Medical professionals are seeing the effects of climate change in their own practices more often and are increasingly concerned. Recently 150 of them gathered in Boston to start planning a response.
Sponsored by the New England Journal of Medicine, Harvard Medical School, and all of Boston’s teaching hospitals, the Climate Crisis and Clinical Practice Symposium aimed “to bring the issue of climate change directly to the bedside,” Dr. Aaron Bernstein told The Boston Globe’s Felice J. Freyer. He is a pediatrician and the interim chief of the Center for Climate, Health, and the Global Environment at Harvard T.H. Chan School of Public Health. He was one of the event’s organizers.
The gathering was the first of eight to galvanize health care systems to face the reality of climate change. Six additional symposiums are scheduled over the next year and a half in the United States. Australia will host another.
“The climate crisis has created an unprecedented future that looks nothing like what we have experienced,” said Dr. Renee N. Salas, an emergency medicine doctor at Mass. General. “We are the ones that are experiencing this first and need to work collectively with the rest of the country.”
On January 2 the Medical Society Consortium wrote an open letter to President Trump urging him not to remove the United States from the Paris Agreement. “Our organizations represent hundreds of thousands of our country’s doctors, nurses and other health care providers,” wrote Dr. Mona Sarfaty, the organization’s executive director. “We are seeing, right now, the harms to our health that global warming is creating. We foresee much greater health harms to all Americans, especially our children and grandchildren, if we do not join with the rest of the world to respond to the climate crisis—because climate change is a public health emergency.”
“Climate change exacerbates chronic and contagious disease, worsens food and water shortages, increases the risk of pandemics, and aggravates mass displacement” Tedros Adhanom Ghebreyesus wrote in an article titled “Climate Change is Already Killing Us” in Foreign Affairs. “The broad environmental effects of climate change have long been discussed as long-term risks; what’s clear now is that the health effects are worse than anticipated—and that they’re already being felt.” He is director-general of the World Health Organization.
Heat stress is one of the health problems that is on the rise. It can lead to heart attacks, kidney stones, and preterm birth, The Globe’s Freyer reported. “Cholera, dengue, Lyme disease and valley fever are all increasing in incidence and also expanding their range. With warmer springs and later winters, the pollen season is getting longer and also more severe, because carbon dioxide prompts plants to release more pollen. That increases asthma attacks, as does air pollution.
“The heat also affects the way medications work. Drugs for depression, heart disease, and kidney failure can be less safe in hot weather. People taking beta blockers for high blood pressure are more likely to faint in hot weather. EpiPens and albuterol can be rendered ineffective by extreme heat if left inside cars.”
Dr. Gaurab Basu, a primary care physician at the Cambridge Health Alliance who attended the Boston symposium, expressed concern about the many people doing physical labor outside, especially in urban “heat islands,” where asphalt and concrete can make the temperature 10 or 15 degrees higher than elsewhere. They could be injuring their kidneys day after day without knowing it. Basu told the group about a 27-year-old patient who developed end-stage kidney disease caused by chronic exposure to heat. The man, an immigrant, had worked on sugar farms in El Salvador. Doctors, she said, need to “add a climate lens” to their diagnostics.
Mental health also can suffer from climate change. Extreme heat "makes all mental illnesses worse,” said Dr. Gary Belkin, a psychiatrist and visiting scientist at the Harvard climate group. Emergency room visits for mental crises and psychiatric hospitalizations go up during heat waves.
Climate change can even affect the availability of medical supplies, Freyer reported. Bernstein had ordered intravenous fluids for an infant who had become dehydrated. He was shocked to receive an alert that IV fluids — a common, life-saving treatment — were being rationed. The reason: Hurricane Maria, which scientists believe was more intense due to climate change, had shut down the Puerto Rican plant that makes them.
Politicians reluctant to act on climate change say that doing so would threaten our prosperity. They obviously are not considering the cost of health problems. It is time for Congress to put a price on carbon that reflects ALL the costs that emissions impose on us.