Sharon Au, Guest Contributor
As the head of the World Health Organization Climate Change Unit, Diarmid Campbell-Lendrum recently stated, “if COVID-19 is a sprint to save lives, then acting on climate change is the marathon”. The coronavirus disease 2019 (COVID-19) has brought unprecedented challenges globally to society and the economy, highlighting the vast impacts that human activities have on the environment.
In efforts to control the spread of COVID-19, China implemented strict self-quarantine measures, traffic restrictions, and closure of businesses and other industrial facilities. The economic slowdown at least partly contributed to the significant reductions in nitrogen dioxide (NO2), as shown from NASA and European Space Agency (ESA) pollution monitoring satellites.
Source: NASA Earth Observatory
““… the silver lining is that it has highlighted the substantial human health benefits of aggressive air pollution control measures…” ”
Similar reductions have been observed globally. NASA satellite data show that March 2020 NO2 levels just across the border in North Eastern U.S. were about 30% lower than the March average between 2015 to 2019.
Source: NASA
Meanwhile in Canada, the Southern Ontario Centre for Atmospheric Aerosol Research (SOCAAR) has released preliminary data which indicate that nitrogen dioxide and ultrafine particulate matter in downtown Toronto have dropped by almost half their concentrations prior to the economic slowdown.
A recent study has estimated that the improved air quality during the quarantine period prevented a total of 8,911 NO2-related deaths, of which 65% were from cardiovascular diseases, such as hypertensive disease, coronary heart disease, and stroke, as well as chronic obstructive pulmonary disease (COPD). On top of that, another 3,214 deaths related to fine particulate matter (PM2.5) were avoided, 73% of which were from cardiovascular diseases and COPD. These estimates are of China alone – so imagine the impact of air pollution reduction on a global scale. While COVID-19 has caused a significant number of deaths, the silver lining is that it has highlighted the substantial human health benefits of aggressive air pollution control measures, including significantly reduced pollution-related mortalities.
A study of air pollution and severe acute respiratory syndrome (SARS) – a viral respiratory infection also caused by a coronavirus – showed that SARS patients with short-term exposure to moderate air pollution indices (APIs) had an 84% increased risk of death from SARS compared to those with short-term exposure to low APIs. SARS patients from regions with high APIs had double the risk of death from SARS compared to those from regions with low APIs. Similarly, a national study from the Harvard T.H. Chan School of Public Health concluded that an increase of only 1 µg/m3 in long-term exposure to PM2.5 leads to an 8% increase in COVID-19 mortality.
““… let’s take COVID-19 as a wake-up call and take a step back to reassess our path moving forward.” ”
Epidemics like COVID-19 will occur increasingly frequently, as the world becomes increasingly interconnected from globalization and urbanization, and the impacts of climate change become more extreme and frequent. Air pollution and respiratory health is just one of the many causal links between environmental and human health. With the strong interconnection between environmental and human health, the solution to addressing both of these complex issues lies in an integrated systems-based approach. Let’s take COVID-19 as a wake-up call and take a step back to reassess our path moving forward. As we begin to recover from this pandemic, many environmental efforts are being abandoned, such as the surge in single-use plastics (particularly for personal protection and healthcare), and suspension of environmental regulations in Alberta and Ontario to support industries. On the bright side, many environmental efforts have emerged that we should continue to support, like more virtual meetings, conferences, and appointments, more time spent outdoors, and the City of Toronto’s road closures for pedestrians and cyclists, which encourage active transportation while practicing safe social distancing.
““We must take the lessons learned from this crisis, and act on environmental and human health simultaneously going forward – ultimately, it will better prepare us for the next pandemic.””
We must take the lessons learned from this crisis, and act on environmental and human health simultaneously going forward – ultimately, it will better prepare us for the next pandemic. Thankfully, the Government of Canada has recognized that air pollution increases susceptibility to viral respiratory infections, and have taken steps to improve air quality by working to reduce emissions, protect against wildfire smoke, conduct research on air pollution, and form international agreements and partnerships. The economic stimulus funding from COVID-19 can be our golden ticket to create a paradigm shift towards prioritizing both environmental and human health – more specifically, to develop a more preventative, resilient, and ultimately sustainable health system.
Healthcare professionals have a commitment to the Hippocratic Oath of “first, do no harm” –that is, to always first consider the potential harm any intervention poses. This has led healthcare in the direction of a reactionary approach with a focus on the avoidance of harm, rather than a preventative approach with an emphasis on the creation of health. What can we do to move towards the latter?
First, exposure to nature has a multitude of associated health benefits, as well as the potential for reducing social and economic costs of poor health. One study demonstrated positive relationships between doses of nearby nature and mental and social health, increased physical activity, and nature orientation. So healthcare practitioners in North America and Europe are now prescribing nature or “nature pills” to those under their care. This effective, simple, preventative, and low-cost treatment for health and well-being should become common practice amongst healthcare practitioners.
With the rising urgency for action on sustainability, it is more important than ever for enhanced cooperation through partnerships across sectors, governments, and the world. Implementing Goal 17 of the United Nations Sustainable Development Goals (UN SDGs) – Partnership for the Goals – is vital to ensure sufficient means to achieve the UN SDGs. Here are some examples of initiatives the healthcare industry can work collaboratively with others to accomplish:
Fund and conduct research and monitoring on the relationship between environmental and human health.
Advocate and provide expertise in health for stricter environmental laws, regulations, and policies.
Raise awareness and promote action through the integration of environmental and human health into formal and informal education programs and awareness campaigns.
Protect, increase, and improve green spaces, such as designing more urban parks, developing more hygiene stations in outdoor settings, and implementing more road closures for active transportation.
Address social determinants of health through initiatives such as: increasing long-term and community support; improving access to healthcare (e.g. evening and weekend access, telemedicine, services in multiple languages or with interpreters, and transportation); and advocate for social change.
Support the transition to a low carbon economy through operational changes within healthcare facilities, and political advocacy.
““The urgent, collective, international response to COVID-19 proves that the world can come together to make quick and impactful changes to protect humanity.””
The urgent, collective, international response to COVID-19 proves that the world can come together to make quick and impactful changes to protect humanity. So let’s take the momentum we’ve gained from the sprint to save humanity from COVID-19, and channel it towards the marathon; that is, to save humanity from climate change!
This moment can be a turning point in our long journey to sustainable development. With current health expenditures making up approximately 10% of gross domestic product (GDP), the healthcare industry has an immense opportunity to influence change. The Centre for Sustainable Health Systems (CSHS) is focused on working together to transform the health system into one that truly supports health. Stay tuned for more resources on actions you can take towards creating a more sustainable health system.
About the author:
Sharon Au is a respiratory therapist turned sustainability professional with 12 years working in frontline healthcare, a Certificate of Environmental Sciences, a Master of Environment and Business, and experience in various sustainability roles. From healthcare to sustainability, she has carried her passion to care for others and make a difference.
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