CLIMATE CRISIS/PANDEMIC 

Possibility of Series of Pandemics: Scientists are Looking at Climate Crisis

A Journal of People report

COVID-19 may only be the beginning of global pandemics – a future scenario in which climate crisis may also play a role.

“We have entered a pandemic era,” said a recent study in the journal Cell. Written by Dr. Anthony Fauci and medical historian Dr. David Morens, both of the National Institute of Allergy and Infectious Diseases, the study paints a picture of a future where pandemics become more numerous.

“I don’t have a crystal ball, but what we are seeing looks very much like an acceleration of pandemics,” Morens told BuzzFeed News

Causes he cited include deforestation, urban crowding and wet markets for wild game.

Climate crisis’ possible role is complicated: We know that the virus survives longer in cold temperatures than hot, so that could mean that a warmer planet would slow the spread of the disease, said meteorologist Jeff Masters, who writes for Yale Climate Connections. On the other hand, he said heat waves cause people to spend more time indoors in air-conditioned spaces, where the spread of the disease increases.

“Thus, Florida had a difficult time with COVID-19 this summer, despite the fact that some parts of Florida recorded their hottest summer on record,” Masters told USA TODAY. “These complexities make it difficult to judge how climate change may be affecting COVID-19.”

Some scientists do believe warming will play a bigger role in future pandemics.

“We do know that climate change alters how we relate to other species on Earth and that matters to our health and our risk for infections,” said Dr. Aaron Bernstein, director of Harvard University’s T.H. Chan C-CHANGE program.

“As the planet heats up, animals big and small, on land and in the sea, are headed to the poles to get out of the heat,” he said. “That means animals are coming into contact with other animals they normally wouldn’t, and that creates an opportunity for pathogens to get into new hosts.”

In addition, Masters said the diseases of most concern globally that are worsened by climate change are the ones spread by mosquitoes, since mosquitoes like it hot and wet – conditions that are becoming increasingly common because of global warming. Malaria, Zika, chikungunya, dengue fever and the West Nile virus are all expected to spread into areas where they currently are not endemic, he said. Tick-borne diseases such as Lyme disease will also spread.

Bernstein said climate change has already made conditions more favorable to the spread of some infectious diseases, including Lyme disease, waterborne diseases such as Vibrio parahaemolyticus (which causes vomiting and diarrhea) and mosquito-borne diseases such as malaria and dengue fever.

“Future risks are not easy to foretell, but climate change hits hard on several fronts that matter to when and where pathogens appear, including temperature and rainfall patterns,” Bernstein said. “To help limit the risk of infectious diseases, we should do all we can to vastly reduce greenhouse gas emissions and limit global warming to 1.5 degrees.”

As for whether climate change could exacerbate future pandemics, Morens told USA TODAY it is too early to draw definitive conclusions.

“One might imagine that if climate change causes further environmental degradation and change (beyond what humans are already doing), then we are likely to see more of these diseases,” he said. “But one could equally argue that we will see less. These are big questions to which we may not have good answers for decades, or even centuries to come.

“But at the end of the day, for many reasons, it is hard to imagine that climate change will be anything good for human health.”

One expert said that almost certainly, the impacts of pandemics such as COVID are exacerbated by climate change.

Meteorologist Michael Mann of Penn State University called climate change a “threat multiplier,” meaning “it amplifies existing challenges and threats by increasing our vulnerability and reducing our adaptive capacity.”

He said to consider, for example, the situation in Puerto Rico, where many people have died of COVID-19 for the simple reason that they have not yet recovered, in terms of their public health infrastructure, from the devastating impacts of Hurricane Maria three years ago.

“There is no doubt in my mind that the storm was made more destructive by unusually warm tropical Atlantic sea-surface temperatures, which provide more energy and moisture for the storm,” Mann said. “This anomalous warmth can only be explained taking into account human-caused climate change.”

He said a case can also be made for at least an indirect connection between COVID-19 and climate change. Environmental degradation, including deforestation, the destruction of rain forests and natural habitats for development may be displacing exotic disease-carrying creatures in a way that does favor increased human contact.

“These same activities – deforestation in particular – are also leading to increased carbon emissions, which are behind human-caused climate change,” Mann said.

In their article – “The Climate Crisis and Covid-19 — A Major Threat to the Pandemic Response” – published in New England Journal of Medicine on July 15, 2020 (September 10, 2020
N Engl J Med 2020; 383:e70
DOI: 10.1056/NEJMp2022011) Renee N. Salas, James M. Shultz, and Caren G. Solomon said:

The United States will increasingly face complex, challenging scenarios, given the confluence of our two most pressing global health threats — the rapid emergence of the Covid-19 pandemic and the insidiously evolving climate crisis. Both these crises disproportionately harm the health of vulnerable and economically disadvantaged people, including those affected by structural racism. Understanding the challenges posed by this conjunction is essential if we are to devise effective and equitable strategies to protect and improve health. Attention must be directed toward key pathways through which the climate crisis threatens efforts to contain SARS-CoV-2 transmission and improve Covid-19 outcomes, which include difficulty maintaining physical distancing, exacerbation of coexisting conditions, and disruption of health care services.

The intensity, frequency, and duration of climate-related extreme events — including hurricanes, wildfires, floods, heat waves, and droughts — are increasing, and these events often overlap temporally and geographically,1 jeopardizing SARS-CoV-2 infection control. Both the Atlantic hurricane and western wildfire seasons are predicted to be worse than average in 2020. But proven standard disaster mitigation strategies — mass sheltering and population evacuation — increase the risk of viral transmission by moving large groups of people and gathering them close together. For example, evacuation orders were issued for more than 1 million people during Hurricane Florence in 2018. Covid-19 health risks are even greater when weather events are more intense, since widespread catastrophic damage results in mass displacement, which risks introducing the virus into new locales and clustering vulnerable survivors together in temporary accommodations.

No other year in recorded history has been as hot as the years between 2014 and 2019, and 2020 has a high likelihood of being the hottest year ever. Despite the hypothesis that higher temperatures and humidity might reduce SARS-CoV-2 transmission, Covid-19 cases are increasing rapidly throughout warm southern states, confirming expert predictions. Extreme heat poses additional challenges to Covid-19 mitigation efforts. For example, wearing a facemask, especially an N95, is uncomfortable in high heat and humidity and may exacerbate risks for heat-related illnesses; conversely, not wearing a mask increases the likelihood of spreading Covid-19. During heat waves, cooler indoor venues, including designated cooling centers, may become crowded with residents from households lacking air conditioning or facing heat-related electrical blackouts.

Cardiovascular and chronic pulmonary disease — recognized risk factors for severe Covid-19 — are closely linked to climate change, through effects including extreme heat, ground-level ozone, wildfire smoke, and increased pollen counts over longer seasons. Moreover, fine particulate matter air pollution — linked to combustion of fossil fuels — increases the prevalence of both conditions. Marginalized groups are at higher risk than others for exposure to high levels of air pollution and associated chronic illnesses, as well as for Covid-19–related illness and death. Recent unpublished data have suggested direct associations between long-term exposure to particulate air pollution and risk of Covid-19–associated death. 

Climate change also complicates the ability of patients with Covid-19 to gain access to and receive the best available health care services. Heat waves and climate-related disasters may generate a surge of “climate casualties” seeking care in facilities already filled with Covid-19 patients. Conversely, health care access for these patients may be acutely compromised in the aftermath of climate-driven extreme events, owing to physical damage to facilities, power outages, supply-chain disruptions, and depletion of staff — leading to cascading disruptions of services.

Our responses in the United States to climate change over recent years and to the Covid-19 pandemic over recent months have been inadequate and dangerous, disproportionately harming the most vulnerable communities. Both responses have been characterized by delayed and disjointed government action, denigration of scientific evidence, distortion of truth, withdrawal from critical global alliances, and reliance on antiquated public health infrastructure and fragile health care systems. To effectively manage both crises, we need an integrated response, firmly grounded in science, that values health as a fundamental right for all. As we collectively reimagine an equitable, all-hazards-responsive health infrastructure, we will need to take concrete actions focused on the key intersections between climate change and the Covid-19 pandemic.

They proposed short-term strategies for managing climate-related extreme events during the Covid-19 pandemic.

Extreme events (e.g., hurricanes, wildfires): evacuation and sheltering:

  • Communicate clearly to the public that the Covid-19 pandemic does not change the imperative to evacuate, given the substantial risks of remaining in place during extreme climate-driven hazards.
  • Use existing community pandemic-communication channels to disseminate critical information.
  • Increase the number of available shelter sites, with lower occupancy per site, more separated spaces within sites, and more space per shelter resident (e.g., using smaller “noncongregate shelters,” hotels).
  • Use standard shelter-registration information (name, contact phone number) for all persons entering, to facilitate contact tracing in case Covid-19 is diagnosed in persons who used the shelter.
  • Implement shelter protocols for infection control, including daily symptom checks, isolation of symptomatic persons, mandatory wearing of face masks, ample supplies of hand sanitizer, hand-washing stations, and meals provided in disposable containers.
  • Adapt guidance for minimizing Covid-19 viral transmission in mass care settings for use with in-home sheltering — because many evacuees shelter with family and friends.

Extreme heat: remaining at home and cooling locations:

  • Provide electricity subsidies and extend moratoriums to prevent electricity and water shutoffs for people with pandemic-related unemployment and economic hardships to allow them to remain in their homes.
  • Ensure effective alternatives to minimize heat exposure if designated cooling centers or popular indoor, air-conditioned venues are closed.
  • Ensure that cooling centers follow guidelines similar to best-practice guidelines noted above.
  • Minimize transmission risks by limiting occupancy and providing or requiring masks and hand sanitizer in air-conditioned venues open to the public, such as malls or movie theaters.
  • Use phone text messages, as used for pandemic communication, for heat-health notifications.

They wrote:

During extreme-heat events, interventions are needed to ensure that the people who are most susceptible to both heat-related illness and severe Covid-19 disease can either remain at home safely or have safe cooling options. More sustained approaches include alterations in the built environment (e.g., expanding green space, making more roofs white) and community outreach programs for the most vulnerable.

Ongoing adaptations and transformations in health care delivery, prompted by the Covid-19 pandemic, can also be effectively applied to climate-driven extreme events. In particular, the expansion of telemedicine — in areas where computer or phone service is intact — and the use of community paramedicine services can improve our ability to address medical and psychological needs, and minimize SARS-CoV-2 exposure, for people who cannot readily obtain care. Investments in strengthening our health care infrastructure and delivery systems, such as supply chains, are also essential to ensuring resiliency during pandemic or climate shocks.

Though evidence-based guidance from federal agencies is important and would be welcome, implementation of strategies at the state and local levels requires capacity, coordination, and attention to subnational needs. Given that states were forced to reprioritize budget allocations because of the pandemic, facing the challenges ahead will require coordinated federal policy and dedicated funding.

The medical scientists wrote:

In recent months, the increasing worldwide attention to the urgency of addressing climate change has been sidelined by the pandemic and the critically needed reckoning on racial inequity. Yet the interconnectedness of these challenges underscores the need for integrated policy initiatives. As emphasized in a letter. opens in new tab from 40 million health professionals to G20 leaders, governments must prioritize investments in health, clean air and water, and a stable climate in stimulus packages for recovering from the Covid-19 pandemic.

Reductions in greenhouse-gas emissions and air pollution that were observed while globally applied lockdown measures were in force to slow the spread of Covid-19 are proving to be temporary. Interventions to create sustained reductions in the use of fossil fuels can reduce the risks for multiple medical conditions — especially in vulnerable communities — by improving air quality and limiting the downstream health harms of the climate crisis.

Until the development and mass deployment of a safe and effective vaccine enables the United States to move past the Covid-19 pandemic, the climate crisis will challenge our pandemic responses; beyond the pandemic, the climate crisis will continue to pose existential risks. It is past time to implement robust and equitable responses to both.

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