Tuesday will likely be the first day in 113 days that the high temperature will be below 100 degrees. We shattered the record of the longest string of 100 degree days this summer, in what will go down in history as the hottest Phoenix summer on record.
And, it’s looking like the number of heat-related deaths in the Valley could break more records. As of Sept. 17, the Maricopa County Department of Public Health reports 256 heat-related deaths, with 393 more under investigation.
Dr. David Sklar, an emergency room physician at Valleywise Health, the county’s large, safety net hospital, says it's still too many people. Last summer, he wrote in an op ed in The Arizona Republic, he was surprised by the sheer volume and severity of the record-breaking heatwave on people in the ER. He compared it to treating patients during the AIDS epidemic and during the outbreak of COVID-19.
Sklar joined The Show to discuss how it compares to what he’s seen so far this summer.
Full conversation
DR. DAVID SKLAR: Well, really, this past summer and even the summer before have been unique in my own personal experience because at times, I felt like I could make a difference in terms of saving people who were dying. But also the numbers of people who are coming in day after day and were on the edge of death was something that I had really never experienced before.
And I've seen people through the COVID-19 pandemic and through the AIDS epidemic that we had back in the ‘80s. And there were a lot of very, very sick people that I ended up taking care of. But what was really different about this was that it was unexpected and the people were in such an acute state of being near death in that they were unconscious and gasping for breath and losing control of urine and bowels and blood pressure was low and they had body temperatures of 108, 109, 110, which was unlike anything I had ever seen.
And this was something that we were seeing day after day, during those really warmest days that we were having in Phoenix. And so, you know, we had to just take action immediately. And fortunately, we had a team of people in the emergency department who kind of had a pretty good idea of what we could do to save people, which was first of all trying to cool them in these ice water baths that we used. And actually we used body bags that were able to kind of hold the water in the ice that we then covered patients.
LAUREN GILGER: I mean, but it sounds like you had to really improvise. Like as you said, this was unexpected, why, why was it so unexpected? Like, I mean, we always have hot summers in the Valley. They are getting incrementally hotter. Was it that stretch through July last summer where we just did not get a respite from 110 and above?
SKLAR: Well, yes. So I think what I noticed was that once we got to really high temperatures, particularly up over about 115, it seemed like the numbers of patients that we were seeing increased substantially and, you know, the year before when we were up around 119, we got lots of patients coming in near death.
This year, although we had more sustained high temperatures. So I think everybody knows we were over 100 degrees for over 100 days but we didn't have quite the blip in terms of these extreme temperatures up in the range of like 118, 119 which seemed to be pushing people really over the edge. And particularly if they were patients who already had vulnerabilities such as problems with their heart or their kidneys or lungs so that they were already vulnerable or people who didn't have good living conditions, they didn't have air conditioning in their home. They may have been living on the street.
In some cases, there were people who had used drugs such as methamphetamine and, and so these were more vulnerable and then the additional amount of heat in the environment in 2023. And we still had high temperatures in 2024, but at that level, a lot of people just couldn't, you know, couldn't sustain it, they couldn't sweat or cool off enough, they couldn't get access to cooling. And so their body temperatures went very high and they became unconscious and collapsed and ended up near death.
GILGER: Right. So you're bringing up the comparison there between this summer and last summer, this summer has, you know, broken more records, probably it's officially the hottest summer on record. But like you said, we didn't have that sustained incredibly high temperatures like we saw last July and the verdict does not end yet on how many heat deaths we will have tallied by the summer's end.
But I wonder from your point of view, has anything gotten better? Have you been more prepared? Have there been better strategies, better outcomes from institutions and from, you know, people on the ground like you?
SKLAR: Yes. Well, I think from the treatment perspective, we have made some great improvements in that we now really have educated all of our health professionals on how to cool patients quickly. And I do believe that how quickly we are able to cool folks makes a huge difference in terms of their outcomes. And we can usually now get people from 110 and 109 down to about 103, which is when we take them out of the body bag within a half hour to 45 minutes. And I think that makes a big difference.
The fire department has also instituted treatment in the field in which they're putting patients in these body bags with water and ice and so cooling them before the patients even arrive at the emergency department. And that's made a big difference, I think.
And then the community, we, we have more resources. So now we have cooling centers, more, more cooling centers, they're staying open longer and they're more, I would say more attention to kind of try and identify people early and recognize that they're in trouble and getting them help. So, from that perspective, I think we've made huge strides where we probably haven't made as much strides. It's just trying to identify who's at risk and intervening before they end up getting overheated because once people get really overheated and if their heart should stop, it's almost impossible to kind of revive them.
So if we can get them before they have the cardiac arrest, even if their blood pressure is low and they're unconscious, we've had a fair amount of success. And I would say more than half of the people who we resuscitate are able to leave the hospital and in many cases, walk out of the hospital under their own power and not have permanent damage.
So, you know, that was, I think an improvement, but I don't think we've made enough progress in terms of preventing this from happening with more housing options for people in the summer and identifying the people at risk and trying to get them out of harm's way.
GILGER: So you're talking about some of the big shifts that have happened on a community level in terms of cooling centers, expanding hours, giving people options, panning out water like these campaigns, right? That are coordinated and really aimed at trying to reduce heat deaths. Is it enough though? Like when you're talking about prevention, what would that look like in your mind?
SKLAR: Well, I don't think it's enough. I think we need to do more work actually in analyzing all the people who are dying. So I've actually talked about developing a death review team. We would get the data from the medical investigator and bring together people from the community to look at the cases where people died. If they died at home or if they died in a park or in some cases, they die in garages or trailers where they don't have air conditioning and, and try to understand each one of the deaths and what we could do to prevent it from happening next year.
Communicating with family members or friends, brothers who knew the people who died and figure out why they died and why we weren't able to prevent this from happening. And we have death review teams for other problems like intimate partner violence or pediatric deaths. And, and I think we could do this for heat.
I don't think it's acceptable to have 600 people in our community dying in the summer year after year. We've had two years in a row. We will probably be up over 600 deaths. And I don't think we should accept that as just one of the unfortunate consequences of living in a hot environment living in Phoenix.
