Excerpt from "The Climate Crisis and COVID-19: A Major Threat to the Pandemic Response" in the New England Journal of Medicine, July 15, 2020, auhtored by Renee N Salas, MD, MPH, MS (lead), James M Shultz, MS, PhD, and Caren G Solomon, MD, MPH.

Just as an active 2020 Atlantic hurricane season is getting underway, the entire U.S. hurricane coast, from Texas to the Carolinas, is witnessing explosive outbreaks of COVID-19 cases in communities where physical distancing restrictions have been eased. As an early wake-up call, Tropical Storm Cristobal made landfall in Louisiana on June 7, triggering coastal evacuation orders and a federal emergency declaration. Concurrently, temperatures continue to set records throughout the southern United States, while Arizona has been battling multiple historic wildfires that are also requiring communities to evacuate their homes. All this as summer had just begun.

"Our responses in the U.S. to to climate change over recent years and to the COVID-19 pandemic over recent months have been inadequate and dangerous..."

Our responses in the United States to climate change over recent years and to the COVID-19 pandemic over recent months have been inadequate and dangerous, disproportionately harming the most vulnerable communities. Both responses have been characterized by delayed and disjointed government action, denigration of scientific evidence, distortion of truth, withdrawal from critical global alliances, and reliance on antiquated public health infrastructure and fragile health care systems. To effectively manage both crises, we need an integrated response, firmly grounded in science, that values health as a fundamental right for all. As we collectively reimagine an equitable, all-hazards-responsive health infrastructure, we will need to take concrete actions focused on the key intersections between climate change and the COVID-19 pandemic.

[cont.]

Though evidence-based guidance from federal agencies is important and would be welcome, implementation of strategies at the state and local levels requires capacity, coordination, and attention to subnational needs. Given that states were forced to reprioritize budget allocations because of the pandemic, facing the challenges ahead will require coordinated federal policy and dedicated funding.

In recent months, the increasing worldwide attention to the urgency of addressing climate change has been sidelined by the pandemic and the critically needed reckoning on racial inequity. Yet the interconnectedness of these challenges underscores the need for integrated policy initiatives. As emphasized in a letter from 40 million health professionals to G20 leaders, governments must prioritize investments in health, clean air and water, and a stable climate in stimulus packages for recovering from the COVID-19 pandemic.

"Interventions to create sustained reductions in the use of fossil fuels can reduce the risks for multiple medical conditions..."

Reductions in greenhouse-gas emissions and air pollution that were observed while globally applied lockdown measures were in force to slow the spread of COVID-19 are proving to be temporary. Interventions to create sustained reductions in the use of fossil fuels can reduce the risks for multiple medical conditions -- especially in vulnerable communities -- by improving air quality and limiting the downstream health harms of the climate crisis.

Until the development and mass deployment of a safe and effective vaccine enables the United States to move past the COVID-19 pandemic, the climate crisis will challenge our pandemic responses; beyond the pandemic, the climate crisis will continue to pose existential risks. It is past time to implement robust and equitable responses to both.