Transnational Environmental Restoration (TER) for Climate Solutions

Big Sur, CA Spring 2019

From Climate Change to Climate Crisis
It behooves us to entertain the validity of climate solutions from the perspective of systems thinking1. As we have outlined in our recent discussion of the increased risk of HIV, AIDS, IRIS and Neuro-AIDS consequential to climate change9, our survival, and the survival of all prokaryotes and eukaryotes, including mammals, and ultimately our species, depends upon their ability to adapt to changes in their microenvironmental milieu and to the challenges of their surrounding macroenvironment. Our microenvironment is our physiology: the context within which our organs, tissues, and the cells that compose our bodies survive, thrive, grow and divide. It is a biological system made up of complex and finely controlled pathways, regulatory feed-back loops and delicate biochemical check-and-balances, which together modify and modulate the expression of our genes to the ultimate end of improving our adaptability to the demands of the surroundings. These epigenetic alterations, which can be short-lived (i.e., one cell division), or sustained for several cell multiplication cycles, are concerted sub-cellular changes, intended to ensure our survival, although they may precipitate cell death either by necrosis or by the programmed process of apoptosis. Epigenetic changes are fundamental alterations in the organism’s molecular, biochemical, cellular and physiological balance, which we call homeostasis, in response to, and for the adapting to disturbances in the complex systems of biologic processes and responses that constitute its microenvironment. The microenvironment system, which preserves us into health and prevents us from falling into ‘dis-ease’, is constantly challenged by alterations in the macroenvironment system multidimensional set of factors (e.g., temperature, humidity, altitude) that surrounds us2.

What biologists and physiologists call the macroenvironment, earth scientists call the climate: that is, the set of data and evidence that defines and characterizes global patterns of weather beyond decades, into centuries and millennia. Climate patterns describe cyclical variation in several meteorological variables, including temperature, humidity, atmospheric pressure, sea currents, polar ice sheet, eternal snow packs, wind and precipitation, atmospheric particle count (O2 content, CO2 concentrations, methane and other toxic gases and particulates) in various regions of the globe over long periods of time. By contrast, the weather describes the short-term conditions of these variables in any given region.

As noted9, the climate of any specific region of the globe arises from that region’s climate system, which is dictated by properties of the air, the earth and the waters. Scientists describe the climate as composed of five distinct components:

  1. atmosphere (i.e., layer of O2, CO2 and other breathable gases),
  2. hydrosphere (i.e., the surrounding mass of water – sea or fresh, drinkable or toxic),
  3. cryosphere (i.e., the proportion of surrounding water that is in ice form),
  4. lithosphere (i.e., the solid mass in that region: ground, plains, mountains, sand, rocks), and
  5. biosphere (i.e., the extent to which that region can sustain life).

Significant variations in the balance of these parameters have been recorded across the globe (e.g., increased global temperature: global warming) in the last decades. These alterations bring about important changes in the earth climate, which are above and beyond expectations due to causes such as processes internal to the earth (e.g., volcanic activity), or external forces (e.g., variations in sunlight intensity). The Australian National Climate Change Adaptation Research Facility, the United Nations Framework Convention on Climate Change (UNFCCC) and other national and international organizations describe as climate variability those variations proved beyond doubt to be of non-human origins.

The changes in climate registered in the last 100-75 years are attributed primarily to wanton human activities9, such as massive and irresponsible deforestation, sea pollution, increased air pollutant emission, among many others. Human activities detrimental to the global climate are so intense and have been so persistent over the past centuries that, even if their effect have been curbed slightly in the past decade, the change in climate they have caused has become an emergency climate crisis.

Heat stress, breathable air and water – fresh and sea – acidity increase due to raised CO2 levels, clean water deprivation and drought, release of toxic gases are among the most important consequences to the climate change crisis all living organisms are experiencing at every latitude. It matters not what the weather is in any given site on any given day: climate patterns have changed widely worldwide. That the situation is growing worse by the day has contributed to the recently proposed Green New Deal10, which, while it is a laudable political effort that hold strong promise toward curbing some of these detrimental consequences, is yet imperfect and incomplete in the solutions it proposes11,12.

Experts do not speak of climate change any longer, but of a climate crisis: a serious, aggressive, existential and extreme crisis that threatens all species – vegetal and animal, is human beings included – and our planet. This is not an overstatement: climate data best available evidence base convincingly show the precipitating downward pattern of life on earth as a direct consequence of climate change2.

Seascape, Cambria, CA Spring 2019

The climate crisis brings along such gargantuan macroenvironmental alterations that our organisms are ill-equipped to face. It engenders medical emergencies that threatens our survival because it causes serious threats to biological system. Together, the macroenvironmental stressors of heat challenge, de-oxygenation and carbon dioxide pollution of potable and sea water sources with consequential poisoning of planktons and fish, air particulates and their impact on depressing cellular immune surveillance to a variety of blood and solid tumors across vertebrate species, worsening lung disease, emphysema and asthmatic conditions, and psycho-cognitive and sleep disturbances are major threats to health in our society9.

Just as serious is the outcome of the climate crisis on ocean and air current (e.g., jet stream, gulf stream), which pushes temperate climatic zone towards the pole. Consequently, the ice caps show dangerous melting patterns, and torrid humidity and heat spreading wider from the equatorial band. With that expansion of the tropical zones, mosquito-borne disease spread wider and faster into heavily inhabited cities. Novel infectious diseases, including Ebola, Zika, Dengue and others pose new challenges to public health and health care in Western societies2-5,9. When making the case for patient-centered care6,7, it behooves us to take into serious consideration the important role of the individual responses of each individual patient to the climatic macroenvironmental stressors. To be clear, patient-centered translational health care will only be achieved when the specific physiologic profile of each patient as it responds to the demands of the climate crisis – the allostasiome2 – will be systemically defined and characterized, and taken in account in the clinical treatment planning and delivery.

Multiplicity of Climate Solutions
Concerted research on the systemic complexity of climate change informs policies directed at countering, salvaging and restoring our healthy survival on our planet9,10. There are two principal classes of policies that counter, and possibly reverse the human-caused climate crisis, and which, we propose, ought to be better integrated in the Green New Deal.

  • Firstly, as noted elsewhere9, solutions arise from individual determination. Individual personal lifestyle changes and choices can make an important contribution in reducing society’s overall carbon impact, and therefore help lower greenhouse gas emissions to safer levels. A voluntary drive to eliminate the burning of coal, oil and, eventually, natural gas could go a long way toward that end; but, many citizens of richer nations rely for their comfort on products from such fossilized materials, and the energy stored in such fuels, which are fundamental to the global economy, and citizens of developing nations want, and arguably deserve the same comforts. Individuals could be advised, or required to move closer to their place of work, or to engage in cycling, commuting or utilizing shared or public transportation: increasingly this is the trend, even in cities such as Los Angeles, which is notoriously a city where people preferentially choose first to drive rather than to share a ride.
  • Secondly, certain solutions to the climate crisis depend on the community, local, national and international politics, institutions and organization, such as the UNFCCC mentioned above, as well as international consortia and treaties, such as the ambitious Paris Agreement. Concerted actions call for infrastructure upgrade almost in every city and in every country: buildings worldwide contribute over 33% of greenhouse gas emissions, and bad roads lower the fuel economy. Visionary politicians must understand that investing in infrastructure – buildings, roads, bridges, and the like – help cut greenhouse gas emissions and drive economic growth by generating new and profitable jobs. One drawback to this calculus is that the cement required for infrastructure rebuilding produces large volumes of CO2: in the US alone, for example, production of cement in 2005 liberated close to 51 million metric tons of CO2. Mining copper and other elements needed for electrical wiring also causes globe-warming pollution. Therefore, before improving infrastructure can be called a beneficial solution to the climate crisis, improved cement production techniques, and mining must be developed to reverse this nefarious trend. Nuclear power could replace fossil power for this and other demands, but it would certainly not be as safe and environmentally sound and clean as wind, sea current or solar energy. Coal still supplies nearly 50% of the electricity demands in the US on average, and no alternative can reliably reduce the dependence on fossil fuels in the US now. States, such as California, have made the laudable commitment to be 100% fossil fuel-independent by 2045 (cf., SB-100), and certain countries, such as Sweden have met their 2030 green energy target as early as 2018. In other words: it is possible! There is hope! As arduous as the process will be, the tipping point is in sight, but we are still far from the goal, in large part because we have now been able to establish systematically which of the solutions now at hand is more effective. In brief, this hopeful stance is the central message of the Green New Deal10, and its proponents fully recognize that it is a work in progress, a systematic portfolio of solutions that need to be worked out in all their fundamental and elemental details.

In brief, the natural gas boom of the last decades has made plastic feedstocks cheap and readily available. An estimated $50 billion will be invested into new and expanded plastic production facilities in the US alone, tripling the amount of plastic exports by 2030! That includes 400 new plastic processing facilities, in addition to plastic manufacturing facilities and plastic additive processing facilities, which can produce some significantly harmful chemicals including pthalates and brominated flame retardants. Polyethylene production alone is expected to increase by as much as 75% by 2022, a rise in production attributed to expected sharp increases in demand for disposable plastics. In other words, should the individual demand for plastic cups, bags and others not increase so dramatically, production of plastics could be curbed, and perhaps arrested if the plastic recycling industry could be improved. The surge in non-biodegradable plastic solid waste that is predicted could be avoided. Any solutions to this crisis needs to be more effectively coordinated at the level of the individual consumer, the community awareness, and national and international interests9.

The Macroenvironmental System
Our planet is mostly air, water and crust. The atmosphere is a thin layer of gases that surrounds the earth. Gravity keeps the gases from drifting away from the planet into outer space. The lower layer of the atmosphere is rich enough in O2 for plants and animals to survive. A substantial portion of the CO2 released by the planet – in greater proportion from human activities beginning with the industrial revolution in the mid 1800’s and largely after WWII in the mid 1900’s – is trapped by the atmosphere, and creates the greenhouse effect that is responsible for increasing the planet’s temperature.

There are two types of earth’s crust: the continental crust contains the continents and rocks of lighter density, and the oceanic crust contains dense rock from the upper mantle that are rich in iron minerals. Both crusts are in constant motion, as a complex function of both the inner and outer temperature of the planet. The top soil that covers the continental crust absorbs a substantial proportion of the atmospheric gases, including CO2 and methane. Polar ice entraps top soil gases, which are released into the atmosphere as polar ice and the permafrost melt consequential to the rise in global temperature.

Oceans are as complex systems as the earth’s crust and its atmosphere. There are four major oceanic zones where plants and animals live in the ocean, which in toto contain the largest ecosystem on earth.

  • Intertidal zone: the area of the seafloor between high tide and low tide, which signifies the bridge between land and water. Tide pools, estuaries, mangrove swamps and rocky coastal areas are examples of the intertidal zone. Much of the superficial water pollution (i.e., oil, floating debris, plastics) is observable in the intertidal zone.
  • Neritic zone: the waters found above the continental, including coral reefs, underwater forest of kelp and grassy meadows of sea grass, which house tiny fish, green turtles, sea cows, seahorses and shrimp. Excessive gaseous polluants, such as CO2 and methane, are found in elevated concentrations and, together with increased temperature of these waters, are responsible for the destruction of neritic flora and fauna.
  • Open ocean zone: the water body that lies beyond the continental slope and contains close to 70-75% of the oceanic waters. This zone is divided further into three subzones.
    1. The sunlit zone is where photosynthesis takes place. Plankton, jellyfish and most animals living in the open ocean inhabit the sunlit zone. Giant oil spills, immense plastic and garbage patches, and increased CO2 and temperature directly threaten that habitat.
    2. The twilight zone is a layer of oceanic waters at a depth of 3,000-4,000 feet, where some light can still penetrate. Viper fish, firefly squid, deep water fish, bioluminescent jellyfish, and the chambered nautilus live in this zone. Its deepest layer, the midnight zone extends into darkness to the seafloor. As the luminosity of the waters is altered by temperature and gaseous rise, the viability of this deep water oceanic zone (i.e., the twilight and the midnight layers) is endangered.
    3. The benthic zone includes the seafloor. It houses close to a quarter of a million species of plants and animals, which do not need sunlight to exist and which survive at relatively cold temperature and strong pressure. Hydrothermal vents provide an exquisite variety of flora and fauna in this abyss, which is threaten by the CO2 absorbed in the oceanic waters.

    As CO2 is absorbed into the oceans, the acidity of the waters increase, which is toxic to corals and to most marine life. As the planet’s temperature increase, the ocean water temperature increases as well, which is deadly to most fish species, plankton and other marine life. As the planetary temperatures increase, not only do oceanic waters rise consequential to polar ice melting, but atmospheric wind patterns (e.g., jet stream) change, and oceanic currents (e.g., gulf stream) are disrupted.

    In brief, a systems perspective1 on our macroenvironment reveals three intertwined domains: the atmosphere, the crust and the oceans. Alterations severe enough to disrupt any one domain will have serious and significant implications for the other two, and therefore for the equilibrium of our planet. It is timely and critical to develop, test and evaluate effective solutions to the climate crisis, because it is a serious existential threat to all flora and fauna of the planet, including us. These solutions must go beyond the current interventions, some of which we have briefly outlined above, and must be stringently evaluated for effectiveness in the same manner as we stringently evaluate clinical interventions for patients: our planet is the patient, and it deserves the same attentive deployment of research activities. Novel interventions must be directed not only at preventing further disruption in the planet’s climate, blunting or blocking global warming, but as well, if not more importantly so, at restoring the balance of our environment system.

    Translational Environmental Restoration (TER)
    Concerted scientific effort must be directed at obtaining evidence-based interventions to the climate crisis. One model provided by the extensive study of climate change in Tasmania supported by the Australian Government (Department of Climate Change and Energy Efficiency) and the National Climate Change Adaptation Research Facility in 2013 serves as Proof of Concept. In a cogent systematic review, the authors explored several domains of the system of climate change in that region of the continent. They concluded that significant gaps of knowledge remain in our understanding of adaptation needs and successes across all areas of the system they studied, including marine life, land use, infrastructure, business, stakeholders and policy makers. A range of research priorities were identified as solutions based on the best available evidence. They noted a need for better climate system understanding, and improved evaluation of adaptation options. Based on their interactions with stakeholders, they resolved a myriad of societal issues around adaptation to the climate crisis. Future evidence-based research needs were identified particularly with respect to engaging stakeholders and end-users at the earliest stages of research design, including the refinement of research objectives and questions8.

    We propose a Translational Environmental Restoration (TER) paradigm that integrates the model proposed by McDonald and collaborators8, and follows the framework of translational health care6,7. In brief, the movement of translation health care emerged as a response to the need to find the best available research evidence from fundamental basic biomedical research, to incorporate the best evidence base into novel clinical interventions, and to evaluate them for effectiveness. Two sides of the same coin soon emerged:

    1. translational research, for basic research on clinical biopsies obtained from the patient to suggest to the clinician treatments that are targeted to that patient, and
    2. translational effectiveness, for direct head-to-head comparison of clinical protocols for efficacy and effectiveness.

    Concerted efforts were made in the last decades to refine and to validate research designs and methods in translational health care to ensure optimal patient-centered care6,7. In translational research, new and improved physiologic, histologic, cellular, biochemical and molecular methodologies were tested and deployed, which now provide valid and reliable data to characterize the pathologic processes in patient biopsies. Based on these characteristics, a patient and pathology profile can be drawn by the clinician, who can, at this stage, entertain alternative treatment modalities. Based on these criteria, the PICOTS question is generated that defines and characterizes the patient (P), the preferred intervention (I) and alternative comparator (C) interventions, the clinical outcome (O) sought, within the projected timeline (T) and in the available clinical setting (S). The resulting PICOTS research question, and the analytical framework that is derived from it in consultation with stakeholders, informs the hypothesis-driven process of the systematic review for translational effectiveness. This research component of translational healthcare utilizes the research synthesis design, psychometrically validated instruments, acceptable sampling analysis and meta-analysis to establish the best evidence base in support of that, among the projected intervention, which is preferable to the others on criteria of effectiveness. Translational health care culminates in the translation of the systematic review into a critical review, a statement of the best evidence base in clinician-friendly and in patient-friendly language, which can be disseminated by tele-care and other means, so that the best evidence base information becomes available to all clinicians globally. In brief, translational health care is, by its very nature and definition, patient-centered care, effectiveness-focused care, and evidence-based care6,7.

    Here, we propose that specific issues and problems consequential to the climate crisis, such as for example, plastic pollution of ocean waters, could be investigated by a two-prong process akin to the study of clinical interventions.

    • Firstly, the clinical situation of the patient is examined and characterized by means of translational research. In a similar manner, the ecological situation of plastic oceanic pollution must be defined and characterized: detailed data must be gathered on the type of plastic, oceanic current, effects of prolonged exposure to sea water on the molecular structure of the plastic, and the like.
    • Secondarily, clinical interventions are investigated and evaluated in the context of translational effectiveness. Similarly, the effectiveness of diverse protocols for the gathering and processing of oceanic plastics should be compared (e.g., shredded vs. composted plastic) in stringent, structured, detailed and accurate systematic review studies.

    The depth and scientific excellence as the systematic review report by McDonald and collaborators8 is a Proof of Concept for the Translational Environmental Restoration (TER) paradigm we propose here.

    The author thanks all the students he was honored to mentor throughout his career for the erudite and thought-provoking discussions. To be clear, he has learned more from them than they from him. The author also thanks the Climate Reality Project for training close to 30,000 leaders now engaged in disseminating the facts (best evidence base, BEB) about the climate crisis, and – more importantly perhaps – the hopeful solutions that are at hand and, in part at least, already working. In that regard, the author thanks Al Gore, Ken Berlin, the hundreds of mentors and the thousands of trained leaders of the Climate Reality Leadership Corps for their consistent, indefatigable, hard and dedicated work at saving our planet. The author thanks other organizations also involved in the laudable fight to restore our planet from the climate crisis, such as for example 5Gyres.


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