Three days of record breaking heat are taking their toll on Oregonians.

Around 200 Oregonians have visited emergency departments or urgent care centers due to heat-related illness since the heat wave began Friday, according to data published by the Oregon Health Authority.

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In Multnomah County alone, 43 people went to emergency departments or urgent care centers due to heat-related illness over the weekend. On a typical June day, there are zero or one cases of heat stroke reported.

The visits this weekend alone represent nearly half the heat illness visits the county typically sees during an entire summer.

In Yamhill County, two people went missing while swimming in the Willamette River on Saturday. In Bend, advocates working at an encampment of people who are homeless found two men dead over the weekend, and suspect they succumbed to the heat. The causes of both men’s deaths are currently under investigation.

“People’s bodies are stressed,” said Dr. Jennifer Vines, the Multnomah County health officer. “My main message is to take this for the serious health threat that this is.”

The heat may have also contributed to a surge in use of emergency services.

On Sunday, Multnomah County EMS received over 410 calls for service — a record number — resulting in about 260 people transported to health care.

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By 2:30 p.m. Monday, the temperature at the Portland Airport had reached 113 degrees, breaking the all-time records set over the previous two days. The National Weather Service reported a record-smashing 116 degrees in Salem. In response, health departments across the state are urging people to make a plan for how to stay cool, take advantage of cooling centers, and check on neighbors and family.

Vines said three factors have combined to make the current heat wave a health emergency: the record-shattering high temperatures during the day, the uncharacteristically warm nights that aren’t giving people a real break from the heat, and the unusual timing of the heat wave so early in the summer.

Vines said it takes one to two weeks for our bodies to acclimate to higher temperatures. But this early in the summer, that process of adaptation hasn’t happened yet.

“For such an early extreme heat wave, without that break at night, we knew that this was going to be life threatening. That’s how we talked about it from the beginning,” Vines said.

In Portland, temperatures are almost 40 degrees higher than normal for this time of year. A normal daily high in June is 73 degrees, according to the National Weather Service.

Temperatures became so extreme in Portland that the city halted all MAX light rail trains until Tuesday.

Several of Oregon’s older prisons don’t have air conditioning, putting vulnerable people at significant risk. The Oregon State Penitentiary and the Oregon State Correctional Institution in Salem, as well as the Shutter Creek Correctional Institution near Coos Bay, all rely on “alternative cooling methods” like swamp coolers, fans and “providing access to ice water for [Adults in Custody] and staff,” the Oregon Department of Corrections said in a statement.

“DOC makes every attempt to keep the adults in our custody and employees comfortable during summer heat waves,” the agency said. “Each of our institutions has plans for inclement weather; modifications vary by location based on infrastructure and other dynamics.”

Civil rights attorney Juan Chavez said he’s heard from some people in custody that faucets are only dispensing hot water and fans are moving around the hot air.

“There’s not ice on every unit,” Chavez said. “If there is ice brought to those units, there’s not enough for everybody. And tensions are high. People are rightfully getting concerned for their own health and safety because they can’t protect themselves.”

While temperatures are forecast to relent for much of western Oregon in the afternoon and evening hours Monday, Central and Eastern Oregon will continue to experience near or above 100 degrees for the remainder of the week.

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