Who Should React and How to Each Heat Alert Level?

Thermometers began to soar at the end of May, and as in recent summers, due to climate change, many more days of high or extremely high temperatures and an increase in heatwaves are expected. This is why, from May 15 to September 30, the Ministry of Health will have a special plan in place to combat high temperatures, which includes the activation of multiple protocols and actions in coordination with the autonomous communities to try to minimize the tens of thousands of hospitalizations and thousands of deaths (at least 2,000 in 2024) caused in Spain by excessive and extreme heat, especially among those over 75 years old.

The central element of the plan is the Meteosalud health alert system, which warns in advance, both citizens and institutions, of the specific heat risk level they will face each day in each Spanish region, so that residents can take individual precautions and public officials can deploy the necessary actions to protect general health according to the alert level. Authorities must disseminate these alert levels daily, but the ministry's website also has an updated search engine and a subscription system that allows receiving the alert daily by email or mobile.

It is a system that provides tailored information for each of the 182 zones into which the territory has been divided, many formed by municipalities from different provinces. Each zone has its own alert level based on the temperature thresholds set for that specific area by the Carlos III Health Institute, which are the degrees at which its inhabitants begin to experience an increase in hospitalizations or deaths. This way, the risk is communicated to the right people in the right place.

The network has four risk levels, according to the increasing danger to health from rising temperatures, identified by a color code. Level zero (no risk), yellow, orange, and red (maximum danger). However, although excessive temperature negatively affects us all, there are risk factors, especially related to age, poverty, or illnesses, that mean each person must individually interpret what specific measures and precautions to take in response to the alert color of the day in their area.

To help citizens, healthcare professionals, and civil protection use each thermal alert correctly, the Ministry of Health has published a guide this year that interprets them. The first essential element to understand who and how each color affects is knowing if one belongs to risk groups due to personal, environmental, occupational, or social characteristics.

Particularly at risk from heat are infants and children under 4 years old, people over 65, pregnant women, and those with cardiovascular, respiratory, or chronic illnesses, but also those undergoing medical treatments, with mental and memory disorders, comprehension or orientation difficulties, or little autonomy in daily life.

Similarly, those at thermal risk include people living alone, the homeless, tourists, those suffering from poverty or many deprivations (with poorly acclimatized homes), and those with excessive heat exposure due to work or sports (especially between two and seven in the afternoon).

In light of the above factors, the Ministry of Health indicates that the yellow level should only be interpreted as a danger (and mild) by those over 65 with risk factors other than age. The orange level, the intermediate one, poses a mild danger to the general population and a moderate risk to those over 65 (high if they have more complications than age) and to young citizens but with several personal, occupational, or social risk elements.

The red level should raise alarms for all inhabitants of the area where it is announced that day. It poses a moderate risk to anyone, a high danger to those over 65 and minors with risk factors, and an extreme danger to those over 65 with additional risk elements.

There is what could be considered a fifth alert level. It is when red days occur consecutively, usually due to heatwaves. The translation is a warning of extreme risk for the entire population, especially for the most vulnerable people.