Quick: what do Zika, West Nile, Chikungunya, Eastern Equine Encephalitis, malaria, yellow fever and Lyme disease all have in common?
They are diseases spread by the vector of biting mosquitoes, and with Lyme disease, ticks [arachnids], whose geography have been disrupted and expanded by the impacts of climate change.
Politicians can deny the existence of climate all they want to, with feverish claims, but all the spraying of all the pesticides in the world will not stop the inexorable march of these disease-bearing insects and arachnids as warming temperatures increase their geographic reach. (And, it won’t stop the landscape companies from advertising that they can provide regular treatments to protect you and your families from mosquitoes and ticks.)
If it seems to resemble the plot from one of those horror movies from the 1950s about the relentless march of ants swarming the landscape, there is good reason for that.
The question is: what is the best public health response to this onslaught?
Recognizing the facts
The first step, of course, to admit to the reality, however disliked: we are in the midst of a rapidly changing climate. The evidence is all around us.
In the midst of a sweltering summer heat wave in Rhode Island, beaches are closed in regular fashion due to high bacteria counts in the water.
Red tide and alga blooms in Florida, that favorite respite for many Rhode Islanders when they retire, have caused thousands of fish and turtles to die.
The lobster population is shrinking in Narragansett Bay, which many researchers link to rising water temperatures.
There is an increasing volatility to the weather patterns; witness the unlikely scenario of four tornados occurring in the last week in Connecticut and Massachusetts just northwest of Rhode Island.
In San Diego, ocean temperatures were recorded as the warmest ever in 102 years of measurement. And, across many Western states, including California, wildfires are raging.
OK, you agree, our weather patterns are being disrupted. And, for sure, the ice caps are melting, and the coastlines of low-lying countries are on the verge of being swept away from monsoon flooding. And, yes, it is blanking hot outside.
What does it have to do with public health? In addition to mosquito- and tick-borne diseases, there are other viruses that appear to be becoming more rampant with the change in climate. A new outbreak of Ebola is now feared in the Democratic Republic of the Congo, the viral respiratory illness known as MERS keeps becoming more prevalent in Saudi Arabia, and then there are the potential fears about H7N9 flu in Asia sparking the next global pandemic.
Oh, yes, if you really want to have nightmares, there new reports that the AIDS epidemic may be expected to explode again.
The best public health response is to be able to produce vaccines for the viruses, and there are many companies, including Rhode Island’s own EpiVax, that are involved in the ongoing work. And, that will take willingness by the U.S. to invest more money in research to develop more, better ways to produce vaccines.
The other part of the story, told by Dr. Paul Farmer, is the recognition that there is a need to build the human infrastructure of caregivers in many countries.
Entering the political realm
The collision between health, the environment and climate change is one that becomes a difficult topic when it enters the political realm.
It is like Galileo attempting to defend his idea, based on science, that the Earth traveled around the sun, who was tried by the Inquisition, found to be “vehemently suspect of heresy,” and forced to recant.
As best I can determine, there were no questions asked by the latest poll conducted by WPRI about the candidates’ positions running for governor in 2018 about climate change, or, for that matter, about health care, which keeps polling nationwide as the number-one concern by voters in the 2018 campaign. Why is that?
Instead, we seem to be analyzing the results of a popularity contest between the candidates, without much substance to the question. For those old enough to remember the Johnny Carson show, we have become like his sidekick, Ed McMahon, asking: “How hot was it, Johnny?”
No safe place
This past weekend, The New York Times Magazine devoted its entire issue to climate change, and how efforts led by a group of U.S. environmentalists failed to convince world leaders to take a stand on carbon emissions in 1989, with the provocative title: “Thirty years ago, we could have saved the planet,” written by Nathaniel Rich.
It is an intriguing read, made more interesting by the fact that I knew and interacted with a number of the players when I was editor of Environmental Action Magazine from 1982-1985. My memories of those times and the stories written and published in the magazine differ strongly with the narrative constructed by Rich.
The idea that a group of scientists and environmental advocates could try and change the way that the world does business – and fail – is certainly an intriguing story line. But it still conforms to the myth of great men and great women changing history.
What is missing from the tale of missed opportunities is precisely why the national environmental floundered, in my opinion: the conversation was never translated into something that could be discussed around the dinner table, in neighborhood bars, or in coffee shops.
In 2013, I attempted to have that conversation with a bunch of folks I labeled the gathering of geezers at a local Starbucks on early Saturday morning, most of whom were diehard non-believers in climate change. I am not sure that any minds were changed, in the long run, but the discussion was held, in the open, sometimes loudly, in a public space.
Today, as we sit, sweat and swelter in the latest heat wave, when we talk about health care, I believe we need to include a conversation about climate change. At the very least, we need to be able to ask the politicians running for office about it. And, to argue about it among ourselves.