Resiliency, Adaptation and Preparedness
All of us who lead busy, fast-moving lives where it is important to be able to pivot when problems arise, know about planning and preparedness. It is what we do.
Now it is what our civilization needs to do!
Contents:
Resiliency, adaptation and sustainability
Resiliency, adaptation and sustainability
Resiliency: The ability to respond to immediate changes that threaten our ability to thrive and even survive. The ability to bounce back from a challenge.
Adaptation: Fundamental and foundational changes to increase the ability to survive. Longer term and often larger scale than resiliency.
Sustainability: The ability of the natural world to replace what resources we use long term. It is not sustainable to live as we do in the United States and some other countries as we use more resources than nature can replenish (as much as five Earths worth!).
It wasn’t long ago that adaptation to climate change was considered secondary, almost a forbidden topic, a form of defeatism, not likely to be all that helpful in any case if things got out of hand.
It was the plan to mitigate climate change so that adaptation would not be a major consideration.
After all, an ounce of prevention is worth a pound of cure.
That has not happened.
We are too far behind, we are already experiencing the pain of climate change, and it will get worse.
Mitigation is, of course, critical to prevent more damage and to keep climate change to a level where we can hope adapting and building resiliency can help us survive and thrive.
We have to build resiliency and adapt; there is no choice.
Personal and household resiliency
We can prepare ourselves and our families for emergencies.
Clinicians can make suggestions to patients . Rather than a long discussion in the clinic, a handout with information, websites listed below, and some local agency contact information could be helpful.
Many of the suggestions in the section on personal actions will help with building personal and family resiliency.
We might not use the term “adaptation” for personal efforts; we cannot in a meaningful way adapt sufficiently if our communities are not adapted.
No matter how wealthy or how far off the grid you are, if things get bad enough, you will be impacted. We need all hands on deck to stop that from happening! But we can strive for some personal resiliency.
The World Health Organization has suggestions for dealing with extreme heat, as does Yale Medicine. The National Weather Service has a one page PDF handout about dealing with extreme heat.
Be prepared:
You must be prepared, just as our communities, nations and the world must be. The next disaster may be where you live, and you can’t wait for the politicians to act.
Emergencies and disasters, advice from the professionals for individuals and families:
From the Red Cross: https://www.redcross.org/get-help/how-to-prepare-for-emergencies/make-a-plan.html
From the CDC: https://emergency.cdc.gov
From Homeland Security: https://www.ready.gov
The important general points:
Know what disasters are likely to occur in your area and look at websites and other sources about those specifically.
The websites above are worth at least glancing through for those postings most relevant to you.
Find out if there are local government and relief agencies that may have specific advice or would take charge in a disaster and whom you can contact if you need to communicate.
Know your neighbors’ contact information to coordinate efforts if possible.
For weather-related events like storms or floods there are many government and weather site alert systems available. This is the National Weather Service: https://www.weather.gov/alerts There are other alerts, including apps.
Wildfires are a particular problem related to climate change in many parts of the United States and the world. Plan ahead and prepare your land and home as best you can: can you create an area that is less likely to burn your house in a wildfire? Do you have N95 or KN95 masks in case you are exposed to smoke from a wildfire? Indoor air pollution (in general, but particularly with wildfires) is more severe than you might think. Consider air purifiers for your home, especially if someone in the household has asthma or other lung or heart conditions.
For wildfire alerts in California: https://www.readyforwildfire.org/more/ready-for-wildfire-app/
Other wildfire information: https://www.ready.gov/wildfires
Here is another site for wildfires: https://livingatlas.arcgis.com/wildfireware/
In many areas, and not just out west, wildfires are a problem made worse by invasive plant species, and that suggests steps we can take.
https://anrcatalog.ucanr.edu/pdf/8397.pdf
Have a plan and checklist for emergencies:
Each household member has a role that others can take up if the person in that role is absent.
Know where things are that you might need immediately (car keys or fob, phone, phone charger, flashlights, first aid supplies, drinking water, appropriate clothing if you have to run out into the cold or rain).
Have plans on how to contact each other and a place to meet up if separated.
Have lights that are battery powered, such as lanterns and flashlights. Make sure they work and that you have extra batteries.
Consider an emergency radio that you can hand crank for power as well as a battery-operated radio or one that is solar powered (not so much for hurricanes!).
Have an escape route and possible places to go mapped out. They may not be feasible, perhaps have alternatives routes as well.
It isn’t necessary to become a survivalist, but try to have the basics covered until systems can be restored or relief help arrives. Some suggest 2 weeks of provisions, (food and water), but certainly at least 5 days if storage space is a problem. Have food that may not need cooking, unless you have something portable like a propane stove for camping or an electric burner, assuming you have electric power or backup. Also, foods that don’t need refrigeration are good. If you have canned foods, make sure you have a manual can opener; the electricity may be out!
Look into water jugs meant to store water long-term (not the typical plastic water is sold in, which isn’t as safe for long-term storage of drinking water because of the chemicals in the plastic) that you can add a solution to keep it safe for a long time, or date them and change the water. Older water can be used for things like flushing toilets.
Is your house storm ready? The roof? Drainage? Do you know where flooding is likely to happen and have escape routes?
The New York Times has a guide for products that may help with emergency preparedness.
Besides the general advice on preparedness for disasters, those with chronic diseases may need to take additional precautions.
The Centers for Disease Control has a website page on how to manage your chronic disease during a disaster with many PDFs that can be printed out.
The American Cancer Society has advice for cancer patients on preparing for a weather emergency for cancer patients, including what to do after a natural disaster. The American Kidney Fund, The Arthritis Foundation has some practical suggestions as well. The Diabetes Disaster Response Coalition has a handout for diabetics.
These webistes recommend some practical ways to prepare that are relevant to all individuals with chronic disease when facing a natural disaster, especially when evacuation may be necessary at a moment’s notice or if community resources are constrained for some period of time: bring/have at least a 3-day supply of medications (and know if they need to be refrigerated; if so have a small portable cooler and ice or equivalent). If you have a special diet, say for diabetes or kidney disease, have some meals ready to go. Make sure you know how to handle medical devices (for example, oxygen tanks in the context of a wild fire, blood sugar monitoring kit if diabetic), talk to your healthcare provider ahead of time (for example if you live in an area with extreme heat, wild fires or floods) for any specific considerations in your case and how they or their coverage may be reached, make sure you have insurance cards with you, have a brief written summary of your diagnosis and treatment with contact information for your providers, if you are at particular risk for infections make sure you have a mask and sanitizer if you have to go to a public shelter.
Personal and household long-term resiliency:
Learn to do more with what you have, be responsible, network, have friends, love the ones you love.
You don’t have to live off the grid, that is not likely what you want to do with your life, and it is a full-time job. You probably have a life that is not just dedicated to personal survival if you are on this website. Being off the grid probably won’t protect you or your family anyway for long if we don’t get on top of this. You can’t hide.
You can try to be more energy efficient and relatively independent. This can include upgrading appliances for water and power savings, weather-proofing, sealing ducts and having insulation, painting your roof white, and installing solar electric panels and a battery if you can afford it and own your home. See Lifestyle Changes.
How to Prepare for Climate Change, a practical guide to surviving the chaos. David Pogue. Simon and Schuster, 2021. The subtitle captures the occasional “survivalist” tone of this long and detailed book, but there are indeed a lot of excellent suggestions for dealing with problems climate change inflicts on us already, from small suggestions for increasing resiliency to preparing for large disasters.
There also may be local groups working on community resiliency. For example, in Los Angeles there is the Neighborhood Council Sustainability Alliance.
Household resiliency includes decreasing the harm from pollution, especially indoor pollution.
Secondhand smoke is an important indoor pollutant. This can come from tobacco products, fireplaces, and wood stoves.
Be careful and sparing with cleaning materials and similar chemicals. Ventilate well when cleaning, painting, varnishing and other times volatile materials are used..
Carbon monoxide detectors for the home are available.
Maintain gas furnaces, stoves and gas hot water heaters. Testing for leaks in natural gas pipes can be considered. Furnace filters should be changed regularly.
Air purifiers, including portable models meant to filter a single room, can remove many, but not all pollutants. HEPA filters can be considered for removing particulate matter. They are effective for allergens and even particulates way smaller than PM2.5 (as small as 0.3 microns).
Wear KN95 masks if near large concentrations of particulate pollution such as wildfires.
Social/emotional resiliency:
Be a solid, responsible citizen. Take pride in your work. Take care of those who need you. Take care of yourself. You got this, as a health professional and a human facing tough times. I know because you are reading this, so you care, and you are resilient. Remember: caring goes deep in us.
The Big Picture
• Wicked problems and the commons
The problems of resiliency and adaptation are, like all aspects of climate change and environmental degradation, wicked problems (yes, that is recognized jargon).
A wicked problem is one with at times unclear markers of success (at least in a timely fashion if the effects are delayed), complex interactions requiring risk:benefit calculations with insufficient information, and necessary trade-offs where there will be some who are harmed by many, if not all, proposed interventions.
It is difficult to have markers to fully predict and evaluate programs of adaptation, but that is not to say that there aren’t sophisticated quantitative tools for assessing projects.
For example, the Global Commission on Adaptation (the World Resources Center and United Nations Resources Institute) used a publicly available tool to predict that early warning systems can play a critical role relatively cheaply, while new infrastructure was more expensive but also very effective. This is intuitive, and likely true. Such tools may miss some complexities, however. Not all predictive models can be sufficiently robust to quantitate all the possible outcomes and complexities. It is possible that not all infrastructure costs will be integrated in the model, for example (see seawalls, below). Because this is a wicked problem that is huge, immediate, complex and very human, that doesn’t often lend itself easily to masked, controlled studies, surveys, focus groups and case studies are also sometimes helpful.
We are trying to read the tea leaves while drinking the tea. Wicked.
It is also the problem of the commons that frustrates our efforts: some actors profit more by doing nothing or actually causing harm and letting others worry about the consequences. The term is based historically on the British community commons, a public patch of green where all could graze their cows, though some over-grazed while others stuck to the agreement.
• Who’s going to do this?
- The international community and governments
The problems are often those that nations and the international community must address. Many require international agreements and have international implications that don’t respect political borders.
Recognizing the reality that climate change was here at the 16th session of the Conference of the Parties (COP)* meeting in Cancun, Mexico (part of the United Nations Framework Convention on Climate Change, UNFCCC) in 2010, an Adaptation Committee was formed, and nations were asked to develop national adaptation plans (NAP).
In 2015, the Paris Agreement article 7 was about adaptation, and governments submitted an intended nationally determined contributions (INDC) for fighting climate change, including a section on adaptation (later the word “intended” was dropped, now it is NDC).
*The alphabet soup is included as these terms may come up in your reading and in the news.
The United Nations has funds to help (the Global Environment Facility, the Adaptation Fund and the Green Climate Fund).
Governments can develop policies, fund and regulate the agricultural sector, infrastructure, energy, transportation, and health and disaster planning to encourage adaptation and have resources to fund research and organize information.
When planning for adaptation, it is hard to have a unified large-scale plan, as adaptation is a long-term process that is responding to a changing environment and local factors can be important to consider. It may be best to pursue shorter-term projects that can themselves adapt to changing needs.
Do all efforts of adaptation have to be mandated from above, top-down big government to be grand enough to succeed? Not at all. In fact, local actions are often best planned and executed by local governments and community groups who know the needs of the area. However, there are risks: local power structures and vested interests, as well lack of local resources and expertise, can hamper local efforts.
- Nongovernmental actors
It isn’t just up to governments, though they have the most power and presumably (best case scenario) the interest and mandate, to make the policies that adaptation requires in order to maintain peace, stability and the “pursuit of happiness.” Civil society organizations (CSO) can play an important role. Relief agencies and health systems on the ground can strive to be prepared and advocate for local solutions and climate justice.
- What about market forces?
Industries are a source of innovation and progress. Unfortunately industries and individual corporations tend to have their own limited agendas, often geared for short-term gain. Much of what they have done has been ineffective (“greenwashing” to look good), or at best modest efforts at decreasing or offsetting GHG, with little attention paid to resiliency or adaptation. There are exceptions, companies that have made real efforts and real contributions.
The positive effects that the economic benefits of “mature” alternative energy technologies such as solar and wind power, and the stimulation to efficiency that carbon pricing can have on industries, is important for mitigation, and are not likely to have analogous effects when it comes to adaptation (see our what can be done section).
In fact, some estimate that two-thirds of the cost of mitigation is borne by the private sector, yet only 8% of financing for adaptation is from the private sector. Perhaps the right incentives aren’t there yet.
However, many corporations and other large institutions, including in the healthcare and academic sectors, have sustainability offices and goals. Consumers have made a difference by demanding more green goods and services.
Maintaining infrastructure and supply chains is certainly important to industry, so perhaps there is hope for more input of substance regarding adaptation from the private sector. There are indictions that industry is paying more attention.
Certainly the insurance industry is giving all this some thought, given the costs of covering the destruction!
- This is a big picture problem that takes well thought-out action at all levels
It is important to take the big picture into consideration. It is “sexy” to have a big project with a big answer (especially if someone profits from it and there are short-term gains, such as jobs), but sometimes there is no choice, you have to go big. Some cities on rivers and flood plains, and coastal cities around the world, have projects to prevent flooding. Some of these are massive projects. These are critical and include the diversion of water, building and maintaining levees, moving structures, and building seawalls and flood gates. These are absolutely necessary to prevent devastating damage in many cases.
However, some efforts may actually be maladaptations.
Take seawalls: they are extremely useful in select situations, but they are expensive (missed opportunity costs, taking vast sums of money that can be used for other forms of mitigation and adaptation) and they create greenhouse gases (GHG) when being built. They use a huge amount of cement, which creates large amounts of CO2, and the construction of seawalls requires fossil fuel-powered heavy machinery, transportation of materials and personnel, all of which produces GHG.
Seawalls can wreak havoc on surrounding coastal communities, as the diverted water goes somewhere. In response, seawalls are built by adjacent communities to divert the diverted water in a chain reaction. Seawalls also have to be maintained, using more resources (lost opportunity cost again), and creating more GHG. One step forward, how many steps backward?
Some adaptations are less controversial. Local interventions can be critical (as in “think global, act local”). Fire prevention by clearing brush and pursuing other preventative measures, maintaining wildfire-fighting capabilities, and having a rapid response to fires with robust early warning systems, are examples of important adaptations.
We need to be certain that our local, state and national infrastructure, including airports, public transportation, roads, bridges and the power grid, is up to the stress climate change will entail. We have to make sure our representatives know this is important, and that they must not kick the can down the road to avoid taking necessary action for political reasons or because of special interests.
Adaptations are probably most successful and lasting when the adaptation is less top-down and more integrated incrementally as part of accepted “mainstream” efforts in established institutions that are involved in health, social services, emergency management and other infrastructure/development sectors. On the other hand, in some areas these institutions are seen as corrupt or inept.
Healthcare professionals and others with relevant expertise can play a role by using their voice and expertise to help in these efforts. Disaster preparedness is critical and requires commitment from members of the healthcare system at multiple levels and coordination with governmental agencies.
Academic and professional institutions and organizations can play a role (see groups). This can be through research, advising policymakers, social and political action, or designing projects that help policymakers make better decisions.
For example, a group at UCLA developed a “heat map” where policymakers, physicians and the public can learn about how many people are going to hospitals and emergency rooms in California for heat-related problems so they can be better prepared.
Much of this section was adapted from the book Climate Change Adaptation, Lisa Dale. Columbia University Press, 2022. Part of the excellent series of Columbia University Earth Institute Sustainability books. An excellent introduction to big-picture policy regarding adaptation.
• What can we do about the big picture?
We can support those responsible for making policy decisions who do their job and give the policies life.
We can vote for those who care, and contact legislators to encourage and correct them.
We can support groups that are making an effort to increase resiliency and adaptation and those who do research and teach.
Look out for local efforts, and perhaps advocate for some that are likely to be useful if not available. Are there local early warning systems and are the local authorities trained in disaster relief?
We can educate ourselves and our communities, speak to our family, friends and neighbors as if our futures depend on us getting this right. We need to “mainstream” this!
We must let politicians know that it is not acceptable to prevent agencies from doing their job to protect us.
For example, we rely on the Federal Emergency Management Agency (FEMA) to plan and be there for all of us in an emergency, regardless of political ideologies! Yet the 2019 FEMA National Preparedness Report did not even mention sea level rise or climate change, clearly a political decision by an administration hostile towards efforts to curb climate change.
Another thing we can do is increase personal resiliency. At least we can take care of our part of the commons.