Climate scientists have been warning us that, “Climate change carries a threat to human health and health care systems in the coming decades,” as ATS journal (of The American Thoracic Society) reported.
I am not saying – and have not heard – that there is any association between the current novel coronavirus and climate change.
However, this outbreak and how we manage it does provide lessons for how we ought to prepare for and manage any potential increase in infectious diseases that scientists predict will come with the extreme weather events, droughts and other environmental ecosystem changes brought on by climate change.
Experts, including from the Center for Disease Control (CDC) tell us that these weather events, warmer temperatures and environmental shifts can breed a range of potential public health problems depending upon the region, from infectious diseases carried by bugs and pests, to water-borne diseases from floods, to air-borne pathogens resulting from droughts and air pollution.
“(H)umans can expect more such illnesses to emerge in the future, as climate change shifts habitats and brings wildlife, crops, livestock, and humans into contact with pathogens to which they are susceptible but to which they have never been exposed,” according to zoologists affiliated with the University of Nebraska-Lincoln
Therefore, it’s important that we, “adapt public health policies, disaster preparedness, societal awareness, and education” to prepare for them, as the ATS suggest, and our real-time coronavirus experience can be instructive.
So, what can we learn from this coronavirus pandemic?
Seeing the coronavirus outbreak, which the World Health Organization now labels a pandemic, as a potential precursor of things to come as the climate changes and warms, here are lessons for how to manage the next outbreak:
1. Develop the Infrastructure – “Policies, procedures, protocols and practice”: Those are the 4 P’s that epidemiologist Dr. Celina Gounder said are key to managing an outbreak, on MSNBC’s “Deadline White House” on Wednesday, March 11th. She said, “pandemics don’t mean panic, they mean policies, procedures, protocols and practice.” These require a solid infrastructure that functions as a well-oiled machine with people at the core. Gounder is Clinical Assistant Professor, Department of Medicine of NYU Grossman School of Medicine,
Most importantly, this includes prioritizing developing and rolling out accurate tests for the virus/disease as quickly as possible, and having reporting systems in place to track who has been tested, where and their results. Countries outside the U.S. have been testing thousands of people for over a month – including thousands each day in South Korea — as the U.S. has not even started rolling out tests yet, as of this writing, a dangerous delay that puts Americans at much greater risk.
2. Coordinate: These agencies and health departments need to be able to coordinate seamlessly when necessary as everyone does their part in managing the public health crisis. This could extend to exchanging testing and other resources and could be a specific component of the infrastructure in #1.
3. Communication: To mitigate the risks from the outbreak, and to build trust, multiple channels of communication of accurate information from credible sources between all parties is absolutely crucial – and to do so with transparency and a sense of urgency. This means open and frequent communication channels: between all government agencies; between the federal government and the people; between the federal government and the states; between the states and their citizens; and between health professionals and all of the above.
Most media outlets have been outstanding in trying to keep the public abreast of the latest recommendations, resources and the outbreak status, deferring to bonafide scientific experts, such as the esteemed Dr. Anthony Fauci, Director of the National Institutes of Allergy and Infectious Diseases.
4. Build trust: What causes panic is the lack of trust in the information we are receiving. Our imaginations can go wild imagining the worst. Accurate information, however, no matter how bad, can be comforting because we can deal with it. The challenge today is the conflicting and inaccurate information coming from non-scientific sources. We can only manage what we know, and pretending things are okay when they aren’t breeds panic and only increases the health risks and potential calamity caused by inaction and lack of preventive measures. We need to listen to the scientific experts who know the facts – only.
5. Make resources widely available – from testing to funding: An outbreak like this is an emergency that calls for urgent measures. State and local health departments know best what is happening in their areas and residents are encouraged to seek advice from them and their personal physicians. State governments can mobilize emergency resources rapidly by declaring an emergency, and the federal government can do the same.
Clearly, health insurance challenges need to be addressed long term, and the recent announcements by the insurance executives that they will waive copays for coronavirus testing and treatments is progress. This is to make sure no one foregoes testing or treatment due to cost, thereby allowing the virus to spread. But we need to do more to ensure that fear of medical bills does not cause people to forego medical care due to the cost for any potential ailment, as well.
In addition, millions of people whose livelihoods depend upon hourly-wage jobs cannot take time off work, either to reduce their risk or to be treated, because they are not paid if they do not work. The U.S. House of Representatives proposed emergency legislation to provide funding for these individuals, as well as meals for children whose nutrition depends upon the meals they would receive in school, when those schools are closed in such an emergency.
6. Create a best practices database – ProMED model: The Program for Monitoring Emerging Diseases, aka ProMED, is a database for healthcare professionals that was launched in 1994 by the International Society for Infectious Diseases (ISID) “as an Internet service to identify unusual health events related to emerging and re-emerging infectious diseases and toxins affecting humans, animals and plants.”
“ProMED is the largest publicly-available system conducting global reporting of infectious diseases outbreaks…Reports are produced and commentary provided by a multidisciplinary global team of subject matter expert (SME) moderators in a variety of fields including virology, parasitology, epidemiology, entomology, veterinary and plant diseases.” This model could be expanded based on our collective experience with the current crisis.
7. Anticipate and prepare in advance: Just as we have to anticipate, prepare for and have systems in place to address potential threats like cyberattacks, election interference and standard military weaponry, we need to do the same for public health crises.
Going forward
As Dr. Fauci told the U.S. House Oversight Committee on March 11th, 2020, “we will see more cases, and things will get worse. How much worse… will depend on our ability to do two things: to contain the influx in people who are infected coming from the outside and the ability to contain and mitigate within our own country…Bottom line: It’s going to get worse.”
Those words could also be spoken of the frequency of potential public health threats from climate change, which we know is already threatening lives through increases in extreme weather events and rising temperatures. The past five years have been the warmest on record and this past January, 2020, was the warmest January on record, so the climate change threats are real and upon us today.
This coronavirus pandemic reminds us that we need to proactively put in place the systems to manage the next such public health crisis, which will come, it’s just a matter of when. The systems developed to manage this coronavirus pandemic could be the foundation of them. The other best way to prepare is to reduce the opportunity for these climate-related public health crises in the first place, by taking actions to reduce global warming.