PUNE, India – Close to 200 people have died in Central India as a result of a severe heat wave in the region with temperatures in the range of 40-43 degrees Celsius, according to India’s Meteorological Department. 

While there has been no official confirmation of the death toll, Associated Press has estimated that close to 200 people have died so far in the states of Uttar Pradesh and Bihar alone. The heat wave is affecting seven states.

Heat-related deaths are notoriously hard to pin down and overwhelmed hospitals are often not able to dedicate the time to clinically establish it in the middle of a heat wave, which gives authorities the alibi to easily downplay the numbers.

Earlier, heat wave warnings were also issued for the months of April and May. Last year, large parts of South Asia experienced the hottest March in 132 years. This was unusual as April and May are usually the hottest months India. 

The current heatwave is also unusual for June when monsoon showers usually cool down the subcontinent. Human-caused climate change doubled the likelihood of the three-day extreme heat wave over India’s most populous state, Uttar Pradesh, between 14- 16 June, according to a new analysis by researchers at climate communication group Climate Central.

With climate change, such anomalies are expected to rise, according to scientists, but heat-related deaths are easily preventable, they say.

Early warning 

India has adequate early warning system in place, Abhiyant Tiwari, the lead of health and climate resilience at NRDC-India, told Health Policy Watch. His organisation works with governments on improving climate resiliency. 

Heat-related deaths can be prevented by improving coordination between weather and city officials, said Tiwari, something his team helped set up in Ahmedabad city in 2013, making it the first city in South Asia to have a heat action plan in place that remains functional to date. 

India’s weather department already releases alerts ahead of heat waves and other extreme weather events. In Ahmedabad, a local officer was charged with coordinating with the weather department and other health and civic officials to kickstart a response in the event of a heat wave. 

Such plans have worked to drastically reduce deaths by simply warning the communities to stay indoors ahead of time, and asking them to keep hydrated. Hospitals too are warned to brace up for additional patients.

“The best part is that it is a low-hanging fruit. Heat-related deaths are easily averted and there are no major costs involved at least in implementing the early warning systems. I’m not talking about the long-term mitigation measures, but at least these short-term measures during summer which can save lives by proper messaging, proper preparedness, proper response,” Tiwari said.

In the past few days, both day and night time temperatures have been high in Central India leading to a high “heat load,” he said. As average global temperatures continue to rise, night-time heat waves are set to worsen, according to studies.

India’s central government has advised affected states to ensure uninterrupted electricity supply and improve the collection of data from the ground on heat wave deaths to improve response, as hours’ long power cuts are still common in the country’s rural areas.

Climate change worsening heat waves

Summers in India are always hot and a time when schools shut down for the annual break. But rising global temperatures linked to the changing climate have significantly worsened the heat, according to scientists.   

An analysis released in May this year by a team of international climate scientists at the  World Weather Attribution initiative, based at Imperial College, London, found that climate change had made the April heat wave over parts of India, Bangladesh, Laos and Thailand 30 times more likely.

“We see again and again that climate change dramatically increases the frequency and intensity of heat waves, one of the deadliest weather events that exist. Our most recent WWA study has shown that this has been recognized in India, but the implementation of heat action plans is slow. It needs to be an absolute priority adaptation action everywhere,” said Dr Friederike Otto, a researcher at Imperial College London and co-lead of World Weather Attribution (WWA).

While many Indian cities and states have developed heat wave action plans in recent years, their implementation remains weak. This week the country’s central government asked all states to develop a plan with the summers increasingly turning deadly.

A scorching heat wave in two of India's most populous states has overwhelmed hospitals, filled a morgue to capacity and disrupted power supply, forcing staff to use books to cool patients. https://t.co/789EGefDXd

— The Associated Press (@AP) June 20, 2023

Images from news reports from the ground in Central India showed collapsed old and young people being carried to the hospital by family members, overcrowded hospital beds, and family member performing the last rites of the dead.

High temperatures also mean increased demand for electricity and higher carbon emissions as roughly half of India’s electricity is primarily generated by burning coal, despite the ongoing attempts to scale up access to solar electricity.

The air pollution connection

India’s toxic air is also making matters worse. High temperatures generally also worsen air pollution levels.

“During heat waves, levels of ozone, and in some cases, production of particulate matter pollution can increase,” said Pallavi Pant, who is the head of global health at the Boston-based Health Effects Institute.

Ozone pollution can damage tissues of the respiratory tract and worsen asthma symptoms, while persistent exposure to particulate matter can cause strokes, heart disease, lung disease, lower respiratory diseases (such as pneumonia), and cancer, according to the UN Environment Programme. High levels of fine particles also contribute to other illnesses, like diabetes, can hinder cognitive development in children and also cause mental health problems.

“This problem is also not unique to India. Cities and regions around the world are experiencing a higher intensity of heat waves and deterioration of air quality.  In California, one study found that exposure to high heat and air pollution at the same time led to nearly three times higher risk of death compared to air pollution or heat alone,” Pant said.   

High heat and air pollution are linked to respiratory diseases and together, they can increase the risk of poor health, especially for people living with chronic lung or heart diseases. In some cases, exposure to high heat and pollution can also lead to death. Older people and outdoor workers are particularly vulnerable.

Central India is already home to a majority of the world’s most polluted cities and an analysis from Delhi by the Centre for Science and Environment confirmed that ozone pollution spikes in summers.

Ozone exposure is already high across India, according to the State of the Global Air report. 

While short-term measures like heat wave plans can reduce deaths, scientists are clear that unless global carbon emissions are brought down and fossil fuels are phased out, such extreme weather events are only going to get worse. 

But on that front, there isn’t enough largescale movement yet and the world is currently headed to an average global temperature rise of 2.8 degrees Celsius by the turn of the century, according to the United Nations.