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brookegoodman

Greenland's melting ice raised global sea level by 2.2mm in two months | Science | The ... - 0 views

www.theguardian.com/...-sea-level-rise-climate-crisis

crisis

shared by brookegoodman on 27 Mar 20 - No Cached
  • Analysis of satellite data reveals astounding loss of 600bn tons of ice last summer as Arctic experienced hottest year on record
  • Last year’s summer was so warm that it helped trigger the loss of 600bn tons of ice from Greenland – enough to raise global sea levels by 2.2mm in just two months, new research has found.
  • Glaciers are melting away around the world due to global heating caused by the human-induced climate crisis. Ice is reflective of sunlight so as it retreats the dark surfaces underneath absorb yet more heat, causing a further acceleration in melting.
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  • The analysis of satellite data has revealed the astounding loss of ice in just a few months of abnormally high temperatures around the northern pole. Last year was the hottest on record for the Arctic, with the annual minimum extent of sea ice in the region its second-lowest on record.
  • More recent research has found that Antarctica, the largest ice sheet on Earth, is also losing mass at a galloping rate, although the latest University of California and Nasa works reveals a nuanced picture.
  • “It is easy for us to be distracted by fluctuations, so the highly reliable long data sets from Grace and other sensors are important in clarifying what is really going on, showing us both the big signal and the wiggles that help us understand the processes that contribute to the big signal.”
Javier E

Trump's authoritarian style is remaking America - The Washington Post - 0 views

www.washingtonpost.com/...rian-style-is-remaking-america

trump rule of law authoritarian politics

shared by Javier E on 14 Feb 20 - No Cached
  • His calls this week for prosecutions of his perceived enemies and public attacks on federal judges and prosecutors involved in cases against his allies were so abnormal that it led to an unlikely rebuke from Attorney General William P. Barr, a Cabinet official largely viewed by Trump’s opponents as shamefully acquiescent.
  • there have been myriad warnings about President Trump’s authoritarian tendencies. He has played to the fears of his critics by blowing past the republic’s increasingly creaky system of checks and balances. And with the aid of a right-wing echo chamber, he has pushed forward a narrative that conflates national interest with his personal gain, patriotism with unflinching loyalty to the occupant of the Oval Office.
  • The Washington Post’s White House reporters described a president “simmering with rage, fixated on exacting revenge against those he feels betrayed him and insulated by a compliant Republican Party.” He is willing to test the rule of law even further and is comfortable doing so, they reported, “to the point of feeling untouchable.”
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  • “If a president can meddle in a criminal case to help a friend, then there’s nothing that keeps him from meddling to harm someone he thinks is his enemy,” Joyce White Vance, a former U.S. attorney, told my colleagues. “That means that a president is fully above the law in the most dangerous kind of way. This is how democracies die.”
  • “Since Trump’s rise to the nation’s highest office, his inflammatory language — often condemned as racist and xenophobic — has seeped into schools across America,” my colleagues wrote. “Many bullies now target other children differently than they used to, with kids as young as 6 mimicking the president’s insults and the cruel way he delivers them.”
  • David Roberts at Vox argued that the United States is in the grips of an “epistemic” crisis: A decades-long right-wing project to create its own media bubble cemented a polarized political reality in which rival camps can’t even agree on the facts of their disagreements.
  • “That is what a tribalist like Trump wants: for communication and compromise across tribal lines to become impossible, so that loyalty becomes the only measure and everything is reduced to pure struggle for dominance,” Roberts wrote.
  • “The Republican Party is betraying democracy, and these are historical times,” Jason Stanley, a Yale philosophy professor and author of “How Fascism Works,” told Business Insider. “The Republican Party has shown that it has no interest in multi-party democracy. … They are much more concerned with power, with consolidating power.”
  • “It should be not only defeated but destroyed — vanquished from the American political scene with a finality that can only be assured not by electoral politics or structural reforms alone, but by a moral crusade.”
  • “The Republican Party is now a reliable opponent of equality and a malignant force in American life — a cancer within a patient in denial about the nature and severity of her condition,” wrote the New Republic’s Osita Nwanevu.
  • An important piece in the New Yorker by Harvard historian Jill Lepore examined the sense of democratic crisis that was felt by many Americans in the 1930s. She details the astonishing New Deal-era civic engagement that took place in response, the profusion of debates, publicly backed artistic projects, town halls and radio shows that drew in millions around the country.
Javier E

What Doctors on the Front Lines Wish They'd Known a Month Ago - The New York Times - 0 views

www.nytimes.com/...new-york-coronavirus.html

Covid-19 treatment

shared by Javier E on 14 Apr 20 - No Cached
  • Doctors, if you could go back in time, what would you tell yourselves in early March?
  • “What we thought we knew, we don’t know,
  • For the disease that drives this pandemic, certain ironclad emergency medical practices have dissolved almost overnight.
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  • The biggest change: Instead of quickly sedating people who had shockingly low levels of oxygen and then putting them on mechanical ventilators, many doctors are now keeping patients conscious, having them roll over in bed, recline in chairs and continue to breathe on their own — with additional oxygen — for as long as possible.
  • The idea is to get them off their backs and thereby make more lung available.
  • Other doctors are rejiggering CPAP breathing machines, normally used to help people with sleep apnea, or they have hacked together valves and filters.
  • Then there is the space needed inside of buildings and people’s heads. In an instant, soaring atrium lobbies and cafeterias became hospital wards
  • rarely-used telemedicine technology has suddenly taken off, and doctors are holding virtual bedside conferences with scattered family members
  • The number of intubations in New York State has declined to 21 new ones a day, from about 300 per day at the end of March
  • “I’m confident that we will have a lot of answers in months,”
  • People who need breathing tubes, which connect to mechanical ventilators that assist or take over respiration, are rarely in any shape to be on the phone because the level of oxygen in their blood has declined precipitously.If conscious, they are often incoherent and are about to be sedated so they do not gag on the tubes. It is a drastic step.
  • not enough time has passed to say if their improvisations will hold up,
  • Some patients, by taking oxygen and rolling onto their sides or on their bellies, have quickly returned to normal levels. The tactic is called proning.
  • Dr. Nicholas Caputo followed 50 patients who arrived with low oxygen levels between 69 and 85 percent (95 is normal). After five minutes of proning, they had improved to a mean of 94 percent. Over the next 24 hours, nearly three-quarters were able to avoid intubation;
  • No one knows yet if this will be a lasting remedy, Dr. Caputo said, but if he could go back to early March, he would advise himself and others: “Don’t jump to intubation.”
  • Yet many Covid-19 patients remain alert, even when their oxygen has sharply fallen, for reasons health care workers can only guess.
  • One reason is that contrary to expectations, a number of doctors at New York hospitals believe intubation is helping fewer people with Covid-19 than other respiratory illnesses and that longer stays on the mechanical ventilators lead to other serious complications
  • “Intubated patients with Covid lung disease are doing very poorly, and while this may be the disease and not the mechanical ventilation, most of us believe that intubation is to be avoided until unequivocally required,”
  • This shift has lightened the load on nursing staffs and the rest of the hospital. “You put a tube into somebody,” Dr. Levitan said, “and the amount of work required not to kill that person goes up by a factor of 100,” creating a cascade that slows down laboratory results, X-rays and other care.
  • For heavier patients, Dr. Levitan advocates combining breathing support from a CPAP machine or regular oxygen with comfortable positioning on a pregnancy massage mattress
  • The first patient to rest on it arrived with oxygen saturation in the 40s, breathing rapidly and with an abnormally fast heartbeat, he said. After the patient was given oxygen through a nasal cannula — clear plastic tubes that fit into the nostrils — Dr. Levitan helped her to lay face down on the massage table. The oxygen level in her blood climbed to the mid-90s, he said, her pulse slowed to under 100 and she was breathing at a more normal pace. “She slept for two hours,” he said.
  • “Obesity is clearly a critical risk factor.”
  • doctors in the region have started sharing on medical grapevines what it has been like to re-engineer, on the fly, their health care systems, their practice of medicine, their personal lives.
knudsenlu

Is There Something Neurologically Wrong With Donald Trump? - The Atlantic - 0 views

www.theatlantic.com/...548759

donald trump politics cognition

shared by knudsenlu on 04 Jan 18 - No Cached
  • Trump’s grandiosity and impulsivity has made him a constant subject of speculation among those concerned with his mental health. But after more than a year of talking to doctors and researchers about whether and how the cognitive sciences could offer a lens to explain Trump’s behavior, I’ve come to believe there should be a role for professional evaluation beyond speculating from afar.
  • Experts compelled to offer opinions on the nature of the episode were vague: The neurosurgeon Sanjay Gupta described it as “clearly some abnormalities of his speech.” This sort of slurring could result from anything from a dry mouth to a displaced denture to an acute stroke.
  • he downplaying of a president’s compromised neurologic status would not be without precedent. Franklin Delano Roosevelt famously disguised his paralysis from polio to avoid appearing “weak or helpless.” He staged public appearances to give the impression that he could walk, leaning on aides and concealing a crutch. Instead of a traditional wheelchair, he used an inconspicuous dining chair with wheels attached. According to the FDR Presidential Library, “The Secret Service was assigned to purposely interfere with anyone who tried to snap a photo of FDR in a ‘disabled or weak’ state.”
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  • Though these moments could be inconsequential, they call attention to the alarming absence of a system to evaluate elected officials’ fitness for office—to reassure concerned citizens that the “leader of the free world” is not cognitively impaired, and on a path of continuous decline.
  • Trump was once a more articulate person who sometimes told stories that had beginnings, middles, and ends, whereas he now leaps from thought to thought. He has come to rely on a small stable of adjectives, often involving superlatives. An improbably high proportion of what he describes is either the greatest or the worst he’s ever seen; absolutely terrible or the best; tiny or huge.
  • Ben Michaelis, a psychologist who analyzes speech as part of cognitive assessments in court cases, told Begley that although some decline in cognitive functioning would be expected, Trump has exhibited a “clear reduction in linguistic sophistication over time” with “simpler word choices and sentence structure.”
ethanshilling

AstraZeneca Vaccine Under More Scrutiny After Denmark Death - The New York Times - 0 views

www.nytimes.com/...-astrazeneca-side-effects.html

vaccine world pandemic

shared by ethanshilling on 21 Mar 21 - No Cached
  • Denmark reported on Saturday that two people had experienced brain hemorrhages after receiving the AstraZeneca Covid-19 vaccine, one of whom died.
  • A spokesperson for the Capital Region of Denmark confirmed the death, and the Danish Ritzau news agency reported that the other person, a female civil servant in her 30s, was critically ill.
  • Millions of people in dozens of countries have received the AstraZeneca Covid-19 vaccine with few reports of ill effects, but the European Medicines Agency, the continent’s top drug regulator, conducted a review after several countries paused the use of the vaccine.
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  • On Thursday, the agency said that it considered the vaccine safe, although it would continue to watch for any connections to blood disorders.
  • “Right now we are examining whether this is the exact same disease picture with multiple blood clots, a low count of platelets and hemorrhages,” Tanja Erichsen, a director at the Danish Medicines Agency
  • This is the second death in Denmark after a person was given the AstraZeneca vaccine. Norway is examining the deaths of two people who received the vaccine.
  • Some of the continuing caution has been driven by preliminary findings from medical experts in Norway and Germany that suggested a possible link between the vaccine and the extremely rare blood disorders.
  • Dr. James Bussel, an expert on platelet disorders and a professor emeritus at Weill Cornell Medicine, said the occurrence of abnormal clotting and low platelets in people under 50 is uncommon.
  • Researchers in both Germany and Norway will continue investigating and in Germany, where the vaccine is again being administered, doctors are now warning anyone receiving an AstraZeneca shot to see a doctor immediately if they have headaches, dizziness or blurred vision more than three days afterward.
mimiterranova

China Will Now Permit Married Couples To Have Up To 3 Children : NPR - 0 views

www.npr.org/...couples-to-have-three-children

china children

shared by mimiterranova on 31 May 21 - No Cached
  • BEIJING - China will now allow married couples to have up to three children as the country attempts to halt a declining birthrate.
  • It is a recognition from the country's top leaders that China will need to undertake drastic measures to counter a rapidly aging society.
  • "Implementing the policy and its relevant supporting measures will help improve China's population structure, actively respond to the aging population, and preserve the country's human resource advantages," China's Politburo, a top Communist Party governing body
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  • Only five years ago, China officially ended its One Child policy, a raft of restrictions that for more than three decades strictly limited couples to only one child. Those who had two or more children in violation of the policy were fined heavily.
  • threatening to halt economic growth and bankrupt state pension funds
  • China's latest census figures released this year show the country's birthrate has dropped to 1.3 live births per woman, far below the rate of 2.1 most demographers agree is needed to sustain a population at its current level.
  • Pregnant women were sometimes effectively kidnapped by local family planning officials who cajoled, intimidated, or forced women to end the birth.
  • The news that the government was now allowing three-child families was initially unclear in China. Popular Chinese social media site Weibo disabled the ability to read the thousands of comments left under news items about the family planning policy change due to what they alleged was "abnormal content".
carolinehayter

In Poland, Protests As Near-Total Ban On Abortions Goes Into Effect : NPR - 0 views

www.npr.org/...-on-abortions-goes-into-effect

protests Politics Culture policy abortion

shared by carolinehayter on 28 Jan 21 - No Cached
  • Protesters gathered in the streets of Warsaw and other cities on Wednesday night after Poland's government announced a near-total ban on abortion had suddenly gone into effect.
  • The country's Constitutional Court had ruled in October to ban terminations of pregnancies with fetal defects – nearly the only abortions that occur in Poland, which already had strict limits on the procedure. Abortion will now only be permitted in cases of rape or incest, or when the mother's health or life is in danger.
  • The implementation of the ruling was delayed after weeks of huge protests in the fall.
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  • "This idiotic ruling will not prevent abortions," Cezary Jasinski, a 23-year-old student, told Reuters in central Warsaw. "But for every woman who will experience pain because of this ruling, or will be forced to give birth to a child with Down syndrome, they (court judges) will be to blame."
  • The months-long delay between the ruling and its implementation appears to be a result of the large protests that ensued. Last October, a planned "women's strike" drew more than 400,000 protesters across more than 400 Polish cities and towns.
  • "In cases when the fetus doesn't have a skull or has no chance to live outside the womb, there should be a choice. We will work on this," Suski told Polish public radio, according to Reuters.
  • Clement Beaune, France's European Affairs minister, wrote on Twitter: "A sad day that reminds us that rights can recede if they are not defended. The fight goes on."
  • There were 1,100 abortions performed last year in Poland; of those, 1,074 were due to fetal abnormalities, The New York Times reports.
  • Doctors in Poland can be jailed for performing illegal abortions.
hannahcarter11

Thailand Legalizes Early-Term Abortions but Keeps Other Restrictions - The New York Times - 0 views

www.nytimes.com/...thailand-abortion-rights.html

thailand abortion restrictions morality

shared by hannahcarter11 on 29 Jan 21 - No Cached
  • Thailand’s Parliament has voted to make abortion legal in the first trimester, while keeping penalties in place for women who undergo it later in their pregnancies.
  • to amend a law that had imposed prison terms of up to three years for anyone having an abortion, and up to five years for those who perform one.
  • Advocates say the measure doesn’t go far enough: Anyone in Thailand who has an abortion after 12 weeks, except under conditions set by the country’s Medical Council, still faces potential fines and up to six months in prison.
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  • To make this kind of law, you have to prioritize women’s participation, especially women who have experience having abortions,” she added. “The deliberation process gave roles to lawmakers and human rights lawyers, but there are no women who had experience with abortion or activists in the process.”
  • The Medical Council says pregnancies can be terminated by a qualified professional after 12 weeks if they are the result of a sexual assault or pose a threat to the mother’s physical or emotional health. Abortion is also permitted if the fetus is known to have abnormalities.
  • Many women in Thailand found ways to get abortions under the previous restrictions, but the country still has a high teenage pregnancy rate
  • About 1.5 million babies were born to teenage mothers in Thailand between 2000 and 2014
  • Ms. Supecha said she would watch closely to see whether the Health Ministry extends early abortion services and pressures doctors to comply with the new rule.
  • Some elements of Thailand’s Buddhist-dominated culture are socially conservative. Yet Thailand also has relatively progressive policies on gender and L.G.B.T.Q. issues.
  • “When governments restrict abortion, women still have abortions — they just have more dangerous ones,” she wrote.
Javier E

H-Debate on Versailles Tr. - Google Drive - 0 views

drive.google.com/...Y6IivTRpbhUV2GVDIqKfGnPvMsN5Rh

Versailles Treaty history

shared by Javier E on 25 Nov 19 - No Cached
  • She points out that the territorial settlement, which deprived Germany of 13% of its territory, 10% of its population, and 13.5% of its economic potential, in fact involved the transfer of much German land that “was French, Walloon, Danish, or Polish in population and culture” (652).
  • hose forced territorial cessions were much less that the huge swath of
  • Her main insight about reparations—which has been highlighted by Mark Trachtenberg6 and others-- is that the Allied leaders in Paris were caught in a terrible dilemma: they recognized that post-war Germany would be incapable of bearing the enormous financial burden of rebuilding the territories ravished by its armies during the war. But they also knew that their publics had been led to expect Germany to pay for the entire cost of reconstruction and would cashier any head of government who settled for anything less than full payment.
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  • territory that Germany wrested from Bolshevik Russia in the March 1918 Treaty of Brest- Litovsk and planned to force France and Belgium to cede if Germany had won in the west.
  • They therefore resorted to a masterly sleight-of-hand: Under Article 231 of the peace treaty, Germany would be required to acknowledge full responsibility for the damage done. Article 232 would concede that Germany could not be expected to pay beyond its capacity. Thus, the Allied publics would have the satisfaction of knowing that Germany would be required to accept responsibility for the damage caused by its military forces in northeastern France, Belgium, and elsewhere. The Weimar Republic should have been relieved to learn that it would it not be required to pay a war indemnity or the actual costs of the war, as France had after 1871 at the end of a war in which no German territory had been damaged. Germany should also have been pleased to note that the reparation bill would be based not on the total amount of damage caused but rather on Germany’s economic wherewithal to pay.
  • But Marks notes that no amount of reparation payment would have been acceptable to the leaders of the Weimar Republic because such payments were erroneously connected in the mind of the German public with the widespread myth of the “war guilt clause.” As she has reminded us in her earlier work, the word “guilt” does not appear in the notorious Article 231, and virtually identical language was included in the treaties signed with Germany’s allies. Yet the myth of the “war guilt clause” unilaterally imposed on Germany, which was propagated in the early 1920s by Weimar officials and opinion makers, has stood the test of time and continues to find its way into histories of the peace settlement.
  • On the question of Germany’s capacity to pay, Marks is merciless in dissecting and disproving the various claims of penury. “There are those, not all German, who claim that reparations were unpayable,” she observes. “After 1871, France, with a much smaller economy than Germany’s fifty years later, paid nearly as much in two years (by French estimate) to liberate its territory as the Weimar Republic paid from 1919 to 1932”
  • She points out that “Germany’s tax rates [in the 1920s] were abnormally low and remained so....Raising taxes would have provided ample funds, as the Dawes Committee discovered. Weimar could have borrowed from the citizenry, as France did after 1871.”Moreover the postwar German economy “was intact, having been spared devastation and denudation [which the major reparation recipients France and Belgium had experienced.] There were lavish social subsidies, unmatched by the victors.
  • In the end, as Stephen A. Schuker has shown, the Weimar Republic actually paid no net reparations at all, discharging its reparation bill with the proceeds from American bank loans and then defaulting on both reparations and foreign debts in the Great Depression.
  • So much for the claim that the ‘burdensome’ reparations requirement of the peace treaty led to the collapse of the German economy and the advent of Hitler.
clairemann

How DHS and ICE Are Making The Case for Trump's Re-Election | Time - 0 views

time.com/...-for-donald-trumps-re-election

gop trump US politics crisis policy

shared by clairemann on 01 Nov 20 - No Cached
  • In the final weeks leading up to the 2020 election, the Department of Homeland Security and U.S. Immigration and Customs Enforcement have launched a highly unusual publicity blitz to spotlight immigration enforcement actions in key battleground states where President Donald Trump is trailing his opponent Joe Biden in the polls.
  • These public announcements by senior leaders ahead of the election, which former officials tell TIME are abnormal, if not unprecedented, have been held to publicize mostly routine immigration enforcement operations that would usually have been revealed with little fanfare.
  • Instead, DHS and ICE officials have used them as a platform to aggressively make the case for the president’s immigration policies, often taking on a markedly Trumpian tone and echoing parts of his stump speech.
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  • Acting Homeland Security Secretary Chad Wolf and his deputy Ken Cuccinelli have talked about immigrants taking American jobs, blasted Democrat-run sanctuary cities, touted “America First” and warned of “evil people who seek to travel to the United States with the intent of harming and killing Americans.”
  • In Phoenix last week, Wolf warned that there would be a surge in migration and an “unimaginable public health crisis” at the southern border if Trump were to lose the election — a series of nakedly political statements that stunned many former officials.
  • “The rhetoric that’s come out of Wolf and Cuccinelli is appearing to be a propaganda arm of the White House,”
  • The arrests were part of “Operation OPTical Illusion,” a crackdown on the federal Optional Tactical Training program, which allows international students to work in their field of study while on a U.S. student visa.
  • Cuccinelli directly tied this immigration enforcement action to Trump’s agenda, saying the arrests “will open up those jobs for American workers” and emphasizing that this “has been a very high priority for this President.”
  • Earlier in October, ICE put up bold black and red billboards in several parts of Pennsylvania, featuring the faces of six immigrants and their charges of burglary, robbery, and assault in big lettering. The agency described them as “at-large immigration violators who may pose a public safety threat” and said the campaign was meant to “educate the public about the dangers of non-cooperation policies.
  • “DHS is showing us a textbook example of why we have a federal law against government officials using their positions to support a political campaign,”
  • The politically significant locations of these press conferences, and the presence of senior leadership, means each event has been covered by local news and circulated on social media, likely reaching their intended in-state audience and beyond.
  • “the Trump administration is building [a] new wall and doing so faster than ever before” and “the Trump admin is putting America first by protecting American workers.” On Thursday, Wolf posted an almost 2-minute video about news media raising questions about Trump’s promised border wall in what was effectively a campaign ad, with the message: “They said it couldn’t be done…They were wrong. 400 times and counting.”
  • “These billboards are clearly intended to fuel anti-immigrant fervor one month before the election,”
  • “Top DHS officials are acting more like campaign surrogates than public servants, and they need to be held accountable.”
  • “I am deeply disturbed that ICE is spending government dollars and putting lives at risk in furtherance of what is described as a political messaging campaign,” Rep. Zoe Lofgren, a California Democrat, wrote in a letter to Pham in early October.
  • Immigration lawyers and advocates have raised concerns the agency has also been timing other law enforcement actions for political purposes. In September, ICE announced that 19 non-citizens in North Carolina had been charged with illegally voting in the 2016 election.
  • This time around, the ICE announcement about the charges — which came more than three years after the investigation started — were also “highly suspect, and likely to be politically driven,” says Helen Parsonage, an attorney who represents five of the non-citizens.
  • While Trump’s 2016 rallies were often filled with vivid accounts of immigrant crime, “build the wall” chants and infamous readings of a poem about a snake to illustrate the threat posed by immigrants and refugees, it’s a theme he’s rarely touched on in his 2020 rallies.
aleija

Opinion | Is France Fueling Muslim Terrorism by Trying to Prevent It? - The New York Times - 0 views

www.nytimes.com/...france-terrorism-muslims.html

crisis history opinion global

shared by aleija on 02 Nov 20 - No Cached
  • MARSEILLE, France — Once again, terrorism strikes France — and once again, terrorism is exposing the country’s dangerous contradictions.
  • First there was the murder of Samuel Paty, a history teacher who was decapitated near Paris on Oct. 16 by a young Chechen man after Mr. Paty showed students caricatures of the Prophet Muhammad in a class about freedom of expression.
  • In addition to security and counterterrorism measures, the French government responded to Mr. Paty’s killing by vigorously reaffirming the right of free speech — including the right to satirize and blaspheme — as well as the central role of France’s version of secularism, known as laïcité, in all state institutions, especially public schools.
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  • One problem with this idea is that it implicitly treats Muslims as though they were a separate category of French people, and immature citizens who lag in their comprehension of secular republicanism.
  • But the French government’s conception of radical Islamism also rests on a problematic assumption: namely that the principal cause of terrorism in France is the failure of French Muslims to fully endorse the country’s secular culture.
  • The president’s notion of “separatism” seems to assume that a significant minority of Muslims are tempted to set themselves apart somehow from the rest of French society, perhaps by creating enclaves in disaffected suburbs or building Muslim ecosystems of sorts around Islamic schools, halal stores or mosques.
  • The political scientist Bruno Etienne once called French Muslims “abnormally normal.”
  • In a study released last year, 70 percent of Muslim respondents said they felt that they could freely practice Islam in France. Some 41 percent also said they thought Islam should adapt in some respects to conform to laïcité — but 37 percent said they wished that laïcité were more flexible.
  • In the course of my own research, I have found numerous examples of Muslim groups condemning terrorism. After attacks in early 2015, a leading federation of Muslim groups called on mosques to say a weekly prayer asking God “to preserve France.” Muslims routinely hold services to grieve for non-Muslim victims of Islamist terrorism — and, of course, Muslims, too, sometimes are among the victims. The imam of the city of Bordeaux has become a leading figure in efforts to prevent radicalization in France.
Javier E

The Lack of Testing Is Holding Science Back - The Atlantic - 0 views

www.theatlantic.com/...611422

testing pandemic response strategies

shared by Javier E on 10 May 20 - No Cached
  • Since late last month, I have been meeting frequently online with a group of nine colleagues: David Baltimore, Mike Brown, Don Ganem, Peggy Hamburg, Richard Lifton, Marc Lipsitch, Dan Littman, Shirley Tilghman, and Bruce Walker. All are well known for their work in areas such as virology, immunology, genetics, and epidemiology
  • One such approach, still in development, would exploit the ability of the well-known bacterial gene-editing system known as CRISPR to recognize coronavirus RNA.
  • we believe that expanding current testing capacity remains a matter of extreme urgency—one that justifies a level of intense, coordinated work at a national, even international, scale that resembles the campaigns we associate with world wars
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  • The shortfall in testing isn’t just a problem for individual patients and their doctors. It is also holding back large-scale surveys of seemingly healthy populations, in workplaces and elsewhere, and scientific research into fundamental properties of the virus and the disease it causes.
  • there is an escalating need to test much larger groups repeatedly—to track the spread of the virus as restrictions ease—and to carry out population-based studies that will reveal more about how this virus behaves.
  • in determining whether an individual is safe to enter a workplace or school on a given morning. Ideally, for the later purposes, tests would be conducted swiftly and at high volume at the places where samples are taken
  • All have served in one or more leadership roles: as presidents of universities or other academic institutions, as heads of government agencies, as advisers to drug or biotechnology companies, or simply as pioneers and mentors in their field. All have sought solutions to the great medical problems of our time. None of us can recall a crisis as stark as COVID-19.
  • While the need for greatly expanded testing in the next phase of this pandemic is widely acknowledged, the United States has no coordinated plan for how to achieve it. The technical building blocks are in hand, but how to put them together is not yet clear. Moreover, major regulatory hurdles limit the use of the results from novel tests in patient care, especially in certain states such as New York. And the logistics of deploying enough personnel to track samples and deliver results are daunting. Because of the complexity and importance of such testing, a centralized program, run by a strong scientific leader and paid for with federal dollars, may be the only solution.
  • rmed with efficient and accurate tests to detect the virus (indicating active infection) and reliable tests to measure antibodies against it (implying prior exposure and possible immunity), public-health programs could paint an accurate picture of the current pandemic. Small and large businesses, schools, health-care facilities, and other organizations could track the outcomes of their attempts to restore normal activities, and scientists could answer key questions about viral transmission and host immunity.
  • decisive answers will come only from studying human beings who are exposed to the virus under real-life conditions. Such studies may be feasible only under circumstances in which natural transmission is occurring at significant rates, as it currently is. Therefore, if we are to get answers to the following questions, we must act now.
  • tudies to answer these questions require identifying enough people who have recovered, then testing them repeatedly for the appearance of a new infection. Such people are relatively easy to find. They include doctors and nurses in hospitals in hard-hit metropolitan areas such as New York City; staff and residents at nursing homes with high rates of infection; and crews of U.S. Navy ships that have experienced outbreaks of COVID-19.
  • identify asymptomatic infections. Following up on those cases will shed light on how many asymptomatic people ultimately develop symptoms; how long it takes for them to do so; whether asymptomatic people who ultimately develop symptoms have higher viral loads than those who don’t get sick; whether symptomatic and asymptomatic people have different immune responses; whether other, simpler procedures (such as tests for some chemical abnormality in the blood) might be used to screen for infection; and how large a contribution asymptomatic people make to the ongoing transmission of the virus.
  • Despite repeated warnings after prior epidemics about the likelihood of new ones caused by novel microbes, the United States and many other countries failed to respond efficiently to this one. Scientists might have detected the new coronavirus much earlier with the better tools for microbial surveillance that already exist; prevented the pathogen’s worldwide spread by more aggressive testing and contact tracing; and supported better and safer health care with larger stockpiles and pipelines for procurement of medical equipment. Humanity should never be this unprepared again.
Javier E

What Would Trump's Second Term Look Like? - The Atlantic - 0 views

www.theatlantic.com/...616466

trump second term politics crisis culture consequences

shared by Javier E on 15 Oct 20 - No Cached
  • Perhaps the most consequential change Trump has wrought is in the Republican Party’s attitude toward democracy. I worked in the administration of George W. Bush, who was the first president since the 1880s to win the Electoral College despite losing the popular vote.
  • Bush recognized this outcome as an enormous political problem. After the Supreme Court ruled in his favor, on December 13, 2000, the president-elect promised to govern in a bipartisan and conciliatory fashion: “I was not elected to serve one party, but to serve one nation,”
  • You may believe that Bush failed in that promise—but he made that promise because he recognized a problem. Two decades later, Trump has normalized the minority rule that seemed so abnormal in December 2000.
  • ...29 more annotations...
  • Republicans in the Trump years have gotten used to competing under rules biased in their favor. They have come to fear that unless the rules favor them, they will lose. And so they have learned to think of biased rules as necessary, proper, and just—and to view any effort to correct those rules as a direct attack on their survival.
  • What I wrote in 2017 has only become more true since: “We are living through the most dangerous challenge to the free government of the United States that anyone alive has encountered.”
  • No one has stopped him from defying congressional subpoenas looking into whether he was violating tax and banking laws. No one has stopped him from hiring and promoting his relatives.
  • Trump’s clemency to Stone reminded others who might hold guilty knowledge—people like Paul Manafort and Ghislaine Maxwell—of the potential benefits to them of staying silent about Trump.
  • How did Trump get away with using a public power for personal advantage in this way? There’s nothing to stop him. The Constitution vests the pardon power in the president.
  • a second-term Trump could demand that associates break the law for him—and then protect them when they are caught and face punishment. He could pardon his relatives—and even try to pardon himself.
  • Abuse of Government Resources for Personal Gain
  • Mr. Trump’s aides said he enjoyed the frustration and anger he caused by holding a political event on the South Lawn of the White House, shattering conventional norms and raising questions about ethics law violations. He relished the fact that no one could do anything to stop him,
  • “No one could do anything to stop him.” No one has stopped Trump from directing taxpayer dollars to his personal businesses.
  • Trump has a lot to hide, both as president and as a businessman. The price of his political and economic survival has been the destruction of oversight by Congress and the discrediting of honest reporting by responsible media
  • No one has stopped him from using government resources for partisan purposes. No one has stopped him from pressuring and cajoling foreign governments to help his reelection campaign.
  • No one has stopped him from using his power over the Postal Service to discourage voting that he thinks will hurt him.
  • The Hatch Act forbids most uses of government resources for partisan purposes. By long-standing courtesy, however, enforcement of that law against senior presidential appointees is left to the president. It’s just assumed that the president will want to comply. But what if he does not? The independent federal agency tasked with enforcing the Hatch Act, the Office of Special Counsel, has found nine senior Trump aides in violation of the law, and has recommended that Trump request their resignation. He has ignored that recommendation.
  • Abuse of the Pardon PowerOn July 10, 2020, Trump commuted the sentence of his longtime associate Roger Stone. As Stone’s own communications showed, he had acted as an intermediary between the Trump campaign and WikiLeaks in 2016. Had Stone cooperated with federal investigators, the revelations might have been dangerous to Trump. Instead, Stone lied to Congress and threatened other witnesses.Just as Stone was supposed to go to prison, Trump commuted his sentence. Commutation was more useful to the cover-up than an outright pardon. A commuted person retains his Fifth Amendment right not to testify; a pardoned person loses that right.
  • The Justice Department would be debauched ever more radically, becoming Trump’s own law firm and spending taxpayer dollars to defend him against the consequences of his personal wrongdoing. The hyper-politicization of the Justice and Homeland Security Departments would spread to other agencies.
  • Directing Public Funds to Himself and His CompaniesIn the 230-year history of the United States, no president before Trump had ever tried to direct public dollars to his own companies—so no Congress had ever bothered to specifically outlaw such activity.
  • Trump’s superpower is his absolute shamelessness. He steals in plain view. He accepts bribes in a hotel located smack in the middle of Pennsylvania Avenue. His supporters do not object. His party in Congress is acquiescent. This level of corruption in American life is unprecedented.
  • A willingness to line the Trump family’s pockets has become a mark of obeisance and identity, like wearing cowboy boots during the George W.  Bush administration
  • The result of this almost-universal Republican complicity in Trump’s personal corruption has been the neutering of Congress’s ability to act when corruption is disclosed.
  • Republicans in the House cheerfully support Trump when he defies subpoenas from Democratic chairs, setting a precedent that probably will someday be used against them.
  • “No one could do anything to stop him.” In his first term, Trump purged the inspectors general from Cabinet departments and punished whistleblowers. In a second Trump term, the administration would operate ever more opaquely to cover up corruption and breaches in national security.
  • In a second Trump term, radical gerrymandering and ever more extreme voter suppression by Republican governors would become the party’s only path to survival in a country where a majority of the electorate strongly opposes Trump and his party. The GOP would complete its transformation into an avowedly antidemocratic party.
  • Inciting Political ViolenceTrump has used violence as a political resource since he first declared his candidacy, in the summer of 2015. But as his reelection prospects have dimmed in 2020, political violence has become central to Trump’s message. He wants more of it
  • “The more chaos and anarchy and vandalism and violence reigns, the better it is for the very clear choice on who’s best on public safety and law and order,” Trump’s adviser Kellyanne Conway said on Fox & Friends on August 27. Two nights later, a 600-vehicle caravan of Trump supporters headed into downtown Portland, Oregon, firing paintball guns and pepper spray, driving toward a confrontation during which one of them was shot dead.
  • The people best positioned to regulate the level of political violence in the country are local police, whom Trump has again and again urged to do their work in ways that support him, no matter how “tough” that requires them to be. The police are represented by unions often aligned with the Trump campaign
  • “I can tell you,” Trump said in a March 2019 interview with Breitbart News, “I have the support of the police, the support of the military, the support of the Bikers for Trump—I have the tough people, but they don’t play it tough—until they go to a certain point, and then it would be very bad, very bad.”
  • Trump’s appeal is founded on a racial consciousness and a racial resentment that have stimulated white racist terrorism in the United States and the world, from the New Zealand mosque slaughter (whose perpetrator invoked Trump) to the Pittsburgh synagogue murders to mass shootings in El Paso, Texas, and Gilroy, California. In recent weeks, political violence has caused those deaths in Kenosha and Portland
  • It’s a trick of authoritarian populists like Trump to proclaim themselves leaders of “the people,” even as large majorities of the electorate reject them. The authoritarian populist defines “the people” to exclude anyone who thinks differently. Only his followers count as legitimate citizens.
  • Legend has it that in the 1870s, “Boss” William Tweed, the famously corrupt New York City politician, taunted his critics by saying, “What are you going to do about it?”* Trump’s relentless defiance of law and decency does the same. Congress has done nothing. So it’s up to voters.
tsainten

Protests in Poland Over Abortion Law Continue for Sixth Day - The New York Times - 0 views

www.nytimes.com/...and-women-abortion-strike.html

Poland Abortion Law Global Culture policy pandemic

shared by tsainten on 29 Oct 20 - No Cached
  • a top court’s decision to ban nearly all abortions, even as the nation’s leading politician urged his conservative supporters to “defend Poland.”
  • One group of women donned long red dresses and white bonnets meant to evoke the subjugated women in the Handmaid’s Tale novel and television series and marched into a cathedral and down the aisle between worshipers.
  • Twice before, in 2016 and 2018, the ruling party moved in Parliament to impose a ban on abortion. But it backed off both times after nationwide demonstrations underscored the political cost. This time, the ban came through the Constitutional Tribunal, which is firmly controlled by party loyalists.
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  • steady erosion of institutions meant to safeguard democracy,
  • The grievance with the church is also, in many ways, the culmination of watching the critical role many of its leaders have played in the political victories of the Law and Justice party.
  • The court’s decision halted pregnancy terminations for fetal abnormalities, virtually the only type of abortion currently performed in the country. Abortions of pregnancies resulting from rape and those threatening the life of women are still formally legal.
  • “ultimate populist manifesto: If you are criticizing us, you are against the nation.”
  • “Now it’s not really just about abortion, it’s a protest about the loss of humanity,
  • right-wing extremists rushing to join the fray. And Mr. Kaczynski’s exhortations to his supporters may encourage them further.
hannahcarter11

Why It Wasn't Normal When Michigan Republicans Refused to Certify Votes - The New York ... - 0 views

www.nytimes.com/...michigan-election-results.html

michigan republicans votes new york times politics trump election

shared by hannahcarter11 on 19 Nov 20 - No Cached
  • For a few hours on Tuesday, it looked as though two Republican officials in Wayne County, Mich., might reject the will of hundreds of thousands of voters.
  • But hundreds of Michiganders logged on to a Zoom call to express their fury. And around 9 p.m., the Republicans reversed themselves, certifying the count.
  • Could the results of a free election really be blocked that easily, in such a routine part of the electoral process?
  • ...20 more annotations...
  • the answer was no, but perhaps only because so many people said so.
  • The Republican members, William Hartmann and Monica Palmer, said they were concerned about small discrepancies between the number of votes cast in some precincts and the number of people precinct officials recorded as having voted.
  • After intense backlash, both from election watchdogs and from voters whom Representatives Debbie Dingell and Rashida Tlaib organized to call in to the canvassing board’s meeting, Mr. Hartmann and Ms. Palmer voted to certify the results after all.
  • Is this sort of dispute normal?In a word, no.
  • This is basically an accounting task. If the canvassers find possible errors, it is their job to look into and resolve them, but refusing to certify results based on minor discrepancies is not normal.
  • The Trump campaign has filed a slew of legal challenges in Michigan and other states, but the courts have repeatedly rejected its arguments.
  • It is also highly abnormal to suggest, as Ms. Palmer did, that canvassers certify the results in one place but not another when there is no meaningful difference between the two in terms of the number or severity of discrepancies.
  • Before the deadlock was resolved, Ms. Palmer had proposed certifying the results in “the communities other than the city of Detroit.” As Democrats and election law experts noted, nearly 80 percent of Detroit residents are Black
  • “It’s hard to ignore the potentially racially motivated actions of at least one of the canvassers,” Kristen Clarke, president and executive director of the Lawyers’ Committee for Civil Rights Under Law, said in an interview shortly before the board’s reversal, adding that her group was exploring “all legal avenues” if Republicans continued to disrupt the certification process.
  • Section 168.822 of Michigan’s election laws says that if a county board fails to certify results, the state board “shall meet immediately and make the necessary determinations and certify the results” within 10 days.
  • Under federal law, election experts say, a state legislature could potentially step in and appoint electors in a disputed presidential election.
  • First, the election is not legitimately disputed. Mr. Biden won multiple battleground states by clear margins.
  • it is extremely rare for members to decline to certify an election that their party lost.
  • Second, even if Republican state legislators appointed a pro-Trump slate, a Democratic governor could step in and appoint a pro-Biden slate.
  • The Republican leader of the Michigan Senate has said that the Legislature will not name its own electors.
  • Several election lawyers said last week that federal law would favor the slate appointed by the governor, including if Congress deadlocked. Congress could also, in theory, toss out Michigan’s electoral votes altogether.
  • If Congress did that, or if it chose the Republican slate against the will of a state’s voters, the country would be in constitutional crisis territory.
  • Regardless of the outcome, the fact that the Trump campaign and other Republicans have managed to inject so much chaos into what should be formalities shows how much disruption is possible in the systems that undergird the democratic process.
  • In other words: The system wasn’t designed for this.
  • A lesson of the Trump era has been that much of American democracy is built not on laws but on norms, which persist by common consent. The episode in Michigan is an example of what can happen when the consent stops being common.
lilyrashkind

Pacific tsunami threat recedes, volcano ash hinders response - ABC News - 0 views

abcnews.go.com/...-ash-hinders-response-82293669

tsunami threat history

shared by lilyrashkind on 16 Jan 22 - No Cached
  • WELLINGTON, New Zealand -- The tsunami threat around the Pacific from a huge undersea volcanic eruption receded Sunday, but the massive ash cloud covering the tiny island nation of Tonga prevented surveillance flights from New Zealand to assess the extent of damage.
  • In Tonga it sent tsunami waves crashing across the shore and people rushing to higher ground.
  • The eruption cut the internet to Tonga, leaving friends and family members around the world anxiously trying to get in touch to figure out if there were any injuries. Even government websites and other official sources remained without updates on Sunday afternoon.
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  • islands.“Communication with Tonga remains very limited. And I know that is causing a huge amount of anxiety for the Tongan community here,” Ardern said.
  • water a vital need.Aid agencies said thick ash and smoke had prompted authorities to ask people to wear masks and drink bottled water.
  • Tsunami advisories were earlier issued for Japan, Hawaii, Alaska and the U.S. Pacific coast. The U.S. Geological Survey estimated the eruption caused the equivalent of a magnitude 5.8 earthquake. Scientists said tsunamis generated by volcanoes rather than earthquakes are relatively rare.
  • “It’s really bad. They told us to stay indoors and cover our doors and windows because it’s dangerous,” she said. “I felt sorry for the people. Everyone just froze when the explosion happened. We rushed home.” Outside the house, people were seen carrying umbrellas for protection.
  • One complicating factor to any international aid effort is that Tonga has so far managed to avoid any outbreaks of COVID-19. Ardern said New Zealand's military staff were all fully vaccinated and willing to follow any protocols established by Tonga.
  • In a video posted on Facebook, Nightingale Filihia was sheltering at her family's home from a rain of volcanic ash and tiny pieces of rock that turned the sky pitch black.
  • The tsunami waves caused damage to boats as far away as New Zealand and Santa Cruz, California, but did not appear to cause any widespread damage. Snider said he anticipated the tsunami situation in the U.S. and elsewhere to continue improving.
  • “We are praying that the damage is just to infrastructure and people were able to get to higher land,” she said.U.S. Secretary of State Antony Blinken wrote on Twitter he is “deeply concerned for the people of Tonga as they recover from the aftermath of a volcanic eruption and tsunami. The United States stands prepared to provide support to our Pacific neighbors.”
  • On Tonga, which is home to about 105,000 people, video posted to social media showed large waves washing ashore in coastal areas and swirling around homes, a church and other buildings. A Twitter user identified as Dr. Faka’iloatonga Taumoefolau posted video showing waves crashing ashore
  • The explosion of the Hunga Tonga Hunga Ha’apai volcano, about 64 kilometers (40 miles) north of Nuku’alofa, was the latest in a series of dramatic eruptions. In late 2014 and early 2015, eruptions created a small new island and disrupted international air travel to the Pacific archipelago for several days.
  • “The surface area of the island appears to have expanded by nearly 45% due to ashfall,” Planet Labs said days before the latest activity.
  • Savannah Peterson watched in shock as the water rose several feet in a matter of minutes in front of her oceanfront house in Pacifica, California, just south of San Francisco.
  • In northern Peru's Lambayeque region, two women drowned after being swept away by ″abnormal waves″ following the eruption, authorities said. A dozen restaurants and a coastal street were also flooded along El Chaco beach in Paracas district.
Javier E

France Faces 'Most Severe' Drought as Heat Persists in Europe - The New York Times - 0 views

www.nytimes.com/...rance-drought-europe-heat.html

europe heat wave crisis history

shared by Javier E on 06 Aug 22 - No Cached
  • Heat waves in Europe are increasing in frequency and intensity at a faster rate than almost any other part of the planet, according to scientists, who say that global warming and other factors like the circulation of the atmosphere and the ocean all play a role.
  • In Germany, more than 100 firefighters battled flames that engulfed parts of Grunewald, a forest in the west of Berlin, after munitions and fireworks exploded at the city’s bomb disposal site on Thursday morning.
  • The drought has been particularly devastating for European agriculture, which was already suffering from an abnormally dry spring season, parching crops, making it harder to feed livestock and raising worries about reduced harvests.
  • ...3 more annotations...
  • n Germany, the Rhine — the country’s most important water transport route — was so low that some ships have been forced to reduce their cargo loads. Uniper, a German power utility, even announced Thursday that it would reduce output from its largest coal-firing power plants because insufficient coal could be shipped to the plant via the Rhine.
  • And in France, which gets about 70 percent of its electricity from nuclear energy, heat waves have hampered power plants because they use water to cool their reactors. Several have been forced to reduce production over the past month, or to exceed normal temperature limits for the water that they release back into natural waterways.
  • “Because of climate change,” he said, “we are going to have to get used to these kinds of episodes.”
Javier E

Opinion | Germany's unlikely success story is an inspiration in tough times - The Washi... - 0 views

www.washingtonpost.com/...z-germany-success-story-europe

germany success story inspiration history politics culture

shared by Javier E on 03 Sep 22 - No Cached
  • One of the most striking positive trends in the world these days can be found in the democratic strength, character and leadership of Germany.
  • This came to mind as I was reading German Chancellor Olaf Scholz’s speech this week in Prague, in which he promised that his country would support Ukraine “reliably and for as long as it takes.” He explained that Germany had “undergone a fundamental change” on providing military aid to Ukraine. He affirmed Germany’s support for a stronger, more integrated Europe — one that would welcome new members that aspire to Europe’s democratic values and ideals.
  • This is all part of what he calls a Zeitenwende in German foreign policy, a “turning of the times.”
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  • it is also the continuation of a remarkably consistent German attitude toward Europe and the world since 1945. Think about how different the world would look if we did not have, at the center of Europe, its most powerful nation — the country that is the largest net contributor to the E.U. — totally committed to democratic and liberal values and willing to make sacrifices for them. Germany today is the rock on which a new Europe is being built.
  • the sacrifices are real and deep. Natural gas prices are up tenfold in Europe compared to last year. The price of electricity for 2023 is more than 15 times higher than it has been in recent years, by one estimate. Vladimir Putin is ramping up the pressure by slowing and even stopping gas exports to Germany
  • But Germany has not given in. Confronted with these massive challenges, it has patiently sought to diversify away from a dependence on Russia, investing even more in green technology, buying liquefied natural gas, reopening coal-fired plants and even debating whether to keep its last three nuclear power plants running longer than planned.
  • The European Union has suggested a 15 percent reduction in the consumption of natural gas this winter. Germany is trying to achieve a 20 percent cut just to be safe. German industry is being resourceful about energy efficiency, and companies are even thinking about sharing resources with competitors, all to get through the crisis.
  • Merkel herself was seen in similar ways when she came to power. Over time she developed the skills and stature to gain respect from all quarters. She might have erred in trying to develop too conciliatory a relationship with Moscow
  • but when Russia invaded Ukraine in 2014, she was at the forefront in condemning it and persuading Europe to impose an ambitious program of sanctions. She also led the world in responding to the Syrian refugee crisis, reassuring her country by declaring, “We can do this.” As of mid-2021, Germany hosts more than 1.2 million refugees, half of whom are from Syria. In fact, Germany has managed this stunning act of integration with minimal problems.
  • We always underestimate modern-day Germany and its leadership. The federal republic has had a remarkable run of leaders in the post-World War II era, from its first chancellor, Konrad Adenauer, to Willy Brandt to Helmut Schmidt to Merkel — and now, let’s hope, to Scholz. Can any other country compare over the past seven decades?
  • In 1945, no one would have predicted that Germany would develop as it has. It came out of the war utterly destroyed, its cities flattened, its population starving. Around 12 million ethnic Germans who had been expelled from other countries poured into Germany. Above all, postwar Germany was scarred by the gruesome legacy of Adolf Hitler and the Holocaust. But the country found a way to overcome its past, to become, in Henry Kissinger’s words, “a normal country … with an abnormal memory.” And that much larger Zeitenwende is one of the great good news stories of our times.
Javier E

Welcome to the blah blah blah economy - 0 views

image

unpredictable economy global

started by Javier E on 17 Dec 22 no follow-up yet
Javier E

Who's Afraid of Early Cancer Detection? - WSJ - 0 views

www.wsj.com/...on-grail-fda-approval-94f071a9

wsj health cancer detection test

shared by Javier E on 04 Feb 24 - No Cached
  • A diagnosis of pancreatic cancer usually means a quick death—but not for Roger Royse, who was in Stage II of the disease when he got the bad news in July 2022. The five-year relative survival rate for late-stage metastatic pancreatic cancer is 3%—which means that patients are 3% as likely to live five years after their diagnosis as other cancer-free individuals. But if pancreatic cancer is caught before it has spread to other organs, the survival rate is 44%.
  • some public-health experts think that’s just as well. They fret that widespread use of multicancer early-detection tests would cause healthcare spending to explode. Those fears have snarled Galleri and similar tests in a web of red tape.
  • Early diagnosis is the best defense against most cancers,
  • ...25 more annotations...
  • But only a handful of cancers—of the breast, lung, colon and cervix—have screening tests recommended by the U.S. Preventive Services Task Force
  • Many companies are developing blood tests that can detect cancer signals before symptoms occur, and Grail’s is the most advanced. A study found it can identify more than 50 types of cancer 52% of the time and the 12 deadliest cancers in Stages I through III 68% of the time.
  • There’s a hitch. The test costs $949 and isn’t covered by Medicare or most private insurance.
  • The trouble is that this cancer is almost never caught early. There’s no routine screening for it, and symptoms don’t develop until it is advanced. Mr. Royse, 64, had no idea he was sick until he took a blood test called Galleri, produced by the Menlo Park, Calif., startup Grail. He had surgery and chemotherapy and is now cancer-free.
  • Mr. Royse visited Grail’s website, which referred him to a telemedicine provider who ordered a test. Another telemedicine doctor walked him through his results, which showed a cancer signal likely emanating from the pancreas, gallbladder, stomach or esophagus.
  • An MRI revealed a suspicious mass on his pancreas, which a biopsy confirmed was cancerous. Mr. Royse had three months of chemotherapy, surgery and another three months of chemotherapy, which ended last February. Because pancreatic cancer often recurs, he gets CT and MRI scans every three months. In addition, he has signed up for startup Natera’s Signatera customized blood test, which checks DNA specific to the patient’s cancer and can signal its return before signs are visible on the scans
  • Grail’s test likewise looks for DNA shed by cancer cells, which is tagged by molecules called methyl groups that are specific to a cancer’s origin. Grail uses genetic sequencing and machine learning to recognize links between DNA methyl groups and particular cancers
  • The test “is based on how much DNA is being shed by tumor,” Grail’s president, Josh Ofman, says. “Some tumors shed a lot of DNA. Some shed almost none.
  • ut slow-growing tumors typically aren’t shedding a lot of DNA.” That reduces the probability that Grail’s test will identify indolent cancers that pose no immediate danger.
  • Grail’s test has a roughly 0.5% false-positive rate, meaning 1 in 200 patients who don’t have cancer will get a positive signal
  • Its positive predictive value is 43%, so that of every 100 patients with a positive signal, 43 actually have cancer
  • the legislation’s price tag could reduce political support. According to one private company’s estimate, the test could cost the government $39 billion to $145 billion over a decade. Mr. Goldman counters that analysts usually overestimate the costs and underestimate the benefits of medical interventions.
  • Because Grail uses machine learning to detect DNA-methylation cancer linkages, the Grail test’s accuracy should improve as more tests and patient data are collected
  • regulators may balk at approving the test, and insurers at covering it, until it becomes cheaper and more reliable.
  • How would the FDA weigh the risk that a false positive on a test like Grail’s could require invasive follow-up testing against the dire but hard-to-quantify risk that a deadly cancer wouldn’t be caught until it’s much harder to treat? It’s unclear.
  • some experts urge the FDA to require large randomized controlled trials before approving blood cancer tests. “Multicancer screening would entail tremendous costs and potentially substantial harms,” H. Gilbert Welch and Tanujit Dey of Brigham and Women’s Hospital wrote
  • Dr. Welch and Mr. Dey also suggested that companies should be required to prove their tests reduce overall mortality, even though the FDA doesn’t require drugmakers to prove their products reduce deaths or extend life. Clinical trials for the mRNA Covid vaccines didn’t show they reduced deaths.
  • One alternative is to rely on real-world studies, which Grail is already doing. One study of patients 50 and older without signs of cancer showed that the test doubled the number of cancers detected.
  • One recurring problem he has seen: “Epidemiologists are always getting cancer wrong,” he says. “Epidemiologists a decade ago said U.S. overtreats cancers. Well, no, the EU undertreats cancer.”
  • A 2012 study that he co-authored found that the higher U.S. spending on cancer care relative to Europe between 1983 and 1999 resulted in significantly higher survival rates for American patients than for those in Europe
  • By his study’s calculation, U.S. spending on cancer treatments during that period resulted in $556 billion in net benefits owing to reduced mortality.
  • He expects Galleri and other multicancer early-detection tests to reduce deaths and produce public-health and economic benefits that exceed their monetary costs
  • Expanding access to multicancer early-detection tests could also help solve the chicken-and-egg problem of drug development. Because few patients are diagnosed at early stages of some cancers, it’s hard to develop treatments for them
  • the positive predictive value for some recommended cancer screenings is far lower. Fewer than 1 in 10 women with an abnormal finding on a mammogram are diagnosed with breast cancer.
  • Mr. Royse makes the same point with personal force. “I would be dead right now if not for multicancer early-detection testing,” Mr. Royse told an FDA advisory committee last fall. “The longer the FDA waits, the more people are going to die. It’s that simple.”
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