Covid-19 should have taught us lessons for the unfolding climate crisis. But sadly, thousands of avoidable UK covid-19 deaths have not been sufficient. In particular, we have not learnt that excessive profits too often damage public health. It is wrong to profit from other people’s pain. The profit motive is embedded in both the pandemic and the climate emergency. Society needs to learn fast and doctors need to teach. Profit attracts deceit and negligence: over 100,000 people have died from covid-19 in the UK, yet we still fail to isolate or quarantine effectively. Instead, we prioritise profit through privatised tracing, and unevaluated mass testing. As lockdown lifts, our eggs are all in the vaccine basket: we feel protected, but remain vulnerable to supply, uptake, and variants. We have failed to learn that private profit consistently undermines public health. Pandemics demand selfless local, national, and worldwide cooperation. But the climate crisis will demand vastly more selflessness which is anathema to commerce. It appears we must expect bigger losses before we choose to cooperate rather than to compete.

We have not learnt to regulate profit because we are, in Charles Dickens’ words, “a cunning and greedy society”, always overreaching ourselves. Covid is a mock exam before our unfolding, disastrous, self-induced climate and ecological crisis. But despite hundreds of thousands of deaths, we remain arrogantly confident that vaccines will trump viruses and that technology will sort the climate emergency. We are inviting a bigger death toll, possibly millions in the UK and billions worldwide, before we see the folly of our hubris. Much of our perceived cleverness is actually raw cunning and much of our jealously guarded, consumerist comfort is greed.

Our cunning is everywhere. We develop tests and wonderful vaccines, but then waste our achievements with inadequate support for poorer countries. Our government gleefully places scientific blessings at the whim of profit-led organisations. Serco and Deloitte’s test and trace squanders money because we fail to support those detected to isolate. We are vaccinating our population before poorer countries, but re-infection and variants from across the world may well undo our haste. We have a government that is happy to lie, tell half-truths, and make promises while enacting diametrically opposite policies. Our government systematically confuses us, misrepresents fact, and abuses science. Our prime minister plays the fool to disguise his cynical commitment to profit-for-the-few. We hear that “almost no-one tells the truth” in a “vacuum of integrity”. Covid-19 and the climate crisis both thrive on deceit. The government sets bold, distant carbon emission targets while subsidising oil companies, roadbuilding, and abolishing green grants. Green-washing the future, while increasing emissions today, is suicidal. 

And greed is everywhere too. The pharmaceutical industry is predicated on profit and often fails to address public need. Optimism around covid vaccines hides a backstory. Public money, poured by governments into private corporations, enables private fortunes. Companies have failed to share their intellectual property and vaccine manufacturing facilities lie underemployed all over the world. We could vaccinate the world quickly, but will not do it because of the greed of those who control pharmaceutical manufacture. Governments repeatedly collude with industry. Big tobacco creates addicts from children then profits from 8 million cruel deaths worldwide, every year. Profit drives obesity and air pollution. Greed is pervasive, ugly, and ubiquitous. It feeds covid-19 and fuels the climate crisis. Governments and media depend on cynical commercial interests. Doctors have failed to expose profit where it exacerbates disease. Do we need millions more deaths from covid, and then the climate crisis, before we tame commerce into serving the public good?

Governments, the media and health are dominated by commercial interests pretending to care while profiting from pain and pollution. Our government talks of the “peoples’ priorities” while looking to the pockets of the rich. Doctors have a duty to see and explain this duplicity to the public. We must choose between truth and comfort, we cannot have both. We, or our children, will pay in full. Our obsession with profit has inflated the costs of covid, but this is nothing compared to it’s fuelling of climate chaos. Irreversible climate change has already occurred, whole societies and ecosystems are dying, and emissions continue to rise. Doctors must now condemn the dominance of cynical, deceitful profit if we are to avoid the worst health impacts of climate-induced societal collapse and mass migration.

We are at a moral and intellectual crossroads. Doctors need to call out unregulated, opaque, corporate control of government and media. Commercially controlled vaccines will protect the rich for a while but, if we do not share them equitably across the world, they will not end the pandemic. Profit-fuelled climate chaos remains a terrifying threat. Doctors must learn to expose those who profit while damaging public health.

Bing Jones, former associate specialist in haematology, Sheffield.

Competing interests: none declared.