Duke Experts on How to Survive Severe Heat

What policymakers and state residents need to know

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Updated June 24, 2024: The National Weather Service forecasts that hazardous heat will continue into the coming weekend for North Carolina, putting people at risk for heat-related illnesses. We’ve updated an earlier story offering Duke experts’ advice on cooling strategies to beat the temperatures.

Severe heat expert Ashley Ward offers 10 tips for staying safe when it's hot.

With summer just around the corner, Duke University scholars have teamed up with North Carolina state agencies to provide counties with new tools for protecting residents and workers from heat-related health impacts.

Launched on Earth Day, the Heat Action Plan Toolkit features a heat action plan template that each of North Carolina’s 100 counties can customize to fit their unique needs and circumstances. The toolkit also includes outreach resources for communities, as well as recommended actions for health care staff and local leaders when extreme heat is in the forecast.

Over the past year, experts from the Heat Policy Innovation Hub at Duke’s Nicholas Institute for Energy, Environment & Sustainability have collaborated on the toolkit with three state agencies—the North Carolina Office of Recovery and Resiliency (NCORR), North Carolina State Climate Office and North Carolina Division of Public Health.

Duke and agency experts worked together to design the plan template and resources with strong research underpinnings. They also engaged with people on the front lines in different regions of North Carolina to glean insights that shaped toolkit development.

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“North Carolina is a leader in creating a county-level heat action plan toolkit that is grounded in evidence, informed by community engagement and customizable for diverse geographic and social contexts,” said Ashley Ward, director of the Heat Policy Innovation Hub. “Providing concrete guidance to counties on how to plan, prepare and respond to extreme heat is critical to protect our communities, particularly those most vulnerable. I hope other states will follow North Carolina’s lead.”

The adaptability of the plan template relies on modeling created by Jordan Clark, senior policy associate at the Nicholas Institute, working closely with the State Climate Office. Clark used historical data for emergency department visits in the North Carolina Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT) to develop regional thresholds for extreme heat. Those thresholds act as triggers for counties to initiate their heat action plans and for the North Carolina Climate and Health Team to issue alerts from its new Heat Health Alert System.

The work hasn’t stopped with the release of the toolkit. Clark and the hub’s partners are further refining the modeling with updated NC DETECT data, and they are incorporating seasonal variation into the thresholds.

The hub also played a key role in community engagement efforts. Representatives from each of the four lead organizations convened a workshop in July 2023 with state agency officials and local leaders from a climatologically and demographically diverse group of 10 counties. Participants helped the organizers better understand how counties would develop and deploy their plans and identified gaps in resources and knowledge.

Beat the Heat: Cooling Strategies to Stay Safe Moving to an air-conditioned or shaded environment is always a good first step. Here are actions you can take with or without AC Know the Signs: Heat Cramps -- Heavy sweating; muscle cramps and spasms. heat Exhaustion: heavy sweating, dizziness, headache, fast, weak pulse, thirst, irritability, nausea. What to do: fans, cool foot bath, cool shower, wet clothing. Heat Stroke -- hot dry skin,l confusion, loss of consciousness, fast, strong pulse, body temperature of 103. What to do: Call 911, sip cool liguids if alert and awake, move to a cool environment, if possible or wipe down with cool towels, heat stroke can cause death or disability without emergency treatment.
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Ahead of the toolkit’s release, Ward joined state and local experts for an introductory webinar on the health risks posed by extreme heat. Topics covered in the webinar included the state's changing temperatures, evidence-based strategies for preventing heat-related illnesses, how communities are already preparing and how the state government can help.

“In North Carolina we're extremely fortunate to have so many strong university and state efforts devoted to addressing our greatest climate challenges, like dangerous extreme heat,” said Kathie Dello, director of the North Carolina State Climate Office. “This partnership with Duke, the State Climate Office at NC State, and state agencies like NCORR and NCDHHS demonstrates our state's strength in developing data-driven, solutions-oriented products to ensure that North Carolinians thrive in a changing climate.”

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The Heat Policy Innovation Hub brings together scientists and communities to develop and deploy innovative policy solutions that reduce the impacts of extreme heat on human health and well-being. The toolkit is just one example of how the hub is partnering with federal, state and local agencies to plan and prepare for extreme heat.

In April 2023, the Federal Emergency Management Agency (FEMA) issued policy guidance that for the first time required state emergency managers to consider climate change and equity in disaster planning. Ward and Clark wrote a supplemental report that offered recommendations for state emergency managers to adequately evaluate the threat of extreme heat as they update their federally mandated hazard mitigation plans.

Ahead of the 2023–2024 school year, Clark published a comprehensive strategy for high school athletic associations to ensure the health and well-being of student-athletes as they train and compete in high temperatures. The policy brief targets improvements in measuring heat stress, activity modification guidelines and emergency action plans that can be implemented across sports and venues.

“As we see all too often, heat-related illnesses are preventable—with the right knowledge, preparation and planning,” Ward said. “Duke’s Heat Policy Innovation Hub is eager to build purposeful partnerships with the public and private sectors to develop practical policy solutions that safeguard communities against the health impacts of extreme heat.”

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