Jason Lee Transcript: June 24, 2025
Kevin Johnson/NPF (00:00):
So this is about climate. As with other subjects, we’ve heard bits and pieces throughout the last few days about climate and its impact on trade and the economy, but we’re fortunate to be able to do a deeper kind of look at it singularly in this last session of the day. As you know, the world’s economies are not only vulnerable to policies pursued by the latest occupant of the White House. They are being transformed by global climate change. Whether we acknowledge it or not, Jason Lee has focused his work on ways extreme heat impact people at very basic levels, including those toiling in key sectors of our societies from work productivity to health, Jason has adopted the chilly notion and pardon the pun, is that extreme heat is eating us alive largely because societies have failed to do just what mentioned earlier acknowledged the risks of climate change.
(01:21):
He is an associate professor at the Department of Physiology, young Lou Lynn School of Medicine at the National University of Singapore. He directs the Heat Resilience and Performance Center and co-leads the Human Potential Translational Research Program. He chaired the scientific committee on thermal factors at the International Commission on Occupational Health and currently co-chairs the heat injury Clinical practice guidelines at the Ministry of Health in Singapore. His main interests are fluid balance, thermo regulation and heat mitigation. He also studies the physiological demands associated with heat stress and how humans adapt to ensure optimum performance and survival. He’s also dressed for the occasion having accompanied a group of young people through its outward bound correct to monitor them and expose them to the elements that he studies. So he is committed to this work and we are lucky to have him to speak with us today. So please welcome Jason Lee.
Jason Lee/National University of Singapore (02:40):
Thank you Kevin. Sure, thank you. Go ahead. Good afternoon first, pardon? Entire and I couldn’t make it in time to change so I came straight from bin. This small little I landed the east. Do take time if you have sometimes spare. There is a small island, island you want to get out Singapore, there’s a small island where we see more greens if you think that the green on the main island is not enough. So this morning we were there to have a discussion on how can we find that switch spots. We exposed about 40,000 15-year-old teenagers to outward bound school. So the intent of course is to that five days to make them more resilient and heat resilience is one, but with the warming world there are concerns obviously not too much of exposure. If not they get he injured. So we’re trying to find that sweet spot.
(03:41):
My intent is to give a quick overview because I know I have an hour so I want to maximize leave time for interaction but I thought it’s important. I set the basis and I’m a exercise and term physiologist. I look at human in this context, hot environment at a very personalized level, not at a population level. First thing I want to emphasize is every heat stroke, death is preventable and therefore if you want to save, every live policies are insufficient. We need to go down to the last men and women also it is our aspiration. We communicate this and I thank you because you play a critical part in our overall mandates to augment retail globally. The other thing is when you buy a property it is all about location, location and location. Heat health advisory is hyper contextualized so I don’t intend to give you that global perspective but narrow down to Southeast Asia and you’ll see afterwards at the end of my deck of presentation there is this new hub called the Southeast Asia Heat health Hub.
(04:57):
First I want to start by reminding you as we sit here and talk about heat health people are suffering out there every minute and this is a case study slightly outside Hanoi, a group of female workers making shoes indoor. I remember this because that morning I received a call from two of my PhD students telling me that life is half doing a PhD. So they were thinking about terminating the PhD altogether. I said hang on, we are busy collecting data and I observed this group of female Vietnamese women, they were so happy because every survey they complete we pay them 10 US dollar and based on epidemiological data, we know many of them whom are pregnant will suffer in terms of the pregnancy outcome. Worst case, a stillbirth if not babies born into the world already compromised yet they were so happy simply because we pay them 10 US dollar per survey.
(06:08):
I communicate that observations to two of my PhD students and say your lives are tough or the women we sampled this morning, I’m glad to say that they took their message and they’re about to finish their PhD next year. Also, my point is we are the privileged ones sitting in this room. We’re about to remind you the power of your communications because if you do it right we are saving lives. So I went to first orientate, it’s not an academic exercise, this is lifesaving. We have entered into the brand new phase. You think global warming, that’s not true. It’s global boiling now and we are right in the midst of the crisis and last year sat gen has issued not just awareness but call for actions, urgent call for actions among the various sectors in the society. My heart goes in, my team of 50 goes to the workers, no heat effects cross the whole lifespan from males.
(07:09):
Fertility, probably women’s fertility to maternal health, thermal comfort in schools, all kinds of occupations, elderly, elderly with disease and even pets. I can’t believe you still see Huskies hovering around in Singapore. They should be banned from Southeast Asia. So you see there still a lot of things that we need to augment to remember the workers, the pandemic reminded us who are the real foundation and fabrics of the society or the healthcare workers that took care of us. The construction workers that give you shelter and the farmers that provide the food on our table also remember it is them and if there’s a lot of good resources there, but I want to point you to the Lancet, calm down. Every year we update the indicators on how climate change impact various aspects on health. So this is one good source of threat reference and here I want to immediately narrow down to what and how at stream heat means in our context.
(08:14):
In fact, the heat waves that most of you weigh off because largely shaped by the literature global north loosely core heat is often presented as heat waves. Meaning if there are no heat waves means heat is not the problem. But in this part of the world there are hardly any heat waves. So does that mean heat is not a problem in Southeast Asia? Not true here because our heat is a slow moderate onset chronic exposure, always warm, always humid and is prolonged. So you might think that Singaporeans or Southeast Asians are heat acclimatized. I tell you that is totally wrong. We are very unheated acclimatized because we spend more than 95% of our time indoor. We are behaviorally very heat acclimatized, very sensitive to thermal discomfort and try all ways to avoid the heat at all costs and therefore inducing lack of incidental physical activity.
(09:11):
Myopia mental health, you see the avoidance of stress in this case heat stress has swing us to the other end that we are not realizing our true health potential. You might say Singapore, not bad Sonoma must be top three in the world life expectancy 85 years. But given the resources the infra we have, I think we must be more demanding. Maybe 85 is not our true potential. Also don’t argue relatively we are doing not bad but from the resources infra healthcare system, I think 90, 95 should be our target, not 85, maybe even a century. Also I want you to orientate you heat in our context is an horizontal and overlay depending how you look at it from a health pillars perspective, you know right how to be healthy is about how you sleep, how you eat and how you exercise. And I’m telling you heat has a direct negative impact on each of these three health pillars.
(10:11):
You probably appreciate hots in Singapore you can exercise well. So you are looking for personal best in your endurance rates. Now you’ll look quite fit here. Please don’t compete in Singapore. You never get your personal best. The trick to doing a good personal best is to work harder, save more money, get a flight and fight to a cool country. Yeah, don’t do it in Singapore. Yeah. How about heat and sleep amongst the various projections we are anticipating every night in best case scenario in this part of the world to be warm nights that is scary. Best case scenario by mid-century almost every night will be a warm night. So heat affect exercise, sleep. Not many of you might be aware heat affects how you eat in this part of the world. I say come on. Last thing is you introducing a new problem called climate change.
(11:00):
We have assisting issues like malnutrition leading to stunting. So we are saying that it’s not a new problem. I’m saying that heat will exacerbate your stunting issue. Do you have that kind of feel when it’s hot you don’t eat as well. When it’s cold you eat more. So knowing that physiological basis might allow us to alter the mechanisms and therefore take your response accordingly. So now we are doing experiments after those swim usually eat more, right? But if you warm the swimming pool, maybe if you’re intent is to lose some weight, maybe a warm pool is better. However the elderly, they can’t eat as well as we hope maybe to cool them down in the warm hospitals might enhance their appetites. You can look at it from a life stages perspective. You can also look at it from a population specific, so seated as an overlay and not necessarily heat waves as a vertical.
(11:59):
So this best depicts us. We are the boiling frogs. We are frogs in the boiling port, not heat waves but nearing that threshold. So that one two degrees makes a lot of difference. So such is a context, it is dangerous that even in Singapore I like to say we are quite progressive. Only just a few years ago we began to acknowledge heat is an issue because before that we met heat to mortality as hardly anyone that of heat and therefore it is not our problem. But because we are constantly exposed to heat, we hun away from the heat productivity, thermal discomfort leading to wrong decision accidents quantified those and the government now has acknowledged this is critical and we need to invest a lot more huge economic implication which means that it’s hard to perform this experiment. If I get a hundred workers to build a skyscraper in Singapore and then do a counterbalance design and build that same project in London, you’ll see how much quicker safer that project will be completed in a cool environment.
(13:13):
At a number in our project that we are embarking on has huge economic implication. We attempted to fill this slides some of the less discussed known impacts, direct and indirect due to extreme heat. I talk about myopia, lack of vitamin D, lack of sun heating the eye, therefore lengthening leading to shortsightedness physical activity. If the health promotion board says 10,000 steps per day is a little bit more difficult to achieve in Singapore because we don’t usually commute to work by cycling or walking because it’s very hot and therefore every cow is slightly intention not incidental. So layer on the Asia workaholic mindset, you hardly have time to exercise. So these are penalizing us so and so forth. The epidemiological data are clear right? When you overlay heat to some of these impacts from suicide to domestic violence to accidents, those are clear, but right now we are pressing hard for the mechanism so that our solutions can be more targeted.
(14:26):
I want to refer to this barber here, the pets. I have a soft spot for PET that say that huskies should be banned in Singapore. Do we need to create evidence to say he’s not bugging, he’s cursing at the owners. Why do you bring me here to suffer? Okay, very quickly, just for your awareness, CDs have a live skill besides your formal work obligations. To thrive in a hot environment you need to understand some of the basics to protect yourself and help us to communicate to individuals at risk the elderly, very young children, workers accordingly. So press this and it should work. Yeah, so you do have very powerful way to lose the heat. Vessel dilation pulls the blood, hot blood onto the skin or you can evaporate when you sweat. Remember the keyword is evaporation. Sweating does not low heat, loose heat sweats, evaporation does.
(15:21):
But when you come to states you keep on pushing, there will be a point that there will be reduction in blood flow to your vital organs and then the toxins we are supposed to be recited within your guts get leak into the porter circulation and then you’ll cause a lot of alarms be there’ll be a systemic inflammation and one leads to another. Eventually your organ will fail and then you get hit through. So my point here is actually it’s not easy to die of his stroke If somebody died of his stroke means many had suffered and there must be something seriously wrong because there’s a lot of app opportunity to stop this from progressing. So when you hear new, somebody died immediately after the marathon race, unlikely is because of his stroke. It does takes time before you complete this process. Last week I’m not sure how many picked up news, there was a 47-year-old man who collapsed during the national day parade rehearsal.
(16:21):
He was cardiac arrest most likely they are still investigating. It’s nobody where conversations could heat exacerbate that conditions. So that is another area we are going to probe more. The other thing I want you to know is too simplified to assume hot weather equates hot human. That’s not true because now you know this simple equation to determine how hot a worker a human can get. It is dependent on three input parameters, the weather, the attire and the physiology. So it’s not so straightforward where it’s hot means that population or that worker will be hot and therefore when it’s not so hot he or she will be safe. Not true. If it’s not so hot the person can choose to work very hard, he or she can still become hot. But this also give us enablers When it’s very hot you can manipulate your attire to a large stance, not to a small extent, but more importantly the physiology of work and of course your own personal capacity so that you can perform well in the hot very well
Yujie Xue | South China Morning Post (17:30):
Parent has been contributions.
Jason Lee/National University of Singapore (17:33):
Yeah, so this is the passing out parade, very common in Singapore. Every soldier have to go through this process. So you see a soldier drop that is called hit syncope where blood gets pulled to the lake light hiddenness. Then soon you see another that dropped. It is not uncommon, it is not good but usually they’re fine because they drop the ground blood get pushed to the heat
(18:03):
And let this finish first. So you see two drop, this is what we call hits single P, but the same physiology in this case occur to a worker performing a task at heights. In this case it led to fatal consequence. It fell from height and he died. In this case the coroner started to probe the case further and concluded heat was a major cause. So my point here is you don’t have to be killed by heat directly because of heat stroke. A simple physiology here that caused light hiddenness and then for whatever reason his safety harness wasn’t on could cause death. Traditionally we have attribute this to be a typical sleep trip or fall in the workplace, but we need to ask question what induce that fall. Here’s another example. We perform a study in our healthcare workers. They were executing an emergency response without going to the details of the study.
(19:11):
This counterbalance them serving as their own control intervention was eye slurry. We administered a test called risk taking is balloon analog risk-taking test to assess their risk-taking behavior. Long story short, we found that when the workers were thermally uncomfortable they began to take more risk, not good for the workers, not good for the patients under their care. Also in this case there was no consequences of mortality. No one that of head stroke but indirectly could induce a wrong decision made leading to other issues. It’s not just heat. I like to speculate. When you are being asked to perform a task in an uncomfortable environment, this case too hot or terribly cold or very smelly or super noisy, what would be your default? Human response is I want to get this job done as good as possible and get out of here. And what it means if you are 10 years old experienced worker you might say they kept telling me step seven out of these nine steps are important, but I think step seven is redundant because I want to get the job done.
(20:23):
You get your hands chopped, you get a near miss, you have accidents. That analogy is so very powerful when you are in the smelly room. After the while the stench doesn’t smell that bad. That is the kind of situation we are in. We are constantly in the warm environment. After the while we got too used to the discomfort and say that it’s okay I a lot because we are Singapore and that is S English one notch above the queen’s English. Yeah, we call it S English. So I want to show two examples of the last talk about consequences of thermal discomfort leading to problems and all this. You can quantify it from an economic perspective, it can quantify it from a social perspective now has huge consequences. Okay, this slide is important because as we communicate het f often not just describing the problems they’ll ask what can we do to beat the heat Being a physiologist, I think this is the most sustainable way to use physiological techniques to beat the heat.
(21:21):
Yeah, this will be very powerful because once you harness this you will do well in the warming world. I’m optimist. Remember as the world gets warmer there are also new enablers and hopefully with good cooperations the net outcome is the world will be a better place. Sometime means say the young people these days have lost the hope, they just want to live what YOLO or whatever you coverage. I think the next generation will be in better shape than us. That’s what I choose to believe because every generation seems to get better. So without any heat management plan, now we are do because everybody has a start state and you have your limit there. If you work your heat that maximum limit your stock work. If you’re motivated, you push beyond, you get heat injured. So a good heat management strategy should reduce the start state attenuates the rate of rise and increase your new limits because by doing so, look at the y axis.
(22:25):
Your ability to do well in a hot environment is now expanded. This has ability, a good implication although that you do well and safe in the hot environment. Okay, I’ll repeat again now. This slide is very important so I don’t want to rush through it without any heat medication, this is your potential. So any good effective medication must reduce attenuate and extend because by doing so your thermal thermal capacity on the y axis is expanded and this has a positive implication to do well and safe in the hot environment and I don’t have time to elaborate each of these techniques. These are what you should do to be the heat. Get yourself aerobically conditioned, endurance, exercise, heat acclimatization, cool yourself before, during, after. Optimize your wood rest cycle and then hydrate properly. A lot of photos I see this or beating the heat is always someone holding a water bottle.
(23:27):
That is one strategy but the least effective option. There are a lot of things you could do to beat the heat and look at the bottom half. You remember my previous slide. Aerobic conditioning is the only intervention that takes all the three faces, which means it is the best investment you should make. We are not being too demanding. Guys before the pandemic we asked you to keep fits by exercising for general health. During the pandemic we say keep fits to have a good immune system, mental health post pandemic in phase of a warming world, we still ask you to do that one solid good thing that is to exercise also keep on exercising. In fact it’s very evidence-based now you know when you see somebody aerobically fit and say that whoa, you are cool and you are hot and it’s actually evidence-based. You see when you are fit you start with a lower core temperature and you can end very safely at a higher core temperature.
(24:26):
So when you make that statement that you are fit and therefore you are cool and you are hot, this is the evidence to support that statement I adjust made. Okay but one can always choose to bypass the expanded limit and special forces very well-trained individuals, workers being paid by piece no matter how you enhance that capacity they often push beyond for obvious reason for immediate gains recognition and therefore there is space for technology to come into. So here we deed in hope to inspire the future. Heat health warning system could be in the form of real time personalized level monitoring. Seeing the greens means okay, amber means keep a looked out and rate means evacuate the individual that immediately this was done more than a hundred runners a couple of years back in the Singapore half marathon. Okay and finally we can leave the next half and of our discussion, but before that I want to create awareness. Another good source or information pertaining to heat health is found at the Global Heat Health Information Network. This is an initiative by WHO and WO and we have now contextualized it it in erecting a few hubs and Southeast Asia hub was the first to go and we made a big announcement in January, held a forum in Singapore. This video will deed our intent hands lead you to take a look
Video from Presentation (26:06):
In a world gripped by rising temperatures. We in Southeast Asia stand at the front line of this global crisis. We are experiencing more intense, more frequent and more severe heat events, creating unprecedented conditions that are threatening our health, our lives and our livelihoods. We have always lived with the heat and humidity so it’s easy to think we are used to it, but as the heat intensifies we must ask are we truly prepared for what lies ahead? Our country’s provinces and homes are feeling the strain of increasing oppressive heat with schools closing work disrupted and heat related illnesses on the rise. The toll of chronic heat stress is also partly impacting our health, productivity and mental wellbeing. The region’s rapid urbanization and aging populations plus socioeconomic disparities further amplify the impacts making this issue impossible to ignore. The time to act is now.
(27:18):
This urgency has led to the creation of the Global Heat Health Information Network. Southeast Asia hub, a regional initiative of the global network which is spearheaded by the W-H-O-W-M-O Joint Office for Climate and Health anchored at the Heat Resilience and Performance Center at the National University of Singapore’s Young Newland School of Medicine. The hub will be central to the region’s transformative action. Our mission to foster collaboration, accelerate knowledge sharing and catechize evidence-based policy and action by focusing on regional specific challenges and priorities to safeguard human health and wellbeing. We strive to prepare communities, protect populations, and empower individuals to thrive in a southeast Asian climate
Video from Presentation (28:12):
Together as a region. This is our opportunity to build stronger heat resilience communities for today, for tomorrow, and for future generations. Let us commit to face these challenges head on and build a heat resilience Southeast Asia that can thrive in face of this warming world
Video from Presentation (28:31):
Together. Let’s rise above the heat.
Jason Lee/National University of Singapore (29:01):
Okay, yeah, those were the 10 different languages in Southeast Asia. It means let’s rise above the heat. This is our goals and our focus areas. I want to highlight that part on tradition and culture practices is critical in our path, but we can go about deriving new evidence. Say cold drinks and cold showers are good to beat the heat. My late grandma wouldn’t believe that statements and say what have you been learning in your lousy medical school? How can you drink something cold and hot? Shall we cold water and drink something cold in the hot environment? That is so wrong mainly because she’s subscribing to traditional medicines and the heat healthiness is nothing what we learn in medical school and then the is probably the balancing of A in and young achieving a certain q and therefore it’s important when we communicate to you as I understand from their perspective, maybe it’s easier for us to have a conversation with the village heads religious leader, tradition physician that my grandma believe in because you know can never argue with your grandma, right? So let’s choose the easier, better. So it’s important how we see from their perspective and not think that wherever we derive from medical research would eventually be utilized by ’em.
(30:27):
Final point is what happened last year. We sort of anticipated there’ll be a lot of new players coming into the scene offering resources, taking leads to champions. That is not a bad thing, but I also ask that as we communicate heat health information, we ask people who finance donors to also coordinate the resources. We do not want too many replicates because the resources are indeed limited. Also, Rockefeller has came into the picture putting resources and we announced it at the World Health Assembly. Good step forward, but it’s important as more of these donors philanthropies come into the picture that’s also in the organization or using the resources appropriately. Also it’s not just coordination among us but from the funders too. Okay, I end my presentation with how I started it. It’s all about the individual and that was in Hanoi, this was in Thailand. When I was there a couple of years back, the farmer taught I had solutions that could bless him so that you could stay out in the farm to cut more.
(31:34):
And I told him no, I’m here as an observer. And he was so disappointed and said don’t waste my time. Don’t come here and observe me. I was telling him that we are thinking about strategies to almond his health through the interpreter. I understood that he doesn’t care about his health, he just want to cut as much as possible. So by 6:00 PM he could bring more bread and butter home such it’s a situation that these people are facing. It’s not about health. Don’t repeat that. Tobacco campaign scaring people. Say you stop smoke now 30 years down the road you pay the price. Humans are interesting individuals or creatures unless you reward or punish them almost immediately. Intentions don’t always translate to actions. So I look upon you as your experts in communications or how to trigger their in interactions from intentions to actions. Okay with that, I thank my team as I speak. They’re still collecting data, trying to augment detail for this part of the work.
Kevin Johnson/NPF (32:34):
Thank you. It’s open for questions. Who’s got any? I’ll start just because we’re here in Singapore. The view out the window beautiful underscores what’s happening here. And I wonder if you mentioned earlier that there is not enough acknowledgement that climate change is happening. What are institutions that are supporting the economy doing that make you believe that there is a increasing acknowledgement that more needs to be done?
Jason Lee/National University of Singapore (33:24):
Yeah, our sites project hit save project Hit save was initiated during the pandemic. For those of you who follow news in this part of the world, it uncovered a lot of gaps in how we were housing our migrant workers. So that’s where crisis brought about opportunities and it sort of reject the whole system a lot of attention and projected save was commission. One of the things that we found in Project Hit Save is often employers or the C-Suite chairman think that this is an altruistic conversation. After all Jason and team is trying to tell me, let’s not profit too much in the expense of the workers because of the warming war and therefore maybe not 10 million per year, 8 million and then protect the workers. But the data actually show good heat management solutions not only protect the health of the workers, but they work more effectively.
(34:23):
Meaning that there’s not a zero sum game. The investment that is introduced to almond’s, health and safety, also augmented, yeah, work productivity. Okay, and this is very contextualized. Most of the work conditions are not paying by piece means there’s a fixed salary every day, every month. So when the temperature gets hot, humans including ourselves, I don’t believe it’s just restricted to the workers, they will pace themself and the prize in the form of presentism, they will slow down and therefore we are bleeding often unknowingly economically. And that studies show that if you rest them well during the break and give them more breaks during the work time, they actually work more effectively. And if I may take this point further, the paying model is key. And right now, earlier this year Singapore rolled out the landmark bill for platform workers, platform workers, a bit complicated, not quite self employed and then not quite employed by an organization.
(35:29):
They’re sometime in between. So don’t be too naive if you think that we can develop a heat health warning system for platform workers and hope they’ll respond because after all this is a conversation of if you don’t take advice from me, you may get heat injured. This is what heat health advisory or heat warning system, it’s all about risk conversation. But if I’m the worker from a colleague perspective is no longer a risk conversation, if I don’t work equally hard, I will suffer by the end of the day. So I’ll ignore all this hit tail warning system. I think to do this well we probably need to communicate to the CEO saying that these are the epidemiological data you need to regulate work. If not, you’re paying out in other ways more accidents, bad customer service, you need to speak to the clients like us.
(36:19):
I hope during raining day or hot days when there’s a premium or the platform workers arrive a little bit late and you receive or her with a smile because someone is taking risk on your behalf. Parametric insurance, I’m not sure how many of you are aware of parametric insurance. That means you pay out immediately and not wait till a bad accident and you make more claims. So if all these actors come into the picture and now tell that worker because it’s hot, you don’t have to perform six orders per hour, but five but that one order that you didn’t do we’ll pay you through. This means your company parametric insurance premium on the client, then I think it increase the challenges of a successful heat health warning system. There’ll be respondents by the intended recipients. More questions.
Si Ying Thian | GovInsider (37:27):
Thanks Jason. I’m Si Ying Thian from GovInsider in Singapore because I know that you’re double hating also in MOH Ministry of Health and I think so I have two questions. One question is how has the public healthcare infrastructure evolved with this new, what is it new but this greater awareness of heat?
Jason Lee/National University of Singapore (37:48):
Yeah, I think for the Ministry of Health, public health stakeholders, if I elevate it sometimes I ask why is this not driven by WHO? By WMO at the highest level I don’t have a good answer, but we are in the midst of trying to tell the public health. This is not just because public health see that we don’t have any heat induced mortality distance. Actually heat is not a problem. But right now we are saying no heat can affect us as a horizontal and the projections of our non communicable diseases not looking great. It will be an increase and then we’ll say there might be a role not just direct death due to heat stroke, but we’ll as exacerbate current conditions. For us, we’re also anticipating super aging population. So I think that is a bigger push why our government is responding more because they know amongst the various group the elderly will likely be compromised in the near future.
(38:47):
For those of you are not aware, within the next four or five years, Singapore will transit from one out of five to one out of four individuals who are above 65 years old. And it’s clear or not there will be a lot of these individuals potentially being compromised by heat and Singapore, we are very blessed. They do look at midterm long-term issues and therefore we are making the investment now. And the co-chairing of the clinical practice guidelines is actually very specific to acquisition head injury every 10 15 years we revise that clinical practice guidelines based on the latest information. So one of the things we want to eradicate more is see treatment of heat stroke patients almost like a CPR and a ED. You do it as quick as possible and not maybe cyber thing is okay, just rest him or her, we activate the ambulance and the hospital will take care of him. That’s not true. Right now the data suggesting the damage is done that first 30, 45 minutes. So we want to advocate for immediate attention to cool the individual now. So this are one of the few updates potentially we’ll be introducing.
Si Ying Thian | GovInsider (40:00):
Thanks. And I think my second question is how does cross-border collaboration look like as under this G-H-H-I-N?
Jason Lee/National University of Singapore (40:07):
Yeah, the Weather agency, the mass agencies actually we got a good grasp of them. They’re all quite in the game, but the public health equivalent for each of these nations in Southeast Asia, it still will work in progress because these are the two key actors that must come together. It Singapore, MOH is responding but many health agencies are not. So, but that will be a work in progress. We’re actually putting them together to have that conversations or basically this partnership in Singapore. Again briefly, how heat the resilience is organized in Singapore is predominantly my two key ministry, the ministry of National Development because they’re in charge of all the infrastructure and the ministry of sustainability and the environment for obvious region climate change. So with that, there are more than 30 agencies under these two agencies and the reports, the prime minister office, when I ask how is heat being organized outside Singapore, definitely not there yet.
(41:12):
People are thinking that heat is there but not quite there. It’s quite dangerous when you say heat is everywhere. It can also mean that it is everyone’s problem but no one’s problem. And also we are looking for that champion and here we organize from a whole of government approach. It’s easier for us, it’s smaller, but definitely a lot of work progress outside Singapore. There’s also both opportunistic and strategic reason why we need to do work around the region. Can you imagine one day we call a rate alert for heat wave. Let’s say we decide it’s 35 degrees Celsius over three days and then across the crossway, our Malaysian counterpart say, I’m sorry, our threshold is 38. Can you imagine the potential confusion you’ll be causing to the public? Understand from Singapore, I say, oh Singapore, you’re always too conservative. Anyhow, call this alert making our lives in the mess because just 500 meters away, our Malaysian friends 38 and there seems to be okay.
(42:19):
So there’s also a need for regional coordination. There’s also other implication that if the farmers in Thailand struggle to spend more time in the field to grow the rise, what it means that our middle class potentially will feel the heat because the same amount of rise will cost more expensive and they have implications to our politics. So I ask that we see this as one whole system, what is affecting the region would affect Singapore. As you know enough, Singapore, we are very dependent on the world, on the region. So many be altruistic, maybe be strategic economy. I think it takes all the boxes why we should do this collectively. Thank you.
Yujie Xue | South China Morning Post (43:09):
Thank you. Jason, correct me if I’m wrong, parametric insurance is more about natural disaster, climate related natural disasters, right? I’m curious about for life and health insurance, how can insurers adapt to the rising claims of this heap related?
Jason Lee/National University of Singapore (43:27):
Yeah, I don’t have a good answer. In fact, when you say disaster, we are still discussing, right? The heat in our context should be framed as a disaster because surely we can’t have disaster every day. But heat is here with us almost every day. And also we don’t have a good answer are questioning politely, do we tackle this problem from a heat wave? Heat wave means that it comes occasionally. It cannot be heat waves every day. Likewise, from a disaster perspective, I dunno the details of how the parametric insurance are being issued right now we are just offering data. They’re asking what kind of threshold should we define? And they have tests certain pilots based on the single temperature threshold and the feedback it’s not working too well, which now you understand why temperature guided threshold means once you cross certify them as pay that worker 20 bucks almost immediately doesn’t work well because now you understand whether it is just one of the three key inputs that determine how hot you will get. Also from a research perspective, we need to provide empiric data to suggest what best determine vulnerability or at risk so that we can trigger the insurance payout more accurately.
Yujie Xue | South China Morning Post (44:43):
Thank you. Yeah. A follow up question besides heat or what do you think are some of the other climate related impacts on human health that are overlooked?
Jason Lee/National University of Singapore (44:53):
Yeah. Oh, in this part of the world, again, air pollution and even in South Asia must be Indian friends here, pollution is key. So in our part of heat and pollution must be the two key environmental stressor. And today there’s a gaba and I apologize that the researchers are not doing a good job. They are looking at heat and pollutions almost independently. So we need to put these two together. It’s not just academy exercise because a typical heat stress advisory, if you remember is get outdoor, go to the cooling malls or water fountain, but a typical pollutions and his advisories close your door, shut your window. If they both happens together to the elderly, like my late grandma, again, she’ll be angry because she’ll be confused. Say now I have the pollution and the heat, one set of advisories going out and one set indoor, are they trying to kill me or what?
(45:52):
So we need to help my grandma and granddad to make that decision by looking things holistically. So I will name heat and pollution and from that they can increase the chemical reaction called this thing ozone and cause additional health implication. So we’re not there yet. You can argue from Southeast Asia, there are really a lot of other big ticket items to resolve. But I’m positioning from a horizontal, not going in and say this is a new problem with limited resources by saying that this will exacerbate your own issues, but potentially bring about new resources to support this endeavor.
Soo-Hyang Choi | Bloomberg (46:39):
Thank you. Jason, Soo-Hyang from Bloomberg News. Can you tell us a bit more about how we can bring this climate change angle when we cover trade issues and trade wars?
Jason Lee/National University of Singapore (46:50):
I’m not an expert in trade. All I could cite is the economy implications or if we don’t augment heat health or heat resilience, productivity will suffer not just from the productive at work itself, it can lead to other damages. I have a video, I know time to show that it depicts a grab worker in Singapore. It’s like your uber equivalent, the platform worker amongst other implications. He said that after this are working Singapore, he has no time for the family and it sort of provide insights to why we see domestic violence itself, everything. Some can be quantified from an economic perspective. So just by investing in a thermal comfortable work worker is not just augmenting work productivity, it potentially can spill off to non-work hours, reducing other risks or implications due to a warming work. Yeah, that’s only how much I can say, but I shouldn’t over speculate because I’m not in the area of the economy side of things.
Kevin Johnson/NPF (48:14):
When you look at models that where countries that you think are approaching this in a holistic way, where do you look for that kind of inspiration and what do you try to emulate from those models?
Jason Lee/National University of Singapore (48:41):
We used to look at the us, they did have a very coordinated effort, bring agencies, I think it was called the National Integrated Heat Health System, something along that line, but it has been dismantled but good that we have a global hit health information network that bring together individuals who are experienced in forming such a system in different parts of the world. So today we look at the global Hit Health Information Network as a source of inspiration and reference to better organize heat governance. But in Singapore, I’m also very proud that while we only make the 180 degrees, because if you talk about heat health in Singapore three years back, right? The response would be this is not a national problem. This is probably a soldiering issue for those who are from Singapore. But now they have acknowledged that it is a national issue and we have organized ourself and even have the emergency task force call Operation Mercury. When it comes to a certain threshold, we can activate our resources accordingly, but we want to take the lead, do more, and hopefully we’ll be the inspiration for our neighbors to follow suit accordingly. So the motivation of the Southeast Asia hub is to do that.
Kevin Johnson/NPF (50:17):
Anybody else?
Lam Le | Rest of World (50:22):
I may have missed it, but do you work with grab or advise grab on how they could price their service and compensate the workers? Somehow that took taking into account the heat because in Vietnam several years ago, they introduced the heat wave surcharge and then the public and the consumer association, they kind of in Vietnam were really loud saying, why did you introduce this increased prices? How do you define heatwave? And it received so much backlash and grab, they didn’t really even try to defend themselves, their decision, and they just scrubbed it. And while on the other hand they do have raining, when it rains really hard, the price always increases and people are fine with that, but for some reason they’re not fine with the heat are surge. And
Jason Lee/National University of Singapore (51:23):
Yeah, we have not what we have conversations. That video I didn’t show it actually was a grip delivery man recommended by the grip himself. But if you ask me to make this most efficient, this is where government must come in. Of course we must create awareness that intrinsic motivation from a business perspective do this because it’s good for your business. But that is where I find sometimes very inefficient. That’s where good government must set off. If you want to operate in my country, this is a set of regulation, almost impose it in a good way because we can’t afford to go around congrat. Then you have many other companies to convince them. So we are looking for good leadership in this case to put forth the regulation in that country and then the companies will follow suit. I mean that is how generally we get things done here and hopefully there are enough incentive for those companies to say, okay, although I don’t like it, but it seems like there’s greater impedance for me to stay on. So yeah, so that’s where the governance I think is important. But having said that, government don’t push for solutions, therefore we’re also inviting the industry players to come onboard. Academia don’t scale solution. We provide the evidence. Government don’t scale solution. They set out the policies and therefore the industry must come in knowing that there’s actually a good business case because I say in good health makes good workers and therefore good business.
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