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Vox - All
The West is burning. Climate change is making it worse.
Firefighters attempt to get control of the scene as the Dixie Fire burns dozens of homes burn in the Indian Falls neighborhood of unincorporated Plumas County, California on July 24, 2021. | JOSH EDELSON/AFP via Getty Images Almost 1.5 million acres of the US are on fire right now. California’s largest active fire continues to burn Sunday after tearing through a small community overnight. The Dixie Fire, which started earlier this month and has now burned more than 190,000 acres, forced a new wave of evacuations in Northern California on Saturday before striking the town of Indian Falls the same evening, destroying homes and vehicles. According to Cal Fire, the blaze is still only 21 percent contained and “continues to display extreme fire behavior.” It’s just one of several massive fires, supercharged by climate change and extreme drought conditions, that are currently burning across the American West, and it comes as other parts of the world confront their own climate disasters while US climate action hangs in balance in the Senate. On Thursday, the Dixie Fire became the second fire to reach “megafire” status — burning at least 100,000 acres — in California this year. California’s Sugar Fire was the first to clear that threshold earlier this month, though it’s now 98 percent contained. In October last year, the August Complex Fire became the first recorded “gigafire” in California history, burning more than 1 million acres. Fire Capt. Eric Limones of @calfireSCU snapped this incredible photo of his crew at the #DixieFire this week. It speaks volumes about what these firefighters are up against as they battle the state's biggest blaze of the year.https://t.co/mk9tABjrOy pic.twitter.com/IHDFgD6pxy— Hayley Smith (@whereishayley) July 24, 2021 California Gov. Gavin Newsom has declared a state of emergency for the affected counties in both the Sugar and Dixie Fires — as well as the Tamarack Fire, which is currently burning along the California-Nevada border near Lake Tahoe. All told, according to the National Interagency Fire Center, at least 86 large fires in 12 states are currently burning in the United States, covering almost 1.5 million acres and casting an oppressive pall of smoke as far away as New York City. More than 2.77 million acres have burned so far in 2021, about 800,000 more than at the same time last year but less than in 2019 and other previous years. Of the fires currently burning, the largest by far is Oregon’s Bootleg Fire, a sprawling blaze that has burned nearly 409,000 acres as of Sunday and even began generating its own weather — high winds and lightning — last week. “The fire is so large and generating so much energy and extreme heat that it’s changing the weather,” Marcus Kauffman, a spokesman for the Oregon Department of Forestry, told New York Times reporter Henry Fountain last week. “Normally the weather predicts what the fire will do. In this case, the fire is predicting what the weather will do.” Mathieu Lewis-Rolland/Getty Images Fire Information Officer Jacob Welsh observes smoldering trees on the northern front of the Bootleg Fire, on July 23, 2021, near Silver Creek, Oregon. The Bootleg Fire, which was ignited by a lightning strike on July 6, is the third-largest in Oregon since 1900, according to CNN, as well as being the largest in the country this fire season. As things stand, it’s 46 percent contained — but hotter, drier weather is expected this week, according to Oregon Public Broadcasting. “It is so dry out here on the ground that to be able to extinguish the fire completely, to be able to have what we call full containment of the fire, we are going to need Mother Nature’s help” in the form of a “season-ending weather event,” Katy O’Hara, a spokeswoman on the firefighting effort, told the Washington Post last week. According to the Post, such an event — a substantial rainfall or even snow — may not arrive in Oregon until “late fall” this year. Mathieu Lewis-Rolland/Getty Images Scorched trees smolder in the Bravo Bravo section of the Bootleg Fire, on July 21, 2021, in the Fremont National Forest of Oregon. Climate change is supercharging wildfire season Like most of the West, drought conditions in California and Oregon have fueled the Bootleg and Dixie Fires, resulting in a fire season that is far worse than usual, far earlier. According to the US Drought Monitor, major swaths of Washington, Oregon, California, Montana, Idaho, Nevada, Utah, Arizona, and New Mexico are all in the midst of a drought, as are other parts of the US. More than 95 percent of that region is experiencing at least “moderate” drought conditions, according to a map produced by the US Drought Monitor, and about 65 percent is facing “extreme” conditions. “This is more like what we would typically see in the late fall, at the end of the fire season before the rains come,” Capt. Mitch Matlow, the public information officer for the Dixie Fire, told the Los Angeles Times on Saturday. “The fuels got drier earlier in the season, which leads to more erratic fire behavior.” Josh Edelson/AFP via Getty Images A Cal Fire firefighter uses a drip torch to light a backfire in an effort to stop the spread of the Dixie fire in the Prattville community of unincorporated Plumas County, on July 23, 2021. As Vox’s Lili Pike reported in April, conditions this year aren’t exactly unexpected. A year plus of hot, dry weather and consecutive underwhelming rainy seasons laid the groundwork for the Dixie Fire long before it ignited in mid-July, and bigger-picture trends are also to blame. According to Pike, Scientists say that [the current drought] is part of a megadrought — a decades-long dry spell, punctuated by severe droughts. This current megadrought began around 2000, and the majority of the land in the West has been at some level of drought ever since. And this striking drought bears the fingerprints of climate change. Using tree ring data, a study published in Sciencein April 2020 found that“anthropogenic warming was critical for placing 2000–2018 on a trajectory consistent with the most severe past megadroughts,” and that megadrought has extended to today. This fits in with a grim picture laid out by the latest National Climate Assessment, authored by 13 US federal agencies in 2018. Rising temperatures will increase the likelihood of megadroughts in the Southwest and make droughts more frequent and severe, according to the scientific literature cited. The devastating effects of climate change have also manifested in other ways this year: In June and July, a series of scorching heat waves shattered all-time temperature records in the Pacific Northwest and British Columbia, killing hundreds and exacerbating existing drought conditions in the region. In Portland, Oregon, a new record-high temperature was set three consecutive days in a row, finally landing at 116 degrees Fahrenheit on June 28. In Washington state, Dallesport, a small town near the Oregon border, reached 118 degrees, tying the state’s all-time temperature record. And in Lytton, British Columbia, the temperature hit a new Canadian record of 121 degrees — one day before a wildfire tore through the town, killing two and destroying most of the village. James MacDonald/Bloomberg via Getty Images Wildfires burn above the Fraser River Valley near Lytton, British Columbia, Canada, on July 2, 2021. The recent heat dome, which experts say would have been “virtually impossible” without climate change, has only contributed to existing drought conditions in the West, and the result has been an “unprecedented” fire season, Canadian firefighter Brady Highway told Vox’s Benji Jones in an interview this month. Highway, a member of the Peter Ballantyne Cree Nation in Saskatchewan, Canada, has been a firefighter for 25 years and fought “around 250 wildland fires” in his career. This year, he says, fires are already “off the charts.” “We’ve already surpassed the number of fires we’ve experienced in previous years in Canada. British Columbia just initiated a state of emergency, and I suspect Saskatchewan and Ontario will do the same in a couple of weeks,” Highway said. “When I first started fighting fires, there was a very defined fire season — mostly July and August. Now, these events are happening in early spring.” It’s not just the US, and it’s not just wildfires As bad as the climate-fueled US fire season is, it’s just one item on a grim list of climate disasters currently battering the world. Siberia is also on fire, for one, and Germany is flooding. So are parts of Turkey. And China. And India. In Colorado, flooding this year has been made worse by wildfires last year. The list goes on. I don’t think I fully grasped how severe the European floods were until looking for photos for this story. Absolutely shocking and widespread devastation https://t.co/e0ioXkvATy pic.twitter.com/bPr0pqs0zW— Brian Kahn (@blkahn) July 16, 2021 Already, the flooding in Germany — which also hit neighboring Belgium and the Netherlands — has killed more than 200 people across western Europe, with more than 150 still unaccounted for. The floods hit with little notice, according to the AP, wreaking havoc and doing billions of euros in damage. And it’s likely to get worse from here: Climate change means future floods could be far more frequent. “The rainfall we’ve experienced across Europe over the past few days is extreme weather whose intensity is being strengthened by climate change — and will continue to strengthen further with more warming,” Friederike Otto, the associate director at the University of Oxford’s Environmental Change Institute, told Deutsche Welle. It’s a similar story in China. Historic rainfall in the city of Zhengzhou, the capital of Henan province, saw more than 24 inches of rain fall in a single day, including about eight inches in one hour. More than a million people have been displaced, and at least 33 killed — including 12 people who drowned when subway cars in Zhengzhou flooded, according to the Washington Post. Conditions in Siberia are also particularly bad, thanks to unusually warm weather and the driest summer in more than a century. Already, according to Guardian reporter Andrew Roth, some 3.7 million acres have burned, blanketing the region in oppressive smog. “It’s a thick smoke, yellow,” Ivan Nikiforov, a volunteer firefighter from Yakutsk, Russia, told the Guardian. “I don’t know how the locals could stand it. It will probably have health effects for them in the future. People are both depressed and angry. This situation should not have been allowed to take place.” Democrats want to act — but Joe Manchin and the GOP might not let them As the toll of climate disasters in the US and elsewhere continues to mount, it’s getting more difficult even for skeptics to deny that climate change is an urgent, immediate crisis — an assessment that has long been the consensus view of climate experts with the UN and elsewhere. With the stakes clearly established, President Joe Biden and congressional Democrats are pushing for sweeping action to address the problem, but it’s still unclear how climate change legislation will fare in an upcoming budget reconciliation proposal. Already, as Vox’s Rebecca Leber and Umair Irfan wrote last month, much of Biden’s climate agenda has been stripped out of the bipartisan infrastructure plan still in the works in the Senate, though some provisions remain. A proposed $3.5 trillion reconciliation package, however, would do more. The bill — which, as proposed, would also cover everything from health care to immigration and a host of other issues — includes a clean electricity standard aimed at reducing emissions by 50 percent over the next nine years, according to E&E News, as well as new clean energy and vehicle tax credits, money for a Civilian Climate Corps, and a clean energy accelerator program. As Leah Stokes and Sam Ricketts wrote for Vox in February, “clean electricity standards are proven, practical, and popular” — and potentially transformational: Clean electricity is the backbone of the energy transition — the critical piece that all the other sectors will slot into. Not only will getting to 100 percent clean electricity directly cut more than a quarter of US carbon pollution, it will also enable large parts of our transportation, building, and industrial sectors to run on clean power. Powering as much of these sectors as we can with carbon-free electricity would allow us to cut US emissions 70 to 80 percent. It would, in short, solve a huge chunk of our climate challenge. Democrats have committed to advance the reconciliation package alongside the bipartisan infrastructure bill as part of a two-track strategy to keep both bills moving ahead of the chamber’s August recess, which is bearing down. But while reconciliation bills only require a simple majority to pass the Senate, unlike most other legislation — which is subject to the 60-vote threshold imposed by the filibuster — the current set of climate provisions could run into trouble with Sen. Joe Manchin (D-WV), a frequent holdout in the Senate Democratic caucus. Earlier this month, Manchin, whose home state of West Virginia produces more coal than any state in the US other than Wyoming, told CNN’s Manu Raju that he was “concerned” about the climate portion of the bill. “Because if they’re eliminating fossils, and I’m finding out there’s a lot of language in places they’re eliminating fossils, which is very, very disturbing, because if you’re sticking your head in the sand, and saying that fossil (fuel) has to be eliminated in America, and they want to get rid of it, and thinking that’s going to clean up the global climate, it won’t clean it up all,” he said. “If anything, it would be worse.” As David Roberts, former Vox writer and current author of the Substack newsletter Volts, explained last month, that’s pretty much nonsense. Manchin & the rest of the dimwits trying to save fossil fuels need to be asked one question about climate policy, over and over again: how will your proposals get us on track to hit our emissions goals? There's an objective metric here. https://t.co/OKDlOIAMpG pic.twitter.com/0btMTbPOPt— David Roberts (@drvolts) July 22, 2021 However, as things stand, Democrats still need Manchin’s vote to get anything done — and so, after a week where wildfire smoke from the West Coast blanketed Washington, DC, thousands of miles away, it’s unclear exactly which climate provisions will make the cut in the Senate.vox.com
How bad is space tourism for the environment? And other space travel questions, answered.
Amazon founder Jeff Bezos just flew to space. Now he wants more people to come along. | Joe Raedle/Getty Images Six questions to consider before launching yourself into space. For many, the rise of commercial space tourism is a vulgar display of wealth and power. Amid several global crises, including climate change and a pandemic, billionaires are spending their cash on launching themselves into space for fun. When Amazon founder Jeff Bezos told reporters after his first space tourism trip on Tuesday that Amazon customers and employees had “paid” for his flight, that only intensified that criticism. But critics won’t deter Bezos and the other superrich. Space tourism is now a reality for the people who can afford it — and it will have repercussions for everyone on Earth. In fact, all signs indicate that the market for these trips is already big enough that they’ll keep happening. Jeff Bezos’s spaceflight company Blue Origin already has two more trips scheduled later this year, while Virgin Galactic, the space firm founded by billionaire Richard Branson, has at least 600 people who have already paid around $250,000 each for future tickets on its spaceplane. Now, as the commercial space tourism market (literally) gets off the ground, there are big questions facing future space travelers — and everyone else on the planet. Here are answers to the six biggest ones. 1. What will people actually be able to see and experience on a space trip? The biggest perk of traveling to space is the view. Just past the boundary between space and Earth, passengers can catch a stunning glimpse of our planet juxtaposed against the wide unknown of space. If a passenger is riding on a Virgin Galactic flight, they will get about 53 miles above sea level. Blue Origin riders will get a little bit higher, about 62 miles above sea level and past the Kármán line, the internationally recognized boundary between Earth and space. Overall, the experience on both flights is pretty similar. Welcome aboard #Unity22, Virgin Galactic's first fully-crewed test flight. Watch the historic moment through the eyes of our mission specialists. pic.twitter.com/DEwbBkgJYl— Virgin Galactic (@virgingalactic) July 13, 2021 The view is meant to be awe-inducing, and the experience even has its own name: the Overview Effect. “When you see Earth from that high up, it changes your perspective on things and how interconnected we are and how we squander that here on Earth,” Wendy Whitman Cobb, a professor at the US Air Force’s School of Advanced Air and Space Studies, told Recode. Another perk of these trips is that space tourists will feel a few minutes of microgravity, which is when gravity feels extremely weak. That will give them the chance to bounce around a spacecraft weightlessly before heading back to Earth. But Blue Origin’s and Virgin Galactic’s flights are relatively brief — about 10 and 90 minutes long, respectively. Other space tourism flights from SpaceX, the space company founded by Elon Musk, will have more to offer. This fall, billionaire Jared Isaacman, who founded the company Shift4 Payments, will pilot SpaceX’s first all-civilian flight, the Inspiration4, which will spend several days in orbit around Earth. In the coming years, the company has also planned private missions to the International Space Station, as well as a trip around the moon. These trips are meant to be enjoyed by space nerds who longed to be astronauts. But there’s another reason rich people want to go to space: demonstrating exclusivity and conspicuous consumption. More than a few people can afford a trip to Venice or the Maldives. But how many people are privileged enough to take a trip to space? “What a nice way of showing off these days than to post a picture on Instagram from space,” Sridhar Tayur, a Carnegie Mellon business professor, told Recode. View this post on Instagram A post shared by Jeff Bezos (@jeffbezos) 2. Does commercial space travel have any scientific goals, or is it really just a joyride? Right now, space tourism flights from Virgin Galactic and Blue Origin have only reached suborbital space, which means that flights enter space but do not enter orbit around Earth. Scientifically, that’s not a new frontier. Though these current flights use new technology, suborbital flight with humans aboard was accomplished by NASA back in the early 1960s, Matthew Hersch, a historian of technology at Harvard, told Recode. Right now, it’s not clear these trips will offer scientists major new insights, but they might provide information that could be used in the future for space exploration. In fact, these trips are also being marketed as potential opportunities for scientific experiments. For instance, the most recent Virgin Galactic flight carried plants and tested how they responded to microgravity. These private companies primarily see opportunities in their commercial vehicles that can be reused at scale, which will allow the same rockets (or in Virgin Galactic’s case, spaceplanes) to go to space again and again, which lowers the overall cost of space tourism. Billionaires and their private space companies also see the development of these rockets as an opportunity to prepare for flights that will do even more, and go even farther, into space. Bezos, for instance, has argued that New Shepard’s suborbital flights will help prepare the company’s future missions, including its New Glenn rocket, which is meant for orbital space. “The fact of the matter is, the architecture and the technology we have chosen is complete overkill for a suborbital tourism mission,” Bezos said at Tuesday’s post-launch briefing. “We have chosen the vertical landing architecture. Why did we do that? Because it scales.” Beyond potential scientific advancements in the future, suborbital spaceflight might also create new ways to travel from one place on earth to another. SpaceX, for instance, has advertised that long-haul flights could be shortened to just 30 minutes by traveling through space. 3. Is it safe? Right now, it’s not entirely clear just how risky space tourism is. One way space tourism companies are trying to keep travelers safe is by requiring training so that the people who are taking a brief sojourn off Earth are as prepared as possible. On the flight, people can experience intense altitude and G-forces. “This is sustained G-forces on your body, upwards of what can be 6 G in one direction — which is six times your body weight for upwards of 20 or 30 seconds,” Glenn King, the chief operating officer of the Nastar Center — the aerospace physiology training center that prepared Richard Branson for his flights — told Recode. “That’s a long time when you have six people, or your weight, pressing down on you.” There’s also the chance that space tourists will be exposed to radiation, though that risk depends on how long you’re in space. “It’s a risk, especially more for the orbital flight than sub-orbital,” explains Whitman Cobb. “Going up in an airplane exposes you to a higher amount of radiation than you would get here on the ground.” She also warns that some tourists will likely barf on the ride. There doesn’t seem to be an age limit on who can travel, though. The most recent Blue Origin flight included both the youngest person to ever travel to space, an 18-year-old Dutch teenager, as well as the oldest: 82-year-old pilot Wally Funk. 4. How much will tickets cost? The leaders in commercial space tourism already claim they have a market to support the industry. While Bezos hinted on Tuesday the price would eventually come down — as eventually happened with the high prices of the nascent airline industry — for now, ticket prices are in the low hundreds of thousands, at least for Virgin Galactic. That price point would keep spaceflight out of reach for most of humanity, but there are enough interested rich people that space tourism seems to be economically feasible. “If you bring it down to $250,000, the wait times [to buy a ticket] will be very long,” Tayur, of Carnegie Mellon, told Recode. 5. What impact will commercial space travel have on the environment? The emissions of a flight to space can be worse than those of a typical airplane flight because just a few people hop aboard one of these flights, so the emissions per passenger are much higher. That pollution could become much worse if space tourism becomes more popular. Virgin Galactic alone eventually aims to launch 400 of these flights annually. “The carbon footprint of launching yourself into space in one of these rockets is incredibly high, close to about 100 times higher than if you took a long-haul flight,” Eloise Marais, a physical geography professor at the University College London, told Recode. “It’s incredibly problematic if we want to be environmentally conscious and consider our carbon footprint.” These flights’ effects on the environment will differ depending on factors like the fuel they use, the energy required to manufacture that fuel, and where they’re headed — and all these factors make it difficult to model their environmental impact. For instance, Jeff Bezos has argued that the liquid hydrogen and oxygen fuel Blue Origin uses is less damaging to the environment than the other space competitors (technically, his flight didn’t release carbon dioxide), but experts told Recode it could still have significant environmental effects. There are also other risks we need to keep studying, including the release of soot that could hurt the stratosphere and the ozone. A study from 2010 found that the soot released by 1,000 space tourism flights could warm Antarctica by nearly 1 degree Celsius. “There are some risks that are unknown,” Paul Peeters, a tourism sustainability professor at the Breda University of Applied Sciences, told Recode. “We should do much more work to assess those risks and make sure that they do not occur or to alleviate them somehow — before you start this space tourism business.” Overall, he thinks the environmental costs are reason enough not to take such a trip. 6. Who is regulating commercial space travel? Right now, the Federal Aviation Administration (FAA) has generally been given the job of overseeing the commercial space industry. But regulation of space is still relatively meager. One of the biggest areas of concern is licensing launches and making sure that space flights don’t end up hitting all the other flying vehicles humans launch into the sky, like planes and drones. Just this June, a SpaceX flight was held up after a helicopter flew into the zone of the launch. There’s a lot that still needs to be worked out, especially as there are more of these launches. On Thursday, the Senate hosted a hearing with leaders of the commercial space industry focused on overseeing the growing amount of civil space traffic. At the same time, the FAA is also overseeing a surging number of spaceports — essentially airports for spaceflight — and making sure there’s enough space for them to safely set up their launches. But there are other areas where the government could step in. “I think the cybersecurity aspect will also play a very vital role, so that people don’t get hacked,” Tayur said. The FAA told Recode that the agency has participated in developing national principles for space cybersecurity, but Congress hasn’t given it a specific role in looking at the cybersecurity of space. At some point, the government might also step in to regulate the environmental impact of these flights, too, but that’s not something the FAA currently has jurisdiction over. In the meantime, no government agency is currently vetting these companies when it comes to the safety of the human passengers aboard. An FAA official confirmed with Recode that while the agency is awarding licenses to companies to carry humans to space, they’re not actually confirming that these trips are safe. That’s jurisdiction Congress won’t give the agency until 2023. There doesn’t seem to be an abundance of travelers’ insurance policies for space. “Passengers basically sign that they’re waiving all their rights,” Whitman Cobb said. “You’re acknowledging that risk and doing it yourself right now.” So fair warning, if you decide to shell out hundreds of thousands of dollars for a joyride to space: You’d likely have to accept all responsibility if you get hurt.vox.com
As the pandemic wears on, some Americans could need booster shots
Willie Golden directs people towards a mobile Covid-19 vaccine clinic, hosted by Mothers In Action in collaboration with LA County Department of Public Health, on Friday, July 16, 2021 in Los Angeles, California. | Irfan Khan / Los Angeles Times via Getty Images Some health officials now think a third shot could help older and immunocompromised people. The Biden administration now believes that fully vaccinated people who are older or immunocompromised may need a booster shot. Though all three vaccines authorized for use in the United States — Pfizer/BioNTech, Moderna, and Johnson & Johnson — are highly effective in preventing Covid-19 infections, recent data suggests that the efficacy of Pfizer’s two-dose vaccine can wane slightly four to six months after vaccination, according to the New York Times. However, a booster shot could lift antibody levels even more substantially than the current two-dose regimen for the Pfizer and Moderna vaccines, and could be especially beneficial for people 65 and older and those who are immunocompromised. People who are immunocompromised may receive significantly less immune protection than the general population after two vaccine doses, increasing the upside of a potential third shot. According to a Centers for Disease Control and Prevention advisory committee, which met earlier this week to discuss the potential need for booster shots, about 2.7 percent of the US population is currently immunocompromised in some way, whether due to ongoing medical treatment like chemotherapy, their status as organ transplant recipients, or another reason. Immunocompromised people are also more likely to become severely ill from Covid-19, and they have a markedly higher chance of experiencing breakthrough infections despite being vaccinated — a concern magnified by a delta variant-fueled resurgence of Covid-19 cases in the US. 10. I am not clear if #ACIP & @CDCgov are legally able to recommend additional doses of #Covid vaccines while @US_FDA's EUAs stipulate the mRNA vaccines are 2-dose vaxes & J&J's is 1 dose. But CDC is making clear it isn't going to move on this till FDA alters the vaxes' status. pic.twitter.com/DMMIU0uKfZ— Helen Branswell (@HelenBranswell) July 22, 2021 As things stand, data from Pfizer indicates that its vaccine — the first to be authorized in the US, and still the most common among US vaccine recipients — declines from 95 percent to 84 percent effectiveness against symptomatic infection after four to six months, according to the Times’ Sharon LaFraniere. Data from Israel, where Covid cases are once again rising, suggest that an even sharper decline in effectiveness against symptomatic infections is possible — but even then, the vaccine remains “more than 90 percent effective in preventing severe disease,” and the small sample size means there is still uncertainty about Israel’s findings. “The goal of this vaccine is not to prevent mild or low, moderate infectious disease,” Dr. Paul Offit, a member of the Food and Drug Administration’s outside advisory committee, told the Times. “The goal is to prevent hospitalization to death. Right now this vaccine has held up to that.” A booster shot administered at the six-month mark could increase antibody levels as much as tenfold, according to data released earlier this year by both Pfizer and Moderna, underscoring its potential value to older and immunocompromised people. Israel is already offering a third Pfizer shot for immunocompromised residents — though millions of Palestinians in the West Bank and the Gaza Strip have yet to be vaccinated — and Pfizer has previously suggested that a booster shot could be needed in the US. Regulatory questions abound Though the US currently has tens of millions of surplus Covid-19 vaccine doses on hand, making a third Pfizer or Moderna shot available to millions of immunocompromised or elderly Americans likely won’t be a quick process. Currently, all three Covid-19 vaccines in use in the US are being administered under an emergency use authorization, or EUA, issued by the FDA, which sets specific regimens for each vaccine: two doses several weeks apart for both Pfizer and Moderna, and a single dose for Johnson & Johnson. Changing that, according to the Washington Post, would require either full FDA approval for the vaccine or an amendment to the EUA. And until that happens, the CDC’s Advisory Committee on Immunization Practices can’t go forward with recommending a third shot for vulnerable populations in the US. According to the New York Times, “doctors would have vastly more leeway to prescribe a booster for their patients” once the vaccine is fully approved by the FDA. However, there are some potential workarounds to get third shots in arms more quickly. According to Dr. Amanda Cohn, chief medical officer for the CDC’s immunization and respiratory diseases center, the US is “actively looking into ways ... to potentially provide access earlier than any potential change in regulatory decisions” — including through “a study, or through an investigational new drug format.” As the Washington Post reported after the advisory board meeting earlier this week, that strategy could open up access to a third shot under the FDA’s compassionate use program, which “would require enrolling individuals in a clinical study where additional doses can be given.” President Joe Biden also struck an encouraging tone on the prospects for the FDA’s full vaccine approval in coming months, at a recent town hall in Cincinnati, Ohio. “They’re [the FDA] not promising me any specific date, but my expectation, talking to the group of scientists we put together... plus others in the field, is that sometime, maybe in the beginning of the school year, at the end of August, beginning September, October, they’ll get a final approval,” Biden told CNN’s Don Lemon on Wednesday. SAUL LOEB/AFP via Getty Images President Joe Biden participates in a CNN town hall hosted by Don Lemon at Mount St. Joseph University in Cincinnati, Ohio on July 21, 2021. Full FDA approval requires a massive amount of data, including at least six months of vaccine efficacy data, and it usually takes about 10 months for the agency to review license applications and reach a decision. “When we were reviewing applications back when they were on paper, there was so much, it would not fit on the freight elevator,” Norman Baylor, the former head of the FDA’s Office of Vaccines Research and Review, told CNN. “That’s how big the application is.” However, the Pfizer/BioNTech vaccine has already been granted a priority review, which shortens the potential timeline to six months, and multiple officials have said approval will likely come even sooner, potentially clearing the way for booster shots for older and immunocompromised people. Moderna is currently “in the process of completing our rolling submission” to the FDA, according to a Moderna spokesperson, and approval for the Moderna vaccine will almost certainly take longer. The company told CNN this week that it has no specific timeline in place yet. Full FDA approval could also have a number of other benefits, in addition to opening up the possibility of booster shots for vulnerable groups. As NBC’s Shannon Pettypiece explained on Tuesday, “the official regulatory signoff would remove a significant legal and public relations barrier for businesses and government agencies that want to require vaccinations for their employees and customers,” and could also boost vaccine confidence. Thus far, the US has largely held back from imposing vaccine mandates, though other countries, such as France, have embraced them to positive effect. Emmanuel Macron announced on Monday that a proof of vaccination (or a negative test) would very soon be needed to access public events, restaurants, cinemas, stations & airports…Since then, more than 2.2 million vaccination appointments have been booked in less than 48 hours. pic.twitter.com/9lAr52iDgf— Edouard Mathieu (@redouad) July 14, 2021 The delta variant is spreading fast As the Biden administration consensus coalesces behind the need for a booster shot for vulnerable groups, the delta variant of Covid-19 is gaining ground quickly in the US, fueling a sharp rise in new cases. On Saturday, the US reported a rolling seven-day average of nearly 50,000 cases per day — the highest level since early May, according to CNN’s Ryan Struyk, and almost 39,000 more cases than the same seven-day average in late June. The United States is now reporting 49,386 new coronavirus cases per day, the highest seven-day average since May 3, according to data from @CNN and Johns Hopkins University.— Ryan Struyk (@ryanstruyk) July 24, 2021 Additionally, at a Thursday White House briefing on the pandemic, CDC director Dr. Rochelle Walensky warned that the delta variant “now represents more than 83 percent of the virus circulating in the United States.” CDC director Rochelle Walensky said that the infectious Delta variant of COVID-19, which was first found in India, now comprises more than 83% of new cases nationwide https://t.co/77YcbvhKMG pic.twitter.com/dXK699zl6J— Reuters (@Reuters) July 22, 2021 “Compared to the virus we had circulating initially in the United States at the start of the pandemic, the delta variant is more aggressive and much more transmissible than previously circulating strains,” Walensky said. “It is one of the most infectious respiratory viruses we know of and that I have seen in my 20-year career.” As Vox’s Umair Irfan explained in late June, when delta accounted for just 20 percent of new Covid cases in the US, the CDC has identified delta as one of five “variants of concern.” Not only does it spread far faster than the original strain of Covid, but it’s better at evading vaccine protections, and, as Irfan reports, there’s some evidence that it can cause “more severe outcomes from Covid-19 compared to the original versions of the virus.” Despite those breakthrough cases, however, the delta surge is overwhelmingly proving to be “a pandemic of the unvaccinated,” as Walensky put it earlier this month. In the US, more than 99 percent of recent deaths and about 97 percent of recent hospitalizations from Covid-19 have been among unvaccinated individuals. As a result, this latest virus outbreak has been especially bad in parts of the US with low vaccine uptake, such as rural Missouri. As The Atlantic’s Ed Yong reported from Missouri earlier this month, “ICUs are also filling with younger patients, in their 20s, 30s, and 40s, including many with no underlying health problems.” According to Yong, Almost every COVID-19 patient in Springfield’s hospitals is unvaccinated, and the dozen or so exceptions are all either elderly or immunocompromised people. The vaccines are working as intended, but the number of people who have refused to get their shots is crushing morale. Vaccines were meant to be the end of the pandemic. If people don’t get them, the actual end will look more like Springfield’s present: a succession of COVID-19 waves that will break unevenly across the country until everyone has either been vaccinated or infected. A swath of southern states, including Louisiana and Florida, are currently reporting more cases per 100,000 people than anywhere else in the US, with Florida alone contributing more than one-fifth of all new cases in the US. “Folks [are] supposed to have common sense,” Alabama Gov. Kay Ivey, a Republican, said this week. “But it’s time to start blaming the unvaccinated folks, not the regular folks. It’s the unvaccinated folks that are letting us down.” Currently, only 34 percent of Alabamans are fully vaccinated — the worst vaccination rate of the any state in the US, along with Mississippi. Getting vaccinated protects individuals — and the whole community As of Saturday, about 57 percent of the vaccine-eligible population in the US — more than 162 million people — have been fully vaccinated, according to data from the CDC. Another 15 million or so more have received at least one dose of the vaccine. That level of widespread vaccination is unequivocally good news, but with US Covid cases on the rise and the delta variant running rampant, it invariably also means some of the new Covid cases in the US are “breakthrough infections” — fully vaccinated people nonetheless testing positive for Covid-19. As Vox’s Umair Irfan explains, The CDC definition of a breakthrough infection is a laboratory-confirmed infection more than 14 days after the final dose of a Covid-19 vaccine, as it can take a while for the full protection of a vaccine to spool up. This definition includes everything from infections that produce no symptoms at all to cases that result in death. “People often think about ‘infection’ and ‘disease’ as being the same thing, and that is not the case,” said Brianne Barker, a virologist at Drew University. It’s only when a virus starts causing symptoms that an infected person is said to have disease, so not all SARS-CoV-2 infections cause Covid-19. But as we’ve seen throughout the pandemic, people can carry and transmit the virus without falling ill themselves, creating a major route for the spread of Covid-19. That’s why tracking breakthrough cases is so important. The good news about breakthrough infections, though, is that if you’re vaccinated and get sick with Covid-19, you’re far less likely to get severely ill than you would without a vaccine. With a vaccine, the chance of hospitalization and death are both reduced compared to unvaccinated individuals, according to Dr. Anthony Fauci, the United States’ top infectious disease expert. “If you look at the number of deaths, about 99.2 percent of them are unvaccinated. About 0.8 percent are vaccinated,” Fauci told NBC’s Chuck Todd on Meet the Press earlier this month. “No vaccine is perfect. But when you talk about the avoidability of hospitalization and death ... it’s really sad and tragic that most all of these are avoidable and preventable.” 9/12Breakthrough infections shouldn't be taken to mean vaccines don’t work; but they SHOULD be taken as even more reason to get that shot in your arm. If everyone was vaccinated, there would be far less reason for the virus to spread & fewer people for it to spread btwn. #velshi— Ali Velshi (@AliVelshi) July 24, 2021 Currently, the country is administering about 537,000 doses per day on average, down from more than a million per day on average at the start of July — and that dropoff could fuel a brutal, self-reinforcing cycle. Specifically, according to Irfan, “with vaccination rates slowing, reports of people becoming infected after their immunizations could feed vaccine hesitancy, which in turn can fuel more breakthrough cases.” In reality, however, getting vaccinated actually heads off the risk of further breakthrough infections by making it harder for the virus to spread. And by the same token, getting more people vaccinated will also go a long way toward protecting older and immunocompromised people who have already been vaccinated but may now need a booster shot. 13. #ACIP member Keipp Talbot made an impassioned plea for people to get vaccinated as a way to protect those who cannot get enough protection from the #Covid vaccines. We all know someone in this situation, she said. We live with them, work with them, worship with them.— Helen Branswell (@HelenBranswell) July 22, 2021 “Each day, hundreds of thousands of Americans are choosing to protect themselves, their kids, and their neighbors by getting their first shot,” White House Covid czar Jeff Zients said this week. “These Americans are stepping up and doing their part. Each shot matters. Each additional person fully vaccinated is a step closer to putting this pandemic behind us.”vox.com
How to become an Olympic sport
Japan’s Hiroto Ohhara rides a wave at the Tsurigasaki Surfing Beach. Surfing is one of six sports that have been added to the 2021 Tokyo Olympics. | Olivier Morin/Getty Images Six new sports will be at the Tokyo Olympics — the most since 1920. An amazing six new sports will be contested at the Tokyo Olympics. That’s the most new additions to an Olympics since 1920, when 11 sports entered the mix. The “new” label Is a bit elastic. Two of the sports added to the Tokyo Games — the closely related baseball and softball — were featured at the Olympics as recently as 2008, before being dropped in 2012 and 2016. But the other four are complete newcomers: karate, skateboarding, sport climbing, and surfing. All six will join Olympic favorites like track and field, swimming, and gymnastics. For the incoming sports, inclusion in the Olympics offers an important global spotlight — and crucially, the opportunity to grow. “The Olympics are the highest, largest, most visible stage for any sport. Surfing being in the Olympic Games will be great for surfing. We’ll be allowed to communicate our message and our lifestyle to billions of people,” said Fernando Aguerre, president of the International Surfing Association. “It’s developing surfing, taking it to Africa, to Asia, to Latin America — to areas where there are incredible waves,” but there aren’t as many surfers. There’s just one catch: These six new-for-Tokyo sports won’t all be part of the Paris Summer Games in 2024. Skateboarding, sport climbing, and surfing will be featured in 2024, with the surfing competition located in Tahiti, nearly 10,000 miles away from Paris. The Paris Games will also add breakdancing for the first time ever. But baseball, softball, and karate will be left out. Yet come 2028 in Los Angeles, the Summer Games will likely re-expand to incorporate baseball and softball again. Whether breakdancing will survive to 2028 is anyone’s guess. This endless shuffling of events all stems from an initiative designed to update and revamp the Olympics. Called “Agenda 2020,” the program was adopted by the International Olympic Committee (IOC) in 2014. It aims to give individual host cities more control over which events are medal sports. The goal, overall, is to make the Olympics less of a behemoth and an economic boondoggle. Unfortunately, the shuffling also leads to uncertainty for a number of sports, which might be included for one Olympics and then cut from the next. The variety of events on offer will perhaps provide more adventurous choices for Olympics viewers who like watching sports they might not be able to see easily. (When was the last time you saw competitive karate broadcast in the US?) Yet, given how much stability and economic freedom is granted by a sport becoming a permanent part of the Olympics, that uncertainty can be devastating. The divide between “core sports” and everything else at the Olympics Laurent Kalfala/AFP via Getty Images The USA’s Kyle Frederick Snyder (in red) wrestles with Azerbaijan’s Khetag Goziumov during the men’s 97kg freestyle wrestling final match at the 2016 Olympic Games in Rio. The Summer Games will always feature a number of “core sports.” These sports have long histories within the Olympics, and they are so closely associated with the event that the Olympics would feel weird without, say, gymnastics or track and field or swimming. An IOC working group suggested that the number of core sports be set at 25 in 2013, with weightlifting, wrestling, and modern pentathlon competing for slots 24 and 25 in that number. At the time, the group initially recommended that wrestling be dropped from the program. It was seen as a sport prone to doping scandals, with ineffectual leadership failing to keep corruption in check. Yet just a few weeks later, the threat against wrestling petered out as the IOC’s full voting membership opted to keep the sport in the games. Wrestling has been part of the roster at every Olympics since and has yet to be dropped from the core sports program. In addition, golf and rugby sevens, first presented at Rio in 2016, have continued to make the cut for inclusion at subsequent Olympics. Thus, the Summer Games sure seem like they have 28 core sports, not 25. But the IOC keeps feinting toward bumping that number back to 25, presumably to keep everybody on their best behavior. The threats against wrestling are a good example of how that IOC pressure works to externally police the sports federations that it recognizes. “When wrestling was potentially going to be dropped from the Olympics, it was a huge shock. The wrestling federation [United World Wrestling, which oversees the sport at the games] got rid of its leadership and got new people in,” said Sydney Bauer, a freelance journalist who has covered the Olympics for nine years. “And the IOC had a vote at its [main] session, and then just put wrestling back in the core sports. So nothing changed. This was an excuse for the IOC to use its political pressure to change the Wrestling Federation.” At any rate, if you’re a core sport, you’re theoretically always in the Olympics. (The IOC can change whatever it wants whenever it wants via a vote, but let’s assume for a second that that isn’t true.) What if you’re not a core sport, though? How do you get onto the program? Before each Olympics, the organizing committee from each host city narrows down a list of proposals from IOC-recognized sports (more on this in a second) to a shortlist of events it thinks it has capacity to host. The host city then further narrows down that list to a bid that it submits to the IOC for approval. Tokyo initially considered nine sports — the six already mentioned (baseball, karate, skateboarding, softball, sport climbing, and surfing), plus squash, wushu, and roller sports — before narrowing that list to the six that will be featured in the Tokyo Games. (Perhaps confusing matters: Baseball and softball have consolidated their organizing bodies into one group since the 2008 Olympics, so while the IOC counts baseball-softball as one sport, “the Tokyo Olympics considered eight sports for inclusion, including baseball-softball” doesn’t make a ton of sense, which is why I’m referring to the two as separate sports.) By the way, pour one out for squash, a constant also-ran at the Olympics despite the sport having grown over decades so that it has a robust international presence. “Squash missed out again, which was a huge shock,” said Bauer. “They’ve been doing everything right but can’t get on the program.” The Paris Olympics, meanwhile, opted not to include baseball, softball, or karate from their shortlist of seven sports, ending up with the four previously mentioned: breakdancing, skateboarding, sport climbing, and surfing. There’s also a historical precedent of introducing new sports at the Olympics based on what’s popular locally.From 1912 to 1992, events called “demonstration sports” were included in the Olympics as an opportunity to allow audiences to check out sports popular in the cities hosting the Games. Sometimes, those sports even went on to become full Olympic sports. In 1984, for instance, Los Angeles presented demonstrations of baseball and tennis, both of which were later added as medal events at future Games. The big difference between the current system and the demonstration sports system is that demonstration sports weren’t full medal events. Now, every sport that makes it into the games sends its victors home with shiny new hardware. If you win a baseball gold medal in the 2020 Olympics, you’re a gold medalist, even if baseball is never played at the Games again. Want to be included in the Olympics? Being popular with the kids will sure help you out. Fabian Ramella/picture alliance via Getty Images Breakdancers compete at the 2018 Youth Olympic Games in Buenos Aires. Becoming an IOC-recognized sport is a long process crowded with bureaucracy, but in essence, it involves building out national, regional, and international organizations that can then be collected under the banner of “IOC-recognized sport.” Essentially, lots of countries need to love your sport, which will give you an athlete base and an audience to hold regional events, which will then allow you to expand to international events, which will hopefully eventually land your event in the Olympics. The IOC has a list of criteria it checks off for inclusion, but those criteria are somewhat nebulous, as you can see discussed here by the international federation governing the sport of muaythai, which was granted provisional recognition by the IOC just this year. There’s also a lot of glad-handing and politicking involved in this process. Building the right connections within the IOC is a must, as is navigating many othersports federations and competitions. Yet you likely have a leg up once you’re a recognized sport if you either appeal to young people or to the citizens of the country hosting that current Olympic Games. In particular, there’s been a pronounced focus in the events that have been added recently on finding sports that will appeal to “the youths.” The IOC has increasingly used the Youth Olympics, a perpetually beleaguered event for athletes between 14 and 18 years old, as a way to try out events that might merit Olympic inclusion. Breakdancing, for instance, will make its Olympics debut in 2024 after a successful trial run at the 2018 Youth Olympics in Buenos Aires. (The Youth Olympics are held every four years but on an alternating schedule, so the Winter Youth Olympics happen in years when there is a Summer Olympics and vice versa.) The use of the Youth Olympics to try out new sports is a hallmark, Bauer said, of the IOC under current president Thomas Bach, who took office in 2013. “It’s an ethos of, ‘Okay, we need to appeal to young people. We need young millennials and Gen Z to be interested in the Olympics, and they don’t care about wrestling. They don’t care about weightlifting. They don’t care about track and field. So how can we get young people interested, but also not change everything we’ve done with these core sports because they’re very old Federations and make a lot of money?’” she said. Bach has kicked off numerous efforts to streamline the Games and make them more flexible. Even with four sports added to the 2024 Games, for instance, the overall number of events will decline from 339 to 329, with most of the cuts coming from the boxing and weightlifting programs. What’s more, the IOC’s efforts to include events that will allow for full parity between men’s and women’s events have improved considerably under Bach. The number of women competing in Tokyo should be 48.8 percent of the total number of competing athletes, and the 2024 Games hope to hit 50 percent on the dot. That’s well up from 38.2 percent at the 2000 Olympics in Sydney. The flexibility developed under Bach also allows individual sports to be tried out one Olympics at a time. If they prove wildly popular, they might be added in future Games — especially if they’re sports that don’t require building expensive facilities. (Surfing, for example, mostly just requires having an ocean.) This approach also allows recognized sports an opportunity to compete to be included in Games hosted by countries where they are popular. Baseball, softball, surfing, and skateboarding seem like cinches to be added to the Los Angeles Games in 2028 because all four sports are wildly popular in the US and in California more specifically. (Aguerre points out that California is the home of surfing and skateboarding culture worldwide.) Any sport that is popular in America (and some sports that are not but that are growing more popular around the world) might bid as well. Already, cricket (which is not super popular in the US but is growing in stature, especially in areas with large South Asian immigrant populations) and flag football(!!) are vying to be added to the 2028 Games. Other sports with a footprint in the US, such as ultimate Frisbee (known as “world flying disc” internationally) might have a shot as well, should they vie for inclusion. Finally, these more recent reforms allow for shifts in the longtime stranglehold that events popular in Europe have had on the Olympics. Baseball fought for years and years to be included, and its struggles have been widely attributed to the fact that while the sport is incredibly popular in East Asia and the Americas, it’s not popular at all in Western Europe. The case against baseball in the Olympics is slightly more nuanced than “people in Europe don’t like it.” Baseball is a sport played only by men, and its previous Olympics inclusions were not commercially successful. The consolidation of baseball and softball into one federation took care of the first problem; a successful event in Tokyo could take care of the second. Baseball is also making great strides internationally, with federations spinning up all over the globe in places like South Africa, Israel, and Brazil. Still, the pro-Europe bias at the Olympics was real — and the IOC is taking steps to combat that problem too. “The IOC has been on a big blitz to make its membership not just be Western European,” Bauer said. “The IOC is huge now. It’s up to around 105 members. There’s an IOC member now from Afghanistan. There’s one from Bhutan. There’s one from Palau. These are countries that are represented now because they’re trying to create geographic diversity, where in the past, if you weren’t from Western Europe, you were being held back because [the IOC is] based in Switzerland.” In the end, even if your sport is selected for the Olympics, there’s no guarantee your event will be a success. That lies with forces beyond anyone’s control. But Aguerre, the ISA president, has high hopes for surfing in Tokyo. “The biggest thing that made me so happy was realizing that there are going to be waves [in Tokyo], plenty of waves,” he said, citing local forecasts. “The only uncertainty is: Are there going to be waves? And we’re gonna have a week of waves. It’s nice.”vox.com
Anti-abortion lawyers are finally being honest about what they want from the Supreme Court
Sen. Susan Collins (R-ME) meets with then-Supreme Court nominee Brett Kavanaugh in her office on Capitol Hill on August 21, 2018. | Zach Gibson/Getty Images For decades, abortion opponents urged the Court to lie about abortion restrictions. They don’t need to anymore. The state of Mississippi begins its brief in Dobbs v. Jackson Women’s Health Organization with a bold claim: The case for overruling Roe v. Wade (1973) and Planned Parenthood v. Casey (1992), two seminal Supreme Court decisions protecting the right to an abortion, is “overwhelming.” Dobbs, which the Court will hear this fall, concerns a Mississippi law that prohibits nearly all abortions after 15 weeks of pregnancy. It’s the first major abortion case to receive a full briefing and oral argument since Justice Amy Coney Barrett’s confirmation gave the Court a 6-3 conservative majority. And abortion opponents have every reason to be optimistic that the Court’s new majority will use Dobbs to undo the right to an abortion. That probably explains why Mississippi’s brief, which argues that “the Constitution does not protect a right to abortion or limit States’ authority to restrict it,” breaks with the tactics anti-abortion lawyers have used to defend restrictions on reproductive freedom. Rather than explicitly asking the Court to overrule Roe, in the past, these lawyers tried to chip away at the abortion right until it is functionally impossible to obtain an abortion in many states. Take, for example, Whole Woman’s Health v. Hellerstedt, the Court’s 2016 decision striking down two provisions of a Texas law that imposed expensive architectural requirements on abortion clinics, while also requiring abortion providers to obtain a difficult-to-acquire credential. The goal of this law wasn’t to explicitly ban abortion, it was to secure the Supreme Court’s permission to ban abortion indirectly — by layering so many legal burdens on top of abortion providers that they are eventually unable to comply with the law. The law at issue in Dobbs doesn’t explicitly ban all abortions either. But Mississippi’s litigation strategy hopes to make such a ban permissible. If the Court overrules Roe and Casey, that’s the ballgame. State lawmakers will be free to ban abortion outright, and without having to dress their ban up as an attempt to regulate the width of hallways in abortion clinics. Anti-abortion lawyers, in other words, are finally being honest about their ultimate goal. Rather than asking the Court to place some arcane and nonsensical limit on Roe and Casey, while simultaneously pretending that these two cases remain good law, Mississippi just asked the Court to eliminate the right to an abortion altogether. Justice Anthony Kennedy turned abortion litigation into a dishonest game Justice Anthony Kennedy, who retired from the Court in 2018, held the pivotal vote on the Supreme Court in abortion cases for many years. Kennedy is quite conservative, and he tended to be skeptical of abortion rights. As David Cohen, a law professor at Drexel University, noted in 2013, Kennedy “has voted to strike down only one of the 21 abortion restrictions that have come before the Supreme Court since he became a justice.” Yet, while Kennedy was open to many laws making it harder to obtain an abortion, he refused to overrule Roe outright. Kennedy was one of three co-authors of the Court’s decision in Casey, which weakened Roe, while also retaining “Roe’s essential holding” affirming “the right of the woman to choose to have an abortion before [fetal] viability and to obtain it without undue interference from the State.” Kennedy, in other words, would not have upheld an explicit ban on abortions. But he was willing to uphold many laws burdening abortion rights. So abortion opponents spent the years when Kennedy held the balance of power on the Court drafting more and more aggressive abortion restrictions that purported to be something other than an outright ban. The culmination of this strategy was the two provisions of the Texas law struck down in Whole Woman’s Health. That law required physicians who perform abortions to obtain admitting privileges at a nearby hospital, and it also required abortion clinics to comply with the same rules that apply to “ambulatory surgical centers,” facilities that are equipped to perform medical and surgical procedures that are far riskier and more complicated than an abortion. Abortion-rights advocates often deride these kinds of laws as “targeted restrictions on abortion providers,” or “TRAP” laws, because they masquerade as regulations intended to make abortion safer, when their real purpose is simply to increase the cost of operating an abortion clinic and drive many clinics out of business. As the Court explained in Whole Woman’s Health, the burdens imposed by Texas’s law did little, if anything, to actually improve health outcomes. A major reason why it is difficult for abortion providers to obtain admitting privileges at hospitals, for example, is that hospitals often require doctors to actually admit a certain number of patients in order to maintain those privileges. But abortions are so safe that they rarely result in complications that could lead to hospitalization. As Justice Stephen Breyer wrote in Whole Woman’s Health, one clinic in Texas performed more than 17,000 abortions over a decade, and “not a single one of those patients had to be transferred to a hospital for emergency treatment, much less admitted to the hospital.” Similarly, the Texas law required all abortion clinics to house expensive surgical facilities. But many of Texas’s abortion clinics do not even perform surgeries — they exclusively offer medication abortions where abortion is induced by pills. It should be obvious why, if the Supreme Court had upheld the law at issue in Whole Woman’s Health, that could have been the death knell for abortion rights. If states can enact regulations whose sole purpose is to drive up the cost of performing abortions, they eventually would be able to drive all abortion clinics out of business. Perhaps Texas might have required all abortion clinics to be built out of solid gold. And yet, even in a world of 24-karat surgical centers, the Supreme Court could have claimed that Roe and Casey remain good law. States still would be forbidden from writing a law that states explicitly that “no one may perform an abortion.” But those states would still be free to ban abortion as long as they were sufficiently dishonest about what they were up to. It’s worth noting, moreover, that while Whole Woman’s Health was one of the most closely watched cases involving an attempt to restrict abortions through deceptive means, it was hardly a unique case. Abortion opponents both on and off the Court have proposed a raft of limits on abortion rights — ranging from limiting who is allowed to sue in order to challenge an abortion restriction to requiring each individual person who wants an abortion to file their own lawsuit in order to obtain one — that would nominally leave Roe and Casey in place while potentially rendering them unenforceable. Yet, with Kennedy gone and Republican appointees controlling a supermajority of the seats on the Court, it’s far from clear that abortion opponents still need to engage in such subterfuge. The Supreme Court could still decide to gut Roe in a dishonest way Although Mississippi’s lawyers are betting that they have five votes to explicitly overrule Roe and Casey, it’s possible that the Court will fall back on the strategy advanced by abortion opponents in cases like Whole Woman’s Health. Perhaps some members of the Court’s GOP-appointed majority will fear that a decision explicitly overruling Roe will inspire more Democrats to vote in future elections. Or maybe some members of the Court want to maintain the illusion of continuity within the law. I don’t know what the Court will do in Dobbs and neither does anyone else. But it’s important to note that, even if the Court does not take Mississippi up on its invitation to openly and honestly abolish the right to an abortion, that doesn’t mean that abortion rights are safe — or even that any vestige of them will still exist. Indeed, while Mississippi’s lawyers devote the bulk of their brief to their argument that Roe should be overruled, they do spend a few pages at the end creating a fallback argument — that the Court should “reject any rule barring a State from prohibiting elective abortions before viability.” Ever since Roe, the Court has held that the state may impose stricter restrictions on abortions later in pregnancy than it can early in the fetus’s development. Roe divided pregnancy up into trimesters, permitting greater regulation of abortion in the latter two-thirds of the pregnancy. Casey abandoned this framework to focus on “viability,” giving the government broader authority over abortion once a fetus can survive outside of the womb. If the Court permits states to impose the same kind of restrictions on pre-viability abortions that those states may currently impose on post-viability abortions, that would severely hobble abortion rights and allow states to forbid most abortions — even if the Court does not explicitly overrule Roe or Casey. The point, in other words, is that abortion rights are still in very grave danger, even if the Court pretends to keep Roe or Casey alive.vox.com