<p>Temperatures have soared to 45 degrees Celsius in many regions in India, causing severe heat wave conditions. Last year, temperatures broke records globally and this year is likely to break records again. Normally, heat waves are more likely after May 15. But this year, temperatures spiked much earlier. <br /><br /></p>.<p>The Indian Meteorological Department (IMD), for the first time, issued a seasonal heat forecast and the news is not good – “warmer than normal temperatures are expected” for the heat season. India already experienced significantly above normal temperatures in January and February 2016. Many areas are hit with a double whammy of both extreme heat waves and acute water shortage due to deficient monsoon in 2015.<br /><br />During the 2015 heat season, the heat-related deaths crossed the 2,000 mark and tragic stories alerted the nation to this effect of global warming. These reported death counts are a gross underestimate of total heat-related mortality since our reporting of death is poor.<br /><br />Ahmedabad had a wake-up call with a very severe heat wave in 2010. Temperatures reached nearly 47 degrees Celsius on May 21, 2010. Our studies of the data from Ahmedabad Birth and Death Registrar revealed that during the hottest week in 2010, about 800 additional deaths occurred in the city due to all causes of which only about 75-80 were reported as “heat stroke.” <br /><br />On May 21, 2010, 310 deaths were recorded against average of only 100 daily deaths in May. Based on this research and other evidence from western European heat waves of 2003 where more than 70,000 additional deaths happened, the city of Ahmedabad, in partnership with the Indian Institute of Public Health, Natural Resources Defence Council (USA), the Climate Development and Knowledge Network and others, developed the 2013 Heat Action Plan for the city – the first ever in South Asia. <br /><br />The Ahmedabad Heat Action Plan (HAP) at first consisted of a pilot seven-day temperature forecasts for the city provided by Georgia Institute of Technology in summer. It set local temperature thresholds where mortality starts rising in the city (43 and 45 degree Celsius). <br /><br />It started community awareness programme via mass media and an alert system, began training of medical and paramedical teams for managing heat related illnesses, and monitored HAP’s impact on mortality using daily all cause mortality. <br /><br />The Plan was led by the municipal commissioner and implemented by the health department nodal officer. It was piloted in 2013 with full scale implem-entation in 2014 and 2015. Each year’s plan was revised based on previous year’s experience and re-launched. This is the fourth year of the Ahmedabad HAP. <br /><br />Ahmedabad was hit by heat waves in 2014 and 2015 in June. Temperatures reached 46 degrees Celsius, but death count in the city was limited to only about half of 310 deaths in 2010 heatwave. Thus, after the implementation of the HAP, the city has shown substantial reduction in mortality on peak heat days. This is very similar to impacts associated with implementation of HAPs in Europe and the US. <br /><br />National guidelines <br />In 2016, Maharashtra implemented the HAP in Nagpur and six other surrounding cities learning from Ahmedabad. The Odisha government has also pr-epared a HAP for the state and key cities. Many other states, including Andhra Pradesh and Telangana among others are developing heat action plans. <br /><br />The National Disaster Management Authority has already made national guidelines for action plans for heat waves and put on their website. This is great progress from just last year when the nation was caught unprepared for the heat waves and thousands died. <br /><br />Heat wave mortality can be substantially reduced nationally if we have an early warning system and take action in earnest. The actions are simple from awareness and alert system, dri-nking more water to seeking immediate medical attention when needed. Early warning of high temperatures is now possible in as IMD has already started predicting five days of maximum temperatures for 100 cities. <br /><br />Now, it is up to the states and cities to develop their local HAP and protect the people. What needs to be done is to adapt the Ahmedabad HAP for local weather conditions by adjusting threshold temperatures and humidity, if needed. This is a very critical step and it needs some simple analysis of correlating the daily temperature and locally-registered all cause mortality. We have also made a “how to manual” to develop local heat action plans that are available online along with the Ahmedabad HAP. <br /><br />Temperatures are going to rise rapidly and heat waves are going to be worse over the years. Heat waves could lead to a terrible toll on humans, animals and plans unless we urgently take action nationally. <br /><br />Prime Minister Narendra Modi who started the first Climate Change Department in the country in Gujarat and wrote a book “The Convenient Action,” needs to take leadership to scale up Ahmedabad Heat Action plan developed from his home state to make the country resilient to increasing heat. <br /><br /><em>(The writer is Director, Indian Institute of Public Health, Gandhinagar)</em><br /><br /></p>
<p>Temperatures have soared to 45 degrees Celsius in many regions in India, causing severe heat wave conditions. Last year, temperatures broke records globally and this year is likely to break records again. Normally, heat waves are more likely after May 15. But this year, temperatures spiked much earlier. <br /><br /></p>.<p>The Indian Meteorological Department (IMD), for the first time, issued a seasonal heat forecast and the news is not good – “warmer than normal temperatures are expected” for the heat season. India already experienced significantly above normal temperatures in January and February 2016. Many areas are hit with a double whammy of both extreme heat waves and acute water shortage due to deficient monsoon in 2015.<br /><br />During the 2015 heat season, the heat-related deaths crossed the 2,000 mark and tragic stories alerted the nation to this effect of global warming. These reported death counts are a gross underestimate of total heat-related mortality since our reporting of death is poor.<br /><br />Ahmedabad had a wake-up call with a very severe heat wave in 2010. Temperatures reached nearly 47 degrees Celsius on May 21, 2010. Our studies of the data from Ahmedabad Birth and Death Registrar revealed that during the hottest week in 2010, about 800 additional deaths occurred in the city due to all causes of which only about 75-80 were reported as “heat stroke.” <br /><br />On May 21, 2010, 310 deaths were recorded against average of only 100 daily deaths in May. Based on this research and other evidence from western European heat waves of 2003 where more than 70,000 additional deaths happened, the city of Ahmedabad, in partnership with the Indian Institute of Public Health, Natural Resources Defence Council (USA), the Climate Development and Knowledge Network and others, developed the 2013 Heat Action Plan for the city – the first ever in South Asia. <br /><br />The Ahmedabad Heat Action Plan (HAP) at first consisted of a pilot seven-day temperature forecasts for the city provided by Georgia Institute of Technology in summer. It set local temperature thresholds where mortality starts rising in the city (43 and 45 degree Celsius). <br /><br />It started community awareness programme via mass media and an alert system, began training of medical and paramedical teams for managing heat related illnesses, and monitored HAP’s impact on mortality using daily all cause mortality. <br /><br />The Plan was led by the municipal commissioner and implemented by the health department nodal officer. It was piloted in 2013 with full scale implem-entation in 2014 and 2015. Each year’s plan was revised based on previous year’s experience and re-launched. This is the fourth year of the Ahmedabad HAP. <br /><br />Ahmedabad was hit by heat waves in 2014 and 2015 in June. Temperatures reached 46 degrees Celsius, but death count in the city was limited to only about half of 310 deaths in 2010 heatwave. Thus, after the implementation of the HAP, the city has shown substantial reduction in mortality on peak heat days. This is very similar to impacts associated with implementation of HAPs in Europe and the US. <br /><br />National guidelines <br />In 2016, Maharashtra implemented the HAP in Nagpur and six other surrounding cities learning from Ahmedabad. The Odisha government has also pr-epared a HAP for the state and key cities. Many other states, including Andhra Pradesh and Telangana among others are developing heat action plans. <br /><br />The National Disaster Management Authority has already made national guidelines for action plans for heat waves and put on their website. This is great progress from just last year when the nation was caught unprepared for the heat waves and thousands died. <br /><br />Heat wave mortality can be substantially reduced nationally if we have an early warning system and take action in earnest. The actions are simple from awareness and alert system, dri-nking more water to seeking immediate medical attention when needed. Early warning of high temperatures is now possible in as IMD has already started predicting five days of maximum temperatures for 100 cities. <br /><br />Now, it is up to the states and cities to develop their local HAP and protect the people. What needs to be done is to adapt the Ahmedabad HAP for local weather conditions by adjusting threshold temperatures and humidity, if needed. This is a very critical step and it needs some simple analysis of correlating the daily temperature and locally-registered all cause mortality. We have also made a “how to manual” to develop local heat action plans that are available online along with the Ahmedabad HAP. <br /><br />Temperatures are going to rise rapidly and heat waves are going to be worse over the years. Heat waves could lead to a terrible toll on humans, animals and plans unless we urgently take action nationally. <br /><br />Prime Minister Narendra Modi who started the first Climate Change Department in the country in Gujarat and wrote a book “The Convenient Action,” needs to take leadership to scale up Ahmedabad Heat Action plan developed from his home state to make the country resilient to increasing heat. <br /><br /><em>(The writer is Director, Indian Institute of Public Health, Gandhinagar)</em><br /><br /></p>
