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“Another thing the Gentiles said about us was that we used the blood of murdered Christian children at the Passover festival,” the Russian Jewish immigrant Mary Antin wrote in The Atlantic in 1911. “Of course that was a wicked lie. It made me sick to think of such a thing.” Antin grew up in the Pale of Settlement, an area spanning from modern-day Russia through Ukraine and Poland where Jews were permitted to reside from 1791 to 1915 but deprived of citizenship. Antin’s vivid essay describes her childhood there before coming to America, including the vibrancy of Jewish life at the time as well as its tribulations under the brutal Russian empire.

According to Jewish tradition, during the evening Passover meal, or seder, children are called upon to ask four ceremonial questions about the holiday, prompting explanations from their elders about the festival’s observance. As Antin noted, this practice meant that as a small child, she knew more about Passover than the adult anti-Semites who assailed her co-religionists in ignorance. “When I asked the Four Questions, about the unleavened bread and the bitter herbs and the other things, and the family, reading from their books, answered me, did I not know all about Passover, and what was on the table, and why?” she observed. “It was wicked of the Gentiles to tell lies about us. The youngest child in the house knew how Passover was kept.”

A Jewish youth might have known in the early 1900s that Jews did not prepare their Passover food with Christian blood, but for centuries, this point has been far from obvious to others. The allegation of Jewish ritual murder of non-Jewish children, often linked to Passover, is known as the “blood libel,” and it originated in medieval Europe in the 12th century. Initially condemned by church authorities, the charge gained legitimacy in 1475, after the murder of a toddler named Simon of Trent led to the torture and conviction of the city’s Jewish residents—some of whom were burnt at the stake—and the establishment of a Christian cult to venerate their alleged victim.

The Fordham University historian Magda Teter follows the spread of these deadly allegations, which exploded after the successful Trent prosecution, in her 2020 book, Blood Libel: On the Trail of an Antisemitic Myth. The work’s accompanying maps trace more than 100 such accusations, delineating them by criteria such as whether there were “legal proceedings” (73 yes, 30 no) or “Jews killed” (31 yes, 55 no, 13 unknown). In 1911, the same year that Antin was published in The Atlantic, a Jewish man named Menachem Mendel Beilis was accused of the murder and mutilation of a 13-year-old boy in Kyiv. Over more than two years, he was imprisoned and tried by the Russian government. Ultimately acquitted, he died in New York in 1934.

Dismissing all of this as ancient history would be comforting. But it’s not. In 2019, a far-right gunman stormed a synagogue in California on the last day of Passover, killing one congregant and injuring several others. The murderer left a manifesto: “You are not forgotten Simon of Trent,” he wrote, “the horror that you and countless children have endured at the hands of the Jews will never be forgiven.” In 2014, CNN’s Wolf Blitzer confronted the Hamas spokesman Osama Hamdan on air with archival footage of him declaring, “We all remember how the Jews used to slaughter Christians in order to mix their blood with their holy matzos,” the Passover flatbread. “This is not a figment of the imagination or something taken from a film; it is a fact acknowledged by their own books and historical evidence.” Hamdan said that his comments were misconstrued but did not recant them—“Will it hurt peace process?” a CNN show subsequently asked on Twitter—and 10 years later, he still holds his official role in Hamas. (That’s job security for you.) Today, you don’t have to look far to find updated Jewish-ritual-murder accusations on social media.

Actual Passover fare, of course, is far more prosaic. In 2010, The Atlantic published its own Passover menu. Disappointingly, none of the entrees included Christian blood. In 2011, Yoni Appelbaum unpacked the origins of Manischewitz, the sickly sweet wine popular on Passover, dubbing the beverage “the 11th plague.”

So much for the blood libel. But fear not. There’s one Passover conspiracy that might be true: that “Passover” may be a mistranslation, and not the real name of the holiday after all.

Anastasia Ivleeva fell foul of a law that sanctions remarks discrediting the Russian military.

In the pandemic winter of 2020, Katie, my family’s 14-year-old miniature poodle, began coughing uncontrollably. After multiple vet visits, and more than $1,000 in bills, a veterinary cardiologist diagnosed her with heart failure. Our girl, a dog I loved so much that I wrote an essay about how I called her my “daughter,” would likely die within nine months.

Katie survived for almost two years. My younger son joked that Katie wasn’t going to let advanced heart failure get in the way of her life goal of never leaving my side, but the truth was that I was the one who wouldn’t let her go. Katie’s extended life didn’t come cheap. There were repeated scans, echocardiograms, and blood work, and several trips to veterinary emergency rooms. One drug alone cost $300 a month, and that was after I shopped aggressively for discounts online.

People like me have fueled the growth of what you might call Big Vet. As household pets have risen in status—from mere animals to bona fide family members—so, too, has owners’ willingness to spend money to ensure their well-being. Big-money investors have noticed. According to data provided to me by PitchBook, private equity poured $51.6 billion into the veterinary sector from 2017 to 2023, and another $9.3 billion in the first four months of this year, seemingly convinced that it had discovered a foolproof investment. Industry cheerleaders pointed to surveys showing that people would go into debt to keep their four-legged friends healthy. The field was viewed as “low-risk, high-reward,” as a 2022 report issued by Capstone Partners put it, singling out the industry for its higher-than-average rate of return on investment.

[From the December 2022 issue: How much would you pay to save your pet’s life?]

In the United States, corporations and private-equity funds have been rolling up smaller chains and previously independent practices. Mars Inc., of Skittles and Snickers fame, is, oddly, the largest owner of stand-alone veterinary clinics in the United States, operating more than 2,000 practices under the names Banfield, VCA, and BluePearl. JAB Holding Company, the owner of National Veterinary Associates’ 1,000-plus hospitals (not to mention Panera and Espresso House), also holds multiple pet-insurance lines in its portfolio. Shore Capital Partners, which owns several human health-care companies, controls Mission Veterinary Partners and Southern Veterinary Partners.

As a result, your local vet may well be directed by a multinational shop that views caring for your fur baby as a healthy component of a diversified revenue stream. Veterinary-industry insiders now estimate that 25 to 30 percent of practices in the United States are under large corporate umbrellas, up from 8 percent a little more than a decade ago. For specialty clinics, the number is closer to three out of four.  

And as this happened, veterinary prices began to rise—a lot. Americans spent an estimated $38 billion on health care and related services for companion animals in 2023, up from about $29 billion in 2019. Even as overall inflation got back under control last year, the cost of veterinary care did not. In March 2024, the Consumer Price Index for urban consumers was up 3.5 percent year over year. The veterinary-services category was up 9.6 percent. If you have ever wondered why keeping your pet healthy has gotten so out-of-control expensive, Big Vet just might be your answer.

To get a sense of what might happen when the profit-seeking dial gets turned up too high in veterinary medicine, we need look no further than human health care. An extensive body of research shows that when private equity takes over a hospital or physician practice, prices and the number of expensive procedures tend to go up. A study found serious medical errors occur more frequently after private equity buys the hospital. Another study found that costs to patients rise, too, sometimes substantially. And that’s in a tougher regulatory environment. In veterinary medicine, there is no giant entity like Medicare capable of pushing back on prices. There is no requirement, in fact, to provide care at all, no matter how dire the animal’s condition. Payment is due at the time of service or there is no service.  

Whenever I told people I was working on this article, I was inundated with Big Vet complaints. Catherine Liu, a professor at UC Irvine, took her elderly pit-bull mix, Buster, to a local VCA when he became lethargic and began drooling excessively. More than $8,000 in charges later, there was still no diagnosis. “Sonograms, endoscopy—what about just a hypothesis of what the symptoms could be? Nothing like that at all was forthcoming,” Liu told me. Shortly before Buster died, a vet in private practice diagnosed him with cancer. The disease, Liu said, had not once been mentioned by the vets at VCA. (Mars Petcare, VCA’s parent company, declined to comment on the episode.)

I don’t mean to single out VCA here—in fact, I should note that a VCA vet’s medical protocol was almost certainly responsible for my dog’s longer-than-expected life. One reason Mars-owned chains attract outsized attention for their high costs and customer-service failures is that the company actually brands its acquisitions. That’s unusual. A study conducted by the Arizona consumer advocate Todd Nemet found that fewer than 15 percent of corporate-owned practices in the state slap their own brand identity on their vets; most keep the original practice name, leaving customers with the illusion of local ownership. (When I asked Thrive Pet Healthcare, a chain majority-owned by TSG Consumer Partners, about why the company doesn’t brand its clinics, a spokesperson replied, “We realize the value of local hospital brands and are committed to preserving and supporting them.”)  

Indeed, some pet owners told me that they realized that ownership of their vet had changed only after what they thought was a routine visit resulted in recommendations for mounds of tests, which turned out to have shot up in price. Paul Cerro, the CEO of Cedar Grove Capital, which invests in the pet industry, says this issue is frequent in online reviews. “People will say, ‘I’ve been coming here for four years, and all of a sudden I’m getting charged for things I’ve never been charged for,’ and they give it one star.”

[Read: The great veterinary shortage]

Big Vet denies charging excessive prices. VCA Canada, for instance, recently told The Globe and Mail that prices can increase after an acquisition because “the quality of the care, the quality of everything we offer to them, goes up as well.” A spokesperson for Mars told me, “We invest heavily in our associates, hospitals, state-of-the-art equipment, technology, and other resources.” NVA, which is planning an initial public offering in 2025 or 2026, did not directly answer a question about why veterinary prices were rising so rapidly, instead sending me a statement saying, in part, “Our vision is to build a community of hospitals that pet owners trust, are easy to access, and provide the best possible value for care.”  

Do rising prices really just reflect higher-quality care? There may be some truth to this, but there is also evidence to the contrary. A study published last year in the Journal of the American Veterinary Medical Association, for example, found that vets working for large corporations reported more pressure to generate revenue, whereas veterinarians working for independent practices reported higher levels of satisfaction for such things as the “ability to acquire new large equipment” and the “ability to get new/different drugs.” Preliminary research by Emma Harris, the vice president of Vetster, a veterinary telehealth start-up, found significant differences in pricing between corporate and privately owned veterinary clinics in the same geographic region. Usually, she told me, the increases “occurred immediately after the sale to a private-equity-owned group.”

All of this doesn’t sit well with many in the sector. Vets tend to be idealistic, which makes sense given that many of them rack up six figures in student-loan debt to pursue a profession that pays significantly less than human medicine. One vet, who worked for an emergency-services practice that, they said, raised prices by 20 percent in 2022, told me, “I almost got to the point where I was ashamed to tell people what the estimate was for things because it was so insanely high.” (The vet asked for anonymity because they feared legal repercussions.) Others described mounting pressure to upsell customers following acquisition by private equity. “You don’t always need to take X-rays on an animal that’s vomited just one time,” Kathy Lewis, a veterinarian who formerly worked at a Tennessee practice purchased in 2021 by Mission Veterinary Partners, told me. “But there was more of that going on.” Prices increased rapidly as well, she said, leading to customer complaints. (Mission Veterinary Partners did not respond to requests for comment.)

The combination of wheeling-and-dealing and price increases in the veterinary sector is beginning to attract the government’s attention. In the United States, the Federal Trade Commission required, in 2022 consent decree, that JAB seek prior approval before purchasing any emergency or specialty clinic within 25 miles of one it already owns in California and Texas for the next decade. In her written comments, FTC Chair Lina Khan said she feared these one-by-one purchases could lead to the development of a stealth monopoly. (JAB denied any wrongdoing.) And in the United Kingdom, where corporate ownership is higher than in the United States (even the practice originally owned by the author of the classic veterinary novel All Creatures Great and Small has been rolled up), government authorities are moving forward with an investigation into high prices and market concentration after an initial inquiry drew what regulators called an “unprecedented” response from the public.

Pet owners used to have an easier time accepting the short lives of domestic animals. Few people were taking the barnyard cat or junkyard dog in for chemotherapy or ACL surgery, to say nothing of post-op aquatic physical therapy. “When we started out over 20 years ago, you had to live near a veterinary teaching hospital to have access to something like an MRI,” Karen Leslie, the executive director of the Pet Fund, a charity that aids people with vet bills, told me. “Now it’s the standard of care. It’s available basically everywhere—but that starts at $2,000.”

Big Vet, in Leslie’s view, helped fuel an increase in expensive services. The same medical progress that’s helped humans beat back once-fatal diseases is doing the same for cats and dogs, extending their life spans to record lengths. But only if you have the money to pay for it. Some pets—my late Katie, Liu’s late Buster—receive one expensive test or treatment after another, sometimes helpful, sometimes not. Other equally loved pets may go without basic care altogether, or even fall victim to what the industry calls “economic euthanasia,” where they are put down because their owners can’t afford their medical bills. (Pet insurance, widely promoted by the industry, is unlikely to help much. Uptake rates are in the low single digits, a result of relatively high costs and often-limited benefits.)

[Watch: Volunteer veterinarians in Ukraine]

The American Veterinary Medical Association’s tracker shows that vet visits and purchases of heartworm and flea-and-tick medications are down compared with this month last year, even as practice revenues are up, suggesting that some owners are having trouble affording routine, preventative care. The market researcher Packaged Facts found that a full third of pet owners say that they would take their animal to the vet more often if it were less expensive. Shelter Animals Count, an animal-advocacy group, reports that the number of pets surrendered to shelters rose in the past two years. Carol Mithers, the author of the upcoming book Rethinking Rescue, told me that some people give up pets because they believe the shelter system will provide them with necessary medical treatment—something that is, heartbreakingly, not true.

The veterinary past is easy to romanticize. The truth is that pets have never received all the needed care, and that wealthy pet owners have always had access to more care. But the emergence of Big Vet and the injection of cutthroat incentives into a traditionally idealistic, local industry threatens to make these problems far worse. It portends a future in which some pet owners get shaken down, their love for their pets exploited financially, while others must forego even basic care for their pets. I don’t think Katie, who loved all animals, would approve. I certainly don’t.

Ukraine’s president Volodymyr Zelenskyy says Kyiv has credible intelligence that Russia plans to disrupt the Global Peace Summit to be held in Switzerland in June.

The symbolically-rich trip comes at a crucial time with Russia advancing in Ukraine and escalating trade tensions between Beijing and Brussels.

This is an edition of The Atlantic Daily, a newsletter that guides you through the biggest stories of the day, helps you discover new ideas, and recommends the best in culture. Sign up for it here.

For the past couple of years, scientists have watched with growing concern as a massive outbreak of avian flu, also known as H5N1 bird flu, has swept through bird populations. Recently in the U.S., a farm worker and some cattle herds have been infected. I spoke with my colleague Katherine J. Wu, who covered the virus’s spread in North America, about the risk of human infection and how, for animals, this has already been “a pandemic many times over.”

First, here are three new stories from The Atlantic:

Welcome to the TikTok meltdown. The Republicans who want American carnage Columbia has resorted to pedagogy theater.

Not a Five-Alarm Fire

Lora Kelley: How does this bird-flu outbreak compare with previous ones?

Katherine J. Wu: When we’re considering the toll on nonhuman animals, this is the largest, most deadly H5N1 outbreak that has been recorded in North America. It has been unfolding slowly for about two and a half years now, but it’s become a gargantuan wave at this point.

Lora: Wow—how alarmed are you by that?

Katherine: I’m medium concerned—and I have been medium concerned for a couple of years now. It’s difficult to gauge the amount of alarm to feel, because it’s so unprecedented. Still, most H5N1 outbreaks in the past have totally fizzled without much consequence, especially in this part of the world.

I am worried because so many species have been getting sick. A huge number of wild birds have been infected, including species that haven’t been affected in the past. And we’ve seen these massive outbreaks in domesticated chickens, which are packed together in farms.

Avian flu is known to be a bird problem. Beyond that, we’ve been seeing these outbreaks in mammals for a couple of years now, which is more concerning because, of course, we are also mammals. Humans seem to be potentially susceptible to infection, but at the same time, it would take quite a lot for this to become another big human-flu pandemic.

Lora: Should we be concerned about getting sick?

Katherine: People should be vigilant and paying attention to the news. But right now, as you and I are talking, there is still not a huge risk to people. You don’t get a pandemic unless you have a pathogen that spreads very, very easily among people, and there’s no evidence so far that this virus has mutated to that point.

There have been some human cases globally so far, but it’s a very small number. They seem to have been cases where someone was highly exposed to the virus in domesticated animals. People got sick, but they didn’t pass it to someone else.

I’m definitely not saying that person-to-person transmission can’t happen eventually, but there’s a pretty big chasm between someone getting infected and someone being able to efficiently pass the virus on. It is concerning that we continue to see more mammal species affected by H5N1, including species that have a lot of close contact with humans. But this is not a five-alarm fire so far.

Lora: How will people’s lives be affected?

Katherine: The virus has already affected our lives. Egg prices went completely bonkers in 2022 and early 2023, and over the course of this outbreak, more than 90 million domestic poultry have died. It’s not that all of those birds got sick—when this virus breaks out on chicken farms, it’s generally considered good practice to cull the chickens to halt the spread. Still, when you have that many chickens dying, egg prices are going to go up.

We’re probably not on track to see that with cows anytime soon. Even though this virus has now been detected in dairy cows, they aren’t getting wildly sick, and transmission doesn’t seem as efficient. I don’t think we’re going to be in a situation where we’re killing all of our dairy cows and no one can get milk.

Lora: The FDA announced yesterday that genetic evidence of this bird-flu virus had been found in samples of pasteurized milk. Is it still safe to drink milk?

Katherine: So far, the answer is: generally, yes, if it’s been pasteurized. Pasteurization is a process by which milk is treated with heat so that it will kill a whole bunch of pathogens, including bacteria and viruses, and H5N1 is thought to be vulnerable to this. Also, researchers have been working to test cows so they can figure out which ones are sick. Only milk from healthy cows is authorized to enter the general food supply, though the trick will be finding all the cows that are actually infected. For now, the main ways that this virus will affect us will be indirect.

Lora: Is there anything that can be done to curb the spread among wild animals?

Katherine: For the animal world, this has already been a “pandemic” many times over. It has been truly devastating in that respect. So many wild birds, sea lions, seals, and other creatures have died, and it’s difficult to see how people can effectively intervene out in nature. There have been very few cases in which endangered animals have received vaccines because there’s a real possibility that their populations could be 100 percent wiped out by this virus.

For most other animals in the wild, there’s not a lot that can be done, except for people to pay attention to where the virus is spreading. The hope is that most animal populations will be resilient enough to get through this and develop some form of immunity.

Lora: Responses to COVID became very politicized. How might the aftermath of those mitigation measures shape how people respond to this virus, especially if it becomes a greater threat to humans?

Katherine: We’re so fresh off the worst days of COVID that if people were asked to buckle down or get a new vaccine, I suspect that a lot of them would be like, Not again. There is still a lot of mitigation fatigue, and many people are sick of thinking about respiratory viruses and taking measures to prevent outbreaks. And, certainly, people have lost a lot of trust in public health over the past four years.

That said, H5N1 is still a flu, and people are familiar with that type of virus. We have a long history of using flu vaccines, and the government has experience making a pandemic vaccine, keeping that stockpile, and getting it out to the public. That gives me hope that at least some people will be amenable to taking the necessary preventative measures, so any potential bird-flu outbreak among humans would not turn into COVID 2.0.

Related:

Bird flu leaves the world with an existential choice. Bird flu has never done this before.

Today’s News

President Joe Biden signed into law a bipartisan foreign-aid package that includes aid for Ukraine, Israel, and U.S. allies in the Indo-Pacific, and a measure that forces TikTok’s parent company to sell the social-media app or face an outright ban. The U.S. Supreme Court seems divided over whether a federal law can require hospitals to provide access to emergency abortions and override state-level abortion bans. George Santos, the embattled former New York representative facing multiple charges of fraud, ended his independent bid for a U.S. House seat on Long Island.

Dispatches

The Weekly Planet: Tesla is not the next Ford, Matteo Wong writes. It’s the next Con Ed.

Explore all of our newsletters here.

Evening Read

Illustration by Matteo Giuseppe Pani

Why Did Cars Get So Expensive?

By Annie Lowrey

Inflation, finally, has cooled off. Prices have increased 2.5 percent over the past year, down from increases as high as 7 percent during the early pandemic. Rents are high but stabilizing. The cost of groceries is ticking up, not surging, and some goods, such as eggs, are actually getting cheaper. But American consumers are still stretching to afford one big-ticket item: their cars.

The painful cost of vehicle ownership doesn’t just reflect strong demand driven by low unemployment, pandemic-related supply-chain weirdness, and high interest rates. It reflects how awful cars are for American households and American society as a whole.

Read the full article.

More From The Atlantic

A Democrat’s case for saving Mike Johnson How baseball explains the limits of AI

Culture Break

Illustration by Ben Kothe / The Atlantic. Source: Ashok Kumar / Getty.

Listen. Taylor Swift’s music often returns to the same motifs: pathetic fallacy, the passing of time, the mythology of love. Her latest album shows how these themes have calcified in her work, Sophie Gilbert writes.

Look. Take a photo tour of several of Chile’s national parks, which protect many endangered species, wild landscapes, and natural wonders.

Play our daily crossword.

Stephanie Bai contributed to this newsletter.

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