When life is disrupted by crisis, some people see opportunities — for change, action, introspection — they might not otherwise.This article is part of a series on resilience in troubled times — what we can learn about it from history and personal experiences.About a year ago, just as the pandemic was hitting New York City, St. John Frizell and his two partners were readying for the grand reopening of Gage & Tollner, a newly renovated, 140-year-old restaurant in Downtown Brooklyn. One day before the March 15 opening — for which the three partners had spent almost a year and a half preparing — they made the difficult decision not to open.Mr. Frizell retreated to his home in Brooklyn. “The only sounds in the street were ice cream trucks and ambulances,” he recalled. Anxious about going to the supermarket but needing groceries for himself and his son, he reached out to one of his vendors, Lancaster Farm Fresh Co-op, to see about having some food delivered. Lancaster was delivering boxes of seasonal produce, but needed an order large enough to be worth the trip. So Mr. Frizell, who suddenly had downtime, did something he hadn’t done in a while: He reached out to his neighbors.“I posted something about it in a local Red Hook group on Facebook and got a big response,” he said. “I thought, OK, I can set this up for all of us.”Mr. Frizell also owns Fort Defiance, a beloved Red Hook bar that he opened in 2009 and that also closed in March; it became the order pickup spot. Neighbors began asking about other grocery items, so Mr. Frizell added things like milk, eggs, cheese and meats. “A lot of people in the neighborhood began looking to us for their staples,” he said.By midsummer, Fort Defiance had permanently become a general store, with new signage painted over the old “Cafe & Bar.” This March, Mr. Frizell started a crowdfunding campaign to help the store move to a bigger space one block away. (Gage & Tollner, which has been open for takeout since mid-February, plans to open for indoor dining on April 15.) The whole experience made Mr. Frizell aware of how much richer his life is when he is connected to the community. “Reaching out and asking what people needed felt really good, like I was doing what I could to help,” he said. “It felt very purposeful.”Fort Defiance in 2018. Now, the business operates as a general store serving the Red Hook neighborhood of Brooklyn.Marian Carrasquero/The New York TimesWhen life is disrupted by crisis, as it has been this past year, some people see opportunities — for change, action, introspection — they might not otherwise. The pandemic has caused many to question the way they live and what is important to them. That’s because a crisis often helps us develop a wider perspective on our lives, said Amit Sood, a physician and executive director of the Global Center for Resiliency and Wellbeing in Rochester, Minn. And that allows us to reframe what we see.Of course, for many people struggling to make ends meet or lacking savings, a big life change — or even just a shift in perspective — may not be possible. But for those fortunate enough to have the psychological space and economic security, this kind of reframing can present real possibilities for change.“When people focus on what is right within what seems wrong in their life (for example, the car has a flat tire but isn’t totaled), that can lead to seeing things that present themselves as opportunities,” he said.This is not the same thing as positive thinking. Instead, said Rick Hanson, a clinical psychologist and author of “Resilient: How to Grow an Unshakable Core of Calm, Strength, and Happiness,” it’s about seeing openings in life for change and transformation, even in difficult circumstances. Mr. Hanson said that although we often think of opportunities as things that exist outside ourselves, like a new job or moving to a different city, opportunities for growth and change exist inside us, too.Justin E.H. Smith, for example, a philosopher, historian and professor at the University of Paris, made subtle but important changes this past year. Mr. Smith describes himself as an introvert with a tendency to lead a rigid life, doing the same things in the same way every day. The pandemic forced him to restructure his daily life and soften his rigidity.“I’m aware of the contingency of these new routines now,” he said, “and my power to restructure them if they don’t suit.” Mr. Smith, 48, also admitted that he used to feel too old to try anything new. But the pandemic gave the professor permission to be a novice again. “It didn’t feel shameful any longer for me to be a beginner.”So after some research, he opened an online brokerage account. He also took up guitar (and now plays every day) and in August, decided to start a paid subscription newsletter on the digital publishing platform Substack, where he writes about the philosophical dimensions of culture, science and politics, and the ways they are changed (and distorted) by technology.Absent the pandemic, Mr. Smith probably never would have considered it, but for the first time in his professional life, he thought about diversifying his income. “I’m thinking ahead in a precarious moment,” he said.Those sorts of moments often shake up all that we believe to be true about the world, and that is what leads to personal growth. “These are core beliefs we have about the world that we generally don’t question, such as how vulnerable or safe we are, how much control we have over things or what our identity is,” said Richard Tedeschi, who, along with fellow psychologist Lawrence Calhoun, coined the term “post-traumatic growth” in the 1990s, naming this phenomenon.Red Hook in November. After the pandemic hit last spring, neighborhood residents began looking to Fort Defiance for basic grocery items.Karsten Moran for The New York TimesWe use these assumptions about the world to make decisions every day and to plan for the future. When a crisis hits, we often have trouble believing and accepting what is happening because it disrupts those core beliefs. “That is what qualifies as trauma,” Dr. Tedeschi said. “And it can set in motion major changes in people’s lives.” In fact, one of the five areas where growth and change occur after a crisis is in recognizing new possibilities.That is what happened to Elaine Mazanec. In mid-2019, she was a co-owner of a public relations agency in Washington and the mother of a 2-year-old when her husband died suddenly. As someone not used to asking for help, she was forced into a position of vulnerability.“I allowed myself to be cared for in a way I hadn’t before,” Ms. Mazanec said. “I had so much support. It wasn’t comfortable for me, but it was what enabled me to find my footing after the loss.”Just as she was getting back into a normal routine, the pandemic descended. “For the first few weeks, I felt similar to when I lost my husband, like the rug got pulled out from under me,” she said. In the weeks that followed she became more reflective, appreciating the positives in her life, especially the security and support she has (and that so many others do not).“I think sometimes when we’re super busy, we don’t get a chance to zoom out and see the bigger picture,” Ms. Mazanec said. “I realized that what had felt the most meaningful for me in the last two years was having the support of others to help me through a terrible loss, to help me process it.”Ms. Mazanec decided she wanted to be a person who supports others going through difficult times, so she started looking into graduate programs in social work. Most deadlines for applying had already passed, so when she learned that the University of Maryland School of Social Work — her first choice — had extended its deadline because of the pandemic, she took it as a sign she was on the right path.Now in her second semester of the program and doing her fieldwork in an elementary school, Ms. Mazanec says she feels that the work has real purpose and is closely aligned with her values.“The loss I experienced, that tragedy, really changed me,” she said. “And then the pandemic gave me an opening. It all came together in a way I couldn’t have predicted, but I know I’m where I’m supposed to be.”Eilene Zimmerman is author of the memoir “Smacked: A Story of White-Collar Ambition, Addiction and Tragedy.”

An emerging branch of neuroscience asks a question long on the minds of researchers. Recent stimulus payments make the study more relevant.New monthly payments in the pandemic relief package have the potential to lift millions of American children out of poverty. Some scientists believe the payments could change children’s lives even more fundamentally — via their brains.Does cash aid to poor parents help their children’s long-term brain development?Karsten Moran for The New York TimesIt’s well established that growing up in poverty correlates with disparities in educational achievement, health and employment. But an emerging branch of neuroscience asks how poverty affects the developing brain.Over the past 15 years, dozens of studies have found that children raised in meager circumstances have subtle brain differences compared with children from families of higher means. On average, the surface area of the brain’s outer layer of cells is smaller, especially in areas relating to language and impulse control, as is the volume of a structure called the hippocampus, which is responsible for learning and memory.These differences don’t reflect inherited or inborn traits, research suggests, but rather the circumstances in which the children grew up. Researchers have speculated that specific aspects of poverty — subpar nutrition, elevated stress levels, low-quality education — might influence brain and cognitive development. But almost all the work to date is correlational. And although those factors may be at play to various degrees for different families, poverty is their common root. A continuing study called Baby’s First Years, started in 2018, aims to determine whether reducing poverty can itself promote healthy brain development.“None of us thinks income is the only answer,” said Dr. Kimberly Noble, a neuroscientist and pediatrician at Columbia University who is co-leading the work. “But with Baby’s First Years, we are moving past correlation to test whether reducing poverty directly causes changes in children’s cognitive, emotional and brain development.”Dr. Noble and her collaborators are examining the effects of giving poor families cash payments in amounts that wound up being comparable to those the Biden administration will distribute as part of an expanded child tax credit.The researchers randomly assigned 1,000 mothers with newborns living in poverty in New York City, New Orleans, the Twin Cities and Omaha to receive a debit card every month holding either $20 or $333 that the families could use as they wished. (The Biden plan will provide $300 monthly per child up to age 6, and $250 for children 6 through 17.) The study tracks cognitive development and brain activity in children over several years using a noninvasive tool called mobile EEG, which measures brain wave patterns using a wearable cap of 20 electrodes.The study also tracks the mothers’ financial and employment status, maternal health measures such as stress hormone levels, and child care use. In qualitative interviews, the researchers probe how the money affects the family, and with the mothers’ consent, they follow how they spend it.The study aimed to collect brain activity data from children at age 1 and age 3 in home visits, and researchers managed to obtain the first set of data for around two-thirds of the children before the pandemic struck. Because home visits are still untenable, they extended the study to age 4 and will be collecting the second set of brain data next year instead of this year.The pandemic, as well as the two stimulus payments most Americans received this past year, undoubtedly affected participating families in different ways, as will this year’s stimulus checks and the new monthly payments. But because the study is randomized, the researchers nonetheless expect to be able to assess the impact of the cash gift, Dr. Noble said.Baby’s First Years is seen as an audacious effort to prove, through a randomized trial, a causal link between poverty reduction and brain development. “It is definitely one of the first, if not the first” study in this developing field to have direct policy implications, said Martha Farah, a cognitive neuroscientist at the University of Pennsylvania and director of the Center for Neuroscience and Society who studies poverty and the brain.Professor Farah concedes, however, that social scientists and policymakers often discount the relevance of brain data. “Are there actionable insights we get by bringing neuroscience to bear, or are people just being snowed by pretty brain images and impressive-sounding words from neuroscience? It’s an important question,” she said.Skeptics abound. James Heckman, a Nobel Prize-winning economist at the University of Chicago who studies inequality and social mobility, said he didn’t see “even a hint that a policy would come out of it, other than to say, yes, there’s an imprint of a better economic life.”“And it still remains a question what the actual mechanism is” through which giving parents cash helps children’s brains, he said, adding that targeting such a mechanism directly might be both cheaper and more effective.Samuel Hammond, director of poverty and welfare policy at the Niskanen Center, who worked on a child allowance proposal by Senator Mitt Romney, agrees that tracking the source of any observed cognitive benefits is tricky. “I have trouble disentangling the interventions that actually help the most,” he said. For example, policy experts debate whether certain child care programs directly benefit a child’s brain or simply free up her caregiver to get a job and increase the family’s income, he said.Yet that is exactly why providing disadvantaged families with cash might be the most potent way to test the link to brain development, Dr. Noble said. “It’s quite possible that the particular pathways to children’s outcomes differ across families,” she said. “So by empowering families to use the money as they see fit, it doesn’t presuppose a particular pathway or mechanism that leads to differences in child development.”Neuroscience has a track record for transforming societal thinking and influencing policy. Research showing that the brain continues to mature past adolescence and into a person’s mid-20s has reshaped policies relating to juvenile justice.In another example, research on brain and cognitive development in children who grew up in Romanian orphanages from the mid-1960s into the 1990s changed policy on institutionalization and foster care, in Romania and worldwide, said Charles Nelson, a neuroscientist at Harvard and Boston Children’s Hospital who co-led that work.Those studies demonstrated that deprivation and neglect diminish IQ and hinder psychological development in children who remain institutionalized past age 2, and that institutionalization profoundly affects brain development, dampening electrical activity and reducing brain size.But that work also underscores how consumers of research, policymakers among them, are prone to give more weight to brain data than to other findings, as other studies show. When Professor Nelson presents these findings to government or development agency officials, “I think they find it the strongest ammunition to implement policy changes,” he said. “It is a very powerful visual, more so than if we said, well, they have lower IQs, or their attachment isn’t as strong.” (He is an adviser for Baby’s First Years.)The vividness of such data isn’t necessarily bad, Dr. Noble said. “If we find differences and the brain data make those differences more compelling to stakeholders, then that’s important to include,” she said. Moreover, brain data provides valuable information in its own right, particularly in infants and young children, for whom behavioral tests of cognition are often inaccurate or impossible to conduct, she said. Brain differences also tend to be detectable earlier than behavioral ones, she said.The field may simply be too young to clock its contributions to policy, Professor Farah said. But increasing understanding of how specific brain circuits are affected by poverty, along with better tools for gauging such circuits, may yield science-based interventions that get taken up at a policy level, she said.Meanwhile, Baby’s First Years hopes to address a broader question that is already relevant at the policy level: whether cash aid to parents helps their children’s brains develop in a way that helps them for a lifetime.Alla Katsnelson is a science journalist in Northampton, Mass. You can follow her on Twitter at @lalakat.

The special project “What Loss Looks Like” presents personal artifacts belonging to those who have left us and explores what they mean to those left behind.Times Insider explains who we are and what we do, and delivers behind-the-scenes insights into how our journalism comes together.As the art director of the Well desk, I’ve spent the last year looking for images to reflect the devastation of the pandemic and the grief it has wrought. As the crisis has stretched on, I’ve thought of all the people who have lost loved ones to Covid-19 — not to mention those who have lost loved ones, period — and how they were cut off from the usual ways of gathering and grieving. Watching the numbers rise every day, it was easy to lose sight of the people behind the statistics. I wanted to find a way to humanize the death toll and re-establish the visibility of those who had died.To help our readers honor the lives of those lost during the pandemic, we decided to ask them to submit photographs of objects that remind them of their loved ones. The responses were overwhelming, capturing love, heartache and remembrance. We heard from children, spouses, siblings, grandchildren and friends — people who had lost loved ones not only to Covid-19 but from all manner of causes. What united them was their inability to mourn together, in person.Dani Blum, Well’s senior news assistant, spent hours speaking with each individual by phone. “It’s the hardest reporting I’ve ever done, but I feel really honored to be able to tell these stories,” she said. “What struck me the most about listening to all of these stories was how much joy there was in remembering the people who died, even amid so much tragedy. Many of these conversations would start in tears and end with people laughing as they told me a joke the person they lost would tell, or their favorite happy memory with them.”The photographs and personal stories, published digitally as an interactive feature, was designed by Umi Syam and titled “What Loss Looks Like.” Among the stories we uncovered: A ceremonial wedding lasso acts as a symbol of the unbreakable bond between a mother and father, both lost to Covid-19 and mourned by their children. A ceramic zebra figurine reminds one woman of her best friend, who died after they said a final goodbye. A gold bracelet that belonged to a father never leaves his daughter’s wrist because she is desperate for any connection to his memory.For those who are left behind, these items are tangible daily reminders of those who have departed. These possessions hold a space and tell a story. Spend time with them and you begin to feel the weight of their importance, the impact and memory of what they represent.Museums have long showcased artifacts as a connection to the past. So has The New York Times, which published a photo essay in 2015 of objects collected from the World Trade Center and surrounding area on 9/11. As we launched this project, we heard from several artists who, in their own work, explored the connection between objects and loss.Shortly after Hurricane Sandy, Elisabeth Smolarz, an artist in Queens, began working on “The Encyclopedia of Things,” which examines loss and trauma through personal objects. Kija Lucas, a San Francisco-based artist, has been photographing artifacts for the past seven years, displaying her work in her project “The Museum of Sentimental Taxonomy.”“Saved: Objects of the Dead” is a 12-year project by the artist Jody Servon and the poet Lorene Delany-Ullman, in which photographs of personal objects from deceased loved ones are paired with prose to explore the human experience of life, death and memory. And the authors Bill Shapiro and Naomi Wax spent years interviewing hundreds of people and asking them about the most meaningful single object in their lives, gathering their stories in the book “What We Keep.”As the pandemic continues to grip the nation, the Well desk will continue to wrestle with the large-scale grief that it leaves in its wake. Other features on this topic include resources for those who are grieving, the grief that’s associated with smaller losses, and how grief affects physical and psychological health. As for “What Loss Looks Like,” we are keeping the callout open, inviting more readers to submit objects of importance, to expand and grow this virtual memorial and provide a communal grieving space.

The president pushed up his target date by two weeks, matching the timetable already being put in place by many states.WASHINGTON — President Biden on Tuesday moved up by two weeks, to April 19, his deadline for states to make every American adult eligible for coronavirus vaccination, following the lead of states around the country that are already meeting that timetable.Mr. Biden’s announcement came as Americans and their elected officials were grappling with competing and seemingly contradictory forces. The pace of vaccinations is accelerating, but worrisome new variants are spreading. The death rate is declining, but caseloads and hospitalizations are on the rise.California officials announced on Tuesday that they plan to lift all coronavirus restrictions on June 15, provided there are enough Covid-19 vaccines available for anyone age 16 or older and hospitalizations remain low and stable. Other states are already lifting restrictions, but Mr. Biden, in remarks at the White House, warned against throwing off the guardrails too soon.“The virus is spreading because we have too many people who, seeing the end in sight, think we’re at the finish line already,” the president said. “But let me be deadly earnest with you: We aren’t at the finish line. We still have a lot of work to do. We’re still in a life-and-death race against this virus.”The president also reiterated and made explicit his pledge to give surplus vaccine to other countries, once he is certain there is enough for people in the United States.Not quite a month ago, Mr. Biden set a deadline of May 1 for states to open up vaccination to all adults. A week after that, he said that by April 19, 90 percent of adults would be eligible for a shot and would be able to get one within five miles of their home.Since then, nearly every state in the nation has accelerated its vaccination program, and the vast majority are now meeting or coming in ahead of the April 19 target. On Tuesday, Oregon said those 16 or older will be eligible for vaccination on April 19.At least 530 new coronavirus deaths and 76,624 new cases were reported in the United States on Monday, according to a New York Times database. Over the past week, there has been an average of 64,855 new cases per day, an increase of 20 percent from the average two weeks earlier.That has put the country in a tenuous situation, with public health officials, including Dr. Rochelle Walensky, the director of the Centers for Disease Control and Prevention, pleading with governors not to lift restrictions and with citizens to continue to follow social distancing guidelines, wear masks and take other public health precautions. Last week, Dr. Walensky said she felt a sense of “impending doom” from a potential fourth surge of the pandemic.But in California, cases have been declining since hitting a peak early this year, with the state now averaging around 2,700 new cases a day, the lowest figure since June. The C.D.C. said that, as of Tuesday, 35 percent of the state’s total population had received at least one vaccine shot, and 18 percent were fully vaccinated.“With more than 20 million vaccines administered across the state, it is time to turn the page on our tier system and begin looking to fully reopen California’s economy,” Gov. Gavin Newsom, a Democrat, said in a statement. “We can now begin planning for our lives post-pandemic.”Many public health experts say that the nation is in a race between the vaccines and the variants and that, for the moment at least, the vaccines appear to have the upper hand. But public health officials are worried that future iterations of the virus may be more resistant.At the same time, they are watching an uptick in cases among young people, particularly those ages 18 to 24. Dr. Walensky told reporters on Monday that the C.D.C. was working with states to investigate outbreaks in young people that she said may be related to extracurricular activities or sports.Mr. Biden spoke on Tuesday after visiting a vaccination clinic at the Virginia Theological Seminary in Alexandria, Va., which is working with community health centers to offer inoculations. Making the rounds of the makeshift clinic, he showed flashes of his old self — the sunny retail politician who likes to get close to people, with a pat on the arm or a squeeze on the shoulder.“He’s gonna be hard — he’s got so much muscle mass there,” the president joked to a nurse as he squeezed the shoulder of a muscular man who was about to get his shot. “I tell you what, I could have been an All-American if I had those.”But his lightness belied the seriousness of the message he would later deliver at the White House. There, he marked a milestone: Since Mr. Biden has been in office, more than 150 million Covid-19 shots have been administered to Americans, which puts the nation on track to reach his goal of 200 million shots by his 100th day in office, at the end of this month.“We’ve vaccinated more people than any other nation on Earth,” the president said. “The vaccines have proven to be safe and effective. That should give us real hope.”But, he added, “we can’t let it make us complacent.”Jill Cowan

SharecloseShare pageCopy linkAbout sharingimage copyrightGetty ImagesPeople diagnosed with Covid-19 in the previous six months were more likely to develop depression, dementia, psychosis and stroke, researchers have found.A third of those with a previous Covid infection went on to develop or have a relapse of a psychological or neurological condition. But those admitted to hospital or in intensive care had an even higher risk.This is likely to be down to both the effects of stress, and the virus having a direct impact on the brain.UK scientists looked at the electronic medical records of more than half a million patients in the US, and their chances of developing one of 14 common psychological or neurological conditions, including:brain haemorrhagestrokeParkinson’s Guillain-Barré syndrome dementiapsychosismood disordersanxiety disorders Anxiety and mood disorders were the most common diagnosis among those with Covid, and these were more likely to be down to the stress of the experience of being very ill or taken to hospital, the researchers explained.Conditions like stroke and dementia were more likely to be down to the biological impacts of the virus itself, or of the body’s reaction to infection in general. Covid-19 was not associated with an increased risk of Parkinson’s or Guillain-Barré syndrome (a risk from flu).Cause and effectThe study was observational, so the researchers couldn’t say whether Covid had caused any of the diagnoses – and some people would have had a stroke or depression in the next six months regardless. But by comparing a group of people who had had Covid-19 with two groups – with flu and with other respiratory infections respectively – the researchers at the University of Oxford concluded Covid was associated with more subsequent brain conditions than other respiratory illnesses.The participants were matched by age, sex, ethnicity and health conditions, to make them as comparable as possible.Sufferers were 16% more likely to develop a psychological or neurological disorder after Covid than after other respiratory infections, and 44% more likely than people recovering from flu. On top of this, the more severely ill with Covid the patient had been, the more likely they were to receive a subsequent mental health or brain disorder diagnosisMood, anxiety or psychotic disorders affected 24% of all patients but this rose to 25% in those admitted to hospital, 28% in people who were in intensive care and 36% in people who experienced delirium while ill. Strokes affected 2% of all Covid patients, rising to 7% of those admitted to ICU and 9% of those who had delirium. And dementia was diagnosed in 0.7% of all Covid patients, but 5% of those who’d experienced delirium as a symptom.Dr Sara Imarisio, head of research at Alzheimer’s Research UK, said: “Previous studies have highlighted that people with dementia are at higher risk of developing severe Covid-19. This new study investigates whether this relationship may also hold in the other direction.”The study doesn’t focus on the cause of this relationship and it is important that researchers get to the bottom of what underlies these findings.”What does Covid-19 do to the brain?How Covid-19 can damage the brainUK biobank scans aim to reveal health legacyThere is evidence the virus does enter the brain and cause direct damage, neurology professor Masud Husain at the University of Oxford, explained.It can have other indirect effects, for example by affecting blood clotting which can lead to strokes. And the general inflammation which happens in the body as it responds to infection can affect the brain.For just over a third of people developing one or more of these conditions, it was their first diagnosis.But even where it was a recurrence of a pre-existing problem, researchers said this did not rule out the possibility that Covid had caused the episode of illness.Prof Dame Til Wykes, at the Institute of Psychiatry, Psychology and Neuroscience, King’s College London, said: “The study confirms our suspicions that a Covid-19 diagnosis is not just related to respiratory symptoms, it is also related to psychiatric and neurological problems.”Looking over six months after diagnosis has demonstrated that the “after-effects” can appear much later than expected – something that is no surprise to those suffering from Long Covid.”Although as expected, the outcomes are more serious in those admitted to hospital, the study does point out that serious effects are also evident in those who had not been admitted to hospital.”LOOK-UP TOOL: How many cases in your area?LOCKDOWN RULES: What are they and when will they end?YOUR QUESTIONS: We answer your queriesGLOBAL SPREAD: How many worldwide cases are there?

As shots roll out to growing numbers of Americans, the political picture is getting more chaotic.Antonio de Luca/The New York TimesPresident Biden today called for governors to open coronavirus vaccinations to all adults within the next two weeks, speeding up a target he had previously set for May 1.But recent polls and political tides, particularly in red states, suggest that if the country is to reach herd immunity, simply making the vaccine available may not be enough. A sizable minority of skeptics remain wary of being vaccinated, polls suggest, with questions about the vaccine’s safety lying at the heart of their doubt.Dr. Anthony Fauci, the nation’s top infectious disease expert, has said the country shouldn’t expect to reach herd immunity — whereby a disease effectively stops traveling freely between infected people — until at least 75 percent of Americans are vaccinated.Some states and businesses are starting to treat proof of vaccination as a kind of passport. Many cruise ships, for instance, are requiring proof of vaccination for passengers, and Gov. Andrew Cuomo of New York last month announced the creation of Excelsior Pass, a way for state residents to easily show proof of vaccination using a smartphone. Proof of a shot is now required for entry into some large venues under New York’s current reopening guidelines.But the political picture is different elsewhere. Yesterday, Greg Abbott of Texas became the second Republican governor, after Ron DeSantis of Florida, to sign an executive order preventing companies from requiring their employees to be vaccinated.Fauci made it clear yesterday that he and the Biden administration were likely to stay out of it. “I doubt that the federal government will be the main mover of a vaccine passport concept,” he told the “Politico Dispatch” podcast. “They may be involved in making sure things are done fairly and equitably, but I doubt if the federal government is going to be the leading element of that.”But without a nudge, polls suggest that it could take a while to get the full country vaccinated.Nearly half of American adults reported that they gotten at least one dose of the vaccine, according to an Axios/Ipsos poll released today, but there is reason to believe that the rise in vaccinations may taper off soon. Among those who had not gotten a shot, people were more likely to say they would wait a year or longer (25 percent) than to say they’d get the vaccine within a few weeks of it being available (19 percent). Thirty-one percent of Republicans said they were not at all likely to get the shot. Partly driving that is deep-seated wariness among white evangelical Christians, a core part of the Republican base, whom polls have shown to be among the most vaccine-averse populations.A separate poll released today by the Kaiser Family Foundation and The Washington Post revealed that more than one-third of the country has little confidence that the Covid-19 vaccines have been “properly tested for safety and effectiveness.” Health care workers tracked evenly with the rest of the population in terms of vaccine skepticism: Thirty-six percent of them were not confident.When it comes to confidence, there’s no stronger measure than whether you’d give something to your child. Fauci has made clear that herd immunity won’t be possible without widespread vaccinations for young people, so any target for the country must include them as well. But nearly half of all parents polled by Axios/Ipsos said they probably wouldn’t be first in line to get their children a vaccine when it became available.Fifty-two percent of respondents with a child under 18 in the home said they would probably take advantage of the vaccine as soon as their kid’s age group was eligible, but 48 percent said they wouldn’t.But even as some vaccine skepticism lingers, Americans are reporting convening in far higher numbers. Fifty-five percent of the country said they had been in the company of family or friends in the past week, more than at any point in the past year. Forty-five percent said they had recently gone out to eat.Thirty-six percent said they hadn’t been practicing social distancing at all over the past week.New York Times PodcastsThe Ezra Klein Show: Did the boomers ruin America?On today’s episode, Ezra spoke with the conservative writer Helen Andrews and the liberal journalist Jill Filipovic about why millennials are so mad at their parents’ generation.Filipovic and Andrews, both of whom are millennials (as is Ezra), agree that the boomers left their generation worse off; but they disagree on just about everything else. They discussed the value of generational analysis, the legacy of the sexual revolution, the impact of boomer economic policies, the decline of the nuclear family, the so-called millennial sex recession, the millennial affordability crisis, the impact of pornography, how much the critique of the boomers is really a critique of technological change and much more.You can listen here, and read the transcript here.On Politics is also available as a newsletter. Sign up here to get it delivered to your inbox.Is there anything you think we’re missing? Anything you want to see more of? We’d love to hear from you. Email us at onpolitics@nytimes.com.

A devastating itching of the skin driven by severe liver disease turns out to have a surprising cause. Its discovery points toward possible new therapies for itching, and shows that the outer layer of the skin is so much more than insulation.
The finding, which appears April 2 in Gastroenterology, indicates that the keratinocyte cells of the skin surface are acting as what lead researcher Wolfgang Liedtke, MD PhD, calls ‘pre-neurons.’
“The skin cells themselves are sensory under certain conditions, specifically the outermost layer of cells, the keratinocytes,” said Liedtke, who is a professor of neurology at Duke School of Medicine.
This study on liver disease itching, done with colleagues in Mexico, Poland, Germany and Wake Forest University, is a continuation of Liedtke’s pursuit of understanding a calcium-permeable ion channel on the cell surface called TRPV4, which he discovered 20 years ago at Rockefeller University.
The TRPV4 channel plays a crucial role in many tissues, including the sensation of pain. It was known to exist in skin cells, but nobody knew why.
“The initial ideas were that it plays a role in how the skin is layered, and in skin barrier function,” Liedtke said. “But this current research is getting us into a more exciting territory of the skin actually moonlighting as a sensory organ.” Once a chemical signal of itching is received, keratinocytes relay the signal to nerve endings in the skin that belong to itch-sensing nerve cells in the dorsal root ganglion next to the spine.

A team led by scientists at the UNC School of Medicine identified a molecule called microRNA-29 as a powerful controller of brain maturation in mammals. Deleting microRNA-29 in mice caused problems very similar to those seen in autism, epilepsy, and other neurodevelopmental conditions.
The results, published in Cell Reports, illuminate an important process in the normal maturation of the brain and point to the possibility that disrupting this process could contribute to multiple human brain diseases.
“We think abnormalities in microRNA-29 activity are likely to be a common theme in neurodevelopmental disorders and even in ordinary behavioral differences in individuals,” said senior author Mohanish Deshmukh, PhD, professor in the UNC Department of Cell Biology & Physiology and member of the UNC Neuroscience Center. “Our work suggests that boosting levels of miR-29, perhaps even by delivering it directly, could lead to a therapeutic strategy for neurodevelopmental disorders such as autism.”
miR-29 and brain maturation
MicroRNAs are short stretches of ribonucleic acid inside cells that regulate gene expression. Each microRNA, or miR, can bind directly to an RNA transcript from certain other genes, preventing it from being translated into a protein. MiRNAs thus effectively serve as inhibitors of gene activity, and the typical microRNA regulates multiple genes in this way so that genetic information is not overexpressed. These essential regulators have been intensively researched only in the past two decades. Therefore, much remains to be discovered about their roles in health and disease.
Deshmukh and colleagues set out to find microRNAs involved in the maturation of the brain after birth, a phase that in humans includes approximately the first 20 years of life. When the scientists looked for microRNAs with more activity in the adult mouse brain than the young mouse brain, one set of miRNA stuck way out from the rest. Levels of the miR-29 family were 50 to 70 times higher in the adult mouse brains than in young mouse brains.

In a recent study published by the Journal of Pain, co-authored by Elizabeth Losin, assistant professor of psychology and director of the Social and Cultural Neuroscience lab at the University of Miami, researchers found that a patient’s pain responses may be perceived differently by others based on their gender.
According to “Gender biases in estimation of others’ pain,” when male and female patients expressed the same amount of pain, observers viewed female patients’ pain as less intense and more likely to benefit from psychotherapy versus medication as compared to men’s pain, exposing a significant patient gender bias that could lead to disparities in treatments.
The study consisted of two experiments. In the first, 50 participants were asked to view various videos of male and female patients who suffered from shoulder pain performing a series of range of motion exercises using their injured and uninjured shoulders. Researchers pulled the videos from a database that contains videos of actual shoulder injury patients, each experiencing a range of different degrees of pain. The database included patients’ self-reported level of discomfort when moving their shoulders.
According to Losin, the study likely provides results more applicable to patients in clinical settings compared to previous studies that used posed actors in their stimuli videos.
“One of the advantages of using these videos of patients who are actually experiencing pain from an injury is that we have the patients’ ratings of their own pain,” she explained. “We had a ground truth to work with, which we can’t have if it’s a stimulus with an actor pretending to be in pain.”
The patients’ facial expressions were also analyzed through the Facial Action Coding System (FACS) — a comprehensive, anatomically based system for describing all visually discernible facial movements. The researchers used these FACS values in a formula to provide an objective score of the intensity of the patients’ pain facial expressions. This provided a second ground truth for the researchers to use when analyzing the data.

Businesses and universities want fast, easy ways to see if students and customers are vaccinated, but conservative politicians have turned “vaccine passports” into a cultural flash point.WASHINGTON — Cathay Pacific airlines, convinced that digital proof of coronavirus vaccination will bring about the return of safe international travel, asked its pilots and crew to try out a new mobile app that showed their vaccination status on a recent flight from Hong Kong to Los Angeles.New York has rolled out “Excelsior Pass,” billed by the state as “a free, fast and secure way to present digital proof of Covid-19 vaccination” in case reopening sports and entertainment venues require proof of attendees’ status.And Walmart, the nation’s largest private employer, is offering electronic verification apps to patients vaccinated in its stores so they “can easily access their vaccine status as needed,” the company says.Around the country, businesses, schools and politicians are considering “vaccine passports” — digital proof of vaccination against the coronavirus — as a path to reviving the economy and getting Americans back to work and play. Businesses especially fear that too many customers will stay away unless they can be assured that the other patrons have been inoculated.But the idea is raising charged legal and ethical questions: Can businesses require employees or customers to provide proof — digital or otherwise — that they have been vaccinated when the coronavirus vaccine is ostensibly voluntary?Can schools require that students prove they have been injected with what is still officially an experimental prophylaxis the same way they require long-approved vaccines for measles and polio? And finally, can governments mandate vaccinations — or stand in the way of businesses or educational institutions that demand proof?Legal experts say the answer to all of these questions is generally yes, though in a society so divided, politicians are already girding for a fight. Government entities like school boards and the Army can require vaccinations for entry, service and travel — practices that flow from a 1905 Supreme Court ruling that said states could require residents to be vaccinated against smallpox or pay a fine.“A community has the right to protect itself against an epidemic of disease which threatens the safety of its members,” Justice John Marshal Harlan wrote in Jacobson v. Massachusetts, the 1905 case.Private companies, moreover, are free to refuse to employ or do business with whomever they want, subject to only a few exceptions, ones that do not include vaccination status. And states can probably override that freedom by enacting a law barring discrimination based on vaccination status.But as the nation struggles to emerge from the worst public health crisis in a century, the arrival of digital vaccine verification apps — a modern version of the World Health Organization’s “yellow card” that provides international proof of yellow fever vaccination — has generated intense debate over whether proof of vaccination can be required at all.On Tuesday, Gov. Greg Abbott of Texas became the latest Republican governor to issue an executive order barring state agencies and private entities receiving funds from the state from requiring proof of vaccination. The World Health Organization, citing equity concerns, also said on Tuesday that it currently did not support mandatory proof of vaccination for international travel.Others are moving forward. Universities like Rutgers, Brown and Cornell have already said they will require proof of vaccination for students this fall. The Miami Heat this week became the first team in the N.B.A. to open special “vaccinated only” sections.And though businesses have yet to announce outright bans on unvaccinated clientele, some states and technology firms are preparing: At least 17 companies or nonprofits are developing websites or apps that might be used by sporting venues, restaurants and other businesses seeking to keep their customers and employees safe, according to Joel White, the executive director of the Health Innovation Alliance, a broad coalition of health providers, tech companies, employers and insurers.Airlines including JetBlue and United are also testing the “CommonPass” app, developed by The Commons Project, a nonprofit trust dedicated to using technology to help people control their personal information. Airlines for America, the trade group for the nation’s major carriers, opposes making proof of vaccination mandatory for air travel but would like a clean, easy way for travelers to show their status. Other countries may require proof of vaccination, and the apps can also be used to prove negative coronavirus test results, which the United States requires for international travelers.“On the face of things, requiring proof of vaccination seems a lot like, ‘No shoes, no shirt, no service,’” said Mark Tushnet, a law professor at Harvard.The Centers for Disease Control and Prevention already provides everyone who is vaccinated a card that can serve as proof, and people can always carry paper records of negative coronavirus tests. But industry leaders liken digital vaccination apps to security screening services like TSA PreCheck; it is not required, but it might make the travel experience smoother.In Israel, a “Green Pass” is already in place that allows vaccinated citizens to go to restaurants, concerts and sporting events.Backers of digital vaccination cards are pressing the Biden administration to become involved, at least by setting standards for privacy and for verifying the accuracy of the records.The White House is clearly skittish.“The government is not now nor will we be supporting a system that requires Americans to carry a credential,” Jen Psaki, the White House press secretary, said on Tuesday. “There will be no federal vaccinations database and no federal mandate requiring everyone to obtain a single vaccination credential.”She promised that the administration would provide some form of guidance — most likely in the form of questions and answers — about privacy, security, discrimination and concerns.Last week, the chief technology officer of the Department of Health and Human Services held a conference call with state and local health officials, who are mystified by the administration’s reticence.“It’s going to be necessary to have this, and there is going to have to be some kind of system where it’s verified,” said Dr. Marcus Plescia, the chief medical officer of the Association of State and Territorial Health Officials. “I think everybody in our network is a little bit perplexed by the way the federal government seems to be at arm’s-length with this.”A man presenting his “Green Pass” vaccination certificate before entering a coffee shop last month in Tel Aviv.Amir Levy/Getty ImagesOne arm of the government has offered some help: The Equal Employment Opportunity Commission has told employers that they can mandate coronavirus vaccination because public health comes first. But if an employee cannot get vaccinated because of a disability or a sincerely held religious belief, and the company cannot make an accommodation, the agency said, “then it would be lawful for the employer to exclude the employee from the workplace.”Conservatives and libertarians, though, are resisting such mandates. Gov. Ron DeSantis of Florida on Friday signed an executive order barring businesses from requiring patrons or customers to show vaccine documentation, under penalty of losing state contracts. Mississippi’s Republican governor, Tate Reeves, said on Sunday that he too opposed the idea.That has left technology executives like Stanley Campbell in the lurch. His firm, EagleForce, which specializes in health records, has created “myVax,” a digital platform that, he said, might even be used by farmers to screen their workers. Mr. Campbell, a Florida native, pitched the idea to Florida’s agriculture commissioner last week — a day before Mr. DeSantis issued his ban.“It’s not really a political football, which is what they keep using this thing as,” said Mr. Campbell, whose wife, Cheryl Campbell, who is also a health care technology expert and who recently joined the Biden administration. “It’s sad because Florida could lead the nation in this if we just took a minute to talk and think it through.”Mr. DeSantis’s order has already altered the back-to-school plans for Nova Southeastern University, based in Fort Lauderdale, which had announced a policy for returning students to be vaccinated. The university’s president and chief executive officer, George Hanbury, said the university was reviewing the order and planned to follow it.“We’re not trying to do anything but protect our students,” he said.Republican critics say vaccine passports raise the specter of centralized databases of vaccinated people, which they view as a government intrusion on privacy.“A vaccine passport—a unified, centralized system for providing or denying access to everyday activities like shopping and dining—would be a nightmare for civil liberties and privacy,” Justin Amash, a former Republican congressman who is now a libertarian, wrote on Twitter last week.But, in fact, every state already has a database, or an “immunization registry.” And under “data use agreements,” the states are required to share their registries with the C.D.C., though the agency de-identifies the information and not all states have agreed to provide it.And digital vaccine cards are not new. STChealth, an Arizona-based health care technology company, created an app called MyIR — my immunization record — about five years ago with the idea of helping parents who need their children’s vaccination records for school or camp. The app, which is free, connects with the immunization registries of five states and can verify vaccination data for those states’ residents.“We never built it as a digital passport kind of thing because that wasn’t an issue at the time,” the company’s chief executive officer, Mike Popovich, said in an interview. “But here in Arizona, I got my Covid shot and four hours later, I could use that to take a look at my record that had been reported to the state information system — and there it was.”With apps already proliferating, the Health Innovation Alliance sent a letter last month to Jeffrey D. Zients, the White House coronavirus response coordinator, calling on the administration to set standards. Mr. White, the organization’s executive director, said the group had not gotten an answer.He said he understood his fellow Republicans’ concerns, but disagreed.“We live in a free society where people are free to work or not, to go to concerts or not, to go to restaurants or not,” Mr. White said. “And when you are dealing with a highly infectious disease that is transmissible particularly in closed spaces — and that can kill you — it is not unreasonable for businesses in a free society to protect their employees and protect their patrons by asking people if they have been vaccinated.”