As record-breaking heat sweeps across Europe and the Netherlands faces the possibility of a Code Red heat warning, we are reminded that preparing our society and our health systems for extreme heat is no longer a future challenge, but a present necessity. On June 2nd, the PDPC organized a panel discussion on extreme heat preparedness during Rotterdam Heat Lab’s yearly Heat Action Day. The discussion explored what it would take to prepare for a prolonged, extreme Code Red heatwave, with particular attention to public health and healthcare system resilience.

Extreme heat is often underestimated as a societal risk, yet severe heatwaves can have far-reaching consequences affecting individual health, straining healthcare services, disrupting critical infrastructure, and spurring social unrest. While everyone experiences heat, risks are not distributed equally. Exposure, sensitivity, and coping capacity are shaped by a combination of factors, including age and health status, housing conditions, access to cool spaces, and occupational or recreational exposure.

Healthcare systems can also face additional pressures through increased demand for care, staffing shortages, difficulties in discharging patients to hot homes, and disruptions to supporting infrastructure and services. For example, while hospitals often have back-up power generation for cooling, not all care homes or residences with home-care support have the same resources. Extreme heat is therefore not simply a weather event – it is a complex systems challenge that unfolds across sectors and scales.

Addressing these challenges requires perspectives from public health, healthcare, urban planning, emergency management, social services, and community organizations. By bringing these together, we can better anticipate impacts, reduce risks, and strengthen our capacity to respond, adapt, and recover during heat crises, while safeguarding public health and continuity of care.

The Code Red panel brought together a range of perspectives on what is needed to prepare for an extreme heat event:

• Associate Professor Marjolein van Esch (PDPC/TU Delft) highlighted the importance of breaking down disciplinary silos to better understand where heat exposures and vulnerabilities are concentrated across neighborhoods, buildings, and homes – and to co-create solutions. She emphasized the need for improved monitoring and research to ensure interventions reach those most affected and are developed most cost-effectively.
• Assistant Professor Mariëlle Beenackers (Erasmus MC) discussed how susceptibility, exposure, and coping capacity are shaped by social and environmental conditions and lead to inequal distributions of risk. She also emphasized that good care starts in the neighborhood, where social connections are strongest, and supported the idea that work is needed to identify cooling areas and make these accessible to those who need them.
• Postdoctoral researcher Tom Oreel (PDPC/EUR) advocated for using complex systems approaches, including modeling, to identify critical vulnerabilities and understand how heat can trigger cascading impacts throughout governance and healthcare systems. Without such a systems approach, the linkages between both the impacts of extreme heat and the effects of proposed interventions are difficult to predict.
• Senior Advisor Josine van den Bogaard (GGD Rotterdam-Rijnmond) shared how the GGD is working with municipalities on neighborhood heat plans. Fittingly, the day also marked the signing of the Rotterdam Heat Plan, which includes a shared commitment to preparing for future extreme heat events. From a governance perspective, there is a need to clarify roles and responsibilities in the event of a heat crisis.

As extreme heat becomes an increasingly defining challenge of the 21st century, preparedness will depend not only on better forecasts, but on stronger coordination across the systems that keep our communities healthy, safe, and resilient. PDPC thanks the Municipality of Rotterdam, the Rotterdam Heat Lab, and Resilient Delta for their work to organize Heat Action Day and invite transdisciplinary collaboration for extreme heat preparedness.

Read more about the contributions of the PDPC to Heat Action Day 2025!

Pictures by Robèrt Kroonen.