Covid-19, climate change, and the environment: a sustainable, inclusive, and resilient global recoveryBMJ 2021; 375 doi: https://doi.org/10.1136/bmj.n2405 (Published 06 October 2021) Cite this as: BMJ 2021;375:n2405
All rapid responses
Degrowth Re: Covid-19, climate change, and the environment: a sustainable, inclusive, and resilient global recovery
On reading the co-authored essay by Professor Stern and Bob Ward
Covid19, climate change, and the environment : delivering a sustainable, inclusive, and resilient global recovery
BMJ 2021; 375:n2405
I was surprised by the paragraph:
“Greater understanding of the urgency required to cut carbon emissions has been accompanied by mounting evidence that it does not mean sacrificing economic development and growth. Annual emissions by the United Kingdom, for example, fell by 43.8% between 1990 and 2019, whereas its gross domestic product rose by 78%over the same period….”
I am assuming that they had not consulted their colleague, at the London School of Economics, Dr Jason Hickel before writing the essay. His recent book “Less is More” underlines the need for Degrowth in the Global North (rather than ever increasing GDP) as the only way to …. "deliver a sustainable, inclusive, and resilient global recovery”.
Some points to remember
• GDP is a flawed metric, better to use a Sustainable Development Index
• continuous growth and material resource extraction in the context of a finite planet does not make mathematical sense
• if negative externalities are included annual emissions of the UK have not fallen between 1990 and 2019
• degrowth, climate justice and better global governance are all vital if the world is to avoid climate catastrophe ie the world needs system change
In the same issue of the BMJ, I would commend the Analysis piece by Professor Theresa Marteau and colleagues
Changing behaviour for net zero 2050
The piece covers the policies needed for net zero very well and highlights the importance that they are driven by evidence and citizen’s values. Also your opening summary for the climate change special issue correctly identifies that "driving system change …. to cut emissions means advocating political action and quickly" because it would have been better if we had started 30 years ago!
The battle is going to be difficult
• renewable energy revolution
• global environmental activism
• vested interests
• status quo inertia
There is hope to be found in action.
Dr Mark Dick
Competing interests: No competing interests
COVID-19: The Possible "reducing" effect of wearing facemask on exacerbating effect of air pollution on chronic diseases
The COVID-19 pandemic has deeply affected people's lifestyles and became one of the biggest health concerns of the world since its outbreak. The factor which is responsible for this pandemic is novel coronavirus known as severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Various strategies have been utilized by different governments worldwide to address the emerging health crisis of COVID-19. In other words, in response to the pandemic, new factors like lockdown, quarantine, face mask, vaccine, drug therapies, etc. came to the fore which could impact human health by themselves. With the increasing number of countries which mandate wearing facemask, it should be considered as an important factor that a large number of people have dealt with during the covid19 pandemic, worldwide.
Air pollution and face mask:
Each year, more than 4 million people die because of outdoor air pollution, according to the World Health Organization (WHO). The main culprits are fine particles with diameters of 2.5 micrometers or less (PM2.5). These can penetrate deep into the lungs, heart, and bloodstream, where they cause diseases and cancers (1). The effects of air pollution on different diseases were assessed in two categories: short-term exposure and long-term exposure. Studies revealed that short-term air pollution correlates with the presentation and incidence of different health-related effects such as neurological, cognitive, respiratory, and cardiovascular diseases as well as COVID-19 infection and cancer. (2-6). Prior research showed increased diagnosis and presentation of lung cancers during the haze seasons compared to non-haze seasons in Southeast Asia. Due to the higher incidence of acute symptoms and total respiratory admissions during the haze periods, this observation of increased diagnosis of lung cancers (especially at an earlier stage) suggests that the haze induced respiratory symptoms which led to higher and earlier detection of lung cancers (7). In another study Particulate matter and gaseous pollutants, both showed a strong temporal relation with mortality from stroke and admission to hospital for stroke. In this study, the strongest associations between air pollution and admission or mortality are attributed to low to middle-income countries (8). also, a positive association between CVD and PM10 at the two-, three- and four-day lag time has been observed (9). On the other hand, previous studies have shown the protective effect of wearing a face mask against health-related effects of air pollution (10, 11).
In the time of the COVID-19 pandemic, with the growing uses of face masks, it can be assumed that it has protected people from harmful effects of air pollution as well as covid19 infection. Moreover, recent research showed a significant reduction of air pollution components during the COVID-19 pandemic (12). The greatest PM2.5 reductions occurred in the capitals of America, Asia, and Africa (13). Taken together, it seems that air pollution-related diseases were affected by the COVID-19 pandemic at least in two ways; first by a reduction in overall air pollution load and second by the protective effect of wearing a facemask. This is probably one of the factors that decreased different diseases diagnoses and presentation in the COVID-19 era (14, 15).
Another point is that, with this reduction in air pollution-related health effects and its probably reducing-effect on presentation of diseases like cancer, it just caused a time delay to diagnosis of these diseases. This, along with delayed or avoided medical care during the pandemic because of concerns about COVID-19, can increase the time delay in diagnosing diseases such as cancer. This diagnosis delay can cause the accumulation of undiagnosed diseases like cancer during the COVID-19 pandemic. By stopping face mask-wearing after vaccination, exposure to air pollution will increase again but this time undiagnosed cases from the covid era will be added to new cases and this may cause increased referral load of these cases after the pandemic. This point should be considered that undiagnosed cases from covid time probably will develop upper stage of disease after pandemic because of delayed diagnosis. Improving screening programs for diseases like cancer in this era could be effective. On the other hand, health systems should be ready for a possible increase in the presentation of these diseases after the pandemic. Further researches should be conducted to reveal the effects of pandemics on the diagnosis and presentation of different diseases and the exact role of air pollution and face mask in this context.
1. Li X, Jin L, Kan H. Air pollution: a global problem needs local fixes. Nature Publishing Group; 2019.
2. Horne BD, Joy EA, Hofmann MG, Gesteland PH, Cannon JB, Lefler JS, et al. Short-term elevation of fine particulate matter air pollution and acute lower respiratory infection. American journal of respiratory and critical care medicine. 2018;198(6):759-66.
3. Zhu Y, Xie J, Huang F, Cao L. Association between short-term exposure to air pollution and COVID-19 infection: Evidence from China. Science of the total environment. 2020;727:138704.
4. Shehab M, Pope F. Effects of short-term exposure to particulate matter air pollution on cognitive performance. Sci Rep. 2019;9(1):1-10.
5. Kwon OK, Kim S-H, Kang S-H, Cho Y, Oh I-Y, Yoon C-H, et al. Association of short-and long-term exposure to air pollution with atrial fibrillation. European journal of preventive cardiology. 2019;26(11):1208-16.
6. Wang N, Mengersen K, Tong S, Kimlin M, Zhou M, Wang L, et al. Short-term association between ambient air pollution and lung cancer mortality. Environmental research. 2019;179:108748.
7. Hassan A, Latif M, Soo C, Faisal A, Roslina A, Andrea YB, et al. Diagnosis of lung cancer increases during the annual Southeast Asian haze periods. Lung Cancer. 2017;113:1-3.
8. Shah AS, Lee KK, McAllister DA, Hunter A, Nair H, Whiteley W, et al. Short term exposure to air pollution and stroke: systematic review and meta-analysis. BMJ. 2015;350.
9. Vidale S, Arnaboldi M, Bosio V, Corrado G, Guidotti M, Sterzi R, et al. Short-term air pollution exposure and cardiovascular events: a 10-year study in the urban area of Como, Italy. International journal of cardiology. 2017;248:389-93.
10. Langrish JP, Li X, Wang S, Lee MM, Barnes GD, Miller MR, et al. Reducing personal exposure to particulate air pollution improves cardiovascular health in patients with coronary heart disease. Environmental health perspectives. 2012;120(3):367-72.
11. Cherrie JW, Apsley A, Cowie H, Steinle S, Mueller W, Lin C, et al. Effectiveness of face masks used to protect Beijing residents against particulate air pollution. Occupational and environmental medicine. 2018;75(6):446-52.
12. Berman JD, Ebisu K. Changes in US air pollution during the COVID-19 pandemic. Science of the Total Environment. 2020;739:139864.
13. Rodríguez-Urrego D, Rodríguez-Urrego L. Air quality during the COVID-19: PM2.5 analysis in the 50 most polluted capital cities in the world. Environmental Pollution. 2020;266:115042.
14. Richards M, Anderson M, Carter P, Ebert BL, Mossialos E. The impact of the COVID-19 pandemic on cancer care. Nature Cancer. 2020;1(6):565-7.
15. De Vincentiis L, Carr RA, Mariani MP, Ferrara G. Cancer diagnostic rates during the 2020 ‘lockdown’, due to COVID-19 pandemic, compared with the 2018–2019: an audit study from cellular pathology. Journal of Clinical Pathology. 2021;74(3):187-9.
Competing interests: No competing interests