1 00:00:01,040 --> 00:00:05,880 Speaker 1: Welcome to Prognosis. I'm Laura Carlson. It's day two and 2 00:00:05,960 --> 00:00:11,440 Speaker 1: twenty three since coronavirus was declared a global pandemic. Today's 3 00:00:11,480 --> 00:00:18,320 Speaker 1: main story Black people are disproportionately affected by coronavirus. One 4 00:00:18,360 --> 00:00:23,040 Speaker 1: reason for that maybe that, particularly in the US, residents 5 00:00:23,079 --> 00:00:28,040 Speaker 1: of black neighborhoods are statistically more likely to breathe bad air, 6 00:00:29,120 --> 00:00:32,960 Speaker 1: and research is beginning to show a clear relationship between 7 00:00:32,960 --> 00:00:40,320 Speaker 1: pollution and severe virus effects. But first, here's what happened 8 00:00:40,400 --> 00:00:49,560 Speaker 1: in virus News today. Spain's case count could be three 9 00:00:49,560 --> 00:00:53,760 Speaker 1: times higher than the official data shows. That's according to 10 00:00:53,840 --> 00:00:57,480 Speaker 1: Prime Minister Pedro Sanchez, who said that the total number 11 00:00:57,520 --> 00:01:01,320 Speaker 1: of people who have contracted coronavirus in the tree likely 12 00:01:01,400 --> 00:01:06,280 Speaker 1: exceeds three million. The much steeper figure is based on 13 00:01:06,440 --> 00:01:11,920 Speaker 1: scerology tests, which measure the body's response to antibodies. Today, 14 00:01:11,959 --> 00:01:17,319 Speaker 1: Sanchez urged citizens to restrict movement and social contact. At 15 00:01:17,319 --> 00:01:21,480 Speaker 1: the same time, he indicated that curbs would not cause 16 00:01:21,680 --> 00:01:27,520 Speaker 1: unnecessary damage to the Spanish economy. All around Europe, curfews 17 00:01:27,560 --> 00:01:31,000 Speaker 1: are being put in place as daily infections hit records. 18 00:01:31,880 --> 00:01:36,199 Speaker 1: In France alone, cases surged by forty one thousand, six 19 00:01:36,280 --> 00:01:41,720 Speaker 1: hundred and twenty two just yesterday. Against that backdrop, authorities 20 00:01:41,720 --> 00:01:45,240 Speaker 1: are expanding a curfew beyond Paris and other large cities, 21 00:01:45,520 --> 00:01:49,200 Speaker 1: with some additional forty six million people told to stay 22 00:01:49,200 --> 00:01:53,480 Speaker 1: at home at night. French Prime Minister Geen Castex called 23 00:01:53,480 --> 00:01:58,920 Speaker 1: the situation grave. Finally, the US Food and Drug Administration 24 00:01:59,000 --> 00:02:05,360 Speaker 1: approved the viral therapy remdesiviere from Gilead Sciences on Thursday. 25 00:02:05,640 --> 00:02:09,840 Speaker 1: Remdesviere is the first drug to obtain formal clearance for 26 00:02:09,960 --> 00:02:15,800 Speaker 1: treating the coronavirus. Regulators had granted an emergency use authorization 27 00:02:15,840 --> 00:02:19,160 Speaker 1: for the drug earlier this year, and since then it 28 00:02:19,200 --> 00:02:24,040 Speaker 1: has become a widely used therapy in hospitalized COVID nineteen patients. 29 00:02:25,080 --> 00:02:27,919 Speaker 1: It was given to President Donald Trump this month when 30 00:02:27,960 --> 00:02:32,560 Speaker 1: he was diagnosed with the virus. The approval will allow 31 00:02:32,720 --> 00:02:36,440 Speaker 1: Guilliad to market the drug to doctors, nurses, and patients 32 00:02:37,000 --> 00:02:39,600 Speaker 1: that could help solidify its position as a go to 33 00:02:39,760 --> 00:02:49,000 Speaker 1: medicine for COVID nineteen patients. And now for today's main story, 34 00:02:50,240 --> 00:02:53,080 Speaker 1: one zip code in Detroit is one of the most 35 00:02:53,120 --> 00:02:57,040 Speaker 1: polluted in Michigan, and it may not be a coincidence 36 00:02:57,080 --> 00:03:00,359 Speaker 1: that COVID deaths and severe cases in the area are 37 00:03:00,480 --> 00:03:04,680 Speaker 1: also high. Researchers have begun to confirm that pollution can 38 00:03:04,720 --> 00:03:09,520 Speaker 1: worsen the effects of the illness. Black Americans have an 39 00:03:09,600 --> 00:03:14,360 Speaker 1: increased vulnerability to COVID. Many explanations have been floated for 40 00:03:14,400 --> 00:03:17,639 Speaker 1: that Black people are more likely to have chronic illnesses 41 00:03:17,919 --> 00:03:21,160 Speaker 1: such as diabetes and high blood pressure many work and 42 00:03:21,240 --> 00:03:27,280 Speaker 1: frontline jobs. But as Cynthia Coon's reports, scientists are increasingly 43 00:03:27,360 --> 00:03:31,080 Speaker 1: certain that bad air plays a role in the coronavirus course. 44 00:03:32,000 --> 00:03:35,520 Speaker 1: I spoke to Cynthia about the relationship between high rates 45 00:03:35,520 --> 00:03:40,120 Speaker 1: of COVID nineteen among the black population and the similarly 46 00:03:40,240 --> 00:03:49,800 Speaker 1: high incidents of pollution in black neighborhoods. So, Cynthia, many 47 00:03:49,840 --> 00:03:53,360 Speaker 1: towns and cities across the US have been hit hard 48 00:03:53,440 --> 00:04:00,200 Speaker 1: by COVID. What makes Southwest Detroit's situation slightly unusual. What's 49 00:04:00,240 --> 00:04:04,280 Speaker 1: going on in Southwest Detroit is decades and decades of 50 00:04:04,360 --> 00:04:09,040 Speaker 1: exposure to pollution colliding with COVID at this moment in time. So, 51 00:04:09,120 --> 00:04:12,480 Speaker 1: this is a community that's surrounded by industrial polluters. There 52 00:04:12,480 --> 00:04:15,320 Speaker 1: are more than a dozen of them, uh surrounding a 53 00:04:15,440 --> 00:04:17,479 Speaker 1: very small area. It's just a little more than two 54 00:04:17,520 --> 00:04:22,279 Speaker 1: miles long. It's a residential community that is predominantly black, 55 00:04:22,680 --> 00:04:25,440 Speaker 1: and they've been living with the effects of pollution and 56 00:04:25,480 --> 00:04:27,320 Speaker 1: some of the health effects from when you talk to 57 00:04:27,400 --> 00:04:30,039 Speaker 1: people and you hear about their health problems and the 58 00:04:30,160 --> 00:04:32,440 Speaker 1: cancers that their family of experience, or the rates of 59 00:04:32,480 --> 00:04:35,800 Speaker 1: asthma within the community, it's clear that they've had that 60 00:04:35,880 --> 00:04:38,880 Speaker 1: pollution has taken a toll on their quality of their 61 00:04:38,880 --> 00:04:42,039 Speaker 1: health for years. And then basically we took them, We 62 00:04:42,120 --> 00:04:44,800 Speaker 1: took this moment in time to look at how COVID 63 00:04:45,200 --> 00:04:49,200 Speaker 1: has impacted this community. You know, in the community or 64 00:04:49,560 --> 00:04:52,760 Speaker 1: next to the community. What are some of the major 65 00:04:52,839 --> 00:04:57,919 Speaker 1: industries or pollutants that are causing these problems. Well, it's 66 00:04:58,000 --> 00:05:03,159 Speaker 1: actually who's who of industries that are surrounding this community. 67 00:05:03,240 --> 00:05:08,240 Speaker 1: There's oil refinery, a scrap yard, a gypsum plant, oil 68 00:05:08,360 --> 00:05:14,240 Speaker 1: storage facilities, metal shredding, wastewater treatment plants, power stations, steel plants, 69 00:05:14,279 --> 00:05:17,680 Speaker 1: asphall plants. Things as basic as the trucks that go 70 00:05:17,760 --> 00:05:21,480 Speaker 1: in and out can actually spew uh find black smoke 71 00:05:21,600 --> 00:05:24,640 Speaker 1: and particles that is so dense that people have told 72 00:05:24,680 --> 00:05:27,120 Speaker 1: me they have to pull over sometimes to avoid these 73 00:05:27,120 --> 00:05:29,360 Speaker 1: trucks that because they might not be able to even see. 74 00:05:29,839 --> 00:05:32,720 Speaker 1: And these are streets where you see these industrial plants 75 00:05:32,720 --> 00:05:34,480 Speaker 1: and then you look to the left and there's a house. 76 00:05:35,080 --> 00:05:39,640 Speaker 1: And some of these schools have industrial plants across the 77 00:05:39,720 --> 00:05:42,400 Speaker 1: street the way schools would normally have a park across 78 00:05:42,400 --> 00:05:44,120 Speaker 1: the street, or you would have suspect it would be 79 00:05:44,120 --> 00:05:47,600 Speaker 1: in a residential neighborhood. So it's pretty unbelievable the collision 80 00:05:47,720 --> 00:05:52,160 Speaker 1: of these industrial polluters and the community how close they 81 00:05:52,160 --> 00:05:55,479 Speaker 1: all live. You know, you've mentioned a whole bunch of 82 00:05:55,480 --> 00:05:59,240 Speaker 1: these already, but even prior to COVID nineteen, maybe you 83 00:05:59,279 --> 00:06:03,760 Speaker 1: could just sketch briefly some of these very serious health 84 00:06:03,800 --> 00:06:06,520 Speaker 1: tolls as a result of living next to these heavy 85 00:06:06,520 --> 00:06:09,479 Speaker 1: pollutants and industries. Yeah, I've heard about a lot of 86 00:06:09,480 --> 00:06:12,080 Speaker 1: different cancers, a lot of different cancer stories, a lot 87 00:06:12,120 --> 00:06:15,080 Speaker 1: of asthma issues. It's very interesting with asthma too. We 88 00:06:15,120 --> 00:06:18,120 Speaker 1: took a look at the rate of hospitalization from asthma, 89 00:06:18,160 --> 00:06:20,719 Speaker 1: for example, because you think of asthma's maybe you know 90 00:06:20,760 --> 00:06:23,360 Speaker 1: and inhaler and needing to use it from time to time, 91 00:06:23,360 --> 00:06:26,239 Speaker 1: but when you think about severe asthma and hospitalizations, people 92 00:06:26,240 --> 00:06:29,280 Speaker 1: in this community are hospitalized at a much higher rate 93 00:06:29,279 --> 00:06:32,400 Speaker 1: than Michigan, and I believe it was five times the 94 00:06:32,480 --> 00:06:36,000 Speaker 1: rate of Americans as a whole, so severe cases of 95 00:06:36,040 --> 00:06:38,800 Speaker 1: things like asthma. So it's it's really it's it's it's 96 00:06:38,800 --> 00:06:42,119 Speaker 1: hard to give a whole list of health problems because 97 00:06:42,120 --> 00:06:44,240 Speaker 1: there's just so many different ones that I've come up 98 00:06:44,279 --> 00:06:47,520 Speaker 1: in my reporting, but it's it's really quite clear that, 99 00:06:48,320 --> 00:06:51,479 Speaker 1: especially with asthma, that the hospitalization rates show that people 100 00:06:51,480 --> 00:06:57,640 Speaker 1: are really struggling to breathe here during with the onset 101 00:06:57,640 --> 00:07:01,640 Speaker 1: of COVID nineteen and the effects and symptoms of COVID 102 00:07:01,720 --> 00:07:05,880 Speaker 1: nineteen obviously very seriously in some cases affecting the lungs, 103 00:07:05,920 --> 00:07:09,840 Speaker 1: that there would be a very costly knock on effect 104 00:07:09,880 --> 00:07:13,280 Speaker 1: of some of these pre existing health conditions if someone 105 00:07:13,520 --> 00:07:17,200 Speaker 1: from this community were to contract COVID nineteen. I was 106 00:07:17,240 --> 00:07:20,560 Speaker 1: just wondering what your research showed you about how this 107 00:07:20,600 --> 00:07:26,920 Speaker 1: community was weathering COVID nineteen given these pre existing health tools. 108 00:07:26,960 --> 00:07:29,840 Speaker 1: So this has been a lot through my anecdotal reporting 109 00:07:29,880 --> 00:07:34,280 Speaker 1: talking to people about um the number of say family 110 00:07:34,280 --> 00:07:36,680 Speaker 1: members or community members they know who have gotten sick 111 00:07:36,960 --> 00:07:39,600 Speaker 1: or who have passed away from COVID. But what I 112 00:07:39,640 --> 00:07:41,920 Speaker 1: found really interesting was the number of people who had 113 00:07:41,960 --> 00:07:46,880 Speaker 1: these quite severe cases and that progressed to pneumonia, that 114 00:07:46,920 --> 00:07:50,280 Speaker 1: progressed to requiring a ventilator. UM. I spoke to a 115 00:07:50,320 --> 00:07:53,320 Speaker 1: woman months after she'd been diagnosed and hospitalized, and she 116 00:07:53,360 --> 00:07:55,320 Speaker 1: was still struggling to catch her breath, and she was 117 00:07:55,360 --> 00:07:57,360 Speaker 1: telling me she used to walk five miles a day 118 00:07:58,040 --> 00:07:59,960 Speaker 1: and now she never plots some walk that's more than 119 00:08:00,000 --> 00:08:02,360 Speaker 1: a half mile because she's quite nervous about, you know, 120 00:08:02,440 --> 00:08:04,560 Speaker 1: not being able to catch her breath and being too 121 00:08:04,560 --> 00:08:07,600 Speaker 1: far from home. So you can see that what's going 122 00:08:07,640 --> 00:08:09,960 Speaker 1: on here from the people I've spoken to her, that 123 00:08:10,040 --> 00:08:13,480 Speaker 1: some of these cases are just they're pretty severe. It's 124 00:08:13,520 --> 00:08:15,560 Speaker 1: not the same story as you hear about kind of 125 00:08:15,600 --> 00:08:19,440 Speaker 1: this mild illness that you you know, you can recover 126 00:08:19,560 --> 00:08:22,320 Speaker 1: from in a couple of weeks. I mean, obviously, COVID 127 00:08:22,480 --> 00:08:25,560 Speaker 1: is something we're still coming to an understanding about, by 128 00:08:25,600 --> 00:08:28,400 Speaker 1: and large, So there's a lot for us to learn here. 129 00:08:28,480 --> 00:08:30,280 Speaker 1: And this was the early days of the pandemic, so 130 00:08:30,320 --> 00:08:33,640 Speaker 1: people weren't necessarily getting treatments that might be available today 131 00:08:33,720 --> 00:08:35,520 Speaker 1: or even tested. I talk to people who've been turned 132 00:08:35,520 --> 00:08:37,839 Speaker 1: away from the hospital. They knew they were exposed to COVID, 133 00:08:37,840 --> 00:08:39,920 Speaker 1: but they're just they were they weren't being tested and 134 00:08:39,920 --> 00:08:41,760 Speaker 1: there was such a shortage of everything at that point 135 00:08:41,800 --> 00:08:44,080 Speaker 1: in March and April. But I think the thing is 136 00:08:44,160 --> 00:08:47,200 Speaker 1: we have to we also should pay attention to the 137 00:08:47,240 --> 00:08:50,240 Speaker 1: severity of COVID because this might not be a story 138 00:08:50,280 --> 00:08:53,480 Speaker 1: about higher death rate. It might be a story about 139 00:08:53,520 --> 00:08:56,760 Speaker 1: more severe cases, because these are people whose lungs may 140 00:08:56,760 --> 00:08:59,760 Speaker 1: be compromised from decades of breathing bad air. And so 141 00:08:59,800 --> 00:09:03,000 Speaker 1: that it's a line of research that I think scientists 142 00:09:03,000 --> 00:09:05,960 Speaker 1: need to explore. And um, you know, there's a small 143 00:09:06,000 --> 00:09:08,440 Speaker 1: group of scientists doing the work. There is some research emerging, 144 00:09:08,480 --> 00:09:10,920 Speaker 1: and that's really exciting. But I think there's a lot 145 00:09:10,960 --> 00:09:12,960 Speaker 1: more to go here, because this isn't just a story 146 00:09:12,960 --> 00:09:15,880 Speaker 1: about Southwest Detroit. There are plenty of parts of the 147 00:09:15,920 --> 00:09:18,280 Speaker 1: US and the rest of the world that have this 148 00:09:18,600 --> 00:09:21,000 Speaker 1: that their reality is that there people are exposed to 149 00:09:21,000 --> 00:09:25,440 Speaker 1: disproportionate amounts of pollution and and I'd love to dig 150 00:09:25,440 --> 00:09:29,480 Speaker 1: further on that of where elsewhere has there been any 151 00:09:29,520 --> 00:09:33,280 Speaker 1: research done or any link found between say, the presence 152 00:09:33,320 --> 00:09:36,920 Speaker 1: of heavy industry and these higher or more serious cases 153 00:09:36,960 --> 00:09:41,319 Speaker 1: of COVID nineteen apart from southwest Detroit. So one interesting 154 00:09:41,360 --> 00:09:44,800 Speaker 1: study out of Europe took a look. This scientist um 155 00:09:44,960 --> 00:09:47,240 Speaker 1: A research scientists took a look. He guys are thinking 156 00:09:47,240 --> 00:09:49,600 Speaker 1: about what different areas that were hard hit by COVID 157 00:09:49,600 --> 00:09:53,000 Speaker 1: in the beginning had in common. His research showed that 158 00:09:53,080 --> 00:09:56,640 Speaker 1: seventy of the deaths and he picked France, Germany, Italy, 159 00:09:56,679 --> 00:09:59,360 Speaker 1: and Spain were in the more polluted parts of this 160 00:09:59,480 --> 00:10:02,760 Speaker 1: country and so and one point five percent of the 161 00:10:02,840 --> 00:10:06,040 Speaker 1: deaths were in the least polluted parts. So he took 162 00:10:06,080 --> 00:10:10,120 Speaker 1: Europe and said, look, the least polluted parts were also 163 00:10:10,679 --> 00:10:13,800 Speaker 1: where people fared better with COVID, using death number of 164 00:10:13,840 --> 00:10:17,960 Speaker 1: deaths as this way of measuring that. Another researcher did 165 00:10:18,000 --> 00:10:23,080 Speaker 1: work out of Harvard looking at long term exposure to 166 00:10:23,400 --> 00:10:28,520 Speaker 1: pollution and what she showed was that even modest increases 167 00:10:29,040 --> 00:10:32,559 Speaker 1: lead to large increases in the death rate. So that 168 00:10:32,600 --> 00:10:36,280 Speaker 1: was interesting just linking together this idea that even having 169 00:10:36,320 --> 00:10:41,480 Speaker 1: a little more pollution exposure or modest amount more does 170 00:10:41,559 --> 00:10:45,800 Speaker 1: have a bigger implication for mortality. So those are some 171 00:10:45,840 --> 00:10:48,000 Speaker 1: studies early on, but there's there's a bit of work 172 00:10:48,000 --> 00:10:50,800 Speaker 1: going on right now. These were the very early research 173 00:10:50,880 --> 00:10:54,160 Speaker 1: projects that were getting done and published or these these 174 00:10:54,559 --> 00:10:56,960 Speaker 1: researchers were putting them out very early on and they 175 00:10:57,040 --> 00:11:01,200 Speaker 1: kind of created a stir and as especially the Harvard study, 176 00:11:01,240 --> 00:11:04,440 Speaker 1: they published it without before doing peer review, and her 177 00:11:04,480 --> 00:11:06,000 Speaker 1: thinking was, let me get this out into the world. 178 00:11:06,040 --> 00:11:09,160 Speaker 1: This is really important, and so it was interesting to 179 00:11:09,200 --> 00:11:11,200 Speaker 1: see the way the world reacted. I think there was 180 00:11:11,280 --> 00:11:14,400 Speaker 1: some positive momentum from that. She was invited to speak 181 00:11:14,440 --> 00:11:17,359 Speaker 1: to Congress and she did an event with Corey Booker 182 00:11:17,400 --> 00:11:20,880 Speaker 1: and a minister from Cancer ALI in Louisiana to talk 183 00:11:20,920 --> 00:11:23,880 Speaker 1: about these issues. So she got some quite a bit 184 00:11:23,880 --> 00:11:26,080 Speaker 1: of kind of attention for it, but she said she 185 00:11:26,160 --> 00:11:28,959 Speaker 1: also faced some people who you know, had points of 186 00:11:29,040 --> 00:11:31,600 Speaker 1: view on this, and so that's part of the process. 187 00:11:31,679 --> 00:11:34,520 Speaker 1: And so, I it's interesting to see but this research, 188 00:11:35,360 --> 00:11:38,240 Speaker 1: these researchers put this research out quite early because they 189 00:11:38,280 --> 00:11:40,880 Speaker 1: really wanted this message to get out into the world. 190 00:11:42,720 --> 00:11:46,680 Speaker 1: And finally zooming back to Southwest Detroit, you mentioned that 191 00:11:46,720 --> 00:11:50,360 Speaker 1: it was a predominantly black community, and research has shown 192 00:11:50,360 --> 00:11:55,800 Speaker 1: throughout this pandemic that many racialized communities, particularly black communities, 193 00:11:55,840 --> 00:11:59,679 Speaker 1: have suffered higher case rates more serious complications from COVID 194 00:11:59,760 --> 00:12:04,000 Speaker 1: ninth teen. How do you think this factors into what 195 00:12:04,120 --> 00:12:08,080 Speaker 1: you saw in Southwest Detroit? What what is that role there? 196 00:12:09,200 --> 00:12:12,600 Speaker 1: You're taking a community that's already dealing with a disproportionate 197 00:12:12,640 --> 00:12:18,200 Speaker 1: amount of pollution, a predominantly black community, and continuing to 198 00:12:18,280 --> 00:12:22,440 Speaker 1: pile on potential more sources of pollution. I mean, this 199 00:12:22,520 --> 00:12:26,640 Speaker 1: community also came to be partly due to the way 200 00:12:26,920 --> 00:12:30,040 Speaker 1: redlining laid out The city of Detroit and where black 201 00:12:30,040 --> 00:12:34,120 Speaker 1: people ended up living is much older history, but it's 202 00:12:34,160 --> 00:12:37,760 Speaker 1: still plays into some of the ways that this community 203 00:12:37,840 --> 00:12:40,920 Speaker 1: was formed. And then the things that started to happen 204 00:12:41,000 --> 00:12:43,560 Speaker 1: with industry. Industry has been there for a long time, 205 00:12:43,600 --> 00:12:46,520 Speaker 1: but continuing to pollute and pulling it off. I think 206 00:12:46,920 --> 00:12:49,840 Speaker 1: some of these lawsuits are really challenging that having happened 207 00:12:49,960 --> 00:12:53,240 Speaker 1: just by accident and maybe being part of this whole 208 00:12:53,240 --> 00:12:56,640 Speaker 1: systemic racism story that is, you know, really coming to 209 00:12:56,679 --> 00:12:59,000 Speaker 1: the forefront in America this year with the Black Lives 210 00:12:59,040 --> 00:13:01,800 Speaker 1: Movement that we need to really consider the way our 211 00:13:01,840 --> 00:13:07,360 Speaker 1: institutions are continuing to disadvantage people of color in this 212 00:13:07,480 --> 00:13:16,400 Speaker 1: country in very subtle and overt ways. That was Cynthia 213 00:13:16,480 --> 00:13:19,720 Speaker 1: Coons and that's it for our show today. For coverage 214 00:13:19,760 --> 00:13:22,000 Speaker 1: of the outbreak from one D and twenty beraus around 215 00:13:22,040 --> 00:13:27,080 Speaker 1: the world. Visit bloomberg dot com slash coronavirus and if 216 00:13:27,120 --> 00:13:29,319 Speaker 1: you like the show, please leave us a review and 217 00:13:29,400 --> 00:13:33,160 Speaker 1: a rating on Apple Podcasts or Spotify. It's the best 218 00:13:33,240 --> 00:13:37,320 Speaker 1: way to help more listeners find our global reporting. The 219 00:13:37,360 --> 00:13:41,760 Speaker 1: Prognosis Alia edition is produced by Tophor foreheads Jordan Gospore, 220 00:13:42,160 --> 00:13:47,000 Speaker 1: Magnus Henrickson, and me Laura Carlson. Today's main story was 221 00:13:47,040 --> 00:13:51,800 Speaker 1: reported by Cynthia Coon's original music by Leo Sidrin. Our 222 00:13:52,000 --> 00:13:56,320 Speaker 1: editors are Rick Shine and Francesca Levi. Francesca Levi is 223 00:13:56,360 --> 00:14:07,040 Speaker 1: Bloomberg's head of podcasts. Thanks for listening, Land and