Rekubit-A Medical Toolkit for Climate Resiliency Is Built on the Latest Epidemiology and ER Best Practices

Harvard University’s Chan School of Public Health has developed a Climate Resiliency Toolkit to aid emergency rooms and Rekubitclinics with protocols for robust medical care during climate emergencies, based on the assumption that they now affect every person on the planet. 

The toolkit, developed jointly by Americares and Chan’s Center for Climate, Health, and the Global Environment contains specific resources and guidance for administrators, physicians and patients at frontline medical clinics to proactively address climate-induced medical emergencies. 

Currently, it is being piloted in 19 clinics along both coasts of the U.S. as they are especially prone to the wildfires, hurricanes and floods. Researchers will formally touch base with clinics in the fall to receive deeper feedback on the toolkit’s performance. 

However, in light of the extraordinarily hot summer, researchers have released the toolkit’s heat resources in Spanish as well as English and are simultaneously piloting a heat alert system that notifies clinics two days before their vulnerable populations are likely to face extreme heat.

Dr. Aaron Bernstein, interim director of C-CHANGE, explains that ensuring healthcare providers have the knowledge to address climate-related challenges is vital. “You can pick any person alive today and find a way that climate change matters to their health,” he said.  

Dr. Caleb Dresser, director of healthcare solutions at C-CHANGE, emphasizes the toolkit’s evidence-based approach. “We offer resources for both clinical staff and administrators providing actionable information that is based on the best available epidemiology and emergency management literature,” he said.  

The Climate Resilliency Toolkit aims to bridge the gap between awareness of climate change impacts and the ability to respond effectively through a series of digital fact sheets for healthcare providers, patients and administrators. Dr. Dresser hopes for a future where climate change is acknowledged to have a large impact on public health.

“What I would like to see long term is a world and a healthcare system in which we look at climate change and climate-related hazards as influencers of health and have intervention that we can deploy to keep people safe or to help them keep themselves safe,” he said. 

This, he explains, is the aim of the toolkit.

The toolkit offers specific, actionable solutions to mitigate the health risks associated with climate change. For example, in its patient-directed fact sheet on heat-related emergencies, the toolkit advises individuals to “avoid sugary drinks, alcohol and caffeine,” monitor the color of their urine and details what to do in case of heat exhaustion and heat strokes. “There are very concrete, straightforward things we can do to try and get a leg up on staying out of harm’s way when these climate shocks happen,” Bernstein explained.  

Feedback from clinics already using the toolkit has been positive, with many finding the resources helpful for both administrators and patients. “We’ve already heard from some clinics that many of the resources are really helpful in providing clear, concise guidance both to administrators and patients about what can be done in advance of disasters,” Bernstein said.

While the toolkit is still in its piloting phase, it has already seen success at clinics like San Jose in Houston, which serves an entirely uninsured population. The toolkit is helping the clinic overcome challenges like those it encountered during Hurricane Harven in 2017. “Even in our preparation there were still so many lacking pieces that we encountered, we did not know how long we would be in the situation,” Dr. Adlia Ebeid at San Jose said.

Often, Ebeid explained, “we just pulled in different pieces from different angles, trying to piece this puzzle together to react as opposed to really being prepared for the climate disaster.”

She explained that the proactive resources and guidance provided by the toolkit have aided her in being prepared for excessive heat, floods and hurricanes, when they come.

Recognizing the global nature of climate change, the toolkit is preparing for international implementation as well. “We have received some funding from Johnson & Johnson to start work internationally. The first country we’re working in, again in partnership with Americares, is the Philippines,” Bernstein said. 

In the long term, Dresser hopes the toolkit will encourage healthcare providers, policymakers and the public to view climate change as an integral part of public health. He believes this shift in perspective will be crucial in developing comprehensive strategies to protect vulnerable populations and reduce the health impacts of climate-related emergencies.