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Analysis | Climate change is pushing hospitals to tipping point – The Washington Post

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Good morning! Climate 202 researcher Vanessa Montalbano is taking over today while Maxine is on vacation this week. 

🚨: In today’s edition, we have an exclusive about a bipartisan group of former Environmental Protection Agency administrators who are pushing the Senate to quickly confirm David Uhlmann as head of the EPA’s enforcement office. More on that below. But first:

Climate change is pushing hospitals to tipping point

When an unprecedented heat wave baked the Pacific Northwest last July, emergency rooms sought any way possible to lower the core body temperatures of patients coming in droves with heat-related ailments. 

Many emergency departments in the region began putting people in body bags filled with ice to help safely adjust their temperatures. But despite their lifesaving efforts, around 1,000 excess deaths occurred from the brutal heat. 

The scramble to save lives paints the challenging reality that many hospitals and medical workers are facing again this year as severe weather-related health emergencies escalate because of extreme climate events. 

“We unfortunately had a real live stress test here for the Pacific heat dome because the temperatures were so high and we had a 69-fold increase in hospital-related presentations,” said Kristie L. Ebi, the founder of the center for health and global environment at the University of Washington

At the same time, the health care sector contributes significantly to the worsening climate crisis, representing nearly 8.5 percent of all U.S. emissions

According to an analysis conducted by World Weather Attribution, that excessive heat wave was made at least 150 times more likely from human-induced climate change. 

Last fall, the editors of over a dozen health journals from across the globe simultaneously published a joint editorial calling for urgent climate action to avert catastrophic warming. Without it, the editorial said, rising temperatures will lead to more deaths from heart and lung illness, allergies, kidney problems and pregnancy complications. 

“The greatest threat to global public health is the continued failure of world leaders to keep the global temperature rise below 1.5° C and to restore nature,” the authors wrote.

The New England Journal of Medicine went one step further this spring in launching a series focused on highlighting health hazards linked to planet-warming pollution, our colleague Sarah Kaplan reports.

Renee Salas, a researcher at the Center for Climate, Health, and the Global Environment at Harvard University and contributor to the series, says that doctors have a moral obligation to speak out against fossil-fuel use and other planet-warming activities.

“The burning of fossil fuels, the root cause of both air pollution and climate change, threaten medicine’s core mission. They harm health and threaten health care delivery, making our jobs not only harder, but sometimes impossible.”

Too heavy of a lift?

As The Climate 202 reported last month, 61 of the nation’s largest hospital and health-sector companies have joined the Health Sector Climate Pledge to cut greenhouse-gas emissions in half by 2030. 

The commitment is meant to help advance President Biden’s target of reaching net-zero emissions by 2050 and includes more than 650 hospitals and thousands of providers, including two of the five largest U.S. private hospital and health systems, Ascension and CommonSpirit Health.

“The health care industry has come to realize that traditional health care accounts for only about 20 percent of an individual’s (or community’s) overall health,” said Craig Cordola, Ascension’s executive vice president and chief operating officer. “Social determinants and one’s physical environment play an even greater role. It’s imperative that we focus where we can have the greatest impact.” 

But Ebi said that it’s difficult to uproot the entire energy system of a health facility. For one, cost is a major factor. Depending on the institution’s profit margin, switching to sustainable machines that leak fewer greenhouse gases might not be possible given their routine expenses. 

There are also some things that hospitals can’t adjust, such as leaving the lights on overnight or being unable to reuse certain plastics for hygiene, to satisfy medical protocols. 

What’s on the horizon for hospitals

Still, Ebi mentioned that there are smaller opportunities that hospitals can — and should — be pursuing to reduce their carbon footprints, whether that be through energy and waste management or by working to improve the well-being of patient communities. 

Each of the organizations that signed onto the pledge — which included public hospitals, health-care centers, pharmaceutical companies, medical-device makers and suppliers — are expected to develop climate-resilience plans for their facilities, including plans to support individuals or communities most vulnerable to the effects of climate change.

According to Ebi, any plan should mention what she called the “low-hanging fruit,” including: 

  • Understanding your patient base, and how it could shift with climate change
  • Outlining community vulnerabilities to global warming (for example, care centers that are based in a flood plain)
  • Planning personnel schedules around forecast weather events, or rescheduling surgeries to ensure anticipated surge capacity
  • Providing opportunities for patients that benefit their health and the environment, such as a garden to supply fresh food for the cafeteria

As for Ascension, the system aims to reach net-zero carbon and waste by 2040. In its climate-resilience plans, Cordola said it will work closely with the individuals and communities most vulnerable to the impacts of a warming planet. 

“Our focus is on creating healthier communities, including reducing the effects of climate change,” he said. “Leading health systems like Ascension have a role to play in demonstrating our commitment to this work not only to others in the health care industry, but to other industries as well.” 

On the Hill

Exclusive: Former EPA administrators push for confirmation of enforcement nominee

Five former Environmental Protection Agency administrators from both Republican and Democratic administrations are calling on Senate leadership to confirm a permanent head of the agency’s enforcement office before the August recess, according to details shared exclusively with The Climate 202.

David Uhlmann was nominated by President Biden more than a year ago to lead the EPA’s Office of Enforcement and Compliance Assurance, which is charged with holding companies accountable when they violate the nation’s environmental laws. But Senate Majority Leader Charles E. Schumer (D-N.Y.) has yet to discharge the nomination vote to the Senate floor after the Senate Environment and Public Works Committee voted 10-10 in April to advance Uhlmann’s nomination. 

A Schumer spokesman previously said in an email to The Climate 202 that “David Uhlmann’s nomination is a priority and we hope to move to discharge soon.”

In a joint letter signed by the EPA administrators from the Reagan, H.W. Bush, Clinton, W. Bush, and Obama administrations, the people argue that Uhlmann’s background as an environmental-crimes prosecutor for the Justice Department does not justify the prolonged delay and instead allows dangerous pollution to continue to go unregulated. 

“We are concerned about the decline in EPA enforcement that has occurred over the last decade, which leaves vulnerable communities less protected from the harmful effects of pollution and puts law-abiding companies at a competitive disadvantage with companies who flout the law,” they wrote. “The failure to confirm an EPA enforcement chief compounds these problems.”

The joint statement was signed by Lee M. Thomas, William K. Reilly, Carol M. Browner, Christine Todd Whitman, and Lisa P. Jackson

Climate policy hangs in the balance after Manchin upends talks

Sen. Joe Manchin III (D-W.Va.) on Friday indicated that he is unwilling to strike a deal on new climate spending over inflation concerns, all but collapsing the Biden administration’s goal of quickly reducing the nations greenhouse-gas pollution. But as Congress remains in a gridlock, the planet continues to warm, Jonathan Weisman and Jazmine Ulloa report for the New York Times. 

The move has frustrated many environmentalists and progressive Democrats who argue that sweeping action is necessary to avert existential disaster, with Rep. Pramila Jayapal (D-Wash.) saying that Manchin’s decision after months of negotiations was “nothing short of catastrophic.” Still, climate change remains an issue that has little power for either party in the face of a weakened economy, despite the nation being the second-largest emitter on Earth. 

Meanwhile, Congress’s failure to secure concrete action on climate has not only wounded trust at home, but also abroad, Maxine Joselow and Brady Dennis reported for The Washington Post on Friday.

“U.S. climate envoy John F. Kerry speaks well about what needs to be done by all countries, but loses credibility whenever the U.S. is unable to deliver even the most modest actions that the U.S. government has promised,” Saleemul Huq, director of the International Center for Climate Change and Development in Bangladesh, said.

Pressure points

The U.S. plan to avoid extreme climate change is running out of time

The United States is falling incredibly short of President Biden‘s 2021 promise to slash emissions by 50 to 52 percent by the end of 2030 compared to 2005 levels, Chris Mooney and Harry Stevens report for The Post. But now, without a major spending package in Congress focused on climate, those emissions reductions are becoming virtually impossible. 

The decision by Sen. Joe Manchin III (D-W.Va.) not to move forward with new climate spending “makes it harder, and it makes any additional actions by the executive branch that much more critical. The stakes are now that much higher,” said John Larsen, a partner with the Rhodium Group, a research firm that closely tracks emissions policies. 

Several analyses have suggested that policies like those contained in the Senate legislation could have accounted for about a billion additional tons of annual U.S. emissions reductions. 

When broken down, however, each of those tons connected to ambitious policy accounts for how much time small islands have to adapt to sea-level rise or whether the Arctic would still have sea ice in the summer, among other extreme events fueled by warming. 

On the Hill this Week

On Tuesday: The House Natural Resources Subcommittee on Energy and Mineral Resources will hold a legislative hearing to examine four pending bills, including one to no longer allow mineral development on certain lands operated by the Interior Department’s Bureau of Land Management

  • The Senate Energy and Natural Resources Committee will meet to assess the authority of federal agencies to regulate the development of interstate hydrogen pipelines, storage, import and export facilities. 
  • The House Oversight and Reform Subcommittee on the Environment will hold a hearing to discuss the role that agriculture can play in combating the climate crisis while increasing food production. 

On Thursday: The House Natural Resources Subcommittee on Water, Oceans, and Wildlife will hold a hearing to consider pending legislation, including a bill Introduced by Rep. Katie Porter (D-Calif.) to reauthorize funding for the Bureau of Reclamation’s Climate Change and Water Program, which requires the agency to create strategies to mitigate the future impacts of global climate change on water resources.

In the atmosphere

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