Record heat in Germany, hospitals under heavy pressure / Experts warn many institutions are not ready for extreme temperatures

A record heatwave has gripped Germany and, as temperatures rise, so does the number of people ending up in hospital. This raises a crucial question: how well protected are patients from the heat inside hospitals themselves?

Not all institutions are at the same level of preparedness, but Hamburg-Eppendorf University Hospital (UKE) is considered to be better equipped. Its grounds have many old trees, there is also a park opposite, while wild vines and other plants grow on the facades of some buildings.

Trees in particular help lower the surrounding temperature, as they create shade, evaporate water and in this way remove some of the heat from the air.

Green facades also play a cooling role because they prevent walls from being hit directly by the sun’s rays. “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.

Europe is warming at a particularly rapid pace because of climate change caused by human activity, and in Germany the number of days when temperatures exceed 30 degrees Celsius is steadily increasing.

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, 19 such days were already recorded, while in the last decade record years have logged more than 20 days with temperatures above 30 degrees.

High temperatures pose a serious risk to the human body. The most problematic are heatwaves, meaning periods when the temperature reaches 30 degrees or more for several days in a row and does not fall below 20 degrees at night.

When a person remains exposed to heat for a long time, the body’s natural cooling system can become overloaded. This can cause skin redness, calf pain or swelling of the legs. Heat puts particular strain on the cardiovascular system and the consequences can include dizziness, headaches, fatigue and even death from heatstroke.

Rising temperatures, combined with increasing humidity, can also lead to more frequent skin infections and slower wound healing, especially if climate change also affects the spread of bacteria. Heat can likewise strengthen or weaken the effect of certain medicines.

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

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

A clear rule now applies: the more days of extreme heat, the greater the need for hospital treatment. In addition to the direct effects of the heat, the number of accidents and emergency service interventions also rises on very hot days.

It is precisely here that the dilemma arises of whether patients in hospitals are being sufficiently protected from high temperatures.

In 2024, the German Hospital Institute conducted a survey of 289 hospitals to see whether they had introduced more heat protection measures compared with the previous year. Sixty percent of them gave a negative response.

The main reason for the lack of better anti-heat measures in hospitals is a lack of funding, according to 96 percent of those surveyed. A large number of institutions are also held back by a heavy administrative burden. “Given the difficult economic situation, many institutions currently have other priorities,” the report says.

According to the German Hospital Federation (DKG), the situation had not changed significantly by 2026 either. This non-profit organisation represents the interests of hospitals in Germany.

DKG Executive Board President Gerald Gaß criticises the fact that the federal states have for decades failed to meet their obligation to finance 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 look for the least costly ways possible to cool their premises.

There are many recommendations involving low-cost heat protection measures, such as lighter work clothes, thinner blankets, food adapted to high temperatures and the installation of a drinking water dispenser.

However, as Gaß stresses, “effective protection for 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 programme worth 31 billion euros to adapt to climate change. Part of this money should be used for heat protection.

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

The same situation exists at the University Hospital in Hamburg, where air-conditioning is found only in certain areas, such as intensive care units and operating theatres, Frank Dzukowski explains. The main building, where around half of all patient beds are located, has been fitted with external sun protection.

“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.”

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

However, experts warn that in the event of a severe heatwave, emergency care is very likely to become overwhelmed. In addition, 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 the heat.

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