What the Numbers Show
Two states that publish detailed heat surveillance are both recording emergency visits well above their own historical baselines, and the season is not over.
NCDHHS documented more than 1,808 emergency department visits for heat-related illness between May 1 and June 28, against an average of 1,363 visits for the same period across 2021 to 2025. That is roughly a third above normal, measured before the July heat arrived.
Virginia's picture is similar and worse in magnitude. The Virginia Department of Health tracks emergency department and urgent care visits for heat-related illness from May through September and updates the dashboard on weekdays in July and August. State figures reported this month put visits since May 1 at 3,832, against an average of 2,548 by the same point in a typical year, a roughly 50% increase.
Why This Matters
Heat-related illness is one of the few serious health risks that is almost entirely preventable, and one of the few where the intervention is a physical place rather than a medication.
The number that should anchor a reader's thinking is not the ER visit count. It is that CDC estimates roughly 700 people die from heat-related illness in the United States each year, and those deaths concentrate among people who could not get somewhere cool.
For a household, that translates into a specific question: does everyone in this family, including an older relative living alone, have reliable access to air conditioning during a multi-day heat event? If the answer is uncertain, that is the thing to solve before the next one.
Reading the Data Correctly
Meredith Davis, an enhanced surveillance epidemiologist at the Virginia Department of Health, has made a methodological point worth carrying into any coverage of these numbers.
Raw counts do not tell the full story, because population centers differ. Virginia also tracks the rate of heat illness per 10,000 visits, which Davis described as a better comparison across regions. By that measure, roughly 18.3 Virginians per 10,000 have experienced heat-related illness this summer, about 29% above the year-to-date average of 14.2.
The rate increase is smaller than the raw count increase, which is a useful corrective. Both show the same direction. Neither supports describing the season in catastrophic terms.
Davis has emphasized the practical point repeatedly, noting that heat-related illness is preventable.
Where the Burden Falls Within a State
Heat does not distribute evenly, and the state dashboards show it.
Virginia's eastern region, covering Hampton Roads, the Middle Peninsula, the Northern Neck and the Eastern Shore, has reported more heat-related illness than any of the state's other four regions, with 1,038 cases representing about 27% of the state total at one recent reading.
North Carolina's own occupational analysis has documented that exposure and sensitivity to extreme heat vary by socioeconomic status, occupation, age and health status. Agricultural and construction work concentrate the risk in specific counties and specific workforces.
That is the pattern to look for in any state's data: heat illness clusters where outdoor work is common, where housing stock lacks central air, and where the population skews older.
Who Faces the Greatest Risk
Outdoor workers face the highest exposure, particularly in agriculture, construction, landscaping and roofing, where the work continues through the hottest hours.
Adults over 65 are at elevated risk because the body's ability to regulate temperature declines with age, because several common medications interfere with heat regulation and sweating, and because older adults living alone may not recognize the warning signs or may resist running air conditioning over cost concerns.
Young children, pregnant people, people with heart or lung disease, people with diabetes, people taking diuretics or certain psychiatric medications, and people experiencing homelessness all face higher risk. Athletes and people exercising outdoors round out the picture.
Symptoms and the Line Between Them
Heat exhaustion and heat stroke are different emergencies, and the distinction is worth knowing before it matters.
Heat exhaustion typically involves heavy sweating, cold and clammy skin, a fast, weak pulse, nausea, muscle cramps, tiredness, dizziness, and headache. The response is to move to a cool place, loosen clothing, apply cool wet cloths, and sip water. If vomiting occurs or symptoms last longer than an hour or worsen, seek medical help.
Heat stroke is a medical emergency. The signs are a body temperature of 103 degrees or higher, hot red skin that may be dry or damp, a rapid strong pulse, confusion, slurred speech, and loss of consciousness. Call 911 immediately, move the person somewhere cool, and work to lower their temperature with cool cloths or a cool bath. Do not give a person with heat stroke anything to drink.
Confusion is the symptom that most often gets dismissed and most often signals the emergency.
What You Can Do Now
Identify a cooling location before you need one. Most counties operate cooling centers during heat events, and calling 211 or checking a county emergency management page is the fastest way to find the nearest.
Check on older relatives and neighbors during heat events, in person or by phone, rather than assuming they will call if they need help. Confirm their air conditioning works before a heat wave rather than during.
For anyone working outdoors, the protective factors are water, rest, and shade taken on a schedule rather than when symptoms appear, and gradual acclimatization for new workers, who account for a disproportionate share of serious heat cases.
Never leave a child, an older adult, or a pet in a parked vehicle, even briefly and even with windows cracked.
Cost and Access
The federal Low Income Home Energy Assistance Program helps eligible households with cooling costs and, in some states, with air conditioner purchase or repair. Applications run through state agencies, and eligibility varies.
Many states restrict utility disconnections during declared heat emergencies or during defined summer months, but these protections differ substantially by state, and some require the customer to apply. Anyone worried about a shutoff should contact their utility and their state public utility commission before service is interrupted rather than after, since reconnection is generally harder than prevention.
Local aid organizations and area agencies on aging distribute fans and window units in some communities, typically with limited supply early in the season.
What Happens Next
Virginia updates its dashboard on weekdays through July and August, and North Carolina publishes updated surveillance during heat events. August is historically a high-risk month, so both totals will rise. MedicalDaily will report updated state figures and any heat-related emergency declarations.
The Bottom Line
The confirmed facts are that North Carolina recorded 1,808 heat illness emergency visits by late June against a 1,363 five-year average, and Virginia is running roughly 50% above its baseline by count and 29% by rate. The people most at risk are outdoor workers and older adults without reliable cooling. The most useful step is identifying a cooling location and checking on a vulnerable relative before the next heat event. The central uncertainty is how the rest of the season unfolds.
