The document discusses COVID-19 within the context of planetary health and global environmental change. It proposes a framework to explore the role of the environment in the proximal and distal causes of the COVID-19 pandemic as well as its short and long term impacts. It examines the complex relationship between infections, climate, air pollution, and other environmental changes before, during and after the pandemic. It also discusses how biodiversity loss, climate change, pollution, and urbanization can facilitate new epidemics and influence their public health impact.

1. COVID-19, global environmental change, and
opportunities to progress towards the SDGs
Prof. Josep M. Antó
ISGlobal (Barcelona Institute for Global Health), IMIM (Hospital del Mar Research
Institute), UPF (Universitat Pompeu Fabra)
COVID-19 and Planetary Health

2. Outline
• Propose a Planetary Health framework to explore the role of
environment as part of proximal and distal causes of the COVID-19
pandemic as well as its short and long term impacts
• Draw the complex relation between infections, climate, air pollution, and
other global environmental changes before, during and after the pandemic
• How do global environmental changes such as biodiversity loss, climate
change, pollution, and urbanization facilitate the occurrence of new
epidemics or modulate their public health impact

3. Fillipo Minelli, Italy.
https://digicult.it/wp-content/uploads/2011/12/numero70_No-puns-01.png

4. Proximal Factors: Adapted from IPCC 5th Report
2014. http://www.ipcc.ch/report/ar5/wg2/

5. Risk, Hazard, Exposure, Vulnerability and Resilience
• Hazard (and host):
– SARS-CoV-2 infectiveness, lethality, immunity
• Exposure:
– Infection by SARS-CoV-2 (necessary cause);
– Co-factors: contagion-contact, seasonal forcing, climate (tª, humidity, season),
air pollution, water and sanitation, urban and rural, SES, education, many others
(e.g.nutrition)
• Vulnerability (& susceptibility):
– Age, sex, comorbidity, immunity, genetics, nutrition, SES, health systems,
• Resilience:
– Mitigation: Interventions as tracing & isolation, social distancing, vaccines,
pharmacological, health and social care
– Adaptation in the short and the long term

6. Influence on Human Health of Changes Related
to Globalization. McMichael AJ. N England J Med 2013

7. COVID-19: The Disease of the Anthropocene (O’Callaghan C, Antó
JM. Submitted) (Adapted from McMichael AJ. NEJM 2013).
• Demographic Changes: urbanization, increased mobility, aging,
• Social Changes: Fragmentation of multilateralism, weakening of public health infrastructure’s, weak
support to WHO, populist/authoritarian governments,
• Economic Activity: increased mobility, unregulated wild meat market,
• Large scale and systemic environmental impacts: extinction of species and decrease of biodiversity,
deforestation and disruption of natural habitats in emerging zoonosis, …
• Refs: Citivello et al. PNAS 2015; Fèvre et al. Trends Microbiol 2006; Jones et al Nature 2008 ;
Laurance et al. Nature 2014 ; Li PJ. South China Morning Post 2020 ; Myers te al. PNAS 2013; Patz et
al 2005; Rorh et al Nat Sustain 2019; Visal J ENSIA 2020; Wolfe et al Nature2005; Wolfe et al. Nature
2007.

8. We are dealing with an unprecedented crisis
• COVID-19 is not a random nor a usual crisis. It’s an unprecedented one.
• COVID-19 reveals a context of global negligence. Research, translation,
implementation and education are crucial to pave the way forward.
• COVID-19 is a systemic crisis which origins and consequences should be
understood in the context of the climate crisis and the Anthropocene.
Maybe a tipping point of the Anthropocene?.
• The Planetary Health approach provides a unique opportunity to
understand how proximal and distal factors are interconnected in the
COVID-19.

9. Isaac Cordal. New York, December 2019.
http://cementeclipses.com/Works/cement-eclipses-new-york-city/

10. MANY THANKS!