key: cord-1002121-7umg7jxr authors: nan title: Department of Error date: 2021-11-13 journal: Lancet DOI: 10.1016/s0140-6736(21)02431-4 sha: ecc13b7964cbd8e2cae8674827fca376bb5efed0 doc_id: 1002121 cord_uid: 7umg7jxr nan www.thelancet.com Vol 398 November 13, 2021 of ChAdOx1 nCoV-19 vaccine might be even lower than the reporting rates in our analysis. Our aim was to show that even when we included all 13 cases in our analysis, the reporting rate was lower than the estimated background rate for TTS determined by the cooccurrence of thromboembolism and thrombocytopenia in an unvaccinated com parator population pre-COVID Lukoye Atwoli and colleagues 1 deliver a compelling call to address interacting global crises and to improve equity. Crucially, they link biodiversity loss with health and clearly warn that the Earth system is now too close to multiple tipping points, beyond which lie "catastrophic, runaway environmental change". 2 However, we think there is risk that the part of Atwoli and colleagues' Comment concerned with future food security could give rise to pessimism. Irrespective of whether crop yield potentials are actually declining, food insecurity is deepening as a result of the effects of the COVID-19 pandemic and as a result of persisting unequal distribution of food and other forms of wealth and human rights. Scientists increasingly warn of synchronous or consecutive crop failures in multiple regions that produce large quantities of wheat and other food staples. 3 Without transformational reform in global thinking, such a scenario is likely to exacerbate inequitable food aid, mirroring the world's self-defeating and unfair COVAX roll-out of COVID-19 vaccines. Alleviative strategies not mentioned by Atwoli and colleagues include markedly reducing the current diversion of crops for use as animal feed and fuel, such as soy (more than 90%), maize, sugar cane, and palm oil. 4 Wild fish need not be fed to farmed, fish and food waste can be reduced. To benefit environmental and human health, a reduction in the average consumption of animal products by humans is crucial, both globally and especially in middle-income and highincome countries. 5 Insect farming is increasing and might offer a way to expand the supply of nutrients for human and animal consumption at a lower environmental cost, including a reduced need for arable land and water. The nutritional status of the global poor can be bolstered by improving access to water and sanitation. Finally, health and other benefits will accrue from increased family planning support and improved education, including in regions that are currently food insecure. Call for emergency action to limit global temperature increases, restore biodiversity, and protect health Climate change, health and existential risks to civilization: a comprehensive review Food production shocks across land and sea Red and processed meat, and human and planetary health Adoption of the 'planetary health diet' has different impacts on countries' greenhouse gas emissions We declare no competing interests.