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Disinfectant use has exploded during the coronavirus pandemic as people try to keep their hands and surfaces clean. But one family of cleaning chemicals is receiving scrutiny for potential health concerns.
Bacterial resistance<img lazy-loadable="true" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTY2MDI5OS9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYyNDgzMTg2NH0.oblpCfGhX2bNUalkkUdxOsf8pjhjaUgs0PA-XF5czHs/img.jpg?width=980" id="c9807" class="rm-shortcode" data-rm-shortcode-id="df25e56e48ba823fb75a0cd6601e2237" data-rm-shortcode-name="rebelmouse-image" alt="bacteria petri dish" data-width="1245" data-height="827" />
Bacteria sample inside petri dish. (Credit: IRRI Photos/flickr)<p>The pandemic has increased demand for products like Lysol wipes that use quats as active ingredients: sales of Lysol wipes were<a href="https://www.cnbc.com/2020/07/16/ceo-of-durex-condom-maker-intimate-occasions-down-during-pandemic.html" target="_blank"> up</a> nearly 50 percent in spring of 2020 compared to 2019. Other cleaning products are also in high demand — aerosol disinfectant<a href="https://www.jpmorgan.com/solutions/cib/research/covid-spending-habits" target="_blank"> sales as a whole have doubled</a> in 2020 in the U.S., a large fraction of which also contain quats.</p><p>All those additional sales mean quats are becoming more present in the environment. "We're in an era now where the concentration [of quats] is certainly higher than ever before," William Arnold, an environmental engineer at the University of Minnesota, told EHN. He published<a href="https://pubs.acs.org/doi/10.1021/acs.estlett.0c00437" target="_blank" rel="noopener noreferrer"> a paper</a> in June that revealed an increased load of quats may be ending up in wastewater plants, with some worrisome implications. Quats can end up in wastewater plants after they're flushed down the drain — at the levels of use during the pandemic, some plants can't keep up, so quats have the potential to pollute waterways. There, they might disrupt marine food chains, as quats have been found to be <a href="https://www.sciencedirect.com/science/article/abs/pii/S0269749115302025?via%3Dihub" target="_blank" rel="noopener noreferrer">toxic</a> to small invertebrates like plankton in lakes. </p><p>The ingredients also may be spurring antibiotic-resistant germs, Arnold said.</p><p>Bacteria are constantly working to shore up their defenses against the antiseptics we use. "We've had an 80- or 90-year head start, but we really need to keep innovating" to stay ahead of microbial evolution,<a href="http://kminbiol.clasit.org/" target="_blank" rel="noopener noreferrer"> Kevin Minbiole</a>, a Villanova University chemist who studies how quats affect bacteria and<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7233851/" target="_blank" rel="noopener noreferrer"> viruses,</a> told EHN.</p><p>Quats work like spears, penetrating the shell on the outside of a bacteria or virus. But some bacteria are getting better at recognizing quats and getting rid of them, or becoming resistant, said Minbiole. He and his collaborator, Emory University chemist William Wuest, are experimenting with new antimicrobial ingredients and recently <a href="https://patents.google.com/patent/US20200277263A1/en" target="_blank" rel="noopener noreferrer">patented their own quats</a> that can mount multiple attacks on a single microbe. These quats are likely even more effective antiseptics than current quats on the market, but the new chemicals haven't yet been tested for safety, so it's not clear how their health or environmental impacts might differ, or not, from current quats, according to Wuest.</p>
Chemistry Professor Kevin Minbiole and his students discuss their research. (Credit: villanova.edu)<p>But the germs may be one step ahead. As they encounter quats and other antiseptics, bacteria can develop broad, rather than specific, resistance. These new bacterial shields, which evolved to block attacks by antiseptics, might also protect them against other threats, including the antibiotic medications doctors prescribe to help fight serious infections.</p><p>It's called cross resistance: when changes bacteria make to get around one threat make them better suited to survive other threats, too. "Those changes make bacteria capable of surviving different compounds, different chemicals that it hasn't seen before," <a href="http://tagkopouloslab.ucdavis.edu/?author=8" target="_blank">Beatriz Pereira</a>, a recent graduate student in microbiology from University of California, Davis, told EHN.</p><p>In lab experiments, Pereira has seen bacteria develop resistance to certain quats, even when she only exposes them to low concentrations of the chemicals. The bacteria shore up their defenses, strengthening their outer membrane — a good way to develop cross resistance to other chemicals as well. It's not clear whether bacteria are yet developing resistance in the wild in response to current levels of quat pollution, or even how much quat pollution currently exists. But to Pereira, these lab experiments alongside a growing <a href="https://aem.asm.org/content/85/13/e00377-19.full" target="_blank" rel="noopener noreferrer">body of evidence</a> suggest that the best way to respond to the problem of antibiotic resistance may be not to develop new quats, which might cause the same problem of antibiotic resistance eventually, but to reconsider whether we should be using them at all, at least in some products.</p>
Birth defects and infertility<p><a href="https://www.vcom.edu/people/theresa-hrubec" target="_blank" rel="noopener noreferrer">Theresa Hrubec</a>, a biologist at Virginia Tech and the Edward Via College of Osteopathic Medicine, has also been publishing work on the potential risks of quats — work that started by accident. While she was using mice to study potential side effects of medications, she noticed that some mice in her control group, the mice that weren't exposed to any medication, were developing birth defects. After ruling out the possibility that she had switched the groups, she found a potential explanation: the facility had recently started using quats to disinfect her lab. The floors were mopped daily, the walls wiped down weekly, and anytime a box of mice was opened, it was wiped down with disinfectant. The mice were all being unintentionally dosed with quats, Hrubec told EHN. And she wasn't the only researcher who had seen problems with mice and quat disinfectants:<a href="https://smb.wsu.edu/faculty-trainees-and-staff/faculty/profile/pat-hunt" target="_blank"> Patricia Hunt</a>, a researcher at Washington State University, had seen similar problems with her mice.</p><p>Hrubec and Hunt have since published several studies that link quats to health problems in mice, from <a href="https://www.ehn.org/the_cost_of_clean_disinfectants_cause_birth_defects_in_baby_mice-2497174322.html" target="_self">birth defects</a> to <a href="https://www.ehn.org/quats-quagmire-common-disinfectants-cause-reproductive-problems-in-mice-study-says-2569921664.html" target="_self">decreases in fertility</a>. For each of the studies, mice were fed a mixture of two common quat disinfectants at high doses for several weeks before being examined for either fetal birth defects or signs of decreased fertility.</p><p>Mice that were exposed to quats were more likely to develop neural tube defects, an early-stage birth defect. And doses of quats decreased the number and size of litters born as well. </p><h3><em>Related: <a href="https://www.ehn.org/how-to-shop-for-cleaning-products-while-avoiding-toxics-2648130273.html" target="_self">How to shop for cleaning products - while avoiding toxics</a></em></h3><p>How exactly quats might cause birth defects is still unknown, according to Hrubec. She has a few theories. Endocrine disruption might be to blame — Gino Cortopassi, who collaborated with Hrubec, found that one quat, although not the same chemical Hrubec used in her research, can <a href="https://ehp.niehs.nih.gov/doi/10.1289/ehp1404" target="_blank">bind to hormone receptors</a>. The same lab also found that quats appear to affect how <a href="https://iovs.arvojournals.org/article.aspx?articleid=2623337" target="_blank" rel="noopener noreferrer">mitochondria function</a>, which can cause a litany of problems in cells. </p><p>Inflammation might be another possible explanation. Quats are suspected to cause occupational asthma — exposure to a toxic or irritating chemical that results in lung inflammation. Japanese researchers <a href="https://pubmed.ncbi.nlm.nih.gov/19762220/" target="_blank" rel="noopener noreferrer">found in 2010</a> that mice exposed to quats at high concentrations by inhalation saw cell death and increased levels of inflammation. However, human studies observing quat exposure and occupational asthma <a href="https://pubmed.ncbi.nlm.nih.gov/31832071/" target="_blank" rel="noopener noreferrer">have had mixed results,</a> with some researchers arguing that quat exposure hasn't been definitively linked with lung problems. </p><p>Most of the research by Hrubec and her collaborators is done in mice, so quats may not have the same effects on humans. Figuring out how quats might be impacting humans is a much more complicated job. In a <a href="https://www.medrxiv.org/content/10.1101/2020.07.15.20154963v1" target="_blank" rel="noopener noreferrer">pre-print</a>, published last year but not yet reviewed by outside experts for accuracy, Hrubec and her collaborators performed a monitoring study of a small group, 43 people. They detected quats in 80 percent of the study participants, and quat levels in the blood were associated with higher levels of inflammation and decreased mitochondrial function. The results are still preliminary, but it is among the first research to attempt monitoring quat levels in humans. </p>
Dose disagreement<img lazy-loadable="true" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTY2MDQzMS9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYxODA1ODc3NH0.3nAukRKSKRzTc84b0HB2stBmoL8qEVT3QUS3Mvco1OY/img.jpg?width=980" id="92f93" class="rm-shortcode" data-rm-shortcode-id="9d609248bc3296f019411881fdef21bf" data-rm-shortcode-name="rebelmouse-image" data-width="1245" data-height="831" />
Applying disinfectant onto wipe for cleaning headphones. (Credit: Marco Verch Professional Photographer/flickr)<p>Not everyone agrees about how the research is being done. In a<a href="https://pubmed.ncbi.nlm.nih.gov/25500365/" target="_blank"> letter to the editor</a> in response to one of Hrubec's<a href="https://pubmed.ncbi.nlm.nih.gov/25483128/" target="_blank"> early studies</a>, Keith Hostetler, an industry representative, raised concerns about the experiment's design. One critique was the dose level — according to Hostetler, the level of disinfectant fed to the mice would be the equivalent of a 155-pound adult drinking about 1.5 quarts of disinfecting solution daily.</p><p>But toxicology studies are pretty typically performed with high doses at first, before being extrapolated down to more realistic doses, according to<a href="https://patisaullab.wordpress.ncsu.edu/" target="_blank"> Heather Patisaul</a>, a biologist at North Carolina State University who studies toxicological effects of hormone-disrupting compounds. She was not involved in Hrubec's studies.</p><p>"Complaining that the dose is too high and the sample size is too low is a common industry response," Patisaul told EHN via email. In this case, she said the dosage was particularly high for some groups. However, Patisaul also notes that Hrubec saw birth defects in fetuses when the father was fed less than 1/15 the dose Hostetler mentioned, which she said is more compelling evidence that quats might cause harm.</p><p>Still, "neither [dose] is anywhere near a human-relevant range," Patisaul said, so the results do not definitively show that quats could harm human health with normal levels of use.</p><p>The doses were high in order to determine whether quats warrant more research, said Hrubec, adding that many mice that were not fed quats, but were merely present in rooms where quats were used, were also found to develop birth defects. To her, this suggests that the disinfectants present in the lab from regular disinfecting were still enough to trigger health problems.</p>
MTA New York City Transit sanitizes stations and subway cars. (Credit: Metropolitan Transportation Authority of the State of New York)
Janitor disinfects elementary classroom. (Credit: Alliance for Excellent Education/flickr)
States take notice<p>Hrubec has been a constant figure at regulatory meetings on quats. She presented her research during a<a href="https://biomonitoring.ca.gov/events/biomonitoring-california-scientific-guidance-panel-meeting-march-2020" target="_blank"> March 2020 meeting</a> with California's Biomonitoring Program. During the meeting, other researchers also presented data on quat's potential for causing<a href="https://biomonitoring.ca.gov/sites/default/files/downloads/WRAPPcomments030420.pdf" target="_blank"> occupational asthma</a> and <a href="https://biomonitoring.ca.gov/sites/default/files/downloads/Xu030420.pdf" target="_blank">endocrine disruption</a>.</p><p>After considering data from researchers and industry, the advisory panel for Biomonitoring California voted unanimously to add quats to the list of chemicals that could be considered for biomonitoring studies, and they plan to discuss quats as potential high-priority chemicals in March 2021, according to<a href="https://agency.calepa.ca.gov/staffdirectory/detail.asp?UID=61347&BDO=6&VW=DET" target="_blank"> Shoba Iyer</a>, a toxicologist for the California Office of Environmental Health Hazard Assessment who works with the biomonitoring program.</p><p>The program's board does not have the authority to ban quats — the purpose of adding quats to the monitoring list and completing biomonitoring studies is to learn more about chemical exposures and inform public health policies and regulations, Iyer told EHN.</p><p>Officials from one agency in Massachusetts also have their eye on quats — and they say the pandemic and the resulting increase in disinfectant use has caused them to examine the chemicals more closely. "That's why we finally decided to take up [quats], because people are using it constantly to try to keep themselves and their workers and customers safe," <a href="https://www.turi.org/About/Staff_List/Harriman_Liz" target="_blank" rel="noopener noreferrer">Liz Harriman</a>, Deputy Director of the Toxics Use Reduction Institute (TURI) in Massachusetts, told EHN.</p><p>Massachusetts state law requires companies that manufacture certain chemicals, or use them to make products, to report use levels of the chemicals and submit plans for safe use. The Scientific Advisory Board for TURI makes recommendations to state agencies on which chemicals to examine, and they are focusing on two classes of quats, both of which are used in surface cleaners, according to<a href="https://www.turi.org/About/Staff_List/Tenney_Heather" target="_blank" rel="noopener noreferrer"> Heather Tenney</a>, who heads the board.</p><p>In January, the advisory board discussed several categories of research on quats, including birth defects and respiratory conditions like<a href="https://erj.ersjournals.com/content/38/Suppl_55/p4936" target="_blank" rel="noopener noreferrer"> asthma</a>, as well as<a href="https://pubs.acs.org/doi/abs/10.1021/acs.estlett.0c00437" target="_blank" rel="noopener noreferrer"> environmental effects</a> of quats like the potential for microbial resistance. The board did not reach a vote, and will reconvene in March to continue discussing potential action on quats.</p><p>Hostetler, the industry representative who has published letters challenging Hrubec's research, also presented at both the March Biomonitoring California presentation and the TURI meeting in January. At the TURI board meeting, he emphasized that the U.S. Environmental Protection Agency has independently concluded that quats do not have effects on developmental or reproductive health, based on tests that follow agency guidelines.</p><p>Manufacturers maintain that their disinfecting products available for purchase have been tested extensively. "They've done a lot of research on their formulations. What they put on the market, they know to be safe and efficacious," James Kim, a Vice President of the American Cleaning Institute, a trade organization that represents manufacturers, told EHN.</p>
Alternatives are available<p>Despite increased attention from states, quats will likely remain available on the market in surface disinfectants for the foreseeable future. But for consumers looking to avoid quats in their <a href="https://www.ehn.org/how-to-shop-for-cleaning-products-while-avoiding-toxics-2648130273.html" target="_self">cleaning supplies</a>, alternatives are available.</p><p>"Given the huge concern for reproductive toxicity and birth defects in humans, it really makes sense to take a precautionary approach,"<a href="https://www.ewg.org/experts/samara-geller.php" target="_blank"> Samara Geller</a>, a research analyst for Environmental Working Group (EWG), an advocacy organization that pushes for regulation of chemicals in consumer products, told EHN. </p> <p>While a large portion of disinfectants on the market include either quats or bleach as their main ingredient, there are other options available. Geller said EWG recommends products that contain citric acid, lactic acid, or hydrogen peroxide as their main ingredients. EWG also publishes <a href="http://ewg.org/guides/cleaners/" target="_blank" rel="noopener noreferrer">a guide</a> to cleaning products that aggregates safety data where consumers can check for options. </p> <p>Consumers can reference the EPA's <a href="https://www.epa.gov/pesticide-registration/list-n-disinfectants-coronavirus-covid-19" target="_blank" rel="noopener noreferrer">list </a>of disinfectants that are expected to be effective against coronavirus, which lists products by active ingredient. </p><p>Liz Harriman, the Massachusetts TURI official, said she also urges the public to consider alternative products to those that contain quats. "It's not so much that we're dead set against quats," said Harriman, "But if there are safer alternatives you can use to accomplish the same thing, why wouldn't you use those?"</p>
1918 redux<img lazy-loadable="true" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTY2MDE2Mi9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYyMzQ0MDUzNn0.hgr3qCLZroUJ_0uqjhczw1cR8Wl1vMIF2GNm2QzZJ_o/img.jpg?width=980" id="60ca4" class="rm-shortcode" data-rm-shortcode-id="8461261ff10b13de3d67266b58e34615" data-rm-shortcode-name="rebelmouse-image" alt="1918 flu" data-width="1500" data-height="900" />
St. Louis Red Cross Motor Corps on duty during influenza epidemic (1918). (Credit: Library of Congress)<p>It is easy to lay immense blame on former President Trump and his administration for setting the tragedy of the US response in motion. He knew very early about the lethality of the coronavirus yet <a href="https://www.npr.org/2020/09/09/911109247/trump-admitted-to-playing-down-the-coronaviruss-severity-per-new-book" target="_blank">chose</a> to purposely "play it down" to the American people because he didn't "want to create a panic."</p><p>In doing so, Trump replicated one of the worst mistakes made by leaders in 1918. Back then, in the last year of World War I, the nation's political leaders were in no mood for additional bad news. Congress passed the <a href="https://www.thirteen.org/wnet/supremecourt/capitalism/sources_document1.html" target="_blank">Sedition Act</a> that year, making it illegal to "willfully utter, print, write or publish any disloyal, profane, scurrilous, or abusive language," about the government. The act's passage <a href="https://www.whitehousehistory.org/the-american-protective-league-and-white-house-security-during-world-war-one" target="_blank" rel="noopener noreferrer">inspired</a> hundreds of thousands of private citizens around the nation to intimidate and even beat people they presumed to be unpatriotic.</p><p>As historian John Barry <a href="https://www.cdc.gov/flu/pandemic-resources/pdf/workshop.pdf" target="_blank" rel="noopener noreferrer">recounted</a> for a 2006 Centers for Disease Control and Prevention workshop on the lessons learned from the 1918 flu pandemic, at that time, "patriotism was more important than truth." When the flu began appearing, a Chicago public health official said, "Worry kills more people than the disease itself." The federal government did so little that the Public Health Service returned most of the $1 million it was given to fight the pandemic.</p><p>Many cities took matters into their own hands and, a century later, the lessons are clear. As multiple <a href="https://biotech.law.lsu.edu/blog/joc70085_644_654.pdf" target="_blank" rel="noopener noreferrer">studies</a> of the 1918 pandemic have <a href="https://www.nationalgeographic.com/history/2020/03/how-cities-flattened-curve-1918-spanish-flu-pandemic-coronavirus/" target="_blank" rel="noopener noreferrer">found</a>, those municipalities that more firmly banned public gatherings, closed schools, or otherwise employed measures of social distancing, experienced fewer deaths. A <a href="https://www.nytimes.com/interactive/2020/04/03/upshot/coronavirus-cities-social-distancing-better-employment.html" target="_blank" rel="noopener noreferrer">study</a> last year by Federal Reserve and MIT researchers <a href="https://poseidon01.ssrn.com/delivery.php?ID=017096020116090007015025002030093098015051021063079059125002022095123126109008071127006055125009047120052112027118021106022079052085021064086098090093092099002089066057085035119004006084096000112123024085070009109076064065031121084124093080099071027117&EXT=pdf&INDEX=TRUE" target="_blank" rel="noopener noreferrer">found</a> that cities with stronger public health protections also tended to have stronger economic recoveries. Co-author Emil Verner, an MIT economist, explained to the New York Times that stronger public health measures, "actually make it safer for economic activity to resume, and they mitigate the negative impact of the pandemic itself on mortality."</p><p>Those insights, though, were completely lost on the ahistorical Trump, for whom the stock market was more important than science or public health. Many governors allied with Trump followed his lead, insisting, to the point of intimidation, on keeping their economies open. Almost as if the Sedition Act, repealed after the conclusion of World War l, was still in force, some governors threatened to <a href="https://blog.ucsusa.org/derrick-jackson/the-push-to-relax-covid-19-protections-exposes-age-old-racial-wounds" target="_blank" rel="noopener noreferrer">punish</a> workers who did not return to work after last spring's lockdowns.</p><p>In many states, this was akin to pouring kerosene on systemic racism in the world of essential work, as White workers disproportionately <a href="https://www.epi.org/blog/black-and-hispanic-workers-are-much-less-likely-to-be-able-to-work-from-home/" target="_blank" rel="noopener noreferrer">stayed safe</a> telecommuting from home. In <a href="https://www.propublica.org/article/early-data-shows-african-americans-have-contracted-and-died-of-coronavirus-at-an-alarming-rate" target="_blank" rel="noopener noreferrer">many</a> states in the early months of the current pandemic, African Americans and Latinx and Indigenous Americans <a href="https://blog.ucsusa.org/derrick-jackson/the-push-to-relax-covid-19-protections-exposes-age-old-racial-wounds" target="_blank" rel="noopener noreferrer">died</a> at grossly higher rates than their White counterparts, with multiple studies <a href="https://blog.ucsusa.org/derrick-jackson/as-the-virus-rampages-through-washington-essential-workers-nationwide-are-paying-the-price" target="_blank" rel="noopener noreferrer">tying</a> death to essential work.</p>
Systemic racism rolls on in vaccine rollout<img lazy-loadable="true" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTY2MDE1Ny9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTY2NDI2NDI2Mn0.i-RT6tcgQHRGUVdzY9efYy6Kr9nHMaQJjOPGyEFdC74/img.jpg?width=980" id="ca0d1" class="rm-shortcode" data-rm-shortcode-id="49b7165c5a00aa10c773aafe6f5fa3b5" data-rm-shortcode-name="rebelmouse-image" alt="puerto rico vaccine covid" data-width="1500" data-height="900" />
Puerto Rico National Guard. (Credit: The National Guard)<p>The Biden administration was elected with many promises to correct the previous administration's mistakes. Biden's quest is to somehow rally a divided nation around possible solutions, especially with new variants of the coronavirus threatening to lengthen the misery. For individuals, the top thing we can do is to wear face coverings and continue to maintain social distance. The IMHE estimates that 34,000 lives could be saved between now and June with universal use of face coverings.</p><p>For state governments, part of the solution is walking the talk of racial equity. So far, despite the promising start of the Biden administration of returning scientists to the podium to deliver authoritative coronavirus updates to the public, systemic racism remains aflame in our pandemic response. The most current wildfire is that the communities most impacted by COVID-19 are consistently last to get vaccinated against it, regardless of the political leanings of a state.</p><p>For instance, Massachusetts, stereotyped as liberal, was severely <a href="https://www.bostonglobe.com/2021/02/03/nation/vaccination-site-roxbury-whom/" target="_blank">embarrassed</a> by <a href="https://www.bostonglobe.com/2021/02/08/opinion/racial-vaccination-gap-is-scandal/" target="_blank" rel="noopener noreferrer">overwhelmingly White</a> lines at the opening of a vaccination center in the heart of Boston's Black community. The state also was <a href="https://www.bostonglobe.com/2021/02/05/metro/baker-unveils-call-center-help-seniors-book-vaccine-appointments-rolls-out-campaign-encourage-people-get-shots/" target="_blank" rel="noopener noreferrer">criticized</a> for establishing its first mass vaccination centers in large sports venues and suburban malls, either physically or culturally light years away from communities of color hardest hit by COVID-19. Whether due to lack of access to the Internet, time needed to book an appointment, transportation difficulties or failure by officials to engage local community centers, Black people have been getting vaccinated at rates less than half their share of state populations in Delaware, Florida, Indiana, Louisiana, Mississippi, Missouri, New Jersey, Ohio, Pennsylvania and Tennessee.</p><p>For Latinx populations, vaccination efforts to date have accounted for less than half their share of the population in Alaska, Colorado, Delaware, Florida, Indiana, Maryland, Massachusetts, Mississippi, Nebraska, New Jersey, North Carolina, Oregon, Pennsylvania, Rhode Island, Tennessee, and Texas.</p><p>The racial <a href="https://apnews.com/article/race-and-ethnicity-health-coronavirus-pandemic-hispanics-d0746b028cf56231dbcdeda0fba24314" target="_blank" rel="noopener noreferrer">vaccination gap</a> is likely even more widespread but the Kaiser Family Foundation, which is <a href="https://www.kff.org/coronavirus-covid-19/issue-brief/latest-data-covid-19-vaccinations-cases-deaths-race-ethnicity/" target="_blank" rel="noopener noreferrer">doing</a> the tracking above, has sufficient data to list only half of all US states. With Black and Latinx populations at the leading edge of death in this crisis, it is unconscionable that states did not proactively prioritize vaccination efforts for those communities.</p><p>It represents another lie to people of color about "being in all this together," especially now as White people collectively realize we're all in the casket together. The disproportionate distribution of the vaccine to White people coincides with national share of White deaths, according to February 10 CDC data, <a href="https://covid.cdc.gov/covid-data-tracker/#demographics" target="_blank" rel="noopener noreferrer">rising</a> steadily in recent months to 62.5 percent, edging past the 60.1 percent White <a href="https://www.census.gov/quickfacts/fact/table/US/PST045219" target="_blank" rel="noopener noreferrer">share</a> of the population.</p>
We all have a hand in this failure<img lazy-loadable="true" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTY2MDE1Mi9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYxODU1ODAzOH0.2xmDO-ci1qSGyuPgk0lrdq1VFHnm5XQdnAJea_WjZwI/img.jpg?width=980" id="da189" class="rm-shortcode" data-rm-shortcode-id="ae39d01bf7ebafbd1ef8fcab771827f0" data-rm-shortcode-name="rebelmouse-image" alt="COVID-19 travel" data-width="1500" data-height="859" />
National Guard assists out of state passengers with information forms arriving at Albany International Airport, Albany, N.Y., in December. (Credit: The National Guard)<p>It is hopeful that the Biden administration has ended Trump's full-scale war on science that chased out scientists from many federal agencies and culminated in turning a deaf ear during the pandemic to the nation's top infectious disease experts. The question now is: can we use science to our best advantage to protect people, especially the <a href="https://www.ehn.org/essential-workers-health-covid-19-2648193289/covid-19-and-frontline-occupations" target="_self">essential workers</a> that are keeping us fed at grocery stores and with take-out meals, the farm laborers and those on the line butchering meat, the sanitation workers picking up our garbage, the delivery folks bringing us the goods from our online purchases, and the frontline health care workers dealing with the ill?</p><p>The question now is: can we use common sense to our best advantage? If we are honest with ourselves, we surely know that, given 103 years to learn from the last-worst pandemic, our current collective behavior is not even close to the best we can do.</p><p>The surges in holiday travel and gatherings, from last Memorial Day to this past Christmas, the <a href="https://www.nytimes.com/2021/02/09/us/colleges-covid.html" target="_blank">desperation</a> of so many colleges to hold in-person classes and play sports, the self-important need of some churches and temples to hold services and the temptation, family by family, to think they could get away with a birthday party, a wedding, or a funeral, are all reminders that a collective response to COVID-19 remains far from reality. The Supreme Court, shaped into almost a conservative super majority by Trump, has compounded the problem by recently <a href="https://www.capradio.org/news/npr/story/?storyid=964822479" target="_blank" rel="noopener noreferrer">striking down</a> state temporary restrictions on in-person services, choosing in-person religious service over public health.</p><p>A last major question is whether COVID-19, which was so weaponized by the Trump administration that his supporters saw face coverings as the theft of freedom, can be turned in to a rallying cry to fuse a divided government. This milestone of a half million dead, the specter of bodies piling up in makeshift morgues, is thus far a headstone for decades of faltering public health funding.</p><p>In a 2020 <a href="https://www.tfah.org/wp-content/uploads/2020/04/TFAH2020PublicHealthFunding.pdf" target="_blank" rel="noopener noreferrer">report,</a> "The Impact of Chronic Underfunding on America's Public Health System," the Trust for America's Health noted that the nation's public health emergency preparedness programs have been cut from $940 million in 2002 to $675 million in 2020. Hospital preparedness programs have been slashed from $515 million in 2004 to $275 million in 2020. That makes the $8.3 billion in Congressional COVID-19 emergency funding last March an exercise in expensive catch-up.</p><p>Add to that our lack of economic safety net stemming from our ragged ethos of rugged individualism. While a wealthy nation like <a href="https://www.washingtonpost.com/business/2020/10/13/germany-unemployment/" target="_blank" rel="noopener noreferrer">Germany</a> has <a href="https://www.dihk.de/resource/blob/27920/a6591ae8f2f43dcf37ff9e4bec50fb72/support-measures-corona-data.pdf" target="_blank" rel="noopener noreferrer">compensated</a> businesses during its lockdowns for 75 percent of pre-COVID sales and workers for about two-thirds of their lost wages, our Congress argues <a href="https://www.nytimes.com/2021/02/08/us/politics/biden-democrats-stimulus.html" target="_blank" rel="noopener noreferrer">bitterly</a> over limited stimulus checks and a few hundred dollars of monthly unemployment relief.</p><p>President Biden has <a href="https://theconversation.com/fact-check-us-can-joe-biden-stop-the-virus-in-the-us-as-he-claims-151322" target="_blank" rel="noopener noreferrer">said,</a> "I am not going to shut down the economy, period. I am going to shut down the virus." Biden's ability to say that, within the bounds of science and public health safety, would be immensely bolstered if Congress was more agile in providing more robust funding to help businesses and workers survive science-based shutdowns and capacity restrictions.</p>
Not time to drop the mask<img lazy-loadable="true" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTY2MDE0NC9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTY2MjUzMDYxMX0.qKlNmj0Z69p7tVdI0e0rPZD6BexgCZ4514fjPJlV0jw/img.jpg?width=980" id="b53b5" class="rm-shortcode" data-rm-shortcode-id="201a24d2a112891a2c9c91eaba9dea54" data-rm-shortcode-name="rebelmouse-image" alt="COVD-19 vaccine" data-width="1500" data-height="900" />
Preparing a COVID-19 vaccine. (Credit: Official U.S. Navy Page)<p>A resuscitation of the federal government from its 1918 coma is critical as desperate states and cities make pandemic choices that lie either on the bare edges of public health or in utter disregard of it. With the hospitality and indoor recreation industries on their knees, liberal governors in states such as California, New York and Michigan are lifting stay-at-home orders and restaurant capacity restrictions. More conservative states have begun lifting mask orders, <a href="https://www.aarp.org/health/healthy-living/info-2020/states-mask-mandates-coronavirus.html" target="_blank">raising</a> the number of states without such orders back to 15.</p><p>Virologist Angela Rasmussen of Georgetown University's Center for Global Health Science Security recently <a href="https://www.propublica.org/article/why-opening-restaurants-is-exactly-what-the-coronavirus-wants-us-to-do" target="_blank">told ProPublica</a> that, with dangerous variants of the coronavirus working their way through the United States, the expansion of indoor dining is "completely reckless." Epidemic expert Sam Scarpino of Northeastern University said that while vaccines give us the chance to bring the pandemic under control, easing up prematurely on social distancing restrictions "may end up wasting all the effort we put in."</p><p>On NBC's "Meet the Press," last Sunday, CDC Director Rochelle Walensky bluntly <a href="https://www.politico.com/news/2021/02/14/cdc-director-states-mask-mandates-469018" target="_blank" rel="noopener noreferrer">said</a> it was "absolutely" too soon for states to lift mask orders. On CBS's "Face the Nation," she <a href="https://www.cbsnews.com/news/transcript-rochelle-walensky-discusses-coronavirus-on-face-the-nation-february-14-2021/" target="_blank" rel="noopener noreferrer">pleaded</a> with the nation not to be as numb to the pandemic, saying its trajectory in the coming months "depends on how we as a country behave." Noting that the current level of death of between 1,500 and 3,500 deaths a day is still more than twice the daily level of last summer, Walensky said:</p><p>"We are nowhere near out of the woods. And as you know, if we relax these mitigation strategies with increasing transmissible variants out there, we could be in a much more difficult spot. So what I would say is now is the time to not let up our guard. Now is the time to double down."</p><p>That thought of doubling down is almost inconceivable given the nation's half-effort to stop the original spread of the virus, the continued defiance of common-sense public health measures such as masking in conservative regions, and the desperation of more liberal states to keep people employed in the absence of sufficient federal support. What Walensky was really calling for, at heart, is for us to summon a shared sense of common good to quell the virus. She called for us to place public health over individual privilege and misguided notions of freedom.</p><p>Her call is likely our last chance to avoid surpassing the 675,000-death toll of 1918. We should not waste it.</p>
As we gradually work our way out of the pandemic with the development and distribution of vaccines, what does our evolving success tell us about the possibilities of resolving the climate change crisis?
Paths forward exist<img lazy-loadable="true" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTU1NjAyMi9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYzNjM0ODkyNH0.b6y9xUVuM6eC1tCfYzTvVDxwfERz_uquH6Fb68HHmmQ/img.jpg?width=980" id="93db0" class="rm-shortcode" data-rm-shortcode-id="541c6326c3cfa2d394eb17db2ddbc4ed" data-rm-shortcode-name="rebelmouse-image" alt="electric vehicle" data-width="1245" data-height="685" />
Car parked at an electric car charger. (Credit: Ivan Radic/flickr)<p>As dramatic and devastating as it is, COVID-19 involves one virus (now mutating) that is causing illness and death. The solution is the vaccine. Fortunately, researchers were exploring vaccine methods in the aftermath of the 2003 SARS pandemic that proved fruitful for COVID-19.</p><p>The analogue to the almost two decades of work including pre-clinical animal testing that laid the foundation for the vaccine in record time is that we've known for a long time what is needed to stop the discharge of greenhouse gases into the atmosphere and how to adapt. </p><p>There have been multiple fully coherent plans to decarbonize the economy. Significant research has been underway for decades identifying and, to some extent, implementing a wide variety of technologies, some as substitutes for fossil fuels, and others that reduce our reliance on energy or make it go farther. We've gathered experience with a variety of regulatory programs including regional systems of emissions trading and the various painfully developed regulations that would nudge and guide society toward more efficient cars, appliances, and power-generation. Despite attacks on these by the Trump Administration, they remain achievable options and the launching point for more. </p><p>There is also a broad base of support for acting on this threat from important actors in society who have come to understand how climate change destabilizes their work. Multiple corporations have expressed support for decarbonization. Military leaders have accepted climate change as a threat multiplier that makes their jobs much more difficult.</p><p>And there is no lack of planning for the inevitable damage from the changes already taking place. Cities and states have been busy for some time thinking about water level rise and weather-related disaster preparation.</p><p>In some ways, all this work is similarly off-the-shelf as was the virus research into the spike protein. It puts residents of planet Earth ready to move forward toward making their existence here safer.</p>
Delivering solutions<img lazy-loadable="true" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTU1NjA1Ny9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTY2MjA5NjgyMH0.q_694I2hDltaDadoPXzGNO4NpLM5M9mqARYTXmnPQaw/img.jpg?width=980" id="39ede" class="rm-shortcode" data-rm-shortcode-id="5eec7657a39253bb349ed15c9ebb6919" data-rm-shortcode-name="rebelmouse-image" data-width="1245" data-height="738" />
President Joe Biden has made addressing climate change a key priority. (Credit: Chairman of the Joint Chiefs of Staff)<p>But the better analogy, and warning sign, if there is one, is not to the development of the vaccine but to its delivery. Delivery of a vaccine requires infrastructure, commitment, funding of multiple actors and coordination at many levels of society. It requires a federal government committed to action, not just wishful thinking. The early hitches in delivery laid bare many of the inequities that allow well-to-do people with access to computers, the internet, and other resources to be vaccinated while poorer people have difficulty even getting into line.</p><p>If we look at addressing the climate challenge as an all-of-government job; if we commit the funding and the political will; if we don't kid ourselves with delusions of quick fixes, and if business walks the walk, and doesn't just talk, we have a chance. </p><p>There is no way to make up lost time; the four years of Trump denial built dangerously on the period before that where Congress never acted. The Arctic is melting and the Antarctic is in danger – just one example but a very big one for current and future weather, and, in turn, for our ability to provide for ourselves. Even if we were completely to stop using fossil fuels today, the loading process in the atmosphere makes it very unlikely we can reverse warming trends very soon. </p><p>The COVID-19 experience is a guide, a useful one, but not a template. Just because answers are available, indeed well-known and vetted, doesn't mean they are easily adopted or applied. The test for the Biden Administration, as it is for COVID-19, is finding the commitments among winners and unhappy losers to put the stuff on the shelf to work. </p>