A Texas doctor's plea to prepare for climate change 

Friday, 19 February 2021 17:07 GMT

Snow fall around a U.S. flag and a tree alongside a highway in Fort Worth, Texas February 4, 2011. A severe winter storm that battered much of the United States on Thursday shut nearly 5 percent of U.S. natural gas output and affected refinery operations as far south as Corpus Christi, Texas. REUTERS/Brian Snyder

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Winter Storm Uri showed me what a public health emergency caused by climate change looks like. The worst is yet to come

Dr. Amy Faith Ho is an emergency physician, published writer and national speaker on issues pertaining to healthcare and health policy.

Emergencies are literally my specialty.

We emergency physicians are braced for the unexpected - always at the ready to grapple the next life-threatening disaster that walks, rolls, limps or is carried through our double doors.

Hospitals and emergency departments train for the acute, sudden and drastic: mass shootings, roadway pileups, bioterrorism. Climate change, as a function of its slow-moving and gradual nature, is almost definitionally excluded from emergency management hotlists.

Looking back at Winter Storm Uri’s wake, nothing can be as acute, sudden and drastic to our health as the destabilizing forces of a weather emergency. The cascade of consequences from systemwide loss of critical resources like electricity, gas, and water quickly devolves into medical catastrophe.

Loss of electricity meant that essential medicines requiring refrigeration like insulin couldn’t be safely used. Life-sustaining medical devices like home oxygen were inoperable. Dialysis centers were unable to open, and their patients whose lives depend on dialysis to filter toxins from their bodies were shunted to the emergency room. 

Loss of heating led to carbon monoxide poisoning and house fires, as desperate families turned to unsafe warming practices like running their cars inside of garages and lighting charcoal grills indoors to combat the bitter cold. Without water, people had no ability to mix formula for their babies, no way to hydrate, no way to take pills.

And, all the while, we operated with a maimed hospital infrastructure: burst pipes flooding waiting rooms and hallways, staff facing treacherous road conditions in addition to a lack of critical resources at home, and no available water to support the most basic of bodily functions much less cleaning patient rooms, washing hands, sterilizing equipment, or performing surgeries.

These are only the immediate crises we saw within the frozen walls of the hospital. We still know that lurking on the horizon will be the countless delayed casualties of the storm: outbreaks of illnesses like cholera, Escherichia coli, and norovirus from drinking unsafe water, sequelae of frostbite or cold exposure injuries, increased homelessness now that homes are flooded, burned, or otherwise destroyed.

The disaster in this situation isn’t just the extremeness of the storm, but also the fact that the storm was such an outlier in likelihood. Winter storms like those of Detroit, Minneapolis or Chicago don’t occur here in Texas. As a result, we had no infrastructure and no preparedness for such an event.

Experts are calling this a once-in-a-century storm based on historical occurrences, but we may not find these events to be so rare in the future. Scientists have already weighed in that Texas will not be the only tragedy of its kind in this era of climate crises. The instability of climate change is going to be our new norm. Patterns will no longer be predictable, true preparedness becomes infeasible, and history is no longer our teacher.

This is why climate change is a public health emergency of epic proportion. It has the power to flip all that we know to be true and make the impossible possible. It may sound like another obscure political buzzword – but it’s awfully concrete when we experience its human toll in our emergency departments. As we witnessed this week in Texas, weather disasters can ravage every aspect of the basic infrastructure necessary to sustain and maintain life.

Economically-disadvantaged areas – with more crowded living, lower quality construction, and fewer resources – are likely to suffer these consequences at a disproportionately higher rate. Most importantly, this vulnerable population is also underrepresented in places of power.

Clinical care has always been about more than just medicine: “social determinants of health” is a catch-all that includes all the factors that impact a population’s health status. We are all very aware of health inequity, but we need to come to grips with the fact that health inequity is just a microcosm of a greater life inequity for all conditions – social, economic, and yes, climate.

Scientists have been sounding the alarm for decades - and just weeks ago, the public was warned of the oncoming polar vortex as a result of the warming arctic stratosphere. It has never been more important to speak up and demand a plan not only for regulation and energy reform, but to frame climate change as the urgent, life-threatening ticking time bomb that it is.

Winter Storm Uri is just the first burst of steam forewarning an eruption of latent weather and energy emergencies.  Climate change may not be traditionally “in our lane”, but in the aftermath of this week’s events, there should be no question that it is not just a public health emergency - it is the public health emergency of the century.