BEATING THE HEAT: GOF ON ALERT

UNCLAS SECTION 01 OF 03 PARIS 005051 SIPDIS E.O. 12958: N/A TAGS: SENV TPHY TSPA TSPL KSCA FR SUBJECT: BEATING THE HEAT: GOF ON ALERT REF: 03 PARIS 6748 AND PREVIOUS SUMMARY -------------- ¶1. Soaring temperatures in France since mid-July are considered responsible for the death of at least 30 people. Anxious to avoid a repeat of the 2003 heat wave catastrophe (15,000 deaths, reftel), the GOF recently implemented an updated heat wave plan (Plan National contre la Canicule, or PNC). The plan includes a new warning and alert system which has, so far, proven satisfactory. Information campaigns to increase public awareness seem to be having an effect and the quality of care in retirement homes has significantly improved since 2003. Nevertheless, with temperatures expected to remain high in the coming days, just as French surgeons and specialists are going on strike in the private hospital sector, tension is growing. The GOF is working hard to mobilize resources and demonstrate its preparedness. End summary. Still Under "Heat Wave Threshold" -------------- ¶2. Facts and figures: Temperatures of well over 95F have been recorded in most of France since mid-July, up to 104F on July 19, and are expected to remain as high as 100F in the coming days. The current heat wave constitutes the first major climatic event since August 2003. Temperatures, however, are still significantly below those of 2003 (which reached 104F-111F). On July 24, 56 departements, out of 96 departements in continental France, were placed on "Orange Alert" (the second highest alert level). ¶3. Health authorities stated that 30 deaths in France in the last couple of weeks were likely due to heat-related problems. Victims included 12 persons aged 80-94, seven outdoor workers, two homeless people, and a 15-month old child. Many hospital emergency units have recorded heat-related activity 15 to 20 percent above average and the mobile emergency medical service for the homeless (SAMU) an increase of 10 to 30 percent. Energy consumption has increased by approximately 3 percent during the first three weeks of July, due to increased use of cooling systems. 2003 Scenario to be Avoided at all Cost -------------- ¶4. The GOF's handling of the August 2003 heat wave -- which caused approximately 15,000 deaths in France -- was sharply criticized. A number of studies and a parliamentary enquiry launched after the crisis were very critical of public health institutions, emphasizing notably: * The lack of communication within the Health Ministry; * A totally inadequate crisis-alert system; * A widespread failure by agencies and health services to work together; * The lack of medical staff and resources (massive exodus of doctors and hospital staff on August vacation); and * A faulty care system for the elderly. In response, the GOF decided on a series of measures to anticipate and face similar crises. France Better Prepared -------------- ¶5. The first PNC was released in 2004 and subsequently revised in 2005 and 2006. The Health Surveillance Institute (Institut National de Veille Sanitaire, or INVS) also released a new Heat Health Watch Warning System which has been integrated into the 2006 PNC. The current alert system, which relies on an increased number of information sources throughout the country, is widely acknowledged as much more "reactive" and efficient. The updated PNC, based on continuous interaction between the French Weather Bureau Meteo-France, INVS, the health authorities, and hospital emergency services, operates on three levels: seasonal surveillance, pre-alert/alert, and maximal mobilization. The plan has been operational since June 1st and should remain in place at least until August 31st. Key Elements in the 2006 PNC -------------- ¶6. Fight against isolation/solidarity: The updated PNC pays specific attention to the elderly and children and underscores prevention measures. (Note: A great majority of elderly people in France live alone in individual dwellings. End note.) Following a decree passed in 2004, all mayors have been requested to maintain a list of "vulnerable" people living in individual homes to help target the action of social and health services. The plan also relies on local services -- post office, apartment managers, local organizations - to help circulate information, spot people at risk, and report potential victims of the heat. ¶7. In case of an emergency crisis, the GOF has earmarked 17 million euros to permit hiring temporary staff in retirement homes and increase home care services. As part of the PNC, the Health Ministry has given hospitals authority to re-allocate resources in order to cope with an influx of patients. Similarly, the GOF can enforce the mobilization of medical staff in hospitals, including by recalling those on summer leave. Air-conditioned spaces are mandatory since 2005 in retirement homes and in care units. According to GOF estimates, 96 percent of retirement homes and hospitals were equipped with such spaces in June 2006. GOF "Highly Mobilized" ... -------------- ¶8. Confronted with a new heat wave, the GOF has been deliberately taking actions to display its vigilance, unlike in 2003. The recent visit of PM de Villepin, Health Minister Xavier Bertrand, and the Minister Delegate for Social Security and the Elderly, Philippe Bas, to a retirement home to "check on the prevention plan" was given, despite pressing international events, significant media attention. President Chirac himself made an appeal for solidarity towards the elderly, and urged authorities and individuals to be cautious about the heat. ¶9. Last week, an interministerial committee led by PM de Villepin, approved further preventive measures in the framework of the PNC, e.g.: a ban on intensive sports activity and the authorization for trucks to transport water during week-ends. The situation in prisons was also reviewed. Specific measures concerning homeless people have been taken: opening of reception centers usually closed in summer time and a significant increase of dedicated patrols in main cities. The PM also invited the French population to follow GOF recommendations concerning energy efficiency. ¶10. Raising awareness at the work place: Labor regulations in France do not mention a specific temperature above which work is forbidden. Concerned with the number of victims at work, the GOF decided to meet with labor inspectors and social partners in professional sectors most exposed to heat-related risks (road construction, building industry, and other outdoor laborers) to discuss means to "reinforce the protection of workers." Nuclear Plants: Specific Dispensation -------------- ¶11. Scorching temperatures are also affecting the production of electricity. Usually a large electricity exporter, the French Electricity Board (EDF) had to import 2,000 megawatt hours of electricity from the international market mid-July due to lower power output at hydro-electric and nuclear power stations and increased energy demand for air conditioning, fans, and refrigerators. ¶12. To avoid a repeat of the problems encountered in 2003 (when nuclear plants had to shut down when river water levels dropped too low to permit the cooling process of the reactors),EDF has taken steps to focus production in summer time on coastal reactors (which do not have to worry so much about the temperature of cooling water returned to the sea). In a further attempt to avoid interruption of energy production from reactors located along rivers, the GOF granted EDF an exceptional exemption to release cooling waters into rivers above legal limits, to the great displeasure of French environmentalists. "The Week of all Dangers?" -------------- ¶13. The heat wave in 2003 hit its climax in August. Several French experts believe the current heat wave is here to stay and that the hottest days are still ahead. New peaks of temperature are expected in the next few days and representatives of the emergency services, already confronted with a 15-20 percent increase of patients over the last week-end, have voiced deep concern for the coming weeks. ¶14. The situation could also quickly aggravate if the broad strike over fees and insurance premiums by surgeons, anesthesiologists, and obstetrician-gynecologists in the private hospital sector, which began on July 24 for an "unlimited period of time," is widely followed. Should this be the case, many patients will have to be reoriented towards public establishments, further contributing to the saturation of the public emergency sector. In response, the Health Minister asked advanced medical students and retired practitioners willing to cooperate to contact hospital emergency units and SAMU services. Comments -------------- ¶15. No summer break for Xavier Bertrand. Since 2003, the heat wave issue has been politically charged. Heavily criticized in 2003 for the tardy response of public services, the Raffarin government was weakened by the crisis, which also put an end to the political ambitions of Health Minister Mattei. Already beset by a number of crises since last fall, the de Villepin government knows it cannot afford another "faux-pas" and is very eager to show its preparedness. Since mid-July, Health Minister Bertrand has been out in front of the issue. Bertrand will meet in the next few days with representatives of the private hospital sector in an effort to rally them to the GOF's mobilization plan against the heat wave. Stapleton