The NHS is used to seasonal extremes putting additional pressure on the service – in the depths of winter. The prospect of additional 999 calls and hospital admissions for dehydration, heat exhaustion and heatstroke at a time of year when the health service is less prepared would be layered on top of a rise in Covid cases. Ambulance services are predicting a 20% rise in callouts. “It feels like a midwinter crisis in the middle of July,” Matthew Taylor, chief executive of the NHS confederation, told the BBC. “This could not be coming at a harder time for us.”
To help deal with the problem, some hospitals are cancelling leave and asking off-duty staff to come in, or cancelling routine appointments and surgeries. There have also been appeals for the public to think carefully about whether a health problem requires a 999 call. Meanwhile, a third of NHS buildings were built before 1965, according to the British Medical Journal, and are ill suited to the hotter summers that have recently become more common.
In care homes, there is still is no centralised data on heatwave preparedness. In the 2003 heatwave, when temperatures reached 38.5C, excess deaths in nursing homes increased by 42% in some parts of the UK.
The temperatures expected on Monday are going to disrupt all kinds of transport. The risks include road surfaces melting and rail tracks warping, which would cause significant delays, while the RAC said it was expecting an increase of 15% to 20% in the number of breakdowns compared with a typical July (and particularly advises against driving if your car doesn’t have effective air conditioning).
The rail network is designed to run effectively at normal maximum temperatures of about 30C: measures are being put in place to make sure train tracks don’t buckle significantly, but this will involve services abiding by lower speed limits of 60mph across much of the network, inevitably meaning journeys take longer. Rail passengers in England and Wales have been urged to travel only if necessary on Monday and Tuesday.
If the pandemic drove people out of their offices, the heatwave – and the promise of building-wide air conditioning – may temporarily tempt some of them back. But the Cabinet Office minister, Kit Malthouse, says that the heat – and transport difficulties – may make this “a moment to work from home”, and some employers are issuing similar advice.
For those who do end up in the workplace, unions and the CBI are asking employers to relax dress codes to allow them to be more comfortable. But while there is a minimum legal working temperature, there is no maximum. The Health and Safety Executive tells employers that a “reasonable” temperature must be maintained to ensure workers’ “thermal comfort”. The Trades Union Congress has called for a “new absolute maximum indoor temperature” of 30C, or 27C for those doing strenuous jobs – a level that may be breached in many workplaces on Monday.
People with disabilities face a range of additional complications as a result of extreme heat that might not be obvious to other people. Guardian columnist Frances Ryan, who frequently writes about the issues facing people with disabilities, adds: “You’re more likely to be in poor housing and poverty if you’re disabled, as well as isolated, so that can also add to the dangers in heat.”
Frances suggests checking in on friends or neighbours who might be vulnerable, and advises employers: “Don’t force people into work or the commute. A lot of disabilities that are impacted by heat are invisible disabilities – such as heart conditions or fatigue – so don’t assume that you know someone’s needs just by looking at them.” For her own part, she will be following advice to stay out of the sun and stay cool by “lying in a darkened room for three days like an infirm Jane Austen character”.
Like workplaces, there is no legal temperature threshold at which children must be sent home. Schools have a responsibility to make sure that conditions are “reasonable” for staff and students but, without a real legal limit, it is down to the discretion of individual schools to make decisions about how best to keep children safe. Some schools are closing because they say they cannot keep buildings cool enough, or cancelling or postponing sports days. Others are planning non-uniform days, minimising outdoor activities including breaks and shifting the timetable to allow pupils to leave before the afternoon heat.
Most of us can retreat to our shady homes and switch a fan on, get plenty of drinking water from a tap, or take a cold shower. Those options often won’t be available to those sleeping rough. In London, where homelessness is particularly acute, the mayor, Sadiq Khan, has asked the city’s boroughs to carry out additional welfare checks. Petra Salva, director of rough sleeping at homelessness charity St Mungo’s, said it would be taking water, hats and sunscreen to rough sleepers who may have underlying health issues, and working with local authorities to increase the provision of cooling rooms to provide a break from the heat.
“Libraries are also a godsend” for those with nowhere else to go, Salva said. “This hasn’t come as a surprise to us. It’s going to be an absolutely normal part of our planning in the future, and it will absolutely put more pressure on our resources to help people.”
It’s not just people who are going to have a hard time coping with the heat – pets also experience extreme discomfort. If pet owners aren’t careful, heatstroke or burnt paws are very possible. A lot of the guidance (you can read the Guardian’s here) is the same as the guidance you’d follow for yourself: make sure your pet is in the shade and hydrated, only go for walks in the coolest parts of the day and avoid being barefoot on pavements. Veterinarians, perhaps counterintuitively, also discourage shaving your pet’s fur as it actually helps keep them cool. There are even pet-safe sunscreen options that will keep your fur babies safe from the sun and prevent sunburn.