Esteve Fernàndez: "We estimate that in Catalonia there are three times more deaths from heat 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 Fernández, warns in an interview with ARA about the serious consequences that high temperatures have for citizens' health 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 heat effects. Additionally, there is another monitoring we do based on mortality attributable to high temperatures, which does not mean there are exactly that many deaths caused by heat, but rather deaths that, statistically, we know can be related. In this case, we estimate there are three times more deaths than last year, and it is obviously a cause for concern.

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 of the last 10 years, the system makes a first estimate of what the current death toll would be. It then 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 mortality than in the previous period.

How many heatstroke deaths have been detected?

— This summer we have not had any notification of death from heatstroke, even though mortality estimates speak of tens of deaths. This is because it is also taken into account that there are many people with chronic illnesses who decompensate when it is very hot. For example, people with underlying cardiac or respiratory pathologies can worsen when there are episodes of extreme temperatures. 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 that worsens. That is why we are also concerned now.

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

— In the last week there have been 595 heat emergencies, of which 400 were heat strokes and 147 were dehydrations. We have mostly diagnosed heat strokes in the age group of 15 to 45 years, normally working population who do so in inadequate conditions, or people who play sports at inappropriate times. On the other hand, dehydrations are indeed more common in the over 80 years age group and in small 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 ourselves, avoiding going out in the street during the hottest hours, and controlling the temperature of our homes.

Here social determinants aggravate the situation.

— Yes, a comprehensive approach is needed to avoid situations such as a dozen people sleeping in a small apartment to harvest fruit 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 health system, but also to prevent them from falling ill solely due to their living conditions.