Greatest Health Challenge of the Century
BC is in the midst of 3 health crises, with recovery plans underway for the COVID-19 crisis and measures still evolving for the opioid crisis. Planning for the recovery of the third health crisis the climate crisis, still seems to be lacking even though the World Health Organization has called climate change the “greatest health challenge of the century”1. The scale of this challenge is much larger, longer term and potentially devastating compared to COVID-19. Direct health effects of climate change, such as injury and disease from storms and floods, droughts, heatwaves and forest fires, are clear.2
Less obvious are the indirect health effects, such as changes in the patterns of infectious disease. Microbes usually found farther south are migrating north. Other health issues such as famine related to droughts, with resultant mass migrations, and the impacts of these traumas on mental health.2 Human health is dependent on, and inextricably linked to, the health of our planet earth Yet most governments appear to have no clear plan to manage this impending crisis.
Similarities between COVID-19 and the Planetary Health Crisis
One can see the similarities between the COVID-19 crisis and the planetary health crisis.
As uncurbed urban development and industrial agricultural expansion encroaches further into natural wildlife habitats, human interactions with wild animals are on the rise. Also on the rise are the concomitant zoonoses, the infections of humans with viruses usually seen only in animals.3 Global commerce and accessible international travel serve to accelerate the spread of these viruses, and a pandemic becomes inevitable. Scientists have been predicting a pandemic like COVID-19 for decades,4 based on ongoing human development and past experiences with other zoonoses such as the Ebola virus and SARS in 2003.
Scientists have been predicting the effects of human activity on the health of our planet for decades as well, once again with unimpeded development as the cause.5 This unimpeded development erodes our ecosystems while ever increasing pollution of our air and waters is compromising planetary health.
Now our lives are turned upside down by COVID-19, the illness caused by the microscopic SARS CoV-2 virus. Scientists have been predicting such a pandemic for many years, and have been advising governments and health systems to prepare. Many public health specialists have also warned us of the role that the health of our planet plays in increasing the chances of a pandemic.
So how did we get to this point?
The emergence of infectious disease is largely a product of anthropogenic and demographic changes, and is a hidden ‘cost’ of human economic development.4 Human population density appears to be a major factor in all new infectious disease outbreaks.4 SARS-CoV-2 appears to have originated in wildlife, presumably from bats as its primary host. A major factor in the emergence of infection in humans from wildlife sources appears to be changes in the prevalence of the host species, which can occur with reduced biodiversity and changing environments. Climate change and ecological destruction are primary drivers of these changing environments. Predicting factors for diseases originating in non-wildlife hosts (domesticated, or wild-domesticated) include human population density and growth as well as latitude.4
Additional factors of human development which may have contributed to the SARS CoV-2 virus include commercialization of bushmeat and large-scale crowded animal farming practices. Many public health experts suggest that modern agricultural practices, urbanization with encroachment into wildlife habitats, and loss of biodiversity due to human activity are major contributors to new infectious diseases in humans.
For the moment, prevention strategies such as environmental, administrative, personal and PPE (personal protective equipment)6 , and public health efforts such as social distancing, prohibiting mass gatherings, and restricting travel amongst others are the main method for managing COVID-19 spread, both here in BC and Canada, and worldwide. By “environmental measures” we mean cleaning procedures, erecting barriers, and visual cues for social distancing. Administrative measures are virtual work and video chat socializing, and staggering the attendance of workers/clients/students. Personal measures include lots of hand-washing, coughing or sneezing into your elbow, and staying home if sick. PPE refers to the wearing of masks, gloves, eye protection, and gowns as the situation may dictate.
We are seeing rising temperatures on the planet as we see fever in humans infected with the SARS-CoV-2 virus. We see difficulties in the Earth’s air quality as we see humans struggling to breathe. The Earth’s circulatory water system is increasingly polluted and malfunctioning with droughts and storms. We see the impairment of all life systems on the planet, as we see soaring extinction rates of all types of living beings, from insects to aquatic plants and animals, to birds and frogs.
As COVID-19 has travelled through many communities and lands, we have seen the disparities in its impact, along the lines of age, race and socio-economic status. Our worsening planetary health is showing similar disparities in its impact on human health, with the most severely affected being the most marginalized and oppressed communities. Climate change is already having a greater impact in the Global South, with poorer countries and regions of the world sustaining the greatest impacts to their societies.
Fighting the Intruder Different from a Thousand Cuts
However, the illness process itself is a bit different than the illness besetting the planet. COVID-19 is caused by a microbe, foreign to the human body. The human then reacts to fight this intruder via its immune system. This immune reaction, in combination with the effects of the virus, produces a cascade of chemical reactions creating the symptoms of fever, fatigue, cough and more, until either the virus is no longer able to survive, or the human host is no longer able to fight the onslaught.
The earth, on the other hand, is dying the death of a thousand cuts at the hands of one of its own organisms. These cuts are individually small and seem inconsequential, but together they are disastrous. A clear-cut here, an open pit mine there, and tar sand here, a hydroelectric dam there – the wounds and scars are easily seen. The Earth’s life force in the form of nature’s biodiversity is being drained, and slowly but surely bleeding out.
We are seeing the earth’s systems reacting to this onslaught, with a changing climate resulting in increasing temperatures, droughts, and storms.
Climate change, like the fever of COVID-19, is not the disease itself but only a symptom of the underlying disease. Treating this symptom alone will not save the planet, just as only treating the fever may not save a human life from COVID-19. A treatment of the underlying disease is instead required. For planetary health, this means a deep comprehensive look at our way of living, and a shift in our understanding of our place in this world, as well as our relationship to our natural environment.
We need to recognize that we are part and parcel of nature, and inseparable from it. We need to recognize that when we harm the natural world, we are also harming ourselves. When we compromise the health of our planet and it’s intricate complex systems, we are also compromising our own health. We need to better appreciate our place in the web of life, and our interdependence on the Earth’s billions of living and non-living beings. At this point, Earth is our only possible home. From this beautiful Earth comes our sources of life: our food, our water, our air.
As a family physician practicing in the Lower Mainland, I am relieved to see the waning of the first wave of COVID-19. At the same time, I have concerns about the impact of a second wave on my patients, and also about another building health crisis. Planetary health and human health are intertwined and inextricably linked. We must act now to minimize climate change and come up with a recovery plan for Earth.
References
- https://www.who.int/news-room/facts-in-pictures/detail/health-and-climate-change#:~:text=Climate%20change%20is%20the%20greatest,to%20human%20lives%20and%20health.
- https://www.who.int/news-room/commentaries/detail/immunity-passports-in-the-context-of-covid-19
- https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200423-sitrep-94-covid-19.pdf
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5960580/
- http://www.precaution.org/lib/05/warming_harms_health.051117.pdf.
- http://www.bccdc.ca/Health-Professionals-Site/Documents/COVID19_IPCGuidanceCommunityBasedHCPsClinicSettings.pdf
