How Outages Actually Hurt People

The folk picture of an outage is running out of food. That is almost never what injures anyone. The hazards, in the order the data supports, are carbon monoxide, temperature, fire, and medical device dependence.

Carbon monoxide from generators is first, and it has a cruel property: it requires owning a generator, which means it selects for prepared households. CPSC’s May 2026 report estimates 892 generator carbon-monoxide deaths from 2012 to 2022, 93 of them in 2022. Guidance is at least 20 feet from the house with exhaust directed away, and the Commission states plainly that opening doors or windows does not provide enough ventilation. The garage, the porch and under a window are where people actually put them and where the deaths happen. When buying, look for automatic CO shutoff. A mandatory federal rule was proposed in 2023 and is not yet final. CPSC’s May 2026 guidance points to models certified to PGMA G300-2023 or UL 2201-2023. Shutoff does not make indoor use safe.

Temperature is second. Heat-related deaths averaged 702 a year across 2004–2018, with adults over 65 making up 39%. Modeling of a heat wave in Phoenix, Atlanta and Detroit used 48 hours of total blackout and then staged restoration, not five days of outage, and found heat-related mortality more than doubling relative to the same heat wave with power on.

Cold produces its own second wave of carbon monoxide deaths from what people burn indoors when the heat fails. A gas oven is not a heater. Never burn charcoal indoors or in a garage.

Fire is third, and it is the easiest to eliminate. Candles start roughly 7,610 home structure fires a year on NFPA estimates, causing about 81 deaths and 677 injuries. Battery lanterns and headlamps solve this for under twenty dollars.

Fourth, medical device dependence — oxygen concentrators, ventilators, powered wheelchairs, dialysis, infusion pumps, CPAP. HHS runs the emPOWER program, publishing county and ZIP-level counts of Medicare beneficiaries relying on electricity-dependent equipment, updated monthly and overlaid with hazard data. It undercounts, because it covers Medicare only.

If someone in your household is device-dependent, write the plan in advance: measured battery runtime, a charging location, utility medical registration, and a named destination.

The numbers you need on paper:

• Refrigerator, about 4 hours; full freezer, about 48; half-full, about 24 — fullness is thermal mass, which is why water jugs in empty freezer space are free insurance. When in doubt, throw it out, and never taste food to judge safety.
• Water at a gallon per person per day.
• Boiling: a rolling boil for at least one minute, three minutes above 5,000 feet.
• Bleach: unscented household chlorine bleach only, and the ratio depends on concentration — 8 drops of 6% or 6 drops of 8.25% per gallon of clear water, 2 drops of either per quart, stand 30 minutes. Write that down rather than memorize it, because it is the one place on this page where a wrong number is dangerous.