Coronavirus has been an unpleasant wake up call of more than one sort

Our human propensity to ignore non-immediate threats until they are upon us has led to many unfortunate tragedies. Rarely though have we had the opportunity to watch one play out so dramatically, as government after government delayed action until it was too late to prevent community spread of the coronavirus. 

Taking a step back; a global pandemic had been predicted for years. We didn’t know exactly which pathogen would be causative; whether influenza, paramyxovirus, picornavirus or coronavirus, but we knew it would come. [1] With 1.4 billion international travel arrivals annually worldwide, and our great exploitation of the environment, a rapidly spreading outbreak was inevitable. After SARS, MERS, and Swine Flu, many commentators, including Bill Gates advised that it was not a case of if, but when the next global pandemic would strike. [2]

And if we take a couple more steps back, we realise that this covid-19 pandemic is the tip of the iceberg; part of a larger, complex puzzle of a delicately balanced world. A far bigger problem is unfolding with catastrophic consequences, arising from our inability to care for the natural world. Unfortunately, we fail to make the connections time and again. The covid-19 pandemic is occurring partially because of excessive human exposure to wild animals, as we destroy their habitats and they encroach on human settlements looking for food [3]. And covid-19 is having such a bad health impact because our current human population is unfit to face the virus, given high levels of hypertension, diabetes, obesity, which are by-products of our industrialised agriculture and motorised transport. 

Even recent human conflicts have some of their roots in nature. Rwandan genocide events, on a bedrock of deep ethnic tensions, were worsened by the chronic stress of prolonged drought and famine, and violence was far more likely where the average daily calorie intake was less than 1,100 per day [4]. The conflict in Syria came off the back of a record drought, and subsequent mass internal migration to the cities [5]. Revolutions, as they say, occur when the common man can no longer afford bread. As EU food production is likely to decrease by as much as 17% just in the next 30 years, by 2100, we will see more climate-catalysed conflicts. [6]

We are entering the 6th great extinction event on Earth; sadly, this one is caused by humans. Many predictions suggest we are on target for 4 degrees Celsius average temperature rise by 2100 [7]. Without unprecedented multilateral action, the cumulative death toll from this disaster, as in previous great extinction events, could account to billions of people, through an unpleasant mix of accelerated (un)natural and “concatenated” disasters, increased arbovirus transmission, drought, famine, and conflict [8]. Imagine this pandemic on the back of a Europe-wide crop failure and record heatwaves. Future disasters will not come alone. 

Even if we let pandemic coronavirus spread unchecked, it would eventually run its course with a death toll of 50-100 million or so. But compared to our mismanagement of the planet, this would be as inconsequential as seasonal flu is to coronavirus. The planet is the body from which all our medicines are made, whose resources feed us, whose weather systems and homeostatic controls govern how many Category 5 storms hit the Caribbean, how many floods, and droughts hit, and where. Temperature governs malaria and dengue transmission. Inundation governs locust swarms. 

But from the ashes of coronavirus, we might derive hope. After all, who believed that governments could stop “business as usual” so effectively. Who believed governments, businesses, and the general public could come together with such collaborative force to repurpose an events arena into a 4000 capacity intensive care ward, engineer much needed ventilators in car factories, and form huge grassroots community support networks in a matter of weeks. 

There is a new level of belief that humanity can pull off big societal projects together, especially when it relates to common interests. And there is no bigger common purpose narrative than the climate crisis. It is the biggest health problem we will ever have to collectively face. 

Over the past few weeks we have been creating a video for Earth day with five other doctors from around the world, along with Mercury music prize nominee Sam Lee; and a poem entitled “If we treat only symptoms.” We want to promote good stewardship of our beautiful home planet as a vital public health strategy; even more than prescribing medicines. Because planetary health is the rock upon which human health sits, and right now it is crumbling beneath us. 

There will soon open up a window before us, as the corona-crisis lifts, for a real change of direction; and if we don’t leap at it with all the force we can muster we will slip back into old habits and waste valuable time; which, as it was for coronavirus, will be measured in human life. 

We ask you as our colleagues to consider the wider context of health, and, on Earth Day, take one small step today to support the planet. 

James Hospedales, Director of the Defeat-NCD partnership, Former Exec Director of the Caribbean Public Health Agency Public Health Consultant 

Chris Newman, Salaried GP ITU ward doctor at the Nightingale Hospital Co-founder of Doctors for XR. 

Competing interests: None declared


[1] The Characteristics of Pandemic Pathogens . Johns Hopkins Center for health Security 10.05.2018
[2] The next outbreak? We’re not ready | Bill Gates (TED Talk) 03.04.2015.
[3] Destroyed Habitat Creates the Perfect Conditions for Coronavirus to Emerge
[4] Natural Resource Scarcity and Violence in Rwanda. James Gasana. 2002.
[5] Climate change in the Fertile Crescent and implications of the recent Syrian drought. PNAS. 02.03.15
[6] Delivering on EU Food Safety and Nutrition in 2050 – Future challenges and policy preparedness. 2016. [7] Sir Robert Watson, former IPCC chair.
[8] The Lancet Climate Countdown. 2019