As a light warm breeze blew through her living room and her gray hair, Donata Grillo, a 75-year-old cancer survivor with a pacemaker and severe vision problems, sat by her balcony, a wet sponge on her lap.
It was all she had to stay cool this week as temperatures topped nearly 106 degrees Fahrenheit, or 41. Celsius, in her native Rome. She has no air conditioning or fans, or even a working refrigerator, in her two-bedroom apartment in a public housing complex on the outskirts of town, next to a hospital and a highway.
“It’s the feeling of stretching dough all day,” Ms. Grillo said, turning her hands to mimic pouring boiling water from a pot. A visit from a social worker was about the only contact she had for days, the heat turning her inside.
“Don’t go anywhere, it’s too hot and dangerous for you,” Carlotta Antonelli, 28, who works with the Roman Catholic charity Caritas, told her on Wednesday.
The back-to-back heat waves that have scorched Italy and the rest of southern Europe over the past week have forced those who can afford it to seek shelter in air-conditioned homes and offices or at seaside retreats. But for many seniors, heat has become the new Covid. The scorching temperatures have settled over the continent like another indiscriminate plague, increasing the isolation of many elderly people and the threats to their health, and pushing governments and social services to take extraordinary steps to try to protect them.
“These days, they’re even more alone,” Ms. Antonelli said as she drove her car through two large, poor suburban areas where her charity routinely helps dozens of residents. She visits Ms. Grillo once a week to help her with daily tasks and help with medical appointments and legal issues.
As temperatures rise, the threat to Europe’s elderly is now widespread, with southern European nations joining others as far north as Belgium in setting up heat-relief plans, many aimed at protecting older populations.
For Italy, the extreme heat forged a pincer with the country’s most pressing demographic trend – an aging population – to present an especially acute crisis. About 24 percent of Italians are over 65, making it the oldest country in Europe, and more than 4 million of them live alone.
Last year, Italy was exposed to extreme temperatures longer than most other European countries, enduring three major heat waves. Almost 30 percent of the 61,000 people estimated to have died last summer from extreme heat in Europe were Italian, with age playing a significant factor. The number of Italians over 80 is now around 4.5 million, almost twice as much as 20 years ago.
“Elderly people with pre-existing diseases are more vulnerable,” said Andrea Ungar, the president of the Italian Society of Gerontology and Geriatrics, in a telephone interview. “But poverty and isolation also play a crucial role.”
Europe’s hottest summer on record, in 2003, left more than 70,000 people dead, according to some estimates, and since then Italy has only gotten older. It struggled to adapt.
“It was hot even before 2003 in Italy, and we already had a large population of elderly people, but not like now,” said Francesca De Donato, the epidemiologist whose department collects meteorological and demographic data from around the country to publish the daily bulletins. for heat-related health warnings, tailored by city.
“The quota of people at risk has been constantly growing here,” noted Mrs. De Donato.
After 2003, Italy became one of the first countries in Europe to put in place a national plan to mitigate the impact of extreme heat, based on the guidelines of the World Health Organization.
The measures include an alarm system to warn people to modify their behavior to protect their health. Authorities have recently urged hospitals and GPs to pay special attention to the most vulnerable people, and they have set up a freephone number where people can seek advice or help for heat problems.
Days like Wednesday, when the heat wave peaked, are marked in red on the daily bulletin that Italy’s Health Ministry issues to warn residents. Television channels periodically broadcast the ministry’s guidelines, advising people to stay indoors during the hottest hours; wear light clothing and sunscreen; drink plenty of water, eat fresh fruit and avoid coffee and alcoholic beverages; and be extra careful when out.
France, which was largely spared the heat waves this summer, has a heat tax to fund programs to protect its most vulnerable people, including regular phone check-ins or personal visits during heat waves. It also has a heat alarm system, or “floor alarm”, which successive governments have activated every summer since 2003.
The hottest summer on record killed 15,000 in France, most of them elderly, living alone in city apartments or nursing homes without air conditioning. Last summer, when consecutive heatwaves hit the country, more than 2,800 French people died, about 80 percent over 75 years old, according to the French public health authority.
As rising temperatures creep north to countries less used to them, Belgium has set up a three-stage warming plan, based on regular monitoring of temperature and ozone levels. In Brussels, the elderly and those who feel isolated or vulnerable can register by phone with city authorities, who will regularly check on them as soon as temperatures rise above 84 Fahrenheit. The social workers distribute fluids and monitor living conditions. However, Belgium’s excess death rate rose to 5.7 percent during the hottest months last summer, the highest in 20 years.
In Greece, the country’s archaeological sites will be closed between noon and 5:30 p.m. until Sunday, when temperatures are set to reach 111 in Athens. The Ministry for Civil Protection said that all government services are “in increased readiness to deal with the consequences of high temperatures.”
There, as elsewhere, the advice of the authorities amounts to a simple imperative: Stay at home. This placed a special duty on governments and social workers to ensure that isolation itself did not become a danger.
In Rome, a team of regional health professionals checks in with phone calls with the most vulnerable people, mostly the elderly and sick, on days marked orange or red for the most severe heat.
While the hardship and isolation of the most vulnerable in many ways echoes the fight against Covid, the pandemic has also left some good practices in place, including visiting and treating people in their homes, health officials said. A 2022 law, approved by the government of the former prime minister, Mario Draghi, pushed for better coordination between health services and telemedicine. Italian health authorities are working to have one digital platform with up-to-date patient information that visiting nurses, doctors, emergency services and hospitals can access.
“Covid changed the mindset about some services, and that helped a lot,” said Andrea Barbara, a public health official who oversees services for about a million residents in Rome. “We are doing more telemedicine, we are increasingly moving equipment – and not the patients – but it takes time.”
Even those who do not need medical help, the help remains crucial and, for many vulnerable people, associations like Caritas are still the most reliable weekly help. Mrs. Antonelli, the social worker, carried two boxes of slightly sparkling water up two flights of stairs for Francesca Azzarita, 91, who lives alone with nothing to cool herself except a piece of cardboard to use as a fan.
“Carlotta, when you don’t come, I feel like I’m lost,” said Mrs. Azzarita in a thick Neapolitan accent that she hasn’t lost despite living in Rome for nearly 50 years.
Mrs. Azzarita, a little girl when the Second World War broke out, never learned to read and write and worked all her life, first in the countryside around Naples and then as a cleaner in Rome, where she moved after separating from her husband.
Now her morning starts with coffee and painkillers for her aching legs. She usually cooks for herself, but today, she doesn’t turn on the oven because it’s too hot and she rarely leaves her home, especially after she fell on the sidewalk last week.
“The temperatures have changed since I was a girl,” she said. “I don’t need to watch TV to know that the rain was normal and the sun was normal, and now it’s not.”
She then glanced at Mrs. Antonelli, still panting from the stairs. “How would I do without her help?” she said.
Niki Kitsantonis contributed reporting from Athens, Catherine Porter from Paris and Monica Pronczuk from Brussels.