In response to a hot day in the past, people would often exaggeratedly refer to the heat that day as a “real killer.” It is just one example of how we often dismiss or fail to see a threat to public health — and act accordingly — even when it is upon us.
“We never think of heat waves as mass casualty events, but they are,” Kristie Ebi, a University of Washington epidemiologist who studies global health and extreme heat events, recently explained to USA Today. According to the National Oceanic and Atmospheric Agency, in June 2021 alone, at least 289 people died in the heat dome that hit Washington, Oregon and California. Reports the Centers for Disease Control and Prevention, at the heat dome’s peak on June 28, there were 1,090 heat-related illness visits to emergency rooms in the region.
In fact, the actual fatality count is probably underestimated. “One of the tough things about heat versus other disasters is it can sometimes be difficult to immediately tell that the temperature was what killed someone,” Scott Sheridan, a professor of geography at Kent State University who studies heat vulnerability, tells USA Today.
As pointed out last week, combined with heat, smog and air quality gets worse. Studies say that air pollution both causes and can worsen respiratory and other diseases. Yet the long-term effects of exposure to poor air quality is not always clear.
For 60 years, experts have documented a steep rise in the incidence of two medical conditions that make up most cases of inflammatory bowel disease (IBD) — ulcerative colitis and Crohn’s disease, reports Time magazine. While acknowledging that genetic factors play a part in a person’s risk for contracting IBD, researchers found a strong association between IBD, air pollution and other environmental factors.
Says Dr. Gilaad Kaplan, a professor and gastroenterologist at the University of Calgary in Canada, “Something about a Western lifestyle seems to be allowing this disease to flourish.”
Writes Time reporter Markham Heid, in a first-of-its-kind study published in 2010, “Researchers examined the association between ambient air pollution and the incidence of IBD. They found that young people who had grown up around high concentrations of nitrogen dioxide were more than twice as likely as other kids to develop Crohn’s disease.”
“How could air pollution affect gut health?” Heid asks. “Research has shown that after breathing in pollutants, the lungs may actually push these out into the throat so that they’re swallowed. This process is known as mucociliary clearance. Once in the gut … these pollutants may cause damage to the gut’s microbiota in ways that promote inflammation.”
Today, news about infectious disease outbreaks seems commonplace and a part of our new reality.
In a separate Time magazine report, Michael T. Osterholm, epidemiologist, regents professor and director of the Center for Infectious Disease Research and Policy at the University of Minnesota, states that while we have always been confronted by pathogens of all sorts, the attacks are now “becoming more commonplace, and more intense, than they ever have before.”
“We are going through an era of epidemics and pandemics, and they are going to be more complex and more frequent,” says Jeremy Farrar, director of Wellcome, a global health charitable foundation that addresses health challenges. “I think we are at the most vulnerable we have ever been in my professional career,” he adds. Osterholm sees the multitude of infectious diseases facing the world today as “the evolution of microbes and humans coming to a collision course.”
As if we needed more of a reminder of our vulnerability, there is life expectancy, the fundamental indicator of population health. As recently announced by USA Today and others, life expectancy in this country dropped for the second consecutive year in 2021. Counting the first two years of the COVID-19 pandemic, “The estimated American lifespan has shortened by (approximately) three years. The last comparable decrease happened in the early 1940s, during the height of World War II,” says the USA Today report.
While COVID-19 deaths were the main reason for the decline, other contributors to the decline reflect longstanding problems we have yet to overcome. “The second largest contributor was deaths from accidental injuries — primarily from drug overdoses, which killed a record-breaking 107,000 Americans last year,” reports Mike Stobbe of the Associated Press. Other factors include heart disease, suicide and chronic liver disease.
While the full impact of the pandemic’s collateral damage continues to be tallied, much of it appears to be self-inflicted. As reported by The New York Times, a new study shows that “the number of Americans who died of alcohol-related causes increased precipitously during the first year of the pandemic, as routines were disrupted, support networks frayed, and treatment was delayed.”
Writes the New York Times’ Roni Caryn Rabin, a number of studies suggest that Americans drank more to cope with the stress of the pandemic. “Binge drinking increased, as did emergency room visits for alcohol withdrawal. But the new report found that the number of alcohol-related deaths, including from liver disease and accidents, soared, rising to 99,017 in 2020, up from 78,927 the previous year — an increase of 25 percent in the number of deaths in one year.”
Adds Katherine Keyes, a professor of epidemiology at Columbia University, who was not involved in the study, “Mental health struggles were also becoming more prevalent before the pandemic, making people more susceptible to substance abuse.”
“We are entering an era in public health where we are talking more about promoting wellness and building resilient people,” says John Kelly, a professor of psychiatry at Harvard Medical School and the director of the Recovery Research Institute at Massachusetts General Hospital. “What we are doing now is not sufficient.”
