"We did some similar work after Cyclone Gabrielle, for populations in Tairāwhiti and Hawkes Bay. The authors have done an impressive work with much larger geographical and population coverage, and longer time series. There is clearly a signal coming through about an upswing in cardiovascular events in the aftermath of cyclones.

"We weren’t able to detect that signal in our own project. I think that is explained by the smaller populations we studied. In this report, there is a higher level of uncertainty in the New Zealand country-specific data. I think this represents our overall smaller population. Interestingly, the strongest signal in New Zealand was for the north of the South Island, not so strong for the East Coast North Island regions we studied.

"In summary, this is the larger study that we have been waiting for, showing the adverse interaction of cyclones and cardiovascular health. As with any epidemiological study, it’s doubtless possible to take it apart and suggest other explanations for the findings. But again, given the size of this work, the inference is strong. Under climate change, we have to expect an increased incidence and severity of adverse weather events. That is a consequence of the greater amount of energy and water in the atmosphere. These incredibly destructive events are adverse for human health in all sorts of ways. Another dimension you can look at is mental health. In our interviews with people in our report Te Weu me Te Wai, we found a lot of pointers to adverse mental health in the aftermath of extreme weather events. This can all be seen in the context of the Sendai Framework for disaster risk reduction. In Te Weu me Te Wai, our vision of success for disaster risk reduction is based on community empowerment, health services in the community, and procurement for continuity. It has been pleasing to see this report accepted by the Ministry of Health.

"Climate change has been identified as the number one risk to human health this century. I see it as one facet of a larger crisis, that relates to the harmful way people interact with each other and our environment, under neoliberal economic regimes. It has been extremely depressing to see the dominance of climate change denial in Western political and social processes. Each of these extra cardiovascular events is ultimately the responsibility of the fossil fuel industry and their supporters. They are long overdue for a reckoning. It was encouraging to see the recent ruling of the International Court of Justice that citizens could hold their governments to account for poor climate change policy. The outlook is extremely dire right now, not only for the natural world but also for humanity."