“The Smoke” came to Baltimore over a week ago. It was bizarre to wake up in the morning and see a scary red sun and not much else. The smoke from the Canadian wildfires has been a powerful visual reminder of our growing climate emergency, it is also a harbinger of the growing climate health catastrophe. Hospitals in New York City have reported an increase in asthma-related emergency room visits over the past week, and the World Health Organization predicts there will be an additional 250,000 climate-related deaths between 2030 and 2050. As the smoke clears and air quality improves, the health threats posed by our rapidly changing climate will only become more frequent and devastating as conditions improve (“Taking Stock of Climate Change: Public Understanding Is Running Dangerously Low,” June 14).
The health effects of climate change will be manifold and will burden our healthcare system. Over the past week we have seen the impact of more frequent wildfires and increased air pollution. As our climate changes, disease-carrying insects will become more common and more widespread. We will see an increasing burden of insect-borne infections such as Lyme disease and West Nile disease, and physicians will be confronted for the first time with diseases associated with warmer climates, such as Chikungunya and Chagas disease .
As emergency physicians, we see the health effects of our changing climate every day. We see the effects of deteriorating air quality: we hear small children panting across the room, struggling to get enough air to breathe during asthma attacks. We see the effects of elevated temperatures when we pack ice in the armpits and groins of our elderly neighbors who are dehydrated and delirious from heat stroke. We fear the impact of more frequent extreme storms and hope we never again have to make the nagging triage decisions other doctors have had to make. Severe floods, droughts and weather events will strain the capacity of our mass casualty management system. With every shift, our patients are getting sicker due to climate-related illnesses.
With so many signs of a mounting catastrophe, surely we must have a plan? While there are multiple efforts at the local level, bold action at the federal level is needed to meet the challenge. The Centers for Disease Control and Prevention has funded limited local initiatives to strengthen public health response to climate change. While this is a start, with the recent debt limit agreement “limiting” public health care, we are a long way from building a coordinated response to climate-related health disasters.
We are running out of time to make our healthcare system more resilient to respond to the escalating climate emergency. We need to adequately fund our public health infrastructure. Recently, US Senator Ed Markey and US Rep. Ro Khanna unveiled a Green New Deal for Health (S.1229) that provides a blueprint for climate resilience and mitigation and takes steps to ensure most communities have adequate access to health care likely to be affected by climate-related health challenges. Because we are on the front lines of the healthcare system in the ER, we see firsthand the impact of climate change on the health of our patients. We must urge our elected officials to take that first step and adopt the plan outlined in the Green New Deal to keep our communities healthy in the face of worsening climate threats.
— Nicholas Rizer, MD and Jace Bradshaw, MD, Baltimore
The authors are resident doctors specializing in emergency medicine.
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