On July 26, 2023

Health effects of climate change are showing up at the hospital


By Dr. Dan Barkhuff

Editor’s note: Dr.  Dan Barkfull is an emergency department physician at UVM Medical Center.

After years of Covid, I’d gotten used to the respiratory complaints. At the height of it, it felt like every patient I saw in the UVM emergency department was there for shortness of breath and fatigue. It seemed half of Vermont couldn’t breathe. 

2020 was bad; 2021 was worse. Once the vaccine came out, the pandemic eased, but, oddly, the respiratory complaints did not.

Vermont’s population is aging rapidly and it’s going to continue. In part, this is due to an influx of older newcomers seeking the bucolic small towns, the healthy living, and the quality of life that consistently places Vermont atop national rankings of best places to retire, though it’s driven by native Vermonters growing older and living longer, an undeniable good. 

But the aging population places pressures upon already strained health care resources in a state just beginning to be impacted by climate change. The severity of this change, unanimously among models, will only increase. The only question is how much.

The fires in Quebec, indeed all of Canada, have filled the air with haze since early June in Vermont. During that same time, hospital admissions for respiratory complaints have increased. It’s not the virus that’s killing and hospitalizing Vermonters now; it’s the air we’re breathing. 

Pediatric asthma visits are up, as are visits to the emergency department for heat exhaustion and dehydration among the very young and the very old alike. Existing scientific studies show that, as the mercury climbs, so do hospital admissions. This is the new normal, in a state listed in almost every index as one of the very best — if not the best — “climate refuge” in America.

Vermont stands to weather the accelerating climate changes better than many places in the U.S., but that is an extremely low bar. Natural disasters will increase globally, and Vermont, according to the state’s own projections, will see an increase in deep, wet snow, flooding, and days over 80 degrees Fahrenheit, among other changes. 

While this will undoubtedly affect Vermont’s leading industries — tourism and agriculture — the trickle-down effects will manifest in health challenges for all, and have dramatic effects on the state’s second-largest employer, the University of Vermont Health Network. 

Simply put, sweltering heat waves, elevated air quality indexes, and floods are the new normal, and so is an average age of 80 on the acute care side of the University of Vermont emergency department.

If Vermont cannot scale solutions to climate change and its effect on our aging population, and fast, the results are going to make Covid look tame. We may be better off than other parts of the country, but we’re also in some ways less prepared for extreme heat. 

We would be wise to seriously consider the effects of lengthy periods of unprecedented heat on the health of seniors, impoverished individuals, and the young under these conditions. Air conditioning and air filtering are no longer a luxury; they are now the front lines of life support for those with medical comorbidities. 

The heat Vermont is feeling is only going to worsen, and there is no Moderna vaccine for the haze of a thousand wildfires. It is past time to address this coming health crisis.

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