Medscape 2050: Renee Salas
'Indirect impacts of climate change on healthcare delivery are broad and insidious,' says Renee Salas. MD, an emergency room physician at Mass General whose work has focused on the climate crisis. 'They can range from supply chain disruptions to power outages to more patients displaced from their home healthcare system.'
As the lead author of the Lancet Countdown on Health and Climate Change U.S. Brief since 2018, founder of its Working Group, and co-director for the Climate Crisis and Clinical Practice Initiative in partnership with The New England Journal of Medicine, Salas has a breadth of knowledge on how climate change is impacting healthcare worldwide. But she has also seen the damage in her own practice. When Hurricane Helene hit the southeastern US, it caused IV saline shortages, forcing Salas to hand out Gatorade to patients in need of fluids.
By 2050, the global temperature is forecasted to be 2 °C above preindustrial levels. 'Extreme heat events that would only occur twice a century without climate change are predicted to be nearly 14 times more likely to occur with increased intensity,' Salas warns. The 2021 Pacific Northwest heat wave in British Columbia caused over 900 excess deaths as emergency rooms were not used to accommodating the heat.
The hotter world will also bring more wildfires, droughts, destructive hurricanes, and floods. 'Right now,' says Salas, 'healthcare is reactive and unprepared.'
Health outcomes will be increasingly impacted by what happens outside the doors of a hospital or a clinic room. And Salas urges healthcare systems to embrace preventative models, including more flexible and nimbler care delivery. We need 'individual heat wave plans, income-based energy assistance, protective cooling, home weatherization, and even home biosensors for patients who are at high risk.'
Facing this issue can be a unifier, Salas believes. 'Healthcare can be that bridge that works across silos for an integrated health centered response, embedding cross sector collaboration with entities like the energy sector or urban planning to create a healthcare system in 2050 that is ready for what climate change brings.'
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