Public health response
How might public authorities protect people’s health in the future?
When Paris sweltered through a prolonged heat-wave in August 2003, its elderly population suffered badly: nearly 15,000 deaths above the normal rate were recorded. In England and Wales an estimated 2,000 excess deaths occurred. A recent study in Adelaide, however, found no evidence of excess deaths during heat-waves. The difference, perhaps, is that Australia is better prepared for periods of intense heat.
In fact, preparedness is something that could be stressed across many areas of public life.
For health systems, key tools will include surveillance systems to spot new infections or emergent outbreaks. Weather monitoring will pinpoint upcoming risk periods, such as heat-waves or floods. Pollen, pollution and ozone monitoring will reveal when respiratory problems are likely.
More attention will need to be given to food-borne and water-borne diseases, to ensure that these do not become major public health problems. This may involve stricter food safety regulations.
Much is likely to depend on individual behaviour. Englishmen, like mad dogs, are notorious for “going out in the midday sun”, as the Noël Coward song from the 1930s goes.
Following 2003 the French government issues an annual heat-wave plan to avoid a repeat of that sweltering summer, with the UK government having followed suit. And researchers have recently devised an algorithm to calculate the excess mortality associated with heat-waves and improve public health research into the effects of extreme temperatures.
US cities, including New York, Chicago and Boston, have opened public ‘cooling centers’.
The biggest challenges are faced by developing countries. There is a strong argument that current development programmes should not be responses to disasters but initiatives that strengthen countries’ infrastructures now, so they are more resilient.