we’re looking at this week:

The most consequential week of Donald Trump’s criminal trial in Manhattan has arrived: The jury could begin deliberating in the next two days. We’ll also get insight shortly about Justice Juan Merchan’s instructions to jurors — basically, a clearer picture of what options they have for a verdict. As for the political impact of any decision by the jury, I think that will take weeks to become clear as Americans learn and absorb the news — as suburban women outside Philadelphia, for instance, weigh the verdict and their feelings about Trump against their views on the economy or abortion rights.

It takes time for voters to process big news, and opinions can shift with time. Part of why James Comey’s Oct. 28, 2016, letter about Hillary Clinton’s classified email was so politically damaging to her was that it came as many people were casting early votes and others were making up their minds ahead of the Nov. 8 election. The Trump verdict will be historic, but the election is five months away. How voters feel about the verdict could surely change in that time.

We’ll also start getting a clearer picture this week about whether Robert F. Kennedy Jr. will qualify to join the June 27 debate between President Biden and Trump. There’s a good explainer here boiling down how Kennedy needs to make the November ballot in a bunch more states first to make the cut for the debate. Given the various rules, I don’t think there’s much time for him to make the June debate; he may have a better shot at the September debate. Either way, I can’t see the Biden and Trump campaigns eager to have him onstage — they don’t want anything distracting voters from seeing the flaws and fumbles in the other guy, and R.F.K. Jr. will be one big distraction.

I’m preoccupied with the Biden-Trump fight for Pennsylvania and whether Biden can borrow from the winning political playbook of Gov. Josh Shapiro, who won a 15-point landslide in 2022. Biden is trailing Trump by a couple of points in the state polling average. As in other swing states, Biden needs to do far better than he’s currently polling with young voters and nonwhite voters, and with voters in Philadelphia and its suburbs. So keep an eye on Biden’s campaign trip to Philadelphia on Wednesday and his pitch for why Americans should want another four years of his presidency.

Trips like Biden’s Philadelphia event are planned weeks in advance, but as it happens, this one will probably happen just as the Trump jury is deliberating on Trump’s fate (or returning with a verdict). The split screen of Biden heralding Ben Franklin and Trump attacking jurors is a news cycle the Biden campaign badly wants.

Bret Stephens

What’s Spanish for ‘Chutzpah’?

This week’s announcements by the governments of Ireland, Norway and Spain that they will recognize a Palestinian state are drawing predictable reactions from predictable quarters. Some see them as useful rebukes to Prime Minister Benjamin Netanyahu’s war strategy in Gaza that will further isolate Israel. Others, including me, view them as feckless gestures that reward Hamas’s terrorism.

That’s a column for another day. For now, it’s enough to note the Spanish government’s sheer nerve.

Though Spanish public opinion overwhelmingly supports swift recognition of Palestinian statehood, it’s another story when it comes to Spain’s own independence movements. In 2017 the regional government of Catalonia held a referendum, declared illegal by Spain’s Constitutional Court , on the question of Catalan independence. Though turnout was low — in part because Spanish police forcibly blocked voting — the Catalan government said nearly 90 percent of voters favored independence.

The central government in Madrid responded by dismissing the Catalan government, imposing direct rule. Two years later, under the current left-wing government of Pedro Sánchez, Spain sentenced nine Catalan independence leaders to prison on charges of sedition, though they were later pardoned. This year the lower house of the Spanish Parliament voted to grant amnesty to those involved in the 2017 campaign as part of a deal to prop up Sánchez’s government, despite a Senate veto. Seventy percent of the Spanish public opposes the amnesty .

Catalans aren’t the only ethnic minority in Spain that has sought independence, only to encounter violent suppression. In the 1980s the Spanish Interior Ministry under a socialist government responded to the long-running Basque separatist movement with state-sponsored death squads, notoriously responsible for a string of kidnappings, tortures and assassinations. The Spanish government called the separatists terrorists — as indeed some were — though their tactics look tame compared with Hamas’s. By the time the conflict ended in 2011, it had claimed more than 1,000 lives.

Spain possesses two cities on the African continent, Ceuta and Melilla, both of which are claimed by Morocco and have been stormed by African migrants seeking entry into the European Union. They are protected by extensive border fences and fortifications strikingly reminiscent of Israel’s breached border fence with Gaza.

There are many other independence movements throughout Europe, from Scotland to Flanders to Corsica and the Balkans. Many of these movements tend to have affinities with Palestinians, for reasons that are obvious. More difficult to explain are governments that suppress independence seekers at home while applauding those abroad. Some might call it deflection. To others, it looks like hypocrisy.

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