EPA Delays Lead and Copper Rule Again, Promises ‘War on Lead’
By Brett Walton
The head of the U.S. Environmental Protection Agency (EPA) pledged that lead regulations will be a prominent feature of the agency's work in 2018—but that work will take longer than anticipated.
The agency expects that a revision to federal rules that are designed to reduce the risk of lead in drinking water will be published in draft form in August 2018, a seven-month delay from a timetable announced this summer.
The delay in rulemaking was announced in the federal regulatory agenda, a document that is updated twice a year and provides a schedule for all agency rulemaking. Other water-related actions were included in the agenda. The EPA's highest-profile example is redefining which water bodies are protected by the Clean Water Act. The agency expects a draft rule to be published in May 2018.
The lead rule was one of 1,579 rules that were cancelled or delayed in the first 11 months of the Trump administration, a presidential goal that Trump reiterated during a photo op Thursday in the Roosevelt Room of the White House.
"We're here today for one single reason: to cut the red tape of regulation," Trump said. He stood next to two piles of printed paper: a smaller one representing federal regulations in 1960 and the other much larger stack encompassing current federal statutes.
The lead and copper rule delay appears to be a result of administrative preference. The agency will meet on Jan. 8, 2018 with more than a dozen national trade groups to discuss the rule. Those groups include water industry mainstays such as the American Water Works Association and the Association of State Drinking Water Agencies, as well as local government groups like the U.S. Conference of Mayors and the National Conference of State Legislatures. The association that represents school officials is invited, too.
The extended timeline is also a matter of personnel. The agency has been short-staffed in the first year of the Trump administration. It was only yesterday, Dec. 14, that the Senate confirmed the assistant administrator in charge of the Office of Water—David Ross, a Wisconsin lawyer.
For that reason and because of the complexity of the rule, the delay did not surprise Alan Roberson, head of the Association of State Drinking Water Administrators. Even during a conversation in August he anticipated that the agency would have trouble meeting the January 2018 deadline because of the change in administration.
The EPA press office offered no explanation for the delay.
Action in 2018
In an interview last month with the Washington Post, Pruitt called lead in drinking water "one of our greatest challenges in this country." He said that he would approach Congress next year to "announce a very strong initiative on a war on lead."
Pruitt discussed the concept during a House Energy and Commerce Committee hearing on Dec. 7. But he provided little additional detail, only promising a "multi-faceted approach" that has the attention of 17 agencies.
"It's one of the greatest environmental threats we face as a country, and one of the things I hope I can work with this committee on in 2018 is a strategy over a 10 year period to eradicate those concerns," Pruitt said. "It's going to be a very ambitious initiative of our agency and it's something we have various offices in the agency working upon."
The most ambitious goal would be to require replacement of the roughly six million to 10 million lead service lines in the country. It's a course of action that health advocates champion. But that is complicated by legal questions about whether the utility or the homeowner is responsible. The cost of such a program, which could reach tens of billions of dollars nationally, is another matter.
When the rule is finalized, it will have made a long journey.
The EPA published the original lead and copper rule in 1991, then made minor revisions in 2007 to the requirements for sampling, public notification and the process for utilities to change water sources.
For more than a decade the EPA has been working on "long-term" revisions—those that the agency asserts will require more detailed analysis and consultation. In the spring 2011 regulatory agenda, the EPA anticipated that the draft rule would be published in May 2012, a deadline that is now five and a half years in the rearview mirror.
If it goes as planned, the draft rule will be published more than three years after the mayor of Flint declared a public health emergency in the city that brought the problem of lead in drinking water to the surface again.
EcoWatch Daily Newsletter
On Monday and Tuesday of the week that President Donald Trump held his first rally since March in Tulsa, Oklahoma, the county reported 76 and 96 new coronavirus cases respectively, according to POLITICO. This week, the county broke its new case record Monday with 261 cases and reported a further 206 cases on Tuesday. Now, Tulsa's top public health official thinks the rally and counterprotest "likely contributed" to the surge.
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As we look for advanced technology to replace our dependence on fossil fuels and to rid the oceans of plastic, one solution to the climate crisis might simply be found in rocks. New research found that dispersing rock dust over farmland could suck billions of tons of carbon dioxide from the air every year, according to the first detailed large scale analysis of the technique, as The Guardian reported.
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By Tim Radford
German scientists now know why so many fish are so vulnerable to ever-warming oceans. Global heating imposes a harsh cost at the most critical time of all: the moment of spawning.
Nearing the Brink<p>Since <a href="https://climatenewsnetwork.net/abundant-fish-need-cool-seas-and-protection/" target="_blank">fish in the temperate zones already experience a wide variation</a> in seasonal water temperatures, it hasn't been obvious why species such as <a href="https://climatenewsnetwork.net/sardines-swim-into-northern-waters-to-keep-cool/" target="_blank">cod have shifted nearer the Arctic, and sardines have migrated to the North Sea</a>.</p><p>But <a href="https://climatenewsnetwork.net/ocean-warming-spurs-marine-life-to-rapid-migration/" target="_blank">marine creatures are on the move</a>, and although there are other factors at work, including overfishing and <a href="https://climatenewsnetwork.net/fish-cant-smell-well-in-more-acidic-seas/" target="_blank">the increasingly alarming changes in ocean chemistry</a>, thanks to ever-higher levels of dissolved carbon dioxide, temperature change is part of the problem.</p><p>The latest answer, Dr Dahlke and his colleagues report in the journal <a href="https://science.sciencemag.org/cgi/doi/10.1126/science.aaz3658" target="_blank">Science</a>, is that many fish may already be living near the limits of their thermal tolerance.</p><p>The temperature safety margins during the moments of spawning and embryo might be very precise, and over hundreds of thousands of years of evolution, marine and freshwater species have worked out just what is best for the next generation. Rapid global warming upsets this equilibrium.</p>
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.
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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