Groundhog day: the signs of a climate emergency are with us again
BMJ 2022; 378 doi: https://doi.org/10.1136/bmj.o1827 (Published 20 July 2022) Cite this as: BMJ 2022;378:o1827
- Tara Chen, fellow,
- John Middleton, president
The signs of a climate emergency have arrived in Europe once more, with this week seeing record breaking temperatures.1 Spain, Portugal, and France have been badly affected by extreme heat, with wildfires raging, an estimated 360 heat related deaths recorded in Spain between 10 and 15 July, and 238 deaths in Portugal in the space of one week. About 14 000 people have been evacuated from the French region of Gironde as wildfires spread, and extreme weather and fire warnings have been issued in Italy, Greece, and Morocco. The Meteorological Office for the UK issued a red warning in anticipation of 40°C temperatures, a prediction that transpired on 19 July, with wildfires following the heat.23
The signs of climate disaster have been building in the northern hemisphere since the spring. In India and Pakistan, extreme heatwaves saw temperatures hit more than 45°C in May,4 causing disruption to healthcare systems that were already strained by ongoing cases of covid-19. Spain and Portugal also experienced temperatures breaking 40°C in May,5 with a second heatwave hitting Spain in June.6 We have been hit, like the metaphorical frog in the slowly boiling water, after years of failing to recognise the deadly change in our surroundings.
Climate breakdown: the main culprit
The root cause of these increasingly high temperatures is climate change, but changes in land use and vegetation, irrigation, air pollution, and other shifts also affect local and regional trends in heatwaves.7
Unexpected temperature spikes harm our individual health and have knock-on repercussions for health systems that are beset by surges in hospital admissions from heat related illness. High temperatures also reduce crop yields, causing critical food shortages. India, for example, reported an expected loss of more than 500 kg of wheat per hectare of its April’s yield because of higher than usual temperatures.8 Disruption to food supplies has already been compounded by the conflict in Ukraine. The 2022 Global Report on Food Crises estimates that about 180 million people across the world will face severe food insecurity because of conflicts, extreme weather, and pre-existing and covid-19 related economic shocks.9 The existing strategies we have for food are increasingly tested as climate change continues to cause upheaval to our fragile agri-food system.10
What is the role of the public health and health community in all this? The new extremes of heat require us to adapt and respond, to mitigate and prevent.
Adapt and respond
In this week of soaring temperatures, the most immediate and obvious role for public health and health services is in responding to the ongoing threat. Local heat wave plans were activated in the UK.11 Many European countries have registers of those who are most vulnerable in the heat so that they can be checked on and protected.12 For some people, the advice on protecting ourselves has been mocked as obvious or facile; “it is the summer,” they say. Yet closing windows and curtains during the daytime and throwing them open at night is not intuitive for everyone in the UK, particularly when we’re not used to these temperatures.
For health systems and other public services, the heat presents complex and compounding challenges. In the UK pressures on ambulance services, which were partly brought about by covid-19, risk extending the amount of time that sick people are exposed to extreme heat in ambulance queues. Power outages, melting of transport infrastructure, and the impacts of extreme heat on essential workers all need to be planned for and mitigated.13 Local authorities with air conditioned spaces such as libraries and community centres are being encouraged to keep these places open for longer hours.12 Sadly, in the UK many of these community facilities have already been closed by austerity cuts. Public authorities also need to protect the health of their staff—a street cleaner who died in Madrid this week had a body temperature of 41°C.14
Mitigate and prevent
Adaptation and response are necessary in the face of the immediate threat, but they are not the long term answer. The recent report from the Intergovernmental Panel on Climate Change shows that limiting global warming to 1.5°C is virtually impossible unless we make immediate, dramatic, and collective changes.15 This climate emergency will not be tackled unless there are fundamental reductions in the burning of fossil fuels. As we witness these harbingers of climate change, governments should make a renewed commitment to global reductions beyond the levels agreed in Glasgow.16
Beyond international commitments by governments, health services and public health systems must play their part in reducing their carbon footprint; if health services were a country, they would be the fifth biggest producer of carbon emissions.17 The NHS commitment to reach net zero carbon emissions is a beacon for what all health systems should be aiming for.18 The NHS now needs to make this pledge a reality and other health systems should look to the changes they should be making too.
People working in public health and health services are also important advocates for climate change policies through their encounters with the public and patients they meet, and in their wider advocacy roles for population health. Health professionals need to be better prepared and informed for this vital role. To this end, education on climate health should be included as a priority in the public health and health competencies set by academic institutions and the continuing education of health professionals.1920
Finally, we should also remember that global health challenges require multidisciplinary responses if they are to be successful. This particular public health problem is no different and needs the insights of climate science, international law, economics, and political science, in addition to the traditional health sciences.
The smashing of heatwave records has now become a grim groundhog day milestone. We should be alarmed that heatwaves are becoming more frequent, happening earlier and earlier each year, with higher temperatures every time. Meaningful climate action is needed now to protect the planet and the health of future generations.
Footnotes
Competing interests: We have read and understood BMJ policy on declaration of interests and declare the following interests: John Middleton is an elected, unpaid official of a non-governmental organisation. Neither authors have any other interests to declare.
Provenance and peer review: not commissioned, not peer reviewed.