Compounding hazards and intersecting vulnerabilities: Experiences and responses to extreme heat during COVID-19

Extreme heat is a major threat to human health worldwide. The COVID-19 pandemic, with its complexity and global reach, created unprecedented challenges for public health and highlighted societal vulnerability to hazardous hot weather. In this study, we used data from a three-wave nationally representative survey of 3036 American adults to examine how the COVID-19 pandemic affected extreme heat vulnerability during the summer of 2020. We used mixed effects models to examine the roles of socio-demographic characteristics and pandemic-related factors in the distribution of negative heat effects and experiences across the United States. The survey findings show that over a quarter of the US population experienced heat-related symptoms during the summer of 2020. Mixed effects models demonstrate that among all socio-economic groups, those who were most vulnerable were women, those in low-income households, unemployed or on furlough, and people who identify as Hispanic or Latino or as other non-white census categories (including Asian, American Indian or Alaska Native, Native Hawaiian or other Pacific Islander, and multi-racial US residents). The study findings indicate that millions of people in the US had difficulty coping with or responding to extreme heat because of the direct and indirect effects of the COVID-19 pandemic. Limited access to cooling as well as COVID-19 related social isolation played a major role in adverse heat health effects. Geographically, the South and the West of the US stood out in terms of self-reported negative heat effects. Overall, the study suggests that the intersection of two health hazards-extreme heat and coronavirus SARS-CoV2-amplified existing systemic vulnerabilities and expanded the demographic range of people vulnerable to heat stress.