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Alfredo Garza Jr. died in his bedroom with two broken air-conditioners, on a downtown street in Laredo, Texas, across from a coffee shop and a bakery. When his body was found, the temperature inside the room was 106 degrees. Nearby on the same June day, in a small home behind his sister’s house, 67-year-old Jorge Sanchez suffered the heat with nothing more than a fan to cool him, and then succumbed to temperatures that reached 113 degrees. A wave of extreme heat also overcame another man, still unidentified by the authorities, who parked his truck on a busy residential street with its hazard lights flashing, and died. Hot weather is nothing new in a place like Laredo, where summer temperatures regularly climb well past 100 degrees. But the seemingly unending wave of punishing heat and stifling humidity that began in the middle of June — parked for weeks over much of the nation’s south and west — is presenting unfamiliar and deadly new hazards. “People are used to being without air conditioning, surviving without air conditioning,” Dr. Corinne Stern, the medical examiner for Webb County, which includes Laredo, said in an interview in her autopsy room. “But it was just too hot. Residents were caught off guard, and we lost a lot of people because of it.” In all, 10 people died from heat-related illnesses within the city limits of Laredo between June 15 and July 3, a toll unheard of in this heat-accustomed corner of Texas. Though public health officials in several states said a full and accurate count of how many people have died from the recent bout of heat is weeks away, if not months, Laredo’s experience suggested that the eventual number could be substantial — a harbinger of a future in which heat waves become a regular public health crisis. Across the country, extreme heat, which can strain the heart, lungs and kidneys, is a leading weather-related cause of death. In Texas last year, 298 people died of heat-related causes, according to the state health department — the highest annual total in more than two decades. Among them were 155 nonresidents, a figure that includes migrants crossing the state’s harsh terrain. During the heat wave in Webb County, at least two migrants were found dead on local ranches, according to the sheriff, Martin Cuellar. The superheated dome of high atmospheric pressure that has been pressing down on much of the country will probably stay in place for a few more days at least, forecasters said, pushing temperatures to dangerous heights from parts of California all the way to Florida. And the temperature readings tell only part of the story, public health officials cautioned, because humid air worsens the heat, making it much more difficult for the body to cool down. And in cities like Laredo, the air can grow even hotter as the sun bakes the pavement, with little respite at night. Around the country, public health officials have begun thinking of new ways to track and respond to heat-related illnesses, in order to better protect residents, particularly those whose jobs require them to work outside. In Louisiana, the state began in April to track in real time the number of people in hospital emergency rooms because of the heat — a system akin to one used during the pandemic to stay on top of Covid-19 outbreaks. Similar medical surveillance systems have been rolled out in Virginia, and the California legislature has approved creating one there. The purpose is to use the data to better educate the public and to direct help to those suffering in the heat, said Dr. Alicia Van Doren, a preventive medicine physician who is advising Louisiana on its heat-illness prevention program. “We’re still in the early days,” she said, adding that more needed to be done — and quickly. “Already we have about 35 danger days a year, where it’s too hot essentially to work outside,” said Dr. Van Doren. With climate change, she added, “that’s predicted to increase to about 100 by 2030.” Several counties in Texas publish data on emergency room admissions for heat-related illnesses, as does the city of Dallas. The figures reflect what is widely known about extremely hot weather: As the temperature rises into dangerous territory, the number of people who suffer from heat exhaustion or a potentially deadly heat stroke rises in tandem. Most of those who were hospitalized have been men of working age, reflecting the fact that, for many Americans, heat is an occupational hazard. “The data is what helps us get the message out there,” said Dr. Peter Huang, the director of Dallas County’s public health department. “Bottom line: The heat is getting bad. Everyone needs to do whatever they can — because we want to prevent people from dying.” The county provides free air-conditioners to residents who can’t afford them, handing out more than 400 last year and nearly 300 so far this year, Dr. Huang said. No such program exists for Webb County, a vast expanse of nearly shadeless ranch land in South Texas that includes the palm-tree-dotted city of Laredo, one of the busiest gateways for international truck traffic to and from Mexico. Instead, the county has opened more than a dozen cooling centers, organized “fan drives” to give away fans, and leaned on a system of “promotoras,” well-connected local people who help officials spread important health information through their networks and at community centers. “It’s like that one aunt that knows everybody, that gets along with everybody,” said Tano Tijerina, the county judge for Webb County, describing the approach. Mr. Tijerina said the county had not contemplated starting a program to provide free air-conditioners to residents. “If you’re going to start giving out air-conditioners, where do you stop?” he said. “We are an aid, we will help, we’ll assist.” But he added, “we’re talking about people’s tax dollars here.” Nearly the entire population of the city and the county is Hispanic, according to U.S. Census estimates, and many residents have lived their entire lives enduring the region’s famously hot weather. A longtime local meteorologist goes by the nickname “Heatwave.” “We’re used to the heat,” Armando Acosta, 24, a metal worker in Laredo, said as he finished erecting the frame of a shade structure outside a house this week, working in the sweltering sun. “But it’s the air that’s suffocating,” he said. His colleague Cristian Patiño, 32, said each of them would drink about 15 bottles of water during the work day, and take breaks roughly each hour. Workers make up a large share of hospital admissions for heat-related illnesses, but in Laredo, the people who died from the latest heat wave were mostly older people who were at home alone, and either did not have air conditioning or chose not to turn it on, said Dr. Stern, the medical examiner. “They thought, ‘I’m used to this heat,’” she said. “That’s what we heard from their family, ‘Oh, I’m used to this heat, I’ve got this.’” One victim, a 68-year-old woman, died despite having a working air-conditioner at home. “Her daughters had seen her the night before, to bring her some food, and told her, ‘Mom, turn the air-conditioner on, it’s hot in here,’ and she wouldn’t,” Dr. Stern said. “Didn’t want to turn it on, to save money.” Money was also a major concern in the home of Mr. Garza, 61, who died in a room with two broken air-conditioners. He had recently stopped most of his work as a vocational nurse, and had moved in with his brother, J.P., and their 71-year-old aunt, in an aging downtown neighborhood of Laredo not far from the county courthouse. The two brothers had grown up in the brick house, said J.P. Garza, 51. “In the 70s and 80s, it got hot,” he said. “But this was a different kind of heat. This is magnifying-the-sun-on-top-of-ants kind of heat. This is beyond anything we’ve had before.” The brothers did not get along well, the younger Mr. Garza said; they fought frequently and often kept to themselves inside the small house, where the temperature on hot days was often higher inside than out. “We really didn’t talk about how hot it was, other than him saying, ‘Man, it’s really hot,’ or ‘Oh man, it’s super hot in there,’” Mr. Garza said of his older brother. “I told him, just open the windows, get yourself a couple of box fans, have one blowing in one direction and out the other.” He said his brother bought an oscillating fan that provided little relief. Early on the morning of June 21, Mr. Garza found his brother collapsed on the floor of the living room. He struggled to get his brother up, making use of their aunt’s cane. “He just looked at me all dazed and said, ‘Thanks, man,’ and went back into his room,” Mr. Garza said. “We weren’t the very talkative types.” Mr. Garza said he began to grow concerned later in the morning when his brother did not emerge for breakfast and there was no noise from the room. His brother liked to sleep late, but not that late. “I told my tia, this is starting to get weird,” he said. He knocked on the door around 2 p.m., he said, and then pulled on it, but found it was latched. Finally, Mr. Garza went around outside the house, removed one of the broken air-conditioners from a window, and peered inside. “I saw him, just stiff as a board,” he said as he sat in the shade just outside the room where his brother died. “I never got along that great with him, but it brought a tear to my eye, because after all, he is my brother.”