
Puget Soundkeeper
By Chris Wilke
The 1960s were a time of great change and upheaval in our society. Perhaps best known for the anti-war and civil rights movements, the decade also saw the birth of the modern environmental movement. With new knowledge about the dreadful effects of pesticides like DDT, and spurred by catastrophic events like the Cuyahoga River catching on fire and a massive oil spill off the coast of Santa Barbara in 1969, citizens of the U.S. rose up and demanded change. At the first Earth Day in 1970—the largest demonstration in American history—20 million people took a stand in the face of increasing environmental destruction. As a direct result of this public outcry, the next three years saw rapid change in U.S. environmental policy. In this brief period, Congress passed the Clean Water Act, the Clean Air Act, the Endangered Species Act and the National Environmental Policy Act—a series of forward-thinking legislation that would become a beacon for the rest of the world.
When the Clean Water Act of 1972 was signed into law, its framers knew that our waters must be protected and restored for the good of the communities that depend on them. They recognized that clean water was a fundamental right of every citizen and that protection of swimmable, drinkable and fishable waters was in the best interest of everyone. In section 101 of the Act, Congress made it the “national goal to eliminate the discharge of pollution into the nation’s waters by 1985." Though we have yet to attain this goal, we have seen significant progress. Permits issued under the Act put in new requirements for modern sewage treatment technologies and industrial discharges became tightly regulated for the first time. Slowly but surely, successive five-year permits were “ratcheted down” to become more protective as facilities were required to employ “best available technologies."
The Act enshrined a long-held (but seldom enforced) value that is attributable to the emergence of English Common Law in the 12th century—the concept that the waters, fishes, the air and the birds are part of the commons which no one has the right to own or destroy, and which must be held in trust and protected for the common good.
Another important provision of the Act gave citizens the right to enforce its provisions. This was very important because implicit in this section is a recognition that local and state agencies are often the captive of special interests and lack the political will to enforce existing laws against powerful polluters. By empowering citizens as private attorneys general, those who were directly harmed by pollution could now enforce the law to ensure protection of the waters they relied upon for health, sustenance, recreation and enjoyment. Through this important provision, citizens are empowered to file cases against polluters in federal court to stop the pollution, recover legal expenses and secure a financial penalty—up to $37,500 per day—to deter future violations. The vast majority of penalties go to fund third-party supplemental environmental projects (SEPs) to mitigate the damage that occurred in the watershed. Throughout the years government entities and citizens alike have successfully used the Act to prevent pollution and clean up our nation’s waters.
Several local examples illustrate the success of the Act. As a local water quality advocate Puget Soundkeeper Alliance (Soundkeeper) has been at the forefront of ensuring the safety of our waters. Through a dual approach of citizen enforcement and improving regulations issued under the Act, this small citizen’s group has helped make our region a leader in water quality protection.
In 1992, wheels put in motion by Soundkeeper’s first citizen Clean Water Act settlement over uncontrolled sewage overflows in the City of Bremerton resulted in the implementation of a massive improvement of sewage infrastructure, the elimination of illegal overflows and the reopening of shellfish beds in the area.
For nearly 20 years since, Soundkeeper has a perfect record of more than 150 cases that have significantly reduced pollution from sewage treatment plants, sewage overflow points, industrial facilities and construction sites. In December 2011, Soundkeeper secured one of the largest citizen settlements in Clean Water Act history resulting in the dramatic improvement of stormwater management at a Burlington Northern Santa Fe Railway facility. The settlement addressed the toxic heavy metals, turbid water and frequent petroleum spills that fouled Elliott Bay, as well as created a $1.5 million restoration and mitigation fund as a SEP to pay for water quality improvement projects in Puget Sound. (As always, no settlement money goes to benefit Soundkeeper).
In addition to enforcement, the Clean Water Act also helps secure better regulations that protect our waters. In 2008 Soundkeeper and its partner organizations People for Puget Sound and Earthjustice secured a landmark decision requiring improvements to Municipal Stormwater Permits, changing the way that development will occur in cities and urbanizing areas in order to address the single-largest source of toxic pollution going into the Sound—polluted stormwater runoff. For the first time, green building techniques like raingardens and pervious pavement will be required in building codes as a best available technology to ensure that polluted stormwater runoff from roads, rooftops and parking lots will be treated and managed on site, like it is in nature.
The year 2012 marks the 40th anniversary of the Clean Water Act. Even as we celebrate the anniversary and the success of so many waterways that have been cleaned up as a result, some special interests feel that this is the time to weaken these very protections. Industry special interests in both the U.S. Congress and in the Washington State Legislature have proposed bills to rollback protections.
In celebration and in defense of the Clean Water Act, Soundkeeper proudly joins the Waterkeeper Alliance in coordinating Swimmable, Drinkable and Fishable Days around the nation and defending against misguided legislation that would unravel important protections. Waterkeeper Alliance, with nearly 200 member organizations around the world—each one a local Riverkeeper, Baykeeper, Coastkeeper, Soundkeeper, or Lakekeeper, based in the watershed they protect—is the fasted growing environmental movement in the World.
The Clean Water Act itself is extremely clear and powerful in its intent, however the trick is often in ensuring that specific regulations issued under the Act (i.e. National Pollution Discharge Elimination System (NPDES) permits) are written in such a way that they actually protect water quality and don’t contain unnecessary loopholes, waivers or excessive compliance schedules. The next piece is ensuring that enforcement of NPDES permits is meaningful so as to bring about widespread compliance.
Educating polluters is extremely valuable to help facilities understand permit requirements and to provide technical assistance in helping them comply. Funding is a critical issue for large municipal projects in particular. For example, King County is finalizing a plan to get their combined sewage overflows (CSOs) under control at a cost of more than $700 million. Although the price tag is large, the environmental and human health cost for not doing the control work is higher and the cost to individual rate payers will only be around $7/month. The draft plan calls for the work to be completed by the year 2030. Considering that CSO standards were finalized in 1988, that is 42 years.
Get involved. Waterkeeper Alliance and a new coalition of licensed Waterkeeper organizations in Washington State including Puget Soundkeeper, Columbia Riverkeeper, Spokane Riverkeeper and North Sound Baykeeper invite you to join us. Click here to find a Waterkeeper near you, and get involved.
For more information, click here.
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A Healthy Microbiome Builds a Strong Immune System That Could Help Defeat COVID-19
By Ana Maldonado-Contreras
Takeaways
- 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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