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“At least 14 Tarrant County residents died from extreme heat last summer … Of those who died from heat, at least eight cases included residents with no air conditioning, no working air conditioning, or who had their air conditioning turned off at the time of their death…” –The Fort Worth Star-Telegram, June 25, 2023
Air conditioners aren’t supposed to make that sound. The gray-white box in the window had always rattled, but this morning it has begun to grind. The grandmother puts her hand in front of the AC’s dust-covered gills, feels nothing but a weak, lukewarm breeze.
She thinks about calling her daughter, whose husband installed the unit in her trailer’s living room window the summer before. She shakes her head to herself: No, they have the baby; it’s a 40-minute drive; she’s a burden enough as it is. She doesn’t have internet in the trailer to see the day’s excessive heat warning. Her cell phone, another gift from her daughter, is dead more often than it’s not, and she can’t find the weather app on it half of the time, anyway.
But the grandmother has been hot before — prides herself, even, on her 68 Texan summers. Besides, she’s not planning anything strenuous today, which would elevate her chances of exertional, or “activity-induced,” heat stroke — the kind that makes the news for killing the young, fit, and healthy, like the California couple who were found dead on a trail with their 1-year-old baby and dog in 2021, or the stepfather who died last month while trying to rescue his 14-year-old stepson, who also died, while hiking in 119-degree weather in Texas’ Big Bend National Park. Like the dozens of promising high school and college athletes who collapse during training, games, and meets every year.
Or like the characters in longtime Outside correspondent and adventure historian Peter Stark’s cautionary tales about succumbing to the elements. Stark is perhaps best known for his second-person narrative about what it’s like to die from hypothermia, which recirculates every winter, but he has a particular, morbid fascination with heat strokes, having now written two different versions (a competitive cyclist dies in one; a hungover, hiking surfer is brought back from the brink in the other). “Out of all the research I’ve done into ways to die — or come close to dying — heat stroke is the one I found the scariest,” Stark told an Outside interviewer last year.
Like Stark’s characters, the grandmother is fictional and illustrative. Unlike Stark’s characters, she has not elected into risk. Exertional heat stroke is often described as “sporadic” because it is circumstantial; it is also less deadly since an athlete often begins to feel terrible, or collapses, before the point-of-no-return. “Classic” heat stroke, which results from unbearably high temperatures, “occurs in epidemic form” in the sense that it strikes the vulnerable at once and all together: the ill, the elderly, the unhoused, the bedridden, the prepubescent. Though heat-related mortality can be hard to pin down, by some estimates classic heat stroke is fatal in over 60% of intensive care cases — part of the reason extreme heat is credited as the deadliest weather phenomenon in the United States.
The grandmother goes to her sink and fills a glass of water. She looks out the window, at the tall grass growing alongside her neighbor’s trailer, and thinks about her grandbaby. Her trailer, which had stayed cool overnight before the AC conked out, has already begun to feel muggy, but she isn’t alarmed.
It is 97 degrees outside and getting hotter.
The human body is a contradiction: It can run a marathon in under two hours; it can scale the tallest mountain in the world; and it can survive episodes of extreme cold and starvation. At the same time, it is hilariously delicate: Only about 8.2 degrees separate our core body temperature of 98.6 from multi-organ dysfunction, which begins somewhere around 106 degrees, depending on the person and circumstances. Because this leaves little margin for error, our bodies spring into a well-rehearsed response when blood warmed by our environments at the surface of our skin makes its way to our brain, causing our hypothalamus to rustle through its bag of cooling tricks.
The grandmother’s body begins to run through them as the trailer’s temperature rises to 100 degrees, the point at which the body ceases to give off heat and begins to absorb it. Her hair follicles relax to release any trapped warm air against her skin. Her sweat glands are activated, and soon she’s covered in a light sheen that serves to transport heat away from her body via evaporation. Crucially, her blood vessels dilate so that the warmed blood can pass closer to the surface of the skin, where it will ideally be cooled by the heat pulling away from her body.
But as an older adult, the grandmother’s blood vessels don’t dilate as well as they used to. Her body strains to cool itself and her heart pumps harder. And despite her glass of water, the grandmother begins to notice she feels … off. She is experiencing some of the most common heat-related symptoms, the ones most of us are probably familiar with: Her stomach starts to cramp and she feels slightly nauseous as blood is redirected from her gut to the surface of her skin. She begins, also, to feel fatigued — unbeknownst to her, the drowsiness is because her body is running its cooling mechanisms full-blast, compensating for the broken AC.
But today, these systems are fighting an uphill battle. The trailer is humid, meaning the grandmother’s sweat isn’t evaporating as efficiently as it would in dry air. She has a sunburn from sitting on her lawn the day before, and her body is using water to try to heal it, leaving her with less liquid overall to sweat out. She can’t drink enough water to replenish what she’s lost, either, since the human body can only absorb, at max, one liter of water an hour, and those in extreme heat conditions can lose that or more in the same span of time.
Little does the grandmother know, either, that because it’s now over 95 degrees in her trailer, the fan she’s turned on is no longer having any cooling effect. Her core temperature tips toward 100 degrees.
Heat exhaustion sets in when the core body temperature is between 101°F and 104°F, as the grandmother’s is now. (Core body temperature cannot reliably be read on an oral thermometer, which is part of why the Centers for Disease Control and Prevention recommends watching for symptoms of heat exhaustion and heat stroke rather than taking your own measurements). In addition to her fatigue, she now feels dizzy. Her heart is pounding as her body tries to regulate itself; if she had a preexisting cardiac condition, she would be in even more danger than she already is. She stands up to get more water and feels a woosh of lightheadedness — a result of low pressure stemming from her dilated vessels — and her vision momentarily goes black. She nearly faints, but steadies herself with a hand on the back of a chair.
If a neighbor checked in on her, as the weathermen on TV are advising good samaritans do, they would see that the grandmother looks pale, that she’s grown irritable and unfocused. The neighbor might suggest she take a cold shower before asking her to come to their air-conditioned trailer, or a local cooling center, for the rest of the day. The most crucial thing, though, would be that she gets to a safe temperature, and fast, before her core hits 104, the threshold of heat stroke.
In her delirium, the grandmother thinks to take an Advil, foggily hoping a fever-reducer might help lower her core body temperature. And though the damage wrought by extreme heat is similar internally to that inflicted by a dangerously high fever, the response systems at play in each case are completely different. For extreme heat, there is no magic pill, no shut-off switch for how the grandmother is feeling aside from getting somewhere cool.
It might seem like a simple thing: getting somewhere cool. In this sense, classic heat stroke is, agonizingly, preventable. Though most Americans have air conditioning, over a quarter — 34 million households — “said they could not [financially] meet their energy needs at some point” during 2020, according to Energy Information Administration data. Of those who were struggling, 10% reported enduring dangerously high temperatures in their homes due to concerns about cost.
Because Americans typically do have access to AC, though, losing air conditioning for reasons beyond their control — say, due to grid failure, a localized blackout, or a mechanical issue — actually makes people more susceptible to dangerous heat-related illness, in part because acclimation has such a large role in how well we tolerate heat. The shock of living in climate-controlled rooms and suddenly finding yourself without one can be deadly.
The grandmother’s internal temperature is now over 105 degrees and still rising; she is well within the realm of heat stroke. Her pulse is rapid and now she is confused and agitated — she stumbles, directionless, toward her living room and collapses on the floor. Her body is rationing water away from vital organs, like her kidneys, which begin to shut down. Her brain is swollen. She cycles in and out of consciousness on the floor.
Her body is past the point of being able to bring its temperature back down by itself. A heat stroke victim may stop sweating. Their cells begin to die — the cerebellum, which controls motor functions, is one of the earliest parts of the brain to fail. They may have seizures or hallucinate or, nearing the end, feel a soaring sense of euphoria. Internally, the body is in freefall; by one estimate, there are 27 different pathways to death once heat stroke sets in, ranging from heart failure to the proteins that control blood clotting becoming overactive and cutting off flow to vital organs.
When the grandmother’s daughter arrives and calls the paramedics, it will only have been two hours since the grandmother first noticed her air conditioner’s grinding. “That’s part of what makes [heat stroke] so lethal,” Willamette Week wrote after the heat wave in the Pacific Northwest in 2021 killed an estimated 250 Americans: “You can go from feeling bothered by the heat to dead in 90 minutes.”
Victims of classic heat stroke are often elderly, often have pre-existing health conditions, often are socially isolated, and often are low-income. In an analysis of heat deaths in Multnomah County (where Portland, Oregon, is located) in 2021, The Washington Post found 61 percent of confirmed deaths were in areas with above-average poverty rates. In the same story, the reporters found that a “direct outreach” program in Philadelphia — which includes a “mass notification system,” “the number for a 24-hour hotline staffed by nurses [flashing] from one of the city’s tallest high rises,” and a 5,000-strong volunteer team that mobilizes “to check on high-risk neighbors” — saves an average of 45 lives per year.
If the grandmother had been younger, she might have been treated with “cold-water immersion,” which is one of the fastest and most reliable ways to address heat stroke. (Willamette Week reports Oregon paramedics resourcefully filled body bags with ice and had those suffering from heat stroke crawl inside). In the case of the elderly, though, it is advised to treat heat stroke with more easily tolerable cooling methods, like the application of ice packs and cold, wet gauze.
Either way, the outcome past the threshold of heat stroke is uncertain. As Stark, the master of the cautionary tale, writes, “A study reviewing 58 of the severe heat stroke victims [after a 1995 Chicago heat wave] found that 21 percent died in the hospital soon after admission, 28 percent died within a year, and all the remaining subjects experienced organ dysfunction and neurological impairments.”
But he sees a grim silver lining. “It could be a small measure of good fortune,” writes Stark, “that confusion, semiconsciousness, or coma overcome victims as they succumb to severe heatstroke.”
The laborer puts the nail gun down on the nearest cinderblock and sweeps the back of his hand across his brow, a portrait of I’m hot. Though the elimination of water breaks won’t go into effect until the fall, his employer has threatened to fire anyone who “slacks off” anyway, and the laborer needs this job. He watches for a moment as the heat makes strange shapes in the air above the new asphalt driveway. He thinks he might have a headache coming on.
There are five more hours to go. It’s 96 degrees out with 66% humidity.
And tomorrow will be another scorcher.
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If you want to donate to fight climate change, what’s the best way to spend your money?
For the past five years, Giving Green has been trying to find out. Each year, the nonprofit recommends a set of nonprofits that are trying to solve the climate problem effectively and efficiently, and get the world closer to decarbonization.
Giving Green, in other words, is somewhat like the climate-specific version of Givewell, an uber-utilitarian group that identifies which global charities maximize the number of lives saved per dollar spent. But it’s much more difficult— or at least much less clear — to identify which nonprofits might best fight climate change than it is which nonprofits might save the most lives through targeted interventions.
Climate change is a globe-spanning sociotechnical problem, a political quandary baked into humanity’s largest-scale engineering systems. Even when a government or technology has seemingly pushed the world forward, it can be unclear why the improvement happened, or whether, in the long run, it will make a meaningful difference. The Paris Agreement, after all, has been around for nearly a decade, the European Union’s cap-and-trade scheme for nearly two. Yet academics, experts, and politicians can (and do) disagree about whether either policy has ultimately helped — and even why they happened in the first place.
To resolve this problem, Giving Green reviews the historical record to identify philanthropic strategies that seem like they have a good shot of leading to emissions reductions. This year, it has focused on eight, including next-generation geothermal, decarbonizing aviation and marine shipping, advancing nuclear energy, and speeding the energy transition in low- and middle-income countries. Then it looks for groups that are working on those problems in time-proven ways. This year, it also started a grant fund so that it could support some of these groups itself.
I spoke with Daniel Stein, Giving Green’s director, earlier this week. Our interview has been edited and condensed for readability.
What is Giving Green’s goal with these recommendations?
The main goal — the problem we are trying to solve — is that we believe that there are lots of people who want to do something about climate, and there’s a lot of money that’s paralyzed by indecision and sits on the sidelines. So we provide a comprehensively researched guide with a systematic approach to try and determine where the high leverage points are in climate philanthropy — and by high-leverage, I’m thinking most greenhouse gas reductions per dollar.
We focus in on what we call philanthropic strategies, specific things that people could be doing. Then we find organizations working on those strategies that are doing a great job and promote them.
Can you tell me about a few of the organizations that you have chosen?
We have some that we’ve recommended for a few years, such as Clean Air Task Force. Last year, one of our big pushes was geothermal energy, and so we’ve recommended Project Innerspace, who are a big advocate for geothermal and work a lot with both private industry and the government.
Another big area of focus for us over the past few years has been heavy industry. The case for philanthropic support for heavy industry is really, really clear. Depending on what estimate you use, heavy industry accounts for roughly a quarter of carbon emissions, but something like less than 5% of philanthropic spending. There’s very little policy teeth almost anywhere in the world on industry, and basically nothing in the U.S., but there are pathways to solving it. We kind of know how to make green steel and green aluminum, and at least have ideas on concrete and plastic. There’s a lot nonprofits can do to pave the way forward in terms of: What does policy look like? How do we get from where we are today — where we kind of know the technology but no one’s using it — to a place where there’s actually supply and demand in the future? So our top recommendations for that is an organization called Industrious Labs in the U.S. and an organization called Future Cleantech Architects in Europe.
Over the past five years, I feel like I’ve seen your mission evolve and your strategies evolve. At the beginning, you recommended giving to a mix of high-end research and policy-development groups, and then also to more grassroots, movement-type groups. But over time, your set of recommendations have become much more focused on groups that are like CATF, that are providing nonpartisan, highly expert information and analysis.
I think that’s right, but it is not necessarily that we have just changed our mind on what works. I think different moments in time call for different approaches. And in those heady years leading up to the Inflation Reduction Act — where there was hope for a Democratic trifecta, and then it happened — there was a major opportunity for a left-driven, all-of-government push on climate. That was what we thought these grassroots groups were in a good position to push forward.
I think when you look back, you see groups like Sunrise having a really powerful influence. Obviously people disagree on what forces got the IRA to happen. But I really do think that you can draw a direct line from this progressive advocacy to the Democrats believing that they had to do something about climate to please their base.
But our view is that that moment has passed. Especially post-IRA, this opportunity for a more progressive-led legislative process has ended. Even if the Democrats were still in control, I think you weren’t going to get big bills like the IRA. We moved to a point where we need to focus on the wonky details of implementing these bills and then passing more technical, focused policy in the future. Our view is that in the U.S., the big opportunities have shifted to what we would call the “insider” groups. But I think that could change again, and it could change based on geography.
Are there any big climate strategies nobody is working on right now — where you identified a place where money could be spent, but you couldn’t find a nonprofit focused on it?
One of our high-level strategies is solar radiation management. That was something that was new for us this year. And within that, we would look at very specific substrategies. Should we be funding research? Should we be funding governance? And within those little sub-elements, we occasionally found stuff where we were like, wow, we really wish there was a group working on this, but we didn’t find anything.
But one of the nice things about having a [grant-making] fund this year, for the first time ever, is that we could help get things started that didn’t exist before. We’re super excited about industry, and so much industry is happening in developing countries. But when you ask, Who is focused on reducing steel emissions in Indonesia?, there were very few organizations. We made a grant to an organization called Climate Catalyst — they were already working on steel in India, and we helped them expand into emissions reduction in Indonesia.
I think some people might see your list and go, Wow, these are a bunch of high-end research and elite advocacy organizations, but what’s actually going to solve the climate crisis is local organizing.How would you reply to that?
I think that’s a reasonable point. We are open to all of these things, and we have considered them, and I think there is a time and place for grassroots approaches and activism. But looking at the historical research and our own research, I believe that the approaches that work on this are ones where the activism is tied to clear policy demands — that are good policies, that can have big, systematic decreases in emissions and seem to have some sort of feasible pathway to success.
What I’ve seen in a lot of grassroots movements in recent years are things like throwing soup at paintings, or blocking streets, which have not had this direct policy connection, and we are pretty skeptical of those approaches. But if grassroots approaches came on our radar that have a super viable theory of change to altering policy, we are very open.
This is the fifth year you’ve put out recommendations like this, right? What have you learned or changed your mind about during that time?
One of the things that’s really crystallized in our mind is that we really think the big levers are in systems. And that can mean a lot of things, but to us, it really means three things — it means policy, technology, and markets.
To solve the climate crisis, you need to change the rules of the game, such that everyday actors — people making decisions, businesses — everybody changes their behavior because some technology got cheaper, or some policy changed. We really use that to focus ourselves to think about, What are the big changes that need to happen, and how do we work backward to the actions that get us there?
So I think that might be why you see some of these more insider, techno-analysis-driven approaches. Because when you step back and you think, alright, we need this market to change in this way, or we need this technology to develop that doesn’t currently exist, and you think about how you get there, a lot of times you need advocacy to change policy, and you need research to make that policy change possible.
This year, Giving Green has recommended six top groups fighting climate change. They are:
On conditional loans, China’s emissions, and primary care clinics
Current conditions: Storm Conall brought more heavy rain and flooding to sodden England • Flash floods killed at least 20 people on Indonesia’s Sumatra island • The northern Plains will be hit with an “arctic outbreak” on Thanksgiving day.
The Department of Energy yesterday agreed to loan Rivian $6.6 billion to resume construction on its factory in Georgia, where the company will produce the upcoming R2 and R3 electric pickups. The loan is conditional, meaning it hasn’t been finalized just yet. “If finalized, the loan will support construction of a 9 million square foot facility to manufacture up to 400,000 mass-market electric sport utility vehicles and crossover vehicles,” the DOE said in a statement. “At full capacity, the EVs manufactured at the facility are expected to yield an annual fuel consumption savings of approximately 146 million gallons of petroleum.” Whether the loan will be completed before the incoming Trump administration takes over – or whether Trump would try to axe the loan – remains to be seen. The Biden administration set a goal for zero-emission vehicles to make up half of new U.S. car sales by 2030.
China’s CO2 emissions will rise slightly this year due to a surge in energy demand, according to new research published today from the Centre for Research on Energy and Clean Air. “The growth in energy consumption and electricity consumption is faster than in the transition pathways,” the report said. Even as China rapidly rolls out renewables and EVs, emissions will rise by 0.4% in 2024. Less than half – 44% – of the experts polled by CREA said China’s emissions have already peaked, or will peak next year. Two years ago, just 15% of experts believed that to be the case. And 36% of experts said China’s coal consumption has peaked, up from 20% who said that last year. China is the world’s biggest emitter of greenhouse gases, and coal is its main source of emissions.
Porsche this week joined a growing list of car manufacturers that are pumping the brakes on the shift to EVs. Instead of rolling out new EV models to accompany the luxury Taycan and Macan, Porsche now plans to produce new gas and hybrid models instead as it feels the effects of a slowdown in EV sales. “We are currently looking at the possibility of the originally planned all-electric vehicles having a hybrid drive or a combustion engine,” the company’s CFO said. “What is clear is that we are sticking with the combustion engine for much longer.” Earlier this year Porsche watered down its goal for 80% of sales to be electric by 2030.
Maine is suing oil giants Exxon, Shell, BP, Chevron, Sunoco, and the American Petroleum Institute, accusing them of knowingly deceiving the public about the role of fossil fuels in the climate crisis. It becomes the ninth state to do so. The new lawsuit claims the oil companies have long known that fossil fuels cause climate change, and that the resulting rising sea levels are especially harmful in Maine because so many of the state’s communities and industries are located near the coastline. The state wants unspecified damages from the companies as well as funds for adaptation and mitigation.
A recent study published in the journal BMC Primary Care examines how climate change is affecting primary care clinics serving “low-income and socially disadvantaged communities.” Surveys were sent to more than 400 staff members at clinics across 43 states. Nearly 85% of the staffers who responded reported that climate change – and especially extreme heat – is affecting their patients’ health. Many said extreme weather events were harming their clinic’s ability to provide care due to effects like power outages and staff shortages. About 16% of respondents said extreme weather contributed to loss or spoilage of vaccines. But just one-third of respondents said they’d spoken to patients about the increasing health risks associated with climate change, saying they had more important topics to discuss in the limited amount of time available during consultations. And 61% cited their own lack of knowledge about the connection between climate change and health. Interestingly, just 34% said politics or polarization were stopping them from bringing up climate change when discussing health risks.
BMC Primary Care
Renewables accounted for 24% of electricity generation in the first three quarters of 2024, up from 22.8% in the same period last year.
Rob talks Ford and GM with BloombergNEF’s Corey Cantor. Plus, Rob and Jesse dig into the Trump transition.
It’s been a news-filled few weeks — so it’s time for a roundup. On this week’s episode of Shift Key, Rob and Jesse talk about what Trump’s cabinet selections might mean for his climate policy and whether permitting reform could still happen. Then Rob chats with Corey Cantor, senior EV analyst at BloombergNEF, about promising Q3 sales for U.S. automakers, General Motors’ turnaround, and how much the Trump administration might dent America’s EV uptake.
Shift Key is hosted by Robinson Meyer, the founding executive editor of Heatmap, and Jesse Jenkins, a professor of energy systems engineering at Princeton University.
Subscribe to “Shift Key” and find this episode on Apple Podcasts, Spotify, Amazon, or wherever you get your podcasts.
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Here is an excerpt from our conversation:
Robinson Meyer: How are you thinking about Ford and GM right now? Because they have basically totally reversed their position since the first time we started talking.
Corey Cantor: I hope I’m not too corny today, but I was thinking Missy Elliott — another New Jerseyan — “flip it and reverse it,” in terms of how people feel about Ford and GM. I think GM’s approach … don’t forget this is their second platform at the rodeo here, meaning GM had the Bolt and the Chevy Volt before it, and a good amount of experience with EVs. And really, what they were trying to do with Ultium was to build a battery and EV platform that could work with a variety of different vehicles.
And so the struggle, as we’ve outlined before, and many publications have outlined was they just couldn’t get the battery production working. They had issues with automation. They had issues with ensuring that they were setting up the necessary suppliers. And I’d say, about maybe nine months ago or so, a favorite EV journalist of mine, John Voelcker wrote in, I believe, InsideEVs, around this idea that GM had finally cracked Ultium and were finally kind of … He had got the head of Ultium at the time on record saying that they had resolved a lot of the issues, and really, you’ve seen it in the sales volume, as well as the fact that EVs like the Cadillac Lyric continue to sell pretty consistently.
Then GM ran into a software issue with the Blazer, and fixed that software issue, and that had slowed things down. And then since, really, June of this year has been off to the races. And so we’ll see how the fourth quarter goes, right? I think you don’t want to get too high on any kind of automaker, but GM is clearly in a better spot because they’re approaching making a profit on each of the EVs sold.
Now, I’ll caveat that with, we don’t know if the EV tax credit itself, you know, at the federal level, plays a role in the fact that they’ll be gross margin profitable, but that is a pretty big turning point. Because at that point, you’re no longer losing money on those EVs, and so you are kind of geared to go more high-volume. Where if you look at Ford, Ford has been losing thousands of dollars on every electric vehicle, really had not been building a platform for the current sales of the Mach-E and the F-150 Lightning, hoping to kind of just price them where they’d be losing little enough on each that they can make their bridge to that next platform.
And then earlier this fall, Ford basically announced pushing back those EV models to 2027, along with the new platform. So Ford kind of runs into the issue that we discussed on the previous conversation with Tesla, in that they’re going to have only really two EVs in the U.S. market for the next couple of years. So GM will have the Bolt back next year and some other Cadillacs. There’s a lot of exciting things on the way for GM.
This episode of Shift Key is sponsored by …
Watershed’s climate data engine helps companies measure and reduce their emissions, turning the data they already have into an audit-ready carbon footprint backed by the latest climate science. Get the sustainability data you need in weeks, not months. Learn more at watershed.com.
As a global leader in PV and ESS solutions, Sungrow invests heavily in research and development, constantly pushing the boundaries of solar and battery inverter technology. Discover why Sungrow is the essential component of the clean energy transition by visiting sungrowpower.com.
Intersolar & Energy Storage North America is the premier U.S.-based conference and trade show focused on solar, energy storage, and EV charging infrastructure. To learn more, visit intersolar.us.
Music for Shift Key is by Adam Kromelow.