Drinking cold water during heatwaves WON’T kill you. Another heatstroke hoax debunked | FACT-CHECK

Imagine being on the top of a mobile tower on a scorching afternoon with temperatures soaring above 42 degrees Celsius. Dizziness takes over as the body grows weak by the second. As the piercing sunlight, takes your consciousness away, there is not much to do but to stay tight and hope help to arrive fast. 

This is no story but what really happened to a worker in Kerala’s Palakkad district. The man was spotted unable to respond on the tower and was brought down using a crane, a doctor who treated him for sunstroke later the day said. He was unconscious on arrival, burning at 106 degrees Fahrenheit, and was quickly intubated. He had suffered a sunstroke, an extreme case of hypothermic disorder.

man offers water to another on a hot summer day, near the Taj Mahal | PTI

man offers water to another on a hot summer day, near the Taj Mahal | PTI

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A thin line separates misinformation from disinformation. The margin further frails when it comes to healthcare. The public falling for groundless claims circulated over the internet produces a negative effect on measures taken on the ground. During the COVID pandemic, medical experts worldwide battled such perpetuated beliefs that led to vaccine avoidance, mask refusal, and consumption of unlicensed medications and conspiracy theories ultimately causing increased morbidity. 

One such bogus claim, though maliciously inferior in comparison to those of the pandemic era, has been doing rounds on social media circles amidst the prevailing heatwave conditions. It warns people against consuming chilled water immediately after returning from the sun. Drinking fluids kept in a refrigerator can harm the consumer’s life as a result of his/her body reacting to the temperature, it says. The ice-cold water can cause the blood vessels in the throat to burst, which can even cause death. People returning from the open should thus ensure that they only consume water kept at room temperature immediately after coming from the heat, the viral posts claim.

Should one be cautious about serving weary men cold water in the heat? THE WEEK can categorically that no harm comes from drinking chilled water during the heat. Here’s why…

Debunking the bogus claim

In Kerala, it was a long forward text accompanied by a bunch of female voice notes that made the claim. Attributed to ”healthcare workers”, it warned the public of severe consequences if chilled water was consumed for relief from the summer heat. It was shared on WhatsApp as well as Facebook.

Workers unload water bottles from a mini truck on a hot summer day in Amritsar | AFP

Workers unload water bottles from a mini truck on a hot summer day in Amritsar | AFP

The April-May period was harsh in Kerala as people struggled with heatwaves, sunstroke and sunburn. However, the viral claim was noticed by younger generations of doctors, who were certain no ”healthcare workers” would bar dehydrated souls from having chilled water. They were quick to debunk the claim. 

”You must understand there is no such scientific finding [that cold water causes blood vessels to burst]. It is chilled saline that is administered to sunstroke patients on arrival [at hospitals]. We even pour cold water on their body or place ice cubes on them. Then, what harm can a glass of cold water possibly do? Maybe, the blood vessels in the abdomen may contract a bit after drinking it, but the human body is absolutely capable of dealing with it,” Dr Danish Salim, who runs the popular Insta handle ‘drdbetterlife’, had explained in a reel. 

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Dr Akhil SL of Palakkad’s PK Das Institute of Medical Sciences, who had treated the man stuck on the telephone tower, agreed with Dr Salim.

The border district gets cases of heatstroke every year, unlike rest of the Kerala. Dr Akhil is an Assistant Professor in the Emergency Medicine Department that deals with heatstroke cases. ”We always store a few packs of chilled drinks for situations like these so that they can be immediately given to the patient on arrival.” 

”Some patients will regain consciousness soon after they are hydrated…  to bring down body temperature by ensuring the body intake of cold fluid.”

This proved one need not think twice before pulling out a bottle of water from the refrigerator immediately upon returning from the heat. It is a practice that is followed even at health facilities.

What is heatstroke?

Heatstroke or thermic fever or heat hyperpyrexia happens due to the failure of the heat regulation center of the hypothalamus, medical books say. It is caused by failure of cutaneous circulation, which ensures heat exchange between the body and the environment, and sweating. The predisposing factors include high temperature and increased humidity among others. 

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Heatstroke can be either exertion-induced or sedentary. Exertion-induced heat stroke is seen in people with prolonged exposure to or physical exertion in high temperatures. Sedentary heatstroke is a disease of elderly or infirm people whose cardiovascular systems are unable to adapt to the stress of a hot environment and release sufficient heat such that body temperature rises.

People bathe at a public shower on a hot summer day in Amritsar | AFP

People bathe at a public shower on a hot summer day in Amritsar | AFP

What are the symptoms of heatstroke?

Patients usually present with a sudden collapse accompanied by loss of consciousness. Typical vital sign abnormalities include abnormally rapid breathing, a heart rate over 100 beats a minute, hypotension, and a widened pulse pressure. Other specific signs include the absence of sweating with dry, hot skin, delirium, coma, convulsions and multiorgan failure. The core temperature of the patient will be above 104.9 degrees Fahrenheit (40.5 degrees Celsius) —  helping the doctors to establish the preliminary diagnosis. 

What happens to heatstroke victims?

”The temperature of the patient will be very high. If it comes to a stage that the body can no longer take it, he/she will start showing systemic effects,” Dr Akhil said. Unable to cope with the extreme temperature, multiple organs including the brain of the person may be affected.

Elaborating on such worst-case scenarios, he said, ”Some heatstroke patients will be unconscious when brought to the hospital, even fully encephalopathy (conditions that cause brain dysfunction) cases arrive.  In such cases, along with decreasing the patient’s body temperature rapidly other usual managements need to be attended and the ABCDE  (Airway, Breathing, Circulation, Disability, Exposure) treatment approach is followed.

”An unconscious patient’s saliva may reach the lungs and cause pneumonia or their oxygen level may drop. So the doctor may have to intubate them or put them on ventilator support.

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”Heatstroke is an extreme scenario. While we hope the patient to get better as the body temperature drops, it may take time for them to become normal. Some may even require ventilator support for a day or two.”

How are heatstroke victims treated at hospitals?

In case a person is hospitalised, the treatment may differ according to the patient’s condition. While some may feel better once they are provided fluids, others may need intubation. The key is to bring down his/her body temperature at the earliest.

”At the emergency room, the priority is to cool the patient’s body. Cold saline is rapidly infused to bring down body temperature. At the same time, ice packs are put on the groin area and the patient’s entire body is wiped with cold water.”

Bladder wash catheterization is also a regular procedure done at hospitals to bring down the victim’s body temperature. It is the insertion of a catheter into the bladder through the urethra to allow urine to drain or to inject liquids used for treatment. In case of a heatstroke, the procedure is done to ensure the body’s intake of cold fluids.

A volunteer distributes free chilled drinking water to passengers on a hot summer day at Jalandhar Cantonment railway station | AFP

A volunteer distributes free chilled drinking water to passengers on a hot summer day at Jalandhar Cantonment railway station | AFP

There are many methods to cool a patient’s body. At some local health facilities, they will turn on a table fan close to the patient. As it starts rotating at a high speed, water is sprayed to provide a kind of sprinkle effect on the patient’s body, Dr Akhil said.

“In north India, where heatwaves are common, medical institutions have set up facilities that resemble bathtubs. Patients are laid down in it so that their entire body can be cooled.”

In a nutshell, when there is a heatwave warning, the key is to remain hydrated along with avoiding exposure to the sun. Adding a pinch of salt may prevent dehydration by replenishing lost sodium. The same can be said about social media posts one comes across.

FACT CHECK

Claim: Drinking chilled water during heatwaves can lead to death as it can cause blood vessels in the throat to burst.

Verdict: Not True

Fact: There is no such scientific study. Heatstroke patients are administered chilled fluids at hospitals immediately on arrival.