Capturing Lessons Learned: COVID-19 Insights for the Climate and Health Crisis
Friday, July 17, 2020 - 11:15
NEHA's Climate and Health Program Committee
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The coronavirus disease 2019 (COVID-19) pandemic has caused profound morbidity and mortality globally. Even the economy has not been spared from the pandemic, with job loss at increased rates in the US. Despite the present threat of COVID-19, climate change remains an ongoing threat to human health. Rising temperatures and sea levels, increasing carbon dioxide levels, and more extreme weather are causing air pollution, changes in vector ecology, increased allergens, impacts on water and food supplies, degradation of the environment, extreme heat, and severe weather events. These, in turn, lead to injuries, fatalities, mental health issues, cardiovascular and respiratory diseases, vectorborne and waterborne diseases, harmful algal blooms, malnutrition, heat-related illness, forced migration, and civil conflict. Though COVID-19 and climate change impact health in distinct ways, there is overlap, including health disparities affecting similar populations and air pollution leads to climate change, and may also increase the risk of COVID-19 mortality (Wu et al., 2020). There are key lessons learned from the COVID-19 pandemic that can be applied to the climate and health crisis, including the value of science and the importance of effective risk communication.
COVID-19 has laid bare health disparities fueled by social determinants of health. When discussing environmental health and, specifically, climate change, the importance and impact of health equity cannot be ignored. The data on health risks shows that the risks are not equal throughout the nation and its demographics. According to the American Public Health Association and Public Health Institute report on Climate Change, Health, and Equity, "African Americans are more likely to live in neighborhoods with few trees and more heat-trapping pavement. The rate of heat-related deaths in African Americans is 150–200% greater than that for nonHispanic Whites." Adverse environmental conditions, combined with pre-existing health conditions, which are frequently more prevalent in minorities and those experiencing poverty, are indicators for how badly climate change will affect health.
These effects are disproportionally burdening minorities while those who are some of the main contributors to climate change - large and wealthy corporations and sectors - are not bearing the brunt of the negative health outcomes or the cost of mitigation at the local level. In terms of community resilience and capacity to respond to emergencies caused by climate change, those who are experiencing inequities will have a more difficult, if not impossible, journey to respond to and bounce back from climate-based emergencies and frequently can languish waiting for aid. The response to Hurricane Katrina is one of the largest examples. Health inequities must be addressed when planning for and responding to climate change.
Importance of Science
This planet is home for all of us, as well as for all living things on Earth. Humans, plants, other animals, and microbes (yes, bacteria, viruses, fungi, and protozoa, etc.) survive across the globe. This orb's address within our solar system, as part of the Milky Way, and in the universe, exhibits the physical nature of the world around us. The plethora of phenomena that we witness each day, such as the moon, sunlight, ocean waters and tides, mountains, deserts, and rivers, presents us with questions like " ?why' and " ?how'.
It is SCIENCE that allows us to answer those questions. It is through science that we learn about the environment around us and how our environment. As we experience, observe, study, and inquire about our world - whether it is the structure of plants, or the locations of stars in the sky, or the components of the human body, or the elements in the periodic table, or air quality - we are gaining knowledge and an understanding of how we fit in.
Knowledge can be defined as the act of understanding or knowing gained through inquiry, experience, and study. Thus, for something to be considered as knowledge, it needs to be accurate (and real) for the person who has attained that knowledge based on the information available to them at that time. For example, you touch something that was heated, therefore it was made hot from its original state. You then explore further and learn how it became hot.
The amount of knowledge acquired about the world through science is astounding, especially when compared to the rate of progress at which humans acquire knowledge in other areas, such as philosophy or history. However, this does not mean that other branches of knowledge should be overlooked or that information gained through scientific procedure is always entirely accurate.
The belief that science was the supreme form of knowledge has been widely accepted throughout history, dating back to Ancient Greece where Aristotle developed the scientific method. At one time, many believed that science, along with math, was the only true type of knowledge. And, as new inquiry, data, findings, and other observations have been collected over time, many positive aspects of knowledge were attained in the realm of science. There are now many different branches of knowledge within the science arena, ranging from ecology to astronomy to physics to mathematics to chemistry to meteorology to physiology, and so on.
Risk Communication in the Era of Climate Change
Considering the ongoing COVID-19 worldwide pandemic, the classic book The Great Influenza by John M. Barry bears increased relevance. In his epilogue, he listed many lessons that we, as a society, should take away from the 1918-1919 H1N1 pandemic that resulted in many of the same outcomes as are currently being observed worldwide. One of the central pieces that he felt needed to be addressed was effective risk communication. His argument was that if the government had been open and honest about the known and unknown risks and realities, that much of the panic that beset Americans could have been better controlled. That pandemic occurred during a time when medical science was at a turning point; where it was transitioning from the old thoughts centered around miasma and the humors toward the novel concepts of Germ Theory and its contemporaries. Today, we are observing much of the same dissonance in risk communication laced with political propaganda from various directions. As a result, both the public and environmental health practitioners do not have a clear direction by which to base their decisions.
Unfortunately, this pandemic may just be the first of many pandemics in our future. Research is starting to show that climate change is resulting in the melting of permafrost deposits, and experts have warned that these deposits likely contain long-forgotten pathogens to which we may no longer have immunity. The topic of climate change has been hotly debated in political forums, but we are seeing evidence of its existence and impacts daily. As environmental health practitioners, we will be alongside our brothers and sisters in public health on the front lines of fighting these pandemics. We will be the people charged with setting up temporary shelters, inspecting temporary water supplies and wastewater treatment facilities, determining compliance of food processing and food service facilities with relevant standards and regulations, and developing public health emergency preparedness and response plans (among many other things). We will be the ones who are asked the tough questions at the local level and will need to have enough of a knowledge base to reply with an educated response. We need to practice effective risk communication.
The H1N1 pandemic of 1918-1919 has shown what can happen when risk communication is politicized. After dissipating late in the fall of 1918, a second (and subsequently third) wave of the disease hit the world population, forming a W-shaped mortality curve. The author attributed much of this to poor risk communication, where people thought that the influenza was gone, and they stopped social distancing and using appropriate precautions too soon. Similarly, we see increases in the incidence of "natural" disasters and the re-emergence (or creation of new) pathogens that increase the worldwide morbidity and mortality regularly. Climate change is real, and we need to find effective ways to communicate that among our colleagues, as well as to the public. We need to learn from the mistakes of the past to prevent future pandemics and other events that could result from uncontrolled climate change.
Threats to the value of science and ineffective risk communication undermine public health. Both threats are experienced through the course of COVID-19 and the climate and health crisis. However, given the urgency to address both public health emergencies, there has never been a more urgent time to value science and risk communication. Science is the substance of public and environmental health. Science underscores evidence-based decision-making, as well as data-driven decision-making, and drives effective policies and interventions. Beyond that, science also informs best practices in risk communication and allows the risks described to be accurate and well-informed.
NEHA members at the Environmental Justice Town Hall in November 2019 in Philadelphia.
About the NEHA Climate and Health Program Committee
The Climate and Health Program Committee is a collection of 10-12 NEHA members and subject matter experts on climate and health. The program committee provides guidance, input, and expertise to NEHA leadership and program staff, fellow environmental health professionals, and partner organizations on climate and health policies and programs. NEHA's Climate Change Policy Statement put forth by the committee, advocates for national, state, and local policies, regulations, research, and resources that will enhance the ability of environmental health professionals to mitigate, adapt, and prevent the environmental and health impacts of climate change and protect public health.
Tania M. Busch Isaksen, MPH, PhD, REHS
School of Public Health, University of Washington
Natasha DeJarnett, MPH, PhD
NEHA, Program and Partnership Development
Kathleen Johnson, MPH
Washington County Department of Health and Human Services
R. Steven Konkel, MCP, PhD, AICP, FRIPH
University of Alaska, College of Business and Public Policy
Niki Lemin, MS, MEP, RS/REHS
Franklin County Public Health
Jennie W. McAdams, MPH
Franklin County Public Health
Christine Ortiz Gumina, MPH
NEHA, Program and Partnership Development
Kari Sasportas, MSW, MPH, REHS/RS
Cambridge Public Health Department
Salt Lake County Health Department
Leon F. Vinci, MPH, DHA, RS
Health Promotion Consultants
Felix I. Zemel, MCP, MPH, CBO, RS, DAAS
Wu, X., Nethery, R. C., Sabath, B. M., Braun, D., & Dominici, F. (2020). Exposure to air pollution and COVID-19 mortality in the United States. medRxiv.
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Editor's Note: The opinions expressed here are those of the author. They do not reflect the policy, endorsement, or action of NEHA or the organization where the author is employed. NEHA does not verify the accuracy or science of the contents of the blog.