Noam Chomsky: 2 Ways Trump Is Pushing the Doomsday Clock to the Brink of Midnight
The following is an transcript of a recent public interview at the University of Arizona with linguist and political commentator Noam Chomsky by Dr. David N. Gibbs.
David Gibbs: The main issue on everyone's minds is the inauguration of Donald Trump as president. The Bulletin of the Atomic Scientists has emphasized the extreme danger that Trump poses, due to the augmented risk of nuclear war and uncontrolled climate change. After inauguration, the Bulletin's metaphoric clock has been repositioned at two and a half minutes to midnight, with "midnight" signifying catastrophe. Do you agree with the Bulletin regarding the alleged dangers posed by the Trump presidency?
Noam Chomsky: One of the dangers is unquestionable. Of the two existential threats—the threats to the termination of the species basically and most other species—one of them, climate change, on that I think there's no basis for discussion. Trump has been very inconsistent on many things; on Twitter he's been all over the place, but some of it is very consistent. That is: Do nothing about climate change except make it worse. And he's not just speaking for himself, but for the whole Republican Party, the whole leadership. It's already had impact, it will have worse impact. We'll talk about this next week, but if there are ways out of this, it's going to be not easy.
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With regard to nuclear weapons, it's kind of hard to say. He's said lots of things. As you mentioned, the national security experts are terrified. But they're more terrified by his personality than by his statements. So if you read people like say Bruce Blair[i]1 one of the leading, most sober, knowledgeable specialists, he says, look, his statements are all over the map, but his personality is frightening, he's a complete megalomaniac. You never know how he's going to react. When he learned for example that he'd lost the election by about three million votes, his instant reaction was insanity; you know, three to five million illegal immigrants somehow were organized in some incredible fashion to vote. On any little issue—Miss Universe, or whatever it may be—he's completely unpredictable, he'll go off into outer space. His guru Steve Bannon is worse, he's much scarier. He probably knows what he's doing.
Over the years, there's been case after case when there were very narrow decisions that had to be made about whether to launch nuclear weapons in serious cases. What is this guy going to do if his vaunted negotiating skills fail, if somebody doesn't do what he says? Is he going to say, "Okay we'll nuke them? We're done?" Remember that in any major nuclear war, the first strike destroys the country that attacks; it's been known for years. The first strike of a major power is very likely to cause what's called nuclear winter, leads to global famine for years and everything's basically gone. Some survivors straggling around. Could he do it? Who knows.
Some of his comments can be interpreted as potentially reducing the threat of nuclear war. The major threat right now is right on the Russian border. Notice, not the Mexican border, the Russian border. And it's serious. He has made various statements moving towards reducing the tensions, accommodating Russian concerns and so on. On the other hand, you have to balance that against expanding our nuclear forces, add to our so-called depleted military, which is already more powerful than the rest of the world combined; attack in Syria, send forces to Syria, start bombing. Who knows what could be next? Michael Flynn, national security advisor,[ii] [his reaction] to the Iranian missile test the other day was very frightening. Now the missile test is ill-advised, they shouldn't have done it. But it's not in violation of international law or international agreements. They shouldn't have done it. His reaction suggested maybe we're going to go to war in retaliation. Would they do it? If they did, you don't know what's going to happen next. Everything could blow up.
This crazy ban on the seven states, where we can't accept immigrants, almost every analyst points out the obvious: It just increases the threat of terror. It lays the basis for terror. It's just like the atrocities in Abu Ghraib and Bagram and Guantanamo. They're the most fabulous recruiting techniques for Al Qaeda and ISIS. Everyone knows it. Now, you ban not the whole Muslim world. You ban seven states, seven states that have not been responsible for a single terrorist act. Those are the seven he banned. But, you leave the ones that really are responsible, like Saudi Arabia, which is the center for propaganda and funding and so on for radical Islamic Jihadism, well you can't touch them because of business interests, also they have oil and so on and so forth. There's actually an article in the Washington Post, I don't know whether it's tongue in cheek or not, which said the criterion for being on the list of banned states is that Trump doesn't have business interests there. Maybe. But it's this kind of wild unpredictability, megalomania, thin-skinned craziness that really has me worried, more than his statements. Now, on the climate change there's just nothing to say, he's perfectly straightforward.
Gibbs: Let us turn to the role of the media in reporting alleged Russian interference in the US electoral process. Mainstream journalists have called Trump a puppet of Russia, a modern version of the Manchurian Candidate. Others have criticized the media for accepting unsubstantiated claims about Russian influence, and reporting such claims as facts. Norman Solomon and Serge Halimi, for example, stated that press reporting on this issue amounts to a mass hysteria reminiscent of the McCarthy era, while Seymour Hersh called the media reporting on Russia "outrageous."[iii] What is your view of this situation?
Chomsky: My guess is that most of the world is just collapsing in laughter. Suppose all the charges are true, I mean every single one, it is so amateurish by US standards that you can hardly even laugh. What the US does is the kind of thing I described in Italy in 1948. Case after case like that, not hacking or spreading rumors in the media; but saying look, we're going to starve you to death or kill you or destroy you unless you vote the way we want. I mean that's what we do.
Take the famous 9/11, let's think about it for a minute. It was a pretty awful terrorist act. It could have been a lot worse. Now let's suppose that instead of the plane being downed in Pennsylvania by passengers, suppose it had hit its target, which was probably the White House. Now suppose it had killed the president. Suppose that plans had been set for a military coup to take over the government. And right away, immediately 50,000 people were killed, 700,000 tortured. A bunch of economists were brought in from Afghanistan, let's call them the "Kandahar Boys," who very quickly destroyed the economy, and established a dictatorship which devastated the country. That would have been a lot worse than 9/11. It happened: the first 9/11, it happened on September 11, 1973, in Chile. We did it. Was that interfering or hacking a party? This record is all over the world, constantly overthrowing governments, invading, forcing people to follow what we call democracy, as in the cases I mentioned. As I say, if every charge is accurate, it's a joke, and I'm sure half the world is collapsing in laughter about this, because people outside the United States know it. You don't have to tell people in Chile about the first 9/11.
Gibbs: One of the surprises of the post-Cold War era is the persistence of the North Atlantic Treaty Organization and other U.S.-led alliances. These alliances were created during the Cold War mainly or exclusively for containing the claimed Soviet threat. In 1991, the USSR disappeared from the map, but the anti-Soviet alliance systems persisted and in fact expanded. How do we account for the persistence and expansion of NATO? What in your view is the purpose of NATO after the Cold War?
Chomsky: We have official answers to that. It's a very interesting question, which I was planning to talk about but didn't have time. So thanks. It's a very interesting question. For fifty years, we heard NATO is necessary to save Western Europe from the Russian hordes, you know the slave state, stuff I was taking about. In 1990-91, no Russian hordes. Okay, what happens? Well there are actually visions of the future system that were presented. One was Gorbachev. He called for a Eurasian security system, with no military blocs. He called it a Common European Home. No military blocs, no Warsaw Pact, no NATO, with centers of power in Brussels, Moscow, Ankara, maybe Vladivostok, other places. Just an integrated security system with no conflicts.
That was one. Now the other vision was presented by George Bush, this is the "statesman," Bush I and James Baker his secretary of state. There's very good scholarship on this incidentally. We really know a lot about what happened, now that all the documents are out. Gorbachev said that he would agree to the unification of Germany, and even adherence of Germany to NATO, which was quite a concession, if NATO didn't move to East Germany. And Bush and Baker promised verbally, that's critical, verbally that NATO would not expand "one inch to the east," which meant East Germany. Nobody was talking about anything farther at the time. They would not expand one inch to the east. Now that was a verbal promise. It was never written. NATO immediately expanded to East Germany. Gorbachev complained. He was told look, there's nothing on paper. People didn't actually say it but the implication was look, if you are dumb enough to take faith in a gentleman's agreement with us, that's your problem. NATO expanded to East Germany.
There's very interesting work, if you want to look into it by a young scholar in Texas named Joshua Shifrinson, it appeared in International Security, which is one of the prestige journals, published by MIT.[iv] He goes through the documentary record very carefully and he makes a pretty convincing case that Bush and Baker were purposely deceiving Gorbachev. The scholarship has been divided on that, maybe they just weren't clear or something. But if you read it, I think it's quite a convincing case, that they were purposely setting it up to deceive Gorbachev.
Okay, NATO expanded to East Berlin and East Germany. Under Clinton NATO expanded further, to the former Russian satellites. In 2008 NATO formally made an offer to Ukraine to join NATO. That's unbelievable. I mean, Ukraine is the geopolitical heartland of Russian concern, quite aside from historical connections, population and so on. Right at the beginning of all of this, serious senior statesmen, people like Kennan for example and others warned that the expansion of NATO to the east is going to cause a disaster.[v] I mean, it's like having the Warsaw Pact on the Mexican border. It's inconceivable. And others, senior people warned about this, but policymakers didn't care. Just go ahead.
Right now, where do we stand? Well right at the Russian border, both sides have been taking provocative actions, both sides are building up military forces. NATO forces are carrying out maneuvers hundreds of yards from the Russian border, the Russian jets are buzzing American jets. Anything could blow up in a minute. In a minute, you know. Any incident could instantly blow up. Both sides are modernizing and increasing their military systems, including nuclear systems.
So what's the purpose of NATO? Well actually we have an official answer. It isn't publicized much, but a couple of years ago, the secretary-general of NATO made a formal statement explaining the purpose of NATO in the post-Cold War world is to control global energy systems, pipelines, and sea lanes. That means it's a global system and of course he didn't say it, it's an intervention force under U.S. command, as we've seen in case after case. So that's NATO. So what happened to the years of defending Europe from the Russian hordes? Well, you can go back to NSC-68,[vi] and see how serious that was. So that's what we're living with.
Right now the threat to our existence is Muslim terrorists from seven states, who have never had a single terrorist act. About half the population believes that. I mean you look back at American history and American culture, it's pretty striking. I mean this has been the safest country in the world forever, and the most frightened country in the world. That's a large part of the source of the gun culture. You have to have a gun when you go into Starbucks, because who knows what's going to happen. It just doesn't happen in other countries.
There's something deeply rooted in American culture. You can pretty much identify what it was. You take a look at the history. Remember, the U.S. is not a global power until pretty recently. It was internal conquest. You had to defend yourself against what the Declaration of Independence, Thomas Jefferson, an enlightened figure, called the attacks of the "merciless Indian savages," whose known way of warfare was torture and destruction. Jefferson wasn't a fool. He knew that it was the merciless English savages who were carrying out these acts. That is in the Declaration of Independence, recited piously every July Fourth, the merciless Indian savages with no reason at all were suddenly attacking us. I mean, you can imagine the reasons. That's one. Also you had a slave population, you had to protect yourself against them. You needed guns. One consequence of that was in southern culture, possession of a gun became kind of a sign of manhood, not just because of slaves but other white men. If you had a gun, you're not going to push me around. You know, I'm not one of those guys you can kick in the face.
There was another element, which was kind of interesting. In the mid to late nineteenth century, the gun manufacturers recognized that they had a limited market. Remember that this is a capitalist society, you've got to expand your market. They were selling guns to the military. That's a pretty limited market. What about all the rest of the people? So what started was all kinds of fantastic stories about Wyatt Earp and the gunmen and the Wild West, how exciting it was to have these guys with guns defending themselves against all sorts of things.
I grew up in that, when I was a kid. My friends and I used to play cowboys and Indians. We were cowboys killing the Indians, following the Wild West stories. All of this combined into a very strange culture, which is frightened. You look at the polls today, I think half the population supports this ban on these dangerous immigrants who are going to come in and do something, who knows what. And meanwhile the countries that really have been involved in terrorism, they're out. It's kind of like I think it was Oklahoma banning Sharia law. Now there's probably fifty Muslims in Oklahoma, and they have to ban Sharia law, you know. This terror which is all over the country is constantly incited. The Russians were part of NSC-68, is a dramatic case. And that case, like most propaganda wasn't totally fabricated. The Russians were doing a lot of rotten things, you can point to them. But the idea that if you consider what Hans Morgenthau called "I called abuse ofe reality," the picture of the world was almost the opposite of what they presented. But somehow this sells and is continually repeated, at least in this kind of situation.
Gibbs: During the Cold War, the political left generally opposed military intervention. After 1991, however, the anti-interventionist movement collapsed and in its place has emerged the idea of humanitarian interventionism, which celebrates intervention as a defense of human rights. Military actions in the Balkans, Iraq, Libya have all been presented as acts of humanitarianism, which aimed to liberate oppressed peoples, and these interventions were at least initially popular among political liberals. Proposals for augmented U.S. intervention in Syria often invoke the humanitarian principle. What is your view of humanitarian intervention?
Chomsky: Well, I don't quite see it like that. Now, if you look back to the anti-intervention movements, what were they? Let's take the Vietnam War – the biggest crime since the Second World War. Those of you who are old enough will remember what happened. You couldn't be opposed to the war for years. The mainstream liberal intellectuals were enthusiastically in support of the war. In Boston, a liberal city where I was, we literally couldn't have a public demonstration without it being violently broken up, with the liberal press applauding, until late 1966. By that time there were hundreds of thousands of American troops rampaging in South Vietnam. South Vietnam had been practically destroyed. The leading, the most respected Vietnam historian, military historian Bernard Fall[vii] – he was a hawk incidentally, but he cared for the Vietnamese—he said it wasn't clear to him whether Vietnam could survive as a historical and cultural entity under the most massive attack that any region that size had ever suffered. He was talking about South Vietnam, incidentally. By that time, we did begin to get some protests. But not from liberal intellectuals; they never opposed the war.
In fact, it's pretty dramatic when you get to 1975, very revealing, the war ends. Everybody had to write something about the war, what it meant. And you also had polls of public opinion, and they're dramatically different. So if you look at the writings of intellectuals, there are two kinds. One said, l"Look, if we fought harder we could have won." You know, the stab in the back. But the others, who were way at the left, people like Anthony Lewis of the New York Times, way out in left stream, his view in 1975 was the Vietnam war began with blundering efforts to do good. But by 1969, it was clear that it was a disaster, that was too costly to us. We could not bring democracy to South Vietnam at a cost that we were willing to accept. So it was a disaster. That' is the left extreme.
Take a look at public opinion. About 70 percent of the population, in the polls, said the war was fundamentally wrong and immoral, not a mistake. And that attitude lasted as long as polls were taken in the early '80s. The pollsters don't ask reasons, they just give numbers. So why did the people think it was fundamentally wrong and immoral? The guys who ran the polls, John E. Rielly, a professor at the University of Chicago, a liberal professor, he said what that means is that people thought too many Americans had beenwere being killed. Maybe. Another possibility is they didn't like the fact that we were carrying out the worst crime since the Second World War. But that's so inconceivable that wasn't even offered as a possible reason.
Now what happened in the following years? Well, I think that among the educated classes it stayed the same. You talk about humanitarian intervention, it's like Vietnam was a humanitarian intervention. Among the public, it's quite different. Take the Iraq War, , it's the second worst crime after the Second World War. It's the first time in history, in the history of imperialism, there were huge demonstrations, before the war was officially launched. Actually it was already under way. But before it was officially launched, there were huge demonstrations everywhere. I think it had an effect. The public still was split.
And [after Vietnam] the type of interventions that are carried out are designed so as not to elicit public reactions. In fact, it was stated early in the first Bush [presidency], Bush I, in one of their documents they pointed out in the future, US wars are going to be against much weaker enemies. And they have to be won quickly and decisively before a popular reaction develops. And Iif you take a look, that's what's done. Look at Panama, for instance, over a couple of days; and Kosovo, no American troops. You wrote a great book about it.[viii] But I'm not convinced that it's different from what it was.
Gibbs: With the end of the Cold War, there has been a decline of activism in the US and elsewhere around the issue of nuclear disarmament. Once again, this state of affairs differs from the period of the Cold War, when there was a mass movement that opposed nuclear weapons – recall the Freeze movement from the 1980s—but this movement largely disappeared after 1991. The danger of nuclear war remains as high as ever, but there is little public engagement on this issue, it would seem. How would you explain the disappearance of the anti-nuclear movement?
Chomsky: Well that's absolutely right. The peak of anti-nuclear popular activism was in the early '80s, when there was a huge movement. And the Reagan administration attempted decided to defuse it and partially succeeded, by presenting the illusion of Star Wars, SDI, that somehow we're going to eliminate nuclear weapons. The Reagan administration picked up the rhetoric of the anti-nuclear movement; they said "Yyeah, you're right." We have to eliminate nuclear weapons. And the way we're going to do it is by having SDI, TStar Wars, the Strategic Defense Initiative, which prevent nuclear weapons from impacting. Well, that did defuse the movement.
And whthen the Russians collapsed, and it looked like as if maybe we can reduce the nuclear tensions. And for a while they actually were reduced. There was a reduction of nuclear weaponsreally were reduced on both sides. Various steps were taken. Nowhere near enough, but some of them were taken.
On the other hand, it's very important to understand the official position of the United States. You should read it. So in 1995, this is Clinton, a very important document came out, still classified, but large parts of it were declassified. It's called "Essentials of Post-Cold War Deterrence."[ix] What does post-Cold War deterrence mean? Deterrence means use of nuclear weapons. This was released by the Strategic Command, which was in charge of nuclear weapons planning and running nuclear weapons. I wrote about it when it came out and have been writing about it since. . Since then, I've never seen a reference to it. But it is an amazing document. Here's what it says basically: It says we have to maintain the right of first strike, the right of the first use of nuclear weapons, even against nonnuclear powers. Nuclear weapons, they point out, are really constantly used, because they cast a shadow over other military actions. In other words, when people know we are ready to use nuclear weapons, they're going to back off if we do something aggressive. So basically, nuclear weapons are always being used.
Now that's a point that Dan Ellsberg has made for years. He said it's kind of like if you and I go into a grocery store to rob it, and I have a gun. The guy may give you the money in the cash register. I'm using the gun even if I don't shoot. Well that's nuclear weapons — essential to post-war deterrence — they cast a shadow over everything. Then, it goes on to say that we must present a national persona of being irrational and vindictive, because that's going to terrify people. And then, they'll back off. And this is not Trump, this is Clinton. It's not Nixon, you know. We have to be irrational and vindictive, because that's going to frighten people. And we have to maintain this for years. And then we'll be able to carry out the actions that we want to carry out.
That's our nuclear weapons strategy, as of the early post-Cold War years. And I think this is a real failure of the intellectual community, including scholarship and the media. It's not like you had headlines all over the place. And it's not secret, the documents are there. And I think that's probably the right picture. You know, people talk about Nixon's "madman theory." We don't really know much about that. It was in memoirs, by somebody else.[x] But this is real. This is the real mad man theory. We have to be irrational and vindictive, so people don't know what we're up to. This is not Trump and Bannon, it's from the Clinton era.
Gibbs: I think we have time for one more question. In popular discussion, the phrase "national security" has come to mean security against military threats almost exclusively. This narrative downgrades the significance of nonmilitary threats, such as climate change, antibiotic resistant bacteria, or viral epidemics. It would seem that there is an imbalance between perceived military threats, which receive overwhelming governmental funding and press attention on the one hand, and nonmilitary threats, which receive relatively little on the other hand. How do we account for the apparent overemphasis on military threats?
Chomsky: Well [with] military threats, you can see them actually, you can imagine it. People don't think about it enough. But if you think about it for a minute, you can see that a nuclear attack could be the end of everything. These other threats are kind of slow, maybe we won't see them next year. Maybe the science is uncertain, maybe we don't have to worry about it. Climate change is the worst, but there's others.
Take pandemics. There could easily be a severe pandemic. A lot of that comes from something we don't pay much attention to: Eating meat. The meat production industry, the industrial production of meat, uses an immense amount of antibiotics. I don't remember the exact figure, it's probably like half the antibiotics. Well antibiotics have an effect: They lead to mutations that make them ineffective. We're now running out of antibiotics that deal with the threat of rapidly mutating bacteria. A lot of that just comes from the meat production industry. Well, do we worry about it? Well, we ought to be. You go into a hospital now, it's dangerous. We can get diseases that can't be dealt with, that are moving around the hospital. A lot of that traces back to industrial meat production. These are really serious threats, all over the place.
Take something you really don't think about: Plastics in the ocean. I mean plastics in the ocean have an enormous ecological effect. When geologists announced the beginning of a new geological epoch, the Anthropocene, humans destroying the environment, one of the main things they pointed to is the use of plastics in the earth. We don't think about it, but it has a tremendous effect. But these are things you don't see right in front of your eyes. You need to think about them a little, to see what the consequences are. It's easy to put them aside, and the media don't talk about them. Other things are more important. How am I going to put food on the table tomorrow? That's what I've got to worry about, and so on. It's very serious, but it's hard to bring out the enormity of these issues, when they do not have the dramatic character of something you can show in the movies, with a nuclear weapons falling and everything disappears.
Professor Chomsky approved this transcript for publication. The interview is presented in full, with only very slight editing for style. Reposted with permission from our media associate AlterNet.
[i] For the recent opinions of Princeton University nuclear weapons specialist Bruce G. Blair, see Blair, "Trump and the Nuclear Keys," New York Times, October 12, 2016.
[ii] Note that Michael T. Flynn resigned as national security advisor on February 13, 2017, several days after this interview took place
[iii] See Solomon, "Urgent to Progressives: Stop Fueling Anti-Russia Frenzy," Antiwar.com, December 21, 2016, http://original.antiwar.com/solomon/2016/12/20/urgent-progressives-stop-fueling-anti-russia-frenzy/ ; Halimi, January, 2017, ; Jeremy , "Seymour Hersh Blasts Media for Uncritically Reporting Russian Hacking Story,"
[iv] The End of the Cold War and the U.S. Offer to Limit NATO Expansion," International Security 40, no. 4, 2016.
[v] On George F. Kennan's warning about the dangers of NATO expansion, see Thomas L. Friedman, "Foreign Affairs: Now a Word from X," New York Times, May 2, 1998.
[vi] 6 Here, Chomsky references the National Security Council memorandum NSC-68, one of the key documents of the Cold War. This document was the topic of Chomsky's lecture, which preceded the interview. The document text is now fully declassified and available online. See "A Report to the National Security Council – NSC 68," April 14, 1950, made available through the Harry S. Truman Presidential Library, https://www.trumanlibrary.org/whistlestop/study_collections/coldwar/documents/pdf/10-1.pdf.
[vii] Regarding Bernard Fall's writings on Vietnam, see Fall, Last Reflections on a War. Garden City, NY: Doubleday, 1967.
[viii] The book Chomsky references with regard to the Kosovo intervention is David N. Gibbs, First Do No Harm: Humanitarian Intervention and the Destruction of Yugoslavia. Nashville, TN: Vanderbilt University Press, 2009.
[ix] This e full text of this declassified document is now available online. See U.S. Department of Defense, Strategic Command, "Essentials of Post-Cold War Deterrence," 1995 [no exact date indicated], made available through provided by the Federation of American Scientists, Nuclear Information Project, http://www.nukestrat.com/us/stratcom/SAGessentials.PDF.
[x] The idea that President Richard Nixon subscribed to a "madman" theory of international relations first appeared in the memoir by former Nixon aide H. R. Haldeman, in Haldeman and Joseph DiMona, The Ends of Power. New York: Times Books, 1978, p. 98.
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The patient in the case report (let's call him Tom) was 54 and in good health. For two days in May, he felt unwell and was too weak to get out of bed. When his family finally brought him to the hospital, doctors found that he had a fever and signs of a severe infection, or sepsis. He tested positive for SARS-CoV-2, the virus that causes COVID-19 infection. In addition to symptoms of COVID-19, he was also too weak to move his legs.
When a neurologist examined him, Tom was diagnosed with Guillain-Barre Syndrome, an autoimmune disease that causes abnormal sensation and weakness due to delays in sending signals through the nerves. Usually reversible, in severe cases it can cause prolonged paralysis involving breathing muscles, require ventilator support and sometimes leave permanent neurological deficits. Early recognition by expert neurologists is key to proper treatment.
We are neurologists specializing in intensive care and leading studies related to neurological complications from COVID-19. Given the occurrence of Guillain-Barre Syndrome in prior pandemics with other corona viruses like SARS and MERS, we are investigating a possible link between Guillain-Barre Syndrome and COVID-19 and tracking published reports to see if there is any link between Guillain-Barre Syndrome and COVID-19.
Some patients may not seek timely medical care for neurological symptoms like prolonged headache, vision loss and new muscle weakness due to fear of getting exposed to virus in the emergency setting. People need to know that medical facilities have taken full precautions to protect patients. Seeking timely medical evaluation for neurological symptoms can help treat many of these diseases.
What Is Guillain-Barre Syndrome?
Guillain-Barre syndrome occurs when the body's own immune system attacks and injures the nerves outside of the spinal cord or brain – the peripheral nervous system. Most commonly, the injury involves the protective sheath, or myelin, that wraps nerves and is essential to nerve function.
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To diagnose Guillain-Barre Syndrome, neurologists perform a detailed neurological exam. Due to the nerve injury, patients often may have loss of reflexes on examination. Doctors often need to perform a lumbar puncture, otherwise known as spinal tap, to sample spinal fluid and look for signs of inflammation and abnormal antibodies.
Studies have shown that giving patients an infusion of antibodies derived from donated blood or plasma exchange – a process that cleans patients' blood of harmful antibodies - can speed up recovery. A very small subset of patients may need these therapies long-term.
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Guillain-Barre Syndrome and Pandemics
As the COVID-19 pandemic sweeps across the globe, many neurologic specialists have been on the lookout for potentially serious nervous system complications such as Guillain-Barre Syndrome.
Though Guillain-Barre Syndrome is rare, it is well known to emerge following bacterial infections, such as Campylobacter jejuni, a common cause of food poisoning, and a multitude of viral infections including the flu virus, Zika virus and other coronaviruses.
Studies showed an increase in Guillain-Barre Syndrome cases following the 2009 H1N1 flu pandemic, suggesting a possible connection. The presumed cause for this link is that the body's own immune response to fight the infection turns on itself and attacks the peripheral nerves. This is called an "autoimmune" condition. When a pandemic affects as many people as our current COVID-19 crisis, even a rare complication can become a significant public health problem. That is especially true for one that causes neurological dysfunction where the recovery takes a long time and may be incomplete.
Though there is clear clinical suspicion that COVID-19 can lead to Guillain-Barre Syndrome, many important questions remain. What are the chances that someone gets Guillain-Barre Syndrome during or following a COVID-19 infection? Does Guillain-Barre Syndrome happen more often in those who have been infected with COVID-19 compared to other types of infections, such as the flu?
The only way to get answers is through a prospective study where doctors perform systematic surveillance and collect data on a large group of patients. There are ongoing large research consortia hard at work to figure out answers to these questions.
Understanding the Association Between COVID-19 and Guillain-Barre Syndrome
While large research studies are underway, overall it appears that Guillain-Barre Syndrome is a rare but serious phenomenon possibly linked to COVID-19. Given that more than 10.7 million cases have been reported for COVID-19, there have been 10 reported cases of COVID-19 patients with Guillain-Barre Syndrome so far – only two reported cases in the U.S., five in Italy, two cases in Iran and one from Wuhan, China.
It is certainly possible that there are other cases that have not been reported. The Global Consortium Study of Neurological Dysfunctions in COVID-19 is actively underway to find out how often neurological problems like Guillain-Barre Syndrome is seen in hospitalized COVID-19 patients. Also, just because Guillain-Barre Syndrome occurs in a patient diagnosed with COVID-19, that does not imply that it was caused by the virus; this still may be a coincident occurrence. More research is needed to understand how the two events are related.
Due to the pandemic and infection-containment considerations, diagnostic tests, such as a nerve conduction study that used to be routine for patients with suspected Guillain-Barre Syndrome, are more difficult to do. In both U.S. cases, the initial diagnosis and treatment were all based on clinical examination by a neurological experts rather than any tests. Both patients survived but with significant residual weakness at the time these case reports came out, but that is not uncommon for Guillain-Barre Syndrome patients. The road to recovery may sometimes be long, but many patients can make a full recovery with time.
Though the reported cases of Guillain-Barre Syndrome so far all have severe symptoms, this is not uncommon in a pandemic situation where the less sick patients may stay home and not present for medical care for fear of being exposed to the virus. This, plus the limited COVID-19 testing capability across the U.S., may skew our current detection of Guillain-Barre Syndrome cases toward the sicker patients who have to go to a hospital. In general, the majority of Guillain-Barre Syndrome patients do recover, given enough time. We do not yet know whether this is true for COVID-19-related cases at this stage of the pandemic. We and colleagues around the world are working around the clock to find answers to these critical questions.
Sherry H-Y. Chou is an Associate Professor of Critical Care Medicine, Neurology, and Neurosurgery, University of Pittsburgh.
Aarti Sarwal is an Associate Professor, Neurology, Wake Forest University.
Neha S. Dangayach is an Assistant Professor of Neurology and Neurosurgery, Icahn School of Medicine at Mount Sinai.
Disclosure statement: Sherry H-Y. Chou receives funding from The University of Pittsburgh Clinical Translational Science Institute (CTSI), the National Institute of Health, and the University of Pittsburgh School of Medicine Dean's Faculty Advancement Award. Sherry H-Y. Chou is a member of Board of Directors for the Neurocritical Care Society. Neha S. Dangayach receives funding from the Bee Foundation, the Friedman Brain Institute, the Neurocritical Care Society, InCHIP-UConn Center for mHealth and Social Media Seed Grant. She is faculty for emcrit.org and for AiSinai. Aarti Sarwal does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.
Reposted with permission from The Conversation.
One of the initial reasons social distancing guidelines were put in place was to allow the healthcare system to adapt to a surge in patients since there was a critical shortage of beds, ventilators and personal protective equipment. In fact, masks that were designed for single-use were reused for an entire week in some hospitals.
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By Jake Johnson
Unity Task Forces formed by presumptive Democratic presidential nominee Joe Biden and Sen. Bernie Sanders unveiled sweeping party platform recommendations Wednesday that—while falling short of progressive ambitions in a number of areas, from climate to healthcare—were applauded as important steps toward a bold and just policy agenda that matches the severity of the moment.
"We've moved the needle a lot, especially on environmental justice and upping Biden's ambition," said Sunrise Movement co-founder and executive director Varshini Prakash, a member of the Biden-Sanders Climate Task Force. "But there's still more work to do to push Democrats to act at the scale of the climate crisis."
The climate panel—co-chaired by Rep. Alexandria Ocasio-Cortez (D-N.Y.) and former Secretary of State John Kerry—recommended that the Democratic Party commit to "eliminating carbon pollution from power plants by 2035," massively expanding investments in clean energy sources, and "achieving net-zero greenhouse gas emissions for all new buildings by 2030."
In a series of tweets Wednesday night, Ocasio-Cortez—the lead sponsor of the House Green New Deal resolution—noted that the Climate Task Force "shaved 15 years off Biden's previous target for 100% clean energy."
"Of course, like in any collaborative effort, there are areas of negotiation and compromise," said the New York Democrat. "But I do believe that the Climate Task Force effort meaningfully and substantively improved Biden's positions."
Today the 6 Biden-Sanders Unity Task Forces are unveiling final language. The Climate Task Force accomplished a gr… https://t.co/gz3broq2qe— Alexandria Ocasio-Cortez (@Alexandria Ocasio-Cortez)1594240617.0
The 110 pages of policy recommendations from the six eight-person Unity Task Forces on education, the economy, criminal justice, immigration, climate change, and healthcare are aimed at shaping negotiations over the 2020 Democratic platform at the party's convention next month.
Sanders said that while the "end result isn't what I or my supporters would've written alone, the task forces have created a good policy blueprint that will move this country in a much-needed progressive direction and substantially improve the lives of working families throughout our country."
"I look forward to working with Vice President Biden to help him win this campaign," the Vermont senator added, "and to move this country forward toward economic, racial, social, and environmental justice."
Biden, for his part, applauded the task forces "for helping build a bold, transformative platform for our party and for our country."
"I am deeply grateful to Bernie Sanders for working with us to unite our party and deliver real, lasting change for generations to come," said the former vice president.
On the life-or-death matter of reforming America's dysfunctional private health insurance system—a subject on which Sanders and Biden clashed repeatedly throughout the Democratic primary process—the Unity Task Force affirmed healthcare as "a right" but did not embrace Medicare for All, the signature policy plank of the Vermont senator's presidential bid.
Instead, the panel recommended building on the Affordable Care Act by establishing a public option, investing in community health centers, and lowering prescription drug costs by allowing the federal government to negotiate prices. The task force also endorsed making all Covid-19 testing, treatments, and potential vaccines free and expanding Medicaid for the duration of the pandemic.
"It has always been a crisis that tens of millions of Americans have no or inadequate health insurance—but in a pandemic, it's potentially catastrophic for public health," the task force wrote.
Dr. Abdul El-Sayed, a former Michigan gubernatorial candidate and Sanders-appointed member of the Healthcare Task Force, said that despite major disagreements, the panel "came to recommendations that will yield one of the most progressive Democratic campaign platforms in history—though we have further yet to go."
We rein in #pharma's greed by: 1) Allowing Medicare to FINALLY negotiate Rx drugs FOR ALL AMERICANS 2) Using Rx d… https://t.co/6k9iUCLMp7— Abdul El-Sayed (@Abdul El-Sayed)1594238411.0
Observers and advocacy groups also applauded the Unity Task Forces for recommending the creation of a postal banking system, endorsing a ban on for-profit charter schools, ending the use of private prisons, and imposing a 100-day moratorium on deportations "while conducting a full-scale study on current practices to develop recommendations for transforming enforcement policies and practices at ICE and CBP."
Marisa Franco, director of immigrant rights group Mijente, said in a statement that "going into these task force negotiations, we knew we were going to have to push Biden past his comfort zone, both to reconcile with past offenses and to carve a new path forward."
"That is exactly what we did, unapologetically," said Franco, a member of the Immigration Task Force. "For years, Mijente, along with the broader immigrant rights movement, has fought to reshape the narrative around immigration towards racial justice and to focus these very demands. We expect Biden and the Democratic Party to implement them in their entirety."
"There is no going back," Franco added. "Not an inch, not a step. We must only move forward from here."
Reposted with permission from Common Dreams.
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