Thursday, February 13, 2020

Starting Green New Deal (Green Industrial Revolution) at the local level

The Green New Deal is about creating jobs to address the ecological emergencies. I have written to my MP about how we could do this meaningfully in our patch. Here is what I have sent him. Feel free to copy amend and send it to your MP too.


13/02/2020

John Penrose MP
House of Commons
London SW1A 0AA

Dear John

Action on human-caused climate change

I have been deferring the writing of this letter for months, but have decided to write after reading the Prime Minister’s speech at the COP26 launch on February 4th. Here are some excerpts:

“…a defining year of action for our country, and indeed for our planet, on tackling climate change but also on protecting the natural world… the global addiction to hydrocarbons has got totally out of control…the evidence is now overwhelming and it is taking its toll”
It would be easy here to raise previous statements and present policy decisions contradicting this position, but the urgency of the situation demands that we should all choose to work together rather than playing politics.

He mentioned Walter Bersey, the inventor of the electric car, “and the tragedy for humanity
was that he allowed himself to be daunted in what he was trying to do because he was in the end defeated by the sceptics and those who thought that his efforts were technologically impossible…”

This is what moves me to write. What I am going to propose here is not at all impossible, either technologically, or even financially, but will be seen as politically difficult to the point of impossible, even though it is a very simple proposal indeed. It is that we should allow, encourage and assist people to move into work that will help solve the climate and biodiversity problems that the PM refers to.

We are very much in a “phoney war” situation regarding climate change. A Climate Emergency has been declared in many quarters, not least in North Somerset, but there is a sense of unreality and a distinct lack of action. Nearly a year has gone by since the speakers at the UNGA declared that we have only 11 years to take meaningful action to hold climate change to 1.5 degrees Celsius, but there is no real manifestation of urgent action.

The actions needed are many and various, and it is important that they do not cause damage to ordinary people. We must remember that the riots in France began with a fuel price increase. The opposite way to address the problem is to enable people to pay less on their fuel bills by insulating the housing stock in North Somerset. This would be a massive task. There are two approved companies in North Somerset who do this work. Both would need to expand their workforce significantly to carry out the necessary work in good time.

This brings me to the core of the present proposal. At present there are many young people in your constituency who are without work. Unemployment has a profoundly debilitating effect on the health of individuals and communities. It is irrational to inflict unemployment on people when there is so much good work, work to heal the environment and society, crying out to be done.

1/2

Please read the attached briefing sheet on Green Wage Subsidy, which would enable local firms to employ local people in reducing the domestic fuel bills of local people. It is extremely simple administratively, yet politically I recognise will be very difficult indeed.

All I am asking at present is that we sit down together and discuss this proposal.

Thank you,

Richard Lawson

____________________________________________________
GREEN WAGE SUBSIDY PILOT IN NORTH SOMERSET


North Somerset Council declared a Climate Emergency on February 19th 2019, and a number of civil societies came together forming Zero Carbon North Somerset to help the Council in its efforts.
At the first meeting I took on the task of stimulating the provision of insulation in North Somerset's housing stock.
 What follows is an extremely brief introduction to an ambitious proposal.

GREEN WAGE SUBSIDY (GWS)
This scheme will stimulate provision of work in energy conservation, renewable energy and energy storage technologies (and later in the whole green sector of the economy) by putting an end to the withdrawal of benefits that occurs on taking up employment.
It works like this:
1.      North Somerset Council, supported by local community, unemployed people, unions, civil society, small businesses, and both MPs will apply to the Department for Work and Pensions for permission to pilot this scheme in their locality.
2.      The Local Authority will designate officer(s) to administer the scheme, primarily to assess and accredit local employers in the fields of energy conservation, renewable energy and energy storage who wish to join.
3.      Approved employers can go to local Job Centres to take on extra workers.
4.      These new workers are allowed to bring their benefits into work with them for an indefinite period.
5.      The employer will bring the new employee’s remuneration up to the going rate for the job.
6.      The employer is not allowed to replace their existing workforce with GWS workers.
7.      The process is entirely voluntary on both sides. Any claimant who may turn down an offer is not sanctioned.



ADVANTAGES OF GWS
1.      It is 100% voluntary. It is not, repeat not, Workfare.
2.      It is simple. The rest of the benefits system is unaffected.
3.      It addresses the Climate Emergency through reduction in energy loss from buildings.
4.      It leads to reduced fuel bills for occupants of houses that have been insulated, causing reduced illness and mortality, and stimulation of the local economy.
5.      It leads to more employment and so leads to reduced illness and mortality.
6.      It stimulates the local economy.
7.      It leads to an overall increase to GDP in the region of £10 billion per year.
8.      It opens the way to its application in other sectors of the green economy – water, agriculture, housing, education, health and social care.
9.      It leads to the gradual introduction of Basic Income.

DISADVANTAGES OF GWS
There is a slight increase in amount paid out in Job Seekers Allowance and other benefits as the scheme progresses over the years. JSA is only 5% of the total welfare budget 2009-10.
GWS is set out in more detail here : http://www.greenhealth.org.uk/GreenWageSubsidy.htm

Development in North Somerset
We are approaching all stakeholders, throwing the net as wide as possible. We are approaching businesses, we will spread the idea among local XR, Transition Town, FoE and all other environmental groups. We will try to get the support of local Unions. We will take it to local Green, Labour, LibDem and Conservative parties. We will take it to North Somerset Council as a formal motion, and we will lobby our MPs to present the proposal as a pilot project to the DWP.
Obviously, this latter is the most difficult hurdle to overcome, but if you don’t ask, you don’t get.

We will aim to get an airing in local media and social media. Radio Bristol has covered the GWS idea in the past. There is a possibility of filming the insulation of one house by volunteers and running it on YouTube.

Many thanks for giving your attention to this communication
Dr Richard Lawson


_________________________________________________________________________________

Tuesday, January 28, 2020

Treating Wuhan Coronavirus with re-purposed medicines



Image/Dr. Fred Murphy & Sylvia Whitfield/CDC


If Wuhan Coronavirus escapes control and becomes endemic, hospitals throughout the world will have their work cut out to cope with treating large numbers of patients. We do not know yet whether antiviral medications will be effective, and specific treatments are probably going to be very expensive. Vaccination will be enormously helpful, but it will take months before it is widely available.

Given that we are probably facing a global medical emergency, doctors  need to try all approaches that offer benefit. We should not be bound by convention. One promising pathway of treatment is to use re-purposed established medicines to treat the "cytokine storm" that causes some patients to become very ill.

Cytokine storm (better termed Cytokine Release Syndrome) is an exaggerated reaction on the part of the cellular immune system. A positive feedback loop forms between cytokines released at the site of infection, which attract more defence cells, which produce more cytokines.

It is this vicious circle that causes Wuhan Coronavirus infection to have such high mortality - currently about 2.5% of cases [source].

Several medicines which are currently licensed for other purposes may be able to moderate and reduce the cytokine release syndrome.

1. Simvastatin and Gemfibrozil, both lipid-lowering drugs in common use, have been shown to have an effect in reducing the cytokine response. In the case of Simvastatin, an effect has been shown in humans, albeit not in acute infection. Simvastatin also has an effect on the replication of some viruses. It decreases OX40 which is a protein secreted by T-cells that keeps them from dying, and therefore perpetuates the feedback loop [i]. Terblanche has reviewed the properties of simvastatin [ii]. Fedson provides a 2013 review of statins and other agents in influenza which is also encouraging.

2. ACE Inhibitors and Angiotensin II receptor blockers are medications in common use against hypertension. The Renin-angiotensin system is involved in the cytokine storm[iii]. ACE is involved in pulmonary inflammation[iv],[v]. They have been shown to reduce the cytokine feedback loop[vi]. A possible connection between the virus and the ACE2 protein has been identified [source].
Mortensen (2012) found improved outcomes in patients age 65 years or over with influenza associated pneumonia who used statins, and lesser imporvements with ACE blockers.

3. TNF Blockers are medications routinely used in arthritis and other inflammatory conditions, and work by inhibiting Tumour Necrosis Factor (TNF) which is implicated in cytokine storm. They may possibly have a role to play in cytokine release syndrome, but they are relatively costly compared to 1 and 2 above.

4. Naltrexone, an established opioid receptor antagonist, may inhibit cytokine storm. There is evidence from animal studies[vii],[viii],[ix],[x] that shows it may be clinically effective. It is inexpensive.

5. Antioxidants such as Ascorbic acid may have a role to play in reducing the adverse effects of cytokine storm.


Note that the above five groups of medicines are already in use, and therefore have been tested for human acceptability. They are relatively inexpensive. Their side effects are known. It is true that we do not know what happens when they are used in patients infected with the the Wuhan Coronavirus, but the only way to find out in good time is to test them.

They may have adverse effects in the given situation, they may have no benefit, but equally, one or more of them, alone or in combination, may prove helpful, and the experiment will be worthwhile – even, possibly, game-changing.

In conclusion, there are several modalities of treatment for Wuhan Coronavirus that must be tried in the present outbreak. Their deployment will be “off-licence” and their effectiveness must be monitored, but to test their effectiveness in the situation that we are currently in would be ethical and rational.

[i] Liu B, Yu G, Yang Z, Sun L, Song R, Liu F, et al. Simvastatin Reduces OX40 and OX40 Ligand Expression in Human Peripheral Blood Mononuclear Cells and in Patients with Atherosclerotic Cerebral Infarction. The Journal of International Medical Research. 2009;37:601-10.
[ii] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1751082/
[iii] Genctoy, G; B Altun et al. (February 2005). "TNF alpha-308 genotype and renin-angiotensin system in hemodialysis patients: an effect on inflammatory cytokine levels?". Artif Organs 29 (2): 174–178.
[iv] Marshall, RP; P Gohlke et al. (January 2004). "Angiotensin II and the fibroproliferative response to acute lung injury". Am J Physiol Lung Cell Mol Physiol (Royal Free and University College London Medical School) 286 (1): 156–164. PMID 12754187.
[v] Moldobaeva, A; EM Wagner (December 2003). "Angiotensin-converting enzyme activity in ovine bronchial vasculature". J Appl Physiol (Department of Medicine, Johns Hopkins University) 95 (6): 2278–2284.
[vi] Ruiz-Ortega M, Ruperez M, Lorenzo O, Esteban V, Blanco J, Mezzano S, et al. Angiotensin II regulates the synthesis of proinflammatory cytokines and chemokines in the kidney. Kidney Int. 2002;62(S82):S12-S22.
[vii] Peng X, Mosser DM, Adler M, et al. Morphine enhances interleukin-12 and the production of other pro-inflammatory cytokines in mouse peritoneal macrophages, Journal of Leukocyte Biology. 2000;68:723-728.
[viii] Hola N V, Zaji Cova A, Krulova M, Blahoutova V, Wilczek H. Augmented production of proinflammatory cytokines and accelerated allotransplantation reactions in heroin-treated mice. Clinical & Experimental Immunology 2003;132:40-45.
[ix] Lin S L, Lee Y M, Chang H Y, Cheng Y W and Yen M H. Effects of naltrexone on lipopolysaccharide-induced sepsis in rats. J Biomed Sci. 2005;12:431-40. 
[x] Greeneltch KM, Haudenschild CC, Keegan AD, Shi Y. The opioid antagonist naltrexone blocks acute endotoxic shock by inhibiting tumor necrosis factor-alpha production. Brain Behav Immun. 2004;18:476-84.

Saturday, January 25, 2020

What if Wuhan Coronavirus (WN-CoV) becomes endemic? If Ill, Stay Home!

It is unlikely that public health measures are going to succeed in containing the Wuhan Coronavirus. Despite placing the whole city of Wuhan in quarantine, the new disease has spread to several countries in Asia, and a case has reached Lyons.

At the moment the diagnosis is relatively easy. You have a flu-like illness and have been in Wuhan in the last 14 days? WN-CoV (2019 nCoV) must be considered. There is a diagnostic blood test available, and the patient has to be quarantined. The infection covers a range of severity from a mild cold, through sore throat and fever to severe pneumonia that needs hospital treatment. The mortality rate in China has been 2-3%, which is in the same order as the 1918 flu pandemic.

We are still learning about this disease. Assuming it cannot be contained by public health work (contacting and isolating people who may have contracted the virus from a known case), the virus will start circulating throughout the world. We do not yet know whether its infectivity will die away in summer, or whether it will just continue to circulate.

If it does circulate in the general population, we are going to have to change our illness behaviour. The rule is going to have to be - If Ill, Stay Home. Going out and about with a cold, sore throat, cough or flu-like illness will have to be treated as an antisocial practice, like drunk driving.

Note that even this will not stop viruses from circulating, since a person can pass the viruses on  for up to two weeks before symptoms appear. What If Ill, Stay Home advice does achieve though is to reduce the number of new cases, and so eases the pressure on health services. It is also likely to reduce the severity and duration of the viral illness. If you have flu, you do not feel like going to work, and if you do, apart from infecting everyone you meet, you are not going to do any useful work. You may make mistakes and you will work more slowly. If you are doing physical work, you may injure yourself.

The problem is that employers tend to frown on people who call in sick. They tend also to demand a doctors certificate. This drives up unnecessary work for GPs, and also exposes health staff and other patients to the virus. This approach is illogical, because it makes the difference between having one worker off and having a whole office out of action. Frankly, if employers think they have a malingering problem in their work force, they should employ a nurse to check up on people who are calling in sick.

So say Wuhan virus is being reported in your area and you get a cold, sore throat, cough or flu-like illness, what do you do? Stay home, and see how things develop. If is is a common virus, it will get better in somewhere between two days and two weeks. The most important thing is whether it is getting better or getting worse. If better, fine. You are likely to get better more quickly if you are resting than if you try to work.

If it is getting worse, with worsening cough, increasing fever, pain in the chest, sometimes one-sided, maybe vivid dreams, and then shortness of breath, with increasing numbers of breaths per minute, then pneumonia may be setting in, and that is when you need to call the doctor. Be ready for them to ask a lot of questions, as they may decide not to visit, but rather, to admit you to hospital.

Let's hope that WN-CoV is contained, or mutates to lose its virulence. But even if it does, If Ill, Stay Home is still the most sensible policy.

Monday, January 06, 2020

HAIL TO THE CHIEF


You flash this filthy flower, this red pustule
with foul black winding sheet that is your final word.

This is your moment of fulfilment,
your argument that cannot be denied,

since everyone who sees this rose of death
is forced to feel the hate that tortures you.

It echoes on and on in desolate triumph
a set of images    caught    in facing mirrors

trapped in a split infinity : hate,  hurt,
hurt, hate,    irrational regress, endless,

your wasted world, where nothing grows,
no bird sings, only a lacerating hate

that stains your too-committed consciousness,
the perfect canvas of your world, with blood of babes,

and us, the bystanders,   no longer innocent,
spattered with hate.

We feel a surge of hate for you, and so it goes
over and even until death,    which does not part us,

until the pity that we feel for your split victims
can grow and blossom into a piteous love that swells

to cover the whole world until it swallows even you,
you pitiful child-leader, engulfing you in

pain-struck, hate-contaminated love,
the leader     who in some way      we have allowed

through lifetimes of inattention, to speak and act for us,
to mouth these  foul excrescences, these blasphemies

against the Life that bears us,
to speak these bombs on our behalf .

We powerless to pity you enough, rightly to pity your pain,
condemned to heal or share your nightmare   

until we die.