Resource

Extreme heat

Seniors drinking water

Extreme heat can be very dangerous. Learn the symptoms of heat stroke, heat exhaustion and how to prepare for the heat season to protect your health and that of your neighbours, friends and family.

People at higher risk

Different people respond differently to heat, and some people are at higher risk of experiencing health effects. Staying cool is especially important for the following groups of people:

  • Older adults, aged 60 years or older
  • People who live alone or are socially isolated
  • People with pre-existing health conditions such as diabetes, heart disease or respiratory disease
  • People with mental illness such as schizophrenia, depression, or anxiety
  • People with substance use disorders, including alcohol
  • People with limited mobility
  • People who are marginally housed
  • People who work or live in hot environments 
  • People who are pregnant
  • Infants and young children

Everyone can be affected and responds differently to heat. Listen to your body and take the necessary precautions during the heat season. Making sure that all people can keep cool and drink plenty of water is the best way to prevent heat-related illnesses.

Health effects of heat

Extreme heat events, also known as “heat waves,” can cause a number of heat-related illnesses, and can lead to an increase in deaths. Heat-related illness is an umbrella term for conditions caused by heat, such as heat rash, sunburn, heat cramps, heat exhaustion, and, the most severe, heat stroke.

Heat exhaustion

Symptoms of heat exhaustion include:

  • New skin rash
  • Heavy sweating
  • Dizziness
  • Nausea or vomiting
  • Rapid breathing and heartbeat
  • Headache
  • Difficulty concentrating
  • Muscle cramps
  • Extreme thirst
  • Dark urine and decreased urination 

If possible, support people with symptoms to move to a cool space. Give them water to drink. Loosen or remove clothing. Put ice packs against their body and/ or cool their body with water, e.g. dampen their clothes, apply wet towels. Continue cooling and giving them water until they feel better. If they do not start feeling better or if symptoms increase, seek medical support.

Heat stroke

Symptoms of heat stroke include:

  • High body temperature (39°C/ 102°F or higher)
  • Fainting or drowsiness
  • Confusion
  • Lack of coordination
  • Very hot and red skin

Heat stroke is a medical emergency. Seek medical attention immediately at an emergency room or urgent care centre. Call 9-1-1 if necessary. While waiting for help, cool the person right away by moving them to a cool space if possible. Quickly begin by putting ice packs against their body and/or cooling their body with cool water, e.g. dampen their clothes, apply wet towels, provide a cool sponge bath or shower. Continue applying cooling measures and watch them until 9-1-1 or medical personnel arrive.

If you are unsure or have any non-emergency questions, call 8-1-1 to speak with a nurse. 

Protect yourself and others from heat

Spending time in a cool space and drinking plenty of water is the best way to prevent heat-related illnesses.

Keep yourself and other people cool:

  • Seek cooler indoor and outdoor spaces (i.e. a local community center, library or mall.)
  • Drink plenty of water and other liquids to stay hydrated, even if you do not feel thirsty.
  • Use water to cool off by taking a cool shower or putting a part of your body in a cool bath.
  • Wear a wet shirt or apply damp towels to your skin to cool down.
  • Wear loose-fitting and light-coloured, breathable clothing.
  • Limit activity, especially during the hottest hours of the day (generally 2 p.m. to 4 p.m. in B.C.)
  • Watch for symptoms of heat exhaustion and heat stroke. For heat-vulnerable people, the risk for heat-related illness may increase at indoor temperatures over 26°C (78 °F) and may be very high at indoor temperatures over 31°C (88 °F).

Keep spaces cool:

  • Close windows and shades/blinds during the day to trap the cooler air inside and block the sun.
  • Open windows and doors at night to let the cooler overnight air in (outdoor temperatures usually cool by 9-10 p.m. – check the outdoor temperature is lower than indoors.)
  • Use one or more fans strategically to help move cooler air into the home overnight.
  • Use exhaust fans, usually located in kitchens and bathrooms, to move warmer indoor air to the outside, and open windows to pull in cooler outdoor air overnight.
  • Consider getting an air conditioner for your home. If you have air conditioning, be sure to turn it on. If you can’t afford to buy an air conditioner, check if you qualify for the BC Hydro free air conditioning program. 
  • Monitor indoor temperatures for yourself and those you are checking on.

Wildfire smoke can also cause health problems. During both wildfire smoke and heat events, consider also filtering your air using HEPA air cleaners. Find out more about wildfire smoke.

Check in with others: VCH heat check-in support and training

Check in on your neighbours, friends and family often to ensure they are able to stay cool and have a plan in place. This can save lives. During previous heat events, a large proportion of the people who died were at home and socially isolated.

Cover of heath check-in support framework

VCH Heat check-in support framework for non-governmental organizations

Heat check-ins happen in a variety of settings and by staff or volunteers with diverse training. Given the wide context, this framework was created so organizations may select the information that is most relevant to their setting to develop their own organizational check-in plans.

Download the heat check-in support framework

Heat check-in training videos

extreme heat check in by NCCEH

NCCEH Guide to health checks during extreme heat events

The National Collaborating Centre for Environmental Health (NCCEH) has developed a guide to help people to check on the wellness of family, neighbours and other community members who may be at higher risk for heat illness. This five-page package provides key information and guidance. Available for download in English, French, Chinese and Punjabi.

Download the NCCEH Health Checks Guide

Cooling centres & clean air spaces

During a heat warning or alert, it is important to spend time in cool spaces. When outdoor temperatures are high, even workplaces and homes can be very hot and increase the risk of heat illness. Several cities and towns in the Vancouver Coastal Health (VCH) region operate specialized cooling centres or encourage people to use other public spaces to cool down (like libraries and community centres). Misting and water fill station stations may also be provided during a heat event.

Many local governments post updated information on their social media, including Twitter or Facebook, about weather alerts and available services. Some local governments also have Extreme Heat webpages.

cooling-centre-signage

Guidance for community organizations

Creating cooling spaces during hot weather

Evidence-informed public health guidance for community organizations to set up and operate inclusive, acceptable, and effective cool spaces.

Download the cooling spaces guide

Heat warnings and extreme heat emergencies

In response to the 2021 heat dome, multiple health sector partners, and Environment and Climate Change Canada (ECCC) developed a BC Heat Alert and Response System (BC HARS). This two-level alert system lays out the criteria that ECCC will use to issue a Heat Warning (Level 1) or an Extreme Heat Emergency alert (Level 2), the appropriate public health messaging for both types of alerts, and the recommended actions for the health sector and other partners. The province will continue to refine and improve the BC HARS in the years ahead.

Read more about the BC HARS on the BCCDC website.

Alerts

Heat Warning (Level 1)
Threat: Daytime and overnight temperatures are higher than seasonal norms and holding steady
Action: Take the usual steps to stay cool. 

Extreme Heat Emergency (Level 2)
Threat: Daytime and overnight temperatures are higher than seasonal norms and getting hotter every day. 
Action: Activate your emergency plan. 

Graphic Illustration of Vancouver's Indoor Heat Study showing houses with the sun

Vancouver’s Indoor HEAT Study (2021-2023)

In 2021, Western Canada experienced an extreme heat event caused by a heat dome that resulted in 619 heat-related deaths across BC. In the weeks following, a team of health and climate professionals at Vancouver Coastal Health, BC Centre for Disease Control, and the City of Vancouver identified indoor temperature as a data gap in the region. To address this gap, these organizations designed a multi-year study – the Indoor Household Exposure to Ambient Temperatures (HEAT) Study – to collect temperature, building, and household data from residents living in Vancouver, BC. The goal of this work is to help inform recommendations for achieving safe cool temperatures inside existing buildings and help prevent heat illness.

Read the results of the study here

2021 BC heat dome and VCH ER Visits

Following the 2021 BC heat dome, the VCH Public Health Surveillance Unit studied data on emergency room visits in collaboration with VCH and Providence Health Care Emergency Medicine programs. Several key findings were identified:

  • The extreme heat event that affected much of British Columbia in 2021 resulted in a substantial increase in Emergency Department visits related to heat-related illness in VCH hospitals.
  • Rates of heat-related Emergency Department visits varied substantially by area of residence. Among the urban neighbourhoods in the VCH region, a higher rate of heat-related ED visits was observed among residents in the Downtown Eastside, Kensington, Victoria-Fraserview, North Vancouver City-East/West, and North Vancouver District Municipality –Central.
  • Among age groups, the highest rate of heat-related ED visits was among those aged greater than 80 years. Slightly more than half of heat-related ED visits and over 90% of hospitalizations among these visits were among those aged 65 years or older.

Comprehensive heat event preparedness is essential to minimize future health impacts, as the risk of extreme heat events in the context of a warming climate continues to evolve.

Read the full report: 2021 BC Heat Dome VCH ER Visits

Mental health and substance use

Extreme climate events such as heat waves can take a toll on physical and mental health and well-being. Don’t hesitate to get help when you need it. If you are struggling, there are supports available. 

Cover of Policy tools to create and support cooler, safer indoor living spaces

Policy tools to create and support cooler, safer indoor living spaces

Vancouver Coastal Health (VCH) conducted a review of policy and regulatory options that could increase thermal safety in homes within the VCH health region. The process included a jurisdictional scan of policy tools as well as key informant interviews with participants from different areas of government, housing and tenancy advocacy groups, and housing providers. In addition to describing a variety of policy options, findings indicate that multiple policy interventions at different levels of government are needed, as are strategies to overcome significant challenges relating to cost and feasibility, and to avoid unintended consequences.

Download the report: Policy tools to create and support cooler, safer indoor living spaces

Extreme heat resources

    • Public weather alerts for British Columbia

      Environment and Climate Change Canada (ECCC) weather alerts including heat and air quality.

    • WeatherCAN App

      Environment and Climate Change Canada (ECCC) weather alerting app for smart phones with heat and air quality alerts.

    • Hello Weather

      Environment and Climate Change Canada (ECCC) automated telephone weather service.

    • Extreme heat poster - English

      Vancouver Coastal Health & Fraser Health

    • Extreme heat poster - Translated

      Vancouver Coastal Health & Fraser Health; Available in: English, Arabic, Chinese-Simplified, Chinese-Traditional, Hindi, Korean, Farsi, Punjabi, Spanish, Urdu, Vietnamese and Gujarati

    • Health checks during extreme heat events - Translated

      National Collaborating Centre for Environmental Health; Available in: English, French, Punjabi, Simplified Chinese, Traditional Chinese

    • Extreme heat preparedness guide - Translated

      Prepared BC; Available in: English, French, Punjabi, Simplified Chinese, Traditional Chinese

    • Fans in extreme heat FAQ

      Vancouver Coastal Health & Fraser Health

    • Build your own cool kit - Translated

      Vancouver Coastal Health & City of Vancouver; Available in: English, Punjabi, Simplified Chinese, Traditional Chinese, Tagalog, Vietnamese.

    • Heat-related illness in infants and young children - Translated

      HealthLink BC; Available in: English, Arabic, Chinese-Simplified, Chinese-Traditional, Farsi, French, Hindi, Japanese, Korean, Punjabi, Russian, Spanish, Tagalog, Ukrainian, Vietnamese

    • Prepared together for extreme heat

      Building Resilient Neighbourhoods and Hey Neighbour Collective; Neighbour-to-neighbour connections may save lives during heat events. See tips to connect, learn, & collaborate with neighbours.

    • AC care

      Aboriginal Housing Management Association; Recommendations on safe and efficient operation of portable air conditioning units.

    • Heat check-in support framework for non-governmental organizations

      Vancouver Coastal Health and Fraser Health

    • Heat Check-In Training Video

      Vancouver Coastal Health

    • Heat Check-Ins: Train-the-Trainer Video

      Vancouver Coastal Health

    • Example heat check-in script

      Vancouver Coastal Health

    • Heat check-In training slides

      Vancouver Coastal Health

    • Heat check-in training: Train the trainer slides

      Vancouver Coastal Health

    • Heat check-in practice scenarios

      Vancouver Coastal Health

    • Heat check-in practice scenarios: Facilitation guide

      Vancouver Coastal Health

    • Extreme weather check-in calls for multilingual seniors

      MOSAIC. Available in multiple languages

    • Creating cooling spaces during hot weather: Guidance for community organizations

      Vancouver Coastal Health

    • Emergency support for seniors framework

      Renfrew Collingwood Senior’s Society

    • Heat stress information for workers

      WorkSafe BC

    • Sample heat and wildfire smoke plan for local governments

      Vancouver Coastal Health

    • Heat response planning for Southern Interior B.C. communities: A toolkit

      Interior Health; Learn what your community can do to prepare for heat.

    • Outdoor gatherings guidance

      Vancouver Coastal Health

    • How to be a heat-healthy business leader

      Fraser Health

    • Heat stress information for workers

      WorkSafe BC

    • Heat guidance for schools and childcare facilities

      Vancouver Coastal Health & Fraser Health

    • Community care facilities and heat

      Vancouver Coastal Health

    • Resource guide: heat planning

      VCH and Health Emergency Management BC; How community care facilities can begin heat planning and recommended months for each step.

    • Heat response plan template

      VCH and Health Emergency Management BC; Fillable heat response plan template for community care facilities.

    • Site assessment checklist

      VCH and Health Emergency Management BC; Detailed site and clinical checklists to assist community care facilities with heat planning.

    • Resident risk identification guidance

      VCH and Health Emergency Management BC; Criteria to identify residents in community care facilities at highest risk from heat-related illness.

    • Heat response preparation checklists

      VCH and Health Emergency Management BC; Brief checklist for community care facilities to complete before each heat season.

    • Heat response temperature log

      Vancouver Coastal Health & Health Emergency Management BC; Indoor temperature recording template for community care facilities.

    • Heat response checklist

      Vancouver Coastal Health and Health Emergency Management BC; Daily readiness check for community care facilities during heat alerts.

    • Heat-related illness: Prevention and Management in Community Care Facilities

      Vancouver Coastal Health & Providence Health Care

    • Extreme heat guidance for restaurants

      Vancouver Coastal Health

    • Pool Operators on extreme heat and wildfire smoke

      Fraser Health

    • Summer heat, wildfire smoke and health: Recommended actions for owners and managers of rental and strata housing

      Vancouver Coastal and Fraser Health

    • Resources to prepare buildings and facilities for extreme heat

      BC Housing

    • Heat wellness check-in card for tenants

      BC Housing

    • Creating cooling spaces during hot weather: Guidance for community organizations

      Vancouver Coastal Health

Resources for health professionals

    • Community care during extreme heat

      Health Canada

    • Acute care during extreme heat

      Health Canada

    • Wildfire Smoke and Extreme Heat Action Plan (with provider instructions)

      Legacy for Airway Health, UBC, VCH Research Institute

    • Health facilities preparation for extreme heat

      Health Canada

    • Technical guide for health care workers

      Health Canada

    • For pharmacists (including medication risk factors)

      Health Canada