key: cord-0956291-u4u3hnfh
authors: Coates, Sarah J.; Andersen, Louise K.; Boos, Markus D.
title: Balancing public health and private wealth: lessons on climate inaction from the COVID‐19 pandemic – a report from the International Society of Dermatology Climate Change Committee
date: 2020-05-08
journal: Int J Dermatol
DOI: 10.1111/ijd.14917
sha: c08c19959a114530d008ee92170e89a99902b414
doc_id: 956291
cord_uid: u4u3hnfh

nan

The 2019 coronavirus disease (COVID-19) pandemic is a unique public health challenge without precedent in modern times. With nearly three million individuals infected worldwide, 1 the disease has already overwhelmed healthcare infrastructure in several countries, disproportionately affecting already-vulnerable populations. Nevertheless, the COVID-19 pandemic has also revealed humanity's ability to quickly and collectively shift its priorities. As government mandates require communities to shelter at home and economic sectors grind to a halt, the clear message from most world leaders has been that preservation of human life and public health takes precedence over economic prosperity. Witnessing rapid enactment of measures necessary to protect human life begs the question of why we cannot take meaningful action to address another global public health crisis that is an existential threat to humanity: climate change.

Climate change is an ongoing, human-propelled phenomenon driven by accelerating greenhouse gas release into the atmosphere over centuries. Although it occurs on a more protracted time scale and its effects are more gradually felt, it shares many important features with the current pandemic:

Like COVID-19, climate change threatens human health globally. Climate-change-related extreme weather events impair crop production, endangering food security worldwide. Sustained warmer temperatures at higher latitudes affect the geographic ranges of infectious microorganisms and their vectors, resulting in greater numbers of people at risk for infectious diseases, including many with dermatologic manifestations. 2 Mass human migration from newly inhospitable areas decreases healthcare access, lowers vaccination rates, limits access to clean water, impairs hygiene, and leads to overcrowding and disease transmission. 2 By 2100, if emission trends continue, climate change is expected to cause an additional 1.5 million deaths annually, worldwide. 3 As of late April 2020, approximately 200,000 people have died from COVID-19. 1 Additionally, neither climate change nor COVID-19 respect geographic boundaries or political ideology. Effective, durable responses to these crises must, therefore, account for all members of society, and governments that fail to do so risk exacerbating existing healthcare disparities and perpetuating socioeconomic injustice. For example, early in the COVID-19 pandemic, some wealthier persons received prompt diagnostic testing and care, while others experiencing symptoms struggled to gain timely access to testing. Similarly, our climate crisis disproportionately affects low-income countries, though they contribute less to global greenhouse gas emissions. Worldwide, already-vulnerable groups (women, children, indigenous people, outdoor laborers) are also more adversely affected. Moreover many low-income jobs cannot be performed remotely or in climate-controlled conditions and do not offer paid sick leave, leading to financial insecurity and joblessness that re-enforce cycles of poverty and homelessness. Low-income persons are also more likely to be uninsured or underinsured, making them less able to access healthcare, despite the health risks of both pandemics and climate change. Over time, failure to meet the ª 2020 the International Society of Dermatology International Journal of Dermatology 2020 tions to support one another. When we shelter in place and practice social distancing, we stem the advance of COVID-19 through our communities. By acknowledging we must work together to promote our collective well-being over narrow selfinterest, we have taken the first steps toward redefining health and wealthnot in terms of laboratory values and gross domestic product (GDP) but in terms of individual and community security.

Our newfound understanding that a challenging but coordinated worldwide response to a catastrophic global event is possible belies the argument that adverse economic outcomes make meaningful action on climate change impossible. Nevertheless, a profound shift in priorities will not occur easily or without cost and requires continued, intentional action, with greater contributions from those of increased means. We therefore urge governments, private industry, and individuals to commit to public health, rather than economic output, as a primary goal; to establish and employ methods of quantifying wealth other than GDP, including physical Earth. If humanity can act to protect our health against a single virus, we can also adopt necessary changes to confront the even greater threat of climate change. As we grapple with the immense social and economic costs of proactively confronting COVID-19, may this moment serve as a wake-up call to our collective capabilities and as an opportunity to renew our understanding of the cost of inaction in the face of our climate crisis.

Coronavirus disease 2019 (COVID-19) Situation Report -97. World Health Organization

The 2019 report of The Lancet Countdown on health and climate change: ensuring that the health of a child born today is not defined by a changing climate

Valuing the global mortality consequences of climate change accounting for adaptation costs and benefits

The Coronavirus Shock: A Story of Another Global Crisis Foretold and What Policymakers Should Be Doing about It

Coronavirus has temporarily reduced China's CO 2 emissions by a quarter. Carbon Brief