The University Hospital Hamburg-Eppendorf (UKE) is well prepared: there are many old trees in its courtyard, there is also a park across the street, wild vines and other plants grow on the facades of certain buildings. Trees in particular cool the surrounding environment by creating shade, evaporating water and thus removing heat from the air.
Plants on the facades of buildings also have a cooling effect because they prevent sunlight from directly heating the walls. “Benchmarks have also been placed under the trees so that mobile patients, visitors and employees can sit in the shade,” says Frank Dzukowski, head of the UKE’s Sustainability Department. The Hamburg hospital developed a comprehensive heat protection plan three years ago.
MORE AND MORE DAYS WITH EXTREME HEAT
Due to human-induced climate change, Europe is warming up particularly rapidly, and in Germany there are more and more days with temperatures above 30 degrees Celsius. In the 1950s, there were only a few such days in most summers, and about eight days of extreme heat were enough to consider the year a record warm one. By the 1980s, the record was ten such days. In 2000, there were already 19 of them, and in the past decade, record years recorded more than 20 days with temperatures above 30 degrees. High temperatures pose a serious risk to the human body. Particularly dangerous are heat waves, i.e. periods when temperatures rise to 30 degrees or more for several days in a row, and do not fall below 20 degrees at night.
HOW HEAT WAVES DAMAGE THE BODY
If we are exposed to high temperatures for too long, the body’s natural cooling system can become overwhelmed, which can cause flushing, pain in the calves, or swelling of the feet. Heat in particular puts a strain on the cardiovascular system, and the consequences can be dizziness, headaches, fatigue, and even death from heatstroke. Rising temperatures, combined with increased humidity, can also lead to more frequent skin infections and slower wound healing, especially if climate change also affects changes in the distribution of bacteria. In addition, heat can increase or decrease the effect of some medications. High temperatures are especially dangerous for people over 65, the chronically ill, pregnant women, and infants and young children.
HEAT FILLS THE HOSPITAL
During the two extremely hot summers of 2018 and 2019 alone in Germany, around 15,500 people died as a result of heat exposure. Models for Germany predict that by mid-century the number of additional heat-related deaths could exceed 5,000 per year. The rule already applies: the more days with extreme heat, the more people need hospital treatment. In addition to the direct consequences of the heat, more accidents and interventions by the emergency services are also recorded on very hot days. But the question arises: are patients in hospitals sufficiently protected from the heat? In 2024, the German Hospital Institute conducted a survey among 289 hospitals on whether they had introduced more heat protection measures compared to the previous year. 60 percent answered negatively.
HOSPITALS NOT ADEQUATELY PREPARED
The main reason why better heat protection is not implemented in hospitals is a lack of money, 96 percent of those surveyed said. Many hospitals are discouraged from taking additional measures by the heavy administrative burden. “Given the difficult economic situation, many institutions currently have other priorities,” the report says. According to the German Hospital Association (DKG), the situation will not have changed significantly even in 2026. This non-profit organization represents the interests of hospitals in Germany.
The President of the DKG Board of Directors, Gerald Gaß, criticizes the fact that the federal states have not fulfilled their obligation to finance the real investment costs of hospitals for decades. “In practice, this often means that hospitals prefer to invest limited resources in direct healthcare, such as the purchase of medical equipment or emergency repairs, rather than in installing air conditioning systems.” Hospitals must therefore find ways to cool their premises at the lowest possible cost.
HOSPITALS NEED MORE MONEY
There are numerous recommendations that include inexpensive measures to protect against heat, such as lighter work clothes, thinner blankets, a diet adapted to high temperatures or the installation of a drinking water machine. But, as Gaß points out, “effective protection of the hospital, its patients and its employees during periods of extreme heat requires investment”. That is why the DKG is asking politicians for a multi-year investment program for climate change adaptation worth 31 billion euros. Part of these funds should be earmarked for heat protection.
Most German hospitals were built at a time when prolonged periods of extreme heat were rare, so they generally do not have air conditioning systems. Similarly, at the University Hospital in Hamburg, air conditioning only exists in specific rooms, such as intensive care units and operating rooms, says Frank Dzukowski. The main building, where about half of all patient beds are located, is equipped with external sun protection. “When this is not possible, internal shading elements or protective films can be installed on the windows to reduce the penetration of heat and solar radiation.”
If possible, especially seriously ill or debilitated patients are placed in rooms that warm up more slowly. Staff rooms can be partially cooled by night ventilation. However, during a severe heat wave, the emergency room will probably be overwhelmed, experts warn. In addition, staff shortages must be taken into account, because employees may fall ill or stay home to care for family members if schools or nursing homes are closed due to the heat. Under the current situation, hospitals will not be able to provide sufficient health care during a serious heat crisis. This is why policy must create appropriate conditions and aim to renovate hospitals in order to make them more resilient to climate change. (DW)