Whilst summer may still feel a way off to some, my attention is now firmly moving towards making sure we have everything in place to protect the health of those most at risk from high temperatures this summer. This is where the annual release of the Heatwave Plan comes in.
We publish this in the month of May to give health and care services sufficient lead-time to be ready for the first hot days.
This is important for many reasons, not least the fact that health effects from heat happen within hours and tend to be greatest earlier in the season.
We also know that heat-related health effects start at relatively moderate warm temperatures, with about 2000 heat-related deaths each year even without a temperatures high enough to trigger a ‘heatwave alert’.
That said, it does help communicate the importance of preparing for hot weather if it’s already warm and sunny. I’ll not readily forget the day two years ago when we launched the plan in the driving rain – the ‘coldest spring ever’ or some such statements were being made. I recall standing huddled under an umbrella as the wind and rain buffeted me while I did my best to talk on TV about the health effects of heat. Cue a fair degree of (good-natured) teasing…
However, even when it does get hot and we start seeing health effects, both in terms of excess deaths and calls to health services about heat and sunstroke, it can be difficult to get the message across.
Firstly, the word ‘heatwave’ often has very positive connotations, something to be welcomed, and we can sound like kill-joys. But whilst many people positively relish hot weather, and find their sense of health and wellbeing improves in the summer, for some ‘at-risk’ groups it can get uncomfortably hot and make them very unwell.
Whilst many people positively relish hot weather, and find their sense of health and wellbeing improves in the summer, for some ‘at-risk’ groups it can get uncomfortably hot and make them very unwell
Also, we don’t experience the kinds of temperatures of some other countries such as Australia or India and the comments pages are often full of the old chestnut that we in England ‘don’t know the meaning of hot’.
But how heat affects us depends on how well acclimatised we are to it – both physiologically and in terms of how we design our buildings/urban spaces. We are not particularly well adapted to heat (yet – a discussion for another blog).
There is a wealth of evidence that shows that people are much more fearful of ‘chemicals’ and ‘contagion’ than they are of natural hazards like heat, even though the risks to health from natural hazards can be significantly greater. We often get accused of over-reacting, but as a good colleague once said to me ‘if it was a chemical in the water that was killing 2000 people a year there’d be an outcry!’
It’s even sometimes said that because deaths from heat exposure are mostly in the old and the ill, that’s somehow less of an issue. For sure, some deaths will be brought forward by a few weeks as a result of heat, but many are avoidable through relatively simple actions.
And indeed perhaps people don’t get as concerned about heat deaths because they see the health advice as simple common sense. Healthy adults who aren’t at risk often level criticism at our heat warnings (such as advice on keeping hydrated, taking action to stay cool and keep our homes cool) saying the advice is obvious or nannying.
But every summer, we hear stories from frontline health care workers about older people, quietly baking in chairs positioned in the full glare of the sun, warmly dressed and dehydrated with worsening cardiac or respiratory disease. Whilst many are socially isolated, others have had visits, yet no-one has attempted to keep them cool because the risk isn’t recognised. Health professionals urge us to do more to get the message out there.
And that brings us back to who we need to reach and how best to do it. We’re trying to reach those most at-risk (particularly older adults and those with chronic illnesses). Reaching these groups can be tricky. We know that many do not perceive themselves to be at risk, either because the ageing process means they no longer notice the heat, or because they don’t want to admit a degree of vulnerability.
We’re trying to reach those most at-risk, particularly older adults and those with chronic illnesses
Alternatively they may be uncomfortable, but unable to adjust their clothing or environment, for instance because of mobility problems or dementia. We know that many older people do not drink enough because they’re fearful of falling on the way to the toilet, or of becoming breathless if they have heart failure. But in hot weather, this increases the risk of dehydration, potentially leading to heart attacks and strokes, as well as urinary tract infections.
That’s why this year, as we’ve done in previous years, we’ll be encouraging health and social care staff to consider the at-risk groups in hot weather, review medication and offer advice as part of their routine care. But we know they can’t possibly contact each and every one of the vulnerable on their case load each time it gets hot.
That’s why we’ll continue to urge friends and family of those who may be at risk to consider what simple things they could do to help, even if it’s ‘just common sense’.