Heat Wave and COVID-19 Clash: Tens of Millions of People at Risk in States Seeing COVID Spikes

A major, long-lasting heat wave that will affect much of the nation is getting underway this weekend, starting in the Southwest today, and then spreading through the country over the next week. The National Weather Service is projecting maximum heat index values exceeding 95oF for much of the southern tier of the country--and even exceeding 105oF in parts of California, Arizona, Texas, Florida, Louisiana, Mississippi and Alabama. Many of these states are also in the throes of a dangerous surge in COVID-19 cases.

Heat waves can be deadly. Amidst the COVID-19 pandemic, the threat of both extreme heat and the virus are compounded in certain ways. To cope with heat waves, people flock to cool refuges like movie theaters, malls and public pools, some of the very settings that are seen as higher risk for virus transmission. In other words, amidst the COVID-19 pandemic, efforts to keep cool could turn a heat wave into a super-spreading event. The challenge then is keeping millions of people cool and COVID-safe.

Heat forecasts, re-opened states, and public health guidance

In most of the states and counties affected by the coming heat, the types of places people go to cool down are open or recently re-opened. These include outdoor spaces, such as beaches and parks, as well as reliably air-conditioned indoor spaces like malls, movie theaters, and libraries. In many counties, such as Clark County (Las Vegas), Nevada, these indoor facilities currently have occupancy restrictions to allow for social distancing. In addition, enforcement likely varies from county to county and even from one establishment to the next, depending on available personnel and actual occupancy.

At the moment, most states require people to wear face masks when in indoor public spaces as well as outdoors where social distancing is not possible. However, many allow people to remove masks when seated in a restaurant or movie theater. Sedgwick County, Kansas, for example, only very recently required wearing of masks in public, and Oklahoma County (Oklahoma City), Oklahoma has not mandated mask use either indoors or outdoors, but does recommend masks in indoor public spaces.

Given both the popularity during heat waves of movie theaters, malls, restaurants, amusement parks, etc., and the relatively high risk of virus exposure at such venues, keeping cool this summer requires great care. When considering venturing out of the house it is critical to keep in mind that face masks have been shown to reduce the number of infections in communities where the virus is actively circulating.

Communities of color face compound risks of extreme heat and COVID-19

Black and Hispanic people have been grievously and disproportionately impacted by COVID-19. They represent a disproportionate number of the workers who have lost their jobs during the pandemic, are more occupationally exposed to the deadly novel coronavirus, and have experienced disproportionately high numbers of cases and suffered substantially higher rates of death.

Compounding this, communities of color are often more vulnerable to the effects of extreme heat. During heat waves, like those on the horizon, cases of heat-related illness rise and hospitalization rates increase. Centuries of systemic racism have left people of color--but especially Black or African American people--more vulnerable to extreme heat because they are more likely to live in neighborhoods and homes where the urban heat island effect is strongest, and that lack or are unable to afford adequate natural cooling or air conditioning, and because they have relatively high rates of underlying health conditions.

The urban heat island effect is a particularly dangerous burden on people living in heavily urbanized neighborhoods. During heat waves, urban areas with more paved or heat-absorbing surfaces and fewer shade-providing trees become even hotter during the daytime and stay hotter at night as the heat-absorbing surfaces give off heat. Studies show that low-income communities and communities of color are more likely to live in neighborhoods where they are exposed to these heat islands, putting their health at risk.

So as conditions heat up across the country over the next week or two, and whenever heat strikes this summer, Black and Hispanic people, and communities with large Black and Hispanic populations stand to be hit hardest by the compounding threats of extreme heat and COVID-19.

Importantly, we cannot lose sight of the fact that the backdrop to all of this is our changing climate, a trend that is unleashing increases in the extreme weather conditions-like punishing heat-that disproportionately harm people of color. The COVID-19 pandemic has revealed how poorly prepared we are to deal with one crisis and keep people safe. COVID amidst deadly heat reveals how poorly prepared we are to cope with our new climate reality and the compounding risks and disproportionate harm we will encounter here.

What we can do now and in the long-term

As extreme heat and COVID-19 surge across the nation in the next weeks, communities need immediate help from local, state and national authorities. African American, Latinx, Native American and low-income communities facing long-standing racial and socioeconomic inequities are specifically at heightened risk from the health and economic toll of the dangerous confluence of these risks.

Cities, counties, and states must be ready to immediately deploy local heat emergency plans, including:

• Access to public cooling centers, where possible, with strong public health guidelines in place (such as social distancing and wearing of masks). The CDC has provided guidelines for this.
• Targeted help for the elderly who may be homebound to reduce their exposure to COVID-19 but who are also especially vulnerable to heat-related illnesses
• Expanded programs to help low-income and fixed income households get free/affordable ACs and fans
• Expanded programs for energy bill assistance
• A continued moratorium on utility shutoffs
• Measures to keep other heat-vulnerable populations safe including those with preexisting health conditions, the homeless, outdoor workers (especially farmworkers, given the harvest season in many parts of the country), incarcerated people
• Measures at local hospitals and health care facilities to isolate COVID-19 patients from patients suffering from heat-related illnesses, both of which may be on the rise in several states.

The effects of long-standing racism and exclusion shape inequitable impacts of COVID-19 and extreme heat

The inequitable human toll of both COVID-19 and heat waves, past and present, lay bare the consequences of systematically excluding Black and African Americans, and other persons of color, from livable incomes, adequate housing (and mortgages), clean and green environments, and affordable health care. These inequities are all indicators of how white supremacy marginalizes and threatens the lives of people of color today and will do so increasingly in a changing climate.

The long-term solution is nothing short of completely rethinking the systems, policies, and attitudes that have enabled the country's racial inequities to endure and remain deeply entrenched for hundreds of years. This summer, millions of people in the US have rallied around the need for that rethinking to demand an end to the devaluation of Black lives. As COVID-19 and extreme heat rage, harming and even taking Black and Latinx lives, the reasons have never been clearer.

Our most vulnerable communities need some immediate assistance to ensure they are able to stay healthy this summer. In the very near term, Congress must take action to keep people living with low-incomes at home and cool during the pandemic and include long-term investments in economic and workforce development among low-income communities and people of color in the next stimulus package. Cities, counties, and states should also consider expanding the heat response plans to include COVID-19-specific measures. New York City's efforts to do so can serve as inspiration for communities considering such an expansion.

As a society, we must do better to keep everyone, but especially our most vulnerable, safe from extreme weather and COVID-19.

This blog post was co-authored by Dr. Kristy Dahl.