Deadly heat wave lesson: ‘This is the future we all face’

Portland was baking this past June and Office of Emergency Management Director Jonah Papafthimiou was in crisis mode.

With temperatures 40 degrees Fahrenheit higher than normal in a city where air conditioning isn’t popular, Papaefthimiou has tried everything possible to help keep residents cool and healthy.

There were jury-rigged fog stations in parks, playground shelters that stayed open all night and hundreds of calls made by Papaefthimiou and her staff to subsidized housing managers begging them to check on elderly residents.

Amidst it all, she remembers one thought piercing the 116-degree Fahrenheit heat: “Oh, F, that’s what climate change does. This is the future we all face.”

Nearly one year into this thermal dome, emergency managers, doctors, and even transportation systems across the Pacific Northwest say they are taking lessons from the unprecedented event to prepare for this summer as climate change increases the potential for similar thermal domes to occur again.

“It was something we knew we needed to prepare for and we applied for grants for mitigation measures, but when it came it was very conscious,” said Lara Whiteley Bender, chief of climate preparedness for King County in Washington.

To understand how unusual the effect of the thermal dome was, it is best to look at the numbers. An analysis by the Centers for Disease Control and Prevention found that during May and June of 2021, 3,504 people went to emergency rooms for heat-related illnesses in 10 regions of the Department of Health and Human Services, which include the Pacific Northwest.

On June 28, when temperatures peaked at 116 F — 42 degrees above the average daily maximum temperature for the area — there were about 2,779 emergency room visits for heat-related illnesses. On the same date one year ago, there were only nine emergency warm-up visits.

‘Damage control’

Ultimately, more than 160 people died from the sweltering heat in Oregon and Washington, many of whom remained without air conditioning or other refrigeration.

Dr. Alex St. John, an emergency physician at Harborview Medical Center in Seattle, only worked one shift during the heat dome, but says the emergency room was as intense as it was during the early days of the coronavirus pandemic.

“It felt like there were more patients than we could stay on top of, and we were in a damage control mode where we were just trying to make sure that all of the sickest people were getting the key treatments they needed,” he said.

One such patient was an elderly woman who came to the emergency room with a core body temperature of 104 degrees – dangerously hot and close to suffering a fatal heat stroke. To calm her down quickly, Saint John pulled her up to her chest into a black corpse bag and filled it with snow.

St. John conducted his medical training in Arizona, treating heat patients by applying cool, wet cloths to their skin. In his nine years in Seattle, he said, he only had to treat a handful of heat-stressed patients and no one had been in such dire conditions. He had only heard of using body bags to treat heat stroke days earlier, when a colleague mentioned his annoyance at having to use it himself.

Although this trick is unconventional, it saved a woman’s life. St John said he wouldn’t hesitate to reach for the body bag for heat stroke in the future, but he fears the high temperatures will one day become so bad and prolonged that they will strain the capacity of the ice machine in the hospital cafeteria.

“It was really fantastic to be on the job in Seattle and have to see patients in worse conditions than I saw in the Sonoran Desert to take care of people,” he said.

“Environmental temperature anomaly”

While excessive heat will affect health in any area, last year’s heat dome was particularly dangerous because residents and municipalities were unaccustomed to the high temperatures of the Pacific Northwest.

Many of them don’t have air conditioners – including private Seattle properties.

During the thermal dome, “cooling stations” have been set up in only three community centers, in part because 21 other cities do not have air conditioning, said emergency planning coordinator Lucia Schmidt.

“Our response has been bogged down by the fact that infrastructure in our city is built, essentially, to retain heat because environmental heat is an anomaly,” she said.

These cooling centers are underutilized and the focus groups have shown since the summer that there is a need for cooling centers that cater to the unique needs of the population. Families with young children like to go to cooling centers in their neighborhoods where their children can run and play, while elderly residents are more likely to visit centers with quiet areas. Meanwhile, people experiencing homelessness need centers where they can access foods and services.

But meeting all of these different needs can be difficult when schools and other city properties in neighborhoods don’t have air conditioning either. Moreover, the heat dome hit last year while pandemic-related closures meant many library sites were not open, but Schmidt said the city and library system are now looking into whether libraries can help people relax on hot days.

“We are very bound by the fact that we don’t have a lot of air-conditioned spaces,” she said.

Emergency planners in King County, which includes Seattle, have faced similar hurdles. Brendan McCluskey, director of emergency management, said his team has begun working with private companies like Petco to ensure residents have places to go, even with their pets, for recreation.

The county also had to open its first 24-hour cooling shelter when emergency managers realized temperatures were not dropping in the evening as they usually do.

McCluskey said the county was fortunate that the heat dome occurred between waves of the coronavirus, so it was able to use a shelter that was originally set up as a place where people with Covid-19 could be isolated as a cooling center instead.

“That area was not in use, so we quickly re-used it to allow people to seek shelter from the heat,” he said.

‘Our entire society has failed’

Back in Portland, Papaefthimiou, who is now the city’s chief resilience officer, found that cooling centers were underutilized — something she attributes to the community’s lack of understanding that high temperatures can be dangerous.

She worries that low-income people who don’t have their own transportation don’t want to wait outside in the heat for a bus ride to a cold shelter or don’t want to pay the fare, so they choose to stay home instead. After the thermal dome, the TriMet bus system has created a new policy that it will not charge passengers traveling to or from cooling shelters any time a state or county issues a heat emergency.

“The people who died mostly didn’t ask for help, as far as we know,” said Papaifthimiou. “They just thought they would stay home and be fine and no one checked on them. It was a failure for our entire community.”

This summer, Portland hopes to engage residents at every level of the importance of thermal safety. They are looking to work with community groups to help set up cooling shelters in neighborhood churches or other places where residents may feel most comfortable. Misting stations that were improvised last year will become permanent fixtures in neighborhood playgrounds, too.

The city’s messages about high heat will include not only the fact that heat kills, but also reminding people to check on their neighbors and family members who may need help.

Furthermore, the city has decided that it will activate wireless emergency alerts from the National Weather Service for personal cell phones during heat waves to remind people of ways to stay calm.

“If you’re trapped in a sea of ​​heat, that bus is like a lifeboat, it’s the thing you have to get on board to be safe, and you can’t charge people to get on the lifeboat,” Papafthimiou said. .

Cooling right

Vivek Chandas, director of the Urban Places Sustainability Research Laboratory at the University of Portland, said he believes last summer’s heat dome was a wake-up call for city residents and emergency managers alike.

“I’ve been in the heat field for 15 years, and it’s been years of talking to people and laughing outside the room when I talk about heat waves because people would say, ‘We’ll never feel hot like that, we have other things to prioritize.'” The Heat didn’t get Lots of playing until last year.”

After last year, Chandas said he thinks people will be more cautious in the heat. But while he praised the city’s efforts to implement more cooling centers in future heat waves, he said he hopes there will be more systematic changes to increase access to cooling in homes.

One of those changes comes from a study that measures temperatures inside public housing units in Portland. Many people living in such units died during the thermal dome, and now the city and the housing authority are collaborating with Portland State University on a project to install temperature sensors in the rooms and corridors of public housing units. The sensors will also warn residents when places are getting dangerously hot.

“Right now, we don’t have a good system to alert people about what they are going through in their homes – which are often hotter than outdoor temperatures,” Chandas explained.

The Oregon legislature has also already taken steps to protect people from future heat events. Lawmakers in March passed a bill that limits the restrictions that landlords and homeowners associations can place on portable coolers. The legislation, known as the Right to Cool Act, also creates a $34.5 million government program to distribute air conditioners and filters to residents in need during emergencies.

Senator Case Gama (D-D) said during the heat dome that he heard from voters who said they were trying to stay calm but were “afraid of being kicked out” by owners who said window units posed a safety hazard if they fell.

“We needed to act quickly and immediately to make sure that the next heat wave could save lives and protect vulnerable populations,” he said.

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