Lomborg-errors: "Cool it!"

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  Comments to pages 126 - 141 in Cool it.

THE WHO STUDY

(COMMENT)
Page 126 top: ". . a headline of `Climate change death toll put at 150,000´ works well"
Comment:
Lomborg does not mention that due caveats are mentioned in the press release, for instance this: "But he acknowledged global deaths from climate change were minuscule compared with the total number of deaths a year, which the WHO puts at 56 million. About 10 times more people die each year from tobacco-linked illness, he said."

(COMMENT)
Page 126: "The analysis was redone in 2005 . . . "
Comment:
The reference from 2005 is not a remake of the analysis, but a review dealing with the WHO analysis as well as with many other studies. It does, however, contain some information that was not included in the chapter in the WHO report.

FLAW
Page 126: " . . . they spend three pages estimating and apparently calculating - though never showing - cold and heat deaths."
Flaw:
They actually show the results of their calculations on their page 143.

FLAW
Page 126, note 651: "They only have old and very limited surveys for these results. . ."
Flaw:
This is not true. The surveys for hot climates are completely new. It is true that for Europe they only use Kunst et al. (1993). Between the lines, Lomborg suggests  that  this  study is old  and hence outdated and not so reliable as newer studies. On the contrary,  the WHO report argues why  exactly this study is better and more reliable than others. In any case, the changes in death rates are mainly in warm climates, and therefore the finer details concerning deaths in Europe are of little importance.

(COMMENT)
Page 126 and note 652: " . . . they simply leave out cold and heat deaths . . . "
Comment:
In note 654, Lomborg cites his source that the effects of extreme temperatures were excluded `for the reasons described above´ , and then writes that "there are no `reasons described above´ anywhere." However, the source gives many reasons why the data are of doubtful value on its page 142.

ERROR
Page 126: " . . leading to the total death toll of 153,000 . . "
Error: The primary source, Campbell-Lendrum et al., does not give any total death toll. The secondary source, Patz et al. 2005, gives a total death toll of 166,000. It seems that Lomborg has subtracted the figure of the death toll due to cardiovascular disease of 12,000, although the result of this (completely unjustified) subtraction is 154,000 rather than 153,000.

ERROR
Page 126 and figure 35: "In the 2005 update  . . they equally leave it out of the total. " "Their result can be seen in the left part of Figure 35".
Error: This is directly wrong. The net effect of cold and heat on cardiovasular disease is actually included in the table referred to by Lomborg on page 312 in the 2005 paper. It has been excluded from Figure 35 not by the authors of the paper, but by Lomborg. So he accuses others of making an omission which he has made himself. This is deliberately misleading.

FLAW
Page 126 bottom: " . . . it gives about 620,000 avoided cold deaths and 130,000 extra heat deaths."
Flaw:
This calculation is made on the basis of Bosello et al. (2006). As explained elsewhere on Lomborg-errors, the data go back to Martens (1998), which has a flawed treatment of the data. In the original data, the increase of heat-related deaths more than outweigh the decrease in cold-related deaths, but on the basis of these data, regression formulae are made which give just the opposite result.

ERROR
Page 126 bottom: ". . there are actually almost 200,000 more people surviving each year. "
Error: First, Lomborg´s calculation is wrong. If we use the figures that he mentions in his text, we obtain the following net change in number of deaths per year: -153,000 + 620,000 - 130,000 = 337,000. Second, the figure cited by Lomborg is just the outcome of one calculation, based on the misuse of original data in Martens (1998). The alternative data in Patz (2005) is that the net effect of cold and heat is an increase in cardiovascular deaths of 12,000 per year. So, one calculation, which is probabaly flawed, gives a net result of +200,000, whereas another gives -12,000. Considering the uncertainty indicated by the difference between these two estimates, it is very misleading to use the word "actually", as if this were well-established fact.

ERROR
Page 127, figure 35 "WHO estimates for today´s annual climate deaths . . ."
Error: This figure is full of serious errors. First, the source Patz et al. (2005), form which the data is taken, has a figure giving the net effect of cold and heat on cardiovascular disease, and that figure is - 12,000 per year. Lomborg - not the original source - has left out this figure. Instead of that, he has taken a figure of +620,000 avoided deaths calculated from Bosello et al. (2006). However, that figure is stated to be the sum of cold- and heat-related changes in mortality due to cardiovascular disease - i.e. it is another estimate of precisely that which is given by Patz et al. as -12,000. The difference is more or less explained be the fact that Bosello et al. rely on Martens (1998), which in itself is flawed. Lomborg´s alleged figure for heat deaths - 130,000 - is actually a figure for extra mortality due to respiratory diseases, and thus does not represent all heat-related deaths. If Lomborg had used a similar conversion of the remaining figures in Bosello et al. (2006), he would have gotten a figure of -170,000 for diarrhea, which is very different from the -47,000 estimated by Patz. et al. Thus, the figures from the two sources are not comparable and cannot be merged into one figure - a procedure which in any case is dubious and should not be performed by a person knowing about statistics. Altogether, the figure is grossly and deliberately manipulated.

ERROR
Page 128: "Had all the relevant data been included, it would more likely have shown the very opposite picture."
Error: This is completely wrong. All the relevant data have indeed been included, and the result is 166,000 extra annual deaths. Lomborg knows this (he has studied the relevant table in Patz et al. 2005), so his text is delibearately misleading, and very grossly so.


MALARIA

SOME GENERAL COMMENTS:
Lomborg uses several pages (pp. 129-134) to explain that the distribution of malaria is mainly governed by socioeconomic conditions, whereas climate causes no serious restriction, as malaria may thrive in very cold climates, such as Finland and Siberia. Although this is correct in outline, the ability for malaria to thrive in cold climates is exaggerated.
    There are several species of malaria parasites. The most deadly is Plasmodium falciparum, which is widespread in the tropics. Another species, Plasmodium vivax, is more widespread in subtropical and temperate climates and is of little concern in Africa, because most tribes/races of Africans are resistant to it. P. plasmodium can hardly develop in its mosquito host at temperatures below 18° C, whereas the corresponding limit for P. vivax is 16° C.
    Details concerning the climatic conditions limiting P. falciparum in Africa are given on this page in Lomborg-errors. As described there, the number of months with temperatures above 18° is crucial. When every month is above this temperature, the parasite may infect at any time of the year. Children will be permanently exposed, and they will gradually develop immunity. However, if some months are too cold, infections occur only seasonally. And if temperatures are not high enough every year, infections will occur only in certain years. Contrary to what you might expect, the latter situation is the most dangerous, because then children will not have developed immunity. Malaria will then occur as epidemics in certain years, and in these years it will kill thousands of children.
    Similar situations may arise in northern Europe or Asia with Plasmodium vivax. This parasite species exists in several forms; the northernmost form does not become infective until it has spent about 8 months in its human host. That is, when people are infected in late summer, the parasite survives in them during winter, and become infective only in the next spring. The life cyclus may be completed if only summer temperatures remain above 16° C for at least one month. But in some years, summer temperatures may become much higher. For instance, temperatures at Arkhangelsk in the summer of 1935 were up to 35° C, which means that during the season when the parasite is in the mosquitoes, it may be subject to "tropical" temperatures, and the development within the mosquito host will be extremely rapid, allowing very fast reinfection of humans. If there are two or three hot summers in a row, the parasite may multiply enormously. Under these conditions, most people have not previously been exposed to the parasite, and have developed no immunity. When there is a sudden mass infection with malaria parasites, they will therefore become very ill, and if they are not treated, many will die. This is the explanation why we hear that mass mortality due to malaria has occurred in northern climates.
    If the climate warms generally, the risk to have series of such hot summers increases, and epidemics may become more frequent.
    At intermediate latitudes, there may be a spreading of other forms of P. vivax which develop fast in their human host and are able to reinfest mosquitoes already after 3 or 4 days. This allows them to have several generations during a summer, and thus to have multiplied considerably by the end of the summer. There may then be a trend towards seasonal increase in malaria infections every year.
    It is therefore much too simple to claim that malaria may occur in the tropics as well as in Finland and Siberia, as if changes in temperature would have little consequence. Even small temperature changes would easily lead to large differences in the prevalence of malaria.
   All this concerns a situation when no chemicals are available to fight the malaria parasite or its mosquito host. It is not possible to eradicate the host - only to decimate its numbers temporarily. On a short term, however, this is enough to break the life cycle of the parasite and thus to eradicate it. For instance, in the years following the Second World War, spraying with DDT eradicated malaria in the Soviet Union. USSR  was declared free of malaria in 1960.
    There is always a risk that the parasite may return, however, because the Anopheles mosquitoes will survive, and because people travelling around may carry the parasite with them. Local mosquitoes will become infested when feeding on migrants, and thereby a local cycle of transmission to resident people will be initiated. This is happening to an increasing extent. In Russia, especially around Moscow, the number of cases of local origin has been growing. Thus in 1998 there were 1,019 "imported" cases and 63 of local origin, while in 2002 the corresponding figures were 764 and 134. Malaria has been imported mainly from Tajikistan, where the disruption of civil war combined with an influx of malaria-carrying refugees from Afghanistan has generated the first post-Soviet malaria epidemic (source: this link).
   If a local cycle of infections starts e.g. at Moscow, it will be interrupted by finding all infected people and treating them with anti-malaria drugs. However, malaria strains resistant to the commonly used drugs are becoming more widespread in South Asia, and may be carried to Russia with immigrants or tourists.
    A similar situation may arise in USA if tourists or migrants import drug-resistant forms of the malaria parasite, e.g. from Mexico or other Central American countries.
    Historically, the malaria parasite has developed resistance to anti-malaria drugs, first to quinine, then to chloroquinine, then to pyrimethamine, and now the very first examples of resistance to artemisinin-derivatives are being reported (for instance this link).  A new cheap anti-malaria drug seems to be underway now (link), but in the end the question is: who wins the race between man and parasite: will the parasite develop resistance faster than man can find new drugs? Once resistance to artemisinin becomes widespread in future (which may very well happen), there may remain no efficient anti-malaria drugs, and if man becomes the loser of the race, there may come a time when malaria cases in highly developed countries will no more be treatable.
  

(COMMENT)
Page 130: "There are more than 400 species of mosquitoes . . "
Comment:
Yes, certainly, there are many thousands. But there are about 400 species of the genus Anopheles which is the only genus with species transmitting the malaria parasite.

FLAW
Page 134: "Similar conclusions have been reached in studies of Italy . . "
Flaw:
According to Romi et al. (2001), an episode of locally transmitted P. vivax malaria occurred in a rice cultivating rural area in Tuscany in 1997. They report that a mosquito species present there is capable of transmitting P. vivax malaria, but not the more dangerous P. falciparum malaria. The number of mosquitoes biting an infected person in this area would be sufficient to sustain the presence of the malaria parasite. Malaria could become reintroduced in rural areas, because the number of migrants from countries with endemic malaria who come to Italy to work, is constantly increasing. They write: "These results indicate the need for more epidemiologic surveillance, especially as the Italian situation is extremely dynamic and changeable." They add that if an episode of local malaria transmission occurred, this would not have serious consequences, as it could quickly be controlled by the health service. One may add, however, that there will be an increasing risk of importing malaria strains that are resistant to the usual anti-malaria drugs.
   When Lomborg writes: " - the reason the Guardian could claim otherwise is only because more immigrants bring in more malaria", this is not completely correct. There has been local transmission of malaria, and this is likely to happen again.

(COMMENT)
Page 135 top: ". . . DDT, which is still the most cost-effective insecticide against mosquitoes  . . "
Comment: Rosenberg (2004) says: "Both bed nets and house spraying can be effective, and studies comparing costs differ on which is cheaper." Schapira (2006) Says: "Few trials have compared insecticide-treated nets [impregnated with pyrethroids] and indoor residual spraying [with DDT], but results so far suggest that the methods are more or less equal in efficacy." Walker (2000) says: ". . the prices of pyrethroids are declining, making some only slightly more expensive than DDT at low application dosages."

(COMMENT)
Page 135 and note 717: ". . . which has made it an easy and general assertion to claim that global warming is the culprit."
Comment: This is not a fair summary of the references in note 717. Especially the paper by Patz et al. (2005) does not make easy, general assertions. Rather, it says that several studies "have not found a link to temperature trends, emphasizing instead the importance of including other key determinants of malaria risk such as drug resistance, human migration and immune status . . ". See also the Lomborg-errors page on malaria in Africa here.

(COMMENT)
Page 135 : ". . . the malaria parasite is becoming resistant. There are new and effective combination treatments based on artemisinin available . . . "
Comment: Optimism concerning the possibility to reduce malaria or to keep it away where it does not occur now is corrupted by the development of resistance to anti-malaria drugs. The very first examples of resistance to artemisinin-derivatives are being reported (for instance this link).  Once resistance to artemisinin becomes widespread in future (which may very well happen), there may remain no efficient anti-malaria drugs.

FLAW
Page 136 top: " . . researchers tried to see whether more people at risk would actually lead to more malaria. "
Flaw: The paper cited by Lomborg in his note 726 states in its abstract: "These results were applied to future climate scenarios to predict future distributions, which showed remarkably few changes, even under the most extreme scenarios." Therefore, what is referred to here is predictions of the geographic distribution of malaria parasites in the future, which by their very nature are uncertain. And no measures of society´s ability to fight malaria e.g. by drug treatment is included in that paper. It is therefore wrong to postulate that the paper investigates whether there will actually be more malaria.

FLAW
Page 136 bottom: " We do, however, have one global estimate on actual malaria deaths . . . "
Flaw: Nobody can know what the number of  malaria deaths in 2050 actually will be. Furthermore, the figures referred to have been transformed in a number of steps, papers citing other papers that cite some third paper that cite the original data.  During this transformation process, errors seem to have occurred which change the overall conclusion. See more about this below.

FLAW
Page 137 and Figure 37: " However, when we compare the full picture in Figure 37 we see that the number of dead . . .  still do not outweigh the deaths saved from cold deaths."
Flaw: In the figure, Lomborg presents data that are correctly cited from Bosello et al. (2006). However, the figures given by Bosello et al. are not original data, but data taken mostly from Tol (2002 a,b), which in turn are taken from Martens (1998) and others. Lomborg has read also these other papers. He should have seen that the data have been changed in such a way that the overall conclusions are turned around. In Tol´s paper, "the reduction in mortality in the OECD is smaller than the increase in mortality in developing countries" (Tol 2002a p. 65). Also in that paper, the combined effect of climate change for China, India and other Third World countries is a net increase in those deaths that are due to other cases than diarrhea. In Bosello et al., on the other hand, the combined effect is a large net decrease. Something must have gone wrong in their calculations, when they took Tol´s data, allocated them to single countries, and combined them again into a new set of regions. In addition, reservations concerning the uncertainty of the figures have disappeared. Tol (2002a p. 64) writes: "In all cases, uncertainties are substantial, so that not even the sign of the impact can be known with reasonable confidence." This reservation has completely disappeared in those papers citing Tol, and Lomborg even speaks of actual deaths, when the truth is that we do not even know for sure if the number of deaths will increase or decrease.
    Furthermore, as to deaths from cardiovascular and respiratory diseases, these are completely unreliable. As explained elsewhere on Lomborg-errors, the data go back to Martens (1998), which has a flawed treatment of the data. In the original data, the increase of heat-related deaths more than outweigh the decrease in cold-related deaths, but on the basis of these data, regression formulae are made which give just the opposite result.

ERROR
Page 137 bottom: " ... for all the developing countries, the number of lives saved actually outweighs the number of lives lost . . . "
Error: As stated above, this is not true. The original source for the figures, Tol (2002a) says: "the reduction in mortality in the OECD is smaller than the increase in mortaltiy in developing countries" . Also, in that source paper, the net effect for China + India + South East Asia is a large net increase in the number of deaths. By some unknown error, this has been changed to a net decrease in Bosello et al. (2006), from where Lomborg has taken the figures.

(COMMENT)
Page 138 top : ". . . this trend will not continue, simply because increasing income effectively will eliminate it.  "
Comment: Nobody can know for sure what will happen. We do not know for certain if Africa will manage to get out of its poverty trap, and we do not know if the malaria parasite will develop resistance faster than we can develop new anti-malaria drugs.

ERROR
Page 139: " . . . it seems likely that Africa will cross the $ 3,100 threshold around 2080. "
Error: The $ 3,100 threshold is taken from Tol & Dowlatabadi (2001) and is extremely uncertain. The figure is obtained by excluding regions that do not fit into the general pattern, especially Africa. So it is not valid for Africa.

(COMMENT)
Page 139 : " If we implement Kyoto. . . this will slightly lower the poor countries´ growth rate . . .  "
Comment: This is postulated by Lomborg´s source (Tol & Dowlatabadi 2001), but the source also mentions that there are other experts who assume an opposite effect. It may be that if we do not attempt to cut our consumption of fossil fuels, the international price of these fuels will rise so dramatically that the poor countries will be hit very hardly by this. So the effect may just as well be directly opposite to what Lomborg claims.

FLAW
Page 140 and note 746: "Many malaria articles talk about nothing but climate."
Flaw: The press article referred to in Lomborg´s note 746 is no longer on the net. However, one may search the archives of that source, chron.com, which gives access to many newspapers. Searching for the period 2001-2007 for articles with titles containing the word `malaria´ in combination with either `climate´, `CO2´ or `rising temperatures´ gives just one hit, from the same date and with the same author as the article cited by Lomborg. Therefore, the phrasing "Many malaria articles. . . " seems unjustified.

(COMMENT)
Page 140 : " However charming this story seems, it is simply wrong."
Comment: The story is not "simply wrong". See the Lomborg-errors page on Malaria in Kenya here. We may also cite the newspaper article found when we search the press story in Lomborg´s note 746 (link). This story is from the slopes of Mount Kenya, 50 miles north of Nairobi. The interviewed scientist finds larvae of the mosquito host in an irrigation ditch there and the article explains:  "Last year Mutunga's team detected them nearby at an altitude of 6,243 feet. "That's the highest ever in Kenya," the young entomologist said."

FLAW
Page 140 and caption to figure 38: "Nairobi is today considered free of malaria."
Flaw:
The source given by Lomborg does say that Nairobi belongs to the malaria-free ecozone. However, the facts are that although Nairobi was free of malaria until recently, today there is a lot of malaria in the shantytowns around Nairobi, with thousands of children being infected, see this link. Without a recent slight temperature increase, malaria would probably not have been massively infective here.

FLAW
Page 140-141: "However, the real reason for the reemergence, the report finds, is not climate change . . . "
Flaw:
The report does not say that. It refers to a number of studies finding a possible relationship between changing climate and changing prevalence of malaria. It goes on to say that these studies have "garnered popular interest among the wider scientitific fraternity", which in turn has stimulated the tendency to link all phenomena to popular scientific themes. And it criticises this tendency. But it does not claim that the studies referred to had made wrong conclusions. Instead, it says that the genesis of epidemics is multifactorial, and that in a number of cases, climate does affect malaria incidence. For instance, El Nino rains have had such effects. The text then proceeds to discuss the cyclical pattern of epidemics occurring at intervals of a few years, and concludes that temperature data cannot explain this cyclicity. Lomborg misreads this part of the text and gets the impression that temperature is without importance for the incidence of malaria.