BRUNSWICK – For many of us, heat waves mean a temporary discomfort, and at best, an excuse for a swim or a trip to the mall. However, for too many, heat is an insidious killer.

And worse yet, Maine is ill-prepared and especially at risk for a heat wave like the one we endured last week becoming a heat disaster.

Over the last 30 years, more people have died in this country from heat than from all other weather events combined, including snowstorms, ice storms, tornadoes, hurricanes, floods, lightning and earthquakes.

For instance, about 700 people died of heat-related illnesses in a July 1995 Chicago heat wave, and 120 died in a July 1993 Philadelphia heat wave. France experienced an enormous disaster when more than 15,000 died in an August 2003 heat wave.

Most of these deaths were among people 65 and older, infants and children, and people with chronic medical conditions, including mental illness. An older person with chronic illness living alone without AC — air conditioning — is at especially high risk.

Maine is not immune. In August 1988, Maine made headlines when five patients tragically died at the Augusta Mental Health Institute during a heat wave, in which the highest temperature recorded in that city was 94 degrees.

Although we do not have adequate data on the health impact of heat waves in Maine, in 2010 the Maine CDC was awarded a federal grant to improve such monitoring systems.

When the heat index (a combination of air temperature and relative humidity) is over 95, and especially 100 and over as it was recently in Maine, air conditioning is the major antidote. Although fans and hydration help mitigate the effects of extreme heat, it is critical for people at risk or displaying symptoms to also have access to cooling devices.

Maine is very vulnerable to the health effects of extreme heat for several reasons. First, we are not acclimated to heat.

Second, many Maine people, especially those at risk for heat illness, do not have access to AC. Our homes and schools lack AC. About half of Maine’s nursing homes lack AC for their residents, according to an informal 2010 phone survey. Very few emergency shelters are equipped with AC.

Lack of acclimatization and AC may account for New England’s heat-related death rates, which are higher than most other areas of the country, including Arizona and Texas.

Third, with Maine having the oldest population in the country, a very high proportion of us are at risk for severe health problems due to heat.

What should Maine do?

1. Establish cooling centers in every community. Examples may include libraries, town offices, other public buildings, church vestries, stores, other businesses or shopping malls.

Establishing them may involve placing chairs in accessible buildings with existing AC (e.g., malls) or placing portable ACs in such buildings with existing chairs (e.g., church vestries).

2. Identify public emergency shelters with AC. If a concurrent emergency occurs, such as a heat-related power outage, then it is critical that nursing home residents and others can be evacuated to an emergency shelter with AC.

3. Ensure the public has real-time information on predictions of, the risks from, and appropriate responses to, heat events. Examples include turning Maine’s 211 system into a “Heat Line” and using broad-base and social media.

4. Make sure those at greatest risk are checked on during extreme heat. Examples include using the “neighbor helping neighbor” approach, asking home health agencies, emergency medical services and emergency management agencies to check on high-risk people, and activating automatic notification systems (such as Reverse 911).

These steps will take a coordinated effort of community, county and state emergency management officials working with many groups and people across Maine. But ultimately, all of us play a role.

These strategies work. Deaths plummeted during subsequent and more severe heat waves after Chicago and Philadelphia implemented these approaches. The strategies are analogous to those we successfully take every winter to mitigate snowstorms.

During the winter storm season, Mainers know to keep informed about the forecast. We know to prepare for storms by stocking up on supplies and laying low inside. We know to check on neighbors. If the situation worsens, our communities have warming centers and heated shelters.

Maine needs analogous strategies for summer heat events.

– Special to the Press Herald