Many places in the world with the highest PM2.5 levels are also urban areas vulnerable to the health risks of extreme heat (doi:10.1136/bmj.n2467).4 Even in Europe the heatwave of 2003 resulted in 70 000 excess deaths;and heat related deaths, primarily from “urban heat islands,” will increase by a factor of 50 by 2100 (doi:10.1136/bmj.n2438).5 Regions of high particulate air pollution and extreme heat are also affected by vaccine injustice—the gross inequity worldwide in vaccine supply and manufacture. If countries that make vaccines will inevitably think of themselves first, then the only solution is to ensure that manufacturing capability exists in as many countries as possible in each region (doi:10.1136/bmj.n2375).6 Inequalities lie at the heart of crisis after crisis, and tackling them must be a priority—for example, in the response to pressures on the UK’s NHS (doi:10.1136/bmj.n2456),7 a crisis that politicians seem intent on downplaying just as frontline professionals and patients see the service falling apart (doi:10.1136/bmj.n2590;doi:10.1136/bmj.n2572;doi:10.1136/bmj.n2594).8910 Nor do politicians seem willing to fully accept the role of covid-19 (doi:10.1136/bmj.n2606;doi:10.1136/bmj.n2597;doi:10.1136/bmj.n2573),111213 and the urgent actions now needed to limit its effects (doi:10.1136/bmj.n2595).14 A new modelling study projects up to 60 000 deaths from covid-19 over the winter unless vaccine boosters are delivered to vulnerable populations and people older than 50 and transmission is controlled (https://bit.ly/3BhsOcT).15 Indeed, a recent government expert review supports the role of airborne transmission and the benefits of mask wearing and improved ventilation (https://bit.ly/3govX).16 It’s little wonder, then, that by ignoring its own science on covid measures and launching a misguided, ill timed, and damaging war on GPs the government seems to be living in its own “multiverse of madness” (doi:10.1136/bmj.n2570;doi:10.1136/bmj.n2584;doi:10.1136/bmj.n2587).171819 How can young people rescue the future from this distressing reality? The onus on world leaders gathering in Glasgow is to abandon their hubris, politics, and pride and instead see the future through young people’s eyes. 1 Wise J. The doctors getting arrested for climate change: a professional duty? BMJ 2021;375: n2565. 2 Chen H Kaufman JS Olaniyan T. Changes in exposure to ambient fine particulate matter after relocating and long term survival in Canada: quasi-experimental study.
Memo to COP26 leaders: abandon your hubris, politics, and pride and see the future through young people’s eyes