How do different COVID-19 recovery paths impact health, food systems, and the environment?

In a recent study published in The Lancet Planetary Health, researchers investigated the effects of different recovery paths of coronavirus disease 2019 (COVID-19) on human health and environmental and food sustainability.

Background

With the increasing rates of COVID-19 infection, governments enforced intra- and international movement restrictions to curb the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Nonetheless, concerns about the resilience of the globalized food system emerged under such restrictions.

The leading cause of global deaths in 2017 was poor diet. Poor health outcomes usually occur due to intake of diets high in sodium and low in fruits, vegetables, whole grains, nuts, seeds, or omega-3. Although research is ongoing about the risk factors and comorbidities that cause severe COVID-19 and deaths, an association has been observed between mortality and diet.

Healthier diets could reduce weight- and diet-related deaths from non-communicable diseases while decreasing mortality risk from COVID-19. Moreover, healthier diets could also augment environmental health. Some (modeling) studies have observed that reducing meat intake could decrease the loss of natural land and biodiversity.

About the study

In the present study, researchers estimated the effects of switching to healthier dietary choices. They used Land System Modular Model (LandSymm) to assess the impact of different COVID-19 recovery paths on the food system. The team designed four scenarios: 1) solidarity and celery (SC), 2) nothing new (NN), 3) fries and fragmentation (FF), and 4) best-laid plans (BLP).

The first scenario assumed that the pandemic would create an impetus for global cooperation, resulting in several vaccines against SARS-CoV-2. Affordable vaccines become available for low-income countries before the end of 2022. With policy interventions and international awareness of the health and environmental impact of diets, the dietary choices move towards a healthy diet during 2020-40, reaching halfway to that goal from existing trends.

In the NN scenario, international cooperation would deteriorate in 2021 with countries imposing export restrictions on vaccines and nations that funded vaccine development stockpiling the supplies. Commitments to low-income countries fade quickly, leading to slow vaccine roll-out in the Global South.

The pandemic would subside in 2022 due to mutations rendering the virus less transmissible/virulent. Countries exit the pandemic focusing on national interests and growth. The elevated risks from COVID-19 to overweight and obesity would be forgotten, leading to no changes in dietary choices.

In the FF scenario, early promises to cooperate globally would be forgotten quickly with the availability of vaccines and countries racing to vaccinate their respective populations. Despite the limited and deteriorating cooperation, the pandemic would subside with priorities of attaining pre-pandemic economic output. Poor collaboration would lead to inaction on policies/strategies for future pandemics.

Consequently, a new SARS-CoV-2 variant would emerge in 2025, causing governments to respond with the same restrictions as in 2020. This would have similar economic effects amid growing distrust among nations and increasing trade barriers. As such, this would result in cyclical pandemics. In the last scenario (BLP), countries adhere to the commitments of pooling resources to eliminate SARS-CoV-2.

As a result, the vaccination program would be a global success with the economy returning to pre-COVID-19 trends in 2023. This would encourage nations to strengthen international health organizations to develop standard guidance and principles to decrease the risk of future pandemics and improve health. Nevertheless, global efforts to reduce the risk of re-emergence of pandemics have become inefficient, with a new COVID-19-like pandemic returning in 2025.

Findings

The changes in the prevalence of weight categories and underlying diets increased premature mortality in the NN and FF scenarios. Additional deaths were higher in upper-middle-income countries (2130/million in NN and 2991/million in FF), with minor differences in high-income countries in FF (18 fewer deaths/million) and NN (48 additional deaths/million) scenarios. In SC and BLP scenarios where dietary preferences changed, global deaths reduced substantially, mainly in high- and middle-income countries.

Across all scenarios, the prevalence of obesity and overweight increased in low-income countries in 2060 compared to 2019. The prevalence of obesity was lower in scenarios with changes in dietary preferences than in scenarios without. In the first scenario, the pasture area decreased by 120 mega hectares (Mha), with an increase in natural land by 119 Mha in 2040. In the BLP scenario, the pasture area increased by 100 Mha while cropland was almost constant at 2019 levels in 2060. The increase in pasture area corresponded to an equivalent loss of natural land.

Natural land was reduced by 481 Mha and 322 Mha in NN and FF scenarios by 2060. This loss corresponded to increases in cropland and pasture area. Across all scenarios, the loss of natural land occurred in the tropics, while the increases occurred in temperate zones. The loss of natural land was the highest in NN and lowest in SC. Nitrogen and irrigation use increased in all scenarios but was higher in NN than in other scenarios.  

The proportion of income expenditure on food was reduced in all scenarios and income levels. Low-income countries showed a marked reduction in spending, i.e., 60% in 2019 to 18% in 2060. The impact of all scenarios on the production of different commodities in 2060 was high. The production of fruits and vegetables was the highest in SC and lowest in FF.

Staple production was higher in NN and FF than SC and BLP. Food prices in SC were lower than in other scenarios. The decrease in prices was due to the reduced consumption of expensive products (animal products). The BLP and FF scenarios were characterized by variable prices that could cause food insecurity.

Conclusion

The current modeling analysis revealed that political decisions on recovery plans/policies for the COVID-19 pandemic significantly impact global health, food affordability, and the environment. In conclusion, COVID-19 emerged at a critical time for the global food system. The four scenarios showed that healthier diets would mitigate the adverse impact of the food system on the environment and reduce deaths from unhealthy diets.