By Christopher Flavelle and Nadja Popovich, Aug. 26, 2019, NYTimes.com
WASHINGTON — Heat-related deaths have increased sharply since 2014 in Nevada and Arizona, raising concerns that the hottest parts of the country are struggling to protect their most vulnerable residents from global warming.
In Arizona, the annual number of deaths attributed to heat exposure more than tripled, from 76 deaths in 2014 to 235 in 2017, according to figures obtained from the U.S. Centers for Disease Control and Prevention. Heat-related deaths in Nevada rose almost fivefold during the same period, from 29 to 139.
Most of those deaths were in the Phoenix and Las Vegas areas, according to state records.
The long-term health effects of rising temperatures and heat waves are expected to be one of the most dangerous consequences of climate change, causing “tens of thousands of additional premature deaths per year across the United States by the end of this century,” according to the federal government’s Global Change Research Program. The effect could be even more severe in other parts of the world, potentially making parts of North Africa and the Middle East “uninhabitable.”
Still, the fact that deaths have already increased so rapidly in Nevada and Arizona is surprising, according to David Hondula, a professor at the School of Geographical Sciences and Urban Planning at Arizona State University. He said heat deaths have generally been declining in the United States, thanks to changes like better health care, more air-conditioning and improved weather forecasting.
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The latest data — which the C.D.C. has compiled for all 50 states — suggests that climate change could be starting to outweigh those advances in the Southwest, at least for some parts of the population. Other states haven’t yet shown such significant spikes, but Dr. Hondula warned they might eventually see more deaths as temperatures keep rising.
“Phoenix and other cities of the Southwest are the canary in the coal mine,” Dr. Hondula said. “We really need to figure out what piece or pieces of the system are lacking.”
Afternoon highs in Phoenix last summer averaged 106 degrees Fahrenheit, almost 3 degrees hotter than the average for the second half of the 20th century, according to data from the National Oceanic and Atmospheric Administration. Las Vegas recorded its hottest summer to date, with average daily highs reaching 105 degrees, more than 5 degrees above the 1950-2000 mean.
Nighttime lows have warmed up, too, giving residents less chance to recover from the heat.
“There’s only so much our bodies can take,” said Rupa Basu, chief of the air and climate epidemiological section for the Office of Environmental Health Hazard Assessment in California, where the number of heat-related deaths doubled between 2015 and 2017. As heat waves become more severe, she said, “I think we’re going beyond that temperature threshold.”
The increase in deaths also illustrates how climate change can exacerbate other challenges. Experts say the death toll is likely to reflect the growing ranks of vulnerable groups, and the failure to protect those groups from global warming.
A particularly vulnerable group, experts say, are the homeless, especially in Maricopa County, which includes Phoenix. “The unsheltered homeless population in Maricopa County has risen every year by about 25 percent since 2014,” said Lisa Glow, chief executive officer of Central Arizona Shelter Services. “We have been turning away hundreds monthly who need shelter.”
She said that reflects rising housing costs as the county’s population grows, as well as a reduction in the number of emergency shelter beds.As Phoenix Heats Up, the Night Comes AliveIn one of the hottest and fastest-warming American cities, residents adapt their summer schedules to find times when temperatures are more tolerable.
Data compiled by the county’s public health department show that the homeless represent a fast-growing share of heat deaths. In 2014, the county recorded seven homeless people who had died from heat-related causes. By last year, that number had increased to 61 deaths, more than one-third of the total.
Cara Christ, director of Arizona’s Department of Health Services, said she didn’t know why heat-related deaths were rising. She said her office had been focusing on increasing public awareness about the risks of extreme heat. “We take this issue very seriously,” she said.
In Nevada, public health officials were similarly unable to explain the jump in deaths. “We’re trying to figure out what it is that needs to be done,” said Rebecca Cruz-Nanez, a health educator with the Southern Nevada Health District’s Office of Epidemiology and Disease Surveillance.
Data suggest the number of homeless people in Las Vegas has fallen since 2014. A better explanation for the increase in heat-related deaths may be the rising number of older residents, according to Erick Bandala, a professor of environmental science at the Desert Research Institute in Las Vegas.
Not only are older adults more susceptible to the physical effects of heat, they’re also more likely to live alone with no one to check on them.
In a paper published this year, Dr. Bandala examined the ages of all 437 people who were determined to have died from heat-related causes in Clark County, which includes Las Vegas, between 2007 and 2016. He found that 76 percent of those who had died were older than 50.
“I would put my money on the increase of retirees coming to live in town in the last eight to 10 years,” Dr. Bandala said, but added that more demographic information is still needed.
Others worried that the problem might be worse than it seems. “Heat-related deaths are just very underreported,” said Dr. Basu, the California official, because coroners often mark a death as heat-related only if no other cause of death is suspected. But that can miss cases in which heat contributed to a death from another cause.
What’s clear so far is that governments need to do a better job protecting people from extreme heat before conditions get worse. “Our strategies are insufficient for the current climate,” Dr. Hondula said, “let alone what might be coming.”
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‘Absolute nightmare’: 4 former Florida nursing home staffers charged in 12 Hurricane Irma deaths
Jorge L. Ortiz, USA TODAYPublished 8:03 p.m. ET Aug. 27, 2019
The Hollywood Police Department said 12 patients at the Rehabilitation Center at Hollywood Hills were killed by “environmental heat exposure.” Video provided by Newsy NewslookCONNECTTWEETLINKEDINCOMMENTEMAILMORE
Appropriate pre-storm preparations gave way to a chaotic response in a Florida nursing home where suffocating heat resulted in 12 patients dying after Hurricane Irma struck in September 2017.ADVERTISEMENT
That’s the scenario presented in a 111-page state report that led to manslaughter charges being filed Tuesday against four of the center’s workers, including its administrator.
And after a two-year investigation, the reckoning may not be over.
Hollywood Police Chief Chris O’Brien said further arrests are expected in a case that drew national outrage upon revelations of near 100-degree temperatures for days at the nursing home after Irma knocked off power to its air conditioning system.
Despite protestations from lawyers for the facility’s workers, O’Brien said they “neglected their duties’’ by failing to evacuate despite the stifling conditions at The Rehabilitation Center at Hollywood Hills, about 20 miles north of Miami.
Eight of the center’s approximately 150 patients, most of them elderly, died of heat exposure on Sept. 13, 2017, three days after Irma ripped through south Florida with winds of 140-mph and above. Another four died from heat-related causes in the following days and weeks.
The medical examiner ruled the deaths homicides. O’Brien said more than 500 people were interviewed and 55 computers were seized in an investigation that continues.
On Sept. 13, 2017, police surround the Rehabilitation Center at Hollywood Hills in Florida, where 12 patients died after being kept inside a nursing home that turned into a sweatbox when Hurricane Irma knocked out its air conditioning. (Photo: John McCall, AP)
Jorge Carballo, then the facility’s administrator, and night shift nursing supervisor Sergo Colin face 12 counts of aggravated manslaughter. Nurses Tamika Miller and Althia Meggie were charged with six and two counts of aggravated manslaughter, respectively, as well as evidence tampering.
Carballo and Colin were in jail pending bail late Tuesday, while Meggie was released. Miller was being held in Miami-Dade County pending transfer to Broward County.
“The families sitting here today should not have lost their loved ones this way,’’ O’Brien said at a news conference attended by relatives of the victims. “They placed their faith and trust in the facility … and that trust was betrayed. They have been living an absolute nightmare.”
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Police said evidence collected in their investigation forms the basis for the state report, which paints a picture of a nursing home staff that initially took the right steps to care for its residents – buying extra food and water as well as seven days’ fuel for the generator, renting portable air conditioners and getting information from regulators in statewide conference calls.
Then things went very wrong.
The transformer that powered the central air conditioner stopped working after Irma’s arrival, and the system was not connected to the backup generator, which otherwise kept electricity flowing in the two-story building.
Massive Hurricane Irma battered Florida in 2017 with winds of 140 mph and above. (Photo: Chip Somodevilla / Getty Images)
Investigators found the first floor’s temporary air conditioners vented into the ceiling, meaning its heat went to the second floor, where 11 of the 12 victims lived.
Carballo and other administrators called the power company and then-Gov. Rick Scott, who had provided nursing homes his cell number. They got no help.
“Nobody came,” said David Frankel, a lawyer who represents Colin. “For three days, these people did everything possible they could to keep everyone stable.’’
Scott, now a U.S. senator, said in a statement the nursing home employees should have called 911.
Early in the afternoon of Sept. 12, Hollywood paramedics made the first of several visits over the next 16 hours: a 93-year-old man had breathing problems. His temperature was measured at 106 degrees and he died five days later.Get the News Alerts newsletter in your inbox.
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Carballo told investigators that when he left at 11 p.m. the temperature inside the home was safe. The report found that “not credible.”
The next day, residents started dying.
At 3 a.m. Sept. 13, paramedics returned to treat an elderly woman in cardiac arrest, with one telling investigators the home’s temperature was “ungodly hot.” Her temperature was 107 degrees, as was another patient’s.
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Paramedics also reported evidence that some patients were not being monitored closely – one of them was in rigor mortis, so he had been dead for hours before anyone noticed – and said Colin tried to keep them from checking on others.
Alarmed by the patients arriving at its emergency room, staff from Memorial Hospital across the street went to check. One nurse said the center felt like “the blast of heat” inside a car that’s been sitting in the sun all day.
The fire department ordered the home evacuated and, within days, its license was suspended. State regulators revoked it in January. South Miami’s Larkin Hospital, which owns the center, is appealing the revocation.
Louisiana-based lawyer Jim Cobb, who represents Carballo, said the defendants are being scapegoated even though they confronted a dire situation as the hurricane cut off power to large swaths of Florida, some of them for weeks.
“They have attempted in these charges to blame healthcare workers and caregivers who showed up to work and were at their posts in the middle of a natural disaster emergency and did the very best they could,” Cobb told the Miami Herald.
He also countered the accusation that the nursing home workers failed to take the ailing patients to Memorial Hospital, which was operational, saying that facility was so overwhelmed with patients, it was referring some to The Rehabilitation Center.
“It was a post-hurricane disaster, for crying out loud, not a slow day at the local urgent care clinic,’’ Cobb said.
Contributing: The Associated Press
