Amid dramatic ocean swells and drenching atmospheric rivers, a new report lays bare a hidden aspect of sea level rise that has been exacerbating flooding in the Bay Area.

The report, which was released Tuesday, maps areas that could flood from groundwater hovering just a few feet, or even inches below ground. This layer of water gets pushed upward as denser water from the ocean moves inland from rising tides. On its way up, even before the water breaks the surface, it can seep into the cracks of basements, infiltrate plumbing, or, even more insidiously, re-mobilize toxic chemicals buried underground.

Communities that consider themselves “safe” from sea level rise might need to think otherwise, said Kris May, a lead author of the report and founder of Pathways Climate Institute, a research-based consulting firm in San Francisco that helps cities adapt to climate change.

“I started working on sea level rise, then I went into extreme precipitation, and then groundwater … but it’s all connected,” May said. She noted that hot spots where the soil is already saturated with rising groundwater were some of the first to flood when a recent series of atmospheric rivers dumped record rainfall onto California: “These huge storms really highlight the magnitude of the risk.”

The report unfortunately does not include all Bay Area counties. May said they expect to publish updated groundwater level data for Santa Clara and Contra Costa counties in about a year.

The new findings are the result of an unprecedented joint effort by May, the San Francisco Estuary Institute (SFEI), UC Berkeley and a wide-ranging team of regulators, building officials, and flood-control agencies to identify where the groundwater along the bay shoreline is close to, or already breaking, the surface. A set of searchable maps, available online to the public, zooms in on Alameda, Marin, San Francisco and San Mateo counties — the first of many jurisdictions that researchers hope will undergo this intensive data-refining process.

The maps build on a new but growing body of research. In 2020, another study led by the U.S. Geological Survey laid the groundwork for this issue along California’s 1,200-mile coast, and state toxic substances control officials have since started their own mapping efforts to better understand how rising groundwater might affect contaminated land.

Similar research into vulnerable communities in Southern California is now also being conducted by a team led by Cal State Long Beach and Cal State Northridge.

This emerging flood risk raises many tough questions, but the data so far make clear the need for urgent action.

“We really need to focus on where contaminants may be mobilized by rising groundwater, because that could have an immediate impact on a 6-year-old, or a pregnant woman, or someone who has extra vulnerability in their immune system,” said Kristina Hill, a UC Berkeley researcher who has been particularly concerned about underserved communities like Marin City and historically industrial areas like East Oakland, where much of the soil is contaminated. “This [remobilization] could be happening now while it’s wet outside.”

When talking about groundwater, there are two types to keep in mind: One, the kind researchers are now worried about, is the unconfined water that gathers in the pore spaces of soil very close to the surface. This is the water that runs off streets and soaks into the ground. The other type, confined in aquifers many hundreds of feet deep, is the water that we tap for drinking.

When the tide moves inland, the shallow freshwater tends to float on top of the denser saltwater — and gets pushed upward toward the surface as sea levels rise. Because the shallow groundwater is not consumed, few people have studied this layer of water in California.

Hill, who directs the Institute of Urban and Regional Development at UC Berkeley, first realized almost a decade ago that this shallow groundwater layer had been overlooked in sea level rise conversations. Together with May and Ellen Plane, who is now an environmental scientist at SFEI, she analyzed data from 10,000 wells across the Bay Area and concluded more than twice as much land could flood from groundwater as the ocean continued to rise.

Then, in a remarkable move to turn these first approximation studies into data that government agencies would actually use, the researchers called on the officials themselves to help fill in the data gaps. City and county staff tracked down geotechnical reports and other possibly useful records that had been archived in various (and often siloed) departments. They sifted through hundreds of PDFs and spreadsheets to compile all the underground data that had been gathered for construction permits and projects.

Public works staff then vetted the updated maps with their own observations — such as storm drains that back up during high tide and roads that tend to flood even when it’s not pouring.

Patterns emerged. Many of the communities most exposed to flooding were built along historical creeks or on top of filled-in wetlands. When you overlay 5.5 feet of sea level rise on the map, the water is projected to move back in to essentially every wetland area that has been filled.

Officials in San Francisco are already taking this data into account as they consider new building projects. Other cities and counties are starting to rethink their flood-protection options — a traditional levee or seawall, after all, would do nothing to stop the groundwater as it moves with the rising sea.

Ultimately, officials need to figure out what to do with all the contaminated sites along the bay that are still awaiting cleanup — or those that need to be further remediated, said Hill, who has been finalizing another set of maps that will show where, and in which direction, rising groundwater might remobilize harmful chemicals underground. The oft-used approach of “capping” a toxic waste site rather than actually removing the contamination from the soil, for example, may no longer be sufficient

Regulators at the San Francisco Bay Regional Water Quality Control Board have been following all this research with great interest and are already diving into the updated maps, said Assistant Executive Officer Lisa Horowitz McCann. The board recently ordered 16 bayfront landfills to account for groundwater rise in their long-term flood protection plans, and caseworkers are now going through hundreds of cases to figure out which sites need further action.

“This data further empowers — and actually legally supports — stronger actions that we can take,” Horowitz McCann said. “We’re looking at a bigger universe of cases now.”

Researchers hope to continue this mapping work for the rest of the Bay Area. Next up is Contra Costa County in the East Bay, where a number of historically contaminated sites are being considered for redevelopment along the industrialized shoreline of Richmond.

A lot more work also needs to be done to understand what the actual damage will look like for gas lines, septic systems, foundations and other buried infrastructure, said Patrick Barnard, whose research team at the U.S. Geological Survey has done extensive flood modeling that is used by officials across the state.

“We need to start merging this information with the engineering world,” he said.

“We built everything assuming the soil is dry… what does it mean to have it now be saturated all the time?”Barnard has also been studying what scientists are starting to call “compound extremes.”

What do we do when seawater is trying to push in during a high tide, at the same time our rivers and storm drains are trying to flush excess rainwater into the ocean, and the ground can’t absorb anything because the groundwater is also flooding?

“We looked at this in one case for the Napa River, and basically, your average annual winter storm could turn into the 100-year flood event if the ground is already saturated,” he said. “Add any amount of rain on top of it, even amounts that are not usually catastrophic … and they turn into catastrophic impacts.

”For Chris Choo, the planning manager for Marin County, helping the latest mapping effort has been eye-opening in more ways than one. She has spent years helping communities plan for climate change, and the challenges have only gotten more complicated the more each disaster seems to overwhelm the next.

“We went from drought, drought, drought and being really worried that we don’t have enough water, to suddenly, within two weeks, seeing the impacts of having way too much of it,” she said, noting not just the flooded roads that have kept her colleagues working around the clock, but also the powerful surf that ripped through much of California earlier this month and even split a pier in two.

“People still tend to think of these things as isolated terrible things, rather than as part of a collective shift … in what the future might hold,” she said. “We live in nature and too often think of ourselves as separate from it … but nature is still very much in charge.”

Staff writer John Woolfolk contributed to this report.

Getty Images announced a lawsuit against Stability AI, the company behind popular AI art tool Stable Diffusion, alleging the tech company committed copyright infringement.

The stock image giant accused Stability AI of copying and processing millions of its images without obtaining the proper licensing, according to a press release issued Tuesday. London-based Stability AI announced it had raised $101 million in funding for open-source AI tech in October and released version 2.1 of its Stable Diffusion tool in December.

“Getty Images believes artificial intelligence has the potential to stimulate creative endeavors. Accordingly, Getty Images provided licenses to leading technology innovators for purposes related to training artificial intelligence systems in a manner that respects personal and intellectual property rights,” Getty wrote in the statement. “Stability AI did not seek any such license from Getty Images and instead, we believe, chose to ignore viable licensing options and long standing legal protections in pursuit of their stand-alone commercial interests.”

Getty declined to comment further on the suit to CNN, but said that it requested a response from the AI firm before taking action. Stability AI did not respond to CNN’s request for comment.

AI art and traditional media suppliers have struggled to coexist in recent months as computer-generated images grow more available and advanced, using human-created images and art as data training.

Once available only to a select group of tech insiders, text-to-image AI systems are becoming increasingly popular and powerful. These systems include Stable Diffusion and DALL-E, from OpenAI.

Shutterstock, a Getty Images competitor and fellow stock image platform, announced plans in October to expand its partnership with OpenAI, the company behind DALL-E and viral AI chat bot ChatGPT, and enhance AI-generated content while launching a fund to compensate artists for their contributions.

These tools, which typically offer some free credits before charging, can create all kinds of images with just a few words, including those that are clearly evocative of the works of many, many artists, if not seemingly created by them. Users can invoke those artists with words such as “in the style of” or “by” along with a specific name. Current uses for these tools can range from personal amusement and hobbies to more commercial cases.

In just months, millions of people have flocked to text-to-image AI systems which are already being used to create experimental films, magazine covers and images to illustrate news stories. An image generated with an AI system called Midjourney recently won an art competition at the Colorado State Fair, creating an uproar among artists, who are concerned that their art can be stolen by these systems without due credit.

“I don’t want to participate at all in the machine that’s going to cheapen what I do,” Daniel Danger, an illustrator and print maker who learned a number of his works were used to train Stable Diffusion, told CNN in October.

Stability AI founder and CEO Emad Mostaque told CNN Business in October via email that art is a tiny fraction of the LAION training data behind Stable Diffusion. “Art makes up much less than 0.1% of the dataset and is only created when deliberately called by the user,” he said.

So how do people still get caught in the crosshairs of megastorms that have proven their ability to flood cars, ravage homes and claim lives? Have Californians—once roundly ridiculed as weather wimps—already become jaded to atmospheric rivers and overconfident that they can handle the hazards?

Meteorologists only really started digging into complicated questions about weather psychology like these around 20 years ago, according to Rebecca Morss, a senior scientist at the National Center for Atmospheric Research.

There’s a long list of reasons why people either can’t stay home in this extreme weather, or simply choose not to, so researchers are focusing on the best ways to help people recognize the risks. They want to avoid normalizing extreme events, or making people so afraid of weather reports that they shut down and reject the information entirely.

“Different people are going respond to different information in totally different ways—some people really trust authorities and science, some people don’t,” Morss said, explaining how political and cultural views complicate weather warnings. “There’s no one-size-fits-all solution. I think if this were an easy problem, we probably would have solved it by now.”

While scientific knowledge and forecast technology has improved by leaps and bounds over the last 30 years, Morss said crafting messaging that encourages emergency preparation without overstating the risks—a sure way to lose the public’s trust—is still a challenge, especially as extreme weather events become more frequent across the country due to climate change.

This messaging—and the collective response to it—has shifted significantly over the last few decades.

A lack of official warnings was partially to blame for hundreds of deaths during a 1976 flash flood in Colorado’s Big Thompson Canyon. But by 2011, after one of the deadliest tornados in U.S. history ripped through Missouri, researchers concluded that many residents had become desensitized to sirens and warnings.

At a basic level, she said it’s important to avoid meteorologist jargon, steer clear of complex information and repeat messaging to help people avoid finding themselves in a tragic situation.

“A lot of people have seen extreme weather on TV or been close to it, but how many of us have really experienced a truly life-threatening situation due to weather?” Morss pointed out. “It’s really hard to know exactly where (flooding) is going to happen, and it’s also just really hard for a person to imagine the place that they know and see every day suddenly being under all this water.”

Storms are unpredictable, she said, and it can be hard for someone to reliably judge when a normally safe roadway or other location has become an unsafe one—until it’s too late.

“We’ve all done things that we look back on afterwards and say, ‘Wow, I was so lucky,’” Morss said.

Significant storm systems in California are a routine occurrence, but Warren Blier, a meteorologist and science officer with the National Weather Service in Monterey, immediately knew the current set of storms was different.

“One day in late December, I was looking at computer model output through the extended portion of the forecast, and I remember thinking, ‘I just don’t see an end to this,’” Blier said. “What was so extraordinary was that even early on, it was starting to look to me like the possibility of just system after system after system.”

It was the first time he remembers seeing that kind of forecast since the El Niño winter of 1997-98.

“Astonished, that would be too strong,” Blier said of his reaction, “but it was more of a ‘wow’ moment—a series of ‘wow’ moments.”

While these weather conditions might generate more of a shrug for people in other parts of the country—from the Rockies and the Great Plains to the East Coast—there’s more potential for extreme impacts in a more vulnerable state like California.

He said it’s all about what people have learned and prepared for over time.

“I think people from other parts of the country who don’t routinely experience significant earthquakes find it a little mind-boggling that it doesn’t discomfort people here more, and the reverse is true when it comes to the weather stuff,” Blier said. “In Minnesota, you kind of know what weather you’re going to have, and things are designed around that. But for a generally reasonable, pleasant climate in California, when you suddenly throw in all these winds and all this water, (the state) is not really designed to accommodate all that because it’s not what routinely occurs.”

One of the most important developments in recent years is more collaboration between meteorologists and local emergency management workers—sharing weather expertise and predictions, and seeking out the best ways to disseminate that information to the community.

Daily weather briefings from the National Weather Service are sent to people like Kia Xiong, Santa Clara County’s emergency risk communications officer, who helps coordinate resources when those forecasts trigger the county’s inclement weather plans.

She said those plans activate outreach teams to reach unsheltered communities, especially along the creeks and waterways, while other public information officers blast messaging over Facebook, Twitter, Instagram, NextDoor and the county’s website.

Xiong said they stick to static posts with text and a photo—avoiding videos and gifs that relay information too slowly—to share what is happening, what people need to do and a URL or phone number to access resources. These posts are translated into English, Spanish, Chinese, Vietnamese and Tagalog, and include accessibility features like alt-text.

“That’s how we made sure that we’re reaching a broad audience and that no one is missed,” Xiong said. “The pandemic certainly changed the way we push out messaging, because now we have to make sure that all of our documentation, all of our social media posts, all of our graphics are accessible to everyone.”

But at the end of the day, community members are left to assess risks for themselves.

“Sometimes people do look out the window and see that it’s not raining as hard as the weather service or public government is saying,” Xiong said. “So it really is up to community members themselves to make those decisions.

“We can only say, ‘Hey, stay off the road’ so many times.”

But is it?

Research hasn’t proved that there is any one day more depressing than all the others, but the PR stunt that has unfortunately cemented itself into modern culture.

It began in 2005 with a news release from the now-defunct British TV channel Sky Travel: With the help of a psychologist, it said, it had calculated the most miserable day of the year.

The team had apparently worked it out with a complex formula developed by UK-based psychologist Cliff Arnall to determine people’s lowest point.

The formula was meant to analyze when people booked vacations, assuming that people were most likely to buy a ticket to paradise when they were feeling down. Arnall came up with reasons why people might want to take a vacation and from those extrapolated the gloomiest day of the year.

Arnall’s formula looks the part: [W+(D-d)]xTQ/MxNA. Upon closer inspection, however, the variables involved are subjective and plainly unscientific. W, for instance, stands for weather. D is debt and d is monthly salary, while T means time since Christmas and Q is the time since you gave up on your New Year’s resolution.

None of the factors he included can be measured, or compared by the same units. The formula can’t be adequately assessed or verified. For example, there is no way to measure the average number of days since people slipped up on their New Year’s resolution. And January’s weather varies among different states, countries and continents. In short, there is no scientific merit to it.

“I had no idea it would gain the popularity that it has,” Arnall told CNN. “I guess a lot of people recognize it in themselves.”

Arnall has also claimed to campaign against his own idea of Blue Monday as part of the “activist group” Stop Blue Monday. But that group, as it turned out, was also a marketing campaign — this time for winter tourism to the Canary Islands.

Now, he told CNN, he’d do it again.

“I don’t regret it at all,” he said, adding he has “used the media” on several occasions with the intention of starting conversations about psychology.

“My problem with academic psychology and peer reviewed publications … they don’t really make that much difference to regular people,” added Arnall, who was paid £1,200 to come up with Blue Monday.

That’s not a popular view in the profession, however.

Critics of the concept of a “Blue Monday” have held that it is irresponsible to attribute clinical depression to external causes and to suggest it could be solved with something as easy as a vacation to a sunny beach.

“This is not the right way to raise awareness,” said Dr. Antonis Kousoulis, director of the UK Mental Health Foundation’s efforts for England and Wales. “By saying this single day is the most depressing day of the year, without any evidence, we are trivializing how serious depression can be.”

“Mental health is the biggest health challenge of our generation,” he added. “Trivializing it is completely unacceptable.”

What is real is the winter blues, more clinically known as seasonal affective disorder, or SAD. It’s a form of depression that people experience usually during the fall and winter months when there is less sunlight. The most difficult months for people with SAD in the US tend to be January and February, and it improves with the arrival of spring.

Psychology Today reported that SAD is estimated to affect 10 million Americans, and that another 10% to 20% may have mild symptoms. For 5% of adults who experience SAD, for about 40% of the year they have symptoms that can be overwhelming and can interfere with their daily lives.

The condition has been linked to a biochemical imbalance in the brain prompted by shorter daylight hours and less sunlight in winter. As seasons change, people experience a shift in their biological internal clock, or circadian rhythm, that can cause them to be out of sync with their regular schedule.

The easiest way to start taking action against SAD is to focus on light exposure, either by seeking out natural sunlight or sitting in front of a light therapy box for a minimum of 20 minutes per day.

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The storm likely will mark the final major blast of precipitation for the foreseeable future, offering the region a chance to recover from deluges that have killed at least 19 people across California since late December.

Still, meteorologists warned residents to remain vigilant a little while longer as flooding risks will remain until Monday due to extremely waterlogged soils.

“The ground is still saturated,” said Colby Goatley, a National Weather Service meteorologist. “There’s still going to be plenty of chance for runoff and localized flooding. We just want everyone to keep paying attention.

“But hopefully,” he added, “this is the light at the end of the tunnel.”

Scroll down for photos and click here to read the whole story.

But 94% of the water that has flowed since New Year’s Eve through the Sacramento-San Joaquin River Delta, a linchpin of California’s water system, has continued straight to the Pacific Ocean instead of being captured and stored in the state’s reservoirs.

Environmental regulations aimed at protecting a two-inch-long fish, the endangered Delta smelt, have required the massive state and federal pumps near Tracy to reduce pumping rates by nearly half of their full limit, sharply curbing the amount of water that can be saved for farms and cities to the south.

The move has angered Central Valley politicians of both parties along with agricultural leaders, who have been arguing for many months that someone must help farmers suffering terribly during the drought. Now they are frustrated that the state Department of Water Resources and the federal Bureau of Reclamation aren’t capturing more water amid the record rainfall.

“It’s like winning the lottery and blowing it all in Vegas,” said Jim Houston, administrator of the California Farm Bureau Federation. “You have nothing to show for it at the end of the day.”

The rules were put in place by the Trump administration in 2019 and reinforced by the Newsom administration in 2020. They also are affecting urban water supplies.

The Contra Costa Water District, which relies on Delta water, has been able to add almost no water to its largest reservoir, Los Vaqueros, in the past two weeks. Its level has gone from 48% full to 50% full. And less water has flowed into San Luis Reservoir, east of Gilroy, a major supply for the Santa Clara County Valley Water District, the Metropolitan Water District in Los Angeles, and others, than otherwise would have. San Luis Reservoir has gone from 34% full on Jan. 1 to 42% full on Thursday.

“This happens every time we have high flows in the winter,” said Cindy Kao, imported water manager for the Santa Clara Valley Water District in San Jose, which provides water to 2 million people in Silicon Valley. “We are able to capture very little of it because of regulations to protect species.”

Karla Nemeth, director of the California Department of Water Resources, said Friday that the state and federal governments do not have much flexibility under the law. She said the current pumping restrictions began Jan. 3 and are scheduled to end Monday.

She said the restrictions have reduced pumping by about 45,000 acre feet over the two weeks. That’s enough water for about 225,000 people a year or enough to fill Crystal Springs Reservoir south of San Francisco 80% full.

“We share the urgency to move as much water as we can during these storms,” Nemeth said. “No question. But we also have species that are hammered by the same drought conditions. And those protections are important so we can operate the system in a balanced way.”

Under the federal Endangered Species Act signed in 1973 by Richard Nixon and the state Endangered Species Act signed in 1970 by then-Gov. Ronald Reagan, it is illegal to kill fish or wildlife at risk of extinction.

The Delta, a vast area of marshes and sloughs between Sacramento and San Francisco Bay that is roughly the size of Yosemite National Park, is where some of California’s biggest political battles over endangered species have been fought in recent decades.

The Delta is the meeting point for the state’s two largest rivers, the Sacramento, which flows south, and the San Joaquin, which flows north. That water mixes and runs westward, eventually flowing into San Francisco Bay and out through the Golden Gate to the Pacific Ocean.

In the 1950s, the federal government built huge pumps near Tracy to send water south to farmers and cities through the Central Valley Project. In the 1960s, former California Gov. Pat Brown built even bigger pumps two miles west, near Byron, that pumps Delta water into the State Water Project, which serves 27 million people.

The pumps are enormous and over time have disrupted fish and wildlife in the Delta, including smelt and salmon, sometimes grinding them up, sometimes making sloughs run backward, and other times removing up to half the Delta’s fresh water. Once plentiful, smelt and salmon numbers crashed. This winter, only five smelt have been found in the Delta by scientists.

After Sacramento River winter-run Chinook salmon were listed as endangered in 1989 and Delta smelt were listed in 1993, state and federal wildlife agencies began limiting how and when the big pumps could operate. That sparked relentless lawsuits from environmental groups, farmers and urban water agencies that continue to this day.

The key rule that has limited pumping the last two weeks is called the “first flush” rule. It requires that the pumps be ratcheted down after the first big rain every winter so that migrating smelt can move westward away from the pumps. The rule was included in the Trump administration’s Delta permits in 2019, called biological opinions, and in the Newsom administration’s state rules in 2020, known as an incidental take permit.

Environmentalists say the fish are “canaries in the coal mine” that indicate the health of the Delta, the West Coast’s largest estuary. The solution, they say, is for farms and cities to use water more efficiently and develop local sources so they take less from the Delta.

“The notion that we should just let some species go extinct because they get in the way of corporate agribusiness profits, I don’t think that’s what Californians want,” said Doug Obegi, an attorney with the Natural Resources Defense Council in San Francisco, who noted that other reservoirs around the state are filling from the rains. “No one should have the right to kill the last Delta smelt, the last chinook salmon or the last bald eagle.”

But political leaders are angry and asking for relief.

“This is no time to be dialing back the pumps,” wrote State Sen. Melissa Hurtado and Assemblywoman Jasmeet Bains, both Democrats from Bakersfield, in a letter to Gov. Gavin Newsom on Tuesday. “After several years of drought and low reservoir levels, it only makes sense to capitalize on wet conditions”

Five Republican congressmen, led by Rep. David Valadao, R-Hanford, wrote to Newsom and President Biden this week. “We have a moral obligation to provide Californians any relief that is within our control,” they said. “Government regulations should not and must not deny our constituents critical water from these storms.”

An immense amount of water was moving through the Delta on Friday. The flow rate was so high that it surpassed the volume raging down the mighty Columbia River near Portland, Oregon.

At that rate, about 159,000 cubic feet per second, the Delta was carrying enough water — 316,500 acre feet a day or 1.2 million gallons every second — to fill an empty reservoir the size of Hetch Hetchy in Yosemite National Park to the top every 27 hours.

When the state and federal pumps are fully running, they can move roughly 10,800 cubic feet per second. That means they are unable to catch most of the current deluge even if maxed out. But since Jan. 1, they have averaged just 6,415 cfs per day — far less than their capacity.

Nemeth said the issue shows the need for Newsom’s $16 billion Delta tunnel project that is designed to catch more water during big storms. She said it also shows the need to construct more reservoirs to capture wet winter flows.

If rain and snow continue this winter, the current reduced pumping won’t make much difference, experts say. But if the rain stops, as it did last year, these past two weeks will loom larger.

“It’s incredibly frustrating,” said Jennifer Pierre, general manager of the State Water Contractors, who said the rules need to be rewritten to allow more flexibility as climate change makes droughts and storms more volatile. “The jury’s still out. In May we’ll know if it was a big deal or not.”

As the University of California’s health system renews contracts with hundreds of outside hospitals and clinics — many with religious affiliations — some of its doctors and faculty want stronger language to ensure that physicians can perform the treatments they deem appropriate, including abortions for women or hysterectomies for transgender patients.

University of California Health is in the middle of a two-year process to renew contracts with affiliate hospitals and clinics that help the university deliver care in underserved parts of the state. Many of the agreements are with faith-based facilities, including prominent hospitals operated by Dignity Health, Providence, or Adventist Health. Such arrangements generate more than $20 million a year for the UC system and help the public university approach its goal of improving public health.

The current policy, adopted in 2021, states that UC physicians have the freedom to advise, refer, prescribe, or provide emergency care, covering cases in which moving a patient “would risk material deterioration to the patient’s condition.” But some UC doctors and faculty worry that physicians would be allowed to perform certain surgeries only in an emergency.

They want to add a clause stating that physicians have the right to perform procedures in a manner they deem advisable or necessary without waiting for the patient’s condition to get worse.

Others have gone so far as to urge the university to reject partnerships with hospitals that have ethical and religious directives against sterilization, abortion, some miscarriage management procedures, and some gender-affirming treatments. The Academic Senate, a faculty body that helps the university set academic policies, and other faculty councils urged the university’s president to avoid working with health care facilities because many have restrictions that “have the potential for discriminatory impact on patients.”

In response, university leaders have pledged publicly to ensure that doctors and trainees can provide whatever care they deem necessary at affiliated facilities but haven’t made changes to the policy language.

“We’ve made it clear that the treating provider is the one to decide if an emergency exists and when to act,” said Dr. Carrie Byington, executive vice president for University of California Health, at a fall meeting of the UC Board of Regents, the governing board of the university system.

UC Health has given itself until the end of this year to make contracts conform to its new policy. During the October board meeting, staffers estimated that one-third of the contracts had been evaluated. Administrators haven’t said whether the current policy thwarted any contracts.

Back in June 2021, the regents approved the policy governing how its doctors practice at outside hospitals and clinics with religious or ethical restrictions. Regent John Pérez made significant amendments to a staff proposal. At the time, it was celebrated as a win by those advocating for the university to push back on religious directives from affiliates.

Pérez noted at the time that his amendments were aimed at “making clear that it’s the regents’ expectation in policy that nothing that is not based on science or [the] best practice of medicine should limit the ability of our practitioners to practice medicine in the interest of the patients.”

But some doctors and faculty said Pérez’s proposal was then wordsmithed as it was converted from the regents’ vote into a formal policy months later. Some questioned whether the policy could be interpreted as restricting services unless there is an emergency, and said it does not go far enough to define an emergency.

“It sounds pretty good,” Dr. Tabetha Harken, director of the Complex Family Planning, Obstetrics & Gynecology division at the UC Irvine School of Medicine, testified before the board. “It passes the commonsense test, but in reality, this is just the federal minimum requirement of care.”

Pérez declined to comment to KHN.

At the regents’ meetings, concerned doctors offered examples of pregnancy and gender-affirming care they believe would be at risk in some hospitals.

One was tubal ligation or sterilization procedures immediately after birth to prevent future pregnancies that may put the woman at risk. It’s a simpler procedure if done postpartum because the uterus is larger than normal and it eliminates the need for additional surgery, said Dr. Jennifer Kerns, an associate professor at UC-San Francisco and director of the school’s Complex Family Planning Fellowship.

Dr. Mya Zapata of UCLA Health described cases of two patients who might not be able to get the same care at a religiously restricted hospital: a trans male who seeks out a hysterectomy based on a mental health referral for gender-affirming surgery, and a cisgender female who seeks out the same procedure for uterine fibroids.

In a hospital with restrictions, Zapata said, the cisgender patient would be able to get the surgery but the trans patient would not, despite both being considered nonemergency cases.

But it’s unclear if physicians are running into problems. UC Health leaders said there have been no formal complaints from university doctors or trainees practicing at affiliate medical centers about being blocked from providing care.

Critics said the lack of complaints may not reflect reality since physicians may find workarounds by transferring or referring patients elsewhere. One researcher, Lori Freedman, who works at UCSF, has spoken to dozens of doctors working at religious-affiliated hospitals across the country. Many have not filed complaints about care restrictions out of fear they’d put their job at risk, she said.

The debate stems from a partnership with Dignity Health, a Catholic-affiliated hospital system. In 2019, UCSF Medical Center leaders considered a controversial plan to create a formal affiliation with Dignity. Critics voiced opposition in heated public meetings, and the plan drew condemnation from dozens of reproductive justice advocates and the gay and transgender communities. UCSF ultimately backed off the plan.

When it became clear that UC medical centers across the state had similar affiliation contracts, faculty members raised additional concerns. Janet Napolitano, then president of the UC system, convened a working group to evaluate the consequences of ending all agreements with organizations that have religious restrictions. Ultimately, the group stressed the importance of maintaining partnerships to provide care to medically underserved populations.

“With 1 in 7 patients in the U.S. being cared for in a Catholic hospital,” the group wrote in its report, “UC’s isolating itself from major participants in the health care system would undermine our mission.”

Dignity Health, which merged in 2019 with Catholic Health Initiatives to form CommonSpirit Health, has already reached a new contract that adopts the updated UC policy. Chad Burns, a spokesperson for Dignity, said the hospital system values working with UC Health for its expertise in specialties, such as pediatric trauma, cancer, HIV, and mental health. He added that the updated agreement reflects “the shared values of UC and Dignity Health.”

Some UC doctors point out that they have not only public support, but legal standing to perform a variety of reproductive and contraceptive treatments. After California voters passed Proposition 1, the state constitution was officially changed in December to affirm that people have a right to choose to have an abortion or use contraceptives. Unlike health systems in other states, some faculty say UC Health can assert reproductive rights.

“We have a lot of latitude, being in California, to be able to make these decisions and stand in our power,” Kerns said. “I think it’s our responsibility to do so.”

“Partnering with faith-based institutions dedicated to serving vulnerable populations affords opportunities to patients who are least able to navigate our complex health systems,” she said.

This story was produced by KHN, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

As the state’s water supply shrinks from too much consumption and not enough replenishment amid climate change and long-term drought, and extreme weather brings floods, companies are paying increased attention to water, and the risks to commerce — including regulation — that arise when supply can’t meet demand.

“Water is the new carbon,” says water-resources engineer Nick Silverman, chief scientist at Bay Area water-risk analysis firm Waterplan, which counts major companies including Facebook parent Meta of Menlo Park — which, like Google, has its headquarters at close to sea level near the San Francisco Bay — among its customers.

From 2000 to 2021, California and the southwestern U.S. have seen the driest 22-year period since at least 800 A.D., “which may be a harbinger of more global warming-fueled extreme megadrought in the future,” according to a December paper in the journal Nature co-written by former NASA senior water scientist and Waterplan adviser Jay Famiglietti. “Stress on groundwater resources under these drying conditions will likely increase in the coming decades, and will be exacerbated by the need to provide more water and produce more food for a growing population.” Recent torrential storms notwithstanding, almost half of long-parched California remained under severe drought as of Jan. 10, according to the U.S. Drought Monitor.

Waterplan uses data from NASA’s Gravity Recovery and Climate Experiment, a program known as GRACE. Variations in the relative positions of the program’s pair of satellites reflect gravity’s pull, and the amount of pull can be analyzed to provide information about where water, including snow and ice, lies on and under the earth. Waterplan, headquartered in San Francisco and launched in 2020, has analyzed every watershed on Earth.

Satellite data, supplemented with information from other sources including client companies, allows Waterplan to calculate a firm’s risks related to water supply, water quality, and flooding, along with hazards associated with regulation and corporate reputation.

The Bay Area News Group asked Silverman about Waterplan’s work. His comments have been edited for length and clarity.

Q: What types of business are affected by water risk?

A: Every type of business. It’s more like, ‘Is it direct or indirect?’ Maybe it’s a supply chain kind of issue, where it’s not your water risk where you’re located but it’s that supply chain: Where do you get your products from? We use water in so many different ways, we use if for cooling in data centers, we use it for energy generation. And of course we use it in agriculture. I’m not aware of a major economic sector that shouldn’t be concerned. Any company has water risk that they should be concerned about.

Q: How does water risk affect a business?

A: If a facility does not have access to water, let’s say, that can be either their water runs out, or water quality decreases … it’s a financial risk. The water risk itself can be translated to financial risk through some fairly simple calculations which I think can hit home for a lot of corporations. You use 100 gallons to produce 100 units of such and such, you sell each unit for this amount, you can calculate how much a gallon of water is worth.

Q: How large a market does Waterplan see in California for its services?

A: The market in California is huge. California’s economy is hugely based on water. I don’t need to tell you how important agriculture is for the state… also all the data centers out there and technology centers. Fifty percent of the state uses groundwater as a water supply, and it’s difficult to track groundwater availability and changes. A third of California’s water supply comes from snowpack. Tracking the amount of water that’s way up in the mountains, oftentimes inaccessible, and also stored deeply underground, which is really hard to track … becomes really critical in terms of California understanding its water.

Q: What are the causes of water risk in California beyond consumption exceeding supply?

A: We can’t forget about water quality as aquifers deplete. Contaminants that are in those aquifers get more concentrated. You also get intrusion in a lot of places of water from the ocean. Saltwater is flowing into the groundwater.

Q: How do you assess water risk?

A: We define it as the combination of hazard exposure and vulnerability. Flooding is a really good example. What’s the probability of magnitude of a flood event? Is your facility located within a flood plain? (What is) the value of infrastructure that’s exposed? Do you have some sort of coping mechanisms if your facility gets flooded? We then break down hazard exposure and vulnerability into indicators that we can capture from hydrologic models or satellite imagery, and also facility-level information that our client provides.

A: California leads the way in water research and science but a lot of that sort of lives in academia or big institutions. There’s tremendous opportunity to connect this available science with the on-the-ground users of water, to make science accessible to the folks that need it to make informed decisions.

Name: Nick SilvermanTitle: Head of science at WaterplanAge: 44Education: PhD in regional hydroclimatology, University of Montana; master’s in engineering, University of Washington; Bachelor’s in physics and engineering, Washington and Lee UniversityFamily: Married 13 years; 8-year-old daughterBorn in: Gainesville, FloridaCity of residence: Missoula, Montana

———————————————————————————————————————————————————-

Five things about Nick Silverman:

1: My favorite thing to do is play in or on top of water: surfing, kayaking, stand-up paddle-boarding or just jumping into a mountain stream on a hot day.

2: I love to read all types of books, especially sci-fi.

3: I have become rather passionate about trying to hunt and harvest my own meat and fish. It has taught me invaluable lessons on land and wildlife conservation, food ethics, and humility.

4: I like to travel by foot, bike, or my pickup truck — planes not so much.

5: I view food in a very utilitarian way. I like to eat healthy things but my wife is the foodie.

The odds that a weather-roiling El Nino will replace the lingering La Nina phenomenon across the Northern Hemisphere this summer are slipping.

There’s a 39% chance that El Nino — a warming of the Pacific Ocean that can shut down the Atlantic hurricane season — will arrive between June and August, according to the US Climate Prediction Center. That’s down from 40% a month ago.

El Ninos are known to spark heavy rains and flooding across California as storm paths are pushed further south across North America. The phenomenon is also noted for bringing droughts across parts of Southeast Asia and India, impacting coffee and other crops. A powerful El Nino in 1997-1998 was blamed for causing $100 billion in damages and losses, along with deaths of 30,000 people around the world.

Meanwhile, there’s a 73% chance La Nina will fade between February and April, bringing an end to the third consecutive such pattern in as many years. If La Nina exits, temperatures in the Pacific will normalize ahead of a possible warming that would trigger an El Nino.

Predictions that call for changes to the larger pattern and those that extend through March to May tend to be less accurate.

La Nina still holds sway across the Pacific and has been blamed for less snow for the large cities of the eastern US, as well as dry conditions across the crop areas of Brazil and Argentina. The phenomenon usually also means a continuation of drought in California, however other weather patterns this year have bucked that trend, leaving the state drenched with flooding rain.

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DENVER — Exxon Mobil’s scientists were remarkably accurate in their predictions about global warming, even as the company made public statements that contradicted its own scientists’ conclusions, a new study says.

The study in the journal Science Thursday looked at research that Exxon funded that didn’t just confirm what climate scientists were saying, but used more than a dozen different computer models that forecast the coming warming with precision equal to or better than government and academic scientists.

This was during the same time that the oil giant publicly doubted that warming was real and dismissed climate models’ accuracy. Exxon said its understanding of climate change evolved over the years and that critics are misunderstanding its earlier research.

Scientists, governments, activists and news sites, including Inside Climate News and the Los Angeles Times, several years ago reported that “Exxon knew” about the science of climate change since about 1977 all while publicly casting doubt. What the new study does is detail how accurate Exxon funded research was. From 63% to 83% of those projections fit strict standards for accuracy and generally predicted correctly that the globe would warm about .36 degrees (.2 degrees Celsius) a decade.

The Exxon-funded science was “actually astonishing” in its precision and accuracy, said study co-author Naomi Oreskes, a Harvard science history professor. But she added so was the “hypocrisy because so much of the Exxon Mobil disinformation for so many years … was the claim that climate models weren’t reliable.”

Study lead author Geoffrey Supran, who started the work at Harvard and now is a environmental science professor at the University of Miami, said this is different than what was previously found in documents about the oil company.

“We’ve dug into not just to the language, the rhetoric in these documents, but also the data. And I’d say in that sense, our analysis really seals the deal on ‘Exxon knew’,” Supran said. It “gives us airtight evidence that Exxon Mobil accurately predicted global warming years before, then turned around and attacked the science underlying it.”

The paper quoted then-Exxon CEO Lee Raymond in 1999 as saying future climate “projections are based on completely unproven climate models, or more often, sheer speculation,” while his successor in 2013 called models “not competent.”

Exxon’s understanding of climate science developed along with the broader scientific community, and its four decades of research in climate science resulted in more than 150 papers, including 50 peer-reviewed publications, said company spokesman Todd Spitler.

“This issue has come up several times in recent years and, in each case, our answer is the same: those who talk about how ‘Exxon Knew’ are wrong in their conclusions,” Spitler said in an emailed statement. “Some have sought to misrepresent facts and Exxon Mobil’s position on climate science, and its support for effective policy solutions, by recasting well intended, internal policy debates as an attempted company disinformation campaign.”

Exxon, one of the world’s largest oil and gas companies, has been the target of numerous lawsuits that claim the company knew about the damage its oil and gas would cause to the climate, but misled the public by sowing doubt about climate change. In the latest such lawsuit, New Jersey accused five oil and gas companies including Exxon of deceiving the public for decades while knowing about the harmful toll fossil fuels take on the climate.

Similar lawsuits from New York to California have claimed that Exxon and other oil and gas companies launched public relations campaigns to stir doubts about climate change. In one, then-Massachusetts Attorney General Maura Healey said Exxon’s public relations efforts were ” reminiscent of the tobacco industry’s long denial campaign about the dangerous effects of cigarettes.”

Oreskes acknowledged in the study that she has been a paid consultant in the past for a law firm suing Exxon, while Supran has gotten a grant from the Rockefeller Family Foundation, which has also helped fund groups that were suing Exxon. The Associated Press receives some foundation support from Rockefeller and maintains full control of editorial content.

Oil giants including Exxon and Shell were accused in congressional hearings in 2021 of spreading misinformation about climate, but executives from the companies denied the accusations.

University of Illinois atmospheric scientist professor emeritus Donald Wuebbles told The Associated Press that in the 1980s he worked with Exxon-funded scientists and wasn’t surprised by what the company knew or the models. It’s what science and people who examined the issue knew.

“It was clear that Exxon Mobil knew what was going on,” Wuebbles said. “The problem is at the same time they were paying people to put out misinformation. That’s the big issue.”

There’s a difference between the “hype and spin” that companies do to get you to buy a product or politicians do to get your vote and an “outright lie … misrepresenting factual information and that’s what Exxon did,” Oreskes said.

Several outside scientists and activists said what the study showed about Exxon actions is serious.

“The harm caused by Exxon has been huge,” said University of Michigan environment dean Jonathan Overpeck. “They knew that fossil fuels, including oil and natural gas, would greatly alter the planet’s climate in ways that would be costly in terms of lives, human suffering and economic impacts. And yet, despite this understanding they choose to publicly downplay the problem of climate change and the dangers it poses to people and the planet.”

Cornell University climate scientist Natalie Mahowald asked: “How many thousands (or more) of lives have been lost or adversely impacted by Exxon Mobil’s deliberate campaign to obscure the science?”

Critics say Exxon’s past actions on climate change undermine its claims that it’s committed to reducing emissions.

“All the research we have suggests that effort to thwart climate action continues to this day, prioritizing the oil and gas industry value chain from the “potentially existential” threat of climate change, rather than the other way around,” said Faye Holder, program manager for InfluenceMap.

“The messages of denial and delay may look different, but the intention is the same.”

Bussewitz reported from New York.