Looking to 2023: What lessons have we learned from the COVID-19 pandemic in the last three years?

by Jeremy Lim, Bryan Chow and Anne Goei, National University of Singapore

Credit: Unsplash/CC0 Public Domain

Last year, German Chancellor Olaf Scholz in a speech on global geopolitics popularized the German word "zeitenwende," which refers to a "turning point" and time for change.

The COVID-19 pandemic has likewise brought about seismic change in how the world looks at global health security and brought to the forefront the critical need for public health capabilities nationally and globally. "Never Again" has been the rallying cry of communities, businesses and public officials the world over and this momentum offers opportunities to fundamentally redefine pandemic preparedness and response.

What have we learned in the last three years?

There are numerous lessons cutting across all sectors of life. We summarize them in five key insights: pre-emptive investment in health security, nimbleness, trust, global cooperation and commitment to equity.

1. Pre-emptive investment

COVID-19 has shown that proactive preparedness remains key to managing future pandemics. Many countries challenged with lesser outbreaks in recent years, preserved the responding infrastructure which positioned them well for the initial containment of COVID-19.

South Korea and Senegal, with prior lessons from the Middle East Respiratory Syndrome (MERS) and Ebola respectively, were able to manage well whilst geographies in Asia affected by the Severe Acute Respiratory Syndrome (SARS) such as Hong Kong and Singapore all had regularly rehearsed response plans in place which could be adapted quickly for COVID-19.

2. Nimbleness

No country can afford to maintain standing resources to deal with Disease X (a term popularized by Singapore Prime Minister Lee Hsien Loong to describe the next pandemic) but creativity and nimbleness in adapting and re-purposing existing infrastructure can go a long way. Project Warp Speed harnessed decades of research into mRNA vaccines intended for cancer care and adapted these for SARS-CoV-2, the virus which causes COVID-19.

Contact tracing systems deployed globally leveraged geospatial technologies used in ride-hailing and other consumer applications. Locally, physical infrastructure such as hotels, holiday chalets, military camps and convention halls were quickly configured to house thousands of COVID-19 patients to mitigate transmission and prevent overwhelming the healthcare system.

The setting up of a community wastewater surveillance program by the NUS Environmental Research Institute is another example, harnessing existing resources to set up a quick system of detection and enabling rapid ringfencing of infections.

3. Trust

Mahatma Gandhi, India's independence leader, exhorted the world: "The moment there is suspicion about a person's motives, everything he does becomes tainted." The pandemic has richly illustrated how corrosive mistrust can be, manifesting in multiple forms such as misinformation campaigns, conspiracy theories and the like.

Open communication and collaborative partnerships built on trust between government agencies, public health entities, religious and community groups, and the public are necessary conditions for successfully combating a pandemic. Sadly, many countries did poorly on this front with delays in vaccinations and inappropriate public health interventions all too common. Even more perniciously, some actors "politically weaponized" public health for their own nefarious purposes, worsening the trust deficit.

The reality of fast-spreading disease is that coordinated responses across all fronts are critical, and "trust is the glue." Trust and the community that trust builds cannot be achieved overnight or only in crises. As Stephen Covey, author of the best-selling The Speed of Trust drily notes, "The best time to plant a tree is twenty years ago. The second-best time is today." Trust barometers show we are, as a world, moving in the wrong direction and this has to be reversed.

4. Global cooperation

Pandemics can no longer be left to individual nations to handle. Widespread migration and travel mean diseases now spread much more quickly across borders, demanding a collective response internationally. Supranational public health agencies such as the World Health Organization (WHO) need to have larger roles and responsibilities as well as resources in pandemic surveillance and response.

The International Health Regulations, the only legally binding health-related legislation was shown to be woefully inadequate and a new order is needed. That said, international organizations are only as strong as their members want them to be, and member states have to determine they are better together under the central collective leadership and direction of a strong WHO than isolated and apart with an enfeebled WHO whose pronouncements are routinely disregarded.

Beyond strengthening the global peak public health body, public health networks should be developed regionally. Resource sharing among existing regional associations is a good start and it is encouraging that within our region, the Association of Southeast Asian Nations (ASEAN) has agreed to establish the ASEAN Centre for Public Health Emergencies and Emerging Diseases (ACPHEED).

At the people-to-people level, the Building Alliances for Pandemic Response (Public Health) Asia [ALPHA] program hosted by NUS will facilitate greater cooperation amongst leaders in the region, allowing an intersection of public health leadership, strong partnerships, and cross-country collaboration.

5. Commitment to equity

Moving forward, to truly achieve global health security, we must ensure equitable health development. Poignantly in Singapore, despite early laudations of stellar pandemic control, we saw an unprecedented outbreak within the migrant worker dormitories.

This reinforced a sobering truth—we are only as secure as the most vulnerable groups among us. United Nations Deputy Secretary-General Amina Mohammed reminded us, "Remember, we are in this together. No one will ever be truly safe until everyone is safe." And this truism holds at the local, national, regional and global levels.

Operationally, Universal Health Coverage or UHC for short is the right overarching framework to steer towards equitable health for all and all countries should be supported to realize this for their citizens. Globally for health security, the Microsoft co-founder turned philanthropist Bill Gates has proposed a global governance framework.

This framework would include establishing a permanent organization of experts to mount a coordinated response to a dangerous outbreak at any time in any country, conducting resilience and preparedness drills in between, a Global Epidemic Response and Mobilization (GERM) team, as well as mechanisms to accelerate vaccine and diagnostics developments and availability particularly in low and middle income countries.

The great American epidemiologist Larry Brilliant has said "outbreaks are inevitable, but pandemics are optional." Early in 2020, a group of public health academics gathered in NUS to discuss whether a two-week global lockdown would avoid the worsts of COVID-19. We decided that it would be highly effective from a public health perspective but that narrow national interests and partisan politics would not permit this reality. We have as a human species learned so many painful lessons these last three years. Will we do better with the next outbreak?

Provided by National University of Singapore 

As COVID-19 becomes routine, Africa readies for next crisis

LEGIONAIRES DISEASE

Water systems study finds Legionella in 41% of samples

by Flinders University

Light microscopic images of trophozoites (active form; image A, B and D) and 

cysts (dormant form; image: C and D circular in shape) of Acanthamoeba

(image A, B and C) and Vermamoeba vermiformis (image D) shown at 100 times

 magnification. Credit: Flinders University

A new study of domestic and hospital drinking water systems found Legionella in 41% of samples—with Flinders University researchers making a key connection between the pathogen's co-existence with a "host" microorganism in all samples tested.

The study found Legionella bacteria "infect the amoeba host and then once inside these hosts are protected from disinfection strategies," says Flinders University Associate Professor of Environmental Health Harriet Whiley, a co-author of the new journal article in Water Research.

Researchers tested for Legionella and its likely amoebae hosts in 140 samples of water or biofilm (the slime found on showerheads and end of faucets) to understand how the potentially dangerous bacterium colonizes and proliferates in both domestic and hospital plumbing and poses a threat to human health.

Legionnaires' disease is a severe pneumonia-like infection that can be fatal. Globally the number of Legionnaires' disease cases is increasing, with elderly and immunocompromised people at the highest risk.

"It is vital that we strive to improve the management of our water distribution systems, particularly in high risk setting such as hospitals, to protect vulnerable populations," says Associate Professor Whiley, from the Flinders College of Science and Engineering.

"Having a better understanding of the relationships between these amoebae and Legionella is an important step in improving future water treatment processes aimed at controlling Legionella and preventing Legionnaires disease."

L. pneumophilia is the main cause of Legionnaires' disease and is not transmitted from person to person but caused by inhalation or aspiration of contaminated water.

Maintenance and monitoring of water systems is a common preventive step to reduce public risk.

"To our knowledge, this is the first time the amoebae Allovahlkampfia and Stenamoeba have been demonstrated as hosts of L. pneumophila in Australian drinking water," says Flinders University Ph.D. candidate Muhammad Atif Nisar, who conducted the study.

The findings support the need further research to investigate the prevalence of Legionella as well as free-living amoebae in domestic and commercial water systems and to improve guidelines to better control water systems and safeguard the public health.

"Free-living amoebae are ubiquitous in the environment and cause both opportunistic and non-opportunistic infections in humans. Some amoebae are the natural reservoirs of opportunistic plumbing pathogens, such as Legionella pneumophila," says Mr. Atif Nisar.

"There is a need for future research to improve disinfection strategies against amoeba to reduce their colonization within building drinking water systems."

Up to 75% of the drinking water or biofilm samples tested positive for free-living amoebae. This included V. vermiformis which was present in 55% of samples and Acanthamoeba was present in 11%.

As well as being hosts for Legionella, Acanthamoeba and V. vermiformis are pathogens that can cause severe eye infections, with contact lens users and immunocompromised individuals at greatest risk.

The water samples were collected from showers and hand basins located in domestic houses and hospitals across New South Wales and South Australia.

These results demonstrate the importance of amoebae in engineered water systems, both as a pathogen and as a reservoir of Legionella.

"Future water management protocols should incorporate improved treatment strategies to control amoebae to reduce the risk to end-users," adds Mr. Atif Nisar.

More information: Muhammad Atif Nisar et al, Molecular screening and characterization of Legionella pneumophila associated free-living amoebae in domestic and hospital water systems, Water Research (2022). DOI: 10.1016/j.watres.2022.119238

Provided by Flinders University Investigators identify optimal conditions for growth of Legionella bacteria

Plant-based diets: What are they, and how do you start?

by Kirstie Ganobsik

As Americans struggle to eat better, plant-based diets have become the rage, but exactly what are those and how hard are they to follow?

A growing number of people have turned to plant-based eating, as evidenced by the fact that the plant-based foods market increased by 29% in recent years, according to the U.S. National Library of Medicine.

Still, even though the Physicians Committee for Responsible Medicine says there are many health benefits to plant-based eating patterns, making the switch from consuming a diet rich in meat to one that centers on plants can be a challenge.

What is a plant-based diet?

"When we talk about a whole foods, plant-based diet, we mean the majority (at least 80% to 90%) of the food should be unprocessed plant-based foods—things like legumes, fruits, vegetables, seeds, whole grains and nuts," Dr. Urvi Shah, a hematologist oncologist at Memorial Sloan Kettering Cancer Center, said in a recent blog post.

"Some people may end up eating minimal amounts of processed plant foods or animal-based foods like dairy or meat occasionally, but not on a regular basis," she added.

Fruits, vegetables, grains, dairy, seeds, fish and meat that contain a variety of micronutrients (vitamins and minerals) and macronutrients (protein, carbohydrates and fat) should be included in a plant-based diet, according to a perspective published in the journal Advances in Nutrition.

The key is to ensure that the largest proportion of your food comes from plants, Harvard Health notes.

Plant-based vs. vegan vs. vegetarian: What's the difference?

The United States Department of Agriculture (USDA) names different levels of vegetarian eating patterns, including vegan, lacto-ovo vegetarian and pescatarian diets. The key difference between all these eating plans and a plant-based diet is that only the latter includes small amounts of meat.

"I tell patients that vegan means zero animal products and is grounded in ethical or environmental or health reasons for a person who has decided very clearly what they want. A vegetarian diet may have similar reasons, but allows dairy or eggs in varying proportions," said Shah.

"A whole foods, plant-based diet can be similar to a Mediterranean diet or other diets that include eating meat rarely. Again, the majority (90%) of foods should be whole plant-based foods," she added.

Plant-based diet health benefits

A review published in the journal JAMA Oncology by Shah and her colleague at Sloan Kettering, medical oncologist Dr. Neil Iyengar, found that evidence supports plant-based diets for reducing cancer risk and improving metabolic disorders.

Better heart health may be another benefit of plant-centered eating. The American Heart Association (AHA) recently published a study in the Journal of the American Heart Association that revealed that young people who eat a plant-centered diet reduced their risk for stroke, heart attack, and other cardiovascular conditions in middle age.

"A nutritionally rich, plant-centered diet is beneficial for cardiovascular health," study author Yuni Choi, a postdoctoral researcher at the University of Minnesota School of Public Health, said about the study.

Plant-based diets have also been shown to help control type 2 diabetes and obesity, and were linked to lower mortality risk, according to a study published recently in JAMA Internal Medicine.

How to start a plant-based diet

The plant-based eating plans that are recommended by the AHA in its 2021 Dietary Guidance Scientific Statement include the Mediterranean diet and the Dietary Approaches to Stop Hypertension (DASH) diet.

The USDA also recommends these two plant-based eating patterns to meet its daily dietary nutritional recommendations.

"We hope Americans can find ways to "Start Simple' and incorporate modest changes each day," Sonny Perdue, then Secretary of the USDA, and Alex Azar, then Secretary of the U.S. Department of Health and Human Services, said in the forward to the 2020-2025 USDA Dietary Guidelines for Americans.

Here are key foods that are part of these plant-based diets:

• Green leafy vegetables like spinach, turnips, green leaf lettuce and kale
• Red, orange and starchy vegetables, including bell peppers, carrots, corn, and whole potatoes
• Whole grains such as brown rice, barley, wheat and oats
• Whole fruits like bananas, berries, oranges and raisins
• Dairy, including yogurt, dairy milk, and low-fat sour cream
• Unsaturated oil, including olive and sunflower oils
• A variety of plant-based proteins, including beans, legumes, seeds, soy, mushrooms, nuts and broccoli
• Limited amounts of protein from meat, fish, eggs, cheese and low-fat poultry
Journal information: JAMA Oncology\
, Journal of the American Heart Association , JAMA Internal Medicine

Copyright © 2023 HealthDay. All rights reserved.

What could a plant-based diet do for you?

Preterm birth linked to chemicals found in the vagina

by Columbia University Irving Medical Center

Credit: CC0 Public Domain

Chemicals that accumulate in the vagina, potentially originating from personal care products, may contribute to spontaneous preterm birth, according to a new study by researchers at Columbia University Vagelos College of Physicians and Surgeons.

The study of 232 pregnant women found that a handful of non-biological chemicals previously found in cosmetics and hygiene products are strongly associated with preterm birth.

"Our findings suggest that we need to look more closely at whether common environmental exposures are in fact causing preterm births and, if so, where these exposures are coming from," says study co-leader Tal Korem, Ph.D., assistant professor in the Program for Mathematical Genomics and the Departments of Systems Biology and Obstetrics and Gynecology at Columbia. "The good news is that if these chemicals are to blame, it may be possible to limit these potentially harmful exposures."

The study was published January 12 in Nature Microbiology.

Preterm birth, childbirth before 37 weeks of pregnancy, is the number one cause of neonatal death and can lead to a variety of lifelong health issues. Two-thirds of preterm births occur spontaneously, but despite extensive research, there are no methods for predicting or preventing spontaneous preterm birth.

Several studies have suggested that imbalances in the vaginal microbiome play a role in preterm birth and other problems during pregnancy. However, researchers have not been able to reproducibly link specific populations of microorganisms with adverse pregnancy outcomes.

The research team, co-led by Korem and Maayan Levy, Ph.D., of the University of Pennsylvania, decided to take a more expansive view of the vaginal microenvironment by looking at its metabolome. The metabolome is the complete set of small molecules found in a particular biological niche, including metabolites produced by local cells and microorganisms and molecules that come from external sources. "The metabolome can be seen as a functional readout of the ecosystem as a whole," Korem says. "Microbiome profiling can tell us who the microbes are; metabolomics gets us close to understanding what the microbes are doing."

In the current study, the researchers measured over 700 different metabolites in the second-trimester metabolome of 232 pregnant women, including 80 pregnancies that ended prematurely.

The study found multiple metabolites that were significantly higher in women who had delivered early than in those who delivered at full term.

"Several of these metabolites are chemicals that are not produced by humans or microbes—what we call xenobiotics," says Korem. "These include diethanolamine, ethyl-beta glucoside, tartrate, and ethylenediaminetetraacetic acid. While we did not identify the source of these xenobiotics in our participants, all could be found in cosmetics and hygiene products."

Algorithm predicts preterm birth

Using machine learning models, the team also developed an algorithm based on metabolite levels that can predict preterm birth with good accuracy, potentially paving the way for early diagnostics.

Though the predictions were more accurate than models based on microbiome data and maternal characteristics (such as age, BMI, race, preterm birth history, and prior births), the new model still needs improvement and further validation before it could be used in the clinic.

Despite the current limitations, Korem says, "our results demonstrate that vaginal metabolites have the potential to predict, months in advance, which women are likely to deliver early."

More information: William F. Kindschuh et al, Preterm birth is associated with xenobiotics and predicted by the vaginal metabolome, Nature Microbiology (2023). DOI: 10.1038/s41564-022-01293-8

Journal information: Nature Microbiology 

Provided by Columbia University Irving Medical Center 

Hormonal treatment in pregnancy won't lower odds for preterm birth

https://libcom.org/article/our-synthetic-environment-murray-bookchin

Our Synthetic Environment - Murray Bookchin - Libcom.org 

Our Synthetic Environment was one of the first books of the modern period in which an author espoused an ecological and environmentalist worldview. It predates ...

Adopting pediatric readiness standards found to improve survival in hospital emergency departments

by NIH/Eunice Kennedy Shriver National Institute of Child Health and Human Development

Credit: Pixabay/CC0 Public Domain

Emergency departments that have the highest levels of coordination of health care, personnel, procedures and medical equipment needed to care for ill and injured children have far higher rates of survival than hospitals with low readiness, according to a new study.

Researchers found that more than 1,400 children's deaths may have been prevented if hospital emergency departments had adopted national pediatric care readiness standards as laid out by the National Pediatric Readiness Project. The six-year study of 983 emergency departments in 11 states followed nearly 800,000 children.

The National Pediatric Readiness Project was established to ensure that all emergency departments have the coordination of health care, personnel, procedures and medical equipment needed to care for ill and injured children. According to the project's checklist, standards include specifications for physician and nurse certification, patient assessment, triage, medication administration, and trauma resuscitation and stabilization.

In the current study, researchers sought to determine if adopting the readiness standards would lower the death rate among children admitted to emergency departments for serious injury or illness. They ranked the emergency departments into four segments (quartiles) according to the extent they had implemented the readiness standards.

Compared to children cared for in low-readiness departments, children with injuries cared for in high-readiness departments had a 60% lower chance of dying in the hospital; and children with medical illness had a 76% lower chance of dying while they were in the hospital. Similarly, among roughly 545,000 children in six states, injured children in the highest quartile had a 41% lower chance of dying within a year and children with medical issues had a 66% lower chance of dying within a year, compared to children cared for in hospitals in the lowest readiness quartile.

The study was conducted by Craig D. Newgard, M.D., of Oregon Health & Science University, Portland, and colleagues. It appears in JAMA Network Open.

More information: Craig D. Newgard et al, Emergency DepartmentPediatricReadiness and Short-term and Long-termMortality Among ChildrenReceiving Emergency Care, JAMA Network Open (2023). DOI: 10.1001/jamanetworkopen.2022.50941

Journal information: JAMA Network Open Provided by NIH/Eunice Kennedy Shriver National Institute of Child Health and Human Development Child death rate linked to hospital preparedness for pediatric emergencies

U$ Health insurance drives medical advances, claims new study

by International Institute for Applied Systems Analysis

Yearly average Social Security benefits from 1965 to 2005 in 2009 US Dollars. 

Credit: Journal of Health Economics (2023). DOI: 10.1016/j.jhealeco.2022.102717

A new study argues that expanding health insurance coverage can drive medical progress, support well-being, and even extend lifespan in the United States.

There is a long-standing debate on whether rolling out health insurance toward high levels of coverage is desirable. For countries with non-existent or only patchy coverage, expanding health insurance would certainly be beneficial. However, in high-income settings where basic coverage is already granted the question remains open.

In a collaborative effort, IIASA Economic Frontiers Program Director, Michael Kuhn, and Ivan Frankovic, now an economist at the Deutsche Bundesbank, analyzed the macroeconomic impact of health insurance expansion in the United States between 1965 and 2005. The study, which has been published in the Journal of Health Economics, used an overlapping generations model of an economy looking at three sectors: final goods production, health care, and medical research and development (R&D).

"This work is the first to tackle the link between health insurance expansion, medical progress, and well-being in a coherent and rigorous analytical model for the United States," says Kuhn. "Our model allows for a thorough integrated assessment of the underlying mechanisms and, as the first of its kind, an assessment of the implications for well-being when individuals do not only care about consumption, but also about their health and longevity."

The authors found that the expansion of health insurance explains about 63% of the increase in health care expenditure and that it was also responsible for a 57% boost to the growth rate of medical patent registrations. Moreover, the expansion of health insurance increased life expectancy by an extra 1.2 years in 2005, mainly due to the stimulation of medical progress.

"The knock-on effects of health insurance on medical progress are relevant both in terms of magnitude and their significant positive impact on well-being," explains Frankovic. "Such effects should be taken into account during policymaking, for example, in the form of an extended cost-benefit analysis."

A side effect of health insurance expansion is that generous health insurance coverage may stimulate the excessive consumption of health care beyond what is really needed, especially by the elderly generation to the detriment of the younger, working-age generation. However, the researchers found that these losses were compensated by the gains in life expectancy and productivity in the younger generations.

"Our analysis demonstrates the importance of taking a broader well-being-oriented and systemic stance when evaluating health care policies," says Kuhn. "One needs to look beyond what might be short-term losses due to excessive consumption and consider the stimulus a high demand for medical care creates for R&D, resulting in new medical treatments."

More information: Ivan Frankovic et al, Health insurance, endogenous medical progress, health expenditure growth, and welfare, Journal of Health Economics (2023). DOI: 10.1016/j.jhealeco.2022.102717

Journal information: Journal of Health Economics 

Provided by International Institute for Applied Systems Analysis 

Medicaid expansion linked to gains in insurance coverage

All-out drone war in Ukraine points to future

by W.G. Dunlop

A Turkish-made Bayraktar -- a type of drone used extensively by Ukrainian forces.

Deployed on a scale never seen before to carry out both surveillance and strikes, drones ranging from small commercially-available models to larger aircraft have become a defining feature of the Ukraine conflict.

Drones have been a part of warfare for years, employed extensively by the United States during the "War on Terror," and they have played important roles in conflicts including in Iraq and in the Nagorno-Karabakh region.

But the degree to which they are being used by both sides in Ukraine—and the benefits they bring, as well as the threats they pose—highlights the importance for militaries to be ready to employ and to counter drones in future conflicts.

"The size and the scale of drone use in Ukraine supersedes all the previous conflicts," said Samuel Bendett, a researcher in uncrewed military systems who is an analyst with the CNA Russia Studies Program.

Bendett stressed the "absolutely unprecedented use of commercial-type drones" for both surveillance and combat in Ukraine, and said the war has shown that "small... tactical drones are absolutely essential—at every unit, every platoon level, every company level."

"Because these are basically expendable with a very short shelf life, they have to be provided to the forces in very large quantities," he said.

A drone approaches for an attack in Kyiv in October 2022.

'Accessible and cheap'

Drones have played key roles from the earliest days of the conflict, with Ukrainian forces using Turkish-made Bayraktars to carry out strikes on Moscow's troops as they unsuccessfully sought to seize Kyiv.

Both sides are using drones to locate and track enemy forces as well as to direct artillery fire, and both are also employing "loitering munitions"—uncrewed aircraft equipped with explosive charges that detonate on impact.

Lauren Kahn, a research fellow at the Council on Foreign Relations, said the Ukraine war came at a time when "a lot of these technologies are maturing and coming of age" and are "accessible and cheap."

This allows for more experimentation, she said.

"Because they're so affordable, they're being used in a way that they're treated (as) much less precious," said Kahn, who focuses on the impact of emerging technologies on international security.

And it poses a challenge for defenders when drones are less expensive than the means used to bring them down, she said, citing Russian strikes on Ukrainian energy infrastructure with waves of drones provided by Iran.

"Better and more effective ways of countering drones, I think, is going to be... the next phase and next focus of development," Khan said, adding that there "needs to be a more economically feasible solution" to match the "cheapness of the offensive technology."

A Ukrainian serviceman poses with a drone on the outskirts of Bakhmut in 

December 2022.

'Absolutely paramount'

The war in Ukraine has served as a proving ground for counter-drone measures, and the United States has provided options to Kyiv ranging from machine guns to dedicated air defense systems.

Drones can be used in "creative and unique ways on the battlefield" and defending against them requires continued effort, Pentagon Press Secretary Brigadier General Pat Ryder said.

Bendett said electronic countermeasures are playing an important role for both sides in Ukraine.

"Both Russians and Ukrainians are now saying publicly that there are parts of the front where their military drones cannot operate, where their commercial drones can be jammed and rendered inoperable," he said.

While drones used to carry out strikes draw more popular attention, the surveillance capabilities of uncrewed aircraft can have a wider-reaching impact, making it more difficult for troops to escape notice by their enemies.

The conflict has shown that counter-drone "systems, technologies and training is absolutely paramount," Bendett said.

"Militaries have to adapt," he said. "They have to adapt to the fact that any belligerent right now and... in future wars may be equipped with the types of drones that we're seeing in Ukraine."

© 2023 AFP

Ukraine war: Drones are transforming the conflict, bringing Russia on to the frontline

Computers that power self-driving cars could be a huge driver of global carbon emissions

by Massachusetts Institute of Technology

Credit: Pixabay/CC0 Public Domain

In the future, the energy needed to run the powerful computers on board a global fleet of autonomous vehicles could generate as many greenhouse gas emissions as all the data centers in the world today.

That is one key finding of a new study from MIT researchers that explored the potential energy consumption and related carbon emissions if autonomous vehicles are widely adopted.

The data centers that house the physical computing infrastructure used for running applications are widely known for their large carbon footprint: They currently account for about 0.3 percent of global greenhouse gas emissions, or about as much carbon as the country of Argentina produces annually, according to the International Energy Agency. Realizing that less attention has been paid to the potential footprint of autonomous vehicles, the MIT researchers built a statistical model to study the problem. They determined that 1 billion autonomous vehicles, each driving for one hour per day with a computer consuming 840 watts, would consume enough energy to generate about the same amount of emissions as data centers currently do.

The researchers also found that in over 90 percent of modeled scenarios, to keep autonomous vehicle emissions from zooming past current data center emissions, each vehicle must use less than 1.2 kilowatts of power for computing, which would require more efficient hardware. In one scenario—where 95 percent of the global fleet of vehicles is autonomous in 2050, computational workloads double every three years, and the world continues to decarbonize at the current rate—they found that hardware efficiency would need to double faster than every 1.1 years to keep emissions under those levels.

"If we just keep the business-as-usual trends in decarbonization and the current rate of hardware efficiency improvements, it doesn't seem like it is going to be enough to constrain the emissions from computing onboard autonomous vehicles. This has the potential to become an enormous problem. But if we get ahead of it, we could design more efficient autonomous vehicles that have a smaller carbon footprint from the start," says first author Soumya Sudhakar, a graduate student in aeronautics and astronautics.

Sudhakar wrote the paper with her co-advisors Vivienne Sze, associate professor in the Department of Electrical Engineering and Computer Science (EECS) and a member of the Research Laboratory of Electronics (RLE); and Sertac Karaman, associate professor of aeronautics and astronautics and director of the Laboratory for Information and Decision Systems (LIDS). The research appears in the January-February issue of IEEE Micro.

Modeling emissions

The researchers built a framework to explore the operational emissions from computers on board a global fleet of electric vehicles that are fully autonomous, meaning they don't require a back-up human driver.

The model is a function of the number of vehicles in the global fleet, the power of each computer on each vehicle, the hours driven by each vehicle, and the carbon intensity of the electricity powering each computer.

"On its own, that looks like a deceptively simple equation. But each of those variables contains a lot of uncertainty because we are considering an emerging application that is not here yet," Sudhakar says.

For instance, some research suggests that the amount of time driven in autonomous vehicles might increase because people can multitask while driving and the young and the elderly could drive more. But other research suggests that time spent driving might decrease because algorithms could find optimal routes that get people to their destinations faster.

In addition to considering these uncertainties, the researchers also needed to model advanced computing hardware and software that doesn't exist yet.

To accomplish that, they modeled the workload of a popular algorithm for autonomous vehicles, known as a multitask deep neural network because it can perform many tasks at once. They explored how much energy this deep neural network would consume if it were processing many high-resolution inputs from many cameras with high frame rates, simultaneously.

When they used the probabilistic model to explore different scenarios, Sudhakar was surprised by how quickly the algorithms' workload added up.

For example, if an autonomous vehicle has 10 deep neural networks processing images from 10 cameras, and that vehicle drives for one hour a day, it will make 21.6 million inferences each day. One billion vehicles would make 21.6 quadrillion inferences. To put that into perspective, all of Facebook's data centers worldwide make a few trillion inferences each day (1 quadrillion is 1,000 trillion).

"After seeing the results, this makes a lot of sense, but it is not something that is on a lot of people's radar. These vehicles could actually be using a ton of computer power. They have a 360-degree view of the world, so while we have two eyes, they may have 20 eyes, looking all over the place and trying to understand all the things that are happening at the same time," Karaman says.

Autonomous vehicles would be used for moving goods, as well as people, so there could be a massive amount of computing power distributed along global supply chains, he says. And their model only considers computing—it doesn't take into account the energy consumed by vehicle sensors or the emissions generated during manufacturing.

Keeping emissions in check

To keep emissions from spiraling out of control, the researchers found that each autonomous vehicle needs to consume less than 1.2 kilowatts of energy for computing. For that to be possible, computing hardware must become more efficient at a significantly faster pace, doubling in efficiency about every 1.1 years.

One way to boost that efficiency could be to use more specialized hardware, which is designed to run specific driving algorithms. Because researchers know the navigation and perception tasks required for autonomous driving, it could be easier to design specialized hardware for those tasks, Sudhakar says. But vehicles tend to have 10- or 20-year lifespans, so one challenge in developing specialized hardware would be to "future-proof" it so it can run new algorithms.

In the future, researchers could also make the algorithms more efficient, so they would need less computing power. However, this is also challenging because trading off some accuracy for more efficiency could hamper vehicle safety.

Now that they have demonstrated this framework, the researchers want to continue exploring hardware efficiency and algorithm improvements. In addition, they say their model can be enhanced by characterizing embodied carbon from autonomous vehicles—the carbon emissions generated when a car is manufactured—and emissions from a vehicle's sensors.

While there are still many scenarios to explore, the researchers hope that this work sheds light on a potential problem people may not have considered.

"We are hoping that people will think of emissions and carbon efficiency as important metrics to consider in their designs. The energy consumption of an autonomous vehicle is really critical, not just for extending the battery life, but also for sustainability," says Sze.

More information: Soumya Sudhakar et al, Data Centers on Wheels: Emissions From Computing Onboard Autonomous Vehicles, IEEE Micro (2022). DOI: 10.1109/MM.2022.3219803

Provided by Massachusetts Institute of Technology 

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