Lessons From the Pandemic: Environmental Health Requires Government Action

By: Jane McArthur

Yes, we’re all tired of hearing it. But it bears repeating: There are many lessons to be learned from the Covid-19 pandemic.

Some lessons are especially critical right now with the Prime Minister naming his new cabinet, and as the government helps set the stage for our future. Mandate letters will soon be written that outline the objectives that each minister will work to accomplish, and the pressing challenges they will address in their roles.

Let’s assume that the government agrees with the World Health Organization’s position that climate change is the greatest global health threat of the 21st century. And with the IPCC report that made it clearer than ever that we need to end our global reliance on fossil fuels to sustain planetary health. And with the IEA report emphasizing the need to immediately end approvals for new oil, coal, and gas development. And also with the UN Human Rights Council’s formal recognition that access to a healthy environment is a fundamental human right. 

Starting with these assumptions, the critical lessons of the pandemic are evident, as are the actions that follow building on these lessons.

Lesson #1: First Do no Harm

Faced with the Covid-19 pandemic running parallel to the crises of climate change and toxic exposures, physicians and other health professionals daily confront what it means to do the work of health care. So much harm has been done in the course of the pandemic that could have been prevented with a view to health promotion and harm prevention. The reality that healthcare providers encounter in their roles treating the outcomes of these crises, along with understandings from training, current scientific knowledge, and experience with patients, invites a revisit of the Hippocratic oath. 

The oath, and its various incarnations over the centuries, is at its essence an expression of ethics. Physicians and health workers are “members of society, with special obligations to all fellow human beings.”  While not part of the original oath, the idea “first do no harm” influences the conduct of physicians and HCPs still today. The idea is that help, not harm, guides those who practice health care. But for reasons of politics and failed governance, the harmful impacts of the Covid-19 pandemic have been wide-reaching. The same is true of fossil fuels. 

Recent research tells us fine particulate pollution generated by the burning of fossil fuels was estimated to cause one in five premature deaths globally. Between 2030 and 2050, climate change is expected to cause approximately 250,000 additional deaths per year from malnutrition, malaria, diarrhea, and heat stress. Health effects of air pollution associated with the burning of fossil fuels, primarily from combustion engines include respiratory and cardiovascular systems, other organ systems, nervous and reproductive systems. Children are particularly vulnerable to transportation-related air pollution exposure as are racialized and socioeconomically marginalized peoples.

In the spirit of doing no harm, and seeing the interconnectedness of health and environments, taking action to eliminate subsidies and public financing for fossil fuels follows.

An accelerated commitment to eliminating subsidies and public financing for fossil fuels is a necessary component of a healthy recovery from the pandemic and the climate emergency. In the interest of the health of people living and working in Canada, an end to all forms of subsidies, public finance and other fiscal support to the oil and gas sector is critical. As well, an immediate phase-out of fossil fuels and a ban on fossil fuel advertising will demonstrate a commitment to a healthy future. Furthermore, the cancellation of the Trans Mountain Expansion Project would be a clear signal of a commitment to a transition away from fossil fuels. Not only are these ethical actions, but they are necessary for environmental and human health.

Lesson #2: We are all connected

The Covid-19 pandemic illustrated the intensity and complexity of our interconnectedness – not only to each other but to our environments. Virus transmission between people is influenced by the environment, whether for health care workers denied adequate respirators, seniors lacking protections in long-term care homes, racialized communities where many are unprotected essential workers, or children in schools without proper ventilation. The understanding of the role of environmental conditions and related policy in the spread of Covid-19 must be extended to other environmental health threats such as the climate emergency and exposure to toxics.  

Air pollution increased COVID-19 infection, transmission, and the risk of mortality. The heat dome this past summer in British Columbia caused the largest loss of life associated with any weather event in recorded Canadian history. And in Ontario, Toronto had some of the worst air quality in the world as smoke from forest fires burning through Indigenous communities and across Northern Ontario contaminated the air.

Making the connection between health and environment illustrates that industrial, economic and political actions have impacts on ecological and human health – that there are social, structural, and ecological determinants of health. Correspondingly, the work to address the climate crisis and toxic exposures must be rooted in the understanding that climate change and other human-induced activities are health threats. 

Government must adopt a planetary health lens, defined by the Lancet as “the health of human civilization and the state of the natural systems upon which it depends.” A planetary health approach helps us to break down silos, create solutions that solve multiple problems at once, while taking feedback loops into account. With devastating health impacts already being felt, a healthy response to climate change comprises two prongs: adaptation and mitigation.

As recommended by the just-released Lancet Countdown on Health and Climate Change Policy Brief For Canada, a well-funded national climate adaptation strategy is required, with an implementation secretariat that has high-level leaders across ministries and arms that connect into provincial and territorial emergency and disaster response systems.

As a near-term step to signal an integrated approach to climate change and health, many countries have committed to climate-resilient, low carbon health systems as part of the WHO’s COP26 health programme. Canada should join this forward-looking group.

For these reasons, it is essential that we hold the government accountable for delivering on ambitious climate commitments. This includes the implementation of the recently passed Net-Zero Emissions Accountability Act and the implementation of a substantial carbon tax. Climate accountability legislation has been successful internationally and Canada too can succeed at being accountable to ambitious emissions targets.

Just as the government took an emergency approach to deal with COVID-19 allocating funding where needed, we need an emergency-level response to addressing the climate crisis and toxic exposures. While the emissions targets go beyond those of any previous government, it is essential that Canada undertake our fair share of emissions reductions at 60% below 2005 levels by 2030 with a plan for decarbonization across all sectors. 

Lesson #3: Apply the precautionary principle

A critical lesson of the Covid-19 pandemic is the need to apply the precautionary principle. It is sadly a lesson we continue to fail to learn, and with deadly consequences. The SARS outbreak of 2003 provided a road map for dealing with future outbreaks. An independent commission conducted hearings to explore how things were handled, and a key recommendation to emerge was for the implementation of the precautionary principle. 

“The precautionary principle is meant to represent the public good in all decisions made under scientific uncertainty. When there is substantial scientific uncertainty about the risks and benefits of a proposed activity, policy decisions should be made to err on the side of caution with respect to the environment and the health of the public.” Furthermore, “when an activity raises threats of harm to human health or the environment, precautionary measures should be taken even if some cause-and-effect relationships are not fully established scientifically.” 

The Canadian Environmental Protection Act (CEPA) – Canada’s cornerstone environmental legislation – governing pollution and toxics is outdated and is inadequate to deal with today’s sources of pollution and toxic chemicals. Today’s environmental health realities must be reflected in legislation, even as some of the scientific evidence of newer chemicals remains uncertain but other indicators in real-life exposures and experiences signal harm.

That’s why we will look to the government, by early 2022, to introduce a significantly stronger bill to reform CEPA and work to pass this bill by Summer 2022. The bill must recognize a right to a healthy environment that underpins the Act and prescribe the implementation and enforcement of the right in a manner consistent with international best practices. It must also include mandatory timelines to reduce delays in the Act, ensure that safe substitution is considered as a mandatory tool in the risk management process, and create a straightforward and expedited process for identifying and banning substances that are deemed to be the most harmful, with limited exceptions.

Lesson #4: Risk management and hazard prevention are different paradigms

Covid-19 responses have largely centred on managing risk, and keeping cases at levels that are controllable by the health care system. While this approach may be effective in keeping case rates below certain thresholds, it is a fundamentally different strategy from broadly preventing the hazard of airborne exposure and infection through ventilation, filtration and the provision of high-level personal protective equipment.

Engineering controls, regulations and protection policies are the responsibility of various levels of government. Individual behaviours, however, tend to be foregrounded in health messaging. But with most health issues, no single level strategy works and governments have important roles to play in prevention. The adoption of a hazard prevention paradigm by governments would not only prevent future cases of Covid-19 but would also prevent other respiratory illnesses, cancers, reproductive harms and more.

The lesson here is that protecting people living and working in Canada including from climate change and harmful chemicals while advancing environmental justice calls for a concerted shift to recognizing hazards and preventing the harms associated with them. Laws and policies that make health the priority, as opposed to prioritizing economic considerations, and making individuals responsible, lead to governing very differently, and to better environmental health outcomes.

That’s why eliminating thermal coal exports is not only the logical action by the government to prevent hazardous exposures, it is also the just approach. Canada’s plan to phase out the mining of thermal coal or coal burned for electricity is a major victory. However, we continue to export coal to countries around the world. Coal is the dirtiest fossil fuel with many associated health harms, not only for people living in Canada, but across the globe. CAPE’s joint campaign to ban thermal coal signifies that people in Canada know the need to enact this is critical. We support the government in seeing this through with hazard prevention as a guiding framework.

Lesson # 5: Prevention is a shared responsibility of individuals and governments

The scientific evidence that has amassed on the airborne transmission of the virus that causes Covid-19 led epidemiologist David Fisman to declare “air is the new poop”.  Just as clean water became a public health and political priority with the discovery of water-borne diseases such as cholera, typhoid and more, Covid-19 begs us to take concerted action to clean the air – both indoors and outdoors. And this extends to environmental health hazards generally. With the scientific knowledge of the causes and conditions in our environments that lead to ill health, and disproportionate impacts on certain populations, plans for preventive action become possible. 

We have to travel a steep curve to phase out fossil fuels in a way that ensures the health and wellbeing of workers and Indigenous peoples currently reliant on the fossil fuel economy. We need plans in place that ensure workers and communities prosper as we move to net-zero. For the health and well-being of all living and working in Canada, a just transition plan is necessary, with Just Transition legislation, guided by feedback from workers, unions, Indigenous peoples, communities, and provinces and territories. The success of this planning and future health depends on engaging in a well-planned transition away from oil and gas with workers and Indigenous peoples as critical members of the process.

For the success of the government commitments across health and environmental issues, it is necessary to uphold the United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP) and implementation of the Truth and Reconciliation Commission (TRC) Calls to Action. The vast majority of the calls remain unaddressed. UNDRIP and the TRC calls must be fully integrated into delivering on climate commitments, a just transition and a healthy recovery, and protecting people and the environment from harmful exposures.

Addressing the adverse health impacts of the climate crisis, exposure to toxic chemicals, structural inequities, and environmental racism by governments must also include cutting methane emissions, addressing plastics production and plastic waste, incorporating zero-emissions vehicles among better, cleaner transportation plans along with natural climate solutions. Importantly, reducing pesticide risks through strengthening the Pest Control Products Act must also be a priority action by the government in recognition that environmental health is connected to human health.

Environment, climate and health are among the top concerns for people in Canada. The course of action on climate change and toxics over the upcoming years is crucial to ensure that everyone has the right to a healthy environment with harm prevention and health promotion as priorities. Healthy people depend on a healthy planet. 

CAPE is ready to work with the government to implement the strongest measures for environmental health protection and justice in Canada.