{"version":"1.0.0","segments":[{"startTime":4.795,"endTime":6.245,"body":"It's so great to see you all."},{"startTime":6.295,"endTime":7.565,"body":"Thank you very much for coming."},{"startTime":9.105,"endTime":14.101,"body":"Um, I thought, uh, as this was my last talk, I should talk about the"},{"startTime":14.101,"endTime":17.765,"body":"quintessentially English and more widely British subject, and that's the weather."},{"startTime":18.705,"endTime":21.925,"body":"Uh, but this is the kind of weather it is genuinely reasonable to grumble about."},{"startTime":21.925,"endTime":23.885,"body":"This is serious weather extremes."},{"startTime":24.545,"endTime":29.576,"body":"We live in one of the most temperate countries in the world, uh, with relatively"},{"startTime":29.576,"endTime":31.925,"body":"small, uh, variations of cold and heat."},{"startTime":32.424,"endTime":37.435,"body":"Uh, and as I'll come on to, uh, other forms of storms even here, uh,"},{"startTime":37.435,"endTime":41.445,"body":"thousands of people in some years die due to weather related issues."},{"startTime":42.105,"endTime":46.245,"body":"So this is a major issue in every country in the world, including this one."},{"startTime":49.025,"endTime":52.315,"body":"Will we ever be able to see beyond the current observable universe?"},{"startTime":52.655,"endTime":52.875,"body":"Oh,"},{"startTime":52.875,"endTime":53.675,"body":"It's much worse than that."},{"startTime":53.815,"endTime":55.675,"body":"The observable universe is shrinking."},{"startTime":56.295,"endTime":60.678,"body":"If you want to know, what are my odds of winning the lottery, you come"},{"startTime":60.678,"endTime":61.555,"body":"straight to probability."},{"startTime":61.625,"endTime":65.795,"body":"Yeah, because probability is all about how likely or not events are to happen."},{"startTime":66.355,"endTime":70.737,"body":"I think the chance of there being an undiscovered second species, very like humans out"},{"startTime":70.737,"endTime":73.075,"body":"there in the world today is pretty slender."},{"startTime":73.185,"endTime":73.675,"body":"However,"},{"startTime":74.295,"endTime":76.235,"body":"And these are the pictures, if you haven't seen them."},{"startTime":76.395,"endTime":77.555,"body":"I mean, New York was orange."},{"startTime":77.855,"endTime":78.835,"body":"The air was orange."},{"startTime":79.065,"endTime":82.915,"body":"They said one day out in that air was like smoking a pack of cigarettes."},{"startTime":83.055,"endTime":86.115,"body":"It had the same effect on the lungs as smoking a number of cigarettes."},{"startTime":86.115,"endTime":89.178,"body":"So people who'd never smoked in their life were suddenly going to suffer some of"},{"startTime":89.178,"endTime":89.995,"body":"the same health effects."},{"startTime":90.815,"endTime":95.719,"body":"Any further questions is a brand new podcast from Gresham College, a place where we"},{"startTime":95.719,"endTime":100.624,"body":"ask our speakers all of your questions that went unanswered following their lecture, guests have"},{"startTime":100.624,"endTime":104.875,"body":"included Ronald Hutton, Robin May, Chris Lin tot, Sarah Hart and Maggie snowing."},{"startTime":105.335,"endTime":106.235,"body":"Any further questions?"},{"startTime":106.495,"endTime":109.195,"body":"All episodes are available wherever you listen to your podcasts."},{"startTime":116.125,"endTime":122.709,"body":"Um, extremes of cold heat, hurricanes, uh, massive floods, severe droughts are rare here, but"},{"startTime":122.709,"endTime":124.465,"body":"of course, common elsewhere."},{"startTime":125.205,"endTime":130.62,"body":"And additionally, as a relatively wealthy country, we have the ability to reduce the effects"},{"startTime":130.62,"endTime":132.065,"body":"of these very significantly."},{"startTime":133.445,"endTime":137.376,"body":"But we do see as I'll come on to thousands of people dying, uh, in,"},{"startTime":137.376,"endTime":138.425,"body":"uh, very many years."},{"startTime":138.525,"endTime":146.185,"body":"In fact, most of these deaths occur at the extremes of life, the very young."},{"startTime":146.885,"endTime":153.063,"body":"But above all those, uh, who are old or very old by, uh, by historical"},{"startTime":153.063,"endTime":159.241,"body":"standards, uh, and for the, for these people, um, streams of temperature in particular are"},{"startTime":159.241,"endTime":160.065,"body":"extremely dangerous."},{"startTime":163.445,"endTime":169.595,"body":"Now, as humans, we have a really phenomenal capacity to keep our temperature in a"},{"startTime":169.595,"endTime":170.825,"body":"very narrow range."},{"startTime":172.465,"endTime":176.538,"body":"Everyone will have learn about this at school, or all of us experience this as"},{"startTime":176.538,"endTime":177.625,"body":"the seasons go through."},{"startTime":178.405,"endTime":179.685,"body":"Uh, in the cold."},{"startTime":180.585,"endTime":185.717,"body":"Our temperature, our temperature, uh, is kept stable by, um, reducing the amount of blood"},{"startTime":185.717,"endTime":190.165,"body":"flow to the periphery, uh, by, uh, having our hair stand on end."},{"startTime":190.165,"endTime":194.245,"body":"Sometimes by shivering, by reflex approach to exercise."},{"startTime":194.665,"endTime":199.815,"body":"In the heat, we sweat and the amount of heat that is gone goes out"},{"startTime":199.815,"endTime":204.965,"body":"to the periphery with peripheral dilatation of the blood vessels, uh, allows heat to be"},{"startTime":204.965,"endTime":209.085,"body":"taken from the core out to the, uh, periphery of the body."},{"startTime":209.585,"endTime":213.203,"body":"So our body is extremely good in the variety of other mechanisms, uh, at doing"},{"startTime":213.203,"endTime":213.445,"body":"this."},{"startTime":214.065,"endTime":219.53,"body":"Uh, and, um, if we over time, are exposed to long periods of cold or"},{"startTime":219.53,"endTime":222.445,"body":"long periods of heat, we have further adaptations."},{"startTime":223.305,"endTime":227.374,"body":"So, for example, if we were, if you were to move or any of us"},{"startTime":227.374,"endTime":231.443,"body":"were to move to very hot climate, you'd start over time to sweat more, but"},{"startTime":231.443,"endTime":235.513,"body":"the amount of salt in your sweat would go down significantly so you retained the"},{"startTime":235.513,"endTime":239.582,"body":"same amount of sodium in your body, and your body will therefore adapt to this"},{"startTime":239.582,"endTime":240.125,"body":"new temperature."},{"startTime":241.155,"endTime":245.005,"body":"Nonetheless, at the extremes of temperature, we need help."},{"startTime":246.265,"endTime":251.797,"body":"And, uh, we have a lot of ways of doing them, uh, to keep temperature"},{"startTime":251.797,"endTime":255.485,"body":"in the comfortable and almost invariably the same safe range."},{"startTime":256.545,"endTime":259.829,"body":"But all of these cost money, some of 'em cost a lot of money, some"},{"startTime":259.829,"endTime":260.925,"body":"of 'em cost less money."},{"startTime":261.654,"endTime":266.194,"body":"Let's take central heating, which is there to help us stay warm when it's colder,"},{"startTime":266.194,"endTime":269.525,"body":"which is the bigger risk at the moment in the uk."},{"startTime":270.705,"endTime":276.255,"body":"Uh, people will have to put a lot of energy and in due course, therefore"},{"startTime":276.255,"endTime":281.805,"body":"a lot of money into central heating or other ways of staying warm capital investment"},{"startTime":281.805,"endTime":283.285,"body":"in insulation, warm clothes."},{"startTime":284.425,"endTime":289.877,"body":"In hotter climates, people tend to be, um, uh, putting their energy and their money"},{"startTime":289.877,"endTime":295.33,"body":"into keeping the temperature cool to things like, uh, central heating building design, uh, and"},{"startTime":295.33,"endTime":298.965,"body":"again, changes to the way in which people are closed."},{"startTime":299.025,"endTime":303.205,"body":"Now, the mechanisms we do this in engineering terms have varied over history."},{"startTime":303.265,"endTime":308.109,"body":"So I've put at the top, um, the hyper course in, uh, Ted Worth villa,"},{"startTime":308.109,"endTime":312.954,"body":"uh, which is one approach to keeping a building warm and at the bottom, uh,"},{"startTime":312.954,"endTime":317.799,"body":"a, uh, heat pump, uh, which is a much, uh, more contemporary methods of keeping"},{"startTime":317.799,"endTime":318.445,"body":"it warm."},{"startTime":318.445,"endTime":324.59,"body":"Nevertheless, the principle has remained the same, and this means that, um, money reduces the"},{"startTime":324.59,"endTime":330.735,"body":"risk from temperature to a fair degree, but not completely, and its absence is an"},{"startTime":330.735,"endTime":331.965,"body":"additional risk factor."},{"startTime":336.265,"endTime":341.078,"body":"Now, in addition to that, there are practical cultural responses that are made in countries"},{"startTime":341.078,"endTime":343.645,"body":"which are, uh, high temperature or low temperature."},{"startTime":344.145,"endTime":345.885,"body":"And I've just given some illustrations here."},{"startTime":346.265,"endTime":351.335,"body":"Uh, high a, a cultural response and a, uh, uh, to a, uh, very hot"},{"startTime":351.335,"endTime":356.405,"body":"dry climate on the left tour eggs who live around the Sahara, uh, to, um,"},{"startTime":356.405,"endTime":361.475,"body":"uh, uh, the very cold environments in which, uh, and to hot and moist climates,"},{"startTime":361.475,"endTime":363.165,"body":"uh, here in Southeast Asia."},{"startTime":363.385,"endTime":364.685,"body":"But there are a variety of other ones."},{"startTime":364.685,"endTime":368.845,"body":"There are cultural adaptations to heat, uh, wherever, uh, humans live"},{"startTime":370.105,"endTime":370.925,"body":"Eating cold."},{"startTime":371.585,"endTime":376.942,"body":"Now, moving on to the, um, health impacts of these, uh, major changes in weather"},{"startTime":376.942,"endTime":379.085,"body":"and in due course in climate."},{"startTime":379.535,"endTime":383.16,"body":"Let's start with cold, which is the much bigger risk in the UK at this"},{"startTime":383.16,"endTime":383.885,"body":"point in time."},{"startTime":385.195,"endTime":390.045,"body":"Cold causes a number of severe illnesses of its own, just cold."},{"startTime":390.045,"endTime":395.09,"body":"There's nothing else that causes them, but it also makes many other diseases that all"},{"startTime":395.09,"endTime":397.445,"body":"of us may have significantly more likely."},{"startTime":398.385,"endTime":403.824,"body":"And what I put here is the excess deaths, the additional deaths in winter compared"},{"startTime":403.824,"endTime":406.725,"body":"to the other months here in the uk."},{"startTime":407.125,"endTime":409.645,"body":"Remembering we are a relatively temperate country."},{"startTime":410.225,"endTime":412.005,"body":"Now, there's some good news and some bad news."},{"startTime":412.065,"endTime":413.965,"body":"The first, let's start off with the bad news."},{"startTime":414.335,"endTime":420.103,"body":"There is still a significant winter excess in terms of deaths in this country of"},{"startTime":420.103,"endTime":423.565,"body":"probably on an average year around about 20,000 deaths."},{"startTime":424.475,"endTime":428.005,"body":"Some years it's more, some it's less, uh, for reasons we'll come on to."},{"startTime":428.705,"endTime":432.746,"body":"The good news is that if we compare that to the 1950s, this has got"},{"startTime":432.746,"endTime":433.285,"body":"substantially better."},{"startTime":433.985,"endTime":437.512,"body":"And this, some of this is due to improvements in medicine, but a lot of"},{"startTime":437.512,"endTime":440.805,"body":"it in fact is due to improvements in housing and heating, uh, over time."},{"startTime":440.945,"endTime":446.045,"body":"So this winter excess has steadily decreased and aberration, of course, around covid."},{"startTime":449.265,"endTime":455.132,"body":"Now, the reasons for this are, are multiple, but there are broadly three, uh, cold"},{"startTime":455.132,"endTime":461.0,"body":"makes, uh, various conditions worse or more likely, it significantly increases the risk of quite"},{"startTime":461.0,"endTime":462.565,"body":"a number of infections."},{"startTime":462.705,"endTime":465.045,"body":"The reasons for this are complex, and I'm happy to answer questions on it."},{"startTime":465.465,"endTime":470.199,"body":"Uh, but at all of us will know that the time you are likely to"},{"startTime":470.199,"endTime":474.933,"body":"get influenza pneumonia, uh, covid, although not quite so clearly seasonal, uh, is in the"},{"startTime":474.933,"endTime":475.565,"body":"winter months."},{"startTime":477.185,"endTime":482.037,"body":"The second, and probably the most important in terms of the numbers after that is"},{"startTime":482.037,"endTime":482.685,"body":"cardiovascular disease."},{"startTime":483.385,"endTime":487.205,"body":"And this is in part because of this physiological response."},{"startTime":487.205,"endTime":491.005,"body":"The body has to cold that it's shutting down the peripheral blood system."},{"startTime":491.105,"endTime":495.824,"body":"The blood gets stickier, a variety of other changes, but there's a significant increase in"},{"startTime":495.824,"endTime":500.544,"body":"the number of heart attacks and strokes, uh, which, uh, you get, and I'll go"},{"startTime":500.544,"endTime":504.005,"body":"through these in slightly more detail in the next few slides."},{"startTime":504.385,"endTime":507.245,"body":"And then, of course, the obvious things like slips and trips on ice."},{"startTime":507.585,"endTime":510.754,"body":"And you think, well, breaking a bone is a, a an unfortunate thing to happen"},{"startTime":510.754,"endTime":512.445,"body":"if you're a child or a young adult."},{"startTime":512.445,"endTime":513.683,"body":"That's broadly true."},{"startTime":514.345,"endTime":518.284,"body":"If you break a bone as an elderly adult, that has a high mortality."},{"startTime":518.784,"endTime":520.885,"body":"So these kind of things are actually non-trivial."},{"startTime":523.945,"endTime":528.602,"body":"Now, here's the, uh, impact, um, on cardiovascular disease, and I think it's quite striking,"},{"startTime":528.602,"endTime":529.845,"body":"uh, on this graph."},{"startTime":529.875,"endTime":535.005,"body":"What we see is the risk of myocardial infarction, heart attack by temperature."},{"startTime":535.625,"endTime":541.267,"body":"So the further left, uh, the temperature down to zero degrees, uh, um, uh, the"},{"startTime":541.267,"endTime":543.525,"body":"more, uh, the lower the temperature."},{"startTime":543.525,"endTime":547.55,"body":"And on further right, uh, the higher the temperature down to about 15 degrees, there"},{"startTime":547.55,"endTime":549.965,"body":"isn't a huge, uh, gradient in terms of temperature."},{"startTime":550.095,"endTime":552.285,"body":"After that, it starts to change significantly."},{"startTime":552.945,"endTime":557.285,"body":"If you are a young person, the impact on cardiovascular disease is almost unmeasurable."},{"startTime":558.345,"endTime":562.285,"body":"If you're an older person over 50, uh, and I'm in, I'm over 50."},{"startTime":562.385,"endTime":563.925,"body":"So to be clear, I might bit older."},{"startTime":564.065,"endTime":566.325,"body":"I'm including people in what I would sort a middle age."},{"startTime":566.705,"endTime":570.645,"body":"Uh, there is an increase in the tar chances of heart disease."},{"startTime":570.945,"endTime":575.928,"body":"But if you've gotta blameless cardiovascular disease, otherwise you'll hit fit and healthy, that impact"},{"startTime":575.928,"endTime":576.925,"body":"is relatively modest."},{"startTime":577.705,"endTime":582.182,"body":"If on the other hand, you have significant health problems already, uh, and the example"},{"startTime":582.182,"endTime":585.765,"body":"here is hypertension, you at all points more likely to have it."},{"startTime":585.765,"endTime":590.035,"body":"But if you get cold, your chances of having a stroke or heart disease are"},{"startTime":590.035,"endTime":590.605,"body":"substantially increased."},{"startTime":591.025,"endTime":595.536,"body":"So the more risk factors you have going into a cold snap, the more likely"},{"startTime":595.536,"endTime":598.845,"body":"you are to have problems with cold when you reach that."},{"startTime":599.105,"endTime":600.605,"body":"Now, this is a complex interaction."},{"startTime":600.605,"endTime":605.334,"body":"Some of it's just straight temperature, some of it is air pollution, so people burn"},{"startTime":605.334,"endTime":605.965,"body":"more fuel."},{"startTime":605.965,"endTime":610.005,"body":"You act, air pollution's a very significant risk factor for cardiovascular disease."},{"startTime":610.005,"endTime":611.725,"body":"It's stroke and heart attack."},{"startTime":612.145,"endTime":617.628,"body":"Uh, and, um, some of it, uh, is that, uh, infections also increase the risk"},{"startTime":617.628,"endTime":618.725,"body":"of cardiovascular disease."},{"startTime":618.725,"endTime":622.205,"body":"So it's not a straightforward, uh, just temperature relationship."},{"startTime":622.205,"endTime":628.055,"body":"Nevertheless, this combination is actually a very powerful driver of cardiovascular axi in the winter,"},{"startTime":628.055,"endTime":630.005,"body":"and it can be lagged."},{"startTime":630.185,"endTime":634.87,"body":"So you, meaning you can have the cold day or the cold week in the"},{"startTime":634.87,"endTime":639.555,"body":"beginning of January, uh, and you're still seeing an excess of cardiovascular mortality in late"},{"startTime":639.555,"endTime":640.805,"body":"January and, uh, February."},{"startTime":643.155,"endTime":648.725,"body":"Then there are some diseases or conditions which are very specific to cold weather."},{"startTime":649.465,"endTime":654.485,"body":"The first one I want to talk about is frostbite, uh, and early frostbites."},{"startTime":654.505,"endTime":659.357,"body":"The early stages, uh, are relatively, uh, benign in the long term, although unpleasant at"},{"startTime":659.357,"endTime":660.005,"body":"the time."},{"startTime":660.025,"endTime":661.365,"body":"People get pins and needles."},{"startTime":661.635,"endTime":667.005,"body":"They, their extremities, uh, their extremities go white, sometimes called frost nip."},{"startTime":667.145,"endTime":670.238,"body":"But if you go back into the warmth relatively quickly, you'll will make a full"},{"startTime":670.238,"endTime":670.445,"body":"recovery."},{"startTime":670.445,"endTime":673.125,"body":"This is, has no long-term, uh, implications."},{"startTime":673.885,"endTime":679.818,"body":"Intermediate, uh, frostbite is rather like having a moderate level of burn on the outside"},{"startTime":679.818,"endTime":681.005,"body":"of the body."},{"startTime":681.625,"endTime":684.405,"body":"The skin go, skin goes cold goes red."},{"startTime":684.585,"endTime":687.205,"body":"It blisters, particularly when people go back into the warmth."},{"startTime":687.785,"endTime":689.565,"body":"And then, uh, it'll lop off."},{"startTime":689.665,"endTime":692.685,"body":"And usually the skin underneath that is relatively viable."},{"startTime":692.785,"endTime":694.885,"body":"So it's unpleasant, but it's temporary."},{"startTime":696.625,"endTime":700.842,"body":"If, however, someone is out in severe cold for a long period, they can get"},{"startTime":700.842,"endTime":701.405,"body":"severe frostbite."},{"startTime":701.945,"endTime":706.54,"body":"And this is where the skin below the, uh, the, so the tissues below the"},{"startTime":706.54,"endTime":708.685,"body":"skin get extremely cold and they die."},{"startTime":709.465,"endTime":712.325,"body":"And the this tissue is now unrecoverable."},{"startTime":713.585,"endTime":717.925,"body":"Uh, and we can have significant damage to muscles, tendons, nerves, bones."},{"startTime":717.985,"endTime":722.045,"body":"If you leave this untreated, well, people will get gangrene and other major problems."},{"startTime":722.045,"endTime":724.445,"body":"This tissue cannot be, uh, resolved."},{"startTime":724.905,"endTime":728.765,"body":"Um, and, uh, this therefore will need quite radical surgery."},{"startTime":729.185,"endTime":734.572,"body":"And very specialist care, usually in this country, done in burns units, so can lead"},{"startTime":734.572,"endTime":737.805,"body":"to people losing, uh, limbs, uh, toes and fingers."},{"startTime":738.025,"endTime":738.725,"body":"Uh, certainly."},{"startTime":738.745,"endTime":743.563,"body":"So frostbite is one of the very specific things you can get with extremes of"},{"startTime":743.563,"endTime":743.885,"body":"cold."},{"startTime":743.985,"endTime":746.565,"body":"And it usually happens at the periphery, hands and feet."},{"startTime":747.145,"endTime":748.045,"body":"Uh, in particular"},{"startTime":751.265,"endTime":752.565,"body":"If someone has frostbite."},{"startTime":752.565,"endTime":757.249,"body":"And it's usually relatively straightforward to see, uh, most of the first aid for it"},{"startTime":757.249,"endTime":760.685,"body":"is relatively obvious, but a couple of things are worth stressing."},{"startTime":761.145,"endTime":765.725,"body":"Uh, first one obvious, move someone to a warmer place, but try and minimize them."},{"startTime":765.725,"endTime":767.445,"body":"Putting pressure on the affected error."},{"startTime":767.445,"endTime":770.621,"body":"So if they've got a frostbite in their foot, try and make sure they don't"},{"startTime":770.621,"endTime":771.045,"body":"use that."},{"startTime":772.105,"endTime":776.725,"body":"Remove, uh, areas of random replace wet things by dry ones."},{"startTime":776.725,"endTime":779.65,"body":"All of these, I think if you were asked from first principles, what would you"},{"startTime":779.65,"endTime":779.845,"body":"do?"},{"startTime":780.025,"endTime":785.085,"body":"People would, would agree, warm someone up, uh, by wrapping them, uh, in blankets."},{"startTime":785.885,"endTime":787.765,"body":"A few things not to do in particular."},{"startTime":788.135,"endTime":791.902,"body":"Don't rub it in the affected area, which is a natural thing to think you"},{"startTime":791.902,"endTime":792.405,"body":"should do."},{"startTime":792.605,"endTime":793.885,"body":"'cause we tend to do that in other areas."},{"startTime":794.305,"endTime":796.645,"body":"Uh, and don't apply direct heat."},{"startTime":796.735,"endTime":800.205,"body":"These can cause further damage in this already damaged skin."},{"startTime":801.265,"endTime":805.776,"body":"Uh, smoking as with so many other things will make it worse because smoking tends"},{"startTime":805.776,"endTime":809.085,"body":"to lead to the blood, the blood vessels contracting almost immediately."},{"startTime":809.185,"endTime":811.765,"body":"So smoking will be an exacerbating factor."},{"startTime":811.765,"endTime":813.925,"body":"Please don't, uh, get people to smoke."},{"startTime":814.305,"endTime":818.782,"body":"And rewarming is generally best done on medical supervision because done un, uh, if you're"},{"startTime":818.782,"endTime":822.365,"body":"not doing care carefully, there'll be further, um, damage than you need."},{"startTime":822.825,"endTime":823.925,"body":"It will be painful."},{"startTime":827.005,"endTime":829.885,"body":"A very different kind of direct effects of, uh, heat."},{"startTime":830.425,"endTime":834.245,"body":"Um, and one which is much more dangerous, but less dramatic is hypothermia."},{"startTime":835.195,"endTime":837.605,"body":"Much more common in elderly and babies."},{"startTime":838.265,"endTime":843.645,"body":"Uh, and this is usually caused by prolonged exposure to cold or immersion in water."},{"startTime":843.745,"endTime":847.273,"body":"So people who've fallen in water, who have been in cold water for a long"},{"startTime":847.273,"endTime":848.685,"body":"period are at risk of this."},{"startTime":849.185,"endTime":852.555,"body":"But a range of conditions, I'm not gonna read them out there, can make this"},{"startTime":852.555,"endTime":853.005,"body":"more likely."},{"startTime":853.345,"endTime":857.382,"body":"So it's not just people who are older in low temperatures, anyone can have it,"},{"startTime":857.382,"endTime":859.805,"body":"and it's made more likely by some medical conditions."},{"startTime":860.625,"endTime":866.052,"body":"It is in practical terms, but you're not usually wa walking around with a thermometer"},{"startTime":866.052,"endTime":871.479,"body":"in your pocket to test this, where the body temperature drops below 30 degrees, 35"},{"startTime":871.479,"endTime":872.565,"body":"degrees, uh, centigrade."},{"startTime":874.185,"endTime":875.645,"body":"Now, suggestive symptoms of this."},{"startTime":875.825,"endTime":878.84,"body":"So how you spot it in someone, and this is something that is really worth"},{"startTime":878.84,"endTime":879.645,"body":"being able to spot."},{"startTime":880.345,"endTime":882.885,"body":"Uh, shivering, pale, cold, dry skin."},{"startTime":883.345,"endTime":885.005,"body":"That's probably not particularly surprising."},{"startTime":885.305,"endTime":886.405,"body":"But here's the key ones."},{"startTime":886.475,"endTime":893.009,"body":"Confusion, slurred speech, uh, and, uh, people doing what's called paradoxical undressing, where they're cold,"},{"startTime":893.009,"endTime":897.365,"body":"it's cold outside, but they start taking their clothes off."},{"startTime":897.785,"endTime":903.085,"body":"Any of these should indicate to you that hypothermia is probably setting in slow breathing."},{"startTime":903.085,"endTime":904.765,"body":"And in babies, they're floppy."},{"startTime":905.025,"endTime":906.765,"body":"Uh, they're unwilling to feed."},{"startTime":908.475,"endTime":913.196,"body":"Hypothermia is a medical emergency, and it may well lead to cardiac arrest where the"},{"startTime":913.196,"endTime":915.085,"body":"body, where the heart just stops."},{"startTime":915.595,"endTime":920.371,"body":"Important point to realize is compared to something like frostbite, the patient themselves does not"},{"startTime":920.371,"endTime":921.645,"body":"know they have it."},{"startTime":922.345,"endTime":925.525,"body":"So they have lost the ability to understand that they are cold."},{"startTime":925.545,"endTime":933.245,"body":"And this is causing, causing damage if someone does have for hypothermia."},{"startTime":933.465,"endTime":938.362,"body":"Um, the first aid, again, some of it is common sense, some of it is"},{"startTime":938.362,"endTime":943.26,"body":"things, uh, we need to learn common sense, move people indoors to a sheltered and"},{"startTime":943.26,"endTime":948.158,"body":"dry environment, get off wet clothes, dry clothes cover their head, not their mouth and"},{"startTime":948.158,"endTime":948.485,"body":"nose."},{"startTime":948.505,"endTime":949.485,"body":"But, uh, everything else,"},{"startTime":951.145,"endTime":954.285,"body":"Uh, warm drinks are a very sensible thing to do."},{"startTime":954.345,"endTime":958.932,"body":"If they can keep them down and sugary food, if they can eat it so"},{"startTime":958.932,"endTime":963.52,"body":"that they're, uh, they can continue to sort of burn, uh, energy, uh, internally, you"},{"startTime":963.52,"endTime":966.885,"body":"must keep them awake because temptation will be to drift off."},{"startTime":968.425,"endTime":972.584,"body":"But do get help if someone's got hypothermia, much better to over call it, get"},{"startTime":972.584,"endTime":976.743,"body":"them to hospital and they find they don't have it than to under call it"},{"startTime":976.743,"endTime":978.685,"body":"and realize you're in trouble too late."},{"startTime":979.555,"endTime":983.125,"body":"Then a few don'ts, and these are things, some of these are not obvious."},{"startTime":984.055,"endTime":985.085,"body":"Don't use a heart bath."},{"startTime":985.315,"endTime":990.493,"body":"That can be extremely dangerous, caused to very rapid, uh, changes, uh, or heat them"},{"startTime":990.493,"endTime":992.565,"body":"to warm them up too quickly."},{"startTime":992.865,"endTime":994.565,"body":"The warming is gonna have to be very gradual."},{"startTime":994.585,"endTime":999.571,"body":"That's one of the key things about hypothermia, despite what it shows in all the"},{"startTime":999.571,"endTime":1004.558,"body":"films with, uh, some Bernard dogs bounding over the snow with, uh, uh, brandy barrels"},{"startTime":1004.558,"endTime":1009.545,"body":"do not give them alcohol, uh, which will definitely make things worse and don't rub"},{"startTime":1009.545,"endTime":1012.205,"body":"their arms or feet, arms, legs or feet."},{"startTime":1012.945,"endTime":1016.668,"body":"People do need to be warmed, but it needs to be in a gradual and"},{"startTime":1016.668,"endTime":1017.165,"body":"controlled way."},{"startTime":1017.565,"endTime":1021.765,"body":"'cause otherwise you get big changes of the, of the salts within the blood, the"},{"startTime":1021.765,"endTime":1023.725,"body":"body, and these can be extremely dangerous."},{"startTime":1027.265,"endTime":1030.204,"body":"Deaths from hypothermia are unsurprisingly age related."},{"startTime":1030.265,"endTime":1033.243,"body":"The older you are, the more likely these are to occur."},{"startTime":1033.743,"endTime":1038.552,"body":"But there are also important external factors, and I'm just using us data here, uh,"},{"startTime":1038.552,"endTime":1043.361,"body":"showing that, uh, for every age, the risk in a rural area, uh, is greater"},{"startTime":1043.361,"endTime":1045.605,"body":"than the risk in an urban area."},{"startTime":1046.025,"endTime":1051.14,"body":"And that's imp practical terms, because generally people live in better heated houses, flats and"},{"startTime":1051.14,"endTime":1052.845,"body":"other things in urban settings."},{"startTime":1052.875,"endTime":1055.205,"body":"It's a, it's a purely practical effect."},{"startTime":1058.225,"endTime":1063.987,"body":"If we look at cold related excess mortality in England and Wales, um, uh, and"},{"startTime":1063.987,"endTime":1067.445,"body":"we compare it to the index in multiple deprivations."},{"startTime":1067.625,"endTime":1072.655,"body":"So for want of another term, uh, the best measure we really have of poverty,"},{"startTime":1072.655,"endTime":1077.685,"body":"relative poverty in the uk, if you compare those two maps, they very closely correspond."},{"startTime":1077.685,"endTime":1080.045,"body":"They correspond in the country as a whole."},{"startTime":1080.385,"endTime":1084.849,"body":"And indeed, if you take London, the city we're in at the moment, they correspond"},{"startTime":1084.849,"endTime":1085.445,"body":"within London."},{"startTime":1085.745,"endTime":1091.645,"body":"Poorer areas of the city have higher relate rates of, uh, cold related deaths."},{"startTime":1091.865,"endTime":1096.448,"body":"And that's largely because people, because they can't afford heating, uh, will run heating at"},{"startTime":1096.448,"endTime":1097.365,"body":"a lower level."},{"startTime":1097.375,"endTime":1098.325,"body":"There are other reasons."},{"startTime":1102.075,"endTime":1105.055,"body":"The impact of this on the NHS is substantial."},{"startTime":1106.585,"endTime":1110.895,"body":"Every year with utter predictability, there will be an NHS crisis."},{"startTime":1110.965,"endTime":1114.335,"body":"This has gone on over multiple, uh, previous governments."},{"startTime":1114.655,"endTime":1117.935,"body":"I, I regret to say it will probably happen over some future governments."},{"startTime":1118.275,"endTime":1123.358,"body":"And that is because the, all these cold effects come together in a period of"},{"startTime":1123.358,"endTime":1128.442,"body":"the year in an extremely tightly engineered system, which there therefore is, uh, under much"},{"startTime":1128.442,"endTime":1130.815,"body":"greater pressure predictably over the winter period."},{"startTime":1131.395,"endTime":1135.538,"body":"And therefore weights in a and e and a variety of indirect effects, uh, get"},{"startTime":1135.538,"endTime":1135.815,"body":"worse."},{"startTime":1139.635,"endTime":1143.175,"body":"So how do we reduce the deaths, uh, from cold related, uh, diseases?"},{"startTime":1143.245,"endTime":1144.495,"body":"Some of this is common sense."},{"startTime":1144.635,"endTime":1145.495,"body":"You'll all know it."},{"startTime":1145.555,"endTime":1151.798,"body":"Layers of clothes, heating spaces where vulnerable people, particularly the oldest and the youngest, uh,"},{"startTime":1151.798,"endTime":1152.215,"body":"live."},{"startTime":1153.115,"endTime":1157.93,"body":"And then the risk is really about reducing the systematically, the various risk factors that"},{"startTime":1157.93,"endTime":1159.215,"body":"make this a problem."},{"startTime":1159.835,"endTime":1164.495,"body":"Reduce the risk of respiratory infections and vaccination is certainly one of the tools."},{"startTime":1164.495,"endTime":1168.175,"body":"There are others reduce the risk of cardiovascular disease."},{"startTime":1168.335,"endTime":1173.24,"body":"'cause if the risk is lower, then, uh, you, you carry that through to the"},{"startTime":1173.24,"endTime":1173.895,"body":"winter months."},{"startTime":1175.035,"endTime":1176.975,"body":"Reduce the risks of chip trips and slips."},{"startTime":1177.235,"endTime":1180.215,"body":"Uh, we tend to do it the old-fashioned way of we do it at all."},{"startTime":1180.475,"endTime":1184.32,"body":"Uh, in the uk in countries that have a lot of cold, for example, that"},{"startTime":1184.32,"endTime":1188.165,"body":"will have heated paves in areas around where elderly people live as a way of"},{"startTime":1188.165,"endTime":1188.935,"body":"reducing these risks."},{"startTime":1189.635,"endTime":1191.855,"body":"Uh, and we must reduce fuel poverty."},{"startTime":1192.175,"endTime":1195.455,"body":"'cause fuel poverty drives a lot of, uh, what, uh, causes this."},{"startTime":1198.205,"endTime":1203.391,"body":"Just going through a few of those, I mean, here are just, uh, three of"},{"startTime":1203.391,"endTime":1208.577,"body":"the, uh, diseases of older age in particular, which are temperature related and which can"},{"startTime":1208.577,"endTime":1213.763,"body":"be prevented to some or a large degree by vaccination, uh, covid influenza, pneumococcal disease"},{"startTime":1213.763,"endTime":1214.455,"body":"already used."},{"startTime":1214.875,"endTime":1220.599,"body":"And hopefully we will shortly have another important infection that affects older people, RSV, uh,"},{"startTime":1220.599,"endTime":1224.415,"body":"added to that list so we can reduce the risks."},{"startTime":1226.545,"endTime":1231.298,"body":"We've been extremely effective, in fact, at reducing the risks of coronary heart disease and"},{"startTime":1231.298,"endTime":1231.615,"body":"stroke."},{"startTime":1232.275,"endTime":1237.015,"body":"Uh, this is looking at the mortality rates over time since the 1970s."},{"startTime":1237.135,"endTime":1240.655,"body":"I consider this as one of the great triumphs of contemporary medicine."},{"startTime":1241.235,"endTime":1246.991,"body":"And as a combination of broadly three groups of things, primary prevention, things the government"},{"startTime":1246.991,"endTime":1252.365,"body":"does, reductions in smoking, reductions in air pollution, reducing, providing exercise facilities for people."},{"startTime":1252.755,"endTime":1253.765,"body":"Secondary prevention."},{"startTime":1253.875,"endTime":1258.576,"body":"What doctors, nurses, pharmacists do, they find someone with a high risk factor, put them"},{"startTime":1258.576,"endTime":1263.277,"body":"on treatment for things like hypertension, high cholesterol and treatment in which indeed the provost"},{"startTime":1263.277,"endTime":1264.845,"body":"is a particular, uh, expert."},{"startTime":1265.115,"endTime":1271.653,"body":"Combination of these has led to year on year, steadily, massively improved risks, uh, for"},{"startTime":1271.653,"endTime":1272.525,"body":"these diseases."},{"startTime":1276.145,"endTime":1280.628,"body":"And then engineering, engineering is actually at the basis of reducing a large number of"},{"startTime":1280.628,"endTime":1281.525,"body":"public health risks."},{"startTime":1281.595,"endTime":1284.885,"body":"I've talked about that many times, uh, over the, uh, years."},{"startTime":1284.885,"endTime":1287.565,"body":"I've had the privilege of being a professor at, uh, Gresham College."},{"startTime":1288.185,"endTime":1293.513,"body":"Um, warehouses are warmer in winter and you can at the same time maintain ventilation"},{"startTime":1293.513,"endTime":1295.645,"body":"that will significantly reduce the risk."},{"startTime":1295.975,"endTime":1297.805,"body":"Those two are in some degree of tension."},{"startTime":1299.305,"endTime":1301.755,"body":"It's important that we insulate homes."},{"startTime":1301.755,"endTime":1307.232,"body":"This is one of the best ways we can do to reduce the risk of"},{"startTime":1307.232,"endTime":1312.709,"body":"cold related disease, actually also heat related disease, uh, without, um, leading to ongoing, uh,"},{"startTime":1312.709,"endTime":1313.075,"body":"expenditure."},{"startTime":1314.175,"endTime":1316.875,"body":"But the UK housing stock whilst improving."},{"startTime":1316.935,"endTime":1322.035,"body":"And on the right, which I've shown is the relative EFF efficiency, uh, of our"},{"startTime":1322.035,"endTime":1326.795,"body":"housing stock is one of the, the oldest and coldest, uh, in Northern Europe."},{"startTime":1328.975,"endTime":1333.835,"body":"Um, as the population ages, in my view, this should be a major priority."},{"startTime":1334.455,"endTime":1339.815,"body":"But when doing this, we need to be aware that there is a trade off"},{"startTime":1339.815,"endTime":1342.675,"body":"between a making a, uh, building better ventilation."},{"startTime":1342.735,"endTime":1347.035,"body":"So reducing things, the risk of things like flu and covid and keeping it warm."},{"startTime":1347.525,"endTime":1352.005,"body":"Those two, uh, if your main means of ventilation is opening the windows, uh, are"},{"startTime":1352.005,"endTime":1354.395,"body":"obviously in, um, uh, some form of tension."},{"startTime":1356.985,"endTime":1360.901,"body":"Just to back up my point, um, that the average, uh, home heat loss over"},{"startTime":1360.901,"endTime":1364.035,"body":"five hours, which is just a measure of how efficient things are."},{"startTime":1364.335,"endTime":1370.018,"body":"The UK scores particularly badly and in particular, particularly badly for Northern Europe, which is"},{"startTime":1370.018,"endTime":1371.155,"body":"where cold dominates."},{"startTime":1371.615,"endTime":1375.515,"body":"So improving our housing stock, I think is one of the most important things we"},{"startTime":1375.515,"endTime":1376.555,"body":"could usefully do here."},{"startTime":1378.455,"endTime":1379.355,"body":"Now, moving on to heat."},{"startTime":1379.735,"endTime":1385.148,"body":"Um, heat can cause, again, multiple forms of illness ranging from dehydration, heat syncope where"},{"startTime":1385.148,"endTime":1388.035,"body":"people just faint in the heat, heat cramps."},{"startTime":1388.035,"endTime":1392.035,"body":"Many of you'll have had these at various points when doing sports in hot climates."},{"startTime":1392.455,"endTime":1397.607,"body":"Uh, heat exhaustion, which I'll talk about, uh, and the most dangerous heat stroke, which"},{"startTime":1397.607,"endTime":1400.355,"body":"I'll talk about at, uh, slightly greater length,"},{"startTime":1403.825,"endTime":1406.595,"body":"Very hot days lead to increased mortality."},{"startTime":1407.055,"endTime":1411.755,"body":"And the number of hot days is steadily increasing as we go through climate change."},{"startTime":1411.755,"endTime":1413.875,"body":"That's just a, a statement of fact."},{"startTime":1415.015,"endTime":1420.85,"body":"Um, LA in 2022, so two years ago, the UK for the first time recorded"},{"startTime":1420.85,"endTime":1422.795,"body":"temperatures over 40 degrees centigrade."},{"startTime":1423.815,"endTime":1428.266,"body":"And that is going to increase now, not every year, but taken dec uh, for"},{"startTime":1428.266,"endTime":1432.125,"body":"the rest of the lives of everybody in this, uh, in this building."},{"startTime":1432.185,"endTime":1439.235,"body":"And indeed, beyond that, in that year, there were about 2,800 deaths due to, um,"},{"startTime":1439.235,"endTime":1442.525,"body":"to heat, uh, in those over 65."},{"startTime":1442.865,"endTime":1444.365,"body":"So these are not trivial numbers."},{"startTime":1444.785,"endTime":1447.205,"body":"So heat is potentially very dangerous."},{"startTime":1447.365,"endTime":1451.325,"body":"I, uh, sometimes find it slightly unhelpful that people say, oh, what people worried about"},{"startTime":1451.325,"endTime":1452.645,"body":"is just a hot summer."},{"startTime":1452.645,"endTime":1457.525,"body":"Like everyone had heat, extreme heat kills people, and particularly it kills older people."},{"startTime":1459.145,"endTime":1464.188,"body":"Um, the specific effects of heat are heat, stroke and heat exhaustion, which I'll talk"},{"startTime":1464.188,"endTime":1464.525,"body":"about."},{"startTime":1464.785,"endTime":1470.002,"body":"But indirect effects include dehydration, which in the elderly is very dangerous and can lead"},{"startTime":1470.002,"endTime":1474.525,"body":"to a, a whole range of other diseases, uh, uh, and cardiovascular disease."},{"startTime":1476.825,"endTime":1478.525,"body":"So just to, again, back that up."},{"startTime":1479.075,"endTime":1482.565,"body":"This, I'm gonna show it two different ways to make two slightly different points."},{"startTime":1483.135,"endTime":1487.205,"body":"These are the number of daily death occurrences compared to the five year average."},{"startTime":1487.265,"endTime":1490.645,"body":"So these actual numbers, they're not, uh, extrapolations."},{"startTime":1491.225,"endTime":1494.885,"body":"And on the, the green line we've got to here is the daily temperature."},{"startTime":1494.885,"endTime":1499.365,"body":"And the bars, the gray bars are the hot periods during the summer months."},{"startTime":1500.065,"endTime":1504.076,"body":"And as you can see with a very degree, high degree of predictability, in the"},{"startTime":1504.076,"endTime":1507.285,"body":"very hot days, the more number of people who died went up."},{"startTime":1507.945,"endTime":1512.282,"body":"That's just a statement of fact and went up in a big enough way that"},{"startTime":1512.282,"endTime":1514.885,"body":"you can really see it with a naked eye."},{"startTime":1514.885,"endTime":1519.405,"body":"You don't need to do complex statistical tests to see that effect is happening."},{"startTime":1521.825,"endTime":1526.231,"body":"If, however, you then split that out by people who are over 70 and under"},{"startTime":1526.231,"endTime":1526.525,"body":"70."},{"startTime":1527.025,"endTime":1529.805,"body":"In fact, the impact on people under 70 was minimal."},{"startTime":1530.625,"endTime":1535.21,"body":"So almost all of this effect is in fact in older people, people in their"},{"startTime":1535.21,"endTime":1537.045,"body":"seventies, eighties, nineties, or indeed above."},{"startTime":1537.785,"endTime":1543.405,"body":"So being older and having very high temperatures is a very high risk situation."},{"startTime":1545.625,"endTime":1551.872,"body":"Now, in terms of specifics, um, there are two broad things which are, again, specific"},{"startTime":1551.872,"endTime":1555.205,"body":"to heat, uh, heat exhaustion and heat stroke."},{"startTime":1555.745,"endTime":1560.584,"body":"And people can move from heat exhaustion into heat stroke, but they are, as I'll"},{"startTime":1560.584,"endTime":1563.165,"body":"come on to quite different, uh, physiological states."},{"startTime":1565.875,"endTime":1571.405,"body":"Heat exhaustion is really an exaggeration of the ordinary response to heat."},{"startTime":1571.625,"endTime":1575.845,"body":"The body is responded normally to heat, but it's very hot heat."},{"startTime":1575.865,"endTime":1578.925,"body":"So it's actually, uh, doing it in a very severe way."},{"startTime":1579.225,"endTime":1584.371,"body":"People will be sweating profusely, they'll be tired and maybe dizzy because they've lost, um,"},{"startTime":1584.371,"endTime":1589.518,"body":"uh, fluid, but they've also got all their blood out in the periphery, they'll be"},{"startTime":1589.518,"endTime":1590.205,"body":"very thirsty."},{"startTime":1590.205,"endTime":1593.405,"body":"These are all normal responses to a hot situation."},{"startTime":1594.355,"endTime":1599.522,"body":"They'll have some, probably some headache, nausea and may have vomiting, which is problematic 'cause"},{"startTime":1599.522,"endTime":1601.245,"body":"it makes rehydration more difficult."},{"startTime":1601.515,"endTime":1602.725,"body":"They may well have cramps."},{"startTime":1602.745,"endTime":1606.165,"body":"And again, many of you may have had these when playing sport in heat."},{"startTime":1606.785,"endTime":1609.805,"body":"Um, clammy, they may have heat rash."},{"startTime":1610.275,"endTime":1611.565,"body":"They'll often feel weak."},{"startTime":1612.705,"endTime":1616.445,"body":"And if you feel that pulse, it'll be fast and they'll be breathing fast."},{"startTime":1617.265,"endTime":1621.789,"body":"All of these are actually normal responses to heat, but just taken to an extreme"},{"startTime":1621.789,"endTime":1624.805,"body":"event, there were early warning signs of what might happen."},{"startTime":1625.225,"endTime":1629.685,"body":"But if you treat people rapidly, uh, the recovery can be very good."},{"startTime":1629.705,"endTime":1633.471,"body":"And the first aid for someone with heat exhaustion is something which most people should"},{"startTime":1633.471,"endTime":1636.485,"body":"be able to just sort out, uh, peripherally you don't need necessarily."},{"startTime":1636.545,"endTime":1640.365,"body":"In fact, normally you do not need, uh, any help from trained professionals."},{"startTime":1640.525,"endTime":1644.485,"body":"A good first aider, indeed, someone with, uh, some basic training will usually be able"},{"startTime":1644.485,"endTime":1648.445,"body":"to do this, uh, much of it common sense, move them to a cool place."},{"startTime":1649.265,"endTime":1652.325,"body":"Uh, remove outer clothing, keeping people's dignity."},{"startTime":1653.185,"endTime":1659.059,"body":"Um, cool water and rehydration with water or sports strengths, cooler, the better generally, um,"},{"startTime":1659.059,"endTime":1664.933,"body":"spray them or sponge them with cool water so that you are cooling them down"},{"startTime":1664.933,"endTime":1665.325,"body":"peripherally."},{"startTime":1665.865,"endTime":1670.083,"body":"Uh, if you've got a fan, use the fan to help, um, uh, reduce their"},{"startTime":1670.083,"endTime":1670.365,"body":"temperature."},{"startTime":1670.785,"endTime":1674.553,"body":"And if you've got cold packs, which you may have if you are in a,"},{"startTime":1674.553,"endTime":1678.322,"body":"in an urban environment, uh, wrap them in cloth so they don't freeze to people"},{"startTime":1678.322,"endTime":1682.091,"body":"and then put them particularly in the armpits and the groin where there's a lot"},{"startTime":1682.091,"endTime":1682.845,"body":"of blood flow."},{"startTime":1682.905,"endTime":1685.925,"body":"And therefore you can cool people down relatively quickly."},{"startTime":1686.825,"endTime":1689.965,"body":"If people have got heat exhaustion, they should improve within about 30 minutes."},{"startTime":1691.105,"endTime":1695.315,"body":"You still want to get 'em home, you want to get 'em calm, you keep"},{"startTime":1695.315,"endTime":1699.245,"body":"want to get 'em rehydrated, but actually the recovery will be rapid by contrast."},{"startTime":1699.515,"endTime":1706.088,"body":"Heat stroke is a medical emergency, and the broadly two forms is something called exertional"},{"startTime":1706.088,"endTime":1706.965,"body":"heat stroke."},{"startTime":1706.995,"endTime":1713.656,"body":"This happens when young fit people are exposed to usually a combination of high temperature"},{"startTime":1713.656,"endTime":1716.765,"body":"and extreme, uh, uh, extreme, uh, activity."},{"startTime":1717.185,"endTime":1722.762,"body":"So, for example, special forces soldiers yoing over the brecken in the summer, carrying heavy"},{"startTime":1722.762,"endTime":1725.365,"body":"packs could get this, their healthy people."},{"startTime":1725.465,"endTime":1728.445,"body":"But, uh, the risk of their, their body has been highly stressed."},{"startTime":1728.745,"endTime":1732.205,"body":"Uh, mortality for this is low, uh, but it's still very dangerous."},{"startTime":1733.345,"endTime":1737.479,"body":"Non exertional heat stroke though, when people just get it, despite ordinary daily living, has"},{"startTime":1737.479,"endTime":1739.685,"body":"a very high mortality, particularly in the elderly."},{"startTime":1739.985,"endTime":1744.166,"body":"So in older people and people with severe heat, stroke mortality can be 50% or"},{"startTime":1744.166,"endTime":1744.445,"body":"more."},{"startTime":1744.465,"endTime":1747.205,"body":"So this is very dangerous here."},{"startTime":1747.505,"endTime":1751.925,"body":"The body is not just doing an extreme reaction, that's the normal reaction to heat."},{"startTime":1752.185,"endTime":1756.01,"body":"It is behaving irrationally in, in the sense to heat, or it's behaving in a"},{"startTime":1756.01,"endTime":1757.285,"body":"way that is very dangerous."},{"startTime":1757.745,"endTime":1760.245,"body":"The body has lost what's called thermo regulation."},{"startTime":1760.245,"endTime":1763.485,"body":"It's lost the ability to realize it is too hot."},{"startTime":1765.245,"endTime":1768.165,"body":"Multiple parts of the body now start to malfunction."},{"startTime":1768.675,"endTime":1771.565,"body":"This will include inflammation clotting."},{"startTime":1771.945,"endTime":1777.588,"body":"The kidneys will start to go heart, uh, brain and muscles, and eventually people will"},{"startTime":1777.588,"endTime":1777.965,"body":"fit."},{"startTime":1778.305,"endTime":1781.565,"body":"Uh, and cardiac arrest, if you don't treat them, uh, is likely to occur."},{"startTime":1781.585,"endTime":1784.005,"body":"So this is very dangerous, uh, indeed."},{"startTime":1786.025,"endTime":1788.045,"body":"Now, how do you recognize someone's got heat stroke?"},{"startTime":1788.505,"endTime":1791.885,"body":"Uh, if you've got a thermometer, that's the most, uh, telling thing."},{"startTime":1792.185,"endTime":1797.035,"body":"If they've got a core temperature over 40 degrees, that's a very strong reason to"},{"startTime":1797.035,"endTime":1798.005,"body":"worry about them."},{"startTime":1798.005,"endTime":1800.245,"body":"Particularly if there's no reason to think they got an infection."},{"startTime":1800.795,"endTime":1806.525,"body":"They will often rather, like, uh, with cold related problems, hypothermia have altered mental state."},{"startTime":1806.745,"endTime":1811.805,"body":"So con confusion, slurred speech, seizures, and in severe cases are gone."},{"startTime":1812.035,"endTime":1816.725,"body":"Coma, their skin will be hot because they are hot but dry."},{"startTime":1816.725,"endTime":1818.365,"body":"They, they are no longer sweating."},{"startTime":1818.365,"endTime":1822.812,"body":"Their body is not, is no longer recognizing what the correct response to the body"},{"startTime":1822.812,"endTime":1823.405,"body":"should be."},{"startTime":1823.435,"endTime":1827.125,"body":"It's, it's basically given up, uh, the correct response."},{"startTime":1827.625,"endTime":1831.005,"body":"Uh, and, um, they'll have, uh, a number of other symptoms"},{"startTime":1834.345,"endTime":1837.725,"body":"In contrast to, um, first aid for heat exhaustion."},{"startTime":1837.835,"endTime":1841.396,"body":"This is something where you're gonna need professional help, but the first things you can"},{"startTime":1841.396,"endTime":1844.245,"body":"do yourself, same, same starting point, take 'em to a cool place."},{"startTime":1844.505,"endTime":1848.18,"body":"But in this case, put them in the recovery position on their side because there's"},{"startTime":1848.18,"endTime":1851.365,"body":"a high chance they may vomit or might go into have a fit."},{"startTime":1851.665,"endTime":1854.165,"body":"Uh, and that makes that easier to, uh, manage."},{"startTime":1855.315,"endTime":1857.285,"body":"Then call 9 9 9 or one one two."},{"startTime":1857.865,"endTime":1860.085,"body":"Uh, remove the outer clothing, cool them down."},{"startTime":1860.085,"endTime":1861.605,"body":"This is similar to heat exhaustion."},{"startTime":1861.985,"endTime":1866.335,"body":"And then ideally put a cold wet sheet over the body and keep on doing"},{"startTime":1866.335,"endTime":1869.525,"body":"so until their temperature comes down, uh, within the normal range."},{"startTime":1869.715,"endTime":1872.525,"body":"Then put it onto a, a dry, um, sheet."},{"startTime":1872.985,"endTime":1882.341,"body":"But hopefully help will have come before then in exact contrast to high colds related"},{"startTime":1882.341,"endTime":1882.965,"body":"mortality."},{"startTime":1883.515,"endTime":1887.085,"body":"High temperature excess is concentrated in, in urban centers."},{"startTime":1887.905,"endTime":1891.525,"body":"Places like London are on average, hotter than the rest of the country."},{"startTime":1891.905,"endTime":1895.885,"body":"And therefore if there's gonna be heat exhaustion, it's more likely to be in these"},{"startTime":1895.885,"endTime":1898.805,"body":"areas and is much less likely to be so economically driven."},{"startTime":1898.985,"endTime":1903.29,"body":"That's largely actually because here we don't tend to use air conditioning and other things,"},{"startTime":1903.29,"endTime":1904.725,"body":"at least in domestic settings."},{"startTime":1904.985,"endTime":1907.925,"body":"So the benefits of being wealthier are much less."},{"startTime":1912.785,"endTime":1917.381,"body":"As with cold, we, we as the UK, can learn a lot from countries which"},{"startTime":1917.381,"endTime":1921.365,"body":"have historically had hotter temperatures 'cause that's the way we're going to head."},{"startTime":1921.905,"endTime":1926.811,"body":"Uh, and just to reiterate, even this incredibly hot period in the uk there were"},{"startTime":1926.811,"endTime":1931.717,"body":"many places in southern Europe which were a lot hotter, uh, at that point in"},{"startTime":1931.717,"endTime":1932.045,"body":"time."},{"startTime":1932.425,"endTime":1936.925,"body":"And they've learned to, uh, adapt society to these hot temperatures."},{"startTime":1937.145,"endTime":1939.165,"body":"And you'll see a very different form of architecture."},{"startTime":1939.165,"endTime":1945.015,"body":"Much smaller windows, uh, white coloring windows tend to be, um, uh, covered if there's"},{"startTime":1945.015,"endTime":1946.965,"body":"very hot, uh, time coming."},{"startTime":1947.145,"endTime":1948.725,"body":"Do draw the curtains of roti."},{"startTime":1948.725,"endTime":1953.045,"body":"Ways you can do that to avoid a literal, uh, greenhouse effect."},{"startTime":1955.905,"endTime":1956.965,"body":"Moving on to wind."},{"startTime":1957.265,"endTime":1960.125,"body":"Um, there are multiple causes of wind at different times of the year."},{"startTime":1960.125,"endTime":1962.942,"body":"And I'm not gonna go into the meteorology of this in detail, but I will,"},{"startTime":1962.942,"endTime":1964.445,"body":"uh, just talk about a few of them."},{"startTime":1965.025,"endTime":1969.045,"body":"Uh, the uk um, as a seafaring nation has always worried about the wind."},{"startTime":1969.645,"endTime":1973.774,"body":"'cause those in peril on the sea are at very high risk of even relatively"},{"startTime":1973.774,"endTime":1974.325,"body":"moderate storms."},{"startTime":1974.705,"endTime":1978.245,"body":"Uh, but on land the risks are generally lower."},{"startTime":1980.665,"endTime":1984.942,"body":"So on land, the direct risks to life and limb from wind usually are caused"},{"startTime":1984.942,"endTime":1988.365,"body":"by flying debris and falling objects, at least in the immediate period."},{"startTime":1988.865,"endTime":1992.878,"body":"But in the longer period, there may be loss of power, there may be loss"},{"startTime":1992.878,"endTime":1996.892,"body":"of water, there may be loss of shelter, and particularly in winter or in very"},{"startTime":1996.892,"endTime":1998.765,"body":"hot time periods, those can be tricky."},{"startTime":1999.825,"endTime":2002.205,"body":"We tend to think of variations of the befor scale."},{"startTime":2002.235,"endTime":2008.874,"body":"Here is the Francis Beaufort, uh, really designed for, um, mariners, uh, originally, uh, and"},{"startTime":2008.874,"endTime":2015.514,"body":"based on on sea conditions, um, damage, uh, sufficient to cause injury to humans is"},{"startTime":2015.514,"endTime":2017.285,"body":"very rare on land."},{"startTime":2017.745,"endTime":2022.928,"body":"Uh, below Force eight, which is, uh, a wind speed of between six to two"},{"startTime":2022.928,"endTime":2023.965,"body":"and 74 kilometers."},{"startTime":2023.965,"endTime":2026.685,"body":"Now, that's the kind of, uh, level we're talking about."},{"startTime":2027.145,"endTime":2031.27,"body":"Um, going all the way up to a hurricane Force 12, which in the UK"},{"startTime":2031.27,"endTime":2032.645,"body":"is an astonishing, uh, thing."},{"startTime":2032.645,"endTime":2034.125,"body":"We very rarely would see this."},{"startTime":2034.665,"endTime":2037.565,"body":"Uh, and, um, here, there can be significant damage."},{"startTime":2037.665,"endTime":2041.445,"body":"But as I'll come onto, uh, we are relatively, uh, protected."},{"startTime":2041.785,"endTime":2045.565,"body":"Uh, this is wind that's going into just, just over 70 mile miles an hour."},{"startTime":2045.865,"endTime":2051.364,"body":"So the top end of the illegal, uh, driving things on a motorway."},{"startTime":2052.995,"endTime":2058.002,"body":"However, there are several other, um, wind scales which other parts of the world have"},{"startTime":2058.002,"endTime":2060.005,"body":"to use much more so significantly."},{"startTime":2060.425,"endTime":2065.213,"body":"And what I've shown here, uh, is the, um, uh, is one of the other"},{"startTime":2065.213,"endTime":2069.364,"body":"scales is the, uh, fujita tornado scale, uh, and the hurricane wind scale."},{"startTime":2069.784,"endTime":2074.445,"body":"And in places which have significant really serious wind issues, these are much more relevant."},{"startTime":2074.445,"endTime":2077.725,"body":"And these start where Force 12 leaves off."},{"startTime":2077.745,"endTime":2079.965,"body":"So 12 Force 12 is really near the bottom of this."},{"startTime":2081.505,"endTime":2086.815,"body":"In the uk, uh, gales and storms are almost all in the Ottman winter, and"},{"startTime":2086.815,"endTime":2092.126,"body":"they are largely related to most the West and mountain areas above Force 10 in"},{"startTime":2092.126,"endTime":2094.605,"body":"the UK is extremely rare in land."},{"startTime":2095.545,"endTime":2099.445,"body":"So we have relatively few of these except in very exposed areas."},{"startTime":2101.765,"endTime":2104.485,"body":"A very different situation is the severe tropical cyclones."},{"startTime":2105.065,"endTime":2110.058,"body":"And these don't occur in winter and autumn, these in fact occur over the summer"},{"startTime":2110.058,"endTime":2115.052,"body":"period, and they're caused by heating over water on, uh, and what you get is"},{"startTime":2115.052,"endTime":2120.046,"body":"these tracks, and these are tracks going out, going out, out, um, since, uh, over,"},{"startTime":2120.046,"endTime":2121.045,"body":"uh, many decades."},{"startTime":2121.825,"endTime":2124.965,"body":"And as you can see, the UK is not at the receiving end of these."},{"startTime":2124.965,"endTime":2130.365,"body":"These tend to move and they hit, in particular the Caribbean and Southern USA, uh,"},{"startTime":2130.365,"endTime":2135.405,"body":"and, uh, the Eastern Seaboards, uh, of um, uh, so Asia and Southeast Asia."},{"startTime":2135.425,"endTime":2137.725,"body":"And these can be extremely strong."},{"startTime":2141.535,"endTime":2144.245,"body":"These pros a very serious risk to life."},{"startTime":2144.905,"endTime":2148.205,"body":"And the major ones are where there's a scale three or above."},{"startTime":2148.205,"endTime":2149.285,"body":"They're very destructive."},{"startTime":2150.305,"endTime":2155.805,"body":"So both at Hurricanes Force 12 start at seven at 118 kilometers an hour."},{"startTime":2156.065,"endTime":2161.306,"body":"Uh, the uh, scale here, scale three here is going at 178 to 208 kilometers"},{"startTime":2161.306,"endTime":2162.005,"body":"an hour."},{"startTime":2162.145,"endTime":2163.445,"body":"And it keeps on going up."},{"startTime":2164.105,"endTime":2168.085,"body":"And the damage these can cause when they hit land can be colossal."},{"startTime":2168.155,"endTime":2170.405,"body":"This is obviously Hurricane Katrina."},{"startTime":2170.405,"endTime":2174.795,"body":"I've shown on the right a category five storm, which then, uh, went down to"},{"startTime":2174.795,"endTime":2176.845,"body":"three by the time it got land."},{"startTime":2177.225,"endTime":2178.565,"body":"Uh, land four,"},{"startTime":2180.805,"endTime":2184.485,"body":"A more localized form of, um, very fast wind is tornadoes."},{"startTime":2184.545,"endTime":2185.525,"body":"And they're different completely."},{"startTime":2185.595,"endTime":2187.365,"body":"They tend to form over land mass."},{"startTime":2187.825,"endTime":2191.485,"body":"And you get a very fast twisting, uh, whirlwind or twister."},{"startTime":2191.785,"endTime":2196.685,"body":"Uh, and the most commonly affected for severe ones are, um, the US and Canada."},{"startTime":2197.185,"endTime":2199.525,"body":"Uh, but they do occur quite frequently in the UK actually."},{"startTime":2199.525,"endTime":2201.565,"body":"But they're weak, they're elegant and weak."},{"startTime":2201.985,"endTime":2205.365,"body":"So they're good to look at and won't do you very much, uh, damage."},{"startTime":2205.625,"endTime":2207.845,"body":"The US ones can be really very severe."},{"startTime":2208.105,"endTime":2212.385,"body":"And just looking at that picture on the right, you can very easily see the"},{"startTime":2212.385,"endTime":2215.525,"body":"track that the tornado took as it went through this town."},{"startTime":2215.675,"endTime":2218.805,"body":"Very, very clearly demarcated in terms of the damage."},{"startTime":2221.105,"endTime":2225.205,"body":"So those are winds, floods, uh, are the final thing I want to talk about."},{"startTime":2225.425,"endTime":2230.485,"body":"And, um, they are the natural hazard that affect most people worldwide."},{"startTime":2231.505,"endTime":2233.845,"body":"And there are a number of things which they can cause drowning."},{"startTime":2234.105,"endTime":2239.668,"body":"And I talked about this when we talked about tsunamis, uh, in the last, uh,"},{"startTime":2239.668,"endTime":2245.231,"body":"lecture, uh, physical trauma, if people are caught in fast flow water, people underestimate quite"},{"startTime":2245.231,"endTime":2250.794,"body":"how, how hard they're gonna be hit or hit other things, exposure to sewage in"},{"startTime":2250.794,"endTime":2256.357,"body":"flood water, but importantly, and for the medium to long term, temporary or permanent, um,"},{"startTime":2256.357,"endTime":2259.325,"body":"uh, destruction of sanitation, uh, leading to infection."},{"startTime":2260.345,"endTime":2266.935,"body":"And there's also gonna be destruction of the physical infrastructure, electrical hazards, carbon monoxide poisoning,"},{"startTime":2266.935,"endTime":2273.526,"body":"'cause people who don't do it, uh, use diesel generators, destructions of homes, livelihoods, and"},{"startTime":2273.526,"endTime":2274.845,"body":"importantly psychological trauma."},{"startTime":2277.305,"endTime":2281.055,"body":"Now, there are lots of reasons why flooding occurs and different reasons occur at different"},{"startTime":2281.055,"endTime":2281.805,"body":"times of year."},{"startTime":2282.945,"endTime":2287.302,"body":"Uh, in general, in winter, which is the ones we tend to get most of"},{"startTime":2287.302,"endTime":2289.045,"body":"in the uk, uh, storm surges."},{"startTime":2289.045,"endTime":2293.676,"body":"And these occur in winter, and they occur in coastal areas where a very high,"},{"startTime":2293.676,"endTime":2298.307,"body":"uh, tide coincides with a storm coming in, pulling, uh, the, uh, the light, the"},{"startTime":2298.307,"endTime":2298.925,"body":"level up."},{"startTime":2300.145,"endTime":2304.561,"body":"The second, uh, one which we tend to get again, manian winters, is what's called"},{"startTime":2304.561,"endTime":2305.445,"body":"fluvial, um, flooding."},{"startTime":2305.745,"endTime":2310.051,"body":"And this is where the, the river breaks, it Spanx and spreads out onto its"},{"startTime":2310.051,"endTime":2314.357,"body":"natural floodplain on which many of the great cities and towns of the UK are"},{"startTime":2314.357,"endTime":2314.645,"body":"built."},{"startTime":2314.755,"endTime":2320.174,"body":"Both of these are much more common in winter, in summer, we get fluvial and"},{"startTime":2320.174,"endTime":2325.594,"body":"flush flash flooding, particularly flash flooding, where the very high temperatures leads to sudden upswing,"},{"startTime":2325.594,"endTime":2331.013,"body":"updraft of temperature, which then cools its very moist water, and you get very heavy"},{"startTime":2331.013,"endTime":2336.433,"body":"what we would, we would call tropical rainfall over very short periods in, in areas"},{"startTime":2336.433,"endTime":2339.685,"body":"that are largely difficult to predict and occur anyway."},{"startTime":2339.825,"endTime":2344.585,"body":"And of course, there are other causes like downbursts, tsunamis, uh, and groundwater by the,"},{"startTime":2344.585,"endTime":2347.125,"body":"by the water literally comes from the ground."},{"startTime":2349.105,"endTime":2353.779,"body":"So just taking a, again, those one by one, um, I showed this before, but"},{"startTime":2353.779,"endTime":2358.453,"body":"tsunamis, but it's worth re reinforcing because drowning is one of the, uh, first aid"},{"startTime":2358.453,"endTime":2358.765,"body":"risks."},{"startTime":2358.975,"endTime":2362.285,"body":"There is a reasonable chance all of you could see at some stage."},{"startTime":2363.025,"endTime":2368.398,"body":"So, um, the key thing is to do CPR chest compressions, to keep the oxygen"},{"startTime":2368.398,"endTime":2373.772,"body":"flowing around the blood, the, the body and in particular, uh, protecting, uh, the brain,"},{"startTime":2373.772,"endTime":2375.205,"body":"uh, heart and kidneys."},{"startTime":2376.185,"endTime":2380.165,"body":"So you do five breaths, uh, and then 30 test compressions."},{"startTime":2380.185,"endTime":2382.685,"body":"And everybody in my view should learn how to do it."},{"startTime":2382.685,"endTime":2383.685,"body":"It's not particularly difficult."},{"startTime":2383.685,"endTime":2385.045,"body":"There's training done by St."},{"startTime":2385.045,"endTime":2391.245,"body":"John's Ambulance and other good organizations throughout the UK really strongly recommend people do this."},{"startTime":2391.675,"endTime":2394.725,"body":"Just do two breaths and just repeat that on a cyclical basis."},{"startTime":2395.425,"endTime":2400.102,"body":"If they vomit, put them on the recovery position as anyone who's done first aid,"},{"startTime":2400.102,"endTime":2402.285,"body":"remember, and they may well have hypothermia."},{"startTime":2402.305,"endTime":2403.925,"body":"So just, uh, remember that."},{"startTime":2406.385,"endTime":2409.605,"body":"But the infectious dangers of flood water extend far beyond that."},{"startTime":2410.025,"endTime":2415.605,"body":"And probably the most important to these is sewage getting into water in substantial amounts."},{"startTime":2416.155,"endTime":2420.63,"body":"Part of this is due to storm, uh, storms, uh, outflows, which of course reach"},{"startTime":2420.63,"endTime":2425.106,"body":"the, uh, news a lot in the last few years, but these are very big"},{"startTime":2425.106,"endTime":2425.405,"body":"storms."},{"startTime":2425.405,"endTime":2430.205,"body":"So you've got a lot of outflow, uh, during these, uh, but in extreme cases,"},{"startTime":2430.205,"endTime":2434.045,"body":"the whole sewage system will become completely flooded and cease to function."},{"startTime":2434.385,"endTime":2439.205,"body":"So all the sewage will go directly into the water, uh, and uh, downstream."},{"startTime":2440.465,"endTime":2445.396,"body":"And you may end up with the drinking water system not working and it becoming"},{"startTime":2445.396,"endTime":2445.725,"body":"contaminated."},{"startTime":2447.305,"endTime":2448.365,"body":"So obvious things to do."},{"startTime":2448.695,"endTime":2450.845,"body":"Avoid any contact with flood water if you can."},{"startTime":2450.845,"endTime":2451.565,"body":"It is dangerous."},{"startTime":2451.945,"endTime":2455.8,"body":"Uh, and if you have to then wash your hands regularly with water, you think"},{"startTime":2455.8,"endTime":2457.085,"body":"comes from a safer source."},{"startTime":2459.665,"endTime":2464.205,"body":"The psychological effects of flooding are often underestimated by those who've not experienced it."},{"startTime":2464.225,"endTime":2467.547,"body":"Any of you who know who's someone who's had a major flood in their area"},{"startTime":2467.547,"endTime":2470.205,"body":"will be aware that this actually can take a really serious toll."},{"startTime":2470.435,"endTime":2474.85,"body":"They've lost their livelihoods, they've lost their houses, they may not have insurance any longer,"},{"startTime":2474.85,"endTime":2477.205,"body":"uh, and they know it could happen again."},{"startTime":2477.325,"endTime":2480.445,"body":"'cause if this happened once this can occur on another occasion."},{"startTime":2483.255,"endTime":2486.605,"body":"Quite a lot of UK cities and towns are at significant risk of flooding."},{"startTime":2486.665,"endTime":2489.125,"body":"And these are the winter flooding, the fluvial and the pvi."},{"startTime":2489.435,"endTime":2493.681,"body":"Here in, uh, London, for example, uh, a lot of the land is quite low"},{"startTime":2493.681,"endTime":2493.965,"body":"lying."},{"startTime":2493.985,"endTime":2498.713,"body":"If it wasn't for the, uh, Thames barrier, the risk of flooding, which is already"},{"startTime":2498.713,"endTime":2500.605,"body":"non-trivial would be, uh, significantly higher."},{"startTime":2500.945,"endTime":2502.805,"body":"And some bits of east are put here."},{"startTime":2502.865,"endTime":2504.125,"body":"Boston underwater."},{"startTime":2504.545,"endTime":2509.987,"body":"Uh, in, in Lincolnshire, uh, flooding is a very significant risk and could occur, uh,"},{"startTime":2509.987,"endTime":2512.165,"body":"across large areas of the country."},{"startTime":2515.985,"endTime":2521.885,"body":"Now with coastal and fluvial flooding, flooding from the river, um, due to, uh, winter"},{"startTime":2521.885,"endTime":2526.605,"body":"flood, winter storms, it's very possible to predict where they will occur."},{"startTime":2527.125,"endTime":2530.645,"body":"'cause it's low lying areas on the coast or around the rivers."},{"startTime":2532.635,"endTime":2536.264,"body":"And it's usually possible with a short lead time to know when the met office"},{"startTime":2536.264,"endTime":2539.893,"body":"will be able to say, five days out, there is a major storm heading our"},{"startTime":2539.893,"endTime":2540.135,"body":"way."},{"startTime":2540.595,"endTime":2542.735,"body":"And here's when the tide tide's going to be."},{"startTime":2546.075,"endTime":2551.056,"body":"By contrast, the summer floods and particular flash flooding, which occurs with a sudden updraft"},{"startTime":2551.056,"endTime":2556.038,"body":"of, of um, uh, hot, hot air leading to, uh, sudden very torrential, uh, flood"},{"startTime":2556.038,"endTime":2561.02,"body":"are unpredictable where they're gonna occur and unpredictable when they're gonna occur so that the"},{"startTime":2561.02,"endTime":2566.002,"body":"infrastructure isn't there, people aren't expecting it, they don't have all the flood barriers in"},{"startTime":2566.002,"endTime":2566.335,"body":"place."},{"startTime":2566.595,"endTime":2570.025,"body":"It just suddenly the heavens open and you've got a major flood in your hands"},{"startTime":2570.025,"endTime":2571.855,"body":"in a place that isn't ready for them."},{"startTime":2572.235,"endTime":2576.535,"body":"So they can lead to actually worse problems because of the lack of preparedness."},{"startTime":2580.685,"endTime":2582.495,"body":"Finally, where are we heading?"},{"startTime":2583.395,"endTime":2588.208,"body":"And there are two really major drivers here, uh, one of which is climate change,"},{"startTime":2588.208,"endTime":2590.455,"body":"and the other is the aging population."},{"startTime":2591.055,"endTime":2593.355,"body":"The aging population is probably the easier one."},{"startTime":2593.585,"endTime":2597.715,"body":"Just to summarize, um, the number of older people is steadily increasing."},{"startTime":2597.875,"endTime":2602.183,"body":"I did a report on this in the last year, uh, over in the uk"},{"startTime":2602.183,"endTime":2606.491,"body":"and particularly in the peripheral areas, many of which are low lying and on the"},{"startTime":2606.491,"endTime":2610.799,"body":"coastal strip and on average at the same level of temperature, whether they're high or"},{"startTime":2610.799,"endTime":2615.107,"body":"low, uh, people who are older are going to be at greater risk of these"},{"startTime":2615.107,"endTime":2615.395,"body":"temperatures."},{"startTime":2615.395,"endTime":2616.835,"body":"So that's just a physiological fact."},{"startTime":2617.175,"endTime":2622.588,"body":"So we are gonna see more heat and cold related, all other things being really"},{"startTime":2622.588,"endTime":2625.475,"body":"equal disease, uh, because of the aging population."},{"startTime":2626.175,"endTime":2628.995,"body":"The other one, uh, is that is important is climate change."},{"startTime":2629.015,"endTime":2634.152,"body":"And for both of these, I've put here the IPCC report, which is a very"},{"startTime":2634.152,"endTime":2639.29,"body":"authoritative, uh, neutrally written, uh, not, uh, shrill, uh, report of the risks, uh, of"},{"startTime":2639.29,"endTime":2642.715,"body":"climate change and the science as it currently is understood"},{"startTime":2645.135,"endTime":2649.131,"body":"In terms of climate change effects in the uk we are going to have effects,"},{"startTime":2649.131,"endTime":2653.128,"body":"quite significant effects, some of which will make some of these things worse or significantly"},{"startTime":2653.128,"endTime":2653.395,"body":"worse."},{"startTime":2653.655,"endTime":2656.115,"body":"But of course, many other countries will have much bigger ones."},{"startTime":2656.895,"endTime":2660.645,"body":"So, uh, on the right, what we put, what I put here is, um, the"},{"startTime":2660.645,"endTime":2662.395,"body":"MET office is these aren't real measurements."},{"startTime":2662.395,"endTime":2666.675,"body":"This isn't a projection of warmer than average days and colder than average days."},{"startTime":2666.675,"endTime":2670.939,"body":"And as you can see, uh, the number of warmer than average days is steadily"},{"startTime":2670.939,"endTime":2672.645,"body":"increasing as, and that will continue."},{"startTime":2672.985,"endTime":2678.181,"body":"So with high confidence, we're gonna have a lot more hot days and therefore the"},{"startTime":2678.181,"endTime":2682.685,"body":"heat effects of, uh, uh, of health on health are going to increase."},{"startTime":2683.965,"endTime":2689.215,"body":"Additionally, high confidence, sea levels are gonna rise for a variety of reasons, and therefore"},{"startTime":2689.215,"endTime":2693.765,"body":"coastal flooding, uh, is, uh, going to increase in some areas high confidence."},{"startTime":2694.235,"endTime":2696.645,"body":"There's also gonna be some decrease in cooler days."},{"startTime":2697.515,"endTime":2702.845,"body":"High confidence, there's a lot more complexity to the effect on major storms."},{"startTime":2703.505,"endTime":2707.972,"body":"If I could summarize really crudely, uh, the frequency of them is unlikely to go"},{"startTime":2707.972,"endTime":2711.845,"body":"up, but the strength of many of them is likely to go up."},{"startTime":2712.425,"endTime":2716.314,"body":"But the impact in the UK is more complex to explain, and I think it's"},{"startTime":2716.314,"endTime":2719.685,"body":"sent and the science of this is still in my view, uh, progressing."},{"startTime":2719.685,"endTime":2723.405,"body":"So I think it's not easy to say with absolute confidence, but I think the"},{"startTime":2723.405,"endTime":2725.885,"body":"general view is, uh, some storms will get, uh, greater."},{"startTime":2726.305,"endTime":2729.685,"body":"Uh, but other countries will have probably bigger effects from this than we do."},{"startTime":2730.065,"endTime":2733.885,"body":"Uh, and we will likely get wetter winters as a result of this."},{"startTime":2735.145,"endTime":2741.342,"body":"But in many countries the effects will be very substantial indeed and particularly more marginal"},{"startTime":2741.342,"endTime":2747.539,"body":"areas already many countries have much greater extremes in the UK of heat, of dry,"},{"startTime":2747.539,"endTime":2749.605,"body":"of cold, uh, of wet."},{"startTime":2749.945,"endTime":2754.005,"body":"Uh, and for those areas, these changes can be catastrophic."},{"startTime":2754.305,"endTime":2756.205,"body":"So the impact on health and places like that."},{"startTime":2756.205,"endTime":2759.245,"body":"So health for example, is going to be really severe indeed."},{"startTime":2759.305,"endTime":2762.165,"body":"And that's before we get onto things like impact on agriculture."},{"startTime":2765.385,"endTime":2771.661,"body":"So my summary, uh, of where, uh, we are with, uh, cold heat, wind and"},{"startTime":2771.661,"endTime":2775.845,"body":"flood, um, death and disability from cold, uh, and heat."},{"startTime":2775.945,"endTime":2781.095,"body":"And in some areas of the world, winter and wind and flood are common and"},{"startTime":2781.095,"endTime":2786.245,"body":"I think more common than most people realize, measured in the thousands and tens of"},{"startTime":2786.245,"endTime":2790.365,"body":"thousands, even here in the uk, uh, more, uh, significantly more elsewhere."},{"startTime":2791.905,"endTime":2794.805,"body":"The old and the very young are the major risk factors."},{"startTime":2794.865,"endTime":2798.125,"body":"But some other medical conditions make these risks also greater."},{"startTime":2799.715,"endTime":2805.434,"body":"High income, both as an individual and as a society can provide a lot of"},{"startTime":2805.434,"endTime":2808.485,"body":"additional protection, largely due to good engineering solutions."},{"startTime":2808.795,"endTime":2812.325,"body":"They will reduce these risks, but definitely not to zero."},{"startTime":2813.305,"endTime":2819.168,"body":"Uh, clearly many countries have much greater extremes than the uk uh, and these are"},{"startTime":2819.168,"endTime":2825.032,"body":"going to get more severe as climate change steadily progresses over the rest of this"},{"startTime":2825.032,"endTime":2826.205,"body":"century and beyond."},{"startTime":2827.105,"endTime":2832.659,"body":"And I think the one thing I would say, and this is true for all"},{"startTime":2832.659,"endTime":2838.213,"body":"three of the talks I gave in this, uh, series where I start off with,"},{"startTime":2838.213,"endTime":2843.768,"body":"um, the medical emergencies come from man created, human created, uh, things radiological, nuclear chemical,"},{"startTime":2843.768,"endTime":2849.322,"body":"moved on to the major geophysical ones, tsunamis, earthquakes, volcanoes, uh, but uh, actually the"},{"startTime":2849.322,"endTime":2852.285,"body":"more, the most common than the weather related."},{"startTime":2852.545,"endTime":2857.485,"body":"And in due course climate related ones, it usually seems unlikely until it happens."},{"startTime":2857.985,"endTime":2862.958,"body":"And at that point, uh, people uh, really do notice and wish greater preparation, uh,"},{"startTime":2862.958,"endTime":2864.285,"body":"had been made beforehand."},{"startTime":2864.865,"endTime":2865.645,"body":"Thanks very much."},{"startTime":2865.645,"endTime":2866.725,"body":"Happy to answer questions."},{"startTime":2875.695,"endTime":2876.685,"body":"Thank you very much Chris."},{"startTime":2876.945,"endTime":2882.322,"body":"Uh, with quite a few questions overlap that have come in online and they're essentially,"},{"startTime":2882.322,"endTime":2887.7,"body":"um, about how you influence policy because you, um, outlined the number of things we"},{"startTime":2887.7,"endTime":2891.285,"body":"might need to do to mitigate all of these stuff."},{"startTime":2892.115,"endTime":2896.323,"body":"They are, in a way, the way we're gonna look after all these young people"},{"startTime":2896.323,"endTime":2897.165,"body":"in the future."},{"startTime":2897.755,"endTime":2902.442,"body":"Some of us in the older generation need to be able to push somebody to"},{"startTime":2902.442,"endTime":2904.005,"body":"make the right leavers move."},{"startTime":2904.705,"endTime":2910.2,"body":"How, from your absolutely central experience in this, how is that done and how easy"},{"startTime":2910.2,"endTime":2912.765,"body":"is it to manipulate policy at scale?"},{"startTime":2914.715,"endTime":2919.837,"body":"Well, I think that, um, the most central thing for changing policy, uh, and I"},{"startTime":2919.837,"endTime":2924.959,"body":"think most people probably don't recognize this to be as true as it is, is"},{"startTime":2924.959,"endTime":2926.325,"body":"a centrality of evidence."},{"startTime":2926.945,"endTime":2931.962,"body":"If you have really good scientific evidence, which is incontrovertible and you can provide a"},{"startTime":2931.962,"endTime":2936.645,"body":"solution, very important, providing a problem without a solution is not a policy response."},{"startTime":2936.645,"endTime":2939.685,"body":"You've gotta provide a solution also based on evidence."},{"startTime":2940.475,"endTime":2947.421,"body":"Then most sensible politicians, whatever their political background, would eventually pay some attention to those"},{"startTime":2947.421,"endTime":2947.885,"body":"changes."},{"startTime":2949.115,"endTime":2952.925,"body":"Once someone has had an immediate emergency, if there's been a major flood, if there's"},{"startTime":2952.925,"endTime":2956.736,"body":"been a major heat wave, then people are much more alive to that problem for"},{"startTime":2956.736,"endTime":2957.245,"body":"a period."},{"startTime":2957.985,"endTime":2962.325,"body":"But I think we shouldn't exaggerate the length of time people remember about these things."},{"startTime":2962.705,"endTime":2966.699,"body":"And I'm not talking about, it's not a disparaging point about politicians, it's true about"},{"startTime":2966.699,"endTime":2967.765,"body":"society as a whole."},{"startTime":2967.945,"endTime":2969.565,"body":"People say, why, oh, why?"},{"startTime":2969.565,"endTime":2973.257,"body":"And isn't it terrible on day one and on, you know, day 60 they say"},{"startTime":2973.257,"endTime":2975.965,"body":"pretty terrible, but are you really gonna put up our taxes?"},{"startTime":2976.545,"endTime":2980.605,"body":"Uh, and on year two, year two people have moved on to another issue."},{"startTime":2981.025,"endTime":2983.725,"body":"So the key thing is you've got to have really clear evidence."},{"startTime":2983.985,"endTime":2985.885,"body":"You've got to be able to say this is what's gonna happen."},{"startTime":2985.915,"endTime":2986.645,"body":"When it does happen."},{"startTime":2986.665,"endTime":2988.565,"body":"You can then say, say that was what's gonna happen."},{"startTime":2988.565,"endTime":2992.246,"body":"That is what has happened and here is the solution and here's what it costs"},{"startTime":2992.246,"endTime":2993.965,"body":"because that's the final bit of it."},{"startTime":2994.465,"endTime":2999.652,"body":"Uh, generally government is about making hard choices between different things, all of which are"},{"startTime":2999.652,"endTime":3002.765,"body":"good to do and all of which cost resource."},{"startTime":3003.075,"endTime":3006.516,"body":"What we have to do is say, here's a big problem, here's a solution and"},{"startTime":3006.516,"endTime":3007.205,"body":"here's the cost."},{"startTime":3007.225,"endTime":3010.772,"body":"And if you don't do that, the implications in the long term are going to"},{"startTime":3010.772,"endTime":3011.245,"body":"be substantial."},{"startTime":3012.185,"endTime":3012.645,"body":"Oh, thank you."},{"startTime":3012.745,"endTime":3017.298,"body":"Um, much of what you've talked about future changes is, is extending some of our"},{"startTime":3017.298,"endTime":3021.245,"body":"understanding of climate change in terms of making the country hotter, climate hotter."},{"startTime":3021.825,"endTime":3025.725,"body":"But, um, I'm the victim of reading too many types of science and I often"},{"startTime":3025.725,"endTime":3029.625,"body":"see things talking about the amor currents in the oceans and also possibly the gulf"},{"startTime":3029.625,"endTime":3033.525,"body":"stream changing and doing quite the opposite, maybe up to 15 or even more degrees."},{"startTime":3034.955,"endTime":3038.565,"body":"Does that affect the advice that you feel, uh, you'd like government to listen to?"},{"startTime":3039.825,"endTime":3043.331,"body":"So I think with all of climate and I, I, I did actually wonder, well"},{"startTime":3043.331,"endTime":3046.605,"body":"I should do a whole talk on climate change 'cause it's a complex area."},{"startTime":3046.815,"endTime":3050.44,"body":"There are some things we're very confident of, some things we're less confident of and"},{"startTime":3050.44,"endTime":3051.165,"body":"some speculative stuff."},{"startTime":3051.675,"endTime":3056.766,"body":"Many of these areas are plausible, but I would say at this point in science,"},{"startTime":3056.766,"endTime":3057.445,"body":"pretty speculative."},{"startTime":3058.185,"endTime":3062.649,"body":"And therefore, if you were, if you were the prime minister or a political leader,"},{"startTime":3062.649,"endTime":3067.113,"body":"given a choice of making a sense of decisions about those and a set of"},{"startTime":3067.113,"endTime":3071.577,"body":"decisions about things which are definitely gonna happen, like there is gonna be a winter"},{"startTime":3071.577,"endTime":3076.041,"body":"excess in mortality next year for sure, then you are gonna tend to put your"},{"startTime":3076.041,"endTime":3078.125,"body":"concentration on these, uh, more immediate effects."},{"startTime":3078.625,"endTime":3082.606,"body":"As back to my previous answer, if the evidence grows that we're going to have"},{"startTime":3082.606,"endTime":3086.587,"body":"some of these tipping point or major effects at that point, I think there is"},{"startTime":3086.587,"endTime":3088.445,"body":"going to have to be a reevaluation."},{"startTime":3088.865,"endTime":3090.285,"body":"But they're quite a long way."},{"startTime":3090.405,"endTime":3093.565,"body":"I think from my view, from the central projection of where we're gonna be."},{"startTime":3093.625,"endTime":3097.87,"body":"And I tend to say, well, the IPCC has a very large number of really"},{"startTime":3097.87,"endTime":3099.285,"body":"expert people in this area."},{"startTime":3099.725,"endTime":3103.625,"body":"I tend to kind of follow their central projections as the people who've actually looked"},{"startTime":3103.625,"endTime":3107.525,"body":"at this, uh, collectively among the people who've got the right, the the right skills,"},{"startTime":3108.755,"endTime":3115.409,"body":"What would be your priority to change how, the list of numbers of things, for"},{"startTime":3115.409,"endTime":3119.845,"body":"instance, housing, where would you put your first policy initiative?"},{"startTime":3120.485,"endTime":3123.445,"body":"I think the, the, the very first one would be insulation."},{"startTime":3124.345,"endTime":3127.885,"body":"And I think it's shocking actually that we have not got better insulation."},{"startTime":3128.185,"endTime":3133.598,"body":"And this goes back decade, over many decades and several governments to be clear, uh,"},{"startTime":3133.598,"endTime":3139.011,"body":"getting our houses to the situation the norm for North Europe seems to me the,"},{"startTime":3139.011,"endTime":3144.424,"body":"the single most simple thing we can do is a capital investment and then means"},{"startTime":3144.424,"endTime":3149.837,"body":"we have, can use less energy to achieve better heat, uh, um, narrow ranges and"},{"startTime":3149.837,"endTime":3153.085,"body":"reduce fuel poverty, uh, as a result of that."},{"startTime":3153.345,"endTime":3154.525,"body":"So that would be my number one."},{"startTime":3154.785,"endTime":3159.508,"body":"If I was allowed as second, uh, it would be be systematic about reducing the"},{"startTime":3159.508,"endTime":3164.232,"body":"risks of infections in the oldest bits of the population by, uh, all the things"},{"startTime":3164.232,"endTime":3168.956,"body":"we know work, uh, of which, um, uh, vaccination, air pollution reductions, uh, and ventilation"},{"startTime":3168.956,"endTime":3173.365,"body":"in public buildings would probably be the group of things I would concentrate on."},{"startTime":3173.365,"endTime":3174.445,"body":"But there is quite a long list."},{"startTime":3174.675,"endTime":3177.365,"body":"They're all achievable and I want to be clear about that."},{"startTime":3177.675,"endTime":3181.205,"body":"None of these are in any sense, sort of pie in the sky."},{"startTime":3181.235,"endTime":3182.845,"body":"Yeah, it'd be lovely to have if we could do it."},{"startTime":3182.915,"endTime":3184.325,"body":"They're perfectly straightforward."},{"startTime":3184.345,"endTime":3187.525,"body":"If we wanted to invest in insulation, we certainly could do so."},{"startTime":3188.015,"endTime":3193.807,"body":"There was a, a cricketer on the radio this week who had been, um, playing"},{"startTime":3193.807,"endTime":3196.125,"body":"cricket I think in um, Pakistan."},{"startTime":3196.785,"endTime":3201.325,"body":"And the temperature was 40 degrees, the humidity was over 90%."},{"startTime":3201.985,"endTime":3208.245,"body":"He was running and um, out there for eight hours in the baking heat."},{"startTime":3209.305,"endTime":3212.485,"body":"Should sporting authorities stop that?"},{"startTime":3213.705,"endTime":3217.43,"body":"Um, well I think firstly, as I said right at the beginning, people who live"},{"startTime":3217.43,"endTime":3221.156,"body":"in very hot or very cold climates are climatized to those over a period of"},{"startTime":3221.156,"endTime":3221.405,"body":"time."},{"startTime":3222.105,"endTime":3227.108,"body":"And if you're a young and healthy person, very fit as all these sports people"},{"startTime":3227.108,"endTime":3232.111,"body":"are, um, they will tolerate a degree of, uh, those issues which you wouldn't otherwise"},{"startTime":3232.111,"endTime":3232.445,"body":"expect."},{"startTime":3232.745,"endTime":3234.485,"body":"But there has to be an upper level of tolerance."},{"startTime":3234.545,"endTime":3240.33,"body":"And I talked about, for example, special forces, uh, soldiers in the UK going over"},{"startTime":3240.33,"endTime":3242.645,"body":"their really, uh, demanding grueling courses."},{"startTime":3243.195,"endTime":3247.648,"body":"There's a, even for them, there is an upper level of tolerance where the risk"},{"startTime":3247.648,"endTime":3251.805,"body":"of someone getting heat stroke is so great that, uh, people will pull back."},{"startTime":3251.825,"endTime":3255.465,"body":"And I think the same would be true at the extremes of sport, but of"},{"startTime":3255.465,"endTime":3259.106,"body":"course the kinds of temperatures we're talking about would not be tolerated by the same"},{"startTime":3259.106,"endTime":3260.805,"body":"cricketer when he is in his nineties."},{"startTime":3261.225,"endTime":3265.662,"body":"So you have to realize that you are particularly the biggest worry tends to be"},{"startTime":3265.662,"endTime":3268.325,"body":"people who are in the, uh, extremes of age."},{"startTime":3268.735,"endTime":3271.045,"body":"Again, professor Chris Wii, thank you so much."}]}