How Physicians Are Preparing for Climate Change and Extreme Heat’s Impact on Human Health

As the U.N. climate conference nears its end, there's concern over whether countries can or will meet prior pledges to hold down global temperatures. If temperatures continue to climb, the impact on health could be profound and some doctors say their profession is not prepared. William Brangham reports in collaboration with the Global Health Reporting Center with support from the Pulitzer Center.

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Read the Full Transcript

Notice: Transcripts are machine and human generated and lightly edited for accuracy.

Amna Nawaz:

As the U.N. climate conference nears its end, there's growing concern over whether countries can or will meet their prior pledges to hold down global temperatures.

If temperatures continue to climb, the impact on human health could be profound, and some doctors say their profession is not prepared.

William Brangham has the story, in collaboration with the Global Health Reporting Center, with support from the Pulitzer Center.

William Brangham:

On a chilly fall day in Cambridge, Massachusetts, the conversation here at Harvard is about extreme heat and how in South Asia alone, it kills tens of thousands of people every year.

Dr. Satchit Balsari, Harvard University:

The water, the portable water becomes so hot, that they can't drink it.

William Brangham:

Dr. Satchit Balsari is an E.R. doctor and co-director of the CrisisReady initiative at Harvard. He's part of a movement to get doctors focused on how climate change impacts human health and how to respond.

You're an emergency room physician. How is it that you are talking so much about climate change?

Dr. Satchit Balsari:

I mean, there is a direct impact on health. Heat waves will lead to heat illness and heat exhaustion and heat stroke. People present to the emergency room when there are wildfires and there is smoke and there's more particulate matter in the air.

And — but there is also a persistent tale of morbidity and mortality that these extreme weather events are resulting in, in this day and age, even in the developed world.

Man:

The rickshaw pullers are the first victims of temperature increase.

William Brangham:

Today, he and his colleagues are working on a project to try and understand and hopefully mitigate some of the impacts of extreme heat in places where millions of the world's poorest people live and work.

In India, Balsari's team partnered with the Self-Employed Women's Association, a union that represents small-scale independent workers, who make up the vast bulk of India's population. By giving them tiny, wearable temperature sensors, they found the women were often experiencing heat extremes well beyond what was officially recorded.

Dr. Satchit Balsari:

So this is Madhuben's house. Madhuben works from home. She's a weaver. I'll just show you a couple of graphs. This one, for example, the green dots are the satellite observations. So that's NASA power data.

William Brangham:

But the gold shows the readings from the sensors in the women's homes.

Dr. Satchit Balsari:

So there is a 10 degree difference between the temperature outside and the temperature at home.

William Brangham:

So the cruder temperature data might tell you, oh, it's actually not so bad because its cooling at night.

Dr. Satchit Balsari:

Yes.

William Brangham:

But when you actually look at what her lived experience is, it's much more unpleasant.

Dr. Satchit Balsari:

It has completely different ramifications, right?

William Brangham:

Living and working in 45 degrees Celsius — that's 113 degrees Fahrenheit — is more than unpleasant. It's dangerous.

Dr. Satchit Balsari:

This has massive ramifications for workplace safety as well. To be able to say that when it is only 40 degrees outside, we know that these kinds of workshops actually are at 45 or 48 degrees.

William Brangham:

This kind of fine-grained data points to problems and solutions which are barely on people's radar now.

Dr. Satchit Balsari:

If we had better information about local climates, you could change school timings, for example. There were a bunch of children of workers that we were working with who stopped going to school because it would get so hot in the afternoon that their feet would burn when they would step on the asphalt.

And so they just stopped going to school. And unless you're on the field studying this, it wouldn't really occur to any of us that school dropouts is because it's too hot to walk back from school.

Dr. Caroline Buckee, Harvard University:

Trying to do better models, using microclimate variation.

William Brangham:

Balsari's partner in this work is Dr. Caroline Buckee, a Harvard professor of epidemiology.

Dr. Caroline Buckee:

A lot of the ways that we are conceiving of the issues of climate change are from large global models, remote sensing data from satellites and things like this.

And the scale in which we're talking about the problem is often too large. So we don't have that granular, human scale data to understand the impacts of climate change.

William Brangham:

Getting better data is critical. Knowing who is most affected could trigger insurance payments, disaster declarations, and more.

For Balsari, Hurricane Maria, the storm which devastated Puerto Rico in 2017, was a crystal clear example of a climate-driven disaster impacting human health.

Dr. Satchit Balsari:

Caroline Buckee and I were involved in a study. While the initial government estimates were that about 64 people had died, the study suggested that the true mortality was closer to about 4,000.

They didn't die on the day of the landfall. They died for months of disruption to other aspects of their lives.

William Brangham:

Disruptions like power outages, shortages of medicine, and a loss of access to regular medical care.

Man:

So I can talk pretty loud, but I can't probably talk that loud.

William Brangham:

And so how can the medical community help prevent these kinds of deadly disruptions?

In a first-of-its-kind program run by the University of Colorado School of Medicine, that's a main focus. These doctors and nurses are working towards a diploma in climate medicine. It involves five separate courses, from making hospitals more environmentally friendly, to this training session at the aptly named Disaster City at the Texas A&M Engineering and Extension Service.

Dr. Terry O'Connor, University of Colorado:

The 911 center will send a liaison.

William Brangham:

Dr. Terry O'Connor, from the University of Colorado, is one of the course directors.

Dr. Terry O’Connor:

Some of these events are coming more and more with less pre-notification. They are amplifying faster than ever before.

William Brangham:

The damage caused by weather disasters is on the rise, not just because of a warming world, but also because more people are moving into vulnerable areas.

Dr. Terry O’Connor:

When we inquire within our own hospital systems or within our medical staff, we find ourselves still pretty unprepared for the scope and scale of these events.

William Brangham:

Jason Moats, who is helping to teach the disaster prep course, says America's medical infrastructure is woefully unprepared. Take what happened to a major Houston hospital during Hurricane Harvey in 2017.

Jason Moats, Texas A&M University:

They had put their generator in the basement of the parking garage. And, OK, there's not a lot of action down there. People won't mess with it. It's secure. But it's also very vulnerable to the floodwater seeping in. Yes, well, it knocked the generator out. They lost power.

William Brangham:

They run through tabletop simulations, how to respond to floods or fires, how to deal with extreme cold or extreme heat.

Woman:

When you lose power, do not automatically — does not every hospital automatically decide to evacuate?

Woman:

No, because you may not have a place to evacuate to. You may not have — like, if there's flooding, how are you going to move your patients if you can't move the vehicles?

William Brangham:

The students come from all over the country, wilderness medicine experts, oncologists, and everything in between.

Dr. Elizabeth Cerceo, Cooper University Health Care:

There are people who are from the emergency room, family medicine. There are nurses. It makes it a lot more fun to have different perspectives. It really does broaden the experience for us.

Dr. Tara Benesch, University of Colorado School of Medicine:

An experience like, this course, will allow me to help serve my patients and my community better.

William Brangham:

And this program is part of a bigger movement. Since 2019, the number of U.S. medical schools requiring coursework on the effects of climate change has more than doubled.

Dr. Terry O’Connor:

We have a storm on the horizon that's coming in, and if we don't do what we can to avoid that problem, we're in for a world of hurt. To put it bluntly, it's giving these providers hope. That's probably the most important thing.

William Brangham:

O'Connor says doctors have to take up the burden together to forge a community and a sense of mission.

For the "PBS NewsHour," I'm William Brangham.