Hospitals at boiling point as crises collide

The most severe heat wave on record gripped the Pacific Northwest and southwestern Canada this summer (Davis/Flickr)

Emergency departments are overwhelmed. Patient beds are lining hallways. Hospitals are at capacity. Patient transfers are delayed due to ambulances scrambling to respond to emergency calls for help. Older adults, outdoor workers, people experiencing homelessness or living in poor housing conditions, and people with existing medical conditions need medical help the most.

This chaos was not caused by COVID-19, but a stretch of extreme, record-breaking heat in Oregon and Washington this summer.

Approximately 175 record high temperatures were set in Northern California, Oregon, Washington, and Idaho between June 25 and 30, part of the hottest June on record in the United States. There were nearly 2,800 heat-related illness visits to hospital emergency departments (EDs) in the Pacific Northwest that week, providing a shocking contrast to previous conditions. On June 28, 2021, there were 1,038 heat-related illness ED visits in that region compared to nine on the same day in 2019.

Weather events like this are growing in number and severity as a result of climate change. Another extreme heat event hit Washington and Oregon this month when wildfires set records for yet another year, and catastrophic floods swept lives away.

U.S. hospitals are now increasingly being asked to address an overwhelming surge in illnesses resulting from extreme heat, wildfires, and other effects of climate-related emergencies as they continue to grapple with the COVID-19 pandemic. One out of five intensive care units are at or near capacity around the country.

The Intergovernmental Panel on Climate Change recently released its latest report of scientific climate analysis and projections, in which the United Nations secretary general issued a “code red for humanity,” as time is running out to avoid the worst increases in global temperatures and their resulting devastating health impacts. If we continue with business as usual, more than 83 million people will die from excess heat by the end of this century. We recognize health care’s role in contributing to the problem, as the sector is responsible for 8.5% of all U.S. greenhouse gas emissions.

We should seek to replicate the successes of hospitals that have been doing their part to reduce emissions through energy management and innovative approaches in transitioning to clean energy. We must also support hospitals as they improve the climate resilience of their facilities and the communities they serve.

We know it’s far more expensive not to prepare for climate-caused events than it is to invest in health care climate resilience. Explore our

The majority of U.S. hospitals are either nonprofit or publicly owned and are operated with limited resources. We cannot endlessly lean on health professionals and health systems without providing them with the assistance they need to prepare and adapt, particularly during the intersection of the worst public health crises of our time.

Policymakers, regulators, national building standards, and patient safety organizations must all support this work without delay.

National health care facilities standards must require climate preparedness and accelerate the adoption of both energy efficiency measures and renewable energy. The quality of care – calculated by outcomes, safety, and service, divided by the total cost of patient care – must include the environmental impacts of the care being delivered. Hospitals, particularly rural and safety-net facilities hardest hit by COVID-19, need funding and technical assistance to decarbonize and ensure they are able to care for those disproportionately impacted by the climate crisis.

Support for climate-smart health care solutions that involve all stakeholders, build resilience, and prioritize the most affected communities is urgently needed to heal the planet and help health care workers and institutions continue to serve as lifelines during public health emergencies.