Planetary Health Perspectives and Implications of COVID-19
Dr. Byomkesh Talukder, Planetary Health Fellow, Dahdaleh Institute for Global Health Research (DIGHR), York University, Canada. Contact: e-mail: byomkesh.talukder@gmail.com; byomkesh@yorku.ca, mobile:+1–226–600–0730
Coronavirus disease 2019 (COVID-19) has spread across the world since the first case was reported in Wuhan, Hubei province, China, in December 2019 (Peeri et al., 2020; Xu et al., 2020). Phylogenetic laboratory analysis showed that COVID-19 is caused by the zoonotic virus SARS-CoV-2 (Andersen et al., 2020; Rothan and Byrareddy, 2020). COVID-19 is a zoonosis, a highly pathogenic viral infection transmittable from animal to person and person to person (Bai et al., 2020; Shereen et al, 2020; Xu et al., 2020). Bats and pangolins are the prime suspects as the source of the virus responsible for the current pandemic (Cyranoski, 2020; Watson, 20202).
Most emerging infectious diseases of humans are viruses that originate from nonhuman animals via zoonotic transmission (Mollentze et al., 2020). “Of 12 major pandemics since the 1980s, 9 were zoonoses — like SARS, AIDS, MERS and now COVID-19” (ILRI, 2020:1). “It is estimated that, globally, about one billion cases of illness and millions of deaths occur every year from zoonoses. Some 60% of emerging infectious diseases that are reported globally are zoonoses. Over 30 new human pathogens have been detected in the last three decades, 75% of which have originated in animals” (WHO, 2014:1).
There are various natural and anthropogenic factors of the emergence and spread of COVID-19. So far, critical preparedness, readiness and response actions for COVID-19 all around the world aim to “slow and stop transmission, prevent outbreaks, and delay spread”; “provide optimized care for all patients, especially the seriously ill”; and “minimize the impact of the epidemic on health systems, social services, and economic activity” (WHO, 2020:1). Nevertheless, the spread of COVID-19 is causing unprecedented direct and indirect risk on non-linearly related complex adaptive systems of the social, political, economic, knowledge/technological and environmental realms which can be framed by the concept of planetary health (Whitmee et al., 2015). Understanding the perspectives and implications of COVID-19 in terms of a planetary health context is important to manage and take action against the financial, political, social and environmental ramifications associated with it. The multiple planetary health-related perspectives and implications of COVID-19 can be understood by systematically employing the complex adaptive systems framework (Holden, 2005) because the direct and indirect consequences of COVID-19 are causally interconnected in a nonlinear way and constantly changing. Using a complex adaptive systems framework as the basis of investigation in this note, a causal loop diagram of multiple perspectives and implications is depicted in Figure 1 to understand the causal connections of the planetary health components and to portray how changes in one component cascade into changes in others and potentially entire systems (Bradley et al., 2020).
In Figure 1, various planetary health perspectives related to the emergence of COVID-19 are presented. For example, loss of biodiversity is associated with the emergence of COVID-19. Over the twentieth century, population growth has put tremendous pressure on ecosystems and biodiversity. As a result, pathogens have unprecedented opportunities to pass between animals and people (Robinson, 2020). Due to ecosystem degradation and loss of biodiversity, one new infectious disease emerges every four months (UNEP, 2016). Climate change along with other factors presented in Figure 1 are jeopardizing the coexistence of humans and nature and decreasing the natural resistance that prevents the emergence of infectious diseases like COVID-19. “By altering land use — for settlement, agriculture, logging, extractive or other industries and their associated infrastructure — humans fragment and encroach into animal habitats. They destroy the natural buffer zones that would normally separate humans from animals and create opportunities for pathogens to spill over from wild animals to people” (Robinson, 2020:1).
COVID-19 has multiple cascading positive and negative implications on social, economic, environmental, political and technological domains. For instance, COVID-19 is disrupting the food supply chain, leading to the possibility of food insecurity (WFP, 20202) that will have serious health impacts around the world. The economic impacts of COVID-19 “could lead to 580 million people — 8% of humanity — being pushed into poverty and see an increase in global poverty for the first time since 1990” (Mandel, 2020:1). On the positive side, NASA reported that air pollution such as NO2 amounts has dropped in China with the coronavirus quarantine (NASA, 2020).
Figure 1 shows various possible implications of COVID-19 on planetary health issues. To further understand the implications of COVID-19 on different dimensions of planetary health, the set of planetary health indicators that are proposed in Lancet Countdown (Watts et al., 2019) have been tested. The Lancet Countdown tracks the progress of health and climate change issues through collaboration among interdisciplinary, multidisciplinary and transdisciplinary teams spanning the realms of political science, geography, mathematics, medicine and engineering. The preliminary results of the study are presented in Table 1.
The United Nations Sustainable Development Goals (SDGs) are “a universal call to action to end poverty, protect the planet and ensure that all people enjoy peace and prosperity by 2030” (UN, 2020). These are also examined as can be seen in Table 2. A rapid check of the impacts of COVID-19 on SDGs reveals that out of 17 SDGs, 6 goals (i.e., Goal 6: Clean water and sanitation, Goal 7: Affordable and clean energy, Goal 11: Sustainable cities and communities, Goal 12: Responsible consumption and production, Goal 14: Life below water, Goal 15: Life on land, Goal 17: Partnerships for the goals) will have some sort of increasing positive impacts, whereas the other 11 goals (i.e., Goal 1: No poverty, Goal 2: Zero hunger, Goal 3: Good health and well-being for people, Goal 4: Quality education, Goal 5: Gender equality, Goal 8: Decent work and economic growth, Goal 9: Industry, Innovation, and Infrastructure, Goal 10: Reducing inequalities, Goal 11: Sustainable cities and communities, Goal 13: Climate action, 16: Peace, justice and strong institutions, Goal 17: Partnerships for the goals) will possibly be negatively impacted.
Examining the impacts of COVID-19 on the indicators of the Lancet Countdown and SDGs shows that COVID-19 poses risks in a wide range of social, economic and natural domains. However, the impacts of COVID-19 will be especially serious in the resource-limited settings in developing countries.
The factors of planetary health perspectives as depicted in Figure 1 are mostly responsible for zoonoses. If the present use of planetary resources continues, the “global wildlife populations could drop two-thirds by 2020 as human demand continues to exceed the planet’s capacity” (GFN, 2016:1). Degradation of all sorts of biodiversity in world’s ecosystems will reach a “tipping point,” meaning that small alterations in environmental situations will lead to huge changes (de Oliveira Roque et al., 2018). This will have a serious consequence on human health as biodiversity “has been described as the ‘infrastructure’ that supports all life on earth. It is, simply, a prerequisite for our modern, prosperous human society to exist, and to continue to thrive” (Barrett et al., 2018:7). Human health as well as SDGs depend on the health of ecosystems and biodiversity (Pecl et al. 2017; Langlois et al., 2012). Degradation of the ecosystem and biodiversity can lead to deficiencies of vital resources, damage livelihoods, destroy ecosystem resilience and facilitate the spread of infectious diseases such as COVID-19.
Furthermore, “climate change – primarily the result of greenhouse gas emissions — exacerbates the situation. Changes in temperature, humidity and seasonality directly affect the survival of microbes in the environment; and evidence suggests that disease epidemics will become more frequent as the climate continues to change. Rapid climate change is challenging to those with fewer resources for responding quickly, leaving them more vulnerable and amplifying their risk of harm from the spread of zoonotic disease” (Robinson, 2020:1).
Apart from biodiversity degradation and climate change, the world is at risk from the new viruses released by the melting of glaciers/permafrost (Zhong et al, 2020). These new viruses will have serious impacts on humans since they are unknown and new, and our immune systems are not adapted to them yet. There is also a huge concern about antimicrobial resistance and food safety and other health impacts due to climate change.
Managing zoonotic disease and other emerging health impacts requires action at the foundations of planetary heath. The foundation of planetary health depends on the health of the planet’s ecosystems upon which human wellbeing and survival ultimately depend. If the world keeps using ecosystems in a “business as usual” model, zoonotic diseases will keep emerging. Therefore, we need to flatten the curve of using the planet’s ecosystem capacity as shown in part [A] of Figure 2. To flatten the curve, we have to understand the causal relationship of planetary health perspectives, zoonotic disease and its implications. There are some frameworks to address flattening the curve, such as green growth (Hallegatte et al., 2011), low-carbon society (Vidal et al., 2013), climate-smart agriculture (Howden et al., 2007), agroecology (Gliessman, 2014), ecosystem-based adaptation (Vignola et al., 2009), circular economy (Stahel, 2016) and so forth. To apply these frameworks at national, regional and global levels alone or in combination, we have to identify the risk from a planetary health perspective, model the risk, forecast the risk and develop interventions to address the risk of the implications. To accomplish these tasks, we need a holistic approach founded on transnational, collaborative and transdisciplinary (natural science, design science, general, human/social science, applied science) efforts as shown in [B] of Figure 2 and framed with a planetary health approach. At present, “our scientific capability to predict abrupt changes in nature such as from disease epidemics is limited” (de Oliveira Roque et al., 2018:1622). Therefore, the proposed transdisciplinary risk assessment approach in Figure 2 will help to develop our capacity to predict the tipping point in nature associated with zoonotic disease such as COVID-19.
