When I first read about the possibility of a multibillion-dollar bailout of the oil and gas sector by the federal and Alberta governments, I was exhausted. I was exhausted from days of ER work, personal protective equipment drills, obsessive counting of ventilators and considering how to encourage Canadians to have courageous conversations around end-of-life care. I was too exhausted to even think about responding. That was precisely the point. Oil and gas companies, lobbyists and the decision makers they have formed relationships with are counting on Canadians being too occupied coping with an ongoing health crisis to register that our country is considering a massive transfer of public funds to support the very industry most likely to cause the next health crisis. And the health crisis after that. And the health crisis after that.

This is unacceptable. Climate change must factor into all of our plans. Recall that just before the coronavirus took over our lives, Australia was on fire — with 20 per cent of its forests burned in a single year. I contributed remotely to grand rounds at a Sydney trauma hospital where ICU and ER staff gathered to discuss patients in critical condition due to smoke-inhalation injury and severe burns. UNICEF, the WHO and the Lancet created an index of “child flourishing,” where Canada ranked 21st out of 180 countries in support for present-day child health, but 170th in terms of sustainability, making us one of the wealthy countries that “threaten every child’s future through climate change.” Our current crisis highlights the need to take planetary health, defined by the Lancet as the “health of human civilization and the state of the natural systems upon which it depends,” into account. The virus of zoonotic origin currently bringing the globe to a near-standstill transferred into humans due to a lack of care at the interface between humanity and the rest of the natural world. Pre-COVID-19, the World Economic Forum’s 2020 Global Risks Report emphasized that the majority of major risks facing the world in terms of both impact and probability have to do with this intersection — they were right.

The only possible positive outcome of this tragedy is a generational pivot: For us to rise to the COVID-19 challenge with courage and unity, learn all we can and surge into a post-pandemic world committed to preventing further crises and bolstering resilience to any that may occur. Knowing that only about 20 per cent of overall health status is determined by health care, this means pushing for measures that make life outside of the hospital stable, clean and equitable. The path to safety includes a national pharmacare system to help avoid future supply shortages, a basic income guarantee and ensuring newly virtual care remains public. It also means investing in renewable energy, funds to support oil and gas workers as they transition to a low-carbon economy and an independently administered fund for cleanup of orphan oil and gas wells. We have a generational opportunity to use this time of crisis and reflection to bring to life a vision of planetary health for all. From what I see in the ER, we are feeling this moment in our minds, in anxiety and decreased ability to sleep, and in our bodies, in tension headaches and stomach aches. Humans need a lot of love right now. And yet, this crisis has already taught us much. It has never been clearer that we are all in this together. Inequality hurts everyone. The spread of this virus, accelerated by inadequate health care, unavailability of swabs, and lack of paid sick leave in the United States, increases the risk for all — not just the vulnerable. Lives are saved when we listen to experts and act within recommended time windows. And when we work together, we can change the world quickly for the common good. In Yellowknife, long-awaited programs such as virtual care and managed alcohol provision blossomed in days as part of our adrenalized coronavirus response. In the time it took me to write this, the Northwest Territories reported its first case of COVID-19. My husband, our hospital’s medical director, midway through his first day off in weeks, is on the move. I don’t know when we will next have a moment to come up for air. So, as we turn toward the hospital, I have a task for those who are outside it. We have a generational opportunity to use this time of crisis and reflection to bring to life a vision of planetary health for all.

As we battle for the health of Canadians inside the hospital, I implore non-health-care providers to stand on guard outside its walls, both through social distancing and by ensuring that the policies we pass at this tipping point of change benefit the many instead of the few, and set us up for a post-COVID-19 future we can step into with confidence.