A complicating factor in combating Covid hot spots: Heat

Heat, environmental problems and the pandemic concentrate in certain neighborhoods. Here’s a new idea for what to do about it.


This article was originally published in POLITICO on March 3, 2021; politico.com

The façade of 2708 East Cesar E Chavez Avenue in Boyle Heights in Los Angeles, Calif.
Last summer, just as cases of Covid-19 began to surge in Southern California, so did the heat.
In the East Los Angeles neighborhood of Boyle Heights, that created a dilemma. Boyle Heights is full of old, brick apartment buildings cooled with window units. On hot days before the coronavirus, its predominantly Latino residents would cluster with multiple generations of family members in the one room that had air conditioning, or seek out cool public spaces like shopping malls or movie theaters to escape the heat.
But the pandemic closed many of those places. Local governments kept a few public cooling centers open during the near-triple-digit heat wave, including one adjacent to Boyle Heights. But residents were fearful: They had been told for months to stay outside to avoid the spread of the virus, but now they were being told to go inside to avoid becoming ill from the heat.

“You saw seniors just outside the building playing cards, socializing, doing their thing, but they wouldn’t go 10 to 20 feet away indoors where they could get access to air conditioning,” said Emily Montanez, planning section chief with Los Angeles County’s Office of Emergency Management. “They were leery. The county’s health order was stay at home, you’re safer at home. And here we are telling them to come indoors.”

The Boyle Heights neighborhood in Los Angeles, Calif.

Boyle Heights is one of the most notable and historic Chicano/Mexican American communities in Los Angeles. It has also experienced hotter temperatures and more serious Covid outbreaks than more affluent neighborhoods. | Nancy Pastor for Politico Magazine

If you overlaid a map of the country’s coronavirus hot spots with its actual hot spots — that is, neighborhoods with the highest levels of extreme heat — the maps would be virtually the same.

These hot spots, better known as “heat islands,” are hotter than other neighborhoods because they often have large expanses of concrete, less greenery, higher density housing, lower average incomes and poorer health status than more affluent neighborhoods. Those same factors have also contributed to skyrocketing Covid-19 caseloads in those neighborhoods.

Researchers and public health officials concerned about the disproportionate death toll the Covid-19 pandemic is having on people and communities of color have noticed the coincidence between Covid and heat. And that makes them concerned about the future, since climate change is expected to exacerbate many of the environmental factors that are disproportionately affecting minority neighborhoods, particularly higher temperatures.
This has complicated efforts to combat the pandemic. Last year’s extreme heat — 2020 tied with 2016 as the hottest year on record — hit at the same time government health officials were telling residents to stay home and isolate. But for people with no or inadequate air conditioning, staying home was also a health risk.

A woman mourns the loss of her husband in a Los Angeles cemetery.

A woman mourns the loss of her husband, who suddenly died of pneumonia from what she thinks was an undiagnosed case of Covid-19, at the Evergreen Cemetery in Boyle Heights. | Nancy Pastor for Politico Magazine

The truth is that the physical landscape of marginalized communities contributes to their vulnerability to disease. Experts attribute that reality to systemic, racist policies in housing, education and health care, among others — an amalgamation of barriers that have limited where many poor people and people of color can live and what resources their communities have access to.

“Climate change disproportionately impacts folks of color. So following a disaster, these people we’re talking about are going to be hit first, worst and the most,” said Sacoby Wilson, an associate professor with the Maryland Institute for Applied Environmental Health and Department of Epidemiology and Biostatistics in the University of Maryland, College Park School of Public Health.

Last summer, extreme heat collided with the coronavirus, drawing the attention of Congress at a time when Covid-19 was ravaging a nation still dealing with the fallout of George Floyd’s death at the hands of a white police officer and the ensuing racial justice protests nationwide.

What’s changed since the House Committee on Science, Space and Technology held a virtual hearing last July titled “Sweltering in Place: COVID-19, Extreme Heat, and Environmental Justice,” isn’t just a new presidential administration and Democratic Congress. Devastating winter storms in Texas have shown that extreme cold is also a climate change issue disproportionately affecting low-income communities amid a global pandemic.

“Extreme weather, period, whatever it is, it impacts communities of color in a disparate way,” said Heather McTeer Toney, a senior adviser to Moms Clean Air Force and climate justice liaison for the Environmental Defense Fund.

People run on a path outlining a cemetery in Los Angeles, Calif.

Runners jog around Boyle Heights’ Evergreen Cemetery, the largest green space in the neighborhood. | Nancy Pastor for Politico Magazine

McTeer Toney, who served as the Southeast regional administrator of the Environmental Protection Agency in former President Barack Obama’s administration, added that greenhouse gas emissions also spike during extreme weather like heat waves or hurricanes as power plants increase output.

“When we are in a pandemic like Covid, it basically means your frontline people, who are first to get sick, first to go to the hospital, folks who are required or essential workers because they are nurses, they are janitors, they are food service workers, they’re at risk whether they leave the house or not,” she said. “You’ve got coronavirus, you’ve got pollution and you’ve got extreme heat or extreme weather. It’s just a recipe for disaster.”

Known as the "silent killer," extreme heat is the deadliest type of weather in the country, contributing to more fatalities than hurricanes, floods or fires.

While more research is needed to draw a more direct biological line between heat and Covid, health experts say the physical effects of heat can exacerbate existing medical conditions that predispose people to Covid. And heat itself can also cause illnesses such as heat exhaustion and heat stroke — conditions that are considered preventable.

“The connection people make is really to redlining — essential parks and green space being allocated to wealthier communities as well as larger lots, safer access to river fronts,” said Anthony Iton, a senior vice president with the California Endowment who oversees the organization’s Healthy Communities project. “Many of these low-income communities are essentially barren, both from the perspective of green space, but essentially paved over, creating these heat island effects.”

Adding to that, people in marginalized communities often live in densely populated substandard housing with poor insulation and ventilation, and limited or no air conditioning. Heat increases cardiac output and may make people breathe more heavily, as they cluster together in the coolest spots of the home. “Just the environmental consequences of heat actually drive people towards behaviors that would put them at high risk of Covid,” Iton said.

The inability to escape the heat can worsen pre-existing conditions. “For people with cardiovascular or respiratory problems, heat can cause an exacerbation of those problems,” said Helene Margolis, an environmental epidemiologist at the University of California, Davis who specializes in the health effects of heat and air pollution.

Similarly, cold snaps can hit hardest in disadvantaged neighborhoods, as was the case in Texas last month. Freezing temperatures led to widespread power outages, leaving many families without access to heat or water for days.

“Extreme weather events across the board are increasing in severity and frequency and duration,” said Sonal Jessel, director of policy for WE ACT for Environmental Justice. “What is concerning is that it is the same communities that are not given adequate resources or investments to be prepared for these types of events or rebuild after these events happen. They get hit over and over and over again.”

Murals of labor leader Cesar Chavez in Boyle Heights, a historic, predominantly Latino neighborhood near downtown Los Angeles.

Murals to labor leader Cesar Chavez in Boyle Heights. | Nancy Pastor for Politico Magazine

Traditionally, cities have set up cooling centers during heat waves, but many residents have avoided them, even before the pandemic. One reason is that they were unwelcoming, offering little except for folding chairs in a school gym or community center.

One idea gaining traction is to reinvent the cooling center as a “resilience hub,” outfitted to help a community weather more than just a heat wave.

Proponents describe a “hub” as an expansion of already trusted, community-managed sites — nonprofits, churches, civic centers — that can serve as a community center for any type of emergency, be it a hurricane, earthquake, flood or extreme heat. These buildings may already be equipped with some of the features needed to help a community through a crisis, but they can be further outfitted with backup generators, high-grade HVAC systems and emergency communications gear so they provide protection as well as serve as a center for information, deliveries and distribution of supplies.

“The idea behind a resilience hub is that so much emergency preparedness, emergency response is top-down — it comes from government telling the community what to do and where to go,” said Aaron Gross, chief resilience officer for the city of Los Angeles. “In times of crisis, people want to go places they are familiar with.”

The city is piloting the concept at the Boyle Heights Arts Conservatory, which is located in an East Los Angeles neighborhood that has consistently reported Covid-19 positivity rates of over 40 percent throughout most of the pandemic, making it one of the top hot spots in a county that has become one of the hardest hit by Covid.

Boyle Heights is one of the city’s oldest neighborhoods, so its residents benefit from the shade cast by larger trees. But its biggest green space is a cemetery, and its old buildings without central air and large swaths of concrete create the heat island effect that amplifies the rising temperatures.

The project is still in the planning phase, but the conservatory, located in a 100-year-old brick building, already has some of the elements of a resilience hub, including air conditioning and emergency broadcast capability. A pizza restaurant in the storefront of the shared building with the conservatory has a wood-burning oven that could be used to make food in the event of a power failure.

Montoya rehearses in the multi-purpose room of the Boyle Heights Arts Conservatory in East Los Angeles.

Leslie Montoya, 20, works through choreography for a personal dance project in the multi-purpose room of the Boyle Heights Arts Conservatory. | Nancy Pastor for Politico Magazine

“The idea is that if everything fails, this building won’t fail,” said Jonathan Parfrey, executive director of Climate Resolve, a nonprofit working with the city to build out the hub.Carmelita Ramirez-Sanchez, the conservatory’s director, said despite the stay-at-home orders, many of the young people who take music and production classes at the center started showing up during the heat wave.

She said many of them lived with their families in small, crowded apartment buildings that lacked air conditioning and simply had nowhere else to go. And despite speculation that the warmer weather would kill the virus, that didn’t happen.

“There was the general fear: How hot is it going to get?” she said.

Rural areas have also been hit with the double whammy of heat and Covid — and often have fewer resources or protections.

Only three states — California, Washington and Minnesota — have standards that require employers to provide outdoor workers with shade, water and frequent breaks when the temperatures heat up. But these laws have the unintentional consequence of encouraging people to gather when they should be social distancing. Farm worker organizations are encouraging employers to provide more shaded structures to allow workers to maintain their distance.