Thursday, October 10, 2013

Book Review: Fevered

by Duncan Gromko


More than anything else I’ve read about climate change, Linda Marsa’s new book, Fevered, illustrates how the changing climate is already affecting people’s lives and how much worse it’s going to get. By focusing on the Western world and primarily the United States, Linda told me she is trying to send the message that climate change “is not something that is going to happen in 20-30 years. It’s going to affect you. I wanted people to wake up.”

Linda Marsa
Linda makes climate change personal with her emphasis on its public health implications. She writes that climate change “could lead to the collapse of our normally well-functioning public health system.”

For instance, she describes the outbreak of dengue fever in towns along the Texas-Mexico border. In 2005, doctors diagnosed a patient in Brownsville, Texas with dengue hemorrhagic fever, which was thought to exist only in the tropics. This prompted health officials to investigate the extent of dengue infections. They found that nearly 1,300 people were infected by dengue fever at the peak of the outbreak.

Of all the public health risks that climate change will exacerbate, the one I found most surprising is the role of CO2 in trapping other pollution. In cities, where CO2 levels can reach up to 600 parts per million (compared to the global average of 400 ppm), CO2 acts as a “carbon canopy,” preventing health-damaging pollutants from escaping. A Stanford University study found that these “domes” might be responsible for up to 1,000 additional deaths from respiratory diseases every year. Moreover, increasing temperatures and the resulting increase in ozone levels, also increase the presence of respiratory diseases. For every 2°F increase in temperature, respiratory-related hospitalizations increase by 4.5%.

That’s why Linda calls climate change a threat multiplier. It doesn’t create new problems. It makes existing problems worse. We’ve always had hurricanes and heat waves, but climate change will make them hurt more.

I thought Fevered came up a little short in offering solutions. Linda writes that we need a “Medical Marshall Plan” to reinvigorate our public health system and increase our resiliency to the effects of climate change. But the book doesn’t illustrate how more funding for the Center for Disease Control will allow us to cope with the threats that Linda describes. I think one reason that people are not motivated to support climate change action more enthusiastically is that there is a feeling that climate change is inevitable and the situation is hopeless. I wish Linda had brought to life the possibilities of a resilient health system with the same vividness that she described the scariest threats from climate change. The solutions she does propose are also limited to adaptation strategies – there’s little mention of how we can reduce greenhouse gas emissions.

Linda is most optimistic about how local governmental and civic institutions have responded to threats. Even in conservative areas of the country, local leaders recognize that adaptation to climate change is an imperative. Orange County, for example, has become a world leader in water management as they attempt to adapt to the desiccation of the South West. Considering that the US government can’t even keep itself open, it’s no surprise that Linda and others are looking to local institutions to pick up the slack. Whether or not they can respond at the scale necessary to mitigate the impacts of climate change is unclear.


I’m grateful that Linda wrote Fevered. It’s well researched, easy to read, and most importantly, focuses on a dimension of climate change that has been under-reported. I hope that the public health angle of the book will draw the attention of new audiences to climate change.