Coronavirus continues to have a calamitous, global impact – significantly affecting all of our lives.

As the UK heads into a second wave of the pandemic, we must not forget another major global health risk that is surprisingly familiar – climate change. For many, however, it may feel difficult to find the headspace to think about this when we are dealing with such an immediate, and often personal, threat as COVID-19.

But the fact remains that the current climate and ecological crisis is an unprecedented threat to population health and a key cause of inequalities. A senior clinician recently contacted me to ask what was happening around the sustainability agenda. They made the point that even in a pandemic, we still need an environment that we can actually live in. Temperature extremes, air pollution and flooding are just a few examples of how our health and wellbeing has already been affected. Recognising these impacts, the Greater Manchester Health and Social Care Partnership became the first integrated care system (NHS bodies and council social care working together) to declare a climate emergency. Of course, work was already underway to reduce carbon emissions and tackle environmental degradation, but we knew these efforts needed to be significantly upscaled if we were to avoid the worst impacts from climate change.

Needless to say, some momentum has been lost during the pandemic with the efforts of the health and care system focused on managing the immediate pressures brought by coronavirus. But we are now seeing climate change start to get attention once more. Last week, the Greater Manchester’s Green Summit brought together (virtually) people from across our city-region to re-emphasise the commitments made last year and ensure this is part of our post-covid recovery planning. NHS England Chief Executive Simon Stevens has been clear that the climate emergency is a health emergency and NHS England has just released an ambitious national guideline for the healthcare system to reach net zero carbon emissions.

It can still feel though that this agenda remains optional when faced with other pressures but perhaps the impact of the pandemic has changed perspectives in how we view global risks. Earlier this year, the executive director of the United Nations environment programme stated that nature was sending us a message with the pandemic and that humanity was placing too many pressures on the natural world with damaging consequences. They warned that failing to take care of the planet meant not taking care of ourselves. Ideas of a ‘wake-up call’ or a ‘warning shot’ featured in much media coverage.

So, how should we act on this ‘wake-up call’? As a critical start, sustainability can no longer be an optional agenda item. It must be front and centre with population health and inequalities action at its heart. The pandemic has brought grief and tragedy for far too many of us but at the same time it has created an opportunity to rethink how we organise our economy, travel, work, recreation and health and social care services. We must build on the positive elements of this experience, such as more active travel and more effective use of technology, while also recognising the risks like the dramatic increase in the use of single use plastics with Personal Protective Equipment (PPE) being a key example. Prior to COVID-19, Greater Manchester hospitals used around 140 million plastic gloves per year. During lockdown, 750,000 gloves a day were being ordered and a walk around our neighbourhoods is a sad reminder of where many single use masks from the public are ending up. Of course, the answer is not to abandon PPE as it’s key to keeping our key workers safe and stopping the spread of the virus. What we can do is rapidly increase already existing efforts to identify and implement reusable PPE options that also build resiliency for the system.

We must also embrace the policy drivers and partnership opportunities that are now available to us. The Delivering a ‘Net Zero’ National Health Service interim report was released on the 1 October. The report sets out the current carbon footprint of the NHS and provides a clear pathway towards net zero carbon by 2040 for emissions that are directly controlled by the NHS. In Greater Manchester, work on sustainability is a core part of our recovery plan and progress continues on the Five Year Environment Plan for Greater Manchester, which includes efforts to decarbonise our public buildings. We have senior leaders who are passionate sustainability champions, helping to push this to the top of the agenda and make sure it is resourced appropriately. And, perhaps most importantly, is our renewed commitment to reduce health inequalities, which cannot be realised without addressing environmental challenges.

I think the main thing we can learn from the pandemic is that behavioural responses to global challenges can be both transformative and rapid. Even if a response has been less than perfect, the speed and scale has been impressive and shows that with sufficient determination, major changes can be made very quickly. We all have it within our power to make a difference.

In the workplace, look at what changes can be made and discuss them with your colleagues and sustainability leads (each CCG and NHS trust has a named sustainability lead). In your communities, look at how you can be a voice for change. Sustainable and active travel are high priorities, but we need to make sure there are safe walkways and cycleways. As a patient, engage with your healthcare services to understand what you can do to reduce their environmental impact. And most importantly – do it now!

The Intergovernmental Panel on Climate Change says we are now less than 10 years away from not being able to undo our mistakes, so this is critical. And because I couldn’t say it any better myself, in the words of climate activist, Greta Thunberg: “I want you to act as you would in a crisis. I want you to act as if our house is on fire. Because it is.”



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