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What if the Covid-19 vaccine only works half the time?

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In the not-so-distant future — we’ll probably know who won the 2020 election, but memories of the weirdest Thanksgiving ever will not have faded — you may be faced with an incredibly important choice. Should you get the Covid-19 vaccine?

It’s been less than a year since the discovery of SARS-CoV-2, the virus that causes the new disease, and we have not just one, but multiple vaccine candidates that may in time truly shut the door on the pandemic.

Though nothing is certain, it’s very likely that some vaccine will be approved soon — and widely available by the end of 2021.

Which leads us to ask an important question: What if that vaccine is not very good?

The paradox of the mediocre vaccine

What do I mean by not very good? 50 percent efficacy. Food and Drug Administration commissioner Stephen Hahn has pledged that the FDA will not grant approval for a vaccine that has less than 50 percent efficacy, so this seems like a reasonable floor.

To give a sense of what vaccine efficacy really means, let’s imagine ourselves in the board rooms and meeting spaces at vaccine manufacturers Pfizer, Moderna, and their ilk as they wait for the results to come in. Each of these companies is running large, randomized clinical trials of 30,000 to 60,000 individuals who have not yet contracted Covid-19 in areas where the virus is prevalent. Half get the vaccine; half get a placebo shot. The companies then wait to see who gets sick.

The best-case scenario for the manufacturer? Zero cases in the vaccinated group and something well north of zero cases in the placebo group. With, say, 150 cases in the placebo group and zero in the vaccine group, they would be able to claim that their vaccine was nearly 100 percent effective. (To be clear, no vaccine has ever been 100 percent effective.)

If there are 150 cases in the placebo group and 75 cases in the vaccine group, now they could say that their vaccine is 50 percent effective. Not as impressive, clearly, but something is still happening. Both Pfizer and Moderna planned on presenting early results after 150 infections had occurred in their study population.

But here’s the problem. The less effective a vaccine is, the more of us need to get it to end the pandemic.

The math is pretty straightforward. Let’s say that, on average, an individual infected with Covid-19 infects two more people (the now familiar R0). Unchecked, that leads to a huge growth in infections.

To end the spread, we need to make sure that each infected person infects less than one additional person. That can be achieved through mask-wearing, social distancing, canceling large gatherings, you know the drill. But it’s not ideal — we want to lift all the restrictions. We need one out of every two people to be immune.

And there’s two ways to become immune — through infection or vaccination. (Caveat: The mechanics and durability of Covid-19 immunity are still being studied).

If there is a 100 percent effective vaccine, and one out of every two people need to be immune, it means that 50 percent of the population would need to be vaccinated to end the pandemic.

But what if we had a 50 percent effective vaccine? In that case, one out of every two people who is vaccinated won’t be protected. To end the pandemic under this scenario, 100 percent of the population would need to be vaccinated.

The worse the vaccine is, the more people need to get it to get us out of this mess. The less effective a vaccine is, the less likely people will choose to get it.

A new survey in JAMA Network Open evaluating factors predictive of whether people would accept the vaccine found that vaccine efficacy was the No. 1 determinant. People were, on average, 16 percent more likely to accept a vaccine with 90 percent efficacy compared to one with 50 percent efficacy.

Get the vaccine anyway

It’s tempting to look at the math of a mediocre vaccine and give up, but a mediocre vaccine can still end the pandemic — just not on its own.

The key is the R0. My example assumed that the average infected person infects two more people, but it doesn’t have to be that way. In fact, due to the policies enacted to stem the tide of the virus, the effective R-value (often called Rt) is probably lower than 2 — maybe around 1.2.

If that’s the case, you’d only need to get a 50 percent effective vaccine to 33 percent of the population to end the pandemic, provided we all continue to wear masks until it’s over.

A chart showing the percent of the population you need to vaccinate with a 50 percent effective vaccine with an R0 ranging from 1 to 2.
A chart showing the percent of the population you need to vaccinate with a 50 percent effective vaccine with an R0 ranging from 1 to 2.
F. Perry Wilson

Most polls suggest that around 70 percent of Americans will get a Covid-19 vaccine when it is available. A 50 percent effective vaccine may have different efficacy in different groups — if a vaccine is highly effective in young people but ineffective in older people, it would complicate matters quite a bit, as this new perspective in the journal Science notes.

What about side effects?

Efficacy is not the only thing to think about when you are lining up to receive a vaccine. The side effects are critical, too.

Researchers categorize adverse events as serious or not depending on how severely they affect the patient. Redness and swelling at the injection site? Not serious. Anaphylaxis that lands you in the hospital? Serious.

There’s no need to be too worried about non-serious adverse events. Every vaccine will have them: fevers, injection site reactions, malaise. It’s the serious adverse events that we need to worry about, and fortunately these are usually rare.

Of course, it is that rareness that leads to uncertainty. Let’s say I’m Moderna and I enroll 30,000 people in a vaccine trial and not a single one develops anaphylaxis, a life-threatening allergic reaction. You might think that implies that the anaphylaxis rate for this vaccine is zero percent, or at least less than 1 in 30,0000. You’d be wrong.

The vicissitudes of chance become clearer if we make the numbers smaller. Imagine this trial only enrolled 10 patients, and, again, none developed anaphylaxis. It would be wrong for me to conclude that anaphylaxis can never happen with this vaccine.

All I can say with absolute certainty is that the anaphylaxis rate is less than 100 percent. But it could be 99 percent. I may have just been lucky enough to enroll 10 people who don’t get anaphylaxis from my vaccine.

We need some way to estimate a plausible side-effect risk, given the observed data. This can be done with some simple statistics.

We can ask what is the plausible range for the anaphylaxis rate given that I saw it zero times out of 10. We’ll define plausible by saying that, whatever the real rate is, I would have a greater than 2.5 percent chance of not seeing it at all in my 10 patient sample (this is a standard rate of plausibility for this type of thing). The answer: 0 to 31 percent.

In other words, if the true anaphylaxis rate is 50 percent, it would be unusual to enroll 10 people and not see a single case. But if the true anaphylaxis rate is 30 percent, I’d have a shot to pitch a no-hitter (I’d get data like mine around 2.5 percent of the time).

That’s a huge range, but fortunately the ongoing vaccine trials enrolled many more than 10 people. How certain can we be about side effects? For serious adverse events that don’t occur at all in the trial, we can be confident that the true rate is less than one in 10,000. That is a really small number, but not necessarily reassuring when we’re talking about vaccinating 350 million Americans (or nearly 8 billion people).

Given that, you may think it’s appropriate to take a wait-and-see approach. Though there is a bit of moral hazard (if we all act this way, we’ll never learn anything and the pandemic will march on), it’s not an untenable position.

In fact, since it’s extremely unlikely that mass vaccination will be available to everyone at the same time, those at highest risk of Covid-19 (including health care workers like me) will be prioritized, take on the unknown risks, and be followed closely for side effects. By the time the vaccine is ready for everyone, we should know much more.

Me versus us

This pandemic has brought to light a particular weakness in American society: a seemingly irreconcilable tension between a perception of individual liberty and collective sacrifice. Nowhere has this been clearer than in the case of face masks, which carry zero risk, provide modest individual protection, and have a strong societal benefit.

Mediocre vaccines are more like face masks than miracles. The real benefit of getting vaccinated may be less to the individual and more to society. Sure, a 50 percent effective vaccine buys you some peace of mind. You’ve cut your risk of infection in half, and (since vaccine effectiveness counts all infections the same, regardless of how severe they are) even if you become infected you may get less sick. But in the end, if all we have is a mediocre vaccine, the goal needs to shift from providing individual protection to ending the pandemic.

That means we need to start convincing people to get vaccinated now. We need to prepare the public for a less-than-ideal scenario — a mediocre vaccine — and show why it is important to get vaccinated anyway. A mediocre vaccine won’t necessarily save you, but if enough of us get it, it can save us.

F. Perry Wilson, MD MSCE (@methodsmanmd) is an associate professor of medicine at the Yale School of Medicine and director of Yale’s Clinical and Translational Research Accelerator. He writes a weekly column on Medscape.com and is the creator of the free online course “Understanding Medical Research: Your Facebook Friend is Wrong.”


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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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