The 11 cities most likely to run out of drinking water – like Cape Town


Dripping tap

Cape Town is in the unenviable situation of being the first major city in the modern era to face the threat of running out of drinking water.

However, the plight of the drought-hit South African city is just one extreme example of a problem that experts have long been warning about – water scarcity.

Despite covering about 70% of the Earth’s surface, water, especially drinking water, is not as plentiful as one might think. Only 3% of it is fresh.

Over one billion people lack access to water and another 2.7 billion find it scarce for at least one month of the year. A 2014 survey of the world’s 500 largest cities estimates that one in four are in a situation of “water stress”

According to UN-endorsed projections, global demand for fresh water will exceed supply by 40% in 2030, thanks to a combination of climate change, human action and population growth.

It shouldn’t be a surprise, then, that Cape Town is just the tip of the iceberg. Here are the other 11 cities most likely to run out of water.

1. São Paulo

Brazil’s financial capital and one of the 10 most populated cities in the world went through a similar ordeal to Cape Town in 2015, when the main reservoir fell below 4% capacity.

At the height of the crisis, the city of over 21.7 million inhabitants had less than 20 days of water supply and police had to escort water trucks to stop looting.

Image copyright Getty Images
Image caption At the height of the drought, Sao Paulo’s reservoirs became a desolate landscape

It is thought a drought that affected south-eastern Brazil between 2014 and 2017 was to blame, but a UN mission to São Paulo was critical of the state authorities “lack of proper planning and investments”.

The water crisis was deemed “finished” in 2016, but in January 2017 the main reserves were 15% below expected for the period – putting the city’s future water supply once again in doubt.

2. Bangalore

Local officials in the southern Indian city have been bamboozled by the growth of new property developments following Bangalore’s rise as a technological hub and are struggling to manage the city’s water and sewage systems.

To make matters worse, the city’s antiquated plumbing needs an urgent upheaval; a report by the national government found that the city loses over half of its drinking water to waste.

Like China, India struggles with water pollution and Bangalore is no different: an in-depth inventory of the city’s lakes found that 85% had water that could only be used for irrigation and industrial cooling.

Not a single lake had suitable water for drinking or bathing.

Will Cape Town be the first city to run out of water?

Image copyright Getty Images
Image caption Pollution in Bangalore’s lakes is rife

3. Beijing

The World Bank classifies water scarcity as when people in a determined location receive less than 1,000 cubic metres of fresh water per person a year.

In 2014, each of the more than 20 million inhabitants of Beijing had only 145 cubic metres.

China is home to almost 20% of the world’s population but has only 7% of the world’s fresh water.

A Columbia University study estimates that the country’s reserves declined 13% between 2000 and 2009.

And there’s also a pollution problem. Official figures from 2015 showed that 40% of Beijing’s surface water was polluted to the point of not being useful even for agriculture or industrial use.

The Chinese authorities have tried to address the problem by creating massive water diversion projects. They have also introduced educational programmes, as well as price hikes for heavy business users.

4. Cairo

Once crucial to the establishment of one of the world’s greatest civilisations, the River Nile is struggling in modern times.

It is the source of 97% of Egypt’s water but also the destination of increasing amounts of untreated agricultural, and residential waste.

Image copyright Getty Images
Image caption The Nile provides 97% of Egypt’s water supply

World Health Organization figures show that Egypt ranks high among lower middle-income countries in terms of the number of deaths related to water pollution.

The UN estimates critical shortages in the country by 2025.

5. Jakarta

Like many coastal cities, the Indonesian capital faces the threat of rising sea levels.

But in Jakarta the problem has been made worse by direct human action. Because less than half of the city’s 10 million residents have access to piped water, illegal digging of wells is rife. This practice is draining the underground aquifers, almost literally deflating them.

As a consequence, about 40% of Jakarta now lies below sea level, according to World Bank estimates.

To make things worse, aquifers are not being replenished despite heavy rain because the prevalence of concrete and asphalt means that open fields cannot absorb rainfall.

Image copyright Getty Images
Image caption Illegal well-drilling is making the Indonesian capital more vulnerable to flooding

6. Moscow

One-quarter of the world’s fresh water reserves are in Russia, but the country is plagued by pollution problems caused by the industrial legacy of the Soviet era.

That is specifically worrying for Moscow, where the water supply is 70% dependent on surface water.

Official regulatory bodies admit that 35% to 60% of total drinking water reserves in Russia do not meet sanitary standards

7. Istanbul

According to official Turkish government figures, the country is technically in a situation of a water stress, since the per capita supply fell below 1,700 cubic metres in 2016.

Local experts have warned that the situation could worsen to water scarcity by 2030.

Image copyright AFP
Image caption A 10-month long drought dried up this lake near Istanbul

In recent years, heavily populated areas like Istanbul (14 million inhabitants) have begun to experience shortages in the drier months.

The city’s reservoir levels declined to less than 30 percent of capacity at the beginning of 2014.

8. Mexico City

Water shortages are nothing new for many of the 21 million inhabitants of the Mexican capital.

One in five get just a few hours from their taps a week and another 20% have running water for just part of the day.

The city imports as much as 40% of its water from distant sources but has no large-scale operation for recycling wastewater. Water losses because of problems in the pipe network are also estimated at 40%.

9. London

Of all the cities in the world, London is not the first that springs to mind when one thinks of water shortages.

The reality is very different. With an average annual rainfall of about 600mm (less than the Paris average and only about half that of New York), London draws 80% of its water from rivers (the Thames and Lea).

Image copyright Getty Images
Image caption London has a water waste rate of 25%

According to the Greater London Authority, the city is pushing close to capacity and is likely to have supply problems by 2025 and “serious shortages” by 2040.

It looks likely that hosepipe bans could become more common in the future

10. Tokyo

The Japanese capital enjoys precipitation levels similar to that of Seattle on the US west coast, which has a reputation for rain. Rainfall, however, is concentrated during just four months of the year.

That water needs to be collected, as a drier-than-expected rainy season could lead to a drought. At least 750 private and public buildings in Tokyo have rainwater collection and utilisation systems.

Home to more than 30 million people, Tokyo has a water system that depends 70% on surface water (rivers, lakes, and melted snow).

Recent investment in the pipeline infrastructure aims also to reduce waste by leakage to only 3% in the near future.

11. Miami

The US state of Florida is among the five US states most hit by rain every year. However, there is a crisis brewing in its most famous city, Miami.

An early 20th Century project to drain nearby swamps had an unforeseen result; water from the Atlantic Ocean contaminated the Biscayne Aquifer, the city’s main source of fresh water.

Miami's sea font

Although the problem was detected in the 1930s, seawater still leaks in, especially because the American city has experienced faster rates of sea level rise, with water breaching underground defence barriers installed in recent decades.

Neighbouring cities are already struggling. Hallandale Beach, which is just a few miles north of Miami, had to close six of its eight wells due to saltwater intrusion.

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25 Years of Data Shows We Missed Something Important About Sea Level Rise


Satellite data measured across a 25-year period shows that not only are the seas rising, they’re rising faster and faster – an acceleration that is on track to double the jump in sea levels by 2100 compared with a fixed increase year-on-year.

The acceleration is driven mainly by more and more of the ice in Greenland and Antarctica melting away, according to the scientists, who are warning that more data needs to be gathered to prepare for the effects of sea level rise.

Right now the oceans rise by around 3 millimetres each year, but that number is going up by 0.08 mm every 12 months, the data shows. By the time the next century rolls around, we could be up to a rise of 10 mm every year.

In total we would be looking at a rise of 65 centimetres (25 inches) by 2100, compared with around 30 cm if the annual rises steadied at the current speed.

“This is almost certainly a conservative estimate,” says one of the team, Steve Nerem from the University of Colorado Boulder.

“Our extrapolation assumes that sea level continues to change in the future as it has over the last 25 years. Given the large changes we are seeing in the ice sheets today, that’s not likely.”

The study looked at altimeter readings from various satellites stretching back to 1992, adding in data from climate change models to factor out the variability of events like El Niño and volcanic eruptions, and reach a baseline figure.

Further corrections were made using tide-gauge data collected on the coasts, to tweak and verify the readings provided by the satellites. The end result is a prediction model that matches up very well with forecasts put forward by the Intergovernmental Panel on Climate Change (IPCC) set up by the UN.

According to Nerem and his colleagues, about half of the 7cm (2.76 inch) rise in global mean sea level we’ve seen since 1992 has been down to thermal expansion – the way water takes up more space as it gets warmer.

The other half is down to melting ice sheets, and this is what’s driving the acceleration. Last year another huge chunk of ice began to break off Antarctica, and scientists are worried that it’s now too late for these glaciers to recover.

This new study is by no means the first to suggest the waters are rising at a faster and faster rate. Last year, research published in Nature Climate Change found that the rise-per-year had gone up by 50 percent between 1993 and 2014.

Again, the melting of the Greenland ice sheet was put forward as the primary cause of this acceleration. Perhaps the only positive we can take from all this is that we’re getting a better idea of what we’re up against, and might be able to do something about it.

Now the researchers want to apply the same techniques to a longer period of time, as well as adding in extra measurements from local records, which should help communities prepare for the worst.

“This estimate is useful for understanding how the Earth is responding to warming, and thus better informs us of how it might change in the future,” write the researchers in their published paper.

The WHO Warns We’re Officially on The Path to a Global Pandemic


We need to prepare.

 

We have a problem. A serious one. At any moment, a life-threatening global pandemic could spring up and wipe out a significant amount of human life on this planet.

The death toll would be catastrophic; one disease could see as many as 100 million dead.

It sounds like a horrifying dream. It sounds like something that can’t possibly be true. But it is. The information comes from Tedros Adhanom, Director General of the World Health Organization.

He spoke today at the World Government Summit in Dubai, and according to his assessment, things are not looking good.

“This is not some future nightmare scenario,” said Tedros (as he prefers to be called by Ethiopian tradition).

“This is what happened exactly 100 years ago during the Spanish flu epidemic.” A hush fell across the audience as he noted that we could see such devastation again, perhaps as soon as today.

Tedros was equal parts emphatic and grave as he spoke: “A devastating epidemic could start in any country at any time and kill millions of people because we are still not prepared. The world remains vulnerable.”

What is the cause of this great vulnerability? Is it our inability to stave off Ebola? Rising incidents of rabies in animal populations? An increased number of HIV and AIDS cases?

No. According to Tedros, the threat of a global pandemic comes from our apathy, from our staunch refusal to act to save ourselves – a refusal that finds its heart in our indifference and our greed.

“The absence of universal health coverage is the greatest threat to global health,” Tedros proclaimed.

As the audience shifted in their seats uncomfortably, he noted that, despite the fact that universal health coverage is “within reach” for almost every nation in the world, 3.5 billion people still lack access to essential health services.

Almost 100 million are pushed into extreme poverty because of the cost of paying for care out of their own pockets.

The result? People don’t go to the doctor. They don’t seek treatment. They get sicker. They die. And thus, as Tedros explained, “the earliest signals of an outbreak are missed.”

Surveillance is one of the most vital forms of protection the world’s public health agencies can offer, but these agencies rely on the money of the governments they serve.

And in the United States, which is presently enduring a flu season of record-breaking severity, the Centers for Disease Control and Prevention (CDC) recently announced they would be cutting their epidemic prevention programs back by 80 percent.

Programs for preventing infectious diseases, such as Ebola, are being scaled back in 39 of the 49 countries they’ve been employed in, according to The Washington Post.

The reason? Quite simply, governments are pulling money from these programs, and it’s not clear whether any more will ever be allocated – at least, not in the US during the current administration.

It might seem a bit obtuse. But, as Tedros pointed out, too often we “see health as a cost to be contained and not an investment to be nurtured.”

Aside from the obvious – avoiding a global pandemic that ravages humanity – healthy societies are advantageous for reasons that are more economic than epidemiological.

“The benefits of universal health coverage go far beyond health,” Tedros said. “Strong health systems are essential to strong economies.”

We know that the quality of pre- and post-natal care a person receives when a child is born has a direct impact on how soon they’re able to return to work (if they choose to).

If we want our children to grow up healthy enough to become functioning, contributing members of society, then the quality of care they receive from birth throughout childhood can’t be underestimated.

“We do not know where and when the next global pandemic will occur,” Tedros admitted, “but we know it will take a terrible toll both on human life and on the economy.”

While Tedros acknowledged there’s no guarantee we’ll one day create a completely pandemic-free world, what is within our reach – if we have the investment and support – is a world where humans, not pathogens, remain in control.

We can do better. And if most of us are to survive in the long term, we must.

Four Lessons Psychology Teaches Us about Inspiring Climate Action


There’s the old line that the first step to solving a problem is understanding it. But when it comes to climate change, what happens when understanding alone isn’t enough?

We know it’s important to educate the public so people understand why climate change is happening, what regions are most at risk, and how impacts like sea-level rise, extreme weather, and ocean acidification continue to harm our health and economy.

But education is the easy part. It’s getting people to take action that can be a challenge – and that’s because changing people’s attitudes and behaviors is a daunting task.

Have you ever made a New Year’s resolution, say, to eat healthier – and you find yourself saying “yes” to that second piece of chocolate cake on January 15? You may know eating too many sugary treats isn’t good for your health (attitude), but you may find it difficult to stick to eating healthier (behavior).

Social scientists of all kinds have studied the question of how to change human behavior in many different contexts from public health to public policy to environmental psychology and more. In the climate context, environmental psychologists have begun exploring this larger question by trying to understand why, for example, more Americans aren’t taking action with their votes and voices. Especially when the majority agree that humans are causing climate change.

There’s no simple answer here. The reality is that changing the behavior of one person is hard enough – let alone millions of citizens around the world. But psychology can give us some insight into better ways to motivate people to change their behavior and stand up for the planet we share.

That’s why we’ve compiled four lessons from the field that any activist can take and use to help inspire their friends, colleagues, family members, and more to act.

1. Connect the climate crisis to what’s happening in real communities to reduce psychological distance.

Climate change is a unique issue because although millions of people in the US and around the world feel the drastic effects of it in their daily lives, many people don’t (yet).

Why does this matter? Because of a construct known as psychological distance. Psychological distance refers to things that are not in our immediate reality or felt in the present moment. For example, you might think about your first year of marriage if you’re still single (temporal distance), what neighborhood or city you might buy a home in one day (spatial distance), how your best friend or family member perceives you (social distance), or how your career would be different if you had studied a different major in college (hypothetical distance).

Why is psychological distance relevant to the climate crisis? Studies have found that people who believe the effects of climate change are unlikely to happen to them or are more likely to affect other people and regions of the world are less likely to be concerned about solving it. In other words, if climate change feels psychologically distant, you worry less about it in your daily life and feel less urgency to take action.

To bridge this gap, research suggests that we should discuss how climate change affects communities and families on the local level. That means calling attention to real-life examples of how the climate crisis is affecting real people, especially in regions experiencing extreme weather. From wildfires destroying homes in the western US to hurricanes damaging homes and businesses along the Gulf Coast and southern US to droughts affecting farms in dozens of countries, it’s clear that extreme weather is devastating the livelihoods of many communities around the world.

 

2. Make climate action a group experience to promote social norms.

Humans are pack animals. In 1943, American psychologist Abraham Maslow created his Hierarchy of Needs, which proposed that humans have certain needs that begin with the most basic needs (food, sleep, safety) and end with ego-centered needs (self-esteem, creativity).

The hierarchy also proposed that once humans have their physical and safety needs satisfied, the next need in the hierarchy is belongingness. Put simply, humans are social beings that respond to group norms, and for our ancestors, group acceptance meant access to shared resources and feeling protected from predators.

Today, humans are just as keenly aware of social dynamics and psychology tells us that we fear feeling socially rejected. That’s why the more we can make climate action the norm in our social and family circles, the more likely others will join in.

3. Talk about what we’re gaining, not what we’re losing, to avoid loss aversion.

The psychological concept of loss aversion is nothing new, but behavioral scientists have started thinking about it more as it relates to the climate movement. One study examined how framing climate change impacts can affect attitudes and perceptions. In the experiment, researchers presented different climate change impacts to participants (sourced from the 2007 Intergovernmental Panel on Climate Change (IPCC) report), who then answered questions about what they saw.

The results showed that framing climate change impacts in a way that highlights possible gains rather than losses increased positive attitudes toward mitigation responses. Participants also perceived climate change impacts as more severe when they were framed as gains.

So when talking about climate change with your friends and family, explain how action is an opportunity. For example, America’s Clean Power Plan, which is now under threat by the Trump Administration, could lead to public health and climate benefits worth an estimated $34 billion to $54 billion annually in 2030. Those are some serious gains! If you agree, we invite you to add your name to support the Clean Power Plan and stand up for clean energy.

4. Give your friends real ways to take action to prevent “environmental melancholia.”

We know that the climate crisis isn’t just an environmental issue. Not only do the people who experience extreme weather, warmer temperatures, drought, rising sea levels, and other devastating impacts feel psychological effects, but many people are affected simply by hearing about the crisis or seeing unsettling images in the news.

Dr. Renee Lertzman, a researcher who promotes climate change activism inside the workplace, explains that people often experience “environmental melancholia.” She explains that although we know the climate crisis is a threat, many people feel anxious and powerless about how they can make a difference, which can prevent them from doing something.

By understanding that people may feel powerless when thinking about the climate crisis, we should communicate and provide real ways to take action and support them throughout the process. If your friends or family members feel powerless or have anxiety about getting involved, one way to help is to share helpful content that gives them specific ways to take action. Our blog post, “Four Ways Anyone Can Take Climate Action,” is a great place to start.

How You Can Make a Difference

Humans are complicated and changing behavior is no easy task, but thinking about how to overcome empathy or powerlessness is the first step to getting others involved with the movement for solutions. If you’re ready to make a difference in your community, download our Make It a Reality Action Kit now to get started. Our climate action kit will give you a thorough look at the climate crisis and ways you can participate in the fight for a bright, sustainable future.

Poor More Likely to Suffer During South Africa’s Dire Drought


Cape Town, South Africa is in the throes of a years-long drought that could earn it a truly alarming distinction: the first major city in the developed world to run out of water.

South Africa as a whole is experiencing its worst drought in a century. The six dams that supply Cape Town’s water have dropped to just 15.2 percent capacity of usable water, according to the Los Angeles Times, down from 77 percent in September 2015. Enforcement of strict water restrictions – which cut permitted daily consumption from 23 gallons per day to just 13.2 gallons – begin February 1.

Shravya K. Reddy, principal at Pegasys Strategy and Development and Climate Reality’s former director of science and solutions, lives in Cape Town and says that while several factors – including relatively rapid population growth, poor planning, and people ignoring previous water restrictions – have all contributed to this crisis, officials’ failure to recognize the role that climate change plays in exacerbating drought has made the situation even more dire.

“Decision-makers well-versed with climate science would have taken it seriously and would have started treating this drought, even in 2015 or 2016, as if it would last longer than usual,” Reddy tells Climate Reality. “Instead, they seemed to never escalate the preparations for additional water supplies or accelerate water augmentation projects in the belief that taking drastic action would be overkill, since the rains would come. If they had taken more concerted action two years ago or early last year, then they would not need to be on such war footing right now.”

Climate change worsens drought because as temperatures rise, evaporation increases. When this evaporation happens over land, soils dry out. Many places are also experiencing both decreases in annual precipitation and longer periods without significant rain, resulting in reduced water levels in streams, rivers, lakes, and (importantly) reservoirs. When rains do come, much of the water runs off the hard ground and is carried back to the ocean before it can fully replenish dams, reservoirs, or the water table.

All of Cape Town’s citizens are feeling the impact of the drought, but the city’s lower-income residents are already bearing the brunt. Should the city, which has a population of more than 4 million people in its greater metropolitan area, run out of water on April 21, as many are predicting, their plight will become truly desperate.

“Socio-economic disparity is evident in both peoples’ access to critical information, as well as in the measures people are taking to prepare for ‘Day Zero,’ the day when the city has to shut off municipal water and taps literally run dry,” Reddy says. “In speaking with people who typically have to work the longest hours just to financially survive, it seems to me that they simply don’t have access to the same levels of information we do, and thus are less empowered to make informed decisions about how they will cope and manage.”

This disparity, she adds, can often be traced back to a lack of computer and internet access among many of South Africa’s lower-income communities.

Another imbalance has become clear: Wealthier citizens have the resources to prepare and safeguard themselves from the worst of the water crisis’ impacts.

“Those with more disposable income can stock up on more bottled water. We can also invest in more water-saving devices,” Reddy explains. “Many of Cape Town’s most under-resourced residents live in what we call townships or informal settlements – what the West would call shanty towns or even slums – and they’re lucky if they have a communal water source amongst eight to 10 families. They certainly cannot buy and hoard bottled water.

“People with means – transportation as well as leisure time – can drive farther out of the city to areas where clean, potable water comes out of natural springs and can collect water to take home. Those who don’t have the luxury of a car and time to drive around are less able to take advantage of such natural springs hours away.”

She notes that some retailers are even taking advantage of the situation, increasing the price of common water conservation tools like buckets, pitchers, and other water storage units because of higher market demand, making them even less accessible to the people who may need them the most.

And beyond the obvious necessity of clean drinking water, Reddy worries that “significant public health challenges will emerge as a result of people not being able to maintain individual and institutional hygiene.” The risk of water-borne diseases and other bacterial infections may also rise sharply, elevating the risk of serious public health issues.


“Money buys other adaptation means too. The wealthy have greater ability to buy more new clothes as a response to less clothes washing, ordering takeout food as a response to less cooking and dishwashing, buying ‘chemical toilets,’ tons of wet-wipes, hand sanitizer, and leaving the city for long stretches of time to escape elsewhere – either by renting places in other cities or staying with friends and family who can afford to accommodate long-term guests,” she continues.

“Based on what several people in my circles have been saying, it is clear that some people will have the ability to temporarily leave the city and move to their second homes out in the countryside, to parts of the province that are not as water stressed. Some may even temporarily move to Johannesburg or leave the country until some semblance of normalcy is restored. The majority of the city’s residents do not have that immense privilege.”

Reddy concludes on a note that has become all too familiar for many already experiencing the climate crisis firsthand: “Certainly in the case of climate change adaptation in any community, anywhere in the world – those with greater means at their disposal will fare better.”

With each new natural disaster, the truth becomes clearer: The most vulnerable among us are on the front lines of a crisis they had the least to do with creating – and if we don’t act now to support solutions and end climate change, we may reach a point of no return.

Medical Errors: STILL the Third Leading Cause of Death


History tells us it can take decades before a medical truth becomes accepted as fact, and recent headlines are a perfect example of this.

Sixteen years ago, I read an article in the Journal of the American Medical Association (JAMA) that stunned me. I was shocked. JAMA published it. Although the article did not explicitly state it, the data was very clear.

So I published my summary of the study, which revealed that doctors are in fact the third leading cause of death in the U.S.[1] You likely have seen this statistic or headline, but you may not be aware that I was the one who created that headline, which has been widely circulated on the internet and virtually never attributed to me as the person who saw through the data to make that conclusion.

Dr. Barbara Starfield was the author of that JAMA study, published in 2000, and her research documented how a staggering 225,000 Americans die from iatrogenic causes, meaning their death is caused by a physician’s or hospital’s activity, manner, or therapy. Her statistics showed that each year:

– 12,000 die from unnecessary surgery

– 7,000 die from medication errors in hospitals

– 20,000 die from other errors in hospitals

– 80,000 die from hospital-acquired infections

– 106,000 die from the negative side effects of drugs taken as prescribed

Back then, few people believed it, but in recent days headlines echoing my original 2000 article have made the rounds in many of the major media outlets.[2],[3],[4],[5],[6],[7]

One of the reasons why many are still surprised by these statistics is due to fundamental flaws in the tracking of medical errors, which has shielded the reality of the situation and kept it out of the public eye.

Medical Errors Are STILL the Third Leading Cause of Death

Starfield’s findings 16 years ago still stand today. In fact, recent research suggests matters have only gotten worse, and the reason for this is because no affirmative action was ever taken to address and correct the situation.

According to a recent study[8] published in the British Medical Journal (BMJ), medical errors now kill an estimated 250,000 Americans each year, an increase of about 25,000 people annually from Starfield’s estimates.

That means medical errors are STILL the third leading cause of death, right after heart disease and cancer. These numbers may actually be vastly underestimated, as deaths occurring at home or in nursing homes are not included.

As shown by Starfield’s research, side effects from drugs, taken as prescribed, account for the vast majority of iatrogenic deaths. Research[9] published in 2013 estimated that preventable hospital errors kill 210,000 Americans each year — a figure that is very close to the latest statistics.

However, when they included deaths related to diagnostic errors, errors of omission, and failure to follow guidelines, the number skyrocketed to 440,000 preventable hospital deaths each year. This too hints at the true enormity of the problem.

Cause of Death Reporting Needs an Overhaul

According to Centers for Disease Control and Prevention (CDC) statistics, the third leading cause of death is respiratory disease, which claims 150,000 lives each year, not iatrogenic causes. In fact, the CDC doesn’t publish any information relating to medical errors at all. As reported by Newsweek:[10]

“The researchers for the study from Johns Hopkins say their findings suggest the CDC’s method for collecting data on causes of death is flawed, leading to inaccurate estimates on just how dangerous a visit to your local hospital has become.

Death certificates currently don’t have a separate coding classification for medical errors, which means estimates are not accurate.

The medical coding system used by the CDC was originally developed for physicians and hospitals to determine what to bill health insurance companies for individualized patient care. The authors recommend an overhaul of how cause of death data is collected.”

The researchers suggest adding an extra field to the death certificate, asking whether a preventable complication or medical error contributed to the death. At present, no such checkbox exists. Instead, when a patient dies from a medical error, the original complaint is listed as the cause of death.

They also recommend a number of strategies to reduce the number of deaths from iatrogenic causes, including increased transparency and communication. As long as health care providers and hospital administrators remain in the dark about the severity of the problem, few course corrections are likely to be made.

Iatrogenic Deaths Are a Global Problem

Bob Anderson, Ph.D. chief of the Mortality Statistics branch for the CDC, claims there are codes that capture iatrogenic causes of death. However, the published mortality statistics do not take them into account. They only look at the condition that led the individual to seek medical treatment in the first place.

As a result, even if a doctor lists medical errors in the death certificate, they are not included in the CDC’s mortality statistics.

Anderson defends the agency’s approach, saying it’s “consistent with international guidelines.” In essence, most countries tally their deaths in a similar fashion, in order to be able to compare mortality statistics internationally.

All that really means is that this is a global problem, and all nations really need to take a closer look at how deaths are recorded and counted. According to Anderson, the CDC is unlikely to change the recording of deaths unless there’s a really compelling reason to do so. But what could be more compelling than the fact that modern medicine is a leading cause of preventable deaths!?

Medical error third highest cause of death

Starfield’s Ironic Tragedy — A Victim to What She Chronicled

Ironically, Starfield became a statistic to her own research. She died suddenly in June 2011, a death her husband attributed to the adverse effects of the blood thinner Plavix taken in combination with aspirin. However, her death certificate makes no mention of this possibility. In the August 2012 issue of Archives for Internal Medicine[11] her husband, Dr. Neil A. Holtzman, writes, in part:

“Writing in sorrow and anger, I express up front my potential conflict of interest in interpreting the facts surrounding the death of my wife, Dr. Barbara Starfield, … Because she died while swimming alone, an autopsy was required. The immediate cause of death was ‘pool drowning,’ but the underlying condition, ‘cerebral hemorrhage,’ stunned me …

Barbara started taking low-dose aspirin after coronary insufficiency had been diagnosed three years before her death, and clopidogrel bisulfate (Plavix) after her right main coronary artery had been stented six months after the diagnosis. She reported to the cardiologist that she bruised more easily while taking clopidogrel and bled longer following minor cuts. She had no personal or family history of bleeding tendency or hypertension.

The autopsy findings and the official lack of feedback prompted me to call attention to deficiencies in medical care and clinical research in the United States reified by Barbara’s death and how the deficiencies can be rectified. Ironically, Barbara had written about all of them.”

U.S. Health Care System Is an Unmitigated Failure at Treating Chronic Illness

The U.S. has the most expensive health care in the world, spending more on health care than the next 10 biggest spenders combined (Japan, Germany, France, China, the U.K., Italy, Canada, Brazil, Spain and Australia). If the U.S. health care system were a country, it would be the 6th largest economy on the entire planet.

Despite that, the U.S. ranks last in health and mortality when compared with 17 other developed nations. We may have one of the best systems for treating acute surgical emergencies, but the American medical system is clearly an unmitigated failure when it comes to treating chronic illness. The fact that properly prescribed and administered drugs kill at least 106,000 should really be food for some serious thought. For starters, drug safety needs to become a priority, not an afterthought.

Indeed, one of Starfield’s points of contention was the lack of systematic recording and studying of adverse events, and her own death highlights this problem. It was the Plavix-aspirin combination that actually killed her, yet if it hadn’t been for an autopsy and her husband insisting on an adverse event report, no one would ever have been the wiser about such a connection.

Only a tiny fraction of all adverse drug reactions are ever reported to the FDA; according to some estimates, as few as 1 percent. In order to truly alert the FDA to a problem with a product they’ve approved, they must be notified by as many people as possible who believe they have experienced a side effect.

By filing a report, you help make medicine safer for everyone. So, if you believe you’ve experienced a side effect from a drug, please report it. Simply go to the FDA Consumer Complaint Coordinator page, find the phone number listed for your state, and report your adverse reaction.

In all, preventable medical mistakes may account for one-sixth of all deaths that occur in the U.S. annually.[12] To put these numbers into even further perspective, medical mistakes in American hospitals kill four jumbo jets’ worth of people each week.[13] According to statistics published in a 2011 Health Grades report,[14] the incidence rate of medical harm occurring in the U.S. may be as high as 40,000 harmful and/or lethal errors DAILY. According to co-author John T. James, Ph.D.:

“Perhaps it is time for a national patient bill of rights for hospitalized patients. All evidence points to the need for much more patient involvement in identifying harmful events and participating in rigorous follow-up investigations to identify root causes.”

Many Tests and Treatments Do More Harm Than Good

Overtesting and overtreatment are also part of the problem. Instead of dissuading patients from unnecessary or questionable interventions, the system rewards waste and incentivizes disease over health.

According to a report by the Institute of Medicine, an estimated 30 percent of all medical procedures, tests and medications may in fact be unnecessary,[15] at a cost of at least $750 billion a year. To learn which tests and interventions may do more harm than good, browse through the Choosing Wisely website.[16]

It’s also important to be aware that many novel medical treatments gain popularity over older standards of care due mostly to clever marketing, opposed to solid science. An investigation[17] by the Mayo Clinic published in 2013 proved this point. To determine the overall effectiveness of our medical care, researchers tracked the frequency of medical reversals over the past decade.

They found that reversals are common across all classes of medical practice, and a significant proportion of medical treatments offer no patient benefit at all.

In fact, they found 146 reversals of previously established practices, treatments and procedures over the past 10 years. The most telling data in the report show just how many common medical treatments are doing more harm than good. Of the studies that tested an existing standard of care, 40 percent reversed the practice, compared to only 38 percent reaffirming it.

The remaining 22 percent were inconclusive. This means that anywhere between 40 and 78 percent of the medical testing, treatments, and procedures you receive are of NO benefit to you — or are actually harmful — as determined by clinical studies.

Safeguarding Your Care While Hospitalized

Download Interview Transcript

Once you’re hospitalized, you’re immediately at risk for medical errors, so one of the best safeguards is to have someone there with you. Dr. Andrew Saul has written an entire book on the issue of safeguarding your health while hospitalized. Frequently, you’re going to be relatively debilitated, especially post-op when you’re under the influence of anesthesia, and you won’t have the opportunity to see the types of processes that are going on. This is particularly important for pediatric patients and the elderly.

It’s important to have a personal advocate present to ask questions and take notes. For every medication given in the hospital, ask questions such as: “What is this medication? What is it for? What’s the dose?” Most people, doctors and nurses included, are more apt to go through that extra step of due diligence to make sure they’re getting it right if they know they’ll be questioned about it.

If someone you know is scheduled for surgery, you can print out the WHO surgical safety checklist and implementation manual,[18] which is part of the campaign “Safe Surgery Saves Lives.” The checklist can be downloaded free of charge here. If a loved one is in the hospital, print it out and bring it with you, as this can help you protect your family member or friend from preventable errors in care.

Basic Tenets of Optimal Health

All in all, leading a common-sense, healthy lifestyle is your best bet to achieve good health, and avoid dying from preventable causes. Following is a list of some of the basic tenets of health that have withstood the test of time. Following these healthy lifestyle guidelines can go a very long way toward keeping you from becoming another preventable death statistic:

Eat real food For a comprehensive guide on which foods to eat and which to avoid, see my nutrition plan. Generally speaking, focus your diet on whole, ideally organic, unprocessed foods. Avoid sugar, and fructose in particular.All forms of sugar have toxic effects when consumed in excess, and drive multiple disease processes in your body, not the least of which is insulin resistance, a major cause of chronic disease and accelerated aging.
Avoid sitting, and get plenty of non-exercise “nutritional movement” and high-intensity exercise Even if you’re eating the healthiest diet in the world, you still need to exercise to reach the highest levels of health, and you need to be exercising effectively, which means including high-intensity activities into your rotation.High-intensity interval-type training boosts human growth hormone (HGH) production, which is essential for optimal health, strength and vigor. HGH also helps boost weight loss.

Non-exercise movement is another critical component. I recommend walking more on a daily basis, over and above your scheduled exercise, and avoiding sitting as much as possible.

Implement stress reduction strategies Your emotional state plays a role in nearly every physical disease — from heart disease and depression, to arthritis and cancer.Meditation, prayer, social support and exercise are all viable options that can help you maintain emotional and mental equilibrium.

I also strongly believe in using simple tools such as the Emotional Freedom Techniques (EFT) to address deeper, oftentimes hidden, emotional problems.

Stay well-hydrated Drink plenty of pure, clean water. Considering how widespread water pollution has become, investing in a high-quality water filtration system is advisable.
Maintain a healthy gut Mounting research shows that beneficial microbes affect your health in a myriad of ways; it can even influence your ability to lose weight.A healthy diet is the ideal way to maintain a healthy gut, and regularly consuming traditionally fermented foods is the easiest, most cost effective way to help optimize your gut flora.
Optimize your vitamin D levels Research has shown that increasing your vitamin D levels helps reduce your risk of death from ALL causes.
Avoid toxic exposures This includes tossing out your toxic household cleaners, soaps, personal hygiene products, air fresheners, bug sprays, lawn pesticides, and insecticides, just to name a few, and replacing them with non-toxic alternatives.
Get plenty of high-quality sleep Even if you do everything else right, you cannot be optimally healthy if you do not sleep well.

Regularly catching only a few hours of sleep can hinder metabolism and hormone production in a way that is similar to the effects of aging and the early stages of diabetes.

Chronic sleep loss may speed the onset or increase the severity of age-related conditions such as type 2 diabetes, high blood pressure, obesity, and memory loss.

 

Article References

25 Years of Satellite Data Uncover Alarming Error in Sea Level Measurements


The Earth is changing in ways that could cause an actual mass extinction during our lifetimes. In recent years, scientists have made it abundantly clear that humans are driving climate change, but what they’ve only recently found out is how quickly we’re making the Earth more inhospitable. In a new study published Monday in Proceedings of the National Academy of Sciences, they report that the rate at which the climate getting worse is actually increasing each year.

In the paper, a team of climate researchers shows evidence that global sea levels are rising at an accelerating rate. Scientists previously thought that sea level rise was constant at 3 millimeters per year or even slowing, but this new study, first-authored by R. Steven Nerem, associate director of the Colorado Center for Astrodynamics Research, shows that the annual global average sea level rise has increased by about 0.08 millimeters each year.

Climate researchers say global sea level is rising at an accelerating rate, contrary to previous research suggesting a stable rate.
Climate researchers say global sea level is rising at an accelerating rate, contrary to previous research suggesting a stable rate.

Sea level rise is a combination of water expanding as sea water temperatures rise and water levels rising as long-frozen glaciers melt and join the oceans. Climate change has exacerbated both of these factors, and this new research suggests that the effect is larger than previously predicted.

Previous calculations were off because of a combination of miscalibrated instruments and unique environmental factors, write the researchers. For example, the satellite TOPEX/Poseidon was launched in 1992 to measure ocean topography, but the year before that, Mount Pinatubo erupted in the Philippines. These seemingly unconnected events actually interacted in a strange way: That eruption caused a modest decrease in global mean sea level, which made the first years of TOPEX/Poseidon measurements show a deceleration in sea level rise.

Mount Pinatubo
Mount Pinatubo’s eruption in 1991 threw off the satellite that measures sea level rise.

The next 25 years combined minor calibration errors in tide-gauges and other satellite altimetry equipment, which ultimately averaged out to show a misleadingly steady increase. As part of the new study, the researchers corrected for this statistical noise, showing that the rate of sea level rise actually slowly accelerated over this time period.

A 0.08-millimeter annual rise sounds small, but over many years, it will add up to a big difference. By these calculations, global sea levels could rise by up to 77 centimetersby the year 2100.

This could worsen coastal flooding, which was already predicted to get more severe when scientists predicted it at previous sea level measurements.

The new PNAS study comes hot on the heels of another study, published in December 2017, that also shows evidence that scientists have underestimated sea level rise. In that study, researchers say satellite altimetry is insufficient for measuring increased water volume because the seafloor is also sinking.

With these two papers, the case is becoming clearer that climate change research is constantly being refined and corrected, and that as that happens, the picture becomes increasingly dire. Let’s see what we find out next.

Abstract: Using a 25-y time series of precision satellite altimeter data from TOPEX/Poseidon, Jason-1, Jason-2, and Jason-3, we estimate the climate-change–driven acceleration of global mean sea level over the last 25 y to be 0.084 ± 0.025 mm/y2. Coupled with the average climate-change–driven rate of sea level rise over these same 25 y of 2.9 mm/y, simple extrapolation of the quadratic implies global mean sea level could rise 65 ± 12 cm by 2100 compared with 2005, roughly in agreement with the Intergovernmental Panel on Climate Change (IPCC) 5th Assessment Report (AR5) model projections.

Fact-Checking Matt Damon’s Clean Water Promise In A Super Bowl Ad


 

In a new Super Bowl ad, Matt Damon makes a bold promise: Buy a limited-edition Stella Artois chalice and your money will help give a clean water supply to someone in the developing world for five years.

The ad, called “Taps,” reminds viewers that water is something we take for granted. Around the world, 844 million people do not even have a basic service providing water to their homes, according to the World Health Organization.

“If just 1 percent of you watching this buys [a chalice], we can give clean water to 1 million people,” says Damon in the ad.

The 30-second spot was purchased by Stella Artois (estimated price tag: $5 million). It’s part of an ongoing partnership between the beer giant and Damon’s nonprofit group, Water.org, whose mission is to provide access to clean water and sanitation in the developing world.

The chalices are sold on Amazon for $13, with $3.13 in proceeds from each purchase going to Damon’s charity. The beer glasses are imprinted with designs by artists from India, Mexico and the Philippines, countries where Water.org currently works.

Damon’s statement about “1 percent of you watching” would add up to roughly 1 million purchases from the Super Bowl audience. According to Water.org, Stella Artois would donate the $3.13 for “up to 300,000 chalices” sold in the U.S. between January 1 and December 31.

And what exactly does that $3 buy? Can it really bring clean water to one person for half a decade? Skepticism surfaced on Twitter.

Even water specialists weren’t clear on how the numbers were calculated.

To learn more, we interviewed researchers and spokespeople for Water.org

What does Water.org do?

Despite its name, Water.org doesn’t actually provide water to people in the developing world. So your $3 won’t go directly toward, say, the delivery of jugs of water or the building of a well.

To fulfill its mission, the nonprofit has set up a custom microlending system called WaterCredit. The group partners with financial institutions in developing countries to lend people small amounts of money so they can pay to get water. That might mean buying a faucet and hiring a contractor to tap into water supplies or buying containers to catch rainwater.

Children drinking from a makeshift water pipe in a village in the Mindanao island in the Philippines.

 

Giving people that kind of choice is a good thing, says Annie Feighery, a co-founder of mWater, a digital platform that water nonprofits use to measure the impact of their work. The group has worked with Water.org for four years.

For a long time, charities would try to fix a community’s water problem by digging wells and then leaving, she says. But the wells would often malfunction and become contaminated within a year, and they cost a lot to maintain. Today, wells are seen as an “old-fashioned approach that we now call the dig-and-ditch model,” she says.

Although in some cases, wells are still a reasonable option. Families who live miles away from a clean drinking water source can take out a loan to pay for the construction of a deep borehole well, which siphons clean water deep in the ground, or a large container to catch and store rainwater. According to the World Health Organization, harvesting rainwater generally provides good quality water.

Is $3 enough to cover those kinds of expenses?

Not exactly.

When someone buys the chalice from Stella Artois, $3 does indeed go to Water.org.

According to Water.org’s calculations, that $3 equals five years of clean water for one person in the developing world. To come up with that number, the group counted up the number of people it helped get water from 2014 to 2016 — roughly 3.3 million — and then divided that figure by the sum of the group’s organizational costs in the same time period: $42 million. (The data is available in the charity’s financial statements on their website.)

And the answer is: $12.50 to give one person access to water.

In this formula, the infrastructure for their water would last about 20 years. Based on these calculations, the $3 from the Stella Artois chalice, says Water.org, would provide five years of clean water.

But that doesn’t mean the loans are only $3.

In fact, the average loan taken out by a borrower from local financial institutions, in partnership with Water.org, is about $300.

According to Water.org, 99 percent of the borrowers pay it back. To date, the group says they have given out 2.2 million loans. When people repay the loan, the money gets lent out to others in the community, creating a multiplier effect, says Julie LaGuardia, a spokesperson for Water.org.

“Sometimes in marketing efforts one needs to over-simplify to make reasonable promises to donors, retailers and investors,” says John Oldfield, a principal at the Washington, D.C.-based advocacy group Global Water 2020. “But it’s a good appropriate claim for the start of the conversation around clean water.”

Asked about the discrepancy between the $3 and the $300 figures, Melanie Mendrys, a spokesperson from Water.org, says, “I don’t consider that a discrepancy. I know that the $3 does in fact help a woman or a family get access to the money needed to get water or a toilet.”

She does not think the ad is misleading. “It’s an opportunity for people to learn more and once they do they get really excited,” she says. “We just reached ten million people who received water or sanitation from our efforts. We know what we’re doing is working and we’re excited to reach more.”

And specialists do think the loan is a good approach.

“What’s novel about WaterCredit is that the loan is being provided for a home improvement,” says Jenna Davis, an associate professor in the department of civil and environmental engineering and a senior fellow at the Woods Institute for the Environment at Stanford University. She has looked at the evidence around the Water.org’s business model.

A tap or some containers to catch rainwater doesn’t sound like much, but it can have a significant impact for low-income families. “In many parts of the developing world, people were paying more for water in a month, for example, buying bottled water, than would be needed to pay a regular monthly bill if they had a piped connection,” says Davis. Research has shown that for low-income households, the obstacle to installing the hardware or other connections is the cost, she says.

Wouldn’t it be more efficient if Stella Artois just gave a few million to Water.org instead of buying a Super Bowl ad?

That was another question raised on Twitter: Why couldn’t Stella just have forked over the money to Water.org?

“It’s important to remember that this is a Stella ad just as much, if not more, than a Water.org ad,” says Jason Wojciechowski, creative director of Corelab, an agency that runs digital campaigns for nonprofits like Oxfam, Save the Children and Global Witness.

Wojciechowski doubts that a Game Day ad alone would rake in a “ton of money” for the charity. The group would need to combine it with aggressive fundraising and social media campaign efforts over a long period of time.

But he does think the ad will provide another service to the Super Bowl audience: planting the seed that change is possible. “Showing people that they have agency, responsibility and a role to play,” he says. “The idea that there’s something people can do to end the water crisis.”

In 1918 We Faced the Flu Pandemic. Today, We’re Still Fighting the War.


 1918: The War We Lost

In 1918, the United States fought two wars. One it lost, and one it won.

You may have learned about World War I in history class, or even from your relatives. As a member of the Allied Forces, the United States defeated the Central Powers — a victory touted by history books, movies, and novels.

The second war, however, had a more elusive opponent. It descended perniciously, quietly claiming lives while armies concerned themselves with foxholes and mustard gas. In the first six months, this enemy killed 25 million people worldwide.

Ultimately, between 50 and 100 million lives — five percent of the world’s population at the time — would be lost as a result of the conflict.

This second enemy was, of course, the flu virus. By the time Americans realized that the country was under siege, it was too late to stop it. The flu made its way through the U.S., Europe, and Asia with terrifying speed; people who had been well in the morning dropped dead in the street by dinner time. Families that had already lost sons, fathers, and brothers to the war abroad dwindled as the virus attacked them, affecting the remaining young and healthy. In just one year, the average life expectancy for an American dropped by 12 years.

Over the century that followed, Americans would face three more pandemic flus, but none of them like the one in 1918. The 1957 pandemic flu killed roughly 1.1 million people worldwide; another in 1968 wiped out about another million globally. Most recently, the 2009 H1N1 pandemic flu killed between 151,700 and 575,400 people worldwide, according to estimates from the Centers for Disease Control and Prevention (CDC).

Today, a century after the 1918 pandemic, we know much more about the virus — how it spreads, how it kills. We now have influenza vaccines — unheard of in 1918 — that provide us with (albeit limited) protection. And sophisticated tracking mechanisms help us predict which flu viruses we might encounter in a given year.

We have not, however, completely vanquished the flu. In this particularly bad flu season in the U.S., we need little reminder that the virus is hardy and evolves rapidly. The flu that ravaged humanity in 1918 is not the same strain making headlines in 2018. Likewise, if another global pandemic flu is inevitable, we can’t assume the virus will be one we’ve seen before.

Today, our relationship with the flu has shifted from an adversarial, bellicose one, to one of competition; we are running a race, no longer fighting a war. To survive another century, or another season, public health experts will need stay one step ahead, armed with an artillery provided by science and a war plan drafted from the history of the battle we lost.

Why (and How) the Flu Still Kills

A high fever, fluid in the lungs, crushing fatigue, and body aches — if you’ve ever come down with influenza, it likely needs no introduction. It’s often easy to distinguish the full-blown flu from the common cold because the flu’s symptoms tend to come on suddenly and with an intensity that makes it hard to deny.

When a person is infected by any pathogen — a virus or bacteria — they usually won’t know it until that pathogen has started damaging cells. That kicks the immune system into gear, making you start to feel sick. The fever, aches, and mucus all too familiar to flu-sufferers aren’t from the virus itself, but rather are the side effects of the body’s attempt to vanquish it.

Even though our immune systems respond rapidly and with such force, they aren’t always successful in stopping the microbes wreaking havoc on the body’s cells. While most of us who get the flu just stay home and rest, the flu makes some people seriously ill — they have to be hospitalized. Some even die as a result of complications from the flu.

(The flu doesn’t directly cause death. Instead, the virus can induce an infection like pneumonia, or exacerbate an underlying condition. But oddly enough, it’s usually the body’s too-aggressive immune response to the flu that ultimately kills people).

A flu virus spreads when a healthy person ingests or inhales virus-infected droplets flung into the air by a sick person’s cough, sneeze, or mere breath. The CDC does not know exactly how many people get the flu each year. The agency doesn’t know how many people die from it either. People who come down with the flu don’t always seek medical attention. Even when they do, doctors don’t always test for it.

Those caveats make the data on this year’s flu season more striking: as of the first week of February, the number of flu cases in the United States was the highest since the 2009 pandemic. The most people have been hospitalized at this stage in the flu season since the CDC started tracking, in 2005. Both numbers are still climbing.

When we talk about the flu, we aren’t talking about a single virus. There are four types of influenza viruses — but only two of them cause serious illness in humans, Catherine Beauchemin, an associate professor of virophysics at Ryerson University in Toronto, explained to Futurism. You might remember hearing about H1N1 (the flu type that hit us in 2009) and H3N2 (the type of flu causing problems this year) — those Hs and Ns stand for hemagglutinin and neuraminidase, proteins found on virus’ surfaces that help either enter cells (H) or separate from cells to go infect another cell (N). The numbers identify groups of strains with similar Hs and Ns.

The flu mutates remarkably quickly, changing dramatically to dodge our antibodies in the span of a flu season or two. That means it can infect people who previously contracted it.

That’s why we get flu shots every year. Even though researchers have a sophisticated global tracking system to anticipate which strain might affect a region in a given year, there’s still a surprising amount of guesswork involved.

Flu seasons typically occur during the colder months, when people are more likely to congregate indoors. Because the flu season is opposite in Australia, the CDC’s Epidemiology and Prevention Branch in the Influenza Division can track that country’s flu season about six months before flu season arrives in North America. As travelers move the virus from Australia to Europe, Asia, and the U.S., public health experts can anticipate which strain will likely be the one to make people sick in the northern hemisphere that year.

The system, and the vaccine made from it, is far from perfect though. “The issue is that the recommendations have to be made some six months before the vaccine is actually used,” Richard Webby, Director of the WHO Collaborating Center for Studies on the Ecology of Influenza in Animals and a member of the Department of Infectious Disease at St. Jude Children’s Research Hospital, told Futurism. Researchers need that time to analyze data from Australia’s flu season, then manufacture and distribute the vaccines.

For a virus that evolves so quickly, that lead time can also be problematic. “There have been instances where the viruses have changed between when the recommendations have been made and when the vaccine has been administered, leading to suboptimal performance.” Webby added. For example, the latest data on this year’s flu vaccine shows it’s around 17 percent effective, though that may change before the flu season ends.

This year’s flu virus, H3N2, isn’t like other strains that have circulated in recent years. It binds to cells differently, and seems to be mutating more rapidly, making it difficult to study and create a vaccine against. The strain also doesn’t grow well in eggs, where bacteria are most commonly grown before being put into vaccines.

“We don’t have a flu vaccine problem so much as we have an H3N2 vaccine problem,” Ed Belongia, a vaccine researcher and director of the Center for Clinical Epidemiology and Population Health at Wisconsin’s Marshfield Clinic, recently told STAT News.

Although we can identify and classify them, track them, and create vaccines to defend against them, the viruses continue to evade us, evolving faster than we can keep up — sickening or killing people in the process.

Fighting the Flu of the Future

In 1918, many of the treatments we have today for secondary infections like pneumonia or strep throat either didn’t exist or were not yet widely available. That partially explains why the epidemic killed so many.

Today, the antiviral Tamiflu can quell symptoms within the first 48 hours of their onset, or even prevent them in the first place. But it’s pricey (a five-day course costs $100 minimum) and comes with risks, especially for children and teens, who are more likely to experience serious psychological side effects and “seizures, confusion, or abnormal behavior early during their illness,” according to the CDC.

In 1918, many people felt that the flu descended upon their community out of nowhere. Today, we can at the very least see the flu coming so our doctors and emergency rooms can be prepared — even if we don’t have weapons powerful enough to completely stop it yet.

One elegant solution is to gather data from smart devices sick people usually use to track the spread of the flu. Smart thermometer company Kinsa does just that. Over the past six years, the device’s 1 million users gather real-time data to track infectious disease with the help of “smart thermometers” and a smartphone app. Though it may seem counter-intuitive that a relatively small number of users could track how many people have the flu and where, the flu-tracking data over the past two years has lined up with CDC data — and the app is gathering it much more quickly than public health agencies are able. Nationally, the number of people with the flu is 39 percent higher than it was at this time last year, according to Kinsa’s most recent report.

Some are thinking bigger than treating or tracking the flu. The holy grail for flu treatment would be a vaccine that doesn’t change from year to year depending on the annual strain. If everyone could just get the vaccine once to protect us from all strains of flu for our entire lives, hundreds of thousands of lives could be saved every year.

We’re talking, of course, about a universal flu vaccine.

A team of researchers out of UCLA is genetically-engineering flu viruses that could become candidates for a universal vaccine. The researchers engineered flu cells to stimulate a bigger, more targeted immune response than the real-life strains. So far, the team has only developed the potential vaccine in the lab; the researchers hope to test two strains in animal models before moving into human trials.

Pharma company BiondVax Pharmaceuticals recently completed Phase 3 clinical trials for its universal vaccine candidate, which incorporates synthetic compounds. It has already received a patent in India. This type of vaccine targets specific areas on the surface of a flu virus that determine the phase and severity of the immune response. Being able to “ramp up” or “tamp down” different aspects of that process in animal models has convinced researchers that the vaccine could be useful in preventing other infectious disease beyond the flu, such as HIV and malaria.

FluGen, a startup out of the University of Wisconsin-Madison, is also working with a genetically-mutated form of the virus to make a universal vaccine. According to FluGen’s website, the company’s genetically-altered  viruses have had a gene deleted so that they “can infect cells, express the entire spectrum of influenza RNA and proteins, yet cannot produce any infectious virus particles.”

But to get there, the researchers encountered substantial controversy. You have to break a few eggs to make an omelet; to create a vaccine against mutating flu viruses, you’ll have to mutate a few flu viruses. Researchers worked to avoid creating some kind of super-virus. When the researchers mutated the H1N1 virus from the 2009 pandemic, and when they recreated the 1918 pandemic flu, the global scientific community called their methods and safety into question.

Other researchers, like those on a team at Georgia State University, are harnessing nanoparticles to facilitate a universal vaccine. Most vaccines target the outside surface of a virus’s protein, which varies across different viruses. But if nanoparticles could target further down, on a part of the protein called the stalk, a vaccine could have broader efficacy. In experiments detailed in a study published in Nature Communications in January 2018, mice inoculated with nanoparticles containing the protein to elicit an immune system response were completely immune to four different strains of the flu, including this year’s H3N2. They will need to conduct more animal studies — first in ferrets, as their respiratory systems are quite similar to those of humans — before testing the vaccine on humans.

There are other logistical hurdles to a universal vaccine. There’s little financial incentive for pharmaceutical companies to develop vaccines, much less universal ones only administered once in a person’s life. Distribution of vaccines can be challenging and shortages are not uncommon. Plus, people just love to find reasons why they shouldn’t get the jab.

But these challenges are not insurmountable. A universal vaccine could be possible within a generation. How well it works, well, that’s another question.

As 1918 came to a close, the editors of the Journal of the American Medical Association published its final edition for the year. The editors reflected on what could be learned from the two wars humanity fought that year, then turned their attention to the future.

“Medical science for four and one-half years devoted itself to putting men on the firing line and keeping them there,” they wrote. “Now, it must turn with its whole might to combating the greatest enemy of all — infectious disease.” In another century, perhaps the flu of today — the damage it causes, the lives lost to it — will seem equally distant, perhaps even innocuous.

Politicians and Innovators Agree: It’s Impossible to Govern AI


This weekend, Futurism got exclusive access to a closed-door roundtable on the global governance of AI. The event was organized by the AI Initiative from the Future Society at Harvard Kennedy and H.E. Omar bin Sultan Al Olama, the UAE’s Minister of State for Artificial Intelligence. With over 50 of the world’s foremost thinkers, leaders, and practitioners of AI in attendance, the conversation was—to be cliché—a hotbed for debate.

These thought leaders convened with the goal of developing a roadmap for nations to follow as we transition to future where humans are no longer the only sentient species on the planet.

During one session, which was focused on how to develop rules to govern AI, a panelist opened the discussion by implying that values are universal. As such, his thought ran, there really shouldn’t be problems when trying to develop a set of basic ethics to govern AI. “Ethics is one. Right? There are not ten,” the panelist said. “I mean, no one thinks that killing is a good thing.”

Broad and deep disagreement was instantaneous.

A Difficult Discussion

A fellow panelist noted that, while the universality of ethics may exist in theory, it exists only in theory. Reality is far more complex. “Once we start talking about privacy rights, everyone has a very different view,” he noted. And he highlighted how nations value even those things we consider the most basic and fundamental, like human life, differently. “Once we start considering rights for women and minorities, nations don’t agree,” he said.

There was a general consensus regarding this point, and another panelist offered a potential solution, suggesting that one way forward may be developing regional ethics. “If we are adopting the same policies in the West, and then the nations in the East are adopting the same policies, then those nations should come together to reduce redundancies,” she said. “From there, we can find our commonalities.”

Others spoke out, noting that, as long as various players continue to have competing goals — preserving jobs, preserving the economy, optimizing government efficiency, saving the environment, satisfying investors — there is little hope for any consensus. “What do we want to say we actually value?” asked one exasperated man. “Until we make that decision, all of these talks are just B.S.,” he concluded.

The conversation turned to who should lead the regulatory efforts. They couldn’t even agree on this.

“Who is going to lead an international cooperation? Because we have a lot of international organizations,” one man noted as the conversation turned.

“Do we really want to say this is about ‘the world’?” another shot back, asserting that the group had no right to talk about “the world” given that a significant portion of the planet wasn’t represented.”I’m not sure how many people are from the global south. We are blessed with one person from Japan, but we’re mostly all western,” he said.

From there, the conversation spun out. “One global hub isn’t possible at this point,” a panelist said, “What we should be pushing for is just more international cooperation.”

The panelist who had posed the question responded, “So you think there is no need to form one cohesive whole for everything that is going on?”

“I think it would be beneficial in some ways,” the respondent conceded, “but it’s just too early.”

Another who had observed the conversation’s many turns succinctly summed the consensus, stating that we have a long way to go before we can begin speaking in definitive terms about international cooperative efforts. “I’m not sure if we are ready for the global level,” he said. “There’s so much research still being done. We need to solve many things before we come to this traditional standardization.”

The frustration was palpable in both words and countenances. “I think it’s too late for a lot of things, like the governance of people’s data in the States [the United States],” one panelist pointed out. The conversation wound down after this lamentable fact was noted.

Yet, the desire to say something decisive, something that seemed to inspire more hope, was strong. One man spoke up and quietly ventured that some solution may not be that far beyond our reach. “I mean, you can regulate [AI] though. We’ve chosen not to modify human genomes, for example,” he said.

But of course, that’s not entirely true: China does not have strong regulations surrounding gene editing. Already, trials are underway.

Questions and Interest

If the absence of solutions here surprises you, you likely aren’t too familiar with artificial intelligence or how young this industry truly is. There’s still a lot yet to be determined. In fact, at this point, basically, all we have are questions and problems, which is precisely why this roundtable took place — to begin discussions about clear and tangible goals.

And these conversations, intense as they are, serve as proof that, while we’re short on solutions at the moment, there’s no shortage of interest.

Towards the end of the conversation, one panelist noted this point, a slight hint of hope in his voice. “The number of both technical papers and start-up companies has exploded in recent years,” he offered. “It’s amazing. But we’re still pretty small. We see the same faces at all these conferences. We still have a chance to make solutions.”

Though frustrations abound, and the specifics may still be a bit murky, one thing is clear: if you’re setting out to build the future of AI, there are worse places you could be than in a room with over 50 of the world’s leading minds.

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