Under The Weather: How Indians Need to Protect Themselves from Heat-related Illnesses

As temperatures touch record highs across north-western India, medical experts are witnessing a surge in cases of heat-related illnesses.

Complications such as loss of consciousness, high-grade fever, extreme dehydration, and low urine output are among the top few that push a patient to get hospitalised for treatment.

Heat-related diseases can manifest in several forms – starting from a simple high fever, to heat exhaustion, syncope attack (sudden drop in heart rate and blood pressure leading to fainting), and other serious conditions.

“This time the cases are slightly more than usual, around 25-30% more. In the past two years, Covid-19 stopped people from reaching out to hospitals. However, otherwise, there is a spike in cases of heat-related sickness,” Sumit Ray, head of the department, critical care medicine, at Holy Family Hospital in Delhi, told News18.com.

The majority of cases, as per Dr Ray, is in the elderly age bracket, mostly complaining of diarrhoea, dehydration, or fever.

However, he clarified that the cases of heat stroke – where fever is upwards of 105°F and extreme cooling techniques are required to treat patients – are still rare and haven’t been reported so far at his hospital.

Dr Ajay Nair, physician at Narayana Multispeciality Hospital, Jaipur, said that there is a 20-25% increase of patients in the outpatient department (OPD) with heat-related illnesses. He added that when the body is exposed to high temperatures, sometimes it is not properly cooled off and, as a result, a person can experience heat stroke, heat cramps, or heat exhaustion.

Other doctors also echoed similar trends.

For instance, Fortis Hospital in Noida has been receiving around 10-15 patients a day with symptoms of heat exhaustion.

According to Dr Ajay Agarwal, director and head of the department of internal medicine at the hospital, the patients are showing various symptoms like headache, fever, dizziness, excessive sweating, etc.

Dr Rajiv Dang, senior director and head of the department of internal medicine and medical director at Max Hospital in Gurugram, said that the patients visiting hospitals are coming with high-grade fever above 104°F, dehydration, headaches, weakness, and low blood pressure.

What are the regular symptoms and what can be done?

However, according to doctors in private hospitals, people are getting more aware about the illnesses and, thus, the severe form is not there in spite of so much heat.

“Gastrointestinal symptoms in the form of nausea, vomiting, and recurrent loose motions cause further dehydration. Many are presenting with severe fatigue, muscle cramps, abdominal cramps associated with high-coloured urine,” Dr Agarwal said.

In a word of caution, experts said that people who are consuming medications for regulating blood pressure should be extra cautious, as they are at a higher risk of dehydration and complications such as cardiac arrest or heart stroke.

“Patients on diabetic medication also need to be more careful,” Dr Dang said.

The only way, as per experts, to prevent heat stress is hydration. Hydration does not mean drinking only water, one should add simple liquids like electrolytes, lemon water, coconut water, etc, to their diet.

Dr Agarwal advises that one should drink plenty of fluids, at least 3-4 litres per day. “One should use sunscreens, a cap or head scarf, and wear loose clothes before going out in the sun. One should avoid drinking alcohol as it causes dehydration,” he said and added that people should carry fluids while stepping out.

“Wear loose cotton clothes, shower twice a day, and stay home. After coming back home, after a period of cooling for 30 minutes, one should take a bath with cold water.”

How to protect children and poor people from heatwaves?

Heat rash is common and heat cramp is also noted among children but not heat stroke, doctors said.

“Heat cramps happen mostly when kids play in hot weather and forget to hydrate. Persistent muscle contractions during and after activity is also a sign,” Dr Maninder Singh Dhaliwal, associate director of paediatrics, Medanta Hospital, Gurugram, said.

Cramping most often occurs in the legs and tummy. It is like a muscle cramp pain not caused by a pulled or strained muscle.

If such signs are spotted, the child should be put to rest and should drink plenty of fluids, preferably one containing sodium and electrolytes.

“Some light stretching and massage might help,” said Dr Dhaliwal.

Dr Dang from Max Hospitals also cautioned that children should not go out to play in the sun.

Several doctors pointed out that while heat-related illnesses can be life-threatening for anyone, poor people become the biggest sufferers.

“The rich can spend money to be in a comfortable zone. But it is the poor, especially the labourers, who are the biggest sufferers as they are the most exposed,” said Dr Neelesh Kapoor, senior consultant physician at online consultancy platform eka.care, adding that extreme heatwaves are very dangerous for health and exposure can cause dehydration, heat stroke, exhaustion, cramps, and even cerebrovascular accidents.

In fact, Dr Agarwal from Fortis added that “we should never leave anyone including our driver in a parked car for too long in the sun”.

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