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Changes to heatwave advice amid pandemic


Anastasia Tsirtsakis


7/12/2020 2:43:19 PM

GPs are being encouraged to help patients prepare and plan for extreme heat this summer – while keeping COVID safe.

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Heatwaves have continued to intensify in Australia, with the annual average temperature expected to increase by up to 1.3°C by 2030.

The Australian Climate Council predicted in 2016 that extreme heat was set to increase across the continent, with heatwaves likely to become longer, hotter and more frequent.
 
But it is no longer a mere prediction.
 
Australia just experienced its hottest November on record, with temperatures soaring almost 20°C above the spring average in some parts of the country.
 
While the usual principles to prepare, plan, and protect against extreme heat still persist, being in the midst of a pandemic means this year’s advice is a little different.
 
‘We used to advise people to go to a public place with air conditioning on very hot days, such as a shopping centre, as we know many people don’t have access to a cool home,’ RACGP Victoria Chair Dr Anita Muñoz said.
 
‘[But] COVID-19 is highly contagious, and the last thing we want is people, particularly vulnerable people, gathering in public places during heatwaves.
 
‘Instead, we want to get the message out to people to prepare for the heat in other ways.’
 
The RACGP is encouraging patients concerned about what to do in times of extreme heat to make an appointment with their GP.
 
Dr Adi Vyas, Acting Director of the Environmental Health Branch at NSW Health, which is behind the campaign Beat the heat, agrees.
 
While it can be difficult to measure mortality directly relating to heatwaves, there is no doubt extreme heat has an impact. The Victorian heatwave in January 2009 saw 374 more deaths than the mean number of deaths for the previous five years.
 
Dr Vyas says GPs have an important role to play in helping patients prepare, particularly vulnerable cohorts.
 
‘It’s really important for all groups of the population to be aware of what the heatwave risks are, and GPs are really well-placed to inform them,’ he told newsGP.
 
‘Anyone is affected by heat, but we know that people with chronic conditions are more susceptible to the effects and that’s a sometimes a missed group.
 
‘Some medications can dehydrate you or increase fluid loss, or change the way the body regulates itself. These things can have a significant impact during heatwaves.
 
‘So what patients and also GPs can do is to make sure that you’re having a conversation now ahead of a heatwave season and make sure that your management plans are up-to-date and in place.’
 
In addition to optimising any medications, Dr Vyas says GPs can help to educate patients regarding actions to take when there is a heatwave, and to apply those actions to prepare their home.
 
‘This is sometimes forgotten,’ he said.
 
‘Some people live in homes that are not well insulated, or they might be older homes, so making sure that simple things are put in place.
 
‘Know what part of the house usually can be cooled and try to focus your efforts there. Make sure your windows have blinds that can be closed and blinds that are not actually going to be reflective and make your home hotter. You might consider external awnings to be put in place, and other things like that.
 
‘Also making sure that if you do use appliances, like an air conditioner or a fan, that it is well-functioning and you’re aware how to use them effectively.’
 
While people are not being encouraged to congregate in public places, in the event they do, Dr Vyas says GPs should remind patients to adhere to COVID-safe behaviours.
 
‘Make sure that we’re staying 1.5 m from other groups, and also have a kit ready with you –  a mask where it’s not possible to physically distance, but also making sure to have a bottle of water and hand sanitiser as well,’ he said.
 
Dr Vyas says people should also be mindful of looking out for those around them.
 
‘When we encourage people to plan ahead and think about protecting themselves during a heatwave, it also means those that are vulnerable around them, and that is about catching up with people and making sure older relatives are looked after,’ he said.
 
‘This means providing them as well with some key messages like staying hydrated and avoiding things that are likely to make you more dehydrated like alcohol, tea and sugary drinks.
 
‘A way to do this would be to make sure that we meet with them virtually where possible, so with a phone call or a video call, rather than visiting them in person.
 
‘There are also services like the Red Cross who provide a check-in service by phone to people that are particularly vulnerable or socially isolated. So it’s good to check up on those services that might be available for patients as well.’
 
The RACGP has released a fact sheet, Emergency planning and response in general practice, which includes heatwaves and features a number of strategies that general practices can implement to support vulnerable patients who may need assistance prior to, during or after an extreme weather event.
 
‘We have done a great job in Australia to stop the COVID-19 virus spreading, and we don’t want to go backwards and see another spike in cases,’ Dr Muñoz said.
 
‘This is why the RACGP is changing its advice for patients in times of extreme heat, particularly those who are more vulnerable, such as older people.’
 
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