Renee N. Salas: Lessons from the covid-19 pandemic provide a blueprint for the climate emergency

Two essential clinical principles have guided my practice as an emergency medicine doctor. First, I must use whatever information is available to predict and prepare for my patient’s next potential crisis, such as identifying my back-up intubation plan from the start. The second is that treatments often must be implemented in a certain window for optimal efficacy; timely intervention is critical.

For the covid-19 pandemic, these two principles were ignored as the United States federal government dismissed early evidence that coronavirus was a global threat and failed to prepare the country—thus missing the optimal window to intervene. As a result, the U.S. currently has the highest death toll in the world

Unfortunately, the U.S. has also not pursued meaningful federal action on the climate crisis despite overwhelming evidence and harms to health through a frighteningly broad array of pathways—such as heat waves, intensification of extreme weather, and vector-borne diseases. Indirectly, it also disrupts the delivery of healthcare and impacts clinical practice. While this already contributes to significant morbidity and mortality, we are still within a window of action to minimize harm and save lives.

Three lessons have emerged from the pandemic that can serve as a blueprint for the medical community’s response to the climate crisis: health professionals must use their voices as trusted sources; prevention must be prioritized; and a rapid, coordinated global response is essential.

Health professionals must use their voices as trusted sources

We are in an era where science is often disregarded, even when it can guide timely, life-saving decisions. In the case of covid-19, misinformation smothered the alarms—feeling eerily reminiscent of the backlash climate scientists have been facing for decades. The repercussions are human suffering and lives lost.

Health professionals are serving as trusted voices in this pandemic, adding crucial narratives to the numbing statistics and neutralizing dangerous misinformation. The same is needed for the climate crisis. Physicians have been shown to be the most trusted source of information for climate change and health, while nurses are consistently the most trusted professionals. Our voices prioritize the health benefits of climate action, and our patient stories add the necessary context.

Prevention must be prioritized

The covid-19 pandemic, just like the climate crisis, reinforces the essential need for resilient public health systems by exposing the limitations of medical treatments and the fragility of our healthcare systems. When covid-19 is ravaging the lungs of my patient, all I can offer is supportive care. Treatments for diseases exacerbated by the climate crisis can also be limited; treating an asthma exacerbation from rising pollen doesn’t remove the cause. 

Even further challenges arise if care delivery is compromised. For covid-19, this includes capacity concerns and the lack of vital resources like personal protective equipment, testing, and ventilators; for the climate crisis, unprecedented heatwaves and extreme weather jeopardize infrastructure, power grids, and supply chains. This places prevention as the utmost priority. 

Preventive efforts in the pandemic to “flatten the curve”, such as social distancing, have been critical as we optimize other public health resources and increase hospital resiliency. For the climate crisis, prevention means reducing carbon emissions and air pollution from the burning of fossil fuels. This intervention improves health, saves lives, and reduces burdens on the healthcare system. If this isn’t enough motivation, in contrast to social distancing, reducing greenhouse gas (GHG) emission can create jobs and be costeffective. Thus, the medical community must advocate for prevention here just as it has in the pandemic.   

A rapid, coordinated global response is essential

This pandemic serves as a poignant reminder of just how interconnected our world is. We are united in a shared vulnerability to this invisible pathogen, just as we are for the unseen GHGs. Both crises are exacerbating underlying inequalities as vulnerable communities—from particular sub-populations to entire countries—bear the brunt of harm. Mismanagement of the pandemic in one country threatens lives in another, just as GHGs can exert their deadly effect halfway around the globe. 

Synchronized global and national action is significantly more effective than uncoordinated subnational responses, whether for ventilator procurement or reducing reliance on fossil fuels. Urgent, coordinated responses provide the optimal path out of both the global pandemic and the climate crisis, utilizing a multi-disciplinary approach that includes health professionals.

The importance of the medical community, and our inherent responsibilities as public servants, is perhaps the clearest it has been in modern day. Yet even as I battle the covid-19 pandemic on the frontlines, my guiding principles compel me to continue to strive for preventive action on climate. Although the U.S. failed to act in January on the pandemic, we are still in the “January” equivalent for the climate crisis. These lessons can serve as a poignant blueprint to mobilize health professionals to save lives before it is too late.


Renee N. Salas is Affiliated Faculty and previous Burke Fellow at the Harvard Global Health Institute, a Yerby Fellow at the Center for Climate, Health, and the Global Environment at the Harvard T.H. Chan School of Public Health, an Assistant Professor of Emergency Medicine at Harvard Medical School, and faculty at the Center for Social Justice & Health Equity in the Department of Emergency Medicine at Massachusetts General Hospital. 

Twitter: @ReneeNSalas_MD

Conflicts of Interest: I have read and understood BMJ policy on declaration of interests and have no competing interests to declare.