A presentation I made at the GLOBAL EMERGENCY MEETING Nov 2015 on how Emergency Medicine may need to rethink itself in the face of Climate Change.

1. Planetary Boundaries, Climate Change and their
effects on Emergency Medicine.
“The greatest global health opportunity of the 21st
Century.” The Lancet Commissions
Viveik Saigal
viveik@gmail.com

2. Conflict
Of
Interest

3. Living in the 3-6-9 World
3degrees
6th extinction
9 billion
The Anthropocene

4. IPCC 5th AR, WG II, Chapter 11
How Climate Change Affects Health
www.thelancet.com

7. The 2006 – 2010 drought turned 60%
of Syria’s fertile land into desert
By 2010, the drought had killed
80% of the country’s cattle

8. “I had 400 acres of wheat,
and now it’s all desert.”
Ahmed Abdullah, Syrian
farmer
• October 2010
© 2010 Julien Goldstein/The New York Times/Redux

9. Refugee Camp, Dael, Syria
March 8, 2011
© 2010 Reuters/Khaled al-Hariri
A million people fled their homes
and farms due to drought

10. “…the Syrian minister of agriculture ... stated
publicly that economic and social fallout from
the drought was ‘beyond our capacity as a
country to deal with.’”
Cable from the U.S. Embassy in Damascus to the State Department
November 8, 2008

11. Extremism and chaos in 6 years.

15. Global Systems Vulnerable to Climate
Disruptions May Lead to Political or Societal Instability
Global Health InfrastructureFood Supply Water
© iStockphoto/Ryan Burke

16. Global Systems Vulnerable to Climate
Disruptions May Lead to Political or Societal Instability
Global Health InfrastructureFood Supply WaterFood Supply

17. A 1° Celsius increase (1.8° Fahrenheit) in projected
mean temperature was found to decrease wheat
yields by nearly 21 percent.
Kansas State University
September 3, 2013

18. Rising concentrations of CO2 are threatening global
nutrition by reducing levels of nutrients in food
crops like rice, wheat, and soybeans.
Source: Bloom, et al., “Increasing CO2 threatens human nutrition,” Nature, April 2014. Image: © 2007 Anzelm/iStockphoto

19. Climate change is also leading to an
increase in plant pests and diseases

20. Global Systems Vulnerable to Climate
Disruptions May Lead to Political or Societal Instability
Global Health InfrastructureFood Supply WaterWater

21. Increase in Annual Water Demand
2005 – 2030
0 150 300 450 600
China
India
SS Africa
Rest of Asia
N. America
Europe
S. America
MENA
Oceania
Agriculture Industry Municipal/Domestic
Billion Cubic Meters
Data: 2030 Water Resources Group, “Charting Our Water Future,” 2012

22. Global Systems Vulnerable to Climate
Disruptions May Lead to Political or Societal Instability
Global Health InfrastructureFood Supply Water Global Health

23. Mortality due to climate change
Density equalling cartogram. WHO regions scaled according to estimated mortality (per million people) in
the year 2000, attributable to the climate change that occurred from 1970s to 2000. Patz et al 2007, in press

24. Extreme Weather Events
Handmer, J. et al .2012: Changes in impacts of climate extremes:
human systems and ecosystems. IPCC

28. Flooding Exposure
Handmer, J. et al .2012: Changes in impacts of climate extremes:
human systems and ecosystems. IPCC

29. Did you know that the Pearl River Delta is already
under threat from severe flooding?

30. Land Use Map in PRD
Red – highly developed area
Current Situation

31. Land Use Map in PRD
Red – highly developed area
Flooding of 3m

33. Sea Level Rise-Coastal Flooding
Handmer, J. et al .2012: Changes in impacts of climate extremes:
human systems and ecosystems. IPCC
°

34. 2° C 4° C
Shanghai
°° °
http://sealevel.climatecentral.org/

35. 2° C 4° C
Mumbai
°° °
http://sealevel.climatecentral.org/

36. 2° C 4° C
Rio
°° °
http://sealevel.climatecentral.org/

37. Health Impact of
Climate Change
IPCC 5th AR, WG II, Chapter 11

38. IPCC 5th AR, WG II, Chapter 11
The
Health Risk/
temperature
Relationship

39. Safety
Net

40. Climate’s Effects on E.M.’s Clinical Mission
1. Increase the incidence, prevalence and severity of many
conditions seen in the ED.
Heat Related Injuries
Exacerbated Chronic Conditions Vector Borne
Zoonotic Disease Respiratory
Water and Food Borne Urinary

41. Climate’s Effects on E.M.’s Clinical Mission
2. Patients who rely
disproportionately on the ED are
particularly vulnerable to
climate change.
-Marginalised Groups
-Extreme of Age
-With mental health concerns

42. 3. Novel Diseases frequently present to the ED and Climate Change
introduces unfamiliar Vector-borne and Zoonotic Diseases into new areas.
-Rare
-Unknown
-Considered Eliminated
Climate’s Effects on E.M.’s Clinical Mission
Higher demand for ED Services
and increased surge capacities.

43. Climate’s Effects on E.M.’s Pre-Hospital Mission:
EMS and Disaster Response.
Local Level
• Increased EMS demand
for day to day
activities.
• Heat Waves
Multisystem Failures,
Extreme Weather
Events.
Regional/National Level
• Disaster response
deployments.
• Multi-agency leadership
Role.

44. SCMP 22nd June ‘14.
“Strain on Hong
Kong's health system
increases as
government dithers
over reform.”
IPCC 5th AR, WG II, Chapter 11

45. Relationship
between
Climate
Change and
Occupational
safety and
health.
A
Framework
Schulte and Chun [2009]

46. Climate’s Effects on E.M.’s Public Health Mission
• Leadership
• Administration
• Policy
formation
• Advocacy

47. Climate’s Effects on E.D.’s Hospital & System Mgt.
1. Hospital ED has high intensity of
energy use.
2. EMS generates emissions through
patient transport.
3. Dependent on other specialties.
Vulnerable during system failure.
4. Reactive specialty.
5. High Cost.

48. The Target to stay within the 2 degree limit.
Assuming a world population of 9.5 billion people by
2050—this means that countries would need to
converge close to a global average of CO2-energy
emissions per capita of 1.6 tons in 2050, which is a
sharp decrease compared to today's global average
of 5.2 tons.

49. Potential for
impact reduction
through
adaptation
IPCC 5th AR, WG II, Chapter 11

50. Adapting to the health Impacts of Climate Change
• Incremental adaptation
• Transitional adaption
• Transformational
adaptation

51. http://dea.org.au/

52. The Holocene: The only known stable state

53. ----- 2°C
----- 0.8 °C
The threshold of danger
2 °C is too High to
be safe and too low
to be possible

54. If
everyone
does a little,
we’ll achieve
only a little.”
David
MacKay, Chief Scientific
Advisor at the
UK Department of Energy and
Climate
Change.

55. ----- 4 °C
2 °C
----- 0.8 °C
Hell on Earth
• Hottest in 20 Million years.
• Sea level Rise of 3-6 Ft.
• Drought over 40% of the
Earth’s Surface.
• 100s of Millions of refugees.
• Half of known species extinct.

56. http://shift-magazine.net/2015/10/18/the-politics-of-addressing-climate-change/

57. ----- 6°C
4°C
2°C
----- 0.8 °C
Where we are headed
International Energy
Agency (May 2014): 6 C
by 2050 with business as
usual

58. Can
Humans
CRASH
Earth
Systems ?

60. It would be the same as
accepting that we would
have 1500 aircraft
crashing every day !

61. It’s not warming, it’s
dying..

62. “Another world is not only possible,
she is on her way. On a quiet day,
I can hear her breathing.”
Arundhati Roy
Common Cause for Nature. Public interest Reseach Centre.

63. EMPTY WORLD
FULL WORLD
Simplified values
circumplex

64. Could it have been foreseen ?
Was it foreseen ?
What did you do about it ?

65. Source: NASA
Viveik Saigal
viveik@gmail.com