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The 2017 National Heat Wave PlanThe National Heat Wave Plan (PNC) is in effect from June 1 to August 31 each year. The objectives are to anticipate a heat wave, protect the public from the health effects of a heat wave by implementing appropriate management measures, inform and communicate to raise awareness and protect the public, and build on experiences after each summer. Health recommendations for healthcare professionals and the general public were updated by the High Council for Public Health in May 2014.The PNC is based on department-level monitoring of temperature forecasts provided by Météo-France (MF). To anticipate a heat wave, MF provides daily weather forecasts at 12:00 PM and, at 4:00 PM, a vigilance map indicating the proposed departmental alert levels for the following day, which are submitted to prefects. The PNC is structured into four management levels:

• Level 1 - Seasonal Watch: active from June 1 to August 31 (green alert for the "heat wave" parameter on the alert map)

• Level 2 – Heat Advisory: preparation for an escalation of management measures (yellow “heat wave” alert)

• Level 3 – Heatwave Alert: triggered by departmental prefects, in coordination with the ARS (orange alert for “heatwave”)

• Level 4 - Maximum Mobilization: triggered by the Prime Minister (red alert for "heatwave").

In the event of a heat wave (Level 3 or 4 of the PNC), daily monitoring of health indicators allows for an assessment of the potential impact of the heat so that the relevant services (health, management, communication, etc.) can adjust management measures. The selection of health indicators is based on a review of the literature¹: number of emergency department visits (all ages, 75 years and older), number of emergency department visits for heat-related conditions (hyperthermia, dehydration, and hyponatremia), number of SOS Médecins calls (all causes and for heat-related conditions—hyperthermia and dehydration), and number of deaths. Given the time lag in reporting deaths, Santé publique France can only assess the impact of a heat wave on mortality after four weeks. Environmental monitoring and health indicators will be presented weekly, throughout the duration of the PNC, in the weekly epidemiological report of the Cire Bourgogne Franche-Comté. In the event of a heat wave, a daily epidemiological report will be issued the day after the heat wave alert is issued. A more comprehensive report will be produced by the Cire four weeks after the heat wave to allow for the inclusion of a mortality analysis.