State by state, we divide further into a Red America and a Blue America

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State by state, we divide further into a Red
America and a Blue America
E.J. Dionne Jr. Washington Post April 6, 2022

SAN FRANCISCO — Former president Barack Obama’s visit to the White House on
Tuesday was aimed at reminding anyone willing to listen of the success of the Affordable
Care Act that he and President Biden championed.

The law widely known as Obamacare has done a lot of good. But the event was an
inadvertent reminder of something else: the extent to which we have become two
nations even in public policy.

In his celebrated 2004 Democratic National Convention speech, Obama insisted that
“there’s not a liberal America and a conservative America — there’s the United States of
America.”

Eighteen years later, red states and blue states are moving further and further away
from each other in how they deal with not just health care but a wide range of issues,
including voting rights, climate change, guns, abortion, LGBTQ rights and education.
“Political polarization” goes from abstract to evident in the sharp contrast in state
choices — and in how entrenched each party is becoming in states that have long leaned
their way.

At the extreme, an unbridgeable gap among the states over slavery led to the Civil War.
We are not at that point, but we can’t ignore how the hardening of political opinions,
especially on the right, as well as the politics of cultural warfare and a series of Supreme
Court decisions mean that state boundaries have a growing effect on how people live.

Tuesday’s White House event brought this home. In praising the Affordable Care Act as
“the most consequential health-care legislation passed in generations in our
country,” Vice President Harris noted that it had expanded health coverage to more than
30 million Americans. She also pointed to the 12 states that have refused to expand
Medicaid under the law, leaving 4 million Americans “locked out of coverage.” This
number includes 2.2 million who have no pathway to coverage at all.

The “Medicaid gap” was not supposed to happen. Originally, the ACA required all states
to expand coverage. But in a move that substantially revised earlier understandings of
federal power, the Supreme Court decision that declared Obamacare constitutional
struck down the expansion requirement as violating states’ rights. A dozen deeply red
states, eight of them in the South, have refused to participate, meaning that for millions
of Americans, crossing a state line can deprive them of access to health insurance.

We are also two Americas when it comes to voting, thanks to the Supreme Court’s
gutting of the Voting Rights Act. As of December, 19 states had enacted restrictions on
ballot access even as 25 states expanded it, according to a Brennan Center for Justice
tally.

And on abortion, the story is comparable. The Supreme Court’s tilt toward states’ rights
could become sharper in an abortion decision expected later this year. Already, the

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court’s inclinations have called forth a burst of more restrictive laws in red states
(see Oklahoma this week) and legislative guarantees of abortion rights in blue states.

The covid-19 pandemic has also shown how state divides have become matters of life
and death. In his State of the State message last month, California’s Democratic
governor, Gavin Newsom, openly contrasted his state’s policies and health outcomes
with those of three Republican-led states. He was especially pointed about the record in
Florida, where Republican Gov. Ron DeSantis has waged war on vaccine and mask
mandates.

“Our lockdowns, distressing as they were, saved lives,” Newsom said. “Our mask
mandates saved lives. Your choices saved lives. California experienced far lower covid
death rates than any other large state. Fewer than Texas, Ohio, fewer than Florida — 35
percent to be exact.”

Newsom spoke with pride about California’s liberal-leaning leadership, especially on
climate issues. He repeatedly touted “the California Way” that rejected “exploiting
division with performative politics and memes of the moment.” It was hard not to think
that Newsom was laying out themes for a future presidential campaign.

It’s true that our system of federalism encourages useful experiments state-to-state that
can pioneer new ways of solving problems. But the increasingly radical divergences
threaten national cohesion and coherent policymaking on climate, covid and health
care, and more. Neither the coronavirus nor the atmosphere recognizes state
boundaries.

The political writer Ron Brownstein, who has paid close attention to the impact of the
growing divide, warned in the Atlantic in December of “a dramatic erosion of common
national rights and a widening gulf — a ‘great divergence’ — between the liberties of
Americans in blue states and those in red states.”

It’s hard to see any politician gaining much traction by launching a new national debate
over what federalism should mean in 2022. But our ability to govern ourselves depends
on facing up to the consequences of what is fast becoming an unsustainable approach to
states’ rights.

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As Yet Another Wave of Covid
Looms, New Yorkers Ask: Should I
Worry?
The Omicron subvariant BA.2 is causing an increase in infections, especially in
Manhattan. But hospitalizations have yet to rise.

By Joseph Goldstein and Sharon Otterman New York Times April 7, 2022

Driven by an Omicron subvariant, Covid-19 cases have been ticking up steadily across
Manhattan, Staten Island and parts of Brooklyn, threatening New York City with a fifth
wave of coronavirus cases just weeks after the city lifted many mask and vaccine
requirements.

The city is registering about 1,500 new cases a day and a positivity rate of nearly 3
percent, both figures more than double what they were a month ago. In Manhattan,
where the last wave also first emerged, the positivity rate is above 6 percent in some
neighborhoods.

In another potentially worrisome indicator, the prevalence of fevers across the city —
which can offer a forewarning of Covid trends — has reached levels last seen at some of
the worst points of the pandemic, according to data from internet-connected
thermometers.

And anecdotal signs of spreading infection are evident across the region. On Broadway,
the actors Matthew Broderick and Daniel Craig have recently tested positive, as have
New Jersey’s governor and at least three members of the New York City Council.
“We may be done with the virus, but the virus isn’t done with us,” Brad Lander, the city’s
comptroller, said after he tested positive last week.

The Omicron subvariant BA.2, which the Centers for Disease Control and Prevention
now estimates makes up 84 percent of cases in the New York region, is even more
contagious than its predecessor.

But so far it has not shown the same explosive speed as the earlier form of Omicron,
which in late December and early January propelled cases in New York City past 40,000
per day. Instead, BA.2 is causing a slowly but steadily rising tide of illness. It has yet to
produce a rise in hospitalizations, and deaths remain low.
As the subvariant spreads, city health officials expect the entire city to enter the medium
risk category in the next two weeks, a threshold that Manhattan has already reached,
they said Wednesday at a coronavirus briefing for Mayor Eric Adams. Officials are not
expressing alarm, but they are preparing to increase the number of city-run testing
sites from the 130 now operating, if necessary, and to distribute some six million free at-
home tests.

Data shows that new infections have predominantly been among adults under 35, who
are less likely to be hospitalized. If the subvariant spreads more widely among older

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people and in nursing homes, it could have more serious impact. Citywide, 83 percent of
people 65 and older are fully vaccinated, and 56 percent have had one booster shot.

Dr. Wafaa El-Sadr, an epidemiology professor at Columbia University, predicted there
would be an “uptick” in hospitalizations but not of the magnitude seen earlier this year
when Omicron packed emergency rooms, stretched hospital staffs nearly to the breaking
point and killed more than 4,000 people.

“I don’t think this is going to be like the prior Omicron surge,” she said.

Health experts point to several factors that make them think that there will be fewer
hospitalizations this time.

For one, some 800,000 New Yorkers have received a booster shot since the Omicron
wave’s peak, and more doses of antiviral pills are flowing into the city than before,
though the most effective one — Paxlovid — would quickly be in short supply if cases
rise precipitously.

Epidemiologists also note that in addition to high vaccination rates, millions of New
Yorkers — by some estimates, over 40 percent of the city — were infected by Omicron
and now are likely to have strong protection against BA.2.

The potential for a new wave, coming just as many companies are calling employees
back to offices and Mayor Adams is pushing for the city to return to a prepandemic
normal, has left many New Yorkers unsure if this is a moment to show extra caution or
to carry on. Many, but not all, vaccinated people experience relatively mild symptoms
from Omicron, including BA.2.
New York City mobilized against the coronavirus as few other American cities did: from the 7
p.m. cheer of spring 2020, to widespread acceptance of indoor masking, to the most stringent
vaccine requirements in the nation. But that collective effort has waned.

In interviews, New Yorkers voiced sharply varied views over how to navigate current
conditions. Some questioned whether this was the right moment for the city to lower its
guard. But others expressed confidence that after two years, four waves and nearly as
many shots, they were sufficiently protected and ready to return to a prepandemic
normal.

“It’s confusing,” Catherine Jordan, 80, said, as she waited for a bus near the
Queensbridge Houses, the public housing project in Queens where she has lived for
about 60 years. “You don’t know what to do.”

Until someone in her circle gets sick, she said, she planned not to worry — and to keep
going to family gatherings, church and her senior center. “If I worry, I wouldn’t come
out,” she said.

Tirsa Delate, a 28-year-old artist and server who lives in Bushwick, Brooklyn, described
feeling “a sense of vagueness and uncertainty in terms of where we’re at collectively with
Covid.” She expressed relief at not having to wear a mask at work, but added that the
city should reinstate mask or vaccine requirements if cases rise to worrisome levels.

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Still others said they conduct a quick risk assessment each time they step indoors —
checking crowds, debating a mask, trying to recall the latest case numbers, wondering
when it will ever end.

“We’re not eating indoors or going to bars or a lot of stuff we’d like to do,” Jim Cashman,
47, said Friday afternoon, as he waited with his family at a Covid testing van near
Washington Square Park. An actor, Mr. Cashman said he was worried that if he tested
positive, it would mean canceled work, not just for himself, but for co-workers, too.

As he spoke, his 8-year-old daughter, who had been circling on her shiny blue scooter,
slowed down long enough to offer a gloomy prediction. “You don’t see people wearing
their masks anymore,” she said. “So many people are going to have it.”

Several people who tested positive in recent days said this was their first case of Covid-
19 — a trend supported by state data. Of the 8,692 New York City residents who
officially tested positive from March 21 to March 27, only 692 were known to have been
previously infected, according to the state Health Department.

Until she tested positive in late March, Nina Kulkarni, a New York City public-school
teacher, had managed to avoid the virus despite teaching in-person classes since the fall
of 2020. She doesn’t know where she was infected, but she had begun wearing her mask
a little less often after the city lifted its mask mandate for school staff and students 5 and
older on March 7.

She called on the city to reinstitute the mask mandates in schools, saying she has started
to see absences going up. City data shows a slow but steady rise in public school Covid
cases recently, to an average of 363 cases per day from about 150 per day three weeks
ago.

“I did relax the mask, and I regret having done that,” she said. “We all want them to
come off. I want them to come off. I hate them. But they do keep us safe.”

Even if this subvariant causes fewer hospitalizations, some experts agree more should be
done to limit transmission, particularly given the risk of long Covid.

Dr. Denis Nash, an epidemiologist at the CUNY Graduate School of Public Health and
Health Policy, said that the city’s decision to lift mask and vaccine mandates while the
subvariant was spreading was “cavalier.”

“Our decision makers have embraced this paradigm that the only Covid crisis at this
point is when the health care system becomes overwhelmed,” he said. “And anything
between where we are now and that extremely bad scenario is something we are going to
accept.”

Getting an accurate measure of the outbreak is increasingly difficult, as more people
now use at-home tests — which are generally not included in the city’s official case
counts. That means the actual number of people testing positive is probably significantly
higher than the official daily count.

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Noting that cases were increasing, Mayor Adams on Monday indicated an openness to
reinstating mandates if necessary. “We are going to pivot and shift as Covid is pivoting
and shifting,” he said.

He decided last Friday the city would maintain a mask mandate for preschoolers that it
had planned to roll back. But he has not yet said he would bring back other school mask
mandates or recently abandoned vaccine requirements, such as the need to show proof
of vaccination at restaurants to dine indoors.

A broad workplace mandate that requires private employers in New York City to verify
that their on-site workers have been vaccinated remains in effect, as do vaccine
requirements for public sector employees. However, Mayor Adams opened a
loophole last month when he lifted the requirement for professional athletes and
performers based here, allowing the unvaccinated Brooklyn Nets star Kyrie Irving to
play home games.

While the growth in cases has been most apparent in Manhattan below 96th Street,
about 40 of the city’s 180 ZIP codes now have positivity rates above 5 percent, including
Long Island City, Queens; Greenpoint, Brooklyn; and Pelham Bay in the Bronx.

In Manhattan’s West Village, which had among the highest test positivity rates in the
city last week, Lisa Landphair, 62, a psychotherapist, was sitting on her stoop Friday
afternoon, reading a newspaper. She still wears a mask in stores, she said, adding that
her main worry at this point is that she might pass the virus on to her husband.

“My partner is significantly older than I am, so I’m a little more concerned for him,” she
explained.

But Steven Lightkep, a 29-year-old nurse who lives in Hell’s Kitchen, said he was ready
to be done with the pandemic. “You’re going to get it if you’re going to get it, and if
you’re not, you’re not,” he said as he walked to a neighborhood gym late last week. “I’m
not going to stop living my life over it.”

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Three scenarios for nuclear risk over Ukraine
— and how NATO can respond
By William Alberque and Fabian Hoffmann Washington Post March 31, 2022

William Alberque is director of Strategy, Technology and Arms Control at the
International Institute for Strategic Studies. Fabian Hoffmann is a PhD fellow at the
Oslo Nuclear Project.

Russian President Vladimir Putin justified his unprovoked and illegal invasion of
Ukraine by claiming it “is a matter of life and death, a matter of our historical future as a
nation.”

These words were not chosen randomly, but rather tie into Russia’s nuclear doctrine. In
June 2020, Russia published a document outlining circumstances under which it would
employ nuclear weapons in conflict, including “aggression against the Russian
Federation with the use of conventional weapons when the very existence of the state is
in jeopardy.” By linking the Ukraine question to the existence of Russia as a state itself,
Putin has opened the door for potential nuclear use.

Though it is unlikely that Russia will use nuclear weapons in Ukraine, the risks are real.
To understand these risks, it is worth describing three possible scenarios:

        1. Putin could authorize the use of a single nuclear demonstration strike to
           signal Russia’s resolve. Russia would detonate a low-yield nuclear
           warhead over an unpopulated area — for example, the Black Sea — to
           show its resolve.
        2. Putin could authorize the use of smaller, battlefield nuclear weapons,
           perhaps to destroy a concentration of Ukrainian soldiers, particularly if
           Ukraine is able to force Russian troops to retreat from its positions near
           Kyiv toward Belarus or Russia.
        3. Putin could use a nuclear weapon to destroy a highly valued and
           symbolic Ukrainian target, such as Odessa or Lviv, to destroy Ukraine’s
           will to fight on.

So how can Western states prevent these scenarios from materializing?
Nuclear deterrence relies upon two factors: capabilities and credibility. You must have
weapons that are usable, and your adversary must believe you are able and willing to use
them. Without credibility, deterrence fails.

Putin has restored Russia’s nuclear capabilities since he came to power in 2000. On
credibility, he has a long-established track record of using threats of force and threats of
nuclear use for coercion and dissuasion. NATO leaders show comparative restraint in
messaging toward Russia, leading to doubts on the credibility of NATO nuclear
deterrence. Putin believes that the West will back down rather than risk a confrontation,
even as he bombs cities, kills civilians and shells humanitarian corridors.

To deter Putin, NATO must make clear that the introduction of nuclear weapons into
the conflict by Russia would entail diplomatic, economic and military costs that dwarf
any seen in its entire history. Indeed, the use of nuclear weapons would result in

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immediate isolation; even erstwhile friends and partners, such as India and China,
would immediately end their economic and diplomatic support. NATO would lead a
global effort to effectively expel Russia from the international community. Russian
embassies would be closed, Russian officials would be ousted from their positions in
international organizations, and efforts to curb Russia’s veto power in the United
Nations Security Council would accelerate.

In addition, leaders must state that nuclear use would risk a military response by NATO.
This response would entail strikes against Russian military targets — either in a targeted
fashion against units involved in the nuclear use (especially in response to the first
scenario), or a wider attack against Russian forces in Ukraine and Belarus, perhaps even
in Russia — crippling Russia’s supply lines, airfields, missile launch sites and command-
and-control infrastructure. Such a response should spell the effective end of Russia’s
military campaign in Ukraine. NATO would not need boots on the ground to conduct
such an attack; massed conventional cruise missile strikes fired from aircraft above
NATO territory and the surrounding seas could do the job.

Without doubt, engaging in direct military action against Russia is not risk-free and
could open the door for further escalation. But leaving unanswered the use of nuclear
weapons as part of an unlawful attack on a neighboring state is untenable. It would
signal to the world that the West will allow aggressors to do whatever they want if they
make nuclear threats, paving the way for further atrocities, nuclear use and, most likely,
uncontrolled nuclear proliferation. No country currently facing a security dilemma and
with the means to develop a nuclear arsenal would forgo doing so if the West backs
down.

If the West is interested in preventing Putin from using nuclear weapons in Ukraine, the
United States and NATO will have to make clear to Russia that they are willing to
respond. Credible deterrent messaging from the United States and NATO would
complicate Moscow’s planning and narrow Putin’s scope for escalation.
It is a terrible thing to advocate against de-escalation in the face of nuclear threats, but
the opposite course would mean acquiescence — and that could lead to suffering on an
unimaginable scale.