The black toe and the virus: A wake-up call for planetary health | Umweltbundesamt

The black toe and the virus: A wake-up call for planetary health

Blogpost by Prof. Dr. Dr. Sabine Gabrysch 

„I am sorry but we need to amputate your toe!” – This was the statement that changed everything for Erik. The 68-year-old overweight diabetic man stared at me, the doctor, in disbelief, swallowed hard, and looked down at that toe of his right foot that was totally black. This moment was the start of a long healing process of his foot, and of his life. One year later, when he visited the hospital of the small town in southern Sweden again, he seemed a different man: slimmer, more cheerful, as if he was ten years younger. He had stopped smoking, was eating well, getting exercise and hardly needed any anti-diabetes drugs. The loss of his toe was the moment when he had realized how precious his body was, how fragile his health, and when he finally decided to take better care of himself.

Why am I telling you this story? Years later, having moved from clinical medicine to epidemiology and global health, I am now part of the scientific community explaining a similarly shocking diagnosis to the population. We are in the middle of the corona pandemic. The world has changed. Humanity is living through a serious crisis. Like that Swedish man Erik, we collectively realize how vulnerable and valuable our health is, our health systems, our societal cohesion. And like him, we become aware of our own responsibility for preserving our health.

Erik’s black toe was the most visible sign of a deeper crisis, of multiple imbalances in his body –  including obesity, diabetes, arteriosclerosis – leading to damages in several organ systems. Similarly, the corona pandemic is the most striking manifestation of a multidimensional planetary crisis, affecting ecosystem functions in various ways. Destruction of forests and other natural habitats, hunting and trading of wild animals are causing a rapid decline in biodiversity and increase the risk that wild animals transfer viruses to humans. Burning forests and burning coal and oil pollute the air and destabilize the climate. Climate change exacerbates stresses on ecosystems and threatens human health. Air pollution is a cause of respiratory diseases, cardiovascular diseases and probably also diabetes – which in turn increase vulnerability to COVID-19. We suddenly realize that everything is connected globally, that human health fundamentally depends on a stable and healthy planet. And that we have been abusing and neglecting our planetary life support systems for far too long. To our own detriment.

This crisis is a wake-up call. Like Erik decided to finally take care of his body, realizing this was his life and it was starting to break, humanity could now decide to take care of the Earth, realizing we are one part of this unique living planet which we are pushing out of balance. That our health, our society, our economy depend on it. The scientific diagnosis is clear, and has been for a long time. We need to act urgently and set the priorities right. We can change the exploitative relationship with nature, with each other, with ourselves. We can decide to take care of our health, our societies, our ecosystems. We can emerge from the emergency in a way that makes us healthier and stronger. More humble and more connected.

What would this new world look like? What are our priorities? Can we imagine a world in which we jointly protect our long-term common welfare against short-term profit interests of a few? The good news is that solutions exist, and even win-win solutions that tackle several problems at once. Protecting intact forest areas and curbing wild animal trade can preserve biodiversity, store large amounts of carbon and reduce the risk of pandemics. A largely plant-based diet with plenty of vegetables and little meat can reduce greenhouse gas emissions, decrease pressure on forests and reduce cardiovascular diseases. Making cities easy to bike and walk while reducing car traffic can reduce greenhouse gas emissions, air pollution and noise, while increasing physical activity, all benefiting health. It is well possible if we all make an effort, but it will not be easy to change our societies, economies and lifestyles fundamentally, as it was not easy for Erik.

It’s a huge challenge here and now, maybe the biggest challenge humanity has faced. In our joint effort of overcoming it intelligently on a global scale, with nature instead of against it, we also need the entire education and health system on board. Universities, colleges and university hospitals can incorporate systems thinking and transformative action in research and teaching. They can promote and evaluate win-win solutions and rebuild their own institutions in a sustainable way. Medical doctors can add their expertise to public debates and they can urge their pension funds to divest from fossil fuels.   

We had our wake-up calls, our “black toes”, we feel the danger coming close. Heat waves and storms, floods, droughts and fires, harvest failures and locusts – and now corona. It’s time to wake up. And to wake up others and act together. To stop harming and start healing. Miracles can happen when many people join together for a common good. They have happened before. Let’s use the billions of Euros from corona stimulus packages not to return to a self-destructive business-as-usual, but to build a healthier, more just and sustainable world. For healthy people on a healthy planet.

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Authors:
Sabine Gabrysch is Professor for Climate Change and Health at Charité and Department head at the Potsdam Institute for Climate Impact Research (PIK). Her research focus is maternal and child health in low-income settings, in particular malnutrition.