It's hard to say exactly at what threshold a high temperature heat wave will knock people out.
It's not like a flood, and it's not like air pollution, which gradually manifests its harm over long years.
Some people say it is a slow knife, but its damage is immediate.
According to incomplete statistics from reporters from China Youth Daily and China Youth Daily, at least 26 people in my country have died of heat stroke since July this year.
Guo Tengxu, a 20-year-old college student in Wuhan, collapsed in the 6th minute of get off work.
It was July 9, the third day of Guo Tengxu's summer job. Early in the morning, the Wuhan Central Meteorological Observatory issued a high temperature yellow warning, "The maximum temperature in most parts of Hubei Province will rise to above 35 ℃."
He went to the factory to carry and assemble the shelves as usual. His colleague said that the factory was sultry that day, and there was only an electric fan, "but it was useless." He often felt that his face was hot, but his work did not stop.
After leaving get off work at 17:30 that day, Guo Tengxu went to the Shaxian Snack near the company to eat and fell down.
120 An ambulance took him to the hospital, where he was diagnosed with heat stroke and died after rescue efforts were unsuccessful.
In Zhejiang, 34-year-old Zhang Gongqian from Yuyao collapsed in a rental house; in Shaanxi, 56-year-old construction worker Wang Jianlu from Xi'an collapsed on his way home; in Sichuan, a 70-year-old man suffering from chronic obstructive pulmonary disease in Nanchong collapsed in a house without air conditioning at home.
The cities and counties where they are located have issued high temperature warning signals.
Early warning is often regarded as the "first line of defense" against meteorological disasters.
However, reporters from China Youth Daily and China Youth Daily found that before and after the early warning was issued, there were many neglected details—the rules and regulations, early warning systems, popular science propaganda, and even life experiences we had to deal with high temperature and heat waves, all of which affected the tragedy. .
Lack of "targeted" high temperature warning system
In the past July, a total of 68,000 warning messages were issued nationwide.
The number of "high temperature red warnings" issued this year has increased the most, 7.5 times that of the same period last year.
More than 5 million square kilometers of land has turned into a steamer under the high temperature, and more than 900 million people have been shrouded in it.
The weather department was the first to sense the heat signal.
According to relevant regulations, when the daily maximum temperature will exceed 35 ℃ for 3 consecutive days, the meteorological department will activate a high temperature warning to remind the public and relevant departments to be alert to high temperature.
On August 12, the Central Meteorological Observatory issued the first "high temperature red warning" this year, which is the highest level of high temperature warning. The next day, the China Meteorological Administration launched a high temperature three-level emergency response.
On the weather map, an obvious red "wound" appeared, which persisted for two months.
According to the news, because of the high temperature, the black bears in the zoo are more willing to lie in the water, the monkeys fall in love with licking the ice, an eagle in Nanjing fell into the river due to heat stroke, and there are fewer mosquitoes in Hangzhou.
This is rare.
On August 12, Chongqing issued a "first-level warning of high temperature and heat stroke", and local media said this was the first time the city had released this information.
In fact, in the past few decades, China has been dealing with high temperatures more and more frequently. In 1998, 2003, 2013, and 2017, extreme high temperature weather was encountered, and the government is also trying to issue early warnings and respond to them.
Many meteorological experts have said that high temperature and heat waves will be the new normal in the next few decades.
In China, what ordinary people are most familiar with in summer is the high temperature yellow, orange and red warning issued by the meteorological department (hereinafter referred to as "high temperature three-color warning"), and the "high temperature heatstroke meteorological grade warning" jointly issued by the meteorological department and the health department. .
Both sets of high temperature warning mechanisms have been officially implemented for 15 years.
Taking the "three-color high temperature warning" as an example, the content of the warning information generally includes the name, icon, standard and defense guide.
When the highest temperature is expected to reach 40°C in a certain place on a certain day, a "high temperature red warning" will be triggered. The defense guidelines include that relevant departments and units should take emergency measures to prevent heatstroke and cool down according to their duties; stop outdoor open-air operations (except for special industries); , weak, sick and young people take protective measures; relevant departments and units should pay special attention to fire prevention.
The high-temperature heatstroke meteorological level early warning is based on the meteorological conditions such as temperature and humidity to predict the potential impact of high-temperature meteorological conditions on the human body for heatstroke.
However, according to Huang Cunrui, a professor at the Vanke School of Public Health and Health at Tsinghua University, the current early warning system lacks pertinence.
"Most early warning systems are only for meteorology, and there are very few early warning systems combined with health risks, and they are relatively simple, and there is still room for optimization." The professor who has long been engaged in climate change health risk assessment and coping strategies said, "We also need to focus on vulnerable Crowd, make refined early warning."
"(The current high temperature warning system) is really not targeted enough." Xu Xiaofeng, president of the China Meteorological Service Association and former deputy director of the China Meteorological Administration, told the China Youth Daily and China Youth Daily reporter, "This is just a forecast for the public."
A study published in the "International Journal of Environmental Research and Public Health" said that about 50% of the respondents knew about the occurrence of extreme heat, but they did not change their behavior. They often did not think they were susceptible. Therefore, The dissemination of health risk information to susceptible populations should be strengthened.
"Heat stroke is the most common health hazard caused by high temperature heat waves, but death from heat stroke is a relatively extreme situation." Huang Cunrui told reporters, "High temperature heat waves will also increase the risk of morbidity and death of cardiovascular and cerebrovascular diseases, respiratory diseases, etc., The elderly, children, pregnant women, and certain occupational groups are more sensitive to heat waves."
Underestimated heat health risks
Many studies have shown that in hot weather, for every 1°C increase in the average daily temperature, many diseases will worsen, and this danger is even fatal.
For example, a study stated that in summer in Beijing, “for every 1°C increase in the daily average temperature, the number of deaths from respiratory diseases increased by 25.7%”; “for every 1°C increase in the daily maximum temperature, the number of emergency room visits for cardiovascular and cerebrovascular diseases increased by 4.2%.” ; "After the temperature exceeds 19 °C, the incidence of diarrhea increases by 7.2% for every 1 °C increase."
A study published in 2012 said that during the heat wave, the number of daily medical visits for mental illness in Jinan increased significantly, and another study published in 2020 also found that the number of hospitalizations for schizophrenia in Shanghai increased during the heat wave.
There are also some studies that show that there is a significant positive correlation between increased temperature and the incidence of suicide, and the mortality rate of diabetes is also significantly increased.
"The whole process of high temperature and heat wave will bring this risk of excess death or induce the occurrence of various diseases." Huang Cunrui said, "At present, we have far underestimated this risk."
In the past 70 years, the annual average surface temperature in China has shown a significant upward trend, with a warming rate of 0.26°C/10 years.
This is the data released at the August press conference of the China Meteorological Administration on August 3.
"The global average temperature in the past 20 years is 1.01°C higher than the pre-industrial level." Yuan Jiashuang, deputy director of the National Climate Center, said at the press conference, "China's warming rate is higher than the global average over the same period, making it a sensitive area for global climate change. In 2021, the average surface temperature in China will be 0.97°C higher than the normal value, the highest value since 1901.
Regarding the high temperature that China is currently experiencing, the assessment at the press conference at that time was that the overall intensity was the third strongest since 1961, second only to 2013 and 2017.
After 10 days, the new forecast said that the overall intensity of this high temperature will be the strongest since 1961.
A study published in March 2022 by scholars from the China Center for Disease Control and Prevention, Peking University and other units showed that in 2017, a total of 16,299 people in China died of all-cause deaths due to abnormal heat waves (referring to all-cause deaths caused by various causes within a certain period of time). Total Deaths - Reporter's Note), in addition, it is estimated that the total economic loss related to death is 61.304 billion yuan.
How to deal with the frequent threats of high temperature and heat waves in the future has long been not just a matter of the meteorological department, but has become a public health issue that urgently needs to be answered.
According to a study co-authored by Huang Cunrui, the death burden related to high temperature and heat waves in China has increased fourfold in the past 40 years, and the death burden is even heavier in the eastern and central regions.
The main drivers of this spatial and temporal change are the increased frequency of heat waves, population growth and aging.
In Huang Cunrui's view, an early warning system for high temperature heat waves and health risks should be established, which is more conducive to the public's access to targeted climate services, thereby reducing the threat of high temperature to human health.
Xu Xiaofeng also felt that, "Strengthening prior forecasting and taking effective countermeasures should be an important part of reducing the impact of disasters."
High temperature and health early warning system that needs to be promoted
In fact, in the past 20 years, China has been trying to establish a "more targeted" "high temperature and health risk early warning" system, but the related early warning business has not been able to be promoted on a large scale across the country.
Judging from past media reports, in the past 21 years, meteorological departments, health departments, and environmental departments have publicly mentioned to the media "the establishment of an early warning system for high temperature heat waves and health risks."
As early as 2001, Shanghai established my country's first "heat wave and health monitoring and early warning system".
Tan Jianguo, director of the Shanghai Meteorological Information and Technology Support Center, once led the research on this project funded by WMO (World Meteorological Organization) and WHO (World Health Organization).
At that time, foreign related research had just started. In 1995, Philadelphia in the United States took the lead in establishing a high temperature and health risk early warning system (commonly referred to as HHWS - reporter's note) on a global scale. During 1998, the system saved an estimated 117 lives.
In the following 10 years, in addition to Shanghai, Washington in the United States, Rome in Italy, and Toronto in Canada all tried to establish such a system.
"But the early warning results of this system have not been officially announced to the public." Tan Jianguo told the China Youth Daily and China Youth Daily reporter, "I tried to promote it at first, but later found that this system is more complicated, not as high as the high temperature three-color warning. Straightforward."
But that attempt led to the establishment of the "Shanghai Key Laboratory of Meteorology and Health" in 2011.
Tan Jianguo said that the laboratory still provides health weather services for the public, and families with asthmatic children and patients with chronic obstructive pulmonary disease will receive early warning of disease risk.
"The previous high temperature warning and heat stroke warning systems usually use the highest temperature or heat index to determine high temperature weather, and only consider the effect of temperature and relative humidity on the human body, without considering the comprehensive effect of other meteorological elements." Huang Cunrui said, "In fact, the human body has The response to high temperature and heat waves is the result of the combined exposure of multiple meteorological elements, rather than the effect of a single meteorological element."
In 2013, a more complex and targeted early warning system for high temperature and heat waves and health risks was led by the China Center for Disease Control and Prevention, and pilots were established in Shenzhen, Nanjing, Chongqing and Harbin.
A researcher who has participated in the development and construction of the system told China Youth Daily and China Youth Daily that the four pilot cities selected are located in different climatic zones and have different climatic characteristics.
"Although the climate is warming overall, in different climate zones, the climate characteristics are different, and its impact on health will also be different." The researcher said, "Our study shows that in Harbin, there is a significant increase in the risk of death. The daily maximum temperature threshold for China is 29°C, but it is 35°C in Nanjing, 33°C in Shenzhen, and 34°C in Chongqing. The temperature threshold for a significant increase in the risk of death is different in different places.”
In that year, researchers collected historical data such as meteorology, air quality, mortality and morbidity, and used mathematical models to establish prediction models between high temperature heat waves and different diseases in various cities.
The early warning system includes five types of early warnings: cardiovascular and cerebrovascular diseases, respiratory diseases, childhood respiratory diseases, heat stroke, and total health risks. "It is a sensitive disease of high temperature and heat waves selected based on literature and our own data analysis."
"The significance of establishing this kind of early warning system is to move forward at the threshold of health risk prevention and control," said the researcher, "to realize early warning, early knowledge and early protection of health risks of high temperature and heat waves."
Risk warnings are divided into four levels: red, orange, yellow, and blue. When the warning reaches the corresponding level, the warning information will prompt the risk level of a certain disease, the corresponding response level, and the response suggestions for different groups of people.
Early warning information is released to health systems, communities, schools, hospitals, etc. by means of electronic displays, text messages, QQ groups, WeChat groups, websites, and weather stations.
"It is equivalent to (making the early warning) more targeted." The researcher said, "For example, the community in Nanjing has 'healthy huts', with relatively complete residents' health records, (doctors) will have a follow-up and risk for key populations. hint."
In Nanjing, the researchers did a comparative study during the operation of the project, "and found that the incidence of symptoms related to hypertension in the warning community was significantly lower than that in the non-warning community."
"Death is the most serious health effect endpoint of heatwave-related health effects, and early warning prediction with illness as a health endpoint has more public health implications," says a paper studying the system.
It is understood that the research project ended in 2016.
It's just that the system has not been rolled out nationwide.
However, in Shenzhen, with the support of the local government, the early warning system was promoted and applied to the whole city from the demonstration community, and in 2017, the "high temperature and heat wave health risk index" was released to the public, and normalized services were launched, while Nanjing's comprehensive intervention The model was promoted and applied to Yancheng, Jiangsu.
"Because the selected pilot cities have a good degree of cooperation, the whole process is relatively smooth." said the above-mentioned researcher, "the main problem encountered is the funding and project support for the continuous operation of the system. Currently, it is mainly based on the Global Environment Facility (GEF) project The remaining funds will pay for the operation and maintenance costs.”
"I hope to see the support of the local government like Shenzhen to continue this project." The researcher said that carrying out community intervention is very labor-intensive and requires financial and government support. "It is difficult to persist." .
That year, this project was one of the first global pilot research projects to adapt to climate change and protect human health in seven developing countries in different geographical locations around the world, carried out by WHO in collaboration with the United Nations Development Programme (UNDP) and GEF.
The results of this project have been fully recognized by international organizations such as WHO and WMO, and have been invited to report and exchange at international conferences many times.
Judging from the papers published one after another, after the system entered the trial operation state, the early warning effect of the total respiratory system and total cardiovascular system disease in some cities was not ideal, but it was not effective for heat stroke, children's respiratory disease, and respiratory system of people over 65 years old. The early warning rate of diseases, cardiovascular and cerebrovascular diseases is more accurate.
On the whole, the early warning system signals are operating well, and "early warning capabilities have been initially achieved, but further adjustments and improvements are still needed," concluded a research paper on the system.
"The accuracy mainly depends on historical monitoring data such as meteorology, air quality, mortality and morbidity, as well as the accuracy of weather forecast data." The researcher told reporters that other factors not obtained during the modeling process, as well as population-related factors The improvement of knowledge and self-protection awareness may have an impact.
Xu Xiaofeng felt that in dealing with high temperature weather, there is no obvious difference between the world and my country in general, but in terms of basic scientific research, there are many international research results worth learning from.
"There are also some advantages in terms of policy support, such as data sharing and access, which is relatively easy."
On August 27, 2021, the China Meteorological Administration issued the "Work Plan for the Construction of High Temperature Monitoring, Forecast and Early Warning Business System (2021-2025)".
Five provinces of Beijing, Jiangsu, Zhejiang, Guangdong, and Chongqing were selected as pilot provinces for business system construction.
The construction of these business systems includes "establishing a strategy model for early warning release of high temperature sensitive areas and groups based on early warning information; establishing a high temperature environmental health meteorological risk forecast and early warning business".
"In general, the health risk early warning system for high temperature and heat waves in China started relatively late, and the model has yet to be developed and optimized." In Huang Cunrui's view, the pilot projects in some cities are the future development of high temperature and heat waves for the whole population, multiple diseases, and the whole region in the future. Foundations of health risk early warning systems.
General alerts to be optimized
At present, it is not only the high temperature health risk early warning system that needs to be optimized, but the most common weather forecast and high temperature three-color early warning, which are the most common and play a major role, also have room for optimization.
"The current high temperature yellow, orange and red early warning signals can already play a very good role in heat wave early warning." Tan Jianguo thinks, "The core problem is that everyone can make good use of this early warning signal."
In many places, people will suspect that the weather data provided by the Bureau of Meteorology is not true, and even speculate that "the Bureau of Meteorology reports low temperature and low temperature", "does not dare to forecast high temperatures above 40°C", and "does not give subsidies for high temperature in order to stop work."
"There is no such thing as a low temperature forecast, which may be related to the actual body temperature." Xu Xiaofeng told reporters, "The weather station is based on the temperature in the shutter box of the observatory, which is different from the temperature that everyone feels in different places. different."
For the construction of weather stations, the state has strict construction standards: there is a certain area of shallow grass on the underlying surface, and the thermometer is placed in a louver box to avoid direct sunlight and maintain ventilation, and the louver box is 1.5 meters above the ground.
"The perceived temperature mainly depends on four factors, air temperature, radiation temperature, wind, and relative humidity." Tan Jianguo said that the impact of humidity on people in a high temperature state is like the temperature that people who take a sauna and dry sauna can withstand. The limit, higher than someone who takes a wet sauna.
Another problem behind the temperature difference is the heat island problem. Tan Jianguo told reporters that usually, the temperature in the weather forecast is generally 1°C to 2°C lower than the temperature in the city center or the center of the heat island.
This is because in the past 20 years, urbanization and other factors have affected the meteorological monitoring environment, and the meteorological representative stations in many cities have also been forced to relocate.
Some meteorological representative stations are located in the suburbs.
In recent years, some places have achieved more accurate forecast and monitoring of meteorological conditions by increasing the density of automatic weather stations.
Taking Shenzhen as an example, the weather forecast information from the Central Meteorological Observatory shows that on July 24, the highest temperature in Shenzhen was 36°C.
The meteorological service information on the official website of the Shenzhen Meteorological Bureau shows that the temperature in Longgang Street at 15:00 that day was 39.3 °C.
The difference is that the meteorological data on the official website of the Shenzhen Meteorological Bureau is collected from "automatic weather stations" with higher density, and the temperature of each street is collected live.
The "Work Plan for the Construction of High Temperature Monitoring, Prediction and Early Warning Business System (2021-2025)" also mentioned that it is necessary to establish a regional high temperature event monitoring business with a fine grid, and to increase the resolution of the global high temperature live product to 5 kilometers, and to increase the regional high temperature event in China. to 1 km.
Nowadays, in some weather forecasting apps, the "feeling temperature" often appears in the forecast information, sometimes as high as 50°C, which is generally 5-10°C higher than the meteorological temperature.
However, local meteorological departments rarely mention body temperature when releasing weather forecast information or high temperature warning information.
After the high temperature and heat wave in July, on August 4, the Hubei Meteorological Bureau released the first physical temperature forecast in Hubei Province, of which the highest physical temperature in Suizhou was 9°C higher than the highest temperature on that day.
Tan Jianguo mentioned more than 10 years ago that local meteorological departments can try to issue "feeling temperature forecasts".
"But in fact, it is rarely done all over the country, because the body temperature of individuals varies greatly, and there is no unified standard to test the forecast, which is also very difficult."
"The somatosensory temperature is more scientific and should be promoted." Xu Xiaofeng said, "If the somatosensory temperature can be provided, it can basically replace the function of the WGBT index meter, and it should be more effective."
The WBGT index instrument is a device used to "comprehensively evaluate the heat load of the human contact working environment", and its basic parameters include temperature, humidity, airflow and heat radiation.
Some factories that have been exposed to high temperature operations for a long time, in order to avoid occupational heat stroke, often place WBGT index meters in the factory buildings. When the index exceeds a certain limit, it is necessary to reduce the working hours or even stop work to avoid injury.
Although the Measures for the Administration of Heatstroke Prevention and Cooling Measures stipulates the measurement of WBGT index for high temperature work in the workplace, occupational exposure limits, etc., not all employers implement it without compromise.
Not long ago, the Beijing Municipal Health and Health Supervision Agency inspected 353 household units, of which 6 failed to implement heatstroke prevention and cooling work as required.
In some ordinary factories, with the more frequent occurrence of extreme high temperature, when they encounter high temperature meteorological conditions, they often face the situation of "high temperature operation", and heat stroke events also occur from time to time.
Among the deaths from heat stroke counted by reporters from China Youth Daily and China Youth Daily, many people worked in an indoor high-temperature working environment caused by high-temperature meteorological conditions, not traditional "high-temperature work".
"Some new problems we are facing now require more professional and detailed policies to deal with." Xu Xiaofeng said.
In Xu Xiaofeng's view, the existing "high temperature three-color early warning" mechanism, facing different groups of people, different fields, and different working environments, how to determine the early warning standards and improve measures is an issue that can be discussed.
"It is necessary to publish targeted forecasts for different groups, and the popular public forecasts currently provided cannot meet the needs." Xu Xiaofeng felt, "Professional forecasting services should be provided according to the needs."
"But this is a problem of service refinement. The refinement of services often does not have to be released through public release, and public release cannot be so detailed." Xu Xiaofeng felt, "Now many commercial services have begun to increase, such as the pollen allergy index. , some companies are willing to process this product better, finer and more targeted, so it is actually possible to play the role of the market.”
Silent Heat Stroke Event Warning
In addition to weather forecast, high temperature three-color warning, high temperature heatstroke weather level warning, high temperature and health risk early warning, China also has a set of "high temperature heatstroke event warning" mechanism, but many people are not familiar with it.
Since August 1, 2007, "cases of high temperature and heat stroke" have been included in the report of "public health emergencies".
The direct reporting of high temperature heatstroke cases has also become an important part of the early warning mechanism for high temperature heatstroke events.
From June 1 to September 30 every year, a set of online direct reporting systems related to "high temperature heatstroke events" will be launched.
Similar to the reporting system for infectious diseases, after a medical and health institution finds a case of high temperature and heat stroke, it is required to fill in the "High Temperature Heat Stroke Case Report Card" and report it through the China Center for Disease Control and Prevention's online direct reporting system on the same day.
For medical institutions that do not have the conditions for direct online reporting, the "High Temperature Heat Stroke Case Report Card" should be reported to the local county-level Center for Disease Control and Prevention in the fastest way on the same day.
The responsible reporters of high temperature and heat stroke incidents are the relevant staff of various medical institutions at all levels, the Centers for Disease Control and Prevention, and even rural doctors and individual medical practitioners.
This system has been implemented since the issuance of the "Health Emergency Plan for High Temperature and Heat Stroke Events" (hereinafter referred to as the "Plan") in 2007.
In the 35 years he served in the meteorological system, Xu Xiaofeng was most impressed that after the SARS incident in 2003, the country began to formulate emergency plans for public incidents, and he participated in it.
On January 8, 2006, my country promulgated and implemented the National Overall Emergency Response Plan for Public Emergencies. Later, various departments also formulated special emergency plans, including the meteorological department.
"The high temperature weather was also officially included in the event sequence of emergency management at that time, which played a positive role in strengthening the early warning and taking countermeasures later." Xu Xiaofeng said.
The plan requires health and meteorological departments at all levels to formulate a targeted emergency plan for high temperature and heatstroke events and formulate emergency response work specifications for high temperature heatstroke events in accordance with relevant laws and regulations and local actual work conditions.
The reporter noticed that some cities and counties announced localized plans many years ago, some cities and counties successively formulated, announced and implemented "plans" last year and this year, and some cities and counties have not yet been able to find relevant plans.
The reporter learned that some staff from local meteorological departments and health departments were not familiar with the plan, and even said, "I really didn't understand it before."
The person in charge of the health and health commission of a city where death cases of heat stroke have occurred told reporters that there is no specific plan in the province or city, but the plan announced by the state in 2007 is now being implemented, including the online direct reporting system for high temperature and heat stroke cases. in operation.
The early warning of "high temperature heatstroke event" is an important part of this plan.
The plan makes detailed provisions on monitoring, reporting, forecasting, early warning, and the release of early warning information for "high temperature and heat stroke events".
The plan divides "high temperature heatstroke events" into four levels: particularly serious (level I), major (level II), relatively large (level III), and general (level IV). into the category of public emergencies”.
The plan requires that the health and meteorological administrative authorities should establish a joint forecast and early warning mechanism.
"Once the meteorological conditions of high temperature and heat stroke or signs of high temperature heat stroke events are found, the forecast information of high temperature weather conditions or high temperature heat stroke events shall be released to the public in a timely manner."
The release of early warning information on high temperature heatstroke events will also affect the start of the "emergency response" at the place where it occurs.
According to the grading standard for high temperature and heatstroke events in the "Health Emergency Plan for High Temperature and Heat Stroke Events", when "within 24 hours, 100 to 149 heatstroke patients or 1 to 3 deaths are reported in a county (city) area" , when classified as "major high temperature heat stroke event (grade III)".
高温中暑事件级别达到Ⅲ级，且高温中暑气象预报级别达“较易发生中暑” (高温中暑气象等级预警为三级时，描述为“较易发生中暑”——记者注)以上，高温天气还有持续或加重趋势的，则满足“高温中暑事件三级预警(黄色预警)”的预警标准。
但记者通过检索查询相关城市的“高温中暑事件预警信息”，在2022年媒体公开报道出现过1例及以上热射病死亡病例的城市，并未发现当地气象与卫生部门通过媒体公开发布过“高温中暑事件预警信息”。记者向其中一些城市的医院急诊或卫生部门核实，确认了“高温中暑病例”网络直报系统的存在与运行。
武汉一位急诊科医生告诉记者，当遇到中暑病例，医生填写病例单时，电脑页面会自动弹出“高温中暑病例报告卡”，必须在填写报告卡后，才能完成后续的诊疗。
据中国新闻网报道，重庆市大足区人民医院急诊科7月13日收治6例热射病患者，当天晚上有两人不幸去世。
7月11日，重庆市气象台发布“高温红色预警”，重庆市卫生健康委员会、重庆市气象局联合发布“高温中暑三级预警”。
两种预警信号所涉及的地区均包括重庆市大足区。据当时的预警信息，7月12日至16日，重庆仍将维持晴热高温天气，大足区等地，易发生高温中暑。
但记者并未从公开渠道查询到，重庆市或重庆市大足区卫生与气象部门联合公开发布过“高温中暑事件预警信息”。
“我认为还是一个部门间的联动问题，不应该存在不公开的问题。”许小峰告诉记者，“从目前的情况看，各地相关制度建设应是基本到位的，而实际差距往往出现在应急联动环节，需要在实际工作中完善。出现了问题，往往也是改进工作的最佳时机。”
“(中暑预警)信号和事件是两码事情。”重庆市某县卫健委应急办一位工作人员告诉记者，进入8月后，她所在的县也发布了“高温中暑三级预警”，“就是提醒你注意预防(中暑)”。
而高温中暑事件预警信息的出现，意味着已有可列入“突发公共事件”范畴的中暑事件出现，而发布高温中暑预警信息的卫生、气象部门需合作联动，向高温中暑事件发生地人民政府提出事件的防控建议，指导、督促高温中暑事件发生地的卫生、气象部门积极开展相关应急工作。
上述卫健委工作人员表示，自己2015年工作以来，到目前并未遇到过中暑引发的突发公共卫生事件。目前，县疾控中心每周一会汇总上周本辖区高温中暑病例情况，报送到县卫健委应急办。“(病例数量)达到一个级别了，他们要跟我们报，我们也是第一时间要跟政府，跟市卫建委报。” 上述工作人员表示。
“从国家到地方，包括各部门，都制定了应急预案，各级政府也都成立了应急部门。之所以发生一些脱节，关键还是抓落实不够。”许小峰说，“这种应对需要各部门的联动，气象、卫健委，当然也包括政府部门、应急管理部门，共同推动这个事情。”
在黄存瑞看来，《高温中暑事件卫生应急预案》起到了一定作用，但目前较少见到中暑事件预警，还是应当加强高温中暑事件的监测、预警和报告。
“(中暑事件预警)可能只是在疾控系统内部。”黄存瑞觉得，“但不对外公布，可能导致公众预防中暑的意识薄弱，以及各政府部门的风险认识不足。”
那些来自全国各地的高温中暑事件，经由直报系统，最终汇集到各省疾控中心与中国疾控中心。由此而来的一些数据，展示了一种值得注意的风险。
一项关于2006年至2012年间济南市所报告的突发公共卫生事件的研究发现，在6年间共报告的158起公共卫生事件中，传染病事件126起，高温中暑事件19起，但高温中暑导致的死亡人数占46.34%。
记者在2014年至2019年间发表于《疾病监测》杂志的“8 月全国突发公共卫生事件及需关注的传染病风险评估”相关文章中找到了部分涉及全国的“高温中暑病例”报告数据。
这些数据是中国疾控中心统计的、截至当年7月31日的全国报告高温中暑病例的数量。2014年全国报告高温中暑死亡病例26例，2015年16例，2016年63例，2017年144例，2018年89例，2019年76例。
相关文章发现，我国高温中暑主要发生在每年七八月，这两个月的中暑病例常占全年的90%以上，中暑死亡病例数常占据全年死亡总数的97%以上。
气候变化下的水土不服
越来越多的证据表明，如今的夏天已经不像传统的夏天。中国东部地区很多地方日最高气温罕见地突破历史极值，比如太行山东侧的灵寿、正定，日最高气温甚至超过了44℃，上海自有气象记录150年以来，超过40℃的天气第一次达到6天。
最高气温还在不断刷新最高纪录。人们本渴望在日落后迎来舒爽的夜风，但夜间温度也在升高，在重庆沙坪坝，有气象数据显示，凌晨的温度也超过36℃。
吐鲁番市托克逊县气象局副局长阿地力·苏拉衣曼对这种炎热非常熟悉。在新疆托克逊县，夏日气温超过40℃，是常见的事情。刚刚过去的7月，托克逊有19天，最高温度达到40℃以上。这里深处吐鲁番盆地，属于温带荒漠气候，以热著称。
“我们这儿中暑的一般都是外地的游客，本地的很少。”阿地力·苏拉衣曼告诉中青报·中青网记者，“因为他(游客)没有经历过这种像我们土生土长的从小就是那样的生活习惯。”
“生活习惯，或者说这种经验，都是养成的，千百年来，肌肉都有记忆。”谈建国说，“好多人水土都不服，那不仅仅是拉肚子的问题，其实是陌生人到从来没有到过的新的气候环境里头了。”
如今，当热浪蔓延到更多地方，一些传统方法已不再适用。
“2003年欧洲热浪，死了好多人，就是因为适应不了变暖后的气候。”谈建国说，“以前欧洲温带海洋性气候，不会很热，家里都不用装空调。”
“从历史上来讲，我们房屋设计并没有应对过热，而是为了保暖。”英国一位从事能源和建筑研究的教授在接受媒体采访时说。国际能源署2018年的一份报告指出，随着热浪的侵扰，在欧洲的一些地方，过去10年的空调拥有量在迅速上升。
“(应对高温)最直接的手段，就是有空调。”谈建国觉得。
重庆璧山68岁的保安冯思元，倒在“只有风扇，没有空调”的门卫室；河南开封54岁的洗碗工韦巧连的工作厂房里，“一个冷风机悬在头顶”“制冷效果也达不到”；福建泉州44岁的车间女工，倒在“没空调但通风条件还可以的”工厂；湖北武汉20岁的大学生暑假工郭腾旭倒在下班后的第6分钟，而此前工作了一天的厂房“有风扇，没空调”。
“当室外气温达到一定程度的时候，开风扇是没有用的，仅仅通风其实已经起不到健康保护的作用。”黄存瑞说。“气候变化让地球大气系统紊乱了，人们过去的很多经验已经不再适用。如果超出我们的应对能力范围，就会带来额外的健康风险。”
“普通人的气候素养是非常重要的。”一位曾参与高温与健康风险早期预警系统研究的工作人员说，自己在不同城市做前期调研时发现，不少人没听说过气候变化，也不知道“高温热浪是什么”，不清楚高温对自己身体或疾病会产生的负面影响，甚至有些人不看天气预报。有一年夏天项目执行期间，去哈尔滨，正好赶上一年中较热的几天，有时去饭店吃饭，发现空调制热不制冷。
2019年有研究者比对了欧洲16个国家的高温与健康预警系统，并发现，“宣传教育是预警系统成功的关键因素。”在大多数欧洲国家，预警系统，不过是“热浪健康计划”的一部分，其他部分通常包括科普、利益相关方的干预、长期规划等。
谈建国觉得，把现有预警系统利用好的关键还在于科普，想要针对脆弱群体提高预警的精准度，也需要更多的科普。许小峰同样觉得，“科普工作不足，影响了社会对高温应对措施的认识和理解。”
“在极端天气增加的背景下，应考虑一些超过以往预期的情况发生。”许小峰告诉记者，“对于极端事件应考虑加大防范力度。”
仅从2022年来看，超预期的情况，也正越来越多发生。
就在8月15日，中央气象台的全国气温实况排行榜上，前10名的上榜线提升到了43℃，在2418个国家级气象观测站中，常居榜首的吐鲁番不见踪影，重庆奉节以44.4℃位居第一。
The consensus of many climate change experts is that 1.5°C is the critical value for global average temperature increase.
Today, human beings are pushing themselves to the edge of the cliff - 1.11°C.
China Youth Daily, China Youth Daily reporter Li Qiang Source: China Youth Daily
August 17, 2022 Version 05