Welcome back, Shit Givers.
Some weeks, the Supreme Court guts your soul. Some weeks they do that and you also have to put your dog down. Feeling sad but grateful for the time we had. RIP Ella. You were loved.
- What the Supreme Court did (and didn't do) to the EPA
- New COVID shots this fall
- Supplements are bullshit and here's why
- How to build an inclusive clinical trial, from the start
- Be careful with those abortion pills you ordered online
Reminder: You can read this issue on the website, or you can 🎧 listen to it on the podcast (shortly).
🕛 Reading Time: 11 minutes
Book of the Week
My book recommendation this week is The Last Days of the Dinosaurs by Riley Black (Bookshop, Libro, Libby).
Riley is among my favorite science writers. Her ability to weave vivid detail throughout the minutes, hours, days, weeks, and centuries after the Chicxulub asteroid took out the dinos is wonderfully compelling and an instructive example of how massive, complex change can happen, fast.
The news: The Obama administration's Clean Power Plan was always a creative, um, enhancement, of the EPA's power, and the Supreme Court just called their bluff.
Ruling 6-3, a gaggle of unelected justices appointed to lifetime terms by presidents who mostly lost the popular vote took up a case funded by fossil fuel interests and essentially said the EPA can't use the Clean Air Act to regulate power plant greenhouse gas emissions, making it that much more difficult to slow the climate crisis.
Justice Kagan wrote (another) scathing dissent, saying the "court appoints itself — instead of Congress or the expert agency — the decision-maker on climate policy. I cannot think of many things more frightening."
I have written often about how these systemic issues of our time require equivalent responses -- the kitchen sink approach. This ruling removes one of our most important tools, though doesn't hamstring us entirely, and not as harshly as anticipated (here's a deep dive thread on the legalese).
The power sector coughs up about 25% of the United States' greenhouse gas emissions, which isn't everything, but sure as shit isn't nothing, either. It's why Obama reached with the CPP (which never even went into effect) and why team Biden tried to pass a clean energy standard packed with carrots and sticks in Build Back Better.
So what's left?
Lots, actually. Anyone who says climate action is dead is a moron.
But first: Republicans and these justices are hellishly intent on dismantling the federal regulatory apparatus (from abortions to elections to pollution), so more and more power is being vested in the states. Three cheers for federalism!
More state power means we have to be relentlessly focused on identifying successful mechanisms for decarbonizing and then repeating them across state lines. It means state and local elections -- and thus, the candidates running in them -- are more vital than ever, to implement repeatable policy and protect what's being taught in classrooms.
It's helpful that renewable energy (now 13% of the world's supply) is, in most places, among the cheapest energy of all time, so capitalism helps (I know) as companies will always, always try to minimize costs and maximize profits -- all the way down the supply chain. If they could just use some of that sweet sweet cash to lobby for good instead of evil, everyone's a winner.
And on the other hand, there's more private climate tech money than ever, and if we can maybe aim a little less at SaaS software to manage imaginary carbon credits and a little more at clean cement, steel, insulation, heat pumps, heavy trucks, shipping, and transmission, we'll be in relatively good hands.
We can organize like hell, everywhere; we can beef up our weather supercomputers, name heat waves as they come, and help the voting public understand exactly what is happening, now, instead of leaving the most marginalized to massive misinformation campaigns by fossil fuel providers.
Climate litigants are also (barely) starting to have their day in court, attacking from all angles.
I want to be clear: we're in the late stages of a 50 year plan to dismantle the administrative state, and it's going swimmingly. This ruling isn't the end all, and while it leaves the EPA some options, it requires Congress to be much more aggressive and specific, and well, we need new Congresspeople to do that.
⚡️What We Can Do: 1) Call inactive environmentalists and transform them into consistent voters with the Environmental Voter Project, and 2) Support progressive state and local candidates -- the ones most likely to directly affect your life -- with Run for Something.
Vaccine equity update: Just 17.4% of people in low-income countries have received at least one dose, and 33.4% of people worldwide have received zero doses.
The news: The FDA is buying another round of shots.
As the more immune-evasive BA.4 and BA.5 subvariants swiftly take over the US like some sort of bizarro TikTok dance, a panel of independent experts advising the FDA said "We have advised manufacturers seeking to update their COVID-19 vaccines that they should develop modified vaccines that add an omicron BA.4/5 spike protein component to the current vaccine composition to create a two component (bivalent) booster vaccine."
Understand it: This is great news, but also, early to mid-Fall is forever away, if we're talking subvariant mutations.
We should be producing these new shots, shipping millions abroad, and then marketing them everywhere, all of the time, as soon as possible. The Biden administration this week dug around enough couch cushions to find $3.2 billion for 105 million fall doses with the option to buy another 195 milly if needed, but not enough for every American.
It is still remarkable to me that the government has yet to put an appropriate amount of funding and effort behind marketing booster shots (and ventilation, etc). Yes, Elmo got a shot last week, and that's great, but there's simply no good reason why our best marketers aren't on the payroll, the equivalent of selling war bonds.
Vaccines aren't everything, but we need the elderly to get boosters now, and the new ones once they're available. We need pregnant people to get these. We need marginalized people to get these but we HAVE TO MAKE IT EASIER AND MORE ACCESSIBLE FOR THEM. We need empowered and employed community health workers.
It's the little things -- a friendly face matters. Language matters. There should be a concerted branding effort, delivered by a trusted source to say "get up to date" (vs "fully vaccinated") -- whereas the latter implies you're done. The same goes for "annual shots" (vs "boosters") -- whereas the latter subtly implies a vulnerability in the shots we simply can't afford to let take further root.
The people most at risk have to begin to trust again -- and maybe for the first time -- that the system is working for them, they have to experience it every day.
When more people are vaccinated, when the windows are open and new air filters...filtering, when spikes in viral wastewater numbers are everywhere and messaged like hurricanes, like heat waves should be, we can better protect the immunocompromised, teachers, and frontline workers who will be continually exposed, improving the baseline care of our entire big-tent community.
Bottom line? We have to care for one another, full stop.
⚡️What We Can Do: Folks it's summer, this is the single best time for schools to upgrade their ventilation and HVAC. There's $122 billion out there waiting to be used for exactly these purposes. Direct your local school board to the Clean Air in Buildings Challenge homepage to tap those funds and get to work.
The news: I'd like to take a one week break from discussing the food crisis to remind you that virtually every nutritional supplement either is, or could be, complete bullshit. They are classified by the FDA as food products, not medicine, despite so many claims.
Understand it: The issue is two-fold.
First: Some claims are entirely false -- disingenuous at best -- because the described ingredients don't actually do anything.
Second: Sometimes, like with St. Johns Wort, the ingredients achieve a "maybe?" for potential effectiveness, but they're worthless (again, at best) because the packaged product isn't what it says it is at all.
Six former FDA commissioners were interviewed in The Atlantic last year, and Margaret Hamburg said said while supplement companies had to voluntarily report any “severe” adverse effects of their products (fun), “it's very hard to even know what's going on.”
To clarify: You don't know what's in them, which means you also don't know how it'll interact with your actual medicine, any allergies, etc.
Here's the dish: Americans spent $50 billy on 80,000 different multivitamins and supplements in 2021. But a meta-analysis of 84 pooled studies and published last week in JAMA showed "Vitamin and mineral supplementation was associated with little or no benefit in preventing cancer, cardiovascular disease, and death, with the exception of a small benefit for cancer incidence with multivitamin use."
Trust me when I say that a lack of regulation -- which, again, I know, being dismantled before our eyes -- around consistent dosing means a tin of weed sleep gummies can vary widely from gummy to gummy.
⚡️What We Can Do: Remember, supplements can't prevent or treat COVID, either. Here's the NIH's long list of shit that doesn't do anything, please bookmark to Snap to your cousin Rachel when your mom tells you her mom said Rachel is taking zinc because an Instagram ad told her to.
The news: Black people continue to be excluded from clinical trials, in a country where health outcomes across COVID, maternal, cardiac, kidney, diabetes, and breast cancer remain devastatingly unequal.
WISDOM is a new breast cancer trial trying to upend those odds, a large-scale effort to find out if a combination of genetic factors and family history can produce a streamlined polygenic risk score and either increase or reduce the frequency of annual mammograms required.
The team behind WISDOM has tried to recruit a far more diverse set of participants. But it sure as hell hasn't been easy. Kirstin Bibbins-Domingo, the editor-in-chief of JAMA and a professor of medicine at UCSF told STAT why the effort matters:
"When we fail to represent Black women in studies of screening in high enough numbers, we just don’t have the scientifically right answer to what should we do and what role does screening play in this very important health problem” she said. “The great rationale for the WISDOM trial is to say, can we think about something else that tells us about the risk for you as an individual. That’s the advance, the new tech, and unless you build in equity in the trials, it actually may not help Black women and in fact make their outcomes worse."
And that's because if all of your data is derived from white populations (which is how virtually all clinical trial data is gathered), you simply don't have any idea whether the risk score is even applicable to the populations that were left out.
But creating more diverse trials isn't so easy. Marginalized people aren't marginalized by choice, obv: systems are intentionally created to do so, iterated on, and enforced.
Like COVID boosters, voting, medical school, or overheated redlined city blocks, we have to do a lot of extra work to unlock those people's ability to participate, much less (again) their trust that the system will work for them.
"To successfully recruit racially diverse participants, Consuelo Wilkins, a professor of medicine and a health equity expert at Vanderbilt University said, researchers should think about three main categories: the study’s inclusion and exclusion criteria, trust and distrust, and access to the study and health care. Making sure each of these things are equitable and just, Wilkins said, takes a lot of time, effort, and money."
⚡️What We Can Do: Help recruit more women of color to the WISDOM study and stop breast cancer in its tracks. Check out WhenWeTrial, a nonprofit dedicated to increasing Black participation in breast cancer trials.
The news: You may have noticed a recurring theme the past month but basically everyone is sending hordes of very specific data to Facebook, and the implications of that lack of data privacy have gotten much more severe post-Roe.
A recap: Last week we talked about the federal privacy bill's tenuous status, two weeks ago I detailed how 1/3 of the 100 top hospitals and crisis pregnancy centers (anti-abortion clinics) are sending vital patient info to Facebook, and a few weeks ago I wrote about the gaping holes in HIPAA and what it means for period apps -- my summaries and analysis standing on the shoulders of incredible reporting by The Markup, among others.
This week, The Markup detailed how the (now critically important) online abortion pill provider "Hey Jane" sent visitor data, including personally identifying information from reviewers, to Facebook, Google, and a bunch of other places. Hey Jane, FWIW, has since reportedly removed those trackers as shit gets way more real.
In parallel, Lockdown Privacy and The Washington Post followed up this week on The Markup's October reporting, saying "Planned Parenthood’s web scheduler can share information with a variety of third parties, including Google, Facebook, TikTok and Hotjar, a tracking tool that says it helps companies understand how customers behave. These outside companies receive data including IP addresses, approximate Zip codes and service selections, which privacy experts worry could be valuable to state governments looking to prosecute abortions."
Look, these orgs and companies -- from Planned Parenthood to VC-funded digital period trackers -- don't want to be suddenly liable for holding your most private information. No thanks.
Biden knows this too, and reportedly will ask the FCC to "to protect the privacy of women and birthing parents online."
⚡️What We Can Do: Use Plan C to find abortion pills where they're available, and info on how late you can take them. Here's an updated list of state laws following the Roe decision. Finally, check out Vote Save America's "Fuck Bans" Action Plan to fight back at the local ballot box, and more.
Thanks for reading, and thanks for giving a shit. Have a great weekend.