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5 Lessons for the Future of Water

Climate
Leon, Spain's main reservoir barely reaches 10% on September 1, 2017 during the country's worst drought in 20 years. Alvaro Fuente / NurPhoto / Getty Images

By Chiara Cecchini

Although it is difficult today to divert attention from the dramatic situation we live in, it is even more important to get closer to our primary needs. Recently, we celebrated World Water Day, and the timing couldn't have been more appropriate to give to all of us the chance to rethink priorities and draw some lessons.


Without water, our lifespan would be 14 days. Our entire existence is closely dependent on one single, exhaustible resource. In a moment where we all feel vulnerable, and surprisingly dependent on more external systems than we imagined, life is reminding us of what makes us human, and where we should probably focus our attention.

Looking at the numbers, desertification is on the increase everywhere in the world. In Europe it already affects 8% of the territory; in Africa, almost 70% of the continent is arid or semi-arid land; and in North America about 40% of the continental land is at risk of desertification. Data shows that this scenario is destined to get even worse, with forecasts saying that 47% of the world population is going to experience water scarcity by 2030.

But where do we consume all this water?

Only 2.5% of the water on Earth is fresh and only 0.1% of it is accessible to humans, while every human being needs it to survive. This explains the reason why in 2010 the UN officially recognized access to safe drinking water as a basic and universal human right, as well as including water among the Sustainable Development Goals.

Global water use has increased by a factor of six over the past 100 years. The majority of it (up to 70%) goes into irrigation of crops that eventually feed us, the animals that we eat, or the clothes we wear. The remaining 30% is consumed by the industry and for domestic use.

While the majority of the available water goes to produce human food, the water impacts of individual products vary considerably. 214 liters of water are needed to produce one kg of tomatoes, 2,500l for a kg of rice, 3,180l for a kg of cheese, and 15,400l for a kg of beef. It is then easy to understand the risks of price increases for food in contexts of water scarcity. As well as the power we have every time we do our grocery shopping. Do we know how much water we eat every single day?

The World Health Organization defines the concept of water scarcity based on the assumption that each person needs between 50 and 100 liters of water per day to meet their primary needs. We know that in most Western countries this percentage is abundantly exceeded.

The average American uses about 340 liters of water each day, and this is calculated as consumption at home only, without considering food consumed. Add to it your morning coffee (140 liters) a banana (80 litres), some grilled chicken (430 liters) and tomatoes (50 liters) for lunch, some cheese (200 liters), olives (200 liters) and a beer (150 liters) as aperitif, and some rice (250 liters) and broccoli (40 liters) for dinner. Your average daily water consumption has already jumped to 1,900 liters per day.

Not to mention current data on food waste. Every day in the United States, consumers throw out nearly a pound of food each, wasting both food and water. When we throw food away, we also throw away all the water and energy used to produce it.

What Can We Do About It?

Now that the whole world is experiencing the effects of a major disaster, we have the opportunity to re-evaluate some of our choices. COVID-19 has transformed everyday life so significantly that the effects are already visible from space, showing us that change is possible and results are tangible. COVID-19 is teaching us (among other things) that our eagerness for creation should not result in the destruction of our planet.

Here are five simple things we can all start doing to have a healthier relationship with water and our environment in the future.

1. Follow the food pyramid, which forms the basis of the Mediterranean diet.

Our weekly food intake should be mainly composed of fruit, vegetables and grains, with minor presence of animal-based proteins. It takes 31 mixed salads to make the water footprint of one burger.

2. Look at how food is produced.

Regenerative agriculture, permaculture and organic farming aim to improve the quality and productivity of soil so that it retains moisture, minimizing the need for excessive irrigation. Hydroponic, aquaponic, aeroponic and vertical farming make it possible to grow produce very efficiently.

3. Eat unprocessed food.

While the water footprint of whole foods is made up entirely of the water needed to grow, processed foods require additional water for cleaning, pre-cooking, and making packaging materials.

4. Reconsider where to live and shop.

As food and other products are traded, their water footprint follows them in the form of virtual water. Which means that every time you consume an imported product, you don't only increase its footprint by the water needed to take care of shipment, but you also take away water from its local population. Supporting your house, neighborhood and city to grow more food can have a hugely positive impact on your water footprint, as well as supporting existing local producers.

5. Think twice before buying new clothes.

It takes about 2,700 liters of water to make just one t-shirt, enough for one person to drink for 900 days. The average woman will own 372 cardigans and 558 pairs of trousers during her adult life. The fast-fashion industry is based on us buying items extremely often, but do we really need all of them?

In a moment where we feel caged, where we are scared of losing our loved ones, and we feel vulnerable in the middle of a pandemic that seems unstoppable, our ecosystem is presenting us with a challenge. It is everyone's personal responsibility whether to accept it or not. Are we able to preserve our main source of life?

Reposted with permission from World Economic Forum.

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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.