• Review the availability of listed cooling centres and check whether they are still willing/able to offer cooling spaces.
• Revise room/building occupancy guidelines to ensure that physical distancing requirements can be followed; and assess the need for additional cooling centres to account for reduced occupancy at existing locations.
• Prioritize cooling center access to those who are most vulnerable to extreme heat in the event that demand exceeds occupancy restrictions.
• Collect contact information according to local protocols for all visitors to non-COVID cooling centres in case of the need for contact tracing.
• Work with health authorities to provide cooling facilities for COVID-19 patients with mild symptoms or recovering. Raise awareness of the difference between signs of heat stress and fever. (See Q&A fever vs. heat stress)
• Offer voluntary registration for the most vulnerable to receive heatwave check-ins, where systems exist.
• Post signs at entrances and in strategic places at all cooling centres providing guidance on recognizing the symptoms of COVID-19 as well as highlighting the importance of hand hygiene, respiratory hygiene, cough etiquette, and wearing face masks.
• Identify and address potential language, cultural and disability barriers to communicating the risk of COVID-19 as well as the protective and preventive measures being taken by the cooling centre.
• Provide educational materials about COVID-19, as well as the details of mental health and social support resources.
• Ensure that everyone at the cooling centre is wearing a face mask and maintaining a sufficient space between people (e.g. 1.5-2 metres (6-10 feet) as locally recommended, unless they are from the same household.
• Ensure staff and volunteers are equipped with and trained to use appropriate PPE.
• Plan for potential staff sickness absences and cross-train essential staff to ensure continuity of operations.
• Simple face masks should be made available for anybody who needs one.
• Ensure the adequate supply of water for drinking/cooling and handwashing/hygiene. Ensure water provision limits contact between people to avoid contamination.
• Ensure that each cooling centre is frequently cleaned and disinfected to minimize the spread of COVID-19, following local guidelines.
• Ensure all air conditioning and industrial ventilation systems high occupancy buildings should be inspected, maintained, and cleaned regularly to prevent COVID-19 transmission. (See Q&A on air conditioning and ventilation)
• If local cooling centre procedures involve the transportation of at-risk people to the site, implement protective measures for the transportation service. Provide PPE for drivers and other relevant staff. Consider using alternative vehicles that can be retrofitted for driver safety, such as paratransit vans with plastic dividers.
• Consider strategies to reduce the need for cooling centres, for example, by providing energy utility assistance that would allow people to maintain a cool environment in their homes.

Physical distancing is one of the most effective strategies/solutions to limiting the spread of COVID-19, which is why national health authorities have advised people to stay in their homes. However, a key reason for high mortality in Europe during the 2003 heatwave was social isolation particularly of older people. Therefore, recommendations for reducing heat-related mortality include leaving home for cooler environments, going to public air-conditioned places, not being alone and regular health visits (Semenza et al., 1996).