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  • Winter Illness This Year Is a Different Kind of Ugly

    Winter Illness This Year Is a Different Kind of Ugly

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    Earlier this month, Taison Bell walked into the intensive-care unit at UVA Health and discovered that half of the patients under his care could no longer breathe on their own. All of them had been put on ventilators or high-flow oxygen. “It was early 2022 the last time I saw that,” Bell, an infectious-disease and critical-care physician at the hospital, told me—right around the time that the original Omicron variant was ripping through the region and shattering COVID-case records. This time, though, the coronavirus, flu, and RSV were coming together to fill UVA’s wards—“all at the same time,” Bell said.

    Since COVID’s arrival, experts have been fearfully predicting a winter worst: three respiratory-virus epidemics washing over the U.S. at once. Last year, those fears didn’t really play out, Sam Scarpino, an infectious-disease modeler at Northeastern University, told me. But this year, “we’re set up for that to happen,” as RSV, flu, and COVID threaten to crest in near synchrony. The situation is looking grim enough that the CDC released an urgent call last Thursday for more vaccination for all three pathogens—the first time it has struck such a note on seasonal immunizations since the pandemic began.

    Nationwide, health-care systems aren’t yet in crisis mode. Barring an unexpected twist in viral evolution, a repeat of that first terrible Omicron winter seems highly unlikely. Nor is the U.S. necessarily fated for an encore of last year’s horrors, when enormous, early waves of RSV, then flu, slammed the country, filling pediatric emergency departments and ICUs past capacity, to the point where some hospitals began to pitch temporary tents outside to accommodate overflow. On the contrary, more so than any other year since SARS-CoV-2 appeared, our usual respiratory viruses “seem to be kind of getting back to their old patterns” with regard to timing and magnitude, Kathryn Edwards, a vaccine and infectious-disease expert at Vanderbilt University, told me.

    Read: The worst pediatric-care crisis in decades

    But even so-so seasons of RSV, flu, and SARS-CoV-2 could create catastrophe if piled on top of one another. “It really doesn’t take much for any of these three viruses to tip the scale and strain hospitals,” Debra Houry, the CDC’s chief medical officer, told me. It also—in theory—shouldn’t take much to waylay the potential health-care crisis ahead. For the first time in history, the U.S. is offering vaccines against flu, COVID, and RSV: “We have three opportunities to prevent three different viral infections,” Grace Lee, a pediatrician at Stanford, told me. And yet, Americans have all but ignored the shots being offered to them.

    So far, flu-shot uptake is undershooting last year’s rate. According to recent polls, as many as half of surveyed Americans probably or definitely aren’t planning to get this year’s updated COVID-19 vaccine. RSV shots, approved for older adults in May and for pregnant people in August, have been struggling to get a foothold at all. Distributed to everyone eligible to receive them, this trifecta of shots could keep as many as hundreds of thousands of Americans out of emergency departments and ICUs this year. But that won’t happen if people continue to shirk protection. The specific tragedy of this coming winter will be that any suffering was that much more avoidable.

    Much of the agony of last year’s respiratory season can be chalked up to a terrible combination of timing and intensity. A wave of RSV hit the nation early and hard, peaking in November and leaving hospitals no time to recover before flu—also ahead of schedule—soared toward a December maximum. Children bore the brunt of these onslaughts, after spending years protected from respiratory infections by pandemic mitigations. “When masks came down, infections went up,” Lee told me. Babies and toddlers were falling seriously sick with their first respiratory illnesses—but so were plenty of older kids who had skipped the typical infections of infancy. With the health-care workforce still burnt out and substantially pared down from a pandemic exodus, hospitals ended up overwhelmed. “We just did not have enough capacity to take care of the kids we wanted to be able to take care of,” Lee said. Providers triaged cases over the phone; parents spent hours cradling their sick kids in packed waiting rooms.

    And yet, one of the biggest fears about last year’s season didn’t unfold: waves of RSV, flu, and COVID cresting all at once. COVID’s winter peak didn’t come until January, after RSV and flu had substantially died down. Now, though, RSV is hovering around the high it has maintained for weeks, COVID hospitalizations have been on a slow but steady rise, and influenza, after simmering in near-total quietude, seems to be “really taking off,” Scarpino told me. None of the three viruses has yet approached last season’s highs. But a confluence of all of them would be more than many hospitals could take. Across the country, many emergency departments and ICUs are nearing or at capacity. “We’re treading water okay right now,” Sallie Permar, the chief pediatrician at Weill Cornell Medical Center and NewYork-Presbyterian Hospital, told me. “Add much more, and we’re thrown into a similar situation as last year.”

    That forecast isn’t certain. RSV, which has been dancing around a national peak, could start quickly declining; flu could take its time to reach an apex. COVID, too, remains a wild card: It has not yet settled into a predictable pattern of ebb and flow, and won’t necessarily maintain or exceed its current pace. This season may still be calmer than last, and impacts of these diseases similarly, or even more, spaced out.

    But several experts told me that they think substantial overlap in the coming weeks is a likely scenario. Timing is ripe for spread, with the holiday season in full swing and people rushing through travel hubs on the way to family gatherings. Masking and testing rates remain low, and many people are back to shrugging off symptoms, heading to work or school or social events while potentially still infectious. Nor do the viruses themselves seem to be cutting us a break. Last year’s flu season, for instance, was mostly dominated by a single strain, H3N2. This year, multiple flu strains of different types appear to be on a concomitant rise, making it that much more likely that people will catch some version of the virus, or even multiple versions in quick succession. The health-care workforce is, in many ways, in better shape this year. Staffing shortages aren’t quite as dire, Permar told me, and many experts are better prepared to deal with multiple viruses at once, especially in pediatric care. Kids are also more experienced with these bugs than they were this time last year. But masking is no longer as consistent a fixture in health-care settings as it was even at the start of 2023. And should RSV, flu, and COVID flood communities simultaneously, new issues—including co-infections, which remain poorly understood—could arise. (Other respiratory illnesses are still circulating too.) There’s a lot experts just can’t anticipate: We simply haven’t yet had a year when these three viruses have truly inundated us at once.

    Read: The big COVID question for hospitals this fall

    Vaccines, of course, would temper some of the trouble—which is part of the reason the CDC issued its clarion call, Houry told me. But Americans don’t seem terribly interested in getting the shots they’re eligible for. Flu-shot uptake is down across all age groups compared with last year—even among older adults and pregnant people, who are at especially high risk. And although COVID vaccination is bumping along at a comparable pace to 2022, the rates remain “atrocious,” Bell told me, especially among children. RSV vaccines have reached just 17 percent of the population over the age of 60. Among pregnant people, the other group eligible for the vaccines, uptake has been stymied by delays and confusion over whether they qualify. Some of Permar’s pregnant physician colleagues have been turned away from pharmacies, she told me, or been told their shots might not be covered by insurance. “And then some of those same parents have babies who end up in the hospital with RSV,” she said. Infants were also supposed to be able to get a passive form of immunity from monoclonal antibodies. But those drugs have been scarce nationwide, forcing providers to restrict their use to babies at highest risk—yet another way in which actual protection against respiratory disease has fallen short of potential. “There was a lot of excitement and hope that the monoclonal was going to be the answer and that everybody could get it,” Edwards told me. “But then it became very apparent that this just functionally wasn’t going to be able to happen.”

    Last year, at least some of the respiratory-virus misery had become inevitable: After the U.S. dropped pandemic mitigations, pathogens were fated to come roaring back. The early arrivals of RSV and flu (especially on the heels of an intense summer surge of enterovirus and rhinovirus) also left little time for people to prepare. And of course, RSV vaccines weren’t yet around. This year, though, timing has been kinder, immunity stronger, and our arsenal of tools better supplied. High uptake of shots would undoubtedly lower rates of severe disease and curb community spread; it would preserve hospital capacity, and make schools and workplaces and travel hubs safer to move through. Waves of illness would peak lower and contract faster. Some might never unfold at all.

    Read: The pandemic broke the flu … again

    But so far, we’re collectively squandering our chance to shore up our defense. “It’s like we’re rushing into battle without armor,” Bell told me, even though local officials have been begging people to ready themselves for months. Which all makes this year feel terrible in a different kind of way. Whatever happens in the coming weeks and months will be a worse version of what it could have been—a season of opportunities missed.

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    Katherine J. Wu

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  • Is Ben Wikler the Most Important Democrat in America?

    Is Ben Wikler the Most Important Democrat in America?

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    The man who has been hailed as “the best state chair in the country” is not a national household name. He’s not even a household name in his own state. But on a recent afternoon in the small village of Grafton, Wisconsin, Ben Wikler might as well have been Bono.

    Two dozen middle-aged and retired volunteers stood in line to clutch the hand of the chair of the Wisconsin Democrats. “Thank you for everything you do,” they said, beaming at Wikler as he took a lap through the Ozaukee County party headquarters. “We’re so happy you’re here.” Like proud children before an admiring parent, the volunteers told him how much money they’d raised and how many doors they’d knocked on this summer.

    “This is Connie,” someone said, patting a woman’s shoulder. “She just won the school-board race.” “Yay, school board!” Wikler cheered.

    He was there to kick off the last day of door knocking for a Wisconsin state-assembly candidate who had very little chance of winning in solid-red Ozaukee County, an exurban district on the shore of Lake Michigan north of Milwaukee. But the point was not to win, it was to lose by less. That afternoon, Wikler managed to deliver a speech with almost the same inspirational zeal as Aragorn at the Black Gate. “This election is a demonstration to ourselves as Democrats and to the country that there is change happening right now,” he told the volunteers—and a reminder to Republicans “that Democrats have not given up on democracy.”

    Since becoming chair in 2019, Wikler has brought his party back from virtual irrelevance in Wisconsin. Four years after Donald Trump had demolished the so-called blue wall in the upper Midwest, Wikler’s leadership helped tip Wisconsin—and the entire presidential election—to the Democrats in 2020. Then, earlier this year, the millions of dollars Wikler had raised helped a progressive candidate prevail in the off-cycle state-supreme-court race, which will likely lead to a reworking of Wisconsin’s extremely gerrymandered maps.

    Wikler’s talent is getting people to show up. He does this by framing every race as the election of a lifetime. “Resources tend to flow toward the places where they can make a difference or their imagination has been captured,” he told me.

    Read: It ain’t over in Wisconsin

    Resources is something of a euphemism; he really means dollars. Thanks to legislation passed by Republicans a few years ago, Wisconsin is one of the few states in which individuals can donate unlimited amounts to political parties, which can, in turn, transfer unlimited funds to candidates. It is Wikler’s particular genius to have turned that weapon of fundraising against the party that made it law.

    In the run-up to next year’s presidential election, American eyeballs will once again be on Wikler’s home. “If we could have a Ben Wikler in all 50 states, the Democratic Party would be in better shape,” Jon Favreau, the podcaster and former Obama speechwriter, told me. But people may be getting tired of elections with existential stakes, however much the party spends persuading them to go out and vote. Capturing imaginations once again, especially on behalf of an elderly incumbent with less-than-great approval ratings, could be Wikler’s most formidable challenge yet.

    I hitched a ride to the Ozaukee County event with Wikler’s posse in their rented minivan. When I slid open the back door, I found the state party chair buckled into a seat in the middle row, his head grazing the ceiling. The 42-year-old Wikler, who is goateed and tall (6 foot 4), was wearing clear-framed glasses and a denim shirt over denim jeans. He looked like a Brooklyn dad—but Wikler is a dad from Madison, a fact he is very proud of.

    I’d hardly sat down before Wikler launched into a 30-minute refresher course, for my benefit, on Wisconsin’s idiosyncratic past. Robert La Follette and the state’s socialist roots. Senator Joe McCarthy. Governor Tommy Thompson’s welfare reform. Then more recent history: Scott Walker’s ascension to the governor’s mansion in 2011, and Republicans’ success in flipping both chambers of the state legislature. Walker’s Act 10 legislation, which eroded the power of public unions. The GOP’s controversial and secretive redistricting project.

    “How many times have you delivered that spiel?” I asked when he was done.

    He smiled. “There’s actually an extended version.”

    Today, Wikler lives in his childhood home on Madison’s west side with his wife, his three kids, and their enormous, excitable Bernese mountain dog. But before moving back to the upper Midwest, Wikler was the Washington, D.C., director of the progressive organization MoveOn, for which he led protests against Republican attempts to overturn the Affordable Care Act. Prior to that, Wikler hosted a politics podcast called The Good Fight after a spell as a researcher and producer for Al Franken. The former senator from Minnesota remains a close friend. “He’s just brilliant—really funny and a really good writer,” Franken told me of Wikler last month, over the phone. “He has the full package, and that’s hard to get in a state chairman.” (The title of Franken’s 2003 book, Lies and the Lying Liars Who Tell Them, was Wikler’s idea, Franken said.)

    Then, in 2016, Trump hurtled through the blue wall, winning Wisconsin’s Electoral College votes for the Republicans for the first time since Ronald Reagan in 1984. Which is why Wikler ultimately decided to move back home and help revive his party’s fortunes.

    As chair, Wikler is known for posting climactic Twitter threads about Wisconsin elections that go viral. He’s constantly giving interviews to convey the urgency of races up- and down-ballot. The central strategy of his chairmanship, Wikler told me, “has been to buy a bigger siren, and put it as high up as we possibly can.”

    Most state parties in America have somewhere around half a dozen full-time paid staff members, but Wikler has expanded his staff from 30 to 70. He has a comprehensive digital operation, an in-house research group, and a full-time staff of youth organizers.

    Since 2019, Wikler has used his connections in national politics to raise more than $110 million, an astoundingly high amount for a state party. His team’s most successful money-gathering endeavor was getting celebrities such as Robin Wright and Julia Louis-Dreyfus to care about the Badger State: In September 2020, the Wisconsin Democrats hosted a Zoom table reading of the 1987 film The Princess Bride that reunited most of the original cast. The event attracted more than 100,000 viewers and raised $4.25 million. So they did it twice more, with the casts of The West Wing and Veep.

    Wisconsin could have gone the way of neighboring Iowa, which has turned sharply to the right in these past six years. In the Badger State, the trend toward Democrats began in 2018, when many voters revolted against Trump. But thanks in large part to the machine that Wikler has built, the party has continued to win by bigger and bigger margins in the state’s metropolitan areas in the past few cycles, and it’s losing by smaller margins in the Republican-leaning suburbs of Milwaukee. Although Democrats nationally have been hemorrhaging voters in rural areas, they’ve managed to at least stop the bleeding in rural Wisconsin, Craig Gilbert, the retired Washington bureau chief for the Milwaukee Journal Sentinel, told me.

    Read: The most dangerous Democrat in Iowa

    Statewide elections have proved to be the most rewarding battlegrounds for Democrats. In Wisconsin, Biden beat Trump in 2020 by 20,000 votes, and last year Democratic Governor Tony Evers narrowly won reelection. The only major disappointment was Mandela Barnes’s loss to the incumbent Republican senator, Ron Johnson. But just this past spring, Wisconsinites elected Janet Protasiewicz to the state supreme court in a race that broke turnout records and attracted donations from George Soros, Steven Spielberg, and Illinois Governor J. B. Pritzker.

    Wikler’s legacy as a Democratic leader will be the nationalization of the state party’s donor base—something he’s achieved by arguing that Wisconsin is at the epicenter of America’s political battle. Whether that’s good for democracy is another matter.

    The wealthy Democrats from California or Illinois who’ve done much of the donating are not ideal stand-ins for regular Wisconsinites. “Elections shouldn’t be a tug-of-war between a handful of billionaires on the right and a handful of billionaires on the left,” Matthew Rothschild, the former executive director of the Wisconsin Democracy Campaign, told me. “But Ben didn’t make the playing field. Republicans in Wisconsin made the playing field. The U.S. Supreme Court made the playing field.”

    If Wikler’s strategy is to make politics in Wisconsin national, he is also committed to hyperlocal campaigning: Democrats should have a presence everywhere, Wikler believes. Which is why the van drove another two hours west from Grafton to Baraboo for an annual agricultural-equipment expo.

    The state party’s Rural Caucus had set up a tent between the crop-spraying-drone display and a demonstration area for grinding forest products. Wikler gave a pep talk to some of his members before striding over to the Sauk County Republicans’ tent. “Hi, I’m the Democratic Party chair,” he said, extending his hand toward a trio of 60-something men chatting in the shade. For a few minutes, the four men went back and forth, a little awkwardly, about the successes and failures of the former Governor Walker and whether any of them were particularly excited about a second nomination of Trump. (They weren’t.) It was all pleasant enough.

    Then, as Wikler turned to leave, one of the men took him aside. “I gotta tell you something,” he said, in a low voice. “I spoke with a gentleman over at your tent this morning, and I have never met a finer man or had a more reasonable conversation.” Wikler beamed. “As a party chair, that’s a delight to hear,” he replied.

    We left Baraboo in the late afternoon for a volunteer picnic in Middleton, a leafy Madison suburb along Lake Mendota. The gathering was held in a lush backyard, full of unruly flowering shrubs and the kind of wacky animal lawn ornaments that seem to announce, A Democrat lives here!

    The yard was full of gray-haired volunteers from different neighborhood door-knocking teams. “I don’t think we could have done anything without Ben,” JoAnna Richard, the host of the event, told me. “His leadership has been key: his connections, and how we fundraise and organize year-round.” A few minutes later, Wikler was giving his third and final motivational speech of the day, thanking people for their work over the past few years. We’re “building something bigger than any of us,” he told them. “You’re at the heart of that project, in a place that is the most key furnace for democracy—the key engine, the center of the web.”

    Republicans are working hard for a rebound in Wisconsin. Later this month, they’ll host the first debate of the GOP presidential primary in Milwaukee, and the Republican National Convention will be held in the same city next summer. That national attention will be good for the state party, which has recently under-raised Democrats.

    “They’ve been very good at getting Hollywood money,” Brian Schimming, the state GOP chair, told me by phone, with what sounded like a mix of shade and envy. “It’s hard to compete with” the Democrats’ celebrities and wealthy out-of-state donors, he said. “I need to nationalize Wisconsin a bit more.”

    This time around, Republicans are certainly going to be more focused on fundraising. “Ben would be kidding himself if he thinks he or his successor can always win the money race,” Rothschild told me. But money is not the race that ultimately matters.

    “I’d rather have my problem than the problem Ben has, which is an extraordinarily unpopular sitting incumbent,” Schimming told me. “Our folks are really fired up about this race.”

    Wikler, in fact, does seem a little nervous. He worries about a low-turnout election—and that people aren’t taking seriously enough the very real possibility of a second Trump presidency. “In 2020, people were ready to do anything to beat Trump. I had people retiring early and moving to Wisconsin to volunteer,” he told me in the car. “None of that’s happening right now.”

    Read: The long-shot candidate who has the White House worried

    Every recent presidential election in Wisconsin has been decided on a razor-thin margin, and Wikler’s job is to engage more than just the highly educated, high-income activist types. He’ll need to stitch together a delicate coalition and get them all to fill out a ballot: young people in Dane County; Black voters in Milwaukee; moderates in the suburbs and the small cities around Green Bay. The hurdles are already high, and Biden doesn’t exactly get many people’s blood pumping. “I’ve been concerned about that since 2020,” Favreau said. “It’s easy to see a scenario where a couple people say, ‘[Biden’s] too old. I’m going back to Trump.’” It’s even easier to see a situation in which some Wisconsinites, weary of it all, simply don’t vote.

    In JoAnna Richard’s backyard in Middleton, Wikler was winding up his pep talk, a little breathlessly. They’d be working “throughout this year, and into next spring in the local elections, and into next fall in 2024,” he said. “And then we’ll continue six months after that in the 2025 local elections! And the next state-supreme-court race—”

    A few people audibly sighed at this point, likely in anticipation of another two exhausting years door knocking and phone banking and envelope licking in defense of democracy. A man near me shouted, “We’re tired!” But that moment of wavering enthusiasm lasted only a fraction of a second before the whole group began to laugh.

    Sure, they’re tired. But for Wikler, they’ll show up.

    Will everyone else?

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    Elaine Godfrey

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  • Please Stop Kissing Strangers’ Babies

    Please Stop Kissing Strangers’ Babies

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    Barack Obama did it. Donald Trump did it. Joe Biden, of course, has done it too. But each of them was wrong: Kissing another person’s baby is just not a good idea.

    That rule of lip, experts told me, should be a top priority during the brisk fall and winter months, when flu, RSV, and other respiratory viruses tend to go hog wild (as they are doing right this very moment). “But actually, this is year-round advice,” says Tina Tan, a pediatrician at Lurie Children’s Hospital of Chicago. Rain, wind, or shine, outside of an infant’s nuclear family, people should just keep their mouths to themselves. Leave those soft, pillowy cheeks alone!

    A moratorium on infant smooching might feel like a bit of a downer—even counterintuitive, given how essential it is for infants and caregivers to touch. But kissing isn’t the only way to show affection to a newborn, and the rationale for cutting back on it specifically is one that most can get behind: keeping those same wee bebes safe. An infant’s immune system is still fragile and unlearned; it struggles to identify infectious threats and can’t marshal much of a defense even when it does. Annette Cameron, a pediatrician at Yale, told me she usually advises parents to avoid public places—church, buses, stores—until their baby is about six weeks old, and able to receive their first big round of immunizations. (And even then, shots take a couple of weeks to kick in.)

    The situation grows far less perilous once kids’ vaccine cards start to get more full; past, say, six months of age or so, they’re in much better shape. But risk remains a spectrum, especially when lips get involved. The mouth, I am sorry to tell you, is a weird and gross place, chock-full of saliva, half-chewed flecks of food, and microbes galore; all that schmutz is apt to drool and dribble onto whatever surfaces we drag our faces across. Flu, RSV, rhinovirus, SARS-CoV-2, and the coronaviruses that lead to common colds are among the many respiratory pathogens that hang out in and around our mouth. Although these viruses don’t usually make adults very sick, they can clobber young, unvaccinated kids, whose airways are still small. Health-care workers are seeing a lot of those illnesses now: Cameron recently treated a two-week-old who’d caught rhinovirus and ended up in the ICU.

    Also on the list of smoochable threats is herpes simplex 1, the virus responsible for cold sores. “That’s the one I worry about the most,” says Annabelle de St. Maurice, a pediatric-infectious-disease specialist at UCLA and the mother of a 1-year-old daughter. Most American adults harbor chronic HSV-1 infections in their mouth with no symptoms at all, save for maybe the occasional lesion. But the super-transmissible virus can spread throughout the body of an infant, triggering high fevers and seizures bad enough to require a visit to the hospital. For the first few weeks of a baby’s life, anyone with an active cold sore—blood relative, presidential candidate, or both—would do well to keep away. (Even a history of cold sores might warrant extra caution.)

    The lip-restraining guidance is most pertinent to people outside an infant’s household, experts told me, which can include extended family. Ideally, even grandparents “should not be kissing on the baby for at least the first few months,” Tan told me. Within a home, siblings attending day care and school—where it’s easy to pick up germs—might also want to sheathe their smackeroos at first. Years ago, Cameron’s own son had to be admitted to the hospital with RSV when he was six weeks old after catching the virus from his 4-year-old sister. Lakshmi Ganapathi, a pediatric-infectious-disease specialist at Boston Children’s Hospital, told me that she didn’t kiss her own two sons on the face before they hit the six-week mark—though experts told me that they don’t expect most parents to get this puritanical about puckering up.

    Read: The worst pediatric-care crisis in decades

    Baby-kissing—especially outside families and tight-knit social circles—isn’t a universal impulse: A few of my friends were rather shocked to hear that such a PSA was even necessary. But people’s threshold for instigating a loving lunge is far lower when it comes to babies than to older kids or adults. One colleague told me that strangers have reached into his daughter’s stroller to stroke her hair; another mentioned that randos have swooped in to tickle his son’s feet. When de St. Maurice takes strolls around her neighborhood with her daughter, she’s surprised by how often casual acquaintances will try to dive-bomb her baby with pursed lips.

    Then again, there is perhaps no lure more powerful than a tiny human. Babies snare us visually, with their wide eyes, round cheeks, and button noses; their scent wafts toward us like the heady perfume of a fresh cream scone. (One colleague with kids told me that inhaling that particular odor was, for him, “like huffing glue.”) Among primates, human infants are born especially vulnerable, in desperate need of help, and so we go into overdrive providing it, even to others’ babies, who—at least in our social species—might benefit from communal care. “It’s programmed into us,” Oriana Aragón, a social psychologist at the University of Cincinnati, told me. “I’m able to get really strong reactions out of people with just a photograph.” Even the urge to plant a wet one on someone else’s baby may have adaptive roots in kiss feeding, the practice of delivering pre-chewed meals to an infant lip to lip, says Shelly Volsche, an anthropologist at Boise State University. Kiss-feeding isn’t very popular in the United States today, but it’s still practiced by many groups around the globe.

    Read: Pregnancy is a war; birth is a cease-fire

    But as important as these acts are for babies, they can also be at odds with an infant’s health when a bunch of respiratory viruses are swirling about. Those costs aren’t always top of mind when a stranger locks eyes with a tiny human across the way, and it can be “a really awkward conversation,” de St. Maurice told me, to deter someone who just wants to shower affection on your child. Cameron recommends being frank: “I’m just trying to protect my baby.” Physical deterrents can help, too. “Put them in the stroller, put the canopy up, buckle the baby in, make it as difficult as possible,” she said. That’s a lot of barriers for even the most dedicated baby kissers to surmount. De St. Maurice also likes to point out that her little infant, as adorable as she is, “could also potentially transmit something to you.” Plus, by the time they’re six months old, babies may be experiencing their first whiffs of stranger danger and react negatively to unfamiliar hands and mouths. “That’s not particularly good for the baby, and the stranger wouldn’t get anything out of it either,” says Ann Bigelow, a developmental psychologist at St. Francis Xavier University, in Canada.

    Again, this advice isn’t meant to starve infants of tactile stimulation. Kids need to be exposed to the outside world and all of its good-germiness. More than that, they need a lot of physical touch. “The skin is our largest sense organ,” Bigelow told me. Skin-to-skin contact stimulates the release of oxytocin, and cements the bond between a caregiver and an infant. Kissing doesn’t have to be the means for giving that affection, though it certainly can be. “Heck, when I’m a grandparent, I’m going to be kissing my grandchild,” Cameron told me. “Just try and stop me.”

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    Katherine J. Wu

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