Texas storm offers glimpse of how climate change threatens public health
February 23, 2021 – An extreme winter storm followed by freezing temperatures, prolonged power outages, and water shortages has threatened the health of millions of Texans. Renee Salas, a Yerby Fellow at the Center for Climate, Health, and the Global Environment (C-CHANGE) at the Harvard T.H. Chan School of Public Health, discussed the health challenges posed by climate change and the complexities of responding to a disaster in the middle of a pandemic.
Can you talk about the intersection of climate change and health risks as you see them playing out with what’s happened in Texas?
To borrow a term from climate scientist Dr. Katharine Hayhoe, climate change is more than warming—it is also “global weirding.” We’re seeing more extremes of temperature, hotter hots and colder colds, and the intensification of extreme events. The Arctic is warming twice as fast as the rest of the world. As it warms, climate scientists are increasingly concerned that this can have significant implications for the jet stream, and cold arctic air is being pushed into areas that are not prepared for these conditions. As a public health practitioner and emergency medicine doctor, that is very concerning.
If we look at Texas, in the short term, we think about the immediate implications from weather exposure—cold injuries such as hypothermia, for example, or carbon monoxide poisoning among people trying to creatively stay warm. But it’s really the cascade of failures that’s occurring that poses the larger burden. Power outages can prevent people with lung conditions such as asthma from plugging in a nebulizer machine or make it impossible for someone with diabetes to keep their insulin at the right temperature. Contaminated water and water shortages can lead to waterborne diseases or ingestion of other environmental toxins. And we know that access to care is disrupted during these types of events—whether it’s someone unable to get to an outpatient facility for dialysis or pick up their medications because the pharmacy is closed.
What are the challenges of responding to a storm like this in the middle of a pandemic?
In July, I co-authored a piece in the New England Journal of Medicine that highlighted four key ways in which climate change threatens our response to COVID-19, and I think all four of those ways have been exhibited in Texas.
First, we want to keep people socially distanced and at home to prevent the spread of the virus. But an extreme weather event like this has forced people to decide between staying at home where they might not be able to warm themselves and their family or going to a warming center where they can potentially contract COVID-19. That’s a horrible decision for a family to have to make. Second, we want to keep people in their state or region to prevent them from traveling and potentially carrying COVID-19 to other areas. But, as we have seen in Texas, people who have the means and ability to leave will.
The third challenge is that hospitals and health care systems were already stretched to the margins fighting COVID-19. Now they’re working in a situation where their ability to deliver care is disrupted through power outages, lack of water, possible workforce shortages, and overcrowded conditions. Lastly, climate change is contributing to and exacerbating the very diseases that put individuals at greater risk of COVID-19, such as heart and lung disease.
As we noted in the NEJM paper, we cannot achieve an optimal pandemic response without also addressing climate change.
What are some steps that you’d like to see taken to better understand how climate change is impacting health and health care delivery?
Broadly speaking, we need a multidisciplinary approach that makes health and health equity central to all policy decisions. A key piece to achieve this goal is research and surveillance that allows us to build an evidence-based path forward. We can’t optimally prepare for what we don’t fully understand. For example, we could develop a national surveillance system for climate-related health exposures and health care delivery disruptions, ideally one that operates in real time. By building this infrastructure, we can start to better understand the cascading failures, how these crises converge, and what populations and communities are most impacted. This will, in turn, allow us to target adaptation and resiliency actions for the communities that are most harmed.
