Heatwave preparedness is important in health and social services

The need for heatwave preparedness is acknowledged, but there is still much to be done

Heatwaves affect health and social services in many ways. They increase pressure on service provision in hospitals, care facilities and private homes. Climate change is leading to more frequent heatwaves, which increase mortality, morbidity and the need for treatment, especially in risk groups, such as the elderly, children and people with long-term illnesses. [1] Heatwaves also burden healthcare workers and weaken their functional capacity [2].

Extreme weather events may interfere with the provision of health and social services. The services depend on society’s infrastructure, such as water supply, electricity and heat distribution, road network and data connections. Extreme weather events, such as heat, storms, heavy rainfall, drought and floods, can cause disruptions in the functioning of infrastructure. [1] Weather events may also occur simultaneously, which increases the potential for adverse effects.

Health service providers are generally aware of the need to prepare for the increasing heat caused by climate change. It is also considered important. However, awareness has not always led to practical action. [3]

Preparedness plans and guidelines are needed to reduce the impacts of heatwaves

It is important for care facilities to have a plan on what kind of measures can be taken to prepare for heatwaves, both in advance and during the heatwave. The plan should, among other things, appoint responsible persons for different measures and provide instructions on how to identify high-risk residents or patients. In addition, the plan should provide instructions on how to ensure the adequacy of personnel during the heatwave. [4]

Heatwave adaptation is facilitated when health and social service workers are specifically trained for the adverse health effects of heat. The workers should particularly be instructed on how to protect patients, customers or residents from these effects. [4] Only about one third of hospitals have written instructions for staff to protect patients from the effects of heat. [3]

Various cooling methods should be used during heatwaves

During a heatwave, adverse effects can be reduced, for example, by setting up cool spaces where possible. In addition, passive and active cooling methods can be used in the premises. An example of passive cooling is protecting windows with curtains, blinds or protective films. Active cooling refers to mechanical cooling of spaces. The possibilities for mechanical cooling vary considerably between different locations. Many do not have any mechanical cooling, or it is only available in some of the rooms. [3]

Patients can be cooled with fans, suitable clothing, cold wraps and showers. Special consideration is needed when discharging patients during a heatwave. Taking care of personnel’s adequate breaks, hydration and cooling is also part of adaptation. [5]

Preparedness planning should also consider vulnerable groups outside care facilities

Adaptation to heatwaves is also needed outside care facilities, as some of the services are provided at the customers’ homes. In fact, identifying vulnerable groups is an essential part of adaptation. [1]

Those who rely on social services often have limited resources and capacity to respond to changing situations. Therefore, vulnerable people can be more susceptible to the health impacts of climate change. [1]

Social services have accumulated a lot of local knowledge and information about vulnerable groups of people in the region and their needs. This information can be important when planning and assessing adaptation measures. [1]

Heat warnings support heatwave preparedness

The heat warnings issued by the Finnish Meteorological Institute [6] support adaptation measures, but only about half of hospitals, for example, consider the warnings in their activities. In addition, only about one third of care facilities have included the effects of heat in their preparedness plans. [3]

For the time being, heat warnings do not include systematic preparedness measures or communication by the authorities [3]. It has been proposed that warnings be developed so that actors in health and social services are automatically informed of the warning and the instructions issued by the authorities. It has also been proposed that measures aimed at preventing health impacts should be linked to the heat warning system. [1], [3]

Urban planning and construction solutions can promote heatwave preparedness in hospitals and care facilities

The planning of cities and buildings has a significant impact on how high temperatures can rise inside buildings, such as hospitals and care facilities, and in urban areas in general. [7] These solutions concern long-term adaptation measures primarily carried out by actors other than healthcare and social welfare services.

In urban planning, green areas and vegetation in the immediate vicinity of buildings, for example, cool and shade buildings. Building overheating can, in turn, be prevented by green roofs and various reflective surfaces. [7]

Finland is preparing a national action plan to prevent heat-related health impacts

Finland is preparing a national action plan to prevent health impacts caused by hot weather [8]. A similar plan has been drawn up in several European countries [9], [10].

The action plan may set out short-term and long-term measures to reduce the health impacts of hot weather. It also guides preparedness at the regional and local level in different sectors. [3], [1]

The sector should also prepare for other impacts of climate change

In addition to heatwaves, other conditions that change as a result of climate change and their impacts are also reflected in health and social services. Thus, they create a need for the sector’s own adaptation measures.

For example, days with icy conditions and slip-and-fall accidents become more frequent, which may occasionally cause congestion in emergency units [1]. The risk of waterborne epidemics increases, as extreme weather events increase and winters become milder [11]. Tick prevalence increases as the climate warms, and the cases of the diseases they spread also increase. This may cause the need to update the national vaccination programme and regional vaccination recommendations. Climate change can also increase mental health challenges. [1]

Checklist for actors in health and social services

The following list of questions can be used to identify key measures to adapt to heat in health and social services.