Heatwaves can significantly affect the health of people, especially the most vulnerable – regardless of age. Climate change exacerbates the problem. The doctor Oliver Opats he is an expert in dealing with extreme conditions. Works at Institute of Physiology at Charitéwhere he studies how humans react to an extreme environment, such as space or the desert.

In Berlin, of course, the situation has not gotten that far. Rising temperatures, however, as a result of climate change, may have serious effects on the health of many people. During the hottest days of summer this is also evident at the Charité clinic, where the condition of many patients worsens, Opats says. Patients with cardiovascular problems, kidney disease or chronic obstructive pulmonary disease (COPD), which affects many older smokers, are at greatest risk.

“The body enters a vicious circle”

In people with COPD, the airways become narrow and their breathing is not good. “When it’s very hot, the circulatory system has to “work” harder, while these people find it even harder to breathe, the organs are oxygenated even worse and therefore work worse. The whole body thus enters a vicious cycle”, explains the expert.

In case of kidney disease, the patient’s fluid intake could be disturbed, because he either drinks too little fluid or too much. And then his illness would get worse accordingly. Finally, in people with cardiovascular diseases, the heart finds it difficult or even fails in hot conditions to supply all the organs with sufficient blood.

Greater risk for stroke

According to the German Society of Neurology (DGN) the heat increases the risk of neurological diseases. A study by German neurologists published in the European Heart Journal found that the rise in nighttime temperatures has significantly increased the risk of strokes – and how dangerous they are for the patient’s life.

DGN also emphasizes that another possible effect of the heat is delirium. This is a confusional state, which is caused by a lack of fluids and occurs especially in older people – and which can have serious consequences if, for example, the patient falls awkwardly and ends up breaking a bone.

“Huge problems” for the elderly

The heat is affecting vulnerable people in particular: “There is a huge problem for the elderly,” Opats says. And it is not the actual age that is critical, but the biological age. “An elderly person is someone whose body no longer functions very well. This could happen in one person’s 60s, in others in their 70s or 80s. But even a 40-year-old can breathe like a train,” explains the doctor.

Heatwaves also have a significant impact on the health of patients with chronic neurological conditions, for example worsening the condition of patients with migraines, multiple sclerosis or paraplegia. People with spinal cord injuries and paraplegia not only have mobility problems, but often suffer because their body does not regulate its temperature properly.

Different need for medicines in the heat

At the same time, Opats also points out that the drugs that patients receive are often not adapted based on the heat conditions that may prevail. The doctor explains that many of the patients he visits have swollen legs, their hearts are not working properly and they have difficulty breathing. And in these cases, constant communication with the family doctor regarding the type and amount of medication consumed by the patient is critical. However, due to the lack of doctors, this is impossible, says Opats. Now an effort is being made to create an app for mobile phones, which will be able to provide some sort of assistance to patients until they can contact their doctor.

In addition to physical problems, the heat may have psychological effects. As Opats explains, “when the temperature stays high at night and people can’t relax and sleep, then there is a problem.” Then the autonomic nervous system comes into play, which keeps the person alert and even fighting. “At some point a person reaches his limits and thus may engage in a conflict or a violent outburst,” says Opats.

More premature births amid heat wave

Other experts add that the heat may also affect pregnant women. “Every day of extreme heat and with every degree that the temperature rises, the risk of preterm birth increases,” observes Petra Ark from the University Clinic Hamburg-Eppendorf (UKE).

A study with data from 42,000 pregnant women over twenty years showed that even a temperature of 30 degrees Celsius can increase the risk of premature birth by up to 20%. If the heat lasts a day or two, then there is no problem. But if a third, fourth or fifth day follows without the temperature dropping, it is possible that the delivery will take place prematurely.

According to last year’s report by the Robert Koch Institute (RKI), two to three heat waves occur annually in Germany. Given global warming these could increase to four or even six per year by the end of the century. The German Meteorological Service (DWD) defines heat waves as temperatures above 28 degrees Celsius that last for at least three consecutive days

“Legislative initiatives are needed”

Experts are asking the federal government to take measures to protect citizens from the heat. “The risk is increasing rapidly and overall we are not well prepared,” says the president of the German Alliance for Climate Change and Health (KLUG), Martin Herrmann. The dangers posed by heatwaves are so great that it is not enough to rely on the free will of everyone to protect themselves. “Legislative initiatives are needed for this.” According to RKI estimates last year the heat wave in Germany cost the lives of around 3,200 people.

Edited by: Giorgos Passas