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What Cyclone Pam and Typhoon Maysak Tell Us About the Future of Island Communities

Climate

Last month, I visited the Solomon Islands to meet with Global Greengrants’ Pacific Islands Advisory Board. I had naively imagined hot sun and wide beaches, with tropical forests at the shorelines. Instead, it rained torrentially for several days. This is because Cyclone Pam was forming off the coast of the Solomons and storming its way toward terrible devastation in Vanuatu.

Cyclone Pam completely wiped out coconut groves like this one on Erromango island, Vanuatu. Photo: Global Greengrants

There were no beaches in Honiara, where I was staying. The shorelines are eroding away due to sea rise and storm surges. Sea level around the Solomons has been rising by 8 millimeters per year, more than twice the global average.

In Honiara, I observed waves crashing just short of a seaside restaurant and onto the floor of an open-air coffee shop and bar. An employee calmly mopped the water away, as if this would stop it from flooding again.

Global Greengrants advisor in the Solomons, Willie Atu, who works for The Nature Conservancy, says, “The Pacific Islands’ small population, limited resources, remoteness and economic dependence on foreign aid increase their vulnerabilities, making them more susceptible to the onslaught of natural disasters, including that of climate change.”

The roof of this cyclone shelter in Erromango blew off within the first few minutes of the storm. Photo: Global Greengrants

Island peoples’ lives are now constantly disrupted by extreme weather and natural disasters. The frequency and occurrence of Category 4 and 5 storms in the Pacific region more than doubled since 1975. Climate change has both short-term and long-term impacts for island peoples. Not only is the frequency and intensity of cyclones—also known as hurricanes or typhoons—increasing, but so is the duration of the cyclone season. These extreme weather events, in combination with sea level rise—which is conservatively projected to upsurge from one to four feet globally by 2100—are already catastrophic for island communities.

According to Jonathan Gregory, lead author on the subject for the Intergovernmental Panel on Climate Change, “It is virtually certain that global mean sea level rise will continue for many centuries.”

Island peoples know best what adaptation and mitigation techniques are most appropriate for their needs. Global Greengrants’ Pacific Island Advisory Board delivers small amounts of money into the right hands at exactly the right moment. It empowers local leaders to take actions that effectively manage the unavoidable impacts of climate change.

Take a $5,000 Greengrant we made last December to Resource Management Trust Board in the Solomons. The group focuses on improving food security during the cyclone season and works with rural women to preserve nuts, fruit and root crops using traditional methods. Having access to enough local food during the monsoon season allows communities to be self-sufficient, preserve their traditional diet and save money. This can be the difference between life and death for a community dealing with devastating storms such as Cyclone Pam and Typhoon Maysack.

Four months later, Global Greengrants responded to an urgent plea to help communities in Vanuatu that were wrecked by Cyclone Pam, the strongest storm ever to hit the South Pacific. Emergency Greengrants will provide temporary shelter for 100 people on the Vanuatu island of Erromango, where many people are homeless and are still awaiting aid.

Victims of Cyclone Pam have constructed temporary shelter from any scrap materials they can find. Photo: Global Greengrants

Barely two weeks after that, we received reports from former grantees about the destruction and urgent need for support in communities in the Federated States of Micronesia, which were slammed by Typhoon Maysak.

The photographs from the area are heartbreaking. Ulithi Island lost all of its crops and most people’s homes have been destroyed; people are building shacks from the very little corrugated iron they can recover. In Chuuk, over 6,760 people have been forced from their homes and 80 percent of the breadfruit, banana and taro crops were damaged. Local food production is vital to the Pacific Islands, where the majority of rural people still depend on subsistence agriculture. Without these crops, people will starve.

Global Greengrants is not an emergency and disaster relief organization. But because we can quickly deliver support to grassroots groups that international and government aid has a hard time reaching, we are being asked again and again to help. Most times, we get there well before large aid agencies arrive with supplies and relief.

I can’t say this doesn’t worry me. Our area of expertise is emboldening people to create change. We never intended to be a reactionary aid group. But our grantees in the Pacific, many of whom receive no other source of funding, are facing a dire future. We must acclimatize to their realities.

Families on Erromango lived in caves such as this one after Cyclone Pam destroyed their homes. Photo: Global Greengrants

Importantly, this means supporting Pacific communities to look ahead and manage the aftermath of climate change well before the cyclones or super storms strike. An example is the Reef Islands, in Northern Vanuatu. In January of 2014, we supported the Ngala'a Indo Project with a $5,000 Greengrant to plant mangroves and set up rainwater collection tanks. The new tanks provided more than 300 people with safe drinking water after their wells were contaminated during natural disasters.

Colonialism and globalization have all but destroyed the cultures that the famous cultural anthropologist Margaret Mead chronicled. Many tribal peoples are trying to hold on to their traditions. But mounting threats to food and water security, infrastructure, health, and safety are expected to lead to increasing human migration.

Climate change will likely lead to few or no islands left in this part of the Pacific Ocean.

My few days in the Solomons helped me see the questions more clearly: Will we in the North—the clear source of the globe's climate problems—continue to pursue dead-end policy solutions that will not turn around the climate crisis and might even perpetuate it? Or will we look to the future with clear eyes and see what must be done? Will we understand that as much as we wish climate change wasn’t happening, there may simply be no way around it?

I believe mitigation has a role to play. But Pacific Islanders, and, indeed, many underserved communities around the world, face a bleak future unless we start to elevate that most reviled word, adaptation, to the international stage. If we don’t start talking more about adaptation in addition to mitigation, soon we will all be focused on compensation.

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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.

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

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

What Is Guillain-Barre Syndrome?

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

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

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

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

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

Guillain-Barre Syndrome and Pandemics

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Reposted with permission from The Conversation.


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"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.