- On January 10, 2020
- January / February 2020
Responding to Crisis
Climate change is impacting our health system. If we are going to respond to 21st century problems, then we need to employ 21st century solutions.
As I write this, Sydney is facing its worst day on record for smoke haze. People are being urged to stay inside and keep their windows and doors closed. Schools have cancelled outdoor activities, sporting groups have cancelled games, and workers have been forced to abandon work sites.
Air pollution is reaching unprecedented levels in the city. Across the whole Sydney basin, ultra-fine particle pollution was at ‘hazardous’ levels. This presents major health challenges for people with asthma and other pulmonary or cardiac conditions.
While the Federal Government continues to deny there is a direct link between greenhouse gas emissions and the fires that have ravaged the nation, the NSW Environment Minister Matt Kean was uncategorical about the weather conditions, telling attendees at the Smart Energy Summit in Sydney that this is “exactly what the scientists have warned us would happen.”
He added, “This is not normal and doing nothing is not a solution.”
From bad to worse
Experts are predicting that unless we receive substantial rain the ‘mega-fire’ on Sydney’s north-western outskirts will likely burn until the end of January or early February.
January is typically one of the hottest months of the year in Australia, and January 2019 was the country’s hottest month on record, since record-keeping began in 1910.
What does all this mean for the health of Australians?
There is robust evidence to show hot weather increases mortality in Australia, with air pollution exacerbating this relationship.
Extreme heat conditions are associated with substantial increases in hospital admissions and deaths. There were 374 excess deaths during the 2009 Victorian heatwave, which represented a 62% increase in all cause mortality. Additionally, there was a 46% increase in ambulance emergency cases over the three hottest days; and a 34-fold increase of cases with direct heat-related conditions.
Projected increases in heatwaves will result in increased heat-related deaths and hospital admissions. Without strong mitigation, temperature-related deaths are expected to rise by 14% and 100% in 2050 and 2100, respectively.
Impact on hospitals
Can our hospitals handle the expected increases from a heatwave? The latest Hospital Quarterly report from the BHI shows a health system that is already under immense pressure.
The July to September quarter was the second time in 2019 that NSW public hospitals set an all-time record for the number of emergency department presentations. To better illustrate this, picture the entire population of Brisbane presenting to our ED departments from January to September.
Quarter on quarter, we are consistently seeing presentations to emergency departments climb over 750,000. There are no ‘horror flu seasons’ to blame this on. This is the consequence of an aging population that is increasingly dealing with complex, chronic conditions. And it will only be exacerbated by health effects of heat waves and air pollution.
Funding for hospitals is always a necessity but stop-gap measures are only helpful in the short-term. If we are to reduce the demand on our hospitals, we need a better understanding of how patients in NSW use the different services in the health system. Once we have a clear picture of the patient journey, we can take steps to minimise potentially preventable hospitalisations.
If we are to tackle the future healthcare challenges, then we must work smarter. Innovative strategies that integrate the health system and make better use of data will help us achieve that aim.