Climate Change and the Health Sector: Lessons learned from the Covid-19 crisis
The pandemic presages many of the challenges of climate breakdown. Now is the opportunity to reform society and healthcare for a carbon-neutral future.
The scientific community sounded alarm about climate change many years ago. Over the decades, mathematical models such as temperature predictions have become increasingly precise and accurate; temperature predictions have been largely quite accurate.
Political players and policymakers have challenged one another on these issues and for years an often cumbersome international negotiation has renewed commitments and programmes – with modest results. Meanwhile, the impact of these epochal changes on the world’s health remains in the background: climate change is still associated with the image of a white bear wandering hungrily over a melting polar ice floe.
Indeed, for many years doctors and public health experts thought that climate change was not their problem, that in any case the impact on health would be in the distant future. They oversaw that the health of people and that of the planet are closely connected.
The health impacts of climate change can be divided into three broad categories: direct, indirect, and those related to social and economic changes. These categories, with different mechanisms, are also associated with significant mental health consequences.
The impact of climate change on health
Direct effects: These are illnesses and deaths that are immediate consequences of climate-related events, such as heat waves, floods, and forest fires. Also: damage to health caused by air pollutants such as particulate matter and ozone.
Indirect effects: The consequences that the transformation of ecological and biophysical systems have on the productivity of agricultural land, which in turn can lead to reduced food availability and consequent malnutrition; the availability and quality of drinking water; and the geographical distribution, seasonality, and frequency of insect-borne diseases, such as malaria and dengue.
Effects related to socio-economic changes: Infectious and chronic diseases, including mental health, as a result of migration, social tensions or conflicts generated by extreme weather events or by scarcity of resources (water and food). Also: depression following the destruction of property and land, and the loss of job opportunities associated with extreme events and long-term changes in climate.
Not the first time
In a nutshell, climate change alters the conditions of the planet and its habitability for homo sapiens. Paradoxically, this is not the first time in the history of mankind that climatic changes have influenced the destinies of entire civilisations. The decline of the Maya civilisation in Central America, for example, has been associated with four periods of severe drought, occurring between the end of the 8th and the beginning of the 10th century, which caused malnutrition, conflict, and the degradation of their cities.
Clearly, extrapolations to the present require caution. However, today's climate changes are much more pronounced, long-lasting, and global than those of the past. Despite great technological and scientific developments, the contemporary social and economic context presents new vulnerabilities that the Covid-19 pandemic has revealed. The pandemic is in some ways a foretaste of the challenges of climate change.
The Covid-19 epidemic caught many countries and their health systems unprepared. They weren’t prepared to deal with an exponentially growing phenomenon. This forced public health to chase the virus when it was too late to limit deaths and serious illnesses. If we do not prepare the necessary adaptation measures in time to limit the damage of extreme events, we will also be forced to chase the dramatic health consequences of climate change. The pandemic underlined the importance of prevention and the social role of the health sector and its leaders. An effective healthcare system protects not only health but also the economy and the well-being of society as a whole.
Many of the strategies useful in responding to climate change are common to those of pandemic response. In particular, it is important to consolidate and maintain efficient and functional monitoring and early warning systems, as well as emergency response structures and protocols that have been tested with periodic simulations.
Global problems, global solutions
The planetary crisis induced by Covid-19 has shown that global problems need global solutions. The spread of the virus, facilitated by travel and relations between economies and peoples, has been accompanied by an intense exchange of information and international collaboration on vaccines and effective therapies. Likewise, climate change can only be countered if the entire world community acts to reduce its magnitude.
In this direction, the 2015 Paris accord represents a milestone in the fight against climate change. The agreement sets out a general framework of commitments to avoid the most dramatic consequences of climate change, with the aim of limiting global warming in the 21st century to below 2 °C and possibly keeping it at 1.5 °C.
In this extraordinary endeavour, the health sector and its leaders can play a decisive role, both by contributing to the reduction of emissions and by promoting better public awareness of the phenomenon.
Health services are responsible for an average of 4.4% of total greenhouse gas emissions. A low-carbon transformation of hospitals and health services is possible by intervening at various levels with the use of energy from renewable sources; energy saving through green architectural solutions; waste reduction; and the involvement of suppliers who have in turn made a commitment to produce in a sustainable manner. A project along these lines is the Meyer paediatric hospital in Florence, Italy, which managed not only to improve its environmental footprint, but also to save on energy costs.
The health sector can act
The world of health can also contribute to the fight against climate change by informing citizens and authorities about health risks, by updating its skills and organisational models to the new risks, and by promoting the initiatives necessary for adaptation and mitigation. The prestige and authority that health professionals have in public opinion can be a valuable asset. By highlighting the health effects of climate change, health professionals can foster public acceptance of adaptation and mitigation programmes, which will have initial costs and will impose changes in lifestyles.
Health professionals can be influential witnesses to the need for an environmental transition, the importance of adaptation measures, and collaboration with other sectors for strategies that put health at the centre of policies, from transport to agriculture to industry.
In emphasizing the role of the health sector, we cannot underestimate the enormity of the problem and the difficulties that exist in trying to prevent environmental tipping points that would make changes irreversible. It is a matter of profoundly changing the way our societies and economies function, and reversing trends that are determined by economic interests and contemporary lifestyles.
Becoming aware of the existence and seriousness of climate change is the first step. But the will of governments and peoples to improve adaptation and trigger mitigation are key, as are the technologies to make them happen. The latter already exist.
Individuals can, too
And it is important to emphasise that, on a personal level, changing some of our habits would not turn our lives into a boring cycle of deprivation and inconvenience. Getting around by bicycle or walking to work or school, eating less meat, using the car less, reducing waste and the use of plastic objects – these are not hardships. By changing our lifestyle we would gain in physical and mental health. We’d reduce pollution and adopt a healthier diet. The pandemic has also taught us that contemporary technologies allow us to meet people and organise business meetings through remote connections, limiting unnecessary travel, and changing our work and living times.
An economic and social reorganisation of this magnitude has costs, even though economists and public health experts agree that the associated health and community benefits would far outweigh the costs of mitigation. Many governments and institutions, such as the EU, in response to the dire consequences of the Covid-19 pandemic, have earmarked billions of euros for economic recovery. This is a unique opportunity to accelerate the transformation towards sustainable and low-carbon societies rather than simply restoring the old models of economics and healthcare.
Roberto Bertollini is the former WHO Representative to the EU and Chief Scientist of the WHO Regional Office for Europe. He is a Richard von Weizsäcker Fellow of the Robert Bosch Academy and currently works as Advisor to the Qatar Health Minister.
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