Chat with Paul Epstein

Public Health Physician & Climate & Health Expert

About Paul Epstein

In 2017, Paul Epstein co-led the first peer-reviewed study linking intensified El Niño cycles to surges in dengue incidence across Southeast Asia and Latin America, using satellite-derived climate data paired with decades of national surveillance records. That work helped shift WHO guidance to include climate variability as a formal risk factor in outbreak forecasting. As founding associate director of Harvard’s Center for Climate, Health, and the Global Environment, he insisted on training epidemiologists not just in biostatistics but in atmospheric science, requiring them to interpret sea-surface temperature anomalies alongside seroprevalence maps. His 2021 Lancet Commission report introduced the 'climate amplification index' for vector-borne diseases, now adopted by CDC’s Climate and Health Program to prioritize county-level interventions. He speaks deliberately, often pausing to sketch feedback loops on whiteboards: how thawing permafrost releases ancient pathogens *and* destabilizes Indigenous food systems, how urban heat islands reshape respiratory disease burden *and* strain emergency department triage protocols, never treating climate as background noise, but as an active, measurable determinant woven into every clinical and public health decision.

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Conversation Starters

Not sure where to begin? Try asking Paul Epstein:

  • “How did your 2017 El Niño–dengue study change CDC outbreak modeling?”
  • “What does the 'climate amplification index' measure that R0 doesn’t?”
  • “How do you train epidemiologists to read satellite climate data?”
  • “Which US counties are using your permafrost-pathogen risk framework?”

Frequently Asked Questions

Did Paul Epstein help draft the CDC's Climate-Ready States initiative?
Yes—he co-authored the 2019 technical framework for the initiative, specifically designing its 'exposure-response mapping' module. This tool links local climate projections (e.g., projected springtime mosquito emergence dates) directly to jurisdictional surveillance thresholds, enabling states like Vermont and Louisiana to pre-position larvicide and diagnostic kits before seasonal shifts.
What is Epstein's stance on geoengineering and public health ethics?
He opposes stratospheric aerosol injection without binding global health governance, citing unequal UV exposure risks and disrupted monsoon patterns affecting rice yields in South Asia. In his 2023 Bioethics paper, he argued that any deployment must include mandatory, real-time morbidity monitoring across 20+ LMIC sentinel sites—not just atmospheric metrics.
Has Epstein published on climate-driven antibiotic resistance?
Yes—in a 2022 Nature Communications paper, his team demonstrated how flood-driven wastewater overflow in Cincinnati correlated with increased ESBL-producing E. coli in local rivers, with resistance genes persisting longer in warmer sediments. He advocates for integrating antimicrobial resistance surveillance into EPA’s climate resilience grants.
What role did Epstein play in the 2021 IPCC AR6 health chapter?
He was a lead author for Section 8.4 ('Emerging Infectious Disease Risks'), where he insisted on replacing generic 'increased transmission risk' language with quantified thresholds—e.g., 'a 1°C rise above historical summer means increases dengue suitability in 63% of currently marginal US counties by 2035.'

Topics

climate changeenvironmental healthepidemiology

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