An ambulance from the towns of Heber and Overgaard on June 24, 2002 in Show Low, Arizona as smoke envelops the evacuated town during a wildfire.

An ambulance from the towns of Heber and Overgaard on June 24, 2002 in Show Low, Arizona as smoke envelops the evacuated town during a wildfire.
Photo: David McNew (Getty Images)

The doctors are here to give the Earth its annual checkup, and they say it’s running a fever which is making people sick. They issued their findings showing all the ways climate change is affecting our health in the annual Lancet Countdown, published on Wednesday.

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“The indicators included in the 2020 global report and U.S. brief are just the tip of the iceberg for how climate change is harming health,” Renee Salas, an emergency medicine physician at Harvard Medical School and the report’s lead author, wrote in an email. “But what we are currently measuring provides the most worrying outlook to-date since the Lancet Countdown began reporting 5 years ago.”

Extreme heat was the most deadly climate impact. In 2019, the world saw 475 million heat waves days—a metric defined as one person over 65 years old who experienced a given heat wave—which resulted in increased mortality from heat stress, heatstroke, and exacerbated cardiovascular and respiratory disease, all especially in people over the age of 65. These heat waves impacted people all over the world, from India to Indonesia, Greenland to Mississippi, but poorer countries suffered the worst effects.

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In addition to the direct health impacts, extreme heat can also take a toll on food security, since high temperatures can singe and dry out crops and leave the soil parched. There’s also the question of lost productivity, because heat waves can make it too hot to leave the house. The report shows that 302 billion work hours were wiped out by heat, a 103 billion-hour increase compared to 2000. Just 13 countries accounted for nearly 81% of those lost hours, with India and Cambodia feeling the worst effects. In the Global South, agricultural workers who labor outside were most at-risk of lost productivity. That inability to work is devastating to those laborers and can also further exacerbate issues with food supply.

Though poorer nations in the Global South were hit hardest by heat, the U.S. saw its share of heat-related havoc, too. Last summer, high temperatures and humidity beat down on the South and sparked massive wildfires in California. In productivity terms, the U.S. lost a total of 2 billion potential hours of labor due to extreme heat. This impacted the service, manufacturing, and agricultural industries. But the worst-affected sector was construction, which alone lost 540 million hours—63% higher than the industry’s 1990-1994 average.

Other extreme weather events slammed countries all over the world in 2019, too. There were floods, droughts, storms, and the aforementioned dangerous and polluting wildfires. According to the report, instances of these weather-related disasters increased between 1999 and 2019. The authors found that countries that reduced or only minimally increased investment into health care from 2000 to 2017 saw a significant increase in the number of people harmed or killed by extreme weather in 2019. But in countries that made the biggest increases in health-care spending during that time period, the number of people affected by extreme weather events decreased between 1990 and 2019, despite the increase in frequency of events. The authors aren’t completely sure why this is, but note “one possible explanation for this finding could be the adaptive effects of health system strengthening.” In other words, a concerted effort to improve healthcare could be making a huge difference as a form of climate adaptation.

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The merciless heat waves, fires, floods, and droughts have all continued into 2020. The year started with record-breaking fires in Australia. In August, Death Valley saw the hottest temperature ever recorded on Earth, and California saw record-breaking blazes of its own. There was also gut-wrenching devastation from floods, chart-topping temperatures in the Arctic, and a hellish hurricane season that also broke records.

But of course, the health challenges that each of those disasters posed has been overshadowed by the unprecedented covid-19 pandemic. That crisis, though, contains lessons for our climate future.

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“A stress test for the heart is used to reveal the problematic arteries so it can be fixed before causing a massive heart attack,” Salas said on a press call. “Well, the pandemic has been a stress test for the U.S., both revealing and exacerbating our problematic areas and clearly illustrating that our nation is not adequately prepared for global-scale health challenges, including climate change. The failures demonstrate on an accelerated scale that when our nation fails to urgently respond to the warnings of scientists there are grave repercussions for health and society.”

The ways that the pandemic has made climate impacts more challenging are well-documented. It’s harder to coordinate emergency responses like evacuations and shelters, for instance, amid the spread of a deadly airborne virus. Covid-19 has also put an increased strain on the hospitals that must also care for patients harmed by climate disasters, too. Like the climate crisis, covid-19 has also disproportionately affected poor people and people of color.

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“In my emergency department, I can’t take just one health problem and place it in isolation when treating a patient,” Salas wrote in an email.One insult on the body creates new problems and worsens old ones, just like climate change. Thus, another key theme is the interconnected nature of our most pressing health challenges, and how climate change continues to underlie and exacerbate them, with cascading and far-reaching failures—whether the global pandemic or systemic racism in the U.S. We must take an integrated approach when tackling these problems because addressing them holistically has wide-ranging benefits. We don’t have the luxury of tackling one crisis at a time.”

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