Heat took at least 430 lives in Maricopa County this year

This article is part of a package of stories and videos that show the challenges extreme heat poses in Phoenix and the Valley to politicians, policymakers, frontline emergency workers, residents, and the people living on the streets who are most likely to die from it.

The Phoenix police officers carried the handcuffed man by his arms over to a shady spot created by one of their patrol Tahoes in the apartment complex’s parking lot. 

“It’s pretty hot,” one of the officers said about the pavement as they set down the motionless man. They adjusted his legs, which were tucked under him. One officer asked the others if anyone had a blanket in their car. They didn’t. 

“It’s alright, buddy. We’re going to get you some medical help,” one of the officers told the man. They propped his shirtless tattooed torso up so his skin wouldn’t touch the ground. His chest rose gently with each breath. They asked his name. He didn’t respond. 

“Could it be an OD?” one officer asked. 

Just a few minutes earlier, they’d responded to a call about a man acting erratically. He was bashing his head into windows of an apartment complex near West Campbell Avenue and Interstate 17. They’d found him huddled in a bush next to the building. Only his hand poked out from the leaves. He loosely grasped a nearby black wrought-iron fence. When the officers spoke to him, he didn’t respond. He hummed softly and slowly let go of the fence pole. The officers tried to coax him out. They encouraged him, they threatened him with arrest, they said they could tell he was injured. They wanted to get him medical help. They spoke to him in Spanish.

“He’s either 918 or very much on 237,” an officer said at one point over the radio, using police code for mentally ill or on drugs.

Within minutes, they realized he wasn’t going to respond. Confident he was unarmed, they went into the bush and carried him out. 

They stood over him next to the Tahoe and looked around for a cooler spot. It was around 4 p.m. on July 28. Phoenix was in the middle of what would become the longest stretch of consecutive days with an excessive heat warning. Eighteen in total. Temperatures reached 107 degrees in the city that day. The pavement was much hotter.  

One officer suggested propping him up against one of the Tahoe’s tires. The others disagreed. Too hot. So they left him where he sat and waited for the Phoenix Fire Department.

The man, later identified by the Phoenix Police Department as 42-year-old Jesse Fred, would die that day. Cause of death: Hyperthermia in the setting of acute polydrug toxicity and environmental heat exposure. 

Fred’s death was one of three dramatic heat emergencies caught on video this past summer, two of which were fatal. The incidents, two recorded on police department body cameras and one on smartphones, show how complicated it can be to respond to heat emergencies. Heat is a silent killer, but in the lead-up, it can be violent as it was in Fred’s case. And often the signs and symptoms are mistaken for other emergencies. 

“Sometimes we may just inadvertently leave it out of the equation till a little bit later,” said Ron Crawford, a retired coroner who responded to thousands of heat death cases during his career, sometimes multiple in a single day. “Maybe it should be at step two, but some places are not thinking about it till, you know, step number five.” 

Fred was one of 13 people to die that day in the county from heat, according to the Maricopa County Heat-Related Illness and Death Dashboard which was last updated on Oct. 17. One more death from that day remains under investigation for heat. The city of Phoenix alone received 210 heat-related calls that week.

Phoenix New Times spent the summer reporting on this crisis, the city’s response and the chaos that often unfolds on the street when someone is dying of heat.

As your body keeps fighting to cool down, you lose water. You lose salt. Your vision blurs. You start to feel nauseated. You get chills. Your heart races and your blood pressure drops. The blood redirected to your extremities leaves your internal organs wanting. Once you reach 104 degrees, you’re at risk for heatstroke. Stay hot enough for long enough and your organs start to fail. Your brain, too. Without enough oxygen, blood, and electrolytes, it starts to malfunction, and it may even swell. You slur your words. You speak incoherently. You hallucinate. You may get restless, agitated and violent or sluggish and comatose.

Eventually your body destroys itself. Certain health conditions and drugs accelerate this collapse. Diuretics, GLP-1s, antipsychotics, antidepressants, methamphetamine, fentanyl, alcohol, Benadryl. Legal or not, they get in the body’s way of saving itself. They make it harder for the body to sweat and to cool down. Or they make you less aware that you need to.

“Many times when these things happen, it’s a combination of factors that come into play,” said Dr. Frank LoVecchio, an emergency room physician who regularly sees people suffering from heatstroke. 

The signs and symptoms of heatstroke mimic those of other emergencies — mental health, drug overdoses, even diabetic shock. Often, everything happens at once. Narcan will only help so much if someone’s body temperature is 105 degrees. Their overdose might be stopped, but that doesn’t matter if their body continues to cook itself from within. 

In Phoenix, it’s not uncommon for a homeless person to be mentally ill, self-medicating with fentanyl and methamphetamine and also succumb to our desert heat. The symptoms and signs compound over time. 

“Some of the difficulty is how they mimic overdose symptoms,” said Maritza Arias, a behavioral therapist on Circle the City’s street medicine team. She regularly sees patients who are homeless and struggling with the heat.

Passersby and first responders can easily mistake, miss or overlook the signs of heatstroke, delaying calls for help or proper treatment when every minute counts. Officers usually approach a call with the mindset of catching a criminal and neutralizing a threat, not the instinct to help a paramedic might bring, a police source said. Delirium or an “altered mental state,” a critical sign of heatstroke, is the least recognized of all. 

Phoenix police officers are trained in basic first aid and heat-related illness, said Dan Wilson, Phoenix’s communications director, in a written statement. But they rely on “the expertise of the Phoenix Fire Department to provide medical attention.”

“Both Phoenix Police and Phoenix Fire provide service regardless of an individual’s housing status,” he wrote.

The fire department declined to comment on the cases mentioned in this story. It responds to multiple heat emergencies a day, especially between June and August, said Todd Keller, a Phoenix Fire Department captain and public information officer. Responders go into every call with dispatcher information and an open mind, he said. If the temperature is in the 100s, they’ll always consider heat in their response. If someone is reported as being in an “altered mental state,” he said, there are many options for what it can be. A person might be suffering from a heat illness when it’s 75 degrees out and they’ve been outside all day. Or they might be acting erratically from low blood sugar but not be overheated, even on a 115-degree day. 

“Our job is to find that out,” he said. 

In Fred’s case, the various first responders trying to help him considered mental illness and drugs. When they saw the blood on his head they wondered if head trauma was a possible cause for his non-responsiveness. Someone asked if he had been beaten up or had fallen. During the discussion, a fire fighter noted his temperature was high. Someone asked if they were going to need to use the ice. It wasn’t until about five-and-a-half minutes after the fire department arrived — and about 30 minutes after officers first received the call — that a responder announced his temperature.

It was over 107 degrees Fahrenheit. “Jesus,” one officer exclaimed when he heard the number.

He pumped Alford’s chest by himself until a second officer arrived. They gave him Narcan and waited for the fire department. Alford was taken to Valleywise Medical Health Center where he was pronounced dead. 

Stacey Champion, a public relations consultant and activist, didn’t need to wait for a cause of death by the Maricopa County Medical Examiner’s Office. She was confident she knew what caused — or contributed to — Alford acting erratically and dying: heat. 

“When people’s internal temperature gets that high, you start acting crazy,” Champion said. “I have seen it with other cases.” 

Champion was right. A few months later, at the end of September, the report from the medical examiner released to Phoenix New Times through a public records request confirmed her suspicions: Alford did die of a fentanyl and methamphetamine overdose. But he also died of heat. 

It was around 4 p.m. when the officer arrived on the scene — nearly the same time of day as when the officers responded to the call about Fred. Temperatures reached around 104 degrees Fahrenheit that day. Alford died an accidental death because of drug use in elevated temperatures, according to the medical examiner’s report. His body temperature at the hospital was 105. 

Alford and Fred’s deaths reminded Champion of Caleb Blair, a 19-year-old who died in police custody in June 2022, she said. When police arrived they found Blair naked in a Circle K parking lot. 911 callers said he pulled his hair and bashed his head on the ground and on a car. 

“There’s a lot of misunderstanding surrounding what it does to your body,” Champion said about heat. “People will start taking off their clothes. They’ll start hitting their head on things. They will start acting erratically.”

Narcan should always come first in a situation like Alford’s. “But there should also be, like, an immediate temperature check,” Champion said.

Alford was one of four people confirmed to have died from heat or for whom heat was a contributing factor in their death on June 28, according to the heat dashboard. So far the county has confirmed 389 heat deaths this year as of Oct. 17. It is still investigating 483 more. In 2025, the county confirmed that 430 people died of heat, a number that some, like Champion, say is an undercount. Of those 430, 233 lived in Phoenix.  

It’s impossible to know whether Alford could have been saved if his body temperature had been lowered sooner, Crawford said after reviewing the medical examiner’s report. There were too many factors at play between the drug overdose and his other existing health issues. But he does know that without those other factors, the heat alone could have killed him. 

“His body core temperature — that is absolutely enough,” Crawford said.

The heat was unrelenting. And it showed. In total, 1,744 calls for service in Phoenix were related to heat — 156 more than last year. 

Yet Phoenix got off easy: The U.S. at large had its hottest-ever summer, topping 2021 and 1936. No big city deals with heat as high or as long as Phoenix’s, yet. But as the climate warms, more and more Americans will be living and dying in extreme heat. The solutions and practices that Phoenix’s policymakers and first responders muddle through today are creating a roadmap that others are sure to follow, for better and for worse.

In 2024, the fire department began using an ice immersion technique to fight heat-related illness that, while simple, was innovative enough to attract a film crew that followed them around as they used it. When a patient’s body temperature is 104 or higher and they are in an “altered mental state,” the fire department will put them in a body-sized blue bag with ice. The ice will cool them down.

“It’s been shown to drastically impact the outcome of our patients when they are in that altered state,” said Keller, the public information officer for the fire department. 

The fire department immersed 234 people in ice bags this past summer, according to the city’s final heat report.

One of those 234 bags was used on the morning of Aug. 1 in the Zone, the informal homeless encampment near downtown Phoenix. Two activists, Sophia Elicia and her partner, Jessica Spencer, provided aid and heat relief to people in the Zone that morning. Elicia, who runs the Instagram account unshelteredphx, asked to be referred to by her first and middle names out of fear of retaliation.

It was just after 10:30 a.m., and the heat was just starting. It was day 10 of the 18-day heatwave. Temperatures were already in the 100s. They would reach 116 later that day. 

Anna, 39, sat on the curb at 11th Avenue and Jackson Street. She was delirious. Elicia knelt behind her and propped her up. Around them stood a group of people, including Spencer, an EMT and security guards who work at the nearby Key Campus, a homeless solutions hub the city partially funds. 

The EMT had given Anna Narcan and a cooling towel, but she and the security guards were brushing off the activists’ suggestions to call 911 or even to ask Anna if she wanted to go to the hospital. Anna was overdosing. Heat was not the problem. 

“If she denies it, then ultimately we just wasted 911 calls,” one of the security guards can be heard saying in the video. A security guard later said it wasn’t the EMT’s responsibility to call 911.

The activists realized the EMT didn’t have a working thermometer to take Anna’s temperature. Then Spencer’s heat gun clocked the pavement Anna was sitting on at 140 degrees. Even if she was overdosing and not at the point of heatstroke, she would never cool down sitting on that pavement. 

Elicia asked Anna, who was barely conscious, if she wanted them to call 911. She mumbled yes. 

The fire department arrived and put Anna in an ice bag and rushed her to the hospital. She survived. 

She wouldn’t have survived if they hadn’t put her in the ice bag, Anna told New Times in an interview a couple of weeks later. She didn’t know how high her body temperature reached that morning, but fire department policy is to use the bags on patients in an “altered mental state” with body temperatures of 104 or higher. Anna qualified. She was one of 45 people who were put in an ice bag that week. 

Anna has stayed on and off in the Zone for two years. She’d been back only a couple of days before she suffered from heatstroke. She’d just been released from jail. She’d drank the night before and wasn’t used to the heat yet. 

“Just being out here, then the heat fresh out of jail,” she said. “It hit me really hard.”

Anna explained that she knew something was wrong when she started to overheat. When the EMT gave her Narcan she tried to get across that she was too hot but couldn’t, she said. She also got second-degree burns from sitting on the 140-degree pavement. 

Anna watched the video. It was difficult. But she was grateful to Elicia and Spencer for advocating for her and calling 911.  

“I’d probably be dead,” she said.

Anna’s hospitalization earned her an immediate spot in CASS, the single-adult shelter on the Key Campus. With it she would have 10 nights of reprieve from the heat. But then she was back out in the Zone. 

A month after surviving a heatstroke, she died of an overdose. 

The highway roaring behind them, Melanie had hiked up her spaghetti strap dress to reveal an old bandage hiding a small, red, angry wound on her lower back. The women cleaned it and applied a clean white bandage. 

When they’d found Melanie, she was half asleep, sitting on the corner of the ramp to I-10 beside a cart overflowing with her belongings and a handwritten cardboard sign that read: “I’m in 4th stage of chronic kidney disease with kidney failure & need some help please. God bless, drive safe & have a nice day.” A blue umbrella was the only object between her and the Phoenix sun. Her blood pressure was lower than the last time and she felt nauseated. She was suffering from the unrelenting heat. 

Aug. 14 was not an excessive heat day, but it wasn’t cool by any means. That morning in the parking lot, it was already 86 degrees with 57% humidity — balmy, by Phoenix standards. With the sun, it felt oppressive. 

And the health effects of heat are cumulative. Just days earlier, Phoenix had finished the 18-day stretch of consecutive excessive heat days. Despite the slight reprieve, temperatures were still reaching the low 100s. People living on the streets struggle to recover because they face high temperatures day in, day out. Melanie’s chronic kidney disease and the suboxone to help with her addiction made her more susceptible to heat.

In the parking lot, Puebla, Arias and Madril tried to cool her down. They gave her a cold bottle of water and some electrolytes. 

“I’ve got three flavors, sweetie. Grape, fruit punch and strawberry lemonade,” Madril said. Then, trying to pawn off an appealing electrolyte flavor: “Fruit punch?”

“Are you feeling better?” Puebla asked her. 

It was late morning, and she hadn’t eaten yet. At her request, they bought her chicken strips with pepperjack cheese sauce and a cold Mountain Dew from Taco Bell. During a previous visit, Arias, Madril and Puebla had convinced her to accept a placement in one of the city’s homeless shelters. She’d agreed, but there was no room. This time they tried to convince her to let them drive her to a cooling center. She declined. 

It was her 10th summer on the street, Melanie said quietly. Normally she sits underneath trees and wets herself down with water from a spigot behind a nearby Jack in the Box to stay cool. The day before yesterday, she lost access to water. 

“They locked it,” she said.

Melanie agreed to let Madril drive her to a shady spot across the street where she liked to rest. Perla and Arias pushed her cart there. The ride was short — just a couple of minutes — so the Winnebago got there first. Melanie waited for her belongings in the shotgun seat, her eyes shut and head resting back. The only noise was the air conditioning, blasting and blowing through her hair. She only climbed out when Perla and Arias arrived sweating and panting with her cart. 

Homeless people make up about 0.21% of Maricopa County’s population. There are just under 10,000 homeless people in a county of around 4.7 million people — the majority of whom live in Phoenix. As of Oct. 17, 44% of the people confirmed to have died from heat in the county were homeless. In 2025, it was 48%. 

To seriously combat heat as a public health issue, the city has to tackle homelessness head on, said Will Humble, executive director of the Arizona Public Health Association. 

“The sexy stuff is ‘Oh, you know, somebody got dizzy-headed on the golf course,’” said Humble. “It happens. But big deal, really. Statistically, that’s not the issue.”

The city expanded its heat relief efforts for 2026 investing more than $5 million. It announced partnerships with organizations for new heat relief sites and expanded hours at other cooling centers throughout the city. Its 24-hour heat relief site at 20 W. Jackson continued to be open at all hours.

“These sites primarily serve people experiencing homelessness,” said Wilson, Phoenix’s communications director. 

At the October meeting, the Phoenix City Council’s Public, Safety and Justice Subcommittee listened to a presentation to wrap up the 2026 heat season. Representatives from the fire department and the city’s Parks and Recreation Department walked committee members through slides detailing the year’s numbers through the end of August. The mean temperature was the third-highest on record: 93.8. There were 39 days at or above 110 degrees. There were 1,744 calls for service related to heat illnesses, about 14% for heatstroke. 

“This was just one presentation of several involving the City’s summer heat response,” Wilson wrote. “Heat and specifically the impact on those experiencing homelessness have been discussed at several City Council meetings.” 

The presenters detailed the ice immersion technique and showed a short video. They outlined its effectiveness, including decreased mortality and shorter hospital stays. Then they turned to the trails. Twelve hikers were rescued on extreme heat warning days, six of which were on trails closed due to heat. 

When the presentation ended, the city council members asked questions. 

“The bags that are being used,” said council member Kevin Robinson. “Is that something we’re able to reuse? Or is it a one-time use, and then that’s the end of it?”

They are not reusable, the presenters replied. 

Council member Laura Pastor went next. 

“I just want to thank you and your partners for saving lives,” Pastor said. “Because this is what it does, it’s saving lives.”

Next, the subcommittee chair took the floor. They’d presented on heat rescues on trails with heat restrictions, council member Ann O’Brien said.

“Do we track the data for how rescues occur on the other mountains in our city?” she asked. Some people think that if they are not hiking Camelback Mountain or Piestewa Peak, they will be okay even in the heat, she noted. 

“I just want to make sure that we have the data to have that conversation in our districts,” she said.  

There was one public comment. It focused on mountain rescues and dangers to first responders. Then the meeting ended. 

How heat affects homeless people was not mentioned once. 

Once the first responders realized Fred’s body temperature was 107 degrees, the firefighters and officers went into action. One of the officers radioed out that the situation was now life-threatening. The firefighters brought out the bag, transferred Fred, now no longer handcuffed, into it and dumped in all of their ice. It wasn’t enough. 

“We’re going to have to get ice,” one of the firefighters said. 

They loaded Fred into the rescue. One of the officers jumped into the back next to Fred and they drove.

Fred lay in the bag in the patient compartment, his tattooed torso uncovered. 

“His stats were good,” one firefighter noted.

They decided to swing by a gas station. The officer offered to go for ice. 

“Pop in there, ask them where their ice is. Just tell them it’s for the fire department,” one of the men monitoring Fred said as the rescue drove. “It takes, like, probably about four minutes.”

But within 10 seconds, everything changed. 

“I’m going to shock him,” one of the firefighters monitoring Fred said. “He’s in V-fib.” Fred was coding. “Just go to the hospital!” the firefighter who told the officer how to get ice yelled at the driver. “Don’t stop for ice!” 

A firefighter said “clear” and Fred’s torso jumped. They began chest compressions and bagged him. The officer manually squeezed the bag that pushed oxygen into Fred’s lungs. The three firefighters worked furiously while the officer squeezed the bag. They spoke quietly among themselves about each step. The only other noises were the machine’s beeping and the rhythmic swish of the bag. 

At the hospital, they rolled him on a stretcher. The officer followed. Medical staff swooped in. The officer walked to a sink and took off his black gloves. He washed his hands. He watched the commotion, then walked back to the hospital door for better reception. They were working on the subject, he radioed.

“There’s a code right now,” he said. “There’s a possibility he goes 901 Henry.”

He was radioing that Fred was going to die.