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Brain Stimulation is transforming neuromodulation, from TMS and DBS to closed loop devices, targeting neural circuits for addiction, depression, Parkinsons, epilepsy, and chronic pain, powered by advanced imaging, AI analytics, and the NIH BRAIN Initiative.

Key Points

Brain stimulation uses pulses to modulate neural circuits, easing symptoms in depression, Parkinsons, and epilepsy.

✅ Noninvasive TMS and invasive DBS modulate specific brain circuits

✅ Closed loop systems adapt stimulation via real time biomarker detection

✅ Emerging uses: addiction, depression, Parkinsons, epilepsy, chronic pain

In June 2015, biology professor Colleen Hanlon went to a conference on drug dependence. As she met other researchers and wandered around a glitzy Phoenix resort’s conference rooms to learn about the latest work on therapies for drug and alcohol use disorders, she realized that out of the 730 posters, there were only two on brain stimulation as a potential treatment for addiction — both from her own lab at Wake Forest School of Medicine.

Just four years later, she would lead 76 researchers on four continents in writing a consensus article about brain stimulation as an innovative tool for addiction. And in 2020, the Food and Drug Administration approved a transcranial magnetic stimulation device to help patients quit smoking, a milestone for substance use disorders.

Brain stimulation is booming. Hanlon can attend entire conferences devoted to the study of what electrical currents do—including how targeted stimulation can improve short-term memory in older adults—to the intricate networks of highways and backroads that make up the brain’s circuitry. This expanding field of research is slowly revealing truths of the brain: how it works, how it malfunctions, and how electrical impulses, precisely targeted and controlled, might be used to treat psychiatric and neurological disorders.

In the last half-dozen years, researchers have launched investigations into how different forms of neuromodulation affect addiction, depression, loss-of-control eating, tremor, chronic pain, obsessive compulsive disorder, Parkinson’s disease, epilepsy, and more. Early studies have shown subtle electrical jolts to certain brain regions could disrupt circuit abnormalities — the miscommunications — that are thought to underlie many brain diseases, and help ease symptoms that persist despite conventional treatments.

The National Institute of Health’s massive BRAIN Initiative put circuits front and center, distributing $2.4 billion to researchers since 2013 to devise and use new tools to observe interactions between brain cells and circuits. That, in turn, has kindled interest from the private sector. Among the advances that have enhanced our understanding of how distant parts of the brain talk with one another are new imaging technology and the use of machine learning, much as utilities use AI to adapt to shifting electricity demand, to interpret complex brain signals and analyze what happens when circuits go haywire.

Still, the field is in its infancy, and even therapies that have been approved for use in patients with, for example, Parkinson’s disease or epilepsy, help only a minority of patients, and in a world where electricity drives pandemic readiness expectations can outpace evidence. “If it was the Bible, it would be the first chapter of Genesis,” said Michael Okun, executive director of the Norman Fixel Institute for Neurological Diseases at University of Florida Health.

As brain stimulation evolves, researchers face daunting hurdles, and not just scientific ones. How will brain stimulation become accessible to all the patients who need it, given how expensive and invasive some treatments are? Proving to the FDA that brain stimulation works, and does so safely, is complicated and expensive. Even with a swell of scientific momentum and an influx of funding, the agency has so far cleared brain stimulation for only a handful of limited conditions. Persuading insurers to cover the treatments is another challenge altogether. And outside the lab, researchers are debating nascent issues, such as the ethics of mind control, the privacy of a person’s brain data—concerns that echo efforts to develop algorithms to prevent blackouts during rising ransomware threats—and how to best involve patients in the study of the human brain’s far-flung regions.

Neurologist Martha Morrell is optimistic about the future of brain stimulation. She remembers the shocked reactions of her colleagues in 2004 when she left full-time teaching at Stanford (she still has a faculty appointment as a clinical professor of neurology) to direct clinical trials at NeuroPace, then a young company making neurostimulator systems to potentially treat epilepsy patients.

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“When I started working on this, everybody thought I was insane,” said Morrell. Nearly 20 years in, she sees a parallel between the story of jolting the brain’s circuitry and that of early implantable cardiac devices, such as pacemakers and defibrillators, which initially “were used as a last option, where all other medications have failed.” Now, “the field of cardiology is very comfortable incorporating electrical therapy, device therapy, into routine care. And I think that’s really where we’re going with neurology as well.”

Reaching a ‘slope of enlightenment’
Parkinson’s is, in some ways, an elder in the world of modern brain stimulation, and it shows the potential as well as the limitations of the technology. Surgeons have been implanting electrodes deep in the brains of Parkinson’s patients since the late 1990s, and in people with more advanced disease since the early 2000s.

In that time, it’s gone through the “hype cycle,” said Okun, the national medical adviser to the Parkinson’s Foundation since 2006. Feverish excitement and overinflated expectations have given way to reality, bringing scientists to a “slope of enlightenment,” he said. They have found deep brain stimulation to be very helpful for some patients with Parkinson’s, rendering them almost symptom-free by calming the shaking and tremors that medications couldn’t. But it doesn’t stop the progression of the disease, or resolve some of the problems patients with advanced Parkinson’s have walking, talking, and thinking.

In 2015, the same year Hanlon found only her lab’s research on brain stimulation at the addiction conference, Kevin O’Neill watched one finger on his left hand start doing something “funky.” One finger twitched, then two, then his left arm started tingling and a feeling appeared in his right leg, like it was about to shake but wouldn’t — a tremor.

“I was assuming it was anxiety,” O’Neill, 62, told STAT. He had struggled with anxiety before, and he had endured a stressful year: a separation, selling his home, starting a new job at a law firm in California’s Bay Area. But a year after his symptoms first began, O’Neill was diagnosed with Parkinson’s.

In the broader energy context, California has increasingly turned to battery storage to stabilize its strained grid.

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Doctors prescribed him pills that promote the release of dopamine, to offset the death of brain cells that produce this messenger molecule in circuits that control movement. But he took them infrequently because he worried about insomnia as a side effect. Walking became difficult — “I had to kind of think my left leg into moving” — and the labor lawyer found it hard to give presentations and travel to clients’ offices.

A former actor with an outgoing personality, he developed social anxiety and didn’t tell his bosses about his diagnosis for three years, and wouldn’t have, if not for two workdays in summer 2018 when his tremors were severe and obvious.

O’Neill’s tremors are all but gone since he began deep brain stimulation last May, though his left arm shakes when he feels tense.

It was during that period that he learned about deep brain stimulation, at a support group for Parkinson’s patients. “I thought, ‘I will never let anybody fuss with my brain. I’m not going to be a candidate for that,’” he recalled. “It felt like mad scientist science fiction. Like, are you kidding me?”

But over time, the idea became less radical, as O’Neill spoke to DBS patients and doctors and did his own research, and as his symptoms worsened. He decided to go for it. Last May, doctors at the University of California, San Francisco surgically placed three metal leads into his brain, connected by thin cords to two implants in his chest, just near the clavicles. A month later, he went into the lab and researchers turned the device on.

“That was a revelation that day,” he said. “You immediately — literally, immediately — feel the efficacy of these things. … You go from fully symptomatic to non-symptomatic in seconds.”

When his nephew pulled up to the curb to pick him up, O’Neill started dancing, and his nephew teared up. The following day, O’Neill couldn’t wait to get out of bed and go out, even if it was just to pick up his car from the repair shop.

In the year since, O’Neill’s walking has gone from “awkward and painful” to much improved, and his tremors are all but gone. When he is extra frazzled, like while renovating and moving into his new house overlooking the hills of Marin County, he feels tense and his left arm shakes and he worries the DBS is “failing,” but generally he returns to a comfortable, tremor-free baseline.

O’Neill worried about the effects of DBS wearing off but, for now, he can think “in terms of decades, instead of years or months,” he recalled his neurologist telling him. “The fact that I can put away that worry was the big thing.”

He’s just one patient, though. The brain has regions that are mostly uniform across all people. The functions of those regions also tend to be the same. But researchers suspect that how brain regions interact with one another — who mingles with whom, and what conversation they have — and how those mixes and matches cause complex diseases varies from person to person. So brain stimulation looks different for each patient.

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Each case of Parkinson’s manifests slightly differently, and that’s a bit of knowledge that applies to many other diseases, said Okun, who organized the nine-year-old Deep Brain Stimulation Think Tank, where leading researchers convene, review papers, and publish reports on the field’s progress each year.

“I think we’re all collectively coming to the realization that these diseases are not one-size-fits-all,” he said. “We have to really begin to rethink the entire infrastructure, the schema, the framework we start with.”

Brain stimulation is also used frequently to treat people with common forms of epilepsy, and has reduced the number of seizures or improved other symptoms in many patients. Researchers have also been able to collect high-quality data about what happens in the brain during a seizure — including identifying differences between epilepsy types. Still, only about 15% of patients are symptom-free after treatment, according to Robert Gross, a neurosurgery professor at Emory University in Atlanta.

“And that’s a critical difference for people with epilepsy. Because people who are symptom-free can drive,” which means they can get to a job in a place like Georgia, where there is little public transit, he said. So taking neuromodulation “from good to great,” is imperative, Gross said.

Renaissance for an ancient idea
Recent advances are bringing about what Gross sees as “almost a renaissance period” for brain stimulation, though the ideas that undergird the technology are millenia old. Neuromodulation goes back to at least ancient Egypt and Greece, when electrical shocks from a ray, called the “torpedo fish,” were recommended as a treatment for headache and gout. Over centuries, the fish zaps led to doctors burning holes into the brains of patients. Those “lesions” worked, somehow, but nobody could explain why they alleviated some patients’ symptoms, Okun said.

Perhaps the clearest predecessor to today’s technology is electroconvulsive therapy (ECT), which in a rudimentary and dangerous way began being used on patients with depression roughly 100 years ago, said Nolan Williams, director of the Brain Stimulation Lab at Stanford University.

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More modern forms of brain stimulation came about in the United States in the mid-20th century. A common, noninvasive approach is transcranial magnetic stimulation, which involves placing an electromagnetic coil on the scalp to transmit a current into the outermost layer of the brain. Vagus nerve stimulation (VNS), used to treat epilepsy, zaps a nerve that contributes to some seizures.

The most invasive option, deep brain stimulation, involves implanting in the skull a device attached to electrodes embedded in deep brain regions, such as the amygdala, that can’t be reached with other stimulation devices. In 1997, the FDA gave its first green light to deep brain stimulation as a treatment for tremor, and then for Parkinson’s in 2002 and the movement disorder dystonia in 2003.

Even as these treatments were cleared for patients, though, what was happening in the brain remained elusive. But advanced imaging tools now let researchers peer into the brain and map out networks — a recent breakthrough that researchers say has propelled the field of brain stimulation forward as much as increased funding has, paralleling broader efforts to digitize analog electrical systems across industry. Imaging of both human brains and animal models has helped researchers identify the neuroanatomy of diseases, target brain regions with more specificity, and watch what was happening after electrical stimulation.

Another key step has been the shift from open-loop stimulation — a constant stream of electricity — to closed-loop stimulation that delivers targeted, brief jolts in response to a symptom trigger. To make use of the futuristic technology, labs need people to develop artificial intelligence tools, informed by advances in machine learning for the energy transition, to interpret large data sets a brain implant is generating, and to tailor devices based on that information.

“We’ve needed to learn how to be data scientists,” Morrell said.

Affinity groups, like the NIH-funded Open Mind Consortium, have formed to fill that gap. Philip Starr, a neurosurgeon and developer of implantable brain devices at the University of California at San Francisco Health system, leads the effort to teach physicians how to program closed-loop devices, and works to create ethical standards for their use. “There’s been extraordinary innovation after 20 years of no innovation,” he said.

The BRAIN Initiative has been critical, several researchers told STAT. “It’s been a godsend to us,” Gross said. The NIH’s Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative was launched in 2013 during the Obama administration with a $50 million budget. BRAIN now spends over $500 million per year. Since its creation, BRAIN has given over 1,100 awards, according to NIH data. Part of the initiative’s purpose is to pair up researchers with medical technology companies that provide human-grade stimulation devices to the investigators. Nearly three dozen projects have been funded through the investigator-devicemaker partnership program and through one focused on new implantable devices for first-in-human use, according to Nick Langhals, who leads work on neurological disorders at the initiative.

The more BRAIN invests, the more research is spawned. “We learn more about what circuits are involved … which then feeds back into new and more innovative projects,” he said.

Many BRAIN projects are still in early stages, finishing enrollment or small feasibility studies, Langhals said. Over the next couple of years, scientists will begin to see some of the fruits of their labor, which could lead to larger clinical trials, or to companies developing more refined brain stimulation implants, Langhals said.

Money from the National Institutes of Mental Health, as well as the NIH’s Helping to End Addiction Long-term (HEAL), has similarly sweetened the appeal of brain stimulation, both for researchers and industry. “A critical mass” of companies interested in neuromodulation technology has mushroomed where, for two decades, just a handful of companies stood, Starr said.

More and more, pharmaceutical and digital health companies are looking at brain stimulation devices “as possible products for their future,” said Linda Carpenter, director of the Butler Hospital TMS Clinic and Neuromodulation Research Facility.

‘Psychiatry 3.0’
The experience with using brain stimulation to stop tremors and seizures inspired psychiatrists to begin exploring its use as a potentially powerful therapy for healing, or even getting ahead of, mental illness.

In 2008, the FDA approved TMS for patients with major depression who had tried, and not gotten relief from, drug therapy. “That kind of opened the door for all of us,” said Hanlon, a professor and researcher at the Center for Research on Substance Use and Addiction at Wake Forest School of Medicine. The last decade saw a surge of research into how TMS could be used to reset malfunctioning brain circuits involved in anxiety, depression, obsessive-compulsive disorder, and other conditions.

“We’re certainly entering into what a lot of people are calling psychiatry 3.0,” Stanford’s Williams said. “Whereas the first iteration was Freud and all that business, the second one was the psychopharmacology boom, and this third one is this bit around circuits and stimulation.”

Drugs alleviate some patients’ symptoms while simultaneously failing to help many others, but psychopharmacology clearly showed “there’s definitely a biology to this problem,” Williams said — a biology that in some cases may be more amenable to a brain stimulation.

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The exact mechanics of what happens between cells when brain circuits … well, short-circuit, is unclear. Researchers are getting closer to finding biomarkers that warn of an incoming depressive episode, or wave of anxiety, or loss of impulse control. Those brain signatures could be different for every patient. If researchers can find molecular biomarkers for psychiatric disorders — and find ways to preempt those symptoms by shocking particular brain regions — that would reshape the field, Williams said.

Not only would disease-specific markers help clinicians diagnose people, but they could help chip away at the stigma that paints mental illness as a personal or moral failing instead of a disease. That’s what happened for epilepsy in the 1960s, when scientific findings nudged the general public toward a deeper understanding of why seizures happen, and it’s “the same trajectory” Williams said he sees for depression.

His research at the Stanford lab also includes work on suicide, and obsessive-compulsive disorder, which the FDA said in 2018 could be treated using noninvasive TMS. Williams considers brain stimulation, with its instantaneity, to be a potential breakthrough for urgent psychiatric situations. Doctors know what to do when a patient is rushed into the emergency room with a heart attack or a stroke, but there is no immediate treatment for psychiatric emergencies, he said. Williams wonders: What if, in the future, a suicidal patient could receive TMS in the emergency room and be quickly pulled out of their depressive mental spiral?

Researchers are also actively investigating the brain biology of addiction. In August 2020, the FDA approved TMS for smoking cessation, the first such OK for a substance use disorder, which is “really exciting,” Hanlon said. Although there is some nuance when comparing substance use disorders, a primal mechanism generally defines addiction: the eternal competition between “top-down” executive control functions and “bottom-up” cravings. It’s the same process that is at work when one is deciding whether to eat another cookie or abstain — just exacerbated.

Hanlon is trying to figure out if the stop and go circuits are in the same place for all people, and whether neuromodulation should be used to strengthen top-down control or weaken bottom-up cravings. Just as brain stimulation can be used to disrupt cellular misfiring, it could also be a tool for reinforcing helpful brain functions, or for giving the addicted brain what it wants in order to curb substance use.

Evidence suggests many people with schizophrenia smoke cigarettes (a leading cause of early death for this population) because nicotine reduces the “hyperconnectivity” that characterizes the brains of people with the disease, said Heather Ward, a research fellow at Boston’s Beth Israel Deaconess Medical Center. She suspects TMS could mimic that effect, and therefore reduce cravings and some symptoms of the disease, and she hopes to prove that in a pilot study that is now enrolling patients.

If the scientific evidence proves out, clinicians say brain stimulation could be used alongside behavioral therapy and drug-based therapy to treat substance use disorders. “In the end, we’re going to need all three to help people stay sober,” Hanlon said. “We’re adding another tool to the physician’s toolbox.”

Decoding the mysteries of pain
Afavorable outcome to the ongoing research, one that would fling the doors to brain stimulation wide open for patients with myriad disorders, is far from guaranteed. Chronic pain researchers know that firsthand.

Chronic pain, among the most mysterious and hard-to-study medical phenomena, was the first use for which the FDA approved deep brain stimulation, said Prasad Shirvalkar, an assistant professor of anesthesiology at UCSF. But when studies didn’t pan out after a year, the FDA retracted its approval.

Shirvalkar is working with Starr and neurosurgeon Edward Chang on a profoundly complex problem: “decoding pain in the brain states, which has never been done,” as Starr told STAT.

Part of the difficulty of studying pain is that there is no objective way to measure it. Much of what we know about pain is from rudimentary surveys that ask patients to rate how much they’re hurting, on a scale from zero to 10.

Using implantable brain stimulation devices, the researchers ask patients for a 0-to-10 rating of their pain while recording up-and-down cycles of activity in the brain. They then use machine learning to compare the two streams of information and see what brain activity correlates with a patient’s subjective pain experience. Implantable devices let researchers collect data over weeks and months, instead of basing findings on small snippets of information, allowing for a much richer analysis.

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Duke Energy zero-coal 2050 plan outlines a decarbonized energy mix, aligning with Paris goals, cutting greenhouse gas emissions, driven by investor pressure, shifting to natural gas, extending nuclear power, and phasing out coal.

Key Points

An investor-driven scenario to end coal by 2050, shift to natural gas, extend nuclear plants, and manage climate risk.

✅ Eliminates coal from the generation mix by 2050

✅ Prioritizes natural gas transitions without CCS breakthroughs

✅ Extends nuclear plant licenses to limit carbon emissions

One of America’s largest utility companies, Duke Energy, is set to release a report later this month that sketches a drastically changed electricity mix in a carbon-constrained future.

The big picture: Duke is the latest energy company to commit to releasing a report about climate change in response to investor pressure, echoing shifts such as Europe's oil majors going electric across the sector, conveyed by non-binding but symbolically important shareholder resolutions. Duke provides electricity to more than seven million customers in the Carolinas, the Midwest and Florida.

Gritty details: The report is expected to find that coal, currently 33% of Duke’s mix, gone entirely from its portfolio by 2050 in a future scenario where the world has taken steps to cut greenhouse gas emissions, and where global coal-fired electricity use is falling markedly, to a level consistent with keeping global temperatures from rising two degrees Celsius. That’s the big ambition of the 2015 Paris climate deal, but the current commitments aren’t close to reaching that.

What they're saying: “What’s difficult about this is we are trying to overlay what we understand currently about technology,” Lynn Good, Duke CEO, told Axios in an interview on the sidelines of a major energy conference here.

She went on to say that this scenario of zero coal by 2050 doesn’t assume any breakthroughs in technology that captures carbon emissions from coal-fired power plants. “We don’t see that technology today, and we need to make economic decisions to get those units moving and replacing them with natural gas.”

Good also stressed the benefits of its several nuclear power plants, highlighting the role of sustaining U.S. nuclear power in decarbonization, which emit no carbon emissions. She said Duke isn’t considering investing in new nuclear plants, but plans to seek federal relicensing of current plants.

“If I turn them off, the resource that would replace them today is natural gas, so carbon will go up,” Good said. “Our objective is to continue to keep those plants as long as possible.”

What’s next: A spokesman said the other details of their 2050 scenario estimates will be available when the report is officially released by month’s end.

Axios reports that Duke Energy will release a report later this month that detail the utility's efforts to mitigate climate change risks and plan carbon-free electricity investments across its operations. The report includes a scenario that eliminates coal entirely from the company's power mix by 2050. Coal currently makes up about a third of Duke's generation.

Duke CEO Lynn Good told the news outlet the scenario ending coal-fired generation assumes no technological advances in emissions capture, seemingly leaving open the possibility.

Last year, a report by the Union of Concerned Scientists concluded one in four of the remaining operating coal-fired plants in the U.S. are slated for closure or conversion to natural gas, amid falling power-sector carbon emissions across the country. Duke's report is expected to be released by the end of the month.

Duke's report on its carbon plans comes at the behest of shareholders, a trend utility companies have seen growing among investors who are increasingly concerned about companies' sustainability and their financial exposure to climate policy.

Last year, a majority of shareholders of Pennsylvania utility PPL Corp. called on company management to publish a report on how climate change policies and technological innovations will affect the company's bottom line. Almost 60% of shareholders voted in favor of the non-binding proposal.

The vote, reportedly a first for the power sector, followed a similar decision by shareholders of Occidental Petroleum, which was supported by about 66% of shareholders.

Duke's Good told Axios that right now the utility does not see the coal technology on the horizon that would keep it operating plants. “We don't see that technology today, and we need to make economic decisions to get those units moving and replacing them with natural gas," Good said. However, it does not mean the utility is making near-term efforts to erase coal from its power mix. However, some utilities are taking those steps as they prepare for en energy landscape with more carbon regulations.

In addition to the 25% of coal plants heading for closure or conversion, the UCS report also said that another 17% of the nation’s operating coal plants are uneconomic compared with natural gas-fired generation, and could face retirement soon. But there is plenty of ongoing research into "clean coal" possibilities, and the federal government has expressed an interest in smaller, modular coal units.

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Hospital Electricity Reliability underpins ICU operations, ventilators, medical devices, and diagnostics, reducing power outages risks via grid power and backup generators, while energy poverty and blackouts magnify COVID-19 mortality in vulnerable regions.

Key Points

Hospital electricity reliability is steady power that keeps ICU care, ventilators and medical devices operating.

✅ ICU loads: ventilators, monitors, infusion pumps, diagnostics

✅ Grid power plus backup generators minimize outage risk

✅ Energy poverty increases COVID-19 mortality and infection

Robert Bryce, Contributor

During her three-year career as a registered nurse, my friend, C., has cared for tuberculosis patients as well as ones with severe respiratory problems. She’s now caring for COVID-19 patients at a hospital in Ventura County, California, where debates about keeping the lights on continue amid the state’s energy transition. Is she scared about catching the virus? “No,” she replied during a phone call on Thursday. “I’m pretty unflappable.”

What would scare her? She quickly replied, “a power outage,” a threat that grows during summer blackouts when heat waves drive demand. About a year ago, while working in Oregon, the hospital she was working in lost power for about 45 minutes. “It was terrifying,” she said. 

C., who wasn’t authorized by her hospital to talk to the media, and thus asked me to only use the initial of her first name, said that COVID-19 patients are particularly reliant on electrical devices. She quickly ticked off the machines: “The bed, the IV machine, vital signs monitor, heart monitor, the sequential compression devices...” COVID-19 patients are hooked up to a minimum of five electrical devices, she said, and if the virus-stricken patient needs high-pressure oxygen or a ventilator, the number of electrical devices could be two or three times that number. “You name it, it plugs in,” she said.  

Today In: Energy

The virus has infected some 2.2 million people around the world and killed more than 150,000,including more than 32,000 people here in the U.S. While those numbers are frightening, it is apparent that the toll would be far higher without adequate supplies of reliable electricity. Modern healthcare systems depend on electricity. Hospitals are particularly big consumers. Power demand in hospitals is about 36 watts per square meter, which is about six times higher than the electricity load in a typical American home, and utilities are turning to AI to adapt to electricity demands during surges. 

Beating the coronavirus is all about electricity. Indeed, nearly every aspect of coronavirus detection, testing, and treatment requires juice. Second, it appears that the virus is more deadly in places where electricity is scarce or unreliable. Finally, if there are power outages in virus hotspots or hospitals, a real risk in a grid with more blackouts than other developed countries, the damage will be even more severe. 

As my nurse friend in Ventura County made clear, her ability to provide high-quality care for patients is wholly dependent on reliable electricity. The thermometers used to check for fever are powered by electricity. The monitors she uses to keep track of her patients, as well as her Vocera, the walkie-talkie that she uses to communicate with her colleagues, runs on batteries. Testing for the virus requires electricity. One virus-testing machine, Abbott Labs’ m2000, is a 655-pound appliance that, according to its specification sheet, runs on either 120 or 240 volts of electricity. The operating manual for a ventilator made by Hamilton Medical is chock full of instructions relating to electricity, including how to manage the machine’s batteries and alarms. 

While it may be too soon to make a direct connection between lack of electricity and the lethality of the coronavirus, the early signs from the Navajo reservation indicate that energy poverty amplifies the danger. The sprawling reservation has about 175,000 residents, but it has a higher death toll from the virus than 13 states. About 10 percent of Navajos do not have electricity in their homes and more than 30 percent lack indoor plumbing. 

The death rate from the virus on the reservation now stands at 3.4 percent, which is nearly twice the global average. In the middle of last week, the entire population of Native American tribes in the U.S. accounted for about 1,100 confirmed cases of the virus and about 44 deaths. Navajos accounted for the majority of those, with 830 confirmed cases of coronavirus and 28 deaths. 

On Saturday night, the Navajo Times reported a major increase, with 1,197 positive cases of COVID-19 on the reservation and 44 deaths. Other factors may contribute to the high infection and mortality rates on the reservation, including  high rates of diabetes, obesity, and crowded residential living situations. That said, electricity and water are essential to good hygiene and health authorities say that frequent hand washing helps cut the risk of contracting the virus. 

The devastation happening on Navajoland provides a window into what may happen in crowded, electricity-poor countries like India, Pakistan, and Bangladesh. It also shows what could happen if a tornado or hurricane were to wipe out the electric grid in virus hotspots like New Orleans, as extreme weather increasingly afflicts the grid nationwide. Sure, most American hospitals have backup generators to help assure reliable power. But those generators can fail. Further, they usually burn diesel fuel which needs to be replenished every few days. 

The essential point here is that our hospitals and critical health care machines aren’t running on solar panels and batteries. Instead, they are running on grid power that’s being provided by reliable sources — coal, natural gas, hydro, and nuclear power — which together produce about 89 percent of the electricity consumed in this country, even as Russian hacking of utilities highlights cyber risks. The pandemic — which is inflicting trillions of dollars of damage on our economy and tens of thousands of deaths — underscores the criticality of abundant and reliable electricity to our society and the tremendous damage that would occur if our health care infrastructure were to be hit by extended blackouts during the fight to stop COVID-19.

In a follow-up interview on Saturday with my friend, C., she told me that while caring for patients, she and her colleagues “are entirely dependent on electricity. We take it for granted. It’s a hidden assumption in our work,” a reminder echoed by a grid report card that warns of dangerous vulnerabilities. She quickly added she and her fellow nurses “aren’t trained or equipped to deal with circumstances that would come with shoddy power. If we lost power completely, people will die.”

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Amur-Heihe ETL Power Supply Tripling will expand Russia-China electricity exports, extending 750 MW DC full-load hours to stabilize northeast China grids amid coal shortages, peak demand spikes, and cross-border energy security concerns.

Key Points

Russia will triple electricity via Amur-Heihe ETL, boosting 750 MW DC operations to relieve shortages in northeast China.

✅ 500 kV converter station increases full-load hours from 5 to 16

✅ Supports Heilongjiang, Liaoning, and Jilin grids amid coal shortfall

✅ Cross-border 750 MW DC link enhances reliability, peak demand coverage

Russia will triple electricity supplies via the Amur-Heihe electric transmission line (ETL) starting October 1, China Central Television has reported, a move seen within broader shifts in China's electricity sector by observers.

"Starting October 1, the overhead convertor substation of 500 kW (750 MW DC) will increase its daily time of operation with full loading from 5 to 16 hours per day," the TV channel said.

"This measure will make it possible to dramatically ease the situation with the electricity supply," the report said. Electricity from this converting station is used in three northeastern provinces of China - Heilongjiang, Liaoning and Jilin, while regional markets are strained as India rations coal supplies amid surging demand today. In 29 years, Russia supplied over 30 bln kilowatt hours of electricity, according to the channel.

The Amur-Heihe overhead transnational power line was constructed for increasing electricity exports to China, where projections see electricity to meet 60% of energy use by 2060 according to Shell. It was commissioned in 2012. Its maximum capacity is 750 MW.

China’s Jiemian News reported on September 27 that, amid nationwide power cuts affecting grids, 20 regions were limited in electricity supplies to a various extent due to the ongoing coal deficit. In particular, in China’s northeastern provinces, restrictions on power consumption were imposed not only on industrial enterprises, but also on households, as well as on office premises, raising concerns for U.S. solar supply chains among downstream manufacturers.

Later, China’s financial media Zhongxin Jingwei noted that the coal deficit had been triggered by price hikes brought on by tightened national environmental standards and efforts to reduce coal power production across the country. Reduced coal imports amid disruptions in the work of foreign suppliers due to the coronavirus pandemic was an additional reason, and earlier power demand drops as factories shuttered compounded imbalances.
 

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Tunisia Smart Grid Project advances with an AFD loan as STEG deploys smart meters in Sfax, upgrades grid infrastructure, boosts energy efficiency, curbs losses, and integrates renewable energy through digitalization and advanced communication systems.

Key Points

A national program funded by an AFD $131.7M loan to modernize STEG, deploy smart meters, and integrate renewable energy.

✅ 430,000 smart meters in Sfax during phase one

✅ 20-year AFD loan with 7-year grace period

✅ Cuts losses, improves efficiency, enables renewables

The Tunisian parliament has approved taking a $131.7 million loan from the French Development Agency for the implementation of a smart grid project.

Parliament passed legislation regarding the 400 million dinar ($131.7 million) loan plus a grant of $1.1 million.

The loan, to be repaid over 20 years with a grace period of up to 7 years, is part of the Tunisian government’s efforts to establish a strategy of energy switching aimed at reducing costs and enhancing operational efficiency.

The move to the smart grid had been postponed after the Tunisian Company of Electricity and Gas (STEG) announced in March 2017 that implementation of the first phase of the project would begin in early 2018 and cover the entire country by 2023.

STEG was to have received funding some time ago. Last year at the Africa Smart Grid Summit in Tunis, the company said it would initiate an international tender during the first quarter of 2019 to start the project.

The French funding is to be allocated to implementation of the first phase only, which will involve development of control and communication stations and the improvement of infrastructure, where regulatory outcomes such as the Hydro One T&D rates decision can influence investment planning in comparable markets.

It includes installation of 430,000 “intelligent” metres over three years in Sfax governorate in southern Tunisia. The second phase of the project is planned to extend the programme to the rest of the country.

Smart metres to be installed in homes and businesses in Sfax account for about 10% of the total number of metres to be deployed in Tunisia.

At the beginning of 2017, the Industrial Company of Metallic Articles (SIAM), a Tunisian industrial electrical equipment and machinery company, signed an agreement with Huawei for the Chinese company to supply smart electricity metres. The value of the deal was not disclosed.

The smart grid is designed to reduce power waste, reduce the number of unpaid bills, prevent consumer fraud such as power theft in India across distribution networks, improve the ecosystem and increase competitiveness in the electricity sector.

Experts said the main difference between the traditional and smart grids is the adoption of advanced infrastructure for measuring electricity consumption and for communication between the power plant and consumers. The data exchange allows power plants to coordinate electricity production with actual demand.

STEG previously indicated that it had implemented measures to ensure the transition to the smart grid, especially since digitalisation is playing an important role in the energy sector.

The project, which translates Tunisia’s energy plans in the form of a partnership between the public and private sectors, aims at reaching 30% of the country’s electricity need from renewable sources by 2025, even as entities like the TVA face climate goals scrutiny that can affect electricity rates in other markets.

The development of the smart grid will allow STEG to monitor consumption patterns, detect abuses and remotely monitor the grid’s power supply, at a time when regulators have questioned UK network profits to spur efficiency, underscoring the value of transparency.

“The smart grid will change the face of the energy system towards the use of renewable energies,” said Tunisian Industry Minister Slim Feriani. At the forum on alternative energies, he pointed out that energy sector digitisation requires investments in technology and a change in the consumption mentality, as new entrants consider roles like Tesla electricity retailer plans in advanced markets.

Official data indicate that Tunisia’s energy deficit accounts for one-third of the country’s annual trade deficit, which reached record levels of more than $6 billion last year.

STEG, whose debts have reached $329 million over the past eight years, a situation resembling Manitoba Hydro debt pressures in Canada, has not disclosed when and how funding would be secured for the completion of the second phase. The company insists it is working to prevent further losses and to collect its unpaid bills.

STEG CEO Moncef Harrabi, earlier this year, said: “The current situation of the company has forced us to take immediate action to reduce the worsening of the crisis and stop the financial bleeding caused by losses.”

He said the company had repeatedly asked the government to pay subsidy instalments due to the company and to enact binding decisions to force government institutions and departments to pay electricity bills, while elsewhere measures like Thailand power bill cuts have been used to support consumers.

The Tunisian government has yet to disburse the subsidy instalments due STEG for 2018 and 2019, which amount to $658 million. STEG also imports natural gas from Algeria for its power plants at a cost of $1.1 billion a year.

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EECBG Program Funding empowers states, Tribes, and local governments with DOE grants to deploy clean energy, energy efficiency, EV infrastructure, and community solar, cutting emissions, lowering utility bills, and advancing net-zero decarbonization.

Key Points

EECBG Program Funding is a $550M DOE grant for states, Tribes, and governments to deploy clean energy and efficiency.

✅ Supports EV infrastructure and community solar deployment

✅ Cuts emissions and lowers utility costs via efficiency

✅ Prioritizes Justice40 benefits for underserved communities

The Biden-Harris Administration, through the U.S. Department of Energy (DOE), today released a Notice of Intent announcing $550 million to support community-based clean energy in state, Tribal, and local governments — serving more than 250 million Americans. This investment in American communities, through the Energy Efficiency and Conservation Block Grant (EECBG) Program, will support communities across the country to develop local programming and deploy clean energy technologies to cut emissions, advance a 90% carbon-free electricity goal nationwide, and reduce consumers’ energy costs, and help meet President Biden’s goal of a net-zero economy by 2050. 

“This funding is a streamlined and flexible tool for local governments to build their electricity future with clean energy,” said U.S. Secretary of Energy Jennifer M. Granholm. “State, local, and Tribal communities nationwide will be able to leverage this funding to drive greater energy efficiency and conservation practices to lower utility bills and create healthier environments for American families.”   

The EECBG Program will fund 50 states, five U.S. territories, the District of Columbia, 774 Tribes, and 1,878 local governments in a variety of capacity-building, planning, and infrastructure efforts to reduce carbon emissions and energy use and improve energy efficiency in the transportation, building, and other related sectors. For example, communities with this funding can build out electric vehicle infrastructure and deploy community solar to serve areas that otherwise do not have access to electric vehicles or clean energy, particularly through a rural energy security program where appropriate.  

The $550 million made available through the Bipartisan Infrastructure Law (BIL) represents the second time that the EECBG Program has been funded, the first of which was through the American Recovery and Reinvestment Act of 2009. With this most recent funding, communities can build on prior investments and leverage additional clean energy funding from DOE, other federal agencies, and the private sector to achieve sustained impacts, supported by a Clean Electricity Standard where applicable, that can put their communities on a pathway to decarbonization. 

Through the EECBG Program and the Office of State and Community Energy Programs (SCEP), DOE will support the many diverse state, local, and tribal communities across the U.S., including efforts to revitalize coal communities through clean energy, as they implement this funding and other clean energy projects. To ensure no communities are left behind, the program aligns with President’s Justice40 initiative and efforts toward equity in electricity regulation to help ensure that 40% of the overall benefits of clean energy investments go to underserved and overburdened communities. 

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