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02 Mar 2021

The world has learned many painful lessons from COVID-19. Let’s put them to work in our fight against climate change.

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Dr. Karthik Balakrishnan

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President and Co-Founder

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Ngozi Erondu

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Climate change and COVID-19 couldn’t seem more different, but the global health crisis can help us shape an effective response to the global environmental crisis. COVID-19 is a unique calamity in the modern world; no community has been spared from its effects. Some confront the effects of illness and death head on—either by choice or by economic necessity—while others have the ability to nearly seal themselves off, accepting temporary isolation as the price to pay to ensure the health of their citizens. Today’s world is so interdependent that even countries with the strictest border controls face ongoing fear of possible outbreaks and must remain vigilant. The impacts of climate change are similar. The effects are felt throughout the world but with unequal reverberations, where some face death and others face inconvenience. Money can help, but is too often spent on insulating one from the symptoms, not on solving the root cause of the problem. Both of these challenges are complex: no silver bullet, competing priorities, complex solutions, highly vocal parties, and a variety of nuances around the world. Understanding the complexities of the COVID-19 crisis can help us better tackle climate change.

Solutions are complex and multifaceted, but worth doing because of the scale of the problem In dealing with complex and multifaceted challenges, it’s key to remember that there are no universal remedies. Each facet requires its own solution, and the only way forward is to stack solutions to achieve defense in depth, also known as the Swiss Cheese Model. Used for years in high performance systems with human factors, such as aviation, this model starts from the basic premise that there is no such thing as a solution which works 100% of the time. The key is to implement multiple solutions in parallel, each with a failure mode uncorrelated from the others. Over the last year, we’ve gotten used to wearing masks, washing hands, testing and tracing, social distancing, and even lockdowns. No solution works perfectly on its own. There are cases of individuals being infected even with masks, and of the virus being detected in countries with closed borders and mandatory quarantines. But some solutions work far better than others, and the places that have taken the crisis seriously from the start, kept vigilant, and have implemented multiple forms of protection have fared much better than those that focused solely on opening up.

Similarly, climate change will also require a multifaceted approach. Reducing transport emissions will require a combination of like-for-like electrification (replacing gas cars with electric cars); mode shifting (increasing transit usage); and major lifestyle and community changes (including transit oriented developments and increasing numbers of people moving from suburbs into cities).

The solutions for both COVID and climate change require sustained effort and are expensive. However, the costs of doing nothing are so much worse.

National self-interest gets in the way when needs and resources are not evenly distributed The poorest countries facing the greatest hardships due to the COVID-19 pandemic are also the ones most likely to face existential threats from climate change. At the same time, higher income countries are almost exclusively directing resources to problems within their own borders. This is evident through the vaccine rollout. While there are joint multinational efforts to dramatically scale vaccine production, there’s substantial competition for allocation which makes it difficult for everyone to get access in a timely manner. Scaling is left to pharmaceutical companies, who have to manage their cash flows and leverage lines of credit—not the ideal solution for a pandemic that has brought the world to a standstill. As a result, low and middle income countries will most likely not see sufficient numbers of vaccine doses administered for several years. This will prolong the pandemic in exactly the areas least able to sustain a response and expose even vaccinated nations to risks from new escape variants as case counts continue to rise.

Climate change is similarly a worldwide challenge. National borders are irrelevant to natural disasters, and the impacts of pollution in one location can have significant ecological and economic consequences on the other side of the planet. This is especially critical as the world is set to dramatically increase its energy usage by at least 75%. No matter how many subsidies California and Norway provide for EV owners, pollution will continue to increase dramatically unless low and middle income countries have the resources to invest in decarbonizing their own economies, and in building new zero-carbon developments. Ultimately this requires a response united around the world: across national, political and ideological borders.

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Adaptations and mitigations are expensive, and out of reach for many Adaptations and interventions cost money, and the expense of COVID-19 interventions and adaptations are no different. In many communities, individuals and businesses were forced to carry the costs of basic supplies like masks and sanitizer, as well as the costs of substantial interventions including plexiglass shields, outdoor parklets, HEPA filters, tents, and even digital solutions to move transactions online. In some regions, the government has been able to effectively provide support, ensuring that everyone is able to implement at least the basic level of needed interventions. This support is especially important because these costs can be significant, but it’s not always possible as the costs can also easily exceed what many governments are capable of providing. The result is uneven implementation, with many forced to live day-to-day with inadequate protection or in the case of businesses, to cease operation entirely.

The cost to adapt to COVID-19 is a fraction of the cost of interventions and upgrades to deal with climate change. Expecting families to spend tens of thousands of dollars upgrading their homes to be climate friendly or resilient becomes difficult when so many rely on food banks. Many American families have less than $1000 available in emergency reserves and this number is orders of magnitude smaller in low- and middle-income countries. COVID-19 has demonstrated that many businesses operate on extremely slim margins, and have just enough reserves to last a few weeks. Just as with families, it’s tough to expect that businesses will spend hundreds of thousands of dollars to deal with global issues like climate change. This is especially difficult after the many successive lockdown measures: many small businesses now have completely drained their reserves, taken on considerable debt, and may not be in a strong financial position for another decade or longer. Making things worse, many interventions don’t actually provide any new functionality to the people paying for them. Instead, they allow people to continue life in a similar way as before, repeating the same actions better and more efficiently. For example, replacing a perfectly functioning gas car with a brand new EV can be hard to justify without external incentives and a structure where one feels like their lives have improved. Simply giving rebates won’t work if it has a negative impact on one’s cashflow and balance. This means that while solutions may be obvious, there needs to be a significant amount of financial backing to make this happen.

At the same time, adaptations and interventions can also be out of the reach of smaller communities and the governments of low- and middle-income countries which face many of the same issues as the small businesses highlighted above. While they may understand the need to take action, a lack of money and borrowing capacity gets in the way. This means that governments can be forced to focus on efforts to stabilize life in the short term at the expense of long-term solutions which attack the root cause.

The Cause-and-Effect delay makes it difficult to take decisive action When you touch a hot stove, you immediately feel pain and quickly remove your hand. But imagine that instead, it took weeks or even years to feel pain after touching the stove. How would you know that touching the stove was responsible for your pain, and not any other incident? This delay between cause and effect is exactly the challenge faced when dealing with COVID-19 and climate change. COVID-19 interventions such as lockdowns and vaccinations, and magnifying events such as holidays and superspreader gatherings, take at least two weeks to show up in case positivity data, and about a month to show up in mortality and recovery data. However, people expect to see feedback during a typical news cycle which is days not weeks, and this leads to significant debate in the public square over the efficacy and suitability of specific interventions. In addition, in communities with widespread COVID-19 transmission and a strong culture of privacy, it can be difficult to perform contact tracing, making it hard to show the impact of specific interventions such as closing schools or outdoor dining when multiple interventions are occurring at the same time.

The cause-effect cycle in climate change is even longer. The effects of a mitigation project might not show up in data for years or decades, potentially long after the useful life of the project installation. Interventions will likely be much more expensive (at least $50 trillion USD) than for COVID ($16 trillion USD and counting) and result in the wholesale transformation of entire communities and lifestyles.

And because of the swiss-cheese model, no intervention will be sufficient on its own. This means that there will be many different solutions working together in parallel to reach a goal. When no solution is solely responsible for the effects, it becomes imperative to use data collection, clear metrics, and closed-loop tracking to be able to show the impact of interventions and justify the financial and social costs.

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Even if warning signs are obvious, action doesn’t automatically follow For years, epidemiologists and health security specialists spoke at conferences and conducted research and wrote policy papers about disease X and the need for health systems that were ready for and resilient to an infectious agent that could spread rapidly due to modernization in transport and global travel and trade. One of the loudest periods of warning followed the West African Ebola outbreak and aligned with the 100 year anniversary of the 1918 Spanish Flu. During this time, some scientists predicted Covid19 down to a t. For example, this 2018 Lancet Infectious Disease paper was highly confident that the next infection of pandemic potential would be of  zoonotic origin, human-to-human transmission, and that if it were viral it would be devastating.  Check, check and check. Bill Gates' famous 2015 Ted Talk on how the world was not ready for the next outbreak has now earned him credit as a soothsayer, yet this and calls from local and top scientists around the world did not lead to any significant investments in health health systems--especially those in low and middle income countries. Nor did it lead to better standardisation of health systems, coordination of global public health entities, or the prioritisation of pandemic preparedness in national governments --in fact the Trump administration disbanded the Global Health Security Office, whose head once reported on pandemic preparedness and biosecurity issues to the National Security Council. Even with all this forewarning, popular headlines still ask: Why weren’t we ready?

The parallels with climate change are chilling. Experts have been shouting from the rooftops for decades, with disturbing precision of what devastating climate change induced impacts lie before us and are already affecting us. NASA, amongst many other official sources, has confirmed that models from 50 years back are proving true with predictions of planet warming. "Unprecedented" disasters strike weekly. Hundred year floods - those that have historically happened no more than once a century - are now happening as often as yearly (and in the best case, three times more often than normal). Disasters are happening today even at 0.97°C of warming, and are especially tragic in low and middle income countries which lack the resources to rapidly rebuild and deploy adaptations. The magnitude of impacts at the 1.5°C and 2°C IPCC targets will undoubtedly be worse. Predictions three years ago of warming arctic air leading to dramatic cold spells in North America hit home in Texas recently, with entire communities losing not only power but also gas and water. Our future are here today, and "unprecedented" no longer applies.

It takes time and money to adapt, and the value may not be immediate There is also a high uncertainty around when adaptations will start to show their value. For example, temporary field hospitals set up around the United States to deal with a surge in patients were being shut down less than 10 weeks into the pandemic to save cost. Lessons which should have been learned during the first surge immediately fell by the wayside for the people pushing for closures. Within 6 months, many of these field hospitals would be reopened, but with delays and additional cost, greatly impacting patient outcomes. Plenty of climate change adaptations and mitigations fall into the same bucket. Projects like sea walls to prevent storm surges and reservoirs to provide enough water supply in a drought have a significant capital expense upfront, and then an ongoing operational expense which remains for as long as the adaptation exists. In the case of climate change, these adaptations might even be in use forever. The challenge is showing that the adaptation has value and is worth the continued operational expenses even if it’s not actively being used.

A complicating factor here is the fact that so much of the world economy runs on “Just In Time'' (JIT) methodology, initially developed for use in Toyota’s factories but now applied in virtually every sector of the economy as a method to properly manage cash flow. JIT works well for stable, well-developed processes which are stable and have ample time for ramp-up. It is a key reason why mass produced goods get cheaper and better each year. However, this approach doesn’t work during scenarios where ramp time is much greater than the ideal response time, such as emergencies. When facing competing priorities, the knee jerk reaction is to put off preparations until the last minute, to avoid operational overhead from being employed too early. But in reality, processes must be created, tested, and optimized in advance. This is evident with the vaccine rollout, where the initial response was haphazard and uncoordinated. Vaccine delivery is improving, but lives could have been saved if the response had been better.

There are two solutions here. The most ideal is to build ahead for the inevitable, creating a playbook and the associated infrastructure with contingency plans and investment. Governments need to acknowledge that the resources and plans may never be deployed, but it means that the response can ramp quickly if needed, and will have a smaller impact. Less ideal is to plan ahead for the inevitable without investing in the associated infrastructure. This results in fewer unused resources if the emergencies don’t pan out, but communities need to be ok with higher costs, longer response times, and poorer outcomes, and in the worst cases, the infrastructure being delivered too late to have any effect.

Data collection and classification are key, and metrics need to be standardized from the start Ultimately, many of these problems stem from a lack of data aggregation, standardization, and analytics. When dealing with complex problems, an agreement on the most important metrics and a clear understanding of their state over time is critical. A lack of this makes it impossible to deal with cause and effect, confounding and chained variables, and the ability to tease apart the impacts of different interventions. Poor data collection standards can make it difficult to predict and proactively address problems.

Over a year into the pandemic, there are still several competing data repositories and formats. Even the most simple metrics with internationally harmonized definitions such as cases/100k or deaths/100k are muddied by irregularities in data collection in classification, testing and data entry lags, among other things. In addition, data is siloed in different formats and locations with varying access rules, making learning across borders more difficult.

To make matters worse, the countries which face the greatest challenges from the pandemic also have the least resources to improve their data collection capabilities.

As we drive towards net-zero emissions over the next few decades, we’re going to have to do a far better job of data collection and reporting than during the pandemic for several reasons. Interventions are financially and socially expensive. Data is necessary to drive public acceptance of costs and impacts in their day-to-day lives in the service of a long term world. Feedback loops are long. Clear data is key to understanding and tracking intervention and adaptation effectiveness across years and decades-long cycles, even through several generations. Climate forecasts are complex, and providing accurate results requires high-frequency and high-fidelity data. And finally, adaptations and mitigations need to be replicated millions of times around the world, and understanding the effectiveness of specific projects is key to improving technology design and delivery.

The key is to standardize data collection mechanisms, reporting standards, APIs, and interoperability standards, ensuring that data gathered can be shared between groups with excess work transforming between standards and incompatible metrics. Similarly, the kinds of data that must be collected should be defined and standardized, so that collection efforts can be kept in line while ensuring that every data set is useful for the full range of needed calculations.

Our fate here is not sealed While the COVID-19 response has been poor around the world, some countries have been able to keep the health effects minimal. Unfortunately, there are likely to be several crises worse than the pandemic over the next 50 years. Each crisis may look different, but we can use the pandemic as a lens to show the systemic problems and atrophy in worldwide crisis management and cooperation that have accumulated over the years. Climate change is an urgent problem with effects being felt today. We must learn from the pandemic and work to:

  • Rebuild our capacity to deliver critical infrastructure

  • Deal with complex multivariate problems

  • Enable data sharing and standardize key metrics across borders

  • Have an honest and holistic look at available budgets, and ensure that local communities are given the capacity to deliver on their needs

  • Work with players around the world, across political and ideological lines. With only one Earth that is becoming increasingly interconnected, solutions have network effects and lead to more peaceful outcomes

  • Need to ensure that the world population understands the true costs of climate change, and how the impacts of inaction are worse than the costs of mitigations and adaptations.

COVID may be one of the first wide scale crises to impact our highly globalized world. Just as COVID knows no borders, climate change knows no national borders: as much as you can try to quarantine a population, you can’t quarantine carbon-emissions. If there’s one major lesson we can take from the pandemic, it’s that global problems of this scale require cooperation and solidarity. Climate change is just as urgent of a problem as the pandemic; let’s use these lessons to propel us toward a solution.

Ngozi Erondu PhD, MPH is trained as an Infectious Disease Epidemiologist and is a health system policy and global health governance expert. She runs a technology start-up called Project Zambezi, which is a novel tech-enabled logistics approach to improve access to essential medicines throughout sub-Sahara Africa. Currently, Dr. Erondu is also a Senior Scholar with the Global Health Policy & Politics Initiative at the Georgetown Law Centre O’Neill Institute in Washington DC and a Associate Fellow at the Universal Health Coverage at Chatham House in London. Dr. Erondu was an Assistant Professor at the London School of Hygiene and Tropical Medicine where she taught disease outbreak response and epidemiology and was a Senior Public Health Advisor at Public Health England. She often provides technical support to the Africa Centres for Disease Control (CDC), the World Health Organisation, the Nigeria CDC, the US CDC, and other governments across sub-Saharan Africa, the Middle East, and South East Asia. Her support is aimed at strengthening institutional capacity to control infectious diseases such as Covid19, Ebola, meningitis, malaria, and poliomyelitis. She is a Trustee at two UK Charities: Imperial Health Charity and Castlepines Medical Foundation and is a Fellow with the Aspen Institute and the John Hopkins University Emerging Leader in Biosecurity Programme.

Illustration by Stefan Gustafsson.

Copyediting by Danica Sachs, a writer and editor based in San Francisco.

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