North Carolina’s heat season runs from May 1 to Sept. 30 each year, and the state has launched an effort to raise awareness about the dangers that high temperatures pose to people’s health.

North Carolina Heat Safety Week, which began Monday and ends Friday, highlights resources to keep residents and visitors safe from extreme heat, Gov. Josh Stein’s office announced Monday.

“Being resilient to extreme heat means understanding how it can affect you and your community,” Stein in the release. “All North Carolinians can take actions to protect themselves and their families, employers can protect their workers, and local governments can protect their residents. Our state agencies and local governments are working hard to help keep people cool and safe.” 

Officials said in the release that heat-related illness and death are largely preventable.

“Recognizing the symptoms of heat illness is key to preventing serious complications, including death. Some signs and symptoms include heavy sweating, paleness, muscle cramps, racing or weak pulse, dizziness, headache, fainting, and nausea or vomiting. Awareness of extreme heat events can help people take the necessary steps to keep themselves safe,” they added.

While heat-related illnesses can affect anyone regardless of age or physical condition, those who live or work outside, are pregnant, children, older, athletes, low income or with underlying health conditions are at a disproportionate risk of experiencing adverse health effects. 

“As our summer days and nights stay warmer for longer, it’s critical that all North Carolinians learn about the symptoms of heat illness and the steps to take to cool down,” North Carolina Department of Environmental Quality Secretary Reid Wilson said. “DEQ’s State Resilience Office is working closely with local governments to help them identify strategies to help manage extreme heat.”

The state highlighted State Resilience Office programs to help communities plan for extreme heat, including the Heat Action Plan Toolkit, the Planning for Extreme Heat Cohort and NC Resilience Exchange website, which provides a complete collection of resources to help local and state leaders easily find information and data to support resilience planning. 

The health department offers the NC Heat Health Alert System, a free email service to alert when dangerous heat is in the forecast. The emails alert recipients of when the daily maximum heat index is expected to reach dangerous levels.

“As we see the number of heat-related emergency department visits continue to increase, it is important that you and your loved ones stay weather-aware as the temperatures rise,” said N.C. Health and Human Services Secretary Dev Sangvai. “We encourage everyone to sign up for the heat health alerts, know the symptoms of heat-related illness and protect your health this summer.”  

Additionally, Operation Fan Heat Relief is underway now through Oct. 31. Contact the local aging agency to see if they qualify for a free fan for the hot summer months.

State and weather officials are hosting a virtual meeting on Monday to discuss ways in which local governments can prepare for North Carolina’s heat season.

During the meeting, which is open to the public but targeted to local government staff including emergency managers, public health personnel, planners and administrators, officials will provide a forecast for the 2026 heat season, review signs of heat illness and preventative actions, and provide tools and resources available to local governments to address heat impacts in their communities.

The North Carolina Department of Environmental Quality’s State Resilience Office is hosting the event 1-3 p.m. in partnership with the N.C. Department of Health and Human Services, North Carolina State Climate Office and the National Weather Service.

Officials will highlight DEQ’s Planning for Extreme Heat Cohort, a free program that aids local governments in developing heat action plans and connecting with climate and policy experts from North Carolina and across the nation, and the North Carolina State Climate Office will present its Southeast Heat Monitor, a new tool that forecasts statewide heat stress threats.

“We all know that it gets extremely hot in North Carolina during the summer, resulting in serious health problems for people of all ages,” DEQ Secretary Reid Wilson stated in a release. “We encourage local governments and the public to participate in our Heat Season Kickoff Meeting May 11 to understand the health risks and identify ways to protect communities from extreme heat.”  

July 2025 was the second warmest July for North Carolina in 130 years. There were more than 5,700 heat-related visits last year to emergency departments in North Carolina, according to DEQ.

Last year was also globally the third-warmest year on record, following 2023 and 2024.

“We want you have to a safe and healthy summer, but with thousands of heat-related emergency department visits last year, it is critical to be prepared for extreme temperatures to protect yourselves and families,” N.C. Health and Human Services Secretary Dev Sangvai stated. “NCDHHS continues to work with state and local partners to inform North Carolinians about health effects from extreme heat and ensure resources are available for people at risk of experiencing heat-related illness.”

During the meeting, DHHS will share its resources to manage heat-related health impacts, including the NCDHHS Heat Health Alert System, which notifies subscribers of dangerous heat indexes throughout the summer months and provides materials to support prevention.

The department also publishes weekly reports detailing heat health impacts for each region of North Carolina, and trains health care workers and others across the state to recognize and respond to heat illnesses.

Extreme heat has broad impacts across the state, damaging roads, electrical infrastructure and North Carolina’s agricultural industry. The state’s heat season began May 1.

Local governments can open local cooling centers, share educational information, integrate heat action into long-term planning for infrastructure, and plant trees to help protect residents from extreme heat.

Those who would like to attend the meeting may register online.

Late June’s scorching temperatures and punishing heat index, now forecasted to bleed into July, have prompted Brunswick County to call for a burn ban.

As of 5 p.m. Monday, a burn ban will be in effect for unincorporated areas within the county. Burning within 100 feet of any structure is banned.

“Current and future weather forecast models indicate conditions that are not favorable to open burning,” according to a Brunswick County release.

The ban was announced shortly after Brunswick County Public Utilities issued a stage 1 water conservation alert, which asks customers to voluntarily adjust their water usage habits to help reduce peak demands.

Open burning permits issued by the North Carolina Forest Service are omitted from the ban, as are permitted fireworks displays scheduled in observance of the July 4 holiday.

“Because of these conditions, officials recommend individuals avoid using personal fireworks this Independence Day weekend and consider attending professional fireworks displays instead,” the release states.

For details and fireworks safety tips, visiting the county fire marshal’s office website.

The burn ban will remain in place until condition improve. For questions, contact the fire marshal’s office at 910-253-2021.

Anyone who resides in a city or town should contact their municipal offices for information related to local burn bans.

Additional information may be found on the county’s burn ban/open burning webpage.

All coastal counties are forecast to reach high heat levels this week.

Beaufort, Bertie, Brunswick, Camden, Carteret, Chowan, Craven, Currituck, Dare, Gates, Hertford, Hyde, New Hanover, Onslow, Pamlico, Pasquotank, Pender Perquimans, Tyrrell and Washington counties are expected to experience on Tuesday, Wednesday and Thursday a maximum heat index of 96 degrees or hotter.

The heat index, also called the apparent temperature, is what the temperature feels like to the human body when relative humidity is combined with the air temperature, per the National Weather Service.

The North Carolina Health and Human Services Climate and Health Program issued the heat-health alerts on Monday, warning that high heat can be dangerous for people who are more exposed to or more sensitive to extreme heat, such as those who are pregnant, living with disabilities or underlying health conditions, are without access to air conditioning, who work or exercise outdoors, or are older adults.

To prevent heat-related illness, the health department recommends drinking plenty of fluids, avoiding caffeinated, sugary or alcoholic drinks, staying in air conditioning as much as possible, stay informed and watch for symptoms, which include heavy sweating, muscle cramps, dizziness, nausea, and headache, the department continued.

The alerts are issued when the forecast is projected to reach or exceed the heat index threshold for the regions, as established by Duke Heat Policy Innovation Hub using historical heat index data and state records to determine when emergency room visits increased for heat-related illnesses.

Visit the state Department of Public Health, Epidemiology: Occupational and Environmental website to sign up for the heat alerts and more information on heat-related illnesses.

Several coastal counties are expected to experience unhealthy heat levels over the weekend.

Chowan, Perquimans and Washington counties are expected to have a maximum heat index of 96 degrees or higher on Saturday.

Craven, New Hanover, Onslow, Pamlico and Pender counties should plan for the same on both Saturday and Sunday.

The National Weather Service explained that the heat index, also called the apparent temperature, is what the temperature feels like to the human body when relative humidity is combined with the air temperature.

The North Carolina Health and Human Services Climate and Health Program sends out the heat-health alerts when the forecast is projected to reach or exceed the heat index threshold for the region.

Duke Heat Policy Innovation Hub established the region-specific thresholds by using historical heat index data and state records to determine when emergency room visits increased for heat-related illnesses.

“Heat of this magnitude can be dangerous to your health, particularly for people who are more exposed to extreme heat or more sensitive to extreme heat,” which includes those who are pregnant, living with disabilities or underlying health conditions, are without access to air conditioning, who work or exercise outdoors or are older adults, the department stated in a release.

To prevent heat-related illness, the health department recommends drinking plenty of fluids, avoiding caffeinated, sugary or alcoholic drinks, staying in air conditioning as much as possible, watch for symptoms and stay informed, the department continued.

Visit the health department’s website to sign up for the heat alerts, or for more information on heat-related illnesses and tools to prevent it.

As North Carolina readies for another extremely hot summer, Gov. Josh Stein’s office warns that federal cuts could affect the state’s heat-related programs.

The National Weather Service projects a 40 to 50% chance that the state will experience above-normal temperatures for June, July and August, based on its seasonal temperature outlook issued earlier this month.

“North Carolina is preparing for another summer of record heat. While you are outside this summer, please take the necessary steps to prevent heat exhaustion and illness,” Gov. Josh Stein said Tuesday in a release announcing May 25-31 as North Carolina Heat Awareness Week.

Stein’s office said Tuesday that federal budget and staffing cuts at agencies like the U.S. Centers for Disease Control and Prevention and the Environmental Protection Agency threaten programs that support heat safety.

“Our environmental health and epidemiology teams conduct critical work every day to inform North Carolinians of potential health effects of extreme heat, as well as ensure resources are available for those who experience heat-related illness,” Department of Health and Human Services Secretary Dev Sangvai said in a release. “Cuts to these services would be detrimental to the health and well-being of the more than 11 million people who call North Carolina home.”

In an email responding to questions, a DHHS representative said Tuesday that the federal cuts “have put environmental health services that support clean drinking water, childhood lead poisoning prevention, food safety, and monitoring of environmental health and climate data at risk at the state and local levels.”

One of the programs at risk is the state’s Climate and Health Program, which “is part of a national public health effort to anticipate and prepare for human health effects related to global and local climate change.”

North Carolina’s Climate and Health program supports a handful of tools, including the state heat health alert system, which sends notifications and alerts when the weather is forecasted to reach unhealthy levels.

“Last year, more than 1,200 alerts were sent to inform local communities, share our Communications Toolkit, and keep people in North Carolina safe,” a representative told Coastal Review.

The state’s surveillance system that tracks emergency department visits for heat-related illnesses is also in jeopardy. Weekly statewide reports are published online “to provide timely and actionable public health information for decision-makers at the state and local levels,” according to the department.

During the summer of 2024, there were 4,688 heat-related illness emergency department visits, nearly a 20% increase from 2023, Stein’s office said.

Also at risk is a new farmworker health training program, in collaboration with the Health and Human Services’ Office of Rural Health, which will help providers identify and treat heat-related illnesses and other farmworker health hazards.

The CDC, under the U.S. Department of Health and Human Services, has funded the state’s Climate and Health Program since 2010, and received in late 2024 funding through 2026, according to the state health agency. The national climate and health program “supports state, tribal, local, and territorial public health agencies as they prepare for climate change’s health impacts.”

HHS Secretary Robert F. Kennedy Jr. announced plans March 27 to restructure the entire agency, and the CDC wasn’t immune.

According to dozens of reports in late March and early April, the Atlanta-based CDC lost around 2,400 employees as part of the restructuring. These cuts wiped out the center’s Division of Environmental Health Science and Practice within the National Center for Environmental Health, which manages programs on climate and health, asthma, and lead poisoning prevention.

“We aren’t just reducing bureaucratic sprawl. We are realigning the organization with its core mission and our new priorities in reversing the chronic disease epidemic,” Kennedy said at the time.

In February, the state Health and Human Services was notified of cuts to National Institutes for Health that impact the Office of Rural Health.

Reports came out in late March that the entire state Health and Human Services would eliminate dozens of positions and lose tens of millions in funding, mostly associated with disease and behavioral health.

“The federal grant funding impacts a number of areas of work including immunization efforts, funding for the new NC Immunization Registry, infectious disease monitoring and response, behavioral health, substance use disorder services, and more. Some of the impacted funding supports work that is completed by local health departments, universities, hospitals and local departments of social services,” a state DHHS representative told Coastal Review on Wednesday.

Kennedy has gone before House and Senate committees in the last few weeks to defend the agency’s draft budget, and was grilled about the previous and expected cuts and gutting of health programs.

Heat health, ‘Climate warming trends’

“Several communities across North Carolina experienced their hottest days ever recorded in 2024, and 2025 is likely to continue this trend,” according to the governor’s office, and extreme heat is responsible for the highest number of deaths each year among weather-related hazards.

Heat-related illnesses can affect anyone regardless of age or physical condition. Outdoor workers, infants and children, older adults, pregnant people, athletes, low-income individuals and people with underlying health conditions are at a disproportionate risk of experiencing adverse health effects.

Recognizing the symptoms of heat illness — include heavy sweating, paleness, muscle cramps, racing or weak pulse, dizziness, headache, fainting, and nausea or vomiting — can help prevent serious complications, including death. Some signs and symptoms.

Stein’s office said that declaring this week as North Carolina Heat Awareness Week is to “bring awareness to ongoing climate warming trends.”

The United States is expected to warm faster than other parts of the world, the EPA explained on its website.

“Across the contiguous United States, average temperatures have already risen about 60% more than the global average since 1970. This is expected to continue as global temperatures rise due to climate change,” the agency continued. “As average temperatures rise due to climate change, the risk of extreme temperatures, heat waves, and record-breaking temperatures increases.”

The World Meteorological Organization in a report released Wednesday forecast that there’s an 80% chance that at least one of the next five years will exceed 2024 as the warmest on record.

“The WMO Global Annual to Decadal Climate Update (2025–2029) projects that global temperatures are expected to continue at or near record levels in the next five years, increasing climate risks and impacts on societies, economies and sustainable development,” according to the organization.

Residents 60 and older and adults living with disabilities can sign up for help with heat relief starting Thursday.

The North Carolina Department of Health and Human Services’ Division of Aging, area agencies on aging, and local service providers will begin distributing fans through the Operation Fan Heat Relief program from May 1 to Oct. 31.

Sign up for assistance with local service providers, contact your area’s agency on aging or call NCDHHS Division of Aging at 919-855-3400.

The relief program has been in place since 1986. In 2024, $86,000 in donations allowed for 3,670 fans and 35 air conditioners to be distributed in 94 counties.

“Keeping cool is important because older individuals with chronic medical conditions are less likely to sense and respond to changes in temperature, and they may be taking medications that worsen the impact of extreme heat. Operation Fan Heat Relief helps vulnerable adults at risk for heat-related illnesses stay safe during the summer,” according to the release.

The North Carolina Department of Environmental Quality State Energy Office has opened the public comment period for the Weatherization Assistance Program’s annual state plan.

The program serves residents in low-income and disadvantaged communities save energy, reduce their utility bills and stay safe in their homes.

The public comment period opened Monday and ends April 21.

In addition to the plan, the public may also comment on the accompanying revised proposed Training & Technical Assistance Plan, Health & Safety Plan and Weatherization Installation Standard Work Specifications, all of which are being considered for adoption.

A public hearing has been scheduled for 1 p.m. April 17 at the DEQ Green Square Office Building on Jones Street in Raleigh, as well as virtually.

The hearing officer may limit the amount of time a speaker may comment to accommodate the total number of speakers.

Written comments can be sent by mail to the NCDEQ Weatherization Assistance Program, 1613 Mail Service Center, Raleigh, NC 27699-1613, or by email to seo.publiccomments@deq.nc.gov, with “2025 Weatherization Comment” in subject line. 

Public comments must be postmarked, emailed or delivered in person to the State Energy Office by April 21.

The plans are available for review at www.deq.nc.gov/wap-hearings. Physical copies of the plan are also available for viewing at any of DEQ’s regional offices.

Heat researchers at Duke University will spend the next two years developing an interactive, web-based tool to help policymakers plan for extreme heat, especially in rural and coastal communities.

The U.S. Department of Commerce and National Oceanic and Atmospheric Administration announced earlier this month that $500,000 was awarded to the university’s Heat Policy Innovation Hub on the campus in Durham.

“Over the last 30 years, heat exposure has killed more people in the United States than any other weather-related phenomenon. The combined economic impacts of labor loss, hospital visits, and reduced agricultural yield — along with the health impacts of exposure — make heat among the most significant consequences of climate change for humanity,” according to the hub.

Funded through the Biden-era Inflation Reduction Act signed in 2022, the hub is partnering on the project with the National Integrated Heat Health Information System, or NIHHIS. Under NOAA’s climate office, the system is a collaboration of 25 federal entities working to reduce heat impacts across the country.

“The economies of rural communities often rely on agriculture and other outdoor industries, while coastal communities exposed to high humidity tend to rely on hospitality, tourism and recreation,” hub Director Ashley Ward said in a release. “Extreme heat poses health and economic hazards in both types of communities, but the risks are different and require targeted solutions.”

Ward said in an interview that while there’s been a lot of research on how heat affects human health, there has been much less work on how it affects the economy.

“We have been so focused, and for good reason, on the health impacts of heat,” but heat’s impact on the economy is “going to have much bigger consequences than we’ve appreciated so far,” she said.

The World Economic Forum for the first time released in December its assessment of what climate change will mean for businesses globally. The report, Business on the Edge, predicts a 70% global loss in fixed assets from heat over the next decade.

That’s hundreds of billions of dollars, Ward said.

“They determined that most of that loss will occur in the communication sector and the utilities, and it will happen because of labor wage loss, labor productivity loss, and damage to hard infrastructure,” she said. “Personally, I think that we have not even begun to understand the catastrophic economic impact that heat will bring in the next 10 to 20 years.”

Ward explained the innovation hub is “very early” in the planning process and that researchers are thinking about what the web-based tool will look like.

The tool’s interactive map is expected to focus on localized heat impacts, offer guidance on developing heat policies, assess heat risks in rural and coastal communities, and facilitate private sector collaboration. The research team plans to work with policymakers to ensure the tool meets their needs.

“A good chunk of this work is going to be quantifying and looking at what the economic impacts of heat will be across six sectors, which are agriculture, transportation, health, energy, housing and labor,” she said.

While researchers won’t be able to cover the entire scope of heat-related impacts in this two-year period, the plan is to establish “the foundation for some really innovative work on pushing people to think about heat differently,” she added.

Ward said the researchers plan to take an in-depth look at extreme heat in rural and coastal communities.

A lot of research has been done on how heat impacts urban places, but “we have growing and greater vulnerability in rural areas, with fewer tools in the toolbox to address it,” she said.

In North Carolina, heat-related illness rates in rural areas are many times greater than in urban areas, and most of the solutions, like cooling centers or tree planting campaigns, don’t really translate into rural environments very well.

The same can be applies to coastal areas that are “plagued by some of the same challenges that rural communities are plagued with — real threats to their livelihoods — but also challenges with solutions,” she said. “We’re seeing a combination of increasing temperatures also destroying some of the economic backbone of coastal communities.”

Oyster farms, for example, are highly vulnerable, with some U.S. shellfish growers reporting 100% crop losses in the last couple of years, Ward added.

Ward’s work on extreme heat can be traced back to her days with NOAA, where she focused on the impacts of climate extremes in the coastal plains of the Carolinas.

In 2015, she was sent into coastal communities to talk to residents about issues of which they were particularly concerned.

“I thought that we would be talking about hurricanes. But when we showed up, a lot of the community partners basically said, we know a lot about hurricanes, we don’t know a lot about heat, and heat is really starting to show up in our communities. It was really the communities that started my interest and work in that topic,” Ward said.

When she arrived at Duke’s Nicholas Institute for Energy, Environment & Sustainability in 2019, Ward said she noticed that researchers had done great work in identifying populations that are vulnerable to extreme heat and communities have responded by thinking about ways to mitigate the impacts of rising temperatures.

But, she said, those conversations were not being carried over to policymakers.

The heat hub was launched in 2023, “with the mission of bringing together a real cross-sector collaboration to try and think about ways to address heat and inform better policy, and sometimes that policy is public policy, but sometimes it’s also thinking about industry and the role that they play,” Ward said.

The hub’s researchers have worked with the state to develop a heat alert system and helped with county-level heat action plans. Last June, the hub held the HeatWise Policy Partnership Summit.

The hub is currently working with faith-based leaders in the Carolinas, exploring private sector and community-based solutions for heat and energy affordability. The hub is also working with the United Nations to develop a heat management system and is assessing readiness among UN agencies to deal with heat globally.

National Weather Service forecasters are expecting “dangerous heat and humidity” over the July Fourth holiday weekend, and state health officials are urging the public to take precautions as they celebrate Independence.

Highs are forecast to be in the mid-80s on the coast and in the 90s farther inland through at least Tuesday. The heat wave comes as many get set for outdoor activities.

The maximum heat index will likely be in the 100s for many coastal counties this weekend, including Beaufort, Bertie, Camden, Chowan, Craven, Currituck, Gates, Hertford, Pamlico, Pasquotank, Pender, Perquimans, Tyrrell and Washington counties, North Carolina Division of Public Health officials said Wednesday.

The heat index is what the temperature feels like to the human body when relative humidity is combined with the air temperature, according to the National Weather Service.

“Heat of this magnitude can be dangerous to your health, particularly for people who are more exposed to extreme heat or more sensitive to extreme heat,” officials said. This includes people without access to air conditioning, those working or exercising outdoors, older adults, pregnant women, those living with disabilities and underlying health conditions, and those who live alone.

To prevent heat-related illness, drink plenty of fluids, avoid caffeinated, sugary or alcoholic drinks, reduce outdoor activities, stay in air-conditioning as much as possible, and watch for symptoms.

Those over 60 and adults with disabilities are eligible can sign up with their county for a fan purchased with donations through the Operation Fan Heat Relief program.

“Summer heat can be dangerous for seniors living without air conditioning,”
Lakisha Williams, Director of Aging Services for Carteret County, said in a statement Wednesday about the fan program. “When temperatures soar, opening windows and using a fan can significantly improve air circulation and help residents stay cool.”

Related: Fans available to eligible adults through state program

During periods of extreme heat, Carteret County officials advised older adults to:

• Wear lightweight, loose-fitting clothing.
• Avoid strenuous activity outdoors or in hot environments.
• Wear a hat when spending time in the sun.
• Drink plenty of fluids, such as water, fruit, or vegetable juices and iced tea
  to replace the fluids lost by sweating.
• Keep your medicine in a cool, dry place.
• Check up on friends or neighbors who live alone.

For more on preventing heat-related illness or to sign up for heat alerts, visit the N.C. Department of Health and Human Services website.

A study on last year’s extreme heat and the National Weather Service’s most recent seasonal outlook both point to 2024 being just as warm or even warmer than 2023’s record-breaking temperatures.

Researchers behind the study, “2023 summer warmth unparalleled over the past 2,000 years,” found that not only was 2023 reported as the hottest year on record, for most of the Northern Hemisphere, the year also included the warmest summer in 2,000 years.

Dr. Jan Esper and Dr. Max Torbenson, geography professors at Johannes Gutenberg University in Germany, and Dr. Ulf Büntgen, a professor from Cambridge’s Department of Geography, wrote the study published this month in the journal Nature.

Esper explained during a recent online press briefing that the study places the 2023 temperature extremes into a long-term context, in this case the last two millennia.

They combined existing meteorological records with data from the nine longest temperature sensitive tree-ring chronologies to examine June, July and August surface air temperatures in the Northern Hemisphere extra-tropics, Esper said. This region is between the latitude line that runs through New Orleans and Cairo, or 30 degrees north, and the North Pole, 90 degrees north.

The researchers also found that the temperature baseline from the 19th century used to contextualize global warming for the Paris Agreement is cooler by a few tenths of a degree than previously thought.

This period is really not well covered with instruments, Esper said of the years 1850-1900, but at least for the region in the Northern Hemisphere that was studied, the tree rings “can do really, really well.” He said the tree ring data can be used as a substitute and show the early instrumental temperature errors.

The study also found that in the last 60 years, greenhouse gas emissions have caused El Niño events to become stronger, leading to hotter summers, and 2023 is consistent with a greenhouse gases-induced warming trend that is amplified by an unfolding El Niño event.

The current El Niño is forecast to end early this summer, and past data shows that there is a lag between extreme El Niño conditions and large-scale temperature deviations, making it likely that 2024 will see temperature records broken again.

“When you look at the long sweep of history, you can see just how dramatic recent global warming is,” Büntgen said in a statement. “2023 was an exceptionally hot year, and this trend will continue unless we reduce greenhouse gas emissions dramatically.”

Officials with the National Oceanic and Atmospheric Administration’s National Centers for Environmental Information explained in its global monthly report that April 2024 is the 11th-consecutive month of record-high global temperatures. The month ranked as the warmest April on record, suggesting that Büntgen is right that the heat trend is continuing.

According to the global annual temperature rankings outlook, “there is a 61% chance that 2024 will rank as the warmest year on record and a 100% chance that it will rank in the top five of warmest years recorded.”

And, “based on current anomalies and historical global annual temperature readings, it appears that it is virtually certain that 2024 will be a top 10 year, consistent with a strong propensity since 1988 for recent years to be initially ranked as a top 10 year,” NOAA officials said.

State relief programs

To help communities take action to reduce the health effects caused by extreme heat exposure, Gov. Roy Cooper’s office announced Tuesday that May 26-June 1 is North Carolina Heat Awareness Week, and reminded residents of the state’s heat-preparedness tools.

“As our summers continue to get hotter, today’s proclamation raises awareness of the many tools and resources available to keep our communities safe from extreme heat,” Cooper said.

On the state level, several programs have been launched to help communities weather the heat, especially for outdoor workers, infants and children, older adults, pregnant people, athletes, low-income individuals and people with underlying health conditions who are at higher risk for heat-related illnesses.

The N.C. Office of Recovery and Resiliency, N.C. Department of Health and Human Services, N.C. State Climate Office and the Duke University Heat Policy Innovation Hub teamed up to create the Heat Action Plan Toolkit for health departments, local governments and other community partners to develop their own plans specific to their needs.

Chief Resilience Officer Dr. Amanda Martin told Coastal Review Wednesday that the state wants everyone to know the signs of heat illness when they are enjoying the summer sun at the coast.

“Extended extreme heat is dangerous to the human body. Perhaps just as dangerous as the actual heat is ignoring the protective factors that reduce and eliminate heat illness and death,” Martin said. “Last year was the hottest year in 2,000 years, so it’s more important than ever for outdoor workers and indoor workers without air conditioning to take breaks, access cooler air, and drink water. Senior citizens, young children and people with health conditions are especially vulnerable to heat waves.”

Also, the state Health and Human Services’ Climate and Health Program launched its Heat Health Alert System this month to notify subscribers when the heat index is expected to reach unhealthy levels in their county. The program operates a Heat-Related Illness Surveillance System from May through September and documents weekly emergency department visits for heat-related illness in the state.

“We want all North Carolinians to enjoy a safe and healthy summer,” said Dr. Susan Kansagra, Health and Human Services Assistant Secretary for Public Health, in a news release. “With more than 3,900 emergency department visits for heat-related illness in North Carolina last summer, preparing for extreme heat at the local level is critical to protecting the health of North Carolina residents and workers.” 

The Office of Recovery and Resiliency announced last week its newest product, the NC Resilience Exchange website, an interactive resource to help local and state leaders find relevant information in the wealth of climate data available online.

“The Exchange offers funding opportunities, a directory of experts, interactive mapping tools, model ordinances and more in a one-stop-shop that is relevant to North Carolina communities,” according to the website.

Federal efforts

At the federal level, the Biden-Harris administration on May 20 announced it had committed $4.55 million for the interagency National Integrated Heat Health Information System  “to enhance community science observations and data collection on extreme heat, and provide assistance to communities planning for and evaluating equitable heat resilience projects.”

NOAA and the Centers for Disease Control and Prevention founded the system in 2015 to lead developing community resilience to the effects of extreme heat.

The Center for Collaborative Heat Monitoring based at the Museum of Life and Science in Durham will assist organizations conduct local climate and health studies. The Center for Heat Resilient Communities that will be based out of California and Arizona is to offer diverse expertise and knowledge-sharing hubs to identify and evaluate policies, protocols, and lessons for heat resilience.

“The impacts of extreme heat caused by climate change are an increasing threat to our health, ecosystems and economy,” U.S. Secretary of Commerce Gina Raimondo said in a statement, adding that this investment will support new Centers of Excellence “to help protect historically excluded communities from the dangers of extreme heat, boost climate resilience and increase awareness on best practices to tackle the climate crisis.”

The Durham center will work with the Arizona Science Center, the Oregon Museum of Science and Industry, and the Museum of Science in Boston to serve the entire country at a regional level.

Officials with the museum said the center will observe, monitor and evaluate factors influencing heat risk at a local scale in 30 historically disadvantaged communities over the next three years. The center is a broad collaborative effort leveraging these place-based institutions and supported by the technical capacity and expertise at CAPA Strategies, Utah State University, the North Carolina State Climate Office, and AQUEHS Corp.

“The past few years have shown us that we can work towards fixing what we can measure,” said Max Cawley, principal investigator for new center and the Museum of Life and Science’s Director for Climate Research and Engagement. “And when it comes to heat imperilment, how you measure also matters. We’re eager to convene a strong collaborative partnership towards expanding where we can measure heat and who’s involved in measuring it.”

Last month, the National Weather Service and the CDC released an experimental online tool called HeatRisk.

HeatRisk provides a color-coded forecast of risk of heat-related impacts that could occur over a 24-hour period. HeatRisk takes into consideration how unusual the heat is for the time of the year, the duration of the heat including both daytime and nighttime temperatures, and if those temperatures pose an elevated risk of heat-related impacts based on data from the CDC, according to the website.

“Climate change is causing more frequent and intense heat waves that are longer in duration, resulting in nearly 1,220 deaths each year in the U.S. alone,” NOAA Administrator Dr. Rick Spinrad said in April when the tool was released. “Last year was the warmest year on record for the globe, and we just experienced the warmest winter on record. HeatRisk is arriving just in time to help everyone, including heat-sensitive populations, prepare and plan for the dangers of extreme heat.”

CDC Director Mandy Cohen explained during a news conference that the tool will help “protect health and improve lives and to prepare for what we anticipate will be a very hot summer. Heat is a threat to our health. Heat can make underlying health conditions worse and heat related illness like heat exhaustion and heat stroke can cause serious illness and even lead to death. Heat can be especially dangerous for certain people, including very young kids.”

It’s not hurricanes. It’s not tornadoes. It’s not floods.

Heat is the No. 1 weather-related killer in North Carolina, but also the most preventable, according to the state’s recently released Heat Action Plan Toolkit, designed to help communities adapt as climate change drives more frequent and intense heat events.

“Our days and nights are getting hotter as the planet warms,” State Climatologist Dr. Kathie Dello told Coastal Review recently.

“We’re seeing more instances of record daily maximum temperatures than daily minimum records. But we’re also seeing more relentless heat — days and nights that are consistently above the temperatures that we’re used to, but maybe not Earth-shattering. And we’re seeing the hot days and nights starting earlier,” Dello said, adding that the temperature in Raleigh hit 92 degrees May 2, “Our first day over 90, about a week and a half earlier than normal.”

Children, older adults, athletes, outdoor workers and those who are pregnant, with chronic health conditions or without access to air conditioning are most vulnerable to the effects of extreme heat, but everyone is at risk.

North Carolina Office of Recovery and Resiliency Resilience Policy Analyst Andrea Webster said that deaths and heat-related illnesses from extreme heat are 100% preventable.

“While residents are used to hot temperatures, North Carolina’s coast has a high number of outside visitors in the summer months. If they come from a much cooler area, their bodies are likely less adapted to extreme heat. Messaging about symptoms, cooling and hydration strategies, and resources to stay cool can drastically reduce health impacts and emergency department visits,” Webster said.

This is where the toolkit comes in.

The 72-page document features a template with fill-in-the-blank language for local governments, health departments and other entities to write its own heat action plan, as well as about the causes and symptoms of heat-related illnesses, groups most at risk, and where to look for funding. Supplemental materials for getting the word out to the public such as sample graphics, factsheets, brochures, and scripts to warn of impending high heat are on the toolkit website.

“With the frequency and severity of extreme weather increasing, it’s more important than ever to build local resilience that will help protect people and save lives,” Gov. Roy Cooper said when the plan was announced in late April. “The new toolkit provides valuable resources that will help local governments prepare for and respond to these potentially life-threatening events. The project also underscores how state partnerships are critical to finding climate solutions that benefit all North Carolinians.”

About the toolkit

The Office of Recovery Resiliency led the effort in partnership with Dello’s State Climate Office of North Carolina, the N.C. Division of Public Health, Duke University Heat Policy Innovation Hub and the National Oceanic and Atmospheric Administration Carolina’s Climate Adaptation Partnership.

The idea for the toolkit came about as part of the Regions Innovating for Strong Economies & Environment, or RISE, program, according to the website. Participants from across the state said a heat action plan template was a priority resilience project.

Dr. Rebecca Ward, a postdoctoral research scholar, was lead developer of the toolkit and collaborated heavily with Webster. Ward is with North Carolina State University’s Coastal Resilience and Sustainability Initiative and the NOAA Carolina’s CAP.

Ward explained that developing the Heat Action Plan Toolkit took about a year, from initial idea to final product.

“Throughout the whole process, I’ve been continually delighted with how many different groups and individuals have shared their time and expertise to help create content and give feedback. We’ve done our best to make sure that this will be useful and usable — very ‘plug-n-play’ — for its target audiences of local governments, primarily health departments and emergency management,” Ward said.

Webster said that local and county governments, health departments and other leaders can use the toolkit to ensure there is a plan in place for when a heat wave is in the forecast, and to ensure that community partners are developing and pursuing resources that help residents and visitors cool down when it’s hot.

“We know that local government leaders are juggling so much — and the more invisible hazards, like heat, may not be top of mind for folks. We’re also just dealing with summers like we haven’t seen in our past,” Dello said. “What used to be a once in a generation hot summer is now happening more frequently. We designed it so it would be helpful and accessible for everyone.”

Webster said the meat of the toolkit is the template heat action plan.

“This word document is already designed with draft text. We want to encourage jurisdictions and community partners to work together to pick out the suggested heat resilience actions that work best for their community and start implementing the actions in the plan,” Webster said.

A list of resources is included for community leaders to contact for help filling in the template ahead of an extreme heat event, and provides instructions on how to identify census tracts with high concentrations of residents especially vulnerable to extreme heat, such as the elderly, she said.

Leaders can access region-specific heat thresholds to know when to send out heat awareness messaging, which is part of the toolkit. There is sample messaging, graphics, fact sheets, checklists, sample community surveys to understand how residents currently deal with extreme heat. Many of the toolkit’s supplemental materials are also available in Spanish.

“NCORR plans to offer workshops for communities to begin developing their heat action plans. Sign up for our e-newsletter to learn about upcoming offerings,” Webster said.

Ward said that the workshops are to take place over the next few months with target users to work through the toolkit.

“I think these will be great opportunities to advance our state’s resilience to extreme heat, and any feedback collected during these workshops will ultimately improve the Toolkit, making it more useful and usable — and we hope used — by local governments across the state,” Ward added.

Webster said that so far, the public health preparedness coordinators are particularly excited about the toolkit, and Chatham County used a draft of the Heat Action Plan Toolkit to publish the first Heat Action Plan in the state.

“Heat affects our residents’ health, and it’s often overlooked as a health concern. Having easy-to-use resources at their fingertips is helpful,” Webster said.

Heat illnesses in numbers

The state Department of Health and Human Services has been recording reported heat-related illnesses for some time.

Every year during the heat season May 1 to Sept. 30, the department’s climate and health program publishes heat-related illness surveillance reports. The first report of the year is expected to be on the website by Wednesday, May 15.

In past years, the reports provided statewide data on heat-related illness. This year, weekly reports will also include regional summaries and some county-level information, the department said.

Last year, North Carolina had more than 3,900 emergency department visits for heat-related illness between May 1-Sept. 30, with 497 of those in North Carolina’s 20 coastal counties. 

The department’s numbers show that between 2016 and 2023, these counties had around 4,300 total reported heat-related illness emergency department visits.

Department officials noted that the annual number of visits are based on the patient’s county of residence, not where they sought medical attention.

For example, a Wake County resident who seeks help at an emergency department for heat-related illness in Carteret County may not be included in Carteret’s count.

“Heat-related illness can affect anyone. People who are accustomed to this weather should still watch for the signs and symptoms of heat-related illness and take precautions to protect their health,” a health department spokesperson said. “Take the heat seriously and do not ignore danger signs like nausea, headache, dizziness or lightheadedness, confusion, and rapid or erratic pulse. They can all be signs of trouble. Get to a cool place, drink water slowly and seek medical help if conditions don’t improve.”

The long-term heat forecast

Webster said her office relies on predictions in the 2020 North Carolina Climate Science Report, which states that, for the coastal plain, “climate models project a substantial increase in the number of these very hot days and very warm nights by mid- to late century under both scenarios.”

By 2100, the number of very hot days is projected to increase by 11 to 49 under the lower scenario and 42 to 94 under the higher scenario, compared to the 1996–2015 average. The number of very warm nights is projected to increase by 14 to 45 under the lower scenario and 48 to 87 under the higher scenario, she sited from the report, adding that the State Climate Office regularly updates their projections, so it’s possible that they may have newer data that aren’t published as a report yet.

“We need to start preparing for more frequent heat waves and high nighttime temperatures. That continued stress on our bodies leads to health impacts such as heat cramps, heat exhaustion, heat stroke and even mortality,” Webster said.

Resources

Webster said that residents can sign up to receive heat alerts when the weather is forecast to reach unhealthy temperatures.

The emails from the state health department’s Heat Health Alert System notify when the heat index is forecast to reach unhealthy levels in their county. The sign-up form is available in English and Spanish.

Other resources include the federally funded Crisis Intervention Program administered by the state Department of Social Services that assists those experiencing crises related to temperature, and Operation Fan Heat Relief for eligible adults to receive fans through their local Area Agency on Aging.

Warning signs and symptoms can be found on the Center for Disease Control and Prevention’s webpage on extreme heat symptoms as well as tips for preventing heat-related illness.

Webster said that visitors and everyone spending time outdoors or in unairconditioned spaces throughout the summer months should pay attention to how they feel in high temperatures.

“Stay hydrated, take breaks in the shade, and cool off in cold water. Watch out for dizziness, nausea, heavy sweating, heat cramps and painful muscle cramps in the abdomen, arms or legs following strenuous activity,” Webster said.

The health department recommends taking the following steps during heat season:

• Increase fluid intake.
• Wear sunscreen of 15 SPF or higher. Sunburn affects your body’s ability to cool down.
• Spend some time in a cool or air-conditioned environment.
• Reduce normal activity levels.
• Cool off by taking cool baths or showers, or placing ice bags or wet towels on the body.
• Stay out of direct sunlight, put shades over the windows, and use cross-ventilation and fans to cool rooms if air conditioning is not available.
• Wear lightweight, light-colored, loose-fitting clothing that permits sweat to evaporate.
• Drink plenty of liquids such as water and sports drinks to replace the fluids lost by sweating. As a person ages, thirst declines.
• Limit intake of alcoholic beverages or sugary drinks. If you are on a low-salt diet or have diabetes, high blood pressure, or other chronic conditions, talk to your doctor before drinking sports drinks.
• Check up on friends or neighbors who live alone.
• Never leave children or pets unattended in vehicles, even for a few minutes, as temperatures inside a car can reach a deadly level quickly.
• This can also be a good time to join your local senior center or take advantage of buildings made accessible to seniors during excessive heat. Your community’s public information office can be contacted for additional information.
• Residents are encouraged to speak with their healthcare provider about how to stay safe. Certain medications make you more vulnerable to heat-related illness.
• Keep your medicines in a cool, dry place.

Vulnerable adults have access to help through Operation Fan Heat Relief to reduce their risk of heat-related illnesses.

The North Carolina Department of Health and Human Services’ Division of Aging is partnering with area agencies on aging and local service providers to distribute fans to adults with disabilities or those 60 and older.

Sign up for assistance from May 1 to Oct. 31 at area aging agencies across the state.

Operation Fan Heat Relief, which has been in place since 1986, was supported with donations from Duke Energy Carolinas, Duke Energy Progress, Dominion and Valassis.

The relief program allows agencies on aging and local provider agencies to purchase fans for eligible individuals, and a limited number of air conditioners based on a person’s specific health conditions. Last year, the division received $86,000 in donations, allowing for the distribution of 3,097 fans and 21 air conditioners.

“As individuals age and develop chronic medical conditions, they are less likely to sense and respond to changes in temperature, and they may also be taking medications that can worsen the impact of extreme heat,” officials said. “Operation Fan Heat Relief helps vulnerable adults at risk for heat-related illnesses stay safe during the summer.”

Officials recommend taking the following steps during high temperatures:

• Increase fluid intake.
• Spend time in cool or air-conditioned environments regularly.
• Reduce strenuous activity during the afternoon.
• Speak with their physician before summer about how to stay safe while taking medication that can affect the body’s ability to cool itself such as high blood pressure medications.

More information about Operation Fan and Heat Relief, including tips on preparing for extreme heat and a list of local agencies distributing fans, is available on the NCDHHS website.

A webinar next week is set to bring together climate scientists, public health professionals and policy specialists to speak on the dangers of extreme heat.

The North Carolina Office of Recovery and Resiliency and the State Climate Office of North Carolina are hosting “Navigating North Carolina’s Rising Temperatures: Understanding and Addressing the Health Risks of Heat.” The webinar is from 10-11:15 a.m. Wednesday, April 17. Register at go.ncsu.edu/heat-health.

“We know North Carolina summers are getting hot. But they’re getting hotter, and we’re especially seeing the increase in nighttime temperatures. Heat illness and death is also preventable. Flooding gets a lot of attention — but heat is more of a chronic, silent threat,” State Climate Office Director Kathie Dello said.

“Each year, on average, heat kills more people than all other natural disasters combined,” NCORR’s Resilience Policy Advisor Andrea Webster told Coastal Review, adding that while many coastal residents are “understandably preparing for the impacts of stronger hurricanes and heavy precipitation events,” they shouldn’t forget about heat.

As more heat records are broken — March 2024 was the warmest March ever recorded globally — stronger hurricanes, more intense wildfires and other climate-related challenges, Webster said the NCORR Resilience Program team is working to help local governments and elected officials reduce economic, social and environmental consequences, and managing the impacts.

Local governments “have protocols they enact when hurricanes or ice storms hit, but they typically don’t have a plan of action for when a heat wave is in the forecast,” Webster said.

Speakers during the webinar will talk about the state’s changing temperatures, the dangers of extreme heat to human health, evidence-based strategies for preventing heat-related illnesses, how communities are already preparing, and how the state can help.

In addition to the host agencies, partners for the webinar are the National Oceanic and Atmospheric Administration’s Carolinas Climate Adaptation Partnership, the Duke University Heat Policy Innovation Hub, Chatham County Public Health Department, and N.C. Department of Health and Human Services Division of Public Health.

Looking ahead, NCORR, the State Climate Office and the Department of Health and Human Services plan to release a Heat Action Plan Toolkit later this month to help local governments and health professionals encourage residents to take care of themselves during extreme heat.

Webster said the toolkit will include extreme heat thresholds to help local governments know when to implement heat preparedness activities. Thresholds for multi-county regions across the state are being developed.

Dello said that the State Climate Office works to help residents understand their weather and climate risks.

“We do this in a few different ways,” Dello said, including with original research in partnership with state agencies, working with N.C. Cooperative Extension and N.C. Sea Grant to raise awareness, and work with K-12 teachers to teach them about the environment.

The webinar came about at the request of communities that are already preparing their residents for extreme heat, Webster said.

NCORR, the State Climate Office and other partners held last a workshop last summer in Fayetteville on heat action protocol development.

“When asked what additional resources would be helpful, the local governments in attendance requested a ‘heat and health 101’ training. This workshop is in direct response to that request,” Webster said.

Dello added that this how a lot of their projects and work begins.

“Someone expresses an idea or need, and we’ll assemble the resources to try to help them out,” Dello said.

NCORR has been working with the local governments in the Community Disaster Resilience Zones, or CDRZ, designated by the Federal Emergency Management Agency last year. These zones, which include nearly all coastal counties, were designated to “build and strengthen community resilience across the nation by driving federal, public, and private resources to the most at-risk and in-need communities,” according to FEMA.

The team is meeting with officials to help them understand the risks of climate change in their community and what resources and solutions are available to help.

“North Carolina residents are used to hot temperatures, but we need to start preparing for more frequent heat waves and high nighttime temperatures,” which Webster said is especially concerning because of the increase in emergency room visits from not being able to cool down several nights in a row. “That continued stress on our bodies leads to health impacts such as heat cramps, heat exhaustion, heat stroke and even mortality. Unlike other climate change impacts, heat-related mortality and morbidity are 100% preventable.”

Webster said NCORR hopes to offer more opportunities to learn about preventing heat impacts on residents and infrastructure in the future. Sign up for the NCORR Resiliency Updates e-newsletter to learn more.

“There are steps we can take to keep our residents and our tourists cool. North Carolina’s coast has a high number of outside visitors in the summer months. If they come from a much cooler area, their bodies are likely less adapted to extreme heat. Raising public awareness of symptoms, cooling and hydration strategies, and resources to stay cool can drastically reduce health impacts and emergency department visits,” Webster said.

State-by-state emergency plans aimed at minimizing the impacts of natural disasters overwhelmingly understate extreme heat as a hazard to human health, according to a Duke University analysis.

The recently released policy brief, “Defining Extreme Heat as a Hazard: A Review of Current State Hazard Mitigation Plans,” highlights the need for states to better evaluate the growing threat of extreme heat as the climate changes, identify populations of people most vulnerable to high temperatures, and implement plans to educate and assist those populations.

Ashley Ward, a senior policy associate with Duke’s Nicholas Institute for Energy, Environment and Sustainability and co-author of the brief, said the report is not a critique, but rather a guide to help states’ emergency management departments better incorporate extreme heat in their hazard mitigation plans.

“We want to give them some easy-to-pick-up roadmaps about how they can do so,” Ward said in a telephone interview. “Our hope is to make their job easier and to supplement what’s already happening at FEMA. We want to be of assistance. That’s what we’re trying to do here.”

The Federal Emergency Management Agency recently announced states must incorporate climate change into their hazard mitigation plans, a move Ward called a “really big deal” in part because it prioritizes extreme heat as a hazard.

Extreme heat is when daytime temperatures rise above 95 degrees and nighttime temperatures do not dip below 75 degrees.

Unlike natural disasters such as hurricanes or tornadoes, extreme heat is not a Stafford Act hazard.

The 1988 Robert T. Stafford Disaster Relief and Emergency Act, which amended the Disaster Relief Act of 1974, authorizes the president to declare disasters and provide financial assistance to state and local governments.

The law mandates states update their hazard mitigation plans every five years. Many states are in the process of renewing their plans, Ward said.

So, the report focuses on current states’ plans, half of which lack a dedicated section to extreme heat, the analysis found. 

Ward and co-author Jordan Clark, a postdoctoral associate for the institute’s Water Policy Program, used a scoring system created by the National Resources Defense Council, or NRDC, to assess each states’ plan.

The NRDC used the scoring system to look at the incorporation of extreme heat in southeastern states’ hazard mitigation plans.

“As we know, this is certainly a pressing problem in the southeast, but we know the southeast isn’t the only region in which heat is a problem,” Ward said.

Heat, she said, is one of the most misunderstood weather events.

Ten years ago, researchers in her field focused on something called the urban heat island effect, which is created when natural landscapes are replaced with pavement, buildings and other surfaces that absorb and retain heat.

This effect is very important and very real, Ward said, but its sole focus is on urban areas, leaving out whole populations impacted by extreme heat.

“In North Carolina, heat illness rates are about seven to 10 times higher in rural areas than they are in urban areas,” she said. “And, in fact, what we’re seeing in the small amount of research that’s coming out of the southern part of the United States is that’s not a North Carolina phenomenon. A recent study came out of Florida that showed the same thing. There’s a lot of reasons this is the case, but that just gives you one example of how broadly heat has been misunderstood.”

North Carolina has an enhanced hazard mitigation plan, also referred to as the 322 Plan, which includes natural hazards as well as man-made, technological and human-caused hazards.

The plan addresses different populations identified by the North Carolina Department of Health and Human Services, which narrows down the largest group of people who suffer heat injuries as men between the ages of 18-34 either involved in athletics or outdoor work such as farming and construction.

The plan was updated last year and approved by FEMA in February. The current plan expires February 12, 2028, according to Chris Crew, North Carolina Emergency Management mitigation plans manager.

Crew explained in an email responding to questions that the plan’s definition of extreme heat is taken from the U.S. Centers for Disease Control and National Weather Service, which identify extreme heat as hotter and/or more humid than average summertime temperatures and unusually hot and humid weather lasting at least two days.

The first recommendation offered in the report is for states to establish their own, specific standard definition of extreme heat.

“That is because extreme heat in North Carolina is not the same as extreme heat in Oregon and it’s important that people think about their geography with respect to how we define extreme heat,” Ward said.

That and other recommendations are intended to provide education and awareness about the complexities of heat, she said, how things like how extreme heat correlates to effects on human health.

Take temperature metrics. Heat index, a metric that combines air temperature and humidity, is a common metric decision makers use to define extreme heat, but it is less robust in determining potential adverse health outcomes than a metric known as wet bulb globe temperature.

Wet bulb globe temperature, or WBGT, measures heat stress in direct sunlight and includes temperature, humidity, wind speed, sun angle and cloud cover. This standard metric is used by the military and high school athletic associations, Ward said.

“And that’s important because if you’re sweating outside and it’s very humid there’s a lot of moisture in the air so your body is not evaporating that sweat off of your skin,” she said. “However, if it’s windy outside then the wind is drying the sweat off your skin and that mimics that evaporative cooling process and actually provides a protective factor for you.”

Therefore, in coastal counties especially, it’s important to think about wind speed, Ward said.

North Carolina’s Sandhills region has the highest rate of heat-related illnesses in the state. Roughly 75% of those who go to emergency departments for treatment are men between the ages of 15 to 45, Ward said.

Counties within that region, including Bladen, Hoke, Robeson, Sampson and Scotland counties, are included in a heat-health alert system through the N.C. Building Resilience Against Climate Effects program.

This CDC-funded program is tailored to vulnerable populations, including low-income and elderly communities, farmworkers, and youth in sports, according to the state’s plan.

“The State’s position is ‘Extreme’ heat is more of an individual and regional value than a specific value for everyone across North Carolina,” Crew said in an email. “Setting a statewide definition of extreme (heat) would limit the State into responding to a single type of weather scenario statewide when the State health agencies need the flexibility to respond to different weather conditions in different regions to the State.”

Ward praised North Carolina’s emergency management department, calling it a “gold star in the nation.”

While the state does include an assessment for heat hazard, it could better incorporate socially or medically vulnerable populations and teach residents how to protect themselves from extreme heat, she said.

Some ways to cool off after being exposed to extreme heat include taking a cool shower then sitting in front of a fan or placing your feet in cool water.

North Carolina’s plan notes the North Carolina Climate Science Report, which projects that much of the Piedmont and coastal plain will experience a jump in very hot days by 10 to 20 days per year between 2021 and 2040 as compared to the 1996-2015 average.

The number of warm nights in those regions is projected to increase anywhere from three to 15 nights a year. Some areas within those regions could see an increase by 18 or more nights a year.

As the state heads into warmer weather, eligible adults at risk for heat-related illnesses can sign up with their area aging agency to receive a fan or air conditioner.

The program, Operation Fan Heat Relief, for residents 60 and older, and adults with disabilities, began Monday and ends Oct. 31.

North Carolina Department of Health and Human Services’ Division of Aging and Adult Services, North Carolina Area Agencies on Aging and local service providers coordinate the effort.

A list of local agencies distributing fans is available on the program website.

At-risk populations also can take the following steps during high temperatures:

• Increase fluid intake.
• Regularly spend time in cool or air-conditioned environments regularly.
• Reduce strenuous activity during the afternoon.
• Speak with their physician before summer about how to stay safe while taking medication that can affect the body’s ability to cool itself.

For more details, may contact their Area Agencies on Aging or the Division of Aging and Adult Services at 919-855-3400.

Duke Energy Carolinas, Duke Energy Progress, Dominion and Valassis marketing company donate to the program. Last year 3,793 fans and 23 air conditioners were distributed.

The effects of high overnight temperatures, especially on vulnerable populations, concern heat and climate experts Dr. Ashley Ward and Dr. Luke Parsons as much as the hot and muggy summer days.

“While extreme heat in the form of daily temperatures is very serious, what we’re increasingly seeing is a strong connection between poor health outcomes and persistently high overnight temperatures, particularly when those overnight temperatures remain at 75 degrees or above,” Ward said during a media conference Thursday on “Preparing for the Next Heat Wave” hosted by Duke University.

Ward, the senior policy associate at the newly rebranded Nicholas Institute for Energy, Environment and Sustainability, has focused on helping communities develop long-term sustainable solutions. Parsons, a research scientist and lecturer in the division of Earth and climate sciences in Duke’s Nicholas School of the Environment, studies the effect of climate and air pollution on human health and well-being. 

Parsons said for him, heat exposure is a health-equity issue. He noted that he was sitting comfortably in his climate-controlled home but not everyone has that luxury. Many people who are the most vulnerable to heat exposure don’t have access to air conditioning. “The average middle- to upper-class person with more income in North Carolina has probably more air conditioning access than a lower income person.”

Ward explained that the high overnight temperatures mean those who don’t have air conditioning, can’t afford to run their air conditioner or live in housing that’s less energy-efficient are particularly vulnerable, especially if they have health conditions or take prescription medications that impede their body’s ability to process heat.

“When overnight temperatures remain high, what we’re seeing is the body doesn’t have a chance to recover from any heat exposure during the day, which starts to trigger a cascading set of events that results in heat-related illness, heat stroke, usually over a matter of days sometimes,” she said. This means in order to address the increasing risks from heat, “we need to think about structural changes not just are individuals doing their part. We need to create environments that mitigate that risk above and beyond what individuals can do and this is where community approaches are effective.”

The many who must work outside, such as agricultural and construction workers, are another group exposed to extreme humidity and heat – people who can’t go inside and cool down in the air conditioning, Parsons added.

Because these workers are unable to cool off, they’re losing hours of work because they have to slow their pace or take breaks. Parsons said between 50 and 100 hours, or roughly a week or two, of labor loss occurs each year with $20-$100 billion in labor productivity losses. 

“As the globe warms, and heat waves get hotter and more frequent, it gets hotter and more humid outside for these workers, and it gets harder and harder for them to safely and efficiently conduct their work,” he said. “They’re really impacted during heat waves or just in general when it’s hot and humid during working hours during daylight.”

Heat exposure costs the public in emergency department visits, as well. Ward said that in the 2010s the National Institutes of Health conducted a study on emergency department visits for heat-related illness. Based on those estimates and the number of emergency department visits in the state during the heat, mainly by men aged 15 to 45, it costs residents around $20 million a year.

She added that through previous research with the National Oceanic and Atmospheric Administration, it was clear that people were going to the emergency department for heat-related illnesses even when temperatures were lower than when the National Weather Service issues heat advisories and warnings. 

Ward’s hypothesis is that because when it gets 100 degrees, for example, people actually do take precautions. It’s at the slightly lower temperatures, below 96 or 97, when people are not quite as cautious and that leads to some of the worst health outcomes. “So there isn’t always an alignment with where the health risk lies and where the National Weather Service warnings are.”

She noted that in North Carolina, heat-related illness rates are much higher in rural areas than they are in urban areas for a variety of reasons, and she said that this pattern would probably be fairly consistent across a large swath of the Southeast. 

Ward said all evidence points to increasing global temperatures, “and what we’re experiencing now is likely our new normal and, frankly, it probably will get worse. Given this, we need to adapt to this new reality by doing things like increasing tree canopy in urban spaces, making changes to our building codes that require energy efficient buildings for this new normal and the new normal that’s projected over the 30- to 50-year time frame.” 

Ward said we also need to support policies that help people increase the energy efficiency in their homes, increase protections for occupational heat exposure, and train doctors, midwives and nurses about the increased risk from high heat for their pregnant patients.

But, both researchers said we shouldn’t give up on preventing heat waves and trying to find ways to adapt, but climate change-related extreme heat should be studied year-round.

Parsons said that if we try to limit global warming to about 2 degrees, relative to continuing with business as usual of our higher greenhouse gas emissions, around 300 million lost workdays per year in the U.S. alone could be prevented. That’s if we work worldwide to limit global warming.

“That being said, we need to adapt too, because in the meanwhile, until we bend that global warming curve to slow it down, we’re going to continue to see temperatures like we’ve seen are all around the globe this summer maybe won’t happen every year, but we’ll see these types of things with increasing frequency. We need to help protect communities that can’t protect themselves right now and encourage people to adapt to the warming that we’re living,” he said.

A California family found deceased in mid-August on a hiking trail near Yosemite National Park likely died due to extreme heat and not algal bloom, which was cited as a possible cause during the investigation.

The cause of death for Jonathan Gerrish, Ellen Chung and their 1-year-old Aurelia “Miju” Chung-Gerrish found deceased on the Savage Lundy Trail Aug. 17 was determined to be hyperthermia, or heat-related conditions linked to abnormally high body temperatures, and probable dehydration likely related environmental exposure, Mariposa County Sheriff’s Office said in a release.

The official cause of death was determined Oct. 15 based on the county pathologist’s completed report that included the autopsy, investigation and toxicology results.

“Heat related deaths are extremely difficult to investigate, and I want to thank you all for being patient with us as we investigated this case. As I’ve mentioned the Gerrish Gung family have been our top priority as we dealt with this horrible event,” Sheriff Jeremy Briese said in an Oct. 21 statement.

The family dog’s cause of death remains undetermined, though evidence points to possible heat-related issues.

The sheriff’s office acknowledged that the Savage Lundy Trail where the family was hiking had been posted by the Sierra National Forest for toxic algae and is known to have mines. Six separate laboratories tested water samples. The testing showed that the water taken from several locations along the South Fork of the Merced River was positive for anatoxin a, which can be toxic to animals.

“We do not have any evidence indicating that Jonathan, Ellen or Miju ingested any of that water. We also know that there has been no recorded death in humans connected with Anatoxin A, we do know that can be deadly to animals,” officials said.

Temperatures ranged between 92-109 degrees Aug. 15, while the family was hiking. The family had an 85-ounce water container that was empty and no other water containers or water filtration systems were found, according to the sheriff’s office.

State Department of Health and Human Services officials urge residents to protect themselves and others against heat-related illness as temperatures across the state rise.
 
Prolonged exposure to heat can lead to dehydration, overheating, heat illness or even death, according to the state.

“Heat exhaustion and other illnesses are serious, and this is the time of year we start to see heat-related hospitalizations rise,” said State Health Director and Chief Medical Officer Dr. Elizabeth Cuervo Tilson, in a statement. “Be aware of the risks, pay attention to how you are feeling when you are outside and take steps to protect yourself.”

The North Carolina Heat Report shows there were 1,042 emergency department visits for heat-related illness from May 1 to July 10. The most frequent heat-related diagnosis was for heat exhaustion. Visits to emergency departments frequently increase in correlation with spikes in the heat index.

Most of the patients at emergency departments with heat-related illnesses are 45- to 64-year-old males and have been seen in hospitals in North Carolina’s Piedmont and Coastal regions. Common activities noted in emergency department visits were working outdoors and recreation.

The number of emergency departments visits for heat-related illness this year are similar to the summer of 2020. The state advises paying attention to the weather if spending time outside as working and recreation outdoors are common activities that precede heat-related illness in high temperatures.
 
Symptoms of heat-related illness include muscle cramps, fatigue, weakness, dizziness, fainting, headaches, nausea and vomiting. Children, adults over 65, people without access to air conditioning and those with chronic health conditions are most vulnerable.

If you or someone you know experiences heat-related illness, move to a cool place, drink water, place cold cloths on the body and seek medical attention..

To reduce the risk of heat-related illness:

• Increase fluid intake.
• Take breaks in an air-conditioned shelter frequently if spending extended time outside.
• Reduce normal activity levels.
• Speak with your physician about how to stay safe if you take medicines that make you more vulnerable to heat, such as drugs for high blood pressure, migraines, allergies, muscle spasms, mental illness and tranquilizers.
• Check on neighbors, and if working outdoors, check on your co-workers.
• Never leave children or pets unattended in vehicles, especially during warm or hot weather, as temperature levels inside a car can reach a lethal level in a matter of minutes.

As emergency departments are seeing increased patients for heat-related illness, health officials continue to urge residents get vaccinated against COVID-19 to protect themselves and others and to reduce the chance of needing care at a hospital. Vaccinations are everywhere and easy to get. People can get a vaccine at no-cost to them and can find a location at www.myspot.nc.gov.

Additionally, Operation Fan Heat Relief — a summer program intended to provide a more comfortable living environment and reduce heat related illnesses for older adults and adults with disabilities — runs through Oct. 31. For eligibility and details on how eligible residents can receive a fan, individuals may contact their Area Agency on Aging or the Division of Aging and Adult Services’ Housing Program Consultant at 919-855-3419.
 

The state Department of Health and Human Services officials are encouraging residents to avoid heat exhaustion and other heat-related illnesses, especially on hot days.

Since May, there have been 1,205 heat-related hospital emergency department visits, the North Carolina Division of Public Health reports. Last year from May 1 to Aug. 31, there were 3,692 emergency department visits for heat-related illness, similar to the summers of 2017 and 2018.

Most patients are 45-64-year-old males, on the coast and in the Piedmont and were working outdoors and recreating when they became ill. Prolonged exposure to heat can lead to dehydration, overheating, heat illness or even death.

Those that are eligible could receive cooling assistance through the Crisis Intervention Program, a federally funded program that helps those  experiencing a heating or cooling related crisis. Check eligibility and apply through the local Department of Social Services until June 30, 2021.

Another program is Operation Fan Heat Relief, which ends Oct. 31. For more information, call the local Area Agency on Aging.

Heat-related illness symptoms include muscle cramps, fatigue, weakness, dizziness, fainting, headaches, nausea and vomiting. Children, older individuals, outdoor workers and those with chronic health conditions are most vulnerable.

To reduce the risk of heat-related illness, DHHS recommends the following precautions:

• Increase fluid intake.
• Take frequent breaks in cool and shady or air-conditioned places if spending extended time outside.
• Reduce normal activity levels.
• Speak with your physician about how to stay safe if you take medicines that make you more vulnerable to heat, such as tranquilizers or drugs for high blood pressure, migraines, allergies, muscle spasms and mental illness.
• Check on neighbors, and if working outdoors, check on your co-workers.
• Never leave children or pets unattended in vehicles, especially during warm or hot weather, as temperature levels inside a car can reach a deadly level in a matter of minutes.

High heat days may also be poor air quality days that can increase the threat to those living with chronic health conditions, older adults and children. Air quality information can be found online.

Each week, staff in the state Division of Public Health Occupational and Environmental Epidemiology Branch compile and publish the North Carolina Heat Report.  To sign up to receive the weekly North Carolina Heat Report via email, go to the Public Health website.

North Carolina can expect large changes in climate by the end of the century, much larger than any time in the state’s history, and it’s very likely that temperatures here will increase substantially during all seasons unless the global increase in heat-trapping gases in the atmosphere is stopped.

Temperatures warmer than historic norms, disruptive flooding from rising seas, increasingly intense and frequent rainstorms and more and more intense hurricanes are “virtually certain” in the next 80 years.

That’s according to an independent, peer-reviewed report released Wednesday by North Carolina State University’s North Carolina Institute for Climate Studies, or NCICS. As a result of hotter temperatures and increased humidity, the state can face public health risks, more frequent and more intense heavy rains from hurricanes and other weather systems, increased flooding in coastal and low-lying areas and severe droughts that are more intense and that will increase the risk of wildfires.

“Increasing concentrations of carbon dioxide and other greenhouse gases are most likely causing much, if not all, of the warming that we have observed,” said David R. Easterling, one of the report’s 15 authors, during a press conference Wednesday.

The institute is a multidisciplinary team of experts collaborating in climate and scientific research. The report was assembled, reviewed and revised over the course of eight months beginning in July 2019 and was prepared in response to a request from the North Carolina Department of Environmental Quality as part of the state’s response to Gov. Roy Cooper’s 2018 Executive Order 80.

While there were no real surprises in the report, which looks at observed and projected climate change in North Carolina and whose findings are consistent with the U.S. National Climate Assessment, it brings the science to the state level and highlights the specific challenges ahead for North Carolina.

The researchers said 2009-2018 was the warmest 10-year period on record in North Carolina.

“It’s about a half degree warmer than the warmest decade in the 20th century, the 1930s, the Dust Bowl era,” Easterling said, adding that as the report was being finalized, 2019 turned out to be the warmest year on record for North Carolina and the second warmest globally.

Also, the past four years saw the largest number of heavy precipitation events on record for the state.

So what does it all mean for folks in coastal North Carolina?

The researchers said government officials should take the report into consideration when planning for new infrastructure, such as roads that will have to be designed to different standards to withstand the climactic changes. Individuals can also do their part to reduce greenhouse gas emissions and concentrations.

State Climatologist Kathie Dello, also an author of the report, suggested that North Carolina residents should talk about the report with their friends, families and neighbors.

“There are so many folks who don’t think about climate all day like we do on the panel, and I’ve heard a number of times from folks, ‘This is the first time someone’s talked to me about climate change or projections or what I should expect in my town.’ So, have the conversation. I think it’s really effective and people trust you as a messenger because they know you, they like you and trust you about other things,” Dello said.

“There are so many folks who don’t think about climate all day like we do on the panel, and I’ve heard a number of times from folks, ‘This is the first time someone’s talked to me about climate change or projections or what I should expect in my town.’ So, have the conversation.”

Kathie Dello, State Climatologist

Reide Corbett, director at the Coastal Studies Institute, dean of Integrated Coastal Programs for East Carolina University, and another author of the report, said coastal residents should be thinking about more sustainable growth, not just after disasters such as Hurricane Dorian’s flooding on Ocracoke Island, but also as high-tide, or “sunny day” flooding becomes more and more an everyday occurrence.

“That’s something that, locally, many of the communities need to start thinking about, preparing for and responding to likely after an event,” he said. “I think Ocracoke is a good example where, as they’re rebuilding, they’re considering the storm that they just had and rebuilding to new standards, not rebuilding to what it was in the past.”

Different responses may be necessary along the North Carolina coast, depending on where a community lies.

Sea level is rising 1.8 inches per decade at Duck on the northern Outer Banks, but only at a rate of 0.9 inches per decade at Wilmington on the southern coast because land along the northern coast is settling or subsiding more rapidly.

Also, the southern coast of North Carolina experiences more tropical storms and stronger hurricanes than the northern part of the state does, said Rick Luettich, director of the University of North Carolina Institute of Marine Sciences in Morehead City and a report author.

“That trend in and of itself will certainly be sustained,” he said, adding that as global mean sea level rise accelerates, the differences will be increasingly less obvious.

“As sea level rise starts going up faster and faster, that difference will become smaller and smaller,” Luettich said.

While the latest report deals mainly with the science of climate change, a risk assessment and resiliency plan are under review. Subsequent reports will deal with the consequences, such as the effects on agriculture, fisheries and other natural and economic resources and how to address those issues.

The authors agreed that examining the challenges specific to the state is an important step.

“The idea that science is being incorporated into policy in North Carolina is a huge step forward, particularly from a sea level and inundation perspective,” Corbett said. “I’m very pleased with the direction that we’re going and this report is the first step for North Carolina and really using it in developing science-based policy.”

Learn more

• Read a “plain language” summary
• Read the full report