The first major heat wave of the summer arrived with more intensity and earlier than usual, but city officials say there are plenty of reasons why the death rate has been relatively low. During 10 days of triple-digit temperatures since June 28, this region confirmed three heat-related deaths. A fourth was confirmed on Sunday. Under similar weather conditions in 1980, heat claimed 153 lives in the St. Louis over a 14-day period.

Start update: On Monday, the St. Louis County Medical Examiner's office announced that the heat had claimed the county's first victim. She was identified as Velma Henderson, 72, of Northwoods. Medical officials said the temperature inside her home was 97.4 degrees when her body was discovered Friday. The office said that air conditioning was not working in the house, and that her body temperature was 106 degrees.

The fourth victim was identified as Dorothy D. Scott, 88, of Troy, Ill. Troy police said family members found her body on Sunday. Before her death, police said the woman had left a message on a relative's answering machine, complaining of feeling ill. Police said the family had been away from home at the time and didn't get the message until later that day. The air conditioner was working but was set to heat rather than cool, according to a Troy police spokeswoman. End update.

With plenty of summer yet to come and the weather unpredictable, city officials aren't about to make predictions on the number of heat-related deaths that might occur over the weeks ahead.  They credit a number of programs, including Cool Down St. Louis and the United Way's 2-1-1 system, for providing additional resources to help the needy cope with the heat. But the officials say some deaths may have been averted as a result of a plan put in place a few years after the summer of 2006 when storms and severe heat battered the region, knocking out power to about half of all city residents.

Then Gov. Matt Blunt responded to the crisis by sending Missouri National Guard troops to St. Louis. Their mission in part was to search for and help victims, particularly the elderly and shut-in.

"But the problem was that we had no idea where to send" the troops, admits William Siedhoff, director of  the the Department of Human Services for St. Louis. "We learned a lesson from that. We needed a system, a database, that identified high-risk residents during power outages, heat and storms."

That dilemma led the city to create what's called a special-needs registry, now consisting of about 4,000 elderly and disabled residents who might need attention during major emergencies. Siedhoff says St. Louis is the only jurisdiction in Missouri that has set up a registry. Some other area communities have expressed interest in the city's system, but, so far, none have set up their own, he said. In the event of a disaster, the city makes robocalls to residents in the registry. If there is no answer, workers from various city departments are then dispatched to the households to make sure the residents are safe.

The robocalls include Mayor Francis Slay's voice, appealing to residents to seek help with air conditioning and utility bills through Cool Down St. Louis and the 2-1-1 emergency phone line run by the United Way of Greater St. Louis. Residents are also encouraged to apply for special energy assistance grants offered through the city's Department of Human Services.

On July 2, Siedhoff and Mayor Francis Slay became part of this outreach effort. They joined others from city government in visiting an estimated 1,000 residents who had not responded to the robocalls. Slay and Siedhoff checked on five residents in the Bevo neighborhood.

"It took us a couple of years to develop the database," Siedhoff says. "We started with the home-delivered meal population and we've since added about 1,600 other people. This program has provided security, protecting lives and keeping people out of harm's way."

During their visits to the five homes in Bevo, Siedhoff says he and the mayor found that four of the people were safe, although they had not responded to the robocalls. The fifth person wasn't home, he said.

"When the person we're trying to reach isn't home, we try to go the extra mile by knocking on a neighbor's door. In this case, that helped. It turned out that the fifth person had gone next door to stay with a son."

Pamela Walker, director of  the St. Louis Health Department, says the number of heat-related deaths so far has been lower than during some previous summers. Last year, she said there were eight deaths, along with eight in 2005 and seven in 2007.

She notes that these numbers don't begin to match those decades earlier, before programs like Cool Down St. Louis and the city registry were put in place. During the 14-day heat wave in 1980, she said about 300 people died across the state, including the 153 deaths in St. Louis.

"That's 10 people a day (in St. Louis). I can't imagine that. We had to do something," says Walker, who was handling environmental health for the Missouri Department of Health during that heat wave. Among other things, she said the deaths led to regulations forbidding utilities to disconnect residents for nonpayment during extremely hot weather. State law says utilities cannot shut off electricity when temperatures are expected to rise above 95 degrees or during a heat index of 105 degrees.

Walker says the registry proved its worth last year when city workers assisted a 103-year-old man in a home where the air conditioning had broken and the temperature was 110 degrees. In addition to the registry, Walker and Siedhoff  praise help coming from all of the sources.

"With this level of heat, there could have been 10 deaths," Walker says. "I'm pleased that we are working together to save lives."

Siedhoff adds that the city is offering special utility assistance grants of up to $1,000 for needy people above age 60. The money is from unused federal dollars from the city's homeless prevention program. He says the deadline for applying is this Friday, July 13.

A different take on why St. Louis may be preventing some heat-related deaths comes from Gentry Trotter, who heads up the volunteer Cool Down St. Louis program. It has distributed about 10,000 air conditioners to the needy since the program began in 2000. The new model of helping the needy involves social media, according to Trotter.

"Before, there were the churches, print media and some television and radio to get out the message," he says. "Now we have other approaches, such as Twitter and email. Technology is saving a lot of souls. But it's scary out there because the three people who died were alone in their homes."

Still, he praises the social media movement, saying it has led to more people-to-people conversations and action. It's encouraging some to check on their neighbors and is making it convenient for others to use credit card donations electronically to offset utility bills, or pay for fans and other material to help people keep cool, Trotter says.

Although the heat is easing, Trotter says Cool Down has received a record 8,500 inquiries for heat-related assistance in recent days.  He says the charity is still urging the public to drop off new or slightly used air conditioners at collection sites at Vatterott College locations in the St. Louis area.

In addition to praising the city's registry program, Siedhoff says individuals and companies have been generous during this crisis. Cool Down has received and distributed about 400 air conditioners in the metropolitan area. Another example, Trotter says, is a donation of 25 air conditioners and $20,000 that Cool Down has just received from Home State Health Plan of Clayton.

The St. Louis Health Department reports that heat-related illnesses are continuing, including 23 illnesses reported Saturday by city hospitals. Even with the registry, additional services and outreach, city officials voice concern about the potential for more heat-related deaths.

"There have been three this summer,"  Siedhoff said last week. "In all of last year, there were eight.  And here we are in the first week of July. That's disconcerting."