Harping on heat and health
In the opening chapter of Kim Stanley Robinson’s provocative novel “The Ministry for the Future” set in near-future India, scores of people on the streets and in hospitals are dying from intense heatwave and high humidity, with the human body no longer able to regulate its temperature. The novel dramatically depicts the grave human impacts of climate change and rising global temperature due to greenhouse gas emissions, a grim reality we are experiencing now.
A couple of weeks ago, the Philippine Atmospheric, Geophysical, and Astronomical Services Administration (Pag-asa) issued warnings on heat index so dangerously high that it caused class cancellations and calls for heat breaks at work, and alarmed our health department anew because extreme heat poses serious threats to human health and well-being. While increasing temperature and heat are expected in the dry season, they can also be due to natural phenomena like El Niño.
In 2023 up to last year which saw record-breaking heat, the country had a long and bad spell of El Niño—exacerbated by climate change—that led to reports of heat-related deaths and illnesses. We had to work with disaster response agencies just to ensure continuous delivery of essential health services.
But at the onset of the wet season, when the rains, typhoons and flooding came, extreme heat somehow ceased to be an issue. It was buried in the headlines especially in late October when the train of six typhoons (Kristine-Leon-Marce-Nika-Ofel-Pepito) pummeled the country (especially northern Luzon) in just 23 days, setting another global extreme weather event record.
Early January this year, we saw dengue outbreaks in key cities, the increasing number abetted by isolated rain showers and the resulting clean, stagnant water that provides a good breeding ground for the disease-carrying mosquitoes. But based on local studies, the likely culprit may be heat. From 2010 to 2019, an Ateneo study showed that around 75 percent of dengue events in the country is related to increased temperature.
This year, it is highly unlikely for El Niño to happen. But we have to brace ourselves for extreme heat that is, without any doubt, another solid proof of climate change.
In fact, it was in the wake of the deadly 2003 European heatwave which killed some 70,000 people when human-induced climate change came to fore as the driver of extreme weather. For people over 65, the risk of dying from heat increases by approximately 85 percent.
Extreme heat also worsens air quality and contributes to air pollution through increased ozone and particulate matter that pose health risks in terms of respiratory and cardiovascular diseases. It also affects behavior and can heighten psychosocial and mental health risks in some individuals. Indirectly, extreme heat can contribute to poor sanitation and water quality and even water scarcity leading to waterborne diseases. With limited refrigeration and improper food storage, foodborne illnesses can also ensue.
Extreme heat also causes droughts that affect the nexus of agriculture, food security, and nutrition. It also fuels wildfires and urban fires that can be health emergencies by themselves.
Extreme heat affects energy use because of the need to cool health facilities lest patients and staff suffer from heat-related illnesses. It can also cause disruption of supply chains and can affect the potency of vaccines and the quality of medicines when power outages arise.
The risks of extreme heat to our health and health system must be anticipated, prevented, and managed. Action plans should be in place and should include the following: Health alert and warning systems through various channels; public information and education campaigns; monitoring of vulnerable populations; provision for cooling, ventilation, and hydration in health facilities and communities; health-care provider outreach to inform the management, treatment and referral of cases; health emergency preparedness, collaboration with other sectors and agencies, and heat-health data collection and analysis.
To build extreme heat resilience over the long term, we should pursue the following: Incorporate heat as an important hazard in all emergency preparedness plans and programs; follow guidance on green and safe health infrastructure particularly on cooling, ventilation, energy and water efficiency, and greening among others; communicate the urgency of extreme heat as a health issue and provide relevant recommendations to other sectors; protect workers and industries from heat stress; design policies and programs to address the health needs of vulnerable populations, and embed heat-health resilience in urban planning and risk governance.
It is high time that we become proactive in managing the impacts of extreme weather events, and address this burning issue.
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Ronald Law is a medical doctor, public health practitioner, and academic working on the intersection of climate and health.
