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The Gathering Storm

Climate

Winston Churchill saw the gathering storm long before the rest of the world. Europe sacrificed millions of people before it openly acknowledged and then directly confronted the crisis. Yet, even after the Allies responded, the outcome was uncertain. Only when the U.S. entered the fray could the Allies see a clear path to end the threat.

The scientific debate about whether human-caused global warming exists is long over. The remaining window of time for the needed transformation is short, and the only real issue is how we respond. This is where U. S. leadership is most critical.
Photo credit: Shutterstock

While meeting that threat, the war mobilization also provided employment for millions and pulled the U.S. economy out of the Great Depression, leading to a half-century of prosperity. Americans mostly look back fondly on that period, as the world became a better place in many ways for the changes that were made.

Today, we face another threat, this time from climate disruption. Again, the U.S. must lead—this time to a clean energy future and a healthier world. As we experience more intense and longer heat waves, prolonged drought, crop failures, rising seas, increasing wildfires and floods, and as natural systems begin to crash, we will see profoundly destabilizing effects.

The scientific debate about whether human-caused global warming exists is long over. The remaining window of time for the needed transformation is short, and the only real issue is how we respond. This is where U. S. leadership is most critical.

Global warming already directly impacts public health, our economy, food and water supplies, and national security. What’s more, a recently leaked UN report details how global warming now most assuredly will lead to “severe, pervasive and irreversible impacts.” In an attempt to alert the public to the danger, it was released by scientists prior to its being substantively amended by government representatives who might feel tempted to censor critical information.

In response to the scale and urgency of the threat, and in solidarity with our colleagues, we call on our fellow scientists to speak clearly to the nation and the world, and if so moved, to sign on to our Scientific Statement on Climate Stabilization. To successfully combat global warming and stay below the 2-degree C heat ceiling, the statement calls for these actions:

First, carbon emissions should peak now. Reducing our greenhouse gas emissions must begin at once in industrialized nations, and within a few years in developing nations. Second, we must reduce emissions by several percent per year and quickly transition away from fossil fuels. Third, the U.S. must lead. The U.S. must embrace the Copenhagen Accord, shape the upcoming 2015 Paris accords, and lead this next great industrial transformation. Our capacity to innovate is unmatched, which means that U. S. industry will benefit from political clarity around climate stabilization.

The statement’s purpose is bring disparate efforts together to work cooperatively on actions that meet the scope, scale, and urgency of the climate crisis. The longer we remain mired in the status quo, the harder and more expensive it will be, and the closer we will come to runaway warming. A recently released Council of Economic Advisors report underscores the importance of action now.

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It is not a question of whether we can make the necessary changes. Much of the technology already exists, and we have significant practical experience to draw upon. For example, California uses nearly 50 percent less electricity per capita as the U.S. average, has one of the most aggressive renewable energy standards in the country, and has set an economy-wide limit on its global warming pollution.

California has developed a visionary economy-wide climate plan, the Global Warming Solutions Act (AB32)that helps promotes job growth in fast-growing industries. Much of this innovation is centered in Silicon Valley, with its strong university-industry partnerships. The Silicon Valley Leadership Group, an influential business organization with nearly 400-member companies, has long supported action to address climate change. Operating out of the Leadership Group Foundation, the California Climate Breakthrough Initiative (CCBI) believes we must hold a national conversation about the future we want.

We agree. Americans have many questions about the climate crisis and what we can do to tackle it. Face-to-face education and dialogue are necessary to come to grips with what we face. Thus, in addition to joining in a call for a climate breakthrough, we ask scientific, community and business leaders to call for and lead public teach-ins at their universities and organizations to discuss the need for immediate and dramatic change in the way we run our world.

Individuals play a key role too. Ask your local universities and libraries to hold teach-ins about the climate crisis. If more Americans understand what we face, they can motivate political leaders to take meaningful, immediate, action.

This Sept. 23, in New York City, we will join world leaders who will come together at the UN for Climate Summit 2014, to “champion an ambitious vision, anchored in action that will enable a meaningful global agreement in 2015.” 2015 is important because of the November 2015 UN Climate Change Conference in Paris, whose objective is to achieve a legally binding and universal climate agreement.

As a lead-up to the 2014 Climate Summit, the UN’s Sustainable Development Solutions Network has produced Pathways to Deep Decarbonization, which shows how countries can transition to a low-carbon economy and meet the 2-degree C (3.6 F) heat limit. During World War II, this country transformed its entire economy, even stopping automobile production for three years to manufacture goods for the war effort. We can do it. We know we can. It is just a matter of public will and effort. 

Michael Mann is Distinguished Professor of Meteorology at Pennsylvania State University, Director of the Penn State Earth System Science Center and author of The Hockey Stick and the Climate Wars: Dispatches from the Front Lines (now available in paperback with a new guest foreword by Bill Nye "The Science Guy")

Daniel M. Kammen is the Class of 1935 Distinguished Professor of Energy at the University of California, Berkeley.  He has served as the World Bank lead on Clean Energy and Energy Efficiency, serves the State Department as an Energy and Climate Fellow to the Americas, and has served as a contributing or coordinating lead author for the Intergovernmental Panel on Climate Change which shared the 2007 Nobel Peace Prize.

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Guillain-Barre syndrome occurs when the body's own immune system attacks and injures the nerves outside of the spinal cord or brain – the peripheral nervous system. Niq Steele / Getty Images

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

The patient in the case report (let's call him Tom) was 54 and in good health. For two days in May, he felt unwell and was too weak to get out of bed. When his family finally brought him to the hospital, doctors found that he had a fever and signs of a severe infection, or sepsis. He tested positive for SARS-CoV-2, the virus that causes COVID-19 infection. In addition to symptoms of COVID-19, he was also too weak to move his legs.

When a neurologist examined him, Tom was diagnosed with Guillain-Barre Syndrome, an autoimmune disease that causes abnormal sensation and weakness due to delays in sending signals through the nerves. Usually reversible, in severe cases it can cause prolonged paralysis involving breathing muscles, require ventilator support and sometimes leave permanent neurological deficits. Early recognition by expert neurologists is key to proper treatment.

We are neurologists specializing in intensive care and leading studies related to neurological complications from COVID-19. Given the occurrence of Guillain-Barre Syndrome in prior pandemics with other corona viruses like SARS and MERS, we are investigating a possible link between Guillain-Barre Syndrome and COVID-19 and tracking published reports to see if there is any link between Guillain-Barre Syndrome and COVID-19.

Some patients may not seek timely medical care for neurological symptoms like prolonged headache, vision loss and new muscle weakness due to fear of getting exposed to virus in the emergency setting. People need to know that medical facilities have taken full precautions to protect patients. Seeking timely medical evaluation for neurological symptoms can help treat many of these diseases.

What Is Guillain-Barre Syndrome?

Guillain-Barre syndrome occurs when the body's own immune system attacks and injures the nerves outside of the spinal cord or brain – the peripheral nervous system. Most commonly, the injury involves the protective sheath, or myelin, that wraps nerves and is essential to nerve function.

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

To diagnose Guillain-Barre Syndrome, neurologists perform a detailed neurological exam. Due to the nerve injury, patients often may have loss of reflexes on examination. Doctors often need to perform a lumbar puncture, otherwise known as spinal tap, to sample spinal fluid and look for signs of inflammation and abnormal antibodies.

Studies have shown that giving patients an infusion of antibodies derived from donated blood or plasma exchange – a process that cleans patients' blood of harmful antibodies - can speed up recovery. A very small subset of patients may need these therapies long-term.

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

Guillain-Barre Syndrome and Pandemics

As the COVID-19 pandemic sweeps across the globe, many neurologic specialists have been on the lookout for potentially serious nervous system complications such as Guillain-Barre Syndrome.

Though Guillain-Barre Syndrome is rare, it is well known to emerge following bacterial infections, such as Campylobacter jejuni, a common cause of food poisoning, and a multitude of viral infections including the flu virus, Zika virus and other coronaviruses.

Studies showed an increase in Guillain-Barre Syndrome cases following the 2009 H1N1 flu pandemic, suggesting a possible connection. The presumed cause for this link is that the body's own immune response to fight the infection turns on itself and attacks the peripheral nerves. This is called an "autoimmune" condition. When a pandemic affects as many people as our current COVID-19 crisis, even a rare complication can become a significant public health problem. That is especially true for one that causes neurological dysfunction where the recovery takes a long time and may be incomplete.

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

Though there is clear clinical suspicion that COVID-19 can lead to Guillain-Barre Syndrome, many important questions remain. What are the chances that someone gets Guillain-Barre Syndrome during or following a COVID-19 infection? Does Guillain-Barre Syndrome happen more often in those who have been infected with COVID-19 compared to other types of infections, such as the flu?

The only way to get answers is through a prospective study where doctors perform systematic surveillance and collect data on a large group of patients. There are ongoing large research consortia hard at work to figure out answers to these questions.

Understanding the Association Between COVID-19 and Guillain-Barre Syndrome

While large research studies are underway, overall it appears that Guillain-Barre Syndrome is a rare but serious phenomenon possibly linked to COVID-19. Given that more than 10.7 million cases have been reported for COVID-19, there have been 10 reported cases of COVID-19 patients with Guillain-Barre Syndrome so far – only two reported cases in the U.S., five in Italy, two cases in Iran and one from Wuhan, China.

It is certainly possible that there are other cases that have not been reported. The Global Consortium Study of Neurological Dysfunctions in COVID-19 is actively underway to find out how often neurological problems like Guillain-Barre Syndrome is seen in hospitalized COVID-19 patients. Also, just because Guillain-Barre Syndrome occurs in a patient diagnosed with COVID-19, that does not imply that it was caused by the virus; this still may be a coincident occurrence. More research is needed to understand how the two events are related.

Due to the pandemic and infection-containment considerations, diagnostic tests, such as a nerve conduction study that used to be routine for patients with suspected Guillain-Barre Syndrome, are more difficult to do. In both U.S. cases, the initial diagnosis and treatment were all based on clinical examination by a neurological experts rather than any tests. Both patients survived but with significant residual weakness at the time these case reports came out, but that is not uncommon for Guillain-Barre Syndrome patients. The road to recovery may sometimes be long, but many patients can make a full recovery with time.

Though the reported cases of Guillain-Barre Syndrome so far all have severe symptoms, this is not uncommon in a pandemic situation where the less sick patients may stay home and not present for medical care for fear of being exposed to the virus. This, plus the limited COVID-19 testing capability across the U.S., may skew our current detection of Guillain-Barre Syndrome cases toward the sicker patients who have to go to a hospital. In general, the majority of Guillain-Barre Syndrome patients do recover, given enough time. We do not yet know whether this is true for COVID-19-related cases at this stage of the pandemic. We and colleagues around the world are working around the clock to find answers to these critical questions.

Sherry H-Y. Chou is an Associate Professor of Critical Care Medicine, Neurology, and Neurosurgery, University of Pittsburgh.

Aarti Sarwal is an Associate Professor, Neurology, Wake Forest University.

Neha S. Dangayach is an Assistant Professor of Neurology and Neurosurgery, Icahn School of Medicine at Mount Sinai.

Disclosure statement: Sherry H-Y. Chou receives funding from The University of Pittsburgh Clinical Translational Science Institute (CTSI), the National Institute of Health, and the University of Pittsburgh School of Medicine Dean's Faculty Advancement Award. Sherry H-Y. Chou is a member of Board of Directors for the Neurocritical Care Society. Neha S. Dangayach receives funding from the Bee Foundation, the Friedman Brain Institute, the Neurocritical Care Society, InCHIP-UConn Center for mHealth and Social Media Seed Grant. She is faculty for emcrit.org and for AiSinai. Aarti Sarwal does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

Reposted with permission from The Conversation.


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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.