When the weather makes you sick

Heat waves, forest fires, the spread of infectious diseases such as Lyme disease… The impacts of climate change on health are intensifying around the world, confirms the latest report from the Intergovernmental Panel on Climate Change. Climate (IPCC), presented on February 28. And Canada is no exception. Health Canada has just published a report of nearly 900 pages which concretely documents the way in which these changes affect health, in addition to quantifying the costs they generate.

Extreme weather events, such as heat waves and wildfires in Western Canada in 2021, have shown the strain they put on health systems. For Céline Campagna, scientific manager of the Climate Change and Health program at the National Institute of Public Health of Quebec (INSPQ) and co-author of the report, the climate crisis is above all a health crisis. « If we continue on this trajectory with a poorly funded network, poorly prepared for climate change, with an aging population, we will end up with what we are experiencing with COVID-19, that is to say a network overload, » she says.

The regional authorities were « not at all prepared for the scale of the crisis », says Céline Campagna, following testimonies received from her counterparts in other provinces. Contingency plans had been drawn up, but not for disasters of this magnitude. In addition to hospitalizations and deaths due to the heat, emergency lines were saturated and healthcare establishments had to evacuate patients in difficult conditions in the face of the arrival of flames and smoke from the fires. The intensification and multiplication of meteorological phenomena are forcing the health network to review its plans across the country, the report concludes. Not to mention that it will be necessary to limit the impacts of climate change upstream.

Few establishments in Canada have assessed the risks and vulnerability of their buildings in the event of extreme climatic events. These “adaptive measures” help to stay ahead of the growing health impacts of climate change. This requires the resilience of infrastructures, the preparation of personnel, the updating of emergency plans as well as warning and monitoring systems for meteorological disasters.

The report does not focus only on healthcare establishments. It shows that land use planning, transportation planning and greenhouse gas (GHG) reduction have a direct impact on health. The stabilization of emissions by 2100 alone would make it possible in 2050 to avoid 5,200 deaths linked to climate change during the summer. The health network itself has every interest in setting an example by focusing on renewable energy sources: it is responsible for 4.6% to 5.1% of national GHG emissions.

Urban greening is commonly cited by environmentalists as an accessible and effective adaptation measure. In addition to eliminating heat islands, the creation of green spaces improves air quality, often makes it more attractive to practice physical activity in a neighborhood and can improve the mental health of people who live there. live. The report mentions that the costs of applying such measures could be offset by mitigating the escalating health care costs attributable to climate change. Heat waves, for example, represent an economic burden of $370 million per year in Quebec.

Governments have nevertheless deployed initiatives in recent years, such as warning systems during oppressive heat events. Quebec is also doing well in this regard with the Surveillance and prevention system for the health impacts of extreme weather events (SUPREME), introduced in 2010. In Montreal, an action plan including awareness campaigns in neighborhoods most at risk, the provision of air-conditioned spaces and door-to-door operations has reduced the number of deaths during heat waves by five. Other systems, such as predicting the path of smoke clouds caused by forest fires, are proving equally effective, as are air quality indices and the prevention of infections such as Lymes.

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More and more health professionals are becoming aware of the important role of the latter in the implementation of actions to fight against climate change. This is the case of the D^D Claudel Petrin-Desrosiers. The latter made climate change her hobbyhorse from the start of her studies in family medicine, after reading in the prestigious journal The Lancet that global warming was the number one threat to the health of the 21st^and century. Today president of the Quebec Association of Physicians for the Environment (AQME), which has more than 500 members, she tries to popularize climate-related health issues with the general public and the medical community and takes a position in some files. “Most environmental problems are not going to be resolved with pills. My role as a doctor doesn’t end with what I do in my office,” she says of her involvement.

In the Hochelaga-Maisonneuve district of Montreal, where she practices family medicine, climate change poses a risk to the health of many of her patients. Seniors, racialized populations, people with low incomes, those with physical or mental health problems, those with disabilities and Indigenous communities are often more vulnerable than other people. The pandemic has also proven it, according to the 29-year-old doctor. Environmental actions must therefore take health inequities into account.

Various environmental groups thus speak of climate justice. Olivier Kölmel, spokesperson for Greenpeace Canada, observed the impacts of climate change on the health of Aboriginal people. «  Their territory is being degraded, they are losing traditional ways of feeding. It affects their diet. We see more problems with obesity, diabetes, cardiovascular disease,” he explains. Canada has a lot of catching up to do on the adaptation front, he said. “Despite the evidence of the close link between health and the environment, both provincially and federally, we are dragging our feet in understanding it and taking action,” he laments.