Science

After New Abortion Laws, Some Patients Have Trouble Obtaining Miscarriage Treatment

Published

2 years ago

July 17, 2022

After New Abortion Laws, Some Patients Have Trouble Obtaining Miscarriage Treatment

Final yr, a 35-year-old girl named Amanda, who lives within the Dallas-Fort Value space, had a miscarriage within the first trimester of her being pregnant. At a big hospital, a health care provider carried out a surgical process typically used as a secure and fast methodology to take away tissue from a failed being pregnant.

She awoke from anesthesia to discover a card signed by the nurses and slightly pink and blue bracelet with a butterfly appeal, a present from the hospital to precise compassion for her loss. “It was so candy as a result of it’s such a tough factor to undergo,” Amanda mentioned.

Eight months later, in January, Amanda, who requested to be recognized by her first identify to guard her privateness, skilled one other first-trimester miscarriage. She mentioned she went to the identical hospital, Baylor Scott & White Medical Middle, doubled over in ache and screaming as she handed a big blood clot.

However when she requested the identical surgical evacuation process, known as dilation and curettage, or D&C, she mentioned the hospital instructed her no.

A D&C is similar process used for some abortions. In September 2021, in between Amanda’s two miscarriages, Texas carried out a regulation banning nearly all abortions after six weeks into being pregnant.

Following the reversal of Roe v. Wade, quite a few states are enacting bans or sharp restrictions on abortion. Whereas the legal guidelines are technically meant to use solely to abortions, some sufferers have reported hurdles receiving commonplace surgical procedures or medicine for the lack of desired pregnancies.

Amanda mentioned the hospital didn’t point out the abortion regulation, however despatched her dwelling with directions to return provided that she was bleeding so excessively that her blood stuffed a diaper greater than as soon as an hour. Hospital data that Amanda shared with The New York Occasions famous that her embryo had no cardiac exercise throughout that go to and on an ultrasound every week earlier. “She experiences having loads of ache” and “she seems distressed,” the data mentioned.

“This seems to be miscarriage in course of,” the data famous, however steered ready to verify and suggested a follow-up in seven days.

As soon as dwelling, Amanda mentioned, she sat on the bathroom digging “fingernail marks in my wall” from the ache. She then moved to the bath, the place her husband held her hand as they each cried. “The bath water is simply darkish crimson,” Amanda recalled. “For 48 hours, it was like a relentless heavy bleed and large clots.”

She added, “It was so completely different from my first expertise the place they had been so good and so comforting, to now simply feeling alone and terrified.”

The hospital declined to debate whether or not Texas’s abortion legal guidelines have had any impression on its medical care. In an announcement, the hospital mentioned, “Whereas we’re not ready to discuss a person’s case attributable to privateness legal guidelines, our multidisciplinary group of clinicians works collectively to find out the suitable therapy plan on a person case-by-case foundation. The well being and security of our sufferers is our high precedence.”

John Seago, the president of Texas Proper to Life, mentioned he considers any obstacles miscarriage sufferers encounter to be “very severe conditions.” He blamed such issues on “a breakdown in communication of the regulation, not the regulation itself,” including “I’ve seen experiences of docs being confused, however that may be a failure of our medical associations” to offer clear steering.

The unsure local weather has led some docs and hospitals to fret about being accused of facilitating an abortion, a worry that has additionally precipitated some pharmacists to disclaim or delay filling prescriptions for medicine to finish miscarriages, suppliers and sufferers say. Final week, the Biden administration warned that if a pharmacy refuses to fill prescriptions for tablets “together with drugs wanted to handle a miscarriage or issues from being pregnant loss, as a result of these drugs can be used to terminate a being pregnant — the pharmacy could also be discriminating on the idea of intercourse.”

Delays in expelling tissue from a being pregnant that’s not viable can result in hemorrhaging, infections, and generally life-threatening sepsis, obstetricians say.

“On this post-Roe world, ladies with miscarriages might die,” mentioned Dr. Monica Saxena, an emergency drugs doctor at Stanford Hospital.

Medical consultants outline miscarriage as a being pregnant that ends naturally earlier than 20 weeks’ gestation. Most miscarriages happen within the first 13 weeks; being pregnant losses after 20 weeks are thought-about stillbirths. Miscarriage befalls about one in 10 recognized pregnancies, and should happen in as many as one in 4 when together with miscarriages that happen earlier than sufferers notice they’re pregnant.

Medical terminology typically calls miscarriage “spontaneous abortion,” a designation that may improve sufferers’ or suppliers’ issues about being focused underneath abortion bans. In medical data, Amanda’s second miscarriage was additionally labeled “threatened abortion: established and worsening.”

In typical early miscarriages, when cardiac exercise has stopped, sufferers needs to be provided three choices to expel tissue, mentioned Dr. Sarah Prager, an obstetrics and gynecology professor on the College of Washington’s Faculty of Drugs.

D&C is really helpful when sufferers are bleeding closely, are anemic, have blood-clotting points or sure circumstances that make them medically fragile, Dr. Prager mentioned. Another sufferers additionally select D&C’s, contemplating them emotionally simpler than a lingering course of at dwelling.

Another choice is medicine — often mifepristone, which weakens the membrane lining the uterus and softens the cervix, adopted by misoprostol, which causes contractions. These identical tablets are used for medicine abortion.

The third possibility is “expectant administration”: ready for tissue to go by itself, which may take weeks. It’s unsuccessful for 20 % of sufferers, who then want surgical procedure or medicine, mentioned Dr. Prager, who co-authored miscarriage administration tips for the American School of Obstetricians and Gynecologists.

When doable, sufferers needs to be allowed to decide on the tactic as a result of lack of alternative compounds the trauma of shedding a wished being pregnant, docs and sufferers mentioned.

In Wisconsin, the place a 173-year-old abortion ban might quickly change into enforceable once more, Dr. Carley Zeal, an obstetrician-gynecologist, handled a girl who mentioned that simply after abortion rights had been nullified, she confirmed up bleeding at a hospital, which decided she had miscarried however instructed her “they couldn’t do a D&C due to the legal guidelines.” The hospital didn’t supply her miscarriage medicine both, advising her to search out an obstetrician-gynecologist to assist. By the point she discovered Dr. Zeal, who gave her mifepristone and misoprostol, the girl had been bleeding intermittently for days, placing her at “elevated danger of hemorrhage or an infection.”

“Even in these simple instances of primary OB/GYN follow, the legal guidelines depart suppliers questioning and afraid,” Dr. Zeal mentioned. “These legal guidelines are already hurting my sufferers.”

Docs say even better dangers might happen with instances of “inevitable miscarriage,” the place there’s nonetheless fetal cardiac exercise, however the affected person’s water has damaged a lot too early for the being pregnant to be viable, mentioned Greer Donley, an assistant professor on the College of Pittsburgh Legislation Faculty.

A research from two Dallas hospitals reported on 28 sufferers whose water broke or who had different severe issues earlier than 22 weeks’ gestation, and who, due to Texas legal guidelines, didn’t obtain medical intervention till there was an “speedy risk” to their lives or fetal cardiac exercise stopped. On common, the sufferers waited 9 days, and 57 % ended up with severe infections, bleeding or different medical issues, the report mentioned. One other article, within the New England Journal of Drugs, mentioned related sufferers returned with indicators of sepsis after docs or hospitals determined Texas’s abortion regulation prevented them from intervening earlier.

In such instances, Dr. Seago of Texas Proper to Life mentioned abortion bans would possibly require delaying intervention. What he characterised as a health care provider saying “‘I need to trigger the loss of life of the kid at this time as a result of I consider that they’re going to go away finally,’” is prohibited, he mentioned. He acknowledged that such delays might trigger medical issues for ladies however mentioned “extreme” issues might legally be handled instantly.

One of many miscarriage drugs, mifepristone, should be prescribed by licensed suppliers and can’t be disbursed by typical pharmacies. Though the certification course of is straightforward, Dr. Lauren Thaxton, an assistant professor within the division of ladies’s well being on the College of Texas at Austin’s Dell Medical Faculty, mentioned some hospitals have expressed “concern about this medicine additionally getting used for abortion and whether or not or not that would create some form of dangerous look.”

So, in some states, docs solely prescribe misoprostol for miscarriages, which may work by itself, however much less effectively. Additionally it is used for different medical circumstances and needs to be simply obtainable at pharmacies, however some have declined to fill miscarriage sufferers’ misoprostol prescriptions or required further documentation from docs, Dr. Thaxton and others mentioned.

Cassie, a Houston girl who requested to be recognized by her first identify, mentioned she realized she had miscarried the day Roe v. Wade was overturned, when her physician detected blood in her uterus and no cardiac exercise.

She was prescribed misoprostol, however mentioned a Walgreens made her wait a day for “additional approval” from its company workplace.

“After I went to choose it up, I then needed to chat with the pharmacist and needed to state once more, though they had been conscious my physician prescribed it, that it wasn’t for an abortion,” Cassie mentioned.

A Walgreens spokesman mentioned some abortion legal guidelines “require further steps for meting out sure prescriptions and apply to all pharmacies, together with Walgreens. In these states, our pharmacists work carefully with prescribers as wanted, to fill lawful, clinically acceptable prescriptions.”

Dr. Thaxton mentioned that when pharmacies delay meting out misoprostol, some sufferers are financially or logistically unable to return for the medicine one other day. As a substitute, some go to docs days later, nonetheless retaining being pregnant tissue or “having important bleeding that must be managed urgently,” she mentioned.

In March in Missouri, which now has a post-Roe abortion ban, Gabriela, who requested to be recognized by her first identify, mentioned she had a blighted ovum, wherein a fertilized egg implants within the uterus however doesn’t develop. “My physique wouldn’t launch it,” she mentioned.

Her physician prescribed misoprostol, nevertheless it didn’t work effectively sufficient. When she requested for mifepristone, the physician mentioned it was troublesome to acquire there, in accordance with a health care provider’s be aware Gabriela shared with The Occasions.

The physician ordered a second spherical of misoprostol, however Gabriela mentioned, “The pharmacist at Walgreens instructed me she couldn’t give it to me if I used to be pregnant. I used to be in a position to stutter out that I used to be having a miscarriage, and he or she gave it to me. I couldn’t assist however cry in entrance of all of the folks at Walgreens as a result of I felt like I used to be being handled like a nasty individual for choosing up a drugs to forestall an an infection.”

Dr. Prager mentioned she’s been instructed that some Texas miscarriage sufferers had been turned away by docs who fearful the patientsmight have really taken abortion tablets that hadn’t expelled the being pregnant, two conditions that seem medically an identical.

“There’s a system being created the place there isn’t a belief between physicians and sufferers, and sufferers are probably going to decide on to not go to a hospital even with one thing like a miscarriage, as a result of they’re fearful,” Dr. Prager mentioned.

Some ladies who’ve miscarried and are susceptible to future losses say they’re contemplating shifting from states that ban abortion or are rethinking life plans.

“We aren’t going to attempt to conceive anymore,” Amanda mentioned. “We don’t really feel prefer it’s secure in Texas to proceed to strive after what we went by.”

Science

There's a reason you can't stop doomscrolling through L.A.'s fire disaster

Published

10 hours ago

January 10, 2025

Press Room

There's a reason you can't stop doomscrolling through L.A.'s fire disaster

Even for those lucky enough to get out in time, or to live outside the evacuation zones, there has been no escape from the fires in the Los Angeles area this week.

There is hardly a vantage point in the city from which flames or plumes of smoke are not visible, nowhere the scent of burning memories can’t reach.

And on our screens — on seemingly every channel and social media feed and text thread and WhatsApp group — an endless carousel of images documents a level of fear, loss and grief that felt unimaginable here as recently as Tuesday morning.

Even in places of physical safety, many in Los Angeles are finding it difficult to look away from the worst of the destruction online.

“To me it’s more comfortable to doomscroll than to sit and wait,” said Clara Sterling, who evacuated from her home Wednesday. “I would rather know exactly where the fire is going and where it’s headed than not know anything at all.”

A writer and comedian, Sterling is — by her own admission — extremely online. But the nature of this week’s fires make it particularly hard to disengage from news coverage and social media, experts said.

For one, there’s a material difference between scrolling through images of a far-off crisis and staying informed about an active disaster unfolding in your neighborhood, said Casey Fiesler, an associate professor specializing in tech ethics at the University of Colorado Boulder.

“It’s weird to even think of it as ‘doomscrolling,’ ” she said. “When you’re in it, you’re also looking for important information that can be really hard to get.”

When you share an identity with the victims of a traumatic event, you’re more likely both to seek out media coverage of the experience and to feel more distressed by the media you see, said Roxane Cohen Silver, distinguished professor of psychological science at UC Irvine.

For Los Angeles residents, this week’s fires are affecting the people we identify with most intimately: family, friends and community members. They have consumed places and landmarks that feature prominently in fond memories and regular routines.

The ubiquitous images have also fueled painful memories for those who have lived through similar disasters — a group whose numbers have increased as wildfires have grown more frequent in California, Silver said.

This she knows personally: She evacuated from the Laguna Beach fires in 1993, and began a long-term study of that fire’s survivors days after returning to her home.

“Throughout California, throughout the West, throughout communities that have had wildfire experience, we are particularly primed and sensitized to that news,” she said. “And the more we immerse ourselves in that news, the more likely we are to experience distress.”

Absorption in these images of fire and ash can cause trauma of its own, said Jyoti Mishra, an associate professor of psychiatry at UC San Diego who studied the long-term psychological health of survivors of the 2018 Camp fire.

The team identified lingering symptoms of post-traumatic stress disorder, depression and anxiety both among survivors who personally experienced fire-related trauma such as injury or property loss, and — to a smaller but still significant degree — among those who indirectly experienced the trauma as witnesses.

“If you’re witnessing [trauma] in the media, happening on the streets that you’ve lived on and walked on, and you can really put yourself in that place, then it can definitely be impactful,” said Mishra, who’s also co-director of the UC Climate Change and Mental Health Council. “Psychology and neuroscience research has shown that images and videos that generate a sense of personal meaning can have deep emotional impacts.”

The emotional pull of the videos and images on social media make it hard to look away, even as many find the information there much harder to trust.

Like many others, Sterling spent a lot of time online during the early days of the COVID-19 pandemic. Back then, Sterling said, the social media environment felt decidedly different.

“This time around I think I feel less informed about what’s going on because there’s been such a big push toward not fact-checking and getting rid of verified accounts,” she said.

The rise of AI-generated images and photos has added another troubling kink, as Sterling highlighted in a video posted to TikTok early Thursday.

“The Hollywood sign was not on fire last night. Any video or photos that you saw of the Hollywood sign on fire were fake. They were AI generated,” she said, posting from a hotel in San Diego after evacuating.

Hunter Ditch, a producer and voice actor in Lake Balboa, raised similar concerns about the lack of accurate information. Some social media content she’s encountered seemed “very polarizing” or political, and some exaggerated the scope of the disaster or featured complete fabrications, such as that flaming Hollywood sign.

The spread of false information has added another layer of stress, she said. This week, she started turning to other types of app — like the disaster mapping app, Watch Duty — to track the spreading fires and changing evacuation zones.

But that made her wonder: “If I have to check a whole other app for accurate information, then what am I even doing on social media at all?”

Science

Pink Fire Retardant, a Dramatic Wildfire Weapon, Poses Its Own Dangers

Published

18 hours ago

January 10, 2025

Press Room

Pink Fire Retardant, a Dramatic Wildfire Weapon, Poses Its Own Dangers

From above the raging flames, these planes can unleash immense tankfuls of bright pink fire retardant in just 20 seconds. They have long been considered vital in the battle against wildfires.

But emerging research has shown that the millions of gallons of retardant sprayed on the landscape to tame wildfires each year come with a toxic burden, because they contain heavy metals and other chemicals that are harmful to human health and the environment.

The toxicity presents a stark dilemma. These tankers and their cargo are a powerful tool for taming deadly blazes. Yet as wildfires intensify and become more frequent in an era of climate change, firefighters are using them more often, and in the process releasing more harmful chemicals into the environment.

Some environmental groups have questioned the retardants’ effectiveness and potential for harm. The efficiency of fire retardant has been hard to measure, because it’s one of a barrage of firefighting tactics deployed in a major fire. After the flames are doused, it’s difficult to assign credit.

The frequency and severity of wildfires has grown in recent years, particularly in the western United States. Scientists have also found that fires across the region have become faster moving in recent decades.

There are also the longer-term health effects of exposure to wildfire smoke, which can penetrate the lungs and heart, causing disease. A recent global survey of the health effects of air pollution caused by wildfires found that in the United States, exposure to wildfire smoke had increased by 77 percent since 2002. Globally, wildfire smoke has been estimated to be responsible for up to 675,000 premature deaths per year.

Fire retardants add to those health and environmental burdens because they present “a really, really thorny trade-off,” said Daniel McCurry, an assistant professor of civil and environmental engineering at the University of Southern California, who led the recent research on their heavy-metal content.

The United States Forest Service said on Thursday that nine large retardant-spraying planes, as well as 20 water-dropping helicopters, were being deployed to fight the Southern California fires, which have displaced tens of thousands of people. Several “water scooper” amphibious planes, capable of skimming the surface of the sea or other body of water to fill their tanks, are also being used.

Two large DC-10 aircraft, dubbed “Very Large Airtankers” and capable of delivering up to 9,400 gallons of retardant, were also set to join the fleet imminently, said Stanton Florea, a spokesman for the National Interagency Fire Center in Boise, Idaho, which coordinates national wildland firefighting efforts across the West.

Sprayed ahead of the fire, the retardants coat vegetation and prevent oxygen from allowing it to burn, Mr. Florea said. (Red dye is added so firefighters can see the retardant against the landscape.) And the retardant, typically made of salts like ammonium polyphosphate, “lasts longer. It doesn’t evaporate, like dropping water,” he said.

The new research from Dr. McCurry and his colleagues found, however, that at least four different types of heavy metals in a common type of retardant used by firefighters exceeded California’s requirements for hazardous waste.

Federal data shows that more than 440 million gallons of retardant were applied to federal, state, and private land between 2009 and 2021. Using that figure, the researchers estimated that between 2009 and 2021, more than 400 tons of heavy metals were released into the environment from fire suppression, a third of that in Southern California.

Both the federal government and the retardant’s manufacturer, Perimeter Solutions, have disputed that analysis, saying the researchers had evaluated a different version of the retardant. Dan Green, a spokesman for Perimeter, said retardants used for aerial firefighting had passed “extensive testing to confirm they meet strict standards for aquatic and mammalian safety.”

Still, the findings help explain why concentrations of heavy metals tend to surge in rivers and streams after wildfires, sometimes by hundreds of times. And as scrutiny of fire suppressants has grown, the Forestry Service has set buffer zones surrounding lakes and rivers, though its own data shows retardant still inadvertently drifts into those waters.

In 2022, the environmental nonprofit Forest Service Employees for Environmental Ethics sued the government in federal court in Montana, demanding that the Forest Service obtain a permit under the Clean Water Act to cover accidental spraying into waterways.

The judge ruled that the agency did indeed need to obtain a permit. But it allowed retardant use to continue to protect lives and property.

Science

2024 Brought the World to a Dangerous Warming Threshold. Now What?

Published

1 day ago

January 10, 2025

Press Room

2024 Brought the World to a Dangerous Warming Threshold. Now What?

Source: Copernicus/ECMWF

Note: Temperature anomalies relative to 1850-1900 averages.

At the stroke of midnight on Dec. 31, Earth finished up its hottest year in recorded history, scientists said on Friday. The previous hottest year was 2023. And the next one will be upon us before long: By continuing to burn huge amounts of coal, oil and gas, humankind has all but guaranteed it.

The planet’s record-high average temperature last year reflected the weekslong, 104-degree-Fahrenheit spring heat waves that shuttered schools in Bangladesh and India. It reflected the effects of the bathtub-warm ocean waters that supercharged hurricanes in the Gulf of Mexico and cyclones in the Philippines. And it reflected the roasting summer and fall conditions that primed Los Angeles this week for the most destructive wildfires in its history.

“We are facing a very new climate and new challenges, challenges that our society is not prepared for,” said Carlo Buontempo, director of the Copernicus Climate Change Service, the European Union monitoring agency.

But even within this progression of warmer years and ever-intensifying risks to homes, communities and the environment, 2024 stood out in another unwelcome way. According to Copernicus, it was the first year in which global temperatures averaged more than 1.5 degrees Celsius, or 2.7 degrees Fahrenheit, above those the planet experienced at the start of the industrial age.

For the past decade, the world has sought to avoid crossing this dangerous threshold. Nations enshrined the goal in the 2015 Paris agreement to fight climate change. “Keep 1.5 alive” was the mantra at United Nations summits.

Yet here we are. Global temperatures will fluctuate somewhat, as they always do, which is why scientists often look at warming averaged over longer periods, not just a single year.

But even by that standard, staying below 1.5 degrees looks increasingly unattainable, according to researchers who have run the numbers. Globally, despite hundreds of billions of dollars invested in clean-energy technologies, carbon dioxide emissions hit a record in 2024 and show no signs of dropping.

One recent study published in the journal Nature concluded that the absolute best humanity can now hope for is around 1.6 degrees of warming. To achieve it, nations would need to start slashing emissions at a pace that would strain political, social and economic feasibility.

But what if we’d started earlier?

By spewing heat-trapping gases into the atmosphere, humankind has lifted global temperatures to record highs.

If nations had started reducing emissions in 2005, they could have made gradual cuts to limit warming to 1.5 degrees.

Starting in 2015, when the Paris agreement was adopted, would have required steeper cuts.

Starting today would require cuts so drastic as to appear essentially impossible.

“It was guaranteed we’d get to this point where the gap between reality and the trajectory we needed for 1.5 degrees was so big it was ridiculous,” said David Victor, a professor of public policy at the University of California, San Diego.

The question now is what, if anything, should replace 1.5 as a lodestar for nations’ climate aspirations.

“These top-level goals are at best a compass,” Dr. Victor said. “They’re a reminder that if we don’t do more, we’re in for significant climate impacts.”

The 1.5-degree threshold was never the difference between safety and ruin, between hope and despair. It was a number negotiated by governments trying to answer a big question: What’s the highest global temperature increase — and the associated level of dangers, whether heat waves or wildfires or melting glaciers — that our societies should strive to avoid?

The result, as codified in the Paris agreement, was that nations would aspire to hold warming to “well below” 2 degrees Celsius while “pursuing efforts” to limit it to 1.5 degrees.

Even at the time, some experts called the latter goal unrealistic, because it required such deep and rapid emissions cuts. Still, the United States, the European Union and other governments adopted it as a guidepost for climate policy.

Christoph Bertram, an associate research professor at the University of Maryland’s Center for Global Sustainability, said the urgency of the 1.5 target spurred companies of all kinds — automakers, cement manufacturers, electric utilities — to start thinking hard about what it would mean to zero out their emissions by midcentury. “I do think that has led to some serious action,” Dr. Bertram said.

But the high aspiration of the 1.5 target also exposed deep fault lines among nations.

China and India never backed the goal, since it required them to curb their use of coal, gas and oil at a pace they said would hamstring their development. Rich countries that were struggling to cut their own emissions began choking off funding in the developing world for fossil-fuel projects that were economically beneficial. Some low-income countries felt it was deeply unfair to ask them to sacrifice for the climate given that it was wealthy nations — and not them — that had produced most of the greenhouse gases now warming the world.

“The 1.5-degree target has created a lot of tension between rich and poor countries,” said Vijaya Ramachandran, director for energy and development at the Breakthrough Institute, an environmental research organization.

Costa Samaras, an environmental-engineering professor at Carnegie Mellon University, compared the warming goals to health officials’ guidelines on, say, cholesterol. “We don’t set health targets on what’s realistic or what’s possible,” Dr. Samaras said. “We say, ‘This is what’s good for you. This is how you’re going to not get sick.’”

“If we were going to say, ‘Well, 1.5 is likely out of the question, let’s put it to 1.75,’ it gives people a false sense of assurance that 1.5 was not that important,” said Dr. Samaras, who helped shape U.S. climate policy from 2021 to 2024 in the White House Office of Science and Technology Policy. “It’s hugely important.”

Scientists convened by the United Nations have concluded that restricting warming to 1.5 degrees instead of 2 would spare tens of millions of people from being exposed to life-threatening heat waves, water shortages and coastal flooding. It might mean the difference between a world that has coral reefs and Arctic sea ice in the summer, and one that doesn’t.

Each tiny increment of additional warming, whether it’s 1.6 degrees versus 1.5, or 1.7 versus 1.6, increases the risks. “Even if the world overshoots 1.5 degrees, and the chances of this happening are increasing every day, we must keep striving” to bring emissions to zero as soon as possible, said Inger Anderson, the executive director of the United Nations Environment Program.

Officially, the sun has not yet set on the 1.5 target. The Paris agreement remains in force, even as President-elect Donald J. Trump vows to withdraw the United States from it for a second time. At U.N. climate negotiations, talk of 1.5 has become more muted compared with years past. But it has hardly gone away.

“With appropriate measures, 1.5 Celsius is still achievable,” Cedric Schuster, the minister of natural resources and environment for the Pacific island nation of Samoa, said at last year’s summit in Azerbaijan. Countries should “rise to the occasion with new, highly ambitious” policies, he said.

To Dr. Victor of U.C. San Diego, it is strange but all too predictable that governments keep speaking this way about what appears to be an unachievable aim. “No major political leader who wants to be taken seriously on climate wants to stick their neck out and say, ‘1.5 degrees isn’t feasible. Let’s talk about more realistic goals,’” he said.

Still, the world will eventually need to have that discussion, Dr. Victor said. And it’s unclear how it will go.

“It could be constructive, where we start asking, ‘How much warming are we really in for? And how do we deal with that?’” he said. “Or it could look very toxic, with a bunch of political finger pointing.”

Methodology

The second chart shows pathways for reducing carbon emissions that would have a 66 percent chance of limiting global warming this century to 1.5 degrees Celsius above the preindustrial average.