The heat is killing thousands of people and major events have not been adjusted

SYDNEY — At major events around the world, scenes of extreme heat stress are starting to look familiar. Older men, shirts unbuttoned, lying with their eyes closed. Aid tents full of unconscious people. And lines of believers – whether they seek religion, music, the polls or sport – sweating under the shade.

The consequences were terrible. In this year’s hajj, the Islamic pilgrimage in Saudi Arabia, at least 1,300 people died when temperatures exceeded 100 degrees Fahrenheit. And in many ways, this high death toll was just the latest sign that crowd control and heat waves fueled by climate change are on a dangerous collision course.

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During India’s recent elections, dozens of election workers died on the job. Last summer, Boy Scout troops visiting South Korea for a jubilee became ill from the heat, as did others at music festivals in Australia, Europe and North America.

Although heat kills more people today than any other extreme weather event, a dangerous cultural lag remains. Many organizers and participants of major events are still behind the climate curve, failing to cope with how much the warming planet has raised the risk for summer crowds.

“As hot seasons lengthen and heat waves arrive earlier, we will have to adapt,” said Benjamin Zaitchik, a climate scientist at Johns Hopkins University who studies health-damaging weather events. Along with personal behavior, he added, infrastructure, emergency management and social calendars must “really recognize this new reality.”

Among the many low-tech ways to prevent illness and death are shade, water stations, sidewalks painted white to reflect heat, and emergency health services to treat serious cases of heatstroke. Some hot and innovative places, like Singapore, have built public spaces that unite the outdoors with the indoors. They added air conditioning in areas where people might have to spend time waiting, like bus stops.

The most difficult solution of all may also be, in some ways, the simplest: educating people about the risks of heat, including those who are used to living in hot places. They are often unaware of the early symptoms of heat stress or how high temperatures are especially dangerous for people with pre-existing health problems, such as kidney disease or high blood pressure. Even medications, such as anticholinergics, that treat allergies or asthma can accelerate problems by restricting sweating.

“Heat is a very, very complex and sneaky killer,” said Tarik Benmarhnia, an environmental researcher and associate professor at the University of California, San Diego. “It’s very quiet.”

A religious pilgrimage can be the most complicated of all events. Devotees of many religions — Christians in the Philippines; Hindus in India; Muslims in Saudi Arabia – have died from heatstroke in recent years during religious rituals.

But the hajj carries perhaps the gravest level of danger.

The entire Arabian Peninsula is hot and warming quickly, with night temperatures also rising, stealing hours when the body normally cools down. The Hajj takes place over five or six days, worsening heat exposure in the holy city of Mecca.

The hajj calendar is also defined by the lunar cycle, so the times scheduled for the trip can be the hottest, as was the case this year. And because pilgrims tend to be disproportionately elderly, they are more vulnerable to the effects of intense heat.

Benmarhnia shook when she heard the news of the deaths at this year’s hajj.

“I thought this could have happened to my grandmother,” he said by phone on Monday.

He paid for her trip to Mecca in 2019. She was 75, but fortunately, he said, she made a smaller pilgrimage during a cooler time in April. With the death toll this year, he suggested that heat experts use what happened to quickly work out adaptation strategies with religious authorities.

The Saudi Ministry of Health has launched educational campaigns urging people to stay hydrated and use umbrellas. Authorities created field hospitals and water stations. They sent thousands of paramedics.

It wasn’t enough for a surge of millions of people, including many who bypassed national quotas meant to limit crowd sizes. And Saudi Arabia has faced criticism over the deaths for the way it conducted the pilgrimage.

This year’s elections in India demonstrated that even in places where people think they are used to heat, much more awareness is needed about the dangers of extreme heat.

In Bihar, at least 14 people had died by the end of May, and at least 10 of them were poll workers, according to state aid authorities. At one point in June, nearly 100 people died within 72 hours in Odisha in cases suspected to be linked to hot conditions.

Health authorities in India had to prepare. Inside heatstroke units in Delhi hospitals, patients were immediately immersed in a soaking tub filled with ice to lower their temperature. In a ward equipped with a refrigerator for making ice, ice chests and fans, critical patients were immediately placed on ice packs and injected with cold fluids.

But in many areas, heatwaves and voting peaked around the same time – including in Bihar’s Aurangabad district, home to 3 million people, where temperatures approached a fickle 48 degrees Celsius (118 Fahrenheit) in end of May.

Ravi Bhushan Srivastava, chief physician at a government hospital, was on his way to assess daily post-mortem reports on a particularly bad day when 60 patients were admitted for heatstroke.

“At least 35 to 40 were in poor condition,” he said. “They were unconscious, with altered consciousness, with very hot bodies and having difficulty breathing.”

“I have never seen patients with heatstroke symptoms in such large numbers and with such intensity in my entire career,” he added.

Election rallies can be particularly vulnerable due to the large crowds they involve. But there are also many viable solutions. Aditya Valiathan Pillai, an adaptation expert at the Sustainable Futures Collaborative, a research organization in Delhi, said participants should be able to see local temperatures in real time, with risk levels color-coded. Water stations, shade and cooling centers can be installed. No less important, public agencies should make use of heat warnings. “We now have pretty accurate heat wave forecasts five days from now,” Pillai said, “so this kind of early awareness is possible.”

Sporting events are already adapting to the dangers of extreme heat. Water breaks for players were introduced during the 2014 World Cup in Brazil, when the combination of heat, humidity and sun exposure led to a temperature of 89.6 degrees Fahrenheit. Authorities have moved the 2022 World Cup in Qatar from the summer months to November and December, when it is colder.

The Paris Olympics seem to seek some kind of balance. Some events, such as the marathon, start earlier and water stations must be available to customers.

“Mega events like the Olympics and the FIFA World Cup have a duty of care to everyone who participates,” said Madeleine Orr, a professor at the University of Toronto and author of the book “Warming Up: How Climate Change Is Changing Sport.”

“We’re talking about hydration and cooling breaks,” she added, “opportunities for athletes and officials to have access to cooling towels and some shade or misting fans, and medical staff on standby to intervene if someone needs additional care.”

For now, this may be enough. Many experts say more radical changes may need to be pursued. The Summer Olympics may have to become the Autumn Olympics. Similarly, elections in India could be postponed to colder months, along with international tennis tournaments. School holidays may be rescheduled due to weather. Summer jobs like painting houses can become spring jobs.

David Bowman, a Tasmanian climate scientist who wrote a paper that attracted widespread attention online during the 2020 Australian bushfires calling for an end to school summer holidays, said people were already starting to adapt in small ways. . Umbrellas are becoming fashion accessories for shade, shorts are becoming more acceptable at work, and highway workers are doing more at night.

Climate change could force major events to change even more.

“All these disasters are like a cultural price signal for climate change,” he said. “Of course, we can be stubborn and carry on regardless of climate change – but in the end, climate will win.”

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