The intensification of heat waves raises important questions for society, says public health expert Mathilde Pascale.
In August 2003, a great tragedy struck France: the heat. 14,802 people died from the hot, dry air that smothered the country for 15 days, most of them elderly, many of them dying alone.
“For me, 2003 is like something that comes from the future and says that you have to prepare because it will come back,” says Mathilde Pascale, director of scientific projects at Santé Publique France.
At that time, France was unprepared, not used to perceive heat as a killer. When the mercury rose to 37C, newspapers described it as fun in the sun, while the Health Minister gave a reassuring speech on television from his holiday home on the Riviera.
Two weeks later, the nation was in shock for what had happened at its doors. The morgues were packed. In late August, when city residents returned from vacation, some found their ceilings stained with the bodily fluids of their elderly neighbors who had died alone. “2003 was an electric shock,” says Pascale.
More than 20 years later, the events of summer 2003 They still weigh on the rulers. “At least in terms of decision making, risk analysis and communication, I think the progress achieved between 2003 and now are enormous,” says Pascale.
According to the country’s national plan against heat waves, a warning system classifies the threat from green to redeach summer, with very strong measures at the extreme of danger. The national meteorological service Météo France, Santé Publique France and the Ministry of Health monitor temperatures and discuss the situation daily.
What did France learn from the 2003 heat wave?
Statistics show that about 82 percent of 2003 victims had 75 years or older. An estimated 92 percent of those who died at home in Paris lived alone.
These horrible scenes permeated the national consciousness and accelerated the action. But 20 years is a long time in the collective memory, and Pascale believes that French awareness of the extreme heat now it is largely due to annual events and efforts.
Subway signs, TV ads, and radio ads keep people alert about danger and inform them of the latest instructions.
According to the national heat wave alert system, each color activates a particular plan, and the departments are in a state of emergency starting from the orange level (which means heat wave).
It varies throughout the country, but is usually declared when temperatures exceed a certain degree during three consecutive days. At this point, for example, cities open designated cooling spaces and increase controls on people sleeping rough.
In it red level (severe heat wave), the national government also intervenes. Local authorities have special powers to close events and public facilities if necessary.
In the summer of 2019France suffered record temperatures: 46°C near the southern city of Nimes and almost 43°C in Paris.
It was issued a rare red alert for a couple of days. The national exam for students going to secondary school, something “symbolically important” in France, was postponed and people were advised not to go to work or use public transport. “It was like completely shutting down everyday life, because of the heat,” says Pascale.
Has the French plan against the heat wave saved lives?
Given the complex relationship between heat and mortality, it is difficult to quantify exactly how many human lives have been saved thanks to French anti-heat policies.
ADVERTISINGOne study estimated that some 4,000 more people could have died in a July 2006 heat wave that killed 2,000 if it had not been for the national heat wave plan.
Another study includes a figure for heat-related deaths during 2015-2019, in which southern France seems less vulnerable next to comparable places in northern Spain and Italy.
Lead author Joan Ballester of the Barcelona Institute for Global Health (ISGlobal) speculates that “there is something in the way France is doing things” that softens the impact of extreme heat. He mentions the health system, the socioeconomic circumstances and the long shadow of 2003 as possible factors.
Pascale warns that this is still a narrow time frame; It could simply be that temperatures were less intense in France during these four years. Comparing countries is another complicated area.
ADVERTISINGIn a controlled study, France would suffer the same heat wave every year and researchers could evaluate the impact of different preventive measures. But heat waves vary naturally and have become increasingly intense with climate change.
In it summer 2022 (the second hottest season in France and the hottest year on record), were estimated about 4,800 deaths related to heat. That year two red alerts were declared and, without a doubt, vulnerable lives were saved. But the death toll shows the limits of adaptation.
How far can emergency measures against heat go?
Just like the lockdowns COVID-19heat waves raise important questions about what citizens are willing to do to protect each other.
“We must also ask ourselves if we are prepared as a society to take these types of measures [rojas] every summer, maybe not for one day, but for two weeks,” says Pascale. “Because exceptional extreme heat events (I don’t even know what kind of adjectives we should use today) happen very frequently.”
ADVERTISINGReduce the risk of heat mortality It’s one part of the equation, he says. “The second part is, at what cost can we limit the risk and impact? And will this cost be sustainable and acceptable? “And, of course, the answer to that is no. And the answer is that we really need to mitigate climate change.”
From short-term relief to long-term heat adaptation
In France, the red threshold remains high to be effective. In parallel with the emergency measures, the plan was always to also develop long-term adaptation strategies.
Initially, this focused on training people to take care of each other during heat waves. Since 2004, all nursing homes must have an air-conditioned room to protect residents. Councils encourage over-65s and vulnerable people to register to receive phone calls when high temperatures arrive.
In recent years, adaptation has expanded in other directions: for example, addressing the effect of urban heat island with tree planting plans.
ADVERTISINGIn 2023, France presented its first heat wave management plan,that incorporates more structural solutions. And, in a significant development for Pascale, heatwave plans are now shared by the Ministry of the Environment and the Ministry of Health, with “adaptation” featuring prominently.
In 2024, more specific guidance has been introduced, for example on outdoor sports, under the motto “living in the heat”. “It’s really a new paradigm,” explains Pascale; Instead of telling people not to exercise, they are offered options such as running at different times or trying different activities.
How could France manage the heat better?
Another focus for Santé Publique France is indoor temperatures, and health experts are beginning to discuss with construction professionals how to make indoor temperatures houses are cooler and safer for people.
“I think it would be useful to have a collective debate and a consensus on what is sustainable and fair use of air conditioning,” says Pascale, although this is not something specific to France.
ADVERTISINGAfter analyzing the data, he believes the country’s heat prevention plan has been effective in reducing deaths, but it is not avoiding all impacts, and there is still room for improvement.
Some actions are mandatory and others function as a “toolbox” from which local authorities can choose. Pascale envisions a tighter network, where local people could share experiences and good practices.
“I think that perhaps the only thing we still lack today is to understand the seriousness of the events that we will face if we do not act against the climate change“, Add.
“Because I think there’s this idea that, well, extremes are a big problem, but we will find a way to adapt and we will find a way to be okay. And adaptation has a limit.”
ADVERTISINGIf fossil fuel-driven climate change is not addressed at its source, the deadly 2003 heat wave will be much milder than what Europeans will experience in the future.
