Seriously Curious

by Tom Standage

  What people want at the end of life

  As death approaches, what do most people want, hope for and worry about? In 2016 The Economist and the Kaiser Family Foundation, an American non-profit focused on health care, polled people in America, Brazil, Italy and Japan to find out. What is most important to people depends on where they live. In America and Japan not burdening families with the cost of care was the highest-ranked priority. (The Japanese may be worrying about the cost of funerals, which can easily reach ¥3m, or $24,000; Americans may be worrying about medical bills, which can be ruinous.) In Brazil, where Catholicism prevails, the leading priority was being at peace spiritually. What Italians wanted most at the end was to have their loved ones around them. Doctors’ efforts to extend life near its end may not always be aligned with their patients’ priorities: living as long as possible was deemed least important of seven options, except in Brazil where it tied with not burdening relatives financially.

  The majority of people in each country had given “some” or “a great deal” of thought to their wishes for medical treatment in case of serious illness. But having spoken with their families about the subject was much less common, and putting wishes down in writing even rarer. Americans were most likely to have planned ahead: 56% had spoken with a loved one about the medical treatment they wanted if the event of serious illness; 27% had put their wishes in a written document. The Japanese were the most likely to have avoided the subject, even though Japan has the world’s oldest population. Less than a third had told their families about their wishes in case of serious illness and only 6% had put those wishes in writing.

  Last orders

  Thinking about your own death, how important is: 2016, % replying “extremely” or “very important”

  Source: Kaiser Family Foundation/The Economist

  In all four countries polled, there was a big discrepancy between what people wanted and what they expected to happen to them at the end. Majorities in each said that if they could choose where to die, they would die at home. Americans felt that particularly strongly, with nearly two-thirds preferring to die at home. In each of the four countries, however, the share who thought they were most likely to die at home fell about 30 percentage points short of the share who hoped to. Expecting to die in hospital was far more common than wishing to die there.

  Around the world, the taboo on talking about death is starting to fade. Over time, that should help narrow the gap between what people want for their deaths, and what they are likely to get. Though death is inevitable, a bad death is not.

  How China reduced its air pollution

  “I’ve never seen Beijing like this,” said Emmanuel Macron, the French president, beneath a cloudless blue sky at the end of a visit in January 2018. The next day Greenpeace East Asia, an NGO, showed that his impression was accurate. It found that concentrations of PM2.5 – the smallest polluting particles, which pose the greatest health risks – were 54% lower in the Chinese capital during the fourth quarter of 2017 than during the same period in 2016. Concentrations of PM2.5 in 26 cities across northern China, clustered around Beijing and Tianjin, were one-third lower. China genuinely has reduced its notorious air pollution. How has it done it, and at what cost?

  The country has had draconian anti-pollution measures in place since 2013, when it introduced a set of prohibitions called the national action plan on air pollution. This imposed a nationwide cap on coal use, divided up among provinces, so that Beijing (for instance) had to reduce its coal consumption by 50% between 2013 and 2018. The plan banned new coal-burning capacity (though power stations already in the works were allowed) and sped up the installation of filters and scrubbers. All this cut levels of PM2.5 in Beijing by more than a quarter between 2013, the time of the city’s notorious “airpocalypse”, and 2016. The measures were notable for being outright bans on polluting activities, rather than incentives to clean up production, such as prices or taxes (though China has those, too, including what is expected to become the world’s largest carbon market).

  The improvement in air quality in northern China was also helped by further command-and-control measures, which were imposed in October 2017. Air pollution spikes in northern China during the winter, because most domestic heating is fuelled by coal. The 26 northern cities, again with Beijing and Tianjin, imposed output controls on steel and aluminium smelters. They mothballed large construction projects in order to reduce smog from cement production and diesel trucks. And they created a new environmental protection agency, with tough enforcement powers, in Beijing and its surroundings. These prohibitions were so tough that in some areas they forced the authorities into an unusual U-turn. The cities had promised to convert almost 4m households from coal-burning to electricity or gas in 2017, and they shut off the use of coal in houses, hospitals and schools even before the replacement systems were ready. When hospital wards froze and schools took to holding classes in sub-zero playgrounds (where at least it was sunny), the government had to allow some coal-burning after all.

  The drop in pollution in late 2017 illustrates why bans in China often work better than elsewhere. First, many of the biggest polluters are state-owned, and so are more easily controlled. Second, with more than half of China’s pollution coming from coal-fired power stations, the government can concentrate on reducing the use of coal, unlike governments in places where the causes of pollution are more varied. Even so, command-and-control measures were most effective when the composition of GDP was anyway switching from heavy industry and infrastructure towards services, as it was from 2013 to 2016. When infrastructure spending rose again, as it did in 2016 and 2017, such measures were unable to do more than stop emissions rising, too. Prohibitions in northern China also seem to have shifted some polluting activities elsewhere. National levels of PM2.5 were only 4.5% lower in 2017 than in 2016, which implies that pollution increased in southern China. Moreover, the costs are high, even leaving aside the impact on schools and hospitals. In 2015 the Clean Air Alliance of China, an advisory group, reckoned that the investment cost of the 2013–18 national plan in Beijing, Tianjin and the surrounding province of Hebei would be 250bn yuan ($38bn). That does not include the opportunity cost of suspending whole industries and construction projects for months on end. In short, China’s measures work, but at a price. The country has won battles against air pollution, but not yet the war.

  Why forests are spreading in the rich world

  Forests in countries like Brazil and Congo get a lot of attention from conservationists, and it is easy to see why. South America and sub-Saharan Africa are experiencing deforestation on an enormous scale: every year almost 5m hectares are lost. But forests are also changing in rich Western countries. They are growing larger, in two senses: they occupy more land, and the trees in them are bigger. What is going on?

  Forests are spreading in almost all Western countries, with the fastest growth in places that historically had rather few trees. In 1990 28% of Spain was forested; now the proportion is 37%. In both Greece and Italy, the growth was from 26% to 32% over the same period. Forests are gradually taking more land in America and Australia. Perhaps most astonishing is the trend in Ireland. Roughly 1% of that country was forested when it became independent in 1922. Now forests cover 11% of the land, and the government wants to push the proportion up to 18% by the 2040s.

  Two things are fertilising this growth. The first is the abandonment of farmland, especially in high, parched places where nothing grows terribly well. When farmers give up trying to eke out a living from olives or sheep, trees simply move in. The second is government policy and subsidies. Governments have protected and promoted forests over the centuries for many reasons, ranging from the need to build wooden warships to a desire to promote suburban house-building. These days they increasingly welcome forests because they are carbon sinks. The justifications change; the desire for more trees remains constant.

  The greening of the West does not delight everyone. Farmers complain that land is bein
g taken out of use by generously subsidised tree plantations. (Farmers get subsidies too, but the ones for tree-planting are especially generous.) Parts of Spain and Portugal are afflicted by terrible forest fires. These burn especially hot in areas with lots of eucalyptus trees – an Australian import that was planted for its pulp but has spread of its own accord. Some people simply dislike the appearance of conifer forests planted in neat rows. They will have to get used to the trees, however. The growth of Western forests seems almost as inexorable as the deforestation taking place elsewhere.

  The Arctic could be ice-free by 2040, 30 years sooner than expected

  Over the past three decades the area of sea ice in the Arctic has fallen by more than half and its volume has plummeted by three-quarters. So says a report “Snow, Water, Ice, Permafrost in the Arctic” (SWIPA), produced under the auspices of the Arctic Council, a scientific-policy club for the eight countries with territory in the Arctic Circle, as well as observers including China and India. SWIPA estimates that the Arctic will be free of sea ice in the summer by 2040. Scientists previously suggested this would not occur until 2070. The thickness of ice in the central Arctic ocean declined by 65% between 1975 and 2012; record lows in the maximum extent of Arctic sea ice occurred in March 2017.

  Arctic sea ice extent

  Source: National Snow and Ice Data Centre

  *Area of ocean with at least 15% sea ice

  In theory, shipping firms should benefit from access to a more open seaway. Using the Arctic to sail from northern Europe to northeast Asia can cut the length of voyages by two-fifths compared with travelling via the Suez Canal. But any Arctic promise has drifted away and the expected shipping boom has not materialised. In 2012 only 1m tonnes of goods were shipped through the northern passage, a paltry level of activity and one not achieved since. That is because even in the summer months the Arctic ocean is stormy, making timely delivery of goods impossible to guarantee. Drifting ice also poses a danger. Ships must be strengthened to withstand it, adding to construction costs. And a lack of coastal infrastructure, such as deepwater ports, means that spills of the heavy fuel-oil that powers most vessels could wreak havoc on both ecosystems and reputations, because clean-up missions would have to set out from much farther away and would take much longer to be effective.

  A new polar code from the International Maritime Organisation, which regulates shipping, came into force at the beginning of 2017 to try to address some of these concerns. It bans discharges of sewage and oily mixtures in polar waters. America and Canada, among others, want to go further. For one thing, they want a ban on heavy fuel-oil (as there is in the Antarctic, which has various special protections).

  Nothing, however, looms larger than the potential for environmental calamity. The question of Arctic thawing is moving up the list of priorities both of countries with territory in the region and those farther afield. An unusual heatwave in the Arctic in February 2018, combined with particularly cold weather in Europe, raised concerns that warming could be undermining the northern polar vortex, a persistent low-pressure zone that keeps cold air trapped around the pole. Sticking to the Paris agreement could, eventually, stabilise temperatures. But more radical measures may be needed, given that countries are unlikely to keep within the limits set in Paris.

  Why there’s something in the water in New Zealand

  Windy cattle have always had an impact on their environment. But in New Zealand, where pastures that once grazed sheep have been converted into dairy farms to feed China’s appetite for milk, the situation is particularly noxious. Bovine burps (for these are the main problem) have contributed to a 23% rise in New Zealand’s greenhouse-gas emissions since 1990. Agriculture accounts for almost half of total emissions, a far higher share than in other rich countries. Consultants reckon that New Zealand needs to cut livestock numbers to meet its target of reducing greenhouse-gas emissions by 30% below 2005 levels by 2030. But gas is not the only problematic excretion. A second, less familiar environmental worry has emerged in a country that stakes its reputation on its purity. The bodily waste of the 6.6m dairy cattle has sullied rivers and groundwater. Almost two-thirds of the country’s waterways are now unsafe for swimming.

  Cows pollute water in a couple of ways. Their nitrogen-rich urine leaches off soil into waterways, where it acts like a fertiliser. Together with phosphorus, which is carried into rivers in soil particles, it can cause slime and toxic algae to grow. Half of monitored river sites in New Zealand contain enough nitrogen to trigger algal blooms, according to the OECD, a club of mostly rich countries. Toxic algae has killed at least 70 dogs since 2006. Across the intensively farmed Canterbury plains, pregnant women are advised to test drinking water for nitrates to avoid blue-baby syndrome, an ailment which can suffocate infants. But it is ecosystems that are most at risk. Too much nitrogen is toxic to fish, and excessive growth of algae depletes the oxygen in the water. Ecologists blame these pollutants for putting almost three-quarters of native fish under threat.

  Further damage comes from manure, which carries nasty bacteria such as E. coli. Cows have an unfortunate fondness for wading, which means that their faeces are often deposited in water. New Zealanders are twice as likely as Britons to fall sick from campylobacter, another bug harboured in cow dung, and are three times more vulnerable than Australians. Doctors say there is a relatively high incidence of gastroenteritis in Canterbury, a region of New Zealand’s South Island with lots of cows and untreated water.

  All this frustrates New Zealanders. Some worry about the impact on tourism, the only export industry that is more important than dairy farming. Over 3m people visit New Zealand annually, expecting it to be, as the tourism campaign promises, “100% Pure”. They might turn away if pollution worsens. Farmers have responded by fencing off rivers to prevent cows from wading in, and planting trees to curb soil erosion. Regional councils are required, at least in theory, to set limits for water quality to ensure that it does not diminish further. In 2017 a plan was hatched to make 90% of rivers safe for swimming by 2040. Yet many environmentalists were disappointed by the high level of the government-imposed guidelines for nitrates in water, which made rivers look safer than many believe them to be. As with emissions, ecologists argue that it is impossible to clean up water without first cutting the national herd. Even the government’s agriculture minister admits that the nation may have got close to the “maximum number of cows”.

  Measures to discourage smoking are spreading around the world

  Every two years the World Health Organisation (WHO) takes stock of the efforts of governments around the globe to curb smoking. Its latest report, published in July 2017, shows that only a single country, Turkey, has implemented to the fullest degree all of the measures recommended by the WHO. These include smoking bans, high cigarette taxes, warnings about the dangers of smoking, bans on tobacco advertising and publicly subsidised services that help smokers quit.

  Can you kick it?

  Source: WHO

  *At most comprehensive level recommended by WHO †Percentage of GDP per person required to buy 2,000 cigarettes of most-sold brand

  Although the number of countries adopting such measures has steadily grown, loopholes remain common. Outside Europe, taxes on cigarettes tend to be low. As a result, smoking in the rest of the world was just as affordable in 2016 as it was in 2008 – and in many places it has become cheaper. Only a tenth of the world’s population lives in countries where taxes make up at least three-quarters of the price of cigarettes, the level that has been shown to be effective in discouraging smoking.

  Around an eighth of all deaths caused by smoking – roughly 900,000 a year – result from inhaling second-hand smoke. Nonetheless, nearly 60 countries have no bans on smoking that fully cover even one type of public place, such as restaurants or universities. And even when governments have passed strict laws, enforcement often ranges from lax to non-existent. For example, Greece prohibits smoking in all public places, yet any visitor to Athens will see
residents lighting up with abandon.

  The most encouraging trend in recent years is the rising popularity of strong graphic warnings on cigarette packs. Between 2014 and 2016 the number of countries that adopted them grew by three-quarters, and they now extend to nearly half the world’s population. This sharp jump gives public-health advocates reason to hope that other proven measures to curb smoking could start to spread faster as well.

  Why “gene drives” have yet to be deployed in the wild

  The chance that a sexually reproducing organism’s offspring will inherit a particular version of a gene from a particular parent is usually 50%. “Gene drives” are stretches of DNA that change those odds to favour one parent’s version of a gene over the other’s. If the odds are stacked sufficiently in favour of one version, then within a few generations it can become the only version of the gene still in circulation within a given population. This could be a useful property. Soon after the discovery of gene drives in nature, half a century ago, researchers realised that they could be made into powerful tools for eradicating diseases and pests. A gene drive spreading a gene that makes mosquitoes unable to host the parasite that causes malaria could eliminate the disease, for example. If the drive makes female mosquitoes sterile, it could eliminate the insect altogether. Yet no such gene drive has been released into the wild. Why not?