scientificamerican--2020-12-01--Take Racism Out of Medical Algorithms

Take Racism Out of Medical Algorithms

COVID-19 has wreaked havoc on Black and Indigenous communities and other people of color , and U.S. medical institutions should be doing everything they can to root out and eliminate entrenched racial inequities .
Yet many of the screening assessments used in health care are exacerbating racism in medicine , automatically and erroneously changing the scores given to people of color in ways that can deny them needed treatment .
These race-based scoring adjustments to evaluations are all too common in modern medicine , particularly in the U.S. To determine the chances of death for a patient with heart failure @ @ @ @ @ @ @ the American Heart Association 's guidelines would use factors such as age , heart rate and systolic blood pressure to calculate a risk score , which helps to determine treatment .
But for reasons the AHA does not explain , the algorithm automatically adds three points to non-Black patients ' scores , making it seem as if Black people are at lower risk of dying from heart problems simply by virtue of their race .
This is not true .
A recent paper in the New England Journal of Medicine presented 13 examples @ @ @ @ @ @ @ a factor .
In every case , the race adjustment results in potential harm to patients who identify as nonwhite , with Black , Latinx , Asian and Native American people affected to various degrees by different calculations .
These “ corrections ” are presumably based on the long-debunked premise that there are innate biological differences among races .
This idea persists despite ample evidence that race—a social construct—is not a reliable proxy for genetics : Every racial group contains a lot of diversity in its genes .
It is true that some @ @ @ @ @ @ @ conditions—the BRCA mutations associated with breast cancer , for instance , occur more frequently among people of Ashkenazi Jewish heritage .
But such examples are rare and do not apply to broad racial categories such as “ Black ” or “ white.
” The mistaken conflation of race and genetics is often compounded by outdated ideas that medical authorities ( mostly white ) have perpetuated about people of color .
For example , one kidney test includes an adjustment for Black patients that can hinder accurate diagnosis .
It gauges the estimated glomerular @ @ @ @ @ @ @ is calculated by measuring creatinine , a protein associated with muscle breakdown that is normally cleared by the kidneys .
Black patients ' scores are automatically adjusted because of a now discredited theory that greater muscle mass “ inherent ” to Black people produces higher levels of the protein .
This inflates the overall eGFR value , potentially disguising real kidney problems .
The results can keep them from getting essential treatment , including transplants .
Citing these issues earlier this year , medical student Naomi Nkinsi successfully pushed the University of Washington @ @ @ @ @ @ @ race adjustment .
But it remains widely used elsewhere .
A recent study in Science examined an algorithm used throughout the U.S. health system to predict broad-based health risks .
The researchers looked at one large hospital that used this algorithm and found that , based on individual medical records , white patients were actually healthier than Black patients with the same risk score .
This is because the algorithm used health costs as a proxy for health needs—but systemic racial inequality means that health care expenditures are higher for white people overall @ @ @ @ @ @ @ were underestimated .
In an analysis of these findings , sociologist Ruha Benjamin , who studies race , technology and medicine , observes that “ today coded inequity is perpetuated precisely because those who design and adopt such tools are not thinking carefully about systemic racism.
” The algorithms that are harming people of color could easily be made more equitable , either by correcting the racially biased assumptions that inform them or by removing race as a factor altogether , when it does not help with diagnosis or care .
The same @ @ @ @ @ @ @ pulse oximeter , which is calibrated to white skin—a particularly dangerous situation in the COVID pandemic , where nonwhite patients are at higher risk of dangerous lung infections .
Leaders in medicine must prioritize these issues now , to give fair and often lifesaving care to people left most vulnerable by an inherently racist system .

COVID-19 has wreaked havoc on Black and Indigenous communities and other people of color, and U.S. medical institutions should be doing everything they can to root out and eliminate entrenched racial inequities. Yet many of the screening assessments used in health care are exacerbating racism in medicine, automatically and erroneously changing the scores given to people of color in ways that can deny them needed treatment.
These race-based scoring adjustments to evaluations are all too common in modern medicine, particularly in the U.S. To determine the chance of death for a patient with heart failure, for example, a physician following the American Heart Association's guidelines would use factors such as age, heart rate and systolic blood pressure to calculate a risk score, which helps to determine treatment. But for reasons the AHA does not explain, the algorithm automatically adds three points to non-Black patients' scores, making it seem as if Black people are at lower risk of dying from heart problems simply by virtue of their race. This is not true.
A recent paper in the New England Journal of Medicine presented 13 examples of such algorithms that use race as a factor. In every case, the race adjustment results in potential harm to patients who identify as nonwhite, with Black, Latinx, Asian and Native American people affected to various degrees by different calculations. These “corrections” are presumably based on the long-debunked premise that there are innate biological differences among races. This idea persists despite ample evidence that race—a social construct—is not a reliable proxy for genetics: Every racial group contains a lot of diversity in its genes. It is true that some populations are genetically predisposed to certain medical conditions—the BRCA mutations associated with breast cancer, for instance, occur more frequently among people of Ashkenazi Jewish heritage. But such examples are rare and do not apply to broad racial categories such as “Black” or “white.”
The mistaken conflation of race and genetics is often compounded by outdated ideas that medical authorities (mostly white) have perpetuated about people of color. For example, one kidney test includes an adjustment for Black patients that can hinder accurate diagnosis. It gauges the estimated glomerular filtration rate (eGFR), which is calculated by measuring creatinine, a protein associated with muscle breakdown that is normally cleared by the kidneys. Black patients' scores are automatically adjusted because of a now discredited theory that greater muscle mass “inherent” to Black people produces higher levels of the protein. This practice inflates the overall eGFR value, potentially disguising real kidney problems. The results can keep Black patients from getting essential treatment, including transplants. Citing these issues, medical student Naomi Nkinsi successfully pushed the University of Washington School of Medicine to abandon the eGFR race adjustment in 2020. But it remains widely used elsewhere.
A 2019 study in Science examined an algorithm used throughout the U.S. health system to predict broad-based health risks. The researchers looked at one large hospital that used this algorithm and found that, based on individual medical records, white patients were actually healthier than Black patients with the same risk score. This is because the algorithm used health costs as a proxy for health needs—but systemic racial inequality means that health-care expenditures are higher for white people overall, so that the needs of Black people were being underestimated. In an analysis of these findings, sociologist Ruha Benjamin, who studies race, technology and medicine, observes that “today coded inequity is perpetuated precisely because those who design and adopt such tools are not thinking carefully about systemic racism.
The algorithms that are harming people of color could easily be made more equitable, either by correcting the racially biased assumptions that inform them or by removing race as a factor altogether when it does not help with diagnosis or care. The same is true for devices such as the pulse oximeter, which is calibrated to white skin—a particularly dangerous situation in the COVID pandemic, where nonwhite patients are at higher risk of serious lung infections.
Leaders in medicine must prioritize these issues now to give fair and often lifesaving care to the people left most vulnerable by an inherently racist system.


scientificamerican--2020-12-01--The Arecibo Radio Telescope's Massive Platform Has Collapsed

After in the span of four months , Puerto Rico 's most venerable astronomy facility , the Arecibo radio telescope , has collapsed in an uncontrolled structural failure .
The U.S. National Science Foundation ( NSF ) , which owns the site , decided in November to in response to the damage , which engineers deemed too severe to stabilize without risking lives .
But the NSF needed time to come up with a plan for how to safely demolish the telescope in a controlled manner .
Instead , gravity did the job this morning ( Dec. 1 ) at @ @ @ @ @ @ @ to reports from the area .
`` NSF is saddened by this development , '' the agency wrote in a tweet .
`` As we move forward , we will be looking for ways to assist the scientific community and maintain our strong relationship with the people of Puerto Rico . ''
The NSF added that no injuries had been reported , that the top priority was to maintain safety and that more details would be provided when confirmed .
`` What a sad day for Astronomy and Planetary science worldwide and one @ @ @ @ @ @ @ time , '' Thomas Zurbuchen , NASA 's associate administrator for science , wrote in a tweet .
`` My thoughts are with the staff members and scientists who have continued to do great science during the past years and whose life is directly affected by this . ''
Images shared on Twitter by Deborah Martorell , a meteorologist for Puerto Rican television stations , compare views of the observatory taken yesterday — showing the 900-ton science platform suspended over the massive dish strung up on cables — and today , when the @ @ @ @ @ @ @ fully , which was one of NSF 's key concerns about leaving the structure as it was .
Martorell 's image does appear to show some damage in the knot of buildings at the base of one of the support towers , which includes administrative buildings and a public visitor 's center , although the buildings are still standing .
In an , Jonathan Friedman , a physicist who works at Arecibo Observatory and lives nearby , said that he heard a loud rumble that he compared to a train or an avalanche @ @ @ @ @ @ @ Puerto Rico in January .
Friedman also confirmed that only the tips of the supporting towers broke off , as Martorell 's image suggested .
Since the first cable failure in August , Arecibo Observatory has enforced a safety zone at the facility , although its size changed as damage was incurred and evaluated , Ralph Gaume , director of NSF 's Division of Astronomical Sciences , said during a news conference held on Nov. 19 , at which the NSF announced its decision to decommission the telescope .
Even during that news @ @ @ @ @ @ @ telescope was clear .
`` The structure , as far as I know , is currently standing , so that implies that it is currently stable , '' Gaume said at the time , while also noting the 2.5-month gap between the first cable failure and the second .
The has been at the forefront of atmospheric science , radio astronomy , and capability for decades .
It was also the unusual telescope to become an icon in popular culture , thanks in part to its leading roles in the movies GoldenEye and @ @ @ @ @ @ @ , Arecibo Observatory also includes a LIDAR instrument that scientists use to study the area where Earth 's atmosphere and space meet .
When the NSF announced that it would decommission the telescope , officials emphasized that a key priority was ensuring Arecibo Observatory as a larger facility would continue .
At the time , the NSF could n't assess whether the telescope would be replaced .
`` This is a really , really hard morning for Puerto Rico , for science , for our connection to the cosmos , '' journalist Nadia @ @ @ @ @ @ @ a former director of Arecibo Observatory , wrote in a tweet .
`` RIP # Arecibo . ''
Copyright 2020 Space.com , a Future company .
All rights reserved .
This material may not be published , broadcast , rewritten or redistributed .

After two cable failures in the span of four months, Puerto Rico's most venerable astronomy facility, the Arecibo radio telescope, has collapsed in an uncontrolled structural failure.
The U.S. National Science Foundation (NSF), which owns the site, decided in November to proceed with decommissioning the telescope in response to the damage, which engineers deemed too severe to stabilize without risking lives. But the NSF needed time to come up with a plan for how to safely demolish the telescope in a controlled manner.
Instead, gravity did the job this morning (Dec. 1) at about 8 a.m. local time, according to reports from the area.
"NSF is saddened by this development," the agency wrote in a tweet. "As we move forward, we will be looking for ways to assist the scientific community and maintain our strong relationship with the people of Puerto Rico."
The NSF added that no injuries had been reported, that the top priority was to maintain safety and that more details would be provided when confirmed.
"What a sad day for Astronomy and Planetary science worldwide and one of the most iconic telescopes of all time," Thomas Zurbuchen, NASA's associate administrator for science, wrote in a tweet. "My thoughts are with the staff members and scientists who have continued to do great science during the past years and whose life is directly affected by this."
Images shared on Twitter by Deborah Martorell, a meteorologist for Puerto Rican television stations, compare views of the observatory taken yesterday — showing the 900-ton science platform suspended over the massive dish strung up on cables — and today, when the observatory's three supporting towers are bare .
None of the three towers collapsed fully, which was one of NSF's key concerns about leaving the structure as it was. Martorell's image does appear to show some damage in the knot of buildings at the base of one of the support towers, which includes administrative buildings and a public visitor's center, although the buildings are still standing.
In an interview with local television station Noticentro , Jonathan Friedman, a physicist who works at Arecibo Observatory and lives nearby, said that he heard a loud rumble that he compared to a train or an avalanche — or to the earthquakes that plagued Puerto Rico in January. Friedman also confirmed that only the tips of the supporting towers broke off, as Martorell's image suggested.
Since the first cable failure in August, Arecibo Observatory has enforced a safety zone at the facility, although its size changed as damage was incurred and evaluated, Ralph Gaume, director of NSF's Division of Astronomical Sciences, said during a news conference held on Nov. 19, at which the NSF announced its decision to decommission the telescope.
Even during that news conference, the tenuous state of the telescope was clear. "The structure, as far as I know, is currently standing, so that implies that it is currently stable," Gaume said at the time, while also noting the 2.5-month gap between the first cable failure and the second.
The massive radio dish has been at the forefront of atmospheric science, radio astronomy, and planetary radar capability for decades. It was also the unusual telescope to become an icon in popular culture, thanks in part to its leading roles in the movies GoldenEye and Contact.
In addition to the telescope, Arecibo Observatory also includes a LIDAR instrument that scientists use to study the area where Earth's atmosphere and space meet. When the NSF announced that it would decommission the telescope, officials emphasized that a key priority was ensuring Arecibo Observatory as a larger facility would continue.
At the time, the NSF couldn't assess whether the telescope would be replaced.
"This is a really, really hard morning for Puerto Rico, for science, for our connection to the cosmos," journalist Nadia Drake, whose father Frank Drake is a former director of Arecibo Observatory, wrote in a tweet. "RIP #Arecibo."
Copyright 2020 Space.com, a Future company. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.


scientificamerican--2020-12-02--The Future of Mars Exploration

The Future of Mars Exploration

Join Scientific American for a conversation about the next steps in humanity ’ s reconnaissance of Mars .
Featuring Casey @ @ @ @ @ adviser at The Planetary Society , and space & physics editor Lee Billings , this @ @ @ @ @ an overview of NASA ’ s upcoming Perseverance rover , slated to land on Mars @ @ @ @ @ for signs of past and present life and to gather samples for future return to @ @ @ @ @ will also discuss the “ post-Perseverance ” future in which space agencies and private companies @ @ @ @ @ Mars exploration strategies , and how those plans could forever change our understanding of—and relationship @ @ @ @

Join Scientific American for a conversation about the next steps in humanity’s reconnaissance of Mars. Featuring Casey Dreier, senior space policy adviser at the Planetary Society, and space and physics editor Lee Billings, this deep dive will begin with an overview of NASA’s upcoming Perseverance rover—slated to land on Mars in February 2021 to search for signs of past and present life and to gather samples for future return to Earth.
Dreier and Billings will also discuss the “post-Perseverance” future in which space agencies and private companies may pursue major shifts in Mars exploration strategies and how those plans could forever change our understanding of—and relationship with—the Red Planet.


scientificamerican--2020-12-02--The U.S. Has Embraced Immigrant Tech Entrepreneurs. Now It's Europe's Turn

The world is on the cusp of a counterattack on COVID thanks to several vaccines that are currently seeking regulatory approval and a swift rollout .
For entrepreneurs and the tech industry , this is a moment when their value to society is demonstrated : business and technology is ( along with medicine ) leading us out of the pandemic .
But Germany ’ s Turkish community , and Europe ’ s minorities in general , are celebrating for a different reason .
Turkish-Germans are an often marginalized group , similar to other minorities around the world .
Like any @ @ @ @ @ @ @ success stories , such as Ugur Sahin and Özlem Türeci , the husband-and-wife co-founders of BioNTech , the firm behind the first vaccine to report a successful phase three trial , based on cutting edge mRNA technology .
These highly visible success stories are relatively rare .
Germany , just like much of Europe , has boardrooms that are almost uniformly white .
This even includes the tech sector , which in the United States is one of the most open and meritocratic places in the world .
In my 20 years in @ @ @ @ @ @ @ I have worked with founders with roots all over the world .
This shouldn ’ t be surprising : many of America ’ s biggest tech success stories are those of immigrant backgrounds .
Google co-founder Sergey Brin was born in Moscow .
Tesla ’ s Elon Musk is South African .
Steve Jobs ’ s biological father is from Syria , and Jeff Bezos ’ s stepfather , Mike Bezos , is Cuban-American .
In the past , things have been very different on the other side of the Atlantic , where @ @ @ @ @ @ @ Paris-born eBay founder Pierre Omidyar , who moved to the United States as a child , along with his Iranian-born parents .
Arguably it is Silicon Valley ’ s open attitude to investment and entrepreneurship that makes these American successes possible .
Despite there still being no European Silicon Valley , I ’ m amazed at the level of innovation I ’ m seeing from start-ups across the continent , including places like Spain and France which are not always thought of as tech hubs .
Many of those founders are from minorities @ @ @ @ @ @ @ techpreneurship .
The huge expansion of tech jobs and tech-based entrepreneurship in the U.S. over the last two decades has created exponential demand for technical skills .
Those are the types of skills that many immigrant kids are nudged towards , thanks to parents from developing nations who often see the value of science rather than , say , liberal arts .
A similar expansion is underway in Europe , despite a large portion of the continent ’ s industries still being traditional .
To continue with the German example , only one @ @ @ @ @ @ @ companies , Siemens , is tech-related ; its culture is very different from the “ move fast and break things ” attitude of Silicon Valley , with the firm being founded in 1847 ( 32 years before Edison filed a patent for his light bulb ) .
It is only in new , innovative industries that the immigrant work ethic and appetite for risk can come into their own .
To create more BioNTechs , European firms have to be ready to make way for the new wave of start-ups—whoever their founders are—without @ @ @ @ @ @ @ centuries-old and may be set in their ways .
At a more basic level , the relationship between host communities around the world and those of immigrant background needs to change .
Most societies are very good at tolerating immigrants as much-needed Uber drivers and restaurant servers , less so at supporting them to develop their skills—and their children ’ s—to equip them for the top .
This isn ’ t sustainable , because each generation has grander designs than the one before .
My parents moved to America in 1971 , and @ @ @ @ @ @ @ life are even broader and more assertive than theirs .
I have started a business , for example , when they didn ’ t .
Just as I was given the opportunity to think bigger than my parents , my children are even more ambitious than I am .
Europe needs to move from a tactical , transactional mindset with migration towards a strategic , vision-based one .
It should be more positive and aspirational : “ We want to be the best , and we need to attract the world ’ s @ @ @ @ @ @ @ are going to achieve that.
” As an American , I sometimes feel that Europe is stuck in the past .
As a young country , America is not as set in its ways as many European nations .
The U.S. still seems to act like a teenager : excited about the opportunities of the future , and perhaps sometimes being naive and getting itself into tricky situations ( like a disputed election result ) .
Europe , on the other hand , acts more like a retiree .
It prizes stability above @ @ @ @ @ @ @ the same .
Sometimes the price of stability has meant sacrificing innovation and opportunity .
The European Union is trying to create a similarly strong narrative to the American Dream to drive it forward .
The post-Brexit United Kingdom is attempting the same with the image of “ Global Britain.
” Whether they succeed will be demonstrated in the names and faces that shape their economies in the 21st century , and how similar they are to those that dominated the 20th .

The world is on the cusp of a counterattack on COVID thanks to several vaccines that are currently seeking regulatory approval and a swift rollout. For entrepreneurs and the tech industry, this is a moment when their value to society is demonstrated: business and technology is (along with medicine) leading us out of the pandemic.
But Germany’s Turkish community, and Europe’s minorities in general, are celebrating for a different reason. Turkish-Germans are an often marginalized group, similar to other minorities around the world. Like any community, they are proud of their success stories, such as Ugur Sahin and Özlem Türeci, the husband-and-wife co-founders of BioNTech, the firm behind the first vaccine to report a successful phase three trial, based on cutting edge mRNA technology.
These highly visible success stories are relatively rare. Germany, just like much of Europe, has boardrooms that are almost uniformly white. This even includes the tech sector, which in the United States is one of the most open and meritocratic places in the world.
In my 20 years in tech, including in Silicon Valley, I have worked with founders with roots all over the world.
This shouldn’t be surprising: many of America’s biggest tech success stories are those of immigrant backgrounds. Google co-founder Sergey Brin was born in Moscow. Tesla’s Elon Musk is South African. Steve Jobs’s biological father is from Syria, and Jeff Bezos’s stepfather, Mike Bezos, is Cuban-American.
In the past, things have been very different on the other side of the Atlantic, where the only possible equivalent would have been Paris-born eBay founder Pierre Omidyar, who moved to the United States as a child, along with his Iranian-born parents.
Arguably it is Silicon Valley’s open attitude to investment and entrepreneurship that makes these American successes possible. Despite there still being no European Silicon Valley, I’m amazed at the level of innovation I’m seeing from start-ups across the continent, including places like Spain and France which are not always thought of as tech hubs. Many of those founders are from minorities, which are a natural fit for techpreneurship.
The huge expansion of tech jobs and tech-based entrepreneurship in the U.S. over the last two decades has created exponential demand for technical skills. Those are the types of skills that many immigrant kids are nudged towards, thanks to parents from developing nations who often see the value of science rather than, say, liberal arts.
A similar expansion is underway in Europe, despite a large portion of the continent’s industries still being traditional. To continue with the German example, only one of the country’s five largest companies, Siemens, is tech-related; its culture is very different from the “move fast and break things” attitude of Silicon Valley, with the firm being founded in 1847 (32 years before Edison filed a patent for his light bulb).
It is only in new, innovative industries that the immigrant work ethic and appetite for risk can come into their own.
To create more BioNTechs, European firms have to be ready to make way for the new wave of start-ups—whoever their founders are—without being suffocated by legacy businesses that are centuries-old and may be set in their ways.
At a more basic level, the relationship between host communities around the world and those of immigrant background needs to change. Most societies are very good at tolerating immigrants as much-needed Uber drivers and restaurant servers, less so at supporting them to develop their skills—and their children’s—to equip them for the top.
This isn’t sustainable, because each generation has grander designs than the one before. My parents moved to America in 1971, and as a second-generation immigrant my goals in life are even broader and more assertive than theirs. I have started a business, for example, when they didn’t. Just as I was given the opportunity to think bigger than my parents, my children are even more ambitious than I am.
Europe needs to move from a tactical, transactional mindset with migration towards a strategic, vision-based one. It should be more positive and aspirational: “We want to be the best, and we need to attract the world’s dreamers, innovators and disruptors if we are going to achieve that.”
As an American, I sometimes feel that Europe is stuck in the past. As a young country, America is not as set in its ways as many European nations. The U.S. still seems to act like a teenager: excited about the opportunities of the future, and perhaps sometimes being naive and getting itself into tricky situations (like a disputed election result).
Europe, on the other hand, acts more like a retiree. It prizes stability above all else—and many of its businesses are the same. Sometimes the price of stability has meant sacrificing innovation and opportunity.
The European Union is trying to create a similarly strong narrative to the American Dream to drive it forward. The post-Brexit United Kingdom is attempting the same with the image of “Global Britain.”
Whether they succeed will be demonstrated in the names and faces that shape their economies in the 21st century, and how similar they are to those that dominated the 20th.


scientificamerican--2020-12-02--On Climate, Biden Must Do More than Undo Trump's Damage

One word sums up what President-elect Joe Biden must do to address climate change : Restart .
In 2015 nearly 200 nations agreed to the Paris Agreement , which aims to prevent the worst impacts of climate change by limiting global warming to belowtwo degrees Celsius above preindustrial levels by 2100 .
The U.S. pledged to reduce its greenhouse gasemissions 26 to 28 percent below 2005 levels by 2025 .
Then Donald Trump was elected .
He soon announced the U.S. would pull out of the accord , and his administration spent four years relentlessly rolling back regulations intended to @ @ @ @ @ @ @ Even though many coal-burning power plants , the worst carbon polluters , shut down as market forces expanded the role of cheaper , cleaner natural gas , wind and solar power , and even though states , cities and some industries cut emissions , Trump ’ s rollbacks could add the equivalent of 1.8 billion metric tons of CO2 to the atmosphere by 2035 , according to the Rhodium Group , a highly regarded , independent research organization .
Joe Biden must now make up for lost time , and he has said @ @ @ @ @ @ @ immediately .
This commitment is important because the U.S. is still the world ’ s second largest emitter , behind China , and it can also return as a world climate leader .
But Biden will also have to ratchet up the original U.S. pledge , because because warming—and its effects—have only sped up since the Paris Agreement was reached .
Biden has promised to issue an executive order calling for net-zero emissions by 2050 , but he will need to set specific interim targets .
The World Resources Institute says reducing emissions @ @ @ @ @ @ @ by 2030 could put the country on track .
Congressional legislation is the most effective way to create the concrete policies to achieve those goals , because it gives federal agencies clear priorities , is much harder to override with presidential actions , and can better withstand legal challenges that might be brought by industry or special-interest groups .
But the divided U.S. Senate will make sweeping laws hard to pass .
Biden will have to work through executive orders , and will have to charge federal agencies such as the Environmental Protection @ @ @ @ @ @ @ laws such as the Clean Air Act .
He will need to “ turn every stone possible , ” says Narayan Subramanian , an environmental lawyer working with the Center for Law , Energy & the Environment at Berkeley Law .
The most immediate focuses are transportation , power plants , methane emissions and pesky hydrofluorocarbons .
With coal plants retiring , transportation has surpassed power generation as the country ’ s largest carbon emitter .
The quickest action Biden can take to tackle those emissions is toreinstate California ’ s waiver to @ @ @ @ @ @ @ state to enforce its Advanced Clean Car regulations .
They set fuel efficiency standards for cars and light-duty trucks that are tougher than federal rules , which means fewer emissions .
In the past , automakers have built their nationwide fleets to meet the state ’ s standards to avoid making two versions of their vehicles , and some states such as New York typically follow California ’ s lead .
The Rhodium Group estimates that reinstating the waiver would save about 573 million metric tons of emissions by 2035 .
To expand @ @ @ @ @ @ @ the EPA and Department of Transportation with rescinding Trump ’ s Safer Affordable Fuel-Efficient Vehicle Rule , which undercut more stringent national standards set under the Obama administration .
Even then , to stay on course to meet the two-degree C goal , 90 percent of U.S. passenger cars and light-duty trucks would need to be electric by 2050 , according to a recent study published in Nature Climate Change .
Because cars last 12 to 15 years on average , new EPA and DOT rules that encourage or requirezero-emission vehicles by 2030 @ @ @ @ @ @ @ turn over in time .
Some major U.S. car companies , including GM and Ford , are increasingly investing in electric vehicles , and did not support the full Trump rollbacks because they would likely end up in court , creating years of regulatory uncertainty .
In the electric power industry , market forceswill not cut emissions fast enough to meet the two-degree goal , according to Dan Lashof , U.S. director of the World Resources Institute .
Biden has pledged to set an ambitious net-zero goal for the power sector by 2035 @ @ @ @ @ @ @ emissions by up to 1,380 million metric tons of CO2 a year by 2030 and 1,510 million metric tons a year by 2050 , according to the Asia Society Policy Institute and the nonprofit climate science and policy institute Climate Analytics .
Reaching those numbers will require replacingTrump ’ s Affordable Clean Energy rule with a more aggressive version ofthe Obama-era Clean Power Plan , which was suspended by the Supreme Court before it could go into effect .
The plan , an EPA regulation , would have set strict limits on emissions @ @ @ @ @ @ @ enact new EPA regulations that can better withstand any future federal court challenge .
Although CO2 emissions are much bigger and stay in the atmosphere for longer , scientists are paying increasing attention to curbing methane emissions , because new studies show they are rising fast , and methane is a more potent greenhouse gas .
The Trump administration recently rolled back several methane regulations , notably EPA rules requiring oil and gas companies to monitor and repair leaks in their infrastructure .
The Rhodium Group estimates that leaks would increase emissions by @ @ @ @ @ @ @ As with power plant rules , Biden will have to work through the EPA to repeal the rollbacks and install tougher new requirements .
Hydrofluorocarbons , used in refrigeration and air conditioning , also pack a major warming punch .
Here is one case where Congress could play a role .
Republican senators , including John Kennedy of Louisianahave backed a bill called American Innovation and Manufacturing Act .
The bill , supported by industry , would cut HFC use 85 percent by 2035 , but it is unclear if Congress will pass @ @ @ @ @ @ @ If not , Congress could take it up again in 2021 .
If passed , the AIM Act would be in line with the 2016 Kigali Amendment to the global Montreal Protocol , which calls for a more than 80 percent reduction in hydrofluorocarbon production and consumption in the next 25 years .
Biden can also expand on legislation that has already garnered bipartisan support , such as maintaining tax incentives to encourage the expanded use of renewable energy and electric vehicles .
Any pandemic-related stimulus packages could include funding for green infrastructure @ @ @ @ @ @ @ charging stations to help grow that market , or plugging abandoned oil and gas wells that leak methane .
The federal government can also use its considerable purchasing power to help bolster parts of the clean energy sector , such as buying electric delivery vans for the U.S .
Postal Service .
In tandem , the Biden administration can strengthen rules under the National Environmental Policy Act that require all federal agencies to consider the environmental impacts of actions they take or projects they approve , such as allowing oil drilling on federal @ @ @ @ @ @ @ act only requires consideration of direct , noncumulative impacts , which effectively took climate change off the table .
The Council on Environmental Quality , which ensures that federal agencies adhere to the act , could specify that future climate change impacts should be considered .
That step could make it less likely that emissions-intensive projects , such as drilling , would be approved by agencies such as the Interior Department .
One important leadership change the Biden administration and its agencies can make is to help cities , states and companies play @ @ @ @ @ @ @ by alerting them to planned federal rules and regulations .
That way they can begin to adapt sooner .
“ At the end of the day , ” Subramanian says , “ one of the biggest tools the Biden administration has is sending signals .
”

One word sums up what the Biden administration must do to address climate change: restart.
In 2015 nearly 200 nations committed to the Paris Agreement, which aims to prevent the worst impacts of climate change by limiting global warming by 2100 to less than two degrees Celsius above preindustrial levels. The U.S. pledged to reduce its greenhouse gas emissions to 26 to 28 percent below 2005 levels by 2025. Then Donald Trump was elected president. He soon announced that the U.S. would pull out of the accord, and his administration spent four years relentlessly rolling back regulations intended to curb emissions and protect the environment. Dozens of coal-burning power plants, the worst carbon polluters, shut down anyway as market forces expanded the role of cheaper, cleaner natural gas, wind and solar power. And various states, cities and industries cut emissions. Yet even with that progress, Trump's rollbacks could add the equivalent of 1.8 billion metric tons of carbon dioxide to the atmosphere by 2035, according to the Rhodium Group, an independent research organization.
Joe Biden must now make up for lost time, and last November he said the U.S. would rejoin the Paris Agreement immediately after he became president. This commitment is important because the U.S. is still the world's second-largest emitter, behind China, and it can return as a world climate leader. But Biden will also have to ratchet up the original U.S. pledge because warming—and its effects—has only sped up since the Paris Agreement was established. Biden promised to issue an executive order calling for net-zero emissions by 2050, but he will need to set specific interim targets. The World Resources Institute says reducing emissions to 45 to 50 percent below 2005 levels by 2030 could put the country on track.
Congressional legislation is the most effective way to create the concrete policies needed to achieve those goals because it gives federal agencies clear priorities, is much harder to override with presidential actions, and can better withstand legal challenges that might be brought by industry or special-interest groups. But the divided U.S. Senate will make sweeping laws hard to pass. Biden will have to work through executive orders and will have to charge federal agencies such as the Environmental Protection Agency with issuing new regulations under existing laws such as the Clean Air Act. He will need to “turn every stone possible,” says Narayan Subramanian, an environmental lawyer working with the Center for Law, Energy & the Environment at Berkeley Law. The most immediate focuses are transportation, power plants, methane emissions and pesky hydrofluorocarbons (HFCs).
With coal plants retiring, transportation has surpassed power generation as the country's largest carbon emitter. The quickest action Biden can take to tackle those emissions is to reinstate California's waiver to the Clean Air Act, allowing the state to enforce its Advanced Clean Cars regulations. The regulations set fuel-efficiency standards for cars and light-duty trucks that are tougher than federal rules, which means fewer emissions. In the past, automakers have built their nationwide fleets to meet the state's standards to avoid making two versions of their vehicles, and some states, such as New York, typically follow California's lead. The Rhodium Group estimates that reinstating the waiver would save about 573 million metric tons of emissions by 2035.
To expand on that action, Biden could charge the EPA and the Department of Transportation with rescinding Trump's Safer Affordable Fuel-Efficient Vehicles Rule, which undercut more stringent national standards set under the Obama administration. Even then, to stay on course to meet the two degrees C goal, 90 percent of U.S. passenger cars and light-duty trucks would need to be electric by 2050, according to a recent study published in Nature Climate Change. Because cars last 12 to 15 years on average, new EPA and dot rules that encourage or require zero-emissions vehicles by 2030 or 2035 would help the U.S. fleet turn over in time. Some major U.S. car companies, including General Motors and Ford, are increasingly investing in electric vehicles. And Ford, along with several leading international companies, opposed the Trump administration's rollbacks because the moves were likely to end up in court, creating regulatory uncertainty.
In the electric-power industry, market forces will not cut emissions fast enough to meet the temperature goal, according to Dan Lashof, U.S. director of the World Resources Institute. Biden has set an ambitious goal for the power sector to be net zero by 2035. If achieved, it would reduce emissions by up to 1.38 billion metric tons of CO 2 a year by 2030 and 1.51 billion metric tons a year by 2050, according to the Asia Society Policy Institute and the nonprofit climate science and policy institute Climate Analytics.
Reaching those numbers will require replacing Trump's Affordable Clean Energy rule with a more aggressive version of the Obama-era Clean Power Plan, which was suspended by the U.S. Supreme Court before it could go into effect. The plan, an EPA regulation, would have set strict limits on emissions from power plants. Biden could carefully enact new EPA regulations that can better withstand any future federal court challenge.
Although CO 2 emissions are abundant and stay in the atmosphere a long time, scientists are paying increasing attention to curbing methane emissions because new studies show they are rising fast, and methane is a more potent greenhouse gas. The Trump administration recently rolled back several methane regulations, including, notably, EPA rules requiring oil and gas companies to monitor and repair leaks in their infrastructure. The Rhodium Group estimates that leaks would increase emissions by 592 million metric tons through 2035. As with power-plant rules, Biden will have to work through the EPA to repeal the rollbacks and install new, tougher requirements.
Hydrofluorocarbons, used in refrigeration and air conditioning, also pack a major warming punch. Here is one case where Congress could play a role. Republican senators, among them John Kennedy of Louisiana, backed legislation to cut HFC use 85 percent by 2035. That provision was part of an omnibus government funding bill passed by Congress in December. The mandated reductions are in line with the 2016 Kigali Amendment to the global Montreal Protocol, which calls for a more than 80 percent reduction in HFC production and consumption in the next 25 years.*
Biden can also expand on legislation that has already garnered bipartisan support, for example, by maintaining tax incentives to encourage the expanded use of renewable energy and electric vehicles. Any pandemic-related stimulus packages could include funding for green infrastructure projects such as the construction of more electric-vehicle charging stations to help grow that market or the sealing of abandoned oil and gas wells that leak methane. Moreover, the federal government can use its considerable purchasing power to help bolster parts of the clean-energy sector, such as by buying electric delivery vans for the U.S. Postal Service.
In tandem, the Biden administration can strengthen rules under the National Environmental Policy Act that require all federal agencies to consider the environmental impacts of actions they might take or of projects up for approval such as oil drilling on federal land. The Trump administration said the act requires consideration only of direct, noncumulative impacts, which effectively took climate change off the table. The Council on Environmental Quality, which ensures that federal agencies adhere to the act, could specify that future climate change impacts should be considered. That step could make it less likely that emissions-intensive projects, such as drilling, would be approved by agencies such as the Department of the Interior.
One important leadership change the Biden administration and its agencies can make is to help cities, states and companies play greater roles in reducing emissions quickly by alerting them to planned federal rules and regulations. That way they can begin to adapt sooner. “At the end of the day,” Subramanian says, “one of the biggest tools the Biden administration has is sending signals.
*Editor’s Note (1/12/21): This paragraph was revised after posting to reflect the passage of legislation to reduce hydrofluorocarbon emissions after the story went to print.


scientificamerican--2020-12-03--The Denisovans Expand Their Range Into China

Much like modern humans , the Neanderthals roamed widely throughout Europe .
We know because they left behind extensive evidence , usually bones or tools .
But their cousins , the Denisovans , are more mysterious .
Until recently , they were conclusively linked only to a single cave in southern Siberia , called Denisova Cave , between Kazakhstan and Mongolia .
There , scientists had found a finger bone , three teeth , and a piece of skull , which tipped them off to the existence of a whole new lineage of ancient human .
Now , scientists have @ @ @ @ @ @ @ Denisovans , says Diyendo Massilani of the Max Planck Institute in Germany .
His team turned up evidence the ancient humans occupied a high-mountain cave on the Tibetan plateau , called Baishiya cave .
`` The cave belongs to monks , and monks think it 's a very holy place . ''
In fact , a monk found a piece of jawbone there in 1980 , which has been tenuously linked to the Denisovans .
But Massilani and his team have now unearthed more conclusive evidence by sifting through cave sediments , and @ @ @ @ @ @ @ behind .
`` Body decay .
Or people bleeding , or pooping , peeing there , they could leave their DNA . ''
The DNA appears in layers—suggesting the Denisovans inhabited the cave as far back as 100,000 years ago , as well as at 60,000 years ago , and perhaps even as recently as 45,000 years ago—meaning the Denisovans might have overlapped in this region with modern humans .
The results appear in the journal Science .
[ Dongju Zhang et al , Denisovan DNA in Late Pleistocene sediments from Baishiya Karst @ @ @ @ @ @ @ says this method could enable more Denisovan detective work , too .
`` There 's so many caves where we have evidence of human activity but we do n't have hominin remains .
So if we can explore the sediment we can actually start to track down in the sediment the Denisovan DNA . ''
Denisovans live on today in the genomes of some modern-day humans , from the South Pacific .
Further genetic work like this might give scientists more clues where early Homo sapiens first met—and mixed with—the elusive Denisovans .
@ @ @ @ @ @ @ of this podcast . ]

Full Transcript
Much like modern humans, the Neanderthals roamed widely throughout Europe. We know because they left behind extensive evidence, usually bones or tools.
But their cousins, the Denisovans, are more mysterious. Until recently, they were conclusively linked only to a single cave in southern Siberia, called Denisova Cave, between Kazakhstan and Mongolia. There, scientists had found a finger bone, three teeth, and a piece of skull, which tipped them off to the existence of a whole new lineage of ancient human.
Now, scientists have uncovered more of the range of the Denisovans, says Diyendo Massilani of the Max Planck Institute in Germany. His team turned up evidence the ancient humans occupied a high-mountain cave on the Tibetan plateau, called Baishiya cave.
"The cave belongs to monks, and monks think it's a very holy place."
In fact, a monk found a piece of jawbone there in 1980, which has been tenuously linked to the Denisovans. But Massilani and his team have now unearthed more conclusive evidence by sifting through cave sediments, and sequencing the genetic evidence the Denisovans left behind.
"Body decay. Or people bleeding, or pooping, peeing there, they could leave their DNA."
The DNA appears in layers—suggesting the Denisovans inhabited the cave as far back as 100,000 years ago, as well as at 60,000 years ago, and perhaps even as recently as 45,000 years ago—meaning the Denisovans might have overlapped in this region with modern humans.
The results appear in the journal Science. [Dongju Zhang et al, Denisovan DNA in Late Pleistocene sediments from Baishiya Karst Cave on the Tibetan Plateau]
Massilani says this method could enable more Denisovan detective work, too.
"There's so many caves where we have evidence of human activity but we don't have hominin remains. So if we can explore the sediment we can actually start to track down in the sediment the Denisovan DNA."
Denisovans live on today in the genomes of some modern-day humans, from the South Pacific. Further genetic work like this might give scientists more clues where early Homo sapiens first met—and mixed with—the elusive Denisovans.
—Christopher Intagliata
[The above text is a transcript of this podcast.]


scientificamerican--2020-12-02--2020 Is a Record Year for Disaster Shelters, Red Cross Says

The American Red Cross has provided record levels of disaster shelter this year as unprecedented hurricane and wildfire seasons forced massive evacuations and the COVID-19 pandemic made evacuees financially needy and reluctant to stay with relatives and friends .
The Red Cross has furnished more than 1.2 million nights of sheltering so far this year to people fleeing disasters .
That ’ s more than four times the disaster-related shelter assistance the organization provides in an average year .
Only 10 % of the evacuees stayed in traditional shelter settings such as schools and civic centers .
The rest stayed @ @ @ @ @ @ @ to avoid having evacuees potentially exposed to the coronavirus .
“ We had just a rampant pace of disasters across the country , ” said Trevor Riggen , the Red Cross senior vice president of disaster cycle services .
“ The number of times people had to evacuate and seek shelter was greater than we ’ ve seen before.
” Although 2020 was a record for disaster sheltering , Riggen said there is a long-term , climate-driven trend toward increasingly damaging hurricanes and wildfires that is creating “ a chronic disaster season for @ @ @ @ @ @ @ nation ’ s leading nongovernmental provider of disaster shelter , has agreements with many states and the Federal Emergency Management Agency to provide evacuees with housing , meals and services .
Other organizations and government agencies also provide disaster shelter .
The 2020 Atlantic hurricane season , which ended yesterday , saw a record 30 named storms this year including 13 hurricanes—six of which were “ major hurricanes ” reaching Category 3 or higher .
A record 12 of the named storms hit the U.S. coastline , breaking the previous high of nine @ @ @ @ @ @ @ Named storms include hurricanes and tropical storms , which have sustained winds of at least 39 mph .
NOAA has calculated that there were 16 “ billion-dollar disasters ” through September , tying the one-year record set in 2017 and 2011 .
The 16 disasters this year—which include storms , tornadoes , heat waves , droughts , extreme winds and wildfires—killed 189 people and caused $ 47 billion in damages , according to NOAA .
“ Families are overwhelmed coping with the greatest number of billion-dollar disasters in a single year—on top of @ @ @ @ @ @ @ CEO Gail McGovern said in a statement .
The year also saw wildfires burn a record number of acres in California and Oregon and force tens of thousands of evacuations in those states and in other areas such as Colorado .
The COVID-19 pandemic amplified the impact of disasters because many people had lost their jobs and could not afford to pay for their own hotel rooms or to travel long distances to stay with friends or family .
“ We ’ ve seen more people seek out help because of that , @ @ @ @ @ @ @ s expensive for a family to find a place to stay , to find a hotel on their own , to eat out every day.
” Evacuees whose homes were destroyed have faced difficulty finding new homes , in part because the pandemic has led to less turnover in housing and fewer vacancies , Riggen said .
In Louisiana—which was hit by five named storms this year , most recently Hurricane Zeta in late October—more than 1,700 people remain in emergency hotel lodging through the Red Cross .
Most of the organization ’ @ @ @ @ @ @ @ evacuating from hurricanes and tropical storms in the Gulf Coast .
The Red Cross minimized the use of congregate shelters and housed almost all of the evacuees it handled in hotel rooms , which were plentiful because the pandemic has sharply scaled back business travel and tourism .
“ We were able to move families much more quickly into hotels than we expected , ” Riggen said .
“ One of the few benefits of the environment we ’ re in now is the rooms were available .
The hotel industry was very @ @ @ @ @ @ @ warned in May that states and counties should minimize both evacuations and the use of congregate shelters to contain the coronavirus .
The Red Cross also was able to maintain much of its volunteer force despite fears that people would decline to offer help to avoid exposure .
“ For the most part , our volunteers showed up , ” Riggen said , citing “ massive recruitment plans.
” Reprinted from Climatewire with permission from E & E News .
E & E provides daily coverage of essential energy and environmental news at @ @

The American Red Cross has provided record levels of disaster shelter this year as unprecedented hurricane and wildfire seasons forced massive evacuations and the COVID-19 pandemic made evacuees financially needy and reluctant to stay with relatives and friends.
The Red Cross has furnished more than 1.2 million nights of sheltering so far this year to people fleeing disasters. That’s more than four times the disaster-related shelter assistance the organization provides in an average year.
Only 10% of the evacuees stayed in traditional shelter settings such as schools and civic centers. The rest stayed in hotel rooms the Red Cross rented to avoid having evacuees potentially exposed to the coronavirus.
“We had just a rampant pace of disasters across the country,” said Trevor Riggen, the Red Cross senior vice president of disaster cycle services. “The number of times people had to evacuate and seek shelter was greater than we’ve seen before.”
Although 2020 was a record for disaster sheltering, Riggen said there is a long-term, climate-driven trend toward increasingly damaging hurricanes and wildfires that is creating “a chronic disaster season for us.”
The Red Cross, the nation’s leading nongovernmental provider of disaster shelter, has agreements with many states and the Federal Emergency Management Agency to provide evacuees with housing, meals and services. Other organizations and government agencies also provide disaster shelter.
The 2020 Atlantic hurricane season, which ended yesterday, saw a record 30 named storms this year including 13 hurricanes—six of which were “major hurricanes” reaching Category 3 or higher.
A record 12 of the named storms hit the U.S. coastline, breaking the previous high of nine storms that made landfall in 1916. Named storms include hurricanes and tropical storms, which have sustained winds of at least 39 mph.
NOAA has calculated that there were 16 “billion-dollar disasters” through September, tying the one-year record set in 2017 and 2011. The 16 disasters this year—which include storms, tornadoes, heat waves, droughts, extreme winds and wildfires—killed 189 people and caused $47 billion in damages, according to NOAA.
“Families are overwhelmed coping with the greatest number of billion-dollar disasters in a single year—on top of the coronavirus pandemic,” Red Cross CEO Gail McGovern said in a statement.
The year also saw wildfires burn a record number of acres in California and Oregon and force tens of thousands of evacuations in those states and in other areas such as Colorado.
The COVID-19 pandemic amplified the impact of disasters because many people had lost their jobs and could not afford to pay for their own hotel rooms or to travel long distances to stay with friends or family.
“We’ve seen more people seek out help because of that,” Riggen said. “It’s expensive for a family to find a place to stay, to find a hotel on their own, to eat out every day.”
Evacuees whose homes were destroyed have faced difficulty finding new homes, in part because the pandemic has led to less turnover in housing and fewer vacancies, Riggen said.
In Louisiana—which was hit by five named storms this year, most recently Hurricane Zeta in late October—more than 1,700 people remain in emergency hotel lodging through the Red Cross.
Most of the organization’s disaster sheltering nationwide was for people evacuating from hurricanes and tropical storms in the Gulf Coast.
The Red Cross minimized the use of congregate shelters and housed almost all of the evacuees it handled in hotel rooms, which were plentiful because the pandemic has sharply scaled back business travel and tourism.
“We were able to move families much more quickly into hotels than we expected,” Riggen said. “One of the few benefits of the environment we’re in now is the rooms were available. The hotel industry was very good to work with.”
FEMA had warned in May that states and counties should minimize both evacuations and the use of congregate shelters to contain the coronavirus.
The Red Cross also was able to maintain much of its volunteer force despite fears that people would decline to offer help to avoid exposure. “For the most part, our volunteers showed up,” Riggen said, citing “massive recruitment plans.”
Reprinted from Climatewire with permission from E&E News. E&E provides daily coverage of essential energy and environmental news at www.eenews.net.


scientificamerican--2020-12-03--COVID Pandemic Reduces Seismic Noise

COVID Pandemic Reduces Seismic Noise

Earthquakes send strong tremors through the earth 's crust , recorded by seismometers planetwide .
Human bustle also creates an @ @ @ @ @ buzz—in the rock .
After cities , states and countries implemented lockdowns to try to @ @ @ @ @ this past spring , the volume of human ground noise fell by up to 50 @ @ @ @ @ regions , as people stayed home instead of taking cars , buses and trains to @ @ @ @ @ businesses and industries curtailed operations .
The decline , evident for months , was recorded @ @ @ @ @ 400 meters underground .
“ We were surprised , ” says seismologist Stephen Hicks of @ @ @ @ @ that noise from daily human activity penetrated that far down .
”

Earthquakes send strong tremors through the earth's crust, recorded by seismometers planetwide. Human bustle also creates an ongoing, high-frequency vibration—a background buzz—in the rock. After cities, states and countries implemented lockdowns to try to slow the spread of COVID-19 this past spring, the volume of human ground noise fell by up to 50 percent on average in various regions, as people stayed home instead of taking cars, buses and trains to work and school and as businesses and industries curtailed operations. The decline, evident for months, was recorded by seismometers as deep as 400 meters underground. “We were surprised,” says seismologist Stephen Hicks of Imperial College London, “that noise from daily human activity penetrated that far down.”


scientificamerican--2020-12-03--Who Will Get COVID Vaccines First and Who Will Have to Wait

Vaccines against COVID-19 have arrived with unprecedented speed .
At least three candidates appear to be extremely effective and are likely to be approved in the U.S. in coming weeks .
By the end of December , the U.S. Centers for Disease Control and Prevention ( CDC ) estimates the U.S. will have enough vaccines to treat 20 million people .
Britain this week approved the vaccine made by Pfizer and BioNTech .
But for the first time in modern U.S. history , not everyone who wants a vaccine will be able to get one immediately .
Figuring out who @ @ @ @ @ @ @ and who has to wait is the job of an obscure CDC panel known as the Advisory Committee on Immunization Practices ( ACIP ) .
This week they announced their first official COVID vaccine distribution guidelines .
The committee makes such plans for all newly approved vaccines , but never before has ACIP had to work so fast .
In its December 1 meeting , the committee voted 13 to one that the approximately 21 million health care workers in the country should be the first to receive any new COVID vaccine , @ @ @ @ @ @ @ like nursing homes .
But deciding who comes second , and third , and even further back in the priority line , is trickier , as health experts weigh factors such as vulnerabilities of specific groups and whether immunizing others can have an outsize effect in stopping the harm to larger society caused by the disease .
Public health specialists who have worked on vaccine plans say the immense effects that COVID has had on the country make these decisions challenging .
“ We do n't have everything in place , because we @ @ @ @ @ @ @ ” says physician Helene Gayle , president and CEO of the Chicago Community Trust , who co-chaired a committee evaluating COVID vaccine priorities for the U.S. National Academies of Sciences , Engineering , and Medicine .
“ In my lifetime , there 's never been such a huge challenge to major swathes of the population that also has such societal impact.
” Lawrence Gostin , a health law expert at George Washington University , says there is virtually universal agreement that health care workers should get the vaccine first .
This group is @ @ @ @ @ @ @ the virus because of their exposure to infected patients .
Health care workers have put themselves at the front lines and their well-being ensures that other patients are treated .
This follows the recommendations of an October report from Gayle ’ s committee .
Still , when Britain approved the Pfizer/BioNTech vaccine , the country ’ s Joint Committee on Vaccination and Immunisation did not give health care workers the highest priority .
Instead , it recommended that long-term care residents receive the very first vaccines .
The committee cited this population ’ @ @ @ @ @ @ @ death ; in one study of four nursing homes , more than a quarter of residents died over the course of two months .
In the U.S. , nursing homes account for nearly half of all COVID deaths .
Still , including long-term care facility residents in the first group , known as phase 1a , was a more contentious point of discussion at the recent ACIP meeting .
Committee members questioned whether this population , which tends to have weaker immune systems , might not respond as well to a vaccine .
@ @ @ @ @ @ @ distribution plan , infectious disease expert Helen Keipp Talbot of Vanderbilt University , said she felt there was not enough data on the vaccine ’ s safety and efficacy in this group , and was concerned that U.S. federal agencies ’ surveillance systems weren ’ t sufficient to track these people ’ s outcomes .
Choosing the second group—people who could begin receiving vaccines in about a month—will present even more difficulties .
Current plans put forward by the CDC suggest essential workers—a population of about 87 million—will be in this category , @ @ @ @ @ @ @ phase , 1c , which could start in about three months , would include the approximately 153 million people who have high-risk medical conditions and those over age 65 .
But those plans are not final , and ACIP will continue to meet and hammer out details after the FDA approves each new vaccine and as more doses become available .
For now , the committee has to consider several factors , says Jeffrey Duchin , a former ACIP member who now directs public health efforts in Seattle and King County in Washington @ @ @ @ @ @ @ about which populations are most likely to spread the disease and who is most likely to have severe effects .
Epidemiological models suggest there is little difference in spread whether a vaccine is first given to high-risk adults , essential workers or people over the age of 65 .
Deciding among these groups , therefore , may come down to factors such as logistics and ethical principles like access to health care .
People from racial minority groups , for instance , comprise a high percentage of essential workers with a high chance @ @ @ @ @ @ @ historically had less access to health care and because COVID is far more likely to be fatal in nonwhite Americans , ethical principles might suggest such underserved populations be prioritized , Duchin says .
Others have argued that vaccines be specifically targeted to minority ethnic groups , regardless of whether they are essential workers , in order to make up for historical inequities .
“ I think there is a very strong ethical justification for giving considerable advantage to people who are socially vulnerable , and I would go further and give explicit @ @ @ @ @ @ @ says .
“ COVID has really amplified public concerns about racial and social injustice.
” But Gostin concedes that such a strategy would face political and legal risks .
Surveys have shown that Black Americans , for instance , are already skeptical about receiving a new COVID vaccine , reflecting a broader distrust of experimental treatments among minority populations .
And a conservative-leaning U.S. Supreme Court would be likely to strike down any plan based explicitly on race , if that plan were challenged in a lawsuit .
Targeting the vaccine to essential @ @ @ @ @ @ @ Gostin says , might be a more viable strategy .
One question that should be relatively easy to resolve is determining which health conditions put people in a high-risk group .
The CDC has amassed a large amount of data on conditions like diabetes and morbid obesity that increase the risk of severe COVID complications , and conditions like asthma that only slightly increase the risk .
This list , Gayle says , will allow public health officials to prioritize the people whose preexisting conditions put them at most risk .
Logistical issues @ @ @ @ @ @ @ well .
The Pfizer vaccine , for instance need to be stored at –70 degrees Celsius , a temperature generally only achievable at health care centers .
So getting this vaccine to rural populations could prove challenging .
Ultimately , the implementation of allocation decisions is not done by ACIP .
It comes down to state and local jurisdictions .
The federal advisory committee can recommend a vaccination triage scheme , but the CDC can ’ t force states to follow it .
Still , Sara Rosenbaum , a legal expert at George @ @ @ @ @ @ @ accept the plans .
“ I ’ d be surprised if they fought prioritization , ” she says , noting that , historically , local public health agencies have always followed federal vaccination guidelines .
But the CDC plans will need to allow local public health officials some flexibility in determining who is part of a particular group , for instance who qualifies as an essential worker or member of a disadvantaged population .
Gostin agrees that flexibility is necessary , but is concerned that “ it ’ s a recipe for hundred @ @ @ @ @ @ @ that during this year many state and local governments have failed to follow federal guidelines on COVID testing and mask requirements : “ We ’ ve seen American federalism fail spectacularly.
” For that reason , Duchin says that ACIP will need to carefully word its recommendations in order to ensure consistency .
“ If vaccination strategies differ in big ways , it will lead to confusion and potentially undermine confidence in the process , ” he says .
Read more about the coronavirus outbreak from Scientific American here .
And read coverage @ @ @ @ @ @ @ .

Vaccines against COVID-19 have arrived with unprecedented speed. At least three candidates appear to be extremely effective and are likely to be approved in the U.S. in coming weeks. By the end of December, the U.S. Centers for Disease Control and Prevention (CDC) estimates the U.S. will have enough vaccines to treat 20 million people. Britain this week approved the vaccine made by Pfizer and BioNTech.
But for the first time in modern U.S. history, not everyone who wants a vaccine will be able to get one immediately. Figuring out who gets the first shots in that country and who has to wait is the job of an obscure CDC panel known as the Advisory Committee on Immunization Practices (ACIP). This week they announced their first official COVID vaccine distribution guidelines.
The committee makes such plans for all newly approved vaccines, but never before has ACIP had to work so fast. In its December 1 meeting, the committee voted 13 to one that the approximately 21 million health care workers in the country should be the first to receive any new COVID vaccine, along with residents of long-term care facilities like nursing homes. But deciding who comes second, and third, and even further back in the priority line, is trickier, as health experts weigh factors such as vulnerabilities of specific groups and whether immunizing others can have an outsize effect in stopping the harm to larger society caused by the disease.
Public health specialists who have worked on vaccine plans say the immense effects that COVID has had on the country make these decisions challenging. “We don't have everything in place, because we've just never faced this before,” says physician Helene Gayle, president and CEO of the Chicago Community Trust, who co-chaired a committee evaluating COVID vaccine priorities for the U.S. National Academies of Sciences, Engineering, and Medicine. “In my lifetime, there's never been such a huge challenge to major swathes of the population that also has such societal impact.”
Lawrence Gostin, a health law expert at George Washington University, says there is virtually universal agreement that health care workers should get the vaccine first. This group is one of the most likely to acquire the virus because of their exposure to infected patients. Health care workers have put themselves at the front lines and their well-being ensures that other patients are treated. This follows the recommendations of an October report from Gayle’s committee.
Still, when Britain approved the Pfizer/BioNTech vaccine, the country’s Joint Committee on Vaccination and Immunisation did not give health care workers the highest priority. Instead, it recommended that long-term care residents receive the very first vaccines. The committee cited this population’s very high risk of infection and death; in one study of four nursing homes, more than a quarter of residents died over the course of two months.
In the U.S., nursing homes account for nearly half of all COVID deaths. Still, including long-term care facility residents in the first group, known as phase 1a, was a more contentious point of discussion at the recent ACIP meeting. Committee members questioned whether this population, which tends to have weaker immune systems, might not respond as well to a vaccine. The lone dissenting vote on the initial distribution plan, infectious disease expert Helen Keipp Talbot of Vanderbilt University, said she felt there was not enough data on the vaccine’s safety and efficacy in this group, and was concerned that U.S. federal agencies’ surveillance systems weren’t sufficient to track these people’s outcomes.
Choosing the second group—people who could begin receiving vaccines in about a month—will present even more difficulties. Current plans put forward by the CDC suggest essential workers—a population of about 87 million—will be in this category, known as phase 1b. The following phase, 1c, which could start in about three months, would include the approximately 153 million people who have high-risk medical conditions and those over age 65.
But those plans are not final, and ACIP will continue to meet and hammer out details after the FDA approves each new vaccine and as more doses become available. For now, the committee has to consider several factors, says Jeffrey Duchin, a former ACIP member who now directs public health efforts in Seattle and King County in Washington State. Foremost is the scientific evidence about which populations are most likely to spread the disease and who is most likely to have severe effects. Epidemiological models suggest there is little difference in spread whether a vaccine is first given to high-risk adults, essential workers or people over the age of 65.
Deciding among these groups, therefore, may come down to factors such as logistics and ethical principles like access to health care. People from racial minority groups, for instance, comprise a high percentage of essential workers with a high chance of exposure. Because these groups have historically had less access to health care and because COVID is far more likely to be fatal in nonwhite Americans, ethical principles might suggest such underserved populations be prioritized, Duchin says.
Others have argued that vaccines be specifically targeted to minority ethnic groups, regardless of whether they are essential workers, in order to make up for historical inequities. “I think there is a very strong ethical justification for giving considerable advantage to people who are socially vulnerable, and I would go further and give explicit priority to racial minorities,” Gostin says. “COVID has really amplified public concerns about racial and social injustice.”
But Gostin concedes that such a strategy would face political and legal risks. Surveys have shown that Black Americans, for instance, are already skeptical about receiving a new COVID vaccine, reflecting a broader distrust of experimental treatments among minority populations. And a conservative-leaning U.S. Supreme Court would be likely to strike down any plan based explicitly on race, if that plan were challenged in a lawsuit. Targeting the vaccine to essential workers and people in underserved communities, Gostin says, might be a more viable strategy.
One question that should be relatively easy to resolve is determining which health conditions put people in a high-risk group. The CDC has amassed a large amount of data on conditions like diabetes and morbid obesity that increase the risk of severe COVID complications, and conditions like asthma that only slightly increase the risk. This list, Gayle says, will allow public health officials to prioritize the people whose preexisting conditions put them at most risk.
Logistical issues may dictate some of the allocation as well. The Pfizer vaccine, for instance need to be stored at –70 degrees Celsius, a temperature generally only achievable at health care centers. So getting this vaccine to rural populations could prove challenging.
Ultimately, the implementation of allocation decisions is not done by ACIP. It comes down to state and local jurisdictions. The federal advisory committee can recommend a vaccination triage scheme, but the CDC can’t force states to follow it. Still, Sara Rosenbaum, a legal expert at George Washington University, expects that states will accept the plans. “I’d be surprised if they fought prioritization,” she says, noting that, historically, local public health agencies have always followed federal vaccination guidelines.
But the CDC plans will need to allow local public health officials some flexibility in determining who is part of a particular group, for instance who qualifies as an essential worker or member of a disadvantaged population. Gostin agrees that flexibility is necessary, but is concerned that “it’s a recipe for hundred different responses across America.” He notes that during this year many state and local governments have failed to follow federal guidelines on COVID testing and mask requirements: “We’ve seen American federalism fail spectacularly.”
For that reason, Duchin says that ACIP will need to carefully word its recommendations in order to ensure consistency. “If vaccination strategies differ in big ways, it will lead to confusion and potentially undermine confidence in the process,” he says.
Read more about the coronavirus outbreak from Scientific American here. And read coverage from our international network of magazines here.


scientificamerican--2020-12-03--Conflicts of Interest and COVID

Conflicts of Interest and COVID

Many of our leaders , from politicians to university administrators to business owners , face difficult trade-offs during the COVID-19 pandemic , which has created increasingly tense conflicts of interest .
Across the globe , decision-makers grapple with dilemmas that weigh economic outcomes with responsibilities for public safety and health .
Conflicts of interest impact decisions to close borders , implement quarantines , impose lockdowns , stagger reopenings , enforce social distancing and mandate mask-wearing .
What 's striking is that many of these decision-makers believe , and sometimes explicitly state , that they are not at all influenced by @ @ @ @ @ @ @ statements is that , if our leaders and decision-makers were influenced by their conflicts of interest , they would not necessarily be aware of it .
Decision-makers may think they are not biased by their conflict of interest , but that assumption is based on an inaccurate mental model of how such conflicts work .
Research has repeatedly shown that conflicts of interest operate without our awareness and sometimes against our best intentions .
Without external accountability , decision-makers will continue to fall prey to their biasing influence .
THE SCIENCE BEHIND CONFLICTS @ @ @ @ @ @ @ policymakers alike appear to make the same assumptions regarding conflicts of interest : that those who succumb to their biasing influence are making a deliberate choice to place financial interests over their professional responsibilities .
By extension , we consider those that do succumb to bias to be corrupt .
In reality , abundant evidence from social science research shows that influence from conflicts of interest often occurs on a subconscious and unintentional level .
Even when decision-makers try to be objective , their judgments are influenced by financial incentives .
And studies @ @ @ @ @ @ @ by financial inducements despite data demonstrating the opposite .
People are unable to remain objective , even when motivated to be impartial , which suggests an unintentional element to their decision-making .
What ’ s more , people succumb to bias while denying they have done so , which suggests succumbing to bias is unconscious .
The implication is that even decision-makers who are ethically engaged can make biased recommendations .
In medicine , for example , physicians typically report that their patients ’ health and well-being comes first and that they would @ @ @ @ @ @ @ A large body of evidence , however , suggests that physicians are indeed influenced by gifts and compensation from pharmaceutical companies and medical device manufacturers .
Physicians who receive payment from industry are more likely to prescribe their sponsors ’ drugs and request that specific drugs be added to a hospital formulary than physicians who are not paid by industry .
Many professionals , including physicians , take offense at the notion that they might be influenced by financial incentives .
Their offense reveals , yet again , the robust belief that bias @ @ @ @ @ @ @ conscious control .
Although conflicts of interest can lead to deliberate corruption and bad decisions in managing the COVID-19 pandemic , the problem of unintentional and subconscious bias remains a pervasive problem that self-regulation can not solve .
Policy makers must consider many factors in the highly uncertain environment of the coronavirus pandemic , which makes their decisions complex .
Under this ambiguity , the effect of conflicts of interest are amplified .
It is not difficult to understand how certain anticipated financial fallouts can at times loom larger for decision-makers than uncertain @ @ @ @ @ @ @ .
During the COVID pandemic , apparent failures such as the United Kingdom ’ s delay in implementing a lockdown , Sweden ’ s relatively loose restrictions , and Florida ’ s inability to mandate face masks likely have driven up the death toll from the coronavirus .
The consequences of biasing influence from conflicts of interest can lead to reversals and confusing messaging .
In the past few months , the U.K. government ’ s call for the public to “ eat out to help out , ” and decisions by U.S. @ @ @ @ @ @ @ of Michigan and the University of North Carolina , Chapel Hill , to reopen their campuses to students have been reversed after they led to somewhat predictable surges of new COVID-19 cases .
With a new virus , uncertainty regarding its impact and danger cloud every decision .
Even as we see mortality rates decrease , the long-term disability and morbidity effects from COVID-19 are yet to be identified .
The trade-off between immediate economic outcomes and public safety may ultimately be moot as the lack of a clear strategy in managing the @ @ @ @ @ @ @ both the economy and public health .
In fact , recent data show that those countries that prioritized protecting their population ’ s health from the start also ended up with greater protection to their economy .
When conflicts of interest arise , attempts at self-regulation and statements of unbiased reasoning are woefully inadequate .
They may even make matters worse , as advocating for a decision you ’ ve made can strengthen your belief that your decision was the right one , even if it is not .
The only effective way @ @ @ @ @ @ @ sincere attempts to eliminate , or at least mitigate , the conflict .
When such conflicts can not be eliminated , leaders must make their decision-making processes transparent and open to public scrutiny to increase accountability .
If outcomes can be observed by others and expectations to be careful and accurate are strong , accountability may reduce displays of bias .
Decision-makers need to accept that if they are influenced by financial incentives , they are unlikely to recognize the bias themselves .
This recognition can make leaders more open to dissenting opinions @ @ @ @ @ @ @ make decisions on our behalf must grant informed stakeholders voice , power and influence in managing the pandemic .
People wrestling with conflicts of interest may not succumb intentionally to their biasing influence , but they nevertheless need to be held accountable for them .

Many of our leaders, from politicians to university administrators to business owners, face difficult trade-offs during the COVID-19 pandemic, which has created increasingly tense conflicts of interest. Across the globe, decision-makers grapple with dilemmas that weigh economic outcomes with responsibilities for public safety and health. Conflicts of interest impact decisions to close borders, implement quarantines, impose lockdowns, stagger reopenings, enforce social distancing and mandate mask-wearing.
What's striking is that many of these decision-makers believe, and sometimes explicitly state, that they are not at all influenced by financial incentives. The problem with these statements is that, if our leaders and decision-makers were influenced by their conflicts of interest, they would not necessarily be aware of it.
Decision-makers may think they are not biased by their conflict of interest, but that assumption is based on an inaccurate mental model of how such conflicts work. Research has repeatedly shown that conflicts of interest operate without our awareness and sometimes against our best intentions. Without external accountability, decision-makers will continue to fall prey to their biasing influence.
THE SCIENCE BEHIND CONFLICTS OF INTEREST
The public, professionals and policymakers alike appear to make the same assumptions regarding conflicts of interest: that those who succumb to their biasing influence are making a deliberate choice to place financial interests over their professional responsibilities. By extension, we consider those that do succumb to bias to be corrupt.
In reality, abundant evidence from social science research shows that influence from conflicts of interest often occurs on a subconscious and unintentional level. Even when decision-makers try to be objective, their judgments are influenced by financial incentives. And studies show that advisors routinely deny being influenced by financial inducements despite data demonstrating the opposite.
People are unable to remain objective, even when motivated to be impartial, which suggests an unintentional element to their decision-making. What’s more, people succumb to bias while denying they have done so, which suggests succumbing to bias is unconscious. The implication is that even decision-makers who are ethically engaged can make biased recommendations.
In medicine, for example, physicians typically report that their patients’ health and well-being comes first and that they would never be biased by financial incentives. A large body of evidence, however, suggests that physicians are indeed influenced by gifts and compensation from pharmaceutical companies and medical device manufacturers. Physicians who receive payment from industry are more likely to prescribe their sponsors’ drugs and request that specific drugs be added to a hospital formulary than physicians who are not paid by industry.
Many professionals, including physicians, take offense at the notion that they might be influenced by financial incentives. Their offense reveals, yet again, the robust belief that bias from conflicts of interest is within our conscious control. Although conflicts of interest can lead to deliberate corruption and bad decisions in managing the COVID-19 pandemic, the problem of unintentional and subconscious bias remains a pervasive problem that self-regulation cannot solve.
AMBIGUITY INCREASES BIAS
Policy makers must consider many factors in the highly uncertain environment of the coronavirus pandemic, which makes their decisions complex. Under this ambiguity, the effect of conflicts of interest are amplified. It is not difficult to understand how certain anticipated financial fallouts can at times loom larger for decision-makers than uncertain but potentially catastrophic future public health consequences.
During the COVID pandemic, apparent failures such as the United Kingdom’s delay in implementing a lockdown, Sweden’s relatively loose restrictions, and Florida’s inability to mandate face masks likely have driven up the death toll from the coronavirus. The consequences of biasing influence from conflicts of interest can lead to reversals and confusing messaging. In the past few months, the U.K. government’s call for the public to “eat out to help out,” and decisions by U.S. colleges and universities such as the University of Michigan and the University of North Carolina, Chapel Hill, to reopen their campuses to students have been reversed after they led to somewhat predictable surges of new COVID-19 cases.
With a new virus, uncertainty regarding its impact and danger cloud every decision. Even as we see mortality rates decrease, the long-term disability and morbidity effects from COVID-19 are yet to be identified. The trade-off between immediate economic outcomes and public safety may ultimately be moot as the lack of a clear strategy in managing the conflict decreases public trust and ultimately damages both the economy and public health. In fact, recent data show that those countries that prioritized protecting their population’s health from the start also ended up with greater protection to their economy.
ACCOUNTABILITY CAN DECREASE BIAS
When conflicts of interest arise, attempts at self-regulation and statements of unbiased reasoning are woefully inadequate. They may even make matters worse, as advocating for a decision you’ve made can strengthen your belief that your decision was the right one, even if it is not.
The only effective way to manage conflicts of interest is through sincere attempts to eliminate, or at least mitigate, the conflict. When such conflicts cannot be eliminated, leaders must make their decision-making processes transparent and open to public scrutiny to increase accountability. If outcomes can be observed by others and expectations to be careful and accurate are strong, accountability may reduce displays of bias.
Decision-makers need to accept that if they are influenced by financial incentives, they are unlikely to recognize the bias themselves. This recognition can make leaders more open to dissenting opinions. Politicians, businesses and others who make decisions on our behalf must grant informed stakeholders voice, power and influence in managing the pandemic. People wrestling with conflicts of interest may not succumb intentionally to their biasing influence, but they nevertheless need to be held accountable for them.