Impact of Heat Waves during the COVID-19 Pandemic and Lessons Learned from Summer 2020

On May 12, 2021 IANPHI held a webinar to discuss how COVID-19 affected heat waves risks in 2020, identify key lessons learned by the NPHIs and other public health stakeholders from this experience and explore solutions and good practices. The webinar featured case studies from several national public health institutes (NPHIs), including the U.S. Centers for Disease Control and Prevention, the National Institute for Public Health and the Environment in the Netherlands, and Public Health England. A panel discussion followed to discuss possible solutions and how to adapt public health practice to address the combined impact of heat waves and COVID-19, with experts from Santé publique France, the National Public Health Institute of Quebec, the Global Heat Health Information Network, and the Red Cross Red Crescent Climate Center.

The session was moderated by Prof. Duncan Selbie, president of IANPHI, and offered interpretation in French, Spanish and Portuguese thanks to funding support from U.S. CDC.

NPHI Case Studies

Heat Waves, COVID-19 and Summer 2020 in England, by Dr. Owen Landeg, Scientific and Technical Lead, Extreme Events and Health Protection Team, Public Health England (PHE), United Kingdom (see presentation)

There were three heat episodes in England during summer 2020. The high temperatures cause a range of heat-related illnesses, in addition to cardiovascular and respiratory diseases that are the main causes of illness and death during the heat waves. The results of PHE surveillance systems showed that health impacts were observed in daily emergency department attendances and in daily ambulance call out during the 2020 heat periods. The COVID-19 pandemic seems to have brought about an excess mortality during the heat periods compared with the previous years and a general shifting of patterns of where death occurred. These observations have stressed the importance of preventive action, for example though the Heatwave Plan for England introduced in 2004 and updated yearly. A new plan, which brings together heat, cold and other climate risks, is being developed. PHE has also updated their “Beat the Heat” guidance for the public, their “Hot weather and COVID-19” slide set for the professionals, and their social media assets for partners. In addition to the heat-health alerts coordinated by the Cabinet Office, PHE is introducing their National Severe Weather Warning Service. All these tools aim to better target public and intervention, particularly for the vulnerable groups.

Heat Waves and COVID-19 in the Netherlands, by Dr. Werner Hagens, Health and Environment Advisor responsible for the Dutch Heat Waves Plan, National Institute for Public Health and the Environment (RIVM), The Netherlands (see presentation)

The Dutch Heat Health Action Plan led by RIVM allows to pass information from the Dutch Met Office to the national association of caregivers, the Red Cross and the municipal health service, in order to reach local stakeholders. RIVM also informs the public through press releases. As RIVM is playing a major role in the COVID-19 response, advising the Dutch government, monitoring the outbreak and conducting research, there are ongoing internal communications between the COVID-19 and heat-health expert teams within RIVM. These dialogues aim to ensure the alignment of all public health messages. RIVM compared COVID-19 guidelines with heat-health guidelines, which allowed to identify a complete overlap for the people at risk and avoid contradictions. This comparison was the basis for the development of new communication materials, like infographics and short animations, in coherence with COVID-19 related restrictions. RIVM also took part in the Heat and COVID-19 project of the Global Heat Health Information Network (GHHIN)

Preventing Heat-Related Adverse Outcomes during the COVID-19 Pandemic in the United States, by Dr. Shubhayu Saha, Health Scientist, Climate and Health Section, National Center for Environmental Health, Centers for Disease Control and Prevention, United States (see presentation)

CDC’s Climate and Health Program is the national leader in empowering communities to protect health from climate change, by serving as a resource, preparing public health practitioners, providing tools, guidelines and planning for climate changes adaptation. CDC assesses health risks from extreme heat exposure and provides their local partners with weather and climate information through the CDC National Environmental Health Tracking Portal. CDC is developing an online tool to link real-time heat illness information with temperatures. During the COVID-19 pandemic, CDC has also revised their guidance for the use of cooling centers to prevent heat-related illness and transmission of COVID-19 virus. Comparable work was done for the CDC guidance for general population disaster shelters. To examine the evolution of heat-related illness during the pandemic, CDC compared and analyzed temperatures data and heat-related emergency visits data of 2018, 2019 and 2020, which allowed to stress discrepancies. Like RIVM CDC is collaborating with GHHIN to better manage risk from extreme heat across vulnerable groups.

Panel Discussion


  • Pr. Geneviève Chêne, Chief Executive, Santé publique France, France
  • Dr. Céline Campagna, Climate and Health Researcher responsible for the Adaptation Plan to Climate Change, National Public Health Institute of Quebec, Canada
  • Juli Trtanj, Steering Committee Member, Global Heat Health Information Network, One Health and Integrated Climate and Weather Extremes Research Lead, National Oceanic and Atmospheric Administration, United States
  • Ramiz Khan, Urban Adviser, Red Cross Red Crescent Climate Center

The panelists first discussed the means to build a comprehensive prevention plan for both heat-health risks and COVID-19. Trust was highlighted as particularly important to build partnerships and strong relationships with the public to ensure the efficient dissemination of information, through the continuous development of communications and tools. Networking across sectors, disciplines and decision-makers is also key to assure that the heat-health and COVID-19 measures are in accord. Such networks must be implemented at both the national and the global levels, in order to coordinate the responses to future health and climate challenges, and the local scale should be included to better target the preventive measures. The discussions also stressed the necessity of taking action before emergencies occur and of drawing lessons from the COVID-19 global response.

The panelists then tackled the issue of mental health, which was especially raised during the pandemic. At the moment, mental health is relatively poorly integrated in heat waves plans and the priority would be to acknowledge heat as a disaster. The panelists agreed that mental health and its social components should be considered more broadly in the different preventive health plans.

The discussions continued about the role of non-state actors, e.g. community-based organizations, in looking out for vulnerable populations. Such programs, that need to be looked at more closely, seem to be extremely cost effective. In this perspective, preventive communications during heat waves show the importance of involving the community and call for taking care of each other. The community-based actions indeed allow to enhance the governmental measures. The COVID-19 pandemic has encouraged a higher level of engagement across communities, which should be sustained to prevent vulnerability.

Finally, the panelists shared thoughts about how to tackle inequities and inequalities within the heat health plans and the COVID-19 recovery plans. Because environmental justice is, and will be, a major issue for the coming years, climate plans should be included in COVID-19 recovery plans. As the most vulnerable populations are also the most affected ones, preparedness is vital to limit the impacts of crises on them, for example through specific vulnerability indicators to better target measures. To face inequities and inequalities, local-level planning and actions, based on strong advocacy strategies, are also key to ensure an equitable distribution of resources. 

The session was concluded with the acknowledgement of the interdependence of economic, social and environmental inequities and the need for coordinated actions with the large range of involved stakeholders, to face inequity and inequality in the post-pandemic era.

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