The death of at least 1,300 people during the pilgrimage at the holy site of Mecca highlights the escalating threat of climate change to human life during large gatherings.
At grand events worldwide, the sight of heat stress is increasingly familiar. Older men, with their shirts unbuttoned, lie down with their eyes closed. Relief tents are packed with those who have succumbed to unconsciousness.
And the lines of faithful — whether seeking religion, music, voting, or cheering for sports — are sweating under patches of shade.
The repercussions of heat are devastating. During this year’s Hajj pilgrimage (the major pilgrimage to the holy site of Mecca, Saudi Arabia), at least 1,300 people died as outdoor temperatures reached 48 degrees Celsius or higher.
This staggering death toll is just the latest sign that crowd control and heat related to climate change are on the brink of becoming deadly.
The Silent Killer
In the recent elections in India, dozens of polling staff died while on duty. Last summer, Boy Scout troops visiting South Korea for a commemorative event fell ill from the heat, as did many others at music festivals in Australia, Europe, and North America.
Even as heat is killing more people than any other extreme weather phenomenon, there is a cultural lag in response. Many organizers and attendees of large events are not accustomed to the temperature curve and cannot grasp how a warming planet has increased the dangers for summer crowds.
“As summers last longer, and heatwaves arrive earlier, we have to adapt,” said Benjamin Zaitchik, a climate scientist at Johns Hopkins University, who studies climate events harmful to health.
The Hajj pilgrimage is referred to as the “death pilgrimage” due to the heat. (Photo: THX).
He added that, in addition to adjusting personal behavior, infrastructure, emergency management, and social schedules must “truly acknowledge this new reality.”
Some simple measures to prevent heat stress, illness, and death from heat include creating shade, water stations, painting sidewalks white to reflect heat better, and emergency medical services to treat severe heatstroke cases.
Some particularly hot areas, like Singapore, have built public spaces that combine outdoor and indoor elements to avoid sun exposure. They have added air conditioning in areas where people may have to wait, such as bus stations.
Another important measure is educating people about health risks associated with high temperatures, even those accustomed to living in hot climates.
Often, they are unaware of the early symptoms of heatstroke or heat exhaustion, which is especially dangerous for those with pre-existing health conditions, such as kidney disease or hypertension. Many do not know that medications, such as anticholinergics for allergies or asthma, can reduce their ability to sweat, raise body temperature, and lead to heat-related illnesses.
“Heat is a very complex and insidious killer. It is the silent killer.“ said Tarik Benmarhnia, an environmental epidemiologist and associate professor at the University of California, San Diego.
Awareness Has Not Caught Up with Heat Waves
A religious pilgrimage can be one of the most challenging events in extreme heat. Devotees of various faiths — Christians in the Philippines, Hindus in India, Muslims in Saudi Arabia — have died from heatstroke in recent years while performing religious rituals.
However, the pilgrimage in Mecca may have reached the most severe level of danger.
The entire Arabian Peninsula is warming rapidly, with nighttime temperatures also rising, leaving no time for the body to cool down. The Hajj lasts 5 or 6 days, exacerbating exposure to high temperatures at the sacred site of Mecca.
The Hajj pilgrimage schedule is also set according to the lunar calendar, so the anticipated time for the trip can coincide with the hottest periods, as was the case this year. And since most pilgrims are older, they are more vulnerable to heat.
Dr. Benmarhnia shuddered upon hearing news of the deaths during this year’s pilgrimage. “I think this could happen to my grandmother,” he said in a conversation with The New York Times.
Benmarhnia paid for his grandmother’s pilgrimage in 2019. She was 75 years old, but fortunately, she traveled during the cooler month of April.
With the death toll this year, Benmarhnia suggested that experts use data on what happened to quickly develop adaptation strategies for religious authorities.
The Saudi Ministry of Health has launched educational campaigns urging people to stay hydrated and use umbrellas. Officials also established field hospitals and water stations while deploying thousands of healthcare workers to assist.
However, all of this is still insufficient to meet the needs of millions, including those who have circumvented regulations to undertake unauthorized pilgrimages due to a lack of “Hajj visas” — permits distributed to each country to control crowd size. Saudi Arabia has faced criticism for the death toll due to its inability to manage the pilgrim crowds.
People gather to get water in hot weather in New Delhi, India. (Photo: Bloomberg).
This year’s elections in India have demonstrated that even in places where people believe they are accustomed to the heat, there is still a need for greater awareness of the dangers of extreme heat.
In the state of Bihar, India, at least 14 people died at the end of May, and at least 10 of them were polling staff, according to state disaster relief officials. At one point in June, nearly 100 people died within 72 hours in Odisha related to high temperatures.
Health officials in India had to plan a response. Inside the heatstroke victim reception areas in Delhi hospitals, patients are immediately immersed in ice baths to cool down. In a ward equipped with ice-making refrigerators, ice boxes, and ventilators, critically ill patients are placed on ice slabs and given cold fluids.
But in many areas, the heatwave and peak voting coincided — including in the Aurangabad district of Bihar, home to about 3 million people, where temperatures reached a record 48 degrees Celsius at the end of May.
Ravi Bhushan Srivastava, the medical director at a public hospital, was on his way to assess autopsy reports on a particularly bad day when 60 patients were admitted due to heatstroke.
“At least 35-40 people were in bad shape. They were either unconscious or disoriented, their bodies were very hot, and they were struggling to breathe,” he said.
He added, “In my entire career, I have never seen so many patients with heatstroke symptoms at such severity.”
Crowds at election rallies can be particularly vulnerable. But there are also plenty of viable solutions.
Aditya Valiathan Pillai, an adaptation expert at the Sustainable Futures Collaborative, a research organization in Delhi, suggested that attendees could see their local temperatures in real-time, with risk levels color-coded. Water stations, shaded areas, and cooling zones can be established. Ultimately, public agencies should have early warnings about temperature.
“Currently, we have fairly accurate forecasts for heatwaves up to five days in advance, so raising awareness beforehand is feasible,” Pillai said.
Heat Is About to Change Everything
Sporting events have begun to adapt to the increasing dangers of heat. Water break intervals for players were introduced during the 2014 World Cup in Brazil, when the combination of temperature, humidity, and sunlight led to heat levels exceeding 30 degrees Celsius. Officials moved the 2022 World Cup in Qatar from the summer months to November and December when the weather is cooler.
This year’s Paris Olympic Games seem to be seeking a balancing solution. Some events, like the marathon, will start earlier in the day, and water stations are reportedly being set up.
Madeleine Orr, a professor at the University of Toronto and author of the book Warming Up: How Climate Change Is Changing Sport, stated: “Major events like the Olympics and FIFA World Cup have an obligation to take care of all attendees.”
“I am talking about break times for hydration and cooling, opportunities for athletes and officials to use cooling towels and mist fans, as well as a medical team standing by to assist in case someone needs additional care,” she said.
Currently, that may be sufficient.
Many experts believe that more radical changes may be necessary. The Summer Olympics may have to become the Fall Olympics. Similarly, elections in India or international tennis tournaments might be pushed to cooler months. Summer vacations could be rescheduled depending on the weather. Summer jobs, like house painting, may shift to spring.
David Bowman, a climate scientist in Tasmania, noted that people have started to adapt in small ways. Sun hats are becoming a fashion accessory, shorts are more widely accepted in workplaces, and road workers are doing more of their work at night.
Climate change may force major events to change even more.
“All climate disasters are a sign for cultural change. We may stubbornly try to maintain normalcy despite the changing climate, but eventually, the climate will prevail,” Bowman said.
