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5 Reasons Why the Critics Are Wrong About the Rio Olympics

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The whole world held its breath in awe on Friday watching the Opening Ceremony for the 2016 Olympic Games in Rio de Janeiro. A day later I arrived back in the city that has become my second home while Mayor Eduardo Paes has been C40's chairperson for the last two and a half years. As I sit writing this article while enjoying the extraordinary new space in Porto Maravilha, though many have criticized the city for its Olympic preparations, it's impossible not to be moved by the significance of the first-ever Olympics to be held in South America.

Olympic cities are always criticized while under the world's microscope. Though there are some shortcomings here—mostly in areas that were the responsibility of the state or federal government—it's impossible not to be impressed by the transformation in sustainable transport and public space the mayor has instigated as a direct result of taking on the challenge of hosting the world's single greatest international contest.

The promise of the Olympics has been on the horizon since current C40 Cities Climate Leadership Group (C40) Chair and Rio Mayor Eduardo Paes was elected mayor in 2008. He has worked tirelessly throughout the intervening years not only to produce an event worthy of the global stage, but also to invest in and develop long-term legacy projects that will benefit the city and its inhabitants for years to come. Indeed, Mayor Paes has followed the advice of former Barcelona (also a C40 city) mayor and Olympic host Pasqual Maragall: The Olympics must serve the city, not vice versa.

Mayor Paes speaking at a press conference at Paris City Hall with C40 Mayors in 2015.C40 / Flickr

Mayor Paes has stayed true to that principle: For every one real invested in the Olympics, the city has invested five Reais in sustainable infrastructure and legacy projects. The city's ambitions for the Olympics have always been high and under Mayor Paes' leadership it has made powerful and lasting improvements for the city and its people that will endure far beyond when the last athletes have left town.

  • There has been a major expansion of the city's public transit systems, including an incredibly rapid development of bus rapid transit that means the proportion of residents using public transport has risen from under 20 percent to more than 60 percent in just 8 years, a brand new light rail system and more than 450 kilometers of cycle paths (as well as the new subway line, built by the state but for which the mayor has been a major advocate).
  • The city has completed a major renovation and revitalization of the Porto Maravilha, the city's historic birthplace. They redesigned the area in terms of mobility to make it more friendly to human-scale transit—removing the brutalist perimetral highway (indeed the first time I met Mayor Paes he apologized for being late with the excuse that he had been blowing up the very same road), adding a light vehicle tram, closing streets to cars, creating facilities for pedestrians and building the arrestingly beautiful Museum of Tomorrow.
  • Mayor Paes inaugurated the Rio Operations Center, a digital nerve center of the city in which critical services—from waste management to emergency response and traffic control—are monitored to improve the city's efficiency and emergency response. It is a model that has captured the attention of other cities across the world.
  • Though the failure to clean up the Guanabara Bay—which has been a contentious location in the lead-up to the games—falls outside the jurisdiction of the Mayor, the city has invested in a new West Zone Wastewater Treatment Plant that will benefit 430,000 people and treat 65 million liters of sewage that would otherwise be dumped in the bay. This is another fulfilled Olympic commitment and it brings better quality of life for thousands of people.
  • More than 70 percent of Olympic facilities were built by converting existing structures and some Olympic venues, like the Handball Stadium, are designed to be converted into community projects, like public schools, after the games.

Hosting an Olympics Games is no mean feat for any mayor, but it is particularly challenging when taking into consideration the political and economic turmoil Brazil has been facing over the past 12 months. Rather than criticizing what has not been done in Rio (and there are still many areas that require improvement and investment), those who care about sustainability should be praising Mayor Paes for delivering an impressive raft of infrastructure improvements, while the rest of the country has been at a virtual standstill.

Moreover, in addition to his job as mayor, Mayor Paes has also been the energetic chair of C40 since December 2013 and has been instrumental to engaging more than 20 new member cities from China, India, the Philippines, Africa and the Middle East, such that we now have a majority of members from the global south.

Under his leadership, Mayor Paes and C40 joined partners in launching the Compact of Mayors, creating a new global standard for urban emissions reporting and creating a program of effective "city determined commitments" to mirror the INDCs being pledged by nation states. Mayor Paes led from the front and Rio became the first city to be compliant with the Compact of Mayors. Rio was also the first Brazilian city to complete a study of its climate vulnerabilities and has mandated emissions cuts of 20 percent by 2020.

It has also been through Mayor Paes' personal leadership that we have created the C40 Finance Facility, to address the the startling omission of most of the world's green funds to finance city government's low carbon projects. Starting from initial generous support from the German government, Mayor Paes aims for the facility to unlock up to $1 billion worth of sustainable infrastructure in cities across low and middle-income countries by 2020.

In part because of Mayor Paes' leadership, Latin America is a focal point for city climate action this year: C40 is looking forward to hosting our flagship event, the C40 Mayors Summit in Mexico City at the end of November. Mexico City Mayor Mancera and Mayor Paes will host this gathering where mayors, urban experts, business people and celebrities from around the world will come together to continue positioning cities as a leading force for climate action around the world.

It is with extreme gratitude that we at C40 thank Mayor Paes for his leadership and passion. And is with great excitement that today in Rio we announced the new C40 chair: Paris Mayor Anne Hidalgo.

From left to right: Eduardo Paes, Mayor of Rio de Janeiro and Chair of C40 Cities Climate Leadership Group and Anne Hidalgo, Mayor of Paris.C40 / Flickr

The C40 Steering Committee voted unanimously to elect Mayor Hidalgo, who has maintained a steadfast commitment to urban sustainability throughout her tenure thus far, emphasizing walkability in Paris, spearheading calls to better air quality across Europe and hosting the Climate Summit for Local Leaders alongside the COP21 climate negotiations in Paris last December. She will be an inspiring champion for city voices around the world, leading by example as the C40 chair-elect. She will take over from Mayor Paes after the C40 Mayors Summit in Mexico City later this year.

It is no coincidence, too, that Paris is currently bidding to host the 2024 Olympics, more than half of the cities that have hosted the Olympics are also C40 member cities. And, given that the International Olympic Committee has outlined a commitment to a sustainable future, it's no surprise that C40's member cities—which represent the most powerful and innovative cities in the world—are not only great places to live, work and prosper, but are also make supremely competent Olympic hosts.

Mayor Paes has been an exceptional leader for the last several years and Rio has set an example for other cities around the world seeking a clean development pathway. We look forward to Mayor Hidalgo carrying that charge forward for the critical years to come.

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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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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.