In the summer of 2022, one of the worst monsoons on record turned swaths of Bangladesh, a low-lying country in South Asia, into huge, muddy lakes. When the brunt of the flooding finally eased, at least 141 people had died and millions of others throughout the region had been injured, impoverished, or displaced. The sheer scale of the destruction made 2022 an outlier year, but data from the past few decades signals that the historic monsoon was part of a larger trend: Climate change is making South Asia’s rainy season more intense and inconsistent. Unusually fierce floods have plagued the region earlier in the year and more often than they used to — a pattern that research shows will continue, and worsen, as the planet warms in the years ahead.
A study published last week shows Bangladesh’s intensifying monsoons come with a staggering death toll, both in the immediate aftermath of the flooding itself, and, more significantly, in the months that follow. The true scale of the toll has not been fully captured by local officials, aid organizations, or the international research community.
The same is likely true for other parts of the world that experience recurrent climate disasters. “In the climate and health field, we often evaluate the health effects of specific acute events because it’s easier to account for all the other potential factors that could be confounding the association,” said Lara Schwarz, an epidemiologist at University of California, San Diego, who was not involved in the study. But a focus on the short-term obscures the larger picture. “Most climate events don’t occur only once and are likely to harm vulnerable populations over and over, through years, decades, and generations,” she said.
A young girl gets treatment for dengue fever, a mosquito-borne illness, at Mugda Medical College and Hospital in Bangladesh in October. MUNIR UZ ZAMAN/AFP via Getty Images
In the new study, researchers from the University of California, San Diego, and San Francisco, found that flooding contributed to the deaths of 152,753 infants — defined as children 11 months old and younger — in Bangladesh in the three decades between 1988 and 2017. The researchers used health surveys conducted by the United States Agency for International Development to collect data on more than 150,000 births over the course of the 30 years. They compared that data against high-resolution maps of major floods over that time span and found a stark difference in mortality risk: There were 5.3 more infant deaths per 1,000 births in flood-prone areas than in non-flood-prone areas. The authors extrapolated from this finding to estimate how many infant deaths, overall, were attributable to flooding in Bangladesh over the time period they studied.
Infants are an especially vulnerable subset of the population, and changes in infant health can reflect the prevalence of health issues in the wider population. “Death is the most severe health outcome,” said Schwarz. “The increased risk of infant mortality suggests that populations living in a flood-prone region may also be at higher risk of other adverse health problems such as improper nutrition, water-borne diseases, and poor mental health.”
A house is seen almost damaged after a heavy storm in Khulna, Bangladesh, in December. Mushfiqul Alam/NurPhoto
The majority of the deaths were likely linked to three flooding-related conditions. The first, diarrheal disease, often spreads when flooding overwhelms local sanitation infrastructure and causes drinking water supplies to be contaminated. Cholera, one of the most common and deadliest water-borne bacterial diseases, is a particular concern in poor countries where sanitation infrastructure is underdeveloped. Flooding also contributes to outbreaks of mosquito-borne diseases like dengue, because standing water creates ample breeding ground for mosquitoes. Finally, flooding turns agricultural fields into bogs and can lead to massive crop losses, which contribute to existing food insecurity in Bangladesh. Babies are extremely vulnerable to hunger. The Lancet, a leading medical journal that publishes an annual analysis of the impacts of climate change on human health around the world, has identified bacterial and vector-borne diseases and malnutrition as top areas of concern.
Drownings and other injuries from the flooding also led to a small percentage of the deaths, the study’s authors told Grist. All of the health-related risks posed by flooding, from the first drowning to the last case of dengue, were exacerbated by socioeconomic factors like food security, family income, vaccination history, access to medical care, and the condition of local infrastructure such as sewage systems and drinking water treatment facilities.
Children play on a flooded road after heavy rains in Dhaka, Bangladesh, in September. Kazi Salahuddin Razu/NurPhoto/Getty Images
The authors of the study told Grist that their results indicate that the risks of environmental health hazards are shifting as climate change worsens. Government health agencies and researchers often collect information on the immediate public health impacts of a single extreme weather event. But, because a warmer world also means a world plagued by more frequent and intense disasters, communities are being affected by extreme weather repeatedly. The long-term, cumulative health consequences of events that occur on a yearly or sometimes even more frequent basis are not well understood by the scientific community. And as such, the world has a flawed understanding of the true human cost of extreme weather.
“We need to understand this kind of long-term impact in the context of climate change because communities are going to be repeatedly and systematically exposed to these hazards,” said Tarik Benmahria, an environmental health researcher at University of California, San Diego, and one of three authors of the Bangladesh study. “These types of issues used to be exceptional by definition,” he added. “They’re not anymore.”
The method used by the researchers to determine the burden of flooding on communities in Bangladesh over multiple years, Schwarz said, “has the potential to be applied to evaluate the long-term effects of other climate exposures.” Extreme heat, hurricanes, and drought, to name a few of the environmental disasters being exacerbated by climate change, can also have compounding health effects that occur weeks, months, even years after the event takes place. If future research pinpoints how and when these effects occur, it could potentially save lives. “The approach is very relevant to other areas of the world that are vulnerable to recurrent climate hazards,” Schwarz said.
For the better part of a decade, researchers working at the intersection of climate change and human health have been desperately sounding alarm bells about the significant public health threats lurking in every tenth of a degree of planetary warming. Billions of people are at risk from illnesses linked to extreme heat; malnutrition following crop failure; bacteria and viruses that lurk in…
For the better part of a decade, researchers working at the intersection of climate change and human health have been desperately sounding alarm bells about the significant public health threats lurking in every tenth of a degree of planetary warming. Billions of people are at risk from illnesses linked to extreme heat; malnutrition following crop failure; bacteria and viruses that lurk in mosquitoes, ticks, and water; and other climate-driven threats.
Yet health has never been on the official agenda at the annual United Nations climate change conference, where leaders representing countries around the globe gather to negotiate climate policy. That changed at this year’s Conference of the Parties, or COP28, which is currently taking place in Dubai, United Arab Emirates. Sunday was the first ever COP “Health Day,” designed to bring together health and environment ministers from dozens of countries to discuss the health effects of climate change and brainstorm potential solutions.
“For too long, health has been a footnote in climate discussions,” Tedros Adhanom Ghebreyesus, director-general of the World Health Organization, said on Sunday. “No more.”
Health researchers and advocates celebrated the milestone, but when Health Day was over and the resulting commitments were tallied, most emphasized that more needs to be done to protect communities from the health impacts of the climate crisis. “We must not lose sight of the actual negotiations happening behind closed doors, especially on the fossil-fuel phase-out, which is what will truly slow and stop climate change from worsening,” said Ramon Lorenzo Luis Guinto, director of the planetary and global health program at St. Luke’s Medical Center College of Medicine in the Philippines and a COP28 attendee.
Even before Health Day began, delegates from 123 countries had already signed the COP28 UAE Declaration on Climate and Health, a nonbinding commitment to protect communities by investing in climate adaptation measures and making health systems more resilient to climate impacts.
People use a mosquito net to protect themselves from dengue in Dhaka, Bangladesh.
Syed Mahamudur Rahman / NurPhoto via Getty Images
The declaration has some significant funding behind it: A coalition of philanthropies and aid organizations, such as the Rockefeller Foundation and the Global Fund to Fight AIDS, Tuberculosis, and Malaria, collectively pledged $1 billion in new funding to address the climate health crisis. A COP28 spokesperson told Grist that the funding had all been pledged recently — either in the lead-up to the conference or during the event. For instance, the $100 million contributed by the Rockefeller Foundation was announced in September as part of the philanthropy’s five-year “climate strategy,” a Rockefeller spokesperson said.
“Climate change is increasingly impacting the health and well-being of our communities,” said President Lazarus Chakwera of Malawi, one of the initial backers of the declaration. “Extreme weather events have displaced tens of thousands of our citizens and sparked infectious disease outbreaks that have killed thousands more.”
More than 40 banks, governments, and other organizations also signed on to a set of 10 broad principles aimed at guiding international financing for climate and health infrastructure, local projects, and solutions. The principles include supporting the climate and health priorities of countries most affected by climate change and simplifying the processes for accessing available climate and health funds.
On Health Day, global donors including UAE President Sheikh Mohamed bin Zayed Al Nahyan and the Bill and Melinda Gates Foundation pledged nearly $800 million to eradicate neglected tropical diseases — a group of 20 climate-sensitive illnesses that affect 1.6 billion of the world’s poorest people, the majority of whom are already extremely vulnerable to the effects of climate change.
In addition to these landmark pledges, Health Day at COP28 included dozens of health-focused events that took place in an official health pavilion, as well as in other pavilions and tents across the conference. Kristie L. Ebi, a climate and health researcher at the University of Washington who has attended every COP since 1997, called the day a “watershed moment” for her field. “Most of us spent our day going from one pavilion to another to talk about climate change and health,” she said. “The visibility overall of climate change and health dramatically shifted with this COP.”
As prior COPs have shown, making climate commitments is often the easy part — actually seeing them through is much harder. Jeni Miller, executive director of the Global Climate and Health Alliance, said the Declaration on Climate and Health was welcome but cautioned against assuming that the declaration will lead to material benefits for affected populations. “It contains no plans for action right now, and does not have clear goals or targets,” she said. “Nor does it mention the extraction and burning of fossil fuels as the leading cause of climate change and climate-related health threats.” The $1 billion pledge, she added, also does not contain language that describes how developing countries can secure funds for local climate and health projects. How that money will be distributed or used remains to be seen.
Speaking at an event on Health Day, Maria Neira, director of the Public Health, Environment and Social Determinants of Health Department of the World Health Organization, put it succinctly: “This is quite historic,” she said, “but it is just the first day of history.”
Sultan Al-Jaber, the president of COP28, and Jim Skea, the chairman of the Intergovernmental Panel on Climate Change, at COP28 in Dubai. Nuran Erkul Kaya / Anadolu via Getty Images
More history could be made at COP28. Negotiators are currently debating “an orderly and just phase-out of fossil fuels,” which, if it is adopted, would be the first international deal on the books to call for an end to fossil fuel use. But progress is extremely tenuous — striking a deal on any climate proposal requires unanimous consent from all participating countries. It takes just one dissenting nation to scramble a negotiation, and Saudi Arabia’s energy minister said on Monday that he will not agree to “phase out” or “phase down” fossil fuels. Saudi Arabia’s commitment to fossil fuels does not make it an outlier at the conference. Recent reporting revealed the president of COP28, Sultan Al-Jaber, has falsely claimed there is “no science” backing up the idea that eliminating fossil fuels is key to keeping global warming in check.
Still, mitigating climate change is just one part of the challenge the world faces. For the world’s developing countries, which contribute a very small amount to the world’s carbon budget, adapting to the consequences of rising temperatures is now more important than mitigating its effects. That’s why the pledges made at Health Day are significant, Ebi said. Preparing these countries for the health-related climate impacts to come is “fundamental to their national development,” she said. At COP28, the preparations finally got underway.
This week, the United States government and leading climate researchers from institutions across the country released the Fifth National Climate Assessment, a report that takes stock of the ways in which climate change affects quality of life in the U.S. The assessment breaks down these impacts geographically — into 10 distinct regions encompassing all of the country’s states, territories…
This week, the United States government and leading climate researchers from institutions across the country released the Fifth National Climate Assessment, a report that takes stock of the ways in which climate change affects quality of life in the U.S. The assessment breaks down these impacts geographically — into 10 distinct regions encompassing all of the country’s states, territories, and tribal lands — and forecasts how global warming will influence these regions in the future.
Unlike other climate change-focused reports that are released annually, the National Climate Assessment comes out once every four years. The length of time between reports, and the volume of research each report contains, allow its authors to make concrete observations about climate-driven trends unfolding from coast to coast and island to island.
In the previous installment of the report, released in 2018, the government warned that rising temperatures, extreme weather events, drought, and flooding threatened to unleash a surge of fungal pathogens, toxic algal blooms, mosquito- and tick-borne illnesses, and other climate-linked diseases. The new report, published on Tuesday, demonstrates that this prediction is unfolding right on schedule.
“Health risks from a changing climate,” the report says, include “increases in the geographic range of some infectious diseases.” West Nile virus, dengue fever, Lyme disease, Rocky Mountain spotted fever, rabies, and Valley fever, carried by mosquitoes, ticks, mammals, and soil, are among the infectious diseases the report has identified as “climate sensitive.” Climate change isn’t the only reason more people are being affected by these illnesses — urban sprawl, deforestation, cyclical environmental changes, and other influences are also at play — but it’s a clear contributing factor.
Here are a few of the diseases that the Fifth National Climate Assessment warns are spreading into new parts of the country as a changing climate sends their carriers creeping into different areas.
A map of climate-sensitive infectious diseases from the report. Fifth National Climate Assessment
Ticks
In the U.S., the vast, vast majority of reported cases of vector-borne disease — defined as diseases spread by blood-sucking invertebrates such as ticks, mosquitoes, and fleas — can be traced to ticks. Lyme disease, which has long been prevalent in the Northeast and mid-Atlantic, is becoming endemic to the Midwest as winters in that region become milder. Western black-legged ticks, which can carry Lyme, are even creeping into Alaska, where conditions have historically been too harsh for the eight-legged bloodsuckers to survive. The costs of treating Lyme, which can cause effects that range from flu-like symptoms to neurological disorders, are “substantial,” the report says. One analysis puts the annual cost of treating Lyme, which affects some half a million Americans each year, at $970 million.
Lyme isn’t the only tick-borne illness expanding in range and severity across the U.S. The Gulf Coast tick, which carries multiple diseases, has been expanding through the Southeast. Deadly illnesses such as Rocky Mountain spotted fever, babesiosis, and alpha-gal syndrome, all spread by different kinds of ticks, could reach new areas as temperatures continue to rise, the report says.
Mosquitoes
Much like ticks, mosquitoes are benefiting from milder winters and longer breeding seasons. The uptick in flooding across major swaths of the country, brought on by a warmer, wetter atmosphere, can also be a boon to the winged insects. Every part of the contiguous U.S. is seeing changes in the geographic range and prevalence of mosquito-borne illnesses.
West Nile virus, a disease carried by Culex mosquitoes, is expanding in the Northeast and becoming a bigger threat in other parts of the country, like the Southeast, as the planet warms. “Black and under-resourced neighborhoods in Chatham County, Georgia, were identified as hotspots for West Nile virus,” the report says. The majority of people who contract West Nile experience no symptoms, but people who are immunocompromised, elderly, or pregnant, or who have comorbidities, often have severe symptoms and can even die.
Dengue fever, a deadly viral infection, is becoming a bigger risk in the contiguous U.S., Puerto Rico, the U.S. Virgin Islands, Hawaiʻi, and the U.S.-affiliated Pacific Islands. Malaria, a parasitic mosquito-borne illness that was eradicated from the U.S. in the 1950s, is now a burgeoning threat in the Southeast and Pacific Islands regions.
A health inspector sprays a neighborhood for mosquitoes in 2016 in McAllen, Texas. John Moore/Getty Images
Bacteria
Climate change is helping to spread a bacteria called Vibrio, which proliferates in warm ocean water and causes an illness called vibriosis. Symptoms include vomiting, diarrhea, and a rash that can progress into an infection called necrotizing fasciitis, or flesh-eating disease. Bad cases, usually caused by eating contaminated shellfish, can lead to death. You can also get sick by swimming with an open wound or accidentally splashing contaminated water into a cut.
Under an intermediate warming scenario where temperatures rise up to 2.6 degrees Celsius (4.7 degrees Fahrenheit), climate change-associated cases of vibriosis are expected to rise 51 percent by 2090. Warming ocean temperatures along the coasts of the continental United States are allowing Vibrio to flourish and expand further north, particularly in the Northeast and the West. Three people died in New York and Connecticut this past summer after contracting the illness.
But Vibrio isn’t the only type of bacteria benefiting from rising temperatures. Leptospirosis, an illness caused by a waterborne pathogenic bacteria that can infect humans and other animals, is spreading in Hawai‘i and the U.S.-affiliated Pacific Islands as ocean temperatures rise and tropical storms challenge this region’s water and sanitation infrastructure. Fecal coliform bacteria, which can lead to dysentery, typhoid fever, and hepatitis A, are also a climate-driven risk in this region, according to the report.
Vibrio vulnificus bacteria.
BSIP/Universal Images Group via Getty Images
Foxes, fungi, and amoebae
The report also identifies some unexpected drivers of illness that are cropping up in states from Texas to Alaska.
In the Southwest, a fungal disease called Valley fever, which occurs when fungal spores take root in people’s lungs and cause painful symptoms such as lumps, rashes, fever, and fatigue, is spreading. As the continental U.S. warms, the fungus will move north into states where it has rarely been seen before, such as Oregon and Washington. If climate change continues completely unabated, cases of the disease will rise 220 percent by the end of the century, according to the report.
In Alaska, rabies is popping up in foxes and other animals, raising concerns about the potential for human cases. There is no cure for rabies and the fatality rate, nearly 100 percent, is the highest of any disease on earth. In the winter spanning 2020 and 2021, Alaska reported 35 cases of rabies in animals, up from an average of four to five cases in the preceding years. Researchers say melting sea ice and changing prey patterns could be reasons for the spike.
Naegleria fowleri, often referred to as the brain-eating amoeba, causes a deadly brain infection when the amoeba gets into the nose canal and, from there, into the brain. A toddler in Arkansas died after contracting the disease playing in a splash pad in September. An adult in Texas also contracted a fatal case of disease this year. Based on these limited cases and other scattered deaths that have occurred in recent years, the authors of the Fifth National Climate Assessment think the disease may be spreading north. “More research is needed,” they write.
Eight years ago, the medical journal the Lancet began compiling the latest research on how climate change affects human health. It was the first coordinated effort to highlight scientific findings on the health consequences of climate change, published in the hopes of making the topic more central to global climate negotiations. The Lancet’s annual reports on this topic, which summarize research conducted by dozens of scientists from leading institutions around the world, have become increasingly dire in tone.
On Tuesday, the journal published its most damning installment yet. Drawing on research published in 2022 and preliminary data on record-breaking heatwaves and floods in 2023, the Lancet Countdown on Health and Climate Change warns of “irreversible harms” due to limited success mitigating the sources of global warming, primarily fossil fuel combustion. “The rising risks of climate change,” the report says, are “threatening the very foundations of human health.”
In a press briefing call last week, experts said the health impacts associated with extreme heat and food insecurity spurred by drought and flooding were among the most concerning developments documented in the new report. Annual heat-related deaths between 2013 and 2022 were 85 percent higher than in the period between 1991 and 2000 — more than double the increase that would have occurred in the absence of man-made warming. The global land area affected by drought between 1951 and 1960 — 18 percent — increased to 47 percent between 2013 and 2022. The confluence of climate-driven heat and drought have put 127 million people at risk of moderate or severe food insecurity. Marina Romanello, the executive director of the Lancet Countdown, called this finding on food insecurity one of the “most shocking” outcomes of this year’s report.
A local aid worker douses a water offering onto the grave of a 2-year-old who died from complications due to malnutrition in January in Doolow, Somalia. v for The New York Times via Getty Images
Unlike prior Countdowns, this year’s report includes projections of the ways climate change will influence human health under a scenario in which global temperatures increase, on average, 2 degrees Celsius (3.6 degrees Fahrenheit) over preindustrial levels. Such warming would produce a 370 percent increase in annual heat-related deaths, put an additional 525 million people at risk of experiencing moderate or severe food insecurity, and potentially spur a 37 percent increase in the spread of the deadly mosquito-borne virus dengue.
None of these impacts is inevitable. Reducing the world’s reliance on fossil fuels is a surefire way to lessen the future effects of climate change on public health. And providing poor countries with funding to protect their residents from the health consequences of disasters, disease, and other climate-fueled health impacts can save lives. Right now, less than 1 percent of international climate adaptation spending goes to funding health-related projects.
The Lancet Countdown is published every year ahead of the annual Conference of the Parties, or COP — the global United Nations conference responsible for producing the Paris Agreement and other international climate accords. The timing of the publication of the report is aimed at prodding climate negotiators to take its findings into account in their discussions. This year’s COP28, to be held in Dubai at the end of the month, will feature a “health day” for the first time in the event’s history — a signal that the climate and health overlap is finally becoming more than just an afterthought for negotiators.
A local resident walks in chest-deep floodwaters towards a rescue boat in an area inundated with floodwaters in August near Zhuozhou, China. Kevin Frayer/Getty Images
Even so, there are limits to what researchers, well-timed reports, and health-focused days can accomplish. “I sometimes describe the health sector as the newest kid on the block when it comes to the climate discourse,” said Ramon Lorenzo Luis Guinto, director of the planetary and global health program at St. Luke’s Medical Center College of Medicine in the Philippines. He said the Lancet reports, which he isn’t involved in, have helped raise awareness about this overlap. But Guinto also noted that the reports have been getting bleaker every year.
“I don’t know if it’s a vicious cycle or a gloom-and-doom continuum,” he said.
The growing recognition that the health effects of climate change need to be addressed is a silver lining, Guinto said, but health professionals are not yet involved in the actual negotiations taking place at COP28. “We still can’t enter the negotiating room,” he said. “At the end of the day, health is on the side. It’s not yet part of the main DNA of the climate negotiations.”
Earth just experienced one of its hottest, and most damaging, periods on record. Heat waves in the United States, Europe, and China; catastrophic flooding in India, Brazil, Hong Kong, and Libya; and outbreaks of malaria, dengue, and other mosquito-borne illnesses across south Asia claimed tens of thousands of lives. The vast majority of these deaths could have been averted with the right safeguards in place.
The World Meteorological Organization, or WMO, published a report last week that shows just 11 percent of countries have the full arsenal of tools required to save lives as the impacts of climate change — including deadly weather events, infectious diseases, and respiratory illnesses like asthma — become more extreme. The United Nations climate agency predicts that significant natural disasters will hit the planet 560 times per year by the end of this decade. What’s more, countries that lack early warning systems, such as extreme heat alerts, will see eight times more climate-related deaths than countries that are better prepared. By mid-century, some 50 percent of these deaths will take place in Africa, a continent that is responsible for around 4 percent of the world’s greenhouse gas emissions each year.
“The interconnection between climate and health is undeniable,” WMO Secretary-General Petteri Taalas wrote in an introduction to the State of Climate Services report. The assessment has been published annually since 2019. This is the first time its authors have focused exclusively on health.
A young girl gets treatment for dengue fever, a mosquito-borne illness, at Mugda Medical College and Hospital in Bangladesh in October 2023. MUNIR UZ ZAMAN/AFP via Getty Images
“Climate services” is an umbrella term for the varied methods governments use to alert communities to pressing climate-related hazards. Seasonal forecasts, flash flood alerts, and excessive heat warnings are all examples. Climate services can be harnessed to safeguard public health, but a small fraction of countries assessed by the report — just 23 percent — use climatological data to inform their surveillance of potential health risks, which means much of the world is at a disadvantage. The report emphasizes that investing in climate services is an effective and relatively affordable way to help the people most vulnerable to the consequences of global warming.
“We’re going to see more and more of these unprecedented weather events, and countries need to start preparing,” said Madeleine Thomson, head of climate impacts at the global charitable foundation the Wellcome Trust, which was one of more than 30 nonprofit, governmental, and academic contributors to the report.
The report highlights a number of examples that demonstrate how governments can successfully harness climate data to produce better health outcomes in their communities.
Up to a million people experience food insecurity in Mauritania every year, particularly during the agricultural lean period, which lasts from May to August. These conditions force families in the northwest African country to sell their livestock at extremely low prices and marry off their minor daughters in order to reduce the number of mouths they have to feed at home. The Mauritanian government, in collaboration with the World Bank, the U.N. World Food Programme, and other groups, developed a predictive early warning system for drought conditions using remote sensing, a vegetation and biomass index, and household food security data. The system, called the Elmaouna program, sent cash to 47,000 of the nation’s most vulnerable households during the 2022 lean season.
Other case studies presented in the report include a climate and health bulletin in Colombia aimed at reducing cases of dengue and cholera, a temperature extremes alert system in Argentina that issued 987 regional heat alerts in 2021 and 2022, a drought alert network in Kenya, and a Lyme disease surveillance system that helped raise awareness about the spread of the disease in Canada.
International institutions, such as the WMO and the United Nations’ Intergovernmental Panel on Climate Change, are waking up to the importance of centering public health in their approach to addressing climate change and its effects. Research journals have been sounding the alarm about the climate and health overlap for years. The Lancet, a leading medical journal that has been covering the health impacts of climate change annually since 2015, published a report in 2020 that warned that the fallout from rising temperatures threatened to undo five decades of progress on public health. Nevertheless, health has never featured prominently in global climate talks — until now.
Next month, the United Nations will hold its 28th Conference of the Parties, or COP28, in the United Arab Emirates. The international climate conference will host its first-ever “health day,” a signal that the topic is starting to become a bigger priority for climate change negotiators. At COP27 last year, a number of wealthy countries announced tens of millions in funding for climate services in underdeveloped nations. That funding helped spur some of the examples outlined in WMO’s report this year. The report and others like it that raise the alarm about the health impacts of warming could inform negotiations at this year’s conference and lead to more funding commitments from developed countries.
“People are being affected and health services are being affected by a changing climate,” said Kristie Ebi, an epidemiologist and climate change researcher at the University of Washington who reviewed WMO’s data but was not involved in the writing of the report. “At the same time, there are insufficient resources to help make sure that we can protect people’s health. One relatively easy way to change the situation is more investments in climate services.”
Hurricane Ian slammed into southwest Florida as a Category 4 storm in September last year, killing 149 people — the most deaths attributable to a single hurricane in the state in nearly a century. But the official death count didn’t include one of the most gruesome ways people died as a result of the storm. A study published this week found that Hurricane Ian led to a spike in cases of vibriosis…
Hurricane Ian slammed into southwest Florida as a category 4 storm in September last year, killing 149 people — the most deaths attributable to a single hurricane in the state in nearly a century. But the official death count didn’t include one of the most gruesome ways people died as a result of the storm.
A study published this week found that Hurricane Ian led to a spike in cases of vibriosis, a life-threatening illness caused by a water-borne bacteria called Vibrio, in Florida. In Lee County, where Ian made landfall, 38 people were sickened by the bacteria and 11 people ultimately died in the month following the storm — the highest number of Vibrio cases in a single month in Florida in more than 30 years. There had been no reported cases of Vibrio in the state in the week leading up to the hurricane.
There are many species of Vibrio, including Vibrio cholerae — the cause of the diarrheal disease cholera, which kills tens of thousands of people per year in the Global South. Vibrio vulnificus, commonly referred to as “flesh-eating bacteria,” is less common globally but more deadly, and it’s becoming more pervasive in the U.S. Vibrio vulnificus kills an estimated 1 in 5 people who are exposed to it, usually either by eating uncooked shellfish or by making contact with the bacteria via an open wound. Three people died after consuming shellfish tainted by Vibrio vulnificus or otherwise being exposed to the bacteria in New York and Connecticut earlier this year.
Vibrio vulnificus bacteria under a microscope. BSIP/Universal Images Group via Getty Images
Past research has shown that warming ocean surface temperatures are leading to more Vibrio bacteria in the world’s oceans, particularly in the Atlantic, which is heating up at an alarming and unprecedented rate. A study published in Nature this year — the most comprehensive scientific assessment of how climate change is influencing the distribution of the bacteria to date — predicted that Vibrio vulnificus is likely to be present in every Eastern U.S. state by the end of this century.
The study published this week, led by Rita Colwell, a microbiologist at the University of Maryland and one of the foremost Vibrio researchers in the nation, is among the first to make a direct link between a specific hurricane and a spike in cases of vibriosis. Colwell and her colleagues found that flooding brought on by Hurricane Ian caused millions of gallons of water to run into the ocean, carrying nutrients with it. The storm also stirred up sediment and warm water off the coast of Florida. The runoff, sediment, and high sea surface temperatures triggered an explosion of Vibrio vulnificus and other types of Vibrio bacteria in the waters off the Florida coast, growth the researchers were able to document using satellite observations and shellfish samples from October 2022.
Gabriel Filippelli, a climate change researcher and director of Indiana University’s Environmental Resilience Institute, said he would have expected Hurricane Ian’s impacts to produce a “blip” in Vibrio abundance off Florida’s coast “and then a recovery back to baseline.” But that’s not what the study says happened. “It actually ramped up not only the abundance of Vibrio but some of the particular species that are problematic,” Filippelli, who was not involved in the research, said.
Colwell wasn’t surprised by her findings — the ocean water around Florida was abnormally warm last year and has continued to warm since. Her own prior research has shown that temperature anomalies lead to the growth of these harmful bacteria. Warm water also breeds stronger hurricanes, and adding a storm to conditions that already favored Vibrio had a predictable outcome. “We took samples and, sure enough, we found lots of Vibrio,” Colwell said.
A member of a search and rescue team is hosed down with bleach and soap after a day of running boat rescues throughout downtown New Orleans in the aftermath of Hurricane Katrina in 2005. The water was contaminated with toxic chemicals and Vibrio vulnificus. Robert Gauthier/Los Angeles Times via Getty Images
The results, she said, signal that public health officials everywhere, but particularly in hurricane-prone states, need to be aware of the potential threat that Vibrio bacteria pose to their communities. Climate change continues to create conditions that are conducive to larger and more intense storms, which could mean more vibriosis in humans as time goes on.
Filippelli hopes this study and other research to come will help local governments limit injuries and death during and after big storms. With the right data, local public health departments would be able to warn communities about the potential for toxins in shellfish and waterways following a hurricane or extreme flooding event. “That’s kind of the point of doing a lot of this,” Filippelli said. “It’s not just watching the climatic horror show emerge but trying to get ahead of it.”
This story is part of Record High, a Grist series examining extreme heat and its impact on how — and where — we live.
This summer was the hottest ever recorded, and 2023 is on track to be the hottest year in history. Next year is likely to be even warmer thanks to a strengthening El Niño, a cyclical weather pattern that contributes to above-average temperatures across much of the globe. The extreme heat has made the consequences of more than a century of reckless reliance on fossil fuels impossible to ignore.
As it gets hotter, more people will succumb to heat-related illnesses. The average number of heat-associated deaths that occur every year in the U.S. rose 95 percent between 2010 and 2022. That data doesn’t include this year’s record-breaking summer. The good news is that heat-related illness is highly treatable. The key is to get the right resources to the right places in time to save lives.
A first-of-its-kind initiative called the Climate Health Equity for Community Clinics Program aims to fight back against the rising tide of heat-associated illnesses in the U.S. by getting resources and training into the hands of doctors and the communities they treat. The program, announced last month by the global health and development nonprofit Americares and the Harvard T.H. Chan School of Public Health, is the result of a year of research on the climate-related health threats that clinicians across the nation face on a daily basis. Heat, the primary cause of weather-related deaths in the U.S. in 2022, quickly floated to the top of the list of clinicians’ concerns, followed by wildfire smoke. Americares and Harvard, with $2 million in funding from Johnson & Johnson, the multinational pharmaceutical company, partnered with 10 clinics in Florida, Louisiana, and Arizona. The program aims to expand to 100 clinics by 2025.
The idea behind the program is to ensure that medical professionals at free clinics and community health centers, which work closely with disadvantaged, uninsured communities, identify which of their patients are most vulnerable to extreme heat and arm them with the tools they need to avoid ending up in the hospital with heat-related illness or heatstroke. Providers at participating clinics will be able to type patient information, symptoms, and relevant environmental factors into an online tool and receive a tailored heat mitigation plan from Americares and Harvard. Clinics in the program will also be alerted when dangerous heat waves are bearing down on their area.
Families get free asthma screening inside a mobile clinic in North Long Beach, California. Brittany Murray/MediaNews Group/Long Beach Press-Telegram via Getty Images
“It’s all about preparedness and how we can help save lives when these heat disasters happen,” said Suzanne Roberts, chief executive officer at the Virginia B. Andes Volunteer Community Clinic in Port Charlotte, Florida. Her clinic, which has served its community since 2008, is one of the first 10 pilot clinics being funded by the new program. “We see our patients coming in with heatstroke, we see our patients coming in with nausea, and they don’t understand that it is related to the heat. We hope to learn the rules of the road so when this happens — and it will continue to happen — we will be prepared.”
Excessive heat erodes human health in a staggeringly wide array of ways. Heat affects our motor functions, appetite, quality of sleep, and our drug and alcohol intake. It puts stress on our bodies and exacerbates underlying conditions such as cardiovascular disease and diabetes. It damages our mental health and affects the medications people take to keep depression at bay. It worsens schizophrenia. It can cause third-degree burns from contact with pavement and hot surfaces. And when people are exposed to high temperatures for too long, heat causes their core temperature to rise. Many people, especially those without access to air conditioning, experience excessive sweating, goosebumps, headaches, dizziness, vomiting, shaking, fainting, and other symptoms of severe heat-related illness. The unluckiest — including more than 1,500 Americans last year — die.
Global health outfits like the World Health Organization and governments have long engaged in heat health action planning to prepare for the health impacts of elevated heat at the national level. Municipalities in the U.S. use this type of planning as well, but community health clinics are rarely looped in. The new program customizes this type of planning for individual clinics, providing funding for ice packs, saline drips, and nausea medication as well as recommendations for how the clinics can help their patients navigate heat outside the clinic walls.
The program also aims to bridge divides between clinicians and local public health officials and emergency management departments in order to make sure local resources are directed to the right places. “Clinics often don’t think of themselves as being an important entity when it comes to emergency response broadly,” said Nate Matthews-Triggs, associate director of climate and disaster resilience at Americares and the head of the project. “But now as we’re seeing more and more extreme weather related to climate change, they’re finding themselves on the front lines.”
A doctor treats an injured man inside a makeshift clinic and relief center in Rolling Fork, Mississippi.
CHANDAN KHANNA/AFP via Getty Images
For example, many cities set up cooling centers during heat waves to help keep residents without air conditioners cool, but those cooling centers often sit empty, even as hospitals fill up with patients suffering from heatstroke. That’s because a lot of people either don’t know about the cooling centers or don’t have a way to get to them. Many clinics, particularly in underserved areas, have contracts with non-emergency patient transportation — vans and buses paid for by the city or funded by the clinics to help patients get to their medical appointments. “Can they leverage those relationships to help their patients get to cooling centers?” Matthews-Triggs asked. That’s one of the interventions the program plans to try out over the next couple of years. Clinicians will also work with emergency managers to make sure air-conditioning units are being provided to those who need them most. Additionally, participating clinicians will teach community aid workers, like soup kitchen volunteers, to be able to identify symptoms of heat-related illness.
The Climate Health Equity for Community Clinics Program, with just 10 clinics in three states, is tiny right now. There are tens of thousands of health clinics across the U.S. with varying degrees of preparedness for the health impacts of climate change. Even when the program expands to its expected 100 clinics, its efforts will just be a drop in the bucket. Heat-related illnesses pose a threat to communities in every state in the nation — hundreds of millions of Americans. But experts not involved in the program told Grist that the initiative seems promising.
“Anything that can help better identify who is in need of what and where the resources are, and connect those two things, is going to be helpful in managing the response to any sort of crisis event,” said Samantha Penta, an associate professor in the department of emergency management and homeland security at the University of Albany. Clinicians, who are often seen as trustworthy by the community, are well-positioned to coordinate resources and bridge gaps between local officials and aid groups once the heat has descended. Americares and Harvard plan to use the information they gather between now and 2025 to bolster community-level responses to extreme heat, first in the U.S. and later in middle- and low-income countries around the globe.
“If they find this is a useful resource, then it’s probably something that we want to see spread,” Penta said. “Everything has to start somewhere.”
Hello, and welcome to the last issue of Record High. I’m Zoya Teirstein, and today, we’re going to talk about the elephant in the room: heat inequity.
In his book Fevers, Feuds, and Diamonds: Ebola and the Ravages of History, the physician and medical anthropologist Paul Farmer explains, unflinchingly, why the 2014 West African Ebola outbreak killed more than 11,000 Africans while almost every single Westerner who contracted the illness survived. The difference between life and death came down to, quite simply, access. In clinics in Guinea, Libera, and Sierra Leone, equipment and fluids that would have saved countless lives were nonexistent. A few simple interventions would have made all the difference. “How many of these deaths were caused more by the virulence of social conditions than by the virulence of the pathogen?” Farmer asked.
I was reminded of Farmer’s book recently while interviewing a researcher about an unrelated topic, a study on the temperature thresholds at which the human body can no longer keep itself cool. That researcher, a scientist at the University of Oxford, found that parts of the world have already become too hot for human survival. As climate change accelerates, more portions of the globe will approach this threshold, what the study calls “the danger zone.” Whether someone dies in that zone depends in large part on their access to cooling strategies — such as fans, cold drinking water, and, of course, air conditioning.
Climate reporter Jeff Goodell writes extensively about this divide between the “cooled and the doomed” in his new best-selling book The Heat Will Kill You First. “There’s a profound gap in every city, everywhere, between people who have air conditioning and people who don’t,” Goodell told me in July, as Phoenix was experiencing what would become a 31-day stretch of 110 degree days — the hottest month in any U.S. city on record.
“There’s a profound gap in every city, everywhere, between people who have air conditioning and people who don’t.”
Heat is swiftly becoming one of the most formidable climate-fueled health threats of our time. It kills more people than any other extreme weather condition. Like Ebola and other deadly outbreaks in global history, it kills unequally. Finding this inequality in the United States is appallingly easy — just follow the racial boundaries that divide many cities and towns. Wealthy, white neighborhoods are less likely to experience deadly heat than non-white areas. A lot of these segregated communities are clustered in Southern states, among the hottest in the nation, and big cities that lack green space.
A recent paper published by the Department of Energy’s Pacific Northwest National Laboratory found that the average Black urban resident is exposed to markedly higher heat stress than the average white urban resident. On average, Black people are exposed to temperatures that are a little more than half a degree hotter than the city average, while white people live in areas that are a little less than half a degree cooler. Much of this temperature imparity — which leads to more hospitalizations and deaths within minority communities — is due to segregation and redlining. “The findings reveal pervasive income- and race-based disparities within U.S. cities,” the study’s authors wrote.
Wall mounted air-conditioning units adorn a building in Hong Kong.Andrew Aitchison / In pictures via Getty Images
This newsletter may be winding down, but heat isn’t going anywhere. It’s likely that in the future, we’ll remember the summer of 2023 — the hottest on record — as among the coolest summers of this century. There are as many right ways to approach the challenge of a hotter world and its health impacts as there are wrong ways. Successfully mitigating extreme heat also necessarily means fighting inequalities in health, the built environment, and local and national government policies, which will determine who lives and who dies as the planet continues to warm. Any effort to address the impacts of extreme heat that doesn’t take that into account the “virulence of social conditions,” as Farmer wrote, isn’t much of a solution at all.
Today concludes our run of Record High, but our team still has a few big stories in the works. We’ll be using this newsletter to (very occasionally) let you know when those new projects publish over the next few months.
Thanks for sticking with us this summer. We’ll see you next time.
P.S. If you’d like to keep seeing Grist content in your inbox, sign up for our flagship newsletter — 10 of our newest stories delivered to you once weekly — here. And if you want to play a role in shaping next year’s extreme weather newsletter, fill out this audience survey. It takes just a few minutes.
In the U.S., non-white populations are exposed to higher temperatures than white populations. Native Hawaiians and other Pacific Islanders experience this disparity most acutely, but all non-white people are subject to elevated temperatures, while white populations experience cooler-than-average temps.
What we’re reading
The strange connection between alcohol and heat: A new study found short-term temperature spikes lead to marked increases in the rate of hospitalizations for alcohol-related disorders. Even a slight increase in temperature, say from 15 degrees Fahrenheit one week to 20 degrees F the next week, or from 60 to 65 degrees F, led to more hospitalizations for substance use. Read more
South America’s hot winter comes to a close: And it’s 110 degrees in parts of Brazil. It looks like an enormous heat dome afflicting much of South America isn’t going away anytime soon. My colleague Max Graham writes about what the beginning of summer following a record-breaking winter means for the continent and the rest of the world. Read more
This summer’s record-breaking heat in charts: Heat this summer has broken previous records “by a truly staggering margin,” Zeke Hausfather, a climate scientist at the Breakthrough Institute wrote in a blog post. Hausfather said there’s a chance 2023 will “emerge as the first year exceeding 1.5C above preindustrial levels. Read more
The worst heat wave ever recorded happened in … Antarctica? A new study shows the most intense heat wave on the planet took place in Antarctica in March 2022, when temperatures on the continent spiked 70 degrees Fahrenheit above normal. Kasha Patel writes about it for the Washington Post. Read more
Another victim of extreme heat: recess. Schools across the country closed early, trimmed recess, and canceled outdoor after-school activities altogether due to sweltering heat this month. This isn’t the first year kids have suffered at school due to rising temperatures, and the trend has experts worried. NPR’s Sequoia Carrillo and Beth Wallis have a great segment about the issue on All Things Considered. Read more
This story was originally published by Grist with the headline The heat gap on Sep 26, 2023.
This story is part of Record High, a Grist series examining extreme heat and its impact on how — and where — we live.
Many studies have shown that climate change threatens alcohol production around the world, from vineyards in France to whiskey distilleries in Scotland. Now there’s alarming evidence that climate change affects hospitalizations for alcohol consumption, too.
A study published this week in the journal Nature Communications Medicine found that temperature spikes due to climate change have led to a marked increase in the number of hospital visits for alcohol-related disorders — such as alcohol poisoning, alcohol withdrawal, and alcohol-induced sleep disorders — in New York state. “We found that there was an almost linear relationship between temperature increases and alcohol-related disorder hospital admissions and visits,” said Robbie Parks, an environmental epidemiologist at Columbia University and the lead author of the study.
The researchers also found associations between temperature and hospitalizations related to cannabis, cocaine, opioids, and sedative use — a result that was felt most acutely in the suburban and rural areas outside of New York City. But the connection between hospitalizations related to alcohol use and temperature was the most “robust” in the study, Parks said.
A growing body of research that shows Americans have become increasingly reliant on drugs, especially opioids, and alcohol over the past few decades. There has been a fivefold increase in overdose deaths in the United States since the turn of the century. This trend could be made even worse “with rising temperatures under climate change,” the study’s authors write.
By looking at hospital admission records and comparing them to weather data over the course of three decades between 1995 and 2014, the researchers figured out how short-term spikes in temperature over the course of a few days affect hospital admission rates related to substance use.
Even a slight increase in temperature, say from 15 degrees Fahrenheit one week to 20 degrees F the next week, or from 60 to 65 degrees F, led to more hospitalizations for substance use. That trend held strong from negative 22 degrees F all the way up to 86 degrees F — the full range of daily average temperatures across New York state between 1995 and 2014.
“It’s not just seasonal,” Parks said. “If today was 5 degrees hotter than this time last week or this time next week, we would expect more hospital visits for alcohol and substance disorders.”
Rescue breathing face shields and naloxone nasal spray, which can be used to treat narcotic overdose. Drew Angerer/Getty Images
Daily average temperatures in New York have risen 3 degrees F statewide since 1970 and are expected to rise another 3 degrees F by 2080, due to the warming effects of fossil fuel combustion. This trend has contributed to the short-term temperature fluctuations Parks and his team compared against local hospitalization rates in their study.
Previous research has shown that temperature fluctuations can influence drug use in the United States and overseas, but this study is among the first to look at different types of drugs and find that climate change is linked to spikes in hospital admissions for alcohol-related disorders in the U.S., specifically. Parks and his team found that the pattern was near-universal across the demographic characteristics they looked at, which included age, sex, and social vulnerability (an umbrella term for socioeconomic and minority status). The study controlled for seasonal variations in alcohol use, such as peoples’ tendency to drink more during the winter holidays and summer months.
“This is obviously relevant in the context of climate change, where we’re anticipating hotter average temperatures, including more frequent and severe heat waves,” said Francis Vergunst, an associate professor at the University of Oslo who has researched the effects of climate change on behavioral disorders and was not involved in the Columbia study. “That means there will be more days in which people potentially could be using substances at harmful levels that could require hospital admission.”
Though it’s not entirely clear why rising temperatures lead to more hospitalizations for substance use, Vergunst said researchers have some ideas about what may be behind the trend. One possible explanation is that people are more impulsive and uninhibited during periods of elevated heat, which leads them to drink more and consume more drugs. For some types of drugs, such as opioids, warm weather can diminish the perceived effects of the drug and lead people to take higher doses to get to their desired level of inebriation, which in turn could contribute to more hospital admissions for overdoses. Drinking alcohol, popularly thought to raise the body’s internal temperature, actually destabilizes the body’s ability to regulate its core temperature, which could also contribute to hospitalizations during periods of elevated heat.
“I think it’s really important to start understanding what those underlying factors are,” Vergunst said, “because that could be the primary potential intervention point.” In other words, understanding what causes people to consume more drugs as temperatures warm will be crucial to preventing them from ending up in the hospital because of an overdose or some other substance-related condition.
The study doesn’t make projections about how future warming due to climate change may influence the prevalence of hospital admissions for substance use, and Parks warned against extrapolating New York’s data to the rest of the country. More research needs to be done to figure out how people living in the United States’ many various and distinct climates respond to rising temperatures. But Parks said that the study hints at the possibility of a larger trend that needs to be investigated. It’s a starting point for beginning to understand how climate change may influence substance use across the nation and elsewhere.
“New York is the fourth-largest state in the country, one of the most diverse, one of the most extreme in terms of socio-demographic profile,” Parks said. “You might surmise, though cautiously, that this would be an issue across the U.S. and worldwide.”
Hurricane Lee, a mammoth peak-season storm in the Atlantic, is making a beeline for New England and Canada. Once a Category 5 storm, Lee weakened to Category 1 by the time it made a northward pivot and began its march toward land on Thursday. But the storm is still expected to lash parts of Massachusetts, Maine, New Brunswick, and Nova Scotia with tropical-storm-force winds, rain, waves, and potentially catastrophic storm surge as it makes landfall over the weekend.
Meteorologists are especially concerned about the Bay of Fundy, a body of water between eastern Maine and Nova Scotia that holds the record for the highest tides in the world — with a difference of up to 53 feet between low and high tide. With a little bit of bad timing, Lee’s powerful winds could force a tremendous amount of water into the bay on top of a high tide and inundate New Brunswick and Nova Scotia with record flooding.
Mark Wiatrowski steps over his mast on board his boat “The Stray” that was in the process of being hauled out of the water ahead of Hurricane Lee. Hyannis, MA, September 13. David L. Ryan/The Boston Globe via Getty Images
Even on an ordinary day, the Fundy tides are so dramatic that they can sweep over whole beaches in a matter of minutes. In some parts of Nova Scotia and New Brunswick, the incoming water at high tide pushes so far inland that it reverses the flow of rivers, a phenomenon known as a tidal bore.
“If the storm goes just west of the Bay of Fundy, and it’s aligned with the correct tide cycle — well, it’s an unfortunate science experiment,” said Jeff Berardelli, chief meteorologist for WFLA-TV in Tampa Bay, Florida. “We’ve never seen something like that exactly.”
Lee’s winds will be blowing west, which makes Nova Scotia, on the east side of the Bay of Fundy, particularly vulnerable to rising waters. There, waves could reach 40 feet in height on top of 3 to 6 feet of storm surge. “The water impacts, just exactly what’s going to happen there, that’s the big question mark,” said Ryan Truchelut, a meteorologist and the founder of the weather substack WeatherTiger. “That’s potentially the most serious aspect of the storm.”
Storm surge could also be an issue on the north-pointing part of Cape Cod, Massachusetts. The National Hurricane Center has issued a storm surge watch for that portion of the cape.
Sixty-four-year-old Howard Zwicker owns the Harbour Grille & Gift House on Grand Manan Island, a small Canadian island between Maine and Nova Scotia at the wide mouth of the Bay of Fundy. On Thursday morning this week, he was unruffled by the forecast. “We’re cleaning up our yard, taking down our hanging plants and our patio furniture, and that’s pretty much it,” said Zwicker, who was born on Grand Manan Island and has run the Harbour Grille with his wife for the past decade. “Everybody is doing their due diligence, but nobody’s panicking.”
Luis Javier and Wichie Torres pull lobster boxes to dry ground at the Stonington Lobster Co-op in preparation for the possible arrival of Hurricane Lee in Stonington, Maine on September 15. Joe Raedle/Getty Images
Storms of Lee’s intensity are not unusual in the northern Atlantic, though they rarely make landfall in New England and coastal Canada. Lee’s impacts will also be abnormal in a couple of respects. It’s a large weather system — the hurricane’s tropical force winds span roughly 600 miles in diameter — which means its effects will be felt in multiple states along the eastern seaboard.
“It’s gigantic,” said Truchelut. “In terms of tropical storm wind radii, this is one of the very largest out there.” Much of coastal New England will experience huge, battering waves that are 15 feet or higher. On Thursday, the governor of Maine issued a state of emergency as the state was put under its first hurricane watch in 15 years.
The other unusual thing about Lee is that the storm will bring flooding to a part of the U.S. that is already waterlogged from a summer so rainy it broke records in parts of New Hampshire and Vermont. This summer was Maine’s second wettest on record, behind the summer of 1917. Record-breaking rainfall is a telltale sign of climate change; research shows a hotter atmosphere holds more evaporated water.
Flooding brought on by Lee on top of the already soaked soil in New England will make the storm’s impacts more dangerous. Heavy gusts of wind can cause trees rooted in saturated soil to tip over, and localized flooding is more likely. “Fifty- or 60-mile-per-hour winds, you get that every year,” Truchelut said. “The difference here is that the trees still have their leaves on and the soil is wet from recent rainfall.”
Climate change doesn’t create large hurricanes like Lee, but it does make them intensify faster and occur more frequently. The Atlantic Ocean is currently going through a period of extreme sea surface warming — water temperatures in parts of the North Atlantic have hovered around 77 degrees Fahrenheit for more than a month, “almost beyond the most extreme predictions of climate models,” the Washington Post reported in July. That record warmth allowed Hurricane Lee to intensify from a tropical depression to a Category 5 storm in less than three days, a phenomenon that has only happened a couple of times before in Atlantic hurricane history.
Two men board up a door in preparation for Hurricane Lee in Scituate, Massachusetts. David L. Ryan/The Boston Globe via Getty Images
“Given the record-high sea-surface temperatures in the North Atlantic, it is interesting that in this year we see a hurricane barreling toward New England,” said Sean Birkel, the state climatologist for Maine. “Because it is rare for hurricanes to reach New England and certainly into Maine.”
Lee is arriving at the meteorological midpoint of hurricane season, and there are multiple other storm systems on its tail. These include Margot, which is churning in the middle of the Atlantic, and a still-forming storm that could become Hurricane Nigel. Forecasts show Nigel taking the same path as Lee, west across the Atlantic Ocean and up past Bermuda. Even if the Northeast escapes major damage from Lee, it may not be out of the woods yet.
Jake Bittle contributed reporting to this article.
This story is part of Record High, a Grist series examining extreme heat and its impact on how — and where — we live.
More than a decade ago, two climate scientists defined what they considered at the time to be the upper limit of human survivability: 35 degrees Celsius, or 95 degrees Fahrenheit, at 100 percent humidity, also known as the wet-bulb threshold. In those conditions, a person, no matter who they are or where they live, cannot shed enough heat to stay alive for more than a few hours. The scientists’ operating assumption was that carbon emissions would need to warm the planet 5 to 7 degrees C (9 to 12.6 degrees F) before the world exceeded the wet-bulb threshold every year. Since then, more advanced work has demonstrated the world only needs to warm by about 2 degrees C (3.6 degrees F) before heat waves in the hottest parts of the world first cross that survivability line.
But just looking at the survivability threshold doesn’t paint the full picture of heat-related risk. The theoretical experiment underpinning that threshold was based on two assumptions: that humans are fully adapted to heat, or used to hot conditions, and that people do everything in their power — seek out shade, fan themselves, and douse themselves with water — to stay cool during an extreme heat event. The reality is that death can occur long before wet-bulb conditions are eclipsed for a variety of reasons that have to do with age, health, adaptation, and access.
A study published in Science Advances this week used a more realistic threshold to determine when and where the world will become dangerously hot for humans. The researchers, from the University of Oxford and the Woodwell Climate Research Center, used a framework called the “noncompensable heat threshold,” the conditions under which a human being can no longer maintain a healthy core temperature without taking action to cool off. Six hours of unmitigated exposure to these temperatures would be sufficient to cause death. This threshold can be reached under different combinations of air temperature and humidity — the hotter the temperature, the less humidity needed to cross the limit. At 40 degrees C (104 degrees F), for example, you need about 50 percent relative humidity to cross the noncompensable threshold.
The researchers found that parts of the world have already surpassed this threshold. They identified 21 weather stations that clocked conditions exceeding the noncompensable threshold between 1970 and 2020, mainly along coastlines in the hottest regions of the planet such as the Persian Gulf and South Asia. Even more people will face such conditions as the planet continues to warm from fossil fuel combustion.
Christopher W. Callahan, an earth systems scientist at Dartmouth University who researches health and heat and was not involved in the research, called the study’s results “striking.” “Some locations are already experiencing these critically hot conditions,” he said. “They’re not just a forecast from a climate model, they’re directly observable using quality-controlled weather station observations.”
As more countries experience abnormally high temperatures every summer, using pure “survivability” as the metric for when heat-related mortality will occur is a dangerous proposition. Death can occur much sooner than that.
At the wet-bulb threshold, “no matter what you do short of air conditioning, you face lethal risk,” said Carter Powis, a researcher at the University of Oxford and the study’s lead author. “The threshold we looked at, noncompensable heat, is you face lethal heat risk unless you do something. Meaning there are still ways you can survive above this threshold such as using a fan, drinking cold water.” Any conditions between these two definitions are what the study’s authors call the “danger zone.” Whether someone dies when they’re in that zone depends on what cooling strategies are available to them and how well adapted they are.
The study shows that, under current climate change conditions, 8 percent of the globe by land area experiences conditions that are in the danger zone once every decade. At 2 degrees C (3.6 degrees F) of warming, a climate change benchmark the world is currently on track to exceed, more than a quarter of the world will experience these conditions at least once a decade. The percentage of the planet that will experience potentially fatal heat continues to grow the more climate change accelerates.
A pharmacy thermometer reaches 41.5°C at 5pm during a record-breaking heat wave in Toulouse, France, 2022.
Alain Pitton/NurPhoto via Getty Images
It’s not just the hottest regions of the planet that are at risk. In the U.S., the Midwest and East Coast could see rapid increases in noncompensable heat exposure. The same is true for the Mediterranean region up north through Europe. These are areas that are not used to extreme heat.
“While prior research has indicated that fatal wet bulb temperatures will occur more often in the most populated and poor regions of the planet, this research suggests that wealthier countries in North America and Europe will also face increasingly dire heat waves,” Cascade Tuholske, a geographer at Montana State University who was also not involved in the study, told Grist.
For Powis, the biggest takeaway is that communities need to be aware that past heat-related mortality events are not a good way to gauge future risk. As the planet warms, the past will become an increasingly poor metric for looking at the future. “The danger is, in the near term, in the next decade or two decades, you have one of these extreme heat waves that departs from the historical maximum by a substantial amount, crosses this threshold, and causes wide-scale mortality,” Powis said. “Everything is fine until suddenly it’s not.”
Burning Man, the transient bacchanal that attracts more than 70,000 party-goers to the remote Nevada desert for eight days every August, prides itself on its environmental bona fides. One of the festival’s main operational tenets is “leave no trace,” an essentially impossible feat for an event of its size. The Burning Man Project, the organization that runs the festival, has set a goal of becoming “carbon negative” — removing more emissions from the environment than the festival produces — by 2030.
It’s a tall order: The festival generates around 100,000 tons of carbon dioxide every year, the equivalent of burning over 100 million pounds of coal. A series of disasters at this year’s festival have brought the gap between Burning Man’s rhetoric and reality into sharp relief: First, a half dozen protesters demanding stronger environmental commitments from the organization blocked the festival’s entrance for roughly an hour before they were forcibly removed. Days later, torrential rain — the kind of event made more likely and extreme by climate change — stranded revelers in a dystopian free-for-all. But the greatest irony of all may be Burning Man’s less-publicized opposition to renewable energy in its own backyard.
Burning Man’s problems began on August 27, the first day of this year’s festival, when a blockade of climate protesters created a miles-long traffic jam on the two-lane highway into the dry lakebed of the Black Rock Desert, about 120 miles north of Reno, Nevada, where Burning Man takes place. In addition to calling for “systemic change,” they demanded that festival organizers take immediate steps to decrease the event’s carbon footprint. Burning Man, which started out as a small gathering of artists on a beach in San Francisco in the 1980s, has grown into a massive event that attracts a growing percentage of the world’s ultra-wealthy every year. The protestors, who were ultimately dispersed by police, demanded the festival “ban private jets, single-use plastics, unnecessary propane burning, and unlimited generator use per capita,” among other requests.
Cars wait in line to get into the Burning Man festival, held 120 miles from Reno, Nevada. Jordan England-Nelson/MediaNews Group/Orange County Register via Getty Images
Then, torrential rain spurred by a late-August hurricane and the onset of monsoon season in the desert turned the festival into a gargantuan mud pit, stranding attendees and forcing Burning Man to close the roads into and out of the festival from Friday until Monday afternoon, when conditions improved. Since no supplies could be trucked in or out, partiers were forced to ration water and other supplies. Some people, including the DJ Diplo and the comedian Chris Rock, abandoned their vehicles in the desert and walked out of Black Rock City, as the festival site is known, on foot. (It’s 15 miles from Black Rock City to Gerlach, the nearest town.) The rain caught festivalgoers off guard, but experts say floods like the one that inundated Black Rock City are a forecasted consequence of climate change.
“The well-known southwestern summer monsoon is expected to yield larger amounts of rainfall in a warming climate,” Michael Mann, presidential distinguished professor in the University of Pennsylvania’s Department of Earth and Environmental Science, told Wired.
Attendees walk through a muddy desert plain on September 3, 2023, after heavy rains turned the annual Burning Man festival site in Nevada’s Black Rock desert into a mud pit.
JULIE JAMMOT/AFP via Getty Images
A broad consensus exists, of course, on how to slow the climactic changes that are beginning to wreak havoc like this: replace the fossil fuels that currently power much of the world with a wide variety of carbon-free sources. In fact, the federal government approved one such project, a geothermal energy initiative in the Nevada desert a mile outside of Gerlach, last year. The exploratory project, funded by an international renewable energy company called Ormat Technologies, aims to find out whether geothermal — which taps naturally-occurring heat under the earth’s surface to produce clean energy — is commercially viable in the Nevada desert.
But the venture faced immediate pushback from the Burning Man Project, one of a group of plaintiffs that sued the Bureau of Land Management, or BLM, over its approval of up to 19 exploratory geothermal wells in the Black Rock National Conservation Area. The Burning Man Project, the lead plaintiff in the lawsuit, also worked with residents of the tiny town of Gerlach, the hamlet closest to the geothermal development, to appeal the BLM’s decision. The wells, the organization said, would “threaten the viability” of Burning Man’s various projects in Nevada by potentially jeopardizing local hot springs in the area and disrupting the desert ecosystem. The plaintiffs argued that BLM had approved the project without adequate environmental review and hadn’t sufficiently consulted local communities, including the Summit Lake Paiute Tribe, in its permitting process.
“People travel to Gerlach to experience the solitude of the vast open spaces and undeveloped vistas present in the Black Rock Desert,” the lawsuit said, “as well as to attend numerous events and to pursue a variety of recreation experiences in the undeveloped desert.”
After the lawsuit was filed, the Washoe County Commission in Reno ultimately voted 3-2 against the proposed geothermal project, a move that baffled clean energy experts and overturned the county’s prior approval of the project.
The claim that the region remains relatively undisturbed, given the 70,000-person party that rolls in every year, rang particularly hollow.
“Some of the hype around Gerlach has been disturbing from a scientific point of view,” James Faulds, Nevada’s State Geologist, told Grist. “The Gerlach area has already been disturbed by man.”
Faulds added that no hot springs in the area besides the ones located immediately above the actual geothermal wells would be affected by the development, and that the geothermal power plant itself wouldn’t be visible from the Burning Man festival. (The Burning Man Project did not respond to Grist’s requests for comment.)
Ormat may try to appeal the county’s decision or scrap the project and apply to build new geothermal development elsewhere in the state instead. “Ormat will continue to press forward with exploration and development of its renewable energy projects throughout the State of Nevada to help the state and federal government meet their renewable energy goals,” the company said in a statement following the county commission’s vote.
A single megawatt of geothermal energy can provide enough power for up to 1,000 residential homes year-round. That gives it a smaller land-use footprint than either wind or solar power, Faulds pointed out.
“Let’s say that power plant is producing 30 megawatts. You could drive by that and say ‘huh, that’s 30,000 homes,’” Faulds said. “That could be a big chunk of homes in a city in southern California or northern California, wherever the power is being sold to — where a lot of the Burning Man folks, of course, come from.”
Hello, and welcome to this week’s edition of Record High. I’m Zoya Teirstein, and today, we’re looking at why the United States undercounts heat-related deaths.
Every week between May and October, the Maricopa County Department of Public Health in Arizona releases a heat morbidity report. The most recent counted 180 people who have died from heat-associated illness in the county this year so far. But in the course of reporting on the topic this week, I found out most people agree that that number is off.
If previous years are any indication, the true number of heat-related deaths in Maricopa County, which includes Phoenix, is much higher: At the end of last summer, the county revised its initial reports upwards by a factor of five, ultimately reporting a sobering 425 heat-related deaths in total.
“The system of death surveillance wasn’t designed for a climate-changed world.”
— Robbie Parks, Columbia University’s Mailman School of Public Health
Nick Staab, a medical epidemiologist for the Maricopa County Department of Public Health, works in the department responsible for compiling the county’s weekly mortality reports. His office is sent cases in which the county’s medical examiner or Department of Vital Records, the office that documents deaths, marriages, divorces, and other life events, has identified heat as a primary or secondary cause of death. Then, he and the other epidemiologists determine what factors contributed to that death. They look at where the death occurred, whether there was air conditioning present, if substance use played a role, and other risk factors.
But undercounting is likely baked into the system even before Staab and his colleagues begin their painstaking work: Any one individual along that reporting chain, from the doctor declaring the cause of death to the medical examiner writing the death certificate, might overlook heat as a contributing factor.
People seek shelter from the heat at the First Congregational United Church of Christ cooling center on July 14 in Phoenix.Brandon Bell / Getty Images
“It’s imperfect,” Staab said. “It relies on human reporting.” In some cases, a provider will make their best educated guess as to the cause of death. If there are comorbidities — heart disease, obesity, mental illness — heat might not make it on the list, and Staab’s office will never see the death certificate to add to the county’s tally of heat-associated deaths.
“When you have something like heat-related kidney disease or heat-related heart attack,” said John Balbus, the acting director of the federal Department of Human and Health Service’s Office of Climate Change and Health Equity, “there’s no reliable way that every doctor is going to think about it in the same way.”
Collecting data on heat-related deaths gets even trickier when you zoom out. Counties with fewer resources, limited know-how, and infrequent exposure to extreme heat events are ill-equipped to record data on climate-related illness and morbidities, let alone report them to the federal government.
But there are ways to harness data to change the status quo.
Last month, the federal government unveiled a new national dashboard aimed at improving how public health officials track heat-related illness. The tracker, modeled after an opioid overdose tool deployed by the Biden administration in 2022, seeks to provide more complete data on heat-related illness across the nation by mapping emergency medical services, or EMS, activity. The online dashboard, run by the Department of Health and Human Services in collaboration with the National Highway Traffic Safety Administration, tracks heat-related EMS activations — that is, calls to 911.
The tracker is an example of how data can help the government visualize trends across the whole country and deploy resources to the areas where EMS activations are most concentrated.
“This is another innovative use of data to show where people succumb, as opposed to tracking it from the emergency room,” Balbus said. Read the full story here.
By the numbers
A gap in reporting exists between deaths directly attributed to heat exposure and those in which heat was listed as either the direct or indirect cause.
Citrus squeezes into the Peach State: A new citrus industry in Georgia is growing rapidly, thanks to a changing climate that makes the fruits easier to grow. As my colleague Emily Jones reports for Grist, there were very few citrus trees in the state a decade ago — now, there are more than 500,000 trees across nearly 4,000 acres.
Even the bayous of Louisiana are now threatened by wildfires: Record-breaking heat and dryness across Louisiana have helped ignite a spate of wildfires across the state. In an average year, wildfires burn roughly 8,000 acres in Louisiana; fires in August alone have set alight more than 60,000. Lylla Younes reports for Grist.
Heat is eroding shade in Nevada: Southern Nevada is at risk of losing its limited tree-cover to extreme heat, a loss that would further expose communities to climate change-fueled extreme temperatures “in one of the fastest-warming metros in the nation,” Jeniffer Solis writes in the Nevada Current.
Extreme heat is making working in Asia’s factories unbearable: We know it’s dangerous to work outside in extreme heat, but experts who spoke to the Washington Post say indoor laborers in Southeast Asia’s manufacturing hubs are also being imperiled by high humidity and scorching temperatures.
50 Cent postpones concert in Phoenix: The rapper was scheduled to perform at an outdoor amphitheater in Phoenix last week but canceled his show due to the intense heat, according to the Arizona Republic: “116 degrees is dangerous for everyone,” 50 Cent said in a tweet.
This story is part of Record High, a Grist series examining extreme heat and its impact on how — and where — we live.
Every week between May and October, the Maricopa County Department of Public Health in Arizona releases a heat morbidity report. The most recent report said that 180 people have succumbed to heat-associated illness in the county this year so far. But everyone agrees that number is off.
If previous years are any indication, the true number of heat-related deaths in Maricopa County, which includes Phoenix, is much higher: At the end of last summer, the county revised its initial reports upwards by a factor of five, ultimately reporting a sobering 425 heat-related deaths in total.
This lag plagues not just heat-related mortality reporting, but climate-related death data in general. It’s hard to get a full picture of the true number of mortalities connected to a given disaster in real-time. The full death toll often isn’t revealed until weeks, months, even years after the event occurs. And an unknown fraction of deaths often slide by undetected, never making it onto local and federal mortality spreadsheets at all. For example, a recent retrospective study found the number of people who died from exposure to hurricanes and tropical cyclones in the U.S. in the years between 1988 to 2019 was 13 times higher than the federal government’s official estimates.
That study and others like it indicate that the U.S. is gravely underestimating the health impacts of climate change. “The system of death surveillance wasn’t designed for a climate-changed world,” said Robbie Parks, who coauthored the study on hurricane-related mortalities and works as a researcher at Columbia University’s Mailman School of Public Health.
As temperatures rise and weather extremes worsen, finding better ways to monitor and report climate-related illnesses and deaths will become increasingly urgent. A full understanding of the climate-driven death toll in the U.S. isn’t just good practice, public health officials and researchers told Grist — it’s also essential for preventing future deaths.
Nathaniel, 5, kisses his mother, Jennifer, as they rest on a cot at a Salvation Army cooling center for the unhoused in Tucson, Arizona, on July 26, 2023. ANDREW CABALLERO-REYNOLDS/AFP via Getty Images
But major obstacles stand in the way. The biggest is that properly diagnosing a death as climate-related requires time, training, and resources that many of the nation’s roughly 3,500 health departments don’t have. While Maricopa County carefully combs through every suspected heat-related death that occurs in the county during Arizona’s long summer, it’s an outlier in that respect.
“It’s unrealistic to expect that we’re able to apply that method to every single person who dies,” Parks said.
A better way to capture the scope of climate-related deaths that occur annually in the U.S. would be to apply a retrospective statistical analysis like the one Parks deployed to conduct his hurricane study. But that route also requires time, resources, and training — investments the federal government would have to make. It’s not clear that documenting these mortalities is a priority for the Biden administration or Congress, which would need to fund the effort.
Maricopa County’s enhanced heat surveillance system, which essentially counts each heat-related death by hand, is something of a state-level gold standard. Even so, the system only gives the county a concrete lower bound. That’s valuable, Parks said, because the county is able to know at least how many heat-related deaths occurred in a given year. But it’s almost guaranteed to be an underestimate. “The perception that that’s the true number is really rather pervasive,” he said. “It’s a very conservative estimate.” That even a rigorous system like Maricopa County’s cannot provide a full accounting illuminates the challenges of counting climate-related deaths nationwide.
People rest at the Oregon Convention Center cooling station in Portland on June 28, 2021, as a heat wave moved over much of the United States. Kathryn Elsesser / AFP via Getty Images
Nick Staab, a medical epidemiologist for the Maricopa County Department of Public Health, works in the department responsible for compiling the county’s weekly mortality reports. His office is sent cases where the county’s medical examiner or Department of Vital Records, the office that documents deaths, marriages, divorces, and other statistics, has found that heat was a primary or secondary cause of death. Then, he and the other epidemiologists determine what factors contributed to that death. They look at where the death occurred, whether there was air conditioning present, if substance use played a role, and other risk factors that have been added on since their system was first developed in 2006. That information helps the department understand how heat influences public health in Maricopa County and advise the county on steps it can take to protect its 4 million residents. “We collect that data to paint a picture of risk,” said Staab.
But undercounting could get baked into the system even before Staab and his colleagues begin their painstaking work: Any one individual along that reporting chain, from the doctor declaring the cause of death to the medical examiner writing the death certificate, might overlook heat as a cause of death.
“It’s imperfect,” Staab said. “It relies on human reporting.” In some cases, a provider will make their best educated guess as to what the cause of death was. If there are comorbidities — heart disease, obesity, mental illness — heat might not make it on the list, and Staab’s office will never see the death certificate.
“When you have something like heat-related kidney disease or heat-related heart attack,” said John Balbus, the acting director of the federal Department of Human and Health Service’s Office of Climate Change and Health Equity, “there’s no reliable way that every doctor is going to think about it in the same way.”
Collecting data on climate-related deaths gets even trickier when you zoom out. Counties with fewer resources, limited know-how, and infrequent exposure to severe weather events are ill-equipped to record data on climate-related illness and morbidities, let alone report them to the federal government.
A person canoes through flooded streets in Tarpon Springs, Florida, after Hurricane Idalia passed offshore on August 30, 2023. Joe Raedle / Getty Images
“From county to county and state to state, you have different people with different skills in charge of assessing the underlying cause of death in each person,” Parks, the Columbia University researcher, said. “Even if you go to upstate New York compared to New York City, you might have someone who’s elected, someone who’s not elected, someone who’s a medical doctor, someone who’s not a medical doctor.”
The only way the federal government can get health data on a national scale is if states report their data to the Centers for Disease Control and Prevention, or CDC. That doesn’t happen very often, Balbus said, because reporting health data to the CDC is largely voluntary. The government receives data on direct heat-related deaths, like death by heatstroke, if those deaths are properly classified as such by emergency departments, but the situation gets murkier with other types of disaster-related mortalities.
“When you start looking at things like hurricanes, or floods, or even wildfires, the sources of those data are really mixed,” Balbus said. “Some of those people will end up in a coroner’s office and get reported to the state,” he said, and others won’t.
These factors help explain why a nation as wealthy as the U.S. doesn’t have a clear sense of how many people are being sickened and killed by events related to climate change every year.
After a deadly wildfire, the town of Lahaina on Maui now resembles a stretch of burned-out homes and obliterated buildings, as seen on August 10, 2023. Rick Bowmer / AP Photo
One promising alternative to relying on cause-of-death reporting is to use a statistical public health technique called excess mortality — the same method Parks and his colleagues used to conduct their study on hurricane deaths. They unearthed previously uncounted mortalities by comparing how many people in the U.S. would statistically be expected to die in a normal year, versus how many died before, during, and after a hurricane or storm hit. Excess mortality essentially asks the question: What would have happened if there had been no hurricane, wildfire, or flood?
“The idea of ‘who would have not died if there had been no event?’ is, for me, the most sensible way of trying to understand the actual direct impact of a climate-related exposure,” Parks said.
The government could do this nationally. In fact, it already has: Excess deaths were counted in order to ascertain the true toll of the COVID-19 pandemic. But transposing this practice into the realm of climate would require investment, training, and infrastructure. Unlike COVID-19, climate risk manifests in myriad ways, some expected (dying of heatstroke) and others less so (dying from exposure to a waterborne bacteria).
“It should be done at the federal level,” Parks said, “but it requires expert scientists to be implementing it.”
Residential neighborhoods near Interstate 10 sit in floodwater in the wake of Hurricane Harvey in 2017. Marcus Yam / Los Angeles Times via Getty Images
That’s where sound policy runs into faulty politics. Balbus’s Office of Climate Change and Health Equity, established by President Biden one week into his tenure, still hasn’t been funded by Congress. Biden requested $3 million to fund the office and staff it with eight permanent employees, but the funding has been stripped out of multiple budget bills by lawmakers.
Still, the government is taking other steps to bridge reporting gaps where it can, particularly when it comes to extreme heat: Last month, the federal government unveiled a new national dashboard aimed at improving how public health officials track heat-related illness. The tracker, modeled after an opioid overdose tool deployed by the Biden administration in 2022, seeks to provide more complete data on heat-related illness across the nation using emergency medical services, or EMS. The online dashboard, run by the Department of Health and Human Services in collaboration with the National Highway Traffic Safety Administration, tracks heat-related EMS activations — i.e. calls to 911.
“This is another innovative use of data to show where people succumb, as opposed to tracking it from the emergency room,” Balbus said. “It’s a potentially really powerful use of data, especially if we can aggregate it over years and see the specific locations where people fall ill.”
However, the mortalities documented by the tracker are only the deaths that occur between the moment when the EMS professionals arrive at the scene and when the ambulance gets to the hospital. Still, the tracker is an example of how data can help the government visualize trends across the whole country and deploy resources to the areas where EMS activations are most concentrated.
“What we’re seeing is this intensity and ferocity of the exposures and stressors to the point where we’re losing the ability to keep up and adapt with the money, resources, and technologies that we have,” Balbus said.
In April 2016, a wildfire burned 2,000 acres of Minnewaska State Park, a nature preserve in New York’s Hudson Valley. The blaze, the largest and most destructive to hit the park in more than half a century, turned a verdant forest into a blackened wasteland. But by summer, the scorched land was regenerating. Green shoots poked out of the charred earth, and dwarf pitch pines — conifers native to the region — bristled with new growth.
The conflagration was an example of what forest ecologists like to call “good fire” — one that consumes underbrush and dead vegetation, opens the canopy to let light and water in, unlocks seeds tightly shut in pinecones, and clears out invasive species that crowd native plants. Many of the wildfires that have burned millions of acres across the United States and Canada in recent years have had this effect; they’re beneficial in the long term because these forests have evolved to coexist with fire. They’re built to burn.
New growth in Sam’s Point after the record-breaking 2016 wildfire in Minnewaska State Park. Zoya Teirstein
A pitch pine shows signs of life after a wildfire in Minnewaska State Park 2016. Zoya Teirstein
Some forests are not built to burn. Earlier this month, wildfires tore through Maui, engulfing the port city of Lahaina, burning 3,200 acres of land and killing at least 115 people, more than any other wildfire in modern U.S. history. Maui was at a unique disadvantage: Two centuries of colonial occupation and large-scale transformations of the natural landscape have transformed large swaths of the island’s moist, native forests into dry prairie littered with highly flammable invasive grasses. A recent flash drought, a rapid-onset dry period connected to climate change, dried out these grasses and fueled the blazes.
Naturally occurring wildfires are not a regular part of Maui’s native ecosystem, which evolved slowly over the course of millions of years. But it is part of the ecosystem in the places where some of the invasive grasses originally came from, like tropical Africa. In the coming weeks, months, and years, those invasive grasses, not Maui’s endemic species, stand to benefit from the wreckage of this year’s wildfires.
“In general, those nonnative invasive species are going to be much more adapted to reoccupying that environment after a fire than native species,” said Creighton M. Litton, a professor and forest ecology researcher at the University of Hawaiʻi at Manoa.
A Maui County firefighter extinguishes a fire near homes during the upcountry Maui wildfires in Kula, Hawaiʻi, on August 13. PATRICK T. FALLON/AFP via Getty Images
As residents rebuild in the weeks and months ahead, wildfire ecologists and botanists say they must consider restoring the native vegetation and forests that existed before Europeans arrived. Maui’s wet season, which spurs new plant growth, is two months away. Without human intervention, the same invasive plants that helped create the wildfires will move in, creating another dangerous cycle of invasive growth and wildfire risk.
“You can’t wait forever,” Mike Opgenorth, a plant ecologist and director of the Kahanu Garden and Preserve on Maui, told Grist. “It’s going to get harder as invasive plants reestablish in these areas that were burned.”
For millennia, before humans came into the picture, every species of plant that took root on Maui got to the island by wind, wing, or wave — carried in by a gale, dropped by a bird, or washed ashore by the sea. The National Park Service estimates that just one species managed to gain a foothold on the Hawaiian islands every 35,000 years. Whatever wildfire defenses these plants arrived with in their genetic codes were mostly lost over time in the absence of a sustained threat.
An aerial view of Lahaina after the fires. MANDEL NGAN / Contributor
Then, between 1,200 and 1,600 years ago, Polynesians arrived in canoes, carrying a plethora of new species with them — taro, sugarcane, pigs, and chickens. Some of these alien species were harmless to the existing ecosystem; others meet today’s definition of “invasive” — prone to overpopulation and damaging to the environment. Still, Polynesians understood the importance of the wet and mesic, or moderately wet, forests they found in Hawaiʻi. The Polynesian name for one of these trees, the ‘Ōhi’a lehua, translates loosely to “water collector.”
The trend accelerated when European colonizers descended on Hawaiʻi some 1,000 years later. Hardier and more aggressive invasive species, introduced both intentionally and by accident, steadily took over. These species included mosquitoes, rats, and cats, as well as flammable grasses such as guinea, buffel, and cane grass, planted by Westerners to feed cattle, seed lawns, and prevent erosion. They were able to spread widely and crowd out native species in the absence of predators. Now, Hawai‘i is the endangered species capital of the world — 100 plant species, subspecies, and varieties have gone extinct and more than 400 are at risk.
Trematolobelia macrostachys, or Koliʻi, a native Hawaiian species that grows in the upper West Maui mountains. Mike Opgenorth, Kahanu Garden and Preserve
European colonizers also introduced sugar plantations, clearing away forest, ponds, and bogs to grow the crop, which quickly became Hawaiʻi’s main export. Toward the end of the 19th century, Hawaiʻi was exporting more than 24 million pounds of sugar, up from just 300,000 pounds in 1846. For the better part of a century, the industry boomed. Then it went bust as rising labor costs made Hawaiian sugar less competitive in the world market. In 2016, Hawaiʻi’s last sugar mill, on Maui, shut down.
Invasive species, stronger and more aggressive than the islands’ native plants, encroached on the vacated land. Nonnative grasses now make up a quarter of Hawaiʻi’s land cover. “These grass-dominated landscapes allow wildfires to propagate rapidly,” according to a 2015 study conducted by several of the state’s foremost wildfire ecologists. That same study showed that, between 1904 and 2011, most of the terrain burned by wildfire on the islands was dry, nonnative grassland. That vegetation encouraged fire to spread into native forests, beating back the endemic species and allowing invasives to expand farther.
Agricultural workers in a sugar plantation in Hawaiʻi.
CORBIS/Corbis via Getty Images
The Maui fires have briefly paused the spread of invasives in parts of Maui by wiping all species — native and foreign — from the landscape. But the fires won’t keep the invasives at bay for long. Research shows that in the aftermath of extreme weather events, invasives tend to regrow faster than native plants. “It’s essentially a blank canvas, where invasive species will thrive much more than our native ones,” Opgenorth said, referring to the Maui fires.
To see what the canvas should look like, Opgenorth pointed to the upper West Maui mountains, where the forests are dynamic, multilayered, and dominated by native plants. In the lowlands that burned, invasive species create a dry, monolithic environment characterized by one or two types of plants. Higher up in the mountains, the native forests are home to a variety of species — mosses such as Thuidium hawaiiense, many types of tree fern, medium-size bushes and shrubs including silversword, and larger trees like koa. Together, these species create a mosaic that traps rainwater and creates a damp, fire-resistant environment.
Replicating that kind of wild forest in Lahaina, a small town of 13,000 people, isn’t feasible. But mimicking some fire-resistant aspects of the upper slopes is possible. In fact, it used to be the status quo there.
A wet forest in the upper West Maui mountains. Mike Opgenorth, Kahanu Garden and Preserve
In the 18th and early 19th centuries, Hawaiians planted a 10½-square-mile breadfruit forest in Lahaina, from Māla to Launiupoko and up into the lower slopes of the West Maui mountains. The diverse forest produced many types of fruits and vegetables in addition to breadfruit, including coconuts, bananas, taro, wild sugarcane, and sweet potato — plants that vary in size and create a multilayered canopy. As Lahaina developed, this food forest and others like it disappeared.
But in recent years, Native Hawaiian farmers have begun replanting those forests. The devastation wrought by the recent wildfires, and the invasive species that exacerbated them, illuminates the importance of such initiatives to ensuring Maui’s resiliency. If Hawaiian officials and lawmakers supported agroforestry systems like the ones being piloted by Indigenous farmers on the island, Maui could accomplish the interconnected goals of better protecting the island against future wildfires, supporting Native Hawaiians, and reconnecting Mauians to their cultural history.
“The goal is to knock the empire down and replace those corporate ag guys with something more environmentally sustainable that reflects our values,” Kaipo Kekona, an Indigenous farmer who planted a food forest on depleted farmland on a mountain ridge on Maui, told the Guardian last year. Kekona is a member of the island’s burgeoning Indigenous sovereignty movement.
Terraced taro fields at Limahuli Garden on Kauai Island, Hawaiʻi. Wolfgang Kaehler/LightRocket via Getty Images
Replanting food forests on Maui is a daunting undertaking. Real estate investors are already trying to snap up charred land. As Mauians fend off speculators hoping to cash in on the island’s tragedy, Opgenorth thinks the time to act is now. Up to 90 percent of Maui’s food is imported, and the island directs less than 1 percent of its budget to agriculture. Real post-fire resiliency would see many different stakeholders, including private landowners, coming together to change that.
“Where is the priority in the grand scheme of things?” Opgenorth asked. “The underlying thing that should be thought about is revitalization — not just ecosystem-friendly outplantings as we recover, but also things that connect us to our past.”
This year, nearly 100,000 people in Bangladesh have contracted dengue fever, a mosquito-borne viral disease common in tropical and subtropical regions of the world. The number of infected patients is overwhelming the fragile hospital system there. More than 450 people have died so far, the deadliest dengue outbreak in the nation of approximately 170 million since record keeping began in 2000. Sri Lanka, nearby, is also experiencing a sharp spike — more than 40,000 cases of dengue this year alone.
In the United States, five cases of locally acquired dengue have been reported in Florida this month alone, prompting local health officials to put Miami-Dade and Broward counties on alert. The state has reported a total of 11 cases of locally transmitted dengue so far in 2023.
Workers from the Florida Keys’ mosquito-control department load a drone to spread BTI larvicide in an effort to eradicate dengue-carrying mosquitos on July 8, 2020, on Key Largo. Joe Raedle / Getty Images
These outbreaks are concerning, but they’re not particularly surprising to experts who have been tracking dengue for the past several decades. Cases of dengue — which can cause fever, rashes, vomiting, and, in severe instances, internal bleeding, organ failure, and death — have been rising for years.
Since the beginning of the century, global cases of the disease, carried by the Aedes genus of mosquitoes, have skyrocketed, from roughly 500,000 in 2000 to more than 5 millionin 2019. In the first seven months of 2023, worldwide cases spiked to more than 3 million, and over 1,500 deaths have been reported — numbers that are expected to rise as the summer continues.
There are likely hundreds of millions more unreported incidents each year, as dengue produces mild or no symptoms in most people. But as more people get infected, the percentage who end up developing the severe form of the disease will increase, too. Experts say a tangled web of factors is driving the surge, but one culprit stands out: climate change.
Dengue patients, protected under mosquito nets, receive treatment at the Dengue Corner of Sylhet MAG Osmani Medical College & Hospital in Bangladesh. Md Rafayat Haque Khan / Eyepix Gr / Future Publishing via Getty Images
In the 1970s, global cases of dengue fever, or break-bone fever as it’s also commonly known, were low. Dengue had been more prevalent 20 years prior, but an aggressive campaign to eradicate Aedes aegypti mosquitoes using the now-banned insecticide dichlorodiphenyltrichloroethane, or DDT, lowered rates. The campaign was particularly successful in the Americas, where dengue and yellow fever, both carried by A. aegypti, were an omnipresent threat.
But spraying DDT, a known carcinogen, into the environment quickly became an unsustainable mosquito-control measure. By the 1980s, as DDT was being phased out and a century of rampant fossil fuel use began to significantly influence the global climate, the disease began to spread again, and fast. In the next couple of decades, dengue would be found in 100 countries, up from just a handful of countries in the 1960s. Today, it’s been detected in more than 140 nations.
“This is the [mosquito-borne] disease that has grown most substantially in the past 10 years,” Felipe J Colón-González, a climate and health researcher who works at the global charitable foundation the Wellcome Trust, told Grist. “There are many factors that are related to climate.”
In order to gauge the influence of global warming on the spread of dengue, researchers look at three interconnected clues: where mosquitoes move, how quickly they develop, and how often they reproduce.
Like any creature on earth, mosquitoes thrive within a specific temperature range. The insects can’t withstand temperatures that are too dry or cold. Anywhere below 57 degrees Fahrenheit, particularly when there’s low humidity, is unlivable. But most mosquitoes can’t withstand temperatures that are too wet or hot, either — large rainstorms wash them out and they tend to die off at 90 degrees F and above.
Human industrial activity has warmed the planet by about 2 degrees F, on average, a seemingly small change that has had enormous implications for the spread of infectious disease — and life on earth writ large.
Nepal, a mountainous country in South Asia, is a perfect example of how even a slight temperature change can open up a Pandora’s box of disease. Dengue wasn’t present in Nepal until 2004, when the first case was recorded. Less than two decades later, in 2022, the country, which is warming more than 1 degree F every decade, experienced its largest outbreak ever — 54,232 cases and 67 deaths. Researchers in Nepal noted that the nation’s mountains are undergoing “unusually large” fluctuations in temperature. Snow cover on those mountains is melting away as climate change accelerates, inviting pests into new, higher territories. Afghanistan, also long considered too mountainous for Aedes mosquitoes, is witnessing a similar trend.
A child infected with dengue at a hospital in Dhaka, Bangladesh, on August 14, 2023. Xinhua via Getty Images
Climate change isn’t just inspiring mosquitoes to move to higher elevations — it’s prompting the bugs to mature more quickly and produce more generations of offspring in a single season.
Warmer temperatures increase both mosquitoes’ rate of survival and development, and the rate at which they feed. Female mosquitoes, the ones that bite humans, digest blood more quickly when it’s warm and humid out. That leads to more disease. “Because the metabolism is faster, they have to feed many more times in a life cycle so there’s more probability of an infection,” said Colón-González.
Even temperatures that should be too hot for mosquitoes don’t always kill them off. The insects hide in cool corners and under couch cushions to escape the heat, seeking shade much like humans do. “Mosquitoes are annoyingly intelligent creatures,” Colón-González said.
It’s clear that climate change is helping mosquitoes, and the diseases they carry, extend their reach across much of the planet. Roughly half the globe is now at risk for dengue, Raman Velayudhan, who leads the WHO’s program for the control of neglected tropical diseases, said recently. But mosquitoes are not invincible. Researchers have had success artificially infecting Aedes mosquitoes with a bacterium that prevents the transmission of dengue from mosquitoes to humans. Pilot studies in South America and Southeast Asia have shown that the bacterium, called Wolbachia, can be incredibly effective: Cases of dengue in Yogyakarta, Indonesia, went down 77 percent following the release of Wolbachia mosquitoes.
And other, more dependable and scalable methods of curbing dengue transmission exist. As is the case with many climate-driven illnesses, keeping communities safe from dengue ultimately comes down to resources and access.
In the U.S., climate projections indicate that the atmospheric conditions for dengue will be ideal throughout much of the country by the end of the century. But it’s unlikely that dengue will become as widespread an issue as it is in underdeveloped countries. That’s because most American homes have window screens that keep bugs out, and a large portion of the population has access to air conditioners that keep humidity low inside. Houses in the U.S. are spaced further apart than elsewhere in the world, which means a mosquito that breeds in one house won’t necessarily bite people in the house next door. Americans also have widespread access to mosquito repellant. And in most areas, drinking water containers and sanitation systems are stored underground, which means mosquitoes can’t breed in them. That’s why in Texas, dengue is a rare disease while as many as 20 percent of all dengue deaths in the Americas occur in Mexico. Two places that share a border and the same environmental conditions can have two completely different health outcomes.
“It’s true that the climate is going to become more suitable for dengue,” Colón-González said, pointing to rising temperatures and cases all over the globe. But the built environment, human behavior, and the quality of public health systems also play important roles — and point at potential silver linings that could help mitigate the dengue burden in countries with fewer resources. “It’s not just the climate,” he said.
One year ago, President Joe Biden inked the largest investment in fighting climate change in United States history. That law, called the Inflation Reduction Act of 2022, or IRA, funnels hundreds of billions of dollars into clean-energy tax credits for power producers, rebates for electric vehicles and heat pumps, and other emissions-fighting measures. After decades of inaction on climate change, the IRA marked a new era in the nation’s belated quest to ratchet down greenhouse gas emissions.
But the fight over the law isn’t over yet. Recent polling shows that a whopping 7 in 10 Americans say they haven’t heard anything substantial about the IRA, an apparent indication that most voters aren’t thinking about it as the 2024 presidential election approaches. Furthermore, even though most new investment from the bill has flowed to red states, many Republican leaders are pushing back against it.
It’s also far from guaranteed that the law will work as planned. The bill consists of more than a hundred different provisions, many of them involving complicated changes to the tax code, and some of those provisions are already hitting snags. Even if everything goes exactly right, experts believe the bill will still leave the U.S. short of President Biden’s stated climate goals. In all likelihood, the U.S. will need to pass more climate legislation to achieve those goals. The public’s appetite for that will hinge on the success of the IRA.
The man tasked with ensuring the bill’s success is John Podesta, a veteran political strategist who served as a senior White House official under Bill Clinton and Barack Obama but became something close to a household name only after then-presidential candidate Hillary Clinton’s emails were leaked. Podesta is fond of saying that he “failed at retirement” — he thought he was done with politics for good when Biden tapped him to shepherd the rollout of his landmark legislative achievement.
“I was ready to ride off into the sunset,” Podesta told Grist. “But then the president asked me to come back.”
Now Podesta spends his days pitching the IRA to the companies and elected officials whose buy-in will determine its success; he also supervises a suite of Cabinet agencies as they work out the kinks in the law. In an interview conducted just before the one-year anniversary of the bill, Podesta spoke with Grist about why he thinks the law will come to be as durable as the Affordable Care Act, how the administration is pushing green technology manufacturers toward “labor neutrality,” and why he thinks you should tell your neighbors about IRA benefits.
This interview has been condensed and edited for clarity.
Q. You’re in charge of implementing the IRA. A lot of our readers might want to know: What do you do all day?
A. Look, this is a multifaceted bill. There’s 135 separate programs in the bill. A good deal of the work is being done through the tax code. So I spent a lot of time working with the Department of Treasury, the Department of Energy, and other related agencies — like the Labor Department on some of the provisions — just trying to get guidance out so that the private sector has clarity about how it can take advantage of the support for clean energy and clean technology that’s in the bill.
One of the interesting elements of the bill was: it’s just not a power-sector-only bill. It attacks all the emitting sectors: power, transportation, buildings, forestry and agriculture, as well as manufacturing and infrastructure. So given the sweep of that, there’s a lot of detail that needs to be worked out. And in addition to talking to a lot of companies who are trying to plan for the future and raising issues about how to interpret various provisions of the bill, I spent a lot of time talking to my colleagues in other federal agencies to make sure that we get clarity. And then there’s $100 billion worth of grants that we’re working to move quickly and expeditiously. The money is available for some period of time, but we want to get it moving upfront because the need is so great.
Q. A recent Washington Post poll found that 7 in 10 Americans don’t know very much about the IRA at all. What does it tell you about the bill? Are there efforts underway to mitigate that?
A. It’s really natural in today’s political environment that people don’t pay attention to legislation, particularly when you’re talking about specific legislative names. They don’t really relate to it on that basis. But they do relate to projects, jobs, companies coming into their communities, and I think the general level of public support remains high across the political spectrum.
I’m a veteran of the Affordable Care Act, and the difference between the ACA and the clean energy investments in the IRA is that the Affordable Care Act, by the time it actually passed, was kind of unpopular. It took a while for people to feel the benefits of it. Now, notwithstanding Republican efforts, they can’t tear it away, because people are really seeing its benefits. I think the same thing will be true of the Inflation Reduction Act. Whether people relate to the name of the bill or not, you know, that’s for others to judge.
Q.You mention there’s a lot of corporate investment happening right now, like big manufacturing investments in electric vehicles, and it’s true that Americans will notice if there’s a new factory in their town. But the consumer-facing side of the bill does rely on people knowing they can claim a tax credit for a home retrofit or a heat pump. Are you concerned that the lack of awareness is going to hinder the uptake of those consumer credits?
A. I think we’re working hard to make sure it doesn’t, and we need consumer-facing businesses to help people know what they can take advantage of. The Department of Energy, for instance, has made a series of grants to upgrade the training of people who are in the HVAC business, so that they know the benefits that are available to consumers. You mention heat pumps — generally those are point-of-failure purchases, so you’ve got to know about the availability. It’s a little easier on the auto side, because the auto companies are all over this movement toward electrification: They’re advertising heavily on it, they’ve committed very substantial capital to it. It’s important for us, as the government, to be out there talking about the benefits, but some of this is neighbor to neighbor.
Q. Four Republican states have said that they won’t take IRA money, even though most of the benefits of this bill are actually going to red states. Does that hold up the implementation? How much does that make your job harder?
A. I mean, it’s an unusual decision to refuse to support at a time when virtually every part of the country is feeling some kind of extreme weather. You don’t have to go to the deadliest fire in the last hundred years of American history, in Maui. It was over 110 degrees for 31 straight days in Phoenix. The floods in upstate New York, in Vermont, and the extreme heat in the south and the Southeast. So, you know, putting your head in the sand and ignoring the reality, and ignoring the science, and ignoring everybody’s lived experience to make a statement that everything has to be a culture war issue, is sort of unusual.
Four [states] turned down the planning money, but 46 states, the District of Columbia, and Puerto Rico took it. So I feel like we’re moving forward. I spend time talking to Republican governors, and unlike their counterparts in the House of Representatives, they’re anxious to attract the investment. I saw Governor [Kevin] Stitt from Oklahoma, and he just landed a big solar plant in Oklahoma. And all he wanted to talk about is why the Volkswagen Battery plant got away from him and what more he could do to attract more clean investment.
Q.You’re drawing a distinction between Republican governors, who obviously want to land these investments, and the House GOP — many members of which have said that they want to repeal the IRA. What happens if come 2025, the credits are rescinded or limited? How damaging do you think that would be for the decarbonization process in the U.S.?
A. This is the most significant piece of our ability to hit the pledge that President Biden made in 2021 to cut our greenhouse gas emissions between 50 and 52 percent by 2030. Around 40 to 42 percent of that is a result of the Inflation Reduction Act, and that depends on tax credits being available through the rest of this decade. House Republicans have tried on several occasions to repeal large parts of it, but I think the more people see and feel the benefits, the harder and harder that will be. These companies are investing [in renewable energy] because the structure of this law gives them certainty. Rather than the on-off, on-off [structure] of previous renewable credits, they have ten years of certainty. I think those investments will prove to be durable, and I don’t know that Republicans, even if they had more power, would walk away from that.
Q.A lot of the investments that you’re talking about so far have gone to red states. In particular, a lot have gone to right-to-work states and states with lower prevailing wages. Is that outcome problematic for an administration that has prioritized union jobs?
A. Because [the legislation is] built into the tax code, companies are going to make individual choices. I think what we expect from them is to give everywhere a fair shot, and we want to push them towards labor neutrality. We saw a bit of success in the Blue Bird [electric school bus factory] being organized in Georgia. There’ll be places where people want to take advantage of whatever state is offering tax breaks or lower personnel costs. But I think for the most part, we’re seeing investment all over. And obviously our voice is critical, and we’re trying to make sure that it’s loud and in support of the right to organize.
Q.We have to ask you about permitting reform, just because it seems like so much of this really hinges on that. Recent negotiations around permitting reform have sputtered out, and permitting reform has become one of those things that keeps coming back and keeps dying. Is that absolutely essential to the longevity of the IRA?
A. Cutting the time to permit and fixing the interconnection queue problems is absolutely essential. It would be great if we get some legislative support for that. But I think we’re doing everything we can to make sure these projects are indeed considered and permitted, and that any real concerns — whether those are environmental justice or environmental concerns — are considered early at the front end so that we can mitigate those concerns and move projects forward.
This is my third White House, and my fourth presidential administration, and we’re doing something I’ve never seen before, which is Cabinet-level, White House-coordinated attention to permitting at a policy level and at an individual project level. We meet regularly at a Cabinet level to try to consider both: Are there things we can do to cut time and ensure quality in the permitting process at a policy level? And then going directly to the individual projects and saying: Why are they hung up? Can we find a way to fix that?
I think when you have political accountability, starting from the [resident, saying, “I want this done,” things will happen. And I think they are happening. But could we use a lot from our friends on Capitol Hill? Yes, we could.
Q.I’m sure you know that local governments, especially in the Midwest, are putting up pretty significant opposition to the siting of wind and solar facilities. There’s one report that found 228 new laws in 35 states that make it more difficult to build these projects. To what extent do you think the local opposition represents a challenge to the rollout of the IRA? And can you even do anything about that at the federal level to make it easier to site these facilities?
A. I think that we have a role in establishing the benefits of clean power: the economic benefits, the health benefits. But I think at the end of the day, some of those decisions are localized. There’s a significant amount of money being spent to slow the buildout, that’s coming from a variety of sources and people who oppose taking action to deal with climate change. We can’t directly get involved, but we can encourage other voices to be involved in those local fights. This is going to be a little bit of hand-to-hand combat in the near term. People [from local political organizations] will come to us and say, “can’t you make [decarbonization] go faster?” And I think it’s a fair point for us to say, “You know, you have local members. What are you doing about this?”
Q.There’s been a lot of debate over a lot of the provisions in the bill, including green hydrogen, carbon capture, and biogas, with many environmental justice advocates raising concerns about them. I just wonder how you think about balancing a strong momentum for decarbonization with the concerns of the communities that are going to be near this infrastructure.
A. In our view, it’s going to be essential that we find a pathway for truly green hydrogen, because it’s going to be a very important element of decarbonizing the industrial sector. It’s also critical in terms of both air and marine fuels. But I think we also have to listen to the communities that are voicing concerns about it. There’s also going to have to be a significant amount of carbon removal in order to hit the net-zero goals by mid-century, and some of that’s going to happen by direct removal of carbon from the atmosphere. I think that it’s incumbent in this decade that we begin to create strong environmental protections for the technologies that are going to be required if we’re going to stabilize the atmosphere. We’re trying our best to make sure we’re listening to people and that we make good decisions.
Q.A lot of the consumer-focused energy efficiency programs, plus the heat pumps and solar panels, require pretty significant upfront investment. Are you concerned that the takeup will lag behind in low-income communities? Even though you get a tax credit, it’s still going to be out of reach for a lot of people.
A. We’re trying to solve for that, particularly on the rebate side. If you’re a low-income household you can switch out to a heat pump for a very, very low cost — in some cases free — but that has to be done at the point of sale, and we need to work with states to implement the credits so that there isn’t a big upfront capital expenditure. It’s a little bit different in terms of taking advantage of the tax rebate advantages, where you get that money back on your tax return, but we’re trying as much as we can to make that consumer-friendly, including working with the auto companies and dealers.
Q.It sounds like you’re kind of saying that, in addition to state and local governments, you guys need help from like, Lowe’s, or something, to make this bill work.
A. I think that’s where people get a lot of their information from, particularly in the home retrofitting area, as it relates to insulation for windows and doors and induction stoves. Those credits are generous, but people have to know about them. And so we’re trying to work with individuals in the install community and with home improvement people to do that.
Q. On the home improvement front, have you personally benefited from any of the provisions in the IRA?
A. Well, I could have, but I did it earlier. I was an early adopter of solar. I haven’t replaced my furnace yet, but when I do, I’ll get a heat pump.
Laurie Harper, director of education for the Bug-O-Nay-Ge-Shig School, a K-12 tribal school on the Leech Lake Band Indian Reservation in north-central Minnesota, never thought that a class of chemicals called per- and polyfluoroalkyl substances, or PFAS, would be an issue for her community. That’s partly because, up until a few months ago, she didn’t even know what PFAS were. “We’re in the middle…
Laurie Harper, director of education for the Bug-O-Nay-Ge-Shig School, a K-12 tribal school on the Leech Lake Band Indian Reservation in north-central Minnesota, never thought that a class of chemicals called per- and polyfluoroalkyl substances, or PFAS, would be an issue for her community. That’s partly because, up until a few months ago, she didn’t even know what PFAS were. “We’re in the middle of the Chippewa National Forest,” she said. “It’s definitely not something I had really clearly considered dealing with out here.”
Late last year, tests conducted by the Environmental Protection Agency revealed that her school’s drinking water wells were contaminated with PFAS. Some of the wells had PFAS levels as high as 160 parts per trillion — 40 times higher than the 4 part-per-trillion threshold the federal government recently proposed as a maximum safe limit.
PFAS, also known as forever chemicals, are a global problem. The chemicals are in millions of products people use on a regular basis, including pizza boxes, seltzer cans, and contact lenses. They’re also a key ingredient in firefighting foams that have been sprayed into the environment at fire stations and military bases for decades. Over time, these persistent chemicals have migrated into drinking water supplies around the globe and, consequently, into people, where they have been shown to weaken immune systems and contribute to long-term illnesses like diabetes, cardiovascular disease, and cancer.
After the EPA’s tests came back, Harper realized that some 250 students and 40 faculty members at the Bug-O-Nay-Ge-Shig School had been consuming PFAS-tainted water for an indeterminate amount of time, perhaps since the school’s founding in 1975. Now, the chemicals are all Harper thinks about, and their presence in the school’s water supply is a constant reminder of a problem with no obvious solution.
“We can’t not provide education,” Harper said. “So how do we deal with this?” Months after discovering the contamination, she’s still looking for answers.
Beyond immediate concerns about how to get students clean water, the situation at the Bug-O-Nay-Ge-Shig School raises larger questions for Indigenous nations across the United States: Is Bug-O-Nay-Ge-Shig the only tribal school with PFAS contamination in its water? And how pervasive are PFAS on tribal lands in general? But data on PFAS contamination on tribal lands is patchy at best. In many parts of the country, there’s no data at all.
“There is very little testing going on in Indian Country to determine the extent of contamination from PFAS to drinking water systems, or even surface waters,” said Elaine Hale Wilson, project manager for the National Tribal Water Council, a tribal advocacy group housed at Northern Arizona University. “At this point, it’s still difficult to gauge the extent of the problem.”
PFAS have been around since the middle of the 20th century, but they’ve only been recognized as a serious health problem in the past decade or so after a lawyer sued DuPont, one of the top U.S. manufacturers of PFAS, for poisoning rural communities in West Virginia. Since then, a growing body of research has shed light on the scope of the PFAS contamination problem in the United States — nearly half the nation’s water supply is laced with the chemicals — and water utilities are finally taking stock of what it will take to remediate the contamination. But for the 547 tribal nations in the U.S., there is nothing resembling a comprehensive assessment of PFAS contamination. Tribal water systems have gone largely untested because many of them are too small to meet the EPA’s PFAS testing parameters.
“We can certainly say that PFAS is an issue for every single person in the United States and its territories, that includes tribal areas,” Kimberly Garrett, a PFAS researcher at Northeastern University whose work has highlighted the lack of PFAS testing on tribes.
The federal government has a responsibility to protect the welfare of all Americans, but it has a legal obligation to tribes. In the 18th century, the government entered into some 400 treaties with Indigenous nations. Tribes reserved specific homelands, or were forcibly moved to places designated by the government, and guaranteed rights like fishing and hunting, as well as peace and protection. Experts say that responsibility to tribes includes protection from contaminants.
“Every treaty that assigns land to tribes impliedly guarantees that land as a homeland for the tribes,” said Matthew Fletcher, a law professor at the University of Michigan and a member of the Grand Traverse Band of Ottawa and Chippewa Indians. “Contaminated land is a breach of that treaty land guarantee.”
If PFAS are as widespread on tribal lands as they are in the rest of the U.S., many reservations likely have a public health emergency on their hands. They just don’t know it yet.
An aerial view of of Tract 33 in Cass Lake, Minnesota, home to several of Leech Lake’s Indigenous families.
Jerry Holt / Star Tribune via Getty Images
In some ways, Bug-O-Nay-Ge-Shig, known as the Bug School, got lucky. In December last year, the Environmental Protection Agency, armed with funding supplied by the Bipartisan Infrastructure Law passed by Congress in 2021, approached Leech Lake leaders to ask if the tribe would like to have its water tested for PFAS. The agency had $2 billion to help small or disadvantaged communities test their water supplies for emerging contaminants. The Bug School qualified as both.
When the tests came back positive, the school immediately started shipping in 5-gallon jugs of drinking water and the cafeteria started using bottled water to prepare meals. The school even paused a community gardening program meant to teach students about the value of fresh foods out of fear that the soil was contaminated.
The school knew that it had a contamination problem on its hands, but believed that the problem would be temporary — the measures it put in place were Band-Aids until a long-term solution was found. Months into the crisis, however, school administrators have yet to figure out a permanent fix. The school still doesn’t know where the contamination is coming from, and the cost of cleaning the chemicals out of its water supply threatens to be prohibitively expensive.
A map of well and septic location sites provided as part of the water quality evaluation of Bug-O-Nay-Ge-Shig School. Courtesy of Bug-O-Nay-Ge-Shig School
PFAS remediation requires equipment, frequent testing, and dedicated personnel who have the capacity to monitor forever chemicals for years. Paying for PFAS cleanup is a tall order in large, affluent communities with the resources to address toxic contaminants. The mid-sized city of Stuar, Florida, discovered PFAS in its water supply in 2016 and, to date, has spent more than $20 million fixing the problem. The PFAS in their water still aren’t entirely gone.
On reservations, figuring out who’s responsible for testing for PFAS and paying for remediation is an impossible puzzle to crack, mainly because no one seems to know where the buck stops.
Federal PFAS testing has largely bypassed tribal public water systems. That’s because tribal systems are smaller, on average, than non-tribal public water systems. Every five years, the EPA tests the nation’s drinking water for “unregulated contaminants” — chemicals and viruses that are not regulated by the agency but pose a potential health threat to the public. The EPA finally included PFAS in its testing for unregulated contaminants in 2012, alongside a list of metals, hormones, and viruses. But it mainly tested systems that serve more than 10,000 people.
A study conducted by Northeastern University found that just 28 percent of the population served by tribal public water systems was covered by that round of PFAS testing, compared to 79 percent of the population served by non-tribal water systems. There were also no PFAS results for approximately 18 percent of the tribal water systems tested by the EPA “due to missing data or lack of sampling for PFAS,” the study said. To make matters more complicated, many Indigenous communities get their water from private wells, which are not monitored by the EPA. A recent study suggests a quarter of rural drinking water, much of which comes from private wells, is contaminated by PFAS.
Data on PFAS in tribal areas, experts emphasized over and over again, is extremely scarce. “We don’t know if PFAS is disproportionately affecting tribal areas,” Garrett said. “We won’t know that until we get more data.”
What limited data exists is outdated. The Environmental Working Group, an advocacy organization that tracks PFAS contamination across the U.S., conducted a rough, preliminary PFAS estimate on tribal lands in 2021 using what data there was available at the time. It showed that there are nearly 3,000 PFAS contamination sites, like garbage dumps, within five-miles of tribal lands. The analysis is almost certainly an underestimate.
The lack of PFAS testing on tribal lands is compounded by the fact that there is no one entity responsible for testing and treating tribal water systems for PFAS. That’s partly due to the fact that PFAS are a relatively new issue, but it also has a lot to do with the lack of centralized monitoring of tribal health in general. For example, American Indian and Alaska Native communities experienced some of the highest COVID-19 infection rates in the United States in 2020. But the siloed nature of tribal, local, state, and federal data collection systems means that no one has a real sense of just how many Indigenous people died in the pandemic, even years after the crisis began.
If history is any indication, Fletcher, the law professor, said, remediating these contaminants will be a game of push and pull between the federal government and tribes. In previous efforts to rid reservations of arsenic and lead contamination, he said, “usually the fights are the tribe insisting that the government do something and the government doing everything it can to avoid any kind of liability or obligation.”
In the 1990s, Rebecca Jim, a Cherokee activist and former teacher who was instrumental in raising awareness about lead poisoning among children in Ottawa County, Oklahoma, had to navigate a complicated patchwork of tribal governments, federal bureaus, and treaties to finally get the government to clean up the Tar Creek Superfund site on the Quapaw Nation — one of the agencies largest Superfunds. It took a decade for Jim and other activists to pressure the EPA into cleaning lead — the legacy of mining for materials used in bullets — out of Ottawa County, and she maintains that the EPA only started paying attention to what was happening in Tar Creek after a local masters student discovered that approximately one-third of children in a town in the county called Picher had lead poisoning.
“There’s always a fight,” Jim said. “It’s all about money and where you’re going to get the money to do the work.”
Jim said that testing for contaminants on tribal lands is generally the responsibility of the Indian Health Service, an agency housed within the National Institutes of Health, or falls to a given tribes’ own environmental protection office. But it becomes the EPA’s problem once the agency designates an area as a Superfund site, like Tar Creek was. Then, the EPA tries to go after the polluters responsible for the mess in the first place. If the agency is successful, Jim explained, there is generally ample funding for cleanup efforts. If a polluter can’t be pinned, it falls on the EPA to fund the cleanup, which is a more laborious and less thorough process because there’s fewer dollars to go around. And if the contamination occurs at a federally-controlled tribal school, like the Bug School, the Bureau of Indian Education is responsible. It’s a veritable maze of jurisdiction — even finding where you are in the maze is a tall order.
Laurie Harper’s efforts to untangle the bureaucratic knot that governs decision-making and testing for contaminants at the Bug School may serve as a lesson to other tribal schools that discover PFAS contamination in their water supplies. In February, two months after the EPA approached the school to offer PFAS testing, the results came back. The agency called the school immediately and said it needed to shut down its water system, an urgent request that caught administrators off guard. “We were still like, what? OK, how long is this going to last? Do we open the water? What do we do with it?” Harper said.
In March, desperate for answers, Harper traveled to Washington, D.C., and met with the director of the Bureau of Indian Education, or BIE, Tony Dearman, who heard her concerns about finding a long-term solution for the school.
What she didn’t find out until later, however, was that the BIE had already conducted its own testing at the Bug School in November 2022, during what Harper and other school administrators had assumed was just the agency’s annual compliance check. “They were already aware that the Bug-O-Nay-Ge-Shig school had tested high for PFAS,” Harper said. “They didn’t tell the school administration nor did they tell the tribe. They didn’t even tell the EPA.”
A USGS watershed report for the Leech Lake Reservation.
Courtesy of Bug-O-Nay-Ge-Shig School
Unbeknownst to her, the BIE had sent a very short email to the school months earlier, in February, telling them that the bureau had found levels of two types of PFAS — PFOA and PFOS — in the school’s water. When Harper finally tracked down that letter and read it, she was appalled by how vague the language was.
“We have received the PFAS (specifically, Perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS)) results from the November 2, 2022 sampling event,” it read. “There were several exceedances of PFOA at Wells 1, 2, 3 and 4 and PFOS detection at Well 3 all were above the State limit for and EPA Health Advisory for PFOA and PFOS, please see attached spreadsheet.” The letter did not define what PFAS were or how dangerous they can be to human health. And it certainly did not make it clear to Bug School administrators that the school was in the midst of a public health crisis. “I’m an educator, not a hydrologist,” Dan McKeon, the school’s superintendent and the primary recipient of the letter. “There was notice of results that exceeded some standards, but no guidance about what that meant or what we should do.”
The BIE concluded the letter by telling the school that it would be conducting a second round of PFAS testing within 30 days to “confirm the analytical results” of its initial tests and then determine next steps, but the bureau didn’t return for testing until April 2023 — more than five months after the initial test, and weeks after Harper’s meeting with director Dearman. BIE, she was told by the bureau’s own leadership, was putting out fires on multiple fronts. “You’re not the only school that’s testing high for PFAS,” she recalls BIE’s supervisory environmental specialist telling her.
In a written response to questions from Grist, a spokesperson for the BIE said the bureau is “committed to providing schools with safe drinking water” that meets federal standards and that it is in the process of collecting water samples from BIE-owned public water systems at 69 schools. The bureau did not respond to questions from Grist about how many tribal schools exceed the EPA’s newly proposed 4-part-per-trillion PFAS limit.
In the past few years, Harper told Grist that two people who worked at the Bug School have died from cancer. Multiple female employees have thyroid issues. Harper knows that these diagnoses could be linked to hereditary, behavioral, or environmental exposures. But the deaths — the most recent, a man who died from testicular cancer just a year ago — have made solving the school’s PFAS situation feel even more urgent. Harper has been meeting with EPA, BIE, BIA, and state agencies to get the problem solved. “I’m so frustrated with how bureaucracy works,” she said. But she’s in the fight for the long haul, whatever it takes. “It’s the long-term solutions we’re interested in, not just the quick fix.”
Harper isn’t working in a vacuum; 2023 has been a breakthrough year for PFAS awareness and remediation nationwide. Earlier this summer, major manufacturers of PFAS, including Dupont and 3M, agreed to multi-billion-dollar settlements with cities and states across the country — the largest PFAS settlements thus far. At the end of July, the Fond du Lac Band of Lake Superior Chippewa, a tribe located about 115 miles southeast of the Bug School, filed a companion lawsuit, tied to those earlier settlements, against 3M for the cost of gathering data on PFAS, treating its drinking water supplies, fisheries, and soil for contamination, and monitoring the health of the tribe.
The Minnesota Pollution Control Agency, a state agency that monitors environmental quality, has conducted a preliminary investigation into the PFAS contamination at the Bug School after school administrators alerted the agency to the problem, but that probe didn’t reveal what the source was. The agency said it will conduct another, “in-depth investigation involving soil and groundwater sampling” at the Bug school in the fall.
Also at the state level in Minnesota, a bill introduced in the legislature this year would permit Minnesotans who are exposed to toxic chemicals to sue the companies responsible for producing the chemicals and force those companies to pay for the cost of screening for conditions that are caused by exposure. 3M has fought these kinds of laws as they’ve cropped up in state legislatures because a legal right to seek medical monitoring will likely lead to a situation in which the company will have to pay billions of dollars’ worth of medical bills. But Harper is sure she can drum up support for the legislation. “I know I can convince other tribes to get behind a law that would allow medical monitoring in the state of Minnesota,” she said. “This is our land. These are our children. These are our families.”
ey there, welcome to another issue of Record High. My name is Zoya Teirstein, and this week I’m taking you inside emergency rooms in Phoenix — a place that just endured 31 consecutive days at 110 degrees Fahrenheit or above. It was the hottest month, on average, in any U.S. city on record.
To understand how those temperatures are affecting residents in real time, I spoke to two physicians in Phoenix about what this summer of extremes looks like in their domain, the emergency room. As I reported this week, Kara Geren and Frank Lovecchio, two emergency medicine physicians in the metro of 1.6 million people, have been seeing patients show up with the same exact symptom: dehydration. No matter what the patient comes in for — whether it’s chest pain or a chronic health condition such as diabetes — they also likely need fluids. “What surprised us is even people that came in for completely unrelated things are dehydrated,” Geren said. “It’s just so hard to stay hydrated.”
The patients presenting with surprise dehydration add to the considerable number of people coming to the ER with symptoms consistent with heat-associated illness: heat rashes, cramps, vomiting, diarrhea — and the most severe form of heat sickness, heat stroke. But Geren and Lovecchio have also seen a number of patients with severe burns from hot pavement and scorching surfaces. On a 100-degree Fahrenheit day, asphalt in direct sunlight will heat up to 160 degrees — more than hot enough to give someone a third-degree burn. “Our burn unit is very, very busy,” Lovecchio said.
Dr. Frank Lovecchio demonstrates an inflatable pool-like device that can be filled with ice, used in the emergency medicine unit at Valleywise Hospital during extreme heat.The Washington Post / Getty Images
The Maricopa County Department of Public Health, covering metro-area Phoenix, has reported 39 deaths connected to heat since April; the medical examiner’s office suspects there have been 312 more deaths associated with heat in the county, which are currently under investigation. The elderly, the unhoused, and people who use opioids are especially at risk of developing severe heat sickness and dying.
Geren and Lovecchio have been cooling people down however they can — they immerse patients in large tubs of cold water or zip them into body bags filled with ice. They chill intravenous fluids and oxygen before administering them, and cool patients with industrial-strength fans. But both doctors worry about the future.
“A lot of people have that billion-dollar question: Is [Phoenix] going to become unlivable? I think it’s pretty close this summer.”
Frank Lovecchio, ER doctor in Phoenix
There are efforts underway at the federal level to fund solutions. Last week, Democratic lawmakers, including Arizona’s Ruben Gallego, reintroduced the Preventing HEAT Illness and Deaths Act, legislation aimed at mitigating deaths by reducing people’s exposure to extreme heat. That’s in addition to Gallego’s efforts to get FEMA to add extreme heat to its qualifying list of major disasters, as my colleague Jake Bittle reported in this newsletter last week.
But it’s unclear how far those bills will get. Many Republican lawmakers, improbable as it sounds, are moving in the opposite direction. In mid-July, House Republicans proposed deep cuts to the budgets of both the Environmental Protection Agency and Department of Interior. The effort is unlikely to be successful, with Senate Democrats sure to block it. But the GOP’s spending bill, which proposes slashing EPA funding by nearly 40 percent, shows how the right is thinking about this summer of extremes.
Policy experts at the Environmental Defense Fund told Grist that one of the programs that could face the chopping block if Republicans get their way is the EPA’s Heat Island Reduction Program. The initiative seeks to decrease exposure to extreme heat in urban areas with little tree cover, particularly in low-income and minority communities that are disproportionately burdened by extreme heat.
Meanwhile, Geren is thinking ahead to next summer and even hotter summers to come. “If we’re keeping the way we are, I just don’t know how people can live here,” she said.
By the numbers
In Arizona, one of the states where heat-related deaths are most common, the number of fatalities in metro-area Phoenix have been rising in recent years. This year, officials have reported 39 deaths connected to heat so far, but that number will likely change as the summer continues and hundreds of other deaths are investigated.
The wacky world of heat insurance: You’ve heard of flood insurance and wildfire insurance, but what about heat insurance? A new suite of unconventional heat insurance products has emerged in a range of countries around the world. Can they help protect us? My colleague Jake Bittle reports.
How heat isolates: Americans are becoming increasingly isolated. Believe it or not, that can make extreme heat more fatal. My colleague Akielly Hu explains how isolation compounds the risks of heat exposure and how cities can reduce those risks.
Children threatened by extreme heat: A United Nations report shows 460 million children under the age of 18 in South Asia are already exposed to 83 or more days a year in which temperatures exceed 95 degrees. Three-quarters of children in the region are exposed, compared to one in three children globally.
South America is rewriting the climatic books: It’s supposed to be the middle of winter in Chile and Argentina, but temperatures in the region are abnormally high — upward of 100 degrees Fahrenheit in some areas. “Some places have even reached all-time maximums — surpassing summer temperatures, even though it is winter,” Ian Livingston wrote for the Washington Post.
Extreme heat is ‘boring’: Scoff at the headline, but give this essay on cabin fever, or “climate ennui,” in Arizona a chance. Caroline Tracey writes a blazingly good first-person account of being trapped indoors during the summer in Tucson for Zocalo Public Square.
Heat comes with a steep price tag: New research shows extreme heat is costing the U.S. economy big time — $100 billion in 2020 and a projected $500 billion annually by mid-century. “From meatpackers to home health aides, workers are struggling in sweltering temperatures and productivity is taking a hit,” Coral Davenport reports for the New York Times.
This story is part of Record High, a Grist series examining extreme heat and its impact on how — and where — we live.
For four out of five people on the planet, climate change made July, the globe’s hottest month on record, even hotter. And in the United States, nowhere has been more consistently hot this summer than Phoenix, which endured 31 consecutive days at 110 degrees Fahrenheit or above — the hottest month, on average, in any U.S. city on record. For 16 days, nighttime temperatures in the metropolis of 1.6 million people didn’t dip below 90 degrees, a telltale sign of climate change.
Extreme heat comes with serious public health consequences. Heat causes more deaths in America than any other weather-associated hazard. More than 11,000 people have died from heat since 1979 and that’s almost certainly an underestimate. Officials suspect seven people may have died due to heat in the Southwest’s state and national parks this summer — an unusually high number for June and July.
In Arizona, one of the states where heat-related deaths are most common, the number of deaths in metro-area Phoenix — 39 deaths connected to heat so far — could surpass last year’s total, potentially by a large margin. The Maricopa County Department of Public Health reported that there may have been 312 more deaths connected to heat in the county this year, all of which are under investigation.
The emergency in Arizona is a harbinger of crises to come: climate-fueled heat is quickly becoming an omnipresent killer.
Cue Ball (L) and Roni (2nd L), who are both homeless, make their way toward a market amid the city’s worst heat wave on record on July 24, 2023. Mario Tama / Staff/Getty Images
Emergency room doctors in Phoenix are on the frontlines of this challenge. This summer, physicians in Arizona have been inundated with patients suffering from heat-related illnesses, but they’ve also been seeing higher volumes of patients with chronic diseases exacerbated by heat. And burn units in the state are tending to people with severe contact burns from blazing asphalt and other hot surfaces.
All summer, Kara Geren and Frank Lovecchio, two emergency medicine physicians in Phoenix, have noticed that no matter what a patient comes in for — whether it’s chest pain or a chronic health condition such as diabetes — they also likely need fluids. “What surprised us is, even people that came in for completely unrelated things are dehydrated,” said Geren, who works at Valleywise Health Medical Center in central Phoenix. “It’s just so hard to stay hydrated.”
The patients presenting with dehydration add to the considerable number of people coming to the ER with symptoms consistent with heat-related illness: heat rashes, cramps, vomiting, diarrhea, and the most severe form of heat sickness, heat stroke.
Loveccio, who is affiliated with Valleywise and also works in a few free-standing emergency departments in the city, has been immersing patients in large tubs of cold water and even zipping them into body bags filled with ice to cool them down. Chilling intravenous fluids and oxygen before administering them to patients also helps, he said.
Dr. Frank Lovecchio demonstrates an inflatable pool-like device that can be filled with ice, used in the emergency medicine unit at Valleywise Hospital during extreme heat. The Washington Post / Contributor/Getty Images
But heat leaves an impact on the body no matter what, especially if the person is elderly, works outside, or uses drugs like opioids.
“A very large percentage of our population has issues with mental illness, drugs, and alcohol,” Geren said. “Once you put those into the mix, people’s sensation of ‘It’s hot. I need to get out of the heat’” is affected, she noted. Part of the problem is the heat hasn’t been dissipating at night, which would give people, particularly Maricopa County’s approximately 9,600 people without housing, a reprieve.
“It’s just never cool,” Geren said. “This is by far the worst year that we’ve ever seen.”
On a 100-degree Fahrenheit day, asphalt in direct sunlight will heat up to 160 degrees — more than hot enough to give someone a bad burn. Geren recently treated an elderly woman who fell on the pavement outside her house and couldn’t get up. She was found hours later and rushed to the emergency room with severe burns. “Our burn unit is very, very busy,” Lovecchio said. “If you walk across the street barefoot, there is no doubt that you would get at least a second degree, if not a third degree, burn to your feet.”
Both doctors worry about what the future might hold for Phoenix and whether they can continue to live in the state.
“This is my home, it’s been so for 30 years or so, and I hope I live here forever,” Lovecchio said. “But a lot of people have that billion-dollar question: Is it going to become unlivable? I think it’s pretty close this summer.”
Climate Connections is a collaboration between Grist and the Associated Press that explores how a changing climate is accelerating the spread of infectious diseases around the world, and how mitigation efforts demand a collective, global response. Read more here.
In the 1990s, two hurricanes devastated Samoa in the South Pacific Ocean, wiping entire communities off the map and killing dozens of people. “Everything was just decimated,” Malama Tafuna’i, a primary care physician in Apia, the territory’s capital, said. “It looked like a bomb had gone off.”
A young girl at the time, Tafuna’i watched as her father, a doctor, would go out to treat patients while her household navigated the aftermath of the storms.
“He still had to go to work and the rest of us had to figure out, you know, how do we make sure that we’ve got a shelter for tonight or where are we going to get food from?’” she said.
Tafuna’i’s early experiences help her navigate the impacts of climate change, both as a physician and as a citizen of Samoa, where extreme weather events frequently upend daily life. She uses the knowledge she has accumulated to help other doctors consider climate impacts when treating patients.
Tafuna’i, who has practiced medicine in Samoa for the better part of two decades, knows that once the hurricane-force winds die down and the flood waters recede, public health disasters — vector-borne disease outbreaks, bacterial infections, malnutrition due to crop loss — soon follow. People lose their homes in these storms and spend days exposed to mosquitoes and other pathogen-carrying insects. Decaying sanitation systems overflow and spread E. coli and other dangerous bacteria through communities. Entire fields of crops are wiped out by flooding, and families already struggling with food insecurity go hungry.
Tafuna’i can spot these links between extreme weather events and disease, but actually treating the effects of rising temperatures on the Samoan population can be tricky. It’s exceedingly difficult to assess a sick patient and determine that climate change itself is the main driver of that patient’s illness, Tafuna’i said. What she does see, however, is that climate change compounds and exacerbates existing health inequities in Samoa.
“Once a disaster hits, it sets back the whole system big time,” said Tafuna’i, adding that then “we have to figure out a way back up to wherever the starting point was at the time.”
As the planet warms, Samoans and millions of other people around the globe will increasingly see their health affected by warming. Climate change, the World Health Organization says, is the “single biggest health threat facing humanity.”
Climate-driven malnutrition, malaria, diarrhea, and heat stress are projected to kill an additional 250,000 people worldwide every year, which will come with an annual cost of between $2 and $4 billion. And those are just a few of the leading causes of climate-related mortality. There are countless other ways in which our changing planet affects human health, some of them still beyond our understanding.
Samoa only has two hospitals, one of which is a 20-bed facility staffed by junior doctors. Ten health clinics staffed primarily by nurses serve Samoa’s rural population. The Samoan medical system, severely underfunded and understaffed, is far less prepared to shoulder the burden of rising temperatures than developed countries in the West. Nevertheless, doctors like Tafuna’i, who have long worked on the front lines of the crisis, have been among the first in the world to recognize the importance of arming doctors with the tools they need to both recognize how climate change will affect human health and to properly treat patients experiencing the health ramifications of a rapidly changing environment.
For many years, Tafuna’i was the only clinical lecturer at the National University of Samoa, a tiny medical school on the island of Upolu. She noticed that the school wasn’t teaching students about climate change — an omnipresent issue on an island that is experiencing some of the most severe sea-level rise on the planet.
“You can definitely see that climate change has a huge impact on health, but it wasn’t in our curriculum at the time, and it wasn’t something we spoke about,” Tafuna’i said. So she invited colleagues from other universities, along with climate and related experts, to come speak to her students about the crisis. She also developed a climate-and-health curriculum that sent fourth-year students into remote parts of the island to analyze how climate change affects the well-being of rural communities.
In recent years, as rising temperatures have triggered public health emergencies of growing magnitude all over the globe, medical professionals and research institutions in the West have begun to catch on.
Renee Salas, a doctor at Massachusetts General Hospital in Boston, remembers the first time climate change walked into her emergency room. It was 2019, and Boston was in the throes of a record-breaking heat wave. A team of emergency medical technicians arrived in an ambulance carrying an elderly gentleman suffering from heatstroke, the deadliest form of heat-related illness. The patient’s rectal temperature was 106 degrees Fahrenheit, which meant death was imminent. The emergency workers told Salas that when they climbed up the stairs and opened the door to the man’s apartment, it felt like they were being “hit with heat from the Sahara desert.” The patient and his wife, who both lived in the apartment, didn’t have air conditioning. Just one window was cracked open.
Salas and her team managed to save the man’s life, but the incident still weighs on her. “I often think about that patient’s wife who still remained in that same apartment,” she said. “We know from data that more than one-third of heat-related deaths are due to climate change, and that is making that disease more likely.”
A year after that incident, in 2020, the Lancet, a premier medical journal, published a frightening assessment of the latest research and data on the intersection of warming and health — its “most worrying” outlook since the journal began publishing the assessments in 2016. Almost every indicator of health tracked by the dozens of interdisciplinary researchers who compiled the report, such as excess morbidity and mortality, showed evidence of climate stress (extreme weather events, vector-borne disease, wildfire smoke, the list of stressors goes on). Two-thirds of the cities surveyed by the report said they “expected climate change to seriously compromise their public health assets and infrastructure.”
After reading the report, Salas saw that climate change was threatening “the very mission” of why she went into medicine in the first place. She decided to dedicate her career to the climate-and-health overlap. But at the time, no one in her circles was thinking about how climate change was going to affect medicine. In the United States, lawmakers were still arguing over whether climate change was even happening.
In the years since, however, Salas has seen a marked shift in the way the public, especially the medical community, thinks about climate change. “This has become mainstream medicine,” she said. Climate change has infiltrated the zeitgeist at hospitals across the U.S. for one key reason: “Fundamentally,” Salas said, “climate change makes our job harder as doctors.”
In the U.S., networks and groups such as ClimateRx, the Medical Society Consortium on Climate and Health, and Climate MD have cropped up with the aim to bring “climate solutions to the bedside.” Those efforts — which include teaching doctors how to recognize climate-related illnesses, such as tick-borne diseases and heatstroke, in patients and communicating about climate change with patients in a hospital setting — haven’t been immune to typical growing pains. The disparate initiatives within the larger climate-and-health movement are disorganized, and there’s no easy way for the various sects to share data and know-how. But that’s starting to change.
In May, the National Institutes of Health funded a first-of-its-kind national Research Coordination Center on Climate and Health, based jointly at Harvard and Boston University. The research center, described as a “clearinghouse to facilitate data exchange and share best practices,” provides a blueprint for what needs to happen on a global scale.
Climate Connections: A warming planet, pathogens, and diseases
How climate change is making us sick: Animals, bugs, algae, and even fungi are shifting to accommodate an ever-hotter planet — and they’re bringing dangerous diseases with them.
Meanwhile, doctors like Tafuna’i are sitting on years of knowledge about global warming’s unbound potential to erode public health and stress health systems. Tafuna’i’s experiences teaching students and treating patients in Samoa could serve to inform and educate countries that are just beginning to confront these challenges. But, thus far, there’s been no indication that the West is looking to Samoa and other nations on the front lines of climate change for guidance.
“You can’t share your wisdom if you’re not at the table,” said Sheila Davis, chief executive officer at Partners In Health, an international public health nonprofit that helped devise a COVID-19 response in the U.S. based on prior efforts to eradicate HIV in Haiti and Ebola in Sierra Leone and Liberia. “Raising the voices of those who have the true expertise, it’s going to take all of us to push for that to happen.”
COVID-19 taught the world a valuable lesson: Pandemics can’t be defeated piecemeal. Studies indicate that the next pandemic may be fueled by climate change. The logical next step is to prepare — not individually, as siloed nations, but as a network of human beings around the world.
“How do you put a program in play that can be sustainable and then be something that’s shared?” Tafuna’i asked. “We have to decide what the priorities are for adapting to climate change.”
Climate Connections is a collaboration between Grist and the Associated Press that explores how a changing climate is accelerating the spread of infectious diseases around the world, and how mitigation efforts demand a collective, global response. Read more here.
In 2022, doctors recorded the first confirmed case of tick-borne encephalitis virus acquired in the United Kingdom.
It began with a bike ride.
A 50-year-old man was mountain biking in the North Yorkshire Moors, a national park in England known for its vast expanses of woodland and purple heather. At some point on his ride, at least one black-legged tick burrowed into his skin. Five days later, the mountain biker developed symptoms commonly associated with a viral infection: fatigue, muscle pain, fever.
At first, he seemed to be on the mend, but about a week later, the man began to lose coordination. An MRI scan revealed he had developed encephalitis, or swelling of the brain. He had been infected with tick-borne encephalitis, or TBE, a potentially deadly disease that experts say is spreading into new regions due in large part to global warming.
For the past 30 years, the U.K. has become roughly 1 degree Celsius warmer on average compared to the historical norm. Studies have shown that several tick-borne illnesses are becoming more prevalent because of climate change. Public health officials are particularly concerned about TBE, which is deadlier than more well-known tick diseases such as Lyme due to the way it has quickly jumped from country to country.
Gábor Földvári, an expert at the Center for Ecological Research in Hungary, said the effects of climate change on TBE are unmistakable.
“It’s a really common problem that was absent 20 or 30 years ago.”
Ticks can’t survive more than a couple of days in temperatures below zero, but they’re able to persevere in very warm conditions as long as there’s enough humidity in the environment. As Earth warms on average and winters become milder, ticks are becoming active earlier in the year. Climate change affects ticks at every stage of their life cycle — egg, six-legged larva, eight-legged nymph, and adult — by extending the length of time ticks actively feed on humans and animals. Even a fraction of a degree of global warming creates more opportunity for ticks to breed and spread disease.
“The number of overwintering ticks is increasing, and in spring there is high activity of ticks,” said Gerhard Dobler, a doctor who works at the German Center for Infection Research. “This may increase the contact between infected ticks and humans and cause more disease.”
Since the virus was first discovered in the 1930s, it has mainly been found in Europe and parts of Asia, including Siberia and the northern regions of China. The same type of tick carries the disease in these areas, but the virus subtype — of which there are several — varies by region. In places where the virus is endemic, tick bites are the leading cause of encephalitis, though the virus can also be acquired by consuming raw milk from tick-infected cattle. TBE has not been found in the United States, though a few Americans have contracted the virus while traveling in Europe.
According to the World Health Organization, there are between 10,000 and 12,000 cases of the disease in Europe and northern Asia each year. The total number of cases worldwide is likely an undercount, as case counts are unreliable in countries where the population has low awareness of the disease and local health departments are not required to report cases to the government. But experts say there has been a clear uptick since the 1990s, especially in countries where the disease used to be uncommon.
“We see an increasing trend of human cases,” Dobler said, citing rising cases in Austria, Germany, Estonia, Latvia, and other European countries.
TBE is not always life-threatening. On average, about 10 percent of infections develop into the severe form of the illness, which often requires hospitalization. Once severe symptoms develop, however, there is no cure for the disease. The death rate among those who develop severe symptoms ranges from 1 to 35 percent, depending on the virus subtype, with the far-eastern subtype being the deadliest. In Europe, for example, 16 deaths were recorded in 2020 out of roughly 3,700 confirmed cases.
Up to half of survivors of severe TBE have lingering neurological problems, such as sleeplessness and aggressiveness. Many infected people are asymptomatic or only develop mild symptoms, Dobler said, so the true caseload could be up to 10 times higher in some regions than reports estimate.
While there are two TBE vaccines in circulation, vaccine uptake is low in regions where the virus is new. Neither vaccine covers all of the three most prevalent subtypes, and a 2020 study called for development of a new vaccine that offers higher protection against the virus. In Austria, for example, the TBE vaccine rate is near 85 percent, Dobler said, and yet the number of human cases continues to trend upward — a sign, in his opinion, of climate change’s influence on the disease.
In Central and Northern Europe, where for the past decade average annual temperatures have been roughly 2 degrees Celsius above preindustrial times, documented cases of the virus have been rising in recent decades — evidence, some experts say, that rising global temperatures are conducive to more active ticks. The parasitic arachnids are also noted to be moving further north and higher in altitude as formerly inhospitable terrain warms to their preferred temperature range. Northern parts of Russia are a prime example of where TBE-infected ticks have moved in. And some previously tick-free mountains in Germany and Austria are reporting a 20-fold increase in cases over the past 10 years.
The virus’s growing shadow across Europe, Asia, and now parts of the United Kingdom throws the dangers of tick-borne disease into sharp relief. The U.K. bicyclist who was the first domestically acquired case of the disease survived his bout with TBE, but the episode serves as a warning to the region: Though the virus is still rare, it may not stay that way for long.
It’s been nearly a year since Democratic lawmakers pushed the first new climate spending legislation in more than a decade over the congressional finish line. The Inflation Reduction Act of 2022, or IRA, includes $369 billion in clean-energy tax credits and funding for climate and energy programs, money that is already trickling into the economy as federal agencies begin to distribute it.
The Biden administration said the bill will help deliver on the president’s pledge to cut the United States’ emissions in half by 2030, and independent analyses estimated that it would help slash domestic emissions by 43 to 48 percent below 2005 levels by 2035. Now, researchers have made an updated prediction. The Rhodium Group, an independent analytics firm that tracks greenhouse gas emissions produced by the U.S. economy, published a report on Thursday that shows just how much climate progress the IRA will usher in — and where the legislation will fall flat.
“Nearly one year after it passed, the IRA’s effects are coming into clearer focus,” a spokesperson for Rhodium Group said.
The report, the ninth edition of Rhodium’s annual emissions assessment, found that the IRA and state-level climate bills that have been signed into law by governors across the country in recent years will drive emissions down between 29 and 42 percent in 2030, compared to 2005 levels. By 2035, greenhouse gas emissions will decrease between 32 and 51 percent. Prior to the IRA’s passage, the nation was on track to cut emissions by 26 to 41 percent by 2035, according to Rhodium’s estimate from 2022. Rhodium called the overall reductions “a meaningful departure from previous years’ expectations for the U.S. emissions trajectory.”
Thanks to the IRA’s subsidies, solar and wind energy are already becoming a lot cheaper: solar by nearly 40 percent and wind by 55 percent. The legislation will also influence the speed with which electric vehicles replace gas-powered cars. In 2035, electric vehicles will comprise between one-third and two-thirds of all passenger car sales, the report said. That’s meaningful progress, but the emissions reductions aren’t steep enough to get the U.S. fully on track to meet its pledge to reduce emissions 50 to 52 percent by 2030 under the Paris Agreement, the 2015 international treaty on climate change that aims to keep global warming below 1.5 degrees Celsius (2.7 degrees Fahrenheit).
That’s because federal policy levers are only one piece of the decarbonization puzzle. A number of other factors could influence the speed and extent to which renewable energy technologies replace oil, coal, and gas, including how the industrial sector behaves and whether states continue to pass ambitious climate policies.
And because the IRA revolves around incentives for clean energy, rather than penalties for fossil fuel use, some of the factors impacting the speed with which the economy decarbonizes won’t be influenced by the federal legislation.
For example, Rhodium projects that natural gas, which made up roughly 36 percent of the nation’s power mix in 2022, will comprise 6 to 29 percent of the power supply by 2035, depending on whether utilities take advantage of the incentives in the bill and what types of renewable energies are feasible in their markets. Natural gas, a cheap source of energy, surpassed coal as the nation’s leading source of electricity in 2016. Despite the incentives in the IRA, gas is still abundant, affordable, and here to stay for the foreseeable future.
In New York City, a city that has positioned itself as a leader in the green transition and has vowed to reduce fossil fuel use 80 percent by 2050, environmental activists successfully lobbied for the closure of the nearby Indian Point Nuclear plant, which prompted the city to temporarily rely on natural gas-powered plants as it works to build infrastructure that can funnel hydropower from Canada to Queens.
Over the course of the next decade, policymakers, regulators, and utility executives will weigh similar trade-offs between cost, climate impact, and public opinion across the country, and they won’t all choose the same path. That will result in a patchy network of green and dirty electricity. The ranges presented in the new Rhodium report account for that patchiness.
But they also show that the IRA is making a difference. “Though there’s uncertainty on just how fast the U.S. scales up renewable energy on the grid or EVs on the road, those levels of deployment would be meaningfully lower than what we’re estimating in our modeling under otherwise the same conditions absent the IRA,” Ben King, lead author of the report, told Grist.
In order to continue making progress on climate change, Congress will likely need to pass additional climate laws, including legislation directed at hastening the permitting process for new large-scale renewable energy projects, beefing up the green energy workforce, and resolving kinks in the supply chain that are hamstringing green technology deployment. That has become harder to do since Republicans retook control of the House of Representatives in January.
The goals of the Paris Agreement are still within reach, the report reads, “but getting there won’t be easy.”
Climate Connections is a collaboration between Grist and the Associated Press that explores how a changing climate is accelerating the spread of infectious diseases around the world, and how mitigation efforts demand a collective, global response.
A young girl, home alone, wakes up in the middle of the night and walks over to her neighbor’s house. She opens the front door and encounters a horrific scene: a zombified grandma committing an act of cannibalism. Instead of teeth in the woman’s mouth, it’s long tendrils of fungus.
That’s one of the first scenes in The Last of Us, the HBO show about a global fungal pandemic that gripped viewers this past winter. The premise is pure fiction. The fungus depicted in the show, cordyceps, is harmless to humans. But the world’s susceptibility to fungal pathogens is genuine. When the real fungal pandemic comes, it won’t look like anything you’ve seen on screen.
In her new book Blight: Fungi and the Coming Pandemic, author, professor, and researcher Emily Monosson unravels the expansive and unsettling history of fungal invasions across the globe and how they have shaped our lives in both visible and invisible ways. A fungus called batrachochytrium dendrobatidis, or Bd, has wiped out more than 200 species of frogs and other amphibians. White-nose syndrome, a fungal illness in bats, has killed millions of the winged critters across North America. A fungal pathogen wiped out the world’s most popular banana, the Gros Michel, in the first half of the 20th century. Fungi are now coming for the Cavendish, the banana we bred to replace the bananas we lost.
And, of course, fungi threaten humans, too — not just by decimating the biodiversity of the world around us, but also by infiltrating our bodies and causing new illnesses. Candida auris, a drug-resistant yeast, emerged in 2009 on three continents simultaneously. The disease, Monosson writes in her book, “seemed to come from nowhere and everywhere at once.” C. auris quickly started claiming lives, particularly in hospital settings, where it preys on the immunocompromised. The pathogen kills roughly one-third of hospitalized patients, according to an analysis of hospital data collected between 2017 and 2022, and that’s likely an underestimate.
Some researchers theorize that C. auris has always lived among us, unable to survive inside the human body due to our species’ high internal temperature. But as global temperatures have risen over the decades, the fungus may have evolved to adapt to a warmer climate. Climate change, the theory goes, has trained C. auris how to infiltrate our bodies. And global warming could help other fungal pathogens spread, too.
A 1964 histological slide shows a lung infected with Valley fever, a disease caused by the fungus Coccidioides immitis. Image courtesy CDC/Dr. Martin Hicklin. Courtesy CDC/Dr. Martin Hicklin, Photo by Smith Collection/Gado/Getty Images
“Over the past century fungal infections have caused catastrophic losses in other species, but so far we have been lucky,” Monosson writes. “Our luck may be running out.” She calls for better prevention measures — regulations on the import of foreign flora and fauna, better testing technologies for plants and animals that cross borders, and more funding for conservation work that protects wild species in their existing habitats. Blight: Fungi and the Coming Pandemic is available this week in bookstores and libraries.
This Q&A has been edited and condensed for clarity and length.
Q.Readers might pick up your book and assume it is entirely focused on the impact of fungal disease on human health. But Blight is about so much more. Can you speak to your approach here? What overarching story were you trying to tell?
A.The thing that got me started thinking about the book was a paper that was written years ago by a group of different scientists across disciplines. They were in medicine, ecology, agriculture, and a few others. That’s kind of unusual, to see a review written by so many different scientists. The focus of the paper was fungi, and they were trying to get people more aware. They felt that people didn’t really appreciate the potential consequences of large fungal infections.
For a lot of us, once in a while in the news we’ll hear, “Oh, we’re not going to have our bananas anymore,” or “The frogs are dying,” or “The bats are dying.” But you hear those warnings and then it goes out of the news cycle and seems like, oh, OK that was a weird thing.
If you talk to somebody who’s in any of these fields, you’ll see that it’s not so odd that this is happening, because fungal pathogens can be really catastrophic when they strike. So the purpose of the book was to put all of this together, to say that these aren’t just one-offs. We need to think about the potential of fungal pathogens and the breadth of impact that they have across species.
Q.Blight is about fungi, yes, but it’s also about facets of modern life that researchers have been worried about for quite some time — globalization, biosecurity, climate change. How are all of these things connected?
A.The first epidemics and pandemics that I write about, the decline of the chestnut and pine blister rust in forests, started about 100 years ago. And for forever before that there were fungal pathogens in agriculture —- probably ever since humans started doing agriculture. But most of the book focuses on the past 100 years. And that’s because there’s been an increase in fungal pandemics or epidemics across species in the last 100 years. That’s because we have been moving plants and animals around, and ourselves around, at a rate that is really unprecedented in our long history on Earth.
Every time you move something around, there’s all sorts of other things on them. And when we take them to another place, they have the opportunity to find a new host. And if that host is susceptible, then you’ve got a problem. So between trade, travel, and the changing climate that you mentioned, there’s potential for fungi to adapt to changes in crops and agriculture, and adapt to warmer temperatures and drought conditions faster than, say, a crop can. Fungi are adaptable. And there’s a pretty good chance that fungi will be able to adapt to a changing temperature or changing climate.
Patients in California undergo treatment for Valley fever. Brian Vander Brug / Los Angeles Times via Getty Images
Q.This book is publishing at a moment when a lot of people are thinking about pathogenic fungi thanks to recent news reports about Candida aurisand the success of The Last of Us. Cordyceps is a harmless fungus, but there are very real fungal threats out there. Can you talk about Candida auris and why you chose to feature it in the beginning of your book?
A.To be honest, I hoped that Candida auris might draw readers in and then they’d read about all the other problems across other species. But it is also one of the newest emergent fungal diseases. It was kind of unknown until 2009 or 2010, and then the CDC issued its first warning about Candida auris in 2016. So it’s really pretty new, and we don’t often get a really new emergence, except for something like COVID. But COVID is viral — that’s almost to be expected. To have a newly emergent fungal pathogen was something different.
What was most interesting about Candida auris, and I think what was most frightening to public health workers and doctors, is that it emerged in many different places at once, within a couple of years. And when it emerged, it was different strains of the fungus, which means that it wasn’t like COVID where it could be traced back to one patient zero. So that was something odd, and I don’t think anyone really knows why.
One thought is maybe climate change: Maybe this fungus was just out living in the environment, as many do, and not bothering us. And it couldn’t really survive in our warmer bodies. It didn’t tolerate our internal temperature. But with warmer and warmer days over time, that fungus eventually evolved to be able to tolerate our temperature and could live in us. And when it did, it became a problem.
I should qualify that humans are pretty well protected against fungal pathogens. We have our temperature, for one, but we also have a pretty robust immune system that can fend off most fungi. We’re all breathing spores right now. And for most of us, it’s not a problem. But if you’re immunocompromised, and there are a growing number of people who are immunocompromised, then the threat of a fungal pathogen is more important.
Q.You’ve written books on a number of topics, including chemicals, genes, and germs. Why did you choose to focus on fungi this time?
A.It was a personal experience of having a fungus-like organism kill my tomatoes. Just seeing that happen, I got interested in it. So I thought I’d write a little article about it. And that’s around the same time that paper I mentioned came out. It was curiosity at first, because I didn’t really think about fungal pathogens back then.
I started this in 2019, before COVID. When it was clear that COVID was something really big and bad, I actually emailed my editor and I was like, “Should I keep writing this? Because who is going to want to read about a pandemic after we get through this pandemic?”
Q.But you kept going. Is that because there’s light at the end of the tunnel?
A.I think the hopeful thing is there’s a lot of really passionate scientists working on these problems. We should support them, the policies that may come out of the science, the conservation organizations that are trying to do prevention work. Really the goal here is prevention, and that involves all of us.
We need to take responsibility for our actions. I know that’s trite. But maybe if we are even a little more thoughtful about how we do things, what we think we “need” in our lives, and how that impacts the world around us — we might do less harm to the natural world and to other humans.
This story is part of Record High, a Grist series examining extreme heat and its impact on how — and where — we live.
On an early August morning in 2021, a family — two parents in their 30s and 40s, their 1-year-old, and a big dog — set out on a hike near Yosemite National Park in California. The temperature was a comfortable 70 degrees Fahrenheit when they started out, but the day became dangerously hot as the four began the climb back up to where their truck was parked. At ground level, the temperature was likely hotter than 110 degrees F. They never made it back. All four of them — the dog, the parents, the baby — died on the trail.
County sheriffs struggled to determine what caused a healthy family to drop dead with no evidence of foul play or struggle. Was it toxic algae from the river that flowed along the bottom of the gulch they hiked beside? Did they accidentally breathe in carbon monoxide from an open mine shaft near the trail? But the answer was right in front of them the whole time. Two months after the bodies were found, authorities announced the official cause of death: hyperthermia and dehydration. The family had overheated.
That story is one of many examples of heat’s deadly toll in The Heat Will Kill You First, author and climate change journalist Jeff Goodell’s new opus about extreme heat. “If there’s one thing in this book that will save your life,” Goodell writes, “it is this: … if your body gets too hot too fast — it doesn’t matter if that heat comes from the outside on a hot day or the inside from a raging fever — you are in big trouble.”
Heat is an invisible, stealthy force, Goodell explains. Because we’re all familiar with it, we think we know how to handle it, how to game it. But heat can’t be negotiated with past a certain threshold — if your body gets hot enough, you die. It’s as simple as that.
The Heat Will Kill You First reveals how heat has fundamentally shaped the arc of human evolution, perhaps even inspiring our ancestors to stand upright, off the hot ground, millions of years ago. The book’s take-home message, however, is about the future. Humans have changed the natural course of the planet. Climate change is forcing us out of the temperature range we’re used to and into uncharted territory. What comes next?
“My goal in this book is to help people understand what risks we face as our world gets hotter and hotter,” Goodell told Grist. The Heat Will Kill You First is available this week in bookstores and libraries.
This Q&A has been edited and condensed for clarity and length.
Q.In your book, you sketch out a full spectrum of heat-related catastrophes across the globe — a deadly heatwave in Paris, the deaths of migrants in the Sonoran Desert, hurricanes in Houston. What overarching story are you trying to tell by bringing those various threads together?
A.I think the overarching idea is that our understanding of the threats and risks of extreme heat is very nil, and that the risks and threats have been greatly underestimated. I really wanted to write about heat as this kind of invisible force in our world. We talk about things being hot in a kind of complimentary way where we meet somebody and they’re hot or we see a new movie and it’s hot, but we don’t really think about what heat is. And my goal in this book is to articulate that.
Q.There are so many climate impacts that are so visible. Heat, as you say, is invisible but it’s extremely visceral once it hits.
A.When anyone talks about climate change, they talk about the litany of things that climate change is going to do: the longer droughts and higher sea levels and increased precipitation and stronger hurricanes. But heat is the primary driver of all this stuff. The reason that the wildfires are burning in Alberta, the reason that there are orange skies in New York is all because of more and more heat. Heat is like the engine of planetary chaos in our world. But it’s very difficult to communicate about because it is not like a hurricane where you have dramatic images of storm surge coming in and trees blowing around and roofs flying off houses. Heat is literally an invisible force that is profoundly shaping our world.
But heat is also really hard to talk about and think about partly because it’s so familiar. I mean, everybody knows temperature, right? Everybody knows what a hot day is, a cold day is. Babies know this, right? I started writing this book when I had to take a walk in Phoenix 10 blocks or so downtown. And I thought I was going to die, it was so hot. And I realized that not only did I not understand the risks of heat and what it does to our bodies, but I didn’t even understand what heat is. And this is after I’ve been writing about climate change for 15 years.
Portland, Oregon, residents fill a cooling center with a capacity of about 300 people at the Oregon Convention Center in June 2021. Nathan Howard / Getty Images
Q.There’s a perception in the wealthy West that climate change will affect us more slowly than other parts of the world. And while that’s true in many ways, you make the case in your book that heat is a universal, democratic force. Can you speak to your conception of heat and how it’s moving through society?
A.Everything that lives, whether it’s me or you or your mom or my mom or your ancestors or the pine trees in the backyard or the ants crawling across the floor or the lions in Africa, they all have thermal limits that they live in. Our bodies are very sensitive to heat. We work really hard to keep our bodies to 98.6 degrees Fahrenheit or thereabouts. And if it goes just a little bit off, I mean, everybody knows if you get a temperature of 101, 102, you’re in trouble. Something’s really wrong. Get to 105 and you better be in an emergency room. So it’s a very narrow range, and that affects all living things. Everything about our world has evolved in this sort of stable climate niche. Not too hot, not too cold, this kind of Goldilocks climate. And as we continue burning fossil fuels and dumping CO2 into the atmosphere, we’re moving out of that Goldilocks climate.
So heat is profoundly democratic in the sense that it affects everyone and everything that lives. People are saying, “Oh, well, yeah, that’s true, maybe. But, you know, we have air conditioning, we’re going to adapt, we’re smart and all that.” And that’s true. We are going to adapt. We do have air conditioning. But not everybody has air conditioning and not every thing has air conditioning. We’re not air conditioning the air. We’re not air conditioning the forest. The cornfields, the wheat fields that produce the food that we eat.
And there’s a profound gap in every city, everywhere, between people who have air conditioning and people who don’t. I wrote about that a lot in my book, this gap between the “cooled and the doomed.” So, yes, we can adapt. But even this notion that you and I are going to be OK, the rich Westerners, because we have air conditioning — well, yeah, fine, except when the power goes out. If you have an extreme heat wave like we’ve been having in Texas, and in the middle of that you lose power for a day or two, people will die. Lots of people, thousands of people. And so our comfort and sense of reliance on air conditioning is also in itself very dangerous.
Q.You’re publishing a book about heat, one that I assume was in the works for a number of years, at an extremely auspicious time. The globe is breaking heat records. The first days of July were the hottest ever recorded in human history. Did you think this might happen?
A.It would be funny if I could say, “Yes, I knew that in July of 2023, when my book was published, that we would have this extreme heat wave.” But no, it’s really weird. It’s like I’m living in my own Stephen King novel. It’s very eerie and spooky. But, that said, when I started this book in 2019, heat was not exactly a secret anymore. We’ve been talking about global warming for 30 years, 40 years. But it became clear to me that we hadn’t given it full consideration. So it seemed like fertile ground for a book.
I had no idea that this summer was going to happen and unfold the way it has. But there was a certain inevitability four years ago, when I started the book, that heat was going to become more and more of an issue because, after all, we are heating up our planet very quickly. And so understanding heat and how to deal with it and what the risks and dangers are seemed to be a pretty important question.
Q.You’ve been a climate reporter for many years, which means you’ve been witness to the many, many iterations of the public’s understanding of climate change. How does this moment feel to you now? Do you feel like we’ve entered a new era?
A.There’s certainly been a cultural shift about it, right? When I first started writing about climate change, I would tell people that I ran into at dinner parties or whatever that I was writing about climate change and they would kind of look at me with this cute little smile as if I was writing about the sex life of porcupines or something. And now everybody’s talking about it. The impacts of it economically and impacts on public health — it’s much more mainstream in the sense of it being a subject of discussion.
But we are — and heat is a great example of this — we are not even at the beginning of the beginning of the beginning of understanding the implications of what we’re doing and understanding the consequences of what we’re doing. I don’t mean that just in the grandest way, but also just in the simplest way. We don’t really understand how fast this can happen and what the real tipping points are.
Two years ago, in 2021, we had an extreme heat wave in the Pacific Northwest that everybody heard about. It was 121 degrees in British Columbia. No climate model was thinking about that, it was like snow in the Sahara or something. And it just shows how complex the system is that we’re messing around with. The great scientist and oceanographer Wally Broecker said two decades ago that dumping fossil fuels into the atmosphere is like poking a dragon, you never know how the dragon’s going to react. And that that is still as true today as it was 20 years ago when he said that.
