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Indian Express
03-07-2025
- Health
- Indian Express
Heat health risks need to be understood as a slow, protracted disaster
The World Meteorological Organisation's 'State of the Climate in Asia 2024' report released on June 23 highlighted that Asia is warming at twice the global average with record highs in sea surface temperatures and marine heatwaves. Asia's warming trend between 1991–2024 was almost double compared to 1961–1990. Within the continent, south and southeast Asia experienced extreme heat during April and May, and in specific, the heat was centred in northern India in May. Are we effectively measuring heat-related illnesses (HRI) and consequent mortalities? How effective are the response mechanisms? The National Programme on Climate Change and Human Health (NPCCHH) was launched in February 2019. HRI surveillance was initiated under the Integrated Disease Surveillance Programme (IDSP) in 2015 (subsequently digitised on the Integrated Health Information Platform), in the more heat-vulnerable states. It has now been expanded across the whole country. Instituting any surveillance system such as the National Heat-Related Illness and Death Surveillance is a complex task and we now have about a decade's experience and learning. The NCDC's evaluation, the 2024 report titled 'Heat-Health Preparedness & Response Activities, National Programme on Climate Change & Human Health', provides rich insights. The surveillance system collects aggregate data on heatstroke cases and deaths, emergency department attendance, cardiovascular and total deaths from all states and union territories from primary health centres and above. There were 48,156 Suspected Heatstroke Cases (SHC), 269 Suspected Heatstroke Deaths (SHD) and 161 Confirmed Heatstroke Deaths (CHD) in 2024 with reported increases in key daily indicators – emergency visits, total and cardiovascular deaths in the facilities. There has been a significant increase in reported SHCs over the last couple of years: 4,481 in 2022 and 19,402 in 2023 – the mark of a maturing surveillance system. Emergency attendance in the Reporting Units (RUs) increased from 3.6 million in 2022 to 30 million in 2024; total deaths in the facility from 86 to 74,216 and confirmed cardiovascular deaths (linked to HRIs to some extent) from 47 to 2,173. What is the robustness of HRI reporting? Reporting by the constituent units exhibit an expected seasonality: 20 per cent in March to 40 per cent in July; and the peak between May 15 and June 10 comprising nearly two-thirds (62 per cent) of the annual cases correlated both with peak heatwave days and dips during the holidays and weekends. In terms of consistency of daily reporting, Gujarat, Telangana and Odisha are the better performers. The NHRIDS had 47,477 Reporting Units (RU) in 2024 and 55 per cent reported HRIs. The top three states were also Gujarat, Odisha, Telangana with 91 per cent, 89 per cent and 72 per cent of the RUs reporting respectively. Contrast this with 23 per cent of the 40,390 RUs reporting in 2023. RUs in key north and central Indian states that experience high heat demonstrated improvements in reporting between 2023 and 2024 but continue to lag behind the top three performers. There was hardly any reporting from Uttar Pradesh and Rajasthan in 2023 but nearly 50 per cent of the RUs reported in 2024. And 30 per cent or less of the RUs in Bihar, Jharkhand, Chhattisgarh, Madhya Pradesh, and Haryana reported during 2024. Health systems preparedness is critical to providing treatment and reducing morbidity and mortality. These include availability of basic utilities, ORS (oral rehydration solution) corners, diagnostic equipment, emergency cooling equipment/appliances at health facilities, capacity building of healthcare staff as well as ambulance services. The NCDC evaluated 5,720 facilities across the country, 87 per cent of these at the primary care level. While there was relatively high reporting of availability of basic utilities, training, and community outreach, some of the more specific and critical elements need a big boost. Emergency cooling preparedness was available in only 32 per cent of health facilities including in only 26 per cent of the primary health centres (PHCs). Diagnostic equipment was available in 53 per cent of the assessed facilities. Six per cent facilities were found to have 'optimal', 32 per cent were 'adequate', 11 per cent were 'basic' and 51 per cent were 'inadequate' in level-appropriate preparedness. Health facilities in Odisha were found to have the highest level of preparedness while those in Andhra Pradesh, Telangana, Haryana, and Punjab were some of the least prepared. Preparedness levels of ambulances and mobile units are a cause for worry: Only 48 per cent had ice packs, 39 per cent had rectal thermometers (for measuring core body temperature, a marker of heat stroke), 13 per cent could provide conductive cooling (for rapidly reducing core temperature in exertional heat stroke), 63 per cent could provide evaporative/combined cooling (relatively less effective) and 57 per cent had paramedics trained in emergency management of severe HRIs. Notwithstanding the NHRDIS, multiple government agencies report varyingly different numbers with respect to heatstroke deaths during 2000-2020: 20,615 according to the National Crime Records Bureau (NCRB); 17,767 according to the National Disaster Management Authority (NDMA) and 10,545 according to the India Meteorological Department (IMD). Independent researchers forecast up to over 1.5 million deaths annually in a high-emissions scenario or a 14.7 per cent increase in daily mortality with temperatures above 97th percentile for two consecutive days. There is a need to look beyond acute disaster framing and Heat Action Plans (HAPs) need to build in more markers such as high night temperatures, heat index or the excess heat factor; as well as making it more local and agile, beyond standard templates. Heat stress is the leading cause of weather-related deaths and can exacerbate underlying morbidities, triggering episodic demands for healthcare. Heat health risks therefore, need to be understood as a slow, protracted disaster. Health programmes are built brick by brick; learning as we go along. At the same time, the climate emergency makes heat-health responses a moving target. The writer is chairperson, Centre of Social Medicine & Community Health, JNU, a collaborator in the Wellcome Trust supported 'Economic and Health Impact Assessment of Heat Adaptation Action: Case studies from India'. Views are personal
Time of India
21-04-2025
- Climate
- Time of India
As summer scorcher burns up, CG gears up for heatwave
Raipur: As temperatures breach 43 degrees Celsius across several districts in Chhattisgarh, the state health department has gone into emergency mode to tackle a looming heatwave crisis. With the India Meteorological Department (IMD) forecasting further rise in temperatures—touching 44°C in places like Rajnandgaon and Bilaspur—the govt has issued clear directives and intensified preparations to prevent heat-related illnesses and fatalities. Raipur, Bilaspur and Rajnandgaon have been sizzling hot with maximum temperatures touching 42-44 degrees Celsius. The weather department warned that the next 48 hours will see further temperature spikes, followed by isolated thunderstorm activity in some districts during late evenings In Raipur, roads wore a deserted look by afternoon as blistering heat and heavy traffic zones emptied out. by Taboola by Taboola Sponsored Links Sponsored Links Promoted Links Promoted Links You May Like Google Brain Co-Founder Andrew Ng, Recommends: Read These 5 Books And Turn Your Life Around Blinkist: Andrew Ng's Reading List Undo Speaking to TOI, Dr Smriti Dewangan, deputy director for the national programme on climate change and human health (NPCCHH) and disaster management, emphasized urgent medical response for heatstroke. "Emergency cooling mechanisms like dark cooling rooms, tub baths, ice-making machines, and cold water units are now operational in Raipur's district hospital and will be rolled out across all districts shortly. Once the body temperature hits 104°F, it stops its natural cooling. Immediate intervention is essential," Dr Smriti said. Dr. Smriti also noted, "Heatstroke is now a notifiable condition, requiring hospitals to conduct audits and postmortem reviews in suspected cases of heat-related deaths. We've instructed all health facilities to maintain readiness. This is not just seasonal anymore—heat-related illness is officially recognized under the climate-health linkage. Daily reporting dashboards have been active for the past few years." The state has adopted the "cool first, transport later" strategy, as per NPCCHH guidelines. This means on-site emergency cooling of patients before transferring them to hospitals—a critical step to prevent fatalities. As per guidelines, the district-level and city-level Heat Health Action Plans (HHAPs) are now in motion, with task force meetings underway to coordinate surveillance data, ambulance preparedness, and health worker deployment. With April heating up and May expected to be harsher, the state health machinery is racing against the clock to ensure zero fatalities from the heatstroke.
