A lesson from Siberia
In 1993, two friends and colleagues of mine alighted from an internal flight in the heart of Siberia. The light was failing and the temperature plummeted as they wound their way from the landing strip into an endless forest. They were lost. Eventually, coming upon a wooden settlement, they found shelter with the village teacher, the only English speaker for many, many miles.
Professor Bill Keatinge later confided in me that he had learned two lessons from this incident. One was to learn Russian (which he later did, with some panache). The second was to dress like the Russians. Because Yakutsk, the city which they had come to visit, is the coldest city in the world. During their trip, the temperature fell to a mere -26C. The lowest winter temperatures reach -60.
And what, may we ask, was the attraction of this cold Siberian city? Ironically, the inhospitable, intractable, bone gnawing cold was the motivation for their journey. They were part of the Eurowinter Group, a collection of Europe’s finest scientists, whose mission was to unravel the complicated story of winter deaths in Europe. Until that time, no-one had a convincing explanation (scientists call this a ‘model’) of the pattern of winter deaths in Europe which varied from one country to another. And the prime question was why on earth should the British Isles, with its temperate maritime climate, be the villain of the piece, with many more ‘excess winter deaths’ than its colder European neighbours?
Indeed, we have a truly unenviable record for deaths in the winter. We have known about the problem since 1841, when William Farr, the Registrar General (and incidentally Florence Nightingale’s statistician) noted an excess of deaths in his 3rd Annual Report. We know that cold is the principal cause (risk of death begins at 13C and gets worse as the temperature falls). We know that deaths are not from hypothermia – but from heart attacks, stroke and respiratory illness (the cold will kill you long before your body loses its heat). And we know that the most affected group are the old. The most recent data tell us that 90% of all winter deaths are in people aged over 65 and we calculate, at Age UK, that over the last 60 years a truly shocking 2.6 million older people have died in the winter. If that were not enough, these deaths are almost all completely avoidable, unnecessary, preventable.
Back to Siberia. Not only did Professor Keatinge learn that he should speak Russian and dress in furs but he made an amazing discovery. In spite of the terrific cold, there were virtually no excess winter deaths in Yakutsk. As this penny dropped, a search for an explanation began. And it was not hard to find. The inhabitants of this region were never cold in the winter, despite the extremes of temperature and the need to venture out. With outside temperatures at -26C, the average inside was a balmy 17C. And stepping outside, no self-respecting Russian would even take off a glove to count their change.
And the lessons for us? Well we are truly fortunate now to have the ‘grand model’. It gives us the evidence as to cause and effect and we would be foolish to disregard it. But year on year, millions of older people cannot warm their living rooms, sleep in cold bedrooms and visit freezing bathrooms. There is widespread ignorance of the risks of heart attack and stroke and little appreciation of the dangers of being ambushed by outside cold.
That is why Age UK has launched ‘Spread the Warmth’. We are tackling these problems head on, working with our local Age UKs and with others, such as local authorities, the Met Office and the NHS, and through our shops where we deliver information and advice, to solve this seemingly intractable problem. As the population ages, the challenge will grow. But you can help us by joining our campaign, by volunteering or by donating discarded winter clothes. By working together and with older people, we can resolve one of the greatest challenges of public health today.