the challenges of planetary boundaries, climate change for emergency medicine

Planetary Boundaries, Climate Change and their effects on Emergency Medicine.

“The greatest global health opportunity of the 21st

Century.” The Lancet Commissions

Viveik Saigal

viveik@gmail.com

Conflict

Of

Interest

Living in the 3-6-9 World

3 degrees

6th extinction

9 billion

The Anthropocene

IPCC 5th AR, WG II, Chapter 11

How Climate Change Affects Health

www.thelancet.com

The 2006 – 2010 drought turned 60%

of Syria’s fertile land into desert

By 2010, the drought had killed

80% of the country’s cattle

“I had 400 acres of wheat,

and now it’s all desert.”

Ahmed Abdullah, Syrian

farmer

• October 2010

© 2010 Julien Goldstein/The New York Times/Redux

Refugee Camp, Dael, SyriaMarch 8, 2011

© 2010 Reuters/Khaled al-Hariri

A million people fled their homes

and farms due to drought

“…the Syrian minister of agriculture ... stated

publicly that economic and social fallout from

the drought was ‘beyond our capacity as a

country to deal with.’”

Cable from the U.S. Embassy in Damascus to the State Department

November 8, 2008

Extremism and chaos in 6 years.

Global Systems Vulnerable to ClimateDisruptions May Lead to Political or Societal Instability

Global Health InfrastructureFood Supply Water

© iStockphoto/Ryan Burke

Global Systems Vulnerable to ClimateDisruptions May Lead to Political or Societal Instability

Global Health InfrastructureFood Supply WaterFood Supply

A 1° Celsius increase (1.8° Fahrenheit) in projected

mean temperature was found to decrease wheat

yields by nearly 21 percent.

Kansas State University

September 3, 2013

Rising concentrations of CO2 are threatening global

nutrition by reducing levels of nutrients in food

crops like rice, wheat, and soybeans.

Source: Bloom, et al., “Increasing CO2 threatens human nutrition,” Nature, April 2014. Image: © 2007 Anzelm/iStockphoto

Climate change is also leading to an

increase in plant pests and diseases

Global Systems Vulnerable to ClimateDisruptions May Lead to Political or Societal Instability

Global Health InfrastructureFood Supply WaterWater

Increase in Annual Water Demand2005 – 2030

0 150 300 450 600

China

India

SS Africa

Rest of Asia

N. America

Europe

S. America

MENA

Oceania

Agriculture Industry Municipal/Domestic

Billion Cubic Meters

Data: 2030 Water Resources Group, “Charting Our Water Future,” 2012

Global Systems Vulnerable to ClimateDisruptions May Lead to Political or Societal Instability

Global Health InfrastructureFood Supply Water Global Health

Mortality due to climate change

Density equalling cartogram. WHO regions scaled according to estimated mortality (per million people) in

the year 2000, attributable to the climate change that occurred from 1970s to 2000. Patz et al 2007, in press

Extreme Weather Events

Handmer, J. et al .2012: Changes in impacts of climate extremes:

human systems and ecosystems. IPCC

Flooding Exposure

Handmer, J. et al .2012: Changes in impacts of climate extremes:

human systems and ecosystems. IPCC

Did you know that the Pearl River Delta is already

under threat from severe flooding?

Land Use Map in PRDRed – highly developed area

Current Situation

Land Use Map in PRDRed – highly developed area

Flooding of 3m

Sea Level Rise-Coastal Flooding

Handmer, J. et al .2012: Changes in impacts of climate extremes:

human systems and ecosystems. IPCC

°

2° C 4° C

Shanghai

°° °

http://sealevel.climatecentral.org/

2° C 4° C

Mumbai

°° °

http://sealevel.climatecentral.org/

2° C 4° C

Rio

°° °

http://sealevel.climatecentral.org/

Health Impact of Climate Change

IPCC 5th AR, WG II, Chapter 11

IPCC 5th AR, WG II, Chapter 11

The

Health Risk/

temperature

Relationship

Safety

Net

Climate’s Effects on E.M.’s Clinical Mission

1. Increase the incidence, prevalence and severity of many

conditions seen in the ED.

Heat Related Injuries

Exacerbated Chronic Conditions Vector Borne

Zoonotic Disease Respiratory

Water and Food Borne Urinary

Climate’s Effects on E.M.’s Clinical Mission

2. Patients who rely

disproportionately on the ED are

particularly vulnerable to

climate change.

-Marginalised Groups

-Extreme of Age

-With mental health concerns

3. Novel Diseases frequently present to the ED and Climate Change

introduces unfamiliar Vector-borne and Zoonotic Diseases into new areas.

-Rare

-Unknown

-Considered Eliminated

Climate’s Effects on E.M.’s Clinical Mission

Higher demand for ED Services

and increased surge capacities.

Climate’s Effects on E.M.’s Pre-Hospital Mission:EMS and Disaster Response.

Local Level

• Increased EMS demand

for day to day

activities.

• Heat Waves

Multisystem Failures,

Extreme Weather

Events.

Regional/National Level

• Disaster response

deployments.

• Multi-agency leadership

Role.

SCMP 22nd June ‘14.

“Strain on Hong

Kong's health system

increases as

government dithers

over reform.”

IPCC 5th AR, WG II, Chapter 11

Relationship between Climate

Change and Occupational

safety and health.

A Framework

Schulte and Chun [2009]

Climate’s Effects on E.M.’s Public Health Mission

• Leadership

• Administration

• Policy

formation

• Advocacy

Climate’s Effects on E.D.’s Hospital & System Mgt.

1. Hospital ED has high intensity of

energy use.

2. EMS generates emissions through

patient transport.

3. Dependent on other specialties.

Vulnerable during system failure.

4. Reactive specialty.

5. High Cost.

The Target to stay within the 2 degree limit.

Assuming a world population of 9.5 billion people by

2050—this means that countries would need to

converge close to a global average of CO2-energy

emissions per capita of 1.6 tons in 2050, which is a

sharp decrease compared to today's global average

of 5.2 tons.

Potential for impact reduction

through adaptation

IPCC 5th AR, WG II, Chapter 11

Adapting to the health Impacts of Climate Change

• Incremental adaptation

• Transitional adaption

• Transformational

adaptation

http://dea.org.au/

The Holocene: The only known stable state

----- 2°C

----- 0.8 °C

The threshold of danger

2 °C is too High to

be safe and too low

to be possible

If

everyone

does a little,

we’ll achieve

only a little.”

David

MacKay, Chief Scientific

Advisor at the

UK Department of Energy and

Climate

Change.

----- 4 °C

2 °C

----- 0.8 °C

Hell on Earth

• Hottest in 20 Million years.

• Sea level Rise of 3-6 Ft.

• Drought over 40% of the

Earth’s Surface.

• 100s of Millions of refugees.

• Half of known species extinct.

http://shift-magazine.net/2015/10/18/the-politics-of-addressing-climate-change/

----- 6°C

4°C

2°C

----- 0.8 °C

Where we are headed

International Energy Agency (May 2014): 6 C

by 2050 with business as

usual

Can

Humans

CRASH

Earth

Systems ?

It would be the same as

accepting that we would

have 1500 aircraft

crashing every day !

It’s not warming, it’s dying..

“Another world is not only possible,

she is on her way. On a quiet day,

I can hear her breathing.”

Arundhati Roy

Common Cause for Nature. Public interest Reseach Centre.

EMPTY WORLD

FULL WORLD

Simplified values

circumplex

Could it have been foreseen ?

Was it foreseen ?

What did you do about it ?

Source: NASA

Viveik Saigal

viveik@gmail.com