PCLM-D-26-00155

Dynamic health risks of sudden temperature drops in sub-tropical winter time: A case study in Hong Kong

PLOS Climate

Dear Dr. REN,

Thank you for submitting your manuscript to PLOS Climate. After careful consideration, we feel that it has merit but does not fully meet PLOS Climate’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

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Kind regards,

Teodoro Georgiadis

Academic Editor

PLOS Climate

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5. In the online submission form, you indicated that "Daily meteorological data can be found from Hong Kong Observatory website (https://www.hko.gov.hk/en/index.html), while daily air pollution data are publicaly available at the Environmental Protection Department of Hong Kong(https://www.epd.gov.hk/epd/english/top.html ). Health data was applied and collected from Hong Kong Census & Statistics Department, Hong Kong Hospital Authority, and Fire and Ambulance Services Academy of Hong Kong Fire Services Department. The dates of the identified events are available upon request to the corresponding authors.".

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Additional Editor Comments (if provided):

Both reviewers, even considering the manuscript of value raise up some concerns about the completeness of the climatic data analysis.

I suggest the authors to fully consider the reviewer's comments and suggestions and to revise their manuscript accordingly

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Reviewers' comments:

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1. Does this manuscript meet PLOS Climate’s publication criteria? Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe methodologically and ethically rigorous research with conclusions that are appropriately drawn based on the data presented.-->

Reviewer #1: Yes

Reviewer #2: Partly

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Reviewer #1: Yes

Reviewer #2: No

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Reviewer #1: Yes

Reviewer #2: No

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Manuscript Number; PCLM-D-26-00155

Title; Dynamic health risks of sudden temperature drops in sub-tropical winter time: A case study in Hong Kong

The issue is relevant to science, but this research needs refinement before publication in an academic journal. Article authors should reassess their main goal in light of the content. Instead of lengthy words, they should summarize the review's main findings. The standard methodology doesn't include methods for improving the research. For readability and consistency, the paper's structure needs to be modified. The conclusion is poorly written and fails to explain or underline the findings.

Evaluation; Major Revision

1. Abstract: The authors should revise the abstract; it is too general. Moreover, it could be further developed, as the article contains a lot of interesting data. An informative and representative conclusion should be added to the abstract.

2. Meteorological data are collected from a single central station, which may not capture spatial variability across Hong Kong.

3. Ambulance (2011–2019), hospitalization (1999–2019), mortality (1995–2021). Different time spans may introduce temporal inconsistency and bias in comparative analysis.

4. Emergency causes were assessed at the scene by paramedics based on immediate signs and symptoms, which may be subject to biases affecting the precision of health risk estimates.

5. Limited sample size of events: Because the study period was relatively short and the number of identified sudden temperature drop (STD) cases was small, a detailed analysis of varying event patterns was restricted.

6. In the main text, many numeric data are given with too many significant figures; two significant figures suffice, and 3 suffice if the first significant figure is "1."

7. You must provide all the figures in high resolution and make the labels and legends more legible.

Reviewer #2: The research project is very interesting and the results presented are equally encouraging, but the text needs to be finalised and the graphics improved:

1 - Explain why, given the excellent statistical performance achieved, the statistical analysis took into account the minimum temperature rather than the maximum temperature and, above all, the diurnal temperature range

2 - There is a lack of any quantitative climatic analysis carried out on the data relating to the latest climate normal CLINo (period 1991–2020), with evidence of any climatic values that might then justify the choice of specific temperature thresholds used in the subsequent analysis

Furthermore, there is no mention of the weather patterns that bring in continental cold air masses responsible for the temperature fluctuations studied. This section, 2.1, should be titled ‘Climatic Characteristics’

3 - Figures 1, 2 and 3 must be redrawn, as they are almost illegible and, in any case, lack clear graphical representation

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Reviewer #1: No

Reviewer #2: No

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Dynamic health risks of sudden temperature drops in sub-tropical winter time: A case study in Hong Kong

PCLM-D-26-00155R1

Dear Dr. REN,

We are pleased to inform you that your manuscript 'Dynamic health risks of sudden temperature drops in sub-tropical winter time: A case study in Hong Kong' has been provisionally accepted for publication in PLOS Climate.

Before your manuscript can be formally accepted you will need to complete some formatting changes, which you will receive in a follow-up email from a member of our team.

Please note that your manuscript will not be scheduled for publication until you have made the required changes, so a swift response is appreciated.

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Thank you again for supporting Open Access publishing; we are looking forward to publishing your work in PLOS Climate.

Best regards,

Teodoro Georgiadis

Academic Editor

PLOS Climate

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Additional Editor Comments (if provided):

The authors have furnished a very grounded and exhaustive replies to the reviewers improving considerably their manuscript that now is worthy of publication.

Reviewer Comments (if any, and for reference):