Liz

Mouse embryos recently generated from stem cells in a lab show more brain development than any synthetic mouse embryos created previously.  

While other researchers had created mouse embryos from stem cells, none had reached the point where the entire brain, including the anterior portion at the front, began to develop, according to the researchers from the University of Cambridge and the California Institute of Technology.

The findings, described in a paper in Nature today, could help scientists learn more about how human embryos develop and provide insights into diseases, as well as providing an alternative to animals for testing.

The new model embryos, which bypass the need for sperm or egg cells, were developed in the lab alongside natural mouse embryos. They mirrored the same stages of development up to eight and a half days after fertilization, developing beating hearts and other foundations of organs, including the neural tubes that eventually turn into the brain and spinal cord.

“I think it’s a major advance,” says Leonardo Beccari from the Center for Molecular Biology Severo Ochoa, in Madrid, who was not involved in the research.

Studying how mouse stem cells interact at this point in development could also provide valuable insight into why human pregnancies fail during the earliest stages, and how to prevent that from happening.

“This is really the first demonstration of the forebrain in any models of embryonic development, and that’s been a holy grail for the field,” says David Glover, research professor of biology and biological engineering at Caltech, a coauthor of the report.

Stem cells are able to develop into specialized cells, including muscle, brain, or blood cells. The synthetic embryos were made of three types of cells from mice: embryonic stem cells, which form the body; trophoblast stem cells, which develop into the placenta; and extraembryonic endoderm stem cells, which help to form the egg sac. 

The embryos were developed in an artificial incubator created by Jacob Hanna of the Weizmann Institute in Israel, who recently kept realistic-looking mouse embryos growing in a mechanical womb for several days until they developed beating hearts, flowing blood, and cranial folds. Hanna is also a coauthor of the new study.

By mimicking the natural processes of how a mouse embryo would form inside a uterus, the researchers were able to guide the cells into interacting with each other, causing them to self-organize into structures that progressed through developmental stages to the point where they had beating hearts and foundations for the entire brain.  

The team also removed a gene called Pax6, which is essential for the formation of the central nervous system and brain and eye development, to test how the model embryos would react. The synthetic models went on to exhibit the same known defects in brain development as a natural animal carrying the mutation. Next, the researchers are interested in knocking out genes with unknown functions in brain development, which could shed light on the cause of some defects.

Human model embryos could play a significant role in helping scientists understand why certain gene mutations happen, and they could help in testing potential treatment for a range of disorders.

While the synthetic embryos were able to reach the same developmental stage as the natural mouse embryos, they stopped growing around halfway through a typical mouse pregnancy period of 19 to 20 days, and they failed to develop past the eighth day. Hanna’s lab experienced the same problem, and the researchers don’t yet understand why. 

The researchers are already working on a synthetic placenta-like structure that they hope will allow the synthetic embryos to continue growing one or two days past the eight-day mark. 

Pushing past that point will be very important for developing new drugs and establishing which drugs are compatible with natural development, says Magdalena Zernicka-Goetz, a professor in mammalian development and stem cell biology in Cambridge’s Department of Physiology, Development, and Neuroscience, who led the research. Her research into artificial embryos was named one of MIT Technology Review’s 10 breakthrough technologies in 2018.

On a cold, dry Tuesday in December, 1940, Rita Levi-Montalcini rode a train from the station near her home in Turin, Italy, for 80 miles to Milan to buy a microscope. Milan had not seen bombings for months. On her return to the Turin train station, two police officers stopped her and demanded to see inside the cake-sized box that she was carrying. With wartime food rationing, panettone cakes were only available illegally. The officers found her new microscope instead. They let her go. Just a week after her trip, British bombers hit Milan.

Levi-Montalcini was a 31-year-old scientist who had been working at the University of Turin. Despite her father’s disapproval, she had trained in medicine, inspired by seeing a nanny succumb to cancer. In 1938, the Italian dictator Mussolini banned Jews from positions in universities. Levi-Montalcini was not raised in the Jewish religion, but her Jewish ancestry would have been evident from her surname. Mussolini’s ban had pushed Levi-Montalcini to leave Italy for Belgium in 1939, where she did research using fertilized chicken eggs as a source of material for her research topic: the developing nervous systems of vertebrate embryos. Levi-Montalcini also spent time with her older sister Nina, whose family was in Belgium as well. Rita wrote home to her mother of an “infinite desire to embrace you again,” but research at the university in Turin would have been impossible had she returned home. Her passion for research alternated with her frustration with challenges. When Hitler invaded Poland in September, launching war, her worst frustrations were realized. The “whole world was in danger,” Levi-Montalcini later wrote. In December 1939, she returned to Italy.

TAKE SHELTER: Author Bob Goldstein traces the steps that Rita Levi-Montalcini and her family took during WWII in Turin, Italy. As bombs fell, they fled into the cellar beneath their apartment building. Levi-Montalcini often brought her microscope and precious glass slides with her.Florian Jug

Levi-Montalcini moved in with her mother, her twin sister Paola, who was an artist, and her architect brother Gino, in her childhood home. The apartment, in the center of Turin, was large, with 10 rooms, including a bedroom for each family member and a common living room. Some of the rooms faced into the apartment building’s common courtyard. There was little for Levi-Montalcini and her family to do outside of the apartment; Mussolini’s laws restricted Jews from most jobs and schools and threatened to confiscate Jewish-owned property. A fascist manifesto asserted that Jews do not belong to the Italian race, and declared, contrary to popular sentiment in Italy, “It is time that Italians proclaim themselves genuinely racist.” In June 1940, Mussolini joined Hitler by declaring war on France and Great Britain, and Britain responded with nighttime aerial bombings of Italy through summer and fall, focused on Turin and other industrial cities. The city was dark each night as a blackout was enforced across Italy. No lights were permitted to be visible from homes or shops.

Levi-Montalcini responded to the tumult by transforming her bedroom into her own research lab. The bedroom was long and narrow, and opposite its entrance was a window, which overlooked the courtyard. In front of the window, she placed a table for opening eggs and a simple microscope for operating on the embryos. Near her bed she placed the more elaborate microscope that she carried from Milan, a new model with two eyepieces so she could look into it with both eyes. It was equipped with a camera, and a device with mirrors that would allow her to see both microscopic detail and her own hand next to the microscope at the same time, so she could trace on paper the tiny nerve cells that she viewed. The bed was against one of the long walls, and at the opposite wall she put shelves, on which sat a heater for melting wax, and an egg incubator that her brother built with a thermostat and a fan. She could embed embryos in the melted wax which, once hardened, she would cut into paper-thin slivers, so that she could view nerve cells in the slices in the microscope from Milan. The experiments “absorbed her completely,” she later recalled, satisfying a childhood dream to explore unknown places, in this case the “jungle” of the nervous system.

I sought to walk in Rita Levi-Montalcini’s footsteps to build a clearer sense of what life was like for her.

Today, few people—even very few scientists—know what it was that Levi-Montalcini uncovered in her bedroom lab in Turin. Textbooks cite her courage but rarely her wartime discoveries, which are usually credited to others. Levi-Montalcini earned a Nobel Prize for scientific accomplishments that she made after the war. But when she died in 2012, at age 103, she left behind only a little writing about her experiences during the war, along with some rarely read technical articles from the time, published in Italian and French.

I had read Levi-Montalcini’s autobiography, In Praise of Imperfection, but it divulged little about her research during the war or about what she experienced at the time. I found her research articles from the time and began to translate them to English, to pore through the details of her discoveries. In 2018, on a work trip to nearby Switzerland, I contacted Levi-Montalcini’s closest living relative—her niece Piera Levi-Montalcini—who agreed to meet with me and talk. I sought to walk in Rita Levi-Montalcini’s footsteps in Italy to build a clearer sense of what life was like for her when she was making discoveries in the midst of a war.

As I reconstructed her experiences, her research articles from the war revealed to me that the experiments from her bedroom were more pivotal than I’d expected based on textbooks. Levi-Montalcini’s wartime experiments asked something fundamental. How do our billions of nerve cells wire up so precisely inside our bodies? Her bedroom discoveries charted a new course for humankind’s understanding of how our nerves connect, allowing us to walk and see and feel.

When you were an embryo, nerve cells shaped like long, thin wires snaked throughout your body, connecting your brain and spinal cord to many targets—to the muscles that each nerve cell will control, for example. Imagine your body as a house under construction, but where the wires grow themselves out from the central circuit box, winding through the walls, and connecting to each outlet, appliance, and light bulb. A human body is more complex than a house, so you’ll need to imagine a house with not dozens of wires, but billions. How can each wire locate each target, making accurate connections in your body—billions of accurate connections—and all while your tiny fetal body is growing and changing shape? Getting wires to connect to all these targets is a formidable task. And miswiring can lead to paralysis. There are birth defects in which babies are born permanently unable to smile, or to walk, because certain nerve cells fail to connect to targets.

Levi-Montalcini had a lifelong obsession with understanding how our nervous system develops. And, in the summer of 1940, she had what she called her “conversion.” She was reading an article by Viktor Hamburger, a German working in the United States exploring how nerve cells develop. She read the article as she sat on the floor of an open train car moving slowly through the countryside, enjoying a backdrop of yellowing corn plants and bright red poppies.

Hamburger’s article described his experiments aimed at understanding how nerve cells connect accurately. Hamburger’s goal in the experiments was to remove some targets­—the muscles that some nerve cells would wire up to the brain­—to learn whether nerve cells grow differently if deprived of targets. He did his work in chicken eggs—nerves in chicken embryos develop much as they do in humans, and using eggs ensured a plentiful source of material for his experiments.

Today very few scientists know what it was that Levi-Montalcini uncovered in her bedroom lab in Turin.

Hamburger described carefully cutting a window in an eggshell at a stage when the chick embryo inside was only about the size and shape of a typed letter “f,” but translucent and nearly invisible on the surface of the yolk. Near the middle of the “f” were two bumps that would normally grow to become wings, at least in fertilized chicken eggs that are not eaten. Hamburger used a glass needle under a microscope to remove one bump—the wing bud on the right side. And about five days after the operation, he examined nine eggs to see the effect of depriving the nerve cells of their targets. He saw that in each egg, the normal wing bud on the left side had grown to a few millimeters long, and nerve cells had grown out to it as expected. But on the right side, where he had removed the wing bud, the nerve cells were missing.

Hamburger surmised that in the absence of targets, the nerve cells had never formed. He speculated that normally, the target muscles must somehow send a signal that can induce other cells to become nerve cells, or perhaps cause young nerve cells to divide, making more nerve cells. In the article he noted a long line of earlier researchers whose experiments or observations of birth defects—in humans or animals—revealed that the number of nerve cells would match roughly the number of targets. Loss of a limb would result in fewer nerve cells found nearby. And increasing the target population would result in more nerve cells nearby. Hamburger’s interpretation suggested a simple solution to how this match was made: Each muscle somehow turns other cells nearby into nerve cells, guaranteeing that a population of nerve cells would be available locally to connect to each muscle.

Levi-Montalcini was struck by the clarity of Hamburger’s writing. By this stage she had trained in Turin with the famous neurobiologist Giuseppe Levi (who only coincidentally shared a surname with her), worked in Belgian labs, and published nine scientific articles reporting new discoveries. She had worked with chick embryos, with mice, and with microsurgery, and she had observed detailed nerve and muscle anatomy. She was an experienced researcher who was well equipped to take some next steps to understand how nerve cells make accurate connections to their targets.

THE STREET WHERE SHE LIVED: A destroyed apartment building, in 1942, in Turin, Italy, where Rita Levi-Montalcini lived during WWII. On some nights during the war, nearly 200 planes flew over the city, dropping hundreds of tons of bombs.© Archivio Storico della Città di Torino

After the aerial bombings began in 1940, Levi-Montalcini could work all day in her bedroom lab. At night, when sirens announced incoming warplanes, Levi-Montalcini and her family would hurry out of their apartment, down a set of stairs, and then across the courtyard to another set of stairs that led to cellars. Levi-Montalcini would bring her microscope and precious glass slides with her. Families would wait for hours in the cellars and hope they would not be buried in rubble.

Levi-Montalcini must have left the apartment frequently to buy chicken eggs for the experiments, at times likely walking among bomb rubble. She repeated the experiment that Hamburger had described, removing a tiny limb bud from each chicken embryo and examining the effect on nerve cells later. Hamburger had used a glass needle to cut out the tiny limb bud; in place of a glass needle, Levi-Montalcini used an ordinary sewing needle that she had sharpened. But Levi-Montalcini also decided to do something new: To see how the embryos developed, she examined the results of the operation each day after removing the limb bud. This required embedding one embryo in wax each day, then slicing the wax, observing the slices on glass slides under the microscope, and counting thousands of nerve cells. Her patience with the experiments would allow her to see how development proceeded little by little after removing a limb bud—like watching a movie made from individual frames—instead of seeing only a single moment in time as others had before her. She also used a silver stain and a blue dye to see the nerve cells more clearly than before, allowing her to distinguish young nerve cells from fully formed ones. And she used a red dye that could highlight dividing cells. She recorded counts of thousands of nerve cells nearly every day from 2 to 19 days after removing a limb bud.

In August, 1941, Levi-Montalcini’s mentor Giuseppe Levi joined her and began to assist with her experiments. Levi had moved to Belgium too and had been working alone in an empty Belgian institute for a year after the Germans invaded. He arrived thin and pale after a difficult trip across Germany. Levi-Montalcini’s bedroom lab became a meeting place where Levi’s friends and former students would visit and talk about the events in the news.

In the chicken embryos, Levi-Montalcini saw what Hamburger had seen about five days after the operation: There were fewer nerve cells on the side of the embryo where the limb bud had been removed. But following this day-by-day revealed to Levi-Montalcini something unexpected.

For the first two days after removing a limb bud, the areas where nerve cells would form looked surprisingly similar on both sides of the embryo. Nerve cells did not fail to form—they were forming in the thousands on both the normal side and the operated side. On the third day after the operation, nerve cells continued to form: Levi-Montalcini saw dividing cells on both sides. Young nerve cells had accumulated as well as more fully formed ones. Only then did she begin to notice slightly fewer of the fully formed nerve cells on the operated side. Peering in the tiny wax slices at embryos on each successive day made clear that nerve cells continued to form after removing a limb bud. But then soon after forming and extending out toward targets, the nerve cells that were deprived of targets would disappear. Only nerve cells that contacted nearby targets, like in the skin along the back, remained.

How were the nerve cells disappearing? In her bedroom lab, Levi-Montalcini saw something that other scientists had not predicted. The nerve cells deprived of targets appeared to be dying after reaching toward targets in vain. In the areas where nerve cells were disappearing, Levi-Montalcini could see signs of nerve cell death—she reported abnormally “conglutinated” masses of nerve cell fibers, and a shrunken nucleus in many of the cells. Dying nerve cells had been described in animal embryos before by others, but what Levi-Montalcini saw was the first sign that nerve cells would die specifically when they lacked targets. Imagine removing a light bulb from a house under construction, and watching as wires snaked through the walls, reaching everywhere—but then shriveling up specifically where they failed to find the missing bulb.

Textbooks nearly always credit what Levi-Montalcini discovered during the war to other scientists.

Levi-Montalcini sent the results for publication in a scientific journal in Belgium—Jewish scientists were barred from publishing in Italian journals. In the article, published in French in 1942, she and Levi reported the discovery: Nerve cells that were deprived of targets formed normally, but then disappeared. Near the end of the article was a promise to better document how exactly the cells were disappearing: “We propose to do this in a more detailed presentation and with more documented results.” But British bombings of Turin intensified that fall. In hindsight, there was no guarantee that Levi-Montalcini or her bedroom lab would have survived to fulfill her promise.

Levi-Montalcini continued to observe her sectioned embryos, in essence replaying the film of nerve cells disappearing but looking more closely at the details of the disappearance. After documenting for herself what she saw, she prepared an article in Italian for a Vatican journal, again evading the ban on publishing in Italian journals. As the earlier article had promised, this one was indeed packed with detail—descriptions of a microscopic world of nerve cells in the throes of death before they vanished near where their targets had been removed. Granules organized in neat stripes had disappeared from the insides of dying cells, and the shrinking nucleus of each dying cell had material that was abnormally organized inside, surrounded at times by only “a thin and pale cytoplasmic veil.” Levi-Montalcini described the details of death in all sorts of nerve cells that are common to chicken or human embryos, from nerve cells that convey to our brains what our extremities feel, to others that allow our toes to move. The research article had 45 pages of detail, including seven pages of photographs and drawings. If there was some doubt left after the earlier paper that nerve cells deprived of targets would die, this next article had settled it.

These two articles charted a new course for understanding how our nervous system is shaped. Cell death sculpts our nervous system: Our brain becomes wired to our body so precisely in large part because those nerve cells that fail to find targets simply die.

In October, 1942, the nighttime bombings of Turin resumed after a seven-month lull. One Thursday night, sirens started near 9 p.m. and sounded for more than three hours, as bombs fell from British planes heading southeast to a coastal city. The next night, the sirens started just after 10 p.m., sounding for more than two hours. The bombings intensified in November. On some nights, nearly 200 planes flew over Turin, dropping hundreds of tons of bombs. Bombs and devices to start fires hit industrial sites, homes, theaters, and hospitals. Hundreds of Turin residents were killed. A Turin resident described in his diary seeing in the mornings the “astonished, amazed faces of the people who wander the streets” surveying the damage from the night before. The strategy of hiding in cellars was abandoned for many citizens of Turin, as they began to evacuate the city en masse. Levi-Montalcini and her family moved to a family farmhouse in the countryside, near the town of Asti.

It was a bright Saturday in April, 2018, when I arrived in Turin. I made my way to a boulevard shaded by horse chestnut trees vying for height and grandeur with ornate, five-story apartments. I admired the carvings on the 12-foot-tall wooden doors. This was Rita Levi-Montalcini’s apartment building. I pushed on the doors, but they were locked. Behind them was the courtyard that was Levi-Montalcini’s view from her window. A woman with her son walked out of the front of the building. After some hesitation, she let me walk back in with them. I passed through a short, covered walkway to the grassy courtyard, which was surrounded by five floors of windows and doors and narrow balconies. The woman had met Levi-Montalcini before, “many times,” she said with a smile. She was Levi-Montalcini’s grand-niece—the daughter of Piera. In a café behind the apartment, I found stairs that led to the cellars where families would hide during the bombings. The cellars were apparently unchanged since the war. I walked on dry dirt and scattered rocks along a narrow passageway of roughly mortared brick walls and old wooden doors, each with a hand-painted number and a small window of metal mesh.

The next day, I drove to Asti, an hour away. I checked into a hotel and walked through town past medieval churches and busy outdoor cafes. On the following day, Gino Montalcini—a cousin of Piera’s who now owns the farmhouse where Levi-Montalcini and her family went in 1942—took me in his car out of the center of town, to the top of a nearby ridge where the house sits. I met Piera, and Gino’s wife, Anna.

PICTURE OF NERVES: Rita Levi-Montalcini took this photo of nerve cells under a microscope she bought on a dangerous trip to Milan during the war. She also illustrated the nerve cells. Her illustrations surround the portrait of her at the top of this article.Rita Levi-Montalcini

Piera, who was Rita’s frequent travel companion late in Rita’s life, bore some resemblance to the Rita I’d seen in photos. They shared an upswept, styled volume of white hair. Piera also shared some of the unconcerned confidence that Levi-Montalcini had while working in a male-dominated field. Piera was an electrical engineer. “If you just walk your own way and you are brave enough—I mean, reckless enough— they look at you as if you were an alien, so they stay away from you,” Piera said with a smile. When she was choosing a career path in the 1960s, Piera visited Rita, who at the time had a lab in Rome. She recalled Levi-Montalcini’s thin hands, the chick embryos, and seeing one of the needles that Levi-Montalcini used, “They appear enormous when viewed through the microscope!”

Behind the house sat a green lawn shaded by a row of linden trees. From the lawn I could see the town below, and the tracks on which the trains came from Turin. Asti was not a frequent target for bombings when Levi-Montalcini was there, but sirens announced British warplane flyovers. A mid-July 1943 nighttime bombing in town probably would have been visible from the house.

I walked to a high spot on a corner of the property, and Gino Montalcini pointed along a path toward a neighbor’s house where Levi-Montalcini stayed when the farmhouse was filled with the extended family. Levi-Montalcini would have walked to the farmhouse each morning along the path, past grape vines, a few cows, goats, and sheep, and some chickens. She relocated her microscope and the other lab equipment from Turin in front of a window in a corner of the dining room. Here she worked through the fall of 1943, when it became unsafe.

I asked how Levi-Montalcini maintained her focus during war. Her niece said she “kept working to survive.”

We went inside and sat down in the dining room. We were just an arm’s length from where Levi-Montalcini would have sat at her microscope. Piera told us, “I think of all the things we often did together. I have memories of the places we’ve been together, the things she would tell me about her life. When she was traveling with me, she knew that I would listen if she wanted to talk, and that if she didn’t feel like talking, she just didn’t have to.” Piera smiled and recalled that Rita would tell her, “‘You’ve always been my best travel companion.’ Because I didn’t bother her, basically.”

I asked Piera how she thought that Levi-Montalcini could have maintained her focus on research in the midst of a war, studying cell death while in real danger of her own death. She said that Levi-Montalcini “kept working to survive, to cope with that weird life of people who didn’t exist. Because they had been erased everywhere.”

Piera recently discovered the letters that Rita and her sister Nina had sent home from Belgium in 1939 soon after the war had begun, while they had waited for visas to return home. The letters elaborate on how Rita maintained her focus on research as a war began around her, describing the escape from despair that her research offered as the war began. Rita wrote, “I am amazed at the complete possibility of escaping to the present, diving into the marvelous charms of nerve conduction.” Nina added in the margins that her younger sister Rita, “here reading next to me … is so well … she is so animated for her studies.”

Back home, in my lab at the University of North Carolina at Chapel Hill, I searched for any signs in Levi-Montalcini’s wartime research articles that the experiments took place in a bedroom. As was typical in scientific articles, the writing focused tightly on the experiments and their results. Levi-Montalcini didn’t mention her home, or the sewing needle that she had used for microsurgery. I could find only one cryptic clue, in the 1942 article, that the site of the work might have been atypical. Every other scientific article in the 1942 volume included the name of the institute where the work was performed. “University of Brussels, Laboratory of Embryology of the Faculty of Medicine.” “University of Liege, Laboratory of Histology.” Levi-Montalcini’s article listed just one word for the address, “Turin.” No institute. I wondered if scientists reading the article in 1942 might have noticed the peculiar omission.

Viktor Hamburger saw the 1942 article after the war ended. Levi-Montalcini’s results confirmed to Hamburger what he had seen earlier—that targets could affect how many nerve cells would be nearby. But they also showed that Hamburger’s speculations about how this worked were wrong. He invited her to come to the United States to continue the experiments in his lab at Washington University in St. Louis. There, Levi-Montalcini discovered that even in normal, unoperated embryos, many nerve cells die where they lack targets—for example in the areas where no limbs form. And the nerve cells that would die in normal embryos could be rescued—they would survive if targets were added nearby, confirming that even in normal development, many nerve cells form but die because they lack targets. Hamburger was clear about his own limited role in this work. He contributed his thoughts and his enthusiasm for Levi-Montalcini’s results, but, as he reported later, “the experiments and observations on the slides were done by Dr. Levi-Montalcini.” And he accepted that the results proved him wrong. “It was a regressive process rather than a progressive process as I had guessed, wrongly,” he reported in an interview. Levi-Montalcini recalled later what she called one of Hamburger’s finest traits, his “whole-hearted joy over fortunate turns in a colleague’s or pupil’s research.”

In the warm evenings of summer 1948, Levi-Montalcini would share dinner with Hamburger and his aged father, and then sit at a table under the porch in St. Louis as they wrote an article describing the results. Levi-Montalcini had published more than 20 research articles by this time, but none in English. That summer, she wrote of her pleasure of re-experiencing the clear thinking in Hamburger’s writing years earlier. Just a mile from where they met in the evenings of summer, 1948, Levi-Montalcini now has a star on the sidewalk in the St. Louis Walk of Fame, along with Chuck Berry, Stan Musial, Maya Angelou, and others.

Levi-Montalcini’s experiments in the 1940s revealed that our brain and spinal cord manage to make connections all over our body because our embryonic bodies become densely filled with an excess of nerve cells—about a twofold excess, scientists now estimate. Those nerve cells that make accurate connections are afforded the privilege of survival. The rest die. The process seems remarkably inefficient, but it is remarkably robust: Birth defects where connections are not made are rare. Even if you were born with an extra body part, it would almost certainly become wired up to your brain. Indeed, people born with an extra finger or toe can generally attest to this: Their brains can move the extra part, and feel using it. And vertebrate animals of all different sizes and shapes no doubt have nervous systems that fit their bodies in large part because of this process. Levi-Montalcini’s bedroom discoveries were the turning point in humankind’s understanding that our nervous system is minutely shaped by death. Cell death is not alone in shaping the nervous system—later scientists discovered that other processes make important contributions as well. And cell death has more complex roles than had been revealed by the end of the 1940s. But Levi-Montalcini’s experiments established a fundamental finding about how our nervous system is shaped.

Nearly every textbook today on the development of the nervous system has a chapter on cell death’s prominent role in wiring our bodies. Some of them note Levi-Montalcini’s courage for doing experiments in a homemade lab during the war. What she discovered in the war, though, is today nearly always credited to other scientists. One book credits a scientist working in the 1930s, who did not report on cell death at all. Others credit Hamburger. Some cite Levi-Montalcini only for guessing that nerve cells lacking targets might die, crediting Hamburger and Levi-Montalcini working together in 1949 to first show it definitively—years after Levi-Montalcini had shown it in the articles she wrote from her bedroom lab. It perhaps did not help that Hamburger and Levi-Montalcini themselves had muddied the history of the discoveries over the years. They each lived beyond their 100th birthdays, and both made statements about their roles at times, particularly late in their lives, that did not precisely match the published record.

I contacted scientists who wrote the textbooks to ensure I had my facts straight. Dale Purves, author of the book Body and Brain, told me that he had never read Levi-Montalcini’s wartime research articles. Dan Sanes, who co-wrote the textbook Development of the Nervous System, said the same. Lynne Bianchi, Bill Harris, David Price—none of the textbook writers I reached had read the articles. I find it hard to place blame, really. English has become the international language of science in recent decades, even at international conferences, and the wartime articles were published in Italian and French. My translations benefitted from Google Translate, which improved after the textbooks were first written. And textbooks cover a lot of ground—thousands of research papers. “You know there’s only so many hours,” Price explained, adding an invitation to correct the record. “I’d love to get it right in my head. And then in the book.”

I offered to share the translations of Levi-Montalcini’s wartime papers with the writers. And based on the translations, it was clear to me that among a muddied record was a detailed historical article by another scientist, Maxwell Cowan, who had read each of the papers and who had the facts straight. I shared that article as well. Some of the writers reached back to say they were already drafting corrections for the next edition of their textbook. Their responses reminded me of Hamburger’s enthusiasm about Levi-Montalcini disproving his own hypotheses. When new facts came to light, he accepted them. Purves, who knew Hamburger, said about Levi-Montalcini’s wartime science, “These were remarkable times, and she was a remarkably resilient person.”

From the time Levi-Montalcini arrived at Washington University, she continued to build on her research during the war: how target tissues like muscles talk to nerve cells, enabling the survival of only those nerve cells that find targets. That led to her co-discovery with Stanley Cohen of Nerve Growth Factor—a molecule that nerve cells take up from target tissues and that enables the nerve cells to survive. Nerve Growth Factor was the first of several growth factors discovered by scientists, and these factors are now known to have critical roles in nervous system wiring and also in cancer. In 1986, Levi-Montalcini and Cohen were awarded the Nobel Prize in Physiology or Medicine for their discovery of growth factors.

Throughout her life, Levi-Montalcini denied that she had experienced discrimination as a woman in science. Her colleagues, though, recall her fiercely defending her own role in her discoveries. After the Nobel Prize, she established a foundation to provide scholarships to African women, and she was made a Senator for Life in the Italian Parliament in 2001. Fifty years after her 1942 article reporting experiments from the bedroom in Turin, she reflected on how she managed to focus on her research in the midst of a war, “when all the values I cherished were being crushed.” She wrote, “The answer may be found in the well-known refusal of human beings to accept reality at its face value, whether it be the fate of an individual, of a country, or of the whole of human society. Without this built-in defense mechanism, life would be unbearable.”

Bob Goldstein heads a biology research lab at the University of North Carolina at Chapel Hill.

Lead collage: Tasnuva Elahi; photo by AP Images; tracings of nerve cells by Rita Levi-Montalcini, made in her home lab.

This article first appeared online in our “Change” issue in December, 2021.

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Albatrosses do not fall in love the way humans do.

When the birds couple up, it’s almost always for keeps. Their lives start lonely—albatross parents lay only one egg at a time, and may leave their offspring unattended for days—and at just a few months old, each juvenile embarks on an epic solo voyage at sea. They fly for months and months and months, learning what it is to be a bird. “It can be three years before you see them again,” Francesco Ventura, a bird biologist at the University of Lisbon, told me.

The adolescent albatrosses return to their colony single and ready to mingle. They touch down, find a group of like-minded individuals, and start to dance. At first, “it’s kind of like being at a club,” Melinda Conners, a bird biologist at Stony Brook University, told me. The young hopefuls are seeking a partner that’s both sexy and in sync with their own moves. Some species will sashay and shimmy and shriek; others are more muted, satisfied to simply bow and nod, and click and clack their beaks together. They are all fumbling at first, wee babes at the dating game—exuberant, but “doing it all wrong,” Conners said.

The birds ultimately find their rhythm. Over the years, the mosh pits get smaller, the duets more intimate, until they each stop dancing with all partners but one. This is their perma-mate, their ride or die, their forever bae; once albatrosses unite, they almost never break up. Year after year, albatrosses fly out to sea alone. And year after year, they return to the same partner to breed, sometimes raising dozens of chicks together, until one of the duo dies at the end of a decades-long life. When Ventura and his colleagues visit black-browed-albatross populations in the South Atlantic Falklands, for instance, they regularly tabulate “divorce” rates below 4 percent, sometimes near zero.

That’s true, at least, when times are good. But during certain years, the separations seem to intensify, leaving more birds than usual stranded in the doldrums of singlehood, unable to reproduce. Fluctuating environmental conditions—likely a symptom of climate change—may be the culprit.

[Read: Long live the albatross]

Ventura, who has been watching albatrosses for years, worries about heightened divorce rates, because the birds benefit so much by engaging in ritualized romance. Hatching and rearing chicks, even just one at a time, is difficult work; parents must take turns leaving the nest to forage for food, sometimes for weeks-long stints, while the other remains on the nest, fasting, guarding, waiting. “The whole breeding season is this carefully timed partnership,” Nina Karnovsky, a bird biologist at Pomona College, told me. Enduring bonds translate into better communication, better coordination, even a sort of trust. The two birds entwine their behaviors so intimately that, somehow, after spending most of the year soaring solo above the ocean, they manage to return to the same nesting spot to breed, at almost exactly the same time. The birds will have extra-pair copulations—that is, cheat—but their modus operandi is monogamy. They know to cling to the relationship that counts.

Under typical circumstances, only a handful of couples will ever truly call it quits. When albatross bonds do break, Ventura told me, it’s almost always a strategy the birds use to “correct for suboptimal partnerships” that keep resulting in breeding failures—eggs that never hatch, or chicks that never fledge. Finally fed up, one bird, usually the female, simply peaces out to find better prospects.

If the original dalliance was a dud, many females will improve their reproductive success after they rewed. But while poring over data gathered during the past two decades, Ventura and his colleagues have started to notice a troubling trend. Some of the albatross couples on New Island, in the Falklands, seem to be divorcing unnecessarily, severing their ties even when everything about them seems to mesh. In many cases, Ventura told me, the birds are probably compatible, with many good years and healthy chicks ahead of them. “They should have stayed together,” he told me, and yet, something in the birds’ surroundings is cleaving them apart.

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Albatrosses do not divorce the way humans do.

When the birds head for splitsville, they don’t hire lawyers, and no alimony changes hands. Sometimes they squabble; sometimes the break is quite clean. “We still don’t fully understand why divorce happens in birds,” Antica Culina, a behavioral biologist at the Netherlands Institute of Ecology, told me. But the repercussions can reverberate throughout populations, perhaps even species, if the events are frequent enough. “Divorce means they are starting over,” Karnovsky told me. “They have to go through the whole courtship again, the whole energetically expensive display.” For albatrosses, whose couplings can take years to solidify, that can mean stripping away multiple opportunities to reproduce—a real waste, if nothing was wrong with their initial choice.

According to Ventura’s research, that’s what’s happening on New Island in years when food grows scarce. In 2017, for example, albatross divorce rates more than doubled from the average of 3.7 percent, up to 7.7 percent. That year, the local sea surface was unusually hot, which generally spells trouble for food availability—toasty top layers of water just don’t mix as well with the nutrient-rich ones below. The link between ocean temperatures and divorces has become clear since the mid-aughts, when Ventura’s team first started tracking the birds’ matrimonial success: “In resource-poor years, everybody struggles,” Ventura told me.

Some of the splits can likely be traced back to breeding problems, the best-studied trigger of divorce. A few birds might forage so poorly, for instance, that they actually can’t produce viable offspring, or they simply prioritize their own survival over sex. But Culina notes that Ventura’s study, which she wasn’t involved in, shows that problems in the environment can drive divorce in more subtle ways too. Crummy environmental conditions can make it tough for even the strongest, fastest, sexiest birds to chum up with their mate. They might struggle to sync their schedules; they might each have a much shorter fuse. Even females that have been very reproductively successful seem more likely to divorce a partner during these bad stretches. Ventura describes it as a sort of misguided “partner blaming,” wherein the birds confuse bad conditions for bad mates. “It’s kind of crazy to think about,” said Conners, who wasn’t involved in the study. “Some of these pairs have potentially been raising chicks for decades … and they’re being broken up by things that were entirely out of their hands.”

Researchers rarely see the moment of divorce in real time, though even imagining it is bleak. Karnovsky has seen a version of the split in Adélie penguins, which also take alternating shifts on their nest. Left alone too long, birds will grow hungry and impatient; they fidget and call out, as if worried they’ve been abandoned. “It’s like they’re saying, ‘I’m so hungry, I have to go,’” she told me. Eventually, the birds jump ship, leaving their partnership broken, their eggs unguarded.

On New Island, where some 15,500 black-browed-albatross breeding pairs make their home, the population is thriving; Ventura and his colleagues aren’t yet seeing divorce wreak havoc, even in pretty rough years. But they fear that resilience won’t hold for all populations, especially as the years wear on. Albatrosses around the world have long been threatened, by plastic pollution that chokes them, by long-line fishing vessels that snare the birds on hooks and drown them, by invasive rodents that attack their nests. Warming seas are “yet another human-caused impact” that the birds don’t need, Karnovsky said. As climate change accelerates, these home-wrecking effects could be magnified. “I don’t think the birds will have time to adapt,” Stephanie Jenouvrier, a seabird ecologist at Woods Hole Oceanographic Institution who has been independently tracking the impacts of ocean anomalies on birds, told me.

[Read: Scientists now know why some seabirds eat so much plastic]

What may eventually be lost to climate change goes far beyond a potential dip in avian numbers. For the birds, breakups come with a personal cost: the vanishing of one of the most compelling emotional bonds in the animal kingdom. Albatrosses in matrimonial sync will tenderly preen each other and cuddle in their nest. They will nuzzle their heads together, and doze breast to breast. “They just kind of dote on each other,” Conners told me. “You see them absolutely celebrating when a mate returns” from a trip at sea, hopping up and vocalizing. The ties that bind them are strong. But they might not be strong enough to withstand the changes wrought by an ever-warming world.

The ongoing feral hog problem has now come to affect one of our biggest international pop stars. In a recent post on her Instagram story, Shakira says that she was recently attacked by two wild boars while walking in a Barcelona park with her eight-year-old son.

Illustrations by Kimberly Elliott

This article was published online on August 2, 2021.

The dispossessed set out early in the mornings. They were the outsiders, the scorned, the voiceless. But weekend after weekend—unbowed and undeterred—they rallied together. They didn’t have much going for them in their great battle against the privileged elite, but they did have one thing—their yachts.

During the summer and fall of 2020, a series of boat parades—Trumptillas—cruised American waters in support of Donald Trump. The participants gathered rowdily in great clusters. They festooned their boats with flags—American flags, but also message flags: Don’t Tread on Me, No More Bullshit, images of Trump as Rambo.

The women stood on the foredecks in their red, white, and blue bikinis, raising their Pabst Blue Ribbon tallboys to salute the patriots in nearby boats. The men stood on the control decks projecting the sort of manly toughness you associate with steelworkers, even though these men were more likely to be real-estate agents. They represent a new social phenomenon: the populist regatta. They are doing pretty well but see themselves as the common people, the regular Joes, the overlooked. They didn’t go to fancy colleges, and they detest the mainstream media. “It’s so encouraging to see so many people just coming together in a spontaneous parade of patriotism,” Bobi Kreumberg, who attended a Trumptilla in Palm Beach, Florida, told a reporter from WPTV.

You can see this phenomenon outside the United States too. In France, the anthropologist Nicolas Chemla calls this social type the “boubours,” the boorish bourgeoisie. If the elite bourgeois bohemians—the bobos—tend to have progressive values and metropolitan tastes, the boubours go out of their way to shock them with nativism, nationalism, and a willful lack of tact. Boubour leaders span the Western world: Trump in the U.S., Boris Johnson in the United Kingdom, Marine Le Pen in France, Viktor Orbán in Hungary, Matteo Salvini in Italy.

[Anne Applebaum: Democracy is surprisingly easy to undermine]

How could people with high-end powerboats possibly think of themselves as the downtrodden? The truth is, they are not totally crazy. The class structure of Western society has gotten scrambled over the past few decades. It used to be straightforward: You had the rich, who joined country clubs and voted Republican; the working class, who toiled in the factories and voted Democratic; and, in between, the mass suburban middle class. We had a clear idea of what class conflict, when it came, would look like—members of the working classes would align with progressive intellectuals to take on the capitalist elite.

But somehow when the class conflict came, in 2015 and 2016, it didn’t look anything like that. Suddenly, conservative parties across the West—the former champions of the landed aristocracy—portrayed themselves as the warriors for the working class. And left-wing parties—once vehicles for proletarian revolt—were attacked as captives of the super-educated urban elite. These days, your education level and political values are as important in defining your class status as your income is. Because of this, the U.S. has polarized into two separate class hierarchies—one red and one blue. Classes struggle not only up and down, against the richer and poorer groups on their own ladder, but against their partisan opposite across the ideological divide.

In June of last year, a Trump regatta was held in Ferrysburg, Michigan. A reporter from WOOD spoke with one of the boaters, a guy in a white T-shirt, a MAGA hat, and a modest fishing boat. “We are always labeled as racists and bigots,” he said. “There’s a lot of Americans that love Donald Trump, but we don’t have the platforms that the Democrats do, including Big Tech. So we have to do this.”

On a bridge overlooking the parade stood an anti-Trump protester, a young man in a black T-shirt carrying an abolish ice sign. “They use inductive reasoning rather than deduction,” he told the reporter, looking out at the pro-Trump boaters. “They only seek information that gives evidence to their presuppositions.” So who’s of a higher social class? The guy in the boat, or the kid with the fancy words?

The Rise of a Countercultural Elite

In 1983, a literary historian named Paul Fussell wrote a book called Class: A Guide Through the American Status System. Most of the book is a caustic and extravagantly snobby tour through the class markers prevalent at the time. After ridiculing every other class, Fussell describes what he called “X people.” These were people just like Fussell: highly educated, curious, ironic, wittily countercultural. X people tend to underdress for social occasions, Fussell wrote. They know the best wine stores and delis. They have risen above the muck of mainstream culture to a higher, hipper sensibility. The chapter about X people was insufferably self-regarding, but Fussell was onto something. Every once in a while, in times of transformation, a revolutionary class comes along and disrupts old structures, introduces new values, opens up economic and cultural chasms. In the 19th century, it was the bourgeoisie, the capitalist merchant class. In the latter part of the 20th century, as the information economy revved up and the industrial middle class hollowed out, it was X people.

Seventeen years later, I wrote a book about that same class, Bobos in Paradise. The bobos didn’t necessarily come from money, and they were proud of that; they’d secured their places in selective universities and in the job market through drive and intelligence exhibited from an early age, they believed. X types defined themselves as rebels against the staid elite. They were—as the classic Apple commercial had it—“the crazy ones, the misfits, the rebels, the troublemakers.” But by 2000, the information economy and the tech boom were showering the highly educated with cash. They had to find ways of spending their gobs of money while showing they didn’t care for material things. So they developed an elaborate code of financial correctness to display their superior sensibility. Spending lots of money on any room formerly used by the servants was socially defensible: A $7,000 crystal chandelier in the living room was vulgar, but a $10,000, 59-inch AGA stove in the kitchen was acceptable, a sign of your foodie expertise. When it came to aesthetics, smoothness was artificial, but texture was authentic. The new elite distressed their furniture, used refurbished factory floorboards in their great rooms, and wore nubby sweaters made by formerly oppressed peoples from Peru.

Two years later, Richard Florida published The Rise of the Creative Class, which lauded the economic and social benefits that the creative class—by which he meant, more or less, the same scientists, engineers, architects, financiers, lawyers, professors, doctors, executives, and other professionals who make up the bobos—produced. Enormous wealth was being generated by these highly educated people, who could turn new ideas into software, entertainment, retail concepts, and more. If you wanted your city to flourish, he argued, you had to attract these people by stocking the streets with art galleries, restaurant rows, and cultural amenities. Florida used a “Gay Index,” based on the supposition that neighborhoods with a lot of gay men are the sort of tolerant, diverse places to which members of the creative class flock.

[From the October 2013 issue: Richard Florida on the boom towns of the post–Great Recession economy]

Florida was a champion of this class. I looked on them pretty benignly myself. “The educated class is in no danger of becoming a self-contained caste,” I wrote in 2000. “Anybody with the right degree, job, and cultural competencies can join.” That turned out to be one of the most naive sentences I have ever written.

The New Elite Consolidates

Over the past two decades, the rapidly growing economic, cultural, and social power of the bobos has generated a global backlash that is growing more and more vicious, deranged, and apocalyptic. And yet this backlash is not without basis. The bobos—or X people, or the creative class, or whatever you want to call them—have coalesced into an insular, intermarrying Brahmin elite that dominates culture, media, education, and tech. Worse, those of us in this class have had a hard time admitting our power, much less using it responsibly.

First, we’ve come to hoard spots in the competitive meritocracy that produced us. As Elizabeth Currid-Halkett reported in her 2017 book, The Sum of Small Things, affluent parents have increased their share of educational spending by nearly 300 percent since 1996. Partly as a result, the test-score gap between high- and low-income students has grown by 40 to 50 percent. The children of well-off, well-educated meritocrats are thus perfectly situated to predominate at the elite colleges that produced their parents’ social standing in the first place. Roughly 72 percent of students at these colleges come from the richest quarter of families, whereas only 3 percent come from the poorest quarter. A 2017 study found that 38 schools—including Princeton, Yale, Penn, Dartmouth, Colgate, and Middlebury—draw more students from the top 1 percent than from the bottom 60 percent.

[From the September 2019 issue: Daniel Markovits on how meritocracy harms everyone]

Second, we’ve migrated to just a few great wealth-generating metropolises. Fifteen years after The Rise of the Creative Class, Florida published a reconsideration, The New Urban Crisis. Young creative types were indeed clustering in a few zip codes, which produced enormous innovation and wealth along with soaring home values. As Florida noted in that book, from 2007 to 2017, “the population of college-educated young people between the ages of twenty-five and thirty-four grew three times faster in downtown areas than in the suburbs of America’s fifty largest metro areas.”

But this concentration of talent, Florida now argued, meant that a few superstar cities have economically blossomed while everywhere else has languished. The 50 largest metro areas around the world house 7 percent of the world’s population but generate 40 percent of global wealth. Just six metro areas—the San Francisco Bay Area; New York; Boston; Washington, D.C.; San Diego; and London—attract nearly half the high-tech venture capital in the world.

This has also created gaping inequalities within cities, as high housing prices push middle- and lower-class people out. “Over the past decade and a half,” Florida wrote, “nine in ten US metropolitan areas have seen their middle classes shrink. As the middle has been hollowed out, neighborhoods across America are dividing into large areas of concentrated disadvantage and much smaller areas of concentrated affluence.” The large American metro areas most segregated by occupation, he found, are San Jose, San Francisco, Washington, Austin, L.A., and New York.

[From the August 2019 issue: Raj Chetty, the economist who would fix the American dream]

Third, we’ve come to dominate left-wing parties around the world that were formerly vehicles for the working class. We’ve pulled these parties further left on cultural issues (prizing cosmopolitanism and questions of identity) while watering down or reversing traditional Democratic positions on trade and unions. As creative-class people enter left-leaning parties, working-class people tend to leave. Around 1990, nearly a third of Labour members of the British Parliament were from working-class backgrounds; from 2010 to 2015, the proportion wasn’t even one in 10. In 2016, Hillary Clinton won the 50 most-educated counties in America by an average of 26 points—while losing the 50 least-educated counties by an average of 31 points.

These partisan differences overlay economic differences. In 2020, Joe Biden won just 500 or so counties—but together they account for 71 percent of American economic activity, according to the Brookings Institution. Donald Trump won more than 2,500 counties that together generate only 29 percent of that activity. An analysis by Brookings and The Wall Street Journal found that just 13 years ago, Democratic and Republican areas were at near parity on prosperity and income measures. Now they are divergent and getting more so. If Republicans and Democrats talk as though they are living in different realities, it’s because they are.

The creative class has converted cultural attainment into economic privilege and vice versa. It controls what Jonathan Rauch describes in his new book, The Constitution of Knowledge, as the epistemic regime—the massive network of academics and analysts who determine what is true. Most of all, it possesses the power of consecration; it determines what gets recognized and esteemed, and what gets disdained and dismissed. The web, of course, has democratized tastemaking, giving more people access to megaphones. But the setters of elite taste still tend to be graduates of selective universities living in creative-class enclaves. If you feel seen in society, that’s because the creative class sees you; if you feel unseen, that’s because this class does not.

Like any class, the bobos are a collection of varied individuals who tend to share certain taken-for-granted assumptions, schemas, and cultural rules. Members of our class find it natural to leave their hometown to go to college and get a job, whereas people in other classes do not. In study after study, members of our class display more individualistic values, and a more autonomous sense of self, than other classes. Members of the creative class see their career as the defining feature of their identity, and place a high value on intelligence. Usage of the word smart increased fourfold in The New York Times from 1980 to 2000, according to Michael Sandel’s recent book, The Tyranny of Merit—and by 2018 usage had nearly doubled again.

Without even thinking about it, we in the creative class consolidate our class standing through an ingenious code of “openness.” We tend to like open floor plans, casual dress, and eclectic “localist” tastes that are willfully unpretentious. This seems radically egalitarian, because there are no formal hierarchies of taste or social position. But only the most culturally privileged person knows how to navigate a space in which the social rules are mysterious and hidden.

Shamus Rahman Khan is a sociologist who attended and then taught at St. Paul, an elite New England prep school. As the meritocratic creative class displaces the old WASPs, he observes, what the school primarily teaches is no longer upper-crust polish or social etiquette, but “ease”—the knowledge of how to act in open environments where the rules are disguised.

A student who possesses ease can walk into any room and be confident that she can handle whatever situation she finds. She knows how to structure relationships with teachers and other professional superiors so that they are treated both as authority figures and as confidants. A student in possession of ease can comfortably engage the cafeteria workers with a distant friendliness that at once respects social hierarchy and pretends it doesn’t exist. A student with ease knows when irony is appropriate, what historical quotations are overused, how to be unselfconscious in a crowd. These practices, as Khan writes in Privilege, his book about St. Paul, can be absorbed only through long experience within elite social circles and institutions.

[From the June 2018 issue: The birth of the new American aristocracy ]

Openness in manners is matched by openness in cultural tastes. Once upon a time, high culture—the opera, the ballet—had more social status than popular culture. Now social prestige goes to the no-brow—the person with so much cultural capital that he moves between genres and styles, highbrow and lowbrow, with ease.

“Culture is a resource used by elites to recognize one another and distribute opportunities on the basis of the display of appropriate attributes,” Kahn argues. Today’s elite culture, he concludes, “is even more insidious than it had been in the past because today, unlike years ago, the standards are argued not to advantage anyone. The winners don’t have the odds stacked in their favor. They simply have what it takes.”

I wrote Bobos in Paradise in the late Clinton era. The end of history had allegedly arrived; the American model had been vindicated by the resolution of the Cold War. Somehow, we imagined, our class would be different from all the other elites in world history. In fact, we have many of the same vices as those who came before us.

[From the June 2000 issue: An interview with David Brooks about Bobos in Paradise]

I got a lot wrong about the bobos. I didn’t anticipate how aggressively we would move to assert our cultural dominance, the way we would seek to impose elite values through speech and thought codes. I underestimated the way the creative class would successfully raise barriers around itself to protect its economic privilege—not just through schooling, but through zoning regulations that keep home values high, professional-certification structures that keep doctors’ and lawyers’ incomes high while blocking competition from nurses and paralegals, and more. And I underestimated our intolerance of ideological diversity. Over the past five decades, the number of working-class and conservative voices in universities, the mainstream media, and other institutions of elite culture has shrunk to a sprinkling.

When you tell a large chunk of the country that their voices are not worth hearing, they are going to react badly—and they have.

The Reaction

If our old class structure was like a layer cake—rich, middle, and poor—the creative class is like a bowling ball that was dropped from a great height onto that cake. Chunks splattered everywhere. In The Great Class Shift, Thibault Muzergues argues that the creative class has disrupted politics across the Western world. In nation after nation, the rise of the educated metro elite has led the working class to rebel against them. Trump voters listed the media—the epitome of creative-class production—as the biggest threat to America. “The more than 150-year-old alliance between the industrial working class and what one might call the intellectual-cultural Left is over,” observes the Swedish political scientist Bo Rothstein. The working class today vehemently rejects not just the creative class but the epistemic regime that it controls. In revolt, populist Trump voters sometimes create their own reality, inventing absurd conspiracy theories and alternative facts about pedophile rings among the elites who they believe disdain them.

The dominance of the bobos has also engendered a rebellion among its own offspring. The members of the creative class have labored to get their children into good colleges. But they’ve also jacked up college costs and urban housing prices so high that their children struggle under crushing financial burdens. This revolt has boosted Bernie Sanders in the U.S., Jeremy Corbyn in Britain, Jean-Luc Mélenchon in France, and so on. Part of the youth revolt is driven by economics, but part is driven by moral contempt. Younger people look at the generations above them and see people who talk about equality but drive inequality. Members of the younger generation see the Clinton-to-Obama era—the formative years for the creative class’s sensibility—as the peak of neoliberal bankruptcy.

A third rebellion is led by people who are doing well financially but who feel culturally humiliated—the boubour rebellion. These are Mark and Patricia McCloskey, the rich St. Louis couple who waved their guns at passing Black protesters last year. These are the people who elected as mayor of Toronto the crude, brash-talking Rob Ford, who attempted to put a very non-bobo shopping mall, a suburban Disneyland, right in the center of the city. These are people who rebel against codes of political correctness.

As these rebellions arose, pundits from the creative class settled upon certain narratives to explain why there was suddenly so much conflict across society. Our first was the open/closed narrative. Society, we argued, is dividing between those who like open trade, open immigration, and open mores, on the one hand, and those who would like to close these things down, on the other. Second, and related, was the diversity narrative. Western nations are transitioning from being white-dominated to being diverse, multiracial societies. Some people welcome these changes whereas others would like to go back to the past.

Both these narratives have a lot of truth to them—racism still divides and stains America—but they ignore the role that the creative class has played in increasing inequality and social conflict.

For all its talk of openness, the creative class is remarkably insular. In Social Class in the 21st Century, the sociologist Mike Savage found that the educated elite tended to be the most socially parochial group, as measured by contact with people in occupational clusters different from their own. In a study for The Atlantic, Amanda Ripley found that the most politically intolerant Americans “tend to be whiter, more highly educated, older, more urban, and more partisan themselves.” The most politically intolerant county in the country, Ripley found, is liberal Suffolk County, Massachusetts, which includes Boston.

If creative-class types just worked hard and made more money than other people, that might not cause such acute political conflict. What causes psychic crisis are the whiffs of “smarter than” and “more enlightened than” and “more tolerant than” that the creative class gives off. People who feel that they have been rendered invisible will do anything to make themselves visible; people who feel humiliated will avenge their humiliation. Donald Trump didn’t win in 2016 because he had a fantastic health-care plan. He won because he made the white working class feel heard.

The New Class Hierarchies

The reaction to the bobos has turned politics into a struggle for status and respect—over whose sensibility is dominant, over which groups are favored and which are denigrated. Political attitudes have displaced consumption patterns as the principal way that people signal class sensibility.

The new map of status competition is worth pausing over, because it helps explain the state of our politics today. Let’s look first at the blue hierarchy.

Atop the Democratic-leaning class ladder sits the blue oligarchy: tech and media executives, university presidents, foundation heads, banking CEOs, highly successful doctors and lawyers. The blue oligarchy leads the key Information Age institutions, and its members live in the biggest cities. They work hard; as Daniel Markovits reported in The Meritocracy Trap, the share of high-income workers who averaged more than 50 hours of work a week almost doubled from 1979 to 2006, while the share of the lowest earners working long hours dropped by almost a third. They are, in many respects, solid progressives; for instance, a 2017 Stanford survey found that Big Tech executives are in favor of higher taxes, redistributive welfare policies, universal health care, green environmental programs. Yet they tend to oppose anything that would make their perch less secure: unionization, government regulation that might affect their own businesses, antitrust or anti-credentialist policies.

With their amazing financial and convening power, blue oligarchs move to absorb any group that threatens their interests, co-opting their symbols, recruiting key leaders, hollowing out their messages. “Woke capitalism” may seem like corporations gravitating to the left, but it’s also corporations watering down the left. Members of the blue oligarchy sit atop systems that produce inequality—and on balance their actions suggest a commitment to sustaining them.

One step down from the blue oligarchy is the creative class itself, a broader leadership class of tenured faculty, established members of the mainstream media, urban and suburban lawyers, senior nonprofit and cultural-institution employees, and corporate managers, whose attitudes largely mirror the blue oligarchs above them, notwithstanding the petty resentments of the former toward the latter.

The bobos believe in human dignity and classical liberalism—free speech, open inquiry, tolerance of different viewpoints, personal autonomy, and pluralism—but our class has not delivered for the people outside it. On our watch, government and other public institutions have deteriorated. Part of the problem is that, steeped in an outsider, pseudo-rebel ethos, we never accepted the fact that we were a leadership class, never took on the institutional responsibilities that go with that acceptance, never got to know or work with people not in our class, and so never earned the legitimacy and trust that is required if any group is going to effectively lead. According to the Institute for Advanced Studies in Culture, 65 percent of Americans believe that “the most educated and successful people in America are more interested in serving themselves than in serving the common good.”

One economic rung below are the younger versions of the educated elite, many of whom live in the newly gentrifying areas of urban America, such as Bedford-Stuyvesant in New York or Shaw in Washington, D.C. More diverse than the elites of earlier generations, they work in the lower rungs of media, education, technology, and the nonprofit sector. Disgusted with how their elders have screwed up the world, they are leading a revolution in moral sentiments. From 1965 to 2000, for instance, about 10 percent of white liberals favored increased immigration. By 2018, according to Zach Goldberg, a researcher at the Center for the Study of Partisanship and Ideology, it was more than 50 percent, thanks to the influence of a rising generation on the multicultural left.

Yet wokeness is not just a social philosophy, but an elite status marker, a strategy for personal advancement. You have to possess copious amounts of cultural capital to feel comfortable using words like intersectionality, heteronormativity, cisgender, problematize, triggering, and Latinx. By navigating a fluid progressive cultural frontier more skillfully than their hapless Boomer bosses and by calling out the privilege and moral failings of those above them, young, educated elites seek power within elite institutions. Wokeness becomes a way to intimidate Boomer administrators and wrest power from them.

On the lowest rung of the blue ladder is the caring class, the largest in America (nearly half of all workers, by some measures), and one that in most respects sits quite far from the three above it. It consists of low-paid members of the service sector: manicurists, home health-care workers, restaurant servers, sales clerks, hotel employees. Members of this class are disadvantaged in every way. The gap in life expectancy between those in the top 40 percent and those in the bottom 40 percent widened from 1980 to 2010—from five to 12 years for men and from four to 13 years for women. Only one in 100 of the children raised in the poorest fifth of households will become rich enough to join the top 5 percent.

This hardship requires a different set of traits and values than are found in more upscale classes. Researchers report that people who feel a weaker sense of personal control are quick to form mutual-support networks; their sense of community clashes with the creative class’s valorization of individualism. Other research has found that members of this class are less likely to behave un­ethically than the creative class when put in tempting situations.

Surveys suggest that members of this class stay at some remove from the culture wars—they are much less likely to share political content on social media than other groups, and more likely to say they “avoid arguments.” Many are centrists or detached from politics altogether, but as a whole they sit to the right of the bobos on abortion and LGBTQ issues and to the left of the bobos on issues like union power and workers’ rights.

Atop the red hierarchy is the GOP’s slice of the one-percenters. Most rich places are blue, but a lot of the richest people are red. A 2012 study of the richest 4 percent of earners found that 44 percent voted Democrat that year while 41 percent voted Republican. Some are corporate executives or entrepreneurs, but many are top-tier doctors, lawyers, and other professionals who aspire to low taxes and other libertarian ideals. This is the core of the GOP donor class, men and women who feel that they worked hard for their money, that the American dream is real, and that those who built wealth in this country shouldn’t have to apologize for it.

Members of this class are in many ways similar to the conservative elite of the Reagan years. Yet they too have been reshaped by the creative class’s cultural dominance. When I interview members of the GOP donor class, they tell me they often feel they cannot share their true opinions without being scorned. Few of them supported Donald Trump in the 2016 GOP primaries, but by 2020 most of the red one-percenters I know had swung enthusiastically pro-Trump, because at least he’s scorned by those who scorn them. It turns out that having a large investment account is no protection against self-pity.

One step down are the large property-owning families, scattered among small cities and towns like Wichita, Kansas, and Grand Rapids, Michigan—what we might call the GOP gentry. (I’ve adapted the coinage from what the historian Patrick Wyman has written about the local elite in his hometown of Yakima, Washington.) This gentry class derives its wealth not from salary but from the ownership of assets—furniture companies, ranches, a bunch of McDonald’s franchises. This wealth is held in families and passed down through the generations. Members of this elite stay rooted where their properties are and form the leadership class in their regions, chairing a community foundation or the local chamber of commerce.

Below them is the proletarian aristocracy, the people of the populist regatta: contractors, plumbers, electricians, middle managers, and small-business owners. People in this class have succeeded in America, but not through the channels of the university-based meritocracy, from which they feel alienated.

In other circumstances, the GOP gentry would be the natural enemies of the proletarian aristocracy, but now they are aligned. Both embrace the symbolic class markers of the sociologically low—pickup trucks, guns, country music, Christian nationalism. Both fear that their children may not be able to compete in the creative-class-controlled meritocracy. Both dislike sending their kids to schools that disdain their values, yet understand that their children will have to adopt creative-class values if they are going to be accepted in the new elite. As Thibault Muzergues writes, “The boubours and the provincial bourgeois thus have a common agenda: to unmake the Creative Class’s societal transformation of the late 2000s and early 2010s.”

A level below the people of the populist regatta, you find the rural working class. Members of this class have highly supervised jobs in manufacturing, transportation, construction. Their jobs tend to be repetitive and may involve some physical danger. As the Princeton sociologist Robert Wuthnow notes, many people in this class have an identity rooted in loyalty to their small town. They are supported by networks of extended family and friends, who have grown up with one another. Like the poorer members of the blue hierarchy, they value interdependence and are less individualistic.

Many members of the red-hierarchy working class feel totally forgotten. In her book White Working Class, Joan C. Williams shares the account of a woman who says she raised three children on $40,000 a year but “didn’t get any assistance because we did not qualify.” Their towns are not diverse. As Wuthnow notes, two of the most common statements you hear in these towns are “Everybody knows everybody else” and “We’re all pretty much the same.” If educated urbanites go out of their way to enjoy diversity and display their superior cultural taste, one-upmanship is despised in this class. Christmas Tree Shop sincerity is prized over academic, art-house pretentiousness.

By and large, members of the rural working class admire rich people who earned their wealth. Their real hatred is for “Washington”—a concept that encompasses the entire ruling class. “Those people up there in Washington, they think they know more than we do,” one of them told Wuthnow. “They treat us like second-class citizens, like we’re dumb hicks.”

How the Class War Ends

As the bobos achieved a sort of stranglehold on the economy, the culture, and even our understanding of what a good life is, no wonder society has begun to array itself against them, with the old three-part class structure breaking apart into a confusing welter of micro-groups competing for status and standing in any way they can. So, for instance, the bobos have abundant cultural, political, and economic power; the red one-percenters have economic power, but scant cultural power; the young, educated elites have tons of cultural power and growing political power, but still not much economic power; and the caring class and rural working class, unheard and unseen, have almost no power of any kind at all. Our politics, meanwhile, has become sharper-edged, more identity-based, and more reactionary, in part because politics is the one arena in which the bobos cannot dominate—there aren’t enough of us.

Into this fraught, every-which-way class conflict walks Joe Biden. Weirdly, he stands outside it.

Biden is the first president since Ronald Reagan without a degree from an Ivy League university. His sensibility was formed not in the meritocracy but in the working-class neighborhoods of his youth. Condescension is alien to his nature. He has little interest in the culture-war issues that drive those at the top of the hierarchies, and spent his 2020 campaign studiously avoiding them. Biden gets prickly when he is surrounded by intellectual preening; he’s most comfortable hanging around with union guys who don’t pull that crap.

Biden’s working-class version of progressivism is a relic from the pre-bobo era. His programs—his COVID-relief law, his infrastructure bill, his family-support proposal—represent efforts to funnel resources to those who have not graduated from college and who have been left behind by the creative-class economy. As Biden boasted in an April speech to a Joint Session of Congress, “Nearly 90 percent of the infrastructure jobs created in the American Jobs Plan do not require a college degree; 75 percent don’t require an associate’s degree.” Those are his people.

If there is an economic solution to the class chasms that have opened up in America, the Biden legislative package is surely it. It would narrow the income gaps that breed much of today’s class animosity.

But economic redistribution only gets you so far. The real problem is the sorting mechanism itself. It determines who gets included in the upper echelons of society and who gets excluded; who gets an escalator ride to premier status and worldly success and who faces a wall.

The modern meritocracy is a resentment-generating machine. But even leaving that aside, as a sorting device, it is batshit crazy. The ability to perform academic tasks during adolescence is nice to have, but organizing your society around it is absurd. That ability is not as important as the ability to work in teams; to sacrifice for the common good; to be honest, kind, and trustworthy; to be creative and self-motivated. A sensible society would reward such traits by conferring status on them. A sensible society would not celebrate the skills of a corporate consultant while slighting the skills of a home nurse.

[Read: The false promise of meritocracy]

Some 60 years after its birth, the meritocracy seems more and more morally vacuous. Does the ability to take tests when you’re young make you a better person than others? Does a society built on that ability become more just and caring?

This situation produces a world in which the populist right can afford to be intellectually bankrupt. Right-leaning parties don’t need to have a policy agenda. They just need to stoke and harvest the resentment toward the creative class.

The only way to remedy this system is through institutional reform that widens the criteria by which people get sorted. For instance, we need more pathways to success, so those who are not academically inclined have routes to social leadership; programs like national service, so that people with and without college degrees have more direct contact with one another; and an end to policies like residential zoning rules that keep the affluent segregated on top. More broadly, changing this sorting mechanism requires transforming our whole moral ecology, such that possession of a Stanford degree is no longer seen as signifying a higher level of being.

The bobos didn’t set out to be an elite, dominating class. We just fit ourselves into a system that rewarded a certain type of achievement, and then gave our children the resources that would allow them to prosper in that system too. But, blind to our own power, we have created enormous inequalities—financial inequalities and more painful inequalities of respect. The task before us is to dismantle the system that raised us.

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This article appears in the September 2021 print edition with the headline “Blame the Bobos.”

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To peer into the soul of a sea cucumber, don’t look to its face; it doesn’t have one. Gently turn that blobby body around, and gaze deep into its marvelous, multifunctional anus.

The sea cucumber's posterior is so much more than an exit hole for digestive waste. It is also a makeshift mouth that gobbles up bits of algae; a faux lung, latticed with tubes that exchange gas with the surrounding water; and a weapon that, in the presence of danger, can launch a sticky, stringy web of internal organs to entangle predators. It can even, on occasion, be a home for shimmering pearlfish, which wriggle inside the bum when it billows open to breathe. It would not be inaccurate to describe a sea cucumber as an extraordinary anus that just so happens to have a body around it. As Rebecca Helm, a jellyfish biologist at the University of North Carolina at Asheville, told me, “It is just a really great butt.”

But the sea cucumber’s anus does not receive the recognition it deserves. “The moment you say ‘anus,’ you can hear a pin drop in the room,” Helm said. Bodily taboos have turned anuses across the tree of life into cultural underdogs, and scientific ones too: Not many researchers vocally count themselves among the world’s anus enthusiasts, which, according to the proud few, creates a bit of a blind spot—one that keeps us from understanding a fundamental aspect of our own biology.

The appearance of the anus was momentous in animal evolution, turning a one-hole digestive sac into an open-ended tunnel. Creatures with an anus could physically segregate the acts of eating and defecating, reducing the risk of sullying a snack with scat; they no longer had to finish processing one meal before ingesting another, allowing their tubelike body to harvest more energy and balloon in size. Nowadays, anuses take many forms. Several animals, such as the sea cucumber, have morphed their out-hole into a Swiss Army knife of versatility; others thought that gastrointestinal back doors were so nice, they sprouted them at least twice. “There’s been a lot of evolutionary freedom to play around with that part of the body plan,” Armita Manafzadeh, a vertebrate morphology expert at Brown University, told me.

But anuses are also shrouded in scientific intrigue, and a fair bit of squabbling. Researchers still hotly debate how and when exactly the anus first arose, and the number of times the orifice was acquired or lost across different species. To tap into our origins, we’ll need to take a squarer look at our ends.

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In the beginning, there was nothing. The back ends of our animal ancestors that swam the seas hundreds of millions of years ago were blank, relegating the entry and exit of all foodstuffs to a single, multipurpose hole. Evolutionary echoes of these life-forms still exist in corals, sea anemone, jellyfish, and a legion of marine worms whose digestive tract takes the form of a loose sac. These animals are serially monogamous with their meals, taking food in one glob at a time, then expelling the scraps through the same hole. (Contrary to what you might have read, not everyone poops.) These creatures’ guts operate much like parking lots, subject to strict vacancy quotas that restrict the flow of traffic.

The emergence of a back door transformed those parking lots into highways—the linear “through-guts” that dominate body plans today. Suddenly, animals had the luxury of downing multiple meals without needing to fuss with disposal in between; digestive tracts lengthened and regionalized, partitioning into chambers that could extract different nutrients and host their own communities of microbes. The compartmentalization made it easier for animals to get more out of their meals, Andreas Hejnol, a developmental biologist at the University of Bergen, in Norway, told me. With the lengthening and uncorking of the end of the gut, he said, many creatures grew into longer and larger body forms, and started to move in new ways. (It would take several more eons for true buttocks—the fleshy, fatty accoutrements that flank the anuses of some animals, such as humans—to evolve. Some researchers I talked with are comfortable using butt to mean any anal or anus-adjacent structure; others are purists, and consider the term strict shorthand for buttocks and buttocks alone.)

The benefits of bottoming out the gut are clear; how the back door was excavated isn’t. Soft, squishy, bone-free holes aren’t exactly fixtures of the fossil record, making just about any anus-heritage theory tough to prove. One of the oldest hypotheses holds that the anus and the mouth originated from the same solo opening, which elongated, then caved in at the center and split itself in two. The newly formed anus then moseyed to the animal’s posterior. Claus Nielsen, a developmental biologist at the Natural History Museum of Denmark, is a fan of this theory. It’s both reasonably parsimonious and evolutionarily equitable: In this scenario, neither the mouth nor the anus technically arose first; they emerged as perfect developmental twins.

Hejnol and others favor a different idea, in which the mouth formally preceded the anus, which spontaneously burst through the other end of the body. “It’s a secondary breakthrough,” Hejnol said. “The gut forms, then [makes] a connection to the outer world.” Punching an extra hole in the body is not so difficult: Some worms have managed the feat dozens of times over. One unusually aerated specimen, a type of polyclad flatworm, sports multiple anuses that speckle its backside like feces-spewing freckles. Two others, a pair of sponge parasites called Syllis ramosa and Ramisyllis multicaudata, will twine their body through host tissues like a tapestry of tree roots, with each tip terminating in its own proprietary butthole; they have hundreds, perhaps thousands, in total. (It’s not totally clear why these animals and others spawned an embarrassment of anuses, but in at least some cases, Hejnol thinks it’s a logical outcome of a branched digestive system, which can more easily transport nutrients to a body’s every nook and cranny.)

Hejnol and his colleagues are still amassing support for their hypothesis, but he said there’s already some argument against the hole-splitting idea: Animals don’t generally express the same genes around their mouth and anus, a knock against the notion that the two openings are cut from the same developmental cloth. A better backstory for the orifice, he said, might involve a body plan stolen from the reproductive tract, which already naturally terminates at the animalian posterior.

If that theory pans out, though, it won’t necessarily close the case on the anus’s evolutionary start. A cursory glance at the animal tree of life might at first suggest that anal openings appeared about 550 million years ago, around the time our own bloblike ancestors straightened out into tubes. But Hejnol and many others think that the anus was so useful that animals independently evolved it at least half a dozen times, perhaps many more, and not necessarily in the same way. This timeline has other snags: Some creatures have since lost their anal opening—and some might have made theirs even further back in history.

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One of the largest potential wrinkles in the smooth anus narrative takes the shape of a comb jelly—a gelatinous animal that vaguely resembles a translucent Darth Vader helmet and is thought to be at least 700 million years old. As far back as the 1800s, scientists have been puzzling over comb jellies’ back end, and whether they were excreting formal feces from a set of strange-looking pores. More than a century passed before their acts of defecation were finally caught on camera, by the biologist William Browne of the University of Miami and his colleagues, who filmed one of the amorphous creatures taking a big fishy dump in the lab. When the clip debuted at a 2016 conference, “everyone in the hall audibly gasped,” Helm, who attended the lecture, told me. If comb jellies were pooping, that poop had to be coming out of some sort of rear hole. Perhaps, some said, the history of the anus ran far deeper in time than many had thought.

In the months after Browne’s team published its findings, scientists sparred repeatedly over their significance. Some hailed the discovery as revolutionary. But others, Hejnol among them, argued that the now-infamous video didn’t signify all that much dogmatic change, and may not be hard to reconcile with what’s long been known. Comb jellies probably cooked up their anuses independently of other animals, and happened upon a similar blueprint by chance; there’s no telling when exactly that might have occurred. Such a scenario would leave the chronology of our own anus, which emerged out of a different line of creatures at a separate point in time, intact.

The various possibilities aren’t easy to prove or disprove. Just as new apertures can rupture into being, useless ones can disappear, as seems to have been the case with brittle stars and mites, which stitched their ancestral anuses shut. Some ambivalent creatures might even gouge out transient anuses—holes that come and go on an as-needed basis. (A 2019 study by the biologist Sidney Tamm suggested that some comb-jelly anuses could fall into this category of “sometimes-butts,” as Manafzadeh calls them.)

Many of the animals that have managed to keep some version of the anus embellished upon it, and now harbor an organ of immense extravagance. Turtles, like sea cucumbers, breathe through their butt. Young dragonflies suck water into theirs, then spew it out to propel themselves forward. Scorpions jettison their posterior when attacked from behind, evading capture but tragically losing their ability to poop (and eventually dying with their abdomen full of excrement). Lacewing larvae incapacitate termite prey with the toxic flatulence they emit from their end—“they literally KO their enemies with death farts,” Ainsley Seago, an entomologist at the Carnegie Museum of Natural History, told me.

Some of the most intriguing (and NSFW) back ends are all-purpose anus analogues called cloacae, which merge the terminal parts of the digestive, urinary, and reproductive tracts into a single opening—essentially an evacuation foyer for outbound feces, urine, eggs, and sperm. Cloacae are fixtures among birds, reptiles, and amphibians, and although they tend to get a bad rap, their internal architecture is actually quite sophisticated, Patricia Brennan, a cloaca expert at Mount Holyoke College, in Massachusetts, told me. They can also be quite convenient: When female birds mate with unsatisfactory males, they can simply eject the subpar sperm and begin the process anew. Cloacae have been around for so long, Hejnol added, that they could even represent the evolutionary bridge between the reproductive and digestive tracts that helped lead to some of the first anuses.

Still, cloacae come with risks: “You have all your digestive waste pretty much in direct contact with genitalia,” basically a gnarly infection just waiting to happen, Brennan said. Any live young who pass through the reproductive tract could also be imperiled by the proximity to poop-borne pathogens. Perhaps that’s why human anuses ventured off on their own.

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Whatever the reason behind it, the partitioning that did away with the cloaca made human anuses, as Manafzadeh said, “completely boring.” As far as exit holes go, ours are standard-issue, capable of little more than extruding waste from the gut, with no frills to speak of.

The only redeeming quality of humans’ humdrum posterior hole is the feature we evolved to cushion it: our infamous buttocks, the most voluminous one documented to date, thanks to our bizarre tendency to strut around on our two primate legs. “Our bipedalism is obligate; it’s special; it’s the only way we get around,” Darcy Shapiro, an anthropologist, told me. That pattern of locomotion reshaped the pelvis, which in turn reoriented our muscles. The gluteus maximus—the hefty muscle that powers our ability to run and climb—swelled in lockstep, and blanketed itself in a cozy layer of fat that some scientists think serves as an energy reserve. Anuses aside, “our buttocks are the real innovation here,” Manafzadeh said.

Evolution blew the human butt out of proportion; our cultural norms quickly followed suit. We regard one another’s bums with lust, disgust, and guilty fascination. We shrink them, we sculpt them; we sexualize them. We rap about them with abandon. They, in return, make it much easier to sprint, but much harder to keep our rear ends clean. Our anus is a sheep dressed in a very fabulous wolf’s clothing, and we simply cannot deal.

Maybe that’s part of why humans are so often embarrassed of their posteriors, and, by extension, so many others. We even opt for butt as a euphemism for anus in casual conversation. Buttocks aren’t anuses, but they do cloak them, physically and perhaps figuratively. They obscure the idea that, from its very start, our digestive end has been a wonder. It cracked open our ancestors’ evolutionary path, and made our own existence possible. Maybe it’s time we made like a pearlfish, and got comfortable with what’s between those cheeks.

Ahead of her musical guest appearance on Saturday Night Live this weekend, St. Vincent has released the second single from her upcoming new album Daddy’s Home, following up “Pay Your Way In Pain” from last month.

Illustrator Tomer Hanuka asked his students at the School of Visual Arts to draw pretend New Yorker covers looking forward to the end of the pandemic.… Read more

The post Pandemic New Yorker Covers appeared first on A Cup of Jo.

The world of Danish children’s television is not for the prudish. Kids who turn on the tube in Denmark might be greeted by gratuitous flatulence, cursing, casual nudity, or cross-dressing puppets. One show centers on a pipe-smoking pirate who wallops ninjas and flirts with Satanism. In another, an audience of 11-to-13-year-olds asks probing questions about the bodies of adults who disrobe before them. As Christian Groes, an anthropologist at Denmark’s Roskilde University, told me, Danish children’s television is not unlike an LSD trip: “Everything is possible in that universe,” he said, loosely quoting a friend, “and people won’t complain about it.”

But people did complain when the Danes debuted a kids’ animated series in January featuring a protagonist with an absurdly long, prehensile penis.

The show, which is produced by DR, the same Danish production company responsible for the pirate and strip-down shows, was written for 4-to-8-year-olds. It centers on the eponymous John Dillermand, a mustachioed Claymation character whose last name translates roughly to “penis man.” (In Danish, diller is a silly, cheeky bit of phallic slang, the equivalent of pee-pee, willy, or weiner in English.) Gifted, or perhaps cursed, with a retractable phallus that seems capable of extending at least 20 times the length of his body, Dillermand must navigate life alongside his über-ostentatious junk, which at times has a mind of its own. His schlong graffities walls, digs up gardens, lassos a moving caravan, and even coils itself into a bobbing, seaworthy boat—not always with Dillermand’s permission.

Scandalized viewers criticized Dillermand as inappropriate, tone-deaf, and a jarring choice on the heels of the country’s growing #MeToo movement. But the series’s creators, and many bemused fans, defended it as a subversive comedy that has served up opportunities for parents to have frank and unsqueamish conversations about anatomy with their kids.

“The series is about being true to one’s self,” Morten Skov Hansen, the head of DR Ramasjang, the company’s kids’ channel, told me in an email. “It’s as desexualized as it can possibly get.”

While I don’t speak Danish, the tone of John Dillermand is not easily lost in translation: The show isn’t about sex. It’s about taking responsibility for your actions, and the awkward realities of inhabiting a human body. But in every minute of the Dillermand jaunt, there’s also a reminder that male bodies are still allowed freedoms that female ones are not.

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John Dillermand is, in some ways, a throwback to the man-children who have dominated kids’ TV across continents and decades. Dillermand, who is middle-aged, lives with his remarkably spry great-grandmother (oldemor, in Danish), and retains the worldview of a young boy. He is clad inexplicably in a red-and-white striped swimsuit (which graciously accommodates his elongating appendage, because a nude penis would have been a bridge too far), and occasionally a pom-pommed beanie. A character reminiscent of Mr. Bean or Inspector Gadget, he lacks street smarts and maturity, and innocently sees the world as his playground.

Were Dillermand typically endowed, he might be merely bumbling or pitiable. But his giant penis—billed in the show’s theme song as the largest in the world—won’t allow him to languish in anonymity. A manifestation of his id, his pecker acts of its own accord. It’s sassy. It’s hedonistic. It’s got an appetite (for food, mostly), and isn’t afraid to buck social norms to sate it.

This tension between man and member drives the show’s zany plot. After Dillermand’s penis plucks an ice-cream cone from a child’s hand and flings it onto a stoplight, Dillermand must redirect traffic and set the situation right. When the diller nearly drowns several kids, John wrangles it into a makeshift propeller to airlift the children to safety. Dillermand’s penis wields weapons with abandon—a dagger, a chain saw, a rifle. It provokes animals and bullies children. It steals. It commits acts of violence. It even terrifies Santa Claus (who mistakes the penis for a snake) so badly that he tumbles down a chimney and injures himself.

Dillermand has enough self-awareness to occasionally bemoan the shenanigans of his wayward penis, pulling his hat over his face and groaning, “Ugh, that dumb diller.” It’s often Oldemor who must remind her man-child great-grandson to pak den væk—put it away!—when Dillermand’s diller runs amok. “What will the neighbors think?” she screeches. But Dillermand always comes through in the end, picking up a lesson or two about conscientiousness along the way.

In the months since its premiere, John Dillermand has accumulated a veritable cavalry of tiny fans. Anne Sofie Pleidrup, who lives with her husband, her son, 6, and her daughter, 7, in Denmark, told me that her entire family has been enjoying the show. Both her children are creeping up to the age when anatomical differences are starting to fascinate them, and she was delighted that “they found the same punch lines funny.”

Dillermand embodies a child’s view of the human body: strange, impossible, invincible, hilarious. He validates the idea that the diller is okay for kids to discuss. Children have parroted the show’s theme song to their parents, requested Dillermand-themed cakes, and packed superlong penises onto snowmen. “It’s removing some of the stigma about talking about a penis—it’s just a body part,” Eileen Crehan, a sex-education researcher at Tufts University, told me. With a squint, one could imagine Dillermand’s genitals as an extra-long arm or leg. By Danish standards, Dillermand is actually “fairly mild,” Andreas Lieberoth, an educational psychologist at Aarhus University, told me. He and many other experts I spoke with shrugged the series off as no big deal—just the latest in a long line of edgy or bodily brazen Danish shows.

The show's success could also be read as a testament to Denmark’s progressive approach to sexuality and autonomy in general. Sex education has been a requirement in Danish elementary schools since 1970 (a year after the country became the world’s first Western nation to legalize pornographic imagery). It's hard to imagine Dillermand sitting well in countries with a more fraught approach to sex, such as the United States, where “we sexualize everything,” Hilary Reno, a sexual-health expert at Washington University in St. Louis, told me. But in Denmark—where people boast of their frisind, a free-spirited, open-minded approach to life—kids begin discussing love, sexuality, relationships, and consent as early as kindergarten, learning while young that their bodies are things to be acknowledged, not repressed.

Perhaps in this context, a penis does not have to be a sexual device—especially when viewed through the eyes of a 4-year-old. “It’s a good message for bodies in general,” Kathryn Macapagal, a sexual-health researcher and clinical psychologist at Northwestern University, told me. “Your body gets you into trouble, but it can also do lots of amazing things.” Dillermand himself learns this lesson: After trying to barter his penis away at a flea market, he ultimately accepts and embraces his misbehaving pecker, hijinks and all.

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Yet despite its candy striping, John Dillermand’s penis is, in the end, still a penis. The diller acts as if morally bankrupt; it is recklessness incarnate. It threatens, perhaps even overtly, to absolve men of responsibility. “To me, this penis is out of control,” Crehan said. Despite its lighthearted tone, John Dillermand—a show about men, dreamed up by men—reinforces the bottom line about male sexuality: It’s so uncontrollable, it can demand its own television series.

Some of the trouble can be traced back to the pure creep factor of the main character. Dillermand, despite his apparent age, is jobless and friendless. He piddles the day away on the front lawn, playing pranks or practicing badminton with his only willing athletic partner, who is—surprise!—his own penis. While Oldemor urges him to rub elbows with doctors and lawyers, Dillermand manages to befriend only a lonely young boy, with whom he filches candy from a shop.

And Dillermand himself is not completely sexless. In one episode, he nurses an obvious crush on his thankfully age-appropriate neighbor Yvonne. His penis, by and large, behaves itself. But the character’s desires evoke the discomfiting possibility of an unwelcome advance nonetheless.

Groes, the gender scholar, worries that the diller’s presence is so commanding that it actually distracts from the rest of the show’s content. When Groes’s 8-year-old son watched the show, “he didn’t get it,” Groes told me. “Because the attention was on something else, which was funnier, stranger, and weirder.”

At its worst, Dillermand, inadvertently or not, threatens to reinforce the same “locker-room tendencies” the Western world has hoped to move away from, Groes told me. “It’s probably the most classic stereotype you can come up with: a man having certain abilities because he has a big penis.” Dillermand’s life revolves around the power of his appendage. The show ultimately glorifies the consequences of an uninhibited penis, rather than grappling with them. Dillermand’s predicament, Groes said, is a “classic macho claim: ‘I can’t control my penis.’”

DR, the company behind the show, has argued that Dillermand and his penis could have "easily" been swapped out for a female-bodied character. And yet, on one point, every person I spoke with agreed: Reimagined with a biologically female lead, John Dillermand would not have worked. Even in Denmark, vaginas and vulvas aren’t considered innocent or endearing enough to delight young minds. Diller jokes are embedded in the cultural zeitgeist; the word itself is emblematic of contrarian playfulness and parody. But the Danes I talked with told me that the impish female counterpart of the word diller does not exist.

“There is still shame with talking about women’s genitalia in public spaces,” Crehan said. An especially large vagina might be labeled as a signal of looseness and corruption—a dangerous “weapon” used to exert undue influence over others.

The idea of a massive, magical vulva taking the place of Dillermand’s penis is difficult to even envision. In the days after the show premiered, the Danish internet overflowed with memes flaunting female versions of Dillermand, some sporting the appropriately gigantic genital accoutrement, or a tangle of unspooling breasts. But “would people receive it the same way with a vulva or vagina reaching out to grab a kid’s ice-cream cone? I don’t think so,” Macapagal told me. From there, the possibilities start to spiral: Would Carol’s clitoris have been celebrated for taming a lion? Would audiences have laughed to see Vicky’s vulva stabbed, smashed, or electrocuted?

This imbalance is a reminder of the dominance of masculinity, Groes said. Although the sexuality of the penis can be toggled on and off, female genitalia occupy a cultural space with decidedly less dynamic range. The sexuality of women is still taboo enough that it is most easily ignored; when it is offered a modest fraction of the spotlight typically reserved for men, it is excoriated for its audacity. While the nuanced lore of the penis thrives, female genitals are struggling to shed their “hypersexualized” identity, says Rachel Hardeman, a reproductive-health-equity researcher at the University of Minnesota.

In John Dillermand, the female presence is so starkly absent that one cannot help but confront the reasons it has been erased. The show isn’t uncomfortable because it’s so radical to make a children’s series about a penis, but because it’s decidedly not.

Researchers discovered that an octopus might punch a fish when both are hunting. Although some of the thrown punches can be explained, others remain a mystery.

On Election Day, Phoebe Bridgers made a promise to fans: if Donald Trump were to lose, she’d release a cover of Goo Goo Dolls’ ’90s rock radio classic “Iris”. While Trump himself remains in denial, Bridgers has now delivered the goods. Even more exciting, she’s found a running mate in…

Please click the link below to read the full article.

Phoebe Bridgers and Maggie Rogers Cover Goo Goo Dolls’ “Iris”: Stream
Alex Young

Editor’s Note: The Washington Post article mistakenly attributed a quote Billie Eilish made about Trump to imply that Trump officials made it about her. In actuality, Trump officials were merely quoting Eilish, who said during the Democratic National Convention that Trump was “destroying our country and everything we care about.”…

Please click the link below to read the full article.

Leaked Trump Docs: Billie Eilish Unfit for Coronavirus Ad Campaign
Wren Graves

Willie Nelson and Karen O have joined forces to cover the Queen and David Bowie classic “Under Pressure”. The all-star collaboration also features Yeah Yeah Yeahs guitarist Nick Zinner and production from TV on the Radio member Dave Sitek. According to a statement about the origins of the cover, Karen…

Please click the link below to read the full article.

Willie Nelson and Karen O Cover Queen and David Bowie’s “Under Pressure”: Stream
Lake Schatz

Wren Chavers offers a humorous step-by-step guide to preparing microwave grilled cheese, something you can do even if you’re too depressed to cook.

Congratulations are in order to Radiohead frontman Thom Yorke and Italian actress Dajana Roncione, who got married this past weekend. According to La Repubblica (via Pitchfork), the ceremony took place at an eighteenth century villa in Sicily on Saturday (Sept. 19th). 120 guests were in attendance — including the members…

Please click the link below to read the full article.

Thom Yorke Marries Italian Actress Dajana Roncione
Alex Young

A professor at Arizona State University does not exist.

I don't want to take part in my GF's (23F) sex ritual on our wedding night... but I still want to marry her https://www.reddit.com/r/relationship_advice/comments/gqsqd8 … pic.twitter.com/siUrpe4UB2

Right before the lockdown started, I was lucky enough to take in performance of the truly phenomenal Jagged Little Pill. With Broadway remaining closed through at least Labor Day, it’ll be some time before people get to witness the stage show again. Thankfully, Alanis Morissette will bring a piece of…

Please click the link below to read the full article.

Alanis Morissette to Host Cast and Crew of Jagged Little Pill for Livestream Benefit
Ben Kaye

The Dresden Dolls singer Amanda Palmer and fantasy author Neil Gaiman have separated. On Sunday night, Palmer broke the news on her Patreon by revealing that Gaiman is living in the UK while she and their son quarantine in New Zealand. On Monday morning, Gaiman took to Twitter to express surprise…

Please click the link below to read the full article.

Amanda Palmer Uses Patreon to Announce Separation From Neil Gaiman
Nina Corcoran

Scientists have long opposed the idea that dinosaurs lived in aquatic habitats. Now, an international team of researchers, supported by the National Geographic Society, has discovered unambiguous evidence that Spinosaurus aegyptiacus, the longest predatory dinosaur known to science, was aquatic.

Grindr is an app for gay men who want a convenient way to watch lava being poured on a goldfish.

A far larger demonstration is planned on April 24 to protest Gov. Tony Evers’ unprecedented order.

I [26m] have never met a single other person who knows my girlfriend [31f] and it’s driving me crazy pic.twitter.com/SbeAIFVZ5P

Updated at 7:22 p.m. ET on April 4, 2020.

As the coronavirus pandemic continues, many people are now overthinking things they never used to think about at all. Can you go outside? What if you’re walking downwind of another person? What if you’re stuck waiting at a crosswalk and someone is there? What if you’re going for a run, and another runner is heading toward you, and the sidewalk is narrow? Suddenly, daily mundanities seem to demand strategy.

Much of this confusion stems from the shifting conversation around the pandemic. Thus far, the official line has been that the new coronavirus, SARS-CoV-2, could be transmitted only through close contact with infected people or contaminated surfaces. But recently, news reports have suggested that the coronavirus can spread through the air. After 60 choir members in Washington State rehearsed together, 45 fell sick, even though no one seemed symptomatic at the time. Now people who were already feeling cooped up are worrying about going outside. Many state guidelines are ambiguous, and medical advice can muddy matters further. When the writer Deborah Copaken came down with COVID-19 symptoms, her doctor chided her for riding her bike through New York City a week earlier. Going outside in the city wasn’t safe, the physician implied, with “viral load everywhere.”

[Read: Grocery stores are the coronavirus tipping point]

To be clear, every expert I spoke with for this piece told me that it’s still mostly safe to spend time outdoors. If anything, they said, such forays should be encouraged for the sake of our mental health. Distance and ventilation matter, and outdoor spaces offer plenty of both. Distance is harder to maintain in bustling cities like New York, but the point remains that any risk lies in the density of people, not in some thick viral miasma suffusing the air.

That’s the good news. The matter of going outside, however, is just the simplest and most easily resolved part of a larger and more vexing set of questions: Does the coronavirus travel through the air? If so, how can we escape it? Should we all be wearing masks? The details of our new uprooted lives hinge on the answers. And the answers are complicated.

Is the new coronavirus airborne?

Confusingly, in public-health circles, the word airborne has a technical meaning that’s not just “carried through the air.” When people are infected with respiratory viruses, they emit viral particles whenever they talk, breathe, cough, or sneeze. These particles are encased in globs of mucus, saliva, and water. Bigger globs fall faster than they evaporate, so they splash down nearby—these are traditionally called “droplets.” Smaller globs evaporate faster than they fall, leaving dried-out viruses that linger in the air and drift farther afield—these are called “aerosols.” When researchers say a virus is “airborne,” like measles or chickenpox, they mean that it moves as aerosols. When the World Health Organization asserts that the new coronavirus is “NOT airborne,” it’s claiming that the virus instead spreads primarily through the close-splashing droplets, which either land directly on people’s faces or are carried to their faces by unwashed, contaminated hands.  

[Read: Why the coronavirus has been so successful]

Such messaging is “really irresponsible,” argues Don Milton, an expert in aerosol transmission at the University of Maryland. The scientific community doesn’t even agree about whether aerosol transmission matters for the flu, so “to say that after three months we know for sure that this [new] virus is not airborne is … expletive deleted,” he says. Milton and other experts who study how viruses move through the air say that the traditional distinction between big, short-range droplets and small, long-range aerosols is based on outdated science. Lydia Bourouiba of MIT, for instance, has shown that exhalations, sneezes, and coughs unleash swirling, fast-moving clouds of both droplets and aerosols, which travel many meters farther than older studies predicted. Both kinds of glob also matter over shorter distances: Someone standing next to a person with COVID-19 is more likely to be splashed by droplets and to inhale aerosols.

The question, then, isn’t whether the coronavirus is “airborne” in the tediously academic way the word has been defined. As the journalist Roxanne Khamsi puts it, the virus is “definitely borne by air.” The better questions are: How far does the virus move? And is it stable and concentrated enough at the end of its journey to harm someone’s health?

[Read: The coronavirus’s unique threat to the south]

A handful of studies have offered preliminary answers. One team of researchers blasted virus-laden fluids into a rotating cylinder to create a cloud of aerosols. They found that the virus remained stable for several hours within that cloud, raising fears about its ability to persist in ambient air. But as the researchers have noted, the study’s experimental setup was artificial. It doesn’t reflect “what’s occurring when you’re just walking down the street,” says Saskia Popescu of George Mason University, who specializes in infection control and who was not involved in the study. “It’s more akin to medically invasive procedures like intubation, which run the risk of aerosolizing the virus, and are unique to the health-care setting.”

A second study suggests that the coronavirus can be released into the air in less dramatic ways. Joshua Santarpia and his colleagues at the University of Nebraska Medical Center found traces of the coronavirus’s RNA—its genetic material—in rooms occupied by a total of 13 COVID-19 patients, most of whom had only mild symptoms. The RNA was on obvious places such as bed rails and toilets, but also on harder-to-reach spots such as ventilation grates, window ledges, and the floors beneath the beds. The RNA even lingered in the air; using air-samplers, the team detected viral RNA floating more than six feet away from the patients, and even in the hallways just outside the patients’ rooms.

This isn’t necessarily cause for alarm. Finding viral RNA is like finding a fingerprint at a crime scene—the culprit was once there, but might be long gone. So far, the Nebraska team has failed to detect live, infectious virus in its air samples. Santarpia told me that further tests are under way, and results will be released soon.

If the Nebraska team does find infectious particles, it would mean that even mildly symptomatic people can expel SARS-CoV-2 into the air, and that the virus can travel at least the length of a hospital room—a claim supported by a few other studies. Even that, though, would not guarantee danger. Are those far-spreading virus particles concentrated enough to infect another person in the same room? How many virus particles does it even take to launch an infection? How far does the virus travel in outdoor spaces, or in other indoor settings? Have these airborne movements affected the course of the pandemic?

These questions have no answers yet. To get those answers, “you’d have to expose animals to different quantities of airborne viruses, see if they get infected, and relate that to measures of the virus [in places] where people are infected,” says Bill Hanage, an epidemiologist at Harvard. “This is the type of stuff people will work on for years, but no one is going to find out for the moment.”

Is it safe to go outside?

Even if coronavirus particles can move through the air, they would still diffuse over distance. “People envision these clouds of viruses roaming through the streets coming after them, but the risk of [infection] is higher if you’re closer to the source,” says Linsey Marr, who studies airborne disease transmission at Virginia Tech. “The outside is great as long as you’re not in a crowded park.”

In February, scientists in Wuhan, China—where the coronavirus outbreak originated—sampled the air in various public areas, and showed that the virus was either undetectable or found in extremely low concentrations. The only exceptions were two crowded sites, one in front of a department store and another next to a hospital. Even then, each cubic meter of air contained fewer than a dozen virus particles. (No one knows the infectious dose of SARS-CoV-2—that is, the number of particles needed to start an infection—but for the original SARS virus of 2003, one study provided estimates many times higher than the levels detected in the Wuhan spaces.)*

These particles might not even have been infectious. “I think we’ll find that like many other viruses, [SARS-CoV-2] isn’t especially stable under outdoor conditions like sunlight or warm temperatures,” Santarpia said. “Don’t congregate in groups outside, but going for a walk, or sitting on your porch on a sunny day, are still great ideas.”

[Read: This is how we can beat the coronavirus]

You could tie yourself in knots gaming out the various scenarios that might pose a risk outdoors, but Marr recommends a simple technique. “When I go out now, I imagine that everyone is smoking, and I pick my path to get the least exposure to that smoke,” she told me. If that’s the case, I asked her, is it irrational to hold your breath when another person walks past you and you don’t have enough space to move away? “It’s not irrational; I do that myself,” she said. “I don’t know if it makes a difference, but in theory it could. It’s like when you walk through a cigarette plume.”

Indoors, experts’ opinions start to diverge. Consider, for example, the grocery store—one of the last vestiges of public life. There, Santarpia is far more concerned about touching shared surfaces than breathing shared air, and he makes sure to sanitize his hands before he leaves. Marr said that she tries to go when it’s less crowded, although that’s obviously harder in a big city. Bourouiba’s best advice is to always keep as much distance from other people as possible, and she adds that the onus is on stores to improve their ventilation or limit the number of concurrent customers. Stores must also devise ways of protecting the people at greatest risk: the cashiers and the workers stocking shelves.

Then there are shared spaces like hallways, stairwells, and elevators in apartment buildings. Elevators pose the highest risk, Bourouiba told me, since they’re enclosed boxes with limited airflow. For stairwells and hallways, she advocated a commonsense approach: “If you hear neighbors going out, and there are 10 people in the corridor right now, maybe wait and go later.”

As for interconnected indoor spaces, such as apartments that share ventilation: “I don’t want to freak people out about their ventilation systems [to the point where] they’re covering their vents,” Marr said. “Just open the windows.” Bourouiba agreed. The calculus might change if you’re in a first-floor unit next to a heavily trafficked street, but in general, “I would encourage people to open their windows and create drafts, once or twice a day.”  

[Read: The dos and don’ts of social distancing]

Apartment life “is not zero-risk, but it’s relatively low-risk, and people shouldn’t be on lockdown to the point that they never get fresh air,” Bourouiba said. The biggest risk—touching contaminated surfaces such as doorknobs and keypads—can be addressed with soap or hand sanitizer. As far as the air goes, “the likelihood of an airborne spread situation—where there’s somebody in the apartment next to you, and you walk by their apartment, and you somehow pick up an aerosol and get sick—seems really small to me,” Santarpia said. “If you know you’re in a shared space, follow social-distancing guidelines, clean your hands, and try to avoid touching your face.”

If people have no choice but to be in a riskier space, such as an elevator or a grocery-store line, the last resort might be to wear a mask. But this issue has become the most divisive one of all.

Should I wear a mask?

For health-care workers, the answer is obviously yes. But which masks? The World Health Organization and the Centers for Disease Control and Prevention both state that doctors and nurses can use basic surgical masks when treating COVID-19 patients, switching to the more advanced N95 respirators if they’re carrying out procedures that might create aerosols. But such recommendations assume that the virus isn’t generally airborne. Because it might be, health-care workers should err on the side of precaution by wearing N95s and using even better respirators for more dangerous procedures, argues Lisa Brousseau of the University of Illinois at Chicago. All of this equipment is in short supply, but health-care workers at least deserve to know what the ideal measures are.

For everyone else, the debate is even trickier. For months, the WHO, the CDC, and most public-health professionals advised that people don’t need to wear face masks unless they have COVID-19 or are caring for someone who does. At the same time, these experts have noted that health-care workers are in dire need of masks, which are running out because of strained supply chains and surging patient numbers. On February 29, the U.S. surgeon general, Jerome Adams, tweeted, “Seriously people- STOP BUYING MASKS! They are NOT effective in preventing general public from catching #Coronavirus, but if healthcare providers can’t get them to care for sick patients, it puts them and our communities at risk!”

If masks are limited, conserving them for the people who need them most makes sense. But that message was lost amid the confusing claim that masks somehow protect health-care workers but are useless for everyone else. In recent weeks, that simmering tension has come to a boil. Opinion pieces, news stories, and scientific papers have urged Western countries to use masks widely, emulating the example set by East Asian countries. Masks are mandatory for anyone entering a supermarket in Austria, and anyone leaving their house in the Czech Republic and Slovakia. In the U.S., the CDC changed its guidelines, recommending that Americans wear cloth or fabric face coverings in public. Many public-health experts have pivoted, too. “I went with the public-health message at the beginning: People don’t need masks,” Marr said. “But I’ve changed because of the mounting evidence that it does seem to be spreading through the air.”

[Read: America needs plasma from COVID-19 survivors now]

If the virus is traveling through the air, then it seems intuitive that masks would block it. But the evidence for this is all over the place, especially for surgical masks, which are more common than N95 respirators, and which don’t form a tight seal with the face. Several past studies have found that face masks could reduce the risk of flu-like infections, slow flu transmission in households, and even reduce the spread of SARS, especially when combined with hand-washing and gloves. Other studies have been more equivocal, finding that masks provide no benefit, small benefits, or benefits only in conjunction with measures like hand-washing. “Airflow follows the path of least resistance, and if it won’t enter through the mesh, it can come in from the side,” Bourouiba said. “There’s no evidence whatsoever to suggest that [surgical masks] are protective against the smallest droplets.”  

There’s still a good case for masks, though, even if they can’t stop viruses from getting in: They can stop viruses from getting out. A new study shows that people who are infected with milder human coronaviruses release fewer viral particles when they wear surgical masks. “I’ve been slightly dismissive of masks, but I was looking at them in the wrong way,” Harvard’s Bill Hanage told me. “You’re not wearing them to stop yourself getting infected, but to stop someone else getting infected.” This might be especially important for SARS-CoV-2, which can spread without immediately causing symptoms. If people are infectious before they fall sick, then everyone should wear face masks “when going out in public, in one additional societal effort to slow the spread of the virus down,” says Thomas Inglesby of the John Hopkins Center for Health Security.

Some commentators have argued that countries that have thus far succeeded in curbing their COVID-19 outbreaks have widely used masks. But this relationship isn’t as perfect as it might appear. China advocated mask use early on and still struggled to contain the disease. Japan uses masks widely but is now seeing an uptick in cases. Singapore reserved them for health-care workers but still flattened the curve of infections. Many successful mask-using countries relied on other measures, such as extensive testing and social distancing, and many were ready for the pandemic because of their prior run-in with the 2003 SARS epidemic.

In Asia, masks aren’t just shields. They’re also symbols. They’re an affirmation of civic-mindedness and conscientiousness, and such symbols might be important in other parts of the world too. If widely used, masks could signal that society is taking the pandemic threat seriously. They might reduce the stigma foisted on sick people, who would no longer feel ashamed or singled out for wearing one. They could offer reassurance to people who don’t have the privilege of isolating themselves at home, and must continue to work in public spaces. “My staff have also mentioned that having a mask reminds them not to touch their face or put a pen in their mouth,” Bourouiba noted.

Or masks could have the opposite effect. Whenever Santarpia sees someone wearing a mask in public, that person is constantly touching it, futzing with it, and pulling it down to wipe their mouth. “Masks are really uncomfortable, and no one wears them correctly,” he said. “Rather than being protective, you’ve put something on your face that makes you want to touch your face more, or to touch the outside of the mask, which is infectious. You’ve created a hazard for yourself that’s right on your face.”

Many public-health experts have voiced similar complaints, based on their own personal experience. But it’s hard to find studies showing that novice mask-users touch their face more, or that such behavior increases the risk of infection. Regardless, if people misuse masks, why not train them? Countless videos and memes have been made to show people how to wash their hands properly, and the WHO already has a good instructional video about using masks.

[Read: The curve is not flat enough]

The debate is somewhat moot right now, because there simply aren’t enough masks for medical professionals, let alone everyone else. No matter their opinions on widespread mask-wearing, everyone I spoke with for this article agreed that health-care workers should get dibs on any existing medical masks. This might well be why public-health officials have been so loath to recommend mask-wearing more broadly: Hoarders have already begun to exhaust the dwindling supplies. Even so, “policy shouldn’t be made to accommodate a lack of the supply,” Bourouiba said. “It should create the impetus to generate that supply.”

In the meantime, citizens (and, unfortunately, many health-care workers) will have to make do with MacGyvering their own alternatives. A few studies suggest that homemade cloth masks are less effective than proper medical ones, but are still better than nothing. In one experiment, a surgical mask filtered 89 percent of viral particles from volunteers’ coughs, a tea towel blocked 72 percent, and a cotton T-shirt blocked 50 percent.** In general, thicker materials are better than thinner ones, Marr said, and a tight fit across the face is important. If people use makeshift masks, they should thoroughly wash them afterward. And most of all, they should remember that homemade masks are not fully protective. They’re a last-ditch measure to be used in situations when social distancing isn’t possible. “It’s not like ‘I’m wearing [a mask] and now I can talk to everyone,’” Bourouiba said.

The mask debate is so intense because both the stakes and the uncertainty levels are so high. “We’re trying to build the plane while we’re flying it,” Hanage said. “We’re having to make decisions with quite massive consequences in the absence of secure data. It’s a nightmare for your average cautious public-health professional.”

The coronavirus pandemic has moved so quickly that years of social change and academic debate have been compressed into a matter of months. Academic squabbles are informing national policy. Long-standing guidelines are shifting. Within days, an experiment that’s done in a hospital room can affect how people feel about the very air around them, and what they choose to wear on their faces. Masks are a symbol, yes, but not just of conscientiousness. They’re also emblematic of a world that is changing so quickly, no one has time to take a breath.  

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* This article originally misstated the estimated number of viral particles in an infectious dose of SARS.

** This article originally misstated the percentage of viral particles that could be filtered by a surgical mask, a tea towel, and a cotton T-shirt.

Last month, Sally Hoelscher published her first crossword puzzle in The New York Times. It was Presidents’ Day; the theme was memoirs by first ladies. Like lots of nerdy subcultures, the crossword puzzle has a buzzing ecosystem, and it whirred into action. Hoelscher posted a photo of the newspaper her husband rose early on his day off to buy, and veteran crossword constructors, as they’re called, offered congratulations in a Facebook group that develops constructors from underrepresented groups. Some of the Times’ 600,000 digital-crossword subscribers finished Hoelscher’s puzzle with their thumbs, extending their solving streaks, and crossword bloggers (yes, they exist) favorably reviewed the puzzle’s theme, non-thematic vocabulary, and clues.

In comments sections on crossword blogs, alongside off-color jokes about hypothetical titles for a Melania Trump memoir, a debate raged. Jenni Levy, an internist and a writer on the review site Diary of a Crossword Fiend, applauded how Hoelscher’s puzzle “passe[d] the crossword Bechdel test.” But Levy bemoaned a “missed opportunity.”

“I went through looking for men’s names with mounting excitement: What if there weren’t any?” she wrote. Alas, 66-Across, DEE, was clued as “Billy ___ Williams,” not as the letter or the grade. Responding to Levy’s lament, a commenter wondered: “Why is it desirable/necessary to have women’s names predominate in crossword puzzles … I ignore the male/female body count.” Levy’s response was a perfect, full-throated call to arms for inclusivity in the crossworld:

Because women are underrepresented in puzzle content and creation. Clues and answers that are stereotypically masculine are “general interest;” clues and answers that are stereotypically feminine are “niche” or “obscure” … We’re so far from [parity] that a few puzzles with exclusively women’s names wouldn’t get us there … [and feminism here means] “we acknowledge the systemic forces that threaten women, we speak up when we see those forces represented in crosswords, and we call on our community to do better.”

Hoelscher appeared, replied to Levy, and said she’d submitted the puzzle with no men, but wasn’t surprised when the Times editors changed that.

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Crossword editors are strange arbiters of cultural relevance. Read tweets by Awkwafina or Olivia Wilde on learning that they’ve been immortalized in the black-and-white grid—it’s the bookish version of handprints on a slab outside Grauman’s Chinese Theatre. But any pub-trivia attendee—exposed to categories on craft beer or things that smell like sourdough or whatever the emcee is into—will tell you that personnel is policy. That crossword mainstays such as The New York Times, the Los Angeles Times, and The Wall Street Journal are largely written, edited, fact-checked, and test-solved by older white men dictates what makes it into the 15x15 grid and what’s kept out.

[Play: The Atlantic crossword]

When editors review a puzzle submission, they mark it up—minus signs next to obscurities or variant spellings, check marks next to lively vocabulary. But one editor’s demerit is another solver’s lexicon. Constructors constantly argue with editors that their culture is puzzle-worthy, only to hear feedback greased by bias, and occasionally outright sexism or racism. (Publications are anonymized in the editor feedback that follows.) MARIE KONDO wouldn’t be familiar enough “to most solvers, especially with that unusual last name.” GAY EROTICA is an “envelope-pusher that risks solver reactions.” (According to XWord Info, a blog that tracks crossword statistics, EROTICA has appeared in the New York Times puzzle, as one example, more than 40 times since 1950.) BLACK GIRLS ROCK “might elicit unfavorable responses.” FLAVOR FLAV, in a puzzle I wrote, earned a minus sign.

“Popular music,” the American Values Club crossword editor Ben Tausig told me, “where lots of young women and people of color are visible, is regularly dismissed as too ephemeral for a ‘Great Crossword Puzzle.’” He added, “Ephemerality is the code word; exclusion is the result.”

And while some corners of culture are kept out of crosswords, some troubling aspects of language creep in. The New York Times puzzle has weathered deep sensitivity issues of late, including allowing a racial slur in the grid in January 2019, despite unequivocal protestations from those who saw the puzzle prepublication. Other transgressions include clues for ILLEGAL (“One caught by border patrol”); MEN (“Exasperated comment from a feminist”); and HOOD (“Place with homies”). In many cases, editorial changes warp a constructor’s original, inoffensive clue.

[Read: How Will Shortz edits a New York Times crossword puzzle]

Will Shortz, the Puzzles editor at the Times, has cited low submission rates from underrepresented groups as one reason for lack of constructor parity, but tone deafness and opacity can put constructors off the newspaper. (I was once Shortz’s editorial assistant, and I contribute crosswords to the Times.) In a Facebook thread with Shortz and other commenters, Rebecca Falcon, a 30-year-old constructor, posted: “I can’t feel good about putting my work into an outlet that I feel has very different values than my own.” She continued: “Is there anything being done to address these issues?” Shortz gave a thoughtful answer citing recent increases in women bylines, saying parity was “an important issue for us.” But when prodded about insensitive edits, he denied them, adding: “If a puzzlemaker is unhappy with our style of editing, then they should send their work elsewhere (or publish it themselves to keep complete control).”

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Inclusivity efforts need triangulation between insider and outsider tactics, angling for unity between the fix-the-system camp and the start-fresh camp. Many constructors I spoke with still submit to publications like the Times, while advocating elsewhere for puzzles that reflect younger, broader sensibilities.

Erik Agard is one such advocate. Recently named the editor of USA Today’s crossword, in a few short months he’s already “brought something pretty radical,” per Andy Kravis, a queer constructor and an assistant for the Times’ puzzle. Almost every USA Today byline has been a woman or a person of color, thanks to Agard’s active recruitment. “It’s a model people would talk about as ‘Surely you can’t mean this; [surely we’ll] compromise along the way,’” Kravis says, and yet, under Agard’s stewardship, the USA Today puzzle is unmistakably diverse.

Part of that diversity is procedural, the Millennial tendency to scrub hierarchy for collaboration. Agard has workshopped grids countless times with newer constructors, providing “a level of support and mentorship that no other editor offers,” says Rachel Fabi, a bioethicist and crossword constructor. “The construction process [with Erik] is so much more efficient and respectful,” another constructor, Stella Zawistowski, agreed, arguing that editors like Agard prove that collaboration need not be cumbersome or slow, and need not sacrifice author voice.

[Read: Down but not out: The uncertain future of the crossword puzzle]

Solvers have noticed. Agard, who once wore a PUBLISH MORE WOMEN shirt to a crossword-puzzle tournament, thinks Shortz and other legacy editors “could snap [their] infinity gauntlets like Thanos, and 50 percent of puzzles would be by women.” But for now Agard is focused on making puzzles for communities rarely represented in puzzles—a project of expansion, not education. A solver lauded Agard for using they pronouns for the singer Sam Smith in a USA Today clue. Even cluing fusty crosswordese like OLE via the song “Big Ole Freak” wins converts and bridges generations; as one person observed on Twitter, “Megan Thee Stallion was in my grandmother’s crossword today.”

And while sensitive wunderkinds like Agard and David Steinberg, the Puzzles and Games editor at Andrews McMeel Universal, breathe new life into existing puzzles, publications old and new are getting into the crossword game. The New Yorker added a crossword in 2018; its editor, Liz Maynes-Aminzade, is the first woman to edit puzzles at a major publication since The New York Times’ inaugural editor, Margaret Farrar. (Full disclosure: I’m a contributor to The New Yorker puzzle.) For Maynes-Aminzade, an inclusive puzzle demands both gender parity and, like at USA Today, a collaborative, transparent editorial process. Crucially, because codification in reference books and Wikipedia can lag behind popular usage of, say, queer or POC colloquialisms, a quick office poll in Slack—as long as the group being surveyed is diverse—can corroborate what a search-engine algorithm might undercount.

Outside of traditional publications, subscription puzzle series such as the Inkubator, Women of Letters, and Queer Qrosswords make space for references or themes made for and by women and queer folks. Rebecca Falcon recently reviewed an Inkubator puzzle titled “Take the Plunge,” by Allegra Kuney. Its theme involved the letters B, O, O, and B extending beyond each side of the traditional 15x15 crossword grid; the terminal B of SPONGEBOB was, literally, part of a SIDE BOOB. Falcon’s enthusiasm for the puzzle was more than admiration for a well-crafted crossword; she was lauding exactly the kind of playful theme you wouldn’t see in most outlets, and the kind that might encourage a new crop of constructors.

Doubly encouraging are role models, and Falcon has made waves there, too. While brainstorming a theme, she had the idea to call for a “Women’s March”—in this case, a month of puzzles with as many female crossword bylines as possible. After coordinating with various publications, and helping source new voices, Falcon estimates that more than 100 women-made crosswords will be published. The New York Times signed on for the first week (“We’re making progress,” Shortz told me). Ben Tausig will feature women guest editors. And Steinberg will devote more than 30 puzzles to female bylines. Among the constructors will be Fabi and Zawistowski; Hoelscher, the Times constructor; and, making her Universal debut, Karen Steinberg, who happens to be David’s mother. “Yup, that’s my mom!” the younger Steinberg tweeted. “I’ve been mentoring her!”

You can learn a lot about a person from the way they try to sell you a truck.

All my real friends consume my tweets via RSS via google reader (it actually still exists) because mine are the only good ones and they don't want to read yours.

What was your original face before your father and mother were born? Did it, too, look tired?

Rice in its bowl, water in its pail, eye contact in your dreams.

The sea persists and the shore endures, but my determination to mispronounce your name will outlast them both.

A monk asked Master Haryo how to attain enlightenment. Master Haryo said, “That’s actually a pretty good question.” At that moment the monk attained great enlightenment.

What is the shape of thunder? What is the color of wind? We can’t afford to lower the bar on thunder and wind expertise.

One cannot climb a mountain with pockets full of luan shi. You don’t know what luan shi is? OK, wow, I thought someone with your degrees and experience would at least be familiar with luan shi. Weird.

The flax cloth, the cracked bowl, the cypress tree in front of the hall: Am I staring at one of these, or at your boobs?

In a storm, the great oak falls but the slender bamboo endures. Then the great oak writes a blog post titled “The Hard Truth About Diversity Quotas.”

To grow tall, the ginseng, like your sentences, must be cut short.

A gold Buddha does not pass through a furnace; a wood Buddha does not pass through fire; a mud Buddha does not pass through water. Yes, I’m aware that your question was about opportunities for advancement. I’m getting to that.

Odd and even are on one die, so your type of bathroom must be around here somewhere.

However wonderful a thing is, it may be that it is better not to have it at all. Hi, I’d like to add you to my professional network on LinkedIn.

Sen. Elizabeth Warren on stage with her husband Bruce Mann and their dog Bailey in Cedar Rapids, Iowa, on February 01, 2020. | Chip Somodevilla/Getty Images

White college grads are living in the Warren bubble.

A lot of people I know are voting for Elizabeth Warren on Super Tuesday. They’re doing so even though they’re aware she’s way down in the polls and that her hopes for becoming the Democratic nominee rest on various contested convention scenarios that would almost certainly be bad for their larger project of defeating Donald Trump.

Her supporters feel somewhat baffled: How did she evaporate from the top tier of contention, especially since so many of the people they know also like her?

There are specific tactical decisions (by both her campaign and her rivals) that brought her to this point. But a larger context to understand is that if you, like many of my friends, find the situation puzzling, that is probably because you know a lot of people who are demographically similar to yourself. I’m a highly educated white person, and most of my friends and acquaintances are also highly educated white people. Elizabeth Warren is very popular with people like us.

The reality is that there aren’t that many people like us — and there’s a valuable lesson in that, not just about the Warren campaign specifically but about some of the larger dynamics in American politics.

People like me love Elizabeth Warren

These charts from the Economist’s polling aggregator tell the tale. Even at a time when Warren had, in its estimate, fallen to fourth place in national polling, she was first with white college graduates and first with Democrats who have advanced degrees.

Warren’s fans often praise her intelligence, which I think is undeniable. Before she was a politician, she worked her way up through the hierarchy of legal academia to get a tenured post at Harvard Law School.

She’s written several books — actually wrote them, not just slapped her name on something done by a ghostwriter — ranging from dreary academic tomes to highbrow nonfiction written for a general audience. I’ve read a couple of her books, and they’re good. There are a lot of bright, hardworking people in the United States Congress (I promise), but Warren’s intellectual achievements leave many of her colleagues in the dust, to the point where she was an influential policymaker before she ever won an election, thanks to her powers as a thinker and an advocate.

Warren seems like she could do my job really well (and, indeed, we briefly overlapped as TPMCafe bloggers years ago). She’s the most interesting person in the field to talk to, and I don’t find it even slightly surprising that most people I know find her to be incredibly appealing and admirable.

The problem is that politics is a numbers game, and we are not in the majority.

It’s a working-class country

Warren stands head and shoulders above her colleagues in Congress in part because her achievements are impressive but also, in large part, because these are not achievements that are normally rewarded in the political process.

One reason for that is the overall level of educational attainment in the United States is simply lower than many college graduates seem to realize.

Win McNamee/Getty Images

Validated data from the 2016 election, for example, suggests that only about one-third of 2016 voters had college degrees. The share among Hillary Clinton voters was higher, at 43 percent, but even among the more educated in the party, most people haven’t graduated college. And among college graduates, about 75 percent attend schools that accept more than half of applicants, rather than the kind of state university flagships or elite private universities whose graduates dominate the media. In my friend group, it’s not unusual for someone to be a lawyer or a doctor or to have a master’s degree in something or other. As a policy journalist, I speak to a lot of experts in academia or the think tank world who have advanced degrees.

But in the actual American population distribution, there are more high school dropouts than people with master’s degrees. The median American under the age of 30 has $0 in student loan debt, not because the median young person is superrich but because most people didn’t attend expensive higher education institutions in the first place.

Too many fish in a small pond

It’s hard to know exactly why Warren is so much less popular with the people who make up the majority of the Democratic Party. Part of the problem is simply that she’s been running against two people — Sanders and Biden — who started the race better-known than she was and who are both well-liked by most Democrats. But it doesn’t seem all that far-fetched to posit that what makes her so impressive to some is precisely what doesn’t resonate with the bulk of the population. After all, if voters wanted to elect writers and intellectuals to office, we would have more of them. Warren is a strong fit for her adopted home state of Massachusetts, which famously has the most educated population of any state.

Warren has been further hampered in 2020 by the fact that two other candidates, Pete Buttigieg and Amy Klobuchar, were also occupying her same “educated white people” lane, albeit with more moderate ideological profiles. If you think about politics in highly ideological policy-oriented terms, that may seem odd, but the fact is a lot of people just aren’t that ideological and, to an extent, the primary sorted into a Biden/Sanders working-class camp and a Warren/Pete/Klobuchar white-collar one.

Win McNamee/Getty Images

Buttigieg, famously, is almost ostentatiously smart — speaking a little Norwegian and checking all the boxes on the high-achiever résumé before becoming mayor of South Bend, Indiana. And Klobuchar, like Warren, is actually the author of a good serious book, Uncovering the Dome, a case study in the corrupt politics of municipal stadium deals.

Within that electoral niche, Warren has done the best (and is still in the race). Unfortunately, she split the educated group three ways while Bernie Sanders and Joe Biden divided up the larger working-class bloc along age and ideological lines.

If you feel like Warren is very impressive and lots of people you know feel the same way, you’re not imagining it — lots of people just like you all across the country feel the same way.

It’s just that most Democrats aren’t all that much like you.

A man walks through Seoul wearing a mask to prevent the spread of the coronavirus. | Chung Sung-Jun/Getty Images

With 602 confirmed coronavirus cases, President Moon Jae-in has raised the country’s threat alert level to the highest of its four levels.

In response to growing concerns about the spread of Covid-19 — the disease caused by the novel coronavirus first observed in Wuhan, China — in South Korea, President Moon Jae-in has raised the country’s threat alert level to the highest of its four levels.

The country is currently struggling to stop the rapid spread of the novel virus, and has the second largest number of confirmed cases in the world, 602 (not counting the passengers of the Diamond Princess cruise ship docked on the shores of Japan). In the span of less than a week, the number of confirmed South Korean cases has jumped more than tenfold, six people have died, and over 8,000 people considered to be at risk of infection are still undergoing testing.

The last time the country raised its virus threat level to four was in 2009, when a novel influenza outbreak killed more than 260 people.

By raising the threat level, the president has given the government the ability to take drastic measures: officials can now restrict public transportation, flights to and from South Korea, bar tourists, lock down cities, and close schools. None of these measures have been implemented as of yet, but Moon said he will not shy away from doing whatever it takes to contain the Covid-19.

“We are faced with a watershed moment in the case of the coronavirus,” the president said, according to The New York Times. “The coming few days will be a critical time for us. This will be a momentous time when the central government, local governments, and the whole people must wage an all-out, concerted response to the problem.”

A controversial religious organization is at the center of South Korea’s coronavirus cases

Health officials point to a woman known as patient no. 31, a resident of the southern city of Daegu and a devout adherent of the controversial religious group the Shincheonji Church of Jesus, as the probable origin of the recent massive uptick in confirmed cases.

The 61-year-old woman first checked in to a hospital following a small car accident. On the fourth day of her stay, she developed a fever, but refused to get checked for the virus because she hadn’t traveled abroad or been in contact with anyone contaminated. She was finally tested on Monday, and on Tuesday she received positive results. Up until that point, she had slipped out of the hospital at least four times to attend services that attracted up to 1,000 people.

Even more concerning was the alleged response of the church: church members reportedly received social media messages that encouraged them to continue evangelical work in small groups and to deny their affiliation to the church if public health officials asked.

Church leadership, however, has denied being behind these messages and said they’ve punished the member who sent them. On Sunday, the group posted a video to their YouTube channel promoting their cooperation with the government: The video claims that not only have they encouraged their membership of over 150,000 people to limit contact with other people, but they’ve also given officials a list of about 9,000 names affiliated with their Daegu branch, according to Shincheonji spokesperson Kim Simon.

The church also used the video as an opportunity to address what it referred to as unfair aggression toward church members, and claim that they are the “biggest victims of a virus that originated in China.”

“We continue to see reports that suggest Shincheonji is hiding something,” Kim said. “We urge you to stop the hatred against Shincheonji followers.”

Health experts are concerned that Covid-19 is shaping up to become a pandemic

South Korea isn’t the only country overwhelmed by a sudden outbreak in confirmed cases. As of Sunday, there are over 78,000 cases of Covid-19 in at least 29 countries,

Iran, which did not have any confirmed cases until last Thursday, now has 43 confirmed cases and a death toll of eight, the highest death toll outside of China. Even more concerning is that cases linked to Iran have already popped up in Lebanon and Canada. As a result, the city of Tehran has closed down all bistros and water fountains as a preemptive response, Al Jazeera reported.

Meanwhile, Northern Italy has also been hit hard: out of the total 132 cases, 89 come from the Lombardy region, which includes financial hub Milan. It’s now the biggest hub of Covid-19 outbreaks outside of Asia, and two people have died from the disease.

It’s not that countries aren’t taking drastic measures to stop the spread of the disease. On Saturday, Israel denied the entry of 130 South Koreans to Tel Aviv, and sent them back home on the same flight (earlier, South Korea informed Israel that a group of Korean tourists had tested positive after returning home from Israel). And the United States has raised travel advisory for South Korea and Japan from Level 1 to Level 2, which calls for increased caution but not a travel ban.

At this point, however, the spread of the virus might be inevitable. As Vox’s Julia Belluz reports, Covid-19 is starting to look more and more like a pandemic (the spread of a new disease across the world) — and might even already be in one. The rapid rise of cases outside of China is a new development, and health officials are saying that our responses should now evolve as well, she wrote:

Public health experts said countries need to move from trying to contain the virus to mitigating its harm — reducing the spread, and caring for the very sick. “It is beyond time,” said Jennifer Nuzzo, an infectious disease expert and senior scholar at the Johns Hopkins Center for Health Security. This means hospitals need to be ready with Covid-19 protocols, health care workers need to be protected with access to protective equipment such as face masks, and countries need plans for maintaining supply chains and carrying on with travel and trade.

To be clear, a pandemic refers to how widely a disease spreads, not how many people die from the virus. It is still unclear how deadly the Covid-19 virus is, although a report from the China’s CDC found it to be less lethal than SARS. Nonetheless, the sheer number of people that need treatment could overwhelm any country’s health care system, leading to a shortage of hospital beds or medical equipment for those suffering from other maladies. Although the US only has 35 confirmed Covid-19 cases so far, South Korea, Italy, and Iran are case examples of why it is necessary to stay prepared.