As Omicron peaks, the US healthcare system is left ‘broken beyond repair’

Despite Covid hospitalizations trending downward, 80% of hospitals across the country are under ‘high or extreme stress’

In the last week of January, 80% of US hospitals were under ‘high or extreme stress’, NPR data shows. 

Photograph: Shannon Stapleton/Reuters


Eric Berger
Fri 4 Feb 2022

Dr Brian Resler, an emergency physician in the San Francisco Bay Area, recently polled a group of doctors on an overnight shift about their jobs.

“Everyone of us said if we could go back, we would choose a different career,” said Resler, who spoke on the condition that the Guardian does not identify his hospital.


Hospitals in half of US states close to capacity as Omicron continues surge

Resler and his fellow doctors feel that way although California has recently seen a sharp decrease in the number of Covid-19 cases after the spike due to the highly contagious Omicron variant. That slump in cases has largely been mirrored across the US as the Omicron wave has peaked and many parts of the US are firmly on its downslope.

But, while some health experts have predicted that the worst of the pandemic is behind us, the ripple effects of the virus, such as its impact on patients needing care for other issues, continue to test the limits of the US healthcare system and its providers.

“Most people got into healthcare because they wanted to help people and make a difference, and I think at this point, it’s just broken beyond repair,” said Resler, 36, who has worked in emergency medicine for seven years.

Across the country, the daily average of Covid-19 cases and daily average of hospitalizations due to the virus has decreased by 49% and 16% respectively over the past two weeks, according to New York Times data.

The ripple effects of Covid have continued to test the limits of the US healthcare system and its providers. 

Photograph: Shannon Stapleton/Reuters

Despite those positive trends, 80% of US hospitals in the last week of January were under “high or extreme stress”, meaning that more than 10% of their hospitalizations were due to Covid-19, according to data compiled by National Public Radio using a framework from the Institute for Health Metrics and Evaluation at the University of Washington.

California was the tenth worst in the country with 69% of hospitals under extreme stress, meaning that more than 20% of those facilities’ hospitalizations were due to Covid-19.

“Even though the odds of getting very sick with Omicron and the odds of getting sick once you are vaccinated and boosted are lower, the sheer number of infections means that there are still going to be a lot of sick people,” said Resler, who explained that most of the Covid-19 patients who were hospitalized were unvaccinated.

Also, because of the threat of the virus, many people earlier in the pandemic were afraid or unable to seek care for their health issues. Now that delay is catching up with patients, Resler said.

“That leads to a lot of overwhelming of the system and a lot of angry patients. A lot of patients hear that things are overwhelmed, but when faced with long wait times and an overwhelmed emergency department, it’s a lot different to see it for yourself when you are sick and seeking care than hearing about it,” he said.

In Missouri, 79% of the hospitals are under extreme stress, which is the second highest percentage in the country. At Mercy hospital in Springfield, in the south-western part of the state, about 28% of their hospitalizations are Covid-19 patients, according to Erik Frederick, the hospital’s chief administrative office.

Many people delayed care for their health issues earlier in the pandemic, leading to delays in hospitals. 

Photograph: Shannon Stapleton/Reuters

Even if patients were admitted for other reasons but happened to test positive for Covid-19, “those patients require the same amount of resources, as far as isolation and all the personal protective equipment and human resources,” said Frederick.

The high transmissibility of the Omicron variant means that the hospitals also have a significant number of staff who test positive for the virus and must then quarantine. This creates an increased patient load for the providers that are left, and hospitals must offer incentives to encourage staff to pick up additional shifts and hire nurses from outside agencies, Frederick said.

“It creates a lot of stress on the healthcare system,” Frederick said.

Children’s hospitals have also not been immune from the strain caused by the Omicron variant. Over two weeks in January, there was a 20% increase in the cumulative number of child Covid-19 cases, according to the American Academy of Pediatrics.

Every few hours at University of Texas Health Science Center at San Antonio, the house supervisor, who coordinates care for patients, sends out alerts about the numbers of available beds in particular units.

“When those numbers get small, it means that we have to make some hard decisions,” said Dr Rachel Pearson, assistant professor of pediatrics and the medical humanities at UT Health San Antonio. “Sometimes that means kids who I would prefer to be upstairs with my hospital pediatrics team are stranded in the [emergency department].”

Sometimes the hospital has to stop accepting transfer patients from smaller hospitals or clinics or had to have those patients wait in the emergency department.

“We are stretched. It seems like we have been able to find creative solutions to safely care for kids for the most part, but I really feel for those rural doctors out there because I know sometimes they are on the phone and making call, after call, after call, trying to find a hospital with a higher level of care that can accept their sick patient,” said Pearson.

Hospitals are short-staffed as medical workers become ill with coronavirus, causing an even bigger strain on the system. 

Photograph: Shannon Stapleton/Reuters

Still, Pearson is encouraged that the Food and Drug Administration could soon authorize the Pfizer vaccine against Covid-19 for children under five.

And Frederick, who also sees patients from rural areas with low vaccination rates, said he is optimistic about the future of the pandemic.

“I’m optimistic about the numbers, but most of my optimism comes from my team and how they have responded and continue to respond,” he said.

Resler isn’t so optmistic. His early interest in emergency medicine came from the rewarding nature of providing care to patients, some of whom don’t initially have a heartbeat. Now he and colleagues talk about the “thank you” to “[expletive] you,” ratio, and the former is consistently outweighed by the latter, he said.

“I spend most of my day apologizing and being yelled at,” said Resler. “We had similar issues years ago, but it’s just gotten much worse, to the point where anytime I go see a new patient, it’s a pleasant surprise when they are not angry at me.”

This article was updated on 4 February 2022 to clarify that Missouri has the second highest percentage of hospitals under ‘extreme stress’, according to NPR data.

Covid-era Americans are using public transit less and having more car crashes

Transport officials are alarmed by a surge in car-related deaths as public transport ridership struggles in the wake of the pandemic

The shuttering of businesses, the rise of working from home and a fear of contracting Covid has resulted in a steep drop in public transport use. 

Photograph: Frank Franklin II/AP

Oliver Milman
@olliemilman
Fri 4 Feb 2022

The Covid-19 pandemic has seen two pernicious trends emerge as to how Americans are getting around their country: public transit is struggling with a reduced number of paying customers, while there has been a sharp increase in car crash deaths.

The shuttering of businesses, the rise of working from home and a fear of contracting the coronavirus saw public transport use plummet across the US – commuter rail alone reported a 79% decline in ridership in the year to September 2020. Despite a slight resurgence in 2021, trips taken on all modes of public transit are still around half of what they were before the pandemic, federal government figures show.

The first half of 2021 saw more than 20,000 people die in car crashes, the highest since 2006. Photograph: Albert Cesare/AP

Meanwhile, transport officials have also been alarmed by a surging number of car-related deaths.

The first half of 2021 saw more than 20,000 people die in car crashes, according to federal government data, up 18% on the previous year and the highest since 2006. Pete Buttigieg, the US transportation secretary, called the death toll, which is claiming the lives of about 3,000 people a month, “a national crisis” as he unveiled a new road safety strategy last week.

Transport experts say that these trends, while complex and not necessarily linked, are slowing progress on road safety while also hampering efforts to improve the livability of cities and to reduce air pollution and greenhouse gas emissions from the US transportation system, which is the country’s largest contributor to dangerous climate change.

“I think, long-term, if we don’t see major changes in transit ridership and road and land uses, we will have huge problems,” said Tara Goddard, an expert in transportation safety at Texas A&M University. “We will see emissions as horrible as they are now, road safety numbers as bad as now, inequities and social problems as bad as they are now. If we aren’t committed to serious change, we will have a lot of problems.”

The reasons behind the increase in traffic fatalities aren’t fully understood but a prevailing theory is that people have been speeding more, and therefore involved in worse crashes, due to roads that were cleared of the congestion when the pandemic hit and people stayed at home more.

Government reports show that trips taken on all modes of public transit are still around half of what they were before the pandemic. 

Photograph: Patrick T Fallon/AFP/Getty Images

“The roadway system in the US is built for speed, so when the traffic disappeared when Covid hit, traffic fatalities went off the chart,” said Benito Perez, policy director at Transportation for America. “People are also spreading out their trips during the day and more people are walking and biking on roads designed for cars. So you’re getting this constant conflict. It’s a recipe for fatal crashes.”

There has also been an “alarming” increase in people dying after being ejected from their cars during crashes because they weren’t wearing seatbelts, Goddard said, along with a rise in crashes because of drug and alcohol use by drivers. This is building upon trends seen since before the pandemic, such as the soaring popularity of hulking SUVs that are far more likely to kill pedestrians when they hit them.

“We have big, wide roads, very poor pedestrian crossings, a lack of lighting and we are buying bigger cars,” said Goddard. “It also seems there is more aggressive, distracted driving now. There is a lot going on in society that Covid has brought to a head.”

The increasing death toll on the roads has played out while public transit, long underfunded and politically overlooked in the US, has suffered from a steep drop in users that only partially rebounded as pandemic restrictions eased last year.

Many bus and train routes across the US have been curtailed, which has suffered a steep drop in users. Photograph: Patrick Semansky/AP

Many bus and train routes across the US have been curtailed, with the recent surge in infections from the Omicron variant stripping the system of a large number of sick drivers and other transit staff. Six subway lines in New York City were suspended during December and January due to a lack of available staff.

The slump in fare revenue has imperiled some public transit lines. “Unfortunately public transit has to justify its existence by showing a profit margin, whereas no such questions are asked of highway funding,” said Perez.

Although low-paid yet essential workers continued to use public transit during the pandemic through necessity, many people who could afford to work from home or take other modes of transport have stayed away from trains and subways. “Transit is so poorly resourced in the US that it makes it very fragile to disruption,” said Goddard. “If it already doesn’t work well for people, it doesn’t take much to push them off it.”

Goddard said there was a “glimmer of hope” in the Biden administration allocating $109bn in grant funds for public transit projects from the bipartisan infrastructure bill – which is the largest single investment in public transport in US history – but that the administration’s greater focus on electric vehicles won’t solve the deep-rooted problems in how America’s towns and cities are structured.

“We need to focus on land use solutions so people don’t have to travel as much because things are closer to them, where driving isn’t the only option,” she said. “EVs certainly have a role to play but if you get hit at 45mph it doesn’t matter if it’s an EV or gas-powered car. We shouldn’t just replicate our existing problems but with new technology.”

PAKISTAN

Women in law

Amber Darr

Published February 4, 2022 - 

The writer is a barrister, an advocate of the Supreme Court of Pakistan and holds a PhD in law.

JUSTICE Ayesha Malik’s appointment as a judge of the Supreme Court of Pakistan is to be celebrated not only because she is the first female to be appointed to this office but also because she is an intelligent, competent, and quality jurist who has proved her mettle in her decade-long tenure at the Lahore High Court. However, is it also right to herald her appointment as the most important, or even the first step in enhancing women’s participation and standing in the legal profession in Pakistan? Is it truly possible for a single appointment, no matter how laudable, to magically erase the very considerable institutional, social, and cultural obstacles faced daily by women lawyers throughout the country?

One way to answer these questions is by reference to other female appointments to historically male positions. For instance, the appointment of Rahat Kaunain Hasan (twice) and Vadiyya Khalil as chairpersons Competition Commission of Pakistan, of Sadia Khan as commissioner Securities and Exchange Commission of Pakistan, of Dr Maleeha Lodhi and Abida Hussain as Pakistan’s ambassadors to the US, and of Justice Ashraf Jahan as the first female judge of the Federal Shariat Court (about which the then chief justice FSC had claimed: “I took the initiative … as it would send the message in the world that we are enlightened people and would dispel many misconceptions”). Each of these appointments represented an important breakthrough for women but there is nothing to suggest that it also automatically transformed the status of women even in the organisations in which these appointments took place.

It is of course tempting to blame the women themselves for failing to look out for their gender. However, it is very likely that if any of these incredibly capable and brilliant women were to be asked why they did not introduce policies specifically favouring women, they may say that once appointed to their positions, their first and perhaps only mandate is to fulfil their responsibilities holistically rather than for the benefit of any particular group even if related to them by gender. These women are also likely to say that despite the stature of their positions they too have faced discrimination, whether in the form of patronising comments from colleagues and even subordinates, in being held to impossible standards not expected of their male counterparts, or in being silently yet firmly excluded from centres of real power even within their organisations.

Read: 'History made' — Lawmakers, journalists rejoice as Justice Ayesha Malik becomes first female SC judge


As the only female member of an historically all-male club, Justice Malik is likely to be confronted with challenges similar to those faced by all other women operating in traditionally male domains. Her oath of office, as much as the patriarchal culture prevalent at the Supreme Court, not only demands that she does justice in all matters that come before her, rather than looking out for women whether as lawyers or litigants, but also that she resists any attempts that may be made to relegate her to deciding women-centric cases or to being used as the token woman to signal Pakistan’s ‘enlightenment’ to the world and to pay lip service to gender parity in the legal profession. In treading this tight rope, Justice Malik is unlikely to be more than a distant role model for women lawyers, which whilst it inspires does not have the power, capacity, or indeed the responsibility to change their situation on the ground.

Can a single appointment, no matter how laudable, magically erase the considerable obstacles faced by women lawyers throughout the country?

Even otherwise, to expect a single judicial appointment to transform the position of women in the legal profession is to fundamentally misunderstand the reasons which hold them back. Whilst male lawyers claim that women fail to progress because they lack commitment and because they are distracted by their family obligations, women lawyers will argue that it is the unnecessarily toxic male culture of the profession rather than any lack of acumen, drive or ambition on their part, that prevents them from making their mark.

Even today there are several well-regarded litigation firms that do not hire women, and many others that employ them only for secretarial, or worse, ornamental purposes. The culture of the courts is equally discouraging. Judges often treat female lawyers as accessories to their male seniors, women lawyers mingle with their male colleagues at the cost of their reputations and encounter many obstacles even in accessing the basic amenity of a functioning washroom — sometimes because they need to obtain a key to the toilet from a remote official and always because they need to cross a corridor full of staring male lawyers or clerks to do so. Even in corporate law firms which have allowed far greater space to female lawyers, women do not make partner as easily as their male counterparts and even when they succeed in doing so, are paid a significantly smaller percentage of the profits allowed to the men.

The situation therefore can only change if women lawyers themselves take the lead and co-opt their more truly enlightened male colleagues into their cause. The Women’s Law Initiative launched nearly six years suggests that women lawyers are increasingly supporting and mentoring each other in their careers, whilst the increasing involvement of women in bar politics gives hope that mainstream bar bodies will also become more sensitive to the needs of their female members. Ultimately, these efforts must generate enough serious women lawyers that instead of waiting for an Asma Jahangir, Ashraf Jahan or Ayesha Malik to emerge every few decades, there exists a critical mass of women lawyers who can come forward and claim not only judicial appointments but also other positions of power within the profession as their right rather than as exceptions made or prizes bestowed on them by the generosity of their male counterparts.

PAKISTAN

Murders for ‘honour'

Editorial

DAWN.COM

Published February 5, 2022 -

A NEW report by a local NGO has revealed, yet again, how prevalent and ‘institutionally acceptable’ is the mindset that condones the cold-blooded murder of citizens on the pretext of honour. A survey of such cases conducted by Sindh Suhai Sath has revealed that as many as 176 people — 48 men and 128 women — were killed across Sindh by their immediate families last year. Not only that but a drastic increase was also witnessed in such cases in four districts of upper Sindh. According to the report, 27 men and women were murdered on the pretext of honour in Kashmore-Kandhkot, 26 in Jacobabad, 23 in Shikarpur and 17 in Ghotki district.

The fact that such a large number of killings continue unabated, despite the existence of laws and rulings by the apex court, shows how deep the rot goes. It is not confined to Sindh. Human Rights Watch estimates that at least 1,000 women are killed on the pretext of honour every year in Pakistan. Meanwhile, the low conviction rate associated with such murders — according to the Sindh police it hovers below 3pc — also underscores the fact that the state machinery is either unable or unwilling to enforce the laws that are in place. That the numbers of such murders are on the rise in upper Sindh indicates that the writ of the state is missing there, emboldening those with narrow-minded worldviews to perpetuate illegal and barbaric practices without fear of punishment. Last year’s attack on a couple in Karachi in broad daylight — they had been returning from a hearing pertaining to their free-will marriage — demonstrates the level of impunity with which these crimes are committed. By continuing with its apathy, the state is only aiding the criminals and normalising such archaic practices. The authorities must do more than ensure maximum punishment for these murderers. They must firmly communicate to society that far from preserving family honour, such barbaric practices only reflect a blindly mediaeval and criminal mind.

KASHMIR

Showing solidarity

Aizaz Ahmad Chaudhry

Published February 5, 2022 -

 
The writer is a former foreign secretary and author of Diplomatic Footprints.

EVERY year on Feb 5, the Pakistani nation reaffirms its solidarity with the people of Jammu and Kashmir. The politicians address gatherings. Kashmiris make a chain of human hands on Kohala bridge. Think tanks hold seminars. Like a ritual, we have commemorated this day every year since 1990, when an indigenous wave of resistance surged against the Indian occupation of Kashmir. Pakistanis have surely been steadfast in extending their support to the Kashmiris. And why not? The people of Pakistan and the people of Jammu and Kashmir share centuries-old ethnic, linguistic and religious bonds. So, the solidarity message to the Kashmiris from Pakistanis for the past 33 years is loud and clear: Pakistan stands with Kashmiris.

Beyond the messaging, however, we also need to look into the impact that this message of solidarity has created on India and the international community.

What is crystal clear to the Indian leadership is that Pakistan is not leaving Kashmiris in the lurch, and that if India wishes to see peaceful and friendly relations with Pakistan, it must resolve the Kashmir dispute in accordance with the UN resolutions and the wishes of the Kashmiri people. Is the messaging enough for India to change its approach towards the Kashmir dispute? Probably not. India seems to have chosen the path of finding a military solution to the Kashmir problem. This would be a fatal mistake. The US made a judgement error in continuing to fight for a military victory in Afghanistan, but learned after immense loss of life and treasure, that political solutions are far more superior and cost-effective

Read: Why Kashmir matters

The Aug 5 Kashmir debacle could prove costly

for India.

Will India learn from the Afghanistan experience and try to go for a peaceful resolution of the Kashmir dispute? Again, not likely. The Modi regime is neither listening to the voices of Kashmiris, nor to voices from within India. Many of the sane voices have called upon India to shun the path of military oppression against the people of Kashmir, roll back the assault on their identity (Kashmiriat), and engage with Pakistan for a peaceful resolution of the dispute.

As for the international community, it is encouraging that serious concerns have been raised by the UN and legislators from the US, the UK, and other countries on the heavy-handed approach being pursued by the Modi regime in occupied Kashmir. The UN has published damning reports on gross human rights violations in Indian-occupied Kashmir.

In August 2019, India revoked Article 370 and Article 35A of the Indian constitution ending Kashmir’s special status and dividing it into two union territories. It is not clear why India chose to assault the very identity of Kashmiris and also engage in demographic engineering when it knew that this would evoke an across-the-board resistance by the Kashmiris. It is also not clear how the Modi government would extricate itself from this messy situation that it brought upon itself. Many questions, but few answers.

Meanwhile, the security and humanitarian situation in occupied Kashmir remains grim. With nearly 900,000 troops stationed in the Valley, prolonged curfews, a blackout of communications, and in the midst of Covid-19, the ‘paradise on earth’ has become a living hell for most Kashmiris.

Read: Constitutional crisis + coronavirus: How the pandemic exacerbated India's clampdown in occupied Kashmir

The Modi government did try to entice some pro-India Kashmiri leaders, the so-called Gupkar alliance, to accept the new situation. The initiative could not result in a solution because there was not a single Kashmiri of any political shade that was ready to accept such a blatant assault on the very identity of Kashmir.

The Pakistani leadership has made it clear that there will be no dialogue with the Indian government until autonomy is returned, and then steps are taken to resolve the Kashmir dispute. Some informal contacts between the two sides have been reported, which can provide a basis for forward movement provided the Indian government rescinds its Aug 5, 2019, decisions. If it does not, the Aug 5 debacle alone could become an albatross around the neck of the Modi government.

If India does not go for a peaceful resolution of the issue, it could opt for creating a distraction as has happened in the past, like conducting false-flag operations to depict the Kashmiri resistance as ‘Pakistan-sponsored terrorism’. This would be a high risk move by Indian strategists because this could plunge the region into a kinetic confrontation. Geopolitical dynamics arising out of the US tilt towards India are also complicating matters, emboldening the Modi regime to pursue hegemonic ambitions in South Asia.

With such an uncertain future facing the Indian polity, will the Modi regime muster the courage to right the wrong it has committed? Only time will tell. However, one fact remains unchanged. Pakistan firmly stands with Kashmiris.

PAKISTAN
POST SECONDARY EDUCATION

Reboot is needed

Why this urge to control and police dress, body, communication and interaction?

Faisal Bari
Published February 4, 2022

The writer is a senior research fellow at the Institute of Development and Economic Alternatives, and an associate professor of economics at Lums.

YOUNG people 18 and above are eligible to vote, drive and marry and have children. But when they start college and universities in this country, these educational institutes assume they need to tell the young adults what they should wear, how much distance they should maintain from each other, who they should or should not meet, and whether they can interact with individuals from the other gender.

We frequently read in the papers that this university or that college has issued a dress code or has started fining students for wearing tights, jeans or T-shirts or for not wearing a dupatta or for sitting with people from the opposite gender. When these adults can make other big decisions about their lives and for the country, why can they not be trusted to make good decisions about their conduct on campus? Why this urge to control and police dress, body, communication and interaction?

There is no doubt that public places need codes of conduct and behaviour: that is not the issue here. We regulate a variety of behaviour through laws and norms in society. The question is about campus life and why these codes of conduct have to be a) made by the administration, b) imposed by the administration, c) administered and monitored by the administration. Why do we not involve young adults themselves to work out the codes, to work out how they are going to be implemented and monitored and how code violations are to be dealt with? Do we not want these young adults to become leaders and citizens who are going to make the Pakistan of tomorrow? Almost all educational institutes that I know of across the country, including the one where I work, give little or no space to student self-regulation and self-governance.

Almost the same thing has happened in the discussion on plagiarism and cheating. Online education has brought this issue up in a much more urgent and immediate form. Most universities and examination systems dependent on online work have seen spikes in plagiarism and the use of unfair practices. Many systems have come down heavily on the students. But the same question should be asked again. Are we going to create citizens who will only behave themselves when there is a policeperson watching over their shoulder? Is that the only way we can get compliance? If that is true, we are making a poor nation and the future of the country cannot be too bright.

Read: Cheating on online exams

Why this urge to control and police dress, body, communication and interaction?

Harvey Mudd College in the US has a strong code of conduct for incoming students who are supposed to adhere to it at all times. Each student pledges to uphold the code of conduct. Students have a buy-in. Violations can be self-reported or reported by others, though self-reports are encouraged. The code is monitored by students. Violations are dealt with mostly through a student-run governance system. This is what the Harvey Mudd website says about implications of the code for the students: “The Honour Code means closed-book exams in your dorm room. It means having an expensive calculator returned to you by a classmate after you left it behind in the lab. And it also means 24-hour student access — via card swipes — to state-of-the-art computers, labs, studios and shops.”

Can we imagine this in Pakistan? Of course we can. Harvey Mudd students are human. As are we. Lahore was not built in a day. Harvey Mudd did not reach where it is in a day too. Many other universities in the US are not at that place either. But if Harvey Mudd can do it, so can others. Question is, do we want to make a start? If we do, the way we think about student engagement and roles has to undergo a deep and complete change. They have to come to the driving seat in a lot of issues pertaining to them.

This is not just about student unions and/or their rights of organisation, though that is a part of it; this is much broader and deeper than that. This is also not about making or not making Pakistan Studies, Islamiat, etc compulsory. Simply stipulating content, even making it compulsory, is not the right way to teach/learn behaviour, or make provisions for how values might be internalised or allow people to practise their values, leadership and citizenship.

This has to be done through the act of doing. Students have to be involved in, if not be driving the process of, making codes of conduct. They have to internalise these codes and ensure that other students do so too. They have to be involved with monitoring the adherence/violation dynamics and also managing the consequences. These codes would cover all aspects of campus life, academic and non-academic.

But this cannot happen in a day. The administrations of most Pakistani universities do not know how to do this. The students also do not know how to do this. What has to start is a dialogue that brings all partners to the table, starts establishing higher trust levels (as trust levels are low on all sides right now) and then starts moving forward slowly. We will make many mistakes in the process, but is there another way to learn new things?

Universities deal with young adults who are already making big decisions that will not only impact them but also their families and all of us as well, and in three to four years, they would be making even larger and more important decisions in their active, professional lives. What kind of adults/citizens do we want? Those who we do not trust in terms of how they dress and who they meet, and who, in turn, do not trust anyone who represents any institution? Or do we want to move towards creating an environment where we work with these young adults to ensure they have an environment where they can learn to make important decisions and to take responsibility for their decisions and their successes and mistakes? The stakes are high. But it is the older generation, the power holders, that has to make the choice.

The writer is a senior research fellow at the Institute of Development and Economic Alternatives, and an associate professor of economics at Lums.

Published in Dawn, February 4th, 2022

Rage against the machine: Do video games increase the propensity for violence among children?

Video games are a wonderful tool for entertainment and learning, but our children still need help to navigate their way safely.

Nazish Imran | Ali Madeeh Hashmi

Published about 23 hours ago

On March 24, 1998, in the small town of Jonesboro, Arkansas, 13-year-old Mitchell Johnson and 11-year-old Andrew Johnson calmly and deliberately shot and killed four of their fellow students and a teacher at their school. Several other students and teachers were wounded in the killing spree in Westside Middle School.

This was just one of a string of school shootings in the USA that made headlines around the world and, at the time, was the second deadliest school shooting in the USA until it was followed, just a short time later, by the massacre at Columbine High school.

The shootings have continued unabated. Many of the perpetrators of these massacres were later characterised as ‘loners’. Some had mental health problems and media reports prominently reported that many or most of them were fond of video games — some of them to an unhealthy extent.
A decades-long debate

The debate about video games and violence has thus been raging for over two decades and is still undecided. The Covid-19 pandemic has led to an increased utilisation of digital entertainment, including online gaming and associated online activities for people of all ages including children and adolescents.

While some games have educational content and may promote learning, problem solving, development of motor skills and coordination, the popularity of video games has also raised concerns about their possible negative effects.

The recent case of a popular video game Player Unknown’s Battlegrounds (PUBG) and its possible connection to the tragic Lahore incident of familicide by a teenager as well as three earlier cases of suicide linked to the same game in Pakistan has brought this question back into the spotlight: do violent video games increase the likelihood of violent behaviour?

Violent video games depict intentional attempts by individuals to inflict harm on others. Many emphasise negative themes in addition to killing people and animals such as foul language, obscene gestures and disrespect for women, law and authority.

Research has shown that violence in media including television shows, movies and online games may be a risk factor for aggressive behaviour, with video games being particularly harmful since they are interactive and encourage role play.

A basic principle of social learning theory is that children learn by observing and adopting the behaviours of those around them. Children who are exposed to violent games repeatedly may become numb to violence, imitate the violence, become confrontational and show more aggressive and disruptive behaviours as well as less empathy and helping behaviours.

Video games can also be harmful in other ways, for example, by reducing sleep time and sleep quality, causing nightmares, impairing school performance, reducing socialisation with friends and family as well as physical activities and taking time away from other hobbies.

It is important to remember though that in proportion to the millions of children and young people who enjoy video games, only a very small fraction ever turn to violence in real life.

In general, research has shown that the children most at risk for exhibiting violent behaviours tend to have other risk factors that make such behaviour more likely: violence and aggression in the family, parenting styles, substance abuse (in a family member or the child) and many other factors.

Certain personality traits, which may be inborn and later conditioned by the home or school, like being highly emotional, prone to anger, hostility, depression, and acting without thinking are also likely to increase the risk of violent behaviour after playing a violent video game for long periods.

There have also been conflicting studies that have disputed the link between violent video games and actual violence. Children with depression, anxiety, shyness and attention deficit hyperactivity disorder may be particularly vulnerable to the negative impact of video games since the games activate the reward system in the brain similar to gambling and some abusable drugs.
Warning signs

As with most aspects of parenting, when it comes to video games, the healthiest approach comes down to moderation and making informed decisions.

Parents should remember that with supervision, video games are thrilling, inspiring and can be lots of fun. But we need to be concerned if a child is exhibiting unhealthy gaming habits.

An obsession with gaming, inability to cut down gaming time for other activities, exhibiting withdrawal symptoms such as sadness, anxiety, irritability when not gaming, lying and deceiving about the time they spend gaming, getting tired due to staying up late and showing decline in grade, for instance, should be danger signals.

In 2019, the World Health Organisation officially recognised “Gaming disorder” as a mental health disorder where gaming becomes the only activity in a person's life and is done to the neglect of everything else. If this happens, parents need to step in and seek professional help for their children.
What can parents and families do?

Having a family media plan to map out your child’s “media diet” can help. The American Academy of Paediatrics recommends no screen time for children less than 18 months of age and a maximum of two hours of screen time till five years of age.

For older children, anything more than a few hours a day is not a good idea.

Since the ongoing Covid-19 pandemic has restricted many outdoor activities and online education is continuing, reducing screen time may be difficult but must be attempted.

Sleep times must be enforced as well as other hobbies and engagement in activities where young people can interact with peers in person rather than online.

For teenagers, experts recommend disallowing gaming in bedrooms and perhaps having a ‘gaming area’ in the home. Warning children about potential dangers of internet contacts while online gaming is also advisable.

Playing video games with children can be a way to share their experience, improve parent-child bonding and discuss the game content as well. There should be clear rules in the home about video game playing time and content.

Checking the Entertainment Software Rating Board (ESRB) ratings to select appropriate games as per your child’s developmental level may get parents more involved in making sure that your child is not playing games unsuitable for his/ her age group. Parents also need to be role models for screen use and set a good example for their children.

Most children and youth, even avid video game players will never turn to violence in real life but this does not mean that parents and families should not be vigilant.

Video games, like all technology, are a wonderful tool for entertainment and learning. But our children, the offspring of a new, slightly scary ‘digital world’, still need our help and guidance to navigate their way safely through it.

Header illustration: Guillermo R. Vallejos/ Shutterstock.com


Dr Nazish Imran is a professor and head of the Department of Child & Family Psychiatry at King Edward Medical University, Lahore. She is a fellow and member of Royal College of Psychiatrists, a medical educationist and also recently completed her PhD in Psychiatry with work related to school mental health. Her main areas of interest are school mental health, adolescent suicide and autism spectrum disorder.

Dr Ali Madeeh Hashmi is a psychiatrist, writer and translator. He is Tenured Professor of Psychiatry at Lahore’s King Edward Medical University. Prior to this, he practiced and taught psychiatry in the United States for 12 years. In addition to his professional activities, Dr Hashmi is the author of five books on poetry and literature including the first (and only) biography of his grandfather, the celebrated poet Faiz Ahmed Faiz, published in 2016. His essays about mental health, literature, poetry and history have been published in scientific journals, magazines, newspapers and literary journals in

 Pakistan, India and the United States.

Punjab police want ‘dangerous’ games banned after tragedy

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Digital warfare tech at sea helping US foes evade sanctions

AP / Feb 3, 2022, 12:22 IST

MIAMI: Technology to hide a ship's location previously available only to the world's militaries is spreading fast through the global maritime industry as governments from Iran to Venezuela — and the rogue shipping companies they depend on to move their petroleum products — look for stealthier ways to circumvent U.S. sanctions.

Windward, a maritime intelligence company whose data is used by the U.S. government to investigate sanctions violations, said that since January 2020 it has detected more than 200 vessels involved in over 350 incidents in which they appear to have electronically manipulated their GPS location.

“This is out of hand right now,” Matan Peled, co-founder of Windward and a former Israeli naval officer, said in an interview. “It's not driven by countries or superpowers. It's ordinary companies using this technique. The scale is astonishing.”

Peled said U.S. authorities have been slow to catch on to the spread of technology that has been part of the electronic warfare arsenal for decades but is only now cropping up in commercial shipping, with serious national security, environmental and maritime safety implications.


Windward was able to identify suspect ships using technology that detects digital tracks that don't correspond to actual movements, such as hairpin turns at breakneck speed or drifting in the form of perfect crop circles.

William Fallon, a retired four-star admiral and former head of the U.S. Pacific Command, said U.S. authorities have been aware for some time of the threat from electronic manipulation, one of a growing number of so-called “gray zone” national security challenges that cut across traditional military, commercial and economic lines.

“Any time you can deceive somebody into believing you're somewhere where you're not is concerning," said Fallon, who is now a board member of the American Security Project, a Washington think tank. “It illustrates the extent to which people who don't have any scruples are willing to go to achieve their objectives and the ease with which they can do it.”

One of the more egregious examples found by Windward involves a 183-meter-long oil tanker that could be tracked sailing to Iraq even as it was in reality loading crude in Iran, which is banned from selling its oil by U.S. sanctions.

The tanker, whose name Windward asked to be withheld so as not to disrupt any potential U.S. government investigation, set sail on Feb. 11, 2021, from the United Arab Emirates, reporting its destination as Basra, Iraq. When it was 20 nautical miles away, its global navigation system began exhibiting strange drifting patterns. Twelve days later, its transmission stabilised and it could be tracked heading back through the Hormuz strait at normal sailing speed, this time fully laden with crude.

Satellite imagery shows that during the two-week voyage a ship of identical length and with the same red deck broken up by a white pole and bridge was spotted dozens of nautical miles away, in Iran's Kharg Island oil terminal. That vessel was then followed on satellite sailing back to the UAE, its course merging with the reported position of the original ship after it resumed its normal transmission.

Under a United Nations maritime treaty, ships of over 300 tons have been required since 2004 to use an automated identification system to avoid collisions and assist rescues in the event of a spill or accident at sea. Tampering with its use is a major breach that can lead to official sanctions for a vessel and its owners.

But what was intended as an at-sea safety mechanism has also driven a proliferation in ship-spotting platforms like MarineTraffic.com.

Experts say such websites can be easily tricked since they partly rely on data gathered from thousands of amateur base stations that function like police radio scanners picking up maritime movements. Last year, two journalists from the Norwegian Broadcasting Corporation managed to register online a fake base station near Somalia and insert the false coordinates of a real vessel. Seconds later, the falsified location popped up on MarineTraffic.com.

"To minimize errors and always ensure data integrity, MarineTraffic has introduced a series of key actions in the last few months as we strive to keep securing incoming data further," MarineTraffic's Anastassis Touros said in a statement. Steps include blocking specific stations and IP addressees that consistently transmit false data.

Despite such quality control efforts, the sheer volume of data has cut into the utility of such open-source platforms, two U.S. intelligence officers told The Associated Press. The officials spoke on the condition of anonymity to discuss what they described as the latest — and most extreme — tactic in the cat and mouse game between authorities and bad actors.

Another blind spot: China. The recent implementation of a harsh data privacy law has cut by nearly half the amount of terrestrial data on maritime activity in Chinese waters, making it harder to track everything from activity at busy ports key to global supply chains to the movements of the world's largest distant water fishing fleet.

Researchers from Global Fishing Watch, which uses satellite data and machine learning to monitor activity at sea, have made similar findings as Windward. It has identified 30 vessels whose locations, as reported on ship-tracking platforms, regularly fell outside the range of the satellite receiving the ship's position.

Among the vessels caught suspected of falsifying its digital tracks was the Tulip, a Panama-flagged oil tanker. For almost six months last year, it broadcast its position along the west coast of Africa. But the satellite that should have picked up the ship's movements was often thousands of miles away, suggesting the ship was likely in Venezuela.

The Associated Press obtained internal documents from Venezuela's state-owned oil company indicating the Tulip loaded 450,000 barrels of fuel oil during the first 15 days of September. Like several other of the suspicious vessels, the crude was purchased by a shell company, M and Y Trading Co., registered in Hong Kong in November 2020, according to the documents. The Tulip is owned by another Hong Kong-registered shell, Victory Marine Ltd. Neither company returned emails seeking comment.

Bjorn Bergman, a data analyst for Global Fishing Watch and Sky Truth, said attempts to hide a ship's position can be easily detected.

“While we need to remain vigilant, vessel operators choosing to manipulate their data are just going to end up shining a spotlight on their activities,” he said.

Of the 200 vessels identified by Windward with similar patterns of deception, the vast majority exhibited no other or just a few classic red flags such as disabling on-ship tracking systems, falsifying a vessel's flag state or constantly changing ownership from one shell company

Book Review: The Foundations of White Anglo-American World Power

Maribel Morey’s book ‘White Philanthropy’ lays bare how a global network of Anglo-American elites shored up White power and supremacy in the 1940s, when the latter were on the global defensive.


Representative image of Carnegie library. Photo: Sandra/Flickr CC BY NC 2.0

Inderjeet Parmar

In most circles today, beyond selected academics, Gunnar Myrdal’s An American Dilemma (1944), remains a landmark achievement, a key moment of blinding clarity about White Americans’ obvious racial prejudices and injustice, starkly contrasting with an otherwise moral American creed of equality, causing moral angst and national guilt, and requiring ameliorative action. In contrasting Americans’ guilt over their racism with the Nazis’ proudly dogmatic ideological racism, Myrdal is seen to renew the notion of American moral virtue, founded on a culture that feels guilty about the gap between its ideals and behaviours. Such people, Myrdal argued, could be trusted to lead the White world after 1945 and maintain White world domination.

Maribel Morey
White Philanthropy
The University of North Carolina Press (November 2021)

Maribel Morey’s book White Philanthropy takes a scalpel to the body of beliefs and myths about the Myrdal thesis, clinically dissects them, and lays bare the starkest truth: that Myrdal’s book was part of an entire hegemonic programme led by a global network of Anglo-American elites that spanned decades whose principal aim was to shore up White power and supremacy in an era when the latter were on the global defensive against rising anti-colonial and freedom movements. The book was about White racial prejudice and practices, for White people with agency, who allegedly felt guilty about their behaviour, and who would rectify the matter at their own pace and in their own way. The victims of centuries-long racist-colonial exploitation and domination would just have to passively await the fruits of Whites’ introspection and reform.

I certainly have not read any book-length study that provides such compelling detail and in so persuasive a manner as to ensure that other scholars do not make the mistake of misunderstanding Myrdal’s study again. Yet, I am also aware that the gate-keepers of knowledge in the major foundations and their extensive scholarly and other networks remain powerful. And important landmark studies, which is what Morey’s book truly is, will make an impact but its full impact is unlikely to be of the proportions it ought to attain. The “free market of ideas” is rigged.

Anglo-Saxonism at the heart of the Myrdal project

Morey’s study critically and in great historical detail deconstructs the underlying racialised Anglo-Saxonist interests and motives behind the funding, researching and writing of An American Dilemma. It argues that the principal overtly stated aim of Myrdal’s study, in conjunction with previous studies (of South Africa, and in Africa more broadly) funded by the Carnegie Corporation under Frederick Keppel’s presidency, was to produce national and international policies to manage America’s national as well as the broader Anglo-Saxon-dominated global colour line – to maintain White supremacy and Black subordination, albeit with superficial reform or elimination of the most brutal aspects of racism and colonialism.

In that regard, the book backs the arguments of contemporary leftist and Black nationalist critics of An American Dilemma, whose voices had largely been censored, suppressed/marginalised until decades after the latter’s publication and rapturous reception by White elites (and, importantly, by the more conservative Black organisations, such as the National Association for the Advancement of Colored People).

Carnegie philanthropy and White supremacy

The ground-breaking character of Morey’s monograph – based on research in several countries’ archives – is especially valuable given the challenge of over-turning dominant understandings of Myrdal’s study as a major anti-racist document when in fact it was designed to shore up White power, even during the Second World War, which was significantly driven by Nazi theories of racial superiority, and its genocidal consequences. Any scholar entering this field of investigation will now have to take into account Morey’s study and sources. In fact, even more, the book brings into question the entire world-view of the Carnegie Corporation including whenever they may claim nowadays (and probably since the revolts against the African Studies Association that the Carnegie Corporation largely established, shaped and funded from the 1950s to the 1970s) to have repudiated such racism and elitism.

The book makes a major, original contribution to an understanding of the racialised basis of elite US institutions, networked into the American establishment; their huge impact on US life especially in this case on ‘race relations’ and understanding of racial power structures. Its greatest contribution is in imperialising and globalising Myrdal’s book as well as the thinking on racial power of US elites as organised on a national and international-imperial basis, with a mentality that was literally a ‘world-view’. In that regard, the material on Britain’s Chatham House and other pro-imperial bodies in the empire, and the roots of Andrew Carnegie’s own thinking, as well as in Myrdal’s European-oriented Mathusianism, is very interesting and impressive. The racialised world views of elite think tanks – the US Council on Foreign Relations, and Chatham House – to which Carnegie donated large sums over decades, help flesh out such elite networks.

Morey’s fascinating book also adds to our knowledge of the philosophy and political manoeuvring of Carnegie Corporation president Frederick Keppel, who is not normally viewed as a decisive figure in the broader (mainstream/conventional) literature on US philanthropy.

Frederick Keppel. Photo: By Unknown author/United States Library of Congress’s Prints and Photographs division, Public Domain

Morey’s book adds to and deepens and broadens in regard to the Carnegie Corporation and its racialised and colonial Anglo-American elite networks the picture sketched in Frank Furedi’s The Silent War (1998). Furedi shows how race was understood in Anglo-American polities from WWI onwards as the major problem of international politics. To cut a long story short, Furedi shows how a ‘race relations industry’ developed in Anglo-America viewed race relations in specific ways in a period of rising anti-colonialism. In their topsy-turvy world, anti-colonialism was seen as anti-White ‘reverse racism’ and, therefore, likely to cause a global race war.

Morey’s work is further buttressed by Robert Vitalis’s study White World Order, Black Power Politics (2015) which uncovered and exposed in great detail the origins of the academic field of International Relations (IR) as “race relations”, not to mention the field’s active marginalisation and exclusion of anti-colonial scholars at the historically-black Howard University in Washington, DC.

White philanthropy speaks to our current crisis

While there is no doubt that Morey’s study is at heart a work of brilliant historical scholarship, it screams with relevance to current discussions of race and inequality, and White supremacy. The book informs current discussions of the roots of White supremacy and the necessity of its eradication via direct action. It is clearly not the main point of the book but the current era with all its symptoms of crisis and legitimacy of elite institutions, the rise of Trumpism, of White nationalism and open White supremacy, and the fascistic coup attempt and insurrection of January 6, 2021, suggests that those historical forces that Morey uncovers remained just beneath the surface of establishment politics, police forces, and immigration law enforcers. The progressive and radical revolts and uprisings of the 1960s weakened but did not destroy racism nor its deep roots in American capitalism and its racialised class system. In such ways, Maribel Morey’s book rises above the specifically historical. The racist heartbeat of American capitalism is alive and well.

Maribel Morey. Photo: Twitter/@MaribelMorey1

My own study of Carnegie and other such major philanthropic foundations [Foundations of the American Century: The Ford, Carnegie, and Rockefeller Foundations in the Rise of American Power (2012)] suggests that those forces continued in such racialised and elitist manner well after the 1960s and I would recommend scholars use Morey as a springboard to continue investigating Carnegie, Rockefeller, and Ford foundations’ roles in the post-civil rights and women’s liberation eras. The power of the major foundations to incorporate and domesticate powerful radical dissent should not be underestimated.


Morey’s scholarship is impeccable, thorough, detailed, painstaking, and extensive. The use of multiple archives across several international collections is remarkable and impressive. This book is a labour of love, deeply-felt, inspired scholarship, but whose interpretation and conclusions are clinically-advanced and stated. It is a book that had to be written – and we should be thankful that Morey took up the task. A truly amazing study.

Inderjeet Parmar is professor of international politics at City, University of London, and visiting professor at LSE IDEAS (the LSE’s foreign policy think tank). He is a columnist at The Wire. His Twitter handle is @USEmpire.

White Philanthropy | Maribel Morey | University of North ...

https://uncpress.org/book/9781469664743/white-philanthropy

White Philanthropy. Since its publication in 1944, many Americans have described Gunnar Myrdal’s An American Dilemma as a defining text on U.S. race relations. Here, Maribel Morey confirms with historical evidence what many critics of the …

Maribel Morey

https://www.maribelmorey.com

a historian of u.s. philanthropy, the social sciences, and racial equality, maribel morey is founding executive director of the miami institute for the social sciences, a nonprofit organization centering the work of global majority scholars in the social sciences as means both for improving the integrity and rigor of these fields and for building …

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White Philanthropy: Carnegie Corporation's An American Dilemma and the Making of a White World Order Kindle Edition

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Since its publication in 1944, many Americans have described Gunnar Myrdal's An American Dilemma as a defining text on U.S. race relations. Here, Maribel Morey confirms with historical evidence what many critics of the book have suspected: An American Dilemma was not commissioned, funded, or written with the goal of challenging white supremacy. Instead, Morey reveals it was commissioned by Carnegie Corporation president Frederick Keppel, and researched and written by Myrdal, with the intent of solidifying white rule over Black people in the United States.

Morey details the complex global origins of An American Dilemma, illustrating its links to Carnegie Corporation's funding of social science research meant to help white policymakers in the Anglo-American world address perceived problems in their governance of Black people. Morey also unpacks the text itself, arguing that Myrdal ultimately complemented his funder's intentions for the project by keeping white Americans as his principal audience and guiding them towards a national policy program on Black Americans that would keep intact white domination. Because for Myrdal and Carnegie Corporation alike, international order rested on white Anglo-Americans' continued ability to dominate effectively.