The hidden death toll from extreme heat

0:01WBWAR Podcasts, Boston.

0:06Quinn Adams:You know, if we think that a thousand people die each year due to heat, it doesn't sound like that big of a problem compared to if we have, you know, over 10 ,000 people dying each year of extreme heat, that starts to sound like a really big problem. Heat is killing way more people than official statistics show.

0:35Quinn Adams:It's Monday, August 31st, and this is Here and Now, Anytime from NPR and WBUR. I'm Chris Bentley. Today on the show, when will it be safe to visit the Grand Canyon again after deadly flash flooding over the weekend? Also, almost 25 years after September 11, 2001, the man accused of organizing the terrorist attacks finally has a trial date. One man whose brother died on 9-11 says awaiting justice has been like psychological torture, and he's glad the death penalty is on the table.

1:11Chris Clements:Now, this thing's gone on for 25 years. If these guys die of old age at Gitmo, I'm fine with that too.

1:18Quinn Adams:What's going on in the case of Khalid Sheikh Mohammed coming up in about 10 minutes?

1:29Quinn Adams:But first, heat plays a role in thousands of American deaths every year, but official statistics are not counting them. That's one finding of a new investigation from NPR and Boston University that took years and produced a paper soon to be published in a scientific journal. Quinn Adams is a lead partner in the investigation. She's with BU's Center for Climate and Health, and she told Peter O'Dowd, heat-related deaths are chronically undercounted. People who record these deaths, either doctors or coroners, tend to record the death based on what they see right in front of them. So somebody might die because of a heart attack or an underlying heart condition, when in reality they died sooner because of an extreme heat event.

2:16Quinn Adams:But those deaths aren't being recorded as heat-related. So we're missing a lot of these deaths in people who have pre-existing conditions that were then made worse or exacerbated by a heat event. Missing quite a few. The investigation found that between 2018 and 2025, heat-related deaths are five times higher than what's been estimated. And I was just looking at one graph, a chart that says in 2022, the CDC reported just over 1 ,700 deaths. The model suggests the real number is close to 11 ,000. So it sounds like the story is similar year after year. That's right. Yeah. And what we're doing in our analysis is looking at more of a statistical measure of when heat goes up, what happens to mortality across the country.

3:06Quinn Adams:And that's why we're able to capture more deaths than are recorded in these official counts. Is this true for the entire country or just in hot places? It's true pretty much across the board. However, we do see a pretty interesting result actually coming out of places like Maricopa County, which is where Phoenix, Arizona is. We see that they actually have official counts that are higher than our modeled estimates. And the reason for that is because they've done a lot of really significant work in understanding how to record heat-related mortality and really how to understand which deaths are heat-related.

3:43Quinn Adams:Well, as someone who is in Maricopa County right now, I can tell you that there has been a real urgency to figure out the statistics and the numbers in the real picture here because a record number of people have been dying because of heat in recent years. So what has happened in Maricopa County in Arizona that might be a model? for the rest of the country? Yeah, well, first of all, they've appointed a chief heat officer, David Hondula, who has done amazing work in really not only identifying the health impacts of heat, but applying interventions across the board. At the city of Phoenix, right.

4:19Quinn Adams:That's correct. So he's been implementing what's called this heat relief network. So it allows, you know, businesses in the area and cooling centers to open during periods of extreme heat, not only allowing for the city to really recognize the true impact of heat and the burden in Phoenix, but also to provide interventions that allow people to escape from the heat. Have we seen this get more complicated and more difficult to track as climate change continues to make heat waves longer and more intense? I think there's some aspect of that, yeah. And I think what we are seeing is that a lot of the estimates that we have had, which there are few and far between.

5:00Quinn Adams:But the ones that we do have of heat-related mortality across the United States are from back in 2006. I think the most recent estimate was up until 2020. And even since then, we've had some of the hottest years on record. So those estimates are far out of date at this point. So we need really methods that allow us to continue to know who's dying and at what rates and in more real time. Forgive the simple question, but why does it matter? if we don't have a full accounting of heat deaths in this country? Yeah, I mean, I think if we are, you know, if we think that a thousand people die each year due to heat, it doesn't sound like that big of a problem compared to if we have, you know, over 10 ,000 people dying each year of extreme heat, that starts to sound like a really big problem.

5:47Quinn Adams:And the methods that we use allow us to look at individual counties to understand, is their heat-related mortality higher than we would expect given their population size or their heat profile. And so we're really able to see where we might need to intervene more strongly than we currently are. And what would an intervention look like exactly? Yeah, well, I think the most important thing is making people aware of their risk related to heat. I think a lot of people don't understand that they are personally at risk for having health effects of extreme heat. So that's the starting point. But also an intervention on a more kind of city level would be, you know, opening cooling centers that are accessible to a wide variety of people or, you know, air conditioning subsidies.

6:33Quinn Adams:I think we know that air conditioning is the most effective relief from extreme heat. So that's kind of where my mind takes me first. But there's lots of other longer scale things like increasing green space, for example. Quinn Adams is a research scientist at Boston University School of Public Health, the Center for Climate and Health. She's also a lead partner in the joint NPR-Boston University investigation about heat deaths getting undercounted in the United States. Quinn, thank you. Thank you so much for having me. Appreciate it. By the way, Boston University owns the broadcast license for our station.

7:06Quinn Adams:That's the BU in WBUR. But it does not decide what we cover or how. Just thought you should know. Coming up next, flash flooding in the Grand Canyon killed at least two people and knocked out the only water pipeline to the park, forcing tourists to evacuate. Indira Lakshmanan has that story after the break.

7:36Quinn Adams:Two people are confirmed dead and more than a dozen are missing in the Grand Canyon after flash flooding along the Colorado River on Saturday. Let's get the latest from Chris Clements at member station KNAU in Flagstaff, Arizona, not far from the southern rim of the canyon. Chris, thanks for joining us. Thanks for having me. So it's monsoon season in Arizona and this flash flood was driven by torrential rains. Are floods like these common in this area this time of year or were there other factors at play in this flood?

8:08Chris Clements:That's a good question. Yes. Now, they're very common in this area. What's somewhat more uncommon is for the level of rainfall that occurred to drop on this specific part of the Grand Canyon. And part of the contributing factor for the floods that we're seeing is that rain fell on a burn scar from the 2025 Dragon Bravo fire. And that led to a lot of the moisture that we saw coming through the canyon.

8:34Quinn Adams:So were there any warnings issued to hikers or was this unforeseeable?

8:39Chris Clements:It's unclear at this time. We're still gathering information ourselves. But what is clear is that around Saturday afternoon, the National Weather Service issued a flash flood warning. And around that same time, a thunderstorm dropped about a half an inch to an inch of rain on this segment of the Grand Canyon, a part that really doesn't see a lot of rainfall typically. And that is incredibly rocky and that doesn't hold moisture very well. So that's part of it.

9:07Quinn Adams:All right. Right. Well, more than 60 people were airlifted from the depths of the canyon over the weekend. Tell us about current conditions and the ongoing rescue effort.

9:16Chris Clements:That's right. As you said, more than 60 people. And right now, the American Red Cross is holding a staging area, if you will, at a cafeteria on the south rim for those who've been affected for evacuees. There's another staging area in Grand Canyon Village. And rescue operations are underway as we speak. And folks have already said, officials have said this morning that the rainfall that we're seeing today and probably the rest of the week is going to impact their efforts.

9:44Quinn Adams:Right. OK, so how much more rain and flooding is expected this week and how long until people can safely visit this remote area within the canyon again?

9:54Chris Clements:There's a flash flood warning in effect for basically all of northern Arizona through midnight tonight. and we're seeing that rainfall and flooding is definitely a possibility going through the rest of this week.

10:07Quinn Adams:All right and and we know that the flood has destroyed foot bridges and campgrounds and cabins as well. I'm sure you'll be keeping tabs for us on the continuing rescue efforts and when people will be able to go back to the Grand Canyon. That's Chris Clemens with member station KNAU. Thank you so much. Thanks.

10:29Quinn Adams:Coming up, the forthcoming trial of Khalid Sheikh Mohammed has taken a major turn. The man accused of plotting 9-11 is supposed to stand trial in 2028. But now a military judge has ruled that prosecutors can't use what they've described as their strongest evidence. More after the break.

10:56Quinn Adams:The CIA captured Khalid Sheikh Mohammed in 2003 and interrogated him in black sites for years before the alleged mastermind of 9-11 was transferred to Guantanamo Bay in 2006. He's been there ever since, awaiting a day in court. And family members of the thousands killed on 9-11 say they've been waiting 25 years for justice. Last week, a military judge set a trial date for June 5th, 2028. He also ruled prosecutors cannot use Muhammad's confessions in their death penalty case against him. That's because those statements were made under duress after Muhammad was waterboarded some 183 times and subjected to what the judge called the CIA's psychological conditioning and severe coercion.

11:46Quinn Adams:New York Times reporter Carol Rosenberg has been following the case for decades, and she told Peter O'Dowd about the latest developments.

11:53Chris Clements:You know, before the five defendants in the case were ever brought to Guantanamo in 2006, the CIA had them in their secret prisons and interrogated them with what the defense lawyers call torture. Now, some of the judges have also called it torture. In the instance of the man who's accused of putting together this devilish plot, coming up with it and pitching it to Osama bin Laden, he was waterboarded 183 times. He was kept nude, strung up by his wrists. And what the judge found was even after that ended, even after he had been brought to Guantanamo and been allowed to write his family through the Red Cross and tell them he was alive, what he said to the FBI agents at Guantanamo was too tainted by the previous activities, the previous experiences.

12:50Chris Clements:He also put a lot of emphasis on the fact that the FBI agents who questioned him did not give him a classic Miranda rights advisement like you'd hear on Law and Order.

13:03Quinn Adams:Like you have the right to remain silent, right?

13:05Chris Clements:Exactly. And the judge felt that, concluded that those interrogations were tainted by the entire experience and threw them out. Briefly, the prosecution had considered this their best evidence in the trial, and they had been arguing now for over a decade to keep them in.

13:24Quinn Adams:Right. So, Carol, if you don't have the confession in this trial, what evidence do prosecutors have to rely on if they want a conviction?

13:33Chris Clements:Documents involving money transfers, telephone intercepts, which I believe involve discussions of the plot.

13:42Quinn Adams:There have been, as you're well aware, so many twists and turns in this case, including a plea deal two years ago, which would have allowed Khalid Sheikh Mohammed to avoid the death penalty, which then fell apart. It was withdrawn by the Biden administration. Why has this taken so long?

13:57Chris Clements:because they've been spending all their time focusing on whether they can use these information that they consider the best evidence. You know, there was a period when the case was going to be tried in New York City. Those prosecutors never intended to use these so-called clean team interrogations. They were going to do a very boring documents case. There's also another set of information that prosecutors in New York very much wanted to use, which is they bugged their yard at Guantanamo Bay. And the prosecutors in New York thought there was material in that could be used at the trial.

14:32Quinn Adams:And what did happen with the plea deal? Why did it fall apart?

14:36Chris Clements:Defense Secretary Austin withdrew the plea after his assigned person overseeing the process agreed to it. He felt personally strongly that there should be a death penalty trial. He had been taken by surprise by these plea negotiations that had gone on for months and months.

14:54Quinn Adams:That's Carol Rosenberg at the New York Times. Carol, stand by because I want to bring in Don Arias now. He lost his brother Adam when the South Tower of the World Trade Center collapsed on 9-11 25 years ago. Don, welcome. And I'm just curious if you're frustrated by how long this has taken.

15:13Chris Clements:I think frustrated would probably be an understatement. If my experience is of any value. I think KSM is pretty proud of what he's done. You know, claimed credit for that back in 2009 when I was in the courtroom where he burst out and said, I did it, just sentenced me, and knowing full well they weren't going to. And as Carroll states, you know, there's a pretty strong documents case to be had as well. So, you know, 10, 15 years ago, I would have screwed myself into the ceiling over this. But as one 9-11 family member said, we've been emotionally waterboarded by our own government for years now.

15:57Chris Clements:There's grinding frustration that 9-11 family members get, or at least I do and my family members get, when we pay too close attention to these things. Like, WTF, what's next with this thing? And it's hearsay, but I have heard that when KSM got arrested, he said, hey, I'll see you in court in New York. And now, am I a fan of torture? No, I think torture is for cowards.

16:23Quinn Adams:And what about the plea deal? Don, I mean, were you frustrated to see that vanish?