COVID-19 is giving us a terrifying preview of the consequences of our mistreatment of nature and each other.
Editor's note: This article was produced in partnership with Wisconsin Health Professionals for Climate Action. They are committed to communicating that the global climate crisis is a public health emergency, and advocating for equitable solutions to decrease the impact of climate change on human health. This article is the first part of a series discussing human health, climate change and social justice.
This ongoing disrespect for the natural world precipitated this public health crisis and is exacerbating the next one. COVID also exposed the inequity in our public health system at a time of worldwide racial reckoning. And even as we start to see the end of the pandemic, we can glimpse a larger, more dangerous, and more unjust public health emergency of our own making: the global climate crisis. The societal disruption from climate change will make covid seem like a minor inconvenience.
The two are connected in several ways. Both are global phenomena with local impacts. Both require urgent international cooperation to effectively tackle. Both disproportionately harm the poor and communities of color. Both demand adaptation strategies that prioritize those vulnerable populations. Both affect every single human being on the planet and, in the case of the climate crisis, every other living being.
Many of the processes driving climate change, including environmental degradation, make pandemics more likely, increasingly inequitable and deadlier. It is a profound injustice that the main driver of climate change - the burning of fossil fuels - disproportionately harms those who contribute least to the problem - communities of color and the poor.
These communities, victims of systemic racism in medicine, already had worse health outcomes in nearly every metric when the pandemic hit. They have spent their lives breathing dirtier air which makes them more sick and more vulnerable to COVID-19. This disparity, along with economic factors that made them less able to adapt to the pandemic, has put them at higher risk for contracting COVID-19 and suffering worse fates from it.
Health professionals dub this confluence of factors the “social determinant of health.” Aside from genetics, health - a state of total well-being, not just freedom from disease - is driven by access to nourishing food, shelter, clean transportation, education, job opportunities, physical activity, social relationships, and healthcare. We are now seeing in real time the vital importance of the environment as another determinant.
Human beings thrive in a narrow range of environmental conditions including a stable climate and range of exposures to animal-borne illnesses, or zoonotics. Intact ecosystems are critical for supporting these. Though climate change did not cause the COVID-19 pandemic, it is driving rapid biodiversity loss, which, along with wanton destruction of Earth’s biomes, is turbocharging the transfer of animal-based diseases to human beings. Though these diseases may seem exotic, they account for a high proportion of diseases in human beings. HIV and Ebola are two very familiar examples of such diseases.
Ecosystem breakdown, driven by our relentless expansion into the wild, will make global plagues more frequent and deadlier. Sixty percent of emerging infectious diseases originate in animals and two-thirds of these come from wildlife. Habitat fragmentation increases the risk of novel zoonotics jumping to humans and worsens existing infections. In the Amazon, for example, one study showed an increase in deforestation by 4 percent increased the incidence of malaria by nearly 50 percent. It is estimated that nearly 3,000 strains of coronavirus already exist in bats.
The climate crisis is not only creating conditions that facilitate the spread of vector-borne diseases, it will make fighting future pandemics more difficult. The frequency and severity of climate-enabled extreme weather events will hamper the deployment of medicine and tax our already overburdened infrastructure. These events would necessarily make sheltering in place impossible. Climate migration will lead to increased local population density, creating conditions that could exacerbate the spread of disease.
We can still stop some of the worst effects of climate change, and we must adapt for those we cannot. This means building climate resiliency into every level of our civilization, starting with communities of color. These communities are more exposed and less able to protect themselves. The pandemic demonstrated this dynamic: by not adequately providing funding so that frontline service workers could stay home, they were forced to go to work, fueling the spread of infection that threatened us all. When one of us is vulnerable it makes us all vulnerable. When we protect the most vulnerable among us, we protect all of us.
We are already seeing how pollution ravages our health. According to an astonishing recent study published in Environmental Research, air pollution kills one in five people worldwide, more than HIV, tuberculosis, and malaria combined.
Health professionals understand that the best treatment for a disease, when possible, is prevention. A person with diabetes can prevent its worst complications - blindness, loss of limbs, kidney failure - by changing their lifestyle and taking their medicine. But once those processes start, they are very difficult to stop. If we knew a pandemic was coming, wouldn’t we plan ahead? We didn’t, and millions of lost lives and billions of dollars of lost revenue later, there is still no clear end in sight. With the climate crisis, we have the foresight to know what is coming. Do we have the fortitude to take our medicine?
Dr. Chirantan Mukhopadhyay is an ophthalmologist and current retina fellow at the University of Iowa. He is passionate about patient care, education, and public health. He became passionate about climate change advocacy when the US withdrew from the Paris Accord after the birth of his second child. He believes action is the best cure for despair.
Dr. Joel Charles is a full spectrum family physician practicing in rural southwest Wisconsin where he serves as medical director for the Kickapoo Valley Medical Clinic. From the University of Wisconsin School of Medicine and Public Health he received his MD and Master of Public Health degrees, the latter focusing on climate and health. He attended both those programs as a recipient of the Jack Kent Cooke Graduate Scholarship. He completed his residency at Sutter Santa Rosa Family Medicine Residency. Upon returning to Wisconsin he helped found and became president of Wisconsin Health Professionals for Climate Action, a fast-growing group of health professionals committed to advocating for equitable solutions to the climate crisis. He has a 2 1/2-year-old son Finn and an infant daughter Juniper, who help him remember why he does this work