Category: Regulations

Ross Douthat’s Self-Doctoring Was “Intensely Empirical”

(p. 12) The early chapters of “The Deep Places” unfold like the first act of a horror movie. Feeling the pull of home and burned out by life on Capitol Hill, Ross Douthat (a New York Times columnist) and his wife buy a 1790s farmhouse on three acres of Connecticut pasture.

. . .

Something is lurking in those woods. Back in D.C., Douthat has a swollen lymph node, a stiff neck and strange vibrations in his head and mouth. The urgent care doctor he sees first diagnoses him with a harmless boil. A few weeks later, he is in an emergency room at dawn with an alarming full-body shutdown, “as if someone had twisted dials randomly in all my systems.” The E.R. doctor suggests stress as the culprit — as do, in subsequent visits, an internist, neurologist, rheumatologist and gastroenterologist. A psychiatrist, his 11th doctor in 10 weeks, disagrees.

Only after Douthat completes his move north to Connecticut, namesake of Lyme disease, does it seem obvious to local doctors that he is suffering from something tick-borne.

. . .

He makes his case that tick-borne disease needs more research and its sufferers deserve more respect.

The trouble is that Douthat also wants to present his reckless journey as a road map. His revelation: “Given a stockpile of antibiotics, the array of over-the-counter medications available on Amazon and crowdsourced data from hundreds and thousands of Lyme sufferers sharing their experiences online, I could effectively become my own doctor, mixing and matching to gauge my body’s reaction to different combinations, like a Lyme researcher working on a study with a sample size, an ‘N,’ of only 1.”

This self-doctoring, he adds, “was in its own way intensely empirical and materially grounded — the most empirical work, in fact, that I have ever attempted in my life.” (Comparing this approach to Khakpour’s introspective memoir, I kept thinking of the couples-therapy trope that women prefer to talk through their problems while men leap to solve them.)

. . .

A subsequent bout of undiagnosed Covid-19, and scientists’ stumbles as they’ve worked to understand the new virus, have only hardened Douthat’s distrust of institutions like the Centers for Disease Control and Prevention and the Food and Drug Administration. “From the beginning of the pandemic to its still unfinished end,” he writes, “there were weirdos on the internet who were more reliable guides to what was happening, what was possible, and what should actually be done than Anthony Fauci or any other official information source.”

For the full review, see:

Sara Austin. “Darkness Invisible.” The New York Times Book Review (Sunday, November 28, 2021): 12.

(Note: ellipses, added; italics, in original.)

(Note: the online version of the review has the Updated Oct. 30, 2021, and has the title “A Transporting and Cozy Biography of a Pottery Pioneer.”)

The book under review is:

Douthat, Ross. The Deep Places: A Memoir of Illness and Discovery. New York: Convergent Books, 2021.

Bans on Natural Gas for Cooking and Heating Could Most Hurt Low-Income Citizens

(p. A13) This week, New York City moved to ban gas hookups in new buildings, joining cities in blue states like California, Massachusetts and Washington that want to shift homes away from burning natural gas because it releases carbon dioxide, which causes global warming.

Instead, developers in New York City will have to install electric heat pumps and electric kitchen ranges in newly constructed buildings.

. . .

But the gas industry is fighting back and has lobbied in statehouses across the country to slow the shift away from gas. It argues that gas appliances are widely popular and still cost less than electric versions for many consumers. Opponents have also warned that a rush to electrify homes could strain power grids, particularly in the winter when heating needs soar, at a time when states like California and Texas are already struggling to meet demand.

Karen Harbert, president and chief executive of the American Gas Association, an industry group, said efforts to disconnect homes and businesses from the extensive network of gas pipelines would make it difficult to supply those buildings with low-carbon alternatives that might be available in the future, such as hydrogen or biogas.

“Eliminating natural gas and our delivery infrastructure forecloses on current and future innovation opportunities,” she said.

The question of whether to use natural gas in homes has become part of the culture wars, pitting climate activists against industry and other interest groups. Some chefs and restaurant owners have argued that they won’t be able to cook certain dishes as well without gas.

. . .

In a statement, Bill Malcolm, a senior legislative representative at the AARP, said the group had “supported legislative and regulatory initiatives allowing customers to continue to use the fuel of their choice to heat their homes and cook their food.” He added: “Outright bans on certain fuel options would run contrary to that choice.”

. . .

For now, natural gas remains the dominant fuel in much of the country, heating nearly half of American homes. Electric heat pumps, by contrast, satisfy just 5 percent of heating demand nationwide.

. . .

Experts have warned that as more homeowners go electric, gas utilities will still have to pay to maintain their existing network of pipelines, which could mean higher costs for the smaller base of remaining customers, many of whom may be low-income.

For the full story, see:

Brad Plumer and Hiroko Tabuchi. “Gas vs. Electric Stoves Join Partisan Battlefield.” The New York Times (Friday, December 17, 2021): A13.

(Note: ellipses added.)

(Note: the online version of the story has the date Dec. 10, 2021, and has the title “How Politics Are Determining What Stove You Use.” The online version says that the New York print edition had the title “Gas vs. Electric Stoves on a Partisan Battlefield.” My National print edition had the title “Gas vs. Electric Stoves Join Partisan Battlefield.” Where there is a slight difference in wording between the versions, the passages quoted above follow the online version.)

Elon Musk Likes Government the Referee, Not Government the Subsidizer

Here are some especially important passages from the Wall Street Journal transcript of the Elon Musk interview:

Joanna Stern

Well, I want to come back to autonomous vehicles, but wanted to just stay a little bit more on the role of government. You said at this conference, actually, a year ago, that you think the government should really just be hands off when it comes to innovation. Though with this bill, there is a lot of support for EVs and it could be the biggest change that we’ve seen throughout the country in terms of the infrastructure of EVs. And it helps Tesla. What do you think the role of government should be?

Elon Musk

I think the role of government should be that of, like, a referee. But not a player on the field. So generally, government should just try to get out of the way and not impede progress. I think there’s a general problem, not just in the U.S., but in most countries, where the rules and regulations keep increasing every year.

Rules and regulations are immortal. They don’t die. Occasionally you see a law with a sunset provision, but really, otherwise, the vast majority of rules and regulations live forever. And so if more rules and regulations are applied every year and it just keeps growing and growing, eventually it just takes longer and longer and it’s harder to do things.

And there’s not really an effective garbage collection system for removing rules and regulations. And so gradually this hardens the arteries of civilization, where you’re able to do less and less over time. So I think governments should be really trying hard to get rid of rules and regulations that perhaps had some merit at some point but don’t have merit currently. But there’s very little effort in this direction. This is a big problem. Continue reading “Elon Musk Likes Government the Referee, Not Government the Subsidizer”

When Sri Lanka Government Banned Chemical Fertilizers, Yields Tanked and Prices “Shot Up”

(p. A4) RATNAPURA, Sri Lanka — This year’s crop worries M.D. Somadasa. For four decades, he has sold carrots, beans and tomatoes grown by local farmers using foreign-made chemical fertilizers and pesticides, which helped them reap bigger and richer crops from the verdant hills that ring his hometown.

Then came Sri Lanka’s sudden, and disastrous, turn toward organic farming. The government campaign, ostensibly driven by health concerns, lasted only seven months. But farmers and agriculture experts blame the policy for a sharp drop in crop yields and spiraling prices that are worsening the country’s growing economic woes and leading to fears of food shortages.

Prices for some foodstuffs, like rice, have risen by nearly one-third compared with a year ago, according to Sri Lanka’s central bank. The prices of vegetables like tomatoes and carrots have risen to five times their year-ago levels.

“I haven’t seen times that were as bad as these,” said Mr. Somadasa, a 63-year-old father of two who sells vegetables in the small town of Horana, just outside the island nation’s capital, Colombo. “We can’t find enough vegetables. And with the price hikes, people find it hard to buy the vegetables.”

. . .

President Gotabaya Rajapaksa cited health concerns when his government banned the importation of chemical fertilizers in April [2021], a pledge he had initially made during his 2019 election campaign.

. . .

The push for organic farming didn’t start with Mr. Rajapaksa’s current government, nor when another brother, Mahinda Rajapaksa, currently the prime minister, was president from 2005 to 2015. Some farmers and agriculture industry officials say they are warming to the idea of reducing dependence on chemicals in farming. But the shift was too sudden for farmers who didn’t know how to work organically, said Nishan de Mel, director of Verité Research, a Colombo-based analysis firm.

Verité found in a July [2021] survey that three-quarters of Sri Lanka’s farmers relied heavily on chemical fertilizers, while just about 10 percent cultivated without them. Almost all major crops grown in the country depend on the chemicals. For crops crucial to the economy like rice, rubber and tea, the dependence reaches 90 percent or more.

The April ban went into effect just before what is known as the Yala planting season, which lasts from May to August, and was felt almost immediately. The Verité survey showed that 85 percent of farmers expected a reduction in their harvest because of the fertilizer ban. Half of them feared that their crop yield could fall by as much as 40 percent.

Food prices shot up in September [2021], . . .

For the full story, see:

Aanya Wipulasena and Mujib Mashal. “A Plunge Into Organic Farming Brings Disaster to Sri Lanka.” The New York Times (Wednesday, December 8, 2021): A4.

(Note: ellipses, and bracketed years, added.)

(Note: the online version of the story has the date Dec. 7, 2021, and has the title “Sri Lanka’s Plunge Into Organic Farming Brings Disaster.”)

“Unanticipated Tragedies Are Unpreventable, No Matter How Many Regulations”

(p. A15) Dr. Offit acknowledges the limits of regulatory fixes, noting that, while regulatory guidelines are important, “unanticipated tragedies are unpreventable, no matter how many regulations, training programs, fines, and penalties are put in place.” He contrasts the tragic death in 1999 of 18-year-old Jesse Gelsinger in an early gene-therapy study—aimed at remediating a rare enzyme deficiency—with the triumphant experience of Emily Whitehead, a girl with leukemia treated 11 years later at the same university with genetically manipulated T-cells. Gelsinger’s death has been ascribed to protocol deficiencies, conflicts of interest and inadequate regulation, but “a closer look,” Dr. Offit writes, “shows that the only difference between the outcomes of Emily Whitehead and Jesse Gelsinger were luck and timing.” The specific supportive approach used by Whitehead’s doctors to address a life-threatening complication of her T-cell infusion stemmed directly from the lessons learned during Gelsinger’s ordeal. We recognize successes, Dr. Offit laments, but “never the failures that made those successes possible.”

One anxiety suffusing every page of “You Bet Your Life” is what to make of the Covid-19 vaccines. Dr. Offit, a member of the FDA’s vaccine advisory committee, has been described in The Wall Street Journal as “an outspoken advocate of the science and value of vaccinations,” including the Covid-19 vaccine. He has described its clinical-trial data as “enormously reassuring” and has seen little evidence of “a very rare, serious side effect that would be something that would cause a long term problem.” Yet his review of the history of vaccination and of its complexities evokes surprising empathy for the vaccine-hesitant. He recounts the early days of the Salk polio vaccine, which saved lives yet also tragically transmitted the disease to some patients when the product was inadequately prepared by one of its manufacturers. He notes that “the first vaccines aren’t always the best, safest, and last” and regrets the “disturbing show of hubris” by the Covid vaccine developers.

Ultimately, Dr. Offit emphasizes, we need to come to terms with the fact that all medical technologies carry risk—as does the decision not to avail oneself of them. “A choice not to get a vaccine is not a risk-free choice,” Dr. Offit notes. Either way, he says, “you’re gambling”—so “choose the lesser risk.”

For the full review, see:

David A. Shaywitz. “BOOKSHELF; The Dangers Of Finding a Cure.” The Wall Street Journal (Tuesday, Nov. 09, 2021): A15.

(Note: the online version of the review has the date November 8, 2021, and has the title “BOOKSHELF; ‘You Bet Your Life’ Review: The Dangers of Finding a Cure.”)

The book under review is:

Offit, Paul A. You Bet Your Life: From Blood Transfusions to Mass Vaccination, the Long and Risky History of Medical Innovation. New York: Basic Books, 2021.

Climate Change Infrastructure Subsidies Mainly Benefit the Rich

(p. A9) Mr. Biden has insisted that at least 40 percent of the benefits of federal climate spending will reach underserved places, which tend to be low income, rural, communities of color, or some combination of the three.

But historically, it is wealthier, white communities — with both high property values and the resources to apply to competitive programs — that receive the bulk of federal grants. And policy experts say it’s unclear whether, and how quickly, federal bureaucracy can level the playing field.

. . .

The new climate provisions in the infrastructure bill inject billions of dollars into competitive grant programs. These are pots of money that towns, cities and counties can access only by submitting applications, which federal agencies then rank, with funds going to applicants with the highest scores.

That system is designed to ensure that funding goes to the most worthwhile projects.

But it also hinges on something outside the control of the federal government: The ability of local officials to use sophisticated tools and resources to write successful applications. The result is a process that has widened the gap between rich communities and their less affluent counterparts, experts say.

The disparity begins even before the application process begins. That’s because local governments must be aware of the grant programs in the first place, which means having dedicated staff to track those programs. Then they need to design proposals that will score highly, and correctly complete the reams of required paperwork.

Even if they are awarded a grant, communities are required to pay a share of the project — often 25 percent, which is unaffordable for many struggling towns and counties.

Governments that can clear those obstacles face a final hurdle: Demonstrating that the value of the property that would be protected is greater than the cost of the project. That rule often excludes communities of color and rural areas, where property values are usually lower than in white communities.

. . .

The Biden administration has touted the program, called Building Resilient Infrastructure and Communities, or BRIC, as a model that should be expanded. The infrastructure bill provides billions more to the program.

But most of the first round winners were wealthy, predominantly white areas in a handful of coastal states, federal data show.

More than half the money went to California, New Jersey and Washington State. The largest single recipient was a $68 million flood-control project in Menlo Park, Calif., where the median household income is more than $160,000, the typical home costs more than $2 million and only one in five residents are Black or Hispanic. The project is in line to get $50 million from FEMA.

For the full story, see:

Christopher Flavelle. $50 Billion Conundrum: Who Gets Climate Protection?” The New York Times (Saturday, December 4, 2021): A9.

(Note: ellipses added.)

(Note: the online version of the story has the date Dec. 3, 2021, and has the title “Billions for Climate Protection Fuel New Debate: Who Deserves It Most.”)

New Nuclear Designs Are “Cheap, Efficient, Extremely Reliable”, “Nearly Carbon-Free” and Much Safer

(p. A17) Jacopo Buongiorno, a nuclear-engineering professor at the Massachusetts Institute of Technology, has calculated that over the life cycle of power plants, which includes construction, mining, transport, operation, decommissioning and disposal of waste, the greenhouse-gas emissions for nuclear power are 1/700th those of coal, 1/400th of gas, and one-fourth of solar. Nuclear also requires 1/2,000th as much land as wind and around 1/400th as much as solar. For any given power output, the amount of raw material used to build a nuclear plant is a small fraction of an equivalent solar or wind farm. Although nuclear waste is obviously more difficult to dispose of, its volume is 1/10,000th that of solar and 1/500th of wind. This includes abandoned infrastructure and all the toxic substances that end up in landfills. One person’s lifetime use of nuclear power would produce about a half-ounce of waste. Even including the Chernobyl disaster, human mortality from coal is 2,000 to 3,000 times that of nuclear, while oil claims 400 times as many lives.

Although the federal government tends to resist nuclear power, many nuclear technologies are being investigated and funded by private capital including molten-salt reactors, liquid-metal reactors, advanced small modular reactors, microreactors and much more. More than 70 development projects are under way in the U.S., with many designs intended to create assembly-line construction facilities to simplify and standardize testing, licensing and installations. One appealing approach is to replace large-scale facilities with many smaller but safer, cheaper and more-manageable ones. The $10 billion 10-year planning and implementation cycle for a large nuclear plant can be cut in half with a small modular reactor and another half with a microreactor.

. . .

Nuclear power is cheap, efficient, extremely reliable and nearly carbon-free. New designs, including smaller reactors, drastically reduce the risk of large-scale radioactive contamination.

. . .

Sacrifice isn’t always the path to progress.

For the full commentary, see:

Andrew I. Fillat and Henry I. Miller. “Nuclear Power Is the Best Climate-Change Solution by Far.” The Wall Street Journal (Friday, Nov. 5, 2021): A17.

(Note: ellipses added.)

(Note: the online version of the commentary has the date November 4, 2021, and has the same title as the print version.)

“Precautionary Principle Would Have Vastly Slowed” Anesthesia, Antibiotics, Chemotherapy and Other Medical Innovations

(p. 15) In his new book, “You Bet Your Life,” Paul A. Offit wants to understand the failures and tragedies that help pave the way to medical innovation. For most of human history, anesthesia did not exist. Patients had to be forcibly restrained while their limbs were amputated and their cancers were removed, typically amid piercing screams and unbearable agony. Things did not start to change until the 1840s, when a carnival barker named Gardner Colton charged people 25 cents to sniff “laughing gas,” also known as nitrous oxide, which made them fall down in hysterics and then go to sleep for a few minutes. On Dec. 10, 1844, a dentist named Horace Wells attended Colton’s show. Soon after inhaling the gas (and making a fool of himself), he told a friend that a person could probably “have a tooth extracted or a limb amputated and not feel any pain.”

Wells sought out Colton immediately after the show, and the very next day, he became the first person to use nitrous oxide as an anesthetic: He asked a fellow dentist to extract one of his own teeth. The procedure was painless. Over the following weeks, Wells used nitrous oxide on 15 of his patients. It worked every time. In January 1845, he asked if he could demonstrate his method to specialists in a large amphitheater at the Massachusetts General Hospital. The demonstration failed. Wells gave too little of the anesthetic to his patient, who woke up during the extraction, in intense pain and screaming. Members of the audience shouted out, “Humbug!” Wells was disgraced.

. . .

Offit is a good storyteller, and he has some terrific stories to tell. He also draws important lessons. In the domain of medical innovation, tragedies cannot be prevented, no matter how many regulations we put in place. Science moves forward in fits and starts, with blunders, failures and losses along the way. New discoveries are rarely immediate; we inevitably learn more over time. Ours is not a risk-free world, which means that we need to choose the lesser risk. New technologies are always a gamble.

All of those claims are true, but I think that Offit also pulls out an even deeper and more provocative moral from this history. In life and in public policy, many people in Europe and the United States are drawn to the “precautionary principle,” which essentially calls for a high degree of risk aversion: Whenever an innovation threatens to cause harm, we should be exceedingly cautious before we allow it. Offit’s examples, and the history of medical advances, demonstrate that in its most extreme forms, the precautionary principle is self-defeating. Simply put, precautions kill. Whether we are speaking of anesthesia, heart transplants, antibiotics, chemotherapy or blood transfusions, the precautionary principle would have vastly slowed down innovations that, yes, carried serious risk and led to real harm, but were ultimately a great boon to humanity.

For the full review, see:

Cass R. Sunstein. “Side Effects.” The New York Times Book Review (Sunday, October 17, 2021): 15.

(Note: ellipsis added.)

(Note: the online version of the review was updated Oct. 25, 2021, and has the title “A History of Medical Innovation That Doesn’t Ignore the Side Effects.”)

The book under review is:

Offit, Paul A. You Bet Your Life: From Blood Transfusions to Mass Vaccination, the Long and Risky History of Medical Innovation. New York: Basic Books, 2021.

California Labor and Environment Policies Reduce Nimble Response to Supply Chain Backups

(p. A17) The backup of container ships at the Long Beach and Los Angeles ports has grown in recent weeks despite President Biden’s intervention to get terminal operators to move goods 24/7.

. . .

The two Southern California ports handle only about 40% of containers entering the U.S., mostly from Asia. Yet ports in other states seem to be handling the surge better. Gov. Ron DeSantis said last month that Florida’s seaports had open capacity. So what’s the matter with California? State labor and environmental policies.

Some 20 business groups recently asked Gov. Gavin Newsom to declare a state of emergency and suspend labor and environmental laws that are interfering with the movement of goods. Opening the Port of Los Angeles 24 hours a day “alone will do little without immediate action from the state to address other barriers that have created bottlenecks at the ports, warehouses, trucking, rail, and the entire supply chain,” they wrote.

One barrier is a law known as AB5. Before its enactment in 2019, tens of thousands of truck drivers worked as independent contractors, which gave them more autonomy and flexibility than if they were employees. As contractors, truck drivers can work for multiple companies, which allows them to nimbly respond to surges in demand.

. . .

Another problem: a shortage of storage space. “There is absolutely no available capacity in the warehousing sector due to the difficulty in developing any new capacity,” the businesses noted in their letter. The vacancy rate for warehouses near the Los Angeles and Long Beach ports was a mere 1%, compared with 3.6% nationwide.

If warehouses don’t have space in their facilities or parking lots to unload goods, drivers can’t make deliveries. Some truck drivers are leaving container boxes along with the chassis outside storage facilities and are picking them up later, but that results in a shortage of chassis at the ports. (About half of chassis are leased to truckers from a common pool supplied by private companies.)

. . .

. . . in California warehouse growth ignited opposition from environmental groups, which complain of pollution and noise. Many cities have limited new logistics facilities.

For the full commentary, see:

Allysia Finley. “California Is the Supply Chain’s Weakest Link.” The Wall Street Journal (Friday, Nov. 5, 2021): A17.

(Note: ellipses added.)

(Note: the online version of the commentary has the date November 4, 2021, and has the same title as the print version.)

N.I.H. Funded EcoHealth Wuhan Research to Make Coronaviruses More Infective and Virulent

(p. A21) EcoHealth Alliance has come under scrutiny because of its collaboration on coronavirus research with researchers at the Wuhan Institute of Virology, which is situated in the city where the pandemic began.

. . .

Last month, The Intercept, an online publication, posted 900 pages of materials related to the N.I.H. grants to EcoHealth Alliance for the research. The materials provided details about experiments designed to provide new insights into the risk that bat coronaviruses have for sparking new pandemics.

In some of their experiments, the researchers isolated genes from bat coronaviruses that encode a surface protein, called spike. Coronaviruses use the spike protein to bind to host cells, the first step to an infection. The spike protein latches onto a cell-surface protein called ACE2.

According to the materials published, the researchers then engineered another bat virus, called WIV1, to carry spike proteins from other bat coronaviruses. They then conducted experiments to see if the engineered WIV1 viruses became better at attaching to ACE2 on cells.

. . .

Dr. Lawrence Tabak, the principal deputy director of the N.I.H., wrote in the letter to Representative Comer that the agency determined that the research proposed by EcoHealth Alliance did not meet the criteria for additional review . . .

. . .

Dr. Tabak noted that in one line of research, the researchers had produced mice genetically engineered to produce the human version of the ACE2 protein on their cells. Infecting these animals with coronaviruses could potentially provide a more realistic sense of the risk that the viruses have of infecting humans than just using dishes of cells.

The N.I.H. required that EcoHealth Alliance notify the agency if the engineered viruses turned out to grow 10 times faster or more than WIV1 would without their new spike proteins.

In some experiments, it turns out, that viruses did grow quickly.

“EcoHealth failed to report this finding right away, as required by the terms of the grant,” Dr. Tabak wrote.

The N.I.H. also sent Representative Comer a final progress report that EcoHealth Alliance submitted to the agency in August [2021].

In the report, the researchers describe finding that WIV1 coronaviruses engineered to carry spike proteins were more virulent. They killed infected mice at higher rates than did the WIV1 virus without spikes from the other coronaviruses.

The filing had been submitted late, the N.I.H. said, nearly two years beyond the grant-specified deadline of 120 days from completion of the work. “Delayed reporting is a violation of the terms and condition of N.I.H. grant award,” Renate Myles, a spokeswoman for the agency, said.

Jesse Bloom, a virologist at the Fred Hutchinson Cancer Center who has called for more research into the origins of the pandemic, said the revelations raised serious questions about the risks of investigating viruses originating from animals, known as zoonotic viruses.

For the full story, see:

Carl Zimmer and Benjamin Mueller. “N.I.H. Says Bat Studies Were Not Submitted Promptly.” The New York Times (Friday, October 22, 2021): A21.

(Note: ellipses, and bracketed year, added.)

(Note: the online version of the story was updated October 28, 2021, and has the title “Bat Research Group Failed to Submit Virus Studies Promptly, N.I.H. Says.”)