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Is Climate Fiction a Subset of Science Fiction—or Something Else Entirely?

Adventure
A tropical storm above Bangkok on Aug. 04, 2016. Hristo Rusev/ NurPhoto / Getty Images

By Jeff Turrentine

First off: Bangkok Wakes to Rain, the intricately wrought, elegantly crafted debut novel by the Thai-American author Pitchaya Sudbanthad, isn't really about climate change. This tale set in the sprawling subtropical Thai capital is ultimately a kind of family saga — although its interconnected characters aren't necessarily linked by a bloodline. What binds them is their relationship to a small parcel of urban land on which has variously stood a Christian mission, an upper-class family house, and a towering condominium. All of the characters have either called this place home or had some other significant connection to it.


But by the end of the story, which jumps through time from the 1800s to the discomfitingly near future, climate change has appeared as a character unto itself — a chaotic agent that transforms the city and its inhabitants' lives entirely. In this flooded megalopolis, renamed New Krungthep, whole neighborhoods are underwater. Streets have become rushing rivers with currents that, "sped by wash-offs from the mountains, gain enough strength to carry fallen houses far out into the gulf, where the wreckage will join other debris tumbling toward the seafloor." Humans share their new aquatic environment with venomous snakes and crocodiles. To the extent that tourists still visit, they do so mainly to experience the "snorkel-through ruins." And they know not to come during monsoon season, when mosquito swarms are so thick that they appear as "black clouds low in the mangroves."

In Sudbanthad's sodden dystopia, technology has advanced far enough to allow human beings to upload their consciousness to giant virtual-reality mainframes. This gives them the chance to live alternate lives beyond their poisoned physical environs, and even to revisit digitally simulated versions of their most beloved places before climate change altered them forever. But advanced technology couldn't save the city's real-life buildings and infrastructure — not once their "concrete foundations and support pillars began to fracture, the ground beneath them more like sponge than stone." Grace and irony combine in one poetic description of a super-saturated Bangkok skyline marked by "the unnerving tilt of distant towers, perceptibly angled toward and away from each other like wild shoots of bamboo."

Many readers who pick up a copy of Sudbanthad's new book may already know that the city of Bangkok is highly vulnerable to climate change. Its 10 million people live on ground that sits only five feet above sea level — and has been sinking by more than a centimeter every year. The World Bank estimates that up to 40 percent of Bangkok could be inundated in little more than 10 years.

In 2011, the worst flooding to hit Thailand in half a century ravaged the densely packed provinces north of the city, killing hundreds and disrupting the lives of millions. Sudbanthad was there. And then a year later he was back in his other home, New York City, which was about to face an unprecedented weather catastrophe of its own. "I helped my parents put up sandbags in preparation for the worst during the 2011 floods," he recently told me. "Then, in 2012, I volunteered at a Brooklyn evacuee shelter in the aftermath of Hurricane Sandy."

The back-to-back experiences had a formative influence on the writer's imagination. "But as someone who was born in flood-prone Bangkok, I may have had a head start, imaginatively," Sudbanthad said. "I can also remember walking across planks on my grandparents' flooded lawn as a child. What I witnessed firsthand definitely helped me shape certain scenes in my novel."

Some of those scenes are horrifying. Others are heartbreaking. When a doctor who's just been transported via motorboat to treat a cholera victim asks her scruffy teenaged crew to take a detour on the way back so she can see her childhood home, they balk. She ultimately relents. "She doesn't know it," one of the crew members narrates, "but we're doing her a favor ... The returnees come back here believing they'll see their old homes, not so different from what they had been ... They imagine stepping back to find the marble still shiny, old lightbulbs flickering on for their arrival. Then they find out it's only the bits in their heads that have endured, and everyone's sad."

Sudbanthad didn't set out to write about climate change. "But when I expanded my narrative into the future," he said, "my imagination of Bangkok decades from now required that I see a far different place than the one I know." The city of his birth, he added, "is measurably sinking. Its depressive topography is exacerbated by subsidence from groundwater use and new buildings that are weighing down the land. Coupled with the fact of rising seas, Bangkok, like so many cities, is under threat."

In the ongoing struggle to convert apathy into activism, said the author, the efforts of creative folk — composers, poets, visual artists and fiction writers — will continue to play an essential role. "Artists and writers can help translate the very real science of climate change into something that's even more real, by making it more viscerally tangible," he said. "It's good imagination that's working against a more sinister imagination: the one that denies or hides scientific truth, all in order to keep gamified abstractions of profit afloat."

As New Yorker writer Katy Waldman has observed, we seem to be witnessing the burgeoning of a new "cli-fi" movement in literature, one that freely employs the liberating devices of fantasy to let us "gaze at our irresponsibility and greed through fiction's tonic filter." But Sudbanthad wonders if the phenomenon will be relatively short-lived — not because it isn't worthy, or because it doesn't deserve its own spot on the genre shelf. Rather, Sudbanthad said, "at some point what we think of as fantastical 'cli-fi' might simply become realist fiction."

Reposted with permission from our media associate onEarth.

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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. Niq Steele / Getty Images

By Sherry H-Y. Chou, Aarti Sarwal and Neha S. Dangayach

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.

Without the myelin sheath, signals that go through a nerve are slowed or lost, which causes the nerve to malfunction.

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.

The majority of Guillain-Barre Syndrome patients improve within a few weeks and eventually can make a full recovery. However, some patients with Guillain-Barre Syndrome have lingering symptoms including weakness and abnormal sensations in arms and/or legs; rarely patients may be bedridden or disabled long-term.

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.

The first reports of Guillain-Barre Syndrome in COVID-19 pandemic originated from Italy, Spain and China, where the pandemic surged before the U.S. crisis.

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.


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Democratic presidential hopefuls Joe Biden and Senator Bernie Sanders greet each other with a safe elbow bump before the start of the Democratic Party 2020 presidential debate in a CNN Washington Bureau studio in Washington, DC on March 15, 2020. Mandel Ngan / AFP / Getty Images

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."

 

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."

 

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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