Colin Greene column: How to prevent heat-related illnesses

Originally posted at

girl in poolAlthough it won’t officially be summer for another month, many Virginians already are facing some days of extremely hot weather. What follows are some recommendations on staying safe in the heat.

Every year, more than 600 people in the U.S. die of heat-related illnesses, and many others experience hospitalization. It is crucial to ensure that we take precautions against heat injury.

Your body has several ways of getting rid of excess heat. The first is to release it into the air (or water) around you from your skin, and to dilate the blood vessels beneath your skin to carry more internal heat to the surface to be released.

The second occurs through breathing, where body-temperature air is exhaled and replaced by cooler inhaled air. The third — and perhaps most important — is through sweating. Water in sweat evaporates, taking heat with it and cooling the skin.

When the body can’t shed enough heat, its core temperature starts to rise, and serious danger can follow. Heat cramps might occur, where muscle pain develops, often after overexertion in the heat. Heat exhaustion might follow, with excessive sweating; cool, clammy skin; extreme fatigue; headache; muscle cramps; nausea or vomiting; dizziness or lightheadedness; confusion; and darker-colored or decreased urination.

Heat stroke is the most serious outcome, where the body’s cooling systems have been overwhelmed. The body temperature rises to 105 degrees Fahrenheit or higher; the skin becomes warm and dry; and rapid heart rate, shallow breathing and significant mental status changes occur. This might lead to permanent brain and organ injury, coma and death.

Extreme heat is especially dangerous in humid climates. As the air temperature approaches body temperature, it becomes harder for the skin or breath to release body heat. In high humidity, sweat evaporates very slowly, losing much of its cooling effect.

Dehydration occurs as body fluid is lost through sweating and evaporation. In turn, dehydration makes it harder to sweat, and increases risk of organ damage due to loss of blood flow.

The best way to avoid heat injury is prevention. Here are few tips from an old soldier, who now is your state health commissioner:

  • Be aware of the weather forecast for any given summer day, and plan ahead. (P.S. This is good advice all year round.)
  • For particularly hot, humid days, limit outdoor activity. Stay in an air-conditioned location as much as possible, and if you will be outdoors, frequently seek shade. Wear light-colored clothing and wide-brimmed hats to reflect the sun’s rays. Apply sunscreen to exposed skin.
  • Limit or postpone outdoor exertion. The hotter it gets, the more time resting (in shade) you need and the less time you should spend working. Play, such as sports or hiking, counts just as much as work.
  • Hydrate, hydrate, hydrate. If you will be outdoors, plan on drinking a quart of fluid every hour or so. Alternating water with a sports-type drink often works best. Skip the caffeine and alcohol: Both of these increase urination and dehydration.

Don’t wait to feel thirsty.

  • Drink fluids on a schedule when you’re outdoors in the heat.
  • Don’t skip meals, especially breakfast. There is water in your food as well as in your drink.
  • Have a buddy, and watch out for each other while in the heat. Include weather in your work planning.
  • Be a buddy, especially to elderly or disadvantaged neighbors, who might not have air conditioning. Check up on them; offer them access to AC during the heat. Homeless people are especially at risk.
  • Never leave children or animals alone in vehicles.

For mild symptoms, in yourself or your buddy:

  • Get out of the heat, into an air-conditioned space if possible, but into the shade as a minimum.
  • Rest in a cool area until symptoms completely resolve.
  • Drink water or sports drinks, as discussed above.
  • Consider calling it quits for the day for any more outdoor exertion.

For any concern of heat stroke (changes in level of consciousness; disorientation or confusion; warm, dry skin without sweating despite the heat):

  • Dial 911 immediately.
  • Cool the victim down as effectively as possible: move to shade/indoors, wet down with water and fan the body.
  • Only give fluids by mouth if fully conscious and oriented.
  • Get to medical attention as soon as physically possible.

Heat is part of summer — and sometimes late spring — but it can be dangerous if not treated with respect. Let’s prevent heat injuries in our commonwealth.

Infant Formula Shortage Information

Fact Sheet: Helping Families Find Formula During the Infant Formula Shortage (from the U.S. Department of Health and Human Services) 
This fact sheet includes information regarding:

  • Manufacturer Hotlines
  • Community Resources
  • WIC -Eligible Families
  • General Guidance

Infant Formula Shortages: Tips on what to do when you can’t find formula at the store (En Espanol)
Visit from the American Academy of Pediatrics for more information regarding healthy children

Other Resources:


(RICHMOND, Va.) – During the COVID-19 pandemic, Virginia’s Emergency Medical Services (EMS) providers have been challenged beyond measure and continue to provide emergency care with the utmost expertise and professionalism. Last year, EMS providers responded to more than 1.59 million calls for help in Virginia, which represents approximately 4,360 incidents per day.

As proclaimed by Governor Glenn Youngkin, May 15-21 is EMS Week in Virginia. This special week honors EMS responders’ commitment to administering the best prehospital emergency medical care to all people in Virginia. EMS for Children Day, May 18, emphasizes the pediatric patient and their required specialized treatment. This year’s EMS Week theme is “Rising to the Challenge,” and Virginia’s first responders have proven time and again their ability to deliver quality lifesaving emergency care to people in need of help.

“The finest hospital facilities in the world don’t help if you can’t get to them,” said State Health Commissioner Colin M. Greene, MD, MPH. “Emergency Medical Service providers bring that access to all, through their dedication, courage and selfless service to their communities. We owe them recognition not just this week, but every week.”

“These past few years have demonstrated Virginia’s EMS providers determination and ability to adapt and respond to various emergency situations presented by the ongoing pandemic,” said Gary Brown, director of the Virginia Department of Health Office of EMS. “I am always so impressed and proud of our well-trained and educated EMS providers, and commend their perseverance and commitment to saving lives during these challenging times.”

During EMS Week, Virginia EMS agencies may host community activities, including first aid classes, health and safety fairs, open houses and more. These family-friendly events encourage citizens to meet and greet the first responders in their neighborhoods. Due to the pandemic, EMS Week community activities may be limited. Please check their websites or social media pages for additional information.

In recognition of Virginia’s fallen fire and EMS personnel, the Virginia Fallen Firefighters and EMS Memorial Service honors fire and EMS responders who died in the line of duty and those who risk their lives daily to serve and protect Virginians. The Annual Fallen Firefighters and EMS Memorial Service will be held June 4 at noon at the Richmond International Raceway.

To learn more about the Virginia Department of Health Office of EMS, visit

EMS Week in Virginia, May 15-21, 2022

Virginians rely on Emergency Medical Services (EMS) personnel to respond to the call for help and to provide quality prehospital care during their greatest time of need. National EMS Week is May 15 – 21, 2022. EMS for Children Day, May 18, focuses on the pediatric patient and the specialized care required when providing treatment to them.

EMS Week recognizes the dedication of 37,758 EMS providers and 564 agencies in Virginia. We commend their continued efforts to provide lifesaving care and their commitment to the EMS system. During the COVID-19 pandemic, Virginia’s Emergency Medical Services (EMS) providers have been challenged beyond measure and continue to provide emergency care with the utmost expertise and professionalism. Last year, EMS providers responded to more than 1.59 million calls for help in Virginia, which represents approximately 4,360 incidents per day.

Virginia Department of Health To Retire Several COVID-19 Dashboards – Goal is to Streamline Data Presentation, Conform to CDC Data Reporting

(RICHMOND, VA) — On Thursday, May 19, four Virginia Department of Health (VDH) COVID-19 dashboards will be retired from public view, along with two data landing pages.

These retirements will streamline the dashboards available, align better with the data presentation of the Centers for Disease Control and Prevention (CDC), and allow focus on actionable data. The dashboards and landing pages that will be retired include the following:

The CDC dashboard is considered the standard when it comes to cases by vaccination status, as the definition of vaccination status is rapidly changing nationwide. To stay in alignment with CDC data and keeping in sync with what other states have done, VDH will link to the CDC dashboard when the Cases by Vaccination Status dashboard is retired. Virginia’s vaccination data is expected to be included in the CDC dashboard this summer, and the dataset also will be archived on the Virginia Open Data Portal,

Reasons for the retirement for the Federal Vaccine Doses and Vaccines Received dashboards include the following: vaccines now are widely available; there is reduced interest in these data; and the rate of change is small. The Vaccines Received accompanying dataset will be archived on the Virginia Open Data Portal. There is no accompanying dataset on the Data Portal for the Federal Vaccine Doses dashboard.

The Cases and Deaths by Date Reported dashboard is redundant with the Cases Dashboard and of less interest as date of illness onset and death date are the focus at this time. These changes are in alignment with the changes made in March 2022. There is no accompanying dataset specific to this dashboard on the Virginia Open Data Portal.

VDH also plans to entirely retire the dashboard landing pages for the Level of Community Transmission and Locality dashboards since these were retired in early March 2022. The pages already point to the CDC COVID-19 Community Levels and the VDH Cases dashboards.

Severe Weather Preparedness

severe weather sign

Understand Severe Weather Terms

Understanding severe weather terms can help you and your loved ones prepare.

  • Hurricane Warning: show the onset of hurricane conditions expected in the warning area within the next 48 hours.
    • During a hurricane warning: complete storm preparation;
    • leave the affected area if directed by local officials.
  • Hurricane Watch: issued when a hurricane with sustained winds of 74 mph (65 knots, 118 km/h) or higher is possible.
  • Severe Thunderstorm Watch: there is a possibility that severe thunderstorms may occur in your area.
  • Severe Thunderstorm Warning: a severe thunderstorm is occurring or will likely occur soon in your area.
  • Flash Flood Watch: due to heavy or excessive rainfall in a short period of time, your area may experience flooding.
  • Flash Flood Warning: Flash flooding is in progress, imminent, or highly likely. Seek higher ground immediately or evacuate if directed to do so.
  • Tornado Watch: Tornadoes are possible in your area. Remain alert for approaching storms.
  • Tornado Warning: A tornado has been sighted or indicated by weather radar. Take shelter immediately.

Prepare For Severe Weather

Download the Ready Virginia mobile app to stay up to date on changing conditions.  More steps that you can take to keep yourself and loved ones safe include:

  • An emergency kit prepared with supplies. Include things such as:
    • Alternate fuel source for heating your home,
    • Flashlights and batteries,
    • Blankets,
    • Food that needs no cooking or refrigeration,
    • 3 day supply of water,
    • Prescription medicines,
    • Battery operated radio,
    • Flashlights, and
    • Cell phone chargers.
  • Prepare your car with emergency supplies. Have maintenance service on your vehicle as often as the manufacturer recommends.
  • Check batteries in smoke detectors and carbon monoxide monitors.
  • Update important documents: insurance information and home inventory. Store them in your emergency kit or a waterproof container.


Know What To Do During Severe Weather:

2022 County Health Rankings Show How Virginia Continues to Improve – Report ranks localities in Virginia by health outcomes and health factors

(Richmond, Va.) — Falls Church city ranks as the healthiest locality in Virginia and Petersburg city ranks as the least, according to new County Health Rankings data published today by the University of Wisconsin Population Health Institute. The report ranks localities in Virginia by health outcomes and the underlying factors that influence health. The health rankings are available at

This year’s report focuses on the importance of economic security for all communities, especially as we recover from the COVID-19 pandemic.  As a result, six new measures were introduced. One is childcare cost burden, which can pose a threat to economic security for families.  In Virginia’s counties, it ranges from 14 to 36 percent. According to the report, the typical cost burden of childcare among U.S. counties is about 25 percent of household income, higher than the U.S. Department of Health and Human Services’ benchmark of seven percent.

Another new health measure included in the report is COVID-19 deaths in 2020.  Virginia’s rate, 56 deaths per 100,000 people, is lower than the national rate of 85 per 100,000. Only 79 percent (103) of Virginia’s localities were included in this measure; 26 percent of them exceeded the national average.

An additional measure that is important as Virginia recovers from the pandemic is the average number of “mentally unhealthy days” people reported in the past 30 days. At 4.2 days, Virginia is slightly better than the national average of 4.5 days. Virginia’s counties ranged from 3.3 to 5.8 days. Mental health outcomes are an important measure because untreated mental health disorders have a serious impact on physical health and are associated with the prevalence, progression, and outcome of some of today’s most pressing chronic diseases.

“The results of the study make it clear that health disparities and inequities occur, not only between regions of the Commonwealth, but also within localities, even the wealthy ones,” said State Health Commissioner Colin M. Greene, MD, MPH. “While change in health-influencing factors takes time, the Virginia Department of Health is committed to supporting its local health departments and focusing on improving the health and well-being of all people in Virginia. We will be taking an analytical, evidence-based look at all of these factors, and incorporating them into the next state health improvement plan, Virginia’s Plan for Well-Being, with the intent of improving measurable health outcomes that truly matter to Virginians.”

For more information on the 2022 County Health Rankings, visit For more information on public health resources throughout Virginia, visit

Governor Youngkin and the Virginia Department of Health Recognize April 4-10 as National Public Health Week

Governor of Virginia Glenn Youngkin has released a proclamation recognizing April 4-10, 2022 as National Public Health Week. This week allows us time to formally recognize the amazing efforts that the staff of the Virginia Department of Health (VDH), and the citizens of Virginia perform to keep themselves and others safe and healthy.

The American Public Health Association’s national theme, “Public Health is Where You Are”, focuses on how our interactions as a community are the foundation for building a healthy population. The VDH regularly collaborates with both public and private sector partners to build strong healthy communities in Virginia.

During this week the VDH has launched its “I Am Public Health Campaign” which showcases how each person is instrumental in creating and maintaining a healthy population. The campaign seeks to inform the general public that VDH performs a wide array of functions including and beyond COVID prevention, while celebrating the role of the public health worker.


Virginia Earns National Recognition as One of the States Best Prepared for Public Health Emergencies

Two Years into the COVID-19 Pandemic, the Commonwealth is Again Ranked in the Top Tier of States in Trust for America’s Health – Ready or Not 2022 Annual Report on Public Health Emergency Preparedness

RICHMOND, VA – For several years running, Virginia has been recognized among the states best prepared to respond to public health emergencies. That trend continues in the latest report by Trust for America’s Health, Ready or Not 2022: Protecting the Public’s Health from Diseases, Disasters and Bioterrorism, which again places Virginia in the top tier of states. The report measures state levels of preparedness to respond to a wide range of health emergencies including infectious outbreaks, natural disasters, and manmade events.

Several recent Trust for America’s Health reports – which also ranked Virginia in the top tier of states in 2021 and 2020 – have been compiled during the ongoing response to the COVID-19 pandemic. In recent years, the Commonwealth has also been ranked among the top states in the National Health Security Preparedness Index (NHPSI) report that evaluates state readiness to respond to public health emergencies.

“This ongoing and repeated validation of Virginia’s public health emergency preparedness is a testament to the hard work of the thousands of employees of the Virginia Department of Health who day in and day out are focused on protecting the health and promoting the well-being of Virginians,” said Acting State Health Commissioner Colin M. Greene, MD, MPH. “Our ongoing attention to preparedness means that when we are faced with situations such as this pandemic or severe weather events or calculated attacks, we have systems, guidance, relationships and community partnerships in place to launch a comprehensive response.”

“Virginia’s hospitals are critical partners in the Commonwealth’s emergency preparedness infrastructure and essential providers of life-saving care to patients, including those whose well-being is compromised by public health emergencies,” said Virginia Hospital & Healthcare Association (VHHA) President and CEO Sean T. Connaughton. “The pandemic has been a real-world stress test of our health care delivery system and its level of emergency readiness. While there are always opportunities to improve, it is gratifying to see that Virginia’s commitment to preparedness continues to place us among the top states in the nation.”

Earlier this month, Virginia marked the two-year anniversary (March 7, 2020) of the first confirmed COVID-19 case in the Commonwealth. Since then, Virginia’s public health agencies, private health care providers such as hospitals and health systems, and many other stakeholders have risen to meet the challenge of a global pandemic. Virginia has recorded more than 1.65 million COVID-19 cases, resulting in more than 105,600 hospitalizations.

When vaccine doses became available, the Commonwealth mobilized public and private sector resources to rapidly get shots in arms – nearly 7 million Virginians have received at least one vaccine dose (hospitals have administered more than 2 million doses) and more than 72 percent of the eligible Virginia population is fully vaccinated. The Virginia Department of Health (VDH), local health districts, hospitals, nursing homes, pharmacies, and other partners have also supported efforts to respond to pandemic surges, outbreaks, and other evolving circumstances through testing, treatment, vaccination, telehealth consultations, and other strategic approaches.

The Ready or Not 2022: Protecting the Public’s Health from Diseases, Disasters, and Bioterrorism report examines a variety of factors to determine ratings including the level of preparedness to respond to wide-ranging health emergencies and provide public health services such as disease surveillance, seasonal flu vaccination, safe water, and expanded health care services in those situations. The report is also intended to serve as a tool to provide policymakers with data that can be used to support improvements and investments in state emergency readiness.

Unvaccinated individuals remain at the highest risk of severe illness and hospitalization due to COVID-19. This population remains VDH’s top priority. Everyone 5 years or older is eligible to be vaccinated. To find free vaccines near you, visit or call 877-VAX-IN-VA (877-829-4682, TTY users call 7-1-1). Assistance is available in English, Spanish, and more than 100 other languages.

About VDH: The mission of the Virginia Department of Health is to protect the health and promote the well-being of all people in Virginia. VDH Central Offices and a network of 35 Local Health Districts serve Virginia communities. Learn more at  Connect with VDH through FacebookTwitterYouTubeLinkedIn, and Instagram.

About VHHA: The Virginia Hospital & Healthcare Association is an alliance of 110 hospitals and 25 health delivery systems that develops and advocates for sound health care policy in the Commonwealth. Its mission is to achieve excellence in both health care and health to make Virginia the healthiest state in the nation. Its vision is through collaboration with members and stakeholders, to ensure the sustainability of Virginia health care system, transform the delivery of care to promote lower costs and high value across the continuum of care, and to improve health for all Virginians. Connect with VHHA through FacebookTwitterYouTubeLinkedIn, and Instagram.

Reflecting on two years of the COVID-19 pandemic

Read this article from Acting State Health Commissioner Colin M. Greene, MD, MPH, reflecting on two years of the COVID-19 pandemic:

​To find a free vaccination opportunity near you, visit the Vaccinate Virginia website at or call the Vaccinate Virginia call center at (877) VAX-IN-VA or (877) 829-4682, Monday through Friday, 8 a.m. to 6 p.m. T-T-Y users may call 7-1-1.