PG&E Guilty Plea Sets A Precedent For Climate Change Culpability

IRA FLATOW: This is Science Friday. I’m Ira Flatow. A bit later in the hour, job burnout in health care workers. We’ll talk about taking care of the people who are taking care of us. But first, there’s still a lot we don’t know about COVID-19, and doctors are finding recovered patients aren’t always out of the woods after they beat the infection. We’re just learning about the long-term complications inflicting some of the survivors.

Here to talk about that and other science stories from the week is Umair Irfan, a staff writer at Vox in Washington. Welcome back, Umair.

UMAIR IRFAN: Thanks for having me.

IRA FLATOW: Let’s start with the story you reported for Vox, and that’s a second round of COVID-19 lockdowns might not work as well as the first time around. Why is that?

UMAIR IRFAN: Well, there are a number of reasons at play. The big one is just that we’re in a very different stage of the pandemic right now. Back when the first lockdowns went into effect, we were seeing tens or dozens of cases per day in states, and now we’re seeing hundreds, if not thousands, of cases per day. So snapping those restrictions back into a place would take a longer time for those numbers to start dropping again.

The other factor is that once you start locking people in place, there’s a higher chance of household transmission, basically people transmitting it to people in their own families. And there’s also likely to be a fair amount more transmission among the essential workers. So there’s likely to be a longer time for this curve to come down. And then finally, people are pretty tired. I mean, they’re fatigued by these measures, by having to wear masks or to keep social distance, and it’s likely that people are not going to be as compliant this time around.

IRA FLATOW: I know here in New York, we’re barely getting out of the first lockdown. What places are considering a second round?

UMAIR IRFAN: Right. I mean, it’s largely going to be in places that are seeing a rise in cases. Right now there are 18 states, states like Tennessee, Texas, Arizona, and South Carolina, and many of those governors are trying to press ahead with plans to reopen their economies. But some city government officials, mayors and county officials, want to snap back their own restrictions in their own places, cities like Houston, for instance. But in some of these cases, those cities are prohibited from setting standards that are more stringent than the state government, and so they’re trying to resolve that right now, trying to give people some of the leeway to impose their own stricter measures, like mandating wearing masks or demanding that businesses close.

IRA FLATOW: Are there any alternatives that might be investigated to explore?

UMAIR IRFAN: Well, the thing we could be doing is the thing we should have been doing all along, which is essentially testing, tracing, and isolating the people that are sick. The purpose of the lockdown was not just to slow the transmission of the virus, but it was also to buy time to set up the infrastructure to do the less costly but more sophisticated methods of controlling the disease, basically finding the people who are transmitting the virus unwittingly, helping them isolate, and then also making it easy for people to isolate, encouraging tactics like work from home, or offering unemployment insurance, or paid sick leave to make sure that people aren’t feeling pressured to go back out, even when they’re maybe sick.

IRA FLATOW: Let’s move on to this other story I began with when we started talking, and that is a lot of patients who have recovered from COVID are dealing with persistent health issues weeks and months later, right?

UMAIR IRFAN: That’s right. I mean, this is still a very new disease, and so it’s hard to get a picture of the long-term trends just a few months in, but we are starting to see some signs. Doctors have also looked at some of our past experiences with other coronaviruses, like SARS, and saw some long-term effects there. The big ones to pay attention to are things that are dealing with the airways.

COVID-19 is a respiratory infection, so that makes sense. Doctors have reported seeing lung scarring in patients. On CT scans, they identify what are called ground-glass opacities– basically patches in the lungs that look like ground glass, essentially showing that there is a diminished lung function. And that can persist and that can be permanent. And then similarly, there are other problems that can also be persistent, like heart and even neurological trouble, because one of the symptoms or one of the signs of COVID-19 is that it can cause blood clots that can choke off blood supply to parts of the body. And if that persists, that can cause some lasting damage.

IRA FLATOW: And even people who have to learn sort of how to speak again, having being intubated in a tube down their throat all this time.

UMAIR IRFAN: Right. Just the fact that people are in intensive care, that’s not an easy thing to recover from. I mean, it still has a lot of a recovery time that is associated with it. And even in younger people– like even though older people are most at risk, younger people who have been hospitalized and received intensive care can also suffer some of these long-term effects.

IRA FLATOW: All right, let’s move on and talk about a promising treatment for COVID-19 we haven’t heard much about. It’s called dexamethasone. Tell us about this.

UMAIR IRFAN: Yeah, researchers at Oxford University in the United Kingdom this week reported some promising results in a fairly large clinical trial of this drug. This drug dexamethasone is a corticosteroid. It’s been around since the 1950s. It’s fairly cheap. It’s available as a generic, and it’s used largely as an anti-inflammatory drug.

And the researchers reported that in this trial, they gave this drug to about 2,000 patients that were randomly selected and compared it to 4,000 patients who were given the conventional treatment. And they found that this drug saved the lives of critically ill patients. This is the key finding here.

This is the first drug demonstrated to save lives. And it reduced deaths by about one third in patients on ventilators, and it reduced deaths by about one fifth for patients who were receiving oxygen support. However, it had no impact on patients that did not receive that kind of intensive care, that weren’t receiving breathing support.

IRA FLATOW: So it was important to give it at the right time?

UMAIR IRFAN: That’s right. This is something that is very useful for critically ill patients, but in earlier stages of the infection it could potentially backfire. And that has to do with the mechanism of this drug. Because this is a steroid, it can actually suppress the immune system.

So in the early stages of the infection, you want to try to control the virus. But in the later stages, you want to try to control the immune response, because sometimes the immune system can overreact and cause a lot of collateral damage. The white blood cells can sometimes start attacking healthy cells, and that’s typically what happens in the more severe cases. So there’s kind of a threshold at which point this drug, where the trade-offs make sense to give it to people.

IRA FLATOW: Does this prevent that dreaded cytokine storm, where the body’s immune system overreacts and attacks itself?

UMAIR IRFAN: Well, it doesn’t necessarily prevent it, but it gives you sort of a counterbalance to that, because one of the key phenomenon of this disease is that it can throw the immune system out of balance. And so by having a drug that can actually tamp down the immune system during the most critical stage of the infection, or through a course of it, that you can actually help gain ground against it. And as this study showed, it saved lives.

IRA FLATOW: Yeah. Is there any pushback? Sometimes these studies come out and then they re-evaluate. Then more people see the results, and say, just wait a minute.

UMAIR IRFAN: Well, that’s one of the big problems with the study, like, we haven’t actually seen the results. This has been one of the key focus points for a lot of researchers who are evaluating this. The findings were not even announced in a preprint paper. They were announced in a press release.

And I talked to a doctor about this, and he was very frustrated because he wants to treat patients, and he says he has no idea how the patients he sees line up with the patients that were in the study. And so a lot of researchers are saying that this is a good way to build a lot of attention for these findings, but without seeing the actual data there’s really no way to scrutinize and validate them.

IRA FLATOW: Now, this drug, as you say, has been around for decades. It’s available by prescription. If word about this gets out, are we going to see a run on the drug, do you think?

UMAIR IRFAN: Probably not, because it’s not like hydroxychloroquine, which people were trying to take it as a prophylactic to prevent the disease. This is a pretty serious drug. Like we mentioned, it suppresses the immune system. Not only does it make your immune system weaker against the virus, it can make you vulnerable to other infections and other pathogens.

So you don’t want to take it willy-nilly. And again, as the study showed, it only had an impact on the most severely ill patients. The vast majority of people who get COVID-19 get better on their own or they have a much milder progression of the disease, and there’s really no impact that we can detect on those lower courses.

IRA FLATOW: OK, let’s shift a little bit and go on to another topic. I know we have just entered hurricane season. And when you were on the show a few months ago, we talked about how hurricanes have been gaining strength since the 1970s because of climate change. And now I understand there’s new research that says something else might be happening. Tell us about that, please.

UMAIR IRFAN: Sure. Some research came out this week that showed that hurricanes are actually slowing down and dumping more rain. And the consequence of that is going to be likely more flooding and more damage from these storms. In this study, they looked at both historical data and climate models, and they found that between 1961 and 2017, tropical cyclones have slowed down by about 10%.

IRA FLATOW: Yeah, now, we’ve seen some of these giant rainstorms, so there is some evidence that’s already happening, right?

UMAIR IRFAN: Yeah. We saw a pretty stark example of that with Hurricane Harvey in 2017. That storm basically parked over Houston and dumped a gargantuan amount of rain and caused a lot of record flooding. And that makes sense because hurricanes dish out a huge amount of rain, and so if you just hold them in place in one area for a longer period of time that place is going to accumulate more rain.

IRA FLATOW: Wow. OK, let’s move on to– from rain, let’s move on to wildfires. The largest utility company in California recently confessed to manslaughter. Tell us what was going on there.

UMAIR IRFAN: Yes. Pacific Gas and Electric, which is the largest utility in California, they this week confessed to involuntary manslaughter for 84 counts. This was in connection to the Camp Fire in 2018. This was the large California fire that was likely sparked by PG&E equipment. This ended up being the most destructive and deadliest wildfire in California’s history.

So the ruling here was basically that PG&E should have done a better job of maintaining their equipment. But the problem is that wildfires have been getting worse in the United States and more destructive for a number of different factors, and almost all of them stem from human activity. People are building closer to wildfire-prone regions, and that means there is more damage when fires do occur and a greater likelihood of fires being ignited. And also, humans are changing the climate. Western forests are starting to dry out, and there’s more fuel to burn.

The Camp Fire came at the edge of a huge drought in California, and there are millions of dead trees throughout the state. So all these problems are working together, and yet one company was found liable for the brunt of it. And this is going to be a bigger problem going forward about dividing the pie as far as who’s responsible for what when it comes from these climate-linked disasters.

IRA FLATOW: It’s very rare to hear of a big company admitting guilt about anything.

UMAIR IRFAN: Yeah, that’s right. I mean, they did get, I think, roughly a $3.5 million fine, but they’re also facing about $30 billion in liability. The company declared bankruptcy. And going ahead, I think legislators are going to have to deal with how do you divide the blame here?

I mean, you can’t really boycott electricity in California. PG&E has largely a monopoly in most of the areas it operates, and people are still going to need power wherever they live. So if you live in a remote mountainous area that has a lot of fire-prone trees, those power lines are still going to be running there. So the question is, over the long term, how do you mitigate these risks? And that’s a tough question to answer at this point.

IRA FLATOW: Let’s end on a bit of a bizarre note that researchers have engineered goats that make cancer medications in their milk. What the heck is going on there?

UMAIR IRFAN: Well, they turned these goats into cancer drug-making factories. And goats are an ideal vehicle for this because they’re very cheap to make. I mean, they grow very quickly, and they generate a large amount of milk for their size. And so researchers used the embryos of goats that were engineered to make this drug called cetuximab. This is a monoclonal antibody.

Now, cancer drugs, especially some of the more sophisticated ones, they’re these complicated molecules, and they become very expensive to make. And for patients, it can cost thousands of dollars a month to get a treatment course for this. So having an animal that can actually make kilograms of this stuff per year is actually a huge step forward in terms of making it much cheaper.

And so they engineered these embryos. They implanted them. After five months, they were born. And when they started to lactate, they were producing basically about 10 grams of this drug for every liter of milk that they produced.

IRA FLATOW: Very cool, Umair. It’s always great to have you on and bring us something different to think about.

UMAIR IRFAN: Great to be here, Ira.

IRA FLATOW: Umair Irfan is a staff writer at Vox in Washington, DC.

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