Medical News

Photographs by Alana Paterson

The police came at dawn. Karen Espersen watched them drive into the valley: more than 40 cruisers in a line. They were on a mission from the government. All of her ostriches must die.

Karen and her business partner, Dave Bilinski, were standing in the outdoor pens of their farm in the mountains of Canada’s West Kootenay. The fate of their flock had been taken up by right-wing media, and had become another front in a spiritual war. An angry group of their supporters, with signs and walkie-talkies, gathered on the property. They’d set up a barricade to slow the cops’ advance: several logs laid across the dirt near the turnoff from the highway. 

The activists had been camping out for months; their numbers sometimes reached into the hundreds. They knew the government was saying that the ostriches had bird flu, but they were convinced that this was cover for some other, bigger scheme. The feds were conspiring with the United Nations and Big Pharma, they said. Small farmers’ rights were being trampled. But Dave and Karen’s birds had other, more powerful friends. Robert F. Kennedy Jr. was making calls to Canadian officials; Dr. Oz had offered to evacuate the ostriches to his ranch in Florida. 

Canada “respects and has considered the input of United States officials,” the nation’s deputy chief veterinary officer had said. But rules were rules, and birds were birds—even if they were the size of refrigerators. And so a convoy of police had been sent to occupy the farm. Law-enforcement drones were flying overhead. The electricity was cut off. 

The farm’s supporters had already threatened local businesses that were renting equipment to the cops, saying they would shoot employees. Then someone claimed that they’d placed a bomb somewhere on the property.

At 7 a.m., while the police were stuck behind the logs near the highway, a man slipped out of sight, donned a balaclava, and grabbed a jerrican of fuel. He crept over to the next-door neighbor’s house and doused its front with gasoline. Not more than 50 yards away, a group of ostrich activists stood around a bonfire, streaming from their phones as they sang “The Battle Hymn of the Republic.” When the neighbor came outside and tried to chase the would-be arsonist away, her screams for help were broadcast live on social media, above the sound of “Glory, glory, hallelujah.” 

For decades, Karen and Dave had been raising hundreds of ostriches on a 58-acre plot in the small town of Edgewood, British Columbia. They’d earned a living from the meat and hide and feathers, and from a moisturizing lotion that they made from rendered ostrich fat. They’d also welcomed tourists to the property, bused in through the Monashee Mountains on a farm safari. But in mid-December of last year, the flock at Universal Ostrich Farms was overtaken by disease. The young birds in particular were having trouble breathing. Mucus leaked from eyes and beaks. Some were clearly feverish: They were roosting in puddles, even in the cold.

Over the next few weeks, the birds began to die, one by one, and then in groups. Dave hauled their carcasses across the property and buried them in 10-foot holes. The vet was out of town, so Karen did her best to nurse the sick. But more than 20 died, so many that they didn’t fit into the pits. Dave had to stash the rest beneath a tarp.

Locals noticed what was going on; you could see ravens feeding on the carnage from the highway. On December 28, someone notified the sick-bird hotline set up by the Canadian Food Inspection Agency, which monitors and manages agricultural diseases. Now the government was asking questions. Was there standing water on the property? Were the ostriches outdoors? Had Dave been aware of any wild birds nearby?

In fact there was some standing water, and the ostriches were never not outdoors, and lots of wild ducks had alighted in their pond and now were poking in the flock’s straw bedding and leaving droppings by the food bowls. To the CFIA, it sounded like a recipe for bird flu. A pair of government inspectors showed up two days later, in masks and Tyvek suits, and swabbed a couple of the carcasses. Their test results came back on New Year’s Eve: The birds were positive for the “H5” part of H5N1, the deadly strain of avian influenza that has raged through North America in recent years. According to the Canadian authorities, and in keeping with the nation’s agricultural-trade agreements, the outbreak had to be stamped out. The birds would have to die. 

An ostrich is of course a grand and silly thing: more than six feet tall with giant eyes, a 350-pound sedan on muscled stilts. It chirps and booms and honks and grunts. It wags its tail and pulls the threads from your sweater. Some ostriches on Dave and Karen’s farm had names: Barney, Peter, Q-Tip, Sarah. One looked so much like Dave himself, with bushy white eyebrows, that it shared his name. Karen used to keep an ostrich as a pet—a Somali blue, the smaller kind—and she called it Newman because it liked to hop up on her couch and watch Seinfeld on TV. Her son remembers riding Newman like a pony.

Now Dave and Karen’s flock of charismatic megapoultry was a threat to public health. They tried to bargain with the government. They said the illness was subsiding. They argued that their older birds had never even gotten sick and might already be immune. They noted that the compensation they would receive for a cull—up to $3,000 per animal—wouldn’t be enough to cover their losses. And then Karen started spinning out a stranger story. Universal Ostrich Farms wasn’t just a farm, she told the CFIA; it was the site of cutting-edge research. She and Dave were working on a novel class of ostrich-based pharmaceuticals—medicines that could one day help rid the world of many different ills, including cholera, obesity, and COVID. The drugs might even put an end to bird flu itself.

H5N1 doesn’t pose a major threat to human beings—or, one should say, it doesn’t yet. The virus has not adapted to our airways. But a current strain has already made the jump from birds to dairy cattle, and more than 70 people in North America have contracted it through exposure to infected animals. Most human cases have been very mild. But around the time that Dave and Karen’s ostriches were getting sick, a teenage girl in their province was rushed to a pediatric ICU with failing lungs and kidneys. She had bird flu and nearly died.

Dave and Karen maintained that their birds were not a danger but a cure. Now that the survivors had been exposed to bird flu, Karen told the government by email, they’d be laying eggs that were full of bird-flu antibodies. That could be the key to something extraordinary: If those ostrich antibodies were extracted and sprinkled into feeders, she said, then wild ducks might inhale them and develop their own immunity. Treat enough birds this way, and the entire epidemic could be stopped. 

Karen’s plan did not impress the experts at the CFIA, and to be clear: It isn’t sound. Extensive tests have not been run to show that ostrich antibodies protect other animals when they’re eaten or inhaled. Even if the antibodies were effective in some way, to stop the spread of H5N1 you’d have to load enough of them in feeders to shield the 2.6 billion migratory birds that cross the border into Canada each year. And CFIA scientists found no reason to believe that Dave and Karen’s ostriches would be a special source of antibodies, an agency spokesperson told me. The farm’s request for an exemption was denied.

But Karen’s email wasn’t entirely deluded, not in every detail. She and Dave had been in touch with Yasuhiro Tsukamoto, a scientist and the president of Kyoto Prefectural University, who has for years been pushing the idea that ostriches, and their powerful immune system, could be the basis for an industry in biomedicine—that the birds’ enormous eggs are factories for mass-producing antibodies in response to almost any pathogen. A single ostrich hen can make about a cup of these a year, Tsukamoto says, which might in turn be layered onto ventilation screens, painted into face masks, or used in ointments, sprays, and pills. A few such products have already been marketed in Japan, among them a soy sauce with ostrich antibodies for E. coli and a cosmetic line with ostrich antibodies for the germs that can lead to pimples.

Dave and Karen first learned about Tsukamoto’s work in March 2020, when he was inoculating ostriches with SARS-CoV-2 antigens. They did the same and hoped to sell their antibodies to a company producing masks. But they couldn’t land the deal, and ended up with freezers full of SARS-CoV-2-resistant egg yolks. A few years later, they’d moved on to something bigger: an ostrich diet pill, made from antibodies for the enzymes that digest sugar and starch. This could be a natural rival for Ozempic, they believed, sold as “OstriTrim.”

In November 2024, just around the time when all those wild ducks began to settle in their pond, Dave and Karen were finishing their business plan. They would partner with Tsukamoto’s licensee in North America, a company called Ostrich Pharma USA, and begin inoculating birds in early March. After that, the money would start pouring in. Within five years, the farmers’ business plan predicted, they’d clear $2 billion in annual sales.

But then an ostrich got a bloody nose and another one began to wheeze, and more were plopping down in icy water.

Katie Pasitney, Karen’s oldest child, grew up among the ostriches. She describes them as her family. So when Katie heard that the CFIA had ordered their destruction, she set out to raise hell. The birds themselves—those “big, beautiful babies,” she calls them—were natural mascots for a social-media campaign. In one early plea for help on Facebook, Katie put up a picture of a favorite ostrich from the farm. “Meet Sarah ♥️,” Katie wrote atop the post. “PLEASE HELP SAVE ME BEFORE I’M KILLED BEFORE FEB 1ST.”

By the end of January, Sarah’s fate had been taken up by right-wing media and online activists. Supporters began to gather at the farm. They built a campsite in the freezing cold and posted signs for Katie’s website, saveourostriches.com. People stopped by for the day and never left. A field kitchen was set up, porta-potties were installed, and volunteers were given jobs. They put up pictures of the ostriches, or wore them on their shirts and hats. At least one walked around in a full-body, feathered suit. At times there were 200 people in the field, just across the road from the ostrich pens. 

The group was there to save the animals, but by and large, they weren’t PETA types. They knew Universal Ostrich Farms had long been in the killing business; in the mess tent, supporters were not averse to eating meat. They were less concerned with harm to living things than with the threat to human liberty. These were freedom activists—people who had joined the convoy protests that swept through Canada in 2022 to oppose vaccine mandates. What brought them back together in the valley of the ostriches was a trailing fury over government intrusion, and suspicion about the aims of public health.

In the front room of her mother’s house, Katie set up a makeshift media center, with seven laptops on the table and cords everywhere. A handwritten ON AIR sign was posted whenever she was being interviewed live. Reporters started showing up in person, too. In one conversation after another, Katie and the farmers argued that the virus had already run its course. By their accounting, the 69th and final bird had died from the disease on January 14. The remaining ostriches were healthy, they insisted, and their location was remote—85 miles from the nearest city. What benefit would come from killing them?

Meanwhile, Dave and Karen brought their case to court and won a stay of execution for the birds until they finished their appeal. As winter turned to spring, the conflict reached a stalemate. The CFIA announced that no more inspectors would be coming to the farm, because of the risk of infection by the birds, and of interference by the protesters. Its staffers were getting threats by phone and email.

Then one night at the end of March, someone showed up with a gun. The birds were sleeping in their pens, some with upright necks, in the ostrich way. In the hours before sunrise, Katie and the farmers said, one was shot just below the ear. Dave and Karen found the carcass in the morning, lying in a pool of blood. The assassinated bird was Sarah, the one from Katie’s Facebook post. 

A couple of days later, one of the farm’s supporters posted a musical tribute to the fallen ostrich on social media, called “Feathers of Resistance (Sarah’s Song).”

Out in the fields ’neath Edgewood skies,
She walked with grace with ancient eyes.

Not just a hen but hope in stride,
Her blood held truth they tried to hide.

“A sniper’s bullet ended her life, but not her story,” the poster wrote.

After Sarah’s death, a deeper sense of dread overtook the valley. The farm began to fortify. Trip lines were laid around the ostrich pens and hooked up to bear bangers to scare away intruders. Supporters equipped themselves with walkie-talkies. And Dave and Karen started sleeping in the ostrich pens. 

Katie’s interviews and Facebook streams grew more conspiratorial. The supporters had been seeing government drones flying overhead at night, she told a podcast host in May. Karen, too, was obsessing over hidden plots. The farm’s website had malfunctioned in December, out of nowhere, even though she was sure that she’d set up the domain to auto-renew. Could it have been a government-associated hack? Could all of this have been a plan to stop her antibody business—to “squish our science,” as she later put it to me? Could it be that certain institutions were trying to hide the fact that H5N1 bird flu wasn’t really all that dangerous? 

Two months after the shooting, a second bird was murdered in its pen. Karen said she heard a drone flying overhead between 1 and 2 a.m., and then she saw an “Army-sized” device flying overhead, as big as the hood of a vehicle. Some folks from the encampment said they saw it too, while sitting by the fire. There was a silent flash of light, and moments later, Karen found one of the biggest roosters on the farm, an ostrich called Joey, with a hole through its head. This time the wound was vertical, starting near the crown and ending 18 inches down the neck. The drone may have been equipped with a gun, Karen told me. Maybe a silencer, too. Dave wondered if it might have been a laser. 

John Catsimatidis, a billionaire supermarket magnate and New York City radio personality, took a particular interest in the story of the ostriches. Toward the end of April, he invited a special guest onto the air: his old friend Bobby Kennedy. The secretary of Health and Human Services had come to talk about his plan for fighting autism, but near the end of the segment, Catsimatidis grabbed the chance to bring up the “awstriches,” as he calls them in his thick New York City accent. “Mr. Secretary, one last thing,” he said. There were these special birds in Canada, with a “natural healing process,” and now they were in danger because Big Pharma wanted them dead.

“I support you 100 percent,” Kennedy responded. “I’m horrified by the idea that they’re going to kill these animals.”

The cause was a natural fit for Kennedy. The anti-vaccine organization that he once chaired, Children’s Health Defense, had already aired an interview with Katie on its video channel in March. And Kennedy himself has often railed against government overreach in efforts to control potential outbreaks. Earlier that spring, Kennedy had declared that the U.S. and Canada’s policy of stamping out H5N1-infected chickens should be stopped. The survivors—the ones with naturally acquired immunity—could be used to repopulate poultry farms with hardier stock, he said. (Experts warn about the dangers of letting the virus spread unchecked; vaccinating poultry makes a lot more sense, two bird-flu scientists told me.) Kennedy also seems to have an affinity for large, flightless birds. He has kept at least one emu as a pet on his property in California.

One late night in May, Katie awoke to a call. At first she was confused, she said, but then she heard Kennedy’s raspy voice; the secretary was on the line with Catsimatidis. Some days later, as the sun set across the Monashees, Katie stood among the farm’s supporters in the field and choked back sobs as she prepared to read from a letter that Kennedy had written to her government. “We are respectfully requesting CFIA to consider not culling the entire flock of ostriches at Universal Ostrich Farm,” it said. The letter was signed at the bottom by three of the most important public-health officials in America: not just Kennedy but also FDA Commissioner Marty Makary and National Institutes of Health Director Jay Bhattacharya. (HHS did not respond to questions for this story.)

Katie’s “Save the Ostriches” campaign had until this point attracted hippies, libertarians, and anti-vaxxers, as well as local politicians in her province. Now it had the U.S. government.

I arrived in Edgewood a few weeks later, having come along the same twisting highway that the CFIA inspectors had used when they first drove out to test the ostriches almost six months earlier. As I pulled into the driveway, I could see the birds peering at my rental car from inside their large enclosures. 

I checked in with a volunteer in a makeshift booth, and he handed me an Ostrich Sheriffs sticker. A Canadian flag hung from the fence at the edge of the encampment, along with handmade posters: STOP the MURDER of 399 OSTRICHES. Save Ostrich Science (S.O.S.). If your child got sick in your family, would you kill the whole family?

Jim Kerr, an ostrich-farm supporter with a long beard, took me on a tour of the premises. Kerr is known among right-wing activists in Canada for his livestreamed protest videos, and for the soap-bubble-blowing art car that he drives to freedom convoys. Kerr explained that the supporters had an action plan for when the feds arrived. Dave and Karen would go into the pens and stand among the birds. Volunteers would block the road and send up drones to document everything that happened. They’d had a dry run just a few weeks before I came, when someone thought they saw a line of SUVs, all white, coming down the road. The sentries notified the camp; barricades went up; three women lay down on the highway. It turned out to be a false alarm. 

When I sat down with the farmers in the kitchen, Karen put out plates of sandwiches and cookies, and then she, Dave, and Katie launched into the story that they’d told so many times before, to politicians and supporters and the press. Katie, in particular, sometimes seemed to speak about the farm on autopilot, winding back to certain formulations about “giving small farmers a seat at the table” and the need to protect the “future of farming.” But still her voice would catch and the tears would flow, even in what must have been her thousandth telling. 

Her connections with right-wing and extremist figures were expanding. She told me that she would soon be headed to a “Truth Movement” conference down in West Palm Beach, where she would share a stage with several noted anti-vaxxers, as well as Enrique Tarrio, the former Proud Boys leader. And she let me scroll through a run of texts that she’d received in recent weeks from Mehmet Oz, who, like Kennedy, had gotten drawn in to her cause by Catsimatidis. Oz, the celebrity doctor who is currently the head of the U.S. Centers for Medicare and Medicaid Services, had suggested that he could bring the ostriches to Florida, but that wasn’t possible on account of the cull order. “I have spread the word widely and cannot understand why they cannot let me take these beautiful birds,” he wrote to Katie in one message. (Oz did not respond to a request for comment.) 

Again and again, the farmers said the Canadian government’s response to their outbreak made no sense. Plainly they were right in some particulars. Why couldn’t the CFIA just test the birds again, to see if the virus was still present? The government had claimed that this was impossible, that its inspectors would have no way to gather swabs from several hundred dangerous animals that can run at the speed of a moped, without handling facilities of any kind on-site. But I’d heard otherwise from independent experts. Adriaan Olivier, an ostrich-industry veterinarian in South Africa, told me that high-volume testing could be done. South Africa has been dealing with bird-flu outbreaks on ostrich farms for years, he said, and could manage the screening of even several hundred adults in one day.

Then again, I could also see—really, anyone could see—that Dave and Karen had been flouting basic rules of biosafety on the farm. At first, they hadn’t told the government that their birds were sick. And their “quarantine” was barely that. The same farm dogs that nosed around my feet inside the kitchen were also running in and out of ostrich pens. After Dave and Karen fed the birds, they sprayed each other down with disinfectant, but they didn’t change their clothes or remove their shoes. And the volunteers were clearly handling the eggs and feathers.

Those who had been around the farm the longest hadn’t simply been exposed to H5N1—they’d been infected. The farmers mentioned this offhandedly. Not long before my visit, Katie had tested positive for H5N1-specific antibodies. Dave and Karen had also turned up positive, as had one of their earliest supporters, a woman who’d arrived at the farm in January. No one could remember having any symptoms, though, and Katie wasn’t willing to concede that she or any of the others had caught the virus from the ostriches. 

The conversation circled back to the phone call from December that had prompted the government’s investigation—the tip-off to the sick-bird hotline. The farmers said it must have come from the woman who lives next door, Lois Wood. If it hadn’t been for her, none of this would have happened.

I spoke with Lois, a 72-year-old widow and volunteer firefighter, by phone a few days later. She lives just up the road from the ostrich farm. She can see the pens from her front yard. She said the situation had gotten out of hand. For months, the activists had been tormenting her: shining headlights in her yard, yelling out her name, tailing her when she was on her way to fire practice. “Finally—finally—somebody wants to hear the other side,” she told me. 

Lois claimed that she never reported the sick birds to the CFIA: She’d tried to call, but no one answered, and she didn’t leave a message. But everyone could tell that the ostriches were dying, she said, and the CFIA was right to get involved.

Elsewhere in the town of Edgewood, the fight to save the ostriches has brought out skeptics of the cause. Jim McFarlane, a local cattle rancher who has known Dave since they were kids, told me that, like Lois, he’d had enough. Dave has been “a total fucking bullshitter all his life,” he said. He asked me what I thought about the story of the murdered ostriches—the ones that supposedly were shot in the head in the middle of the night. “I mean, come on,” Jim said. “I’m a hunter, and you’re going to go out there in the middle of the night and shoot at a little fucking ostrich head when you’ve got a 300-, 400-pound body there?”

It’s true: An ostrich head is like a Q-tip protruding from a very large piñata. The idea of aiming for it, at least while sneaking in the dark, seemed preposterous. Yet Dave and Karen insisted that not one but two birds had been killed like this. Jim thinks that Dave and Karen might have killed the birds, that maybe they were trying to draw attention to the farm for the sake of more donations. Lois had another theory: What if the birds were still sick? What if the outbreak hadn’t ended, and the farmers didn’t want the government to know? (Both ostrich murders are still under investigation, according to the Royal Canadian Mounted Police. When I brought the claim to Dave that he’d shot the birds himself, he told me, “That’s insane.”)

The matter of the ostrich shootings is one of many that’s been taken up by a local Facebook group, “Edgewood—Uncensored,” in which a group of grumpy neighbors and others in British Columbia debate the ostrich farm and what they deem to be its hidden motives. They obsess over every open question and apparent inconsistency, such as who really called the CFIA about the sick ostriches, and how many birds were really in those pens. Some even wondered if the so-called standoff was a piece of theater, concocted by the government and its contacts in Big Pharma. Maybe no one ever really planned to cull the birds. After all, hadn’t Dave and Karen been involved in biotech? Hadn’t they injected ostriches with COVID?

If Katie, Dave, and Karen had built their movement from the bricks of outrage and suspicion, then those bricks were also being hurled against their walls. Paranoia had sustained them to this point, but paranoia was a force that they couldn’t quite control. 

I drove out to the farm again in late September. The line of police cruisers had snaked into the valley just a few days earlier, and I could see the marks of occupation. The property was divided at the edge of Langille Road. Yellow tape stretched across the northern side, at the entrance to the pens, and officers were taking shifts on guard. Just across from them, the farm’s supporters had put up a set of wooden bleachers so they could try to watch and record everything that happened. An inscription had been carved into the top row: In Appreciation: Robert F. Kennedy, Jr. Some of the birds had been dedicated too: There was now an ostrich Charlie Kirk, an ostrich Dr. Oz, an ostrich Donald Trump.

I’d arrived at a moment of uneasy calm. Not so long before, every sign had suggested that the standoff was about to end. After many hours’ worth of yelling and negotiations, the police had seized the pens; Karen and Katie were driven off in handcuffs, and briefly held. The CFIA had put up a wall of hay bales in the field, presumably to hem in the flock and hide the coming slaughter. But hours later, just as Dave and Karen were finishing a group prayer, their lawyer called to say that the Supreme Court of Canada had intervened. The justices were considering whether they would hear the case, and that meant the ostriches would not be killed just yet. Everyone agreed that this intervention was divine. 

Now the camp was far more crowded than it had been in June. No one took my name and phone number, or handed me a badge, when I arrived. Near one corner of the pens, I met a man named Thomas, who was taking footage of the Mounties with a camcorder. “I hate cops,” he said. “If one of those guys got a bullet to the head, I wouldn’t shed a tear.” Thomas told me that he’d been incarcerated for assault and fraud, but that his days as a criminal were over. “I don’t condone violence,” he said, “but I’ve started to think some violence might be necessary when there’s no other way to make people pay attention.”

Over at the house, Dave and Karen were meeting with the police department’s liaisons. Dave looked as though he hadn’t slept for days. His ears were bloody from the ostrich pecks that he’d sustained during his vigil in the pens. When I asked him what he’d do if the cull was carried out, he cried into his hand. If the ostriches were killed, Dave and Karen would have nothing left. They may no longer be eligible for compensation for the loss of the birds, according to the CFIA rules. They also owe tens of thousands of dollars to the government in fines and legal expenses. In the meantime, they’d been deprived of revenue for months, and the farm had already been facing heavy debts when all of this started. “There’s no recovery from this,” their lawyer, Umar Sheikh, told me.

Next door, in the grass outside Lois’s double-wide trailer, the smell of gasoline still lingered. When she came outside to say hello, I saw that she had bruises on both arms, cuts on her face, and a black eye. She’d only stopped the would-be arsonist by chance, she said: She’d come out to feed one of her cats and there he was, reaching into his pocket, as if to grab a lighter. She’d lunged at him, bit him on the elbow, and kicked him in the groin. Then he punched her in the face and fled. The police identified their suspect by the tooth marks on his arm. 

The man was a freedom-convoy veteran, Karen’s son told me, who’d warned the others in the group that he planned to go to jail before this all was over. Both Katie and her mother claimed, at least at first, that the attempted arson never really happened—that the whole thing was a setup by the members of the local “hate group” who had criticized the farm online.

I asked Lois if she felt unsafe. She told me that she’d gone to stay with a friend on the night after the attack, but had come back to the farm to tend to her cats and her tomatoes. She said that there were a lot of cops around for protection, but also that she didn’t see herself as having many options. “People say, ‘Well, you should do a civil suit against them for slander, libel, whatever, harassment,’” she told me. “I say, ‘I could not bear to do that. Can you imagine going up against Katie? You wouldn’t win.’” 

Moving out of Edgewood didn’t seem to be an option, either. Lois’s property, her 120 acres in the valley, was all she had, and who would ever buy it now? She was living on the site of a bird-flu quarantine. Fair or not, she was just as trapped as Dave and Karen. “I keep thinking it’s going to be over,” she said. And then it never is.

An end did come at last, six weeks later. On November 6, the Supreme Court decided not to hear the farmers’ case. The Notice of Requirement to Dispose of Animals issued by the CFIA more than 10 months earlier was reinstated for the final time. Shortly after nightfall, once the police had cut their floodlights and sealed off Langille Road, gunshots started ringing out behind the hay bales. At first there were a dozen, then many dozens more, as hired marksmen fired on the flock from platforms.

Katie squatted at the border of the pens, pulling at the fence and screaming, “Make it stop.” Karen stood beside the line of officers who blocked the road. “They’re killing my babies,” she said.

By the next morning, the cull was over. All of the ostriches—314 of them, by the government’s final count—were dead.

It was gray and it was cold in the valley. Autumn had returned: one full cycle of the seasons from the day Dave and Karen’s birds first began to falter in the slush. Waves of wild ducks were passing overhead once more. Since the start of fall, the bird-flu virus has again been spilling over into poultry flocks in North America. Another 8 million birds have been killed on U.S. farms in recent months, and 3 million more in Canada.

While construction vehicles shoveled up the ostrich carcasses and dumped them into trucks, the farm’s supporters gathered for a vigil, in person and online. It had been 297 days, they claimed, since any of the birds were sick. Whether this was true no longer mattered. The outbreak on the Universal Ostrich Farms had reached its end; yet even now, no one could agree about the nature of the threat. Had the poultry been a risk to public health? What about the farmers, who never thought the rules applied to them? And what about the government, which chose annihilation over compromise? Any middle ground was now awash with blood. Some kind of danger had been present in those pens; that was clear enough. Now that danger is stamped out.

Load up on linguine and stock up on spaghetti. In the new year, high-quality pasta may be a lot harder to come by in American stores. Several weeks ago, the U.S. Commerce Department announced that, starting in January, most pasta imported from Italy could be subject to a preliminary 92 percent tariff—on top of the 15 percent blanket duty on goods from the European Union. Outraged Italian pasta manufacturers are threatening to pull their products from American shelves.

The proposed tariff, the result of a year-long investigation into the pasta industry, targets 13 Italian companies that have allegedly undercut U.S. manufacturers by selling underpriced pasta. Pasta tensions between the United States and Italy have been simmering since the 1990s, but this new proposal has turned up the heat. White House Press Secretary Kush Desai told me that some of the companies “screwed up” their initial response to the probe by providing the U.S. government with incomplete data, but if they comply going forward, the Commerce Department may yet recalculate its tariff. The pastifici insist that they’re being unfairly targeted, and an Italian agricultural industry group has said they won’t give in to pressure. That could leave American noodle connoisseurs in an impastable situation.

The affected companies, which include La Molisana, Pasta Garofalo, and Rummo, manufacture the usual penne and rigatoni as well as fancier shapes: tubular bucatini, spiraling elicoidali, and delicate rings of anelli siciliani. Notably, all of them specialize in “bronze-cut” pasta. This term refers to the tool, known as a die, used to extrude the pasta dough into shapes. Using a bronze die gives the pasta a slightly sandpapery texture, which clings better to sauce and results in a more satisfying bite. (Indeed, I have tasted bronze-cut pappardelle, and it is spectacular.) Bronze-cut pasta imbues the water in which it is boiled with extra starch, and ladling some of that water back into the pan while mixing pasta and sauce—nonnegotiable for pasta enthusiasts—creates a silky dish, the chef J. Kenji López-Alt told me.

Most of the pasta made and sold in America is not bronze-cut, but extruded using plastic molds coated with Teflon, according to Tom Sheridan, president of sales and international development at the U.S.-based Kensington Food Company, which makes bronze-cut pasta. A pasta die is about the size of a car tire, dotted with 40 to 60 inserts that extrude the dough, Scott Ketchum, a co-founder of the American bronze-cut-pasta brand Sfoglini, told me. Bronze inserts aren’t as durable as plastic ones, so they need to be replaced more often. Ketchum said that he spends roughly $4,000 every two years to buy new inserts from Italy. Each shape requires a different insert, Tony Adams, the owner of Mill Valley Pasta, told me. And a major downside of making more textured pasta is that it produces huge amounts of pasta dust, necessitating even more equipment and labor to clean up the machinery, according to Dan Pashman, who hosts the Sporkful podcast and created his own pasta shape that launched with Sfoglini in 2021. Teflon pasta is cheaper to make because the dough simply glides out of the die, resulting in a faster and more streamlined process—and pasta that is gummier and less adherent to sauce.

These days, the average American is likely more concerned with price than the mouthfeel of their macaroni. Still, over roughly the past decade, demand for better-quality pasta has grown. Barilla, known in the United States for its inexpensive American-made products, launched its Al Bronzo line of imported Italian pasta in 2022. Even midrange stores such as Target and Wegmans sell their own bronze-cut pasta. House-brand pastas are usually imported from Italy, so they too may be affected by tariffs, Ketchum said.

[From the July 1986 issue: Pasta]

Bronze-cut pasta’s popularity is growing in part because Americans are becoming more savvy about their food. “Pretty much all the pasta was Teflon” until people started learning that there were tastier alternatives, Pashman told me. Recently, the appetite for bronze-cut pasta has also been whetted by health fears. In wellness circles, Teflon is basically synonymous with poison because it comes from a family of chemicals, called PFAS, that have been linked to certain cancers and reproductive issues. On TikTok, lifestyle influencers encourage viewers to seek out bronze-cut pasta because it is supposedly healthier than its Teflon-extruded kin.

The concerns are largely a nonissue. Teflon cookware can release harmful chemicals when it’s overheated, but extruding pasta is a room-temperature affair, Sheridan told me. Teflon bits could flake off into the pasta, but the health effects of this are unclear, and the company that makes Teflon maintains that those particles are inert. As I have written previously, the health consequences of using PFAS-coated cookware are generally not well studied.

If the pasta tariff goes into effect, bronze-cut pasta will almost certainly be rarer on U.S. shelves. More than half of America’s pasta imports—much of which is bronze-cut—come from Italy. Historically, and even more so now, companies don’t have much incentive to start making it domestically: “It’s gonna cost you a quarter of a million dollars or more to get into the game,” Sheridan said. Bronze-cut-pasta equipment from an Italian company called Fava Storci, which he called the Ferrari of pasta machinery, can cost upwards of $500,000. Such machines are hard to come by in the U.S., so they’re usually imported from Europe—and subject to their own tariffs.

[Read: A great way to get Americans to eat worse]

If the pastifici accept the Trump administration’s proposed tariffs, Americans who are fussy about their pasta—for culinary or health reasons—may soon have to make tough decisions: stomach another meal of slippery, Teflon-extruded penne, or pay extra for ridged radiatori? The alternative—that bronze-cut noodles simply won’t be available—is scarier still. After a decade of growing accustomed to the chewy, high-friction delight of bronze-cut shapes, many American foodies may find that they can’t get their teeth on them at all.

Last Thursday, in lieu of my afternoon coffee, I placed a sticker on the inside of my wrist. It was transparent, about the size of a dime, and printed with a line drawing of a lightning bolt—which, I hoped, represented the power about to be zapped into my radial vein. The patch had, after all, come in a box labeled Energy Boost.

So-called wellness patches have recently flooded big-box stores, promising to curb anxiety, induce calm, boost libido, or dose children with omega-3s. Their active ingredients are virtually indistinguishable from those of the many oral supplements already hawked by the wellness industry. Whether the skin is a better route for supplements than the stomach isn’t entirely clear. But the appeal of wellness patches seems to have less to do with their effects and more to do with how they look.

Wellness patches are generally pitched as an easier, safer way to take supplements. The website for The What Supp Co., a British brand that launched in the United States this year, describes its products as “super convenient” because users don’t have to take a pill or mix a drink—plus, they’re extra portable. That brand, like many patch sellers, laments the filler ingredients (such as corn starch and gelatin) that can show up in oral supplements, plus their digestive side effects; patches, it says, come with no such risks. The slogan for Kind Patches, which rolled out across Walmart locations last month, is “No pills. No sugar. No nonsense.” Half Past 8, a patch company that launched last week, says that its products sidestep the crash and comedown associated with some pills and gummies by offering a slow drip of wellness. Some brands also advertise that, unlike a pill, you can take a patch off when you’ve had enough. But that cuts both ways: I put another patch on my wrist yesterday morning, and it had fallen off by the time I got to the office.

Most of the products are labeled as remedies for common complaints. Stickers from The Good Patch include Nite Nite for better sleep, Think for boosting focus, and Rescue for hangovers. Several brands sell patches that purport to mimic the appetite-reducing effects of GLP-1 drugs; you can buy them on the fast-fashion website Shein. And whereas traditional oral supplements tend to be marketed as vectors for specific compounds, leaving users to mastermind their perfect mix, patches are usually cocktails that advertise their active ingredients less prominently. Putting on The Friendly Patch Co.’s Relax and Let Go sticker really is easier than consuming supplemental forms of its seven key components, which include the herb ashwagandha, the neurotransmitter GABA, and magnesium. (Neither The Good Patch nor The Friendly Patch Co. responded to a request for comment.)

[Read: The return of snake oil]

Whether those ingredients will actually help you chill out is an open question, as is whether they can pass from a sticker into the bloodstream. The whole point of skin is to keep most things out of the body, and although some compounds are known to pass through the skin—nicotine and birth-control patches have been used for decades—little is known about the permeability of the many ingredients used in wellness patches. Some basic principles are well established: For compounds to pass through the skin, they need to be both tiny and fat-soluble; caffeine and vitamins A, D, E, and K all meet those criteria, says Jordan Glenn, the head of science at SuppCo, an app that helps supplement users optimize their intake.

But other common wellness ingredients—such as coenzyme Q10, vitamin B12, folic acid, and zinc—require extra processing to permeate the body’s exterior, Glenn told me. My lightning patch was made by Barrière, whose co-founder Cleo Davis-Urman told me that the company uses a process called micronization to break down large molecules into particles small enough to enter the bloodstream. Micronization is a real technique used for pharmaceutical drugs, transdermal or otherwise, so it’s certainly possible that it could help big compounds pass through the skin. Yet this assurance, together with claims that patches offer a gentler and more sustained release than oral supplements, simply isn’t backed up by independent research; Meto Pierce, a co-founder and the CEO of Half Past 8, told me that the industry is “still developing in terms of published data.” “There might be claims of skin patches being more effective or more consistent, but we can just ignore that at this point because there’s no proof,” Elise Zheng, a health-technology researcher at Columbia University, told me. Dietary supplements aren’t regulated for safety or effectiveness by the FDA, and patches can’t even be regulated as dietary supplements, because they’re not ingestible.

[Read: Everything is a multivitamin]

Wellness patches seem most useful for people who are already supplement enthusiasts—not only because they’ve already bought into the idea that ashwagandha works but because they take so many oral supplements that their mouth needs a break. “Pill fatigue” is a common complaint among the wellness set, Glenn said, though patch users notably still need to remember to apply their supplements. (Glenn also pointed out that patches might be more convenient for people who have digestive problems or difficulty swallowing.)

An hour after I put on my sticker last week, I thought I felt marginally less groggy than usual. Maybe micronization really did make its B12 and folate particles tiny enough to seep into my skin. Or maybe the source of my energy was the sunny 15-minute walk I’d taken to acquire the sticker. By far the most noticeable impact of my thunderbolt was that I kept admiring it, as if it were a tattoo I’d gotten on a whim.

Wellness patches are meant to be seen, as their fun colors and designs suggest. Ads for Kind Patches show wrists adorned with pepperoni-size stickers whose color matches their claim: Dream patches are a dusty blue, Energy is electric yellow, and Period Patches are, of course, bright red. The What Supp Co.’s patches are shaped like a w and come in lavender (for chilling out), kelly green (for detoxing), and pink (for beautifying). “We want the experience to feel joyful and intuitive, not clinical,” Ivana Hjörne, the founder of Kind Patches, told me. Kelly Gilbert, the founder of The What Supp Co., suggested that a patch on your skin could remind you to make other healthy choices throughout the day. It’s also free advertising for the company. Davis-Urman, Barrière’s founder, told me that with patches, customers are “elevated to brand ambassadors, because the product sparks conversation.”

Before the rise of social media, personal wellness was a more private endeavor. These days, people post their run stats, sleep scores, and workout selfies; they wear fitness trackers and brand-name athleisure to the gym. This shift has reordered the priorities of personal health. It’s not just about taking care of yourself; it’s about taking care of yourself in a visible and socially sanctioned way, Marianne Clark, a sociologist at Acadia University who studies wellness culture, told me.

[Read: The perilous spread of the wellness craze]

Accordingly, wellness has also become a notably aesthetic pursuit—it’s no surprise that you can find patches to release skin-firming collagen or strengthen hair and nails. Conspicuous consumption has been part of the beauty industry since at least the 1920s, when Chanel No. 5 first hit shelves and became synonymous with wealth and luxury. (Wellness patches, too, don’t come cheap: My pack of 36 was $15, and other brands charge significantly more.) Social media has made the labor of beauty all the more visible. The online beauty community is rife with selfies glamorizing branded sheet masks and under-eye depuffing patches, photos called “shelfies” that showcase collections of expensive cosmetics, and images of celebrities sporting pimple patches in public. Brightly colored vitamin stickers similarly glorify the work of wellness. Not all wellness patches are beauty products, but many are meant to enhance appearance nevertheless.

By 11 p.m. last Thursday, seven hours into the eight that my sticker journey was supposed to last, I was not sure whether I was less tired than usual. (Davis-Urman assured me that, although the effects of the patch differ for everyone, “cellular-level benefits” were occurring whether or not I felt them.) But I did get a tiny hit of dopamine when my husband noticed it and said, “Cute tattoo.” My lightning bolt also nudged me toward self-reflection, a pillar of modern wellness. Whenever I glanced at it, I asked myself: How do you feel? The answer was the same every time: Tired.

In his run for governor of Maine, Nirav Shah holds standard Democratic positions. He aims, his campaign says, “to fix housing, fund health care, feed kids, and fuel growth, while fighting back against the overreaches of the Trump administration.” But Shah’s background is less conventional: In addition to being a lawyer, he’s an epidemiologist who directed Maine’s CDC during the coronavirus pandemic and was the principal deputy director of the federal CDC until earlier this year. Shah decided to resign from the CDC in part because of Robert F. Kennedy Jr.’s confirmation as the secretary of health and human services. If he wins in 2026—a big if this early in the race—Shah suspects that he might be one of the first, if not the first, top CDC officials to secure such a prominent elected office.

Many science and health professionals have shied away from politics in the past. But as the Trump administration has rescinded its support for scientific research, restricted vaccine access, dismissed expert advisers, attacked doctors and scientists, and worked to curtail health-insurance coverage, researchers and health-care workers have had a surge of interest in running for office. Shaughnessy Naughton, the president of 314 Action, a political-action committee focused on electing Democrats with science backgrounds, told me that since January her team has seen almost 700 applications for candidate guidance, training, or funding, about seven times what the group would expect during an election off year.

Some of that interest has already translated into active campaigns. Candidates running in 2026 elections include a mathematician and a microbiologist, along with multiple pediatricians and former health officials. They are entering crowded races, in which even the primaries are months away. But many of these candidates argue that amid the administration’s attacks, voters will want to support scientifically minded politicians who can help fill the gaps in expertise that the nation’s leaders have left. Several told me that they specifically began their campaigns after Kennedy was confirmed and began to remake U.S. vaccine policy.

The number of candidates with science or health backgrounds is one more indication of how these fields are being forced to reckon with their role in the current political landscape. Plenty of science professionals still argue that their work shouldn’t be political. “Let’s get the politics out of public health,” Daniel Jernigan, who directed the CDC’s center for emerging and zoonotic diseases before resigning in protest of HHS’s approach to health policy, said at a rally in August. At the same time, the Trump administration’s attacks have created a political opening that many health and science experts are taking, even if it means politicizing science further.

Science and health representation in elected office is sparse: Three percent of state legislators are scientists, engineers, or health-care professionals, according to Rutgers University’s Eagleton Institute of Politics. The majority of those politicians are Republicans, Eagleton data show; so are most of the STEM professionals currently in Congress. But as groups, both scientists and, at least in recent years, doctors have leaned liberal, and many of those now motivated to speak out against the Trump administration are Democrats, Kristoffer Shields, the director of Eagleton’s Center on the American Governor, told me. Hawai’i’s Josh Green, the only Democratic physician currently serving in a state governorship, gained prominence during the coronavirus pandemic, when he advanced proactive mitigation measures as lieutenant governor. (This year, Green partnered with 314 Action to launch a $25 million campaign to elect 100 new Democratic physicians to office by 2030; he is up for reelection next year.)

Some science-minded candidates are entering electoral politics for the first time. For New Jersey’s Tina Shah (no relation to Nirav), an ICU physician now running for the U.S. House of Representatives, the push was the Trump administration’s approach to health care: She told me that she now regularly encounters patients who can’t afford medication or who are being denied coverage for important procedures. Others have made bids for public office before, including Abdul El-Sayed, a former health director with an M.D., who ran, unsuccessfully, for the Democratic nomination to Michigan’s governorship in 2018. He feels more confident in his current bid for U.S. Senate because the second Trump administration has made the harms of inaccessible care even more visible. He is gaining some traction: In the most recent quarter, he raised close to $1.8 million, the second-highest amount in his Democratic primary. Tina Shah, meanwhile, has raised more money from donors in a single quarter than any other Democrat in her district.

After the pediatrician Annie Andrews lost a congressional race in 2022, “I had no intention of running again,” she told me—then she changed her mind after watching Kennedy rise to the top of HHS. Andrews is running to unseat Lindsey Graham in the U.S. Senate, but she said she has found success in casting Kennedy—arguably the country’s most polarizing health secretary to date—as an opponent, too: “The more I speak out against the absurdity of RFK Jr. and his recent actions, the more traction I am getting.” For Richard Pan, a pediatrician and former California state senator, Kennedy’s threat is less abstract: When Pan was working on legislation that would make school vaccine exemptions harder to get, Kennedy, one of America’s most prominent anti-vaccine activists, traveled twice to Sacramento to oppose those measures, he told me. Pan’s now running for Congress in part to counteract Kennedy’s anti-vaccine policies at the federal level.

Many of the candidates I spoke with have considered just how much they want to lean into their credentials. For voters worried about health-insurance coverage or the future of research in the United States, scientists, health-care workers, and public-health experts may have particular appeal right now, Shields told me. Still, several of the candidates I spoke with told me they weren’t running “on an explicit science platform,” as Nirav Shah put it. The candidates I interviewed were all critical of Kennedy, but several were reluctant to fixate on him, arguing (as any politician might) that voters care more about changes that directly benefit their community.

In Nirav Shah’s view, behaving as though health and science are severed from politics is “a nonstarter.” As the Trump administration has worked to dismantle its own health agencies, members of Congress have fought to keep some of those agencies’ budgets intact. And as the administration has dismissed expert scientific advisers, state and municipal leaders have stepped in: Fifteen governors, for instance, recently announced the formation of a public-health alliance to dictate policy that diverges from the federal government’s. Although the coalition bills itself as nonpartisan, all of the participating governors are Democrats.

Under Donald Trump’s leadership, polarization around several scientific issues has deepened. The administration argues that research has been corrupted by ideology and claims that it’s restoring “gold-standard science.” Polls suggest that Republicans have been more supportive than Democrats of new restrictions on vaccine recommendations and research-funding cuts. If some Democrats are making an issue of the Trump administration’s record on health and science, so are Republicans. At least one Republican doctor running for the U.S. House has played up his opposition to mRNA vaccines; some members of Congress with health backgrounds who are running for reelection have embraced Trump-administration criticisms of COVID-era policies and gender-affirming care for children.

Several health and science professionals remain skeptical that getting into politics in any way will help their cause. Jernigan, the former CDC official, told me his call to “get the politics out of public health” at the rally meant that, for health policy, politics shouldn’t supersede evidence, not that politics can be fully extracted from public health, he told me. At the same time, he noted that enmeshing science and politics too deeply risks casting evidence and the practice of research as the business of only one political party. “Perhaps we are in a situation where there needs to be a more vocal, assertive public-health voice,” Jernigan told me. “But does it have to translate into political office? I don’t think so.”

And yet, the perception of public-health overreach has been a radicalizing force among Trump supporters; whether through electoral politics or not, any attempt to fight the administration’s actions may bolster its narrative that scientists have been corrupted by liberal ideology. When I asked candidates whether their campaigns might deepen partisan divides in attitudes toward science, many of them skirted the question—and few offered answers when asked how they’d cope with that reality. Instead, candidates told me that they felt fairly boxed in. “Politics came for us,” Andrews said. “You can’t fight bad politics by staying apolitical.”

Donald Trump was giddy. In the Oval Office today, the president announced that he had secured a deal to dramatically slash the price of obesity drugs. Soon, Wegovy and Zepbound will be sold on a new website—dubbed TrumpRx—for only about $250 a month, a fraction of their current retail price of more than $1,000. “Did I do a good job?” Trump asked the assembled reporters. “Do you think Biden could have done this? I don’t think so. ”

In some ways, the announcement heralds a breakthrough in expanding access to some of the nation’s most popular drugs. For years, millions of Americans have been priced out of these medications. Many private insurance plans do not cover these drugs, forcing people who want the weekly injections to pay out of pocket. The same situation has been playing out with Medicaid and Medicare. Only about a dozen states currently cover these obesity drugs for low-income Americans insured through Medicaid. And most seniors have been blocked from accessing the drugs, because Medicare is legally barred from covering weight-loss drugs.

Still, the announcement is more of a step forward than a leap. Both Novo Nordisk and Eli Lilly, the makers of Wegovy and Zepbound, respectively, already sell their drug directly to consumers for $499 a month. And most patients using TrumpRx won’t actually pay $250 for these drugs, at least initially. The price will be closer to $350 (exact costs will vary by dose), although the companies have promised to drop the price over the next two years, administration officials told reporters earlier today. (Novo Nordisk and Eli Lilly declined to comment for this story; the White House did not respond to my email.)

[Read: The obesity-drug revolution is stalling]

Patients are remarkably price sensitive when it comes to their medication—even when those drugs can mean the difference between life and death. A study from 2018 found, for example, that when out-of-pocket costs for cancer drugs were more than $100, a third of patients abandoned those prescriptions at the pharmacy counter. “Even at the lowest prices being offered by drug manufacturers, many people will struggle to pay out of pocket for these products,” Stacie Dusetzina, an expert on drug-pricing policy at Vanderbilt University, told me.

Under Trump’s deal, Medicare will now cover obesity drugs for the first time, allowing seniors to pay no more than $50 a month; the price for those insured by Medicaid will be even less. Even before today’s announcement, though, Medicare could cover the drugs for other conditions that often accompany being overweight, such as diabetes and sleep apnea. The Trump administration is opening up eligibility to those with prediabetes or certain heart conditions, among other comorbidities. Meanwhile, only seniors with severe obesity will be able to access these drugs through Medicare solely because of their weight. Overall, the Trump administration anticipates that roughly 10 percent of Medicare enrollees will be eligible to access these drugs following the announcement. It’s still unclear exactly what will happen with Medicaid. Coverage decisions ultimately rest not with the White House, but with the states.

What all of this means is that the biggest winners of today’s announcement might be the patients who are so desperate to access these drugs that they are willing to pay out of pocket. That’s only a small subset of patients. (A Novo Nordisk spokesperson told me before today’s announcement that roughly 10 percent of patients currently pay its discounted cash price for Wegovy.) How much someone with insurance pays for these drugs depends on their health plan; Eli Lilly notes on its website that through private insurance, people can pay as little as $25 a month.

Another factor is at play. Soon, patients may not be clamoring for Wegovy or Zepbound like they were before. America is about to enter a new era of GLP-1 drugs: Eli Lilly is expected to imminently submit an application to the FDA requesting approval to sell a new GLP-1 pill for weight loss. Novo Nordisk’s application for an oral pill is already pending before the FDA. As part of the deal with the government to cut prices, both companies were awarded vouchers that speed up the FDA’s review of their drugs. The announcement includes a commitment from both companies to sell the starting dose of new oral GLP-1 drugs for about $150; the higher doses for Eli Lilly’s drug will be capped at $399. (It’s still unclear how much Novo Nordisk will charge for higher doses of its oral drug.) Eli Lilly is similarly developing a new injectable GLP-1, retatrutide, that appears to be even more effective than the current drugs on the market—and which the company confirmed is not currently included in its agreement with the White House.

In his announcement, Trump gave himself credit for driving a hard bargain with drugmakers. “You think it was easy dealing with these people?” he said today. “It wasn’t.” But these companies are getting something in return. Both Eli Lilly and Novo Nordisk have made billions charging as much for these drugs as the market will allow. They’re on the cusp of brand-new drugs that are sure to be profitable.

Millions of the poorest Americans are stuck in food-stamp limbo. They still do not know when their benefits will arrive—or if they will at all.

In the past few days, the government shutdown has thrown the food-stamp program, formally known as SNAP, into chaos. On Friday, after the Trump administration said that SNAP was on the verge of running out of money, a federal judge ordered the White House to tap into a reserve of funds and pay out billions of dollars in benefits. Then, yesterday, the administration said that it had the funds to provide people on food stamps with only half of their monthly allotment of benefits. To make matters even more confusing, President Donald Trump today appeared to contradict his own Justice Department: SNAP benefits, he posted on Truth Social, “will be given only when the Radical Left Democrats open up government.”

White House Press Secretary Karoline Leavitt later appeared to walk back the president’s post. The administration is “fully complying” with the court order, she said. (When reached for comment, the White House pointed me back to Leavitt’s press briefing.) If the administration makes good on its promise, Americans still might not get their benefits for quite some time. In a legal filing, the administration said that it may take some states several months—yes, months—to get the benefits released, despite the fact that the judge ordered the benefits to be released by tomorrow.

None of this is normal. Food-stamp benefits have never been cut like this in the current program’s more-than-60-year history. “It is a significant inflection point in the program’s history,” Christopher Bosso, a political scientist at Northeastern University who wrote a book on SNAP, told me. “Where we go from here is anyone’s guess.”

This dustup likely means that some of the nation’s most vulnerable will end up going hungry, at least temporarily. In 2023, 5 percent of U.S. households qualified as very food insecure, meaning that at least one household member’s “normal eating patterns” were disrupted because of a lack of food. Even in cases where immediate hunger isn’t a risk, the delay in getting food-stamp money will create stress for Americans who rely on the program. SNAP provides low-income Americans with a monthly stipend loaded onto prepaid cards that they can use to buy groceries, and government data on SNAP transactions show that roughly 40 percent of households have less than $1 left at the end of the month.

[Read: America’s grocery lifeline is fraying]

These are signs that once the funds are released—assuming they are—many Americans will still struggle to make due on half of their usual food-stamp budget. The average SNAP household with children receives $574 a month, meaning that those households will now receive less than $300 in food stamps for the entire month. The Department of Agriculture, meanwhile, estimates that it costs nearly $1,000 a month to feed a family of four a “nutritious, practical, cost-effective diet.” In such a situation, SNAP beneficiaries are likely to gravitate toward the cheapest, most calorie-dense foods they can find.

Facing hunger, “your body is hardwired to go find food, whatever food you can find, regardless of whether it’s nutritious and regardless of whether it’s safe,” Hilary Seligman, a professor at UC San Francisco who researches food insecurity, told me. In the era before food stamps, that meant making decisions that now seem unconscionable: A 1954 survey of pregnant Black women in Louisiana found that 38 percent were eating laundry starch to satiate their hunger; 25 percent reported eating clay. In present-day America, the poor are likely to turn to ultra-processed foods. Packaged snacks full of industrial additives are ubiquitous and cheap: A bunch of kale is much more perishable than a bag of Doritos. An artisanal loaf of bread will set you back more than Wonder Bread. At my local grocery store, a pound of ground beef costs nearly $8, but a frozen entrée of six Salisbury steaks with gravy can be purchased for only $5. Ultra-processed foods cost just 55 cents per 100 calories, compared with $1.45 for unprocessed foods, according to a recent study.

These same ultra-processed foods have been targeted by the Trump administration and particularly by Robert F. Kennedy Jr., the secretary of Health and Human Services. He has pointed to junk food as a major contributor to America’s chronic-disease problem and has declared emphatically that food-stamp recipients should not be able to use government funds to buy soda. Several states will be testing a ban on the purchase of soft drinks and other sugary foods with food stamps starting next year.

The reasons ultra-processed foods are so troublesome are also the reasons they may, in this situation, provide a lifeline until SNAP benefits are fully restored. Yes, soft drinks might not do much to help a family stave off hunger, but faced with all of this uncertainty about if and when their benefits will come, SNAP households are going to be stocking up on the cheapest food they can rely on, even if they know it’s unhealthy. Now more than ever, healthy foods are a luxury in the United States.

My patient’s lungs were filled with blood, and he lay intubated in an ICU bed. His kidneys were failing, too. The cause of his illness was not a mystery: He had been previously diagnosed with an autoimmune disease that, in many cases, leads to severe organ damage, and he clearly needed the same treatment he’d received before, a drug that suppresses the immune system. With it, he started to improve in days.

At a follow-up visit, I suggested re-dosing the medication in a few months, to prevent future episodes of life-threatening inflammation. That word caught his attention. “What caused it?” he asked. “The inflammation, I mean.”

He and his wife exchanged uncertain glances as I explained that doctors don’t know what sets off most autoimmune inflammatory diseases: It’s likely a complex interplay between genetics, environment, and bad luck. But we do know how to treat them. At the next visit, his wife asked me about the potential causes of chronic inflammation that she’d read about online—tick bites, heavy-metal exposures, nutritional deficiencies—as well as anti-inflammatory treatments including herbal supplements, acupuncture, and energy healing. I began to worry that framing the conversation around inflammation—a word that clearly meant one thing to me and quite another to this couple—had been a mistake.

Doctors caring for patients with autoimmune diseases have long thought of inflammation in precise terms: Cells of the immune system lodge in tissues and release messenger molecules, called cytokines, that rev up the body’s response to a perceived insult. In recent years, scientists have been able to identify many cytokines and create targeted therapies for a host of disabling, sometimes fatal, diseases.

At the same time, popular culture has latched on to the concept of inflammation and made it a catch-all term for “something amiss in the body”—a bête noire for wellness gurus, health influencers, and the “Make America Healthy Again” movement. A YouTube or TikTok search for chronic inflammation might lead to Josh Farris, also known as “The Gut Guy,” who argues that rubber-soled shoes prevent us from connecting to the earth and force the body to steal energy from other cells, causing “an inflammation loop cycle.” The MAHA report, which the White House released in May, suggests that ultra-processed foods and the overuse of medications may be contributing to chronic inflammation in children. Even as conventional treatments for autoimmune diseases have become more effective than ever, alternative treatments, including nutritional supplements, breathing exercises, hyperbaric oxygen chambers, and cold plunges in frigid water, have proliferated.  

Andrew Weil is perhaps the person most responsible for inserting the phrase anti-inflammatory into the American lexicon. Weil, a Harvard Medical School graduate who completed his internship before deciding to explore nontraditional medical practices, told me that his views on inflammation are simple and have not changed over the decades. According to Weil, acute inflammation is a natural, protective response to injury or infection and is an important part of healing. Chronic inflammation is a low-level, persistent activation of the immune system that can damage the body over time and is linked to ailments such as cardiovascular disease, neurodegenerative diseases, cancer, and autoimmune conditions. Weil argues that following his anti-inflammatory food pyramid and taking up practices such as meditation, yoga, and tai chi can help prevent and treat these diseases of chronic inflammation.

To support his claims, Weil cites population studies showing that people who maintain a diet high in fruits, vegetables, and whole grains have lower rates of heart disease, diabetes, and some cancers than those who don’t consume these products. He also points to studies showing that certain foods and spices, including turmeric and ginger, can inhibit key regulators of the immune system, reducing cytokine production. When I asked Weil about proof that these interventions work, based on randomized clinical trials, he told me that he believes such studies are not necessary when an intervention is unlikely to cause harm. “I grade evidence on a sliding scale,” he said.

Weil’s anti-inflammatory message has germinated across the internet in tweets, podcasts, and YouTube Shorts. The result is a hodgepodge of myths and theories about how to address the issue that go well beyond advice to just eat well and meditate. Juice cleanses are fashionable in certain anti-inflammatory circles, even though they can cause electrolyte imbalances. A popular notion on TikTok is that hidden parasites are a common cause of chronic inflammation and that ingesting wormwood—a bitter herb that can lead to liver injury—will rid the body of this problem. Other videos encourage viewers to ingest water laced with borax, a powdery substance found in laundry detergent, in order to reduce inflammation and joint pain.  

Most claims made by health gurus and social-media influencers are exaggerated. “If it sounds too good to be true, it is,” Richard Panush, a rheumatologist and emeritus professor at the University of Southern California, who has studied alternative therapies for autoimmune diseases, told me. Some of their recommendations are outright dangerous. Still, these ideas are clearly enticing to patients feeling beaten down by chronic disease. One recent study showed that, among people with an autoimmune condition, more than 80 percent have tried some form of complementary and alternative medicine. In my experience, most patients gravitate toward interventions on the milder end of the spectrum, such as acupuncture and herbal remedies, but even these can be problematic if taken to the extreme. One patient of mine told me that, at a certain point, he was consuming 60 supplements a day, putting him at risk of adverse interactions with his prescription medications.  

In decades past, alternative therapies may not have seemed so outlandish compared with conventional therapies, which often had significant side effects and limited efficacy. Now, though, doctors like me can prescribe treatments that turn many debilitating diseases into manageable conditions. People with rheumatoid arthritis can be treated with one or two medications and expect to experience disability-free lives with few to no symptoms. Surgeons used to routinely remove the colons of individuals with ulcerative colitis, but an injection or infusion of medication every few weeks can put those patients in remission. The key to these advances has been the development of certain biologics that target key pathways in the immune system and selectively block the activity of pro-inflammatory cytokines. Dozens of FDA-approved biologics are now available to patients for diseases including psoriasis, Crohn’s, and multiple sclerosis. The future is even more promising with therapies like CAR T cells, which are genetically modified “living drugs” that have had remarkable success in clinical trials, particularly for lupus.

This is not to say that conventional therapies come without costs. Using a medication meant to suppress the immune system has an inherent trade-off: Autoimmunity may be better controlled, but the risk of infection increases. The list price for some biologics can reach $7,000 a month, and patients receiving infusible medications must arrange travel plans around the timing of their therapy.

Alternative health might be appealing for another reason. Because doctors cannot give a simple explanation as to why most autoimmune conditions developed in the first place, patients may look elsewhere for insights and solutions. Some autoimmune diseases also can remit on their own for reasons that remain unclear, implying that not every patient may require lifelong therapy.

For doctors, though, taking the wait-and-watch approach feels risky when the stakes are high: Not treating a disease, in the hopes that it’ll resolve naturally, could leave someone with, say, joint erosions or renal failure. “I frequently tell patients, ‘I’m overtreating you’ because we can’t predict if your disease will cause irreversible damage,” Philip Seo, a rheumatologist at Johns Hopkins University, told me. “We can’t go back in time.”

Conversations with patients about if and when to start medication have always been complex, but online lore about inflammation, coupled with declining confidence in doctors since the coronavirus pandemic, have made such discussions more fraught. “It comes down to trust,” Panush, the rheumatologist who researches alternative therapies, told me, “which I’m afraid doctors are losing from patients who have adopted a different belief system than their own.”

I saw that happen with my own ICU patient, whose condition had been so dire. He and his family were willing to accept immune-suppressing therapy when he was critically ill, but his calculus changed once he was doing better. I tried to provide clear recommendations while making him and his wife feel heard, but it seemed like we were talking past each other. Eventually, he stopped showing up for appointments. I called multiple times to check in, but there was no answer. A year later, I learned that he had died. His obituary didn’t mention his autoimmune disease, the most likely cause of his death. Instead, it said he had died from agricultural and industrial pollution.

The Trump administration is by its own account devoted to stamping out obesity, cancer, and many other chronic diseases in America. But its public-health officials are also attuned to a very different sort of threat: a faulty cast of mind. “Groupthink is the fundamental problem,” said National Institutes of Health Director Jay Bhattacharya in May. The nation’s scientific institutions have become hidebound.

According to Bhattacharya, Health Secretary Robert F. Kennedy Jr., and other top figures in the “Make America Healthy Again” movement, the pandemic brought this problem to the point of crisis. A small group of elite scientists settled upon the use of masks and lockdowns to fight the coronavirus. They closed ranks around their strategies and expelled dissenters. All of this was classic groupthink, the MAHA crowd has argued: a psychological phenomenon that occurs when people’s tendency to go along with the crowd prevents them from considering other courses of action. As a result, in their view, the public-health response to the coronavirus turned into catastrophe. Kids fell behind in school. Drug-overdose numbers exploded. Poor nations starved from supply-chain disruptions.

[Read: Revenge of the COVID contrarians]

Now the government is out to quash this plague of poor decision making. In June, when Kennedy sacked all 17 members of the nation’s top vaccine-advisory panel, a Health Department spokesperson said that it was a remedy for “vaccine groupthink.” Upcoming changes to the U.S. dietary guidelines have been cast as a way of fighting groupthink too. Both Bhattacharya and the MAHA leader Calley Means have decried the groupthink infestation in our scientific institutions. And two months before his nomination to be FDA commissioner, Marty Makary published an entire book about the perils of medical groupthink. Health Department Press Secretary Emily Hilliard told me via email that Kennedy is “confronting groupthink by rebuilding a culture where scientists can question, debate, and follow evidence freely so that truth—not conformity—drives public health decisions.” The epidemic of consensus, as he sees it, must be stopped.

Yet, ironically, MAHA’s core concern—that the nation’s most seasoned public-health experts have been rendered senseless over many years by a groupthink dynamic—is itself the product of a shaky sort of group belief. The phenomenon of groupthink has been studied now for decades. More than 1,300 academic papers and dozens of books have been published on the topic. Even after all of this time and effort, the evidence is wanting. In fact, most experts now believe that the old story of groupthink being a prime cause of bad decision making is wrong. Some don’t think that the phenomenon is even real.

“A very curious thing has been taking place in this country—and almost without our knowing it,” the journalist William H. Whyte Jr. warned in a story touted on the cover of the March 1952 issue of Fortune: College kids had gotten meek and group-oriented. Corporations were hiring social scientists to cultivate conformity in their workers. Even literary heroes had been growing more submissive, Whyte claimed. Riffing on George Orwell’s 1949 dystopian nightmare Nineteen Eighty-Four, which popularized words such as doublethink, he dubbed this new American herd mentality groupthink.

The coinage went viral. As his biographer later noted, groupthink was a “broad term that could be used to cast any number of aspersions.” And in mid-century America, there were so many aspersions to be cast! “If you want creativity, abandon the groupthink and concentrate on the lonethink,” begins a news report from an advertising conference in 1959. (“Meetings are for meatheads,” one groupthink-hating executive declared.) One columnist with the New Pittsburgh Courier even slapped Whyte’s label on the United Nations, suggesting that countries, like individuals, had a primal aversion to yielding their sovereignty to the groupthink of world governance.

[Read: Pete Hegseth’s Pentagon is becoming a bubble]

Whyte’s concept started to appear in management textbooks, too, identified as a concerning philosophy in which people “begin to worship the group.” But the idea really found its place in academia when Irving Janis, a Yale psychologist, borrowed Whyte’s buzzword to label a novel bureaucratic disease that he’d identified. In a 1971 article for Psychology Today titled “Groupthink,” Janis described how the White House had been overcome by a psychological contagion in the lead-up to the Bay of Pigs invasion. Despite their brainpower, President John F. Kennedy’s famously eggheaded advisers had fallen prey to a crowd mentality that had caused them to set aside their misgivings about the attempt to overthrow Fidel Castro’s government so as to preserve, as Janis put it, the cozy and cohesive “we-feeling” of the group. Groupthink explained not just the Bay of Pigs, he claimed, but also the government’s failure to anticipate Pearl Harbor, the Korean War stalemate, and the quagmire in Vietnam.

This rebranding of groupthink, from Whyte’s pop critique of 1950s corporate life to the specific management dysfunction described by Janis, raised its stakes dramatically: Now the epicenter of the problem was in Washington, and an Ivy League scientist was saying that the contagion was to blame for many world-shaking tragedies. In his follow-up book from 1972, Victims of Groupthink, Janis insisted that he was only laying out a “hypothesis,” and he acknowledged that he had no idea what percentage of fiascos were really caused by group pressures that could impel people to set aside their misgivings. But his idea took off just the same.

In the years that followed, whenever a big-time screw-up happened, someone would swoop in and attribute it to groupthink. That included academics, who cited Janis in the context of many of the 20th century’s lousiest decisions, including: Nazi Germany’s invasion of the Soviet Union, Ford’s decision to market the Edsel, Chemie Grünenthal’s distribution of the drug thalidomide, the Carter administration’s approach to rescuing American hostages in Iran, and NASA’s launch of the Challenger space shuttle. Over the course of two generations, then, from the Boomers through Gen Xers, groupthink had come to signify a dark energy that seemed to exert its power at the worst possible times.

Sally Riggs Fuller, an organizational sociologist and a retired University of South Florida professor, remembers hearing about groupthink in a decision-making seminar taught by Ramon Aldag, her graduate-school adviser at the University of Wisconsin at Madison School of Business. He was giving the standard groupthink spiel, starting with the Bay of Pigs and explaining Janis’s model. This was part of the management-studies canon in the late 1980s. “Students loved it,” Aldag told me. But Fuller was skeptical. The groupthink story sounded wrong.

After class, Fuller said, she hustled to Aldag’s office. “I think there’s a lot of other explanations for those bad decisions,” she told him. For a decade before grad school, Fuller had worked various office jobs in the aerospace industry, and she felt that she had a good understanding of how groups made hard decisions. Usually, several factors came to the fore: internal power struggles, organizational self-interest, the legacy of past decisions. It wasn’t just some herd mentality, she insisted. Aldag suggested that she start digging through the scientific literature so that they could evaluate the published evidence.

By the time Fuller and Aldag had done enough research to give a talk at a 1990 professional meeting, the picture wasn’t pretty. The baseline problem, both Fuller and Aldag told me, was that Janis had more or less dreamed up his groupthink model based on his own intuitions and inferences: It was an armchair theory—he hadn’t measured anything. The concept was so sticky and compelling, though, that others started mining histories of notorious debacles for more examples of the same. “It’s a lot of retrospective sensemaking,” Aldag said. (Janis died in 1990, a few years before Fuller and Aldag’s critique of his idea was published in an academic journal.)

[Read: Seven tips from Susan Sontag for independent thinking]

A few experimental studies of groupthink had been attempted over the years, but these were plagued with methodological problems. Researchers would construct hypothetical decision-making scenarios for groups of college students, and then measure dozens of variables to test Janis’s model. When a handful of those findings came back as “statistically significant,” researchers concluded that their study provided “partial support” for the theory, Fuller said. “We were aghast at what these academics were doing,” she told me. Contrary to Janis’s theory, the evidence suggested that tight-knit groups—ones with that cohesive “we-feeling”—tend to make better decisions, Aldag said.

“Groupthink is a compelling myth,” Fuller and Aldag argued in their contribution to an academic journal’s special issue for the 25th anniversary of Janis’s theory. “Despite a quarter century virtually devoid of support for the phenomenon, groupthink refuses to die.” Other papers in the journal took more specific aim at the theory. One argued that what Janis took to be a herd mentality might just as well be seen as deliberate, venal compliance. In other words, the misguided bureaucrats weren’t so much “victims” of groupthink as they were savvy operators who were minding which way the political winds were blowing. Another paper, by the Stanford psychologist Roderick Kramer, drew upon newly declassified documents to reanalyze the Bay of Pigs and Vietnam cases from Janis’s book, and found that much of the new evidence did not support the original interpretation. According to Kramer, neither case showed groupthink; they both showed “politicothink.” (Needless to say, Kramer’s coinage has not caught on.)

That special issue marked a turning point for the academic bandwagon that Janis had kicked off. “It would be hard now to get a groupthink paper published in a top journal,” Aldag, who is retired but still sits on editorial boards, told me.

The implosion of Janis’s model has left groupthink in an odd place. In popular discourse, the word has taken on a life of its own, as an insult deployed without clear reference to any theory of psychology. “I don’t think people always know what it means,” Fuller said. Dominic Packer, a Lehigh University psychologist who has written about groupthink, told me that the term has become a useful pejorative. “It’s what the other people think,” he said. “You never hear people say it to their own group.”

Taking potshots at groupthink has become especially popular on the political right, where rugged individualism is beloved and elite consensus makers are not. From 2016 to 2023, Tucker Carlson often signed off from his weeknight Fox News show with a tagline declaring it “the sworn enemy of lying, pomposity, smugness, and groupthink.” Before taking roles in government, both Makary and Bhattacharya joined the chorus in their appearances on Fox News, taking whacks at the groupthink in the U.S. pandemic response.

To be sure, there is something deeply familiar about the idea that human beings will sometimes follow the crowd because they cherish their place in the group. Yet the claim that our public-health mistakes can be pinned on some special force called groupthink is both unhelpful and misguided. For one thing, the label implies that we’d all be better off if a monkish master of “lonethink” could be recruited to weigh the science on their own, and then arrive at the objective answer to a thorny problem, such as whether to shut down schools and when to reopen them. But decisions like these are usually carried out in the face of competing values, squabbling constituencies, and genuine uncertainty about the facts. Deciding what to do requires negotiation and democratic politics. It’s a group activity.

[Read: Kennedy’s hand-picked vaccine committee is a mess]

Indeed, the failure of our leaders to explain that public health is never just a matter of “following the science” may be one of the pandemic’s most enduring fiascos. Now the MAHA crusaders themselves seem ready to repeat that error in extravagant ways. “This group is going where the science takes them,” Hilliard, the HHS spokesperson, told me when I asked about Kennedy’s decision to stack the nation’s vaccine-advisory panel with a group of his like-minded associates. To insist that this was necessary to rescue the committee from “vaccine groupthink” is to get the matter backward: It labels a triumph of systematic decision making—one that has saved countless lives—as a tragedy; it courts disaster rather than forestalls it. (Hilliard did not respond to a question about the scientific controversy surrounding groupthink.)

Well-managed groups operating under clear and transparent rules—groups such as the vaccine-advisory committee and the U.S. Preventive Services Task Force (which Kennedy seems ready to also dismantle)—are some of the most powerful and trustworthy decision-making tools that we have. They are guided by published research and hard-won experience on how to avoid bad group decisions. For example, group leaders should not impose their views at the outset, and should make it clear that they value candid input from the team.

But our MAHA leaders don’t appear to be heeding this advice. “A core aspect of the Trump administration is that these leaders are not willing to admit a single mistake ever,” Packer told me. That might drive team members to hide their own mistakes, and to never criticize their bosses, even when leadership is screwing up, he said. Any group decision comes with a degree of acquiescence and a leap of faith. But the best decisions involve bringing groups together, hearing out their different views, and not denying that we have a social nature. Our nation’s thinking isn’t broken, and this administration shouldn’t try to fix it.

Updated at 3:42 p.m. ET on October 31, 2025

During America’s hardest economic times, canned goods were a lifeline. From 1929, the start of the Great Depression, to 1941, when the United States entered World War II, people ate nearly 50 percent more canned fruit, by weight, compared with the preceding 13 years. Some used new community canning centers to safely preserve food for the long term, or depended on the U.S. government’s first food-stamp programs to buy “surplus goods,” including canned beef, mutton, goat, and peas.

Millions of Americans are now waiting to find out whether they will receive their November benefits from the Supplemental Nutrition Assistance Program. SNAP was set to run out of funds on November 1—tomorrow—because of the ongoing government shutdown. As anxiety about hunger mounts, some state agencies have advised SNAP beneficiaries to stock up on canned goods such as beans, soup, fruit, and tuna. Only, those foods aren’t so reliably affordable as they once were, in part because of restrictions on the materials that go into the cans themselves.

Roughly 42 million Americans rely on SNAP for food. This week, a number of Democrat-led states sued the Trump administration for refusing to tap into a $5 billion SNAP emergency reserve. After this article was published, a federal judge in Rhode Island ruled that the administration had to continue funding SNAP through the shutdown. But the administration could appeal the decision to the Supreme Court—or simply ignore the court order, as it has several others this year. “SNAP benefit recipients wouldn’t have to worry at all if Democrats would stop using them as political ‘leverage,’” Kush Desai, a White House spokesperson, told me earlier this week; when I reached out to the White House again today to ask about the administration’s plans to respond to the federal judge’s ruling, I was directed to the Office of Management and Budget, which did not immediately respond to my questions. The USDA website also blames Democrats for the suspension in food assistance; when I emailed the USDA’s press office, an auto-reply from a spokesperson said they were furloughed and would respond when funding was restored.

Canned foods have been a lifeline in lean times because they’re long-lasting, generally nutritious, and, most of all, cheaper than their fresh counterparts—largely because the necessary materials could be imported reliably and cheaply. Canning requires a special type of metal called tin-mill steel, which the U.S. imports from Canada, Germany, the United Kingdom, and the Netherlands, Tom Madrecki, vice president of supply-chain resiliency at the Consumer Brands Association, told me. Tin-mill steel is unwieldy and fragile, he said, and less valuable than steel meant for cars and machinery. So U.S. steel manufacturers have deprioritized making it. As a result, the U.S. produces only about 20 percent of the tin-mill steel used by domestic can manufacturers, Scott Breen, the president of the Can Manufacturers Institute, a trade group, told me. “We have no choice but to import the other 80 percent,” he said.

Since Trump’s first term, those imports have been subject to a 25 percent tariff; in June, it rose to 50 percent for steel coming from most countries. Trump’s tariffs are meant to stimulate American manufacturing, but the U.S. is simply not equipped to produce enough tin-mill steel: Since 2018, the nation’s 12 plants have dwindled to three, and there’s no sign of further investment, Breen said. The administration has not yet heeded the canning industry’s calls for a tariff exemption on tin-mill steel. Trade negotiations with Canada, which involved metal tariffs, recently disintegrated. (The U.S. also imports roughly $2 billion worth of canned food a year, Breen said—about 10 percent of the national supply. According to the Can Manufacturers Institute, nearly a quarter of that food comes from China, which negotiated a 47 percent average tariff on imports that Trump announced yesterday morning.)

[Listen: SPAM: How the American dream got canned]

The price of tin-mill steel has never been higher, Madrecki said. Canned-food manufacturers have been passing the extra cost to retailers and, inevitably, consumers. From September 2024 to September 2025, the average consumer price of canned fruits and vegetables rose by 5 percent, nearly double the increase observed in food in general, according to government data. Over time, a 50 percent tariff on tin-mill steel could raise the sticker price of canned foods by as much as 15 percent, according to a June analysis by the Consumer Brands Association.

That increase is a matter of cents per can, but it does add up quickly. “It’s really hitting the lower-income customers that rely on SNAP benefits,” Usha Haley, an international-business professor at Wichita State University, told me. In an average week, a SNAP beneficiary eats seven cans of food, according to the Can Manufacturers Institute. (Those who don’t use SNAP consume about five.) With a 15 percent price increase, the same amount of money that beneficiary spends would cover only six cans. “At the end of the day, you put one fewer can in your cart,” Madrecki said.

The government itself has been affected, too. One of the biggest purchasers of canned goods is the USDA, Madrecki told me, which uses them to supply food to prisoners, for school meals, and to the Women, Infants, and Children program. By raising tariffs, “the government is increasing its own prices,” Breen said.

State governments have encouraged families to continue to gather shelf-stable foods at food banks if the SNAP benefits stop coming. But charitable food organizations are already strained: Rising food costs due to inflation have driven more people to seek donated items. The implications of taking SNAP away would be “catastrophic” for food banks, Ami McReynolds, interim chief of government relations at Feeding America, told me. Plus, some of the goods such centers stock are donated, but the rest are purchased wholesale by the organizations that run them. “The prices go up for them as well,” Breen said. (Several states have announced plans to send more money to food banks next month.)

Most families spend all of their SNAP credits within three weeks of receiving them at the beginning of each month, Joel Berg, the CEO of the nonprofit Hunger Free America, told me. Those who want to follow states’ guidance to stock up now, before a SNAP cliff, most likely don’t have anything left to budget. Families who can’t afford as much canned food as they normally buy now have limited alternatives for supplementing their diet: Delaware’s suggestions for shelf-stable foods include cereal, oatmeal, peanut butter, nuts, applesauce, pasta, and granola bars—hardly a filling or nutritious diet. A can of beans for protein, or canned pears for fiber, could turn a bowl of carbohydrates into a healthier and more satisfying, if still meager, meal.

[Read: A ‘MAHA box’ might be coming to your doorstep]

Modern-day hunger isn’t as stark as it was during the Depression: In 1933, a New Yorker died every 12 days from hunger, according to The New York Times, and many more Americans developed illnesses associated with malnutrition. Today, when budgets run low, people tend to reduce portion size, skip meals, or buy less healthy food; they generally don’t go long periods without eating, Berg told me. But if the first few days of November pass without the restoration of SNAP benefits, he said, “you’re going to start seeing, for the first time in modern American history, large amounts of Americans going without any food at all.”

For most of my adult life, I’ve felt helpless about being overweight. When I met with a doctor a few years ago to discuss my high cholesterol, he held up a hunk of faux flesh meant to model a pound of excess fat and encouraged me to lose 20 of said gelatinous blobs. Perhaps, he suggested, I should eat less red meat and start exercising. I still remember his perplexed stare after I told him I had an established gym routine and had been a vegetarian for the better part of a decade.

Starting an obesity drug was supposed to be triumphant. The days of being winded after walking up the stairs to my apartment, and buying T-shirts marketed for guys with big bellies, would finally be over. Or so I thought. My health insurance didn’t cover Wegovy or Zepbound, the two GLP-1 drugs approved for weight loss. (Both medications are also sold for diabetes, under the brand names Ozempic and Mounjaro, respectively.) Despite my pleading, the insurance company wouldn’t budge.

For all the hype over GLP-1s, Americans have struggled to access these weekly injections. Seniors can’t get these drugs because Medicare is barred by law from covering them for obesity. Drugmakers previously couldn’t make enough of the drugs to keep up with demand, prompting the FDA to formally declare a shortage. The supply issues have now abated, but getting these drugs has somehow become even harder. The problem is that insurance companies are refusing to cover them.

Consider Zepbound, the more effective GLP-1 for weight loss. More than half of all private insurance plans do not cover Zepbound at all, up from 18 percent last year. That’s according to recent data from GoodRx, a site that compares prescription-drug prices. Plans are more likely to cover Wegovy, according to GoodRx, but a dwindling share let you get the drug without first going through barriers that may end up curtailing access.

Eli Lilly, the pharmaceutical company that makes Zepbound, blames the lack of coverage on the stigma of obesity. “Despite obesity being recognized as a chronic, complex disease, insurance and federal programs still do not provide broad coverage to people who live with this disease,” the company wrote in a statement. But that isn’t the full story. Many Americans get health insurance through their job, and GLP-1s are so expensive that many companies simply can’t afford the drugs. It might feel like magic when insurance picks up the tab for your prescriptions, but part of those cost savings are actually paid by your employer. A month’s supply of a GLP-1 retails for at least $1,000. When you consider that roughly three-quarters of American adults are overweight or obese, employers could be faced with hundreds or even thousands of GLP-1 bills each month. (Americans who are overweight but not obese are eligible for GLP-1s if they have high cholesterol or certain other health conditions.) “It’s brutal, and it’s forcing employers to make tough decisions,” James Gelfand, the president of the ERISA Industry Committee, a lobbying group that advises large employers on health-insurance issues, told me.

[Read: Ozempic or bust]

For companies looking to manage the costs, “the solution to the problem is just making it more difficult to get the drugs,” Ameet Sarpatwari, a drug-pricing expert at Harvard, told me. Smaller companies are especially struggling; a survey released last week by the Kaiser Family Foundation found that just 16 percent of employers with 200 to 999 employees are covering Wegovy or Zepbound, compared with 43 percent of employers that have 5,000 or more employees. But even major corporations are making patients go through hurdles before they can access these drugs. One of the most common policies requires doctors to submit additional paperwork explaining why a patient needs these drugs before a prescription can be picked up. That might not sound all that onerous, but peer-reviewed research shows it delays patients from getting the drugs their doctors say they need. In my experience, it also requires sustained effort from the patient to corral a doctor’s office into submitting the necessary paperwork.

If employers need to put restrictions on the GLP-1s patients can access, it would seem logical that they would start with Wegovy. Notably, the drug costs about $300 more a month than Zepbound—and it also works less well. (A head-to-head trial of the two medications, funded by Eli Lilly, found that patients on Zepbound lost an average of 20 percent of their weight, versus about 14 percent for those on Wegovy.) Nevertheless, it’s much harder to get Zepbound than Wegovy. “You can’t assume that just being the best product means that you’ll be on the formulary,” Gelfand said.

Insurers are basing their coverage decisions, in part, on “rebates,” discounts that are offered by drugmakers as a negotiating chip to persuade insurers to cover one product over a competitor. For example, in July, CVS Caremark, a pharmacy-benefit manager hired by insurance companies to help determine which drugs to cover, began recommending Wegovy over Zepbound in most cases. Ed DeVaney, the president of CVS Caremark, told me that the decision was made because his company deemed the two drugs very similar in terms of efficacy, and because the deal represented “the highest value” for the health plans and employers the company works for. But the move hasn’t been popular. Doctors favor Zepbound over Wegovy, according to prescribing data analyzed by the analytics firm Truveta. Prescriptions may go unfilled once patients realize that their insurance companies won’t foot the bill. (CVS Caremark is facing a class-action lawsuit filed by customers who were prescribed Zepbound but weren’t able to get it through their insurance. )

Without insurance coverage, patients have to turn elsewhere for these drugs. Eli Lilly and Novo Nordisk sell their drugs to patients directly for a major discount, but they still are prohibitively expensive: A vial of Zepbound costs $500 a month when purchased straight from the manufacturer. Patients can opt for cheaper versions of these drugs that are made by compounding pharmacies, but they can be unreliable and unsafe. Neither of these alternatives were solutions for me, and they likely won’t be for many Americans. Although I tried a few months of compounded drugs, the risks of injecting myself with a serum that hadn’t been reviewed for safety by the FDA started to weigh on me. Ultimately, I was able to get on my fiancée’s insurance, and now I finally have access to Wegovy. (Her plan refuses to cover Zepbound.) But very few patients can turn to this sort of backup plan when their own insurance comes up short.

GLP-1s are hardly perfect. They come with sometimes severe side effects, including nausea, and the weight-loss results last only as long as people keep taking them. But the upside for people with obesity is undeniable. Eventually, millions of Americans who are waiting for these drugs should be able to get them. More competition should lead to modestly larger rebates, making it cheaper for employers to cover these drugs, Sarpatwari said. Novo Nordisk is developing a new obesity drug that clinical trials suggest rivals Zepbound in effectiveness, and Eli Lilly is testing a drug that could end up being even more effective than the current products on the market. Several companies, including Novo Nordisk and Eli Lilly, are also developing oral versions of these drugs for those who do not want to inject themselves weekly. The new drugs will almost certainly be more expensive than those already on the market, but they should make it slightly easier for patients to access older GLP-1 drugs.

That future remains far away. The start of the GLP-1 era focused on the exciting transformations patients have made on these drugs. If something doesn’t change, the next few years are going to focus on all the people who could benefit from GLP-1s but are unable to access them.