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9 experts reflect on the US reaching 200,000 Covid-19 deaths

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This week, the number of Americans confirmed to have died from Covid-19 crossed 200,000. It is a staggering loss of life, and this unfortunate milestone warrants some reflection.

In that spirit, I asked a question of several of the public health experts whose knowledge I have relied upon over the last six months: If you had been told back in February (when the first Covid-19 death in the US was recorded) that before the end of September 200,000 more people would be dead, what would your reaction have been?

“I thought we would be much more resilient in our public health, our policymaking, and trust in public health leaders,” Albert Ko, a Yale School of Public Health professor, told me. “I would have thought we would have done a better job protecting our nursing homes.”

I thought I would share the responses in full, with some light editing for clarity.

Jennifer Kates, director of global health and HIV policy at the Kaiser Family Foundation:

My February self was indeed worried. Things were escalating fast and I increasingly believed, from reviewing the emerging data, that the U.S. was barreling toward treacherous territory. However, I in no way envisioned we would get to 200,000 deaths. In part because that was not (yet) the scale being discussed but also because this was not inevitable. Many of these deaths could have been prevented, if the response had been different.

Josh Michaud, associate director for global health policy at the Kaiser Family Foundation:

It was really hard in February to imagine there would be 200,000 dead in the US in a matter of months. After all, the first state emergency declaration in the US didn’t come until the end of February (in Washington), and we didn’t know the extent of the disease in Italy, Iran, and other places. It wasn’t until March that the Imperial College model was released (projecting the potential for a million deaths or more in the US), the NBA shut down, Tom Hanks was infected, etc. We didn’t know about the US testing debacle yet. Stay-at-home orders were not yet being talked about. So back in February I don’t think it had dawned on most just how bad things could get.

Even so, looking back it’s clear that many US deaths could have been prevented with a different national course of action and it’s not like 200,000 deaths was a foregone conclusion at all.

David Rehkopf, a social epidemiologist at Stanford University:

There are a lot of proximal reasons here specific to how we didn’t react, how people didn’t take it seriously, the lack of universal health care, the distrust of government right now, lack of a clear message that really matter.

But I’d like to point out that the US is currently 46th in the world in terms of life expectancy. So why would COVID-19 deaths be any different? All of these same factors that impact our COVID prevalence and COVID deaths also are in many ways similar to what leads to our higher overall deaths as well.

But what is important to realize is that is wasn’t always this way in the US. From 1975-1980, we were 17th in the world in life expectancy. But there has been a slow (and recently not so slow) decline since the early 1980s.

David Celentano, chair of Johns Hopkins University’s epidemiology department:

Shocked – that would be the word that I would say captures my response to our current death numbers from the vantage point of February. By mid-March we were locked down. The doubling time of numbers of infections has truly shown we are not serious in regard to a national approach to COVID-19. This represents the failure of the national leadership, the failings of the executive branch, the emasculation and politicization of the CDC and FDA, and the skepticism of science by large segments of the public, egged on by the president. My guess is that we will be at 400,000 by the close of the year; I certainly hope not.

Kumi Smith, an epidemiology professor at the University of Minnesota:

The things that have surprised me most in hindsight:

– That it took so long for the US CDC to develop and distribute a test. Precious time was lost as they tried to recover from the first failed test; this set us on a whole different epidemic trajectory.

– That the White House would ever try to assume the role of public health messenger to the public. And that the CDC has taken as much of a back seat as it has. There’s a protocol for issuing out consistent and up-to-date public health messaging to the public but you wouldn’t know it from how things have gone.

– That mask wearing would become so politicized (though someone did recently share with me a story about anti-maskers during the 1918 pandemic so maybe I shouldn’t have been surprised).

If you take into account all of these things, the death toll is sadly not all that surprising.

Eleanor Murray, a Boston University epidemiologist:

In February, I was definitely watching COVID carefully, but I also felt confident that the administration would activate a coordinated epidemic response and that such a response would control the spread of the virus relatively quickly and successfully. Clearly I was very wrong about that. Not only was there no clear coordinated response, many of the pandemic preparations that had been made over the previous two decades had been scrapped, canceled, or left to lapse/ expire, making it difficult for other levels of government to step in to the leadership void.

I made a tweet sometime in February in response to someone asking for a prediction of what COVID would look like that said something like: right now our best guess for what will happen is to look at historical examples of similar outbreaks – those are SARS & MERS and both were pretty much contained by one year out; not at all like the 1918 flu.

I still think that at the time that was a reasonable prediction, given what we knew, but it’s clear that the pandemic has not played out like SARS or MERS. Some of that has to do with features of the virus – the presence of pre-symptomatic spread makes control much harder for SARS-CoV-2 than for SARS. But a lot of it has to do with failures in response.

Tara Smith, an epidemiologist at Kent State University:

In February, I knew 200,000 deaths were theoretically possible, but I honestly didn’t believe we’d get to that point. Surely we’d get it under control well before that level of mortality, right? I hadn’t anticipated not only the lack of federal response, but the active undermining of our federal scientific leadership within the CDC, FDA, and NIH. I had expected a potentially bumpy road, and resistance from anti-science folk (though I anticipated that being directed toward the vaccine; I hadn’t considered mask mandates in February), but not this level of dysfunction that we’ve seen only amplify since early in the epidemic.

Caitlin Rivers, senior scholar at the Johns Hopkins Center for Health Security:

I think we started off on the wrong foot with our struggles to scale diagnostic testing and identify cases. By the time community transmission was first recognized, I think we already had substantial outbreaks underway. We fell behind and have struggled to catch up ever since, though for more reasons than just diagnostic testing shortages. There have been gaps in the federal response, notably a lack of clear overall strategy. Although state and local leaders have done the best they can, I think a lack of a national approach has held us back.

Natalie Dean, a biostatistician at the University of Florida:

In the spring, I participated in a series of expert surveys facilitated by Nick Reich and colleagues at UMass. I was able to look back and see what I had put for predictions. My May predictions for the year-end totals are below. So by December, we will likely exceed my 90th percentile prediction.

It is sad. I expected that this would be challenging, but I didn’t expect how desensitized we as a country would become to over 1,000 Americans dying a day. The goalposts keep moving, and what once seemed unimaginable is now a daily reality. Sometimes I think it is worth reminding people that we have various models to forecast cumulative deaths, but infectious diseases are not the weather. What ultimately will happen depends upon our actions, and so much more death does not need to be foretold. What more can we be doing to keep people safe? Be it testing, tracing, ventilation, mask-wearing, finding safer alternatives to activities. And demanding greater action from our politicians to make this possible.

This story appears in VoxCare, a newsletter from Vox on the latest twists and turns in America’s health care debate. Sign up to get VoxCare in your inbox along with more health care stats and news.


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All the products we found to be the best during our testing this year

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(CNN) —  

Throughout the year, CNN Underscored is constantly testing products — be it coffee makers or headphones — to find the absolute best in each respective category.

Our testing process is rigorous, consisting of hours of research (consulting experts, reading editorial reviews and perusing user ratings) to find the top products in each category. Once we settle on a testing pool, we spend weeks — if not months — testing and retesting each product multiple times in real-world settings. All this in an effort to settle on the absolute best products.

So, as we enter peak gifting season, if you’re on the hunt for the perfect gift, we know you’ll find something on this list that they (or you!) will absolutely love.

Coffee

Best burr coffee grinder: Baratza Virtuoso+ Conical Burr Grinder With Digital Timer Display ($249; amazon.com or walmart.com)

Baratza Virtuoso+ Conical Burr Grinder
Baratza Virtuoso+ Conical Burr Grinder

Beginner baristas and coffee connoisseurs alike will be pleased with the Baratza Virtuoso+, a conical burr grinder with 40 settings for grind size, from super fine (espresso) to super coarse (French press). The best coffee grinder we tested, this sleek look and simple, intuitive controls, including a digital timer, allow for a consistent grind every time — as well as optimal convenience.

Read more from our testing of coffee grinders here.

Best drip coffee maker: Braun KF6050WH BrewSense Drip Coffee Maker ($79.95; amazon.com)

Braun KF6050WH BrewSense Drip Coffee Maker
Braun KF6050WH BrewSense Drip Coffee Maker

During our testing of drip coffee makers, we found the Braun KF6050WH BrewSense Drip Coffee Maker made a consistently delicious, hot cup of coffee, brewed efficiently and cleanly, from sleek, relatively compact hardware that is turnkey to operate, and all for a reasonable price.

Read more from our testing of drip coffee makers here.

Best single-serve coffee maker: Breville-Nespresso VertuoPlus ($165; originally $179.95; amazon.com)

Breville-Nespresso VertuoPlus
Breville-Nespresso VertuoPlus

Among all single-serve coffee makers we tested, the Breville-Nespresso VertuoPlus, which uses pods that deliver both espresso and “regular” coffee, could simply not be beat for its convenience. Intuitive and a snap to use right out of the box, it looks sleek on the counter, contains a detached 60-ounce water reservoir so you don’t have to refill it with each use and delivers perfectly hot, delicious coffee with a simple tap of a lever and press of a button.

Read more from our testing of single-serve coffee makers here.

Best coffee subscription: Blue Bottle (starting at $11 per shipment; bluebottlecoffee.com)

Blue Bottle coffee subscription
Blue Bottle coffee subscription

Blue Bottle’s coffee subscription won us over with its balance of variety, customizability and, most importantly, taste. We sampled both the single-origin and blend assortments and loved the flavor of nearly every single cup we made. The flavors are complex and bold but unmistakably delicious. Beyond its coffee, Blue Bottle’s subscription is simple and easy to use, with tons of options to tailor to your caffeine needs.

Read more from our testing of coffee subscriptions here.

Best cold brewer coffee maker: Hario Mizudashi Cold Brew Coffeepot ($25; amazon.com)

Hario Mizudashi Cold Brew Coffeepot
Hario Mizudashi Cold Brew Coffeepot

This sleek, sophisticated and streamlined carafe produces 1 liter (about 4 1/4 cups) of rich, robust brew in just eight hours. It was among the simplest to assemble, it executed an exemplary brew in about the shortest time span, and it looked snazzy doing it. Plus, it rang up as the second-most affordable of our inventory.

Read more from our testing of cold brew makers here.

Kitchen essentials

Best nonstick pan: T-fal E76597 Ultimate Hard Anodized Nonstick Fry Pan With Lid ($39.97; amazon.com)

T-fal E76597 Ultimate Hard Anodized Nonstick Fry Pan With Lid
T-fal E76597 Ultimate Hard Anodized Nonstick Fry Pan With Lid

If you’re a minimalist and prefer to have just a single pan in your kitchen, you’d be set with the T-fal E76597. This pan’s depth gives it multipurpose functionality: It cooks standard frying-pan foods like eggs and meats, and its 2 1/2-inch sides are tall enough to prepare recipes you’d usually reserve for pots, like rices and stews. It’s a high-quality and affordable pan that outperformed some of the more expensive ones in our testing field.

Read more from our testing of nonstick pans here.

Best blender: Breville Super Q ($499.95; breville.com)

Breville Super Q
Breville Super Q

With 1,800 watts of motor power, the Breville Super Q features a slew of preset buttons, comes in multiple colors, includes key accessories and is touted for being quieter than other models. At $500, it does carry a steep price tag, but for those who can’t imagine a smoothie-less morning, what breaks down to about $1.30 a day over a year seems like a bargain.

Read more from our testing of blenders here.

Best knife set: Chicago Cutlery Fusion 17-Piece Knife Block Set ($119.74; amazon.com)

Chicago Cutlery Fusion 17-Piece Knife Block Set
Chicago Cutlery Fusion 17-Piece Knife Block Set

The Chicago Cutlery Fusion 17-Piece Knife Block Set sets you up to easily take on almost any cutting job and is a heck of a steal at just $119.97. Not only did the core knives included (chef’s, paring, utility and serrated) perform admirably, but the set included a bevy of extras, including a full set of steak knives. We were blown away by their solid construction and reliable execution for such an incredible value. The knives stayed sharp through our multitude of tests, and we were big fans of the cushion-grip handles that kept them from slipping, as well as the classic look of the chestnut-stained wood block. If you’re looking for a complete knife set you’ll be proud of at a price that won’t put a dent in your savings account, this is the clear winner.

Read more from our testing of knife sets here.

Audio

Best true wireless earbuds: AirPods Pro ($199, originally $249; amazon.com)

Apple AirPods Pro
Apple AirPods Pro

Apple’s AirPods Pro hit all the marks. They deliver a wide soundstage, thanks to on-the-fly equalizing tech that produces playback that seemingly brings you inside the studio with the artist. They have the best noise-canceling ability of all the earbuds we tested, which, aside from stiff-arming distractions, creates a truly immersive experience. To sum it up, you’re getting a comfortable design, a wide soundstage, easy connectivity and long battery life.

Read more from our testing of true wireless earbuds here.

Best noise-canceling headphones: Sony WH-1000XM4 ($278, originally $349.99; amazon.com)

Sony WH-1000XM4
Sony WH-1000XM4

Not only do the WH-1000XM4s boast class-leading sound, but phenomenal noise-canceling ability. So much so that they ousted our former top overall pick, the Beats Solo Pros, in terms of ANC quality, as the over-ear XM4s better seal the ear from outside noise. Whether it was a noise from a dryer, loud neighbors down the hall or high-pitched sirens, the XM4s proved impenetrable. This is a feat that other headphones, notably the Solo Pros, could not compete with — which is to be expected considering their $348 price tag.

Read more from our testing of noise-canceling headphones here.

Best on-ear headphones: Beats Solo 3 ($119.95, originally $199.95; amazon.com)

Beats Solo 3
Beats Solo 3

The Beats Solo 3s are a phenomenal pair of on-ear headphones. Their sound quality was among the top of those we tested, pumping out particularly clear vocals and instrumentals alike. We enjoyed the control scheme too, taking the form of buttons in a circular configuration that blend seamlessly into the left ear cup design. They are also light, comfortable and are no slouch in the looks department — more than you’d expect given their reasonable $199.95 price tag.

Read more from our testing of on-ear headphones here.

Beauty

Best matte lipstick: Stila Stay All Day Liquid Lipstick ($11, originally $22; amazon.com or $22; nordstrom.com and stilacosmetics.com)

Stila Stay All Day Liquid Lipstick
Stila Stay All Day Liquid Lipstick

The Stila Stay All Day Liquid Lipstick has thousands of 5-star ratings across the internet, and it’s easy to see why. True to its name, this product clings to your lips for hours upon hours, burritos and messy breakfast sandwiches be damned. It’s also surprisingly moisturizing for such a superior stay-put formula, a combo that’s rare to come by.

Read more from our testing of matte lipsticks here.

Best everyday liquid liner: Stila Stay All Day Waterproof Liquid Eyeliner ($22; stilacosmetics.com or macys.com)

Stila Stay All Day Waterproof Liquid Eyeliner
Stila Stay All Day Waterproof Liquid Eyeliner

The Stila Stay All Day Waterproof Liquid Eyeliner is a longtime customer favorite — hence its nearly 7,500 5-star reviews on Sephora — and for good reason. We found it requires little to no effort to create a precise wing, the liner has superior staying power and it didn’t irritate those of us with sensitive skin after full days of wear. As an added bonus, it’s available in a whopping 12 shades.

Read more from our testing of liquid eyeliners here.

Work-from-home essentials

Best office chair: Steelcase Series 1 (starting at $381.60; amazon.com or $415, wayfair.com)

Steelcase Series 1
Steelcase Series 1

The Steelcase Series 1 scored among the highest overall, standing out as one of the most customizable, high-quality, comfortable office chairs on the market. At $415, the Steelcase Series 1 beat out most of its pricier competitors across testing categories, scoring less than a single point lower than our highest-rated chair, the $1,036 Steelcase Leap, easily making it the best bang for the buck and a clear winner for our best office chair overall.

Read more from our testing of office chairs here.

Best ergonomic keyboard: Logitech Ergo K860 ($129.99; logitech.com)

Logitech Ergo K860
Logitech Ergo K860

We found the Logitech Ergo K860 to be a phenomenally comfortable keyboard. Its build, featuring a split keyboard (meaning there’s a triangular gap down the middle) coupled with a wave-like curvature across the body, allows both your shoulders and hands to rest in a more natural position that eases the tension that can often accompany hours spent in front of a regular keyboard. Add the cozy palm rest along the bottom edge and you’ll find yourself sitting pretty comfortably.

Read more from our testing of ergonomic keyboards here.

Best ergonomic mouse: Logitech MX Master 3 ($99.99; logitech.com)

Logitech MX Master 3
Logitech MX Master 3

The Logitech MX Master 3 is an unequivocally comfortable mouse. It’s shaped to perfection, with special attention to the fingers that do the clicking. Using it felt like our fingers were lounging — with a sculpted ergonomic groove for nearly every finger.

Read more from our testing of ergonomic mice here.

Best ring light: Emart 10-Inch Selfie Ring Light ($25.99; amazon.com)

Emart 10-Inch Selfie Ring Light
Emart 10-Inch Selfie Ring Light

The Emart 10-Inch Standing Ring Light comes with a tripod that’s fully adjustable — from 19 inches to 50 inches — making it a great option whether you’re setting it atop your desk for video calls or need some overhead lighting so no weird shadows creep into your photos. Its three light modes (warm, cool and a nice mix of the two), along with 11 brightness levels (among the most settings on any of the lights we tested), ensure you’re always framed in the right light. And at a relatively cheap $35.40, this light combines usability and affordability better than any of the other options we tested.

Read more from our testing of ring lights here.

Home

Best linen sheets: Parachute Linen Sheet Set (starting at $149; parachute.com)

Parachute Linen Sheets
Parachute Linen Sheets

Well made, luxurious to the touch and with the most versatile shopping options (six sizes, nine colors and the ability to order individual sheets), the linen sheets from Parachute were, by a narrow margin, our favorite set. From the satisfying unboxing to a sumptuous sleep, with a la carte availability, Parachute set the gold standard in linen luxury.

Read more from our testing of linen sheets here.

Best shower head: Kohler Forte Shower Head (starting at $74.44; amazon.com)

Kohler Forte Shower Head
Kohler Forte Shower Head

Hands down, the Kohler Forte Shower Head provides the best overall shower experience, offering three distinct settings. Backstory: Lots of shower heads out there feature myriad “settings” that, when tested, are pretty much indecipherable. The Forte’s three sprays, however, are each incredibly different and equally successful. There’s the drenching, full-coverage rain shower, the pulsating massage and the “silk spray” setting that is basically a super-dense mist. The Forte manages to achieve all of this while using only 1.75 gallons per minute (GPM), making it a great option for those looking to conserve water.

Read more from our testing of shower heads here.

Best humidifier: TaoTronics Cool Mist Humidifier (starting at $49.99; amazon.com)

TaoTronics Cool Mist Humidifier
TaoTronics Cool Mist Humidifier

The TaoTronics Cool Mist Humidifier ramped up the humidity in a room in about an hour, which was quicker than most of the options we tested. More importantly, though, it sustained those humidity levels over the longest period of time — 24 hours, to be exact. The levels were easy to check with the built-in reader (and we cross-checked that reading with an external reader to confirm accuracy). We also loved how easy this humidifier was to clean, and the nighttime mode for the LED reader eliminated any bright lights in the bedroom.

Read more from our testing of humidifiers here.

Video

Best TV: TCL 6-Series (starting at $579.99; bestbuy.com)

TCL 6-Series
TCL 6-Series

With models starting at $599.99 for a 55-inch, the TCL 6-Series might give you reverse sticker shock considering everything you get for that relatively small price tag. But can a 4K smart TV with so many specification standards really deliver a good picture for $500? The short answer: a resounding yes. The TCL 6-Series produces a vibrant picture with flexible customization options and handles both HDR and Dolby Vision, optimization standards that improve the content you’re watching by adding depth to details and expanding the color spectrum.

Read more from our testing of TVs here.

Best streaming device: Roku Ultra ($99.99; amazon.com)

Roku Ultra
Roku Ultra

Roku recently updated its Ultra streaming box and the 2020 version is faster, thanks to a new quad-core processor. The newest Ultra retains all of the features we loved and enjoyed about the 2019 model, like almost zero lag time between waking it up and streaming content, leading to a hiccup-free streaming experience. On top of that, the Roku Ultra can upscale content to deliver the best picture possible on your TV — even on older-model TVs that don’t offer the latest and greatest picture quality — and supports everything from HD to 4K.

Read more from our testing of streaming devices here.

Travel

Best carry-on luggage: Away Carry-On ($225; away.com)

Away Carry-On
Away Carry-On

The Away Carry-On scored high marks across all our tests and has the best combination of features for the average traveler. Compared with higher-end brands like Rimowa, which retail for hundreds more, you’re getting the same durable materials, an excellent internal compression system and eye-catching style. Add in smart charging capabilities and a lifetime warranty, and this was the bag to beat.

Read more from our testing of carry-on luggage here.

Best portable charger: Anker PowerCore 13000 (starting at $31.99; amazon.com)

Anker PowerCore 13000
Anker PowerCore 13000

The Anker PowerCore 13000 shone most was in terms of charging capacity. It boasts 13,000 mAh (maH is a measure of how much power a device puts out over time), which is enough to fully charge an iPhone 11 two and a half times. Plus, it has two fast-charging USB Type-A ports so you can juice a pair of devices simultaneously. While not at the peak in terms of charging capacity, at just $31.99, it’s a serious bargain for so many mAhs.

Read more from our testing of portable chargers here.

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Trump’s misleading tweet about changing your vote, briefly explained

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Open Sourced logo

Searches for changing one’s vote did not trend following the recent presidential debate, and just a few states appear to have processes for changing an early vote. But that didn’t stop President Trump from wrongly saying otherwise on Tuesday.

In early morning posts, the president falsely claimed on Twitter and Facebook that many people had Googled “Can I change my vote?” after the second presidential debate and said those searching wanted to change their vote over to him. Trump also wrongly claimed that most states have a mechanism for changing one’s vote. Actually, just a few states appear to have the ability, and it’s rarely used.

Twitter did not attach a label to Trump’s recent tweet.
Twitter

Trump’s claim about what was trending on Google after the debate doesn’t hold up. Searches for changing one’s vote were not among Google’s top trending searches for the day of the debate (October 22) or the day after. Searches for “Can I change my vote?” did increase slightly around the time of the debate, but there is no way to know whether the bump was related to the debate or whether the people searching were doing so in support of Trump.

It was only after Trump’s posts that searches about changing your vote spiked significantly. It’s worth noting that people were also searching for “Can I change my vote?” during a similar period before the 2016 presidential election.

Google declined to comment on the accuracy of Trump’s post.

Trump also claimed that these results indicate that most of the people who were searching for how to change their vote support him. But the Google Trends tool for the searches he mentioned does not provide that specific information.

Perhaps the most egregiously false claim in Trump’s recent posts is about “most states” having processes for changing your early vote. In fact, only a few states have such processes, and they can come with certain conditions. For instance, in Michigan, voters who vote absentee can ask for a new ballot by mail or in person until the day before the election.

The Center for Election Innovation’s David Becker told the Associated Press that changing one’s vote is “extremely rare.” Becker explained, “It’s hard enough to get people to vote once — it’s highly unlikely anybody will go through this process twice.”

Trump’s post on Facebook was accompanied by a link to Facebook’s Voting Information Center.
Facebook

At the time of publication, Trump’s false claims had drawn about 84,000 and 187,000 “Likes” on Twitter and Facebook, respectively. Trump’s posts accelerated searches about changing your vote in places like the swing state of Florida, where changing one’s vote after casting it is not possible. Those numbers are a reminder of the president’s capacity to spread misinformation quickly.

On Facebook, the president’s post came with a label directing people to Facebook’s Voting Information Center, but no fact-checking label. Twitter had no annotation on the president’s post. Neither company responded to a request for comment.

That Trump is willing to spread misinformation to benefit himself and his campaign isn’t a surprise. He does that a lot. Still, just days before a presidential election in which millions have already voted, this latest episode demonstrates that the president has no qualms about using false claims about voting to cause confusion and sow doubt in the electoral process.

Open Sourced is made possible by Omidyar Network. All Open Sourced content is editorially independent and produced by our journalists.


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Nearly 6,000 civilian casualties in Afghanistan so far this year

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From January to September, 5,939 civilians – 2,117 people killed and 3,822 wounded – were casualties of the fighting, the UN says.

Nearly 6,000 Afghan civilians were killed or wounded in the first nine months of the year as heavy fighting between government forces and Taliban fighters rages on despite efforts to find peace, the United Nations has said.

From January to September, there were 5,939 civilian casualties in the fighting – 2,117 people killed and 3,822 wounded, the UN Assistance Mission in Afghanistan (UNAMA) said in a quarterly report on Tuesday.

“High levels of violence continue with a devastating impact on civilians, with Afghanistan remaining among the deadliest places in the world to be a civilian,” the report said.

Civilian casualties were 30 percent lower than in the same period last year but UNAMA said violence has failed to slow since the beginning of talks between government negotiators and the Taliban that began in Qatar’s capital, Doha, last month.

An injured girl receives treatment at a hospital after an attack in Khost province [Anwarullah/Reuters]

The Taliban was responsible for 45 percent of civilian casualties while government troops caused 23 percent, it said. United States-led international forces were responsible for two percent.

Most of the remainder occurred in crossfire, or were caused by ISIL (ISIS) or “undetermined” anti-government or pro-government elements, according to the report.

Ground fighting caused the most casualties followed by suicide and roadside bomb attacks, targeted killings by the Taliban and air raids by Afghan troops, the UN mission said.

Fighting has sharply increased in several parts of the country in recent weeks as government negotiators and the Taliban have failed to make progress in the peace talks.

At least 24 people , mostly teens, were killed in a suicide bomb attack at an education centre in Kabul [Mohammad Ismail/Reuters]

The Taliban has been fighting the Afghan government since it was toppled from power in a US-led invasion in 2001.

Washington blamed the then-Taliban rulers for harbouring al-Qaeda leaders, including Osama bin Laden. Al-Qaeda was accused of plotting the 9/11 attacks.

Calls for urgent reduction of violence

Meanwhile, the US envoy for Afghanistan, Zalmay Khalilzad, said on Tuesday that the level of violence in the country was still too high and the Kabul government and Taliban fighters must work harder towards forging a ceasefire at the Doha talks.

Khalilzad made the comments before heading to the Qatari capital to hold meetings with the two sides.

“I return to the region disappointed that despite commitments to lower violence, it has not happened. The window to achieve a political settlement will not stay open forever,” he said in a tweet.

There needs to be “an agreement on a reduction of violence leading to a permanent and comprehensive ceasefire”, added Khalilzad.

A deal in February between the US and the Taliban paved the way for foreign forces to leave Afghanistan by May 2021 in exchange for counterterrorism guarantees from the Taliban, which agreed to sit with the Afghan government to negotiate a permanent ceasefire and a power-sharing formula.

But progress at the intra-Afghan talks has been slow since their start in mid-September and diplomats and officials have warned that rising violence back home is sapping trust.

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