COVID-19 shows the link between human and planetary health

This year marks the 50th anniversary of Earth Day, which was established in 1970 to highlight the need to protect our environment. Since then, our current geological era has been proposed as the Anthropocene, in recognition of the impact of human activities on the planet.

The concept of planetary health, meanwhile, highlights the fine balance between human health and the ecological disturbances that our social structures engender, and demonstrates that, in addition to our impact on the planet, any alteration of the human-ecological balance has implications for our health too.

The current COVID-19 pandemic has encouraged this reality. While it manifests as a health emergency, it could be more accurately framed as a planetary health emergency. This is because continued urban growth (two-thirds of the world’s population is expected to live in cities by 2050) has been associated with disruption of ecological balance, increased risk of exposure to new pathogens, and the emergence of new diseases. .

When considering the health impact of new pathogens like COVID-19, it is useful to think about the characteristics of the host and the interaction between the host and the pathogen. The health of the human host before it becomes infected plays an important role in determining outcomes; In addition to advanced age, there is evidence of an increased risk of a severe case of COVID-19 when there are comorbidities such as obesity, heart disease, respiratory disease, or diabetes.

Meanwhile, the host’s environment is a factor in their health, and thus their vulnerability to COVID-19, in several ways. Uneven access to safe homes increases exposure to indoor and outdoor air pollution and wet conditions, increasing the risk of respiratory and heart disease. Inadequate access to affordable and nutritious food puts a healthy diet out of reach for significant parts of society in rich and poor countries alike, increasing the risk of obesity and diabetes.

In terms of transmission, a combination of high-density living conditions in many of the world’s large urban centers and greater global interconnection will increase the likelihood that people will come into contact with the virus.

Infection control measures such as hand washing will play an important role in ending this pandemic. However, unequal access to water and sanitation means that the most vulnerable have a reduced capacity to carry out this simple protection measure. Meanwhile, poor job security makes it difficult for many to stay home or practice physical distancing, further exacerbating the risk.

And for the unfortunate who get sick, unequal access to medical care, be it for disease management or access to a vaccine, further increases the likelihood of poor outcomes.

In summary, we have developed societies that alter ecology, increase vulnerability to disease, facilitate the transmission of disease, and in which many are unable to take necessary preventive precautions or access care.

How is this not a crisis of civilization?

Responses to the current COVID-19 pandemic have demonstrated an unprecedented ability for all sectors of society to come together. Why should this be, given the shortcomings we have shown in addressing the similar existential emergency of climate change?

History has shown that we collectively find it easier to understand the nature of an emergency when:

one) Cause and effect are side by side; for example, when exposure to the new coronavirus is directly and visibly linked to symptoms consistent with COVID-19. Any disconnection, whether in time (if it took three years to get sick, for example) or in space (if, for example, the exposure in London resulted in deaths in Lagos) seems to affect our understanding, perception of risk and sense of urgency. .

two) It is impossible to carry out normal daily life, either by measures to address the emergency or the emergency itself.

3) The consequences cannot be “considered” since it affects all sectors of society, not just particular groups.

Additionally, calls to action to address an emergency are more likely to generate a response when:

one) The question is clear and finite.

two) Action does not require long-term structural change.

3) The beneficial effect of the action can be attributed to the responder.

The combination of this dissonance in our perception of emergency and the factors that influence the way we respond have implications for our motivation, urgency and our choice of action.

What if we could activate our social imaginations to think differently about our health systems? What if we address the social determinants of health, aware of the natural systems on which we depend? Our responses to COVID-19 have shown that intersectoral collaboration is possible, that global cooperation is necessary for perverse problems, and that extraordinary efforts to communicate and involve all levels of society are possible.

What if we also thought differently about emergencies with a greater focus on forecasting, aware of our perception bias?

This would require us to deal with complex and evolving realities and environments that increase the risk of new emerging diseases and that accelerate climate change. It would also require recognition of the evolving roles that we can and should play. Finally, it would require systems-based prevention approaches to reduce the risk of emergencies and (if they occur) to prevent disasters.

The central principles of such an approach would include:

one) The need for clear global leadership, highlighting the importance of organizations like the WHO.

two) Recognition of the need for various urban sectors such as transportation, energy, and housing to work together to improve health outcomes in cities.

3) Risk sharing, with stakeholders investing and benefiting from cross-sector collaboration also share costs.

4) Innovative strategies to incorporate impacts on health and the environment into performance indicators in the public and private sectors.

5) A focus on the curative and preventive aspects of medical care.

An imaginative approach to addressing the planetary health emergencies we face would include strategies to:

one) Flatten the curve for medical care. Decreasing the basic need for medical care by reducing inequality would serve to make populations more resilient to emergencies, as well as enable humanitarian and emergency services to respond more effectively during health and / or environmental crises.

two) Vaccinate the entire society by providing the natural and man-made environments necessary to protect health and avoid ecological disruption, and achieve ‘herd immunity’ by addressing the social determinants of health, thus reducing people’s vulnerability to ill health .

3) Complement epidemiological models with value models based on our shared purpose. While it would be naive not to acknowledge divergent and divergent views on social goals around the world, the shared global experience of the COVID-19 pandemic has perhaps suggested a common starting point: a world in which emergencies that They disturb social functioning, like pandemics, they are not an everyday reality.

The planetary pause we are experiencing on the 50th anniversary of Earth Day should be used to reevaluate our purpose. In doing so, we quickly realize that we cannot address this or any future health or environmental emergency without addressing its social, economic, and political determinants; Our response cannot be limited to any sector, but must adopt a comprehensive approach to society; and we must recognize that it is short-sighted to focus on health to the detriment of ecological boundaries.

We have to consider the interconnected systems that influence planetary health and the balance between human and ecological well-being, as we move forward in the slow work of reusing the basic components of society to address the socio-ecological determinants of health and build greater Sustainable future.