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. ‘ACTING ERRATICALLY’ A month before Fred died, another officer responded to a similar call at a Bank of America at the corner of 44th Street and Thomas Road. A caller had reported a man, later identified as 34-year-old Devin Alford, acting erratically. When the first officer arrived, Alford was writhing on the ground shrieking. The officer asked if he was alright. The officer rolled him onto his stomach and cuffed him. Alford lost consciousness. He took his pulse and radioed for help. He uncuffed Alford and began chest compressions. He pumped Alford’s chest by himself until a second officer arrived. They gave him Narcan and waited for the fire depart- ment. 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 tempera- ture had been lowered sooner, Crawford said after reviewing the medical examin- er’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. TEST CASE 2026 was a hot summer for Phoenix — the second highest on record. This year saw 47 excessive heat days, with temperatures reaching 105 or higher, according to a presentation to the Phoenix City Council on Oct. 7 marking the end of the heat season. Eighteen of those 47 happened consecutively from July 23 to Aug. 9. The first happened on March 19 — the earliest on record. Between May 1 and Aug. 31, the city experienced 39 days with tempera- tures higher than 110 degrees. 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 prac- tices 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 tempera- ture is 104 or higher and they are in an “altered mental state,” the fire depart- ment 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 unshel- teredphx, 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 heat stroke, 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 heat stroke. She’d just been released from jail. She’d drank the night before and wasn’t used to the heat yet. Jesse Fred’s body temperature was over 107 degrees. (Phoenix Police Department) A Phoenix police officer performed chest compressions on Devin Alford by himself for more than five minutes. (Phoenix Police Department) Jesse Fred coded in the ambulance on the way to the hospital. (Phoenix Police Department) >> p 16