New Delhi: India is “most likely” undercounting heat-related deaths due to a lack of robust data but the government is now improving surveillance to minimize the impact of extreme conditions on health, former WHO chief scientist and health ministry advisor Soumya Swaminathan has said.
In an interview with PTI on the sidelines of TERI’s World Sustainable Development Summit, she also stressed the urgent need for better tracking, preparedness, and policy interventions as the country braces for another extreme summer.
Asked if India was undercounting heat-related deaths, the former director general of the Indian Council of Medical Research (ICMR) said, “Most likely. We do not have a good record of every death in the country. So we have to make some estimations. We have to do some sort of calculations or modeling based on what is happening.”
But recently, there have been several scientific papers that have tracked what are called excess deaths, Swaminathan said.”When you look throughout the year, deaths every month will be the same in number in general. But then if you suddenly see a spike, like during COVID we saw a spike.”So you are going along with your death rate every month fairly stable and then suddenly, in May-June, you see a spike.
You can then attribute that the excess deaths are possibly due to heat,” she explained. India experienced brutal heat during last year’s summer, recording 536 heatwave days, the highest in 14 years, according to the India Meteorological Department. Official data showed that India recorded 41,789 suspected heat stroke cases and 143 heat-related deaths during one of its hottest and longest heat waves.
Public health experts say the official number of heat deaths is an undercount as 20 to 30 percent of heat stroke cases usually result in fatalities.The IMD has forecast above-normal maximum and minimum temperatures over most parts of the country this summer season too.While the health ministry has introduced surveillance for heat-related deaths, Swaminathan cautioned that fatalities represent only ”the very tip of the iceberg”.”For every one death, there are probably 20 people who are suffering the impact of heat by high blood pressure or exacerbation of their cardiac disease or heat exhaustion and not being able to go to work,” she added.
”There is a lot of productivity loss and economic loss which is happening, which may not be a death, but it is having a big impact on families. That is where we need to focus our attention because we need to make sure that people remain comfortable and productive,” Swaminathan told PTI. She added, ”Of course, we have to minimize deaths. We do not want anyone to die of heat stroke but we also want them to be in thermal comfort.”
She also warned of the consequences on mental health. ”If you do not get any relief from heat for a prolonged period, then we know, for example, suicides go up, psychiatric illnesses get worse, and domestic violence increases,” Swaminathan added. The former WHO chief scientist called for a coordinated response involving multiple sectors, including labour, housing, and urban planning to reduce the impact of heat.
”You need the labour department, industry, factories, and workspaces to come in. You need the housing sector to think about heat and especially the low-income housing people who live in tenements with corrugated sheets as roofs. How do we improve the temperature inside those kinds of homes so that people can at least sleep at night?” Asked how governments, local administrations, and people should prepare for another brutal summer, she stressed the urgent need to conduct vulnerability mapping in every district.
”You can now, using technology, be able to map out and you will know exactly which wards are going to be more impacted by heat. Because there are always some parts that are highly built up and those are usually the places where low-income people are living. You have to focus more attention there.” Swaminathan urged hospitals, local governments and employers to take proactive measures.”Prepare your health system, train the health workers. Make sure that you have supplies in your health system, that you have ice, saline and cool rooms, if possible, to put the people who come with the heat,” she said.
She also called for creating awareness among people, as well as among employers in workplaces, so that they do checks to make water available in multiple places. ”Shade is very important in every community where there is a high chance of this happening.” Swaminathan highlighted simple, low-cost solutions, such as shaded waiting areas at traffic signals.
”Many cities have now started putting green shade on top at traffic signals where people on two-wheelers are waiting for a signal to change so that they are not directly exposed to the sun’s heat.” Some of these interventions can be fairly low-cost and can be scaled up right away to prepare for the summer months. A lot of awareness, as well as training needs to be done and longer-term actions need to be taken, she said.
