WHO should declare climate change a public health emergencyBMJ 2020; 368 doi: https://doi.org/10.1136/bmj.m797 (Published 30 March 2020) Cite this as: BMJ 2020;368:m797
All rapid responses
I respond to Debenham and Nouhan.
Their diagnosis is spot on. Next is the question of therapy.
The old saying “Physician ! Heal thyself" comes to mind.
Should we doctors - working and retired - now take one or more actions? We all have different abilities, opportunities.
Stop travelling to climb mountains (like Everest).
Do not buy new clothes until the old ones are threadbare.
When you do buy new clothes, as far as possible, buy from the local tailor, seamstress - using linen. Did you know, Northern Ireland linen was exported the world over?
Buy wool. Pure wool.
Boycott nylon of all sorts.
Use only pure soap. NO COSMETICS.
Cut your own hair.
Return to making Steel in Sheffield.
Here, dear Readers, is something to start with.
I am wearing out my old clothes.
Competing interests: Old chap. Hands not as good as they were. Otherwise I would take up knitting (pure English wool)
The ongoing COVID-19 pandemic is reducing demand for oil and a concurrent trade war is increasing supply, causing chaos in oil markets.  This lower price of oil threatens companies which rely on expensive extractive methods such as shale exploration which predominate western markets including those in Canada and the USA.  Private investment is less likely to come to the aid of these companies while the economy suffers the shock caused by COVID-19. However, governmental support remains possible and they have already begun stepping in to protect other oil-intensive industries, with the US government setting aside $25 billion in loans for commercial airlines.  This indicates that governments are still well and truly behind the exploitation of fossil fuels.
It is well-established that oil extraction and the consequent greenhouse gas emissions have a plethora of effects on health, with a conservative estimate suggesting global warming cost 5.5 million disability adjusted life years, in 2000 alone.  However, inaction has always been justified on the grounds that the short-term economic and political costs outweigh any long-term benefits. Until now, the sort of coordinated global politico-economic response required to rid the world of a perceived evil has only ever been achieved in the context of the World Wars and the Cold War. We live in the first era where massive coordinated global change has occurred for the good of all its people – to fight the spread of COVID-19.
Once the medical community gets on top of this pandemic, the primary concerns of governments are likely to shift towards economic recovery. With historically low oil prices, we may see an explosion in its use as people make deferred trips, and industry resumes to normality. It seems probable that global leaders will use this period of extended economic recovery to delay costly action supporting more expensive renewables and addressing the climate crisis in other ways.
While the world is listening to us, we need to sound the alarm that any recovery from this pandemic must be coupled with efforts to support a transition from reliance on fossil fuels and prevent backsliding into profligate use of cheap oil. Actors such as NGOs, academics, doctors, medical students, chief medical and scientific officers should spread this message and strive to coordinate a globally-organised response calling on governments to re-affirm and extend their commitments to shift away from fossil fuel use. We consider the COP-26 an opportune forum for this kind of commitment and call upon citizens to organise and lobby for strong, decisive action. Public health concerns permitting, we encourage private citizens to follow the model of COP-21, where a huge para-conference of ‘alternative ideas’ comprising hundreds of NGOs, private citizens and artists met to brainstorm and lobby governments on the most effective measures to address climate change while hundreds of thousands demonstrated across the globe. 
Has there ever been a more important time for the medical profession to speak up about climate change and its impact on health?
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Competing interests: No competing interests