Esteve Fernàndez: "We estimate that in Catalonia there are three times more heat deaths than last year"

BarcelonaCatalonia is experiencing the second heatwave of this summer, which is expected to be extraordinarily long and will not end until next week. The Secretary of Public Health of the Generalitat, Esteve Fernàndez, warns in an interview with ARA about the serious consequences that high temperatures have for the health of citizens and calls for extreme precautions, especially among the most vulnerable.

Can we foresee how this heatwave will affect health?

— We monitor emergencies in primary care and hospitals due to the effects of heat. In addition, there is another monitoring we do based on mortality attributable to high temperatures, which does not mean that there are exactly this number of deaths caused by heat, but rather deaths that we statistically know can be related to it. In this case, we estimate there are three times more deaths than last year, and it is, obviously, a concern for us.

These are the estimates from the daily mortality monitoring system (MoMo) of the Carlos III Health Institute.

— Yes, based on the historical mortality series from the National Statistics Institute over the last 10 years, the system makes an initial estimate of what the current death toll would be. Then it uses another statistical model and includes the temperature parameter, taking into account that we know that an increase in temperature is associated with an increase in mortality. With this information, it makes a new estimate of deaths and subtracts it from the two estimates. The result is that there are currently three times more deaths than in the previous period.

How many heatstroke deaths have been detected?

— This summer we have not had any notification of death from heatstroke, despite mortality estimates indicating dozens of deaths. This is because it is also taken into account that many people with chronic illnesses decompensate when it is very hot. For example, people with underlying cardiac or respiratory conditions can worsen during extreme temperature episodes. The same happens in winter. Many deaths are precipitated by pneumonia or flu, but the cause of death is an underlying condition that normally affects the heart or lungs and which worsens. That is why we are also concerned now.

And the number of emergencies due to the effects of the heat?

— In the last week there have been 595 heat emergencies, of which 400 were heatstrokes and 147 were dehydration cases. Heatstrokes were mostly diagnosed in the 15 to 45 age group, typically working population who do so in inadequate conditions, or people who exercise at inappropriate times. On the other hand, dehydration is more common in the over 80 age group and in young children, who suffer greatly from the effects of dehydration.

What other effects do high temperatures have?

— They also affect our emotional well-being or how we sleep; we have tropical nights and people cannot rest in good conditions. Thermal stress continues to affect us at night and this then has consequences during the day. There must be structural interventions to try to mitigate the heat, especially in large cities, but it is complex. We must protect ourselves from the heat as best we can, by hydrating, avoiding going out in the street during the hottest hours and controlling the temperature of our homes.

Here social determinants worsen the situation.

— Yes, a comprehensive approach is needed to avoid situations like a dozen people sleeping in a small apartment for the fruit harvest in Lleida or in the Ciutat Vella district. The living conditions of the vulnerable population must be improved, not only so that they can access the healthcare system, but also to prevent them from falling ill solely due to their living conditions.