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Will Elon Musk's Tesla Model 3 Recharge the U.S. Electric Vehicle Market?

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Few product launches in recent memory have captured as much attention as last week’s unveiling of the Tesla Model 3 electric vehicle (EV), Tesla’s first vehicle pitched at the mass market.

Orders were flooding in even before Tesla CEO Elon Musk revealed the car to a giddy audience last Thursday evening, with prospective buyers queuing at Tesla stores throughout the day to place a deposit on a vehicle they might not even receive for two years or more.

Tesla Model 3: cheaper than its predecessors, but is $35,000 really within reach of "mainstream" buyers? Photo credit: Tesla Motors

Musk made the case for EVs being “really important for the future of the world,” combating rising greenhouse gas emissions and air pollution.

The Model 3 is really important for the future of Tesla and the future of EVs. It promises the sales growth that automotive wunderkind Tesla needs to survive and renews interest in a technology that is yet to have significant real-world impact. Yet even with the introduction of Tesla’s flashy new sedan, more pieces need to be in place before the EV market goes truly mainstream.

Battery Prices Dropping

When the Chevrolet Volt plug-in hybrid and Nissan Leaf battery-electric vehicle hit U.S. showrooms in December 2010, the price of gasoline was rising and so were expectations for the future of EVs.

Shortly after, President Obama articulated the goal of having one million EVs on U.S. roads by 2015 and committed billions of investment in EV manufacturing capacity, recharging infrastructure deployment and vehicle purchase incentives.

Five years later, the reality is somewhat different, with the market for hybrid and electric vehicles stagnating (see figure below). Only 415,000 plug-in hybrid and battery-electric vehicles have been sold to date, achieving no more than one percent of new vehicle sales and conventional hybrid vehicles have fared little better, following the price of gasoline down over the past two years.

With gas cheap, sales of SUVs and pickups are booming and all evidence suggests that mainstream car buyers simply do not want the green vehicles that are available currently.

After rising during a period of high gas prices, sales of hybrids and electric cars have started to plateau and fall. Photo credit: HybridCars.com, U.S. Energy Information Administration

Why then might prospects for EVs be different looking forward? The answer lies in the rapid reductions in lithium-ion battery prices that are being achieved, falling 70 percent since 2007 to US$300 per kWh.

These battery improvements have the potential to significantly affect EV performance compared to gasoline-powered cars. The next wave of electric vehicles, led by the Tesla Model 3 and Chevrolet Bolt, promise more than 200 miles of electric range for $35,000, which advocates hope will be a sweet spot for consumers.

To say that $35,000 for a midsize car is affordable for mass-market consumers, as some have suggested, is optimistic to say the least. However, continued development of these second-generation EVs could soon challenge (again) the gasoline/internal-combustion regime that has dominated global automotive markets for the past 100 years.

Not Just for Techies and Treehuggers

But when a mass-market transition to EVs may occur remains uncertain even with falling battery prices.

A recent report by Bloomberg New Energy Finance received widespread attention for suggesting that EVs would be cost-competitive with gasoline vehicles by 2025. Significant further advances with batteries would be needed for that to occur.

Even so, building a market for EVs that is ecologically and economically sustainable requires more than just cheap batteries. EVs will go mainstream only when everyday car buyers understand the technology, have a wide range of EV makes, models and body styles to choose from and have access to a ubiquitous network of fast charging stations for long trips.

Only Tesla can claim to offer significant charging infrastructure coverage today with their growing network of proprietary Supercharger stations and Tesla faces other challenges internally as they learn to manufacture vehicles at scale with high quality.

The greatest impact of the Model 3, then, to the benefit of the entire EV industry, may be in convincing consumers that EVs are no longer just for treehuggers and techies.

In launching presales far in advance of production, Tesla has empowered 275,000 people (and counting) to tell everyone they know that their next car will be electric, long before the first Model 3 hits the road. For the struggling field of electric cars, that’s a real vote of confidence.

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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.

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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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