The first thing to be said about the terrorist attacks on Paris is that they are a dreadful crime that deserves only the most fervent condemnation.
The attackers showed a total contempt for human life and chose soft, civilian targets where their victims were unable to put up any defence against military grade weaponry.
But we must also ask: Why Paris? And why now?
Yes, France has been especially active in its air strikes against ISIS in Syria. And yes, there there is a huge reservoir of discontent among the socially excluded youth of the banlieue, the concrete jungle of impoverished outer suburbs that surround Paris and other big cities—where ISIS can perhaps find willing recruits to its ranks.
But is that all? In just a few weeks time, the COP21 climate conference will take place, in Paris, the biggest such event since COP15 in Copenhagen six years ago. The event offers the world a desperately needed opportunity to reduce its carbon emissions and limit global warming to 2C.
And that's surely something the attackers, or at least their (presumably) ISIS commanders, must know all about.
Could the attacks and COP21 possibly be related?
To answer that question we should first ask, what do the attacks mean for COP21?
For a start, the negotiations taking place at the conference centre at Le Bourget will surely be even more isolated from Paris itself, and civil society, than they were already going to be. Le Bourget is home to one of Paris's main international airports—perfect for VIPs to fly in and out without ever leaving the airport and conference complex.
Undoubtedly France already had a high level of security planned for Le Bourget. But now, whatever those plans are, they will be redoubled. Expect a ring of steel and concrete to go up.
Expect it to be far harder for accredited journalists, campaigners, activists, even businessmen to gain access to the conference, with stringent searches, long queues, and arbitrary refusals to people who may have travelled thousands of miles to be there.
Expect leaders, politicians, negotiators present at the conference to remain more firmly ensconced in their secure surroundings at Le Bourget—instead of traveling into central Paris to enjoy the city's many charms.
And as for civil society ...
It's estimated that ten thousand or more climate activists from around the world may be planning to stay in Paris for the duration of the conference, both to demand a strong and effective agreement, and to develop their own agenda, alliances and plans for climate action.
There is certain to be a far larger and more repressive security presence around them than previously planned—not just at Le Bourget but in central Paris where most of the events, conferences and demonstrations are due to take place.
Police surely fear the presence of terrorists taking shelter among the climate activists—and in many a policeman's world view, there may be no huge difference between murderous terrorists and (generally) peaceful demonstrators anyway. Both are likely to be seen as the "enemy."
Meanwhile the activists could reasonably fear terrorism themselves. What yesterday's attacks tell us is that any target will do. Climate campaigners have no reason to feel any safer than anyone else. And a demonstration of tens of thousands densely packed on the streets of Paris would offer a highly vulnerable target.
So the effect of the attacks on COP21 is likely to be a chilling one. Faced with a combination of terrorist threat, and likely heavy-handed policing, their numbers—and their political impact—are likely to fall.
Eyes off the climate ball?
Another outcome that will surely be felt at the highest levels in the conference itself is a loss of focus on the climate, and a refocusing among world leaders present in Paris on terrorism and security.
Yes, negotiators will still be arguing over square brackets in texts as they always do. But the potential of important 'big picture' climate deals cemented between presidents and prime ministers now look less likely than before—for the simple reason that world leaders are likely to take the opportunity of COP21 to talk about more immediately pressing security matters.
So with world leaders distracted from questions of climate, the prospects of serious inter-governmental agreement on the key issues at stake in the talks—from climate finance to the legal status of any agreement reached—have just receded.
Of course, this may all be accidental. Maybe Paris was just hit because of French attacks on ISIS. And maybe the now more likely failure of COP21 to achieve its aims is mere collateral damage in the increasingly savage 'great game' of global power politics.
ISIS Inc defending its corporate interests?
But it may not be. As the FT put it last week in an article titled Isis Inc: how oil fuels the jihadi terrorists:
"Oil is the black gold that funds Isis' black flag—it fuels its war machine, provides electricity and gives the fanatical jihadis critical leverage against their neighbours ...
"Estimates by local traders and engineers put crude production in Isis-held territory at about 34,000-40,000 bpd. The oil is sold at the wellhead for between $20 and $45 a barrel, earning the militants an average of $1.5m a day ...
"While al-Qaeda, the global terrorist network, depended on donations from wealthy foreign sponsors, Isis has derived its financial strength from its status as monopoly producer of an essential commodity consumed in vast quantities throughout the area it controls. Even without being able to export, it can thrive because it has a huge captive market in Syria and Iraq."
But ISIS's ambitions surely don't stop there. Its aim is to consolidate its hold of the regions it already occupies, extend its empire to new regions and countries, and establish a Caliphate whose power and income will largely derive from oil. So the last thing it needs is a global climate agreement that will, over time, limit global consumption of fossil fuels.
Oil prices are low at around $50 per barrel. The IEA estimates that OPEC states have lost half a trillion dollars a year in revenues since the oil price fell from over $100 a barrel in 2011-2014 to current levels. And this is causing deep tensions among OPEC members—due to meet on Dec. 4 in Vienna to thrash out solutions.
The main problem is that Saudi Arabia is over-producing oil in order to suppress investment in and production of high cost oil in the the U.S., Canada, UK and other countries—and so capture the lion's share of an oil market it thinks will keep on growing for decades to come.
Thus OPEC scenarios foresee oil demand increasing from 111 to 132 million barrels per day (mb/d) by 2040. However the International Energy Agency thinks that even modest carbon constraints will see demand for oil slump to around 100 mb/d by 2040—and considerably lower with tough climate policies.
And that is surely an outcome that not just ISIS but all major oil exporters fear and wish to avoid.
Was it or wasn't it?
So, assuming—as seems probable at this stage—that the Paris outrage was carried out by or for ISIS, was it in any way motivated by a desire to scupper a strong climate agreement at COP21? And so maintain high demand for oil long into the future, together with a high oil price?
Let's just say that it could have been a factor, one of several, in the choice of target and of their timing. And of course ISIS was not necessarily acting entirely on its own. While not alleging direct collusion between ISIS and other oil producing nations and companies, it's not hard to see a coincidence of interests.
So if that is the case, or even if it might be the case, there's an important message in it for us all. The effort to shrink the importance of fossil fuels in the global energy landscape—and oil in particular—just took on a whole new dimension.
Yes, it's still about the climate, very much so. But there are also immediate and compelling reasons of national and global security to reduce the world's demand for oil even faster than the IEA's projections.
And an important part of achieving that is to reach a strong agreement in Paris next month, sending a clear message to energy corporations and investors that oil and other fossil fuels are no longer a smart investment—and instead to put their resources into the clean, green, renewable energy technologies of the future.
So as well as standing with France in at this time of horror, we must also take a powerful resolve—and communicate it it ceaselessly to our leaders—for a strong, effective climate agreement: the Paris Treaty.
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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.
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.
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."
Today the 6 Biden-Sanders Unity Task Forces are unveiling final language. The Climate Task Force accomplished a gr… https://t.co/gz3broq2qe— Alexandria Ocasio-Cortez (@Alexandria Ocasio-Cortez)1594240617.0
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.
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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.
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