'We know that it can take a while before the accumulation of heat in the body starts affecting our cells and organs; it’s usually not until about 24 hours after the onset of a heat wave that people begin dying.'
As heat exposure drags on, older adults will get hotter and hotter, but they’ll be unable to perceive the threat in the same way younger adults do. They have a weaker thirst drive and don’t sweat as readily. This is why it’s so important to check on older loved ones on hot days, ideally in person. “These elderly people will tell you they’re okay,” Dr. Kenny said. “It’s very late in the game, after eight hours or so, that they’ll start to say, ‘I’m not feeling well.
“People will get what’s called an after-rise,” Dr. Kenny explained. Although a person may feel cooler while in the cooling centre, lots of heat is still being stored in the muscles. Upon return to the hot conditions, that heat gets shunted back to the core, causing a rapid increase in body temperature. “The solution can’t just be, ‘Put them in the cold and then let them go home thinking they’re safe.’ Because they’re not.
And then there’s the matter of fans, which is particularly important to consider in typically temperate locations with low rates of air conditioning. According to the coroners report, the majority of heat-dome victims died indoors in places without AC. At least 149 people died in a location where a fan was in use.
A model isn’t enough to support a change in international guidance on safe fan use. That’s why Dr. Kenny applied for a grant from the Canadian Institutes of Health Research to fund 600 day-long human trials on the topic. Approved in March, the nearly $1-million, five-year project will evaluate heat-mitigation strategies, including the use of readily available, store-bought fans in older adults and those with chronic disease.
Melissa Lem, a family doctor in Vancouver and president-elect of the Canadian Association of Physicians for the Environment, said temperatures reached the low-30s inside her home in Kitsilano. She remembers doing live television interviews about the heat dome with an ice pack pressed against her abdomen.
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