In the United States, heat-related illness kills more people each year than any other weather-related event, according to the Center for Disease Control and Prevention. Public health officials are concerned the extreme temperatures of summer are about to be at odds with the coronavirus pandemic, which requires individuals to shelter at home, presenting the potential for millions of people to be forced to endure record-breaking heat in cramped apartments without air-conditioning. Many communities vulnerable to COVID-19 - the elderly, disabled, low-income, or homeless individuals - are also more susceptible to heat-related illness.
Heat-related illness, also called hyperthermia, results from exposure from extreme heat where the body is unable to properly cool, resulting in rapid rise of body temperature, as per the CDC. Of heat-related illnesses, heat exhaustion or heat stroke are the most serious. Heat exhaustion is characterized by muscle cramping, fatigue, headache, nausea, vomiting, dizziness or fainting, while heat stroke involves red, hot dry skin, rapid pulse, throbbing headache, nausea, confusion, or unconsciousness. Exposure to extreme heat can also worsen pre-existing conditions, such as heart disease or respiratory disease. All of the above conditions will make individuals more susceptible to contracting serious cases of COVID-19, but immediate intervention to heat-related illness requires aggressive fluid replacement and cooling of core body temperatures, which might be environmentally impossible amid the pandemic.
Many of the city locations public health managers rely on to provide cool refuge on hot days - libraries, senior centers, public pools, gyms, repurposed stadiums or arenas, homeless shelters - are potential hotbeds for COVID-19. It’s difficult to create accessible public spaces for individuals to cool off that also accommodate enough space to decrease risk of coronavirus transmission. If people are unable to gather in a public space for cooling down, increasing access to air-conditioning, water, or food, and providing education on how to prevent heat-related illness while homebound, can help state leaders minimize the potential increase in heat-related deaths.
Why Are Vulnerable Communities More Susceptible To Heatwaves?
Not everyone in the United States has access to air-conditioning or cooling during heatwaves, and in particular, low-income families will be susceptible to heat-related illness. For example, a recent study conducted by USC found that 40% of homes in Los Angeles County do not have access to cooling, and most of those homes are located in low-income census tracts. Temperatures tend to be higher in cities, due to "urban heat island effect", or the fact that regions with more concrete and asphalt absorb more sun and tend to be several degrees hotter on average, as per the CDC.
Estimating the public health impact of extreme heat is difficult, because heat-related illnesses and heat-stroke do not require reporting to public health agencies, meaning the statistics around heat-related deaths might be underreported. Many factors that contribute to heat-related illness risk, such as access to medical care, transportation, and cooling centers. Economic inequalities heighten coronavirus risk along similar demographic lines.
Climate scientists are predicting hotter-than average weather, meaning the summer months will force people to choose between risking contracting COVID-19 or heat illness. Financial strain caused by the coronavirus crisis will further endanger struggling families during periods of extreme heat. Energy bills cost money, and if individuals, facing unemployment or other economic complications, are unable to pay higher utility costs for air-conditioning, heatwaves can become a bigger crisis.
Local leaders must find innovative solutions to keep communities safe, including retrofitting homes, subsidizing utility costs if possible, establishing social-distancing compliant cooling centers, opening more public outdoor space, and creating a vulnerable needs registry to identify high-risk individuals.
How To Protect a Community From A Heatwave?
The CDC recommends state and local leaders develop heat response plans ahead of the summer season. The organization recommends that these plans include identifying local populations at high-risk for heat-related illness, and use this data to determine which strategies are most effective for preventing heat exhaustion or heat stroke during the COVID-19 pandemic. A vulnerable needs registry can help emergency managers, public safety, and health leaders identify individuals most at-risk in a community during a summer heatwave, leveraging citizen-sourced data such as age, location, and preexisting conditions for analysis, planning or emergency response. Once data has been volunteered by residents, public health leaders can better direct utility bill assistance, distribute information about cooling centers, and provide informed medical care as necessary.
Data can inform public health policy, and using this information, local leaders should explore all possible strategies to address excessive heat and its impact on vulnerable populations. Many cities are considering subsidizing energy costs for low-income households, especially those where family members are out of work due to the pandemic. Utility providers should be encouraged not to conduct shut-offs of water or power to households unable to pay bills, as this could prove fatal during a period of extreme heat. The CDC recommends, at minimum, expanding programs that help people pay energy bills, such as the Low Income Home Energy Assistance Program, as a way to reduce the number or people who might need a public cooling center.
CDC recommendsations suggest cities and states open cooling centers at a limited capacity, while screening visitors, including doing temperature checks, and allowing at least six-feet of space between each person, as per the Los Angeles Times. If possible, the department recommends opening a separate cooling center for individuals who have tested positive or are showing symptoms of COVID-19. Cities are also considering opening hotel rooms to homeless individuals to ride out the high-temperatures, especially as homeless shelters continue to struggle to keep people housed in a social-distancing compliant manner, as per Gizomodo.
Expanding access to bottled water or food can also mitigate the damage of a heatwave, allowing residents to live without making impossible decisions about which resources to spend their money on. Advocates are also urging states to look into innovative infrastructure solutions, such as installing better insulation, painting roofs to reflect the sun, and and planting rooftop gardens to keep buildings or homes cooler, moving investment from public cooling spaces to helping people stay cool at home.
Public officials in metropolitan areas should also consider opening up more free-space for residents to roam outside while adhering to social distancing. For example, New York City planned to close a 40 miles of streets to traffic due to decreased motor vehicle congestion, freeing up new pedestrian pathways, and in Oakland, California, officials planned to open up 74 miles of city freeway to pedestrians, according to CBS.
It’s critical that residents understand the risks of being at home without proper air flow and the undue stress this can cause, especially for those with underlying conditions like asthma or heart disease. Leverage a mass notification system to communicate heat risks for those stuck indoors, including basic safety tips about hydration or clothing. Administrators can also use the system to send targeted alerts to individuals in-need of cooling centers, information about food pick-up or drop-off points, utility bill assistance, or any other program related to reducing heat-related illness risks.
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