Protect the climate: just live healthy!

The climate crisis is also taking place on our doorstep. Climate expert and general practitioner Dr. Katja Goebbels.

BRIGITTE WOMAN: The hot summer is long gone, and in winter we don't really seem to feel any effects from climate change. A mistake?

Yes, because the winters are getting milder. Everyone with a garden will notice this because some pests can now survive the cold months well. Fewer ticks also die; they can pass on Lyme disease, for example. In addition, new carriers such as the Hyalomma giant tick are making their home. And the pollen starts much earlier.

What health effects are already evident in Germany?

Above all, these are the many heat deaths in the past hot summers, according to a completely new study there were around 22,200 in Germany in the summer of 2018, among the over 65s alone. Heat is very unhealthy, and heat exhaustion and heat shock are immediately life-threatening. The body temperature is then over 40 degrees. The body can no longer cool itself sufficiently, attempts are made to dissipate excess heat through the body surface and through sweating. In addition, if too little is drunk, blood pressure drops and the heart cannot provide enough blood to supply blood to the brain and other important organs. Organ failure occurs.

This is certainly particularly dangerous for people with cardiovascular diseases.

Yes, and they often take diuretics, which make the body more dehydrated. Here, the medication dose has to be adjusted before a heat wave and the doctor has to give instructions on what to do. This also applies to drugs that reduce sweat production as a side effect, for example some psychotropic drugs or drugs against Parkinson's.

Anyone with a weak heart should step on the scales every day. If you gain more than a kilo within one to two days, this speaks for water retention, i.e. a deterioration in cardiac output. Incidentally, wound infections also increase during higher temperatures, so planned operations should be carried out in the cooler months.

At what outside temperature does it become dangerous for healthy people?

Circulatory collapse can occur from around 40 degrees. With high humidity, which prevents the evaporation of sweat on the skin, 37 degrees can be too much.

The British medical journal "The Lancet" put it this way: "Climate change is the greatest threat to global health in the 21st century." Exaggerated?

No. Unfortunately, not at all. The "Lancet" also stated that the climate crisis is also the greatest opportunity for global health to really change something now. Because we can still react. Everyone can do something for the climate, every day.

But many have not yet realized how big the topic is, right?

Unfortunately, most people are not really aware of the problem and, above all, its urgency. You can tell from the terminology: "Climate change" doesn't apply, I would always speak of a "climate crisis" or "climate catastrophe". Dealing with it can be depressing at first.

At least for us doctors, something is slowly happening. There are working groups on the subject of "Climate and Health" that have joined international organizations. But: The majority of doctors and society do not understand it yet.

It is also not very convenient to do something for the climate.

I think you shouldn't sell it to people as something negative if, for example, they leave the car behind. After all, there is actually a very personal gain associated with many alleged victims, namely better health. Those who ride a bike instead of a car are doing something about obesity, diabetes and heart disease. And if you eat less or no meat for climate protection reasons, you also prevent colon cancer and cardiovascular diseases – I think it helps to keep this clear.

What does the corona virus, the most current health threat, have to do with the climate?

The climate crisis has favored the corona pandemic, but indirectly. We have several crises: global warming, species extinction, acidification of the oceans and so on. The deforestation of primeval forests is driving the climate crisis forward by destroying CO2 stores. This also destroys habitats, and if species do not become extinct as a result, they will try to survive differently, in case of doubt with and with humans. Viruses can then cross species boundaries through close animal-human contact. It is therefore not unlikely that a pandemic will repeat itself.

Does such close animal-human contact also take place in factory farming?

Basically yes, because the animals are fed and looked after by humans. How quickly it affects human health was seen in the autumn, when millions of minks were culled in Denmark in order not to circulate a possibly vaccine-resistant mutation of Sars-Cov-2 in humans. Pathogens spread very quickly among animals, which is one of the reasons why many antibiotics are used in factory farming.

This is where the areas of climate and health come together in an unpleasant way: Factory farming is a huge source of CO2 and is thus driving the climate crisis forward, and it not only promotes the transmission of pathogens to humans, but also the development of multi-resistant germs.

In extreme temperatures, doctors often recommend staying at home. But even there, the temperatures can be unbearable in summer. Many therefore buy small air conditioning systems – and that is then again bad for the global climate. A vicious circle?

It is of course best to insulate houses better, this helps with cold and heat extremes and even saves money in the long run. But if you put a mobile air conditioner in your home, it doesn't necessarily have to be bad for the environment. For example, there have been so-called balcony power plants for some time, these are mobile solar modules that can easily be used to operate air conditioning during the day.

What about the concern about novel exotic diseases, is it justified? Mosquito species have also been spotted here that can transmit malaria.

These so-called tropical diseases have so far only been brought in by travelers from other countries. We are not very worried about malaria because mosquitoes die in our latitudes before the malaria pathogens in them have matured. In southern Europe, however, this could become an issue, in Greece there have already been minor malaria outbreaks.

Viral diseases such as dengue fever could become a bigger problem, especially since there is no effective therapy for it. In the future, doctors will have to think about such infectious diseases when the areas in which these pathogens become native expand.

The health consequences of the climate crisis are palpable and may get worse. Is our health system prepared for it?

We are still at the very beginning. In France, for example, there are already official heat action plans. The "German Alliance for Climate Change and Health" has drawn up a proposal. For example, he provides for cooled rooms in the clinics for particularly vulnerable patients or so-called outreach services that check the elderly and the chronically ill at home to see whether everything is in order. And information for doctors, where they can look up which drugs can be dangerous at certain temperatures.

But of course, clinics and practices must also help to reduce CO2 emissions by investing in cold and heat insulation or by reducing power consumption. Reducing the amount of plastic waste created by single-use medical products can also lower emissions through less production and storage. And we can adapt intelligently in many other areas: Agriculture and forestry must put an end to monocultures that defy the climate crisis more poorly than mixed cultures, the cities need different, heat-resistant street trees and, above all, every individual can do something to protect the climate.

The state of our planet is that Berlin general practitioner Dr. Katja Goebbels has long been a concern. She is not only involved in the German Climate Change and Health Alliance, which was founded in 2017, but is also a long-standing member of the International Doctors for the Prevention of Nuclear War (IPPNW e.V.).

Do you feel like reading more about the topic and exchanging ideas with other women? Then have a look at the "Health Forum" BRIGITTE community past!

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BRIGITTE WOMAN 03/2021