{
  "schemaVersion": 1,
  "generatedAt": "2026-08-23",
  "title": "Heat Reaches the Emergency Department Unevenly",
  "subtitle": "Temperature, age, and acute-care pressure in a changing German sentinel, 2022-2026",
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      "end": "2026-08-22"
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      },
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        "heatExcessMeanPp": 0.0148
      },
      {
        "week": "2026-W30",
        "weekStart": "2026-07-20",
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        "heatExcessMeanPp": -0.2206
      },
      {
        "week": "2026-W31",
        "weekStart": "2026-07-27",
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        "temperatureMeanC": 21.321,
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        "heatShareMean": 1.3606,
        "heatExcessMeanPp": -0.1658
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      {
        "week": "2026-W32",
        "weekStart": "2026-08-03",
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        "temperatureMeanC": 22.2,
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        "heatExcessMeanPp": 0.2309
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      {
        "week": "2026-W33",
        "weekStart": "2026-08-10",
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        "temperatureMeanC": 21.279,
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        "heatShareMean": 1.3728,
        "heatExcessMeanPp": -0.2657
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    ],
    "models": {
      "temperature": [
        {
          "field": "heatBurden20",
          "scale": 1,
          "observations": 240,
          "coefficient": 0.0345,
          "standardError": 0.068,
          "lower95": -0.0987,
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          "rSquared": 0.7793
        },
        {
          "field": "heatBurden22",
          "scale": 1,
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          "coefficient": 0.0238,
          "standardError": 0.1504,
          "lower95": -0.271,
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          "visitCoefficientPer100": -0.8368,
          "rSquared": 0.7792
        },
        {
          "field": "heatBurden24",
          "scale": 1,
          "observations": 240,
          "coefficient": 0.2045,
          "standardError": 0.2228,
          "lower95": -0.2322,
          "upper95": 0.6412,
          "visitCoefficientPer100": -0.8718,
          "rSquared": 0.7794
        }
      ],
      "heatExcess": {
        "field": "heatExcessMeanPp",
        "scale": 1,
        "observations": 240,
        "coefficient": 6.571,
        "standardError": 2.4546,
        "lower95": 1.76,
        "upper95": 11.3819,
        "visitCoefficientPer100": -1.4883,
        "rSquared": 0.7912
      }
    },
    "rawCorrelationHeat20Los": -0.0386
  },
  "stationPanel": [
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      "id": "00259",
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      "elevationM": 275,
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      "state": "Baden-Württemberg",
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      "firstDate": "2022-01-01",
      "lastDate": "2026-08-22"
    },
    {
      "id": "06263",
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      "historicalFile": "tageswerte_KL_06263_20040701_20251231_hist.zip",
      "state": "Baden-Württemberg",
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      "lastDate": "2026-08-22"
    },
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      "id": "00232",
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      "firstDate": "2022-01-01",
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    },
    {
      "id": "04706",
      "name": "Simbach/Inn",
      "latitude": 48.2718,
      "longitude": 13.0273,
      "elevationM": 358,
      "historicalFile": "tageswerte_KL_04706_19810101_20251231_hist.zip",
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      "firstDate": "2022-01-01",
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    },
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      "latitude": 48.5451,
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      "elevationM": 476,
      "historicalFile": "tageswerte_KL_05856_19961231_20251231_hist.zip",
      "state": "Bayern",
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    },
    {
      "id": "03155",
      "name": "Manderscheid-Sonnenhof",
      "latitude": 50.1015,
      "longitude": 6.8009,
      "elevationM": 415,
      "historicalFile": "tageswerte_KL_03155_19611101_20251231_hist.zip",
      "state": "Rheinland-Pfalz",
      "observations": 1695,
      "firstDate": "2022-01-01",
      "lastDate": "2026-08-22"
    },
    {
      "id": "02480",
      "name": "Kahl/Main",
      "latitude": 50.0643,
      "longitude": 8.993,
      "elevationM": 108,
      "historicalFile": "tageswerte_KL_02480_19470101_20251231_hist.zip",
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    },
    {
      "id": "04813",
      "name": "Staffelstein, Bad-Stublang",
      "latitude": 50.0806,
      "longitude": 11.0467,
      "elevationM": 318,
      "historicalFile": "tageswerte_KL_04813_20200801_20251231_hist.zip",
      "state": "Bayern",
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    },
    {
      "id": "00222",
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      "latitude": 50.5908,
      "longitude": 12.7139,
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      "state": "Sachsen",
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      "firstDate": "2022-01-01",
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    },
    {
      "id": "02252",
      "name": "Bertsdorf-Hörnitz",
      "latitude": 50.8992,
      "longitude": 14.7456,
      "elevationM": 271,
      "historicalFile": "tageswerte_KL_02252_19470101_20251231_hist.zip",
      "state": "Sachsen",
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    },
    {
      "id": "07374",
      "name": "Ahaus",
      "latitude": 52.0813,
      "longitude": 6.9409,
      "elevationM": 46,
      "historicalFile": "tageswerte_KL_07374_20060301_20251231_hist.zip",
      "state": "Nordrhein-Westfalen",
      "observations": 1695,
      "firstDate": "2022-01-01",
      "lastDate": "2026-08-22"
    },
    {
      "id": "04371",
      "name": "Salzuflen, Bad",
      "latitude": 52.1042,
      "longitude": 8.7521,
      "elevationM": 135,
      "historicalFile": "tageswerte_KL_04371_19350101_20251231_hist.zip",
      "state": "Nordrhein-Westfalen",
      "observations": 1690,
      "firstDate": "2022-01-01",
      "lastDate": "2026-08-22"
    },
    {
      "id": "06266",
      "name": "Huy-Pabstorf",
      "latitude": 52.0305,
      "longitude": 10.9626,
      "elevationM": 112,
      "historicalFile": "tageswerte_KL_06266_20040901_20251231_hist.zip",
      "state": "Sachsen-Anhalt",
      "observations": 1682,
      "firstDate": "2022-01-01",
      "lastDate": "2026-08-22"
    },
    {
      "id": "02856",
      "name": "Niedergörsdorf-Langenlipsdorf",
      "latitude": 51.9173,
      "longitude": 13.0878,
      "elevationM": 92,
      "historicalFile": "tageswerte_KL_02856_19930601_20251231_hist.zip",
      "state": "Brandenburg",
      "observations": 1695,
      "firstDate": "2022-01-01",
      "lastDate": "2026-08-22"
    },
    {
      "id": "06170",
      "name": "Neißemünde-Coschen",
      "latitude": 52.0192,
      "longitude": 14.7254,
      "elevationM": 39,
      "historicalFile": "tageswerte_KL_06170_20000201_20251231_hist.zip",
      "state": "Brandenburg",
      "observations": 1695,
      "firstDate": "2022-01-01",
      "lastDate": "2026-08-22"
    },
    {
      "id": "03631",
      "name": "Norderney",
      "latitude": 53.7123,
      "longitude": 7.1519,
      "elevationM": 12,
      "historicalFile": "tageswerte_KL_03631_18580301_20251231_hist.zip",
      "state": "Niedersachsen",
      "observations": 1695,
      "firstDate": "2022-01-01",
      "lastDate": "2026-08-22"
    },
    {
      "id": "01200",
      "name": "Elpersbüttel",
      "latitude": 54.0691,
      "longitude": 9.0105,
      "elevationM": 3,
      "historicalFile": "tageswerte_KL_01200_19980101_20251231_hist.zip",
      "state": "Schleswig-Holstein",
      "observations": 1695,
      "firstDate": "2022-01-01",
      "lastDate": "2026-08-22"
    },
    {
      "id": "00596",
      "name": "Boltenhagen",
      "latitude": 54.0027,
      "longitude": 11.1908,
      "elevationM": 15,
      "historicalFile": "tageswerte_KL_00596_19470101_20251231_hist.zip",
      "state": "Mecklenburg-Vorpommern",
      "observations": 1695,
      "firstDate": "2022-01-01",
      "lastDate": "2026-08-22"
    },
    {
      "id": "05097",
      "name": "Tribsees",
      "latitude": 54.0654,
      "longitude": 12.7655,
      "elevationM": 10,
      "historicalFile": "tageswerte_KL_05097_19910101_20251231_hist.zip",
      "state": "Mecklenburg-Vorpommern",
      "observations": 1695,
      "firstDate": "2022-01-01",
      "lastDate": "2026-08-22"
    },
    {
      "id": "05142",
      "name": "Ueckermünde",
      "latitude": 53.7445,
      "longitude": 14.0698,
      "elevationM": 1,
      "historicalFile": "tageswerte_KL_05142_19360901_20251231_hist.zip",
      "state": "Mecklenburg-Vorpommern",
      "observations": 1695,
      "firstDate": "2022-01-01",
      "lastDate": "2026-08-22"
    }
  ],
  "methods": {
    "temperature": "Fixed 20-station DWD panel selected from a four-by-five geographic grid before outcome analysis. The daily national index is the unweighted station median of TMK; TXK and TNK are summarized separately. Historical archives supply 2022-2025 after completed quality control; the recent feed supplies 2026 and is not yet fully quality controlled.",
    "thresholds": "Heat degree is max(0, national median daily temperature minus 20, 22, or 24 °C). All three thresholds were specified before model fitting and are reported as sensitivity checks.",
    "outcome": "RKI HEAT relative_cases and relative_cases_7day_ma for ed_type=all, all eight published age bands, and 00+. Values are percentage shares of presentations with complete syndrome-defining fields among participating emergency departments.",
    "baseline": "For each age and calendar day, the reference is the median seven-day moving-average HEAT share among 2022-2025 observations within a circular plus-or-minus seven-day calendar window. Excess is the observed moving average minus that reference in percentage points.",
    "responseCurve": "Local linear LOESS with a 0.30 span, estimated separately by age from all daily 2022-2026 observations. One-degree bins show medians and interquartile ranges; the curve is descriptive and does not identify a causal dose response.",
    "lagModel": "Age-specific OLS of seasonal excess on heat-degree terms at lags 0-3, two annual harmonics, day-of-week indicators, a linear trend, and reporting-ED count. Newey-West HAC uncertainty uses 14 daily lags. Adjacent temperatures and a seven-day outcome moving average make individual lag coefficients unstable; cumulative effects are more informative.",
    "congestion": "Weekly AKTIN los_difference is merged by ISO week to DWD heat burden and the aggregate RKI HEAT excess. OLS controls visit_mean (per 100 visits), reporting-ED count, two annual harmonics, and a linear trend; Newey-West HAC uncertainty uses four weekly lags. The LOS and syndrome sentinels are not guaranteed to contain the same emergency departments.",
    "caveat": "Neither RKI series is representative of Germany. Participation, coding completeness, emergency-department mix, and denominators change over time. Associations are descriptive and should not be reported as Germany-wide heat-illness rates or causal capacity effects."
  },
  "diagnostics": {
    "rkiHeatRows": 15255,
    "temperatureDays": 1695,
    "stationDays": 33881,
    "minimumStationsPerDay": 19,
    "weeklyCongestionRows": 240,
    "sourceManifestSha256": "b47d9e92c5225fd862fd61a8effa8b1fd42bd1e125f54e8f47dfcbf548640e0c"
  }
}