NEW CHALLENGES IN CONTAINING HEAT ILLNESS

‘The biggest concern is if somebody is not going to seek care’

For many, the start of summer heralds beach trips, and barbecues. Rising temperatures mean a spike in heatrelated illnesses — or HRIs— such as heat exhaustion and heat stroke.

On average, 658 people die from HRIs each year.

Heat exhaustion results from prolonged exposure to high temperatures, and its symptoms include nausea, fatigue, heavy sweating, weakness, and clammy skin. Heat stroke — the more deadly of the two — occurs when the body’s core temperature exceeds 104 degrees and is marked by symptoms such as hot and dry skin, vomiting, changes in consciousness or behavior, and convulsions.

Heat-related illnesses are already a serious concern for medical professionals, and the COVID-19 pandemic has created a new set of challenges in preventing HRIs this summer. Charles Barbera, the vice

president of Emergency and Unscheduled Care at Tower Health in Reading, said, when addressing COVID-19 and HRIs, “we have to think about them together.”

The COVID-19 pandemic is causing people to refuse to seek emergency treatment, even in acute cases. “The biggest concern is if somebody is not going to seek care,” said Barbera.

Michael Baram, a critical care physician working in the COVID-19 ICU at Jefferson University Hospitals in Philadelphia, added, “we know people are not coming in for their healthcare,” and anxieties about contracting the virus in a hospital setting can cause people to ignore serious symptoms.

Common symptoms of heat exhaustion include heavy sweating, paleness, muscle cramps, dizziness, headache, nausea or vomiting and fainting, according to Brendan Sullivan, an Orthopedic Clinical Specialist at Chester County Hospital.

If left untreated, heat exhaustion can result in heat stroke, a true medical emergency that can prove fatal if not treated promptly and properly, Sullivan said. Key differences between heat stroke and heat exhaustion are that heat stroke signs include: the absence of sweating with hot red or flushed dry skin, difficulty breathing and strange behavior: agitation, confusion, hallucinations and/or disorientation.

Choosing not to seek treatment for HRIs is potentially life-threatening, and the CDC reports that heat is a leading cause of weather-related deaths in the United States, with an average of 658 people dying of HRIs each year. In Pennsylvania alone, there were four heat stroke fatalities in 2016, according to PennLive. Considering the dangers of HRIs, “don’t let COVID prevent you from seeking medical care,” Barbera said.

Some COVID-19 precautions do align safely with HRI precautions and have the potential to work doubly. “Staying indoors and social distancing in a well-ventilated area where you limit your contacts is pretty much the same [as HRI precautions],” said Barbera.

Even precautions like hand washing, which have no direct result of preventing HRIs, can actually decrease HRI risk, according to Barbera. “If you say ‘I’m going to wash my hands twice an hour,’ then it forces you to go inside away from the heat,” he said.

On the flipside, stay-athome orders can also elevate the risk of HRIs, especially among vulnerable populations. Many elderly individuals live alone or lack an adequate support system to monitor them during the pandemic and the upcoming hot summer months.

Low income individuals are less likely to be able to afford air conditioning and are therefore at an increased risk, as stay-athome orders require them to shelter in place in un-air conditioned homes.

“There are people that are going to stay home in their hot houses without air conditioning, alone, maybe not getting the food and drink they need,” Baram said. We’re telling people to be isolated, which obviously increases the risk [of HRIs].”

Another challenge presented by the coronavirus is that the symptoms of HRIs and COVID-19 often overlap, according to Barbera, with both presenting symptoms such as sweating, fever, and shortness of breath. This overlap can confuse and frighten patients, and it underscores the danger of leaving these symptoms untreated.

Patients who are highrisk for COVID-19—including the elderly, immunocompromised, and chronically ill—are often more vulnerable to HRIs, compounding their risk of severe medical emergencies this summer.

As for specific precautions to take to prevent HRIs, Baram recommended “drinking water and finding shade,” as well as using the 911 system for medical emergencies. Barbera added that individuals should “get medical care as soon as possible” if they experience the symptoms of HRI or COVID-19.

Baram and Barbera stressed the importance of community support during this time of isolation. Baram said, “people need to continue to do reasonable things and look out for each other.”

Said Barbera: “Every year, we encourage people to check on those at risk. This year it’s more important than ever.”

PETE BANNAN — MEDIANEWS GROUP Joel Herrera, 2, gives his father, Manuel Herrera, a cool surprise at the Coatesville splash pad.

PETE BANNAN — MEDIANEWS GROUP Kevin Buckingham wipes his face while working at his lawn maintenance company, KRB Landscaping. “I drink lots of fluids and start by 6a.m.,” Buckingham said. “That way I’m finished by noon and the worst heat, at least that is the goal.”

PETE BANNAN — MEDIANEWS GROUP Ricardo Maxi of West Chester Public Works cools his head with some water Wednesday morning. “It’s bad out and going up,” Maxi said. “I put a cool rag around my neck and some cool water over my head. Working like this in the sun really is beating on you.”