What combating climate change can teach us about fighting COVID-19

A conversation with child health expert Dr. Aaron Bernstein

The Global Insight team
31 May 2020
Expert Q&A  |  9 minute read

Can pandemic solutions be climate solutions, and vice versa? Why are collaborative learning activities better than science books for teaching children about climate and pandemic issues? What do mothers in the anti-vaccine movement tell us about those anti-lockdown protesters? The Global Insight team invited Dr. Aaron Bernstein, a pediatrician at Boston Children’s Hospital and Interim Director of the Center for Climate, Health, and the Global Environment at the Harvard T.H. Chan School of Public Health, to share his thoughts on the potential to combat climate change and health crises in the wake of COVID-19. In the Q&A below, our partnership lead Yoonie Choi followed up with Dr. Bernstein on some of the most interesting aspects of our discussion. The transcript has been edited for length and brevity.

You mentioned during our discussion that climate solutions are pandemic solutions. What are some specific examples and how can they benefit children?

Aaron Bernstein: There are many ways that addressing climate change can help prevent pandemics. Some of the big ways include preventing deforestation, which is responsible for between 10 and 20 per cent of carbon pollution. And we also know that deforestation contributes to the spillover of pathogens from animals to people. Because emerging infections overwhelmingly come from animals, preventing that spillover is a key part of preventing pandemics.

Burning fossil fuels has immense health consequences because it produces air pollution, and air pollution particularly harms children, including by putting them at risk of respiratory infections. While we don't have direct evidence that air pollution is making COVID-19 spread, we do have evidence that air pollution can speed the spread of other viral and bacterial respiratory infections. Breathing polluted air is particularly a problem for children in low- and middle-income countries, where a major cause of under-five mortality is pneumonia. Air pollution contributes to a large share of these pneumonias. By preventing burning fossil fuels, we can improve air quality, and given children a better shot at avoiding and surviving potentially life-threatening respiratory infections.

Adolescents collecting air pollution data
Adolescents collect air pollution data in the outskirts of Ulaanbaatar, Mongolia, using a portable air quality monitor provided by UNICEF (September 2018).

Children are thankfully up to now (as of 07 May), mostly spared from the direct health impacts of COVID-19. But there are some worrying cases now coming out of New York as well as Germany and the Netherlands. Could you share more on the latest assumptions and hypotheses in the health community? 

AB: We've seen what we now call multisystem inflammatory syndrome (or MIS) from COVID, particularly coming out of New York City in the United States. A small number of children, maybe 50–60 right now, have developed this syndrome that is in some ways similar to Kawasaki syndrome which we know well. We expect that, like with Kawasaki syndrome, the underlying driver of this is an overactive immune response to an infection, which is COVID-19 in this case. We still obviously need to know much more about how similar this syndrome is to Kawasaki. One of the reasons that researchers and clinicians were particularly interested in the connection is because in both cases, the blood vessels that supply the heart can be affected. The good news is that this syndrome, and the involvement of the heart, is quite rare. My hope is that the treatments that would effectively treat Kawasaki and prevent harms from that will be effective in this, too.    

I want to underscore that even if children’s health is often not directly at risk from COVID-19, children are being and will continue to be very much affected by this disease. The disease has effects on learning and education, mental and emotional health especially due financial and emotional stress in families, and growing food and economic insecurity that has hit the poorest hardest which can contribute to adverse childhood events that can affect health across the lifespan. This is something that we, as health professionals and you in UNICEF may have to deal with in the future.

You stressed in our discussion that having the right messenger matters now more than ever in achieving environmental and health goals. Could you elaborate more on who that should be?

AB: We have to meet people where they're at in terms of knowledge and understanding. We've already seen how people have wildly differing understandings of the virus and its risks, often not based on any amount of scientific grounds but on where people's greatest concerns are. If you've been put out of a job and you live in a place where there don't seem to be many people infected, and your livelihood is at risk, you're rightly going to want to keep working rather than stay at home. In this context, continued closure of workplace on the basis of protecting health seems bizarre because it doesn't seem like a major threat.

But this virus is traveling around the world and spread in one corner of the world — or a country — matters to other corners. There is no perfect answer right now about how much risk we can take as decisions are made about how quickly we should return to normal. In part, this is because we don't have enough testing in many countries, and in part because we still need to know more about how bad the virus is.

What I hope for is that we use science as far is it warrants us to and listen closely to the needs and wants of those who have been affected most and who are most at risk as we find our path forward. One set of data that I’ve found particularly worth noting is how the pandemic has led to even greater trust and attention to local leaders, especially for the organizations we are already closest to, which could be where we work or pray, or our local elected officials. So the best listeners and messengers are people we know and can relate to.        

Siblings reading together
Siblings reading in the German version of the Convention on the Rights of the Child (May 2020).

When we discussed potential opportunities with climate education after COVID-19, you focused on the importance of teaching mindsets and values, as opposed to knowledge per se, in primary schools. Do you also see opportunities emerging from this pandemic when it comes to teaching scientific facts to adolescents and young people?

AB: The biggest challenge we face is helping children around the world to understand that many problems require collaboration. They need to learn to recognize that to be a citizen in this world requires some understanding of people who are different from you, and that your welfare is dependent on others. Cultivating that at an early age is critical.

Beyond these broader points about learning, I think the pandemic shows clearly why science matters. There’s good news in the data that shows more people trust in science than in a long time. And COVID-19 is a real test of trust in science because, as history shows, when people encounter crisis, we don’t routinely trust science. Sometimes we’ve turned to alchemy and other fantasies for help.

But more important than knowing scientific facts, children need to understand what science really is and how it works: Scientists observe the world to gather data, measure things, and use those measurements and observations to gain insights into reality through experiments. Science is imperfect because we cannot observe everything, and our tests are not perfect. But if enough people do those experiments often enough, and all of their experiments lead in the same direction, we have and continue to better our understanding of how everything in the observable world works. If our children understand that, they will be much more able to recognize what science can and cannot do in the face of a crisis like COVID or climate change — and that will mean we’ll all be better off.

Trust, science and messengers are core factors that play a big role when it comes to public awareness. Are there any insights you could draw from the health sector on how to combat misinformation in COVID-19 and in climate?

AB: The power of misinformation has never been greater because of social media. We see this all the time in the anti-vaccine movement. A mother, for example, watching a nurse hurt her child with a needle during a vaccination can feel like she’s let someone harm her child. That’s the perception, but it’s not the full reality, which includes many children getting sick or dying from infections if we didn’t vaccinate. When parents don’t understand that reality, all they see is their child being hurt. This fear conspires to make scientifically baseless statements about vaccine risks more dangerous.     

So, you have to understand where their fear is coming from and try and address it as best as possible because fears are an overwhelming force in trying to come to grips with a broader reality. In the context of COVID misinformation and climate misinformation, think about what people are really afraid of and what's driving their fears. Finding the people who can address those fears and present evidence to counter those fears as best as possible is critical. The mistake we make is pretending that people will respond purely to facts — that simply providing the information will change people’s minds. 

A girl standing outside of her school
A girl standing outside of her school, which is made out of 100% recycled plastic bricks, in Toumodi-Sakassou, in the center of Côte d'Ivoire (28 May 2020). School has resumed after being closed for several weeks to limit the spread of COVID-19.

Do you see COVID-19 altering urbanization trends, such as safety concerns driving high-income households outside of cities? If so, what would be the implications on children who remain?

AB: I don’t see COVID radically changing the trend for people to live in cities. I do see equity implications from COVID, though, particularly for children and disadvantaged minority communities. Even though the virus is relatively less severe in children, it's important to recognize that children have guardians — parents and caregivers. If guardians have their lives destroyed, that's a big problem for children. We have more and more evidence about adverse childhood events and its effects on children’s lifespans. We need to pay even more attention to this - especially in vulnerable communities — because children today are going to face potential economic insecurity and social insecurities that are potentially unprecedented.    

Allied to this is the fact that so many of the things we can do to build resiliency in cities — to things like climate change — are exactly the things we would need to do to build resiliency for children whose parents’ livelihoods and, potentially, lives have been put at risk with this virus. I’m talking about improving educational systems, childcare, urban parks, transportation systems that allow for more accessible and affordable transits, and improved food security. A recent FAO report talked about anticipated famines that are coming from COVID-19, which will overwhelmingly burden children because malnutrition during childhood has such profound effects across the lifespan. So, these resiliency measures are another example of how pandemic solutions and climate solutions line up.   

If this crisis provides an opportunity for climate action, how can UNICEF seize it?

AB: UNICEF is one of the few organizations with global reach whose core mission is to protect the interests of children. In this context, now is a powerful moment to be asking governments about their spending in the crisis: Are you spending these dollars to protect the interests of children, and if so, how, and how are you valuing children? Particularly, when these investments are going to things like infrastructure, energy systems and transportation, how are you addressing climate change? How are your investments working to protect those children who come from disadvantaged families and communities?

Having had so much of the economy idled, we may see opportunities to restart on a new path that both reduces health burdens today, addresses inequities and protects the future for children. A really important point of engagement here is simply asking questions on behalf of children. The intergenerational equity concerns about what we are leaving for our children really do weigh on many people's minds, but they need to be brought forward. During a crisis like this, we need to remind ourselves that we have voices that must be heard but that may not be able to speak loudly or that we may not have given space to hear. voice to our children’s concerns as we address COVID will make for a better recovery and, of course, protect the needs of future generations.

Headshot of Aaron Bernstein

Aaron Bernstein is the Interim Director of The Center for Climate, Health, and the Global Environment at the Harvard T.H. Chan School of Public Health (Harvard Chan C-CHANGE) and a pediatrician at Boston Children’s Hospital. He focuses on the health impacts of the climate crisis on children’s health and advancing solutions to address its causes to improve the health and wellbeing of children around the world. @DrAriBernstein