Welcome back, Shit Givers.

In brief: FDA got next?; Flooded subways; Delta's a game-changer; Epic (AI) fail; Fire predictions; Food stamp groceries delivered

Plus: new here? Got some climate anxiety? Check out pod guest and good friend Molly Peterson’s helpful piece in the NYT on how to manage. You’re not alone.

This Week is now Do Better Better

...because everyone loved those essays, but they went from weekly, to every two weeks, to once a month, to...it’s been a while.

So for the time being at least, those ideas will live here.

Let’s talk about self-awareness.

Coming to terms with my inability to write a quasi-regular DBB column meant taking a step back from my to-do list and calendar and doing some audits of my time and my obligations, and then culling what isn’t necessary right now, or that I don’t have time for, and prioritizing and scheduling what I do.

You can apply the same lesson to your workout schedule, meditation, caffeine intake, or even getting your nation over the herd immunity threshold so a future variant doesn’t emerge and kill another million of your citizens.

The mRNA COVID vaccines have been available for almost half a calendar year. The same percentage of people who said “no thanks” after celebrating New Years indoors with a few hundred of their closest friends are still in the “no” camp.

Disinformation and misinformation are a rampant cancer destroying most of our best societal intentions (more on that below), but that doesn’t explain away an entire 15% of the population.

A lot of folks know the risks that come with infection. They know the side effects. They know the incentives, too. We’ve offered huge amounts of cash, donuts, beer, and more.

We’ve made vaccines vastly more accessible (if only in isolation -- millions of hourly workers still have no childcare or paid time off to actually go and get one).

And yes, millions of historically and currently marginalized Americans have zero trust in the medical system and for-profit medicine, and an FDA that can’t just do the right thing.

But otherwise, self-awareness means acknowledging the simple fact that plenty of people just don’t fucking want one.

You don’t want to wear a seat belt, or a bike helmet? Fine, man. That’s on you. I’m not going to waste energy and precious time explaining basic life lessons to adults.

I don’t call this “science for people who give a shit” for fun.

We’ve known for eons that it’s nearly impossible to convince people of shit they don’t want to hear.

So I’m explicitly interested in supplying people who already want to move the needle of progress with the most measurable actions they can take to do so.

But a virus is another thing. A virus is between you and me.

28 million American children under the age of 11 can't get the shots yet. People with a history of severe allergic reactions to any component of the vaccine can't get it.

And as Ed Yong explained, as miraculous as these vaccines are, and as many people as already have them, 15% of Americans refusing to get them and billion of people around the globe starved of them means the firewall of protection will only last so long before some freak escape variant comes along and we’re starting the vaccine push all over again.

So if I’m President Biden, and Congress, and every business leader in America, I’m trying to Do Better Better, and getting self-aware.

I’m pushing the FDA as hard as I can to finally acknowledge America’s stupid commitment to exceptionalism, and approve and mandate the vaccines to come to work, to go to a restaurant, or club, or cruise, or movie theater, university or high school, to attend (or play in) an NFL game, to serve as a police officer.

Call Apple and Google back, hell, call Stripe, too, and beg them to help build an open-source vaccine passport, and then let states and cities and colleges and businesses API into it, so this doesn’t turn into Healthcare.gov 2.0.

Want to remind America of her exceptionalism?

Spend a billion dollars with TikTok on a marketing campaign to remind 50 million freedom-loving patriots that two hundred and forty-four years ago, smallpox survivor George Washington got real and reluctantly mandated absolutely brutal vaccines -- during a war, during the winter, in total secret, in PHILADELPHIA -- for his fledgling army.

And here we are.

Climate Change & Clean Energy

Wet bulbs and swimming through subways

Understand this: Being an ancient millennial, I was inclined to detail out our dangerously under-explored water risks by describing them as a “global thirst trap”, but I understand that I may be using that term incorrectly, so.

Let’s talk about water in the discontinuity, and where we go from here.

Everybody needs water. We need clean water to drink, to bathe, to wash, to do experiments, and for some reason, we require clean water to flush toilets, which is an entirely different issue.

In America, we have this (surprising, I know) dichotomy, where we value water so cheaply that we’ve spent decades wasting an enormous amount in said toilets, on lawns, and to grow monocrops that are mostly fed to industrialized animals.

But our entitlement and inequality also means clean water is unaffordable for many, and delivered via an antiquated (at best) infrastructure.

And finally, now, we understand the true impact of water.

• We’re all learning what “wet bulb” records are, and how they could make it too humid to survive in certain parts of the globe (and US)
• How the drought is devastating wheat crops and driving up the price of bread, among others
• How the lack of water and dry heat in other areas are killing unprotected migrant farmworkers
• How hydropower doesn’t really work without water
• In California, which really shouldn’t exist for the most part, a century of hodge-lodge manmade water infrastructure is under threat as the mountains and reservoirs dry out, as tech giants regret building on the bay

We’re learning what it will mean to adapt:

We’ve got maps of what our coastlines will look like once all the ice melts, and Apple Maps is semi-secretly building in detours for flash floods.

In Iran, droughts have led to violence.

Speaking of Apple, your iPhone’s birthplace is underwater, and subways across the world are (because they’re underground in cities built on water) flooding.

Chile’s scrambling to un-privatize its water model.

Indian’s monsoon has become wetter and more unpredictable (go deeper with Episode #72: The Monsoon is 11 Days Late, from 2019, but evergreen as hell).

⚡️ Action Step: You really need to understand this, because water is helpful for survival, and because we have some enormous opportunities to change our perspective on use and conservation.

Go deeper with an excellent water explainer from our friends at Climate Tech VC.

COVID

Back to the future

Understand this: 500,000 Americans got their first COVID vaccine on Wednesday, the most in a while.

It’s great timing, because Delta is for real -- called “one of the most infectious respiratory viruses we know of.” Possibly as infectious as chickenpox. And now we're pretty sure that vaccinated people can spread it.

So mask guidelines are back, if confusing (just wear one).

Federal workers will be mandated to get a shot, or have to wear a mask, distance, and get tested on the regular. And that may apply to the armed forces, too.

Let's talk about kids.

Young children are, even with Delta, for the most part, safe.

However:

• 4.1 million children have tested positive for COVID.
• Most have no symptoms. Great!
• But 500 US children have died, and 75% of the deaths have been Black, Hispanic, or American Indian children.
• 2-10% of those who are infected but don’t die experience “long COVID”.
• The FDA -- not completely asleep at the wheel -- has urged Pfizer and Moderna to expand their trials for kids ages 5-11 to check for rate heart inflammation problems

It’s not a level playing field: While no government is perfect, and this one certainly isn’t, it’s helpful to understand the whole context, and the forces arrayed against them:

• Antivaxxers are more likely to be influenced by Facebook than Fox News and wow
• GOP state lawmakers are disassembling public health powers
• Simultaneously, GOP-appointed judges are limiting states’ ability to limit in-person gatherings or even follow CDC guidelines, which is fun
• This isn’t just a rip on elected officials party. The seeds of distrust run deep: in 1975, 72% of Republicans have “a great deal” of confidence in science. Today, it’s 45%.

In Europe:

• The Moderna vaccine was approved for kids 12-17
• Countries are getting more aggressive:

⚡️ Action Step: Wear a mask, get a shot, spread the word.

Medicine & Biotech

Survey says...

Understand this: his “ethics in AI” thing is going as expected (way more to come on this soon for your 🎧).

From STAT:

“Several artificial intelligence algorithms developed by Epic Systems, the nation’s largest electronic health record vendor, are delivering inaccurate or irrelevant information to hospitals about the care of seriously ill patients, contrasting sharply with the company’s published claims, a STAT investigation found.

Employees of several major health systems said they were particularly concerned about Epic’s algorithm for predicting sepsis, a life-threatening complication of infection.

The algorithm, they said, routinely fails to identify the condition in advance, and triggers frequent false alarms. Some hospitals reported a benefit for patients after fine-tuning the model, but that process took at least a year.”

What it means: Well, it’s not great, Bob.

We’ve talked about this before. Paired with advancements in electronic health records (EHR), machine learning could theoretically help relieve medical personnel from various administrative time-sucks, improve radiology, diagnoses, and treatments, reduce inefficiencies in billing, and more.

But we’re very clearly not there yet, and the rush to let for-profit companies implement biased and/or poorly designed, poorly communicated, and poorly understood algorithms over questionable data sets is only setting us back even further.

⚡️ Action Step: We need to elect young people who are inherently more likely to understand the implications of the technologies of tomorrow.

Sign up to Run for Something, or support their amazing progressive candidates right here.

Job of the Week

Help beat addiction

Senior Software Engineer, Eleanor Health (Remote)

Saying America’s got an addiction problem would be a bit of an understatement.

Eleanor Health is focused on delivering whole-person, comprehensive care to transform the quality, delivery, and accessibility of care for people affected by addiction.

Join and collaborate with a growing team to build and maintain HIPAA-compliant and incredible value tech. Apply here.

The Human-Machine Interface

Where there’s smoke, there’s fire, and (checks notes) also apparently AI

Understand this: Wildfires are everywhere. But can we predict where they’ll go, can we get ahead of them?

A few thousand years of collective Indigenous experience says “yes, morons”, but also so does Dr. Ilkay Altintas.

From The New York Times:

“Altintas is the founder and director of the (University of California San Diego)’s WIFIRE Lab, where she and her team have worked over the past eight years to use data to help fire managers and scientists.

And in the last decade or so, the quantity of data has increased. A lot.

Where once there were basic weather cameras used by surfers, there are now vast systems taking in almost real-time satellite views, sensing wind patterns, tracking utility service and more.

All that information, coupled with troves of data about past blazes, can be used with artificial intelligence to quickly predict how fires will burn once they have ignited, and to help plan measures, like prescribed burns, aimed at preventing bigger, more dangerous fires.”

⚡️ Action Step: Dr. Altintas and her team built a firemap. Bookmark it.

And then subscribe to our podcast to get Monday’s episode on how to protect yourself from wildfire smoke.

Food & Water

Everybody should be able to order groceries

It’s about time: With millions of Americans facing food insecurity for the first time (or the fortieth), Feeding America is one of our most vital organizations.

And where you and I might’ve spent the past year tipping Instacart delivery people, there’s a hell of a lot of folks that can’t afford to do that.

And with the eviction moratorium (and other emergency social benefits) ending tomorrow, that number may grow. A lot.

Which makes today’s news very exciting:

From Grocery Dive:

“With a network of more than 200 food banks, Feeding America is looking to lower barriers to food access as the organization estimates 42 million people in the U.S. may face food insecurity this year.

Feeding America started piloting grocery e-commerce in October 2020, and since then 11 food banks and 18 distribution sites have reached nearly 15,000 people through more than 9,000 orders, according to its announcement. Feeding America aims to add 20 more food banks to the OrderAhead program over the next year.”

What it means: This system’s not only more convenient, it’s a hell of a lot safer during a pandemic, and alleviates some of the stigma of visiting a food bank.

⚡️ Action Step: Let’s feed some people. Help fund the new system by donating to Feeding America, one of our favorite orgs.

The Round Up

Facebook’s whistleblower speaks up.

How will governments prepare for the next pandemic? (I’m thankful as hell to have friends Nahid and Sam on the case)

Next in Biogen: they pulled a paper from JAMA before it could be damaging.

Very few clinical trials report transparent data. That’s gotta change.

The first candida cases are here and let me tell you this is the nightmare fuel, folks.

On the other hand -- what can we do with the incredible new protein folding database? Everything.

Important Jobs

Every week, we share Featured roles from Important Jobs right here in the newsletter.

Hiring and want to get your open role in front of our incredible community? Submit a Featured role for free right here.

• Senior Software Engineer, Eleanor Health (Remote)
• Scientist, Cell-Free Applications, LanzaTech (Illinois)
• Controller, C16 Biosciences (New York)
• Policy Lead), Evergreen Action (Remote)

Browse 40+ open roles, or add your own for free at ImportantJobs.com.

Important Pod Guests - In The News

Mary Grant on the PFAS Action Act of 2021, improving water standards for Americans

Leah Penniman on our very broken food system

Mohammed AlQuirashi on the paradigm shift in biology from DeepMind

Dr. Katharine Wilkinson & Dr. Ayana Elizabeth Johnson and All We Can Save are ON THE MOTHERFUCKING BEST SELLER LIST

Thanks for reading, and thanks for giving a shit. Have a great weekend.

-- Quinn