HEAT RASH
In recent weeks and months there has been a whole rash of articles about rising temperatures killing people. The reporting started with the tragic news of all the folks who had died in this year’s pilgrimage to Mecca. As temperatures rose above 51°C, outside authorities admitted almost 600 had succumbed to extreme heat exhaustion. A fuller estimation after the event reported the number was more than twice as high and that 1,300 pilgrims died there in 2024 due to their inability to avoid some of the hottest temperatures on the planet.
I’m well aware that many die every year at the event. And each year those are figures Saudi officials work to minimize or entirely conceal. Not only do hundreds die every year, as will happen at almost any event attended by millions of people, but many of those people are elderly and have saved for many decades to purposefully travel there at the end of their life and are commonly travelling from afar. So the situation is really pretty far from unexpected.
And it’s not just heat that strikes people down. There are also very regular accidents, such as stampedes, bridge collapses, unintentional stonings (yes, you read that right), and the like, any one of which has killed hundreds and even thousands of people at a time. The annual Hajj is also notorious for being a super-spreader event. Millions of visitors, many from nations plagued with poor health care systems, mingling in rather intimate circumstances for days on end has resulted in global outbreaks of cholera, smallpox, meningitis, polio, and yellow fever. (You might think such a notoriously lethal event should get moved, in time or space, or cancelled altogether but, of course, many consider dying and being buried in the holy city to be a blessing...)
For me at least, such volume and regularity of death makes the events reported this year rather unremarkable. I don't know how this messaging is maintained when you can easily find examples from a century prior, such as 1927, in which the situation was at least as bad, but probably worse:
The temperature reached 124 degrees [51°C] (shade). The Government admit a total mortality at Muna of 1,500 pilgrims, though the figure is probably much higher. The official organisation was unable to cope satisfactorily with the problem of removing the dead in a sufficiently short space of time; the consequent sights and odours were so revolting that thousands of pilgrims, including my Egyptian colleague, returned to Mecca without completing their religious duties.
If there were hundreds (thousands?) more heat-related deaths at that time, with temperatures the same or worse, doesn't the current situation seem less like a wild, CO₂-related aberration? No. Apparently not. Despite all this well-known, or at least easily found, context people still offered up their press releases, news stories, and opinion pieces about everyone dying from a unique, modern, anthropogenically-induced temperature extreme.
THE DELUGE
A month later, far more fatal hot weather stories arrived. In fact, the UN Secretary-General, António Guterres, held a press conference, bringing up many examples of extreme heat-related problems throughout the globe including the Hajj deaths. He goes on to mention how:
Those most at risk when the mercury soars include the urban poor. Pregnant women. People with disabilities. Older people. The very young, the sick, the displaced, and the impoverished – who often live in substandard housing without access to cooling. For example, heat-related deaths for people over 65 years of age increased around 85 percent in 20 years.
And if you go look, it’s true: heat-related deaths among people over 65 has nearly doubled since 2000. But that figure isn’t a per-capita rate, just a raw number. So what do you think the over 65 population has done in that same timeframe? Well, it looks to me like that cohort’s population numbers are up 92%, from 421 million to 808 million between 2000 and 2023. So, the heat-related deaths are not going up. And, in fact, if the numbers were extremely accurate (which they cannot be) then the same information would tell us that deaths from extreme heat among seniors had declined slightly over two decades, right?
Not only was none of the above amended or retracted since it went to press but more stories came in hard and fast and in all varieties and from every source. Here's a tiny sample:
Rising heat in Europe and Central Asia killing almost 400 children a year: UNICEF
Extreme Heat Is the Deadliest Weather Disaster: Hundreds of thousands of people die from extreme temperatures every year, more than any other type of weather disaster
Heat is the deadliest form of extreme weather. Why are fatalities so hard to track?
Extreme heat is a global killer — and worse for our health than previously thought, new research shows
What these and many other stories like them have in common are that they manage to miss that heat deaths have halved over the last few decades, deaths from cold are far higher everywhere in the world (including at the equator), and deaths from extreme heat are among the least of all threats to human life.
Most folks die from noncommunicable diseases, like heart disease, cancer, and diabetes. That’s 74% of all human deaths. Infectious disease is 14% of all deaths, which are things like pneumonia, tuberculosis, and malaria. Neonatal, maternal, and nutritional deaths make up 4% of deaths. Suicide is 1.3%. War, terrorism, and homicide is 1%. Though it can be partially responsible for some of these conditions, extreme weather does not make any lists of things humans need to be worried about or focussed on.
But it’s actually more obscene than that. Most people who die from hot or cold don’t die from extreme hot or cold but from “moderately cold” conditions! (Imagine that: things are counterintuitive.) So if your concern is about the threat posed by temperature and you're weirdly focussed on extremes you're volunteering to ignore the overwhelming majority of the problem. That's a disturbingly odd orientation to have.
More than that, a recent study in Nature showed that, across all countries between 2001-2019, climate change was responsible for over 30% of heat-related deaths, or a roughly estimated 175,000 fatalities. Yet, they also found over that same period climate change “reduced the burden of cold-related neonatal deaths by an average of 30% (country range: 10–63%), equalling 457,384 (95% UI: 170,106–868,519) fewer neonatal deaths in total.” Interesting, right?
So then, the real worry with heat-related deaths is that the situation will worsen in the future and become a threat in places where heat-related deaths were never before a concern. Okay. Yes. Someone should have their eye on that problem. But, like three people at a university in Japan or Norway, not everyone reading every newspaper and magazine in the English-speaking world. And while they're working on that, climate change will be busy saving the lives of young countless children throughout Sub-Saharan Africa. “The largest positive effects (>110 per 100,000) from the reduction in cold-related neonatal mortality were observed in Liberia, Ethiopia, Sierra Leone, Uganda and Guinea.”
So, as far as I can tell, every hour and dollar spent worrying about or trying to solve for extreme heat is another life lost to diseases, infections, and circumstances that are far more easily resolved. Mobilizing resources to combat extreme heat (not a problem) when you could attack real issues such as tuberculosis or diabetes or infant and maternal mortality or any number of other things (or even attending to moderate cold!) seems, if only to me, truly mad.
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