Opinions

Climate change is a health care emergency

“Reducing greenhouse gas emissions is literally a matter of life and death.” — Jeff Duchin, Seattle Chief Public Health Officer

We are today tenuously living the extremes. The undeniable scientific truth is that homo sapiens — we humans — combusting fossil fuels is the cause and the driver of rapidly escalating climate change — in truth, climate crisis and global heating plus pollution. We are saturating our only atmosphere with gases — CO2, methane, nitrous oxide, and H2O — yes, water vapor — which quite successfully entrap Earth’s heat and thus endow our Earth with this climate crisis and global heating. Ironically, water, the giver of life, when subjected to extreme heat, evaporates but does not only not cool but leaves desiccated lands, intolerable humidity and enters the atmosphere as heat-trapping water vapor.

“These climate crisis extremes … are the suffering that is here and now,” said professor Katharine Hayhoe.

The climate crisis will entail:

• Extreme weather events. Increasing frequency and ferocity of storms, sand storms, hurricanes, tornadoes, tropical storms, rogue windstorms (and those generated by massive wildfires), causing injuries, drowning, mass fatalities, and mental heath crises.

• Rising seas: coastal flooding, mass migrations.

• Ocean acidification: dying seas, changing food supplies, coral deaths, species extinctions.

• Warming seas: rapidly changing food ecology, extreme weather causation, species extinctions.

• Changing vector ecology: pestilence — viral, bacterial, and parasitic infections, emerging zoonotic diseases (coronavirus), malaria, dengue, Lyme, chikungunya, and West Nile virus, among others and those yet to appear.

• Pollution and particulates: asthma, respiratory failure, COPD, MS, diabetes type 2, cardiovascular disease, stroke, lung cancer, pneumonia, and dementia, among others.

• Deteriorating water quality: cholera, leptospirosis, campylobacter and many others.

• Changing water and food impacts: malnutrition, mass starvation, diarrheal diseases, massive crop failures. Water stress — aridity and desertification.

• Environmental degradation: forced mass migration, civil wars, ongoing mass species extinctions, desertification, crop and forest deaths, wildfires, mental health impacts.

• Global economic collapse.

Among the most concerning for people is extreme heat and humidity. The human body cannot long tolerate heat greater than 95 degrees F and 100% humidity. In those conditions the body is simply unable to sweat and remove heat. Consider the recent heat dome phenomenon in the western U.S. In those conditions, all body organs — especially heart, lungs, muscles, gut, liver and the brain — must labor harder and are imperiled. Essential proteins break down and cause multi-system failure, particularly renal and liver failure. This is heat stroke, and, unless rehydrated, it is fatal.

Those most affected by the climate crisis are children, the disabled and disadvantaged, poor, elderly, immunocompromised and Indigenous peoples.

As health care providers, we fully and completely recognize the immediacy and urgency of the moment. We must act without delay or hesitation. Seventy-four health organizations, including the American Medical Association, American Academy of Pediatrics, American Academy of Family Physicians, American College of Physicians and the American Academy of Nursing created the U.S. Call to Action on Climate Health and Equity. The charge: To meet our legal and moral obligation to protect all. Thus is inclusive of all living creatures and the seas, land, life-sustaining forests and our indispensable biodiversity.

As the New England Journal of Medicine wrote, we must “heed an absolute imperative for climate change. The climate crisis impacts all life, the practice of medicine, and the very stability of the health care system.”

History can tender indispensable perspectives for us.

The ancient Greek in his Hippocratic text on Airs, Waters, Places advised physicians “to attend to all aspects of the environment, to the seasons, direction of the winds, and the quality of sails and waters.”

In 1848, Rudolph Virchow observed, “Medicine is a social science, and politics is nothing else than medicine on a large scale.” These “diseases of civilization” are determined by global industrialization.

In 1992, the Union of Concerned Scientists decreed, “… a great change in our stewardship of the Earth and life on it is required if vast human misery is to be avoided and our global home on this planet is not to be irretrievably mutilated.”

Today, the Intergovernmental Panel on Climate Change has declared that we are in a Code Red. Climate change is accelerating faster than we can determine how to act. Furthermore, emissions reductions and decarbonization efforts must increase beyond earlier projections.

Caren G. Solomon, M.D., M.P.H.; and Regina C. LaRocque, M.D., M.P.H., wrote: “We must focus our voices —emphasize climate change in med schools, demand fossil fuels divestment, and how we relate to our fragile environment. Human health and survivability depends on the health of the planet’s life support systems. Medical ethics and practice must expand to address Earth’s ecosystems and climate change.”

How then must a united force of health care providers address the immediacy of the crisis before us today? We must employ every agency-local, state, and federal governments; the global banking and financial industries-Wall street, World Bank, and the IMF; NGO’s; the vast environmental community; and every means imaginable.

We are aware of a measure with great promise, and one which has the attention of Congress: the institution of a carbon fee.

To summarize, it would sharply reduce greenhouse gas emissions, or GHGE, and return the fee proceeds to individual household as dividends. The mechanism: a fee on every ton of greenhouse emissions. This fee would sharply reduce GHGE by up to 38% by 2030, and 82-84% in the fossil fuel power sector. We would observe a substantial decrease in pollutants — mercury, sulfur dioxide, nitrous oxide, CO2 and particulates. Carbon fees would increase annually until emissions goals were met and, ultimately, become revenue neutral. If fossil fuel energy costs were to rise, the fee dividends would concomitantly rise and cushion such increases. Enactment would encourage an express progression to alternative, renewable energy, and incentivize innovation, infrastructure development, and carbon efficiencies. The carbon fee would provide regulatory certainty for industry. We hope U.S. leadership would encourage global adoption and application, with enhanced competitiveness, and, ultimately, climate stability.

The Health Care Professional’s Climate Action and Carbon Pricing Declaration has been endorsed by the AMA and more than 100 American health organizations as well as the World Bank and the IPCC. Moreover, it enjoys bipartisan congressional support.

We in the health care professions must heed the words and wise counsel of Sir David Attenborough, “The impacts of climate change will be upon us for thousands of years ... The future of humanity and, indeed, all life on Earth, now depends on us.”

Peter Mjos, M.D., Anchorage; John Finley, M.D., Anchorage; William M. Cox, M.D., Anchorage; Greg Gerboth, M.D., Anchorage; Beth Baker, M.D., Anchorage; Hal Smith, M.D., Homer; Bill Bell, M.D., Homer; John Christopherson, M.D., Anchorage; and Madeleine Grant, M.D., Anchorage, are Southcentral Alaska-based health care providers who are concerned about the global health effects of human-caused climate change.

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