Japan’s government announced on Tuesday (April 13) that it will dump more than a million tons of contaminated wastewater from the Fukushima nuclear power plant into the Pacific Ocean. The highly contaminated water contains more radioactive material than previously acknowledged.

Roughly 1.25 million tons (1.13 million metric tons) of water have accumulated around the Fukushima Daiichi nuclear power plant in northeastern Japan since 2011, after a magnitude-9.0 earthquake and resulting tsunami devastated the region. The twin disasters killed nearly 20,000 people, according to NPR, and caused meltdowns in three of the plant’s six reactors, triggering the worst nuclear disaster since Chernobyl.

To keep the remaining reactor cores from melting, officials with the Tokyo Electric Power Company (TEPCO) have been pumping nearly 200 tons (180 metric tons) of cooling water through the site every day, according to The New York Times.

The contaminated wastewater is stored in more than 1,000 enormous tanks on site and automatically filtered to remove most of the radioactive material, except for tritium — a radioactive isotope of hydrogen that is considered hazardous to human health in large amounts, according to the nonprofit Health Physics Society.

Now, 10 years after the disaster, TEPCO is running out of room to store the wastewater.

The disposal plan, which was approved in a government cabinet meeting on Tuesday, will see the wastewater gradually discharged into the Pacific Ocean, most likely over the course of several decades.

One large concern is that TEPCO’s claims about the water’s safety may be wrong. A study published in the journal Science in August 2020 found traces of several other radioactive isotopes in the Fukushima wastewater, many of which take much longer to decay than tritium, some with a toxic radioactive half life hundreds of years..

Hiroshi Kishi, head of Japan’s National Federation of Fisheries, told reporters that his group was still opposed to the ocean release. Neighboring countries including China and South Korea have also expressed concerns.

Responding to Japan’s decision, the U.S. State Department said in a statement, “In this unique and challenging situation, Japan has weighed the options and effects, has been transparent about its decision, and appears to have adopted an approach in accordance with globally accepted nuclear safety standards.”

The International Atomic Energy Agency welcomed Japan’s announcement and said it would offer technical support. It called the plan to release the water into the sea in line with international practice.

“Today’s decision by the government of Japan is a milestone that will help pave the way for continued progress in the decommissioning of the Fukushima Daiichi nuclear power plant,” the agency said in a statement. The decommissioning process is expected to take decades.

Hawaii’s physician shortage is a serious and growing statewide problem.

A rising trend in all island counties

• Oahu, the doctor shortage has increased from 377 (in 2019) to 475 (in 2020).
• Hawaii Island there was an increase from 230 to 287 last year
• Maui saw their shortage increased from 153 to 185 doctors, while
• Kauai experienced a mild doctor shortage increase, from 60 to 61.

Dr. Michelle Mitchell, a Hilo family physician described the situation this way… “We are all overworked before we entered a pandemic. And now we’re extremely overworked.”

Hawaii ranks last

Including all 50 states and Washington D.C. — when it comes to physician pay, Hawaii is at bottom of the pay scale, and with the highest cost of living.

The U.S. Census Bureau estimates that about 27 percent of Hawaii’s population will be over age 60 by the year 2030, an increase of 33 percent from 2012

The proportion of Hawaii’s population that is over 60 is growing much more rapidly than the proportion that is under 60. This growing elder group also represented greatest percentage of medical pre-existing conditions which are under some kind of doctor and or medical specialist management.

The demand for doctors, specialists and medical support services is not the root cause or explains the reason for Hawaii’s doctor shortages. In fact, it’s the one sector of the state’s economy that shows the greatest promise for growth, i.e. medical services.

Lisa Rantz, president of the Hawaii Rural Health Association and executive director of the Hilo Medical Center Foundation, said that because private practice doctors are not exempt from the state’s general excise tax, a doctor in Hawaii can expect to make comparable income to a doctor in rural Ohio, balanced against struggling to make a living in one of the highest cost states in America.

In fact, if the COVID-19 Pandemic has demonstrated anything, it is how fragile and inefficient America’s medical system today is, even as automation seeks to stream line and lower costs, it still takes doctors, specialists, and a medical infrastructure to deliver 21st century medicine.

Hawaii, a world class retirement destination

Hawaii could be leader in medicine, and create the foundation for an economic renaissance that is no longer dependent on the economic swings of the tourist trade.

With an increasing national and international population of retirees, Hawaii could take a cue from Florida in developing a diversified economy, in part catering to a retiring class of Americans with wealth spend in the state they call home.

A Brookings study last year found that from 1989 to 2016, the median net worth of families with a head of household age 65 or older increased by 68 percent.

If Hawaii’s state legislature seeks to address the inequalities among its resident population, Robin Hood tax schemes will only feed the exodus of its population now paying the majority of state taxes and funding programs dear to many of the state’s political class and its union supporters.

On the other hand, state policies which encourage the growth of medical services and the development of associated support services will be quality high paying jobs, each contributing to Hawaii’s economy, and they will provide the foundational draw for retirees seeking Aloha and quality medical care as they age and spend their retirement dollars, and a welcome change for a grateful and growing kupuna population.

A Pandemic, Doctor Shortages, An Aging Population, and a Tax-Happy State Legislature – the perfect Storm

Hilo radiologist Scott Grosskreutz, who helped form a Hawaii Physician Shortage Crisis Task Force to work with the state Legislature on the issue, said Hawaii County has an estimated 53% fewer physicians than similar-sized communities on the mainland.

Furthermore, more than one-third of the doctors the county does have are 65 years old or older, meaning many will retire soon, leaving the county in even worse straits.

This year’s legislature has multiple tax bills designed raise and/or create kinds of taxes in a mad dash to raise revenue. On such bill, SB 56, designed raise state income taxes on the so-called rich, would among other things, impact resident medical practices and would raise taxes on doctor salaries. It’s like pouring gasoline on a fire you’re trying to put out.  SB 56 is but one more example of ways to disincentivize doctors from setting up shop in Hawaii, and for existing medical practices to close down.

“It seems like there’s not a good understanding (in the Legislature) of how physicians are trained,” Grosskreutz said. “They forgo 10 years of employment opportunities during med school and residencies and fellowships … so they enter the job market in their 30s, saddled with $250,000 in student debt, and then they have to pay to move to Hawaii and set up.”

Sustainability and Resiliency

A path to Sustainability and Resiliency (often thought of as separate problems to be solved) are both in fact linked. Each require both the state and country governments to undertake coordinated policy changes, beginning with the substantial reduction in a statewide dependency on a fragile supply chain made up of locally replaceable imported fossil fuels and imported foods.

Hawaii’s 2021 legislative session is presently taking baby steps towards agriculture and energy reforms.  While the private sector, including Matson, are gearing up for access to expanded port facilities capacity in Honolulu, in order to better supply the state’s tenuous mainland lifeline.

With food as major statewide import, moving towards greater self-sufficiency will require something different than just enabling the state’s current dependencies.

The State’s Legislature this year appears to recognize this need in development of several bills encompassing the promotion and development of a diversified local agriculture system. None so far appear to address the need  for  a farm-to-consumer infrastructure as an essential first step forward towards this end.

Necessary supporting elements for resilient supply-chain are not limited to a reliable and flexible inter-island ocean-air transport system, further supported by a cold and longer term storage infrastructure to ensure an adequate domestic food supply from local as well as imported sources. Today’s neighboring island food retailers food inventory is dependent, container-to-container.

On the road to Sustainability and Resiliency, there will be necessary infrastructure and economic changes which will more than likely be disruptive to the status quo, but a plus for local jobs and a self-sufficient statewide economy prepared for the challenges of the 21st century.

1. Eliminating Statewide imported fossil fuels dependencies:
   • ENERGY – Engage in a statewide shift to economic electrification through local clean power sources: solar, wind, power battery – pump storage, and ocean energy
   • TRANSPORTATION – Implement a 20 year phase out of gasoline and diesel vehicle dependencies, replaced through zero emissions land transportation electric vehicle alternatives, integrated mass transit systems, bike lanes, and smarter urban design
2. Strengthening and integrating water supply and power systems, through the development of pumped-power storage solutions, is just one obvious solution which serves both Big Island power and water utilities.  West Hawaii Island examples:
   • WATER – Electricity and water supply are interdependent – no power, no water.  Hawaii’s water utilities (locally DWS) spend over 65% of the utility’s operating budget on electricity, a cost they freely pass-on to both agricultural and residential, and business water customers. DWS presently has no emergency power back-up to keep its pumps running and the water flowing during power interruptions and full blow blackouts.
   • POWER – Hawaiian Electric (Hawaii Island) faces increasing supply and demand power management issues, or industry nomenclature; load-balancing. Hawaii’s goal of 100% Renewable (electricity) by 2045 is dependent on the state and utilities cooperating in the development of energy storage options – problem and opportunity in which both water and power utilities can work together to mutual and public cost benefits.
3. Addressing infrastructure vulnerabilities to rising sea-levels and increased island storm impacts are also another link in the chain to sustainable and resilient outcomes. Future infrastructure development and housing, e.g., must incorporate planning and permissions which fully consider climate-compatible development.
   • Public and private housing developments incorporating self-powering micro grids, linked to the Island’s power grid is step one.
4. Advancing the state’s digital economy, first by working with private sector vendors in the creation of a high speed, broadband, telecommunications infrastructure serving all island communities
5. Developing self-powered solid waste and water treatment management systems which do not pollute and create opportunities for re-use, as well efficient and managed disposal.
   • Reduce Waste, beginning with consumer education
     • Develop reuse options which avoid the landfill, beginning with an effective reverse supply system incorporating both public and private collection-drop off centers, repurposing of goods for sale and donation
     • Develop municipal waste water systems which return gray water to R-1 Recycle, e.g. Kealakehe Wastewater Treatment Plant.  Everything pumped into the ground in Hawaii will find its way into the state’s pristine marine environment.
     • When You Can’t Avoid Waste: compost and recycle in a public waste management system designed to serve public requirements, not the other way around.
6. Education Opportunities – Supporting a statewide K-12 and college degree education system designed to serve local economic and environmental job opportunities .
7. Social Equity – Historically, some parts of our community have been left behind economically. Efforts to improve resiliency and sustainability need to ensure that ALICE (asset-limited, income-constrained, employed) and other disadvantaged communities benefit equally in the state’s economic an social transition to sustainable and self-sufficient future.
8. Developing parks and recreation opportunities which support more robust community interactions and environmental education and appreciation of Hawaii’s ania, values directly link to livability in Hawaii — translated, a greater appreciation for the interdependencies of living in and with the natural world.

• Of the Epidemiologists surveyed, the majority foresee that even with vaccines, it would probably take a year or more for many activities to safely restart, and that some parts of their lives may never return to the way they were.

• Some have begun going to the grocery store again, but don’t see vaccines making life normal any time soon.  

• Even with coronavirus vaccines on the way, many epidemiologists do not expect their lives to return to pre-pandemic normal until most Americans are vaccinated. In the meantime, most have eased up on some precautions — now going to the grocery store or seeing friends outdoors, for example — but are as cautious as ever about many activities of daily life.

• A minority of the epidemiologists said that if highly effective vaccines were widely distributed, it would be safe for Americans to begin living more freely this summer: “I am optimistic that the encouraging vaccine results mean we’ll be back on track by or during summer 2021,” said Kelly Strutz, an assistant professor at Michigan State University.

• Half surveyed said they would not change their personal behavior until at least 70 percent of the population was vaccinated. Thirty percent said they would make some changes once they were vaccinated themselves.

Concerns

• Epidemiologists are worried about many unknowns, including
  • how long immunity lasts;
  • how the virus may mutate;
  • the challenges of vaccine distribution; and the
  • possible reluctance to accept the vaccine among some groups.

On the eve of the Covid winter, the epidemiologists are living with stringent precautions and new workarounds in place, far stricter than those of many ordinary Americans. Yet those precautions have evolved since last spring, as scientists have learned more about how the coronavirus spreads and what prevents it.

Of 23 activities of daily life that the survey asked about, there were only three that the majority of respondents had done in the last month: gathering outdoors with friends; bringing in mail without precautions; and running errands, like going to the grocery store or pharmacy.

Herd Immunity

Most scientists say around 70 percent of the population will need to be immune for the United States to reach herd immunity, when the virus slows down significantly or stops. Moncef Slaoui, who is leading the government’s Operation Warp Speed vaccine development program, said this week that vaccines may roll out quickly enough for the United States to reach herd immunity by early summer. But scientists do not yet know if vaccinated people could still spread the virus.