Wednesday, October 21st– Selim MILED & Pierick BERGERAN

HEATWAVES 2015

1.National heatwave plan2.Initialisation phase3.Management phase4.Health impacts5.Lessons learnt

• General principles

– National heatwave plan : interministerial action, constantly evolving– Led by the Ministry of Health– 4 strategic axis :

• Axis 1 : Prevent the effects of a heatwave• Axis 2 : Protect populations by implementing measures adapted to the meteorological vigilance• Axis 3 : Inform and communicate• Axis 4 : Build up on experience

• Technical sheets

• Recommendations of the High Council of Public Health (HCSP)

Sheet 1 : communicationSheet 2 : isolated personsSheet 3 : homeless or precarious situationSheet 4 : childrenSheet 5 : working peopleSheet 6 : health care or medico-social facilities

Sheet 7 : general principles of vigilance and alertingSheet 8 : level 1 – seasonal vigilanceSheet 9 : level 2 – heat warningSheet 10 : level 3 – heatwave alertSheet 11 : level 4 – maximal mobilisationSheet 12 : applying the national plan at the local levelSheet 13 : CSEP

1. National heatwave plan

Vigilance Levels Associated measures

green level 1 – seasonal vigilance

- General preventive communication

yellow level 2 – heat warning

- Reinforce local coordination- Reinforce information and communication- Prepare the regional health agencies (ARS) for mobilisation- This level is not activated by the Prefect

orange level 3 – heatwave alert

- This level is activated by the Prefect, advised by the regional health agency- Use of local rescue plans - Daily follow-up of health indicators- The measures can be maintained as long as the situation demands, even if the level is back to yellow or green

red level 4 – maximal mobilisation

- Coordinated State response- Interministerial crisis center activated with invovled ministers- The measures can be maintained as long as the situation demands, even if the level is back to orange, yellow or green

Levels defined in the plan

2. Initialisation phase

-Anticipation and mobilisation of health professionals enables an adaptative response to the heatwave consequences.-The initialisation phase is based on the following actions:

-Awareness of the regional health agencies-Inform syndicates and associations of health professionals.-Identify hospital capacities for the summer.-Adapt the activation level of the CORRUSS (level 2).-Activate the national helpline.-Take actions on the regional level by regional health agencies.

Emergency medical response

ORSAN : regional preparedness scheme

-Daily interministerial meetings

-Permanent link and follow-up with the COGIC (Ministry of Interior)

-Adapt hospitals capacities by postponing summer closures

-Exceptional evaluation meeting, in anticipation of the first weekend of holidays.

-Early communication for both general and high risk populations

-Local actions at the regional level, coordinated by the prefectures, and frequent reporting from healthcare facilities

3. Management phase

- During the three episodes of 2015, mortality and morbidity linked to heat-related pathologies rose in all impacted regions. - We estimate a total mortality increase of +3 300 deaths (+6.5%), between june 29th and august 9th. The pathologies taken into count are : hyperthermia, dehydration and hyponatremia.

4. Health impact

-This mortality increase is considerably inferior to the 2003 heatwave(15 000 death, +55%).

-The impacts on the health care services were limited and controlled.

- Ministry of health leading for the first time in 2015. To be included in the national plan.- Coordinated and efficient interministerial response.- A structured national health organisation relying on a robust information channel.-Anticipation is the key.

- A high level of expertise is required for efficient decision making.- Local actors should be better informed.- Air pollution control should be included in the plan.- National communication has to be done before reaching level 4.

5. Lessons learnt

Thank you for your attention