A sweltering Saturday with 16 cities on red alert; mortality rates rising among the very elderly

On Friday and Saturday, 16 Italian cities are under a ‘red alert’ for heat, with the highest alert level affecting Bologna, Brescia, Campobasso, Civitavecchia, Florence, Frosinone, Genoa, Latina, Milan, Palermo, Perugia, Pescara, Rieti, Rome, Turin and Viterbo; seven cities are on ‘orange alert’: Bari, Catania, Messina, Naples, Reggio Calabria, Venice and Verona; four cities are on ‘yellow alert’: Ancona, Bolzano, Cagliari and Trieste. On Sunday, the number of cities on ‘red alert’ will fall to 14.

Meanwhile, whilst the Old Continent is grappling with extreme temperatures, there has also been an excess mortality linked to the heat in our country. This phenomenon has so far claimed nearly 10,000 lives across five European countries. However, in Italy, the increase in deaths so far has been limited to 3 per cent and is confined to the very elderly. This is what emerged from the latest meeting of the steering committee set up under the Ministry of Health’s National Operational Plan on the Effects of Heat, which also reported that last June was “the second hottest on record”.

During the meeting at the Ministry of Health, data covering the period 25 May to 30 June were analysed with the support of the Department of Epidemiology of the Lazio Regional Health Service (Dep). It should also be noted that, both globally and across Europe, June 2026 was the second hottest on record. Heatwave warning systems in Italia forecast risk levels 2 and 3 (orange and red alerts) from 18 June until the end of the month, with an average of 10 days in the North, 10 in the Centre and 4 in the South. The Ministry highlights the case of the city of Turin: here, there were 23 days with alert levels 2 and 3 during the reference period, accounting for 63 per cent of the total. Analysis of surveillance data on daily mortality among the over-65s showed, across all the cities considered, “that the average excess mortality was modest (3 per cent), even when compared with figures from other European countries”. In Italia, this phenomenon was limited to those aged over 85, the so-called ‘very elderly’. During the second and most intense heatwave (18–30 June), the data confirmed a statistically significant excess mortality among the over-65s in Turin. What now? Whilst the heatwave bulletin suggests difficult days ahead, the public helpline 1500 has already received over a thousand calls. As for visits to A&E departments, no significant changes have been reported during the days of extreme heat, “apart from slight increases in Venice, Milan and Palermo”, the Ministry clarifies.

In light of all these figures, FIASO (the Italian Federation of Healthcare and Hospital Organisations), which attended the meeting at the Ministry of Health, has reaffirmed the commitment of healthcare facilities across the peninsula to the continuous and comprehensive monitoring of the effects of heatwaves on the population. The data and the vulnerability of the very elderly “confirm the need to strengthen the involvement of local authorities and to ensure that health and social-healthcare measures are increasingly integrated with social services”. Particular attention is being paid to elderly people living alone and those at risk of isolation. “In these cases, health fragility is intertwined with social fragility and requires a coordinated response.” Meanwhile, bad news has emerged from WHO Europe: the Old Continent is the region warming most rapidly, with temperatures rising at roughly twice the global average rate. Extreme heat now poses a growing threat to public health. And things will get worse year on year. Preliminary data, drawn from just five European countries, already show nearly 10,000 additional deaths due to the heat.

 In light of the continuing extreme temperatures, the Federation of Associations of Hospital Internal Medicine Directors (Fadoi) is drawing attention to the health risks, particularly for the elderly, vulnerable people and patients with chronic conditions. “Temperatures of 35 degrees are no longer the exception. Our bodies have very effective mechanisms for maintaining a constant body temperature, but when the heat is combined with high humidity, these systems are put under severe strain. We lose fluids and minerals, the heart has to work harder, and fatigue, weakness and drops in blood pressure set in,” explains Andrea Montagnani, Fadoi’s national president. According to hospital internists, the risk increases further when temperatures reach or exceed 40 degrees. “Under these conditions, the body may no longer be able to dissipate heat,” warns Montagnani. “The body’s internal temperature rises and severe dehydration, changes in blood pressure and mental confusion may occur, potentially leading to heatstroke, which is a genuine medical emergency as it can compromise the functioning of the brain, heart and kidneys and requires immediate intervention,” emphasises Montagnani. Furthermore, when the heat persists for many consecutive days, “the body can no longer recover, especially if night-time temperatures also remain high. Progressive dehydration sets in, cardiovascular stress increases, and we see a rise in hospital admissions for heart failure, kidney failure, infections and respiratory complications”.