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What’s Waiting for Gina McCarthy as New EPA Administrator

Climate

Union of Concerned Scientists

By Kathleen Rest

The Senate has finally confirmed Gina McCarthy, President Obama’s choice to head the U.S. Environmental Protection Agency (EPA). She starts with a very full plate. I have some personal experience with what lies ahead for Administrator McCarthy—I once directed a federal agency myself.

For 14 months, I was the Acting Director of the National Institute for Occupational Safety and Health (NIOSH) in the Centers for Disease Control and Prevention. Though NIOSH doesn’t have the challenges of a regulatory agency, I know what the responsibility, demands and stress of the job can feel like. During my tenure at NIOSH—a worker health and safety agency—we were on the front lines of public health challenges in the aftermath of the September 11, 2001, terrorist attacks, as well as the anthrax events that followed shortly thereafter.

There was an enormous amount to do and a multitude of stakeholders to engage—first responders, laborers, iron and construction workers, postal workers, Senators and their staffs, public health officials, health care workers, law enforcement agencies—not to mention the rightly worried public. All while ensuring the agency continued to meet its mandates and responsibilities.

Administrator McCarthy’s Inbox

Administrator McCarthy knows what it’s like to set priorities, juggle multiple balls and make things happen; her decades of government experience and her commitment to public service put her in good stead to take on this new leadership position. And on behalf of Union of Concerned Scientists, I congratulate—and thank—her for taking on this role at this most critical time. Like the past presidents of the American Association for the Advancement of Science have said, I believe Gina McCarthy is exceptionally qualified and ready to get to work.

And there is surely plenty to do. One of the most urgent items on her desk is finalizing the cleaner gasoline and tailpipe standards. These cleaner gasoline and vehicle standards (the so-called Tier 3 standards) will reduce air pollution, save lives and create thousands of new jobs. This is precisely why the standards are supported by a diverse coalition of industry, public health, environmental, labor and science-based organizations representing millions of Americans. Failure to finalize the standards this year would result in losing an entire 2013 model year’s worth of benefits. EPA estimates that by 2030 these standards would prevent up to 2,400 premature deaths, 3,200 hospital admissions and 22,000 asthma attacks each year.

Also on the administrator’s to-do list is the serious heavy lifting needed to implement President Obama’s Climate Action Plan. Strong and focused leadership is necessary to make sure that the EPA not only sets standards for power plants that will reduce carbon pollution, but also help us prepare for the impacts of climate change that we are already experiencing and simply can no longer avoid.

New Power Plant Carbon Standards Will Be Critical

On June 25, President Obama issued a Presidential Memorandum to the EPA on the Power Sector Carbon Pollution Standardsoutlining a specific timeline for the EPA to draft and issue standards to reduce carbon pollution from power plants. The president’s memorandum instructs the EPA to issue standards under the Clean Air Act to limit carbon pollution from both new and existing power plants.

More than 3 million Americans already voiced their support for draft standards for new power plants issued last year. The memo indicates that the EPA intends to propose a new draft by September 20, 2013. We need Administrator McCarthy to ensure that the re-proposed standard stays strong so that they foster a transition toward cleaner power generation sources. Draft standards for existing sources, which include our nation’s oldest and dirtiest coal-fired power plants, must be released by June 1, 2014, and finalized within a year. States must then submit their implementation plans no later than June 30, 2016.

This clear timeline provides ample opportunity for stakeholder input. We need Administrator McCarthy’s leadership to ensure the process stays on track. We cannot afford further delays on reducing emissions from power plants, the single largest source of carbon pollution.

More Progress on Clean Vehicles and Clean Fuels

The president’s climate plan also directs the EPA to continue to reduce carbon emissions from our transportation system, including establishing the next round of standards for heavy duty vehicles, such as big-rig trucks. According to the analysis in our Half the Oil plan, doubling the efficiency of commercial vehicles could reduce oil consumption by 1 million barrels a day in 2035. The EPA should build upon the successful stakeholder engagement of the first round of standards to create robust, stringent standards that achieve significant and measurable reductions in global warming pollutants.

The Renewable Fuel Standard is another important policy to reduce oil use and expand the use of clean low-carbon renewable fuels. Congress amended the law five years ago, adding ambitious targets to take the biofuels industry beyond food-based fuels and including science-based life cycle emissions requirements. While the framework is sound, the devil is in the details. The EPA needs to use the authority Congress gave it to revise the targets for advanced biofuels between 2016 and 2022. The agency should consider competition for agricultural commodities, constraints in our infrastructure and ensuring that the life cycle accounting and volume mandates avoid expanded use of palm oil and other biofuels implicated in the enormous emissions generated through clearing of peat and other tropical forests.

Administrator McCarthy has an excellent reputation for crafting regulations based on the best available science that will provide the maximum benefit at the least possible cost—as well as a tradition of working in an open and inclusive manner with multiple stakeholders. This is what the American people need and deserve as the EPA sets standards and takes action that will protect our health, clean up our environment and help build community resilience to the impacts of climate change.

Visit EcoWatch’s ENERGY and CLIMATE CHANGE pages for more related news on this topic.

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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.

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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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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.