Introductory Chapter: Transitioning International Health Security Focus from COVID-19 Pandemic to Climate Change

1. Introduction

The current Coronavirus Disease 2019 (COVID-19) pandemic has changed virtually every aspect of our societal matrix and daily existence, considered from both individual and collective perspectives, for generations to come. It has transformed our healthcare systems, how we work and study (e.g., widespread implementation and acceptance of remote presence), existing supply chains, biotechnology and information technology industries, in addition to re-defining (and reinforcing) our understanding of the term, carpe diem. For many, work-life balance turned upside down, as home-based work became the norm. At the same time, hands-on education (e.g., nursing and medical training) became the norm for the future generation of doctors and other medical providers [1, 2]. Finally, the pandemic also made us acutely aware that we live in a global community, and how very quickly challenges that start in one area of the world can spread and become substantial global issues. A pictorial representation of keywords and themes related to the current discussion is provided in Figure 1.

Figure 1.

Pictorial representation (word cloud) of keywords and themes related to the current discussion.

During these turbulent times, humanity came together to devise novel treatments, vaccines, and other far-reaching scientific and clinical advances. These considerable developments will endure both as a proof of our collective achievements when working together as a civilization and as a reminder of our ability to overcome the nature’s indifference and, at times, ruthless power. Although the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pathogen will undoubtedly keep surprising us with new variants and mutations, the overall “advantage” may have gradually shifted toward human ingenuity and resourcefulness. Consequently, it is the Editors’ hope that the pandemic is now on its “last legs” and that a “new normal” will continue to be restored over the next several years. But, we also recognize that we will continue to see spikes and surges and variants of all flavors may come and go as we all continue to learn and adapt.

2. Re-focusing for the future

The current book reflects the current “out-of-pandemic” transition while ensuring that our focus on the overall “health security” remains laser sharp, primarily because numerous international health security threats remain. The biggest and most pronounced contemporary challenges are now clearly emerging, and the now undisputed climate change dominates the priority list [3]. As these words are being written, forest fires rage across numerous geographic areas of the world, while a combination of unpredictable flooding and droughts (due in large part to climate-dependent redistribution of water resources) threaten to make entire regions of the planet uninhabitable. Along with climate change, we are very likely to see an increase in natural disasters and various other health risks. Among these emerging health risks are malnutrition/food insecurity, the appearance of invasive species, and acceleration in discovery of novel pathogens [4]. Accordingly, these “continuation and readiness” themes warrant more attention and in-depth discussion. Regarding the specifics of climate change, what is also of substantial concern are not just the primary issues (as mentioned), but also some of the unknown and/or intended consequences that will only be fully appreciated as we collectively experience this global megatrend. For example, recent heat waves in England have impacted airport runway and train track usability—and hence the mobility of a work force that resulted in reports of healthcare workers being unable to travel to work in remote areas of the country. Similar concerns are occurring across the world and involve a mixed array of factors, from extreme heat waves, to rapid saltwater intrusion across coastal freshwater reservoirs, to tidal flooding and to extreme wind events such as cyclones, hurricanes, and tornadoes [5, 6].

3. The “forgotten” pandemic

When looking at the COVID-19 pandemic, including some of the more common points of scientific focus, it becomes clear that there are several topics that have not received as much attention as they arguably deserve. These relatively “neglected” areas include the effects of COVID-19 on pregnancy and the perinatal period, the pandemic-related appearance of toxic stress, as well as some of the corresponding “lessons learned” during the pandemic. Additionally, more emphasis is needed when it comes to new and emerging concerns related to topics of climate change and its effects on human, animal, and environmental health and well-being, as well as the importance of system-wide adaptation in the context of the anticipated increase in natural disaster frequency and severity. An important discussion on occupational accidents provides a excellent segway into non-pandemic topics, followed by a compendium on the impact of climate change on international health security. In this manner, we hope to “transition” the focus of our future work away from the COVID-19 pandemic and toward the overarching issue of climate change and its effects on the well-being of humans. Nevertheless, the impact of COVID-19 cannot be overstated, especially with regard to its global implications on healthcare delivery, mental health consequences, our overall collective response, as well as any other secondary implications—such as increasing reports of opportunistic pathogens, surprising pathologies and disease patterns that have resulted from “letting our guard down.” This includes spikes in cancer and cardiovascular disease rates due to less-than-optimal health maintenance and follow-up availability during the pandemic.

4. Climate change and pandemics: A call to action

Climate change with its forest fires, floods and droughts, as well the colonization of pristine forests by humans is causing the depletion of wild animal reservoir species, transforming zoonotic into anthroponotic pathogens with the emergence of super plagues, a real menace to mankind. Almost all of the most impactful human plagues in history are either zoonotic or originated as zoonoses before adapting to the human host. As mentioned, it is the Editors’ hope to see this COVID-19 pandemic subside; however, this is just one of those plagues that have evolved and managed to adapt to humans. As a matter of fact, there are likely many similar coming plagues, and it is just a matter of time before the next one enters our reality. One potentially impactful action we can undertake to more effectively face this treat can be the creation of an integrated human, animal, and environmental international health surveillance system that can provide early detection of emerging diseases outbreaks, nutritional vulnerabilities, and non-communicable disease patterns. Some might suggest that this falls under the domains of the World Health Organization (WHO) or even the United States (and other similar) Centers for Disease Control (CDC). However, the response should not be limited to the traditionally understood “experts” and should be much more “grassroots” in character. If we have learned anything from the events of the past few years, especially with the political agendas, concerns of “fake news,” conspiracy theories, religious/cultural beliefs, distrust in the scientific methods, and the roles of industry—the one overarching take-home message is that there is clearly a lot of room for improvement in our response as rapidly evolving global concerns emerge [7, 8, 9]. Such global monitoring paradigm can help facilitate the reduction of various impacts of climate change, implementing a rational use of water and land, and preserving biodiversity. In turn, the aforesaid initiatives can translate into downstream benefits that could be expected to ameliorate the impacts of climate change on human, animal, and environmental health and well-being.

5. Synthesis and conclusion

In conclusion, the Editors of the current volume of the International Health Security series hope that the reader will discover a valuable resource that is both comprehensive and easily accessible. When we began this book series, we did not expect that it will evolve into a multi-tome collection. We certainly hope that the continued success of the initial installments in this series, along with the addition of the current book, will provide justification for further work in this important area.