The week that Death Valley National Park rangers realized David Kelleher was missing, temperatures soared to 123 degrees Fahrenheit. On Wednesday, June 8, a ranger spotted the 67-year-old’s car in the Zabriskie Point parking lot, where sweeping views of the badlands and salt flats make it one of the most popular stops in the park, which straddles the California-Nevada border. On Saturday night, after a 122-degree day, the same ranger noticed that Kelleher’s car was still there—with a note inside reading “out of gas”—and launched an investigation.

Heat that weekend slowed the search. In temperatures over 115 degrees, helicopters can’t generate the lift to fly safely, and daytime ground searches are dangerous, too. When they could, searchers focused on the trail system nearby. But he wasn’t found until early the following week—park visitors discovered him about 2.5 miles away from his car, his body hidden by a tree just 30 feet off the main road.

When Abby Wines, the park’s public information officer (PIO), prepared the press release the next day, she wrote that it seemed he’d been walking toward Furnace Creek, where there’s an inn, a visitor center, and a gas station. She also noted how hot it had been, figuring readers would make the connection with that week’s heat wave. But, as in most park deaths she thinks are likely heat related, she couldn’t formally say that it was. This is because it is tough, sometimes impossible, to identify heat as a cause of death . Investigations of fatalities like these by medical examiners can take weeks and even months, if they happen at all, leaving the public no better informed about just how dangerous local conditions are and who is at risk of illness or death on the trail.

It’s part of a problem that plagues heat-fatality data nationwide. These deaths occur in parks, cities, stadiums, farm fields, senior-living apartments, and homeless camps, both during extreme heat events but also on regular hot days. Most who die from heat-related illness are never officially counted as having died from hot conditions, which epidemiologists, coroners, local and state governments, the Environmental Protection Agency, and the Centers for Disease Control and Prevention all say hampers the public’s understanding of the dangers of heat and stymies efforts to prevent further deaths.

Kelleher’s was the second such death in a matter of weeks, following John McCarry, 69, whose body was found June 1. In 2021, of six hiker fatalities in Death Valley, park press releases noted the high temperatures at the time related to three. A fourth, a 27-year-old woman who died hiking in November, was speculated by some media as a heat-related fatality, but her cause of death was never publicized.

“It becomes very awkward for me as a PIO,” Wines says. “There’s no sign of foul play. That’s the only thing I can say. There’s no sign of suicide or someone attacking them. But the difference between a heat-related medical event and a medical event that’s just your time to go—and you happen to be in the middle of nowhere—usually that nuance isn’t very clear.”

Outdoor adventurers of all stripes are used to databases, logs, and publications that help them (and researchers) understand how people die outside so they might avoid a similar fate, including the national avalanche-fatality database, the American Alpine Club’s annual report Accidents in North American Mountaineering, the American Whitewater Accident Database, and more.

Heat, the “leading weather-related killer in the United States,” according to the EPA, has no such database. But as public-health experts around the country call for a better accounting of heat-related illnesses and deaths, efforts to do so are taking hold in places from Phoenix to California to the CDC’s offices in Atlanta. These initiatives could help us better understand a phenomenon that doctors and climate scientists agree is getting deadlier, preventing future deaths from occurring.

In the 1990s, two of the nation’s worst heat waves swept the country, killing 118 people in Philadelphia in ’93 and 739 in Chicago in ’95. In reports on both disasters, the CDC noted that its understanding of the deaths was limited, because medical examiners had “no uniform definition for heat-related death.”

CDC officials later estimated the number of heat-related deaths by comparing those numbers to average deaths from previous years—a practice called “excess death analysis,” which is still the preferred method to estimate fatalities during disasters, including the COVID-19 pandemic. But the incomplete data meant that officials in Chicago couldn’t specify which deaths were heat-related or whether certain groups had been impacted disproportionately and why. It also meant that, outside of large disasters like these, officials had no reliable understanding of how many people die from heat, because it’s so hard to definitively identify with an autopsy, and because not everyone who dies of heatstroke gets one in the first place.

In response, in 1997, the National Association of Medical Examiners (NAME) published “Criteria for the Diagnosis of Heat-Related Deaths” in The American Journal of Forensic Medicine and Pathology. But even these criteria have limitations. If a person’s core temperature before death is at least 105, the criteria states, “cause of death should be certified as heat stroke or hyperthermia.” Lower readings can still qualify if witnesses or blood tests before death verify symptoms of heatstroke, such as confusion, low sodium, or heat-damaged muscle proteins leached into the blood.

If a person is found dead, which is often the case on trails and during heat waves, the criteria are squishier. An autopsy can’t identify those same conditions. Environmental factors might be unknown. In older individuals with underlying conditions, which are often exacerbated by heat, diagnosis can be even trickier.

Kathryn Pinneri, current president of the NAME and director of forensic services for Montgomery County, Texas, says that, given the hypothetical of a hiker who died in Death Valley when conditions were known to be hot but the body wasn’t found for several weeks, she would probably classify their death as “undetermined.”

“Unless there’s something really clear, like a specific note or text message saying, ‘I forgot my water and it’s 120 degrees,’ most of us would classify those deaths as undetermined if there was no definable cause of death,” she says.

The CDC, which pulls from coded death-certificate data, reports that about 700 Americans die each year from heat-related illnesses. A highly regarded excess death analysis published in 2020 by puts that number at more than 5,600. Greg Wellenius, an environmental epidemiologist and an author of that analysis, says that even those numbers are “probably an underestimate,” pointing to another research group that calculates it closer to 10,000.

“That number—whether it’s 6,000, 10,000, or 15,000—is in the ballpark of something we should pay attention to,” he says. “It’s worth investing in better understanding: Who is at risk, when are they at risk, and, importantly, what can we do about it?”

The nature and scale of heat-related deaths make them difficult to compare with other environmental accidents, but the way we handle avalanche deaths stands out as a case study in what’s possible when the resulting deaths are both well documented and widely communicated to the public.

At their most basic, heat and avalanches are common natural phenomena that regularly cause preventable deaths. Researchers who study both talk similarly about the value of learning from previous incidents, but while heat has remained largely underestimated by the public and the data, the systems in place to forecast avalanches, educate the public, and document exactly who dies in such events and why is a public-health success story.

The national avalanche-fatality database, maintained by the Colorado Avalanche Information Center (CAIC) in partnership with the U.S. Forest Service, grew out of an effort to understand a new and pressing problem: the exploding popularity of skiing in the mid-20th century in the Mountain West, which placed more recreationalists at risk. The Forest Service developed avalanche-safety and forecasting programs to protect skiers—along with mountain-town residents, drivers, and workers—and a group of forecasters “saw the value in starting to better document” incidents, says Karl Birkeland, director of the Forest Service’s National Avalanche Center.

The first Snowy Torrents, which publishes detailed accounts of every fatal avalanche accident on record, came out in 1968 and has since grown into a that records accidents from the mid-1800s through the present day.

“It resonates with people when you tell them exactly what happened in an accident, so hopefully they can avoid it,” says Ethan Greene, who runs the CAIC. “People relate much better to real-world narratives than a kind of esoteric description of a potential threat.”

Today, he says, reports are based on data collected as quickly as possible by staff of the nearest avalanche center, who travel to document snow and weather conditions, narratives from witnesses and survivors, and any available information from first responders and coroner reports. Although resource intensive, this kind of information has proven invaluable in the effort to increase public understanding of conditions and risks during the winter season and has helped researchers, policymakers, and rescuers alike understand long-term trends about how and why people die in avalanches.

Birkeland says that since the mid-1990s, when their reports and forecasts became easily accessible online, annual deaths have stabilized at around 25 to 30 per year despite an estimated 12-fold increase in recreation. “We can use that as a rough measure of the effectiveness of our avalanche forecasting and education programs,” he says. Education, outreach, and data collection about heat deaths could help equip people to better navigate that public-health crisis, too.

Public understanding of the deadly nature of extreme heat seems to be improving. In the aftermath of the 2021 Pacific Northwest heat wave, The New York Times published an excess death analysis showing that 600 people had died, while death-certificate data recorded less than 200. An investigation in the Los Angeles Times later that year noted that heat deaths in California are as much as six times higher than official counts.

Now, Wellenius says, “there’s a huge movement to address the problem.”

The epidemiologist points to the city of Phoenix, which last year created an Office of Heat Response and Mitigation, and to Miami, which appointed the world’s first chief heat officer. This spring, California Governor Gavin Newsom’s office launched an extreme-heat action plan; one goal is to “modernize the Electronic Death Registration System to register heat-related deaths” in order to help prevent them. And the CDC says it continues to improve its new Heat and Health Tracker, a dashboard launched in 2021 that tracks weather conditions and heat-related ER visits.

David Hondula, who leads the new heat office in Phoenix, says that his work advocating for solutions and preventing deaths is possible because the Maricopa County Public Health Department has a complete grasp of who is getting sick and dying from heat. Because that department monitors hospital discharge data for heat-related diagnoses using an especially broad set of criteria, “we’re able to precisely understand” who is dying, how, and where, he says. He knows how many of the 339 who died in 2021 were houseless, had underlying conditions, or were out hiking on Camelback Mountain, a popular area hike where average temperatures hover above 100 degrees four months of the year.

This means he can direct hydration and cooling stations where data shows they’re most needed, advocate for affordable housing, because more people die without it, and ensure appropriate signage on trails where conditions and rescues are particularly dangerous in heat.

Back in her office in Death Valley National Park, Wines has nothing like this. In fact, she says, she hardly has any data at all. She recalls a recent call from another reporter, who requested annual stats on heat-related emergencies and deaths.

“It looks like we’re just avoiding the question, but we don’t have everything coded that way in our system,” Wines acknowledges. “I would love it if it was a clear thing and we could say: this many people on average die because of heat, and we have this many medical responses by law enforcement, and it costs the taxpayers this much money.” But she doesn’t have that data.

If she did, she says, “I think it would be a lot easier to tell people how dangerous it is.”

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It was a hot September day almost 20 years ago, but Mark Tanaka remembers it like yesterday.

He was 36, just a few months into his first job as an ER doctor in the San Francisco Bay Area, running his first 50-mile race up and down the sweltering slopes of nearby Mount Diablo.

Around mile 38, approaching the summit, he started cramping. He felt nauseous and slightly disoriented. His ears were buzzing. A mile or two later, he collapsed at an aid station in spasms. After resting, he kept going, even as diarrhea and cramps wrecked his body. At the summit, race staff forced him off the course and called an ambulance.

By that point, he said, he was overcome by a symptom hard to ignore: an “impending sense of doom.” Blood tests in the ER showed dangerously low sodium levels and a serious condition called rhabdomyolysis, in which damaged muscle tissue leaches proteins into the blood that can cause heart damage, kidney failure, and death. Both are signs of heatstroke, the most serious and final stage of heat illness.

Despite medical training and knowing the dangers of heat, Tanaka, who has since finished at least 200 ultramarathons, nearly died that day after pushing through the early and escalating signs of heat illness. Countless others haven’t been so lucky.

According to the Environmental Protection Agency, heat is the “leading weather-related killer in the United States,” causing at least 700 deaths each year—though . Among those who die each year are hikers, cyclists, runners, and parks employees, mostly in scorching arid states across the West or the humid, hot Southeast. As climate change pushes average temperatures higher and causes longer, hotter heat waves, doctors and climatologists agree the danger is only increasing.

“It is very easy to underestimate heat’s effect and overestimate your ability to cope,” Tanaka says. “You’ve got to be really careful.”

But of all the hazards recreationalists face on the trail, death by heat is among the most preventable. It’s vital to understand the risk of heat illness, the early warning signs, what to do if you or your companions start to experience it, and when to modify your plans.

What Is Heatstroke?

Heatstroke is the final stage of heat illness, an umbrella term that includes heatstroke and exhaustion, as well as rashes and cramps, as your body runs out of ways to lower your core temperature, and athletes are among those most at risk. When you exercise on a hot day, your body’s cooling mechanisms are working double-time, burning through water and electrolytes to fight both the outside temperature and the heat generated by your own muscles.

“At some point, as you continue to exert yourself, your cooling system can’t keep up,” says Caleb Dresser, a Harvard faculty member, emergency physician, and expert on extreme heat. This can happen much more quickly than many people understand: internal temperatures can rise above 104 degrees—the widely-recognized threshold for heat stroke—in as few as 10 to 15 minutes.

The earliest symptoms usually include cramps, headaches, and dizziness. Athletes, often used to pushing through pain, don’t always recognize these warning signs. “You compensate pretty well until you crash,” Dresser says. Without immediate, aggressive medical intervention in an ER, Dresser says, that crash can end in seizures, organ failure, coma, and death. Minutes matter, he says, and without emergency care, cases can be fatal.

How Hot Is Too Hot to Exercise?

Experts hesitate to suggest any one temperature as the cut-off point for exercising when it’s hot out, because with proper preparation and precaution, you can train in even the hottest temperatures. Every year, highly experienced and heat-trained athletes compete in the Badwater 135, a 135-mile ultramarathon across Death Valley, the hottest place on earth, in the middle of July. Those athletes have undergone weeks of heat training to prepare (which often includes sitting or working out in a sauna for weeks before the race) and run with a support team icing them down at aid stations.

But while the most prepared athletes may safely be able to run in extreme heat, far lower temperatures are still plenty hot to kill you. Abby Wines, who has worked at Death Valley National Park for 17 years, says the days she’s most concerned for hikers are “when it’s hot—but not really hot.” In a park that regularly tops 120 degrees, she says most visitors know to avoid hiking in the hottest weather. But when temps are in the 90 to 100 range, she says, hikers get in over their heads and calls for rescue go up.

You need to pay attention to humidity, too. In places like the Midwest and Southeast—or on stormy days in the West—high humidity can make milder temperatures more dangerous, in part because evaporative cooling (sweating) doesn’t work as well when there’s lots of moisture in the air already.

The , a chart showing perceived temperatures based on the heat and humidity level, shows a red zone of temperatures when you should avoid activity. According to this chart, a 90-degree day at 40 percent humidity feels like 91 and falls in the yellow zone of “extreme caution,” when prolonged activity might lead to heat exhaustion or stroke. A 90 degree day at 95 percent humidity feels like 127—by which point heatstroke is “highly likely.”

“It surprises many people to learn that the heat index values
are for shady locations,” writes the National Weather Service. In direct sunlight, the perceived temperature can be 15 degrees higher. Exercising in anything over a perceived heat of 103, they say, is “likely” to result in heat illness.

How Do I Know I’m in Trouble? What Should I Do?

You should know the forecast, but you should also know your own body. “My first warning sign when I’m starting to overheat, is my arms start to get goosebumps,” Wines says. “When that happens, I always seek shelter, drink water, take a break, lower my heart rate, and just let my body calm down.”

Symptoms like confusion, dizziness, and headaches should not be ignored, Dresser explains. “One of the first organ systems that starts to produce symptoms is the brain,” he says. Same with cramps and other signs of dehydration, which signal that your body is struggling to compensate.

Fluids, electrolytes, finding shade or a cooler location, and stopping activity are key to recovering from the early phases of heat exhaustion, Dresser says. “This is a very correctable state.”

When a person shifts from heat exhaustion to heatstroke, it’s common for the body to transition from profuse sweating to an absence of sweat. If you or your companions have stopped sweating, have a racing heart rate, or experience a seizure, call for emergency help immediately and make every effort to cool down.

How Can I Prevent Heat Illness?

Take it slow, and give yourself time to acclimate. Wines recommends taking “baby steps” to test yourself in heat. Start with a shorter hike that’s near services before trying something challenging or remote. Like acclimating to altitude, it can take two to three weeks of regular exposure to heat before your body adapts. If you’re preparing for a longer trip or event in high heat, research heat training protocols to prepare for the temperatures you might experience. Also note that heat acclimation is lost very quickly. In Death Valley, park staff who spend more than three days outside the area are considered no longer heat-adapted, and must adjust their workloads.

The recommendation to carry water seems obvious, but it’s often overlooked. Ethan Veneklasen, an ultra runner and co-director of the near Lake Tahoe, says he rarely carries water on short runs. But on a hot day, he won’t leave that weight behind. “It’s really easy to make bad decisions on the front end, and then those bad decisions compound,” he says. Dehydration can lead to dizziness and confusion that impair further decision-making and push an athlete deeper into trouble. The Centers for Disease Control recommends during exertion in heat, you need about eight ounces of water every 15 to 20 minutes, spread out in sips.

Eating salty snacks is equally important. Sweat requires sodium too, so replacing water but not electrolytes can also lead to heat illness. The American College of Sports Medicine recommends taking in 500 to 700 milligrams of sodium per hour of exercise. Research has shown that most so check the labels of your favorite snacks to plan ahead.

Wearing lightweight, loose clothing and sunscreen can help, too: sunburned skin makes it much harder to cool off.

Make a Plan and Stick to It

After his friend Philip Kreycik died running on a hot day last summer, Chris Thoburn, a 33-year-old ultrarunner familiar with long, scorching runs, realized that on top of his usual preparation, the most important thing he can do to stay safe is to stick to his plans. He makes sure he knows how far he’s going, how long it will take him, and where he can access water along the way. He ensures his devices have battery power to last his run, that somebody knows where he’ll be, and that he won’t feel pressured to push hard to get back in time for another commitment.

Once he’s on the trail, the only change he’ll make is to turn around or end early, even if he’s feeling good. “As athletes, we often go out and go, ‘Hey, I’ve never been on that trail before,’ or ‘I’m feeling pretty good today, I could push a little bit further. But the trouble with all those decisions is they are taking away a piece of your safety net.  You go from being perfectly prepared, maybe even overprepared, to being not prepared at all,” he says.

“I can point to times before Phil’s passing when I made the wrong decisions. And understanding better now what the decision matrix should be, I think will keep me much safer into the future.”

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A few days after the Fourth of July in 2021, Chris Thoburn swiped open his texts to see two waiting from his friend Philip Kreycik.

“I’ve got a free pass Friday night and Saturday morning if you’re up for a run,” Kreycik wrote. His wife, Jen, had taken their kids, ages ten months and three years, to visit her parents for the night.

Kreycik, 37, and Thoburn, 32, had been friends since Kreycik moved to Berkeley in 2017. They’d met on Strava, when Thoburn spotted Kreycik dropping fast times on some steep trails and reached out about meeting up. Over the years, they’d run all over the Bay Area.

It would be fun, Kreycik’s second text read, to check out somewhere new.

Though their only time together was spent running, the pair had become close, spending long runs talking about their lives. Thoburn, a software engineer, was trying to become a professional ultrarunner. Kreycik had just started a new job at Pacific Gas & Electric, developing the utility giant’s electric- vehicle charging strategy.

“Very interested,” Thoburn shot back. The men settled on a mellow Friday-evening run in the Oakland hills.

Another runner met them there, and when the trio stopped that night at the Redwood Peak summit around sunset, it was still warm out. News reports that week had warned of approaching triple-digit temperatures, the latest in a series of record-breaking heat waves that baked the West all through that summer and had already killed hundreds of people across the Pacific Northwest. That night and in the coming days, nearly all of Northern California was under an excessive-heat warning, but the most dangerous temperatures would be felt only farther east, too far from the ocean to feel its cooling effects.

In Oakland, it was a rare and perfect 80-degree night. Thoburn unzipped his pack and passed each man a beer. They talked about the weekend, and Kreycik’s hopes to run. His drive to meet his family at Jen’s parents’ house in Stockton, 90 minutes east, seemed like a good opportunity to try a new route in the vast network of parks along the way.

Back home that night, Kreycik opened Strava and mapped a nine-mile loop in Pleasanton Ridge Regional Park, a 9,100-acre swath of public land 30 minutes southeast of Berkeley. The run might take a little over an hour. The trailhead, in a neighborhood near the park, was just a mile off the 580 freeway.

Saturday morning, Kreycik talked to Jen on the phone. Make sure to wear sunscreen, she told him, and bring water. She was worried about the heat. “Of course,” he said.

He texted her from the trailhead later that morning: “Eta 12:35ish.” That didn’t give him enough time for the full loop he’d planned, but the route was easy to modify—he’d take a straight shot up to the ridge, then out on the Northridge Trail until he ran out of time. He pulled off his shirt and tucked his phone under the front seat.

He left his water bottle in the center console, locked the Prius, clicked start on his Suunto sports watch, and set off down the narrow dirt track. The trail dipped into the oak and laurel trees, hugging the side of a ravine before turning steeply upward toward the ridge. It was 10:49 A.M. A nearby weather station registered the temperature at 87.

Kreycik pushed hard, his five-foot-11-inch frame all elbows and angles under a sweep of overgrown brown hair. He broke course records on nearly every Strava segment he covered, laying down times most runners would be hard-pressed to beat, even on a cooler day.

Cresting the ridge, the trail opened up into sweeping views of the rolling landscape below: the earth like a wrinkled hide under a stubble of golden grass, with oak-forest oases in every canyon crease.

At the Northridge Trail intersection, the access gate was closed, but the lowest strand of barbed wire strung beside it was usually loose, and many trail users just slipped underneath. Kreycik turned south into the park.

A few minutes later, he took a side trail. Then, 25 minutes into his run, at a T in the trail, he turned around, leaving a single footprint in the dust.

As Kreycik’s 12:35 arrival approached, Jen pulled out her phone to check his location and ETA. Google Maps showed that his phone was still at the trailhead parking lot in Pleasanton. Annoyed and confused, she delayed their meal. By 2 P.M., Jen and her parents had given up waiting, and Jen called Kreycik’s folks to see if they’d heard from him. Wait an hour, Keith and Marcia Kreycik suggested, then try the police. Cops make welfare checks all the time, they said. It’s probably nothing.

Jen hung up. She waited five more minutes, then dialed.

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