Liz Szabo: Some COVID-19 patients hit by friendly fire

The Warren Alpert Medical School at Brown University, in Providence’s old “Jewelry District.’’ Most people still just call it the Brown Medical School.

From Kaiser Health News

Dr. Megan Ranney, of Brown University, has learned a lot about COVID-19 since she began treating patients with the disease in the emergency department in February.

But there’s one question that she still can’t answer: What makes some patients so much sicker than others?

Advancing age and underlying medical problems explain only part of the phenomenon, said Ranney, who has seen patients of similar age, background and health status follow wildly different trajectories.

“Why does one 40-year-old get really sick and another one not even need to be admitted?” asked Ranney, an associate professor of emergency medicine at Brown.

In some cases, provocative new research shows, some people — men in particular — succumb because their immune systems are hit by friendly fire. Researchers hope the finding will help them develop targeted therapies for these patients.

In an international study in Science, 10 percent of nearly 1,000 COVID patients who developed life-threatening pneumonia had antibodies that disable key immune system proteins called interferons. These antibodies — known as autoantibodies because they attack the body itself — were not found at all in 663 people with mild or asymptomatic COVID infections. Only four of 1,227 healthy individuals had the autoantibodies. The study, published on Oct. 23, was led by the COVID Human Genetic Effort, which includes 200 research centers in 40 countries.

“This is one of the most important things we’ve learned about the immune system since the start of the pandemic,” said Dr. Eric Topol, executive vice president for research at Scripps Research, in San Diego, who was not involved in the new study. “This is a breakthrough finding.”

In a second Science study by the same team, authors found that an additional 3.5 percent of critically ill patients had mutations in genes that control the interferons involved in fighting viruses. Given that the body has 500 to 600 of these genes, it’s possible researchers will find more mutations, said Qian Zhang, lead author of the second study.

Interferons serve as the body’s first line of defense against infection, sounding the alarm and activating an army of virus-fighting genes, said virologist Angela Rasmussen, an associate research scientist at the Center of Infection and Immunity at Columbia University’s Mailman School of Public Health.

“Interferons are like a fire alarm and a sprinkler system all in one,” said Rasmussen, who wasn’t involved in the new studies.

Lab studies show interferons are suppressed in some people with COVID-19, perhaps by the virus itself.

Interferons are particularly important for protecting the body against new viruses, such as the coronavirus, which the body has never encountered, said Zhang, a researcher at Rockefeller University’s St. Giles Laboratory of Human Genetics of Infectious Diseases.

When infected with the novel coronavirus, “your body should have alarms ringing everywhere,” said Zhang. “If you don’t get the alarm out, you could have viruses everywhere in large numbers.”

Significantly, patients didn’t make autoantibodies in response to the virus. Instead, they appeared to have had them before the pandemic even began, said Paul Bastard, the antibody study’s lead author, also a researcher at Rockefeller University.

For reasons that researchers don’t understand, the autoantibodies never caused a problem until patients were infected with COVID-19, Bastard said. Somehow, the novel coronavirus, or the immune response it triggered, appears to have set them in motion.

“Before COVID, their condition was silent,” Bastard said. “Most of them hadn’t gotten sick before.”

Bastard said he now wonders whether autoantibodies against interferon also increase the risk from other viruses, such as influenza. Among patients in his study, “some of them had gotten flu in the past, and we’re looking to see if the autoantibodies could have had an effect on flu.”

Scientists have long known that viruses and the immune system compete in a sort of arms race, with viruses evolving ways to evade the immune system and even suppress its response, said Sabra Klein, a professor of molecular microbiology and immunology at the Johns Hopkins Bloomberg School of Public Health.

Antibodies are usually the heroes of the immune system, defending the body against viruses and other threats. But sometimes, in a phenomenon known as autoimmune disease, the immune system appears confused and creates autoantibodies. This occurs in diseases such as rheumatoid arthritis, when antibodies attack the joints, and Type 1 diabetes, in which the immune system attacks insulin-producing cells in the pancreas.

Although doctors don’t know the exact causes of autoimmune disease, they’ve observed that the conditions often occur after a viral infection. Autoimmune diseases are more common as people age.

In yet another unexpected finding, 94 percent of patients in the study with these autoantibodies were men. About 12.5 percent of men with life-threatening COVID pneumonia had autoantibodies against interferon, compared with 2.6 percent of women.

That was unexpected, given that autoimmune disease is far more common in women, Klein said.

“I’ve been studying sex differences in viral infections for 22 years, and I don’t think anybody who studies autoantibodies thought this would be a risk factor for COVID-19,” Klein said.

The study might help explain why men are more likely than women to become critically ill with COVID-19 and die, Klein said.

“You see significantly more men dying in their 30s, not just in their 80s,” she said.

Akiko Iwasaki, a professor of immunobiology at the Yale School of Medicine, noted that several genes involved in the immune system’s response to viruses are on the X chromosome.

Women have two copies of this chromosome — along with two copies of each gene. That gives women a backup in case one copy of a gene becomes defective, Iwasaki said.

Men, however, have only one copy of the X chromosome. So if there is a defect or harmful gene on the X chromosome, they have no other copy of that gene to correct the problem, Iwasaki said.

Bastard noted that one woman in the study who developed autoantibodies has a rare genetic condition in which she has only one X chromosome.

Scientists have struggled to explain why men have a higher risk of hospitalization and death from COVID-19. When the disease first appeared in China, experts speculated that men suffered more from the virus because they are much more likely to smoke than Chinese women.

Researchers quickly noticed that men in Spain were also more likely to die of COVID-19, however, even though men and women there smoke at about the same rate, Klein said.

Experts have hypothesized that men might be put at higher risk by being less likely to wear masks in public than women and more likely to delay seeking medical care, Klein said.

But behavioral differences between men and women provide only part of the answer. Scientists say it’s possible that the hormone estrogen may somehow protect women, while testosterone may put men at greater risk. Interestingly, recent studies have found that obesity poses a much greater risk to men with COVID-19 than to women, Klein said.

Yet women have their own form of suffering from COVID-19.

Studies show women are four times more likely to experience long-term COVID symptoms, lasting weeks or months, including fatigue, weakness and a kind of mental confusion known as “brain fog,” Klein noted.

As women, “maybe we survive it and are less likely to die, but then we have all these long-term complications,” she said.

After reading the studies, Klein said, she would like to learn whether patients who become severely ill from other viruses, such as influenza, also harbor genes or antibodies that disable interferon.

“There’s no evidence for this in flu,” Klein said. “But we haven’t looked. Through COVID-19, we may have uncovered a very novel mechanism of disease, which we could find is present in a number of diseases.”

To be sure, scientists say that the new study solves only part of the mystery of why patient outcomes can vary so greatly.

Researchers say it’s possible that some patients are protected by past exposure to other coronaviruses. Patients who get very sick also may have inhaled higher doses of the virus, such as from repeated exposure to infected co-workers.

Although doctors have looked for links between disease outcomes and blood type, studies have produced conflicting results.

Screening patients for autoantibodies against interferons could help predict which patients are more likely to become very sick, said Bastard, who is also affiliated with the Necker Hospital for Sick Children, in Paris. Testing takes about two days. Hospitals in Paris can now screen patients on request from a doctor, he said.

Although only 10 percent of patients with life-threatening COVID-19 have autoantibodies, “I think we should give the test to everyone who is admitted,” Bastard said. Otherwise, “we wouldn’t know who is at risk for a severe form of the disease.”

Bastard said he hopes his findings will lead to new therapies that save lives. He notes that the body manufactures many types of interferons. Giving these patients a different type of interferon — one not disabled by their genes or autoantibodies — might help them fight off the virus.

In fact, a pilot study of 98 patients published Thursday in the Lancet Respiratory Medicine journal found benefits from an inhaled form of interferon. In the industry-funded British study, hospitalized COVID patients randomly assigned to receive interferon beta-1a were more than twice as likely as others to recover enough to resume their regular activities.

Researchers need to confirm these findings in a much larger study, said Dr. Nathan Peiffer-Smadja, a researcher at Imperial College London who was not involved in the study but wrote an accompanying editorial. Future studies should test patients’ blood for genetic mutations and autoantibodies against interferon, to see if they respond differently than others.

Peiffer-Smadja notes that inhaled interferon may work better than an injected form of the drug because it’s delivered directly to the lungs. While injected versions of interferon have been used for years to treat other diseases, the inhaled version is still experimental and not commercially available.

And doctors should be cautious about interferon for now, because a study led by the World Health Organization found no benefit to an injected form of the drug in COVID patients, Peiffer-Smadja said. In fact, there was a trend toward higher mortality rates in patients given interferon, although this finding could have been due to chance. Giving interferon later in the course of disease could encourage a destructive immune overreaction called a cytokine storm, in which the immune system does more damage than the virus.

Around the world, scientists have launched more than 100 clinical trials of interferons, according to clinicaltrials.gov, a database of research studies from the National Institutes of Health.

Until larger studies are completed, doctors say, Bastard’s findings are unlikely to change how they treat COVID-19.

Dr. Lewis Kaplan, president of the Society of Critical Care Medicine, said he treats patients according to their symptoms, not their risk factors.

“If you are a little sick, you get treated with a little bit of care,” Kaplan said. “You are really sick, you get a lot of care. But if a COVID patient comes in with hypertension, diabetes and obesity, we don’t say, ‘They have risk factors. Let’s put them in the ICU.’’

Liz Szabo is a reporter for Kaiser Health News

Liz Szabo: lszabo@kff.org, @LizSzabo

William Morgan: Raymond Hood and the drama of the American skyscraper

In 1916, a little known, 35-year-old architect and Rhode Island native proposed a monumental civic structure for downtown Providence. Raymond Hood's Civic Centre would have been sited where the Industrial Trust Building was later built; it was to be 600 feet tall and would serve as courthouse, library and prison. Its tower would symbolize progress and prosperity at the head of Narragansett Bay. 

A few years earlier, Hood had done his thesis at the prestigious École des Beaux Arts, in Paris, on a design for a city hall for his hometown of Pawtucket. While neither of these fanciful schemes was built, they demonstrate the early vision of a man destined to become of one of the 20th Century's most significant skyscraper architects.

Raymond Hood, Proposed City Hall for Pawtucket. Year-Book of the Rhode Island Chapter, American Institute of American Institute of Architects, 1911

“Raymond Hood and the American Skyscraper,’’ an exhibition initially organized for showing to the public at the David Winton Bell Gallery, at Brown University, opened online only on Sept. 11. The show, underwritten by the Brown Arts Initiative and Shawmut Design & Construction, features loans of drawings and photographs from RISD, MIT, Columbia, the University of Pennsylvania and the Smithsonian Institution. Hit this link to see the show.

Ralph Adams Cram (left) and Raymond Hood in Bermuda, c.1930. Hood worked for Cram as a young architect; Cram designed the Pawtucket Public Library. Courtesy, Cram & Ferguson Architects

 

Beyond the lectures and other materials associated with the show, one can access information on Hood through the handsome 48-page catalog written by two of the show's co-curators, Prof. Dietrich Neumann and Brown doctoral student Jonathan Duval (the other curator is Jo-Ann Conklin, director of the Bell).

Catalog cover with Rockefeller Center, with the soaring RCA Building.

Hood would go on to design several iconic skyscrapers of the 1930s, serve as the head designer of Rockefeller Center, and would be, in Neumann's words "the most powerful architect in New York City."  Significant exhibitions like this one reacquaint us with sometimes forgotten figures and force new assessments of their contributions to our cultural landscape.  

RCA building at Rockefeller Center, photographed in 1933. Library of Congress.

Hood died far too young at 53. And in one of those ironies of architectural history, Modernists denigrated as too conservative the skyscraper that secured Hood's career and transformed him from dreamer to real player.

Howells & Hood, Chicago Tower. PHOTO ©Hassan Bagheri

As Neumann and Duval remind us, Hood was a struggling draftsman when he teamed up with the fashionable New York architect John Mead Howells (designer of Providence’s Turks Head Building) to enter the major international competition to build the Chicago Tribune's headquarters building in 1922. Howells and Hood beat out 262 other entrants from 23 countries with their skyscraper scheme.

I remember professors in college and graduate school ranting about the shortcomings of the Tribune Tower, labeling it "dishonest" for hiding its modern steel frame underneath a cloak of eclectic, historicist detail. It is time to acknowledge that Hood's design was the one that deserved to win, and to accept that the verticality of Gothic was wholly appropriate for such a soaring form. 

Almost 100 years after that famous controversial contest, the Tribune Tower remains an absolute triumph, proudly standing in the skyscraper capital. Hood's more streamlined skyscrapers in New York – the RCA building, the Daily News Building and the McGraw-Hill Building – still inspire us, and they are especially instructive when placed against formless pieces of real estate such as Providence's proposed Fane Tower. 

McGraw-Hill Building, New York, PHOTO © Hassan Bagheri

The effort that Brown has applied to the work of Raymond Hood is the sort of public service that universities offer the commonweal. Such scholarship is especially welcome now, as study of great architecture and urbanism is crucial to rebuilding after a time of pandemic.

Providence-based architecture critic and historian William Morgan has taught the history of architecture at Princeton University, The University of Louisville and Roger Williams University.

His latest book is Snowbound: Dwelling in Winter

Llewellyn King: Thank God for electricity, especially now; but the grid is always under threat

The Continental U.S. power transmission grid.

WEST WARWICK, R.I.

Nothing will be the same again

Those are words that that challenge the heart and the imagination. The heart because, as in a death or the loss of a job, some things will be very missed. The imagination because it needs inspired speculation to know how the present crisis will reshape the way we live; how we are governed, how we educate, how we do business and how we play.

Some losses are somewhat predictable. Most of us may never sit in a movie theater again because there may be no movie theaters. They were already having a hard time with the competition from streaming services, now many may just not reopen. Question: What will be done with those buildings? They are mostly part of shopping centers where many of the tenants for restaurants and specialty shops will also go out of business.

Here’s my answer: In that glorious time when we have licked COVID-19, many new entrepreneurs will get their start in those empty shells. A myriad of yet-unknown businesses will crop up, coming out of these times of ultra-difficulty. Failing shopping centers offer habitat to startups.

We are in a state of war and in war, despite its horror, there is invention. As we try to defeat this pandemic, there will be inventions aplenty.

War has always spurred creativity, in art and in science, and in its aftermath, a time of optimism and opportunity. Catastrophe shakes up society and reorients it. There is a high price but a great reward

Needs must, there will be a re-evaluation of values and the goods and services which are essential. High on that list will be electricity. Over and over again we will be asking ourselves if the electric grid is safe and if so, how safe?

As Morgan O’Brien, co-founder of Nextel and now CEO of Anterix, which offers utilities secure communications systems, told me, “The coronavirus pandemic is putting more stress on the infrastructure which keeps our society functioning. Critical infrastructure like the electric grid will be more stressed as it is the essential lifeline for Americans sheltering in place.”

A loss of all or part of the grid is an existential fear that has had experts worried since the first computer hackers had a go at it. Utility presidents have told me that it is grid security that keeps them awake at night. It should. CPS Energy, the utility in San Antonio, gets more than 2 million hits a day, I believe.

Late last year the president’s National Infrastructure Advisory Council warned strongly of the dangers of cyberattack. It said the electric utility industry is good at tackling small, short-term outages but it is essentially unprepared for catastrophic outages lasting a long time.

Earlier this year James Woolsey, a former CIA director and an honorary co-chair of the Secure the Grid Coalition, wrote to the Federal Energy Regulatory Commission demanding it order more physical security for transformers, pylons, etc. Woolsey cited a lack of improved physical security since that became an issue with the sophisticated disabling of Pacific Gas & Electric’s substation in Metcalf, Calif., in 2013.

John Savage, professor emeritus of computer science at Brown University, who is writing a book on cybersecurity, raises a less-mentioned dimension of threat to the grid: the role of GPS. With the advent of global positioning satellites, he explained, the utility industry switched from using atomic clocks to using GPS timing as the basis for its nationwide synchronization.

Savage told me, “Dependence on GPS for timing is a security risk. If GPS timing signals are distorted or lost, serious damage may be done to the grid.

“GPS signals can be lost due to a local jamming, blackouts, produced by a solar flare, or spoofing. A GPS anomaly alone or a cyberattack combined with one can cascade and bring down a large portion of the grid for an extended period of time.”

Gen. James Jones, a retired Marine commandant and NATO commander, told me, “For the past several years, I have been preoccupied by the proximity of threats, particularly in the cyber realm.”

Much will change, but the need for reliable electricity will remain paramount.

Llewellyn King is executive producer and host of White House Chronicle, on PBS. His email is llewellynking1@gmail.com, and he’s based in Rhode Island and Washington, D.C.

Campus expansionism

On the Brown campus

From Robert Whitcomb’s “Digital Diary,’’ in GoLocal24.com

Brown University wants to build two dorms, housing a total of 375 undergraduate students, at the southern end of its main campus, on Providence’s College Hill. This would require tearing down three undistinguished houses, a small commercial strip and a police substation, all properties owned by Brown.

Presumably there would be  some pushback from neighbors concerned about, for example, even tighter parking on neighborhood streets, which are increasingly monopolized by Brown-connected people, but I’d be very surprised if the project didn’t happen. Colleges and universities, especially rich “elite’’ ones such as Brown, are constantly trying to expand and they usually get their way.

Despite the complaints  that Brown doesn’t pay property taxes (it does fork over some payments in lieu of taxes to the city -- $6.7 million a year at last count) and more generalized complaints about its power and huge footprint, the fact is that its presence, along  with that of the Rhode Island School of Design, are key factors in making the College Hill/East Side of Providence so attractive. Brown has some facilities and activities that local residents can enjoy; it ensures that there are many physicians  and other health-care professionals (and the Brown teaching hospitals they help staff) and other useful experts close by, and includes a large, generally beautiful, almost parklike campus – a lovely amenity to have near the middle of a city. Indeed, some of those complaining all the time about Brown live on the East Side/College Hill because Brown is there, whether or not they work there

An old joke is that “Providence is Fall River with Brown.’’ Well, as a state capital and former industrial and foreign-trade center, it was always much more than that, but certainly Brown has had something to do with keeping Providence viable as a mid-size city as its old industrial base shrank. Brown’s expansion is, all in all, good for the city, though taxpayers would like it to chip in more money in lieu of taxes. And no, I didn’t go  to Brown.

In general, having a college or university brings wealth and energy to their hosting communities, albeit with some irritations and costs.

To read more about Brown’s latest expansion plans, please hit this link.

Let's table this

“Peonies, Dragonfly Vase, and Common House Spider (at the Acupuncturist) “ (watercolor monoprint), by Stella Ebner, at Cade Tompkins Projects, Providence, through Jan. 23. The gallery is in the College Hill neighborhood, dominated by Brown University.

Providence a growing center for study of Alzheimer's

Comparison of a normal aged brain (left) and the brain of a person with Alzheimer's (right). Characteristics that separate the two are pointed out.

From Robert Whitcomb’s “Digital Diary,’’ in GoLocal24.com

With the aging of the U.S. population (and far too many policymakers and others sticking their heads in the sand about its vast social, economic and political implications) it was happy news, especially for our region, that the National Institute on Aging has awarded Brown University and Boston-based Hebrew SeniorLife a $53.4 million grant as part of an effort to improve the health care and quality of life for those living with Alzheimer’s Disease, which affects millions of people. The official count of those Americans suffering from the disease is about 5.8 million (with about 5.6 million 65 or older) but I suspect that’s a big undercount because many victims and their families cover up cases. (And let’s not forget that there are other forms of usually age-related dementias too, such as Frontal-Lobe Dementia and Lewy Body Dementia.)

The award is Brown’s biggest federal grant so far and will further amplify its reputation for advanced work in neuroscience-related matters.

Vincent Mor, a nationally known expert on aging and a Brown professor of health services and policy, told GoLocal:

“This grant will revolutionize the national infrastructure for research into how care is delivered to people living with dementia and their caregivers. The key is figuring out how to take an idea that worked in an ideal situation and adapt it so it can be piloted in the messy real-world system of care providers that exists across the U.S.’’

I hope that the news will lure more researchers to Brown to work on the scary challenges associated with aging.

By the way, there are plenty of local samples available. Rhode Island has the 11th oldest population in America, with 15.84 percent of the population 65 or over. Massachusetts is 25th, with 15.06 percent in that cohort, which may say a little bit about why the Bay State is more economically dynamic than the Ocean State.

To read the GoLocal article, please hit this link.

To see a hauntin movie about treating Alzheimer’s with art, please hit this link.

Auguste Deter in 1902. She had what became known as Alzheimer's Disease, named for Alois Alzheimer, M.D., her physician/psychiatrist, who first described the disease.

Nicholas Boke: Interactive climate simulation

From ecoRI News (ecori.org)

MIT Prof. John Sterman recently visited Brown University to engage students and the public with interactive climate modeling. (Nicholas Boke/ecoRI News)

PROVIDENCE — “Climate is a complicated, noisy problem,” John Sterman told an audience of the climatologically inclined at Brown University’s Watson Institute for International and Public Affairs on May 1.

“Climate change is real,” he continued. “The problem is that the costs are deferred to the future.”

But the worst part, he explained, is that as soon as any climate expert anywhere projects yet another graphic of the rise of atmospheric carbon dioxide onto a screen, then superimposes the parallel rise in the Earth’s temperature, “most talks on climate go off the rails.

“We start off saying, ‘Lemme tell you the facts,’ because we know that science needs to show the evidence, about which there’s no credible doubt any more. But the public’s not there yet. And we’ve got research that shows just providing information doesn’t work.”

At which point, Sterman projected a photo of an audience dozing contentedly through a presentation on climate change.

Sterman, an MIT professor of management, and his colleagues believe that they’ve found a way around this public-awareness Catch-22: an interactive online world climate simulation called the Climate Rapid Overview and Decision Support (C-ROADS), which allows visitors to see what happens to temperature increase, sea-level rise and related impacts when countries make various decisions about carbon dioxide emissions.

So twice  Sterman took audiences through the C-ROADS process. The first time was during the hour he spent with the general public at an event sponsored by the Institute at Brown for Environment & Society. The second, a three-hour event, was with several dozen students in Eric Patashnick’s system dynamics class.

The principle is simple. Participants run three-dimensional climate models on their laptops, plugging in “decisions” and watching the impact on global temperature rise.

This interactive Web site is well beyond beta-testing. It’s been used by participants in the 2014 China-U.S. negotiations on climate change, at the 2016 Paris meeting at which the latest U.N. climate accords were agreed upon, and at more than 800 events in 76 countries involving more than 40,000 participants.

Participant then-Secretary of State John Kerry effused, “I have to tell you, it works … I used it,” and the Dalai Lama, who has also engaged in the process, promised, “I will join you, shouting!”

Explaining that “If [Secretary of State] Pompeo wants to get serious and fill the seat of the special envoy on climate change, I’ll run him through it,” Sterman said.

The process

At Brown University earlier this month, Sterman ran both groups through the process.

With the general audience he flashed the C-ROADS page on the screen. It offered graphs showing carbon dioxide emissions by group and temperature increase by year, 2000-2100. Below was a chart on which each group could project decisions they would make: the peak-emissions year, the year CO2 emissions would begin to decline and by what annual reduction rate, the amount of deforestation allowed, and the amount of “afforestation” — replacement of forests — that would be targeted.

When decisions made by each group — the United States, the European Union, China and developing nations — were entered into the system, the program would alter the slopes on the graphs and calculate the amount by which the currently projected 2100 temperature rise of 4.2 degrees Celsius (7.5 Fahrenheit) would be diminished.

“People say they don’t even know what they’re going to do after lunch,” Sterman said. “I ask if they have children, or if they might have children someday. So let’s figure out what you’re going to do after lunch, then figure out what to do about what really matters.”

With the hour-long general public group, he asked individuals to think like Putin or Trump or Xi Jinping, and to make decisions about each topic.

A woman — briefly thinking of herself as  German Chancellor Angela Merkel — suggested that the European Union might be willing to cut emissions by 5 percent. Trump has agreed to 2 percent. Putin has said Russia would cut less than the United States. Xi Jinping said China would try for a 1 percent cut by 2035. India and Chile, of course, were reluctant to cut much, given their economic circumstances. The result, after further commitments, would be to bring the temperature rise from 4.2 degrees to 3 degrees.

“So the temperature keeps rising,” Sterman said, “because we’re still emitting and the concentration is still accumulating. It’s like pouring water into the tub at twice the rate it’s draining. We get ocean acidification, which affects the base of the food web, sea levels will rise by 1.8 meters [nearly 6 feet] and we’ll get more superstorms.”

Pictures of the projected impact of this level of sea-level rise on Shanghai and Bangladesh appeared, followed by a discussion of the social and political impacts of climate refugees.

Sterman flashed a picture of how much of Providence would be flooded with a 6-foot rise.

“Don’t think you’re safe at Brown,” he said. “The power plant is under water. At that level, what was once a hundred-year storm will take place every year.”

He and the audience went back and revised their figures, finally bringing the temperature rise down to 2.6 degrees Celsius.

“You can see what a game of Russian roulette this is we’re playing,” Sterman said. “You have to let people go through this process, not just tell them about it, if you want them to pay attention.”

Students give it a try

Later that afternoon, Sterman broke Patashnik’s class into groups of five or six, each of which were to play a role in the simulation: the United States, the European Union, other developed nations, China, India, other developing nations, the U.S. Climate Alliance (14 states and Puerto Rico), the fossil-fuel industry, and climate activists.

They were given a few minutes to plan their strategies, then sent out to negotiate with others.
The India delegation told the U.S. delegation that they couldn’t afford to cut much, but they’d participate more aggressively in the war on terror in exchange for big cuts by the United States and contributions to the global climate fund. The fossil-fuels group was willing to agree with China that reforestation was an effective tool. Africa and other developing nations didn’t feel they had much to bargain with.

The groups reported what they were willing to do, including how much money they would commit to support countries that needed help carrying out their commitments. Sterman entered their numbers into the C-ROADS program.

Once each group had entered its commitments, temperatures would rise by 3.1 degrees by 2100, resulting in a situation not unlike what the morning group had confronted.

“You’ll cross that two-degree threshold at 2050,” Sterman said, “when all of you are still alive and your children may be just about to enter college.”

He sent them back to renegotiate. The groups were eventually able to bring the temperature rise down to 2.3 Celsius by 2100, after China saw that it would lose Shanghai, the United States saw it would lose New Orleans, and that, as Sterman put it, “they realized that there’s no wall high enough to protect the developed world from the consequences.”

The Brown University students thought that the process was generally a productive one, though all acknowledged that real-world negotiations would be much more politically fraught than their efforts had been.

“It certainly put things into perspective,” Byron Lindo, a member of the developing nations group, said, “but everybody here already pretty much agrees about the problem.”

This online interactive program is open and free to all. Sterman said the program is appropriate for high school and up, for business leaders, government officials, and just plain folk.

Nicholas Boke is a freelance writer and international education consultant who lives in Providence.

The old town vs. gown danse macabre

Entrance to Ochre Court, Salve Regina University's first building. Salve is in the middle of the famous mansion district of Newport, R.I. (See Salve news below.)

From Robert Whitcomb's "Digital Diary,'' in GoLocal24.com:

The fierce opponents of Brown University’s plan to tear down four historic houses and move another one to make way for a new performing-arts center have won a victory. The university has decided to move the site of the facility. This would be smaller than the one originally planned and some of it would be underground. Four houses that had been threatened will be unmolested. Meanwhile, the quirky Lucien Sharpe Carriage House Sharpe Building will be moved from its present site to another in the neighborhood.

The people on College Hill want it both ways: They want to live near a prestigious university with a (mostly) beautiful campus but they don’t want to let the institution do some things that a growing university needs or at least wants to do in and around its campus.

It’s Brown, and to a lesser extent the Rhode Island School of Design, that prop up property prices and make College Hill such a vibrant urban neighborhood. But Brown, if it’s to remain competitive with the Ivy League and other institutions it sees as its peers, must continue to build. Expect more battles.

The latest big town-gown battle around here is in Newport, where Salve Regina University wants to build two big dorms to house hundreds of additional students. Some of the neighbors are scared that this would mean a flood of rowdy young people. And the preservationists think that the proposed buildings would be way out of scale for the neighborhood.

But the leaders of even relatively poor colleges like Salve feel that their institutions must grow or die. And even tiny colleges change their name to “university’’ to sound more important.

Frank Carini: The selfish slobs of Brown University

Photo  and article by FRANK CARINI, ecoRI News

The trashy scene above recently left behind after the Brown University Class of 2015 graduated perfectly exemplified growing U.S. selfishness.

Kindergartners leave a cafeteria with more grace than the  elite who exited the Main Green by dumping their lunch trays on the ground. It’s sickening how little we think of others and the places we share that it’s considered acceptable to leave behind an easily-avoidable mess for someone else to clean.

After celebrating the accomplishments of young men and women, the  elitists who attended the May 24 graduation left the university lawn littered with half-drunk plastic water bottles, newspapers, commencement programs, half-empty coffee carafes, pieces of lightly bitten fruit and other barely touched foods, and, of course, all things plastic.

The elitists  ignored the many bins, barrels and totes  that Brown University had thoughtfully placed throughout the area to collect trash and recyclables. Plastic crunched underfoot and litter was inadvertently kicked as graduates and their guests slowly left. The workers responsible for folding the chairs and removing the rest of the commencement infrastructure were left to navigate the debris.

It would be nice to think that the  elite kindly left their unwanted food for hungry squirrels, but, sadly, they just thought someone else should pick up their mess. The littering elite couldn’t even be bothered to freshen the trampled lawn with the water they left locked in jettisoned plastic bottles.

There’s little wonder the U.S. recycling rate is a lackluster 35 percent, our composting rate considerably less, consumption is soaring, apathy increasing and our collective concern negligible. Wasted food makes up the largest percentage of all material buried in our landfills. We throw away up to 40 percent of our sustenance, according to the Environmental Protection Agency (EPA).

In fact, the average American wastes 10 times as much food as the average Joe in Southeast Asia — up 50 percent from Americans in the 1970s.

Of the more than 150 million mobile devices we discard annually — many still in fine working order but no longer socially fashionable — only about 12 percent are recycled.

A mobile phone contains about 40 elements, including heavy metals and persistent organic pollutants such as flame-retardants, PVC, lead, cadmium, chromium, mercury, bromine, tin and antimony. Such chemicals have been linked to birth defects, impaired learning, liver toxicity, premature births and early puberty.

Our response to this problem has become the American Way. For instance, the United States is the only industrialized country that hasn’t ratified the Basel Convention, an international treaty that makes it illegal to export toxic e-waste. The convention’s main goal is to protect human health and the environment from hazards posed by trans-boundary movements of hazardous waste.

Since 1990, U.S. greenhouse-gas emissions have increased by about 6 percent, according to the EPA, and we have been one of the largest, if not the largest, emitter of climate-changing emissions for decades. Our response has been to blame China and India for now polluting as much as we do.

Unfortunately, thinking of others and the environment aren’t ideals that get you elected or make you rich and powerful. The trickle-down effect of our expanding self-indulgence was on full display last Sunday at Brown University. The mess is likely unseen in the background of countless selfies.

It has become increasingly OK to leave our trash at college graduations, on airplanes, in movie theaters, at ballparks, in public parks and at the beach. Someone else will pick up mess ... or birds will choke on plastic bottle caps mistaken for food ... or donations will eventually be made to the Great Pacific Garbage Patch.

Since we can’t even be bothered to properly dispose of trash and recyclables at an event that celebrates society’s potential, what sacrifices are we truly willing to make to ensure a prosperous and healthy future for others?

Frank Carini is the editor of ecoRI News.

Plutocrats and their kids in the Ivy League

See how the super-rich help their kids get into and prosper at Ivy League schools. This piece might be the best example  yet of how America is no longer the land of opportunity it was long touted to be but a self-perpetuating plutocracy, where overwhelmingly the most important thing you can do for success in life is to pick rich, powerful and, preferably, pushy parents. Harvard and Brown universities are  paradises for this sort of thing.

Another is Dartmouth College. Read this.

On Seekonk: Heirs to crew who beat Hitler's

 

 The 1936 University of Washington crew.

 

See this video clip about the Brown University men's crew hosting  the four-time Intercollegiate Rowing Association champion the University of Washington at a race on the mighty Seekonk River on Saturday morning, April 4.

 

And read The Boys in the Boat: Nine Americans and Their Epic Quest for Gold at the 1936 Berlin Olympics, about the University of Washingt0n team, mostly composed of working-class young men, who transformed the sport in defeating elite rivals from Eastern and British universities and then the crew rowing for Hitler.

Blame Russia for Russian aggression

By ROBERT WHITCOMB (rwhitcomb51@gmail.com)

Some denounce the United States for Russia’s reversion to brutal expansionism into its “Near Abroad” because we encouraged certain Central and Eastern European countries to join the North Atlantic Treaty Organization. The argument is that NATO’s expansion led “Holy Russia” to fear that it was being “encircled.” (A brief look at a map of Eurasia would suggest the imprecision of that word.)

In other words, it’s all our fault. If we had just kept the aforementioned victims of past Russian and Soviet expansionism out of the Western Alliance, Russia wouldn’t have, for example, attacked Georgia and Ukraine. If only everyone had looked into Vladimir Putin’s eyes and decided to trust him.

Really? Russia has had authoritarian or totalitarian expansionist regimes for hundreds of years, with only a few years’ break. How could we have necessarily done anything to end this tradition for all time after the collapse of the Soviet iteration of Russian imperialism? And should we blame Russia’s closest European neighbors for trying to protect themselves from being menaced again by their gigantic and traditionally aggressive neighbor to the east? Russia, an oriental despotism, is the author of current Russian imperialism.

Some of the Blame America rhetoric in the U.S. in the Ukraine crisis can be attributed to U.S. narcissism: the idea that everything that happens in the world is because of us. But Earth is a big, messy place with nations and cultures whose actions stem from deep history and habits that have little or nothing to do with big, self-absorbed, inward-looking America and its 5 percent of the world population. Americans' ignorance about the rest of the planet -- even about Canada! -- is staggering, especially for a "developed nation''.

And we tend to think that “personal diplomacy” and American enthusiasm and friendliness can persuade foreign leaders to be nice. Thus Franklin Roosevelt thought that he could handle “Joe Stalin” and George W. Bush could be pals with another dictator (albeit much milder) Vladimir Putin. They would, our leaders thought, be brought around by our goodwill (real or feigned).

But as a friend used to say when friends told him to “have a nice day”: “I have other plans.”

With the fall of the Soviet Empire, there was wishful thinking that the Russian Empire (of which the Soviet Empire was a version with more globalist aims) would not reappear. But Russian xenophobia, autocracy, anger and aggressiveness never went away.

Other than occupying Russia, as we did Japan and Western Germany after World War II, there wasn’t much we could do to make Russia overcome its worst impulses. (And Germany, and even Japan, had far more experience with parliamentary democracy than Russia had.) The empire ruled from the Kremlin is too big, too old, too culturally reactionary and too insular to be changed quickly into a peaceable and permanent democracy. (Yes, America is insular, too, but in different ways.)

There’s also that old American “can-do” impatience — the idea that every problem is amenable to a quick solution. For some reason, I well remember that two days after Hurricane Andrew blew through Dade County, Fla., in 1992, complaints rose to a chorus that President George H.W. Bush had not yet cleaned up most of the mess. How American!

And of course, we’re all in the centers of our own universes. Consider public speaking, which terrifies many people. We can bring to it extreme self-consciousness. But as a TV colleague once reminded me, most of the people in the audience are not fixated on you the speaker but on their own thoughts, such as on what to have for dinner that night. “And the only thing they might remember about you is the color of the tie you’re wearing.”

We Americans could use a little more fatalism about other countries.

***

James V. Wyman, a retired executive editor of The Providence Journal, was, except for his relentless devotion to getting good stories into the newspaper, the opposite of the hard-bitten newspaper editor portrayed in movies, usually barking out orders to terrified young reporters. Rather he was a kindly, thoughtful and soft-spoken (except for a booming laugh) gentleman with a capacious work ethic and powerful memory.

He died Friday at 90, another loss for the "legacy news media.''

***

My friend and former colleague George Borts died last weekend. He was a model professor — intellectually rigorous, kindly and accessible. As an economist at Brown University for 63 years (!) and as managing editor of the American Economic Review, he brought memorable scholarship and an often entertaining skepticism to his work. And he was a droll expert on the law of unintended consequences.

George wasn’t a cosseted citizen of an ivory tower. He did a lot of consulting for businesses, especially using his huge knowledge of, among other things, transportation and regulatory economics, and wrote widely for a general audience through frequent op-ed pieces. He was the sort of (unpretentious) “public intellectual” that we could use a lot more of.

***

I just read Philip K. Howard’s “The Rule of Nobody: Saving America From Dead Laws and Broken Government.” I urge all citizens to read this mortifying, entertaining and prescriptive book about how our extreme legalism and bureaucracy imperil our future. I’ll write more about the book in this space.

Robert Whitcomb (rwhitcomb51@gmail.com), a former editor of The Providence Journal's editorial pages, is a Providence-based writer and editor, former finance editor of the International Herald Tribune and a partner and senior adviser at Cambridge Management Group (cmg625.com), a consultancy for health systems, and a fellow of the Pell Center for International Relations and Public Policy.

member of.

George Borts, 1927-2014

George H. Borts, 86, a distinguished economist, writer and editor, died May 2 in Providence.

Professor Borts was born in New York City on Aug. 29, 1927, and educated at Columbia University, where he earned an undergraduate degree at 19 and worked on the student newspaper, The Spectator. He received both his master’s degree (1949) and Ph.D. (1953) from the University of Chicago, where he studied under Milton Friedman, the famed libertarian economist – an experience that profoundly influenced his thinking about economics and other aspects of society for the rest of his life.

Professor Borts spent 63 years at Brown University, where he joined the Department of Economics in 1950 at 23. During his long and distinguished career, he served as chairman of the Department of Economics at Brown and led its rise to prominence as one of the leading departments of economic teaching and research. He was also the managing editor of one of the economics profession’s pre-eminent journals, the American Economic Review, for more than 10 years.

His career gave him the opportunity for travel, research and other learning as a visiting professor/research fellow at Hokkaido University, the London School of Economics and the National Bureau of Economic Research. He retired last year as the George S. and Nancy B. Parker Professor Emeritus of Economics.

Professor Borts was an expert in international finance, industrial organization, regulation and transportation. His legacy as an economist includes not only his books and dozens of scholarly papers, but the many lives he touched as a colleague, teacher, friend and adviser. Over more than six decades at Brown, George Borts had instructed and mentored thousands of undergraduate and graduate students. He supervised dozens of senior theses and doctoral dissertations and until last year, he was teaching undergraduate courses on international finance and on the welfare state in America, as well as leading several independent studies on a variety of topics.

His intellectual curiosity and professional interests allowed him to analyze complicated issues without pre-judgment. He led discussions about political, economic and social issues in ways that were clear and engaging for undergraduate seminars and senior colleagues alike. Generations of Brown students, economics majors and non-majors alike, discovered the intellectual creativity of economics through his classes.

His interest in promoting excellence in education was also demonstrated by his leadership of Brown’s Phi Beta Kappa chapter for many years.

He gave frequent testimony before U.S. and Canadian regulatory agencies and commissions and served on many boards, including those of the Rhode Island School of Design, Dartmouth’s Amos Tuck School of Business, Rhode Island Blue Shield, Junior Achievement of Rhode Island and Temple Beth-El in Providence. And he advised political candidates of both parties on economic and tax policy and provided commentaries for The Providence Journal. In 1990-91 he was the editor of the Brown World Business Advisory.

The managing editor of that publication, who became The Providence Journal’s editorial-page editor, Robert Whitcomb, called Professor Borts a “joy to work with’’ over the two decades of their occasional projects together. “He combined intellectual rigor with great humor and congeniality, including when we didn’t agree on a specific issue. I particularly enjoyed his often amusing application of the law of unintended consequences to many societal situations at our numerous pleasant meals together.’’

Although he was a tireless advocate of the free market, he viewed political issues through an economic lens that was fair and open-minded. He valued greatly his relationships with both Keynesian and Monetarist economists. His closest personal relationships were with such prominent advocates of alternative points of view as Hyman Minsky, Phillip Taft, and Jerome Stein. Further evidence of this non-ideological approach was his pronounced belief in the need for immigration reform.

He is survived by Dolly, his wife of 65 years, three sons, three grandchildren and many friends and admirers around America and beyond.

Traumatized by speech and psycho-ceramics

  By ROBERT WHITCOMB

‘Father Hoffman mixed personal opinion and church teaching in a way that offended everyone present, causing great harm,” said Prout School Principal David Carradini a couple of weeks ago. He was profusely apologizing for having the Rev. Rocky Hoffman, a host of Relevant Radio, a Catholic radio network, speak to the students of the Catholic high school, in South Kingstown, R.I. Father Hoffman, a member of the conservative Catholic society Opus Dei, spoke against homosexuality and divorce.

His views would have been considered standard Catholic fare only a few years ago, and are still held by many Catholics, and others.

Now, I’m not Catholic. Still, I salute the Church for much of its work, especially for the poor, and, yes, for the quality of Catholic schools. Anyway, we’re in a bad way in America if high-school students are to be prevented from hearing someone else’s views on morality. Where, exactly, is the “harm”? If these kids are seen as imperiled by listening to some priest, then how will they survive in the big, bad world? And how does Mr. Carradini know that the talk “offended everyone present”? (And so what if it actually did?)

Are our kids (and some of their complaining parents) really such lambkins that they can’t take the expression of strong opinions without collapsing in a heap? What’s there to apologize for, Mr. Carradini? Why doesn’t he just bring in some Catholic luminary with more “up-to-date” views as an offset? As they say, the cure for unsettling free speech is more free speech disputing it. And give all the kids debate lessons that nurture the capacity to understand and tolerate other views, including Father Hoffman’s traditionalist views.

Meanwhile, I’d suggest that if you don’t like Catholic beliefs, then don’t be a Catholic. Free will is an important part of the Church’s theology, at least for people from confirmation age on.

In other academic silliness, the student senate at the University of California at Santa Barbara (that cool, rich place) has passed a resolution requiring faculty to issue “trigger warnings.”

As Maria LaMagna reported in Bloomberg View: “Professors would write notes on their syllabi to alert students on which occasions a course’s material will be, say, sexually graphic. Students could then excuse themselves from class without being punished academically.”

Well, I think today’s college students are pretty familiar with sex, graphic or otherwise. They can handle such images. More to the point is that many courses that provide such material are devoid of academic rigor and a waste of time and money, sort of like Brown University’s long joked-about and nonexistent Prof. Josiah Carberry and his  discipline of “psycho-ceramics”.

***

Northern Maine is poor, with lots of smokers and obesity, and yet their health-treatment outcomes metrics rank higher than much of the country (especially when compared with the South).

The reasons, summarized by Noam Levy in the Los Angeles Times, include:

•A strong safety net, which provides, among other benefits, more recommended screenings and medical treatments.

•An emphasis on preventive care, aided by Maine’s high number of primary-care physicians.

•Highly coordinated and data-driven care.

•Highly advanced data systems.

•Close collaboration between two competing hospital groups.

•A strong sense of civic obligation, including strong leadership by the public and private sectors.

The glue that keeps this all together is a vibrant sense of community, a sense missing in much of sprawling suburban America, with its subdivisions, gated communities and ever wider divisions of wealth. Mr. Levy quotes Dr. Jack Wennberg, founder of the Dartmouth Institute for Health Policy and Clinical Practice, as saying, “We used to joke that everyone gets along in northern New England because every hospital is separated by a mountain and the winters are long, so we’re happy to see someone.”

Or maybe Robert Frost’s related phrase will do: “Home is the place where, when you have to go there, They have to take you in.” New Englanders may not be the friendliest people in the nation, but, especially like Upper Midwesterners (who are friendlier), they have a strong sense of obligation, both in what their governments should do and what they should do individually.

***

The first words of T.S. Eliot’s poem “The Wasteland” are too often dragged out now. “April is the cruellest month ... ” (breeding tax bills out of ... ) Instead, how about the cheery first few lines, in Middle English, of the prologue of Chaucer’s “The Canterbury Tales”? We had to memorize the prologue’s first 18 lines in school and I’m glad we did, especially after this long winter.

Whan that Aprille

with his shoures soote,

The droghte of March

hath perced to the roote,

And bathed every veyne

in swich licóur

Of which vertú engendred

is the flour;

Or, more realistically, for New Englanders, Hemingway’s line from “A Moveable Feast”: “When the cold rains kept on and killed the spring, it was as though a young person died for no reason.”

 Respond via rwhitcomb51@gmail.com

Baby Boomers as shut-ins; Gees' infernal groves of academe

By ROBERT WHITCOMB

(rwhitcomb4@cox.net or rwhitcomb51@gmail.com)

Will America soon get more realistic about the “Silver Tsunami” of Baby Boomers heading into old age? So far, the nation’s policymakers have mostly been in denial, though it’s probably the biggest fiscal and social challenge of the next few decades in America and Western Europe.

But then, most Boomers themselves have been in deep denial. Many have not saved nearly enough money. They might have been lulled into complacency by seeing how many of their parents, beneficiaries of historical luck, have lived comfortably on old-fashioned defined-benefit pensions (and Social Security), which many of them started enjoying upon remarkably early retirements.

Some of the oldest Boomers — those born in the late 1940s — have those traditional pensions; most of the younger ones will have to settle for, at the most, 401(k)s. Meanwhile, most Boomers underestimate how much ill health will beset them as they age.

But there are even bigger problems. Consider how dispersed America (capital of anomie) has become. As always, many families with children break up as couples divorce — though more and more the couples don’t get married in the first place — and people move far away from “home” to seek jobs or better weather, or are just restless. This leads to a sharp decline (accelerated by modern birth control) in the number of large but close-knit families. At the same time, there has been a huge increase in the number of younger families where only a very harried mother, who may well never have been married, is the sole parent in place, amidst a societal emphasis on “self-actualization” above family and civic duties. All these factors mean that a lot of old people won’t have the family supports enjoyed by previous generations of old people, even as they generally live longer, albeit with chronic illnesses.

There are, of course, retirement communities, with some of the high-end ones set up like country clubs. The better ones have gradations of care, from independence, within a rather tight if safe community, organized by for-profit or nonprofit organizations, to “assisted living,” which usually involves residing in an apartment and getting help with some daily tasks, and, last, the nursing-home wing for those who have slipped into full-scale dementia or are otherwise disabled.

But plenty of people can’t afford to live in a retirement community.

More realistic and pleasant for many folks are such organizations as the Beacon Hill Village model, in Boston. In this, for hundreds of dollars a year in dues you become part of a formal network of old people (and thus indirectly the networks of their families and friends) and get such services as easy access to transportation, shopping, some health-care connections and trips to cultural events. The central idea is to let people “age in place” — to stay in their homes as long as possible.

Of course, most old people eventually get very sick and end up in the hospital and/or nursing home. But the Beacon Hill approach is attractive — if you can afford the dues.

The fact is that most oldsters will have to create their own informal networks of family and friends to help look after each other as their mobility declines. And in the end, the majority must depend on family members, if they can find them. So often, obituaries report that the recent decedent was at the time of demise in some strange place with no seeming link to his or her past. It’s very often the community where a child — more often a daughter — has been living. As Robert Frost said: “Home is the place where, when you have to go there, they have to take you in.” “They” generally means a relative, not a friend.

Until then, will you have enough loyal friends to look after you when you get really old? You’d better make sure that your pals include some folks too young to live in retirement communities.

***

Hurrah for “Higher Education: Marijuana at the Mansion,” Constance Bumgarner Gee’s well-written memoir. Most of the self-published book is about her time as the wife of the very driven, peripatetic and big-spending E. Gordon Gee, who has led the University of Colorado, West Virginia University (twice), Ohio State University (twice) and Brown University, where he had the tough luck to succeed the much-liked  and world-class hugger Vartan Gregorian, who had gone on to run the Carnegie Corporation of New York.

There’s lots of, by turns, hilarious and sad personal stuff in the book — about her sometimes bizarre relationship with her immensely well-paid and workaholic husband, the silly controversy about her using marijuana to treat her Meniere’s disease, her love of her riverfront house in Westport, Mass., and her ambivalent attitude toward her native South. But best is her vivid portrayal of university boards and administrations these days.

It’s not a pretty picture. The social climbing, empire-building, brand obsession, backstabbing and money-grubbing don’t present many good civic models for today’s students. The  stuff at Brown was bad; it was much worse at Vanderbilt in Mrs. Gee's story. Big universities are starting to look like New York City hedge funds whose partners are driven to build ever bigger houses to show off to each other in East Hampton.

Now to reread Mary McCarthy's novel "The Groves of Academe''.

Robert Whitcomb (rwhitcomb51@gmail.com), a former editor of The Providence Journal's editorial pages,  is a Providence-based editor and writer. 

Generally beautiful Brown

There are architectural disasters on the Brown Universiy campus, such as the hideous science skycraper, the crumbly-looking Rockefeller Library and the brutalist List Art Gallery, but all in all, the campus is one of the most beautiful urban campuses anywhere, with buildings from Colonial days through most of the styles since then, including a bunch of recent "starchitects''. See my friend William Morgan's take on it.