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Global Warming Will Mean Mental Shock and Adversity for Nearly 200 Million Americans

Climate

National Wildlife Federation

By Kevin Coyle

In the past few weeks, an unprecedented wave of seasonally early tornadoes spread devastation across a dozen U.S. states. Media coverage and interviews around this leveling of towns, businesses and homes focused mostly on the immense physical damage and a few of the most dramatic human survival stories. Media interviewers asked affected people in each place to describe “what was it like” to witness the raging wind and face such a monstrous force of nature. These people spoke of the unbelievable noise, the tearing apart of structures, the loss of property, pets and neighbors and how grateful they were to have made it through. And, they often tried to end on a high note by saying they “planned to rebuild.”

But even as these interviews were occurring, you could see tears on their faces. They began the interviews with seeming calm. As they went on, however, their voices began to shake and they welled-up. Soon they could hardly finish their sentences and could only shake their heads, speechless. This happened over and over as media interviewers traveled about in the aftermath of the twisters. These victims and thousands of people throughout these stricken areas have become text book examples of people in the early throes of post traumatic stress disorder (PTSD). And yet, the stunning shock they felt and the piercing pain of their loss and uprooting will largely be glossed over as efforts quickly shift to rebuilding their communities. The problem is, without proper treatment, the PTSD and other related mental problems will only get worse. Violent weather is becoming a known by-product of climate change, and even if climate change is not to blame for this year’s early onset tornado season, it demonstrates what a few degree temperature increase will produce in the years ahead.

A new National Wildlife Federation report says that the damage inflicted by “global weirding” and related violent weather does not stop with loss of property and businesses. The report finds that, in coming decades, 200 million Americans will be figuratively and literally smacked in the face with climate change’s many violent manifestations just like the people we recently witnessed breaking down on National television.

Climate scientists now say that warming trends will trigger significant increases in violent weather, more intense and longer heat waves, larger and more frequent floods, massive wildfires, agonizing crop failures, worrisome water shortages, pest infestations, military conflicts and more. These will cause mass psychological misery on scale never before seen. By examining this often overlooked subject, coauthor Lise Van Susteren, MD and I hoped to reveal the human dimension of global warming and how it will have millions of people coping with fear, trauma and loss. Examples include:

Summer heat waves: the physical distress arising from prolonged heat waves is well known.  A 2003 wave heat spell killed 70,000 people in Europe. But psychological distress and aggression also triggered by rising temperatures.  

Coastal and river flooding: these weather and climate related events are especially likely to force people from their homes as we saw when 1 million people were evacuated along the Atlantic coast during 2011’s Hurricane Irene.  There is huge psychic injury from such displacement which could, with rising seas, someday become permanent in low lying areas.

Higher-impact storms: The Hurricane Katrina in 2005 shattered a culture, broke up families, sparked outbursts of outrage and blame at a government that was slow to respond, and lead to a jump in violence in at least one city that took them in (Houston). Six years later a third of the victims have experienced post-incident stress and/or post-traumatic stress disorder.

Severe drought: the unrelenting day by day despair of watching and waiting for water that doesn’t come will have a singularly damaging impact on the psyche of the people who have depended on Mother Nature’s rainfall for their livelihood. Texas has recently experienced a drought (with accompanying wildfires) the likes of which has not been seen in more than 50 years.

Increased large-scale wildfires: raging wildfires are dangerous and have a particularly savage effect on our psyches by devastating landscapes, wiping out homes and possessions, incinerating wildlife and clogging the air with pollutants that sicken people locally and can travel hundreds of miles to sicken people at a distance. Persistent psychological stress is common, with anxiety reactions recurring from unavoidable re-exposure to the odors, smoke and ash.

New disease threats: higher temperatures favor the formation of ozone which triggers asthma attacks. Anyone who has asthma and parents of children with asthma are familiar with the fears this illness engenders. People die from untreated asthma. Many other fears linked to disease are harder to “nail down.” As malaria and dengue fever and other infectious diseases march northward due to warmer temperatures, inchoate fears of threat and vulnerability drift into people’s consciousness.

The report, funded by the Robert Wood John Foundation, aims to fill a gap in public understanding of the profound mental health implications of the climate threat. It summarizes an extensive body of research showing how people will react to global warming’s many impacts including—widespread experiences of stress, anxiety and depression and even full blown psychotic episodes.

Tragically, certain segments of American society, such as children, the elderly, low income Americans, and those with preexisting mental health conditions will be particularly hard hit. And, people living in disaster-prone areas such as along coasts and rivers, in heat-prone urban centers, or places where the economy depends on predictable climate conditions will likewise experience great hardship. Existing mental health services will be stretched far beyond their current capacity. It calls upon mental health professionals to use their unique skills to help people work through a range of potentially severe psychological responses to global warming’s many approaching human horrors.

Download the full report by clicking here.

For more information, click here.

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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.

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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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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.