Rising temperatures: How to avoid heat-related illnesses and deaths

In Boston, we believe warmer is better. Our cravings for warmth are formed in the cold, dark winter nights when the prospect of summer seems impossibly remote. But with July temperatures reaching near 100° F, our winter dreams are becoming a summertime nightmare. Dangerous heat exposures in Boston and other cities across the US aren't felt equally. Urban areas with less green space and more pavement can be up to 15 degrees hotter than other, greener places. These urban heat islands are much more likely to be poor, minority neighborhoods, and their origins can be traced straight back to redlining that began in the 1930s.

This summer, the disparate heat risk these communities face has piled onto the outsized harm that COVID-19 has already wrought upon them. The good news is that we can take actions that protect our most vulnerable urban neighbors and ourselves from COVID-19 and extreme heat.

What is heat-related illness?

Our ability to cool off has limits. When the heat is too strong, our bodies overheat. When that happens, we can get headaches and muscle cramps, and vomit. Severe overheating, when body temperature reaches 104° F or higher, can lead to heatstroke that can damage kidneys, brains, and muscles.

Even for people who are healthy, heat can be dangerous and cause heat-related illness. Outdoor workers, athletes (especially football players and young athletes), and women who are pregnant should be especially careful when it's hot outside.

Who is at greater risk from high temperatures?

Heat can be a risk for those who are healthy, but it's particularly risky for people who have existing health problems. It can even be lethal. Decades of research show that people die during heat waves, and that these deaths are not occurring among people who were likely to die soon anyway.

Many of us probably know someone who is at greater risk from too much heat. The elderly — particularly those with heart failure, kidney disease, and chronic lung disease — and the homeless are at high risk when temperatures soar. Less well known are the others who need to be vigilant when extreme heat hits, including parents of children with asthma and people with diabetes. Anyone taking medicines, such as diuretics, that can affect their body's ability to sweat or hold onto water may also be more vulnerable.

How can you keep yourself and others safe during heat waves?

More than half the people in the US may have received some form of warning during our most recent heat wave. But research on these mass alerts shows they may not be as effective as we'd like. And now, with COVID-19, many people may understandably be less interested in going to cooling centers, which are often a mainstay of heat wave response plans. This makes actions you can take all the more important. You can keep yourself and others safe by taking these steps:

• Think about whether your health, or the health of your neighbors or loved ones, is at risk from heat. If so, make sure everyone — including you — understands how to stay safe during heatwaves.
• Check up on your neighbors and friends. Call or text first, and knock on a door if you have to. You can do this while wearing a mask and practicing physical distancing.
• Sign up for heat alerts. Many city or town governments have a website where you can sign up to receive text messages to alert you of dangerous heat conditions. Free services, such as iAlert, also can send you alerts. Be aware, though, that the alert may go out at temperatures above what is known to be risky for health.
• Find out where the cooling centers are in your city, and whether they are still open during the pandemic. Many may be implementing new social distancing guidelines or limiting their capacity. Tell others who might be at risk about them. During heat waves, many cities offer free transportation to these centers. Many cities have websites that can help you find the cooling center nearest you. Or a citywide number to call or text, such as 311 for the city of Boston, may connect you to many different services like these.
• Drink plenty of water during heat waves. Avoid too much caffeine and alcohol, which can promote dehydration.
• Cover windows with curtains, shades, paper, or any material that will keep the sun from shining in.
• Eat food that can be served cold, so you don't have to use your oven or range.
• If and when the temperature falls below 70, which in many places happens early in the morning and at night after the sun has gone down, open windows and use a fan to circulate air.

What other steps can you take?

It's right to focus our immediate actions on protecting people most at risk. But we also need to consider recent heat waves a sign of things to come. We know climate change has already led to more severe heat waves throughout the United States. Curbing carbon pollution by taking these actions and others can help prevent more frequent and dangerous heat waves.

We can make our cities greener. The difference in temperature between the hottest and coolest parts of cities can be 20° F or more, because of how much the urban landscape absorbs heat. Planting trees and other plants can make a big difference toward reducing heat in cities. Green space doesn't just keep us cool, it also keeps us healthy. Trees remove air pollutants that can further harm people who are at risk from heat. Vegetation prevents water runoff. In Boston, runoff from heavy spring rains last year led to pollution levels in the Charles River that forced cancellation of all summer swimming events. Climate change has increased heavy downpours in New England and around the country. Trees can help make our cities more resilient to climate change.

We can work to reduce traffic congestion. This is a growing problem in cities all over the country, although the pandemic has cut down on commuting traffic in many places. Use public transit or carpool when possible, given the need to protect yourself and others from COVID-19. If you buy a car, remember that greater fuel efficiency reduces carbon pollution and other pollutants that damage lungs, hearts, and brains — and lowers monthly costs. Improvements to make public transit accessible, affordable, and reliable help everyone. Find out what's going on in your community about transit, bike lanes, and pedestrian ways. Advocate by speaking out at community meetings (many of which have moved online), and by voting for improvements through local and state referendums.

We can conserve energy at home. If you are redoing your roof, consider getting a green roof, or at least choose light-colored roofing material. Many cities and states offer free home energy audits, plus incentives to improve a home's insulation and replace old appliances with newer, more energy-efficient models.