As we approach what is expected to be a hotter than normal summer, extreme heat and the coronavirus pandemic will create a compounded public health emergency. The city of Boston’s usual tactics for combating extreme heat — like opening cooling centers — will be more difficult to enact in a world where physical distancing is necessary to protect ourselves from coronavirus. To keep people safe this summer, Boston and surrounding areas must develop COVID-19 heat emergency plans now to reduce the risks of greater health challenges.
The coronavirus pandemic has shined a light on health disparities that extreme heat will further exacerbate. Both public health issues have disproportionate impacts on the same vulnerable populations — the elderly, the immunocompromised, those with pre-existing conditions, those without stable housing, low-income populations and otherwise marginalized communities. Across the city of Boston, a heat mapping project conducted last year found that temperatures can vary by upwards of 15 degrees on a hot day, with hot spots in places like Roxbury, East Boston and South Boston.
Typically, Boston provides resources like cooling centers and malls, libraries or splash pads during heatwaves, but under physical distancing and state-mandated closures, it may not be possible to provide cooling as normal. To keep people safe, cities will need increased access to cooling at home, which can be difficult in places like Massachusetts, where 20% of households lack any type of air conditioning. The state must continue electricity shutoff moratoriums so that those who do have access don’t lose power during heat waves. We can use energy assistance programs, like the Low Income Energy Assistance Program, to provide financial assistance for purchasing and operating air conditioners, weatherizing homes and providing sprinklers or blackout curtains for those most at risk. However, these programs are often severely underfunded, typically only covering 20% of those in need each year. Future coronavirus economic packages must expand these programs and their eligibility criteria.
As we begin to reopen, we must ensure that our essential workers are protected both from the coronavirus and from extreme heat, especially for high-risk groups like first responders, outdoor workers and those working in non-air conditioned spaces. My research has shown that fire department calls increase on hot days in Boston, as do other emergency services. Wearing masks, shields, gloves or goggles help protect these workers from coronavirus, but may interfere with regulating body temperature. On hot summer days, workers will need more frequent breaks in shaded areas that allow for physical distancing, increased hydration and ventilation.
We need to ensure that those who are most at risk are the focus in our response to the inevitable overlap of coronavirus and extreme heat. Gov. Baker, Mayor Walsh and other local leaders should communicate early and frequently about strategies individuals can take to keep themselves and their homes cool. This could include closing shades or using blackout curtains during the day, turning off heat-producing lights and appliances, and opening windows to circulate air.
This information can be distributed through existing communication channels that are more visible due to the pandemic, like regular press briefings from the governor or social support programs like food banks and the MA pandemic assistance 2-1-1 helpline. Communication networks that have been developed for extreme heat can be retrofitted for physical distancing. Instead of visiting elders or other vulnerable individuals during a heatwave, use texting or video chatting to check in.
Most importantly, it’s vital that we don’t wait until we’ve reached an emergency to take steps to prevent it. We must increase long-term investments in climate change mitigation and adaptation. Investing in renewable energy to reduce greenhouse gases and air pollutants can reduce environmental health disparities and mitigate future warming, while also decreasing the risk of future pandemics.
Augusta Williams, Sc.D., MPH, is a Postdoctoral Research Fellow at the Center for Climate, Health and the Global Environment at Harvard T.H. Chan School of Public Health. She will join the Occupational Safety and Health Administration as a Health Scientist in June.