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Severe frostbite in Billings homeless follows record-breaking cold - Billings Gazette

The record-breaking cold that settled over Billings this week is the kind of cold that can freeze bare skin in minutes. And for those experiencing homelessness, frostbite and hypothermia are a major concern.

By Wednesday, temperatures dropped to minus 21 at the airport and minus 26 on the West End of Billings. The high for the day was minus 3.

Already this winter, at least a dozen people without homes have wandered into Billings’ day shelter on the South Side near downtown with frostbite.

But this week brought the most severe cases of the season, said Camron Cook, development director of St. Vincent de Paul, a charity that aims to serve those facing the worst cases of homelessness in Billings.

“We had one gentleman come in and the staff member said his fingers looked like banana peppers,” Cook said. It was severe frostbite.

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After the HUB closed in October 2020 and the Off The Streets shelter closed in January, St. Vincent de Paul has become the primary site for day services and shelter, leaving the facility packed with people trying to escape the cold. Blankets and gloves have been flying off the shelves and the center is in need of men’s pants, socks, underwear and shoes. 

With multiple nights below freezing temperatures, doors are opening earlier in order to get people inside. Normally they open at 7:30 a.m., but Cook said this week that doors are opening at 5 a.m. and staying open as late as staffing allows.

“It’s so hard on the homeless when it’s cold like this,” Cook said. “When it gets like this, we just try to get them inside and out of the cold.”

Frostbite occurs more frequently in those experiencing homelessness due to multiple factors that impede their ability to respond to the cold, such as access to resources and mental illness, according to Crystal Friedrich, RiverStone Healthcare for the Homeless program manager.

Frostbite generally occurs in extremities that are exposed to the cold, causing the tissue to freeze. Lack of adequate clothing is one reason why fingers, toes, ears, noses and cheeks are the first to show signs of frostbite.

Friedrich recounted one man who came in to receive care for frostbite on his feet.

“He was mingling around downtown without a shoe…he has other health issues, and it’s pretty likely that he might lose that foot,” Friedrich said, but it can be months from frostbite to amputation.

During frostbite, the tissue goes through two phases of trauma between freezing and warming. The results are painful nerve damage that can feel like pins and needles and pain in the affected area that is usually treated with over-the-counter medications.

“There are better medications that you can take to help those pains, but a lot of times those aren’t medications that we want walking around on the streets,” Friedrich said.

Once the tissue goes through frostbite once, there is higher likelihood that it will happen again.

Smokers and those with substance abuse disorders are also at increased risk of frostbite due to constricted blood vessels and disorientation while under the influence of drugs or alcohol.

Billings Police Resource Officer Sergeant Brad Mansur has been busy in his community caretaker role where he works to connect people sleeping on the streets to services in town, especially during extreme weather. When necessary, Mansur can mandate a hospital visit if someone is clearly in need of medical assistance.

Once this week, Mansur encountered a man who had been drinking, was passed out outside and exposed. His clothes were damp and there were large areas of his body that likely had frostbite.

“Both his hands had frostbite. They looked like inflated gloves,” Mansur said.

With the cold weather also comes an increase in survival crimes such as trespassing, resulting in more contact between police and homeless people.

But Mansur mentioned one silver lining. During extreme weather, he comes in contact with people he doesn’t normally see, and that way he is able to help connect them with treatment and mental health services.

Often, officers will take homeless people to the Community Crisis Center where they are assessed and connected with the resources they need.

But every time there is a cold snap, the Crisis Center is inundated with people who don’t necessarily meet the traditional definition of being “in crisis,” which is usually constrained to those in need of immediate support.

By Thursday, Marcee Neary, executive director of the Community Crisis Center, saw at least six people recently treated for frostbite and desperately looking for a place to get out of the cold.

“We’re trying to stay true to our (mission), but there aren’t many daytime solutions,” Neary said.

Neary has had to rotate people outside during the cold weather, constantly triaging for beds and sending at least 40 people to spend the night at the First Congregational Church.

Besides bed space, transportation is the other major challenge when cold temperatures make it dangerous to walk outside.

“We have clients begging us to give them a ride. We’re busy anyway, but the cold adds a layer of persons who aren’t in typical crisis. But if they’re outside much longer it will be a crisis,” Neary said.

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Severe frostbite in Billings homeless follows record-breaking cold - Billings Gazette
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