Webinar: Facing Extreme Heat - Vulnerability and Resilience

Hello everyone and welcome to the Woods Hole Research Center's KNEB Webinar series. For those of us for those of you, I'm sorry, who are not familiar with Woods Hole Research center with us, we are an organization of world class scientists working with a global network of partners to understand and combat climate change. And you're going to see that in action today in our discussion of vulnerability and resilience in facing extreme heat. Before we get into that, I'm curious how many of you have been with us for some of our other webinars. We're going to get to know each other a little bit before we dive into today's topic. So do me a favor and if you would, we still have folks joining us. It is a beautiful afternoon here in New England, so we may have people streaming in a little bit late, but we've got a little over 125 people with us right now and I'm curious if you would raise your hand if you have attended a previous K Neb webinar with Woods Hole Research center this spring or summer. I'm seeing a few dozen hands, hands still going up. Terrific. So at least some of you are familiar with some of the ways that we try to get to know each other in this virtual setting. It's not like streaming into an auditorium and being able to look around the room. You can't see each other. That's why I'll give you some hints about how many of you are here. And as I said, the numbers are still going up where we've still got people joining us us, but I've got a couple of polls just to get to know everybody a little bit and I'm going to launch the first one here and just ask an easy question. Shouldn't take too much work. How old are you? And get a sense of the age range we have in the room, as it were today. And we've got about 75% of people have voted so far. We'll give it a few more minutes or a few more seconds, I should say, to get some answers in here. As it stands Right now, almost 60% of attendees are 65 or older, a quarter in the 51 to 65 year age range and then 12 or 13% each in the 30 to 50 and 19 to 29 year age range. And I can actually share those results up so that you can see them instead of just hearing me rattling off numbers. So that's a quick one to just get you used to the polling feature. We'd also love to know where it is you're joining us from. Because of course while we miss our in person events, one of the great opportunities with these webinars is the ability to bring people together from different parts of the world to have these conversations and learn about our work at Woods Hole Research Center. Let me launch this second poll and tell us where you live, where you're joining us from. Today we've got a few people answering so far, most people saying coming from the US Northeast and Canada, somewhere here in our relative backyard being based on Cape Cod. Let's see here. Still about 75% of people saying the Northeast and Canada, about 4% each from the U.S. south and the Midwest, a few more people from the Western part of the United States. And then fun to see a few people joining us from Central and South America, from Europe, from Asia or the Middle East. And feel free if you feel so moved to use the chat or the Q and A to tell us where you're joining us from. If you're joining us from outside the US we know there's a rather large geographic areas that we're describing with those categories, but just trying to get a sense of how distributed everyone is and where we're all coming from. Thank you for sharing that about yourselves. We're really excited to have you all with us today for this conversation. It's really a very timely conversation. We are here just past the June solstice in 2020 with a significant chance, according to the data so far for this year of 2020, setting the record for the hottest year on record. Whether or not it does, it seems likely that it will fall in the top five. And of course up until now, the five hottest years on record have all happened in the past five years. So this isn't just a one off. This is part of a trend, a very strong warming trend. But a climate scientist once said to me, and it really stuck with me, nobody lives the global average temperature. And that's what we're talking about when we say these things like being the hottest year on record. That's typically based on an average for the whole year. What we all live are the daily highs and lows, those extremes that can happen. And that is of course what we're going to be talking about today is extreme heat. And that's also already been on display this year in 2020. And in fact, just in the past week, most of you told us you were joining from the Northeast or from Canada. Well, Boston had its first 90 degree day of 2020 this past weekend, but a small town in the Siberian Arctic decided to outdo our heat wave here in the Northeast and actually set an Arctic temperature record breaking 100 degrees this weekend, this past weekend, which I think is just an example of the fact that of course, not only do temperatures fluctuate day to day, but temperatures are different in different parts of the world. In different parts of the world are vulnerable or susceptible to extreme heat to differing degrees. And even in any given place, different people are not equally affected. Some people are more at risk because of health conditions, because of their housing, or. Or any number of a host of socioeconomic factors that can be in play. And in fact, this year, one of them is the COVID 19 pandemic. So we're gonna touch on all of those things with our two panelists today. Before we do that, I wanna ask a couple more questions in our polling, and more than just getting to know you and where you're coming from, we'd like to get a sense of your experience where with extreme heat. So I'm launching this poll here, just asking, how often do you experience extreme heat? And I'm not going to define extreme heat in any technical way. I'm going to let you do that. According to your definition of extreme heat, how often do you experience that? So we've got answers rolling in here with the majority of people saying multiple times each year they experience extreme heat. But about 6%, 5 or 6%, a handful of you saying never experience extreme heat. So again, getting at that diversity of experiences. We've still got answers coming in, but we're close to 90% of people who have voted. So we'll give this a couple more seconds and then end that poll and share those results. So you can see, just ended up just shy of 50% of people saying multiple times each year, with then another close to 50% saying once a year or occasionally. Again, these are not technical definitions. We just wanted to get a sense of how familiar extreme heat feels to you. And then because, of course, as I mentioned, it's not just about the temperature, it's about a whole host of factors. When it comes to thinking about the risk that extreme heat poses. I wanted to ask whether you personally think that you and your community have the tools and the resources to cope with extreme heat. How vulnerable are you and your community to extreme heat? Oh, and I'm going to love putting up these results. This is really interesting, you guys. As the votes are coming in here, it's wavering back and forth. Who's in the lead? The yeses or the nos? But, but split, I would say maybe more evenly than I had expected. I'm not sure what I was expecting, but we're running about 60, 40, yes and no. I'm going to go ahead and end that and show you those results. But about 60% of you saying yes, we have the tools and the resources to cope with extreme heat, but 40% saying no, and that's significant. With that, I'm going to stop talking and turn this over to our expert panelists today, who I will just briefly introduce here. And I'm going to invite them to start their videos as well so that you can see them, because it's always nice to see the faces as you're hearing somebody talk, even in this virtual setting. Our panelists today are Dr. Zach Zobel, who is a project scientist in Woods Hole Research Center's risk group. He works with many of our private sector partners very closely to quantify the socioeconomic risks of climate change in the next 10, 20, 30 years. And of course, extreme heat is very high on the list of those risks. So he's going to talk us through some of what we at the center are learning through our science about the risks of extreme heat globally and in different parts of the world. And then we're really happy to have with us today Eugenia Gibbons. She is the Boston Director of Climate Policy with health care without harm. That's a relatively new position for her. And before that, when I first encountered Eugenia and her work, she was in a role as the Clean Energy Programs Director with the Mass Energy Consumers Alliance. And so she's going to help us kind of connect the dots from our individual experience of heat and the health risks to our energy system and socioeconomic confounding factors. And I think it's going to be a really great discussion. We're going to have each of our panelists give us a little bit of an introductory presentation and then we'll jump into some Q and A, which I'll be moderating as you have questions as they occur to you, either during the presentations or afterwards. One of the other great things about this virtual setting is that you can jump in with a question anytime. We'll ask them all at the end, but feel free as questions occur to you, to put those into the Q and A section that you'll see at the bottom of your screen, and we'll work our way through as many of those as we can later in the program. So without further ado, Zach, I'll invite you to pull up your presentation and get us Started.

Hi everybody. As Heather mentioned, I'm Zach Zobel and I'm part of the climate risk group at whrc. Today I'm going to be talking to you guys about the extreme heat, and not only just extreme heat, but what we mean by that, how a warmer climate is affecting the frequency at which we see extreme heat events as well. I'll give you a couple examples of how our climate risk group thinks about extreme heat in terms of how it actually affects the human body. To start off. And this is probably the most important thing I can tell you. So if you take one thing out of my talk, this would be it. And it's that a mean shift in the climate, as far as mean temperature shift, kind of like how Heather was talking about a minute ago, isn't indicative of how quickly extreme heat events are increasing. I used a very idealized example here on this slide, and it's a three panel slide and it shows how distributions change as you change certain aspects of the distribution extreme events. And so what I mean by that is, is if you consider a temperature distribution like I show here in this first plot, A, the peak of a temperature distribution is usually right around the yearly average, meaning the most frequent type of day typically takes place in a pretty small temperature range in the more rare events. Or the extremes will be the events in the two tails, as they're known in math and science world, of the distribution curves. And those are the events we're really going to be focusing on. And so as this top panel depicts, a shift to the right in the distribution or a shift towards a hotter climate will actually increase the temperature extremes, as you would expect. But what also is going on to temperature distributions in reality is, is that we're seeing a shift towards the warmer direction, but we're also seeing an increase in variance or an increase in the extreme events and less days that are focused around the average of the distribution. And when both of those occur, when both of those occur at the same time, you really see a huge increase in extreme events. And this has actually been shown in observations. This figure here shows actually observed temperature distributions. For the top row, it is the global distribution of June, July and August temperature distributions. And then the bottom row is just Northern hemisphere. And as you can see for both of those land areas rather large in size, you see this clear shift to the right as you move into the more recent decades, but you also see an increasing variability. And that's really why average temperature doesn't do justice on how quickly extreme heat events are increasing around the world. So I also wanted to start off by defining a couple of the different metrics we use to quantify heat stress on humans. Those are a wet bulb temperature measure and a heat index, both of which are very similar in nature to each other. They both incorporate both the air temperature in the atmosphere, along with the moisture content or the relative humidity, as a lot of people know it as a wet bulb temperature, in layman's terms really is just the temperature or is just really a measure of how effective the human body can cool its core temperature through the act of sweating. So basically, can we sweat out enough to maintain the rising core temperature of our body through the environment? And I'll touch more on that in a minute. But first I wanted to focus on the heat index. And based on the poll we just did, it seems like a lot of you are probably familiar other countries in Southeast Asia and along with Northern Australia, we start to see these events pop up all around the world. And I don't think I mentioned, but including the Sahel, which is also a very vulnerable part of the world that doesn't have easy residential access to air conditioning, much like India. And to conclude, I just wanted to take this a step further to 32C. If we use that as a threshold, these heat waves are unprecedented outside the areas adjacent to the Persian Gulf, right around here. Nowhere else in the world have these events even been possible in the historical timeline. And again, toggling through to the future, we see at least a 5%, which is now what the red color is showing, chance of These type of 32 unprecedented heat waves occurring across very high population rich areas of Pakistan, India and Bangladesh. And the population living with just inside the highest contour of those locations is close to 100 million people. And only about 10% of them have access to residential air conditioning. The problem is very much true in the United States of heat stress increasing, but globally, we have to kind of put that into context and think about even more vulnerable populations outside the United States. And I'll pass it back to Heather.

Great.

And I'm actually going to pass it right over to Eugenia to jump into her presentation.

I had to unmute myself. You would think after four months of nothing but zoom calls, I'd remember unmute before talking. But no. Thank you so much, Zach. That was a great presentation and teased me up very nicely. So if you want to go to the next slide, please, Heather. As Heather noted, my name is Eugenia Gibbons. I'm the Boston Director of Climate Policy with Healthcare Without Harm. I'm actually on my 12th day of the job. So it is a very new role. Prior to that, I was the. The last I held was policy director at Green Energy Consumers alliance, formerly Mass Energy. But my role at Healthcare Without Harm is really focused on continuing to push Massachusetts and work within our global health team, our US Health team, which is part of a global organization to really help the healthcare sector transform the way we make and use energy in the sector and then elsewhere. So Healthcare Without Harm was founded in 1996. As I said, we work to transform the healthcare sector worldwide so that it reduces its environmental footprint, becomes a community anchor for sustainability and resilience, and is a leader in the global movement for environmental health and justice. Hospitals have a mission, have a mandate to do no harm. And so the work that we do as Healthcare Without Harm really does rest within the nexus of health, climate and environmental justice and social justice. Healthcare Without Harm has regional offices and partner organizations in 10 countries. We have an international network of about 36,000 hospitals and healthcare centers in 60 countries. For those who might be familiar with the organization, you might recall that we got our first campaign. Our first campaign was launched around the elimination of mercury in the hospital sector. We started with one Boston hospital and eventually scaled up to global collaboration with the World Health Organization. And the world's governments eventually signed an agreement to phase out mercury by 2020 in medical devices. So really indicative of how much of an impact we can have by tackling these issues in the sector. Next slide, please. So why the healthcare sector? Why are we thinking about things like climate equity, justice, community resilience and environmental action? Well, there are a number of reasons, but the main thing is that not only do health professionals need to know about the health impacts of climate change in general, but they also need to be aware of how the healthcare sector is contributing to and is impacted by greenhouse gas emissions. The healthcare industry contributes about 10% of U.S. greenhouse gas emissions. And the typical areas of the largest impact are indicated in these gray bubbles, these clouds. But the thing is, hospitals are very energy intensive facilities. They use about 2.5 times more energy per square foot than any other commercial building. They're the third most water intensive public building after senior care facilities and hospitals, using about 500 gallons of water per staffed bed per day. Water is also a major contributor to greenhouse gas emissions because of the energy needed to distribute it, treat it and heat it. There's also the food that is served in hospitals contributes to their overall carbon footprint. About 14.5% of global GHGs comes from the livestock Sector hospitals comes from the livestock sector. And hospitals have the ability to make a big difference on how we reduce emissions from that sector. And then also waste is a factor. So US hospitals generate about 29 pounds of waste per patient day in a hospital. So we have a big footprint. That's the long and short of it is hospitals have a very large footprint. And as Zach was indicating, where fossil fuels are the primary contributor to global warming and climate change, and we're seeing in real time what the effects are on the communities where we are located, where hospitals are located. Next slide, please.

So.

Oops, give me just a second. We are, as Heather indicated, at a really critical juncture in the way we as a country and as a Commonwealth are thinking about things like how to address climate change, how to prepare for crises, whether they are health crises, economic crises, or the climate crisis. And we're also having to do so really quickly. We're having to adapt very quickly to things that we thought we had plenty of time to plan for, because COVID 19 has truly laid bare all of the inequities and disparities that exist in our communities, in our country. And honestly, the Commonwealth is no exception to this. So just last week, the Massachusetts Department of Public Health released recommendations of COVID 19 from the COVID 19 Health Equity Advisory Group to address the pandemic's impact on communities of color and the DPH data. When I'm done with this, I'll put the link to the report in the chat. But the DPH data highlighted that there's a notable difference in COVID 19 cases, hospitalizations and deaths for different races and ethnicities, with black and non Hispanic, black, non Hispanic and Hispanic Massachusetts residents having three times higher, higher positive case rates than white non Hispanics in Massachusetts, as well as higher hospitalization rates and age adjusted mortality rates. So in other words, COVID 19 is decimating black and Latinx communities in Massachusetts. And the reason why this is relevant to extreme heat is because the pandemic only amplifies and exacerbates the health risks associated with extreme heat. So just at a basic level, our response to the pandemic potentially limits our ability to manage comfort and relief from the heat in ways that we would traditionally do and in ways that are traditionally beneficial to vulnerable communities, low income communities and communities of color. So things like cooling centers, pools, public pools, public splash pads, because of the pandemic, we obviously have to limit access to an operation of these facilities. But then we're also seeing that responding to worst case scenarios related to extreme Heat are challenging in the pandemic because our hospital and healthcare facilities are strained addressing people exposed to COVID 19. So this slide just reiterates that for months scientists have warned and journalists have reported on the dangerously high summer temperatures that we are expected to see be reached this summer. And when you consider that we already know that certain communities are being devastated and decimated by Covid when you layer on top of that the risks associated with extreme heat, there's a potential for, if we, if we fail to act and be proactive, there's a potential for very negative outcome. So next slide please. And what are some of the health effects of extreme heat? Well, you can see on this slide we will see and Zach sort of spoke to this. We'll see more frequent, very hot days, high humidity, higher heat waves. Many more Americans experience to extreme heat, increased numbers of illness and death from heat and from heat stroke and dehydration. And air quality is also compromised because we'll see longer seasons for allergens. And allergens will be worsened. And for some people might be aware that in Massachusetts in particular, we had several communities in Massachusetts that had the unenviable distinction of being worst places to live if you suffer from asthma or allergies. So Boston, Springfield and I believe Holyoke might have been another one of the ones that were in the top top 10 worst places to live if you or top 20 worst places to live if you have asthma or allergies. So who are vulnerable populations I mentioned in the study? The vulnerable populations that were identified in the COVID study are low income communities, communities of color. In the Commonwealth, essential workers fall into the vulnerable population category. From a health perspective, vulnerable populations include those with chronic conditions such as cardiovascular or respiratory disease or illness, outdoor workers and players, people without air conditioning, pregnant women and people taking certain medications. Oops. Bear with me just a second. I just lost one thing. Sorry. So I'm going to ask folks if I can. I should have sent you a survey question, Heather, but I didn't. But perhaps by show of hands, because you might see it in the chat. I'm just curious if folks could raise their hand if they think it's true that heat is the number one cause of weather related deaths in the country. Are you able to see?

Okay, my screen has just filled with people raising their hands. Let me let the screen clear for a moment and see where we are. Numbers wise. It's going up, but we're at about 77, 78 people and counting who, who have raised their hand out of almost 200 attendees. So a little less than half.

A little.

Say it's the number one.

Yes, and that is correct. It is actually the number one cause of death, weather related death on average. The good news is though, that almost all heat related illness and death are preventable. Raise your hand if you think it's true that extreme heat is only a problem in certain parts of the country.

Hmm.

Okay, again, my screen is being covered in notifications of raised hands, so we'll let that clear. And lower numbers here, about 40 people saying yes, raising their hand.

Okay, well that's good because it's not only limited to the south and as Zach alluded to, we are seeing increasingly high temperatures throughout the country, in the Midwest and even here in New England. All right, so quickly, if you want to go to the next slide, I will just very quickly cover sort of what does this mean in the immediate term? So in the summer of 2020, you know, that's now it's right in front of us. And as I mentioned, the challenge facing decision makers at this moment is how to balance both responding the pandemic and responding to extreme heat. And so we will see that, you know, at this time public cooling centers are closed. There's some conversations being had among municipal decision makers about when and how to reopen those facilities on the most extreme days. Is it possible, and if so, with what sorts of limitations and restrictions put in place? What sorts of limitations need to be put in place? In some places we're seeing splash pads reopen and sprinkler parks. There are some municipalities that are exploring similar to cooling centers, exploring ways to open public pools again to provide relief for residents. But again, those will be with certain restrictions. And the other thing that's being considered at the time, at this time is how do we deliver cost effective strategies to support folks who are sheltering and cooling in home. So if you have residents who maybe live in, you know, a home without air conditioning or in a multi unit building or something like that, what are ways that we can get cooling devices to them proactively? So before the temperatures really spike? And what are habits that we can help people embrace and practice to help maintain comfort and a healthy level of being cool before the heat hits? There's an example from one community a few years back that delivered air conditioning units to low income residents. That was an interesting attempt to help deliver cooling technology and comfort. There was an additional cost associated with that in the electricity bill. So again, when communities are thinking through how to deliver these solutions to vulnerable populations or Vulnerable residents. You have to take a holistic view of what does it really mean to do this. Not everybody can plug in an air conditioner and then afford the $200 electricity bill that comes at the end of the month. But in any event, so we're seeing communities really grapple in real time with some of these solutions. Next slide please. But in the long term, this is really going to boil down to, and our ability to address extreme heat and be prepared for it is really going to boil down to how we as a commonwealth prioritize getting off of fossil fuels and how we work to reduce our carbon footprint and really drive change that transforms not only Massachusetts, but the country and the globe in terms of eliminating carbon pollution. So the first place is through energy efficiency. And I put it there three times with exclamation marks because it is so critically important. Energy efficiency, energy efficiency, energy efficiency and conservation. At the moment, there are actually a number of barriers to access for vulnerable populations to be able to benefit from our nation leading energy efficiency programs. So in Massachusetts we have this fantastic program that has been award winning for multiple years in a row, but we've consistently found year after year that low income residents, renters, low to moderate income residents, excuse me, renters, people who speak English as a second language, are not actually able to take advantage of the programs that they are paying into. So we really need to be pushing, and I would urge anybody on this call call to really think about how we can break down barriers to access to our nation leading program so that everybody is able to benefit from energy efficiency through weatherization, insulation and air sealing in our buildings. The next thing is statewide. We need to prioritize and support decarbonization across all sectors. So at this moment, you know, the legislature and the Baker administration are balancing a number or juggling a number of different balls at at this time. And you know, they are thinking about how to balance the budget, how to make sure we're responding to Covid, how to move police brutality legislation. So many different things. But the other thing that's also happening at the administrative level is the state has an obligation to complete the development of a clean energy and climate plan for 2030 and a roadmap to net zero by 2050. These are both intended to provide a policy framework that will map out how Massachusetts is going to reduce its emissions across various sectors. And at this moment, those reports and those frameworks are being developed so there's an opportunity to weigh in with the administration and to weigh in with the decision makers to make sure that we're prioritizing things like robust, binding, interim GHG emission reduction targets. So in other words, set a really bold target for 2030, but make it binding so that we have there's accountability built into meeting it. Enable things like electrification, so through renewable, through heat pumps, for example, a high efficiency way to both heat and cool a building, or the adoption of renewable thermal technology, which is really more relevant. It's relevant across the board, but particularly in the sector where I work in healthcare care. And really so yes, so challenge your decision makers today to prioritize deep, deep, deep decarbonization efforts and lay the framework to be able to get there in the next decade. Because what we do between now and 2030 is really going to determine how well we're able to prepare for climate change and how well we actually ratchet down emissions in a significant amount of time. And then the last thing is really engage locally, think through. I saw one question was what can municipalities do to help promote cooling? Think through what your community is doing to be prepared for extreme heat, particularly as it relates to vulnerable residents in your community. Are there cooling places? Is there an outreach program? Are there, you know, is there green space? Could investments be made in increasing green space or in increasing shading? Just ask, ask locally what's happening and find a way to challenge and to push decision makers locally to do things that will actually inform and guide the process that's happening at the state level. So that's the end of my presentation. I'm going to put into the chat box. In addition to the study that I linked, I'm going to put a link to a brochure that Healthcare without harm prepared around extreme heat, which also gives some recommendations for how you can combat extreme heat and what you should be considering or looking for when we have our next 90 degree day. And with that, I look forward to answering any questions.

Well, great. Thank you so much, Zach and Eugenia for those great presentations. We have just about 15 minutes left in our hour here and plenty of questions. I have questions, our audience has questions, so we'll see how many of these we can get through. But I'm curious, Eugenia, from your last slide, talking about where we go from here, a lot of the items that you're mentioning there with energy efficiency and reducing greenhouse gas emissions, obviously, obviously critical to reducing the overall risk of extreme heat. Moving forward, I'm curious whether things like energy efficiency and for that matter renewable energy also have a shorter term role to play in mitigating the harm of extreme heat and adapting to extreme heat, especially in these vulnerable communities.

Yes, I would say yes, they absolutely do. Which is why we should be prioritizing energy efficiency at every turn. Efficiency of appliances, efficiency, efficient use of energy. Obviously, the longer term benefit is that you can help reduce peak demand and you can help alleviate strains that are on the grid during these high, these hot periods where we also see a high peak in energy, which has to do. Which will affect energy prices and costs, which is another thing that we haven't talked about. But in the immediate term, Absolutely. I think that if folks are able to benefit from our energy efficiency programs and they'll have to use, they'll be more comfortable in their homes, they'll have to use less energy to stay cool. And same with our large buildings. So our very large buildings that are heating and cooling, if they could do so in a more efficient manner, then it requires less resources to power. And with the renewable piece. Yeah, I mean, if you, a perfect scenario would be a home that's powered by its solar panels and has a heat pump plugged into it so it's cooling itself with the energy that it's generating. So there's definitely and maybe has this battery as storage, as battery backup when, God forbid, the sun doesn't shine or the wind doesn't blow. So, yes, I think that those things have value in the immediate term, but we also need to accelerate adoption and ramp up the access to those things over the long term to have the.

Real impact, though, Zach, we've had a number of questions going back to the basic science underpinning some of those maps that you showed us. And I think also a lot of curiosity wanting really localized answers. You know, why didn't you show Alaska what's going to happen on Cape Cod? What about my town? Right. A lot of curiosity at a very local level. And so it would be great if you could walk us through a little bit of briefly the assumptions, kind of how you go about figuring out what the next three decades might look like in a given place and how difficult it is to get to that local level in terms of those predictions.

Yeah, sure. So I guess to answer your first question, the length of our call was the only reason I couldn't show everywhere. I could have gone from continent to continent and talked about different heat extremes and different thresholds that are going to impact that localized society. I chose to use the continental United States in India and the Middle east as both a local example and an extreme example. But like I said, I could go to Australia, I could go to Alaska and I could talk about the heat issues there because it wasn't limited to what I showed. Additionally, the thresholds I did talk about were kind of the extent of what is hot no matter where you are. But what is hot no matter where you are doesn't necessarily mean Cape Cod doesn't experience heat stress. For example, a hot day on Martha's Vineyard is very different than a hot day in Houston, Texas. The two would consider a hot day very different. And in fact, the hottest day in Martha's Vineyard is a pretty pleasant summer day in Houston. That's not the same. The people that live on Martha's Vineyard experience heat stress. It's about the climate that you've become adapted for. And really, this all. The whole point I'm trying to make is this all goes back to the first slide I showed where I talked about the changing in extreme values. And notice, I didn't have any temperatures on those charts. Those charts were representative of how many standard deviations we're getting away from the climate that we are used to locally. So no matter where you live and no matter what the temperature is, on average, when you get three or four standard deviations greater than that mean, which is what those maps were. Sure. That what those charts were essentially showing, you start to experience heat stress based on where you live. And that's a very general term. I know, but like I said, we could have spent an hour just listening to me ramble on about different heat problems and 100 different locations around the world, but I tried to keep it as brief as possible.

Well, I appreciate that, given our time constraints, but it would be interesting, if not fun, to flip through and see all those different scenarios. It also strikes me, and we've had a couple of questions along this line, that of course, heat is not happening in a vacuum. We've got a lot of different factors. And, Eugenia, you've hit on some of the kind of socioeconomic and societal and health factors that compound extreme heat. But there are other environmental factors and other changes happening at the same time. We have one question about dealing with water scarcity at the same time as extreme heat. We've got a lot of different changes happening, and I'd love to hear both of you kind of weigh in on how you, in your work think about all of these different aspects of. Zach, maybe start with you and just again, kind of on the challenge of modeling this. When you think about the risk facing any given community, you could look at temperature, you could look at water, you could look at each of these things separately. But are we at a point where we can start to look at those multiple stressors together and get a sense of overall risk for a given community or region?

Yeah, that's absolutely the main goal of our climate risk group. Climate risk in general is a very vague term, and it should be. And the fundamental building block on everything that we do is the changing temperature. The changing temperature affects your drought, your water supply. It affects everything. And it's what a lot of scientists like to call a threat multiplier. And 2020 is the perfect example. I know this was already mentioned today, but 2020 is the perfect example. When you get a heat wave in a pandemic, there are a lot fewer options. And so heat is really just the start of what we want to consider when we consider climate risk. But, yes, that's very much what we're doing as a climate risk group is trying to take all the different threats a certain location might have and their ability to adapt to those threats, whatever they may be, when it comes to a changing climate. And we're able to develop some kind of risk index to try to quantify how much an area is going to be not only impacted by climate change, but do they have the ability to adapt to the changing climate? Those are two very, very different questions.

Yeah, absolutely. And we can touch on that a bit more. But, Eugenie, I want to give you a chance to weigh in on this issue of multiple stressors and how perhaps communities are or could be thinking about starting to adapt to and mitigate that kind of situation.

I mean, I think, as you said, you can't really silo any one of the issues. Zach said we have threat multipliers. And I think from the hospital sector, there's a lot of time and attention being placed on how to become more resilient, both as a sector and also how to contribute to the resilience, the climate resilience, of the communities where we're located. And so that means having to take a holistic view of everything from operations and maintenance and services provided to interactions in the community with residents that are not necessarily always from a healthcare perspective. So I think the way that we're seeing hospitals and institutions begin to think about this is in the investments that are being made in energy efficiency measures, in things like thinking through backup power and being able to run consistently over a long period of time on backup generation if the grid goes down, and thinking about all of the different ways that climate change is impacting the health of the communities where we're located. So I think that it takes time and it's a process. And certainly Covid is both reminding us exactly why this matters and why we need to be prepared to face and address crises when they happen. But it's also taking a bit of the oxygen out of the room in terms of being able to think about some of these other longer term strategies, because in the immediate term there is a need to respond to Covid. However, I remain optimistic that across the sector and across the economy, we're going to see people who recognize that there is an inextricable link between climate justice and equity, health care and health care and community resilience. And we're going to see more and more effort made to contribute to ensuring that these things happen. I mean, certainly why I'm doing what I'm doing, why we do what we do.

In thinking about community resilience, and my apologies to our audience, we have so many questions that I'm kind of drawing broad inspiration from your questions rather than going through each of them individually. But as we think about some of the strategies that you've talked about that we're not able to really rely on this summer because of COVID things like splash pads and cooling centers, these community wide resources for cooling and coping with extreme heat, as opposed to some of the at home cooling resources and the changes that you've been talking about, the need for greater efficiency and more affordable energy and greater cooling resources in homes, how do you think about the balance between those in terms of a resilient community? Is a resilient community, in the end, one where everybody can cool in their home, or do those community resources still play a role? I guess are those stopgap measures because not everybody has the ability to cope with extreme heat at home, or do they have a role in and of themselves? Even if we had everybody's home set.

Up, I think that it's a combination of both. I do want to say when we think about cooling in the home and maintaining comfort in the home, sometimes it really does come down to staying hydrated, limiting your time outside in the most extreme temperatures and using a fan. I mean, that sounds silly to say, but it doesn't necessarily, at least now doesn't necessarily require that everybody plug in their air conditioner. If we get to a point where, you know, in Zach's graphs and his maps, where suddenly we have such extreme temperatures that a fan won't cut it, then maybe we will be at a place where it does require some other technology to cool our home. But in the immediate term, I think that there is a way to balance both the use of public spaces to support comfort and cooling and health, community health and resilience, and also staying leveraging community resources to help people stay comfortable and safe and cool in their homes. But it really does depend on outreach and engagement and making sure that people have what they need and community wide, I just want to flag one of the things I mentioned was shade the benefit of shading and trees. We're still going to need communities to think about how they can invest in green space not only to provide shading and cooling in a hot day, but also because there's value in having green space, in trying to mitigate the heat island effect and trying to combat it contributes to combating climate change and mitigating climate change in other ways. So many of the proposed solutions that solve the problem that we're facing in one space also tick the boxes in other spaces, and we need both.

So there are multiple risks, but sometimes one solution can also help address multiple risks. Zach, we're closing in on 4:30 and I want to go back to something that you of course called out for all of us, that we've been talking a lot about the nature of risk and inequalities in those risks here in the United States. But when you go to the global perspective, the risks may be very, very different. And you mentioned India, where in fact one of the risks is not even so much about cooling at home, but the fact that work is not in a building that could be cooled, it's outdoor work. And so that's a whole other class of risk, which of course exists here in the US as well. But I just wonder when you look around the world at both the heat risks and this more holistic picture of the multiple risks that you model.

How.

Different are those risks? Are there solutions that if we talk about the solutions that Eugenia is describing at the community level for communities here in Massachusetts, do those scale or do we need fundamentally different solutions around the globe to deal with these risks?

Yes, I think they do scale. Obviously the population of India is much different than what goes on in the United States, meaning they have a much higher population density and so how much resources need to be devoted to cooling. Community obviously is going to be higher and India is doing a decent job at starting to get residential air conditioning units as more of a common thing rather than only for the upper class. And like I said, they still have a long ways to go, but they're at least working towards that. And it's something that they're investing heavily in on a governmental level. It's not just temperature though that scales. The United States and Europe actually have laid the blueprint for how to clean our air. Air quality is a huge issue in India and China, as I'm sure many of you have read in the news and the epa. And while the United States still has areas that need work when it comes to air quality, but it pales in comparison to what goes on in India and China, specifically those locations. And the blueprint is out there on how we were able to clean our air and get better air quality. So that very much would scale along with the community type efforts of cooling and getting lower income populations. More access to air conditioning will be a big a big over a big task that the Indian government is going to have to overtake in the next couple decades.

Well, it is 4:29. Rather than lobbing a big question at one of you and saying you've got 30 seconds to answer it, I think we will wrap it up there. I want to thank both of you, Zach Zobel of Woods Hole Research Center, Eugenia Gibbons of Health Care Without Harm for this stimulating discussion today. And I want to thank all 150 or so of you who are here right now and have been here with us for the entire hour. Thank you for joining us so much. We hope to see you back here again in two weeks time. We will be talking about a different topic in climate change. Another aspect of Woods Hole Research Center's work looking at the Amazon, at defense, deforestation and the fire season that is ramping up there. Just an example of the breadth of the work going on at Woods Hole Research Center. So please do check out our website for more information about our upcoming events and all of our work. And thank you again so much for being here. And again thank you Zach and thank you Eugenia.

Thank you for having us.

Thanks guys.