Eve here. This post of collateral damage, like unnecessary deaths and other damages caused to patients when hospitals are overloaded by an extreme climate episode. This work shows that excessive mortality resulting from hospital distribution can become the norm.
This result was Principal in New York City during the 2020 “wild type” Covid. The patient who produced the hospitalized Offen was on the path to death for two to three weeks as his lungs turned into bloody goo. This is much longer than the much longer time in the hospital bed Oxtracy, and henches are planned. And thanks to neoliberalism, reducing the number of hospital beds has become a priority. This means that even if Anchoch’s doctors and nurses are marshalled to handle the horrifying outbreak, physical plants limit how much disease and injuries they can handle. In New York, during peak covid, there have been many reports of waiting more than 36 hours just to join the emergency room, and these delays have spread. Victims of these types of stokes, heat attacks and accidents are fatally dangerous.
The authors point to the obvious need to increase hospital capacity to deal with higher and extreme levels of extreme events. But the cost of omission, what does it take to achieve this?
By Sandra Aguilar-Gomez, Joshua Graff Zivin and Matthew Neidell. Originally published on Voxeu
As extreme thermal events become more frequent and more severe, elevated temperature increases the incidents of heat stroke, kidney damage and cardiovascular stress. This column considers extreme fever not only a direct health threat, but also a system-level shock that exposes and exacerbates existing vulnerabilities in healthcare delivery. To prepare for the future of Acte Heatwaves, leaders of Polycymakers and Healthcare must once again reassure that hospitals are run effectively during sensory crisis. Addressing the indirect impacts of climate change is a factor in broader climate adaptation efforts.
As climate change accelerates, extreme heat events become more frequent and more serious, posting health risks. Policymakers and public health experts are well aware that rising temperatures increase incidents of heat stroke, kidney damage and cardiovascular stress. However, the critical dimension remains unrestrained. How extreme fever strains the health care system and compromises patient outcomes. Although previous studies documented the direct effects of fever on morbidity and mortality (Basu 2009, DeChenes 2014, Geruso and Spears 2018), our study is important, so far, highlighting the distant ripple effect of the past: how patient heat is not associated with temperature exposure (Aguilar-Gomez et al. 2024).
Healthcare System Extreme Heat Enhanced Pregnancy
When a heat wave strikes, hospitals and emergency departments (EDS) experience a rapid increase in patient influx. An ever-growing number of research has shown that hospital overcrowding can have a serious imagination in patient care. For example, pollution-driven surges in studies of influenza outbreaks (Gutierrez and Rubli 2021) and pediatric hospitalizations (Guidetti etal. 2024) reveal troubling patterns.
Based on this literature, our study (Aguilar-Gomez etal. 2025) examines how extreme fever affects hospital crowding and patient outcomes in Mexican hospitals. Countries offering private events are predicted to have higher disasters compared to high-cost countries (Desmet and Rossi-Hansberg 2024, Murray-Tortarolo 2021, Pertner et al. Our findings suggest that overcrowding in hospitals during heat waves is not merely an operational challenge, a major factor in excess mortality, including conditions unrelated to heat exposure among patients.
How heat waves destroy hospital systems
We are an extensive dataset over an eight-year journal (2012-2019) that includes records of all emergency department and hospital visits in emergency departments and hospitals (MOH) facilities serving two-thirds of the Mexican population. By linking health data with weather records, we examine how temperature surges affect hospitalizations, patient migration within the health system, and health outcomes.
The effect is impressive. When daily maximum temperatures exceed 34°C, ED visits increase by 7.5% (approximately 3 visits per day) and hospitalizations increase by 4%. In the face of this, hospitals look like distribution care. Figure 1 shows that as temperatures rise, ED patients are admitted to hospitals, keliofo feels the share of patients has increased homes, suggesting that the hospital is reaching capacity.
Figure 1 Changes in triage in patients with ED.
Furthermore, extreme heat likely accelerates patient discharge as a response to overcrowding. Our findings show that hospitals reduce the average length of stay on extreme heat days and release more patients from early-released beds. Even more strangely, patients are less healthy than patients who are discharged on a cool day, raising concerns about their health outcomes after discharge.
Hidden tolls: Excess mortality rates due to heat-driven overcrowding
Sub-observers may assume that Thue is discharged early or seeking care elsewhere away from the ED, but our findings suggest that this is not the case. Using important statistical data, we can see that Mortes raises boys both inside and outside the hospital during extreme heat events. Figure 2 shows that deaths outside the hospital increased at a greater rate than the toas within it, consistent with scenarios in which critically ill patients are overdispensed or denied hospitalization due to overcrowding.
Figure 2. Death share by location
To separate the role of hospital crowding from direct heat-related effects, we examine the excess mortality rates of patients already admitted prior to the onset of HeatWaveve. Even within this group, additional days with high temperatures above 34°C increased mortality by 5%, suggesting that busy hospitals rather than heat exposure are a key factor in death. Additional analysis focusing on cancer participants (which should not be physiologically vulnerable to temperature fluctuations) yields similar results and reinforces the congestion hypothesis.
Policy impact: adapting healthcare systems to a warmer future
Housing air conditioning, along with tools such as urban structure changes and climate-prevention transport systems, was an important focus for climate adaptation discussions (Barreca et al. 2016, Costa et al. 2024). Our findings highlight an overlocked path for climate adaptation: strengthening the resilience of the health care system. Equality is important for hospitals to regain that they can cope with the surges caused by climate-related demand. This may include passing hospital capacity, increasing staffing during heat waves, and improving management protocols. The health care system is already burdened with high interests in developing countries where access to air conditioners is limited (Escobar etal. 2025), with the highest impact on extreme heat mortality (Geruso and Spears 2018).
Investments in hospital infrastructure and labor expansion could reduce not only the direct health impact of climate change, but also the ripple congestion of hospital congestion. Additionally, improving patient triage and care coordination can help put pressure on hospitals during extreme heat events.
Conclusion
Extreme fever is not only a direct health threat, but also a system-level impact that uncovers and exacerbates existing vulnerabilities in health care delivery. Our study highlights the importance of collecting and addressing these indirect effects as part of a broader climate adaptation effort. Polymakers and healthcare leaders are preparing for the future with more frequent and severe heat waves, so it is paramount that hospitals remain functional and effective in times of crisis. Investing in healthcare resilience today can save lives tomorrow.
For more information, readers can rely on our complete research (Aguilar-Gomez etal. 2025).
See original bibliographic submission
