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The US worried about vaccine tourists. Now it’s encouraging them.

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The US worried about vaccine tourists. Now it’s encouraging them.


A few days after Tedros’s press conference, in response to mounting international pressure, the Biden administration pledged 20 million doses from its stash of Pfizer-BioNTech, Moderna, and Johnson & Johnson vaccines to COVAX. This represented a significant shift in policy: it was the first time the US was donating doses that could have been used domestically. (The administration has also committed to donate 60 million doses of AstraZeneca to COVAX but has yet to do so.) 

Glenn Cohen, a law professor who directs Harvard Law School’s Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics, says that the pledge of 20 million doses is “a good first step” for a country that cannot get enough of its own people to use up its vaccine supply quickly enough. 

But, he adds, it does not negate the ethical murkiness of having American cities and states offer, or consider offering, vaccines to visitors as official policy. Cohen, who has written a book on medical tourism, says vaccines were meant to go first to “those who are most in need” and not to “people who are able to travel, who have visas, who are able-bodied.”

To put it another way, he says: it’s as if “someone loans you their car to take your mother to the hospital, and then you decide to take that car and instead of giving it back to the person—or taking other people to the hospital—you run it as an Uber.”

Outsourcing ethical quandaries 

Robert Amler, the dean of New York Medical College’s school of health science and practice, says that encouraging travelers to fly to the United States from places with low vaccination rates—and potentially higher levels of infection—may itself be bad for public health.

“Any risk of ‘importing’ covid infections will depend on the volume of incoming travelers and the percent of travelers arriving who already have covid infection,” says Amler, a former chief medical officer at the CDC. “We also can’t predict with certitude the city’s ability to manage their numbers if they become excessive.”

To combat this danger, some people who are traveling to get vaccinated are taking their own precautions to avoid becoming unwitting vectors for the virus—or causing other kinds of harm. 

“Michael” (also a pseudonym) and his wife flew from Quito, Ecuador, to New Orleans for a five-day trip in mid-May, during which he received the J&J shot and she got her first dose of the Pfizer vaccine.

Michael’s family in Canada have yet to meet the couple’s twin boys, who were born in January 2020. By going to Louisiana for their shots, he estimates that they’ve sped up their vaccination status—and therefore their family reunion—by six to nine months. 

Still, the couple wanted to make sure they were not taking vaccines that could have gone to someone else. “Our first thought was to go to a red state, because we knew supply outstripped demand,” he explains. 

They took extra precautions before and during their trip, too. Having both contracted covid much earlier in the pandemic, they got antibody tests before flying. Then they kept to themselves to limit their exposure. 

“The question is really about what states are doing with their resources and which countries are continuing to use them [vaccines] for their own advantage. Globally, that’s really wrong.”

Nicole Hassoun, Binghamton University

By taking the initiative, they may have dampened the potential negative impact from their trip, but this highlights another problem of vaccine tourism as policy—and of much of the world’s covid-19 response in general. Difficult ethical decisions that could have—or, some argue, should have—been matters of policy are instead being pushed onto individuals. 

“The city is the one who sets the queue,” says Pamela Hieronymi, a philosopher at the University of California, Los Angeles. So if you have an issue with vaccine tourists in, say, New York, “it seems your complaint should be made to the city, not to the person using the line offered to them.”

Nicole Hassoun, a philosophy professor at Binghamton University and the head of its Global Health Impact Project, also argues that while vaccine tourists may grapple with their choice, the real ethical issue is not at the individual level. “I think the question is really about what states are doing with their resources and which countries are continuing to use them [vaccines] for their own advantage,” she says. “Globally, that’s really wrong.”

There may also be second-order effects like exacerbating local inequality, says Yadurshini Raveendran, a graduate of the Duke Global Health Institute, who points out that richer individuals in low-income countries—those who travel internationally and are thus more likely to take advantage of vaccine tourism—already have better access to health care than poorer people in those countries. Israel has the highest vaccination rates in the world, she notes, but Palestine has administered one dose to just 5% of the population. 

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The Download: a long covid app, and California’s wind plans

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The Download: a long covid app, and California’s wind plans


1 The Twitter Files weren’t the bombshell Elon Musk billed them as 
His carelessness triggered the harassment of some of Twitter’s content moderators, too. (WP $)
+ The files didn’t violate the First Amendment, either. (The Atlantic $)
+ Hate speech has exploded on the platform since he took over. (NYT $)
+ Journalists are staying on Twitter—for now. (Vox)
+ The company’s advertising revenue isn’t looking very healthy. (NYT $)

2 Russia is trying to freeze Ukrainians by destroying their electricity 
It’s the country’s vulnerable who will suffer the most. (Economist $)
+ How Ukraine could keep the lights on. (MIT Technology Review)

3 Crypto is at a crossroads
Investors, executives, and advocates are unsure what’s next. (NYT $)
+ FTX and the Alameda Research trading firm were way too close. (FT $)
+ It’s okay to opt out of the crypto revolution. (MIT Technology Review)

4 Taylor Swift fans are suing Ticketmaster
They’re furious they weren’t able to buy tickets in the botched sale last month. (The Verge)

5 The internet is having a midlife crisis
What is it for? And more importantly, who is it for? (Slate $)
+ Tim Berners-Lee wanted the internet to have an ‘oh, yeah?’ button. (Slate $)

6 We need a global deal to safeguard the natural world
COP15, held this week in Montreal, is our best bet to thrash one out. (Vox)
+ Off-grid living is more viable these days than you may think. (The Verge)

7 What ultra-dim galaxies can teach us about dark matter  
We’re going to need new telescopes to seek more of them out. (Wired $)
+ Japanese billionaire Yusaku Maezawa has some big plans for space. (Reuters)
+ A super-bright satellite could hamper our understanding of the cosmos. (Motherboard)
+ Here’s how to watch Mars disappear behind the moon. (New Scientist $)

8 An elite media newsletter wants to cover “power, money, and ego.”
It promises unparalleled access to prolific writers—and their audiences. (New Yorker $)
+ How to sign off an email sensibly. (Economist $) 

9 The metaverse has a passion for fashion 👗
Here’s what its best-dressed residents are wearing. (WSJ $)

10 We’ve been sending text messages for 30 years 💬
Yet we’re still misunderstanding each other. (The Guardian)

Quote of the day

“There is certainly a rising sense of fear, justifiable fear. And I would say almost horror.”

—Pamela Nadell, director of American University’s Jewish Studies program, tells the Washington Post she fears that antisemitism has become normalized in the US, in the light of Kanye West’s recent comments praising Hitler.

The big story

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California’s coming offshore wind boom faces big engineering hurdles

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California’s coming offshore wind boom faces big engineering hurdles


Research groups estimate that the costs could fall from around $200 per megawatt-hour to between $58 and $120 by 2030. That would leave floating offshore wind more expensive than solar and onshore wind, but it could still serve an important role in an overall energy portfolio. 

The technology is improving as well. Turbines themselves continue to get taller, generating more electricity and revenue from any given site. Some research groups and companies are also developing new types of floating platforms and delivery mechanisms that could make it easier to work within the constraints of ports and bridges. 

The Denmark-based company Stiesdal has developed a modular, floating platform with a keel that doesn’t drop into place until it’s in the deep ocean, enabling it to be towed out from relatively shallow ports. 

Meanwhile, San Francisco startup Aikido Technologies is developing a way of shipping turbines horizontally and then upending them in the deep ocean, enabling the structures to duck under bridges en route. The company believes its designs provide enough clearance for developers to access any US port. Some 80% of these ports have height limits owing to bridges or airport restrictions.

A number of federal, state, and local organizations are conducting evaluations of California and other US ports, assessing which ones might be best positioned to serve floating wind projects and what upgrades could be required to make it possible.

Government policies in the US, the European Union, China, and elsewhere are also providing incentives to develop offshore wind turbines, domestic manufacturing, and supporting infrastructure. That includes the Inflation Reduction Act that Biden signed into law this summer.

Finally, as for California’s permitting challenges, Hochschild notes that the same 2021 law requiring the state’s energy commision to set offshore wind goals also requires it to undertake the long-term planning necessary to meet them. That includes mapping out a strategy for streamlining the approval process.

For all the promise of floating wind, there’s little question that ensuring it’s cost-competitive and achieving the targets envisioned will require making massive investments in infrastructure, manufacturing, and more, and building big projects at a pace that the state hasn’t shown itself capable of in the recent past.

If it can pull it off, however, California could become a leading player in a critical new clean energy sector, harnessing its vast coastal resources to meet its ambitious climate goals.

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How Twitter’s “Teacher Li” became the central hub of China protest information

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How Twitter’s “Teacher Li” became the central hub of China protest information


It’s hard to describe the feeling that came after. It’s like everyone is coming to you and all kinds of information from all over the world is converging toward you and [people are] telling you: Hey, what’s happening here; hey, what’s happening there; do you know, this is what’s happening in Guangzhou; I’m in Wuhan, Wuhan is doing this; I’m in Beijing, and I’m following the big group and walking together. Suddenly all the real-time information is being submitted to me, and I don’t know how to describe that feeling. But there was also no time to think about it. 

My heart was beating very fast, and my hands and my brain were constantly switching between several software programs—because you know, you can’t save a video with Twitter’s web version. So I was constantly switching software, editing the video, exporting it, and then posting it on Twitter. [Editor’s note: Li adds subtitles, blocks out account information, and compiles shorter videos into one.] By the end, there was no time to edit the videos anymore. If someone shot and sent over a 12-second WeChat video, I would just use it as is. That’s it. 

I got the largest amount of [private messages] around 6:00 p.m. on Sunday night. At that time, there were many people on the street in five major cities in China: Beijing, Shanghai, Chengdu, Wuhan, and Guangzhou. So I basically was receiving a dozen private messages every second. In the end, I couldn’t even screen the information anymore. I saw it, I clicked on it, and if it was worth posting, I posted it.

People all over the country are telling me about their real-time situations. In order for more people not to be in danger, they went to the [protest] sites themselves and sent me what was going on there. Like, some followers were riding bikes near the presidential palace in Nanjing, taking pictures, and telling me about the situation in the city. And then they asked me to inform everyone to be cautious. I think that’s a really moving thing.

It’s like I have gradually become an anchor sitting in a TV studio, getting endless information from reporters on the scene all over the country. For example, on Monday in Hangzhou, there were five or six people updating me on the latest news simultaneously. But there was a break because all of them were fleeing when the police cleared the venue. 

On the importance of staying objective 

There are a lot of tweets that embellish the truth. From their point of view, they think it’s the right thing to do. They think you have to maximize the outrage so that there can be a revolt. But for me, I think we need reliable information. We need to know what’s really going on, and that’s the most important thing. If we were doing it for the emotion, then in the end I really would have been part of the “foreign influence,” right? 

But if there is a news account outside China that can record what’s happening objectively, in real time, and accurately, then people inside the Great Firewall won’t have doubts anymore. At this moment, in this quite extreme situation of a continuous news blackout, to be able to have an account that can keep posting news from all over the country at a speed of almost one tweet every few seconds is actually a morale boost for everyone. 

Chinese people grow up with patriotism, so they become shy or don’t dare to say something directly or oppose something directly. That’s why the crowd was singing the national anthem and waving the red flag, the national flag [during protests]. You have to understand that the Chinese people are patriotic. Even when they are demanding things [from the government], they do it with that sentiment. 

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