Protecting our health from weather extremes needs planning at home right now

In anti-science fantasy worlds, climate change is a mere theory, an abstraction to be ignored for now. This view would be foolish under any circumstance.

But it has become more counterfactual than ever, as people come to grips with horrific heat waves blamed for hundreds of deaths recently in the Pacific Northwest and Canada, as well as dozens of deaths in Arizona.

Who can ignore the parching drought in the West, the 1 million-plus acres burning in 12 western states due to raging wildfires, record flooding in Europe (which has claimed more than 100 lives and left more than 1,000 missing) and torrential rains in China — not seen in 1,000 years and which have killed dozens and displaced more than 1 million?

Climate change is a real threat to our health and our very existence.

The Centers for Disease Control and Prevention lists multiple areas where its experts see big issues ahead due to rapid, harsh changes in the environment. The National Institute of Environmental Health Sciences lists its own range of impacts, including:

§ Asthma, respiratory allergies, and airway diseases § Cancer § Cardiovascular disease and stroke § Foodborne diseases and nutrition § Human development § Mental health and stress-related disorders § Neurological diseases and disorders § Diseases borne by pests and animals and  § Waterborne Diseases

Arming ourselves with a few basics can protect and save the lives of the vulnerable — the young, old, and those who toil through extreme weather.

Human beings, across the millennia, have shown we can be hearty and adaptable. But can we react as needed to survive what many experts consider a major danger to our species — one that can take a terrible toll on our health if we fail to respond appropriately?

An estimated 650-plus Americans on average die annually due to sizzling temperatures, with another 500-plus fatalities attributable each year to deep freezes. These are mostly preventable casualties.

Weather extremes have become obvious markers of climate change — and they are among the conditions about which we can do the most to reduce their health risks.

Here is what the CDC says about combating illnesses and deaths due to scorching temperatures and high humidity:

“Heat-related illness, also called hyperthermia, is a condition resulting from exposure to extreme heat where the body becomes unable to properly cool, resulting in a rapid rise in body temperature. The evaporation of sweat is the normal way to remove body heat, but, when the humidity is high, sweat does not evaporate as quickly. This, in turn, prevents the body from releasing heat quickly. Prompt treatment of heat-related illnesses with aggressive fluid replacement and cooling of core body temperature is critical to reducing illness and preventing death.”

As the chart above (adapted from the Centers for Disease Control and Prevention) shows, there are different levels of injury due to high heat, including cramping, exhaustion, and stroke. It is important to distinguish among them and to respond to each in specific ways.

In general, though, it also is vital to know that certain groups of people are highly vulnerable, including kids (infants and children younger than 4), seniors (those age 65 and older), those who carry excessive weight or who may have chronic medical conditions (like diabetes or heart disease), the poor, and the isolated. The athletic, surprisingly, also may put themselves in harm’s way during hot spells.

People may heighten their heat risks by taking in intoxicating substances, especially alcohol, or because they take prescription or over-the-counter drugs that affect the body’s temperature regulation, some by inhibiting perspiration.

Common sense safeguards

Common sense can go a long way to reduce excessive heat’s toll. When temperatures climb, try to tackle outdoor activities and chores in cooler times of the day. Take frequent breaks. Avoid exposure to the blistering sun, and don’t fool yourself that skimpy garb is always the best way to go. Instead, wearing cool, light-colored, loose-fitting clothing may be more helpful. Hats and umbrellas also can provide sun relief.

Whether fair-skinned or not, slather on that sunscreen, especially in summer. Experts are offering more detailed advice about what products to apply to protect against damaging UV rays that not only can age and wrinkle the skin but also may cause cancers. The product guidelines may require even more consideration due to recalls and certain chemical ingredients in sunscreens that can pollute some waters.

When temperatures soar, a few protective basics come into play, big time: Keeping hydrated, avoiding over-exertion, and staying in cooler spots.

Most people do not require special drinks to stay hydrated in the heat. Cool water, in regular and sufficient supply, should do the trick. Don’t guzzle beverages for their own sake because you can overdo liquids. Eat lightly, maybe with smaller, more frequent meals to maintain key electrolyte balances, especially of sodium and potassium — two substances your body runs through a lot in the heat.

If possible, the savvy stay indoors, in well-cooled areas, to beat high temperatures. Fans may be useful and less power- and budget-draining than air conditioning. It may be possible to put a dent in the summer and fall heat and cool a home, apartment, or condo enough by opening windows and doors and capturing the night’s chill, then pulling shades and shutting the place up during the day.

Still, people need to recognize when the heat becomes too much for resources they can throw at it. Many homes and buildings are not air-conditioned, and they quickly may become uncomfortable and unsafe to stay in during hot spells. People long have learned to head to swimming pools, water parks, and, of course, air-conditioned public libraries, movie theaters, and shopping malls to stay cool. Many local governments, including the District of Columbia, open special centers to assist those in need during hot and cold spells.

Looking out for others

While it may be tempting to turn into a cranky recluse during weather extremes, the intemperate periods can demand the best of us — notably in our looking out for each other and helping those in need.

The old, sick, and disabled can benefit hugely from concerned friends, colleagues, and loved ones checking in on them during extreme heat and cold. The lives of the homebound can be changed — even saved — if Good Samaritans bring them food, water, and other supplies (fans) or walk or drive them to places where they can stay appropriately cool or warm.

Please pay extra attention to kids during weather extremes. In the heat, do not leave youngsters alone in the car, especially if they are restrained in child seats or by safety belts from which they can’t free themselves. Don’t run in a store “just for a second,” and think that cracking the windows a little and parking in a spot that seems shady will make things all right. It won’t. Your kids don’t react to heat as adults do — they can overheat much faster and suffer dire consequences as a result. Authorities have put in place stiff penalties for grownups guilty of this abusive neglect of children. (It should go without saying that pets also should not be left unattended in hot vehicles, and that humanity’s four-footed companions need heat protections, too, as outlined in this newsletter.)

Avoid over-exertion

Let’s add one more preventable heat-related harm: athletic over-exertion.

Few of us are elite competitors who are maintaining world-class standings with 24/7 training, including in difficult circumstances. Instead, many of us can and should ease up or ease off on the workouts, especially in extreme heat (and in extreme cold). Maybe instead of running when it’s hot, athletes can switch to swimming. It won’t be optimal, but it may be better to play tennis under the lights, rather than on scorching midday courts.

Overexertion in heat can cause the condition known as rhabdomyolysis or “rabdo,” which the CDC describes:

“Rhabdomyolysis is a medical condition associated with heat stress and prolonged physical exertion, resulting in the rapid breakdown, rupture, and death of muscle. When muscle tissue dies, electrolytes and large proteins are released into the bloodstream that can cause irregular heart rhythms and seizures and damage the kidneys. Symptoms of rhabdomyolysis include: Muscle cramps-pain, abnormally dark (tea or cola colored) urine, weakness, and exercise intolerance.”

This condition can result in hospitalization and the need for intravenous fluid replenishment, as well as more serious interventions for kidney harms, including dialysis and even transplantation for organ failure.

Coaches need to get wise

Grown-ups — coaches, trainers, and athletic administrators — can be blamed for the abject failure in judgment, of course, in pushing youthful players to work out and suffer harms in high summer and fall heat. The National Center for Catastrophic Sport Injury Research reported in March this awful information:

“Since 1995, 70 football players have died from heat stroke (51 high school, 14 college, 2 professional, 2 organized youth, and 1 middle school). During the most recent five-year period from 2016-2020, there was an average of 2.2 heat stoke deaths per year compared to 2.2 per year during the previous five-year period 2011-2015. This lack of change supports continued efforts to educate coaches, school administrators, medical providers, players, and parents concerning the proper procedures and precautions when practicing or playing in the heat. During the most recent five-year period, 7 of the 11 deaths were during conditioning sessions compared to 1 of 11 during the previous five-year period. This highlights the need for appropriate oversight and monitoring of conditioning sessions … “

Let’s not forget that University of Maryland leaders in 2018 were forced to apologize and concede that the school shared blame for the tragic and preventable heat stroke death of Jordan McNair, 19, a Terps offensive lineman. Coaches forced the young man to run and over-exert himself during a practice. More importantly, they failed to diagnose the severity of his condition, neglecting so much as to take his pulse and blood pressure. They also did not deal appropriately with his seizures nor did they act fast to drop his body temperature with ice and cooling baths.

Long after his death, the university and the state settled for $3.5 million with McNair’s parents, agreeing that part of that sum would go to a memorial foundation that seeks to help educate communities about heat-related illnesses, the Washington Post reported.

McNair’s tragic death, the newspaper also noted, “sparked two investigations, cost DJ Durkin his job as Terrapins head coach, hastened the departure of Wallace Loh as school president and prompted the resignation of James T. Brady as chair of the University System of Maryland’s board of regents.”

Health safeguards against frigid cold and other weather extremes can remind all of us of the importance of planning, preparation, and following expert recommendations.

Low temperatures can harm humans in two notable ways: § frostbite, the injury to specific tissues by cold, and § hypothermia, a broader collapse of body systems resulting from cold. The CDC says:

“When exposed to cold temperatures, your body begins to lose heat faster than it can be produced. Prolonged exposure to cold will eventually use up your body’s stored energy. The result is hypothermia, or abnormally low body temperature. Body temperature that is too low affects the brain, making the victim unable to think clearly or move well. This makes hypothermia particularly dangerous because a person may not know it is happening and won’t be able to do anything about it. Hypothermia is most likely at very cold temperatures, but it can occur even at cool temperatures (above 40°F) if a person becomes chilled from rain, sweat, or submersion in cold water.

“Victims of hypothermia are often (1) elderly people with inadequate food, clothing, or heating; (2) babies sleeping in cold bedrooms; (3) people who remain outdoors for long periods — the homeless, hikers, hunters, etc.; and (4) people who drink alcohol or use illicit drugs.”

In adults, the CDC advises, the symptoms of someone in serious trouble due to the cold include shivering, exhaustion, confusion, fumbling hands, memory loss, slurred speech, and drowsiness. Infants may show symptoms including “bright red, cold skin and very low energy.”

Emergency care for hypothermia and frostbite focuses on getting the patient warm and dry, handling them gently to avoid further injuring already cold-damaged tissues. With hypothermia, treatment should seek to warm the patient’s core areas first — the head, neck, chest, and groin — with heating devices, blankets, and, if necessary, human contact, skin to skin. It may be warranted during the warming period to also continue resuscitation efforts longer than rescuers think because victims who may be believed dead successfully can be revived.

Emergency readiness as a paramount issue

Preventing people from adverse exposure to frigid conditions and other weather extremes — including hurricanes, tornadoes, and inundating rains — is becoming a paramount issue for forecasters and planners. All of us, no matter what part of the country we live in, find ourselves needing to think about disaster readiness for ourselves, our loved ones, businesses, governments, and other enterprises.

When public emergencies arise, please heed authorities’ warnings and advisories. This can be a life and death matter. It is confounding why some people decide to play on beaches as hurricanes approach, or why golfers and anglers don’t take shelter in lightning storms, or others ignore wildfire alarms — and perish as a result.

Let’s utter the I word, at least briefly. To cope with rising conventional demand and the crushing scenarios of climate change, our nation must improve its infrastructures of all kinds. The coronavirus pandemic smacked many of us in the face with our vulnerabilities in this area and in so-called supply chains, compounding what we’re already experiencing with environmental extremes.

To be specific, and without sounding like 1950s extremists who built nuclear-bomb shelters in their yards, we’re all too aware of how difficult conditions can make even the most fortunate among us instantly insecure about basics like food and water supplies. Yes, you need emergency rations now, because you may be forced to be self-reliant for an uncertain period due to earthquakes, wildfires, hurricanes, disease outbreaks, or … well, you name the growing list of calamities.

Different agencies issue planning guides for dire circumstances. These no longer can be jammed in kitchen drawers and ignored. (See one preparatory list in illustration above). Instead, a little careful stocking up can keep you and yours out of a world of troubles. You won’t sit in the dark and fret if you have a few working flashlights, a portable radio, plenty of batteries, and lots of chargers and fully powered electronic devices such as the cell phones on which we all now rely.

Keep health needs in mind

During the pandemic, doctors, and pharmacists got with the program and made it easier and almost routine for patients to fill prescriptions in “emergency” quantities. If extreme weather is forecast, be sure you have on hand ample supplies of medications that you need. Ditto any other health or medical supplies. Please also consider that doctors, hospitals, and other medical providers likely will be overwhelmed in extreme conditions, as happened during the Pacific Northwest heat wave.

Patients with chronic conditions who need regular, sustained treatments should consult with their caregivers — in advance — about disaster plans.

You, your family, and your neighbors may want to think hard about even more detailed and expansive emergency preparations. If you have problems with your mobility, eyesight, hearing, or cognition, do you have care and evacuation plans? If you have medical needs that require steady, sustained electrical power, do you and others in your area need back-up generator or battery capacity? If your homes are heated or cooled with certain sources, including electricity and gas, will these function in weather extremes?

Investigations continue to determine the true death toll due to the failure of the Texas power grid last winter. That disaster left millions of customers shivering in an unexpected cold snap, resulting officially in more than 150 deaths — though media investigations suggest that number may be as high as 700. In the parched and scorching West, huge utilities are warning regulators and customers that they suddenly may have their electricity shut off to prevent powerline arcing and sparking that already has been shown to cause sprawling, lethal wildfires. On an individual level, alas, 500 or so people die and more than 1,000 suffer serious injuries annually due to residential fires blamed on defective or faulty use of home heating devices, notably space heaters.
 

While extreme weather may offer the most obvious displays of how climate change affects people’s health, big alterations of the environment likely will lead to other major harms, too.

These effects are forecast by experts but will take time for ordinary folks to see in more concrete ways.

Respiratory illnesses, for example, will worsen as climate change increases airborne pollutants. These include surface ozone and particulates (as spread from wildfires). They also mix with other atmospheric chemicals and materials, interacting with heat and sunlight in toxic ways, experts say. Parts of the country seemingly unaffected by disasters like the Western wildfires still may be choked by huge plumes of polluting smoke. In rigorous research scenarios, patients with asthma and other chronic lung disorders, as well as those struggling with heart disease, face increased risks and burdens.

The early signs of how different rain, sun, and wind patterns affect our health have been detected by allergy sufferers. They complain that their seasonal discomfort starts earlier, lasts longer, and has been more severe as pollinating plants in many parts of the country bloom in response to weather changes.

Cancer experts worry that different problems with ozone — the erosion of a protective upper atmospheric layer, despite efforts to ban certain chemicals to protect it — may increase skin cancers as people are exposed to more and more powerful UV rays. Increased rainfall in swaths of the country, sometimes also unleashing torrential flooding, may result in broader populations being exposed to toxic, cancer-causing chemicals spreading on the land and into our waters, staying there, and causing long-term health damages.

America long has prospered, of course, because of its agricultural bounty. But as the nation’s bread baskets grapple with drought, flooding, temperature swings, and other menaces of climate change, food insecurity may become a bigger threat to us all, experts say. This is likely to be accompanied by troubles in securing and protecting our drinkable water supplies.

Health experts fear that climate-change-related problems with food supplies— with crops diminished or wiped out by drought or flooding — could result in famines and other nutrition nightmares that affect the health and development of future generations. Further, will persistent environmental shocks drag down the economy — and, combined with bigger and more frequent calamities, cause young people to reconsider having kids? Will persistent climate crises, almost akin to biblical plagues, cause serious erosion of more people’s mental health?

By the way, let’s not ignore that climate change already may be altering the pests that plague us, as well as the infectious diseases they spread (see sidebar).

In dealing with the giant crisis of climate change, there also are some other important, debilitating conditions that must be dealt with by us all: pessimism, despair, and apathy.

Reciprocal altruism vs. numb nihilism

We must come to grips with feeling so overwhelmed by it all — the pandemic, climate change, natural disasters — that we grow numb or even nihilistic. What, after all, can one individual do about global warming, excessive C02 emissions, ozone depletion, deforestation, and more? You may be saying you’ll never give up that posh, gas-guzzling vehicle gracing your driveway and you’re going to fly whenever and wherever you please. You’re going to eat and wear what you want, and you’ll keep your home and office lit up and toasty in the winter and chilly in the summer, thank you very much.

Really? The kids in the neighborhood are watching, as are your nieces, nephews, grandkids and all the young people in the office. Every generation must rise to its own challenges, and leaving the planet in better, healthier shape than we found it must be ours.

The next time the nightly news is filled with seemingly endless blah-blah-blah from prominent politicians about major issues like infrastructure and climate change, know this: We’ve got urgent work to do.

The least among us and the vulnerable, in the wealthiest nation on the planet, should not be exposed to excessive heat or cold, especially because they live in less-than-optimal housing — or are not housed at all. It is unacceptable that this country, which feeds the world, has so many hungry people of its own. And we can’t shrug and assume that Big Agriculture will protect our supplies past their immediate profits and into the future. We can discuss how best to power and heat our businesses and homes but having these services in reliable fashion cannot just be for the rich few, while the rest of us sit, shivering or broiling, in the dark.

Health care, as always, cannot be a privilege but must be a right for all Americans — and this will be yet another challenge as the climate changes.

The pandemic has underscored the importance of reciprocal altruism. We rely on myriad “essential” workers, and we need to safeguard them — not only from the coronavirus but also from toiling in dangerous weather extremes for our benefit and without adequate protections. We need to worry about our neighbors, colleagues, and loved ones in dire conditions so we all thrive in the days ahead.

Huge challenges may seem less forbidding if they’re broken down and tackled, bit by bit, just as researchers make medical advances incrementally, leading eventually to major breakthroughs. We need to trust science more than ever, to follow in big and small ways the guidance that will keep us, our health, and the planet as fit as possible.

Of course, as always, here’s hoping that you and yours stay not only as environmentally tip-top as possible but also healthy and well through the rest of 2021 and beyond!