Climate crap in a medical journal

No sign of critical thought.  They just assume the truth of global warming holus bolus.  Given what we know of the replication crisis, low-grade reasoning is to be expected in even prestigious medical journals.

And these authors below are real dumb bunnies, real patsies.  I wonder how they explain the fact that there was an 11 year hiatus in landfalling hurricanes in the USA before the present bout of hurricanes?  It does not remotely fit the global warming theory.

And why in any case are they confident of the cause of the recent hurricanes?  There is no way they can prove that attribution.  It's just faith supported by models with no known predictive skill

They probably feel warm assurance that they are going along with the consensus about climate.  Given how often the medical consensus has reversed (on dietary fat and much else) one would have thought that medical writers would be more careful about accepting a consensus.  But perhaps they know no history either

The Need to Integrate Climate Science Into Public Health Preparedness for Hurricanes and Tropical Cyclones

James M. Shultz, et al.

Hurricane Florence made landfall as a Category 1 storm near Wrightsville Beach, North Carolina, on Friday, September 14, 2018, with 90-mph winds. At the same time, 3 other named storms—Helene, Isaac, and Joyce—roamed the Atlantic; Tropical Storm Olivia had just passed over Hawaii; and “Super Typhoon” Mangkhut, the strongest tropical cyclone of 2018, was hours away from sweeping over the Philippines with 165-mph (Category 5) winds.

September is often a busy month for global tropical activity, but there has been a changing scenario in recent years. The warming planet is likely to be influencing the characteristics and behavior of extreme storms.1 At the same time, public health preparedness is not keeping pace with advancing climate science knowledge about how tropical storm systems are changing and potentially becoming more dangerous.1 A closer integration of climate science with public health planning and response will be essential to mitigate the worsening health consequences of future extreme storms.

New Developments in Climate Science

Several developments in the understanding of climate-driven changes in the behavior of tropical cyclones have implications for public health preparedness.

* First, the forward speed of storms over land has been slowing.2 Some storms deviate from their predicted course and stall. This pattern was evident for Hurricane Harvey in 2017 and again for Hurricane Florence as each storm generated record-setting precipitation rates and rainfall totals.3

Water hazards, rather than winds, are posing the major risks to coastal populations. Evacuations are geared toward areas of expected storm surge. Changes in storm behavior are complicating emergency response because of the unpredictability of freshwater flash flooding. Both Harvey and Florence produced relentless precipitation and widespread inundation extending far inland.3 Unable to pinpoint which areas would be submerged, many residents could not escape the flood threats. Improvised citizen-initiated water rescues likely saved many lives during both storms.

* Second, some tropical storms undergo extremely rapid intensification.4 This was seen with the strongest storms of 2017—Harvey, Irma, and Maria—and during the initial development of Florence. Storms are reaching and maintaining very high peak intensities, as happened with Irma in 2017.5 Major hurricanes (Category 3 and higher) may also be increasing in frequency.1

* Third, storms such as Mangkhut are reaching peak intensity farther away from the equator.6 Such “poleward migration”6 means that, in the western North Pacific hurricane basin, strong storms can now cause severe damage on coastal populations living farther to the north. Populations that were previously rarely affected by hurricanes and, thus, whose built environments are structurally vulnerable to tropical cyclone winds and surge, are now within the reach of these powerful forces.

* Fourth, recent experience has highlighted the disproportionate risks for climate-induced public health consequences encountered by residents of small island developing states. Island-based populations dwelling in the ocean corridors above and below the equator, where tropical systems develop, contribute negligibly to climate change but are vulnerable to the effects of extreme storms.7,8

Lessons From Hurricane Maria

If the nature of storms is changing, the public health consequences of these storms will also likely change, as exemplified by Hurricane Maria. Maria became a Category 5 storm in the eastern Atlantic, decimated the island nation of Dominica and St Croix, and bisected Puerto Rico. Maria exemplified rapid intensification over anomalously warm waters, which are becoming more common, and produced high-end wind, surge, and rainfall hazards.

Puerto Rico was paralyzed as Maria destroyed the electrical grid and disrupted vital infrastructure. Loss of power led to protracted disruption of hospital operations and access to life-sustaining treatments. Without power or available health care, the people of Puerto Rico sweltered for months in high heat and humidity and were involuntarily exposed to contaminated water supplies and vector-borne disease risks.8

The debate swirling around a small vs large death toll in Puerto Rico attributable to Maria distills to one core distinction. A limited number of deaths occurred because of direct exposures to the storm’s hazards as Maria moved across Puerto Rico on September 20, 2017. Advanced storm detection and warning systems alerted residents to take shelter (island populations cannot evacuate) and minimized fatalities from hurricane-force winds, storm surge, and mudslides. However, in the months following Maria, the inability to restore power and health care services in a timely manner contributed to thousands of storm-related excess deaths.9

Improving Public Health Response to Match the Changing Dynamics of Tropical Systems

The global public health challenge related to storms is bound to become more complicated in the coming years. Therefore, it seems important to integrate climate science into population health science and to ensure that the public health response evolves to reflect changing climate realities. There are at least 4 important considerations to meet this challenge.

The first is to establish public health surveillance of storm-affected populations. Hurricane Maria highlights the need to extend the monitoring of storm-related medical conditions and mortality to include the recovery and reconstruction phases. Surveillance needs to include the physical and mental health conditions that emerge months after the storm strikes the area and represent some of the most consequential public health outcomes. Public health and response capabilities need to maintain a better watch over storm survivors whose communities often require years to recover.

Second, tropical cyclone water hazards will become increasingly important determinants of health. It is evident that more people will be exposed to surge, rain, and flood hazards as coastal and island populations increase. This will require innovating water management and flood mitigation, extending flood insurance coverage to more citizens, and improving water rescue capabilities.

Third, public health preparedness for tropical storm hazards must expand its purview. In 2017, across all storms and affected populations, the single deadliest hazard was storm-damaged infrastructure throughout the Caribbean. Anticipating this challenge requires state-of-the-art reformulation of electrical power, water, and health care systems and training cadres of specialized response professionals.

Cuba serves as an example of the life-sustaining potential of this approach. Cuba redesigned its ailing, blackout-prone power system around a decentralized, microgrid architecture. Cuba trained teams of electrical power specialists to respond during power outages. Hurricane Irma put Cuba’s energy self-sufficiency to the test, battering the Cuban Keys and northern coast with Category 4/5 winds for 3 days. Power was initially disrupted for most of Cuba’s 11 million citizens. Specialist brigades deployed and rapidly repaired damaged segments of the grid, restoring power to 70% of citizens within 10 days and nationwide within 3 weeks. Indeed, in the United States, regional responses often do occur, with large numbers of power specialists traveling from unaffected states to affected states as happened when 15 million Floridians lost power during Irma. In addition, before Irma made landfall in Cuba, 1.4 million residents were relocated to shelters. Thousands of physicians and health care professionals were embedded in these shelters, prepositioned in remote areas, or on duty throughout the nation’s network of neighborhood polyclinics, all equipped with generators. Although hundreds of clinics sustained damage, these distributed services ensured that there was no discontinuity in health care access, even as Irma was striking.

A fourth enhancement to public health response will be to advocate for upgrading building codes and retrofitting coastal and island built environments to withstand stronger storms. Extending community storm resilience is essential as more citizens populate coastal areas and stronger storms extend their reach into latitudes farther from the equator.6


As climate scientists expand knowledge about climate-induced effects on storm behavior, health professionals must transform these findings into innovations in public health preparedness. The challenges posed by climate change will only intensify in coming years; population health will be served by adapting to these evolving realities.


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