PDPH Advisory – Preventing Heat-related Illness during Excessive Summer Heat and COVID-19

On June 2, the Philadelphia Department of Public Health released a health advisory regarding the prevention of heat-related illness during excessive summer heat and COVID-19:

Summary Points:

  • Patients should not let COVID-19 stop them from accessing medical care for heat-related illnesses.
  • Educate patients about how to stay cool and recognize early symptoms of heat-related illness.
  • Discuss environmental risks in patients’ homes during clinical assessment.
  • Encourage family members and caretakers to check in on seniors, especially individuals who are living alone.
  • Raise awareness about City services that may be activated during a Heat Health Emergency.

COVID-19 may present additional challenges for individuals at risk of heat-related illnesses and exacerbation of chronic conditions caused by excessive heat. You can help prevent heat-related health complications by providing guidance about risks and sharing information about resources with patients and their caregivers. This summer, strategies to prevent the spread of COVID-19 must also be considered when identifying ways to stay cool.

Many patients at increased risk for heat-related illness are also at increased risk for complications resulting from COVID-19 infection. Assist the following groups to safely reduce their risk of COVID-19 infection and stay safe in the heat:

  • Individuals that are 65 years of age or older
  • People with chronic health conditions, including:
    • Cardiovascular, respiratory, or renal disease
    • Metabolic disorders (e.g., diabetes)
    • Psychiatric illness, such as schizophrenia
    • Cognitive or developmental disorders that impair judgment or self-care
    • Patients taking medications that impair thermoregulation (e.g., diuretics, anticholinergics, and neuroleptics)
  • People who use alcohol or drugs
  • People who are socially isolated, living alone or have limited mobility
  • People experiencing homelessness
  • Outdoor workers, particularly those who work during the day
  • People who do not have air conditioning in their homes

During the summer season and COVID-19 pandemic, the Philadelphia Department of Public Health (PDPH) recommends that healthcare providers assess patients for both COVID-19 risk and heat-related illness risk:

  • Remind patients and caregivers about the importance of seeking medical attention for heat-related illnesses. Patients experiencing symptoms of heat stroke should call 911. Patients who are vomiting or experiencing worsening symptoms of heat exhaustion for more than 1 hour should seek immediate medical attention.
  • Expect that patients may be reluctant to access care due to fear of exposure to COVID-19. Remind and assure patients of telehealth options and infection control and safety measures that are being taken at your facility.
Heat Stroke Heat Exhaustion
Very high body temperature Heavy sweating
Red, hot, dry skin (no sweating) Headache
Rapid, strong pulse Weakness
Headache Fatigue
Dizziness Dizziness
Nausea Nausea and vomiting
Confusion, loss of consciousness Muscle cramps
  • Educate at-risk patients on ways to stay cool, hydrated and safe from COVID-19:
    • Stress the importance of using air conditioning at home if available.
      • Suggest that air conditioners be set to 78° or “low” at home to provide relief while also conserving energy and reducing electricity costs.
      • If seeking cooling outside the home, advise to continue to practice social distancing and maintain six feet of distance between themselves and others.
      • Discuss environmental risks in patients’ homes during regular clinical assessment, such as the lack of air conditioning or improper ventilation.
    • Advise patients to increase fluid intake (if appropriate), preferably by drinking water. Alcohol, caffeine, and sugary drinks should be avoided.
    • Masks and face coverings should continue to be worn when patients are in public and unable to social distance. Hot weather will make masks more uncomfortable, so public outings should be limited if possible.
      • Advise to choose lightweight, cotton fabrics and to change the mask if it gets damp.
  • Encourage caregivers and family members to monitor at-risk patients frequently.
  • Raise awareness about government services that may be activated during a Heat Health Emergency:
    • Philadelphia Corporation for Aging (PCA) Heatline (215-765-9040): callers can get information on heat safety or talk to a nurse about heat-related medical concerns.
    • PECO has suspended service disconnections through July 1. Utility shut-offs will also be halted during declared heat health emergencies.
      • Additional assistance to pay electric bills is available through the LIHEAP Recovery Crisis Program. Eligible households can apply for up to $800 at www.compass.state.pa.us or by calling 215-560-1583.

Additional information about staying safe during excessive heat and ways to protect patients from COVID-19 are available on the Health Information Portal.

 

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