COVID-19 and thermoregulation-related problems: Practical recommendations

Abstract

The COVID-19 pandemic started in the cold months of the year 2020 in the Northern hemisphere. Concerns were raised that the hot season may lead to additional problems as some typical interventions to prevent heat-related illness could potentially conflict with precautions to reduce coronavirus transmission. Therefore, an international research team organized by the Global Health Heat Information Network generated an inventory of the specific concerns about this nexus and began to address the issues. Three key thermal and covid-19 related topics were highlighted: 1) For the general public, going to public cool areas in the hot season interferes with the recommendation to stay at home to reduce the spread of the virus. Conflicting advice makes it necessary to revise national heat plans and alert policymakers of this forecasted issue. 2) For medical personnel working in hot conditions, heat strain is exacerbated due to a reduction in heat loss from wearing personal protective equipment to prevent contamination. To avoid heat-related injuries, medical personnel are recommended to precool and to minimize the increase in body core temperature using adopted work/rest schedules, specific clothing systems, and by drinking cold fluids. 3) Fever, one of the main symptoms of COVID-19, may be difficult to distinguish from heat-induced hyperthermia and a resting period may be necessary prior to measurement to avoid misinterpretation. In summary, heat in combination with the COVID-19 pandemic leads to additional problems; the impact of which can be reduced by revising heat plans and implementing special measures attentive to these compound risks.

COVID-19 and heat waves: New challenges for healthcare systems

“…There are existing recommendations to protect staff from heat stress and ensure their occupational health and safety exist on national and international levels ( Jacklitsch et al, 2016 ). For the current situation, there are a few suggestions to protect employees who use PPE at elevated temperatures ( Daanen et al, 2020 ; Foster et al, 2020 ; Lee et al, 2020 ; Luze et al, 2020 ; Morabito et al, 2020 ; Workplace Safety and Health Council, 2020 ) GHHIN has developed some recommendations (Global Heat Health Information Network (GHHIN), 2020). Since the global temperatures are increasing these recommendations will remain relevant also for future summers (with or without out COVID-19).…”

“…The second, revised draft was sent out to an international team of experts, 3 which was formed during this workshop on “hot but habitable” in Leiden at the Lorentz Center ( https://www.lorentzcenter.nl/hot-but-habitable.html ). Several of the workshop participants, including GHHIN members, published a paper: “COVID-19 and thermoregulation-related problems - practical recommendations” ( Daanen et al, 2020 ). The GHHIN information series is the result of scientific collaboration of over 70 contributors and reviewers (see acknowledgement).…”

“…Many Western countries already have adopted and implemented heat health action plans ( Bittner et al, 2014 ; Casanueva et al, 2019 ). With the Covid-19 pandemic, is it necessary to adapt these plans to address the conflicting advice for protection against Covid-19 and for heat management ( Daanen et al, 2020 ; Foster et al, 2020 ; Lee et al, 2020 ; Martinez et al, 2020 ; Morabito et al, 2020 ). Information addressing this issue was compiled and the first recommendations have been published on national and international levels (Global Heat Health Information Network (GHHIN), 2020).…”

“…Hence, health systems need to prepare for heat events — in addition to managing COVID-19. Heat health action plans and recommendations may need modification in cases where they are restricted, unavailable or in contradiction due to COVID-19 measures and guidelines ( Daanen et al, 2020 ; Martinez et al, 2020 ; Morabito et al, 2020 ). Additionally, prolonged heat can put an additional burden on health systems and emergency services that are already under pressure due to the COVID-19 pandemic.…”

Household Energy Insecurity and COVID-19 Have Independent and Synergistic Health Effects on Vulnerable Populations

“…The lack of cooling systems in households amidst humid temperature and heat waves can mean an increase in visits to cooling centers, which are commonly implemented in hot regions within developed countries to provide a safe location to low-income populations from heat-related morbidity and mortality ( 19 ). Daanen et al ( 20 ) assert that going to public cool areas in the hot season interferes with stay -at-home recommendations to reduce the spread of the virus. For households bound by stay-at-home orders, constraints on movement mean energy-insecure households in cold climates may have to continue to live in the cold with an increased risk of hypothermia, while those that live in hot and humid climates have an increased risk of hyperthermia.…”