A heatwave is like the COVID-19 virus. During the pandemic, the virus infected and killed many people. When vaccines became available, the mortality rate dropped even though the virus continued to spread. But vaccines weren’t the only way to keep people from dying. The COVID-19 virus killed more people if the people were already unhealthy

In India, an important cause for people being unhealthy is the state itself. In many places, the roads are poorly laid, kicking dust exposed by traffic use up into the air, where it joins the PM2.5 particles emitted by industrial facilities allowed to set up shop near residential and commercial areas without proper emission controls. If this is one extreme, becauses these experiences are so common for so many Indians, at the other is the state’s apathy towards public health. India’s doctor-to-patient ratio is dismal; hospitals are understaffed and under-equipped; drug quality is so uneven as to be a gamble; insurance coverage is iffy and unclear; privatisation is increasing; and the national government’s financial contribution towards public health is in free fall.

For these reasons as well, and not just because of vaccine availability or coverage, the COVID-19 virus killed more people than it should have been able to. A person’s vulnerability to this or any other infection is thus determined by their well-being — which is affected both by explicit factors like a new pathogen in the population and implicit factors like the quality of healthcare they have been able to access.

A heatwave resembles the virus for the same reason: a person’s vulnerability to high heat is determined by their well-being — which in turn is affected by the amount of ambient heat and relative humidity as well as the extent to which they are able to evade the effects of that combination. This weekend, a new investigative effort by a team of journalists at The Hindu (including me) has reported just this fact, but for the first time with ground-zero details that people in general, and perhaps even the Tamil Nadu government itself, have thus far only presumed to be the case. Read it online, in the e-paper or in today’s newspaper.

The fundamental issues are two-pronged. First, Tamil Nadu’s policies on protecting people during heatwaves require the weather department to have declared a heatwave to apply. Second, even when there is no heatwave, many people but especially the poorer consistently suffer heatwave conditions. (Note: I’m criticising Tamil Nadu here because it’s my state of residence and equally because it’s one of a few states actually paying as much attention to economic growth as it is to public health, of which heat safety is an important part.)

The net effect is for people to suffer their private but nonetheless very real heatwave conditions without enjoying the support the state has promised for people in these conditions. The criticism also indicts the state for falling short on enforcing other heat-related policies that leave the vulnerable even more stranded.

The corresponding measures include (i) access to clean toilets, a lack of which forces people — but especially women, who can’t urinate in public the way men are known to — to drink less water and suppress their urges to urinate, risking urinary tract infections; (ii) access to clean and cool drinking water, a paucity of which forces people to pay out of their pockets to buy chilled water or beverages, reducing the amount of money they have left for medical expenses as well as risking the ill health that comes with consuming aerated and/or sugary beverages; and (ii) state-built quarters that pay meaningful attention to ventilating living spaces, which when skipped exposes people to humidity levels that prevent their bodies from cooling by sweating, rendering them more susceptible to heat-related illnesses.

And as The Hindu team revealed, these forms of suffering are already playing out.

The India Meteorological Department defines a heatwave based on how much the temperature deviates from a historical average. But this is a strictly meteorological definition that doesn’t account for the way class differences create heatwave-like conditions. These conditions kick in as a combination of temperature and humidity, and as the report shows, even normal temperature can induce them if the relative humidity is higher and/or if an individual is unable to cool themselves. The state has a significant role to play in the latter. Right now, it needs to abandon the strictly meteorological definition of heatwaves in its policy framework and instead develop a more holistic sociological definition.

Featured image credit: Austin Curtis/Unsplash.