ST. LOUIS — A searing week concluded with a vengeance on Friday, with temperatures hitting a daily record of 104 degrees, and the heat index tying a record six-day run.
The effects throughout the week were widespread: Schools sent kids home. Construction crews postponed work. Firefighting teams rotated frequently when battling a blaze.
The heat was so severe, it even sent more patients to the emergency room: Barnes-Jewish Hospital in the Central West End was full Friday, and reported a 10% bump in ER visits this week.
“The heat is definitely impacting our health care system … straining the system a little bit,” said Dr. Robert Poirier, Washington University clinical chief of emergency medicine at Barnes.
But a cold front entering the St. Louis area was set to end the almost week-old excessive heat warning late Friday night, and drop temperatures on Saturday to a high near 89, although some humidity will remain, according to the National Weather Service.
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“At long last, some cooler weather is finally coming soon!” the local forecast office wrote in an online post Friday.
Conditions will cool off even more by Sunday, with an expected high around 83 degrees.
The week’s heat was remarkably rare. Since the beginning of local records in 1946, there have only been eight years in which the heat index has ever reached 115 degrees. And that threshold was met or exceeded in four of the last six days.
Friday tied the area’s longest streak of days with a heat index of 110 degrees or higher — matching a six-day run in 1980.

St. Louis firefighter Tyler Midkiff, center, cools down with his crew after working at a house fire in record triple-digit temperatures in the 5900 block of Lotus Avenue in the Wells Goodfellow neighborhood on Friday, Aug. 25, 2023. Later, while at a different fire in the Kingsway East neighborhood, Midkiff said, “This is only my second fire of the day. Some of the guys out here have been to three.” Photo by Robert Cohen, rcohen@post-dispatch.com
And St. Louis set two records this week for its hottest daily low temperatures, with Wednesday and Thursday never dropping below 82 degrees.
“That was really the thing that was going to make this particularly dangerous. … It’s not just the daytime heat, but it’s those overnight lows not dropping far enough,” said Melissa Mainhart, a meteorologist for the local forecast office of the NWS. “When we are starting from that — gosh, that’s already pretty warm.”
Medical experts warned that the week likely carried a steep public health toll.
“Heat stroke is only the tip of the iceberg,” said Dr. Pope Moseley, a thermoregulatory physiologist and biomedical researcher at Arizona State University who focuses on heat risks. “Most of the death occurring in a heat wave is occurring because heat is the force multiplier of illness. … Many, many, many diseases are made worse by heat.”
Some of that appeared to hold true this week at Barnes-Jewish, at least. Officials said about 230 to 270 emergency patients had been coming in each day during the heat wave, compared with the 210 to 240 daily patients that its emergency department typically sees.
Only a sliver of those cases — about 16 to 20, all week — were for ailments like heat stroke or heat exhaustion. The rest were likely underlying health conditions exacerbated by the extreme heat and dehydration, experts said.
Poirier, the Barnes clinical chief, said that, fortunately, the hospital’s mortality percentage has stayed stable throughout the week. “They are more sick, but we’re not seeing a lot of deaths from the heat, at least at Barnes-Jewish,” Poirier said.
That’s not always how it goes, though. More than 60,000 excess deaths occurred during a recent heat wave in Europe, Moseley said, compared to normal rates of mortality. Even suicide rates and drug overdose deaths in the U.S. go up during heat waves, he said.
And at least one study showed that, for each day of a heat wave, there’s a corresponding 8% to 12% rise in mortality, Moseley said.
This week’s heat shows “that climate change is having a measurable impact on conditions in St. Louis,” said Climate Central, a nonprofit that focuses on climate science and data.
Area officials on Friday reiterated the dangers of exertion and exposure to the heat, as they did all week.
Of course, not everyone can avoid prolonged exposure to the heat.
Friday, some St. Louis firefighters were responding to their third fire of the day, at the site of an auto repair shop in the Kingsway East neighborhood, where cars were burning inside a roofless building.
Firefighters exiting the building on Martin Luther King Drive immediately tried to cool down with cold towels around their heads and necks, by hydrating, and by dousing their heads in water spouting from a hose line.
“It’s brutal for the guys,” Battalion Chief Paul Weil said at the scene. “We just try to rotate crews in and out as fast as we can.”
Photos: Brutal heat wave roasts the St. Louis region

St. Louis firefighters cool down after working at a house fire in triple digit temperatures in the 5900 block of Lotus Avenue in the Wells Goodfellow neighborhood on Friday, Aug. 25, 2023. There were no reported injuries on the scene. Photo by Robert Cohen, rcohen@post-dispatch.com
St. Louis firefighter Corey Franklin of Engine 28 cools off at the scene of a house fire in the 5900 block of Lotus Avenue in the Wells Goodfellow neighborhood on Friday, Aug. 25, 2023. There were no reported injuries as firefighters worked through triple digit temperatures. Photo by Robert Cohen, rcohen@post-dispatch.com
A St. Louis firefighter cools down after working at a house fire in rapidly rising morning temperatures in the 3000 block of N. Taylor Avenue in the Greater Ville neighborhood on Friday, Aug. 25, 2023. There were no reported injuries on the scene. Photo by Robert Cohen, rcohen@post-dispatch.com

“This is only my second fire of the day. Some of the guys out here have been to three,” said St. Louis firefighter Tyler Midkiff, who pours water on his face to cool off after responding to fire at Action Auto Repair on Friday, Aug. 25, 2023, in the Kingsway East neighborhood. Photo by Laurie Skrivan, lskrivan@post-dispatch.com

Sprinklers douse the field at the St. Louis University Medical Center Recreational Complex as the sun rises over downtown on Thursday, Aug. 24, 2023. Photo by Robert Cohen, rcohen@post-dispatch.com

Damarion White, 3, of St. Louis, cools himself in the water spray at Barrett Brothers Park on Thursday, Aug. 24, 2023 in the Wells-Goodfellow area on St. Louis’ north side.

“My car does not have air conditioning. I do this to cool off, and sometimes go inside the walk-in cooler,” said Imo’s driver Cross Cardinale, who hoses himself down in the alley after making a delivery on Thursday, Aug. 24, 2023, behind the store in the Central West End.

“It’s a race to get the AC on,” said Jake Wheeler of Wheeler Mechanical as he lights a torch in triple digit temperatures while installing a new air conditioner at a home in the South Hampton neighborhood on Thursday, Aug. 24, 2023. Wheeler works with a cooperative of independent contractors trying to keep up with the work as temperatures stress cooling systems in the area. Photo by Robert Cohen, rcohen@post-dispatch.com

Jesse Irwin of Carondelet Mechanical and Catherine Kustelski of Southwest Garden Mechanical move out an old furnace from the basement of a South Hampton home where they are installing a new heating and air conditioning system on Thursday, Aug. 24, 2023. Irwin works with a cooperative of small independent contractors to keep up with the work. The homeowner’s air conditioning failed last week and he has been using window units in the meantime. Photo by Robert Cohen, rcohen@post-dispatch.com

Roofer Joe Braddy wipes sweat from his face as he works on a home in St. Charles as temperatures soar into the triple digits on Thursday, Aug. 24, 2023.

“I am in town for a job interview. It’s hot,” said Madison Kerr, left, of Canada, as she grabs breakfast with Dorian Block as condensation covers a window on the Dennis & Judith Jones Visitor & Education Center on Thursday, Aug. 24, 2023, in Forest Park.

Lawn mower Alberto Garcia takes his lunch in the shade of a tree in the New Town development in St. Charles County on Thursday, Aug. 24, 2023. Temperatures soared into the triple digits on Thursday with heat indexes in around 115. Photo by David Carson, dcarson@post-dispatch.com

Condensation from the air-conditioning covers the a window as a runner enters the Dennis & Judith Jones Visitor & Education Center on Thursday, Aug. 24, 2023, in Forest Park. The National Weather Service said Thursday’s high temperature in St. Louis will be near 102 degrees, though stifling humidity will make conditions feel far worse, with the heat index expected to reach as high as 114 degrees. Photo by Laurie Skrivan, lskrivan@post-dispatch.com

Sprinklers cool one of few runners on the track at the St. Louis University Medical Center Recreational Complex on Thursday, Aug. 24, 2023. Photo by Robert Cohen, rcohen@post-dispatch.com

Seven-year-old Jeremiah Lewis, of St. Louis, tries to stifle the splatter of water on Thursday, Aug. 24, 2023, as he and his brother, Messiah Lewis, play at a water spray at Barrett Brothers Park on St. Louis’ north side. Photo by Christian Gooden, cgooden@post-dispatch.com

Athletic trainer Matt Zalewski takes a Wet Bulb Globe Thermometer (WBGT) reading on the football field Monday, Aug. 21, 2023, at Francis Howell Central High School in St. Charles County. Sports practices at the high school lasted only an hour due to the results, per the Missouri State High School Activities Association guidelines. Photo by Christine Tannous, ctannous@post-dispatch.com

Softball player Hailey Paul puts away equipment after heat forced practice to end early Monday, Aug. 21, 2023, at Francis Howell Central High School in St. Charles County.
Kirkwood’s Jaiden Sloan (1) gets ice water poured on his back by athletic trainer Kelsey Cunningham in the second half of a football game against De Smet on Friday, Aug. 25, 2023, at Kirkwood High School. De Smet defeated Kirkwood 44-21. “It’s just so hot,” Cunningwood said. Photo by Christine Tannous, ctannous@post-dispatch.com
Meteorologist Sean Sublette explains a Heat Advisory vs. an Excessive Heat Warning, and the symptoms of heat exhaustion vs. heat stroke.