When an unprecedented heat wave baked the Pacific Northwest last July, emergency rooms sought any way possible to lower the core body temperatures of patients coming in droves with heat-related ailments.

Many emergency departments in the region began putting people in body bags filled with ice to help safely adjust their temperatures. But despite their lifesaving efforts, around 1,000 excess deaths occurred from the brutal heat.

The scramble to save lives paints the challenging reality that many hospitals and medical workers are facing again this year as severe weather-related health emergencies escalate because of extreme climate events.

“We unfortunately had a real live stress test here for the Pacific heat dome because the temperatures were so high and we had a 69-fold increase in hospital-related presentations,” said Kristie L. Ebi, the founder of the center for health and global environment at the University of Washington.

At the same time, the health care sector contributes significantly to the worsening climate crisis, representing nearly 8.5 percent of all U.S. emissions.

According to an analysis conducted by World Weather Attribution, that excessive heat wave was made at least 150 times more likely from human-induced climate change.

Last fall, the editors of over a dozen health journals from across the globe simultaneously published a joint editorial calling for urgent climate action to avert catastrophic warming. Without it, the editorial said, rising temperatures will lead to more deaths from heart and lung illness, allergies, kidney problems and pregnancy complications.

“The greatest threat to global public health is the continued failure of world leaders to keep the global temperature rise below 1.5° C and to restore nature,” the authors wrote.

The New England Journal of Medicine went one step further this spring in launching a series focused on highlighting health hazards linked to planet-warming pollution, our colleague Sarah Kaplan reports.

Renee Salas, a researcher at the Center for Climate, Health, and the Global Environment at Harvard University and contributor to the series, says that doctors have a moral obligation to speak out against fossil-fuel use and other planet-warming activities.

“The burning of fossil fuels, the root cause of both air pollution and climate change, threaten medicine's core mission. They harm health and threaten health care delivery, making our jobs not only harder, but sometimes impossible.”

Too heavy of a lift?

As The Climate 202 reported last month, 61 of the nation's largest hospital and health-sector companies have joined the Health Sector Climate Pledge to cut greenhouse-gas emissions in half by 2030.

The commitment is meant to help advance President Biden’s target of reaching net-zero emissions by 2050 and includes more than 650 hospitals and thousands of providers, including two of the five largest U.S. private hospital and health systems, Ascension and CommonSpirit Health.

“The health care industry has come to realize that traditional health care accounts for only about 20 percent of an individual's (or community's) overall health,” said Craig Cordola, Ascension’s executive vice president and chief operating officer. “Social determinants and one's physical environment play an even greater role. It’s imperative that we focus where we can have the greatest impact.”

But Ebi said that it's difficult to uproot the entire energy system of a health facility. For one, cost is a major factor. Depending on the institution's profit margin, switching to sustainable machines that leak fewer greenhouse gases might not be possible given their routine expenses.

There are also some things that hospitals can’t adjust, such as leaving the lights on overnight or being unable to reuse certain plastics for hygiene, to satisfy medical protocols.

What’s on the horizon for hospitals

Still, Ebi mentioned that there are smaller opportunities that hospitals can — and should — be pursuing to reduce their carbon footprints, whether that be through energy and waste management or by working to improve the well-being of patient communities.

Each of the organizations that signed onto the pledge — which included public hospitals, health-care centers, pharmaceutical companies, medical-device makers and suppliers — are expected to develop climate-resilience plans for their facilities, including plans to support individuals or communities most vulnerable to the effects of climate change.

According to Ebi, any plan should mention what she called the “low-hanging fruit,” including:

• Understanding your patient base, and how it could shift with climate change


• Outlining community vulnerabilities to global warming (for example, care centers that are based in a flood plain)


• Planning personnel schedules around forecast weather events, or rescheduling surgeries to ensure anticipated surge capacity


• Providing opportunities for patients that benefit their health and the environment, such as a garden to supply fresh food for the cafeteria

As for Ascension, the system aims to reach net-zero carbon and waste by 2040. In its climate-resilience plans, Cordola said it will work closely with the individuals and communities most vulnerable to the impacts of a warming planet.

“Our focus is on creating healthier communities, including reducing the effects of climate change,” he said. “Leading health systems like Ascension have a role to play in demonstrating our commitment to this work not only to others in the health care industry, but to other industries as well.”