Cooling centers, the gold standard for heat relief efforts, are increasingly serving the populations most vulnerable to extreme heat and at risk of infections from diseases such as Shigella, seasonal influenza or other respiratory viruses. Integrating infection prevention into cooling center operations can ensure safe and effective heat relief options.
As early as March 2026, communities across the Southwest and other parts of the country started seeing unusually hot days, well before summer. In Tucson, the first 100°F day arrived on March 19—weeks ahead of historical norms (NOAA, 2026).
Extreme heat is now arriving earlier, lasting longer, and stretching local public health capacity.
Whether it’s chronic heat in places like Arizona, where dangerous temperatures can run from April through October, or shorter, intense heat waves elsewhere, cooling centers have become the default community strategy for keeping people safe from the heat. They provide what people need most in high temperatures: a cool space, water, restrooms, a place to sit, and time to recover. Studies show that access to cooling centers can significantly reduce the risk of heat-related death.¹
But cooling centers do more than serve people at risk of heat illness—they also serve populations more vulnerable to infectious diseases. Older adults, young children, people experiencing homelessness, outdoor workers, and those with chronic conditions are more likely to rely on these spaces. At the same time, local health departments are responding to ongoing infectious disease concerns, including Shigella outbreaks in congregate settings, (CDC, 2025–2026).
That overlap matters. When people gather indoors for hours at a time—often in crowded, high-turnover settings—cooling centers can unintentionally create conditions for disease spread if infection prevention isn’t built into daily operations.
As heat season lengthens and the need for cooling spaces increase, infection prevention should not be an add-on, but a standard practice to ensure effective and safe heat relief.
High-touch surfaces, shared restrooms, water fountains, pet relief areas, and crowded seating can all quietly become points of transmission. The good news: many of the steps that make cooling centers safer are practical, low-cost, and align closely with existing protocols. In fact, many community partners such as shelters that provide heat relief already have infection control practices in place; the goal should be to align and adapt those practices for heat response.
Integrating Infection Prevention into Cooling Center Work
In Arizona, the Pima County Health Department’s Office of Heat Relief and Response and the University of Arizona’s Southwest Center on Resilience for Climate and Health, have worked together to develop a Cooling Center Toolkit that integrates infection prevention practices. The Toolkit provides guidance for the variety of community partners that make up the County’s Heat Relief Network that includes the City of Tucson, the Tohono O’odham Nation, the Pascua Yaqui Tribe, libraries, faith-based organizations, and nonprofits. The toolkit highlights practical steps that local health departments and community partners can adapt in their own settings.
Small Steps with Larger Impact: Core Practices to Consider
Many health departments and partners may find it helpful to encourage a few core practices at cooling sites, tailored to local context and capacity:
- Prioritize basic cleaning and disinfection. Regularly cleaning and then disinfecting high-touch surfaces, such as door handles, chair arms, tables, faucet handles, and shared equipment with EPA-registered products can help reduce germs in busy spaces.2,3
- Make hand hygiene convenient. Placing hand sanitizer stations at entrances, near restrooms, and by water fountains, along with clear, bilingual signage, can make it easier for visitors and staff to clean their hands at key moments. It can also be helpful to build routine checks so that sanitizer dispensers are refilled before they run empty, especially in high-traffic areas where daily refills may be needed.
- Check restrooms throughout the day. Periodic spot-checks to restock soap, paper towels, and toilet paper can help restrooms stay usable and welcoming during high-traffic periods. It is recommended that public restrooms be cleaned and disinfected at least once or twice a day, with more frequent cleaning when surfaces are visibly soiled or facilities are very busy.
- Adjust layout to ease crowding. When space allows, arranging chairs to create a bit more distance or setting up simple flow patterns around water stations and restrooms can support more comfortable and safer movement.
- Support basic respiratory etiquette. Providing tissues and visible trash cans, and posting brief reminders to cover coughs and sneezes, can offer low-lift support for respiratory hygiene.
Full list of EPA registered products can be found here: www.epa.gov/pesticide-registration/selected-epa-registered-disinfectants
DfE-Certified Disinfectants: www.epa.gov/pesticide-labels/dfe-certified-disinfectants
These practices are not meant to transform cooling centers into clinical settings. Instead, they can help shared spaces feel cleaner, safer, and more inviting—particularly for people who are more vulnerable to both heat and infection.
Soldier petting a dog in a shelter (stock photo).
Pet-Inclusive Planning with Health in Mind
For many people, especially people experiencing homelessness or housing instability, pets or a companion animal are a key part of their support system. If pets cannot be accommodated, some people may choose to remain outside or in unsafe conditions in the dangerous heat.
Cooling centers that can welcome pets should consider:
- Setting aside a defined pet area, separated from human-only seating when possible.
- Providing water, shade, and a simple system for pet waste, such as bags and designated trash cans.
- Using leashes or crates where appropriate to help reduce stress for both animals and people.
This type of planning can help reduce barriers to accessing cooling centers, while also supporting cleanliness and overall comfort in the space. When cooling centers or outreach teams hand out heat-relief supplies, such as water, electrolyte drinks, cooling towels, hats, and sunscreen; they might also consider including a few pet-focused items, such as collapsible pet water bowls or extra waste bags. These small additions can make it easier for people to keep their animals hydrated and cared for while they seek relief from the heat and can reinforce the message that heat safety is critical for both people and pets.
Building on existing systems
PCHD is using the Cooling Center Toolkit as a practical guide for its own heat response and for partners across the county. The toolkit provides simple tools and recommendations so that cooling centers, whether they are libraries, community centers, shelters, or faith-based sites, have a common approach to infection prevention woven into their heat operations.
Health departments can support cooling centers in implementing these recommendations by:
- Sharing ready-to-use materials, such as basic cleaning checklists, restroom and hand hygiene reminders, and bilingual signage, that sites can post and adapt to their own spaces.
- Offering a brief pre-season training session for staff and volunteers that cover both heat safety and infection prevention practices.
- Encouraging the use of visitor counts to understand how busy locations are, which can help guide where supplies like cleaning products, sanitizer refills, and heat-relief items need to be adjusted.
- Hosting weekly briefings to provide updates and obtain feedback on needs and limitations.
This approach allows infection prevention to be integrated into systems that many partners already use (e.g., shelter infection control routines) while keeping the focus on making cooling centers welcoming, safe, and responsive to the people who rely on them.
As extreme heat seasons lengthen and grow more complex, cooling centers are likely to remain a key part of community protection. By incorporating practical infection prevention measures into routine operations, cooling centers can continue to serve as trusted, welcoming spaces where people can find relief from the heat and support for their health more broadly.
For More Information, Visit:
- Pima County’s Cooling Centers Webpage
- Pima County’s Cooling Center Toolkit
References
- Bedi NS, Adams QH, Hess JJ, Wellenius GA. The Role of Cooling Centers in Protecting Vulnerable Individuals from Extreme Heat. Epidemiology. 2022;33(5):611-615. doi:10.1097/EDE.0000000000001503
- Boone SA, Gerba CP. Significance of fomites in the spread of respiratory and enteric viral disease. Appl Environ Microbiol. 2007;73(6):1687-1696. doi:10.1128/AEM.02051-06
- Centers for Disease Control and Prevention. (2024, April 24). When and how to clean and disinfect a facility. https://www.cdc.gov/hygiene/about/when-and-how-to-clean-and-disinfect-a-facility.html
