India Most Likely Undercounting Heat-Related Deaths | Former WHO Chief Scientist Soumya Swaminathan

According to Soumya Swaminathan, an Indian health ministry advisor and former WHO chief scientist, India seems to be ”most likely” underestimating death counts caused by extreme heat due to insufficient data, though the government is currently working on improving monitoring systems to reduce the adverse effects of extreme weather on health.

While attending the World Sustainable Development Summit, she gave an interview to PTI in which she highlighted the need of tracking and policy readiness for another harsh summer. The ICMR Ex Director was also asked if he felt India was under reporting deaths due to heat. He responded by saying, "Most likely. The country does not maintain a concrete record for every death, so some estimation is needed.” Estimation means some form of calculation or modelling based on current happenings. To him, it is inevitable.

Swaminathan said “But there are some recently published scientific literature that I think track what is called excess deaths.” “For example, when you look at the entire year, the number of deaths for every month is generally stagnant. But, if you look closely, you notice spikes. Like during COVID, we noticed spikes.” “So, we notice there is a baseline death rate every month, and then in May-June, there is a spike.”

“Excess deaths can potentially be attributed to heat,” she said. During the summer months last year, India suffered gruesome heat with the Indian Meteorological Department reporting 536 heatwave days, the highest in over a decade and a half. Official records show that out of an extending and scorching heatwave, India was considered to have 143 heat-related deaths alongside 41,789 suspected strokes.

As per public health experts, the recorded numbers of heat death are extremely low since estimates show that 20 to 30 percent of diagnosed heat strokes tend to be fatal. Swaminathan stated that although the health ministry has introduced a system to track heat related deaths, it is crucial to consider that fatalities indicate “the very tip of the iceberg.” The IMD has also predicted that most parts of the country will face abnormal minimum and maximum temperatures this summer season. “For every one death, there are probably 20 people who are suffering the impact of heat by high blood pressure or exacerbation of their cardiac disease or heat exhaustion and not being able to go to work,” she stated.

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“Here, a lot of productivity decline and capital loss is happening... which is not costing a man's life, but greatly affecting quality of life for families. This is where attention is urgently required as we ensure that there is comfort in the life and high productivity,” Swaminathan told PTI. She further stated, “We surely have to reduce the number of dead bodies. No one wants to see people die from heatstroke but we want them to be enjoying thermal comfort.”

She also raised red flags regarding the other side of the story focusing on social wellbeing.

“If there’s no relief from heat for an extended period, we know suicides go up, there is an increase in domestic violence as well as psychiatric disorders,” Swaminathan noted. The formerly WHO chief scientist urged a joined action from different parts of the system, such as labor, housing and town planning, to mitigate the sufferring caused by time pressures.

“You need the labor department, industry, factories, workspaces to come in. You need the housing sector to care about heat, especially for those people in low cost housing squalid tenement buildings with corrugated iron roofs. How do we cool those kinds of homes down so people can actually sleep at night?” When asked how governments and local authorities and the society themselves need to get ready for another hard summer, she pointed out the need for vulnerability mapping in every district as there is no time to waste.

You can now use technology to ‘zoom’ on a specific area before you even go there and know which wards are going to be more susceptible to heat. Because there are certain areas that are highly developed, And that is usually the areas where poor people tend to reside. That is where you have to pay more attention.” Swaminathan called local governments, hospitals, and employers to take action. “Prepare your health system, train the health workers. Make sure that you have supplies in your health system, Ice, saline, and cooled rooms, if at all possible, to put the people who come with the heat.”

Her advocacy went to the other extreme of warning employers in workplaces, as well as the general populace, so that they make sure there are a number of places with free access to water. “Shade is very important in every community where there is a high chance of this happening,” Swaminathan pointed out inexpensive solutions like providing shade at traffic light stops.

“Certain efforts, in my opinion, are not too expensive and can be implemented quite quickly in anticipation of the hotter months. This is why, for example, many urban centers have started installing green canopies on top of signals where motorbike riders wait so that they are partially protected from the sun.” There is much information that must be disseminated and taught and much more that has to be done in the long run, she indicated.

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