County outlines review of heat event: incorporating death investigations, vulnerable populations and toolkit evaluation

July 6, 2021

Many people have asked what Multnomah County will do to prepare for the next catastrophic heat wave. 

Scientists have warned that extreme and deadly heat waves could begin to occur in the temperate Pacific Northwest because of a changing climate. In anticipation, beginning in 2016 the County began developing tools based on the Centers for Disease Control and Prevention Climate and Health Intervention Assessment to help the County better respond. These tools included online tools on the “Help for When It’s Hot” webpage, extreme-heat standard operating procedures, cooling centers, street response teams, and other protocols designed to protect County workers and residents. 

Death investigations continue; final accounting could take months

The unprecedented heat dome that settled over the region for nearly five days between June 25 and June 30 was a mass casualty event. On June 28 alone, the Multnomah County Medical Examiner Program responded to four times the typical number of deaths, and did so in person in 116º F degree heat.

As of Tuesday, July 6, the Multnomah County Medical Examiner Program has identified 67 deaths in which the suspected cause of death is hyperthermia. Of those, 40 have been formally ruled hyperthermia deaths. The people who died ranged in age from 44 to 97; with an average age of 68. 

Investigators make preliminary findings from the basic information they are able to obtain, but death investigations require the detailed gathering and recording of facts: from scene observations, medical records, fingerprints and examinations to interviews with witnesses and next of kin. Toxicology reports shed light on deaths and can take several months to be considered final. 

County death investigators must gather and record information for each death, and they’ve had to do that while still responding to a high volume of new calls, such as the fatal apartment fire in Portland July 4 that killed two people. They must also provide timely responses to calls from distraught family members. The sheer volume of work requires weeks of staff time to properly complete their forensic investigations that will inform future planning. The picture of what occurred is expected to come into focus as details from each death come together for analysis. That information will form the basis for change to the County’s heat response and is hoped to ultimately save lives in future events.

Chair Deborah Kafoury directs departments to conduct after-action report 

At the same time, Chair Deborah Kafoury said the Multnomah County’s Emergency Management, Health Department and County Human Services and other staff will be reviewing their toolkit (updated in 2018 and 2021), and the County’s work to open three 24-hour cooling centers and nine cooling spaces; directly contact tens of thousands of seniors, people with disabilities and pregnant women; as well as coordinate more than 60 outreach teams who focused on people without housing or shelter.

To actually make a difference going forward, this review must be informed by the complete findings in our death investigations, and it will focus on the County’s efforts and staffing, and what other government and nonprofit agencies and community partners can do as part of a combined response. 

We'll review the most recent evidence about interventions, fatalities during this event, and urban heat island and other environmental vulnerabilities (such as multi-story apartments) to more effectively target resources in future events. We'll update the County Extreme Heat Standard Operating procedure as needed to more effectively respond to future events.

County seeks federal, state help to address climate crisis

The County will also be looking at state and federal interventions going forward. The County has already been participating in statewide rule-making for the state Department of Environmental Quality’s climate protection plan to make sure it maximizes health benefits for vulnerable populations.

“The number of people and infrastructure harmed by this event is consistent with worst-case climate models for the Pacific Northwest and predict there is worse to come in the absence of aggressive global action to stop the use of fossil fuels,” said John Wasiutynski, Multnomah County Sustainability Director. 

He said Multnomah County is asking that the state and federal governments take immediate action to reduce carbon emissions by setting a national renewable energy standard, making common sense investments in the national grid to accommodate renewable energy and increase efficiency and resilience, making investments in high efficiency low-income housing to protect people from extreme weather events, and ensuring that the climate-related investments proposed in President Joe Biden’s Infrastructure Plan are included in any final legislation. 

“We also understand that directly preparing residents to survive the next heat wave shouldn't wait until a forecast tells us another one is imminent. We should all be looking, at all levels of government, to pursue climate adaptation work that can be done right now, to save lives later,’’ Wasiutynski said.

In addition to the deep review, these actions locally include ongoing efforts like home weatherization and tree planting in low-tree canopy neighborhoods in West Gresham, and new efforts that will be needed based on the experience gained during the heat-dome emergency. 

“Whether it’s a global pandemic or climate crisis our community is being pushed to extremes in new and frankly, terrifying ways,” said Chair Deborah Kafoury. “Our top priority has been and will continue to be protecting lives and ensuring that those with the least ability to protect themselves have what they need to survive.”