Earth, air, fire and water – since the earliest years of civilisation when we first congregated into cities, we have thought of these as the elements of our environment. We live on the earth and use it to build our homes and grow our food, we breathe the air, we use fire to warm us and cook, and we require water to drink and to sustain our crops. Each of these essential elements also includes the potential for harm, from an insufficiency or, most notably recently, disastrous floods, storms, landslides, droughts and wildfires.
There is a fifth element of the environment that is sometimes forgotten as it includes us – the biomass. Have you ever thought of yourself as a bit of biomass? When, at funerals, the minister tells us that we all came from dust and are destined to return to it, we are hearing a profound truth. All the atoms, the elements of our bodies which we acquired from the food and water we consumed over our lives are indeed returning to the earth and air in the great cycle of life. The forces of evolution have given us, Homo sapiens, the power of reason, the ability to ponder these facts and to explore the mechanisms behind them. To do so leads to a sense of humility, but to understand them also gives us power that few if any other species have ever had. We can change our environment fundamentally, for better and for worse, and this is what we have been doing since the Industrial Revolution.
Collectively over the millennia of civilisation the most imaginative among us, philosophers and scientists, have come to an understanding of mankind's place in the environment of Earth, and this is shared as common knowledge. Humanity has a common brain that allows us to understand what no other species can, and we use it to our perceived advantage. But we also have a common underlying driving force which we do share with all other living organisms: the imperative to survive and to reproduce our species. Unfortunately, as in all species, this force overrules all others, including common sense. It is the force that answers the question as to why desperate Afghan refugees have such large numbers of children.
Over the past 18 months, I have been writing about two major environmental catastrophes that have been foreseen for decades but for which we, in the UK and internationally, were unprepared. Climate collapse and pandemics are associated, both in causation and in consequences. It is no surprise that they have occurred simultaneously, nor that our governments should have been so poorly prepared. Ideology unsupported by factual evidence is a form of magical thinking.
In the UK and more broadly, the concept that everything can be left to an unregulated market has now been shown to have had the opposite effect to that expected (wealth trickling down) by its adherents. Now we have a huge and increasing gap in wealth between the rich and the poor. The concept that all problems would be solved by release from the fetters imposed by Europe is similarly being discovered to have been folly. Both concepts were promoted by wealthy individuals who expected (largely correctly) to benefit personally from their adoption – they appealed to personal and collective greed for wealth and power, gaining the support and votes of the uncritical masses.
None of our present challenges are likely to be easily fixed, to use a verb beloved of the Prime Minister. On the contrary, his stated ambition to 'level up' our social differences is becoming even more difficult to achieve as the effects of Brexit, the pandemic and climate change are all hitting the poorest hardest.
Mr Johnson is temporarily in a key position to influence other world leaders on action to reduce the impact of climate change and we must hope that his recent conversion to environmentalism is sincere. This commitment must be continuous and prolonged, looking well beyond any future election, and must be backed by public money being diverted from politically expedient matters to long-term green energy projects. If he is sincere about reducing the gross financial and social inequalities in the UK, there are great opportunities to combine this with action on housing and energy supply. Perhaps other political parties will notice this, shed their ideological quirks, and concentrate on attacking the big problems.
With respect to COVID-19, we are now in the First World War situation of stalemate. It is the endemic situation I discussed in an earlier article in which the big waves of severe illness become multiple smaller ones, ripples that nevertheless represent many hospitalisations and deaths (15 September 2021
). These are sufficient to keep the NHS and social services under intense pressure, and so more routine services, such as non-urgent surgery and home visits to the disabled and elderly, start to fail.
In Scotland, we did indeed have a fifth big wave; this was short-lived and we are now recording daily deaths in the 20s but infections in the 2,500s. Across the UK, the numbers of infections are proportionately much higher and rising, over 45,000 infections daily, but so far death rates are proportional at about 200 daily. At such times, the efficiency of the test, trace and isolate system is critical. This has been the outstanding failure of governments during the pandemic but does seem to be improving somewhat, at least in Scotland.
The reason the sea has calmed a bit is primarily vaccination, but this is not a panacea. We can still catch COVID-19 and indeed die of it, even if fully vaccinated. The likelihood of doing so depends on exposure to infected people, both in terms of numbers of contacts and the closeness of the contact. In other words, the risk depends on our own behaviour much more than any action the government takes. However, governments can influence us with sensible advice, and the cautious action in Scotland of requiring masks to be worn indoors in public places and in requiring us to show evidence of vaccination at large events is wholly prudent and correct. I expect and hope that England will get the message shortly.
Meanwhile, we must press on with what is likely to become a permanent cycle of mass immunisation, improved contact tracing and continuing use of personal protective measures, including widespread use of masks. Fortunately, the greatest success in the whole sorry story of COVID-19 is that vaccine technology has improved dramatically, and it is possible even to hope that vaccines against multiple common viruses and their genetic variants will become available. Already we have seen extraordinary advances in the speed at which vaccines can be introduced although mass worldwide distribution is likely to remain a huge problem.
I have previously described climate change and pandemics as existential threats to civilisation, comprising, with socio-financial inequity and warfare, the four modern horsemen of the apocalypse. The word 'existential' is often used lightly; I use it in its literal sense. We have seen civilisation break down in many countries, currently Afghanistan, Lebanon and Ethiopia, and have seen it seriously tested in USA as the mob stormed the Capitol. Such threats require long-term solutions, longer than the life of any government. Part of the solution must be in understanding the causes and reasons why proposed remedies have failed to ameliorate the problem.
We shall soon, during COP26, see how seriously the world's leaders take climate change and what solutions they endorse. But next week I hope to discuss the lessons we have learnt from the pandemic so far and how we can adapt as a society in order to co-exist with this virus.
Anthony Seaton is Emeritus Professor of Environmental and Occupational Medicine at Aberdeen University and Senior Consultant to the Edinburgh Institute of Occupational Medicine. The views expressed are his own