Wednesday, May 30, 2018

UK Heatwave Plan & Excess Mortality Due To Elevated Ambient Temperatures


While it likely comes as a surprise to many people, the biggest weather-related killer in the United States each year isn't hurricanes, tornadoes, lightening, floods or blizzards . . .  but rather heat waves.
Excessive heat has likely killed more Americans over the past 50 years than all of the tornadoes, floods, and hurricanes combined.
In 2002 Rupa Basu and Jonathan M. Samet wrote in the Journal Epidemiological Reviews (see Relation between Elevated Ambient Temperature and Mortality: A Review of the Epidemiologic Evidence): 
An average of 400 deaths annually are counted as directly related to heat in the United States, with the highest death rates occurring in persons aged 65 years or more (3). The actual magnitude of heat-related mortality may be notably greater than what has been reported, since we do not have widely accepted criteria for determining heat-related death (4, 5–7), and heat may not be listed on the death certificate as causing or contributing to death. 
This disparity between counted and estimated heat-related deaths can be illustrated by the reports from the infamous heat wave of 1980, which `officially’ claimed `more than 1250 lives’ (cite NOAA Heat Wave: A Major Summer Killer) but which unofficially may have killed as many as 10,000  (Tracking and Evaluating U.S. Billion Dollar Weather Disasters, 1980-2005 (Lott and Ross, 2006). 
Eight years later, a heat wave across the central and eastern part of the nation killed as many as 7,500 people (cite). More recently, in 1999, a prolonged heat wave along the Eastern seaboard is believed to have killed 500 (cite).
The situation in Europe, Asia, and elsewhere around the world can be equally dire - and between climate change, growing urban populations, and increasingly fragile infrastructure - the public health threat from prolonged heat waves is only expected to rise.

In 2015 the WMO (World Meteorology Organization) and the WHO (World Health Organization) issued new guidance on Heat Health Warning systems. From the press release:
WMO, WHO Issue Guidance on Heat Health Warning Systems
1 July 2015
Geneva 1 July 2015 (WMO) The World Meteorological Organization (WMO) and the World Health Organization (WHO) have issued new joint guidance on Heat–Health Warning Systems to address the health risks posed by heatwaves, which are becoming more frequent and more intense as a result of climate change.
“Heatwaves are a dangerous natural hazard, and one that requires increased attention,” said Maxx Dilley, Director of WMO’s Climate Prediction and Adaptation Branch, and Maria Neira, Director of WHO’s Department of Public Health, Environmental and Social Determinants of Health. “They lack the spectacular and sudden violence of other hazards, such as tropical cyclones or flash floods but the consequences can be severe.”
Over the past 50 years, hot days, hot nights and heatwaves have become more frequent. The length, frequency and intensity of heatwaves will likely increase over most land areas during this century, according to the Intergovernmental Panel on Climate Change. In addition to the health impact, heatwaves also place an increased strain on infrastructure such as power, water and transport.
       (Continue . . . )

The UK has updated their Heatwave Guidance plan (see excerpt below), and it is a good reminder as we go into the Northern Hemisphere's summer of the importance of preparing to deal with heat waves.

First a link and an excerpt, then I'll return with more.

Heatwave plan for England

Executive summary
The Heatwave plan for England is a plan intended to protect the population from heat-related harm to health. It aims to prepare for, alert people to, and prevent, the major avoidable effects on health during periods of severe heat in England.

It recommends a series of steps to reduce the risks to health from prolonged exposure to severe heat for:
•     the NHS, local authorities, social care, and other public agencies
•     professionals working with people at risk
•     individuals, local communities and voluntary groups
The heatwave plan has been published annually since 2004, following the devastating pan- European heatwave in 2003. This year’s plan builds on many years of experience of developing and improving the ability of the health sector and its partners to deal with significant periods of hot weather.
(Continue . . . )

While rarely mentioned, modern building architecture and home design often contribute to heat related deaths. Many windows no longer open, ceilings are lower, overhangs shorter, and temperature control is nearly completely dependent upon high tech equipment and a steady supply of electricity.

Following Hurricane Irma last September in Florida, I - along with millions of other Floridians - were without electrical power for days.  According to press reports, at least a dozen people died due to heat-related complications at one Florida nursing home.   
How many others succumbed around the state is unknown.   
While less is known about the particulars, yesterday's NEJM carried a statistical analysis (Mortality in Puerto Rico after Hurricane Maria) suggesting that 4645 excess deaths occurred in the 3 months following the storm.
It is a pretty good bet that some number of those were heat related.
Living in Florida, included in my Hurricane/General Disaster preparedness plan are ways to cope with the heat when the power grid is down.
First and foremost, I have water.  Lots of water.  Enough stored to last a month for myself, and my cat.  If the power is out, water (and sewer) services are often not far behind.
But I also have several solar panels (see Rethinking Solar Power On A Budget), including several small ones suitable for a bug out bag.  An excerpt from that post-Irma blog:
I've just started my conversion over to 5 volt solar charging (and I'll keep my old system, since it still works), so I'm hardly an expert. The most basic system (see photo below) can be put together for about $40.
A 10,000 milliamp battery with (3 fold) solar panal, a USB fan, and USB LED light.
The beauty of this system is it will fit in a backpack, weighs about 2 lbs, and while the solar charging will be slow and you'll have to be judicious with their use, it should keep phones, lights, MP3 players, and fans going for a few days.  Longer if you don't need the fan.

For under $100 you can buy a couple of bigger power bricks, and a much larger solar panel (20 watts plus), which will increase your capabilities significantly. That will be my next step.

Lest anyone think these sorts of preps are only important for those of us who live along the coastline during Hurricane season, in the summer of 2012, a powerful Derecho swept across the Mid-Atlantic states (see Picking Up The Pieces), killing 15 and leaving nearly 4 million people without power, some for more than 2 weeks.

While 15 people died during the storm, at least 32 died of heat-related illnesses in the two weeks that followed (see 2013 MMWR Heat-Related Deaths After an Extreme Heat Event — Four States, 2012, and United States, 1999–2009).

During any disaster, the most likely large-scale impact with be prolonged power outages, and with that can come many challenges, not the least of which include  heat-related illnesses and deaths. 
Being prepared - in advance - to deal with these types of threats can mean the difference between days or weeks of misery and relative comfort, and sometimes the difference between life and death.
For more on general preparedness, you may wish to revisit:
When 72 Hours Isn’t Enough

In An Emergency, Who Has Your Back?

#NatlPrep: The Gift Of Preparedness 2017

No comments: