Although nearly all heat-related deaths are preventable, heat waves kill thousands of people worldwide every year.
At this very moment, an extreme heat wave in India and Pakistan, affecting about 1 billion people, is “testing the limits of human survivability,” warned Chandni Singh, a lead author of the Intergovernmental Panel on Climate Change’s Sixth Assessment Report.
In April, the average maximum temperature for northwest and central India was the highest in 122 years.
This is not just a South Asian problem. In the past few years, similarly extreme conditions occurred in the US, Australia, Europe, Scandinavia and Japan, resulting in thousands of hospitalizations and excess deaths.
Extreme heat is also linked to increases in premature births, babies born with low weight and stillbirths, as well as reductions in worker productivity, higher rates of chronic kidney disease of unknown origin and increases in suicide.
Extreme temperatures are an “all-of-society” problem.
Such conditions not only harm human health, they also have detrimental effects on infrastructure, crop yields and poultry mortality, threatening livelihoods and undermining food security. Last year’s heat dome in the US’ Pacific northwest and western Canada was a case in point.
It was an event that would have been virtually impossible without climate change. Temperature extremes were about 5°C above previous records, causing approximately 1,000 excess deaths and a 69-fold increase in heat-related hospitalizations.
Yields from wheat and cherry crops plummeted, and millions of mussels, clams and oysters were cooked in their ocean habitats, threatening food security and livelihoods for indigenous peoples and low-income communities.
Nearly 40 percent of heat-related deaths are attributable to climate change, and because climate change is expected to increase the frequency, intensity and duration of heat waves, the need for additional measures to protect people is to become more urgent.
Without immediate and significant investment to enhance community and health system resilience, the deaths associated with heat exposure are to increase.
Well-communicated, evidence-based action plans are needed to keep people cool, and reduce hospitalizations and deaths. In addition to early warning and response systems, longer-term planning is needed for life on a warmer planet. That means providing more blue and green spaces, changing building materials, and focusing on ways to cool people, rather than the surrounding environment.
Early warning and response systems require more than just a single threshold for determining the start of a heat wave.
Effective systems should also include collaborative processes to ensure that interventions account for local capacities and constraints.
Health ministries would need to work closely with hydrometeorological services, police and fire departments, emergency services, agencies responsible for elder care, and trusted voices for vulnerable populations, such as those aged 65 or older, and marginalized communities.
Resources should not be a barrier. Effective early warning systems already exist worldwide, including in low-resource settings such as Ahmedabad, India.
Moreover, organizations such as the Global Heat Health Information Network are collecting and sharing data on local and national experiences, as well as best practices.
The demand for additional guidance is growing rapidly, in tandem with the increasing frequency and severity of heat waves.
However, most of today’s early warning systems do not explicitly account for the risks of a changing climate. To be more adaptive, planners should adopt time lines for reviewing changes at the beginning and end of the summer season, while also developing regional collaborations to ensure consistent messaging.
There would also be a greater role for tiered early warning systems that account for multiple thresholds, such as temperature readings combined with local knowledge of particularly vulnerable populations.
For example, initial warnings might be issued several days before the peak of a heat wave to alert at-risk groups, such as older adults, young children and pregnant women.
A second set of warnings could then be issued at somewhat higher temperatures for outdoor workers and people engaged in sports or related activities, followed by a third set of warnings for the general public at the usual threshold for declaring a heat wave.
These warnings would need to be paired with effective communications, so that people are properly motivated to take the appropriate measures to stay cool.
Even after these improvements, early warning systems should be stress-tested to determine their robustness to unprecedented heat. This could be done through desk-based exercises to identify weaknesses.
Stress tests should incorporate not just heat waves, but also compound risks such as back-to-back events: a heat wave combined with a wildfire or a heat wave coinciding with a pandemic, as the Pacific northwest experienced last year.
Vulnerability mapping can be an effective tool to help decisionmakers determine where interventions are needed most to protect human health and well-being.
A much warmer future requires urgent and immediate investment that capitalizes on best practices and lessons learned from existing heat adaptation plans. Proven models need to be scaled up to enhance resilience and sustainability. Unprecedentedly higher temperatures are survivable, but not unless we prepare for them.
Kristie Ebi is a professor of global health and environmental and occupational health sciences at the University of Washington.
Copyright: Project Syndicate
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