Christmas weathers and moods

One year when I was a schoolboy I remember a neighbourhood sweepstakes about Christmas Day weather: would it break 100 on Christmas Day? That's 100 degrees Fahrenheit, the old scale we used in Australia in those far off prewar days. It was an even-money bet, almost half the time it did, although the really hot weather didn't arrive until after New Year. There must have been more to that sweepstakes than just yes or no to the simple question: the winner would have been the one who made the nearest guess to the actual temperature. Nonetheless, the sort of weather they've had in Adelaide this December didn't happen in the 1930s: in the middle of December there were five days consecutively with temperatures over 40 Celsius in my home town, Adelaide.  That's unprecedented, and a rather convincing bit of empirical evidence to add to all the rest, that climates are changing, that the world is getting warmer. This year the Adelaide forecast is for 39 C on Christmas Eve and 37 C on Christmas Day, with rain - not a very pleasant combination. My son David and his wife Desre are there, renewing connections with his aunt and uncle (my brother Peter) and his cousins and their kids - and cousin Kate's grand-children. His cousin Anne dropped in on us in Ottawa a few years ago but he hasn't seen the other Adelaide relations since 1968, when he was 9 years old. The Adelaide branch of the family is large, rather noisy, the nearest we have these days to a Victorian or Edwardian extended family. My brother has four children, an array of grand children, and three great grandchildren. There are to be several festive meals at different cousin's homes over the 4 days the Canadian contingent will be in Adelaide. I hope the weather is kind to them. I'll be with them all in spirit and wish I could be there in the flesh.

Jenny, Anne, David and Peter Last, Adelaide, Dec 24, 2015

Here in Ottawa we seem certain to have a green Christmas this year, our first really green one, with above-zero temperatures,perhaps a little drizzly rain, as we are having today.

It sets me thinking about weather and moods I've known at other Christmases around the world. There've been Christmases in Adelaide when it wasn't searingly hot, just pleasant, although for sheer perfection, nothing comes close to two or three we had in New Zealand. In Scotland it was still dark when we got the kids out of bed about 8 am, and dark again by 4 pm, very short, gloomy sort of days but not very cold: we never had a White Christmas in our five Edinburgh years although we could see snow on the Pentland Hills south of our home, but we did once in London, or rather with our friends Hazel and Bill Wheeler who lived in Surrey on the southern outskirts. There was a hard frost overnight that froze their pond, and gentle feathery snowflakes in the afternoon and early evening, just enough to cover the ground and decorate the trees. There wasn't enough to make a snowman and we were all too snug by the fireside to bestir ourselves anyway, kids as well as grown-ups. That was the Christmas when we had a small miracle. We were too poor to afford a Christmas tree that year but Wendy brought a dead tree branch indoors, we stuck it in a bucket of sand that we watered a little bit so the branch would stand upright, and decorated it with milk bottle tops that we pressed on the pointed end of our lemon squeezer to turn them into little bells, silver, red or gold, depending on the quality of the milk in the bottle. When we got back from our brief break at the Wheeler's home in Surrey, our bare, dead tree branch had burst forth in little green leaf buds - it wasn't dead after all, just dormant, and it had been warm enough in our house for it to come  to life in a premature spring. Ten years earlier during my first experience of Christmas in London, I was a house officer (junior physician) at Hillingdon Hospital at Uxbridge, Middlesex on duty on Christmas Day, mouth sore after having a tooth extracted a day or two before, heart sore because I'd just been dumped by my girl friend of the time and unhappy, but happy by the end of the hospital festivities, patients as cheerful as possible, and nurses very affectionate. I suppose I've had only one really unhappy Christmas, in 2010, six weeks after my beloved Wendy had died. That's not a bad track record after all these years.

Climate change - 2: Health impacts

Climate change has several kinds of impact on human health. as well as on the health and survival of domestic and other plants, and domestic and other animals.

Climate change includes both rising average ambient temperatures and increased frequency and ferocity of weather extremes. Both have direct and indirect effects on health. They also have important effects, mostly adverse, on food crops and on animals, including marine animals that are staple parts of human diets. In short, climate change seriously threatens food security. 

Weather extremes -- droughts, floods, violent storms -- have obvious effects on human health. Hurricane Katrina which struck New Orleans and the Mississippi delta in 2005 caused about 2,000 deaths and displaced several hundred thousand people.  But it was only a Category 3 hurricane by the time it made landfall. Several more severe storms have hit the southern USA and Mexico since 2005, but most have struck unpopulated regions.  Hurricane Sandy (2012) caused tremendous property damage along the New Jersey and adjacent New York coasts but relatively little loss of life. Similar severe storms in other parts of the world with less efficient disaster preparedness, e.g. south China, can lead to far greater numbers of deaths, injuries and infrastructure damage. Droughts and floods disrupt food crops and are a serious threat to food security. The effects of extreme weather are most pronounced in regions where the people are poverty-stricken, can't afford air conditioning, have flimsy huts rather than solidly built homes, or are crowded in shanty towns on flood plains. 

Many insect species flourish in warmer weather. These include insect vectors of diseases that have great public health importance, particularly the varieties of mosquitoes that carry malaria and dengue. Epidemiologic surveillance and monitoring habitat of insect vectors have revealed that the range of vectors has extended further into previous temperate zones and higher altitudes that in the past have been free of malaria and dengue (and other vector-borne diseases).  Nairobi, Harare, Kampala, and other large cities in the East African highlands are outside the range of vectors for malaria and dengue, but as the climate gets warmer these dense human settlements will become vulnerable. Some ecological relationships between vectors, pathogens and people are complex. For instance, Lyme disease is spread by ticks that feed on deer which normally are not in contact with humans; but as affluent suburbia extends further into rural regions, humans and wild deer become more likely to be in closer contact. Hence the risk of Lyme disease is increased.  Other ecosystem disruptions also occur. For instance, marine species such as salmon and mackerel reproduce successfully within a narrow temperature range. As sea surface temperature rises there are many disruptive consequences, among which collapse of marine species such as mackerel may be relatively minor in the grand scheme of things. But it is a calamity for predators (seabirds, dolphins, etc) that feed on mackerel, as well as a serious loss of seafood for humans.

Rising temperature in inland freshwater lakes and rivers accelerate reproductive cycles of micro organisms, including pathogens. The ecological consequences are complex, and include an increase in waterborne diseases -- cholera, diarrhea, parasitic infections. The South American cholera epidemic that began in the early 1990s and lasted over 10 years was started when the cholera organism was introduced by ships trading from the Bay of Bengal. It was facilitated by a symbiotic relationship between the cholera vibrio and other freshwater organisms, notably zooplankton. This epidemic caused over half a million cases and almost 100,000 deaths. Persistence of the epidemic was fostered by interaction of the cholera vibrio, marine zooplankton, and the warmer water temperature of river estuaries along the Pacific coast of South America. A southward fluctuation of the El Nino tropical Pacific Ocean current made those coastal waters unusually warm, thus enhancing survival of the cholera vibrio and increasing the risk of infection. Warmer weather also leads to proliferation of allergenic grasses and weeds, and is responsible for rising prevalence of asthma and hay fever.

There are many other health-related consequences of rising environmental temperature. For instance, riots and civil disturbances occur more often in hot weather than cold, which tends to encourage people to stay indoors to keep warm, rather than congregate in unruly crowds. on city streets These social disturbances tend to cause deaths and injury of those who take part. The moral of this story: avoid crowds and eschew demonstrations in hot weather. 

There is much more I could say, but this is probably more than enough for casual readers. There's plenty more available for anyone interested. See, for example, 

Safeguarding human health in the Anthropocene epoch: report of The Rockefeller Foundation–Lancet Commission on planetary health in Lancet July 15, 2015

Climate change

Everyone is talking about the unseasonably warm weather in this corner of North America. It's the same story in other parts of the world. In the southern hemisphere it's extremely hot in my home town of Adelaide. Current temperatures two weeks before Christmas are in the 40s.  This is not unprecedented but it is highly unusual to have sustained extreme heat as early in the summer as this. It is almost certainly attributable to global climate change. There are already serious consequences for human health and wellbeing, and soon there will be more. 

Climate change first appeared on my radar in the early to mid-1980s. I spoke about global warming and the greenhouse effect with graduate students and at public health meetings from 1987 onward. I was invited to speak to ministers of health of Commonwealth nations at their biennial conference in Nicosia, Cyprus, in 1987. My first published paper on the implications of atmospheric changes for public health appeared in the  Canadian Medical Association Journal in 1989. It attracted attention, and soon afterwards I was invited to write a comprehensive review for the trend-setting Annual Review of Public Health. In that review article I focused on two human-induced changes in the atmosphere, rising carbon dioxide concentration caused by combustion of carbon based fuels, and depletion of the ozone layer in the stratosphere caused by several ozone destroying substances such as freon.

The potential harm to all forms of life on earth from rising levels of ultraviolet radiation due to destruction or attenuation of the protective stratospheric ozone layer was readily recognized even by ultraconservative right-wing politicians like Margaret Thatcher, UK prime minister, and she, along with other world leaders, signed the Montreal Protocol (1987), aimed at restricting production and release into the atmosphere of ozone-destroying substances. The danger to all forms of life from exposure to high concentrations of UV radiation has been fended off, at any rate for the time being.

Reaction and responses to the equally grave threat to the stability of life-supporting ecosystems from global climate change has not been so unanimous nor as effective. Wealthy and powerful interest groups in the carbon fuel industries, i.e. oil and coal, and transport industries have fought determined rearguard actions to maintain the status quo.  They have had support from many quarters, for example the Australian media mogul Rupert Murdoch, and several influential members of the US Congress.  Several global conferences convened under the auspices of the United Nations have been little better than fiascos. So it is gratifying that all the world's nations gathered in Paris in early December 2015 achieved a rare show of unanimity in recognizing the gravity of the threat to global life-supporting ecosystems from rising atmospheric CO2 concentration and resolved to reduce, perhaps eventually to eliminate use of carbon-based fuels. It remains to be seen, of course, whether the resolutions voted into effect in Paris actually lead to effective action by all nations, especially China and India. These two large nations rely on large quantities of low grade coal to generate most of their energy.  In China it powers the high speed rail network that the Chinese have built in recent years. 

I summarized the impact of global warming on individual and population health most fully in a chapter in the 2nd edition of my book Public Health and Human Ecology (1997). The impacts are all adverse. Prolonged heat kills large numbers of people, an estimated 50,000 in the widespread European heatwave of 2003. Wendy and I were in Edinburgh when that heatwave began (I was there for the convocation where I received the honorary degree of Doctor of Medical Science).  We stayed in the posh and prestigious North British Hotel, but it had no air conditioning, so it became very uncomfortable.  It was even hotter in London, although at least the Domus Medica of the Royal Society of Medicine, my London 'Club', is air conditioned. But it was very oppressive out of doors. The Eurostar train that we took from London to Paris is air conditioned too, thank goodness, and so was our hotel in Paris, although inadequately. We sat a while in a park in the Marais, but abandoned our plans to stay a week in Paris to sample its many charms yet again. Instead we escaped after 2 days on the TGV to Geneva where the Cornavin Hotel, my favourite there, is air conditioned. But outdoor patios of restaurants aren't, so there too it was oppressively hot. It's easy to understand why so many died of heat stroke and heat exhaustion. Most were old and frail, or young and ailing. Wendy and I were in our late 70s then, and we found it hot enough to be distressing.  

Since 2003, just as in the preceding 100 years, global average temperatures have continued to rise, in parallel with rising atmospheric concentrations of CO2. The rising global temperature has thawed polar and alpine ice-caps, exerting maximum effect at high latitudes: ambient temperatures have risen higher near the poles than anywhere else. I last flew over Greenland in August 2011 and saw for myself the dramatic impact of global warming on this large ice-covered island. It's no longer ice-covered, at any rate in late summer. Far below our plane as we flew over at 11,000 meters, we could see vast pools of melt-water everywhere; and the seas to the east and west of Greenland were dotted with innumerable icebergs, calved off the glaciers that run down to the fiords and drain into the sea along the coasts of Greenland. All that melting ice is coming from above sea level, so it is contributing to rising sea levels. So are even larger volumes of melt water from the land mass of Antarctica. The IPCC reports estimate that sea levels around the world will rise by at least a meter before 2100. In addition to rising concentrations of CO2 the atmosphere is being burdened by large quantities of methane, released from frozen bogs and from permafrost as this thaws. Methane is an even more powerful greenhouse gas than CO2, so it accelerates global warming. Most of the IPCC scientists say privately that the sea level will rise by much more than a meter, but even that modest rise will gravely threaten many small island states, e.g. the Maldives south of India, Kiribati and others in the Pacific, as well as low lying coastal regions of south China, Japan, India, Bangladesh, Holland, Miami and much of south Florida, the Mississippi delta, London and East Anglia and many other parts of the world. The habitat and food-growing regions of several hundred million people are at risk. Soon there will be many millions more environmental refugees. 

I'll say more about the implications for food security, and about the direct and indirect impact of global warming on human health in another post.

Trumpeting

When he first surfaced over my horizon a few years ago I thought Donald Trump was a loud-mouthed, empty-headed buffoon. At that time, he was obsessed with the belief that Barack Obama was not born in the USA and therefore was not eligible to be president of the USA.  In retrospect and in view of his current pronouncements, this obsession would seem to have its roots in a racist belief that non-European people are unfit for high office. Cautiously observing his increasing appeal to all that is worst about the masses and their reaction to demagogues, I am becoming more than a little alarmed. His ignorant ravings have done nothing to erode his appeal to the masses -- if anything, the reverse.

He reminds me more of Hitler every time I see and hear him speak in the sound bites that appear on my TV screen whenever I turn it on. We didn't have TV in 1938-39 when Hitler's face and speeches dominated our newsreels in the 'shorts' that preceded the main feature
 at the movies. Trump's mannerisms resemble those of Hitler's that I remember from those long-gone days. 

There is one interesting difference.  Hitler was very clear about his demands and his political agenda. Trump isn't. Apart from a proposal for a wall between Mexico and the USA, and perhaps one between Canada and the USA, and an edict (or whatever it takes) to keep all Moslems out of the USA, I have no clear notion of Trump's political platform. I wonder if he has actually defined his platform yet. I get an impression that he has a list  of undesirable people and events but is less sure of what he actually wants to do in the event that he achieves the Republican nomination for President of the USA, and the even more unlikely event (I hope!!) that he gets elected.

There have been dystopian fictions about a fascist takeover of the United States. I fervently hope life isn't going to imitate art, but Trump is unquestionably a fascist demagogue, as intelligent, cool-headed clear thinking Americans instantly see. It worries me, however, that there are increasing proportions who perceive him as the saviour who will restore the USA's lost greatness.  How he proposes to go about achieving his ill-defined and undefined aims is troubling.  A demagogue who develops or invents his cause or causes  and his policies and political agenda after the fact of being identified as a national leader is a truly terrifying prospect.

America has undoubtedly lost much of its former greatness, I believe as a direct result of a misplaced national hubris.  Thucydides knew it well, understood it, and eloquently described its tragic consequences in his history of the Peloponnesian War, fought between Athens and its adversaries more than 2000 years ago. Aspiring leaders of America and other countries should be required to read Thucydides as a condition of running for office. One of the signs of decline from greatness is the lack of merit demonstrated by aspirants for high political office. This is manifest emphatically in the dozen or more who seek the Republican nomination, most of all in the worst of them all, Donald Trump.  

Periodic madness

I attribute the phrase 'periodic madness' to John le Carre, the nom de plume of the British writer David Cornwall. It's a useful descriptor. Bouts of periodic madness have gravely damaged the American psyche and the body politic. Obvious examples include the Civil War, in which about a million young men died, Prohibition, which fostered gangsterism, the concepts of 'manifest destiny' and American exceptionalism, which absolves the USA from obligations held in common by other civilized nations, especially in wartime. 

When Wendy and I lived for a year in Burlington, Vermont in 1964-65, we saw several manifestations of 'periodic madness' that persuaded us to turn our backs on the American variant of 20th century civilization. I've mentioned these in previous posts on this blog.  They include strident militarism and a paranoid view of the USA's place among the community of nations, which was displayed in the early 1960s in the Vietnam War. Americans saw this as a conflict between the (good) forces of Capitalism and the (evil) forces of communism. Even now, half a century after it ended, many of them apparently continue to believe this distorted, misguided view of the reality, which was a war of liberation of the Vietnamese from French colonial rule. The French were decisively defeated when the fortress of Dien Bien Phu was overrun by the Viet Cong. But American 'advisers' were already operating in Vietnam. Instead of embracing Ho Chi Minh as a fellow spirit of George Washington, American policy makers saw him as an agent of the mythical communist hordes that sought to convert the world to their evil system. They expended huge amounts of American blood and treasure opposing the irresistible urge of the Vietnamese people to control their own destiny. The Vietnam War ended and so did the Cold War. But America found other adversaries, notably in the Middle East. Perhaps 'periodic madness' is the wrong phrase to describe this feature of the American psyche: it's not periodic but perpetual madness.

One constant feature is violence, commonly lethal violence. This week there was another mass shooting: fourteen people at a pre-Christmas party in a disabled people's centre in California were slaughtered by a young married couple who had a baby a few months old. They left the baby with relatives, put on body armour and used large calibre assault rifles, weapons of war that have no possible civilian use. The man was American-born, has an 'Arab' name, and acquired his wife in what sounds like an arranged marriage while visiting Saudi Arabia last year. Several aspects of this mass shooting are unusual and puzzling. The unanswered questions about it will doubtless soon be answered. This might have been a terrorist attack. None of the other mass shootings in the USA this year - 355 according to the Daily Beast, an 'average of one a day' according to the NY Times - is associated with international terrorism, although some, for instance one a week ago, were associated with another manifestation of madness in the body politic, an attack on a Planned Parenthood clinic, a rather common form of domestic terrorism in the USA. Many Americans seem to believe it's OK to destroy facilities and terrorize, even kill staff of family planning clinics, because every foetus has the right to live. Nurses and doctors who help women with reproductive problems on the other hand, apparently don't have a right to life, according to this warped view. Political reactions to this latest mass shooting have been the same as to all the others: condolences and prayers for the bereaved, and total silence on possible legislative or regulatory measures that might be adopted as ways to reduce or control this mindless and preventable loss of life.