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The ‘health emergency’ of climate change

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Climate change is a global emergency. Global warming is bringing serious consequences in the form of catastrophes of all kinds. More intense weather events are expected and in shorter periods of time; snowstorms, heavy rains, extreme temperatures, heat waves, sea storms etc. that will lead to droughts, floods, etc. which can affect our cities but also the entire territory simultaneously.

It will also lead to health problems in the form of air pollution, epidemics that can affect the general population. Migrations of people will lead to security problems of all kinds, etc.

Emergency services will face widespread situations of great intensity and their planning and organization should be prepared to respond to these new scenarios that are already here.

Global warming is causing a health emergency and can “undermine the achievements made in the last 50 years in terms of development and public health,” is stated, bluntly, in a report signed by a commission of experts in epidemiology, biodiversity, public policies or energy from different research centres in China and Europe. This document is the “2018 report of the Lancet Countdown on health and climate change[1]”.

The conclusions of the document make it clear that “there is no time to lose,” because climate change not only has direct consequences on people’s health, but also involves a long chain of indirect effects that have the potential to turn upside down even to the most solid of health and emergency systems.

It is not only about the damage that is closely linked to phenomena such as heat waves, floods, droughts or intense storms – much more frequent as the planet’s temperature increases – experts warn. The effects that climate change has on the biosphere – for example by affecting the availability of food or the distribution and dissemination of certain disease vectors – also have a direct impact on the health of citizens – or when determining social changes – promoting migratory waves, among other phenomena.

After a warming of only 0.85 ° C, many of the threats that had been anticipated have become real impacts, “reflects the report that, although acknowledging that some population groups, such as children, the elderly, the poor or outcasts “are particularly vulnerable” to the consequences of climate change, it also emphasizes that no one will remain oblivious to these effects due to the interconnection between societies and ecosystems.

“Climate change will limit development aspirations, including the provision of health and other services through an impact on national economies and infrastructure. It will affect well-being from a material point of view and in other ways. For example, it will exacerbate the perception of insecurity and will influence aspects such as cultural identity in directly affected places, “remarks the text.

There are more and more examples to be mentioned of how direct and indirect effects can be combined to create a ‘perfect storm’ of consequences: “The most severe heat wave occurred in the summer of 2010 in Russia.” There were more than 25,000 fires in an area of ​​1.1 million hectares, which increased the concentration of pollutants. “In combination with the heat, air pollution increased mortality between July and August 2010 in Moscow, resulting in more than 11,000 additional deaths” compared to those produced in the same period in 2009.

Among the different scenarios considered by experts, even if the CO2 reductions are reduced to zero (a highly unlikely situation), the sea level would rise on the Spanish coasts 40 centimetres in 2100, which would mean the loss of 11 meters of beach. If on the contrary the emissions continue to increase, by that date the sea level could rise even 80 centimetres by that same date, which would be equivalent to a loss of 23 meters of beach. Without forgetting that the temperature of the water would also be higher, which implies a greater number of storms and an increase in its virulence.

 

Recommendations

But the text, signed by 45 specialists, not only warns of the dangers of letting the energy model continue to be based on fossil fuels, but also brings light on how to deal with what it considers “the greatest health opportunity of the 21st century.” Through ten recommendations, it proposes to governments and political authorities around the world a model to change the tables. Among other changes, it advises investing in research on the subject, betting on the strengthening of health systems throughout the planet, the acquisition of real international commitments or the transition to cities “that support and promote healthier lifestyles for both individuals as for the planet. ”

Measures such as the reduction in the use of fossil fuels, especially in the field of transport, can reduce traffic in cities where more than 50% of the population in Europe lives. This can translate into a significant reduction of air pollution and noise in urban areas, but also in fewer accidents due to traffic and higher levels of physical activity in the population by stimulating healthier means of transport, such as use of the bicycle, recommend other experts.

In a comment accompanying the report in The Lancet, Margaret Chan, the director of the World Health Organization (WHO) recalls that the UN agency has estimated, without taking into account all the associated risks, that climate change will follow being responsible until 2030 of at least 250,000 annual deaths and that, today, 88% of the population breathes a polluted air. Therefore, it calls on the health community to promote “this growing movement to achieve a cleaner, more sustainable and healthier future.” And he concludes by paraphrasing the Secretary General of the United Nations, Ban Ki-moon: “We don’t have a plan B. There is no planet B”.

“Climate change is a medical emergency, so it requires an urgent response,” says Hugh Montgomery, director of the UCL Institute for Human Health. Healthcare and emergencies professionals must provide leadership in the struggle against climate change.

“Climate change’s effects on natural disasters can be expected to induce a rise in humanitarian crises. In addition, it will surely impact the population’s long-term general health, especially among the most fragile. There are foreseeable health risks that both ambulatory care organizations and hospitals will face as global temperatures rise. These risks include the geographic redistribution of infectious (particularly zoonotic) diseases, an increase in cardiac and respiratory illnesses, as well as a host of other health hazards. Some of these risks have been detailed for most developed countries as well as for some developing countries. Using these existing risk assessments as a template, organizational innovations as well as implementation strategies should be proposed to mitigate the disruptive effects of these health risks on emergency departments and by extension, reduce the negative impact of climate change on the populations they serve. [..] Emergency caregivers are the first actors in the case of natural disaster or in the case of an increased influx of patients in the hospital with a quasi-systematic arrival in Emergency Department. Consequently, emergency medicine and disaster medicine should be prepared to be active players in the planning to prevent and fight against the new risks linked to climate change.”[2]

Bibliography

  • Nick Watts, Markus Amann, Nigel Arnell, Sonja Ayeb-Karlsson, Kristine Belesova, Prof Helen Berry et al. The 2018 report of the Lancet Countdown on health and climate change: shaping the health of nations for centuries to come. Lancet. 2018 Dec 8;392(10163):2479-2514. doi: 10.1016/S0140-6736(18)32594-7. Epub 2018 Nov 28.
  • Watts N Neil Adger W Agnolucci P et al. Health and climate change: policy responses to protect public health. Lancet. 2015; 386: 1861-1914
  • Reuveny R, Climate change-induced migration and violent conflict, Polit Geogr. 2007; 26: 656-673
  • McMichael AJ, Globalization, climate change, and human health, N Engl J Med. 2013; 368: 1335-1343
  • Ghazali DA, Guericolas M, Thys F, Sarasin F, Arcos González P, Casalino E. Climate Change Impacts on Disaster and Emergency Medicine Focusing on Mitigation Disruptive Effects: an International Perspective. Int J Environ Res Public Health. 2018;15(7):1379. Published 2018 Jul 1. doi:10.3390/ijerph15071379

[1] https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)32594-7/fulltext

[2] Ghazali DA, Guericolas M, Thys F, Sarasin F, Arcos González P, Casalino E. Climate Change Impacts on Disaster and Emergency Medicine Focusing on Mitigation Disruptive Effects: an International Perspective. Int J Environ Res Public Health. 2018;15(7):1379. Published 2018 Jul 1. doi:10.3390/ijerph15071379