Countermeasures against the killer heat and that spectre of the summer of 2003 that caused over 4 thousand deaths

Forty-three degrees in Spain (after 46 on Saturday) and in the south of Portugal. Forty degrees in France and Italy. But half of Europe is gripped by the African anticyclone that has pushed well beyond our country. “At this moment” a wave of “torrid heat is hitting the WHO European region, breaking records, putting health systems to the test and putting countless lives at risk”. The alert was launched by the regional director of the World Health Organization (WHO) for Europe, Hans Kluge , who in a note explains why heat waves are a health crisis and how to prepare. Because heat can be an insidious killer, especially for the elderly, as the record-breaking torrid summer of 2003 reminds us, when the heat lasted without pause for more than 30 days between July and August, killing over 20,000 people in Europe: in France alone, the “canicule” had claimed 11,000 victims among the elderly, while in Italy, according to conservative estimates collected at the time by the Istituto Superiore di Sanità, over 4,000 deaths had been recorded.

Extreme heat, WHO reminds us, “silently threatens those who need protection most: older people, children, outdoor workers and anyone living with chronic conditions”. And “climate change means that heat waves are no longer rare. They are becoming more intense, more frequent and more dangerous. Extreme heat can overwhelm our bodies’ ability to cope with high temperatures, causing serious illness and even death. The good news? Most heat-related health impacts are preventable”. This is why WHO Europe has launched “the annual #KeepCool campaign”, to remind us of the simple life-saving measures that we can all adopt”. The campaign is based on four pillars. First rule: keep the heat away “by staying indoors during the hottest hours of the day, in the shade where possible and never leaving children or pets in parked cars. Point number 2: keep the house as cool as possible “by airing it out at night, closing curtains and blinds during the day and turning off unnecessary lights and devices”. Point 3: Keep your body cool “by wearing light clothing and drinking plenty of water. And to close point 4: Stay in touch with family, friends and neighbors, “especially those who may need additional help.”

“But we can’t stop there. Every country and every community needs robust heat and health action plans: timely warnings, clear communication and support for those most at risk,” the WHO note concludes. “It’s not just about surviving the summer, but about protecting our health in a changing climate. Let’s make sure everyone knows how to stay safe and healthy, no matter how hot the weather gets.”

But what are the main health risks caused by heat waves? High temperatures, combined with high humidity, can trigger heat stroke, dehydration, heart failure and respiratory crises in the most vulnerable patients. It is therefore necessary to pay attention to the warning symptoms. "Systemic heat pathologies can manifest themselves with more or less severe effects on the entire organism which is no longer able to dispose of, for example through sweating, the heat produced internally, so that the body temperature begins to dangerously increase", warns Mauro Minelli , clinical immunologist and professor of Human Nutrition at the Lum University. "The mildest systemic form is sunstroke, also called heatstroke, which, in terms of symptoms, can manifest itself with erythema extending to the parts most directly exposed to the sun which are also quite hot and, perhaps, covered with blisters. Other typical manifestations of heatstroke can be hyperemia of the conjunctiva with tearing and great sensitivity to light, low-grade fever, pain in the neck region and a feeling of heaviness in the head sometimes with a vague sense of confusion and dizziness. In these cases - warns the doctor - the treatment, generally rapidly effective, can simply consist of moving to a cool and airy place, rehydrating with abundant quantities of water added with mineral salts, lying on your stomach with your legs slightly raised, loosening belts or ties or tight clothing and, if necessary, applying baths of water at room temperature, therefore not excessively cold, to the forehead, wrists and neck which could lead to an effect completely opposite to that expected due to vasoconstriction phenomena. It is not necessary that all these symptoms are simultaneously present in the same circumstance. In any case, however, the resolution of sunstroke is generally rapid and the clinical picture does not involve complications”.

The month of June that has just ended has recorded very high temperatures well above average and already seems to evoke the nightmare of the summer of 2003, when there was a high pressure practically uninterrupted from June to September. A grip that had caused many deaths in Europe, over 20 thousand according to the estimates of the time. In France there was a real massacre of elderly people, because the retirement homes were not equipped, so much so that the memory is still alive of that peak of heat that would have caused over 11 thousand deaths, of which at least 80% among the over 75s. The data was calculated on the increase in deaths in the period compared to the average of previous years. The same calculation was carried out in Italy by the Istituto Superiore di Sanità. The survey was based on an active search for additional deaths registered compared to 2002 between July 16 and August 15, both among residents and those present, in the registers of the 21 provincial capitals: compared to the previous year, in 2003, an increase of 2,222 deaths was recorded (from 17,493 deaths in 2002 to 19,715 in 2003). Finally, an empirical estimate was made of the excess mortality throughout the country, in the same period, among people aged 65 and over, and the data that emerged was 4,175 deaths presumably caused by that anomalous heat wave. After that record summer, Italy began to equip itself with ad hoc plans against heat waves.