Net-zero Emissions Future
Inquiry--Debate Continued
February 14, 2023
Honourable senators, I rise today to speak to Senator Coyle’s inquiry on climate. I will focus on the impact of climate change on human health, and how health care systems could respond.
To begin, let us acknowledge the leadership and hard work that Senator Coyle has demonstrated in creating and advancing Senators for Climate Solutions.
Climate change is not only a threat to our global environment and economy, but it is also an existential threat to human health and our health care systems. In 2009, the medical journal The Lancet identified climate change as the most significant global health threat of the 21st century. These impacts are both direct and indirect. In terms of direct impacts, frequent extreme weather events, such as floods, hurricanes, heat waves and wildfires, impact both health and our ability to provide health care. Various water-borne diseases occur in flooded areas, and access to timely, critical care becomes extremely difficult due to damages to infrastructure, such as roads and bridges. Wildfires disrupt access to acute care sites, while concurrently increasing demand for care due to their impact on respiratory conditions. We are all aware of the impact of hurricanes on health care infrastructure, and how heat waves lead to increased deaths.
Perhaps less appreciated, however, is the indirect impact of climate change on the geographical spread of disease, or the emergence of new diseases — especially infectious diseases. For example, in my home province, there has been an increase in tick-borne infections that can lead to Lyme disease. This is due to an increase in the numbers and longevity of blacklegged ticks as a result of warmer winters. Their biting spreads the bacterium Borrelia burgdorferi, the cause of Lyme disease, resulting in increased numbers of people who have contracted the disease. According to the Canadian Public Health Association, this outcome — of indirect climate change impacts on human health — is driven by numerous complex changes in the pathways of disease transmission that are sensitive to climate changes. For example, the West Nile virus arrived in Ontario in 2013, and has since spread across that province.
I want us to be aware — now — of some of the nasty tick‑borne and mosquito-borne illnesses that seem to be spreading into Canada due to our changing climate. They have impressive names, such as human granulocytic anaplasmosis, babesiosis and La Crosse encephalitis. Trust me; none of us wants to have a severe case of any of these diseases, even if we could pronounce their names. Their impacts are most severely felt in populations that are already at risk of poor health, and face barriers to appropriate affordable housing, food security and quality health care. The impact of climate change will make those inequalities worse. Addressing this issue requires dealing with the social determinants of health, as well as undertaking actions needed to protect health care settings from severe weather events, such as moving them away from flood plains.
We need to be ready. There are two key areas where preparation within our health systems is needed now: These are treatment readiness and risks to health infrastructure.
The first area is treatment readiness. As we all remember, when COVID-19 arrived, we were not prepared. We had insufficient stockpiles of personal protective equipment; we had insufficient surge capacity in our emergency rooms and intensive care units; our surveillance, reporting and tracking systems were inadequate; we lacked national coordination in our response; and much more. This must not happen again. We need a coordinated national disease surveillance capacity with single-point national accountability. This includes a national health database that can provide real-time information to guide policy decisions, and help direct resources and interventions where and when they are needed.
We also need to be able to rapidly provide treatments that we expect may be required. For example, to treat many various tick‑vector bacterium diseases, effective antibiotic treatments are available; there are medications such as doxycycline, clindamycin and azithromycin. They are not exotic drugs; they are commonly used medications.
But as we have learned, we can’t expect that just because they are commonly used that they will be there when they are needed. We are now experiencing challenges obtaining other types of common medications, such as paediatric fever and pain medication. I recently went to Shoppers Drug Mart stores all over Ottawa to try to find specific medications for sinus congestion and found only empty shelves. We can’t let ourselves get into the same situation again.
In conjunction with this is the preparation of our health care providers. I know there are a number of excellent physicians in this chamber. I do wonder, however, how many of us, if faced with a person who presented with persistent and severe malaise, sweats, headaches, nausea and fatigue, would consider a diagnosis of babesiosis? If our basic workup identified the presence of a hemolytic anemia, which is a condition where red blood cells are being destroyed, we would certainly look at all possible causes, but we might not think of asking for a microscopic parasite analysis or ordering a babesia IFA antibody test.
To be clear, this is not pandemic preparation I am talking about. We might indeed experience pandemic disease outbreaks due to climate change, but we might more likely see a gradual increase in various types of infectious diseases. They will slowly sneak up on us unless we are keeping a close eye out.
In September 2020, The Lancet published “A pledge for planetary health to unite health professionals in the Anthropocene,” which proposed an interprofessional planetary health pledge. The pledge adds protecting planetary health to the fundamental commitments health practitioners make when they enter their profession.
Recognizing that, the Canadian Medical Association’s 2020 strategic plan mentions environmental well-being. The Canadian Federation of Medical Students, through its Health and Environment Adaptive Response Task Force, has been working on developing educational materials that could be embedded in medical curricula.
While much more needs to be done, initiatives across all of Canada’s medical schools are under way, and I am pleased to say that the Faculty of Medicine at Dalhousie University is one of the early leaders in this work.
I have great faith in our infectious disease colleagues. I know they are up to this challenge. I would also like to acknowledge and thank our colleague Senator Osler for her exemplary national work on this file.
I am hopeful that this necessary work will be done well and expeditiously.
The second is the risks to health infrastructure. Health infrastructure is something that many of us, especially in large urban areas, take for granted. The hospital? Yes, just down the road. Ambulance station? There is one about 15 minutes away. Drug store? There is one in the Rideau Centre.
Health care settings are subject to extreme weather events that can damage or destroy anything from roads, making it difficult to access a hospital in an emergency, to damage to ports and, thus, to the smooth functioning of the medical products supply chains. This reality raises the uncomfortable possibility that when this critical infrastructure is most needed, it can be unavailable.
Let’s take the issue of floods, for example. In a study of the impacts of floods on health infrastructure, it was noted that health care facilities faced both diminished capacity and increased demands. Regarding the recent floods in Bangladesh, UNICEF noted that:
The flooding damaged water points and sanitation facilities increasing risk of waterborne diseases . . . . Access to healthcare and nutrition services was reduced due to the damage of 90 per cent of health care facilities.
Closer to home, during the recent British Columbia floods, numerous patients had to be evacuated from hospitals and long‑term care facilities, and access to acute-care settings in flood‑ravaged areas became problematic.
A recent flood mapping exercise of Canadian health care centres at risk of flooding concluded:
There are a surprising number of facilities at risk of flooding in most provinces and territories. Manitoba and Yukon have the largest percentage at risk of flooding. . . . Yukon’s high percentage of facilities in the floodplain and small total number of facilities illustrate how weather-related disasters driven by climate change could disrupt and damage important health infrastructure when it is most needed.
So, in the face of our climate change reality, what is to be done? Thankfully, many things. We can consider opportunities for action in two complementary categories: developing environmentally sustainable health care facilities and creating climate-resilient health care facilities.
Health care systems account for about 4% of total global carbon emissions, and health care facilities can act to substantially reduce their carbon footprint. At COP 27, the World Economic Forum produced an article entitled “Here’s how healthcare can reduce its carbon footprint,” which addresses this important issue. For example, hospitals have the highest energy intensity of all publicly funded buildings and emit 2.5 times more greenhouse gases than commercial buildings. Therefore, switching from fossil fuels to renewable energy can have a major impact.
Other innovative solutions can also help.
Another direction is shifting outpatient care away from hospitals into more energy-efficient community settings and by increasing the use of high-quality virtual care with less environmental impact, such as home-based health monitoring systems and telehealth care. A secondary gain will be the avoidance of travel from home to hospital, thus decreasing the carbon footprint of transportation.
Health care facilities also need to become more climate resilient. In this domain, some good initiatives are under way. I will briefly touch upon a few of them here.
The World Health Organization has created the WHO Guidance for Climate Resilient and Environmentally Sustainable Health Care Facilities. More recently, the WHO report, Measuring the Climate Resilience of Health Systems, has provided substantial guidance on how to mitigate climate-change impacts on human health and health care.
Our federal government has created the Climate change and health vulnerability and adaptation assessments: Workbook for the Canadian health sector. This is designed to help health care facilities evaluate and then address their climate-change preparedness.
The Canadian Coalition for Green Health Care, in partnership with the Province of Nova Scotia, has created The Health Care Facility Climate Change Resiliency Toolkit that can be used by health care settings to assist them in their climate preparedness work.
As we can see, honourable senators, much work is being done, but much more is needed.
Canada’s health systems, collectively, have the third-largest per capita carbon footprint in the world. Our health care systems were responsible for about 5% of Canada’s annual greenhouse gas emissions prior to the pandemic. Per-capita GHG emissions in our health sector actually increased from 2018 to 2019.
In 2021, Canada committed to the WHO COP 26 Health Program initiative directions, which include building climate‑resilient health systems, developing low-carbon sustainable health systems, adaptation research for health, the inclusion of health priorities in nationally determined contributions and raising the voices of health professionals as advocates for stronger ambition on climate change. To those, I would add this: ensuring that our Indigenous, Inuit and Métis communities are fully integrated into the creation, development, deployment and evaluation of all the work that needs to be done.
We need a cohesive national initiative to set directions, coordinate efforts across jurisdictions and support legislation and implementation of sustainable changes to health systems. That will require collaboration amongst federal-provincial-territorial partners; input from Canadian expertise, such as Health Canada, the Public Health Agency of Canada, l’Institut national de santé publique du Québec, our universities and granting agencies; and international expertise, such as the WHO and the U.S. Centers for Disease Control and Prevention. The National Adaptation Strategy currently under way is an ideal place to address this need. We must not let this adaptation strategy get stranded on the rocks of inactivity.
This is a tall order — an existential challenge — but it is our challenge. As we Canadians have shown time and time again in our history, we are up to any challenge. Wela’lioq, thank you.
Honourable senators, I rise today to speak in support of the collaborative efforts in raising our awareness of the challenges facing our global environment. My remarks today will briefly focus on the marine sector and share some of the progressive efforts of that sector to improve its environmental performance generally and specifically here in Canada.
Before I begin, I want to acknowledge the leadership of our colleagues Senators Coyle and Kutcher, who have provided such by bringing together Senators for Climate Solutions. They have organized discussions and presentations by international and national experts working to inform the public and governments of the serious climate change challenges facing our planet, and as one of our presenters so poignantly noted, “it is not just about saving our planet; it is in fact about saving humanity.”
I thank Senators Coyle and Kutcher for their leadership in that area that is so important for all of us as global efforts need to contribute to work that will build on and find solutions to slow down, and hopefully some day reverse, climate change and its devastating effects.
Marine transportation has always been a backbone for moving people and cargo locally, nationally and indeed globally. There is no denying its impact on our global economy. Over the past couple of years, we’ve seen serious disruptions in global supply chains resulting in shortages of essential goods and rapidly increasing prices. Indeed, this situation was and is driven largely by high consumer demand, and this in turn has resulted in historic cost for marine shipping. After all, globally, approximately 90% of everyday goods from food products, electronics, automobiles, clothing, energy products, furniture — you name it — is mainly moved by vessels.
In the Canadian context, over 80% of our everyday goods pass through our ports. Our 17 Canadian port authorities handle 340 million tons of cargo every year, maintain over 200,000 jobs and contribute a direct economic impact of $36 billion.
With the huge volume of vessels moving around the globe and the continuous operation of ports — all essential activities supplying goods to our world community — there’s no doubt that we need to advance ways of reducing their environmental impact. So, too, is taking a global approach in finding solutions to reduce the environmental impacts of this shipping activity.
The United Nations’ International Maritime Organization, more commonly referred to as the IMO, is the focal point for working with its 175 member states in dealing with all matters tied to shipping. It has four pillars of focus, one of which deals with the prevention and, indeed, the reduction of pollution from ships.
Over the decades, numerous standards and regulations have been collaboratively developed by this organization, dealing with numerous topics such as increasing strict regulations concerning ships’ discharge, rules governing the handling of ships’ water ballast to reduce the risk of invasive species being introduced to domestic waters, requirements for the types of paint ships may use — that may sound strange, but ships use a lot of paint — eliminating things like lead and so many other initiatives that are aimed at reducing ships’ environmental impacts.
But perhaps one of the more important initiatives has been the establishment of Emission Control Areas, which are areas that have been designated in different regions of the world where ships must burn fuels that are required to dramatically reduce emissions such as sulphur, nitrous oxide and others.
In our case, together with the United States, our Emission Control Area creates a 200-mile-wide boundary that requires vessels to burn much cleaner fuels while operating offshore and coming into our waters. This ensures that vessels operating in our coastal waters and ports have significantly reduced emissions, delivering important benefits to large segments of our population as well as to our marine and terrestrial ecosystems.
Canada itself has also provided leadership in this important area of reducing pollution and greening of operations at sea and in ports.
In 2007, various players in the marine industry in Canada formed Green Marine, the leading environmental certification program for North America’s maritime industry. It’s a voluntary initiative that helps its participants to improve their environmental performance beyond regulations. Green Marine targets key environmental issues related to air, water, soil quality and community relations. It’s an inclusive, rigorous and transparent initiative that brings together several types of participants: ship owners, ports, terminal operators, shipyards and the seaway corporations based in Canada and the United States.
To obtain Green Marine certification, participants must complete a progressively rigorous process that has clear, measurable results that are audited by industry experts every two years to ensure results are maintained while encouraging continuous improvement. The membership also encompasses associations, supporters and partners that each, in their own way, support participants in their efforts to reduce their environmental footprint.
From its humble beginnings that focused on the Great Lakes and St. Lawrence Seaway, Green Marine now brings together hundreds of members from across North America with different backgrounds that all share the same objective: to improve the maritime industry’s environmental performance through concrete and measurable actions.
Its influence has reached across the Atlantic Ocean to France, where Green Marine Europe was formed in 2020. It operates on the same proven model created right here in Canada. Most recently, a large ferry operator in Australia has become a member of Green Marine, clearly demonstrating its value, its work and its leadership in addressing marine-related activities at sea and in port, and how steps can be taken to reduce environmental impacts. I applaud the great work of Green Marine and the leadership it provides on that global stage.
As a long-serving CEO of one of Canada’s busiest ports, Port Saint John, New Brunswick, I would be remiss if I did not speak briefly of our Canadian port authorities and how climate change can affect them and our economy. I would also like to mention some of the initiatives they have introduced and continue to implement.
Ports are part of Canada’s critical infrastructure, connecting land to water and subsequently connecting interior roads and rail links that are particularly vulnerable to climate change-related weather, erosion, fire, flooding, rising water levels and other events.
A couple of examples demonstrate the reality and the risk potential of these climate change-related factors. All of us can recall the fires and floods that affected our West Coast ports, notably Vancouver. Those events cost our economy billions of dollars and significantly disrupted our supply chains. Our West Coast ports are not alone, as our central and eastern ports have also experienced various weather events that have disrupted operations and compromised supply chain efficiencies.
Our ports also face other significant climate change risks, such as in the Tantramar marsh area that connects New Brunswick and Nova Scotia. That area is protected from flooding by a series of very old dikes that will fail as weather events continuously promote erosion and rising sea waters, which will, in the short-to-medium term, exceed the limits of protection offered by the dikes.
Failure of these dikes is not an option as the Port of Halifax, Canadian National Railway and the Trans-Canada Highway — all critical components of Canada’s supply chain — cross the marsh and would be inoperable. Certainly, such a failure would have disastrous effects on local communities such as Sackville, New Brunswick, and Amherst, Nova Scotia, as well as many others. That flooding would have a devastating impact on local, provincial as well as our national economies.
Our ports have also been taking action to reduce and mitigate their own impact on climate change, while taking action to protect the environment and port ecosystems. All Canadian port authorities are members and active participants in Green Marine, and I’m pleased to say that they have been very successful in advancing through the various levels of the program.
Ports are committed to improving their performance and hold themselves to account, not only for the ongoing greening of their operations, but also to being responsible partners with their local communities. The development of port environmental policies is another aspect of this, as well as environmental audits and reports that make themselves accountable to the public. The creation of green programs — such as reduced rates for shipping companies that operate vessels accredited with their own green programs that guide reduced emissions from their operations — is another way of promoting ports’ activities in this area.
Ports are creating port-public and Indigenous partnerships to ensure concerns and inputs help guide port projects in an environmentally sustainable manner. Ports are also providing vessels that are capable of “plugging into” shore power facilities, thereby allowing the vessel to shut down fuel-burning generators and engines while in port. Ports are also providing the protection and creation of fish habitat. They are working with local experts, universities, colleges, Indigenous groups and environmental groups in creating monitoring and protection programs from marine mammals and other species, and there are so many other initiatives.
Finally, I want to mention initiatives that Port Saint John has undertaken. It will see them source 100% of power for all cruise terminals, corporate offices and port-owned terminals from the soon-to-be-commissioned nearby Burchill Wind Project, drastically reducing the port’s carbon footprint. This fits into the new Port Saint John decarbonization and sustainability plan, which is being developed in partnership with stakeholders, including a post-secondary pitch competition all about decarbonizing the port ecosystem with New Brunswick students.
In closing, I hope my presentation underscores that today there is a renewed interest and a sense of urgency to push further and faster to build a green economy that includes an environmentally sustainable marine sector. I hope that I painted a picture that clearly shows that Canada is indeed a world leader in the marine sector, as it is in other sectors in advancing climate change solutions.
Thank you for listening, and again, I want to thank Senators Coyle and Kutcher for their leadership. Meegwetch. Thank you.
