A story of (in)coherence: climate adaptation for health in South African policies.

Climate adaptation strengthens and builds the resilience of health systems to future climate-related shocks. Adaptation strategies and policies are necessary tools for governments to address the long-term impacts of climate change and enable the health system to respond to current impacts such as extreme weather events. Since 2011 South Africa has national climate change policies and adaptation strategies, yet there is uncertainty about: how these policies and plans are executed; the extent to which health policies include adaptation; and the extent of policy coherence across sectors and governance levels. A policy document analysis was conducted to examine how South African climate change, development and health policy documents reflect the health adaptation response across national and Western Cape levels and to assess the extent of coherence across key health and environment sector policy documents, including elements to respond to health-related climate risks, that can support implementation. Our findings show that overall there is incoherence in South African climate adaptation within health policy documents. Although health adaptation measures are somewhat coherent in national level policies, there is limited coherence within Western Cape provincial level documents and limited discussion on climate adaptation, especially for health. Policies reflect formal decisions and should guide decision-makers and resourcing, and sectoral policies should move beyond mere acknowledgement of adaptation responses to a tailored plan of actions that are institutionalized and location and sector specific. Activities beyond documents also impact the coherence and implementation of climate adaptation for health in South Africa. Clear climate risk-specific documents for the health sector would provide a stronger plan to support the implementation of health adaptation and contribute to building health system's resilience.

A Descriptive Analysis of the Scientific Literature on Meteorological and Air Quality Factors and COVID-19.

The role of meteorological and air quality factors in moderating the transmission of SARS-CoV-2 and severity of COVID-19 is a critical topic as an opportunity for targeted intervention and relevant public health messaging. Studies conducted in early 2020 suggested that temperature, humidity, ultraviolet radiation, and other meteorological factors have an influence on the transmissibility and viral dynamics of COVID-19. Previous reviews of the literature have found significant heterogeneity in associations but did not examine many factors relating to epidemiological quality of the analyses such as rigor of data collection and statistical analysis, or consideration of potential confounding factors. To provide greater insight into the current state of the literature from an epidemiological standpoint, the authors conducted a rapid descriptive analysis with a strong focus on the characterization of COVID-19 health outcomes and use of controls for confounding social and demographic variables such as population movement and age. We have found that few studies adequately considered the challenges posed by the use of governmental reporting of laboratory testing as a proxy for disease transmission, including timeliness and consistency. In addition, very few studies attempted to control for confounding factors, including timing and implementation of public health interventions and metrics of population compliance with those interventions. Ongoing research should give greater consideration to the measures used to quantify COVID-19 transmission and health outcomes as well as how to control for the confounding influences of public health measures and personal behaviors.