SEATTLE — No one needs to die in a heat wave.
That's the message from experts, who say simple interventions — by a family member, church group or local government — can prevent the worst outcomes when temperatures soar.
"Those deaths are preventable," said Kristie Ebi, a professor in the University of Washington Center for Health and the Global Environment.
But at least 91 Washingtonians did perish during the late June heat wave that boiled the Pacific Northwest and toppled historic temperature records. Additional reports of deaths are expected. Many of those killed were older Washingtonians. Others were living without shelter.
Heat waves test the fabric of society. They reveal who can't get to a cooling center, access water or find the help they need to beat the heat.
And these deaths raise questions over the region's preparedness for heat and other climate-spurred natural disasters.
The city of Seattle, which has the most resources of any Washington city, did not have a specific plan for heat response, only two of its community centers have air conditioning and only 20% of its public drinking fountains, which had been turned off during the COVID-19 pandemic, were operational before the June heat wave struck.
In our current climate, a heat wave of similar severity could be expected, roughly, once every 1,000 years across the Pacific Northwest, according to a recent study that has yet to receive peer review. But as global warming advances, such a severe heat wave could be expected once every five to 10 years, the research suggests.
As temperatures continue to rise, and other effects of climate change intensify, such as wildfire smoke, experts say the need for coordinated planning grows.
"I don't really get the sense that there is planning and preparedness around the worst possible set of events," said Dr. Jeremy Hess, a professor of environmental and occupational health sciences at the University of Washington. "It's the kind of thing that needs to be addressed well in advance."
How Seattle Got Ready
In the days leading up to the heat wave, Seattle marshaled its resources, and the efforts of hundreds of city workers, to prepare for a forecast promising historic heat.
City plumbers rushed to turn on wading pools, the library system scrambled to staff branches that served as cooling centers and outreach workers sought out people living without shelter.
Seattle Mayor Jenny Durkan pushed out news releases warning of the heat and held a news conference detailing the city's preparation. Behind the scenes, the Seattle Office of Emergency Management began coordinating with the National Weather Service and other agencies on June 22, four days before the heat wave.
Seattle City Light called off all scheduled maintenance work in advance of the heat wave. The Durkan administration lobbied Gov. Jay Inslee's office on June 24, asking it to relax COVID-19 restrictions for cooling centers, to which the governor assented.
But the city's actions did not follow a specific advance game plan for extreme heat, and some of its infrastructure was ill-equipped to deal with a heat-related disaster.
The heat wave — which began June 26 — would send temperatures at Seattle-Tacoma International Airport above 100 degrees for a record three days. Normal high temperatures for Seattle in late June hover around 74 degrees; they would climb to a record 108 on June 28.
Few City Buildings, Facilities Ready
Fewer than half of Seattleites have home air conditioning, according to data from the U.S. Census Bureau's American Housing Survey, leaving many people without simple options to cool down at home. It is the least air-conditioned metro area in the U.S.
"If you are vulnerable, or if you have vulnerable people in your household, it's important to have cooling resources," said Dr. Deepti Singh, a climate researcher at Washington State University — Vancouver, in the days before the heat wave hit.
But many city facilities aren't equipped to be cooling centers.
Only two of the city's 26 community centers (Northgate and Chinatown International District) have air conditioning, according to Jesús Aguirre, the superintendent of Seattle Parks and Recreation. A third, Rainier Beach, "has some cooling capacity in the lobby."
Tom Fay, The Seattle Public Library's interim chief, said 19 of 27 branches have air conditioning, but staffing limitations allowed only 13 to open.
Durkan on June 21 announced the 13 branches would be open at various points during the weekend, and later added six senior centers and three community centers to the lineup.
The cooling sites were distributed across the city, but there were gaps in coverage. There were no sites in Georgetown or Queen Anne, and none below 95th Street in Northeast Seattle, for example, until June 28 — the third and hottest day — when the city opened one in Magnuson Park after residents in a low-income housing development raised concern.
The city's decisions about how many cooling sites to open, and where, were based on availability and ideas about where sites might be most needed, rather than set standards, said Curry Mayer, the emergency management office's director.
Just 20% of public drinking fountains at Seattle Parks were operational when the heat wave struck, though many park bathrooms with water were open. The city had shut off the fountains early in the pandemic after guidance from the federal Centers for Disease Control and Prevention about high-touch infrastructure.
Months ago, in March, Public Health — Seattle & King County officials encouraged city officials to turn the drinking fountains back on, citing diminishing COVID-19 case counts and widespread vaccinations. They hoped to quell an outbreak of shigella among people experiencing homelessness. Shigella is a bacterial disease that causes fever and diarrhea and is more likely to spread if people lack access to clean drinking water.
The city waited for months before deciding to reactivate the fountains, starting with parks downtown. As the heat wave approached, the city focused plumbing resources on opening wading pools and spray showers, rather than drinking fountains, Aguirre said.
"They couldn't do both," he said of the plumbers.
Plans, But Not Specific to Heat
While Seattle's All-Hazards Mitigation Plan does mention excessive heat events, Seattle does not have a specific plan for dealing with them.
During crises, the city relies on a general emergency operations plan. That plan has no heat-specific section but does address how to provide widespread care during an emergency for basic needs, such as first aid, shelter, food, housing and human services. It lays out how agencies are supposed to work together to provide various sorts of shelter during emergencies, including cooling sites.
The city does not keep a master list of its air-conditioned buildings or a list of places where those vulnerable to heat might live, such as senior living communities.
Mayer said the city's planning process is designed to adjust to all manner of crises, build upon consistent citywide communication and allow for fine-tuning to a situation's needs.
The city has developed specific operations plans for winter storms and earthquakes.
The city's Office of Emergency Management leads preparations for individual events. During the recent heat wave, the office produced detailed action plans for June 26-28, and kept its Emergency Operations Center running on those days.
Seattle is one of many local governments that has yet to develop fundamental plans for heat waves, experts say. So-called "heat action plans" are common in areas with more frequent heat waves, such as Phoenix and Chicago.
Ebi, a top researcher on heat-wave preparedness, said she knew of nowhere in the state with a heat-action plan. Historically, extreme heat kills more people in the U.S. than any other weather phenomenon.
As part of these plans, local meteorologists typically work with city or county governments to develop a tiered early warning system based on temperature thresholds. When a forecast reaches a certain point, emergency managers can send out specific messaging to residents about cooling centers, how to spot symptoms of heat illness, and other advice. They can also notify doctors and pharmacists, who would then warn patients taking medication that might place them at higher risk.
In the days approaching the heat wave, Seattle and King County public agencies sent some of these key messages — through Twitter, emails, news releases and other means — but it was more of an ad hoc approach, not part of an established early-warning system.
"People need to know not just that it's hot. People need to understand what actions they can take and what services are available," Ebi said.
A review of these agency messages shows they largely comported to what experts view as best practices; what's less clear is how effectively they reached the people most vulnerable.
Historic Spike in Emergency Response
Heat can kill by myriad methods.
Organs can overheat dangerously if the body loses its ability to regulate temperature, risking death. Heat can also exacerbate symptoms from underlying ailments like cardiac disease, diabetes or kidney problems.
When the heat wave struck, doctors compared the onslaught of patients in hospitals to the early days dealing with COVID-19.
The Seattle Fire Department grappled with a historic spike in medical and fire calls during the heat wave, Chief Harold Scoggins said. It responded to 334 incidents June 26; 386 June 27; 544 June 28; and 380 on June 29, including 117 heat-related medical responses over the latter three days. There were increases in wait times for ambulances, as well.
"Our units were really running hard," Scoggins said.
The department's Health One unit, composed of specially trained firefighters and a social worker, normally operates only on weekdays but was called into action during the superheated weekend. The unit made contact with as many as 60 people on the streets, providing drinks, food and information on cooling centers, took four people to cooling sites and medical clinics, and answered 18 nonemergency 911 calls.
Other city departments also were busy.
Seattle City Light, the electric utility, had to buy extra power to meet record demand, as residents cranked air conditioning units. That cost $3 million, General Manager Debra Smith said. Line workers meanwhile sweated in underground vaults to deal with repeated, heat-related power outages in neighborhoods like Wedgwood.
Nine library branches open on June 27 served 1,682 people throughout the day; eight open on June 28 served 2,127 people.
The city's beaches, spray parks, wading pools and swimming pools were crowded throughout the weekend, and about 700 parks employees were working.
But only 107 people visited community centers that were open for cooling (just one person visited Rainier Beach Community Center), while 100 people used the Amazon Meeting Center downtown, which the Durkan administration had requested the company open.
More than 110 case managers who work for the city and county Aging and Disability Services agency worked during the heat wave. They made phone calls to check 2,137 vulnerable clients and distributed 88 fans. The senior centers that opened as cooling sites contacted clients, as well.
Did the Message Get Out?
Older people and those without shelter are among those most vulnerable to heat.
Scoggins, Seattle's fire chief, said the median age of those asking for his agency's help was 66. About 11% were homeless.
The city of Seattle sent out notifications during the heat wave through Alert Seattle, an emergency communications system that uses text messages, emails and voice messages. But people have to sign up for the system, typically by computer or at a library.
Most of the city's outreach to vulnerable populations was by phone, email or text message.
"You have to think if your most vulnerable populations are going to opt in," Ebi said.
City workers did not conduct widespread canvassing to check on residents or inform of heat concerns.
Scoggins said the city needs to develop a more robust outreach plan to help reach older Seattleites before they need emergency help.
"I think a strategy, in the future, for the elderly population would benefit us," Scoggins said.
Looking Forward
The recent heat wave was rare, but risks are expected to grow.
And even smaller heat events can take a toll.
Tania Busch Isaksen, a University of Washington researcher who has studied the impacts of heat here, said King County begins to see health impacts "on a mid-80s day" when humidity percentages are in the 40s.
Seattle's All-Hazards Mitigation Plan is being updated this year to include more emphasis on heat events, identifying them as a deadly hazard "projected to become more intense in the future due to climate change."
The updates, for 2021 to 2026, are pending approval by the City Council and call for improving community centers so they can be cooling sites and expanding the city's tree canopy, among other actions. These plans are not meant to guide the city's response during crises.
Ebi said specific heat-action plans should be developed and then stress-tested for worst-case scenarios, such as a two-week heat wave during which the power grid fails.
"That could happen now," she said. "There needs to be thinking more about what climate change is going to throw at us, and how we can be better prepared."
