We're Not Ready for the Next Global Health Crisis

    “Global mean temperatures will continue to rise over the 21st century if greenhouse gas (GHG) emissions continue unabated.” The Intergovernmental Panel on Climate Change (IPCC) stated that the projections of temperature change are likely to exceed above 2°C in the next century. 


    Data source: Luthi, D., et al..2008; Etheridge, D.M., et al. 2010; Vostok ice core data/J.R. Petit et al.; NOAA Mauna Loa CO2 record

    This graph shows the atmospheric COconcentration levels in the last 400,000 years up till now. There have been many glacial periods and interglacial periods in the past. Most of these climate changes are correlated to variations in Earth’s orbital geometry that change the amount of solar radiation the Earth receives.1 As of August 21, 2020, the global atmospheric CO2 concentration levels reached 412ppm2. Since the 20th century, Earth’s climate has reached atmospheric CO2 concentration levels higher than ever before. The IPCC Fifth Assessment Report which represents hundreds of scientists across many nations has stated, “Human influence on the climate system is clear, and recent anthropogenic emissions of greenhouse gases are the highest in history. Recent climate changes have had widespread impacts on human and natural systems.”3


    What’s Global Warming and Climate Change?

    Global warming is the increase of the average temperature in Earth’s surface due to greenhouse gas emissions that increase the levels of carbon dioxide, CFCs, and other pollutants.4 Climate change refers to the effects of global warming such as rising sea levels, shrinking mountain glaciers, increasing ice melting in Greenland, Antarctica and the Arctic, and changes in flower/plant blooming times.



    Many scientific and technological advances have allowed scientists to collect relevant data of the climate globally. In the mid-19th century, scientists found that gases in the atmosphere affect the planet's temperature.5 Data collected on ice cores from Antarctica, Greenland, and tropical mountain glaciers show that the Earth’s climate reacts to changes in greenhouse gas levels.6 In addition, scientists were able to gather information about the climate as far as 800,000 years because of evidence found in ocean sediments, layers of ice in glaciers, tree rings, coral reefs, and layers of sedimentary rocks.7 Using the evidence, scientists have been able to build a record of Earth’s paleoclimates (past climates).


    The Greenhouse Effect

    The “greenhouse effect” is a term describing the warming that happens when the atmosphere traps heat radiating from Earth toward space. When the sunlight reaches Earth, some of it is reflected back into space and some absorbed and re-radiated as heat. Most of the heat is absorbed by greenhouse gases which block heat from escaping and reflect in all directions, warming the Earth. Greenhouse gases include carbon dioxide (CO2), water vapor (H20), methane (CH4), nitrous oxide (N2O), chlorofluorocarbons (CFCs), and more. Gases in the atmosphere that don’t react to changes in temperature are described as climate “forcings”. Gases that react to changes in temperature are described as climate “feedbacks”they could double the warming caused by CO2 alone. Feedbacks include snow and ice, water vapour, clouds, and the carbon cycle. The largest example of a feedback is the water vapour feedback. Water vapour increases as the Earth warms which traps heat, warming the atmosphere even more. This is called a positive feedback loop because it increases the effects of global warming. 


    Water vapour that evaporates and remains in the atmosphere will condense and form clouds. Clouds can add to the greenhouse effect by trapping heat, or they can reduce the effect by reflecting solar energy back to space. This is called a negative feedback loop since it can help cool the planet. 

    Radiative Forcing

    Radiative forcing (RF) are measurements used to quantify a radiative change in Earth’s atmosphere either from natural changes or anthropogenic activities. Forcing’s include variations in solar output, volcanic eruptions, changes of greenhouse gases in the atmospheree and many other factors. The US fourth national climate assessment stated, “Natural emissions and sinks of GHGs and tropospheric aerosols have varied over the industrial era but have not contributed significantly to RF. CO2 emission sources have grown in the industrial era primarily from fossil fuel combustion (coal, gas, and oil), cement manufacturing, and land-use change from activities such as deforestation.”8

    Source: (a) Radiative forcing (RF) from the major WMGHGs and groups of halocarbons (Others) from 1850 to 2011; (b) the data in (a) with a logarithmic scale; (c) RFs from the minor WMGHGs from 1850 to 2011 (logarithmic scale); (d) the annual rate of change ([W/m2]/year) in forcing from the major WMGHGs and halocarbons from 1850 to 2011. (Figure source: Myhre et al. 2013,8 Figure 8-06; © IPCC, used with permission).


    Increases in the concentrations of carbon dioxide and methane were concurrent with the start of the Industrial Revolution. This graph shows the increase of both gases by measurements from atmospheric samples and measurements from Antarctica ice cores. The NASA Earth Observatory stated that carbon dioxide levels have increased 38 percent and methane levels increased 148 percent since the Industrial Revolution began in 1750.9

    Source: NASA Earth Observatory9 (NASA graphs by Robert Simmon, based on data from the NOAA Paleoclimatologand Earth System Research Laboratory.)


    Solar Activity

    Source: NASA Global Climate Change12 "The graph compares global surface temperature changes (red line) and the Sun's energy that Earth receives (yellow line) in watts (units of energy) per square meter since 1880. The lighter/thinner lines show the yearly levels while the heavier/thicker lines show the 11-year average trends. Eleven-year averages are used to reduce the year-to-year natural noise in the data, making the underlying trends more obvious."

    As discussed previously, natural changes have contributed to the warming of the climate such as the light energy from the sun measured at the Earth. This graph portrays the global temperature change compared to the changes in the amount of solar irradiance. Solar changes since 1870 have contributed to an increase of 0.1°C. Although today, scientists have observed a cooling in the upper atmosphere whereas the surface and lower atmosphere has been warming due to increased greenhouse gas emissions.13 Greenhouse gases such as carbon dioxide and methane are projected to cause a cooling in Earth’s upper atmosphere by the mid-21st century.13 Theoretically, if the warming today was caused by increased solar activity, then scientists would observe warming in all layers of the atmosphere. 


    Climate Change

    Global warming has had many noticeable effects on the environment. Mountain glaciers are shrinking, ice is melting rapidly in Greenland, Antarctica and the Arctic, ice on lakes and rivers are breaking up, plant and animal ranges have shifted, and flowers/plants blooming times have changed.    


    Arctic Sea Ice                                                                       

    Data collected by satellite observations portrayed in this graph shows the Arctic sea ice minimum since 1980. Pascal Peduzzi, Director of GRID-Geneva and part of the UN Environment Programme (UNEP) says, “Under the influence of global heating caused by human-induced greenhouse gases emissions, we have seen a sharp decrease in the extent of Arctic sea since 1979.” White snow reflects sunlight whereas water absorbs it, so the melting of the Arctic sea ice will just increase the warming of the Arctic. The Arctic sea ice is also becoming thinner which reduces the reflection of light, thermally expanding the oceans. This affects habitats, ecosystems, marine species, their spatial distribution, and the millions of people living there. For example, reduction in the ice cover has been affecting the habitat of polar bears which need to travel greater distances, threatening younger cubs.14

    Graph by UNEP/GRID-Geneva, based on data from the National Oceanic and Atmospheric Administration and the National Snow and Ice Data Center.


    Antarctica & Greenland Ice Mass


    Data source: Ice mass measurement by NASA's GRACE satellites. Gap represents time between missions. Credit: NASA

    Antarctica and Greenland have been losing mass since 2002. This data was collected by NASA’S GRACE & GRACE-FO satellites. Since 2004, Greenland has lost 303 gigatons of ice per year while Antarctica has lost 118 gigatons of ice per year.15


    Rising Sea Levels


    This graph shows the continued rise of sea levels of the world’s oceans since 1880. Added water from melting ice sheets, glaciers and the water expansion contributes to rising sea levels. 



    Source: EPA's Climate Change Indicators in the United States16: Data source: CSIRO, 201517; NOAA, 2016.18


    Ocean Heat

    Oceans have absorbed more than 90 percent of the Earth’s extra heat since 1995.22 23 Earth’s atmosphere would have warmed more rapidly if it weren’t for the oceans' high heat capacity. This graph shows the ocean heat content since 1995. As mentioned previously, when sunlight hits Earth’s surface, it is absorbed and stored as heat. Some of it is then stored into oceans and the amount of heat absorbed is called “ocean heat content”. Water has a higher heat capacity than air so it can absorb large amounts of heat and only show slight temperature changes. Currents also move this heat around the world. As greenhouse gases continue to increase, this traps more energy from the sun and therefore increases the ocean heat content. This poses a threat to marine ecosystems such as plants, animals, and microbes. Changes in temperature can alter migration and breeding patterns and threaten corals. 

    Source: EPA's Climate Change Indicators in the United States16: Data source: CSIRO, 201619; MRI/JMA, 201620; NOAA, 201621.


    Ocean Acidity

    These graphs show the connection between the dissolved CO2 in oceans and ocean acidity. Anthropogenic CO2 emissions are absorbed by the ocean, resulting in a more acidic pH. Carbon dioxide reacts with seawater to produce carbonic acid and changes the balance of minerals in the water. This makes it difficult for marine creatures such as corals that produce a mineral called calcium carbonate which is the main ingredient in their skeletons. In acidified seawater, corals have to use more energy to build skeletons. Consequently, this affects the mutual dependencies between coral reefs and fish that depend on corals for food and habitat. Ocean acidification is influenced by the increase of atmospheric CO2 concentration from human activities such as deforestation and fossil fuel combustion. In the last 250 years, oceans have absorbed 28 percent of the atmospheric carbon dioxide.17

    Source: EPA's Climate Change Indicators in the United States16: Data sources: Bates, 2016; González-Dávila, 2012; Dore, 2015 


    Sea Surface Temperature

    Source: EPA's Climate Change Indicators in the United States16: Data source: NOAA, 2016

    This graph shows the global trends in the average sea surface temperature since 1880. As the oceans absorb more heat, the sea surface temperature will continue to rise. This poses a threat to marine ecosystems such as plants, animals, and microbes. Changes in temperature have altered migration and breeding patterns and threatened corals.24 Increases in sea surface temperature has also increased the amount of atmospheric water vapour around the oceans.17 This has produced intense precipitation; heavier rain and snow storms. Heavy precipitation could erode soil, damage crops, and increase floods which affects human health. Pollutants from land wash into water bodies and vitiate water quality causing water borne illnesses.29 Increases in sea surface temperature can also cause foodborne illness which affect human health by lengthening the growing season for certain bacteria that contaminate seafood.25                                                             


    Human Health

    Global warming has various effects on human health such as heat-related illnesses and deaths, increase in asthma and allergies, and storms and floods putting the risk of loss of life and property. 


    Ragweed Pollen Season


    Source: EPA's Climate Change Indicators in the United States16: Data source: Ziska et al., 2016

    This figure shows the changes in ragweed pollen season in Canada and the United States from 1995 to 2015. Allergies are a large public health concern which affects at least 30 percent of the population and nearly 80 percent of families.26 Pollen seasons have increased to be 11 to 27 days longer. Temperatures that are warmer from climate change cause flowers and plants to bloom earlier increasing the amount of carbon dioxide emitted. This causes an increase in pollen concentration in the air which causes allergy symptoms. Those who are exposed to these strong concentrations of pollen in the air could develop allergies and asthma.27


    Infectious Diseases

    One of the main effects of global warming on human health are infectious diseases.28 Global warming has an indirect yet profound effect on infectious diseases. Deforestation and fragmentation of large areas are increasing infectious diseases and expanding epidemic areas. Expansion of mosquitos, tick-infested areas, and mosquito activity increases the risk and number of patients with mosquito-borne infectious diseases (dengue & malaria). For example, major flooding events have caused severe outbreaks of mosquito-borne diseases in Australia such as the Murray Valley encephalitis virus and the Ross River virus. Contamination of water and foods with bacteria also increases the risk of patients with water or food-borne diseases. The IPCC ‘Special Report on the Impacts of Global Warming of 1.5 °C’ stated, “Climate-related risks to health, livelihoods, food security, water supply, human security, and economic growth are projected to increase with global warming of 1.5 °C and to increase further at 2 °C. Any increase in global warming is projected to affect human health, with primarily negative consequences (high confidence). Risks from some vector-borne diseases, such as malaria and dengue fever, are projected to increase with warming from 1.5 °C to 2 °C, including potential shifts in their geographical range (high confidence)."29


    Vector-borne Infectious Diseases 

    Vector-borne diseases are pathogens transmitted by vectors such as mosquitoes, ticks, and fleas. They carry infective pathogens such as viruses, bacteria, and parasites that transmit into another living organism. Pathogens from vectors can be transmitted directly from mosquitoes or from animals to humans. Read how infectious diseases can emerge. Climate changes like flooding, increased precipitation, and warmer weather are all factors that affect vectors.30 Rising temperatures cause vector migration patterns to change. Mosquitoes also need water to hatch, making floods a prone area for vector-borne diseases. According to the World Health Organization, vector-borne diseases account for 17 percent of all infectious diseases with 700 000 deaths annually.31 Vector-borne diseases that have been reported to be affected by global warming include malaria, dengue virus (DENV), Lyme disease, Japanese encephalitis (JE), Zika virus, West Nile virus (WNV), Murray Valley encephalitis virus (MVEV), yellow fever, and tick-borne encephalitis. The Fourth National Climate Assessment shows that various arthropods that carry vector-borne diseases have been moving into northern latitudes in response to warmer temperatures.8



    Malaria has been the main vector-borne disease globally. The WHO has reported an estimate of 228 million cases of malaria worldwide only in 2018.32 Malaria is a fatal disease caused by parasites in female Anopheles mosquitoes that are transmitted to humans through bites. Sub-Saharan Africa has had high cases of malaria and deaths. Reports of global warming changing the distribution, severity of transmission, and seasonality of malaria in Sub-Saharan Africa are clear.33 Kenya has also reported an association between high precipitation, unusually high temperatures and the number of malaria cases.34 There are reports in Ethiopia that malaria epidemics were often preceded by a month of abnormally high minimum temperatures.35


    Aedes Mosquitoes

    Aedes, genus of more than 950 species of mosquitoes are the main vectors for the transmission of dengue virus, Chikungunya fever, Zika virus, and yellow fever. The main two vectors are Aedes albopictus and Aedes aegypti. Multiple studies have analyzed the potential for anthropogenic climate change to shift the global range of Ae. aegypti (Campbell et al. 201436; Capinha et al. 201437; Khormi and Kumar 201438; Rogers 201539). The global distribution and population dynamics of Ae. aegypti have been largely influenced by climate variability. Elevated temperatures were proved to influence the global distribution of Ae. aegypti and Ae. albopictus.40 According to a study, the potential effects of Ae. aegypti mosquitoes could increase up to 13 percent (RCP 8.5) by 2061-2080.41 Considering only climate change, the largest percentage of human exposure to Ae. aegypti are projected to be seen in Australia, Europe, and North America.


    Dengue Virus

    Dengue virus (DENV) is also considered one of the main vector-borne diseases globally. Symptoms of dengue virus include fever, heachaches, nausea, rash, joint and muscle pain, and more severe complications. Severe dengue epidemics were first reported in the 1950’s in the Philippines and Thailand. Today, The WHO has reported epidemics in more than 100 countries in the African, Americas, South-East Asia, Eastern Mediterranean, and Western Pacific regions.42 Aedes aegypti and Aedes albopictus mosquitoes are the main vectors of dengue virus that is transmitted to humans through bites.43 44 The dengue virus has four serotypes: DEN-1, DEN-2, DEN-3, and DEN-4, so you can be infected four times. Humans can also transmit dengue virus when uninfected mosquitoes bite an infected human, and then transmit it through bites to other humans. Public health researchers published a study of the potential effects of climate changes on the global distribution of dengue virus.45 They’ve modelled that long-term average vapor pressure (humidity) can account for 89 percent of the distribution of dengue fever cases. They’ve also projected that about 5-6 billion people (50-60%) would be at risk for dengue transmission by 2085, compared to 3.5 billion people (35%) if climate change did not happen.


    Zika Virus

    Zika virus disease is also a virus transmitted by Aedes mosquitoes through bites—mainly Ae. aegypti. Symptoms of Zika virus include red eyes, fever, headache, skin rash, fatigue, and muscle/joint pain. Zika virus can be transmitted from mother to fetus, causing birth defects such as microcephaly and other congenital malformations.46 Zika virus infections have also been correlated with Guillain-Barré syndrome.47 Climate change has been largely associated with the spread of Zika virus. For example, high precipitation with an increase in Aedes population after 1-2 months has been reported in Thailand.48 Many of the poorest nations have suffered from Aedes diseases because of their geographical location. Countries with poor education, lack of water and health policies, low income, and difficult access to health care reduce the ability to effectively respond to Zika virus.49 Insecticides that interrupt the transmission of Anopheles mosquitoes to control malaria have not been effective for Ae. aegypti. 


    Lyme Disease

    Lyme disease is mainly caused by the bacterium Borrelia burgdorferi. Lyme disease is transmitted by the bite of an infected black-legged tick, referred to commonly as a deer tick. Lyme disease can cause fever, fatigue, skin rash, joint pain, muscle aches, and more severe complications years after infection. Studies have provided evidence that climate change has contributed to expanding the population of ticks in areas where they were unable to survive, such as areas in Canada.29 Deer ticks thrive and are the most active in areas with 85 percent humidity and temperatures that are above 7°C. The population of ticks in areas in Canada has increased from 10 percent in 2010 to over 80 percent in 2020, increasing the risk for human Lyme disease.50 Dramatic climate changes in the northern U.S. is also predicted to increase tick habitats.


    Culex Mosquitoes

    Culex is a genus of mosquitoes that are known to spread the West Nile virus, St. Louis encephalitis, and Japanese encephalitis. Culex quinquefasciatus is the main vector for the West Nile virus and Japanese encephalitis. Cx. quinquefasciatus has recently been brought as a potential vector for Zika virus.51 Climate change can trigger changes in the projected distributional areas of Cx. quinquefasciatus.52 Higher summer temperatures have also been recognized as a factor associated with the West Nile virus expansion in British Columbia, Canada.53  


    Water and Food-borne Infectious Diseases

    Food-borne diseases are caused by ingestion of food contaminated with viruses, bacteria, parasites, or heavy chemical substances. The WHO has estimated that food-borne diseases have led to over 420 000 deaths per year.54 Water-borne diseases are transmitted by drinking contaminated water. Important water-borne diseases include cholera, diarrhoeal diseases, shigella, hepatitis A and E, typhoid, and poliomyelitis. The WHO has reported 829 000 deaths of diarrhoeal disease caused by poor water, sanitation, and hygiene.55 Water and foodborne infectious diseases have been heavily affected by global warming. For example, the estimated effects of high and low rainfall on the number of cholera cases were reported in Bangladesh.56 The study found that for each 10-mm increase above the average rainfall, the weekly number of cholera cases increased by 14 percent. The number of non-cholera diarrhoea cases also increased by high temperatures and high and low rainfalls.57 Climate change can alter patterns in cropland and potentially spread pathogens into the food chain. In 2017, the FDA warned from the consumption of fresh produce that had been in contact with the water flood from Hurricane Irma.58 Potential effects of temperature and reported cases of food-borne illnesses were analyzed.59



    Scientists use the data we have to build computer models and simulations to predict the future warming by integrating many possible scenarios. They also take into account many factors that influence the Earth’s climate to create predictions. The models predict that greenhouse gases will continue to rise as the world continues with the rate of fossil fuel combustion and deforestation resulting in an increase in Earth’s average surface temperature. The IPCC Fourth Assessment Report states that the projections of global temperature changes are to increase between 1.4°C to 5.5°C by the end of this century.

    Source: Nasa Earth Observatory9 "Model simulations by the Intergovernmental Panel on Climate Change estimate that Earth will warm between two and six degrees Celsius over the next century, depending on how fast carbon dioxide emissions grow. Scenarios that assume that people will burn more and more fossil fuel provide the estimates in the top end of the temperature range, while scenarios that assume that greenhouse gas emissions will grow slowly give lower temperature predictions. The orange line provides an estimate of global temperatures if greenhouse gases stayed at year 2000 levels. (©2007 IPCC WG1 AR-4.)”


    Hypothetically, even if we stopped emitting greenhouse gases now, increases will still continue to warm the Earth. Greenhouse gases that are already emitted will remain in the atmosphere for decades or centuries. It takes years for greenhouse gas emissions to completely heat up the atmosphere. For example, excess energy is now being absorbed by the ocean, but the warming ocean will continue to heat the upper and lower layers of the ocean atmosphere in the next century. The IPCC Fourth Assessment Report Summary of Chapter 7 states, “About 50% of a CO2 increase will be removed from the atmosphere within 30 years, and a further 30% will be removed within a few centuries. The remaining 20% may stay in the atmosphere for many thousands of years.”60



    Global atmospheric temperatures have already reached 1°C above the pre-industrial level. Warming melts ice and glaciers, increases ocean heat content and acidity, causes a rise in sea levels, and increases the risk for infectious diseases to spread. Although the effects of global warming will continue well into the future, we still have the opportunity to manage the severity of the consequences. Hoesung Lee, Chair of the IPCC from the September 2019 report said, “If we reduce emissions sharply, consequences for people and their livelihoods will still be challenging, but potentially more manageable for those who are most vulnerable. We increase our ability to build resilience and there will be more benefits for sustainable development.”61



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