Heat wave puts hospitals in Germany to the test, experts warn of a lack of preparedness for extreme temperatures

Germany is facing record temperatures, and as the heat rises, so does the number of people ending up in hospital. In this situation, one essential question also arises: how well protected are patients themselves from the heat inside hospitals?

One example of better preparedness is the Hamburg-Eppendorf University Hospital (UKE). Its grounds have many old trees, there is a park opposite, and wild vines and other plants grow on the facades of some buildings.

Trees in particular help reduce the surrounding temperature, as they create shade, evaporate water and remove heat from the air. Greenery on walls also has a cooling effect because it prevents the sun’s rays from directly heating the surfaces of buildings.

“Benches have also been placed under the trees so that mobile patients, visitors and staff can stay in the shade,” says Frank Dzukowski, head of UKE’s Sustainability Department. According to him, the Hamburg hospital drew up a comprehensive heat protection plan three years ago.

Because of climate change caused by human activity, Europe is warming at a particularly rapid pace, while in Germany the number of days with temperatures above 30 degrees Celsius is increasing day by day.

In the 1950s, most summers had only a few such days, and around eight days of extreme heat were enough for a year to be considered record warm. By the 1980s, that record had risen to 10 days. In 2000, the number had reached 19, while in the past decade record years have registered more than 20 days with temperatures above 30 degrees.

High temperatures pose a serious threat to the human body. The most problematic are heat waves, meaning periods when temperatures climb to 30 degrees or more for several days in a row and do not fall below 20 degrees at night.

When the body remains under high temperatures for a long time, its natural cooling system can become overwhelmed. This can cause rashes, calf pain or swelling in the legs. Heat places a particular strain on the cardiovascular system, and the consequences can include dizziness, headaches, fatigue and even death from heatstroke.

The combination of rising temperatures and higher humidity can also lead to more frequent skin infections and slower wound healing, especially if climate change also affects the spread of bacteria. Likewise, heat can strengthen or weaken the effect of some medicines.

Those most at risk from high temperatures are people over 65, the chronically ill, pregnant women, babies and young children.

During just the two exceptionally hot summers of 2018 and 2019 in Germany, around 15,500 people lost their lives as a result of heat exposure. Models for Germany predict that by the middle of the century, additional heat-related deaths could exceed 5,000 per year.

It is already becoming clear that the more days of extreme heat there are, the greater the need for hospital treatment becomes. In addition to the direct effects of the heat, very hot days also bring more accidents and more emergency service interventions.

In 2024, the German Hospital Institute conducted a survey of 289 hospitals to see whether they had increased heat protection measures compared with the previous year. Sixty percent of them responded negatively.

According to those surveyed, the main obstacle to better heat protection in hospitals is a lack of funding, as stated by 96 percent. Many institutions are also discouraged by the heavy administrative burden that additional measures bring. “Given the difficult economic situation, many institutions currently have other priorities,” the report says.

The German Hospital Federation (DKG) believes the situation has not changed significantly even in 2026. This non-profit organization represents the interests of hospitals in Germany.

DKG Executive Board President Gerald Gaß criticizes the fact that the federal states have for decades failed to meet their obligation to cover the real investment costs of hospitals. “In practice, this often means that hospitals prefer to invest limited resources in direct healthcare, such as purchasing medical equipment or carrying out emergency repairs, rather than installing air-conditioning systems.” For this reason, hospitals are forced to find ways to cool their premises at the lowest possible cost.

There are a number of low-cost recommendations for heat protection, such as using lighter work clothes, thinner blankets, a diet adapted to high temperatures or installing a drinking water dispenser.

However, Gaß stresses that “effective protection of the hospital, its patients and its staff during periods of extreme heat requires investment.”

For this reason, the DKG is calling on policymakers for a multi-year investment program worth 31 billion euros to adapt to climate change. Part of these funds should be used for heat protection measures.

Most hospitals in Germany were built during a period when long episodes of extreme heat were rare, so in general they were not equipped with air-conditioning systems.

At Hamburg University Hospital as well, according to Frank Dzukowski, air conditioning is available only in some specific areas, such as intensive care units and operating rooms. In the main building, where around half of all patient beds are located, external sun protection has been installed.

“Where this is not possible, internal shading elements or protective films can be installed on windows to reduce the penetration of heat and solar radiation.”

Whenever possible, the most seriously ill or frail patients are placed in rooms that heat up more slowly. Meanwhile, some staff areas can be partially cooled through night-time ventilation.

However, experts warn that during a severe heat wave, emergency departments would most likely become overwhelmed. Staff shortages must also be taken into account, as employees may fall ill or be forced to stay home to care for family members if schools or nursing homes close because of high temperatures.

Under the current circumstances, hospitals will not be able to provide sufficient healthcare in the event of a serious heat crisis. For this reason, policymakers must create the necessary conditions and aim to renovate hospitals so that they become more resilient to climate change. /DW