Play-by-Play: Trump's First 100 Days
Since taking office, President Trump and the Republican-controlled Congress have unleashed the worst-ever assault on our right to breathe clean air, drink safe water and enjoy healthy lands, moving to undo the historic progress of recent years to address climate change.
Rolling back a half century of bipartisan advances in protecting our health and our environment is not a plan that puts America first. It's a brazen payoff that puts polluters first and the rest of us at risk.
As we approach the 100-day mark, here are the highlights or lowlights, of what Trump and the GOP Congress have accomplished so far―and what they have not.
Spoiler alert: Much of Trump's orders cannot be pushed through simply by fiat; there's often an extensive administrative process, public engagement period and rulemaking required, all of which takes months, even years, to complete. Much can also be slowed, stopped and reversed, as illustrated through some key legal challenges that the Natural Resources Defense Council (NRDC) and our allies have already taken to thwart this dangerous agenda.
April 19: EPA asks court to stop work on a power plant pollution case.
The U.S. Environmental Protection Agency (EPA) is preparing to ask a federal court to delay an oral argument challenging federal standards limiting mercury, lead and other toxic air pollution, although the power sector has largely complied with the rule advanced in 2012. John Walke, director of NRDC's Clean Air Project, said, "This disgraceful move is the first step toward weakening or reversing health standards limiting toxic air pollution from the nation's power plants."
April 13: EPA Administrator Scott Pruitt calls for exiting international climate agreement.
Pruitt incorrectly calls the landmark Paris accord, which the U.S. helped broker, a "bad deal" and falsely asserts that China and India won't do anything to curb climate change until 2030. In fact, both countries are acting now to curb dangerous carbon pollution and dramatically expand renewable power from the wind and sun. Trump and Pruitt would damage the air Americans breathe, the water we drink and the planet we inhabit, just to let polluters get away scot-free, said Han Chen, NRDC's international climate advocate, who analyzed China's and India's climate commitments.
April 7: Pruitt moves to kill smog protections.
As Oklahoma attorney general, Pruitt sided with polluters challenging federal limits on ozone pollution. Now, at the EPA, Pruitt has backed away from defending the standards for ground-level ozone—a byproduct of fossil fuel pollution that produces smog and is linked to respiratory and heart ailments. The EPA asked a federal court to delay oral arguments in the lawsuit, saying it needs time to "fully review" the rule. "President Trump is aiding baseless litigation mounted by Scott Pruitt before he was put in charge of EPA over the consensus of doctors and scientists," NRDC's Walke said.
March 30: EPA skirts banning dangerous pesticide.
Pruitt gave a green light to chlorpyrifos, a pesticide sprayed on crops including apples, almonds, broccoli, strawberries and citrus fruits, giving new meaning to the notion of the poisoned apple in the Garden of Eden. The pesticide is linked to learning disabilities in children. Pruitt rejected his agency's own analysis in declining to ban chlorpyrifos.
March 28: Trump signs Climate Destruction Order.
The far-reaching order:
• Calls for "review" of the Clean Power Plan, the landmark Obama administration clean air standards. These would clean up existing dirty plants, reduce climate change, save thousands of lives and prevent hundreds of thousands of respiratory ailments and asthma attacks. But presidents don't get to reverse federal rules by fiat; they have to go through a public process and demonstrate that their actions are consistent with law and science. Trump has a long, hard road ahead of him in his effort to reverse the Clean Power Plan and NRDC and its allies will fight for it every step of the way. More here.
• Calls for "review" of new plant carbon pollution standards. In contrast to the Clean Power Plan, the rules for new power plants have not been stayed by the courts. So for this rule, EPA Administrator Pruitt cannot give his industry allies relief except by going through the rulemaking process. That's why Pruitt has asked the federal courts to stop work on a case addressing this rule, an inappropriate stalling tactic aimed at scrapping the rule by stealth, said NRDC's David Doniger, head of the Climate & Clean Air program.
• Eliminates estimating costs of climate change. The order withdraws documents that lay out the social cost of carbon estimate and disbands the interagency working group that calculated it. Why? Because it reveals something polluters don't want widely known—carbon pollution imposes real costs on Americans' health and the economy.
• Ends a moratorium on new coal mining on public lands. This derails the effort to promote development of clean energy and to overhaul a broken federal leasing program that's shortchanged taxpayers to the tune of more than $30 billion, according to Theo Spencer, a senior advocate at NRDC.
• Repeals protections against methane pollution. If Trump succeeds, the oil and gas industry will continue leaking hundreds of millions of dollars' worth of this potent climate change pollutant into the air every year, harming public health and our climate.
• Ends a methane pollution reporting requirement. This measure affects pollution from oil and gas wells on national wildlife refuges. Nixing the reporting requirement favors the fossil fuel industry, allowing toxic pollution that threatens human and wildlife health to continue, noted NRDC's Bobby McEnaney, senior deputy director of the Western Renewable Energy Project.
• Embraces fracking. It begins the process to repeal standards for hydraulic fracturing or fracking, on public lands and methane limits for new oil and gas fracking anywhere. This endangers public lands and neighboring communities, worsens climate change and shows "where Trump's loyalties lie—with polluters, not the people," said NRDC President Rhea Suh.
• Eliminates climate guidance. The White House Council on Environmental Quality had issued guidance to federal agencies on how they could analyze the climate impacts of their proposed actions before deciding on how to proceed. Trump wants to revoke guidance from this council. More here.
• Promises to bring back coal jobs. Trump signed the order surrounded by coal miners. But coal has been declining for years as natural gas has steadily replaced coal-fired power, renewable energy has boomed and machines have displaced miners, with jobs plunging from about 170,000 in 1985 to 50,000 today. Miners need help making the transition away from coal, not empty promises.
March 28: The administration stops work on Clean Power Plan.
Trump urged a federal court to stop work on the Clean Power Plan case. His intent is eminently clear: to keep the judiciary from ruling on the legality of the Clean Power Plan. A 10-judge panel heard the case six months ago and the argument didn't go well for critics, so Trump wants to head off a ruling, which could affirm that the climate plan is legal. NRDC's Doniger calls it a stealth plan to kill the Clean Power Plan.
March 24: Keystone XL resurrected from the dead.
Trump signed a cross-border permit approving construction of the Keystone XL tar sands pipeline, which would imperil water, lands and the climate. Six days later, NRDC joined Friends of the Earth, Bold Alliance, Center for Biological Diversity, Northern Plains Resource Council and the Sierra Club in suing the administration for illegally granting the permit.
March 22: Republicans tout smog.
On Capitol Hill, congressional Republicans held a hearing to shine a spotlight on their bill to weaken health protections against ozone pollution. Critics call the measure the "Smoggy Skies Act." The GOP legislation would block ozone standards that the EPA updated under former president Obama; it would also delay updates on other pollutants, such as lead and carbon monoxide. Improving ozone standards, according to the EPA, can help avoid up to 660 premature deaths, 230,000 childhood asthma attacks and 160,000 days when kids miss school.
March 16: Trump to EPA experts: "You're fired."
Trump's proposed budget for 2018 calls for a 31 percent cut in EPA funding, the largest percentage cut of any agency. The stakes for public health are enormous. The budget would eliminate as many as 3,200 of the agency's 15,000 employees. Programs to be slashed include those for criminal enforcement, Energy Star certification, Superfund sites, air-quality monitoring, climate protection and cleanup of America's most iconic bodies of water, including the Great Lakes, Puget Sound and Chesapeake Bay. But Congress determines federal spending and already there's resistance, including from some Republicans, suggesting that Trump's budget for EPA is D.O.A.
March 16: Trump overlooks national parks.
Trump envisions a 12 percent cut to the U.S. Department of the Interior, which even its secretary, Ryan Zinke, thinks is too much. Sharon Buccino, head of NRDC's Land & Wildlife program, pointed out that our national parks are huge generators for the economy, with more than 300 million visitors last year, yet have a $12 billion backlog in maintenance. And instead of investing in conservation, funding cuts pave the way for dirty energy development.
March 15: Trump retracts decision to keep strong clean car standards.
The president moved to weaken carbon pollution standards for light-duty vehicles for model years 2022–2025. Mileage standards save consumers money at the gas pump, make Americans less dependent on oil, reduce carbon pollution and advance innovation. If the rollback succeeds, thousands of manufacturing jobs could be lost in Michigan alone, where nearly 70,000 workers are building clean vehicle components. The current standards helped auto companies move from bankruptcy to profitability and there is no reason they cannot be met, said NRDC President Suh.
March 14: Trump's EPA "reconsiders" chemical plant safety rule.
EPA granted a request by chemical manufacturers to sideline implementation of a rule developed over three years to improve emergency coordination and remove hazards. The rule came in response to a 2013 fertilizer plant explosion in Texas that killed 15 workers. That wasn't the only tragedy. There were 1,500 similar incidents from 2004 to 2013 that killed 58 people and injured 17,000.
March 2: EPA Administrator Pruitt caves in to polluters on methane pollution.
Pruitt signed a directive canceling a November 2016 information-gathering request that oil and gas operations report their emissions of methane, a potent climate pollutant. NRDC's Meleah Geertsma, an attorney in NRDC's Midwest program, called out Pruitt for dancing with the "fossil energy AGs," referring to Pruitt's now-infamous Oklahoma e-mails obtained by a court order.
Feb. 28: Trump supports water pollution.
The president signed an executive order directing the EPA and the Army Corps of Engineers to begin repealing the Clean Water Rule, a landmark measure many years in the making. Likewise, EPA Administrator Pruitt recently told Fox News that he plans to go "full speed ahead" to attack the rule. Their happy obedience to Trump insults all Americans―especially the 117 million of us who get drinking water drawn from streams that the rule would help protect from pollution, said NRDC water expert Jon Devine.
Feb. 24: Trump adds roadblocks to new standards.
He signed an anti-regulatory executive order directing each federal administrative agency and department to designate a "regulatory reform officer" and to establish a "regulatory reform task force," implementing the administration's plan to attack the process by which safety, health and environmental standards are set.
Feb. 17: Trump and Republicans make bribes easier.
They killed an SEC requirement that oil, gas and coal firms report gifts to foreign governments for developing natural resources on their lands.
Jan. 30: Trump signs measure getting rid of rules without justification.
He signed a two-for-one executive order, opposed by more than 130 groups representing small business, labor, good government, financial protection, community, health, environmental, civil rights and public interest advocates. "If implemented," they wrote in a letter to Trump, "its flawed reasoning and vague drafting would leave Americans more vulnerable to financial, safety, health and environmental hazards."
Jan. 24: Trump signs order requiring pipelines be made of U.S. steel.
Notably, just days before, Trump had repeated a false statement that the pipeline would be built with U.S. steel, notes Josh Axelrod, a policy analyst in NRDC's Canada Project. And soon after, the White House said the Keystone XL tar sands pipeline, for which the steel had already been purchased―including from non-U.S. sources―would be exempt.
He abruptly reversed a determination by former president Obama that those projects are not in the national interest and reignited the debate over pipelines carrying dirty fuel that threaten land, water and the climate. His order calls for the Army Corps of Engineers to "review and approve in an expedited manner" the projects, over vehement objections by landowners and indigenous people in their path. "It's appalling that Trump wants to throw open our borders and fragile lands to big polluters," said NRDC President Suh, who vowed to use every tool available to "help ensure that they are not built."
Jan. 24: Trump signs executive order short-circuiting public engagement.
This order, aimed at green-lighting big projects, cuts the national interest determination period for projects like the Keystone XL pipeline to just 60 days. This stifles public engagement and makes it all but impossible for the government to adequately study the merits and drawbacks of major infrastructure projects.
Congressional GOP Assaults
Since early January, the GOP-led Congress has voted 42 times against the environment, according to an analysis by the Center for American Progress. Key votes include:
Feb. 3: House backs increased methane pollution.
The House voted on a Congressional Review Act measure to do away with a Bureau of Land Management rule limiting the venting, flaring and leaking of methane from oil and gas operations on public lands. The rule aimed to reduce harmful methane emissions, prevent the waste of taxpayer dollars and curb a potent climate-change polluter. Congressional leaders "doing the bidding of oil and gas industry lobbyists are hell-bent to block these safeguards," NRDC's Doniger wrote in an analysis of the measure.
Feb. 1: Streams put at risk from coal waste.
At the behest of polluters, Congress used the Congressional Review Act to overturn the Obama-era Stream Protection Rule, safeguarding waterways from toxic coal mining waste. Appalachian Voices, an environmental group, estimates that coal companies have buried more than 2,000 miles of streams in the region by mountaintop-removal mining.
Jan. 11: House okays broad assault on federal regulations.
In approving the Regulatory Accountability Act, the House allowed well-financed special interests to interminably delay needed health and safety protections and undermined laws requiring that health standards be based on science, not cost. Thirteen national groups including NRDC voiced opposition in a letter to House members, saying the legislation would, if passed, "leave Americans unprotected, giving industry an opportunity to pollute, damage health and engage in financial disruption." The bill is pending before the Senate.
Jan. 5: House limits new standards.
It approved, the Regulations from the Executive in Need of Scrutiny (REINS) bill would make it harder for the executive branch to issue new health standards, such as air quality protections. "The public expects the government to be able to protect it from toxins in food, consumer products, air and water. The REINS Act would make that virtually impossible," a coalition of groups wrote in a letter to senators in March. The bill is pending before the Senate.
Jan. 4: House sweeps away public health safeguards.
By passing the so-called Midnight Rules Relief Act, Congress is moving to be able to eviscerate public health, environmental, safety, consumer and financial safeguards with little consideration, NRDC and allies wrote in a letter sent in March to senators. The bill is pending before the Senate.
Going to Court Against Trump's Anti-Environmental Agenda
NRDC and allies have fought back to try to stop the rollbacks, repeals and eliminations of safeguards sought by team Trump and their Capitol Hill allies. Highlights include:
April 5: Defending the Clean Power Plan.
NRDC, joined by Earthjustice, Environmental Defense Fund, Sierra Club and the Center for Biological Diversity, filed a response opposing Trump's request that the U.S. Court of Appeals in Washington stop work on the Clean Power Plan case before the court. NRDC's Doniger likened Trump's move to trying to kill the landmark plan by stealth; he called on the court to finish its work and issue its ruling.
April 5: Protecting children.
NRDC and Pesticide Action Network filed a motion to enforce a previous court order and require the EPA to make a decision on a proposed ban on chlorpyrifos, a pesticide linked to learning disabilities in children. Earlier, on Jan. 17, more than 45 doctors, scientists, nurses and public health professionals sent a letter urging the EPA to cancel remaining agricultural uses of the dangerous neurotoxic pesticide. An EPA assessment in 2016 found that chlorpyrifos residues in foods can be 140 times higher than EPA's acceptable exposure limit.
April 3: Pushing for delayed energy efficiency standards.
Legal challenges were filed charging the Department of Energy with dragging its feet on six energy efficiency standards that could save Americans as much as $23 billion. Kit Kennedy, head of NRDC's Energy & Transportation program, labeled the delay illegal and warned it was hurting families and businesses.
March 30: Stopping Keystone XL pipeline—again.
NRDC joined Friends of the Earth, Bold Alliance, Center for Biological Diversity, Northern Plains Resource Council and the Sierra Club in suing the administration for illegally granting a construction permit for the tar sands pipeline. If ever built, Keystone XL could carry up to 830,000 barrels of tar sands oil through the U.S., imperiling our water, land and climate.
March 21: Challenging EPA's botched weed-killer review.
Another dangerous chemical hit the spotlight when NRDC filed a petition for review in federal court of the EPA's illegal approval of Enlist Duo, a weed killer that poses a risk to human health and monarch butterflies.
March 15: Protecting clean water.
NRDC and the National Wildlife Federation opposed the Trump administration's effort to delay litigation over the Clean Water Rule and thus delay the rule's implementation indefinitely while the White House moves to kill it. "Rolling back the rule's safeguards endangers critical bodies of water―including the streams that feed the drinking water supplies of more than 117 million Americans," said NRDC's Devine.
Feb. 8: Fighting senseless rollbacks of safeguards.
NRDC filed suit seeking to block Trump's two-for-one order. NRDC President Suh likened the executive order to a doctor declaring that we can't find a cure for cancer unless we abandon vaccines for polio and smallpox. "New efforts to stop pollution don't automatically make old ones unnecessary. When you make policy by tweet, it yields irrational rules. This order imposes a false choice between clean air, clean water, safe food and other environmental safeguards," she said.
Feb. 1: Opposing EPA's rollback of mercury safeguards.
NRDC sued the agency for illegally rescinding, on Jan. 20, safeguards that would protect the public from tons of mercury discharges each year. Mercury, which can disrupt brain function and nervous system development, is especially harmful to pregnant women, babies and young children. "EPA's withdrawal of the mercury rule is not just illegal, but senseless. The rule imposes minimal burden, drew widespread praise from dental providers and benefits public health and the environment," said Aaron Colangelo, litigation director at NRDC.
NRDC President Suh recently penned a blog post, "100 Days of Harm." In it she addressed the first days of Trump's presidency and the Republican-led congressional assault on health and environment, discussed how out of step with public opinion they are and ended with a call to arms:
"A hundred days into Trump's presidency, we've already seen more than enough. It's time to gather as one and speak out against his senseless campaign to turn back the clock on 50 years of environmental gains and stanch the promise of more progress to come ... Let's put Donald Trump on notice. Let's show him what we believe. We won't back down from this challenge. We won't back down from this fight. We'll defend our health and environment. We'll hold fast to the values we share. We'll stand up for our children's future and their right to a livable world."
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By Ana Maldonado-Contreras
- Your gut is home to trillions of bacteria that are vital for keeping you healthy.
- Some of these microbes help to regulate the immune system.
- New research, which has not yet been peer-reviewed, shows the presence of certain bacteria in the gut may reveal which people are more vulnerable to a more severe case of COVID-19.
You may not know it, but you have an army of microbes living inside of you that are essential for fighting off threats, including the virus that causes COVID-19.
How Do Resident Bacteria Keep You Healthy?<p>Our immune defense is part of a complex biological response against harmful pathogens, such as viruses or bacteria. However, because our bodies are inhabited by trillions of mostly beneficial bacteria, virus and fungi, activation of our immune response is tightly regulated to distinguish between harmful and helpful microbes.</p><p>Our bacteria are spectacular companions diligently helping prime our immune system defenses to combat infections. A seminal study found that mice treated with antibiotics that eliminate bacteria in the gut exhibited an impaired immune response. These animals had low counts of virus-fighting white blood cells, weak antibody responses and poor production of a protein that is vital for <a href="https://doi.org/10.1073/pnas.1019378108" target="_blank">combating viral infection and modulating the immune response</a>.</p><p><a href="https://doi.org/10.1371/journal.pone.0184976" target="_blank" rel="noopener noreferrer">In another study</a>, mice were fed <em>Lactobacillus</em> bacteria, commonly used as probiotic in fermented food. These microbes reduced the severity of influenza infection. The <em>Lactobacillus</em>-treated mice did not lose weight and had only mild lung damage compared with untreated mice. Similarly, others have found that treatment of mice with <em>Lactobacillus</em> protects against different <a href="https://doi.org/10.1038/srep04638" target="_blank" rel="noopener noreferrer">subtypes of</a> <a href="https://doi.org/10.1038/s41598-017-17487-8" target="_blank" rel="noopener noreferrer">influenza</a> <a href="https://doi.org/10.1371/journal.ppat.1008072" target="_blank" rel="noopener noreferrer">virus</a> and human respiratory syncytial virus – the <a href="https://doi.org/10.1038/s41598-019-39602-7" target="_blank" rel="noopener noreferrer">major cause of viral bronchiolitis and pneumonia in children</a>.</p>
Chronic Disease and Microbes<p>Patients with chronic illnesses including Type 2 diabetes, obesity and cardiovascular disease exhibit a hyperactive immune system that fails to recognize a harmless stimulus and is linked to an altered gut microbiome.</p><p>In these chronic diseases, the gut microbiome lacks bacteria that activate <a href="https://doi.org/10.1126/science.1198469" target="_blank" rel="noopener noreferrer">immune cells</a> that block the response against harmless bacteria in our guts. Such alteration of the gut microbiome is also observed in <a href="https://doi.org/10.1073/pnas.1002601107" target="_blank" rel="noopener noreferrer">babies delivered by cesarean section</a>, individuals consuming a poor <a href="https://doi.org/10.1038/nature12820" target="_blank" rel="noopener noreferrer">diet</a> and the <a href="https://doi.org/10.1038/nature11053" target="_blank" rel="noopener noreferrer">elderly</a>.</p><p>In the U.S., 117 million individuals – about half the adult population – <a href="https://health.gov/our-work/food-nutrition/2015-2020-dietary-guidelines/guidelines/" target="_blank" rel="noopener noreferrer">suffer from Type 2 diabetes, obesity, cardiovascular disease or a combination of them</a>. That suggests that half of American adults carry a faulty microbiome army.</p><p>Research in my laboratory focuses on identifying gut bacteria that are critical for creating a balanced immune system, which fights life-threatening bacterial and viral infections, while tolerating the beneficial bacteria in and on us.</p><p>Given that diet affects the diversity of bacteria in the gut, <a href="https://www.umassmed.edu/nutrition/melody-trial-info/" target="_blank" rel="noopener noreferrer">my lab studies show how diet can be used</a> as a therapy for chronic diseases. Using different foods, people can shift their gut microbiome to one that boosts a healthy immune response.</p><p>A fraction of patients infected with SARS-CoV-2, the virus that causes COVID-19 disease, develop severe complications that require hospitalization in intensive care units. What do many of those patients have in common? <a href="https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm" target="_blank" rel="noopener noreferrer">Old age</a> and chronic diet-related diseases like obesity, Type 2 diabetes and cardiovascular disease.</p><p><a href="http://doi.org/10.1016/j.jada.2008.12.019" target="_blank" rel="noopener noreferrer">Black and Latinx people are disproportionately affected by obesity, Type 2 diabetes and cardiovascular disease</a>, all of which are linked to poor nutrition. Thus, it is not a coincidence that <a href="https://www.cdc.gov/mmwr/volumes/69/wr/mm6933e1.htm" target="_blank" rel="noopener noreferrer">these groups have suffered more deaths from COVID-19</a> compared with whites. This is the case not only in the U.S. but also <a href="https://www.washingtonpost.com/world/europe/blacks-in-britain-are-four-times-as-likely-to-die-of-coronavirus-as-whites-data-show/2020/05/07/2dc76710-9067-11ea-9322-a29e75effc93_story.html" target="_blank" rel="noopener noreferrer">in Britain</a>.</p>
Discovering Microbes That Predict COVID-19 Severity<p>The COVID-19 pandemic has inspired me to shift my research and explore the role of the gut microbiome in the overly aggressive immune response against SARS-CoV-2 infection.</p><p>My colleagues and I have hypothesized that critically ill SARS-CoV-2 patients with conditions like obesity, Type 2 diabetes and cardiovascular disease exhibit an altered gut microbiome that aggravates <a href="https://theconversation.com/exercise-may-help-reduce-risk-of-deadly-covid-19-complication-ards-136922" target="_blank" rel="noopener noreferrer">acute respiratory distress syndrome</a>.</p><p>Acute respiratory distress syndrome, a life-threatening lung injury, in SARS-CoV-2 patients is thought to develop from a <a href="http://doi.org/10.1016/j.cytogfr.2020.05.003" target="_blank" rel="noopener noreferrer">fatal overreaction of the immune response</a> called a <a href="https://theconversation.com/blocking-the-deadly-cytokine-storm-is-a-vital-weapon-for-treating-covid-19-137690" target="_blank" rel="noopener noreferrer">cytokine storm</a> <a href="http://doi.org/10.1016/S2213-2600(20)30216-2" target="_blank" rel="noopener noreferrer">that causes an uncontrolled flood</a> <a href="http://doi.org/10.1016/S2213-2600(20)30216-2" target="_blank" rel="noopener noreferrer">of immune cells into the lungs</a>. In these patients, their own uncontrolled inflammatory immune response, rather than the virus itself, causes the <a href="http://doi.org/10.1007/s00134-020-05991-x" target="_blank" rel="noopener noreferrer">severe lung injury and multiorgan failures</a> that lead to death.</p><p>Several studies <a href="https://doi.org/10.1016/j.trsl.2020.08.004" target="_blank" rel="noopener noreferrer">described in one recent review</a> have identified an altered gut microbiome in patients with COVID-19. However, identification of specific bacteria within the microbiome that could predict COVID-19 severity is lacking.</p><p>To address this question, my colleagues and I recruited COVID-19 hospitalized patients with severe and moderate symptoms. We collected stool and saliva samples to determine whether bacteria within the gut and oral microbiome could predict COVID-19 severity. The identification of microbiome markers that can predict the clinical outcomes of COVID-19 disease is key to help prioritize patients needing urgent treatment.</p><p><a href="https://doi.org/10.1101/2021.01.05.20249061" target="_blank" rel="noopener noreferrer">We demonstrated</a>, in a paper which has not yet been peer reviewed, that the composition of the gut microbiome is the strongest predictor of COVID-19 severity compared to patient's clinical characteristics commonly used to do so. Specifically, we identified that the presence of a bacterium in the stool – called <em>Enterococcus faecalis</em>– was a robust predictor of COVID-19 severity. Not surprisingly, <em>Enterococcus faecalis</em> has been associated with <a href="https://doi.org/10.1053/j.gastro.2011.05.035" target="_blank" rel="noopener noreferrer">chronic</a> <a href="https://doi.org/10.1016/S0002-9440(10)61172-8" target="_blank" rel="noopener noreferrer">inflammation</a>.</p><p><em>Enterococcus faecalis</em> collected from feces can be grown outside of the body in clinical laboratories. Thus, an <em>E. faecalis</em> test might be a cost-effective, rapid and relatively easy way to identify patients who are likely to require more supportive care and therapeutic interventions to improve their chances of survival.</p><p>But it is not yet clear from our research what is the contribution of the altered microbiome in the immune response to SARS-CoV-2 infection. A recent study has shown that <a href="https://doi.org/10.1101/2020.12.11.416180" target="_blank" rel="noopener noreferrer">SARS-CoV-2 infection triggers an imbalance in immune cells</a> called <a href="https://doi.org/10.1111/imr.12170" target="_blank" rel="noopener noreferrer">T regulatory cells that are critical to immune balance</a>.</p><p>Bacteria from the gut microbiome are responsible for the <a href="https://doi.org/10.7554/eLife.30916.001" target="_blank" rel="noopener noreferrer">proper activation</a> <a href="https://doi.org/10.1126/science.1198469" target="_blank" rel="noopener noreferrer">of those T-regulatory</a> <a href="https://doi.org/10.1038/nri.2016.36" target="_blank" rel="noopener noreferrer">cells</a>. Thus, researchers like me need to take repeated patient stool, saliva and blood samples over a longer time frame to learn how the altered microbiome observed in COVID-19 patients can modulate COVID-19 disease severity, perhaps by altering the development of the T-regulatory cells.</p><p>As a Latina scientist investigating interactions between diet, microbiome and immunity, I must stress the importance of better policies to improve access to healthy foods, which lead to a healthier microbiome. It is also important to design culturally sensitive dietary interventions for Black and Latinx communities. While a good-quality diet might not prevent SARS-CoV-2 infection, it can treat the underlying conditions related to its severity.</p><p><em><a href="https://theconversation.com/profiles/ana-maldonado-contreras-1152969" target="_blank">Ana Maldonado-Contreras</a> is an assistant professor of Microbiology and Physiological Systems at the University of Massachusetts Medical School.</em></p><p><em>Disclosure statement: Ana Maldonado-Contreras receives funding from The Helmsley Charitable Trust and her work has been supported by the American Gastroenterological Association. She received The Charles A. King Trust Postdoctoral Research Fellowship. She is also member of the Diversity Committee of the American Gastroenterological Association.</em></p><p><em style="">Reposted with permission from <a href="https://theconversation.com/a-healthy-microbiome-builds-a-strong-immune-system-that-could-help-defeat-covid-19-145668" target="_blank" rel="noopener noreferrer" style="">The Conversation</a>. </em></p>
By Jeff Masters, Ph.D.
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