Climate change is the biggest health threat this century — here’s how medical schools are adapting

More medical schools are training doctors to recognize and treat the effects of climate change

Illustration by Doug ChaykaThe past five years have been

 the hottest on record, nearly 1.7 degrees Fahrenheit warmer 

than the 20th century average, according to the National

 Oceanic and Atmospheric Administration.

By RACHEL KONING BEALS NEWS EDITOR 

Published: Feb 26, 2020 

On the lakefront campus of the University of Wisconsin in Madison, which in 60 years could have average temperatures resembling those felt currently in Kansas City nearly 500 miles to its south, the next wave of aspiring doctors settles in for a “Climate Change and Medicine” elective filled to capacity.

Students at Wisconsin learn under Dr. Jonathan Patz, who had already been consulting for the United Nations on accelerating man-made climate change’s health impacts decades ago. The students examine, for instance, heat-related mortality, as well as the healthy “upside” of adapting to the effects of climate change. Reducing one’s reliance on cars and eating smarter benefits the human body and Mother Earth alike, Patz argues.

Wisconsin is just one of roughly two dozen medical schools leading — although only typically by offering a few courses — in the training of physicians, nurses, pharmacists and other practitioners who will take to the front lines of diagnosing and treating the impact of climate change. That impact is showing up increasingly in emergencies, such as wildfires, and in complicated-pregnancy statistics even in developed nations. More broadly, the spread of toxins, asthma cases, cardiovascular disease and Lyme disease is on the rise, all part of what The Lancet has deemed the biggest global health threat of the 21st century.

Yet the slow drip of new or amended medical-school programs that address climate change must be accelerated, some experts stress. Their efforts got an important boost after the American Medical Association in 2019 gave its backing to expanding climate-change training.

“Climate change is our reality. It is going to change the way we provide clinical care. For that reason, it needs to be taught in every medical school across the nation,” said Dr. Ashish Jha, the K.T. Li Professor of Global Health and Health Policy at Harvard’s T.H. Chan School of Public Health, writing in the Journal of the American Medical Association.

So far, climate-related scholarship has emerged in the last few years via elective courses and one-off lectures rather than treated as a portion of core curriculum, according to a study published in 2018 in the journal Academic Medicine. Those researchers found that a database was created but is lacking comprehensive reporting by schools of what climate-change lessons are taught. The lingering challenge: many schools believe they can’t devote significant attention to climate change in an already packed curriculum.

“With the ubiquitous presence of information technology...students and physicians now have ready access to all the medical knowledge ever created… [Many medical schools] still spend too much time teaching topics such as laboratory methods and having students memorize anatomic details that can be covered more quickly or not at all.”Dr. Ashish Jha, in the Journal of the American Medical Association.

The time burden may be eased via shared materials. Columbia University’s Mailman School of Public Health formed the Global Consortium on Climate and Health Education in 2017 to begin to share ideas on how to train health professionals. To date, it can count some 180 signatories of mostly public-health programs, but also over 20 medical schools and another two dozen nursing programs.

Even without dedicated coursework, existing classes should include more climate-change teaching, say proponents.

For instance, an asthma-diagnosing exercise with questions more closely tied to pollution exposure has now been in practice at the University of Illinois College of Medicine at Urbana-Champaign and is driving curriculum priorities at the University of California, San Francisco, near where deadly fires raged over the last couple of years.

Air pollution is responsible for about seven million deaths a year worldwide, according to the World Health Organization, which found that reducing the burning of fossil fuels could avoid 2.5 million premature deaths each year by 2050. Pollen and other aeroallergen levels are also higher in extreme heat. These factors can trigger asthma, which affects around 300 million people but can usually be treated.

Physicians also need better training in screening for vector-borne illnesses (infectious pathogens spread from one living organism to another; think ticks or mosquitoes) which are expected to increase with higher temperatures. Diagnosed cases of tick-spread Lyme disease, for instance, doubled between 2004 and 2016, according to the Centers for Disease Control and Prevention. Mosquitoes are cold-blooded vectors of disease, so any mosquito-borne disease will be affected by very small changes in temperature.

Environmental changes also affect respiratory disease, cardiovascular disease and cerebrovascular mortality or stroke, said Harvard’s Jha. Globally, the medical profession also has a stake in policy around access to clean drinking water and fighting nutrient depletion in crops and food from climate effects.

These conditions are susceptible to increased risks from climate change
Asthma As temperatures increase, warmer air helps to form ground-level ozone, sometimes called smog, which is a powerful air pollutant. Ozone irritates the lungs and acts like a sunburn on the lungs which may trigger an asthma attack, says the American Lung Association.

These conditions are susceptible to increased risks from climate change

Asthma As temperatures increase, warmer air helps to form ground-level ozone, sometimes called smog, which is a powerful air pollutant. Ozone irritates the lungs and acts like a sunburn on the lungs which may trigger an asthma attack, says the American Lung Association.

Cardiovascular disease Asthma isn’t the only issue, temperature gains equal more air pollution, which stresses both the heart and lungs.

Allergies In hotter temperatures, plants and grass give off pollen for longer periods of time, lengthening and intensifying the allergy season that claims many sufferers. Carbon dioxide can also increase the allergy-causing effects of pollen, says a report in this biology journal.

Pregnancy complications and low birth weight Pregnant women are more vulnerable to heat, especially heat waves, and air pollution, which can cause prematurity, even in developed nations, according to a limited-but-expanding collection of obstetrics studies. In the developing world, pregnancies have been impacted in the past by vector-borne illnesses that may be on the rise, such as the mosquito-spread Zika virus, according to this Stanford University journal and other sources.

Kidney strain Hotter temperatures and related dehydradration are linked with electrolyte imbalances, kidney stones and kidney failure, according to the New England Journal of Medicine.

Infectious disease and contamination Temperature and rainfall extremes can change insect behavior, impacting the diseases they spread, such as malaria, dengue, Lyme disease and West Nile virus. Waterborne cholera and cryptosporidiosis increase with drought and flooding. Meanwhile, heat is linked with higher risk for salmonella and campylobacter outbreaks.

Depression and anxiety The American Psychological Association created a 69-page guide on how climate change can induce stress, depression and anxiety. The APA wants more education for its professionals. “The connections with mental health are often not part” of the climate-health discussion, it says.

The benefits of the work under way at UC, San Francisco, part of a broader statewide system, is that new practices might be implemented throughout its several hospitals, clinics and classrooms, and much of the new training is geared toward layering on to existing course work. For instance, it’s important for medical students to understand the effects that hotter temperatures can have on the effectiveness and risks of pharmaceuticals, such as antipsychotics and diuretics, said UCSF’s Dr. Sheri Weiser, an epidemiologist and practicing internist at Zuckerberg San Francisco General Hospital, who also holds a master’s degree in public health.

Arianne Teherani, Ph.D., a professor of medicine and education at UCSF, says medical training in climate awareness isn’t just about diagnostics but fully understanding the role of medicine in creating and fixing the effects of climate change. If the U.S. health-care system were a country, it would rank 13th in the world for greenhouse gas emissions, the article in Academic Medicine cites. Professors of anesthesia, radiology and pharmacy, for example, are encouraged to teach that anesthetic gases, imaging technologies and pharmaceuticals all have a significant carbon footprint that may need to be offset, at the least, with green best-practices elsewhere, such as a shift to more energy efficiency in hospitals and offices. More work is needed, Teherani says, in cutting the industry’s footprint overall.

There’s also mental health to consider. Sobering climate-change statistics, no matter their projected year for realization, are already having an impact.

Dr. Karla Ivankovich, Ph.D., a licensed clinical professional counselor and professor of psychology at the University of Illinois at Springfield, said the mental-health profession has seen growing political anxiety from a widening trench of partisanship carry over into climate-change dread, and many therapists would welcome additional training.

Ivankovich said that she and other therapists are seeing patients who, among other concerns, find themselves troubled by the choice to have children more than past clients had, which Ivankovich linked in part to their fears for climate change and their response to the pickup in media coverage.

Not all who wear the white coat think that addressing climate change in the exam room is true to the profession’s intent.

“The zeitgeist of sociology and social work have become the driving force in medical education. The goal of today’s educators is to produce legions of primary care physicians who engage in what is termed ‘population health.’ This fits perfectly with the current administrator-rich, policy-heavy, form-over-function approach at every level of American education,” wrote Dr. Stanley Goldfarb, a former associate dean of curriculum at the University of Pennsylvania’s Perelman School of Medicine, in an opinion piece for The Wall Street Journal. “Meanwhile, oncologists, cardiologists, surgeons and other medical specialists are in short supply.”

Jha, writing in JAMA, would argue that view neglects both the climate warning signs and the way medicine should evolve.

“With the ubiquitous presence of information technology, including clinical decision support tools, students and physicians now have ready access to all the medical knowledge ever created… [Many medical schools] still spend too much time teaching topics such as laboratory methods and having students memorize anatomic details that can be covered more quickly or not at all,” he says

Health professionals operating as a gatekeeper for climate-change risks is effective, argues Dr. Courtney Howard, an emergency physician in Canada’s subarctic Yellowknife, Northwest Territories, where the changing conditions risk major life changes for her native patients in particular.

Howard routinely argues, including in this TEDx talk, that the trust medical professionals tend to cultivate with patients positions them to best teach about climate-change impacts; she cites survey statistics showing nurses routinely rank at the top of a list of professionals that people trust, with doctors in second place and politicians in dead last.

“We all have pull and we need to use it” to combat climate change, Howard regularly tells health professionals.

If Wisconsin’s Patz has his way, the future of climate curriculum will break slightly with med-school norms, equipping doctors and nurses to better engage with experts outside of the health-care setting. That includes urban planners, civil and environmental engineers, and of course, public-health officials.

Treatment and advocacy should never be separate pursuits, he argues.

Joe Biden wants a first-time homeowner tax credit, Amy Klobuchar would clear public-housing backlog — where the Democratic candidates stand on affordable housing

‘One sure way we can make sure that kids get a good start is if they have a roof over their head and a stable place to live,’ Sen. Amy Klobuchar said at Tuesday night’s Democratic presidential debate

HOUSING IS A RIGHT 

IT SHOULD NOT BE REAL ESTATE SPECULATION

Getty Images Some 85% of Americans ‘believe ensuring everyone has

 a safe, decent, affordable place to live should be a top national priority,’ 

a recent survey found. Almost every Democratic presidential candidate

 has released a comprehensive plan to address affordable housing.

By JACOB PASSY  Feb 26, 2020

Housing hasn’t traditionally been a hot topic in presidential elections, but with homeownership financially out of reach for many Americans, the candidates vying for the Democratic nomination have been eager to discuss the issue.

Several candidates brought up housing at Tuesday night’s Democratic presidential debate during the one of the evening’s tense back-and-forths.

In response to a question from the debate’s moderators, Sen. Amy Klobuchar mentioned the need to work through the backlog of people who have applied for federal housing vouchers that help low-income households offset the cost of housing.

“One sure way we can make sure that kids get a good start is if they have a roof over their head and a stable place to live,” Klobuchar said. “So the way you do that is, first of all, taking care of the Section 8 backlog of applicants. There are literally hundreds of thousands of people waiting. And I have found a way to pay for this and a way to make sure that people get off that list and get into housing.”

Klobuchar also mentioned concerns related to housing deserts and the need to pay for more affordable housing.

Sen. Elizabeth Warren and former New York City Mayor Michael Bloomberg, meanwhile, repeated their dispute from the last Democratic presidential debate over comments Bloomberg made years ago about the discriminatory practice of redlining, that were recently resurfaced by the Associated Press

“It is important to recognize the role that the federal government played for decades and decades in discriminating against African-Americans having an opportunity to buy homes,” Warren said. “And while Mayor Bloomberg was blaming the housing crash of 2008 on African-Americans and on Latinos, in fact, I was out there fighting for a consumer agency to make sure people never get cheated again on their mortgages.”

Bloomberg argued that his comments on redlining were taken out of context before mentioning his record as mayor. “When you’re talking about affordable housing, we created 175,000 units of affordable housing in New York City,” he said.

During a debate in November, MSNBC CMCSA, -2.20% moderator Kristen Welker asked billionaire hedge fund manager Tom Steyer whether he was the best person to address this issue, citing the housing crisis in Steyer’s home state of California. “We need to apply resources here to make sure that we build literally millions of new units,” Steyer responded.

Multiple other candidates, including Senator Bernie Sanders and former South Bend Mayor Pete Buttigieg, have released detailed plans showcasing how they would tackle the trouble many Americans face when looking to find a home to rent or to buy.
‘For the first time in recent memory, affordable housing is a topic on the presidential campaign trail.’— Diane Yentel, president and CEO of the National Low Income Housing Coalition


“For the first time in recent memory, affordable housing is a topic on the presidential campaign trail,” said Diane Yentel, president and CEO of the National Low Income Housing Coalition.

Some 85% of Americans “believe ensuring everyone has a safe, decent, affordable place to live should be a top national priority,” according to a nationwide public-opinion poll commissioned between the National Low Income Housing Coalition and Hart Research Associates.

But the primary calendar itself may be largely the cause of candidates’ enthusiasm, said Rick Sharga, a mortgage-industry veteran.

“California — perhaps the epicenter of unaffordable housing — is scheduled to have its primary earlier than in past election cycles, and voters in the Golden State will very likely pay more attention to the affordable housing proposals being presented by the Democratic hopefuls than voters in many other states,” Sharga said.

The Trump administration has taken steps recently to address housing-related issues. Last year, the Treasury Department and the Department of Housing and Urban Development unveiled plans outlining how America’s housing-finance system could be overhauled, including ending the conservatorship of Fannie Mae and Freddie Mac. The White House recently released an extensive report detailing the forces contributing to chronic homelessness, particularly in states like California.

Don’t miss: 5 major changes the Trump administration wants to make to housing finance

Here’s what other Democratic candidates are saying about affordable housing:
Former Vice President Joe Biden

Former Vice President Joe Biden was the latest candidate to release an extensive plan for tackling issues related to affordable housing and homelessness. In a break with his fellow candidates, Biden explicitly called for tougher standards for real-estate appraisers as part of his proposal.

Doing so, he argued, would curb bias against black and Latino communities, which some say has depressed home values in those neighborhoods. Appraisers argue that current standards prevent bias, however.

Here are some of the other proposals Biden has made to address Americans’ housing issues:

• Draft and pass legislation to create a Homeowner and Renter Bill of Rights, modeled on a similar policy in California.

• Beef up tenant protections so fewer Americans are evicted.

• Expand the Community Reinvestment Act to include mortgage lenders and insurers to ensure communities of color have access to financial services.

• Revive anti-discrimination policies at the federal level.

• Create a new refundable $15,000 tax credit for first-time home buyers to help them build a down payment and offset the costs associated with buying a home. Similarly, he has advocated for a renter’s tax credit that would reduce housing costs to no more than 30% of a household’s income for low-income households and families who don’t qualify for Section 8 vouchers.

• Providing Section 8 housing vouchers to all eligible families.

• Expand housing benefits for public-sector workers, including teachers and first responders.

• Form a strategy to make housing a right for all Americans.

• Allocate more funds to tackle issues related to homelessness.
Sen. Bernie Sanders

Bernie Sanders, a Vermont independent, released a plan dubbed “Housing for All,” that addresses everything from the need to build more housing units to combatting gentrification.

Like many of his policies, the Sanders campaign framed its housing proposal in the context of what the average American faces versus Wall Street’s profits. “In America today, over 18 million families are paying more than 50 percent of their income on housing, while last year alone the five largest banks on Wall Street made a record-breaking $111 billion in profits,” the campaign said in its description of Sanders’ plan.

Here are some of the many ways in which Sanders hopes to address Americans’ housing needs:

• Preventing Wall Street funds from selling large pools of mortgages

• Investing $1.48 trillion over a decade in the National Affordable Housing Trust to fund the building, rehabilitation and/or preservation of 7.4 million affordable housing units.

• Setting aside $70 billion to repair and modernize public housing.

• Creating a national cap on annual rent increases at no more than 3% or 1.5 times the Consumer Price Index (whichever is higher).

• Forming an office in the Department of Housing and Urban Development designed to strengthen rent control, tenant protections and inclusive zoning.

• Making federal funding contingent on states encouraging development that promotes integration and public transportation access.

• Instating a 25% home flipping tax on real-estate speculators who sell non-owner-occupied properties that sell for more than their original purchase price if sold within five years.

• Creating an independent National Fair Housing Agency in the vein of the Consumer Financial Protection Bureau that protects people from housing discrimination and enforces housing standards for renters.

• Investing $8 billion across HUD and the Department of Agriculture to form a first-time homebuyer assistance program

Affordable housing also features as part of Sanders’ proposal for an “Economic Bill of Rights.” During a campaign speech earlier this year, Sanders claimed that some Americans are “paying 40%, 50%, 60% of their limited income in housing” and called the situation “absurd.” Sanders has further referenced urban gentrification as an issue that needs to be addressed.

In the first Democratic presidential debate, Sanders also mentioned the country’s homeless population in response to a question about his calls for expanded government benefits.
Mayor Mike Bloomberg

Michael Bloomberg, the billionaire former mayor of New York City, has set forth a housing agenda that would aim to cut homelessness in half by 2025. As part of that plan, he said he would double the federal spending on homelessness programs from $3 billion to $6 billion annually, including extra support for rehousing programs and short-term rental assistance.

Bloomberg has also laid out the following initiatives as part of his housing plan:

• Providing housing vouchers to all Americans at or below 30% of their area median income and expanding programs to avoid evictions.

• Increasing the supply of new affordable housing units, expanding the Low-Income Housing Tax Credit and raising funding for the National Housing Trust Fund.

• Providing matching funds to aid renters in building up down payments.

• Curbing discrimination in rental housing and bringing more landlords into the voucher system.
Mayor Pete Buttigieg

Pete Buttigieg, the former mayor of South Bend, Ind., has released “an agenda for housing justice in America” aimed at improving affordability and reducing homelessness.

“Pete is committed to housing justice,” the campaign noted on his website. As President, he will use housing policy at every level of government as a tool to address injustices, reverse the discriminatory impacts of racist redlining, and build pathways to lasting economic and social opportunity.”

The broad plan included the following recommendations:

• Supporting the construction or renovation of more than 2 million rental units, mainly through allocating an additional $150 billion in new National Housing Trust funds.

• Investing $4 billion in matching funds to scale successful low-income homeownership programs in order to assist households in becoming homeowners.

• Combatting lending discrimination and reverse Trump administration changes to policies under the Fair Housing Act.

• Passing legislation to regulate interstate landlords and holding bank executives and mortgage lenders liable for robo-signing and other predatory lending practices

• Expanding housing assistance to families with children.

• Creating an emergency rental assistance fund to help families avoid eviction among other rental protections.

Additionally, Buttigieg has put forth an extensive proposal, called the Douglass Plan, to address racial disparities in homeownership and wealth. The plan would create a “21st Century Community Homestead Act” that would be piloted in select cities across the country.

Through this program, a public trust would purchase abandoned properties and provide them to eligible residents. These people would include those who earn less than the area’s median income or those who live in historically redlined or segregated areas. Residents who participate would be given full ownership over the land and a 10-year forgivable lien to renovate the home so it could be used as a primary residence.
Sen. Elizabeth Warren

As she has done on other issues, such as student debt, Elizabeth Warren, the senator from Massachusetts, has released a detailed plan to tackle a wide variety of housing-related issues.

“Housing is not just the biggest expense for most American families — or the biggest purchase most Americans will make in their lifetimes,” the Warren campaign said in a post to the site Medium. “It also affects the jobs you can get, the schools your children can go to, and the kinds of communities you can live in. That’s why it’s so important that government gets housing policy right.”

To that end, Warren has introduced the American Housing and Economic Mobility Act, which serves as the backbone of her affordable housing plan:
Elizabeth Warren has a plan to build, preserve or rehabilitate 3.2 million housing units for lower- and middle-income people to lower rents by 10%.


Warren’s plan includes, among other things:

• Building, preserving or rehabilitating 3.2 million housing units nationwide for lower- and middle-income people in order to lower rents by 10%. This, she said, would be funded by raising the estate tax back to Bush-era levels.

• Creating a down-payment assistance program designed to address the black-white homeownership gap by providing assistance to first-time home buyers who live in a formerly red-lined neighborhoods or communities that were segregated by law and are still currently low-income.

• Expanding fair-housing legislation to bar housing discrimination on the basis of sexual orientation, gender identity, marital status, veteran status or income.

• Extending the Community Reinvestment Act to require non-bank mortgage lenders invest in minority communities.

• Providing $2 billion in assistance to mortgage borrowers who are still underwater on their home loans following the financial crisis, meaning they owe more than their homes are worth.

• Instituting new requirements for sales of delinquent mortgages .
Sen. Amy Klobuchar

Sen. Klobuchar from Minnesota has included multiple housing-related initiatives as part of her outline of more than 100 actions she plans took take in her first 100 days in office, if she is elected. They include:

• Reversing the Trump administration’s proposed changes to federal housing subsidies.

• Expanding a pilot program that provides mobility-housing vouchers to families with children to help them relocate to higher opportunity neighborhoods.

• Suspending changes to fair housing policy ushered in by HUD Secretary Ben Carson in order to combat segregation in housing.

• Overhaul housing policy more broadly as part of a national infrastructure plan.

Coronavirus latest: Stark CDC, WHO warnings add to global gloom: 'This could be bad'


Anjalee Khemlani Senior Reporter,Yahoo Finance•February 25, 2020


CDC to Americans: this could be bad

Grim warnings on Tuesday from public health officials about the spread of the coronavirus coincided with new cases appearing across Europe, sparking a sell-off in markets and stirring new worries about a global pandemic.

China, the epicenter of the outbreak, continues to see a declining number of new cases. However, the outbreak has spread to South Korea, Japan, Italy and Iran.

Meanwhile, isolated infections in Austria, Croatia and Spain have added to global concerns about a worldwide emergency and weighed heavily on Wall Street, even though officials have downplayed the prospect of a pandemic.

At a daily news briefing, Nancy Messonnier, the Centers for Disease Control’s director of the National Center for Immunization and Respiratory Diseases, warned that the risk of the virus spreading domestically is on the rise — and could prove severely disruptive to everyday life.

“We are asking the American public to prepare for the expectation that this might be bad,” Messonnier told reporters, as the Trump administration stepped up its efforts to manage the virus’ after-effects.

Messonnier added it is no longer “a matter of if, but when” the virus spreads, and how many people in the country end up contracting a severe case of the virus.

An active list of all the countries affected by the virus

U.S. Health and Human Services Secretary Alex Azar told lawmakers at a budget hearing Tuesday the department is requesting $2.5 billion in emergency supplemental funding, half of which would go directly to fund the outbreak response.

The spread of the outbreak is an “unprecedented...health care challenge, globally,” Azar said, pushing for more funding to conduct lab testing and field work.

To date, the pathogen has infected over 80,000 worldwide, causing more than 2,700 deaths. The U.S. has recorded 57 cases, most of which are related to evacuees from Asia, or the Diamond Princess cruise that was quarantined off of Japan for two weeks.
What’s happening in the market

A screen shows numbers of stocks after the closing bell at the New York Stock Exchange (NYSE) on February 24, 2020 at Wall Street in New York City. - Wall Street stocks finished with steep losses February 24, 2020, joining a global rout on mounting worries that the coronavirus will derail economic growth.

U.S. benchmarks on Tuesday tried to claw back from the prior day’s ugly beating, but fell by over 2% after new cases popped up around the world, and Italy’s toll mounted. The S&P 500 (^GSPC) and Nasdaq (^IXIC) all hit their lowest levels since December, while the Dow’s (^DJI) two-day losses topped 1,500 points.

While travel and leisure have taken the brunt of the sell-off, tech stocks like Apple, Google and Tesla, among others, have been punished by investors.

On Tuesday, Federal Reserve Vice Chair Rich Clarida said the disruption in China could spill over to the rest of the global economy, but warned it was too early to quantify.

William Lee, the chief economist of the Milken Institute, told Yahoo Finance that when talking about the pathogen’s impact on tech giants, the markets should not be “overreacting, but they are,” Lee said.

Deepening concerns about the impact to global demand, and the worldwide supply chain, are weighing on multinational companies overall. The U.S. Food and Drug Administration reportedly contacted 20 pharmaceutical companies that are likely to be vulnerable to supply chain disruptions from China, the world’s largest source of active pharmaceutical ingredients.

“If production in an important American industry were to grind to a halt due to supply chain disruptions originating from abroad, then a domino effect could take hold in the U.S. industrial sector,” Wells Fargo analysts wrote in a research note on Tuesday, citing chemical, petroleum and coal as industries that would take a hit.

Some pharmaceutical names saw their stocks move amid hopes that a vaccine could be found. A clinical trial of coronavirus vaccines will begin in partnership with the National Institute of Health at the University of Nebraska — which include Gilead’s (GILD) remdisivir, HHS’s Azar told Congress.

Separately, Moderna (MRNA) got a 22% intraday boost from news that its vaccine candidate is set to be tested in the U.S.

But lawmakers were concerned that the list of needs HHS presented Tuesday would be hard to find and stockpile in time for an outbreak in the U.S., and criticized the diagnostic kits the CDC has sent to states.
Around the world

The U.S. and other countries took steps to limit or restrict travel to China, Hong Kong and other surrounding countries. On Monday, China announced restrictions on travel to the U.S., while Germany said it would keep its borders open as the virus spreads in Italy.

The outbreak has raised questions about whether the Olympics will go on in Tokyo this summer, as planned. Dick Pound, a key member of the International Olympic Committee told the Associated Press on Tuesday that organizers could cancel the iconic global event, rather than postpone or relocate it.

Bruce Aylward, WHO lead of the international experts mission in China said during a press briefing Tuesday that the world should prepare as if the coronavirus hits their country tomorrow.

The coronavirus “is going to come soon, potentially, you’ve got to be shifting to a readiness, rapid response thinking,” he said.

Meanwhile, reports of factories slowly ramping up operations and at least one-third of businesses open, including half of all Apple stores in China, has given some hope. Yet the damage to first quarter growth is likely to be substantial, analysts say.

Anjalee Khemlani is a reporter at Yahoo Finance. Follow her on Twitter: @AnjKhem


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Labor union unveils $150M campaign to help defeat Trump

STEVE PEOPLES,Associated Press•February 26, 2020

WASHINGTON (AP) — One of the nation’s largest labor unions is unveiling plans to invest $150 million in a nationwide campaign to help defeat President Donald Trump, a sweeping effort focused on eight battleground states and voters of color who typically don’t vote.

The investment marks the largest voter engagement and turnout operation in the history of the Service Employees International Union, which claims nearly 2 million members. The scope of the campaign, which quietly launched last month and will run through November’s general election, reflects the urgency of what union president Mary Kay Henry calls “a make-or-break” moment for working people in America under Trump’s leadership.

“He’s systematically unwinding and attacking unions. Federal workers rights have been totally eviscerated under his watch,” Henry said in an interview. “We are on fire about the rules being rigged against us and needing to elect people that are going to stand with workers.”

The union's campaign will span 40 states and target 6 million voters focused largely in Colorado, Florida, Michigan, Minnesota, Nevada, Pennsylvania, Virginia and Wisconsin, according to details of the plan shared with The Associated Press. The union and its local members will pay particular attention to two key urban battlegrounds they believe will play a defining role in the 2020 general election: Detroit and Milwaukee. There may be some television advertising, but the investment will focus primarily on direct contact and online advertising targeting minority men and women who typically don't vote.

Few groups of voters will be more important in the 2020 general election. Trump won the presidency four years ago largely because of his popularity with working-class whites and a drop-off in turnout from minority voters.

The union's political director, Maria Peralta, noted that Trump’s campaign has been working effectively in recent months to win over some minority voters, particularly men, who have traditionally voted Democratic.

“He’s going after our communities in ways that are pervasive. We’re deeply aware of that,” Peralta said. “They’re talking about the strength of the economy.”

The Service Employees International Union, like the Democratic Party and its allies across the nation, faces significant headwinds in its fight to deny Trump a second term. Voters who may dislike his overall job performance are generally pleased with his leadership on the economy, and unemployment for black Americans has hit record lows in recent months.

At the same time, Trump’s campaign is far ahead of where it was four years ago, when it had little national organization.

On Wednesday, the Trump campaign announced plans to open 15 “Black Voices for Trump Community Centers” in battleground states and major cities, including Michigan and Wisconsin. The offices will feature a line of campaign swag adopting the “woke” label, and videos of prominent Trump surrogates like online stars Diamond and Silk explaining their support for the president and pamphlets outlining the president's record.

SEIU is the most diverse union in the United States. The union’s membership features those who work in health care, food service, janitorial services and state and local government workers, among others. Half its members are people of color, and more than half make less than $15 an hour.

The 2020 investment is designed to benefit Democrats up and down the ballot this fall, though defeating Trump stands as a primary goal.

That said, SEIU’s political team has determined that a message simply attacking Trump isn’t effective with its target audience, which includes a significant number of conservatives.

“We don’t want to get too caught up in the Trump bashing,” Peralta said. “Data shows people care about wages, and they care about health care across the board.”

The union also determined that it’s particularly effective to highlight Trump’s work to weaken labor unions and conditions for working-class Americans.

After campaigning for a higher minimum wage, Trump has done little to raise the federal minimum wage, which has been stuck at $7.25 for more than a decade. His administration has also taken steps to make it harder for new groups of workers to form unions. And labor officials have decried his appointments to the National Labor Relations Board and the Supreme Court, which dealt a huge blow to labor in 2018 by ruling that government workers no longer could be required to pay union fees.

When asked, Henry had little to say about the specific Democratic presidential contenders fighting for the chance to take on Trump. SEIU may endorse a candidate in the coming months, she said, but it has decided to stay out of the messy nomination fight for now.

“We’re trying to figure out, inside our union as we walk through Super Tuesday and through March, what do working people and our members think about the choice in the field,” Henry said.

___

Coronavirus fatality rates vary wildly depending on age, gender and medical history — some patients fare much worse than others

A new paper published in JAMA reviews a China-based sample of 72,000 COVID-19 cases, which suggests dramatic variations in the death rate of the illness

Getty Images

No deaths occurred in those aged 9 years and younger, but cases in those 

aged 70 to 79 years had an 8% fatality rate and those aged 80 years

 and older had a fatality rate of 14.8%, according to a study of Chinese 

coronavirus cases released this week.

By QUENTIN FOTTRELL PERSONAL FINANCE EDITOR
Published: Feb 26, 2020
As the coronavirus spreads, scientists are learning more about the disease’s fatality rate.

The medical journal JAMA released a paper this week analyzing data from the Chinese Center for Disease Control and Prevention on 72,314 coronavirus cases in mainland China, the figure as of Feb. 11, the largest such sample in a study of this kind.

The sample’s overall case-fatality rate was 2.3%, higher than World Health Organization official 0.7% rate. No deaths occurred in those aged 9 years and younger, but cases in those aged 70 to 79 years had an 8% fatality rate and those aged 80 years and older had a fatality rate of 14.8%.

No deaths were reported among mild and severe cases. The fatality rate was 49% among critical cases, and elevated among those with preexisting conditions: 10.5% for people with cardiovascular disease, 7.3% for diabetes, 6.3% for chronic respiratory disease, 6% for hypertension, and 5.6% for cancer.

The fatality rate was 49% among critical cases and worsened by those with preexisting conditions.

The latest China-based study, which was not peer-reviewed by U.S. scientists, found that men had a fatality rate of 2.8% versus 1.7% for women. Some doctors have said that women may have a stronger immune system as a genetic advantage to help babies during pregnancy.

The Chinese study is likely not representative of what might happen if the global spread of the virus worsens. In China, nearly half of men smoke cigarettes compared to roughly 2% of women, which could be one reason for the higher death rate among males.

There were 81,191 confirmed cases of COVID-19 and at least 2,768 deaths as of Wednesday, according to a tally published by the Johns Hopkins Whiting School of Engineering’s Centers for Systems Science and Engineering. (As of Wednesday morning, WHO’s COVID-19 case dashboard, which had been regularly updated, was not working.)

The fatality rate of the novel coronavirus so far appears to be a fraction of that of Severe Acute Respiratory Syndrome (9.6%) and Middle East respiratory syndrome (34.4%). The fatality rate can affect how fast an outbreak spreads: If people die from an illness sooner, they are less likely to be working, shopping or flying on airplanes and, thus, less likely to spread the virus.

“COVID-19 rapidly spread from a single city to the entire country in just 30 days,” the JAMA paper added. “The sheer speed of both the geographical expansion and the sudden increase in numbers of cases surprised and quickly overwhelmed health and public-health services in China.”

The World Health Organization said on Monday that the fatality rate in Wuhan, China, considered the epicenter of the outbreak, is between 2% and 4%. Outside of Wuhan, it is thought to be 0.7%.


Recommended: This is how the illness has spread across the world so rapidly

The majority of illnesses and deaths are in Hubei Province where Wuhan — believed to be the epicenter of the outbreak — is located. The illness has spread to around 40 countries or territories. (WHO has declared a global health emergency.)

While the outbreak has largely affected China — China’s Hubei Province has reported 94% of total deaths and mainland China has 96% of total cases — the emergence of COVID-19 clusters in these other countries has spooked markets this week, Johns Hopkins said.

Coronavirus has an incubation period of up to two weeks, helping the virus to spread. A previous study published in JAMA suggests some patients may be more contagious than others. One patient spread the virus to at least 10 health-care workers and four patients at a hospital in Wuhan.
‘The sheer speed of both the geographical expansion and the sudden increase in numbers of cases surprised and quickly overwhelmed health and public-health services in China.’

“In this single-center case series of 138 hospitalized patients with confirmed novel coronavirus–infected pneumonia in Wuhan, China, presumed hospital-related transmission of 2019-nCoV was suspected in 41% of patients, 26% of patients received ICU care, and [the] mortality was 4.3%.”

SARS had a fatality rate of 9.6%. “The incubation period for SARS is typically 2 to 7 days, although in some cases it may be as long as 10 days,” the CDC said at the time. “In a very small proportion of cases, incubation periods of up to 14 days have been reported.”

Maciej Boni, an associate professor of biology, at Pennsylvania State University, wrote in the online science magazine LiveScience that the 2009 H1N1 flu pandemic initially overestimated the final fatality rate, while the SARS fatality rate rose as the virus spread.

Initially, scientists estimated a fatality rate of 7%. “However, the initially reported information of 850 cases was a gross underestimate,” Boni wrote. “This was simply due to a much larger number of mild cases that did not report to any health system and were not counted.”

“After several months — when pandemic data had been collected from many countries experiencing an epidemic wave — the 2009 influenza turned out to be much milder than was thought in the initial weeks. Its case fatality was lower than 0.1% and in line with other known human influenza viruses.”

“Every now and then a disease becomes so dangerous that it kills the host,” Matan Shelomi, an entomologist and assistant professor at National Taiwan University, wrote on Quora in 2017. But, ideally for the host at least, it must strike a balance.

“If the disease is able to spread to another host before the first host dies, then it is not too lethal to exist. Evolution cannot make it less lethal so long as it can still spread,” he added. “If a hypothetical disease eradicates its only host, both will indeed go extinct.”

As coronavirus cases surge, the U.S. military prepares for possible pandemic

WILL TRUMP USE CORONAVIRUS TO DECLARE MARTIAL LAW?

Sean D. Naylor National Security Correspondent,Yahoo News•February 26, 2020


As the novel coronavirus continues to spread beyond China, the U.S. military announced its first confirmed case and commanders across the globe braced for the worst.

The military had remained virtually untouched by the virus until this week. But late Tuesday U.S. Forces Korea announced that a 23-year-old male soldier stationed at Camp Carroll in southeastern Korea had tested positive and was in “self-quarantine” at his off-base home. Shortly afterward, USFK raised its risk level to “high” and restricted U.S. military personnel from attending “non-essential” gatherings at restaurants, bars, clubs and theaters away from their installations. In the same memo, USFK directed its forces to limit all non-mission-essential meetings and travel, and to avoid handshakes, among other steps intended to reduce vulnerability to the virus.

South Korea, where 28,500 U.S. troops are based, had 977 confirmed cases of the virus by Tuesday, with 10 deaths, according to the World Health Organization, making it the second-hardest-hit country after China, where the virus originated. The scale of the outbreak is already affecting military plans.

During a Pentagon press conference Monday with his South Korean counterpart, Jeong Kyeong-doo, Defense Secretary Mark Esper told reporters that U.S. and South Korean military leaders “are looking at scaling back” upcoming command post exercises on the peninsula “due to concerns about the coronavirus.”
Defense Secretary Mark Esper and South Korean National Defense Minister Jeong Kyeong-doo at a news conference at the Pentagon on Monday. (Erin Scott/Reuters)

Those exercises, scheduled for March, take place mostly in headquarters buildings and “actually put a lot of people in combined spaces [with] people living and sleeping and working together,” said David Maxwell, a retired Army Special Forces colonel who previously served in South Korea and remains in close contact with national security figures there. Such conditions create “a petri dish for spreading disease,” he said, comparing the proximity of personnel in the headquarters exercises to the situation on the cruise ship Diamond Princess, on which 691 of 3,711 passengers and crew became infected with the virus.

The South Korean military, which has about 600,000 troops on active duty, had 13 confirmed cases of the virus as of Sunday, and had canceled leave and restricted troop movements between installations, according to Jeong. “The situation is quite serious,” and grows more so by the day, he said through a translator.

But he and Esper each tried to downplay any effect the virus might have on their ability to defend South Korea. “I’m sure that we will remain fully ready to deal with any threats that we might face together,” Esper said.

The U.S. military and South Korean medical systems should prove up to the challenge presented by the virus, according to Maxwell. “South Korea’s an advanced country,” he said.

A South Korean marine wearing a mask stands in front of a navy base

 on Feb. 21, after a member of the unit was confirmed to have been 

infected with the coronavirus. (Woo Jang-ho/Yonhap via AP)

Before Tuesday’s announcement of the confirmed U.S. military case in South Korea, Marine Maj. Cassandra Gesecki, a spokesperson for the U.S. Indo-Pacific Command, said a widowed dependent in South Korea was the only known case of the virus connected to the military in the command’s area of responsibility, which stretches from India to Hawaii and Japan to New Zealand.

The Indo-Pacific Command has restricted all travel to China by Defense Department personnel and contractors, and has advised any personnel already in China to leave the country as soon as possible, according to Gesecki. Meanwhile, U.S. Forces Japan has restricted all nonessential travel by its personnel and their family members to South Korea, according to Marine Capt. Tyler Hopkins, a U.S. Forces Japan spokesman.

Other than in Korea, the U.S. military has not yet canceled or curtailed any training in East Asia, said Gesecki Tuesday, adding that about 6,000 U.S. troops are currently taking part in Cobra Gold, an annual multinational exercise in Thailand. Nor has the Navy canceled any port visits in the region, she said.

The virus is also spreading in Europe, with more than 300 cases confirmed on the continent, Air Force Gen. Tod Wolters, the head of U.S. European Command, told the Senate Armed Services Committee Tuesday. The World Health Organization reported 229 of those cases, including six deaths, were in Italy, where more than 35,000 U.S. troops are stationed.

Air Force Gen. Tod Wolters, head of the U.S. European Command and 

NATO's supreme Allied commander Europe. (Tom Williams/CQ Roll 

Call via Getty Images)

Questioned by Arkansas Republican Sen. Tom Cotton, Wolters confirmed a Stars and Stripes story that said the military had closed dependent schools, activity centers, theaters and chapels for 72 hours around U.S. military facilities in Vicenza, where between 6,000 and 7,000 U.S. troops are stationed, most of them with families. Wolters said he had also banned U.S. military personnel from traveling to two provinces in Italy, and that it was “50-50” whether the ban in Vicenza would be extended when it expires at the end of Wednesday.

Wolters said he might also need to close facilities and restrict U.S. service members' travel in Germany, where the bulk of U.S. forces stationed in Europe are based and where the World Health Organization reported only 16 cases on Tuesday. “We’re anticipating an increase in the number of cases reported in Germany and we’re prepared to execute,” Wolters said.

'Anti-Greta' teen activist to speak at biggest US conservatives conference

David Smith in Washington,
The Guardian•February 26, 2020


'Anti-Greta' teen activist to speak at CPAC conference

Seibt is in the pay of the Heartland Institute, a think tank closely allied with the White House that denies...

A German teenager dubbed the “anti-Greta” – climate sceptics’ answer to the schoolgirl activist Greta Thunberg – is set to address the biggest annual gathering of US grassroots conservatives.

Related: Greta Thunberg and Malala Yousafzai meet at Oxford University

Naomi Seibt, 19, who styles herself as a “climate sceptic” or “climate realist”, will this week address the Conservative Political Action Conference (CPAC) near Washington, joining speakers including Donald Trump and Vice-President Mike Pence.

Seibt is in the pay of the Heartland Institute, a thinktank closely allied with the White House that denies established science showing humans are heating the planet with dangerous consequences.

CPAC will be the biggest stage yet for Seibt, a so-called “YouTube influencer” who tells her followers Thunberg and other activists are whipping up unnecessary hysteria by exaggerating the climate crisis.

“Climate change alarmism at its very core is a despicably anti-human ideology,” she has said.

The teenager, from Münster in western Germany, claims she is “without an agenda, without an ideology”. But she was pushed into the limelight by leading figures on the German far right and her mother, a lawyer, has represented politicians from the Alternative für Deutschland (AfD) party in court.

Seibt had her first essay published by the “anti-Islamisation” blog Philosophia Perennis and was championed by Martin Sellner, leader of the Austrian Identitarian Movement, who has been denied entry to the UK and US because of his political activism.

A Facebook post by the AfD youth wing names Seibt as a member and she spoke at a recent AfD event, though she has denied membership of the party.

In May 2019 she posted her first video on YouTube, reading out verses submitted for a poetry slam competition organised by the AfD.

The impact of the clip and its follow-ups put her on the radar of the Heartland Institute, which is based in Chicago. It has lobbied on behalf of the tobacco and coal industries but recently concentrated its efforts on challenging the scientific consensus on climate change.

Last December, as Thunberg addressed the United Nations’ Cop25 global warming summit in Madrid, Seibt gave the keynote speech at a rival conference organised by the Heartland Institute a few miles away.

In a sting operation carried out for German broadcaster ZDF and investigative outlet Correctiv, the Heartland Institute strategist James Taylor told journalists posing as potential donors his thinktank had signed up Seibt to record climate change sceptic videos for young people.

Seibt has admitted that she receives “an average monthly wage” from the institute. According to official figures, the average net monthly income in Germany is just under €1,900 (£1,590, $2,066).

The Heartland website features a low-budget video introducing Seibt, who speaks to the camera from what appears to be a home.

“I’ve got very good news for you,” she says. “The world is not ending because of climate change. In fact, 12 years from now we will still be around, casually taking photos on our iPhone 18s

“We are currently being force-fed a very dystopian agenda of climate alarmism that tells us that we as humans are destroying the planet. And that the young people, especially, have no future – that the animals are dying, that we are ruining nature.”

In another film, Naomi Seibt vs Greta Thunberg: Whom Should We Trust?, Seibt says: “Science is entirely based on intellectual humility and it is important that we keep questioning the narrative that is out there instead of promoting it, and these days climate change science really isn’t science at all.”

Seibt has also uploaded a video with the title Message to the Media – HOW DARE YOU – an obvious reference to a speech by Thunberg at the UN in which she rebuked world leaders: “We are in the beginning of a mass extinction, and all you can talk about is money, and fairytales of eternal economic growth. How dare you!”

Thunberg began her activism at 15 by missing school and camping outside the Swedish parliament. She has since met the pope, addressed members of Congress in Washington and heads of state at the UN and helped inspire 4 million people to join a global climate strike. Last year she became the youngest Time magazine Person of the Year, much to Trump’s chagrin.

The Washington Post observed: “If imitation is the highest form of flattery, Heartland’s tactics amount to an acknowledgment that Greta has touched a nerve, especially among teens and young adults.”

Related: Malena Ernman on daughter Greta Thunberg: ‘She was slowly disappearing into some kind of darkness’

Since Trump’s election, CPAC has paraded hard-right figures such as the former White House officials Steve Bannon and Sebastian Gorka as well as numerous climate sceptics.

In his speech there last year, the president mocked the Green New Deal, proposals championed by Democrats including Alexandria Ocasio-Cortez.

“No planes,” the president said. “No energy. When the wind stops blowing, that’s the end of your electric. ‘Let’s hurry up. Darling, darling, is the wind blowing today? I’d like to watch television, darling.’”

Connor Gibson, a researcher for Greenpeace USA, said: “Climate science is understood by a majority of Americans, liberal and conservative alike. Unfortunately, you won’t meet any of those people, or any climate scientists, at an event like CPAC.

“The Heartland Institute is funnelling anonymous money from the US to climate denial in other countries. It relies on the media to advance false equivalence strategies to attempt to normalise fringe beliefs. Climate denial is not a victimless crime, and it’s time for the perpetrators to be held accountable.”

Ann Coulter may have just given the American people ‘the best reason to vote for Elizabeth Warren’ yet

Published: Feb 26, 2020 


Did Ann Coulter just endorse Elizabeth Warren?


By
SHAWNLANGLOIS
SOCIAL-MEDIA EDITOR

Right-wing lightning rod Ann Coulter surely is not endorsing Sen. Elizabeth Warren, but don’t tell that to supporters of the Massachusetts Democrat.

‘Sen. Warren has convinced me that Bernie isn’t that worrisome. He’ll never get anything done. SHE’S the freak who will show up with 17 idiotic plans every day and keep everyone up until it gets done.’

That is the tweet that sent Coulter flying up Twitter’s TWTR, -1.65% trending list in the wake of the latest Democratic presidential debate Tuesday night. Judging from the spirited response, her comment probably didn’t strike its intended note:


This might be the best reason to vote for @ewarren I’ve seen yet. She’ll get stuff done that people like Ann Coulter find idiotic. pic.twitter.com/7I9ycfrvc1— Veronica Miron (@veronicamiron) February 26, 2020


Ann Coulter just endorsed Warren, I think https://t.co/ncLlJggOTo— Paul Krugman (@paulkrugman) February 26, 2020


Elizabeth Warren’s competence frightens both Ann Coulter and Peter Thiel. That’s reassuring as hell. When both white nationalists and diabolical billionaires fear your ability to usher in progress, you’re doing something right.— Adam Best (@adamcbest) February 26, 2020

I was not sure about Elizabeth Warren.
Ann Coulter said that she is "afraid" of her.
Thanks, Ann.
Warren it is.— Robert People (@PeoplesCourt79) February 26, 2020

I don’t think Ann *intended* this as an endorsement but it wouldn’t surprise me if Warren HQ decided to blow the tweet up and put it on a poster. https://t.co/bue6QVe334— Sahil Kapur (@sahilkapur) February 26, 2020

Apparently, the Boston Globe editorial board agrees — sort of — with Coulter.

The paper endorsed Warren on Wednesday for basically the very same “worrisome” reason inspiring the Coulter tweet: that Bernie Sanders is “less likely to deliver” the “profound changes” that both candidates are pushing to enact.

“Warren is uniquely poised to accomplish serious reform without sacrificing what’s working in our economy and innovation ecosystem,” the Globe editorial argued. “She would get under the hood to fix the engine — not drive off a cliff, but also not just kick the tires.”

The newspaper announced its endorsement via this video:

The @GlobeOpinion editorial board endorses Elizabeth Warren as the Democratic nominee for president. Read the full endorsement: https://t.co/cRY0braMoQ pic.twitter.com/mQXFwfhkXH— The Boston Globe (@BostonGlobe) February 26, 2020

Rep. Alexandria Ocasio-Cortez has admitted she feels unsafe in Washington D.C. over her home in the Bronx, New York — which is fueled, in part, by the threats she's received after President Trump tweeted against her.

Wells Fargo executives are getting the treatment Wall Street deserved after 2008
Jeff Spross

Illustrated | Ashva73/iStock, kimiko/iStock, Wells Fargo
January 27, 2020

After the 2008 financial crisis, American lawmakers set a terrible precedent. The big banks faced billions in fines, and new regulations were imposed on them. But for the individuals in charge of the banks when they almost destroyed the global economy, there were virtually no consequences: Few fines, and even fewer prosecutions. The executives basically skated, and many of them remain in their positions today.

But it looks like things may actually go differently for the people who were in charge of Wells Fargo.

You might recall how, back in 2016, a scandal suddenly exploded around the bank. Wells Fargo employees had defrauded customers on a massive and industrial scale by opening accounts they didn't ask for, signing them up for products they didn't want, and charging them fees they shouldn't have had to pay. Public outrage ensued, the bank was raked over the coals by Congress, and the CEO who presided over the debacle, John Stumpf, stepped down. (Amazingly, Stumpf's successor, Tim Sloan, also dropped out as CEO last year, after failing to clean up Wells Fargo's act to everyone's satisfaction.) The bank's board also clawed back $69 million worth of stock payouts it had given Stumpf on his way out the door.

As welcome as those repercussions were, they were basically compensation losses. They were not society at large demanding accountability. That changed last week, when the Office of the Comptroller of the Currency (OCC) brought the hammer down: In an announced settlement with the office, Stumpf will pay a $17.5 million fine and agree to a lifetime ban from the banking industry.

It's unclear how large Stumpf's personal fortune is now, but it was around $200 million before the scandal broke in 2016. That $17.5 million could be a decent chunk of what's left, but you could also argue it should be even larger to really act as a deterrence to others. But $17.5 million is also the biggest penalty the OCC has ever leveled against an individual. And it wants to impose an even bigger $25 million penalty on Carrie Tolstedt, who ran the division where most of the abuses occurred. (Tolstedt retired from Wells Fargo in 2016, a few months before the scandal broke.) The lifetime ban is striking too — one should never underestimate how much pride and hubris these sorts of financial titans derive from their position.

Two other lower-level former executives from Wells Fargo have agreed to lesser fines and punishments. Five others, including Tolstedt, have also been charged by the OCC, but are fighting it in court. And everyone could still face criminal charges from the Justice Department.

This is already a remarkable outcome compared to how the 2008 financial crisis was handled, not to mention other scandals, as multiple outlets noted. "Even though the biggest American banks paid billions of dollars to settle civil cases stemming from their mortgage activities in the lead-up to the 2008 financial crisis, their chief executives have not given up a penny to federal bank regulators," The New York Times wrote. Kenneth Lewis, CEO of Bank of America during the crisis, paid no fines to federal regulators, to take one example. (He did have to fork over some money to New York State prosecutors.) JPMorgan Chase CEO Jamie Dimon led the bank through the $6 billion London Whale scandal, and the bank has paid $44 million in fines since 2008, but none of that came out of Dimon's own pocket.

The differences in treatment are all the more infuriating when you consider how the same system-wide mad scramble for profits drove both scandals.

The OCC released a massive 100-page legal brief detailing how Wells Fargo's demands and sales goals, imposed by the higher-ups, turned the bank into a thunderdome for "hundreds of thousands" of mid- and low-level employees. They basically had to either rip off customers, or be fired. An employee wrote directly to Stumpf's office, admitting that "I had less stress in the 1991 Gulf War than working for Wells Fargo." Workers at one Wells Fargo branch were told they would be "transferred to a store where someone had been shot and killed" if they didn't hit their sales targets. The OCC's brief includes a cascade of emails and memos and other evidence showing Stumpf and the rest of Wells Fargo's executive hierarchy either approved of what was going on, or were grossly negligent. The agency sensibly concluded that Stumpf should be held personally accountable for overseeing the ecosystem that created this whole mess; the buck, after all, stops with him.

When it came to the housing bubble, junk financial engineering allowed bad mortgages to be passed off as super-safe investments, sliced and diced into numerous instruments, then sold off throughout the system. This ability to essentially launder bad investments opened up a world of profit possibilities, but it also meant tons of bad mortgages had to be created to fuel the money grab. And that led to a massive effort throughout the banking industry to sucker customers into taking on shoddy loans and poorly-designed mortgages. Necessary paperwork was flubbed or falsified, and millions of families were shoveled though inappropriate and straight-up illegal foreclosures to protect the banks' bottom line once the housing bubble popped.

Again, the people in charge of the banks were either completely complicit, or criminally incompetent. But in the latter case, federal lawmakers and regulators essentially lost their nerve, refusing to go after the executives out of fear of creating a panic.

It's worth wondering how American politics might have evolved differently over the last decade if all the C-suite occupants on Wall Street had gotten the same treatment as Stumpf. Would the country have suffered from the same simmering populist resentment that ultimately gave us President Trump? Maybe not.

Finally, the other striking aspect of this is that it's Trump's regulators who decided to throw the book at Stumpf and his lieutenants. Trump's man in charge of the OCC, John Otting, is a textbook case of putting the fox in charge of the henhouse: Before taking over the OCC, he was in charge at OneWest Bank, which was neck deep in the mortgage abuses of the crisis. And in other instances, Otting has happily pushed Trump's kid gloves approach to Wall Street. Yet it was the Obama administration, supposedly a sober and technocratic operation by comparison, that basically let all the titans of Wall Street off the hook after 2008.

It's no secret that Trump's White House is basically a grift machine. But perhaps there's a paradoxical lesson in that: Having dismissed the demands of technocratic sobriety, Trump's people are both more willing to hand the big bank executives their heart's desire, and more willing to throw them under the bus if popular anger demands it. Something to think about there