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For the first time at a major United Nations climate conference, human health is emerging as a prominent issue, a reframing that highlights the far-reaching and long-lasting effects of climate change.

While health has been addressed at conferences leading up to the first UN environment summit in 1992, it has never played such a central role. The 2015 Paris agreement, the global agreement between countries to reduce greenhouse gas emissions, is billed as a historic environmental moment after all.

However, director of the World Health Organization’s environment, climate change and health department, Dr. “The Paris Agreement is not an environmental agreement,” said Maria Neira. “It is a fundamental public health treaty.”

There is a growing body of research showing that climate change contributes to a wide variety of health risks worldwide. It exacerbates heatwaves, intensifies wildfires, increases flood risks and worsens droughts. These are increased heat-related mortality, pregnancy complications, and cardiovascular diseases, respectively. And as with so many climate-related things, the risks and harms are particularly acute where they can interfere the least.

There are also a number of indirect health consequences that threaten to unravel decades of progress in improving water quality and food security. Dryer soil can contribute to malnutrition. Warming temperatures and changing humidity levels can expand habitats suitable for mosquitoes that carry dengue or malaria, lyme-carrying ticks, and pathogens that cause diseases such as cholera and Valley Fever.

At the same time, grappling with the coronavirus pandemic for two years has underlined to politicians the importance of health as a national and global priority.

For such reasons, the health community has developed the strategy that political leaders may be more inclined to take action if they can confront people facing climate change, rather than traditional environmental symbols like polar bears or forests.

In the months leading up to the Glasgow conference known as COP26, the world’s leading public health organizations, medical journals, and professional organizations published a number of reports and articles putting health at the center of the climate problem. A letter signed by organizations representing 47 million global health professionals declared the climate crisis “the single greatest health threat facing humanity.” The World Health Organization estimates that at least 250,000 additional deaths will occur each year as a result of climate change between 2030 and 2050.

In a sign of the emphasis placed on health this year, 15 countries, including Ireland and Mozambique, have already made significant commitments to decarbonize their national health systems.

“This year represents a quantum leap in how health is covered at the COP,” said Josh Karliner, international program and strategy director for Health Care Without Harm, an organization working to reduce the environmental footprint of the healthcare industry.

Healthcare providers around the world said they have already seen the effects of climate change on their patients and the ability of hospitals to continue providing care in extreme weather conditions. At the same time, there is a growing awareness of the health sector’s contribution to greenhouse gas emissions.

The challenges of providing care

Hospitals around the world have been heavily impacted by extreme weather conditions and are increasingly grappling with the fact that they are not designed for the increasingly common storm, heat and other challenges. Covid patients died as a result of flooding in a hospital in Mexico. Hospitals in India suffered severe flooding. Hospitals struggled to maintain indoor air quality as wildfires burned on the West Coast. A tornado tore the roof of a rural Louisiana hospital.

During the Pacific Northwest heat wave this summer, Dr. Jeremy Hess used to work in the emergency room at Harborview Medical Center, the top trauma center for several states. Dr. Hess worked in the emergency rooms during the mass death toll, but the heatwave came to the fore.

“It became more permanent,” he said. “It was a non-stop environmental emergency.”

He said that for days, patients came in with third-degree burns to their feet from walking on hot asphalt. Many succumbed to heat-related death before they could even get to the hospital. Doctors tried to fill body bags with ice on stretchers.

Hospitals in the area were highlighted in other ways. Providence, a major western health facility, had no spare beds in its emergency rooms, which stretched from Washington state north to southern Oregon. A hospital shut down the psychiatric unit to make sure there was enough power in the more critical parts of the building.

This week, More than 1000 heat related emergency visits Compared with less than 10 visits in the same period of 2019, it was reported in the Pacific Northwest. Researchers have found that such an intense heat wave almost impossible without the impact of human-induced climate change.

Doctors say they also see the health effects of the changing climate in their daily interactions with patients.

An emergency medicine physician at Massachusetts General Hospital, Dr. Renee Salas said she has noticed over the years that allergy seasons are getting longer, highlighting her patients with asthma and lung disease. He thought climate change might be behind this, and science confirmed his suspicions. Studies have found That since 1990 pollen seasons have not only gotten longer but also contain higher pollen concentrations, and climate change has been a driving factor.

Co-author of The Lancet Countdown, a report on climate change and health, Dr. “I think of climate change as a secondary diagnosis in my patients,” Salas said.

It is unlikely that the health burdens will be shared equally.

one in September Report from the Environmental Protection Agency While all Americans will be affected by climate change, minorities are likely to face greater health risks. For example, black Americans are 40 percent more likely to live in areas with the highest death rates from extreme heat.

Interim director of the U.S. Department of Health and Human Services Office on Climate Change and Health Equity, Dr. “The same vulnerable communities that are disproportionately damaged by Covid-19 are disproportionately harmed by climate change,” said John Balbus. an e-mail.

Hospitals as pollutants

Meanwhile, there is growing recognition in the healthcare industry for its own contributions to climate change.

The healthcare industry is estimated to be responsible for about 5 percent of all global carbon dioxide emissions. Some of this comes from powering energy-intensive hospitals and clinics 24 hours a day, but the majority – an estimated 70 percent – ​​has to do with the supply chain and the energy needed to manufacture, ship and dispose of used machinery, medicines and equipment. Everyday.

Over the past decade, 43,000 hospitals and health centers in 72 countries have signed up as members of Global Green and Healthy Hospitals, a network of organizations that aim to reduce their environmental impact.

“It’s a trend,” said Alison Santore, head of advocacy and sustainability for hospital chain Providence, a member of the green hospital group. “But on the whole it’s still a minority of hospitals.”

Last year, amid the pandemic, Providence promised to make it carbon-negative by 2030, meaning the company aims to remove more carbon dioxide from the atmosphere than it adds.

Health centers and hospitals are 2.5 times more energy intensive than other buildings. Rooms and corridors are full of computers and machines. Many products in hospitals are disposable to prevent infection. It is estimated that hospitals generate between 29 and 43 pounds of waste per patient per day.

“We are called to recuperate, but we are still damaging the environment,” Ms Santore said.

The transition has not been easy so far. Beth Schenk, a registered nurse and managing director of environmental management in Providence, said meeting the company’s goals requires rethinking every aspect of its operations. In addition to adding solar panels to the roofs and switching to low-flow water, they removed the heavily waterlogged grass and redesigned the surgical kits.

Even for the few hospitals making progress, significant obstacles remain. Clinica Biblica, a major hospital in San Jose, Costa Rica, achieved carbon neutrality by installing solar panels on its roof, purchasing carbon offsets, and relying on the nation’s electricity grid that would otherwise be powered by 99 percent renewable energy. But the commitment to be carbon neutral throughout the entire supply chain will be a huge challenge when there is little transparency over it. greenhouse gas emissions from overseas suppliers and waste disposal.

Many healthcare providers are also learning that greenhouse gases can be found where you least expect them. For example, the main components of essential medical devices such as anesthetic gases and inhalers are actually potent greenhouse gases such as hydrofluorocarbons.

However, healthcare leaders point out that despite their own efforts, it will be difficult for the industry to meet carbon neutral goals without changes beyond their control, such as the wider availability of renewable energy in the power grid.

Burning fossil fuels costs society $5 trillion to treat chronic diseases, and air pollution results in 7 million premature deaths each year, Dr. He added that Neira and “society need to balance this out.”