Coronavirus pandemic has shown how health systems can fall short to handle climate change

India saw the second-highest number of heat-related deaths in the world among those over 65 years of age in 2018. At an estimated 31,000 deaths, India was right behind China which had an estimated 62,000 deaths, as per a new report.

Heat stress, heat strokes and their impact on existing cardiovascular and respiratory diseases claimed 296,000 lives of those over 65 years of age across the world in 2018, said the fifth edition of the Lancet Countdown on Health and Climate Change report published in The Lancet on December 3. This crisis was observed in both big and small economies indicating that wealth cannot shield countries from the health impacts of climate change.

The Lancet report termed its latest findings as “the most worrying outlook” observed since the inception of its Countdown series in 2016. It noted productivity losses equivalent to billions of working hours, increasing intensity of wildfires and droughts and rapid transmission of diseases such as dengue and gastrointestinal infections as potential dangers.

The elderly have been increasingly exposed to high levels of heat since the early 2000s, and globally, fatalities caused by heat in those above 65 increased by 53.7% over 18 years to 2018, the report said. The reason is a combination of increasing instances of heatwaves and ageing populations.

The Covid-19 pandemic has shown that a global health crisis can bring entire countries to a standstill and without urgent action, climate change too can cause similar damage to lives and livelihoods, the report said. Just like the ongoing pandemic, climate change can overwhelm healthcare systems across the world.

Whether the world can limit the global temperature increase to below 2 degrees Celsius will depend on how countries deal with the post-pandemic recovery, the report said – by aligning both climate and pandemic recovery, the world can deliver near-term and long-term health benefits. A green recovery requires that countries invest in climate-friendly projects that reduce/avoid fossil fuel use and promote clean transport, buildings and so on.

“The threats to human health are multiplying and intensifying due to climate change, and unless we change course, our healthcare systems are at risk of being overwhelmed in the future,” said Ian Hamilton, executive director, Lancet Countdown.

Yet, countries have been slow in factoring climate change fallouts into national health plans. Half of the countries surveyed for the report (51 of 101) have developed national health and climate change strategies. Financing still remains a challenge: Of the 45 countries that have plans to tackle climate change impacts and the funding needed for it, only four (9%) reported availability of adequate national funding to fully implement such strategies, the report found.

India’s approach to heat and related mortality has similar shortcomings, IndiaSpend reported on June 16. Heat-related deaths are under-reported in India due to its medical practices and its adaptation strategy is underfunded, we found.

The annual average temperature in India has risen by 2 degrees Celsius over 200 years till 2006. It is predicted to rise further by 0.6 degrees Celsius to 2.4 degrees Celsius by 2030. Within 50 years, 1.2 billion people in India would live in areas as hot as the Sahara, if greenhouse gas emissions keep rising. India’s poorest and most underdeveloped areas are the most vulnerable to heatwaves. The country is set to lose millions of working hours in the agriculture and construction sectors.

Millions of working days lost

While most deaths were reported from China and India, other countries too dealt with fatalities in the thousands – Germany (around 20,200), the United States (nearly 19,000), Russia (18,600) and Japan (around 14,200), the report estimated.

The last two decades have seen a 54% increase in heat-related deaths in older people globally, with a record 2.9 billion additional days of heatwave exposure affecting those over 65 years in 2019, it said.

Other than mortality, rising heat also has significant, direct implications for a country’s economic output and livelihoods – heat is increasingly affecting people’s ability to work outdoors in developing regions, the report found. For instance, in 2019, the world lost a total of 302 billion work hours due to heat – that is, about 40 hours for every person on the planet and 100 billion more than in 2000. India and Indonesia were among the worst-affected countries, losing potential labour capacity equivalent to 4% to 6% of their annual GDP.

India is projected to lose 5.8% of working hours in 2030, a productivity loss equivalent to 34 million full-time jobs, either because it would be too hot to work or because workers would have to work at a slower pace, particularly in agriculture and construction, IndiaSpend reported on June 16.

For India, the impact of heat stress is not limited to sectors where employees are directly exposed to sunlight. Small industries, such as cloth-weaving units, which cannot afford air-conditioning, are also vulnerable to production losses due to temperature rise, found a 2018 study by the Energy Policy Institute, a think tank at the University of Chicago.

For every 1 degree Celsius rise in temperature beyond 27 degrees Celsius on a hot day in India, productivity of workers drops by as much as 4%, said the Energy Policy Institute study.

More wildfires, droughts and disease

The changing climate has downstream effects, impacting broader environmental systems, which in turn harm human health, the report said. Heat and droughts are also driving up wildfires, for example. Since the early 2000s, 128 countries have experienced an increase in population exposure to wildfires resulting in burns, heart and lung damage from smoke, and the displacement of communities. The US has seen one of the biggest increases in this disaster.

Based on current populations, between 145 million to 565 million people face potential inundation from rising sea levels. Global food security is threatened by rising temperatures and increases in the frequency of extreme events: global yield potential for major crops declined by 1.8% to 5.6% between 1981 and 2019, said the report.

Changing climate patterns are also impacting the transmission of various diseases: Since the 1950s, disease transmission capacity has been growing rapidly, with a 15% increase for dengue in 2018 and regional increases for malaria and vibrio bacteria causing foodborne infections.

Covid-19 and climate change

Covid-19, a zoonotic disease whose roots can be traced back to environmental degradation, brought the world to a standstill in 2020, killing millions and exposing the holes in the healthcare systems of several countries.

The health harms of climate change are compounding the impacts of the pandemic. Wildfires, cyclones, heatwaves, floods and other extreme weather events have affected communities at the same time as the pandemic. Without urgent actions to mitigate and adapt to climate change, its health impacts are set to worsen, potentially overwhelming facilities. But the world does not have the luxury of tackling one crisis at a time.

“Addressing climate change is a powerful way to reduce the risk of future zoonotic pandemics,” said a Lancet editorial published alongside the new report.

The recovery from the Covid-19 pandemic offers a key moment to act on climate change. A joint response that addresses all the crises, including the pandemic and the threat to the environment, would help improve public health, create a sustainable economy, and protect the environment.

Green recovery

The anniversary of the Paris Agreement falls on December 12 and countries are set to update their national climate commitments that come up for review every five years. The next five years can be critical: To reach the 1.5 degrees Celsius target and limit temperature rise to “well below 2 degrees Celsius”, the 56 gigatonnes of CO2 equivalent currently emitted annually will need to drop by more than half to 25 gigatonnes of CO2 equivalent within only 10 years to 2030, the report said.

This will require a 7.6% reduction in emissions every year, representing an increase in current levels of national government ambitions by a factor of five. With no interventions in the next five years, the reduction needed to achieve this target increases to 15.4% every year, moving the 1.5 degrees Celsius target out of reach, said the Lancet Countdown report.

But this journey will mostly depend on how countries deal with the post-pandemic recovery, the report said, calling for an alignment of climate and pandemic recovery for near- and long-term health benefits.

For a green recovery, countries must move away from fossil fuels across sectors, increase their forest cover and make their economies energy efficient, as we said earlier.

Getting rid of polluting fuels could help the world avoid some, most or all of the 7 million annual deaths from air pollution associated with the combustion of fossil fuels, the report said. Countries like India, with the highest absolute number of deaths from air pollution, around 1.6 million annually, can have huge health benefits from a green recovery.

In Europe, modest steps to promote cleaner energy and transport sectors saw pollution-related deaths from ambient PM 2.5 – tiny particulate matter that can sicken or kill people by entering the bloodstream – fall from 62 per 100,000 in 2015 to 59 per 100,000 in 2018. Globally, deaths from ambient PM 2.5 associated with coal fell by 60,000 in the same year.

The European Union’s marginal air quality improvements from 2015 to 2018 could be worth an estimated $8.8 billion every year if sustained, the report said. Stemming from the annual average reduction in years of life lost, the figure will grow with further improvements in air quality.

Nevertheless, most countries of the world including India seem to be moving towards a fossil-fuel-led economic recovery instead of a green one, IndiaSpend reported on June 11.

This article first appeared on IndiaSpend, a data-driven and public-interest journalism non-profit.