What lessons can be drawn from the response to the COVID-19 crisis for the climate crisis? Both are global health emergencies and health professionals have an essential role in both.
Christiana Figueres, the previous executive secretary of the UN Framework Convention on Climate Change, identified five major lessons to be learned from COVID-19: global threats do not recognise national borders; we are only as safe as our most vulnerable; global challenges require systemic change; prevention is better than cure; and we need to listen to the scientific experts.
Health and social inequalities became startlingly clear in the pandemic, and radical measures to address these were called for by many progressive public health organisations, among them Medact. The poor, with cramped or no housing and no financial buffers, suffered, and are suffering, most from the effects of COVID-19 and climate change, and a system that prioritises profit over health needs to change.
Consistent preventive health messages, provided by doctors and trusted scientific experts have changed behaviour and saved lives. The populist and divisive message that experts are part of the establishment and to be dismissed has lost credibility, and this new willingness to listen to and value health expertise will be crucial in the response to the climate emergency. There are clear links between looking after individual patients, including those with serious viral infections, and contributing to planetary health. With patients we are expected to be honest about the diagnosis; discuss management plans, including living wills; have good communication about the problems and possible solutions; and we need to be realistic about resource constraints (for example, ventilators). When the sick patient is the earth, climate activists are calling for honesty from the government about the extent of the earth’s sickness, clear plans for carbon reduction, and good communication through citizens’ assemblies. We need to make intelligent decisions about our limited resources.
Why is it harder to get people and politicians to engage with the climate crisis than the COVID-19 crisis? For many, the climate crisis seems more abstract; there is not such a clear cause and effect. But they are connected and, as climate patterns change and animals and vectors move to adapt, people will be exposed to new infections against which they have little or no immunity. By working to limit climate change we are working to limit the number of future pandemics. So what, as health professionals, can we do?
By advising people to walk or bicycle and to eat local nutritious food we are already having a positive effect on their health and on pollution and carbon emissions. The NHS consumes vast amounts of energy and produces vast quantities of waste. The Sustainability Development Unit is working hard to reduce these. Young doctors and medical students are generally, more engaged with the climate crisis. They see the problem; they want to be part of the solution. There are many opportunities in medical school modules to input on the health effects of climate change.
The GMC released a welcome statement in March saying that any complaint raised about a doctor during the COVID-19 crisis would be considered in the context of the stress they are working under (A message from Dame Clare Marx, Chair. GMC Newsletter, 24 March 2020). Perhaps they will be similarly supportive to doctors responding to the urgency of the climate emergency.
The wonderful book Active Hope: How to Face the Mess We’re in Without Going Crazy, by Chris Johnstone, a GP, and Joanna Macy, an eco-philosopher, examines climate anxiety and how to respond creatively to it. We are suffering bereavement, the loss of the world we have known. First we have to acknowledge the pain of loss, then we experience sadness, anger, acceptance, and, as a part of the healing process, become active. Similar psychological processes have applied during the pandemic with people grieving the loss of the lifestyle and freedom they were used to. Hopefully, as part of healing, people may appreciate the value of more low-carbon lives and make permanent behavioural changes to benefit themselves and their communities.
The response of health professionals and students to the COVID-19 crisis is inspiring and heartwarming. Imagine if we could mobilise an equivalent response to the climate crisis.
- © British Journal of General Practice 2020
