Unless something changes this fall, 2024 will go down as another year in which the United States made major progress in reducing homicides. Murder rose nearly 30 percent during the pandemic, but many cities have returned to pre-pandemic levels and are continuing to see the numbers decline. As summer ended, murder was down 17 percent in American cities compared to the same time last year. Plenty of cities still struggle with gun violence: This weekend, four people were killed and at least 17 were injured in a shooting outside of a nightclub in Birmingham, Alabama, part of an epidemic that explains why the United States has a gun homicide rate that is 26 times higher than other comparable countries. Still, the decline in overall homicides is essential to saving lives and creating safer communities. What explains such a dramatic rise and then fall in homicides? The US did not experience a rise in crime more generally during the pandemic. It was violent crime, particularly homicides, that drove the surge. The increase in homicides, in turn, was driven largely by gun homicides — which make up the vast majority of homicides in the United States.  The risk wasn’t shared equally across the population, either: Nearly two-thirds of the victims of gun homicides in 2020 were Black, with the largest increases in gun deaths happening among men and boys between the ages of 10 and 44, and most of these murders took place in cities. For this reason, experts understand the rise in murder during the pandemic to have been primarily a problem of urban gun violence. Experts say there are a few possible explanations for why gun homicides have since abated: The end of the pandemic reestablished a sense of normalcy. The turmoil over the role of police following the murder of George Floyd — followed by protests and violence in some communities and a reduction in policing — has also eased. But those explanations overlook an important truth. The drop is also partly the result of carefully coordinated efforts by local officials, community leaders, and law enforcement, backed in many cases by an infusion of cash from the federal government. As leaders formulate violence reduction strategies, many are doing it with the help of a quietly influential book — a how-to guide in the fight against urban gun violence. Bleeding Out by Thomas Abt, was published in 2019. It makes a compelling argument: that urban gun violence, rather than being an immovable facet of American life, can be effectively reduced using specific, evidence-based strategies. By following the principles in the book, Abt writes, cities can save lives right away, without completely overhauling their budgets or waiting for long-term investments that might take decades.  While it’s still early, the book’s lessons are having a real-world impact. Bleeding Out draws on existing research about what works to reduce urban gun violence, as well as Abt’s own experience from stints in the Obama administration and under then-New York Gov. Andrew Cuomo.  He points to evidence that most of this violence is highly concentrated among a small number of people, and in a small number of places. In 2015, he notes, more than a quarter of the nation’s gun homicides happened in only 1,200 neighborhoods, containing just 1.5 percent of the population.  The challenge of reducing gun violence, then, is to reach the people and the places at the center of the crisis, and find ways to disrupt the patterns that perpetuate it.  Abt lays out three guiding principles: focus, balance, and fairness. The ideas work, he argues, if you intensely focus on the most at-risk people and places, balance the work of law enforcement with prevention and community intervention, and enforce the law fairly. “Punishment by itself has not worked,” Abt writes. “Neither has prevention.”   Abt cites research suggesting that direct outreach from “credible messengers” and other community workers can help prevent this violence. He narrows in on the promising results that cognitive behavioral therapy (CBT) has shown in communities where gun violence is in part driven by retaliation between rival networks or gangs. Law enforcement, for their part, should inform the individuals most at risk of committing violence that they will be prosecuted if they shoot someone — but also offer them resources to help if they decide not to.   The primary value of Bleeding Out isn’t that it presents brand-new strategies, but that it helps disseminate valuable existing knowledge. “He gathered all of the evidence-based policy and research that was out there, in a way that was very balanced between law enforcement piece and the community piece, and put it into something that was digestible by not just researchers but policymakers and community members,” says Volkan Topalli, a criminology professor at Georgia State University. In other words, Abt took a big, complex issue and distilled it into a concise problem leaders weren’t helpless to solve. In 2020, the year after the book’s release, the pandemic lockdowns started, followed by a summer of protests over police brutality. In many cities, police clashed with the protesters, and violence erupted. By the end of the year, the US had recorded its highest increase in homicide rates in modern history, according to the Centers for Disease Control and Prevention.   “That was a really difficult time,” Abt says. But it was also a moment where the ideas in the book could be put to the test.  In July 2021, the Council On Criminal Justice (CCJ), a nonpartisan think tank in Washington, DC, convened a Violent Crime Working Group to study the problem and try to offer solutions for cities facing the surge. The group, chaired by Abt and composed of experts, community leaders, law enforcement, and judges, met nearly a dozen times, issuing bulletins on their findings. In their final report, the group recommended ten “essential actions” communities could take to fight urban gun violence. The broad scope of the essential actions closely echoes the strategies and the three guiding principles — focus, balance, and fairness — that Abt recommends in Bleeding Out. Over the following year, communities like Manchester, New Hampshire, began adopting some of the recommendations.  In December 2023, the Department of Justice announced its Violent Crime Reduction Roadmap, a “one-stop-shop to assist local jurisdictions” in fighting community gun violence. The recommendations were familiar: They were the exact same “essential actions” proposed by Abt and his colleagues in the CCJ’s working group. As Adam Gelb, president of the CCJ, put it, “The core ideas in Bleeding Out not only became the basis of violent crime working group report, but the foundation of federal violence reduction policy.”  Helping establish the federal guidelines for gun violence reduction isn’t the only way the book has influenced policy. Leaders at every level are reading the book as they begin to form their own plans for violence reduction. Alex Piquero, former director of the Bureau of Justice Statistics and a criminologist at the University of Miami, was on the CCJ working group and read early drafts of Bleeding Out. He recalls seeing it on the desk of a Miami police official in a 2021 meeting and thinking: “That’s exactly the audience who Thomas wanted to read the book.”  The police official wasn’t alone. US Attorney Dawn Ison, who oversees Michigan’s Eastern District, told Vox that she turned to Abt while developing a summer violent crime reduction plan called “OneDetroit.” “I sent him our OneDetroit mission statement, and he gave it a thumbs up,” Ison says. The precincts OneDetroit targeted saw a 17 percent reduction in homicides and were part of a successful strategy of reducing murders in the city last year. It’s not just law enforcement and government officials who have found value in the book. “When Thomas’s book came out, we were like: See? We’re not crazy!” says Molly Baldwin, founder and CEO of Roca, a community program that does outreach to youth affected by urban gun violence in Massachusetts, Connecticut, and Maryland. In November 2022, Abt founded the Violence Reduction Center at the University of Maryland, to assist cities wanting help. VRC is partnering with three cities: Knoxville, Tennessee; Boston, Massachusetts; and St. Louis, Missouri, and its surrounding counties.  As testing grounds for urban violence reduction, the cities couldn’t be more different. Boston, the largest of the three, has a strong history of this kind of work, but Abt “helps us redirect and organize,” says Isaac Yablo, Boston’s senior advisor for community safety.   Knoxville, the smallest, is newer to the effort. “We could have spent a lot of time flailing about, figuring out how to put this together,” without VRC’s help, says LaKenya Middlebrook, the city’s first director of community safety. St. Louis, which is approaching the effort on a regional level and is anchored by a city with one of the highest murder rates in the country — is still in the planning stages, but local officials say VRC’s expertise has been valuable as they coordinate a strategy across multiple county governments.   Abt provides access to experts and offers suggestions, but leaves it to policymakers to decide their priorities. While he has formal relationships with the three cities, informal discussions happen all the time. “Not everybody needs or is ready for some big intensive thing,” Abt says, of his relationships with leaders in other cities. “You could just email me.”  He tries to be realistic about his role. “I have high hopes,” Abt says, but at the same time, “a little humility is in order here. The VRC is a help in all of the cities it works in, but ultimately it’s the good people in these cities — the mayors, the chiefs, and all of the people on the ground — who are doing this work.”  Not everyone agrees with his approach. Critics have described Abt’s focus on “stopping the bleeding” over addressing “root causes” of violence — economic disinvestment and racial segregation — as dismissive. Others have called it an oversimplification.  Abt says he’s been criticized by the left for arguing against the idea of defunding the police, and by the right for emphasizing that for some crime reduction efforts, law enforcement is not the solution. “People are dunking on me from all directions. There are people on the far left who think I’m placing the emphasis wrong, and worry that my message could be misinterpreted and misused to go back to tough-on-crime policies,” Abt says. “I try to be exquisitely careful about that. I’ve had many debates with tough-on-crime people, too.”  Still, he is confident in his strategy, and in its position as a middle path, a data-driven approach that cuts across the long-held controversies over the role of policing and urban violence and prioritizes saving lives. A lot of people, he says, want relief from the violence. “This is particularly true in these most marginalized communities,” Abt says. As he tells the mayors he works with: “They will reward you at election time if you can make them safer.” Update, September 23, 11:00 am: This story was originally published on September 5 and has been updated to include news of a shooting outside a nightclub in Birmingham, Alabama, on September 21.

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A box and a tablet of Roche Pharmaceuticals' Tamiflu pills for influenza. Since reports emerged earlier this year that dairy cows across the country had been infected with H5N1 bird flu, the prospect that the virus could evolve to spark another pandemic has stoked serious concern. But unlike COVID-19, the flu is an old, well-known foe. And health authorities have reassured the public that the US has squirreled away millions of doses of the flu medication oseltamivir, known under the brand name Tamiflu. As health policy expert Leana S. Wen wrote in a Washington Post opinion piece, the drug “works against seasonal flu and is expected to work well against H5N1.” While oseltamivir may help in cases of severe flu, some experts are concerned that the US is banking far too much on a so-so drug while failing to prioritize research on new treatments.

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