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Friday, December 31, 2021
Thursday, December 30, 2021
A film about a comet hurtling towards Earth and no one is doing anything about it? Sounds exactly like the climate crisis by Peter Kalmus
The film, from director Adam McKay and writer David Sirota, tells the story of astronomy grad student Kate Dibiasky (Jennifer Lawrence) and her PhD adviser, Dr Randall Mindy (Leonardo DiCaprio), who discover a comet – a “planet killer” – that will impact the Earth in just over six months. The certainty of impact is 99.7%, as certain as just about anything in science.
The scientists are essentially alone with this knowledge, ignored and gaslighted by society. The panic and desperation they feel mirror the panic and desperation that many climate scientists feel. In one scene, Mindy hyperventilates in a bathroom; in another, Diabasky, on national TV, screams “Are we not being clear? We’re all 100% for sure gonna fucking die!” I can relate. This is what it feels like to be a climate scientist today.
The two astronomers are given a 20-minute audience with the president (Meryl Streep), who is glad to hear that impact isn’t technically 100% certain. Weighing election strategy above the fate of the planet, she decides to “sit tight and assess”. Desperate, the scientists then go on a national morning show, but the TV hosts make light of their warning (which is also overshadowed by a celebrity breakup story).
By now, the imminent collision with comet Diabasky is confirmed by scientists around the world. After political winds shift, the president initiates a mission to divert the comet, but changes her mind at the last moment when urged to do so by a billionaire donor (Mark Rylance) with his own plan to guide it to a safe landing, using unproven technology, in order to claim its precious metals. A sports magazine’s cover asks, “The end is near. Will there be a Super Bowl?”
But this isn’t a film about how humanity would respond to a planet-killing comet; it’s a film about how humanity is responding to planet-killing climate breakdown. We live in a society in which, despite extraordinarily clear, present, and worsening climate danger, more than half of Republican members of Congress and many more wish to block action, and in which the official Democratic party platform still ; in which the current president ran on a promise that “nothing will fundamentally change”, and the speaker of the House dismissed even a modest climate plan as ; in which the , and the to a huge tract of the Gulf of Mexico after the summit; in which world leaders say that climate is an “existential threat to humanity” while simultaneously expanding fossil fuel production; in which , and climate news is routinely overshadowed by sports; in which entrepreneurs push incredibly and billionaires sell the absurdist fantasy that .
World leaders underestimate how rapid, serious and permanent ecological breakdown will be if humanity fails to mobilize
After 15 years of working to raise climate urgency, I’ve concluded that the public in general, and , underestimate how rapid, serious and permanent climate and ecological breakdown will be if humanity fails to mobilize. There may only be before humanity expends the remaining “carbon budget” to stay under 1.5C of global heating at today’s emissions rates – a level of heating I am not confident will be compatible with civilization as we know it. And there may only be five years before the and a pass irreversible tipping points.
The Earth system is breaking down now with breathtaking speed. And climate scientists have faced an even more insurmountable public communication task than the astronomers in Don’t Look Up, since climate destruction unfolds over decades – lightning fast as far as the planet is concerned, but glacially slow as far as the news cycle is concerned – and isn’t as immediate and visible as a comet in the sky.
Given all this, dismissing Don’t Look Up as too obvious . It’s funny and terrifying because it conveys a certain cold truth that climate scientists and others who understand the full depth of the climate emergency are living every day. I hope that this movie, which comically depicts how hard it is to break through prevailing norms, actually helps break through those norms in real life.
We need stories that highlight the many absurdities that arise from knowing what’s coming while failing to act.
I also hope Hollywood is learning how to tell climate stories that matter. Instead of stories that create comforting distance from the grave danger we are in via unrealistic techno fixes for unrealistic disaster scenarios, humanity needs stories that highlight the many absurdities that arise from collectively knowing what’s coming while collectively failing to act.
We also need stories that show humanity responding rationally to the crisis. A lack of technology isn’t what’s blocking action. Instead, humanity needs to confront the fossil fuel industry head on, accept that we need to consume less energy, and . The sense of solidarity and relief we’d feel once this happens – if it happens – would be gamechanging for our species. More and better facts will not catalyze this sociocultural tipping point, but more and better stories might.
Peter Kalmus is a climate scientist and author of Being the Change: Live Well and Spark a Climate Revolution
Wednesday, December 29, 2021
Tuesday, December 28, 2021
After 40 years of fighting debilitating depression, Emma was on the brink. “I was suicidal,” said Emma, a 59-year-old Bay Area resident. KQED is not using her full name because of the stigma of mental illness. “I was going to die.” Over the years, Emma sat through hours of talk therapy and tried countless anti-depression medications ‘to have a semblance of normalcy.’ And yet she was consumed by relentless fatigue, insomnia and chronic nausea.
Depression is the world’s leading cause of disability, partly because treatment options often result in numerous side effects or patients do not respond at all. And there are many people who never seek treatment because mental illness can carry heavy stigma and discrimination. Studies show untreated depression can lead to suicidal ideation.
Three years ago, Emma’s psychiatrist urged her to enroll in a study at Stanford University School of Medicine designed for people who had run out of options. When she arrived, scientists took an MRI scan to determine the best possible location to deliver electrical pulses to her brain. Then for 10 hours a day for five consecutive days, Emma sat in a chair while a magnetic field stimulated her brain.
At the end of the first day, an unfamiliar calm settled over Emma. Even when her partner picked her up to drive home, she stayed relaxed. “I’m usually hysterical,” she said. “All the time I’m grabbing things. I’m yelling, you know, ‘Did you see those lights?’ And while I rode home that first night, I just looked out the window and I enjoyed the ride.”
The remedy was a new type of repetitive transcranial magnetic stimulation (rTMS) called Stanford neuromodulation therapy. By adding imaging technology to the treatment and upping the dose of rTMS scientists have developed an approach that’s more effective and more than eight times as the current approved treatment.
A coil on top of Emma’s head created a magnetic field that sent electric pulses through her skull to tickle the surface of her brain. She says it was like a woodpecker tapped on her skull every 15 seconds. The electrical current is directed at the prefrontal cortex, which is the part of the brain that plans, dreams and controls our emotions. “It’s an area thought to be underactive in depression,” said Nolan Williams, a psychiatrist and rTMS researcher at Stanford. “We send a signal for the system to not only turn on, but to stay on and remember to stay on.” Nolan says pumping up the prefrontal cortex helps turn down other areas of the brain that stimulate fear and anxiety. That’s the basic premise of rTMS – electrical impulses are used to balance out erratic brain activity. As a result, people feel less depressed and more in control. All of this holds true in the new treatment, it just works faster.
A recent randomized control trial, published in the American Journal of Psychiatry, shows astounding results are possible in five days or less. Almost 80% of patients crossed into remission — meaning they experienced a normal mood within days. This is compared to about 13% of people who received the sham placebo. Patients did not report any serious side effects. The most common complaint was a light headache.
Stanford’s new delivery system may even outperform electroconvulsive therapy, which is the most popular form of brain stimulation for depression, but it requires both general anesthesia and a full medical team. “This study not only showed some of the best remission rates we’ve ever seen in depression,” said Shan Siddiqi, a Harvard psychiatrist not connected to the study. “But also managed to do that in people who had already failed multiple other treatments.”
Siddiqi also says the study’s small sample size, which is only 29 patients, is not cause for concern. “Often, a clinical trial will be terminated early (according to pre-specified criteria) because the treatment is so effective that it would be unethical to continue giving people placebo,” said Siddiqi. “That’s what happened here – they’d originally planned to recruit a much larger sample, but the interim analysis was definitive.”
Mark George, a psychiatrist and neurologist at the Medical University of South Carolina, agrees. He points to other similarly sized trials for depression treatments like ketamine, a version of which is now FDA-approved. He says the new rTMS approach could be a game changer because it’s both more precise and faster. George pioneered a rTMS treatment that was approved by the federal Food and Drug Administration for depression in 2008. Studies show it produces a near total loss of symptoms in about a third of patients, another third feel somewhat better, and a third do not respond at all. But the main problem with the original treatment is that it takes six weeks, which is a long time for a patient in the midst of an urgent crisis. “This study shows that you can speed it all up and that you can add treatments in a given day and it works,” said George.
The shorter treatment will increase access for a lot of people who cannot get six weeks off work or cover childcare for that long. “The more exciting applications, however, are due to the rapidity,” said George. “These people [the patients] got un-suicidal and undepressed within a week. Those patients are just clogging up our emergency rooms, our psych hospitals. And we really don’t have good treatments for acute suicidality.”
After 45 years of depression and numerous failed attempts to medicate his illness Tommy Van Brocklin, a civil engineer, says he didn’t see a way out. “The past couple of years I just started crying a lot,” he said. “I was just a real emotional wreck.”
So last September, Van Brocklin flew across the country from his home in Tennessee to Stanford where he underwent the new rTMS treatment for a single five-day treatment. Almost immediately he started feeling more optimistic and sleeping longer and deeper. “I wake up now and I want to come to work, whereas before I’d rather stick a sharp stick in my eye,” said Van Brocklin. “I have not had any depressed days since my treatment.” He is hopeful the changes stick. More larger studies are needed to verify how long the new rTMS treatment will last.
At least for Emma, the woman who received Stanford’s treatment three years ago in a similar study, the results are holding. She says she still has ups and downs but ‘it’s an entirely different me dealing with it.’ She says the regimen rewired her from the inside out. “It saved my life and I’ll be forever grateful,” said Emma, her voice cracking with emotion. “It saved my life.”
Stanford’s neuromodulation therapy could be widely available by the end of next year, that’s when scientists are hoping FDA clearance comes through. Nolan, the lead researcher at Stanford, says he’s optimistic insurance companies will eventually cover the new delivery model because it works faster, so it’s likely more cost effective than a conventional rTMS regimen. Major insurance companies and Medicare currently cover rTMS, though some plans require patients to demonstrate that they’ve exhausted other treatment options.
The next step is studying how rTMS may improve other mental health disorders like addiction and traumatic brain injury. “This study is hopefully just the tip of the iceberg,” said Siddiqi. “I think we’re finally on the verge of a paradigm shift in how we think about psychiatric treatment, where we’ll supplement the conventional chemical imbalance and psychological conflict models with a new brain circuit model.” In other words, psychiatrists will use electricity instead of talk therapy and drugs to treat mental health disorders. KQED.org
Monday, December 27, 2021
This Is What You Should Know Before Taking a Rapid COVID Test by Theresa Tamkins, BuzzFeed News Reporter
Last week, President Joe Biden announced that the US government is buying 500 million at-home COVID tests for the nation. If you’ve tried to buy or get a COVID test lately, you may have found long lines, empty shelves, and a frustrating lack of availability in general. This is happening as Omicron is making up the majority of new cases in the country, including more than 90% in some parts of the US.
While increased test availability is a good thing, those government-supplied, at-home COVID tests may not be available to request until January and could take months to be distributed. And if you are able to get your hands on rapid COVID tests, a lot of questions remain. How reliable are they? When should you use them?
Here are some important things to know about at-home COVID tests.
When should you use rapid COVID tests?
Rapid COVID tests are, well, rapidly becoming a way of life in the US. After being absent in the US for much of the pandemic, they are more widely available — and often sold out — in pharmacies and grocery stores as well as online. The pro is that they give fast results — in about 15 minutes, allowing you to make quick changes in behavior if you get a positive result. The con is that they may not be as accurate very early in an infection compared with other tests, like a PCR, that can take a day or more to get results.
“Rapid tests are one of the most powerful tools that have not really been utilized in a powerful way in this pandemic,” said longtime testing advocate Dr. Michael Mina, a former Harvard epidemiologist who is now the chief science officer of eMed, a digital platform that facilitates at-home testing. “The government is in a position now where it’s bringing these tests forward, and now is the time to start creating a strategy around how will they be most effectively used,” he said Tuesday at a press briefing.
You can take a COVID test for any reason at all, but here are the times the FDA recommends you get tested, even if you have been vaccinated: If you have COVID symptoms, including cough, shortness of breath, fever, and other respiratory virus symptoms. You have been within 6 feet of someone with a confirmed case of COVID for a total of at least 15 minutes. (If you are unvaccinated, get tested right away; if you are fully vaccinated, get tested within five to seven days after exposure, according to the CDC.) If you took part in high-risk activities, including any time you couldn’t socially distance as recommended, such as when traveling, in crowded indoor places, or attending large gatherings or mass events
Many people who are asymptomatic are now getting screening tests for COVID at work, school, or before or after travel or events. Although vaccines, especially when combined with a booster, are likely to protect against hospitalizations and death due to the Omicron variant, “we know we will continue to hear more about people who get infected who were vaccinated,” CDC chief Rochelle Walensky said at a press briefing on Wednesday. “These people may get mild or asymptomatic infections and could unknowingly spread those infections to others.”
Regardless of vaccination status, you should wear a mask in public indoor settings. “I would encourage people to take an at-home COVID-19 test ahead of time to help protect you and your family and friends who may be at greater risk of COVID-19 or severe outcomes,” Walensky said.
How many different at-home COVID tests are there?
There are now (at least) 11 over-the-counter antigen tests, which are the rapid tests that you can buy, take yourself, and generally cost about $20 to $35 for two — if you can find them. An antigen test detects proteins produced by the SARS-CoV-2 virus, which can be picked up with a nasal swab. Keep in mind that no test is perfect. Any given medical test is measured by its sensitivity, or how good it is at picking up actual cases and not generating false negatives, and specificity, how good it is at ruling out people who aren’t sick and not generating false positives.
Here are some of the at-home antigen tests that have been approved via the FDA’s emergency-use authorization:
BinaxNOW COVID-19 Antigen Self-Test
iHealth COVID-19 Antigen Rapid Test
Flowflex COVID-19 Antigen Home Test
BD Veritor At-Home COVID-19 Test
CareStart COVID-19 Antigen Rapid Test/On/Go COVID-19 Antigen Self-Test
SCoV-2 Ag Detect Rapid Self-Test
InteliSwab COVID-19 Rapid Test
Celltrion DiaTrust COVID-19 Ag Home Test
Quidel QuickVue At-Home OTC COVID-19 Test
Ellume COVID-19 Home Test
There are also over-the-counter molecular tests that are similar to PCR and can detect the virus earlier than an antigen test, but they cost more, Mina said. They include Detect, Cue Health, and Lucira, which can be done at home, as well as other molecular tests that are done in doctor’s offices. “Rapid molecular tests are slightly more sensitive, but they are a lot more expensive,” Mina said. There are also fewer of them available. “It’s a much more difficult technology to build than a rapid antigen test,” he said.
Are rapid COVID tests accurate and reliable?
In general, yes. But you should know that false negatives are more likely to occur early on with rapid tests than with laboratory tests, like PCR. False positives are much less common. However, the chances of a false positive can vary by brand, ranging from one in 150 tests to one in 5,000, said Mina. That said, if your rapid test gives a positive result, you should assume you probably have COVID and isolate until you follow up with another type of test, like PCR. Rapid tests are about 30% to 40% less sensitive than PCR tests, and they are more accurate in people with symptoms than without symptoms.
In one study, a popular at-home rapid test had a sensitivity of about 35% in asymptomatic people and 64% in people with symptoms when compared with PCR but was around 100% accurate when it came to people who tested positive for COVID, whether or not they had symptoms. In the study, there were only a handful of false positives, all in asymptomatic people — but 47% were false negatives compared with PCR.
These are still good tests! It’s not fair to compare rapid tests you can do at home in 15 minutes to a lab-based result that might be more accurate but takes a day or more (often many more) to get a result, Mina said. You may just need to keep all that in mind when taking a rapid test and know that taking multiple rapid tests is part of the strategy. “The test is very good when it’s positive, but when negative may frequently give you a false negative result,” said Dr. Stanley Weiss, a professor of biostatistics and epidemiology at the Rutgers School of Public Health in New Jersey.
If you get a negative result, follow up with additional rapid tests in a few days to see if it becomes positive, especially if you have reason to believe that you were exposed or infected. Wait at least 24 hours for your next test, according to the CDC, but retesting a few days later can help you feel comfortable that a negative result is a true negative. Mina recommends that if you start having symptoms, assume you have Omicron and self-isolate. Take your first rapid test 24 hours after symptoms start and test again two to three days later. When interpreting and making decisions based on a test result, it’s a good idea to take into account a person’s history of vaccination, mask use, exposures to others, and their general likelihood of actually being COVID positive, Weiss said.
Can rapid tests detect the Omicron variant?
Yes, that seems to be the case. “So far what we are seeing is on a per viral particle basis the rapid tests are working as well today as they did with Delta earlier,” Mina said. It makes sense that a variant might change the reliability of the tests used to detect the virus and the FDA is asking manufacturers to test their products to make sure they work against Omicron and future variants. The FDA said BinaxNow and Quidel QuickVue tests can pick up Omicron, but they have also identified a few PCR-based tests that don’t and have recommended that labs don’t use them.
If you do have COVID symptoms, can it now take longer for tests to show a positive result than at the beginning of the pandemic?
Yes, according to Mina. That’s because early in the pandemic, humans had not been exposed to the virus previously and symptoms — which are a sign the immune system recognizes and is fighting the virus — started later in the timeline of infection.
Now that millions of people have either had COVID, been vaccinated, or in some cases both, symptoms generally start sooner. (And it’s clear that you can get COVID two or more times.) “You're going to become symptomatic potentially within a day after exposure because your immune system kicks in so early,” Mina said. He also noted that’s why COVID symptoms have changed and now include congestion and runny nose. “That’s your immunity working,” he said.
Is a lateral flow test the same thing as an antigen test?
Not exactly. A lateral flow test is a specific type where you dip a piece of paper in a liquid and after a few minutes one line appears — a positive control to show the test is working — and another line appears if the test is positive. While all rapid antigen tests currently on the market for COVID are lateral flow tests, not all lateral flow tests are COVID tests. For example, pregnancy tests also work in this way but use urine rather than a nasal swab for testing.
Can a rapid test protect you from getting sick?
Not really. Rapid tests are more about protecting other people, not making sure you don’t get the virus. (That’s what vaccines, masks, and social distancing are all about.) However, when people get tested before going to work, a party, school, or traveling, it helps protect everyone. (Although it also helps you get treatment sooner, which is important because almost all effective treatments for COVID are more likely to work the sooner they are started.) Rapid testing is particularly good to help stop super spreaders of the virus, Mina said. “For somebody who’s really spewing out tons of virus and is very likely to infect a lot of people, then the tests are more likely 95% or 98% sensitive for those individuals,” he said.