Those without a home are becoming increasingly at risk as arctic weather conditions continue to sweep across the UK.
Rough sleepers already have to suffer the insecurity and hardship of living on the streets, but being outside and exposed to temperatures well below freezing is leaving many at breaking point.
"Sleeping at night is the hardest part - it breaks you," one homeless man, Anthony, told Birmingham Live. "Words can’t express how hard it is - you’d have to experience it to believe it."
Anthony has been on the streets of Birmingham for the past five years after his family broke down in the wake of his mother's death from cancer.
He said that he sleeps "wherever he can lay his head" but that the sub-zero temperatures have made the already ghastly task of sleeping rough even more impossible.
"You have to break yourself to make yourself on the streets," he said. "It’s never easy - summer or winter - but the cold is the worst part, it's indescribable."
Chris takes a seat outside the Greggs on High Street. A kind-hearted shopper offers to buy him a warm coffee and a sandwich - but no amount of food can prepare Chris for the challenge of making it through the night.
"I’m dreading tonight," he tells me. "I’ve spent the last few nights in town - subways, shop fronts, anywhere with a bit of shelter in case it snows - but everywhere is freezing."
"A few of us rough sleepers sometimes spend the night in empty buildings but even there it's ice cold. You wake up in the morning and there's ice everywhere. It's horrible but we just have to get on with it."
"It’s very lonely at night," he adds. "Even though you're teamed up with other people on the streets they’re not your mates, they’re associates - you’re all just trying to make it through the night and see the morning.
"That's all we're trying to do - just survive the cold. I take each day, each minute, at a time. What more can you do?"
Approximately 274,000 people in England are homeless this winter, with at least 2,7000 sleeping rough on any given night.
There are some protocols in place to help assist the homeless at times of extreme weather.
Local authorities send out Severe Weather Emergency Protocols (SWEP), which trigger the opening up of short-term accommodation for homeless people to go when there is an increased risk of death due to the weather conditions.
These warning systems are designed to act as a temporary response measure to adverse weather conditions and provide humanitarian assistance at times of increased risk.
They function alongside homeless shelters that are already coordinated by local authorities and independent providers.
Organisations such as StreetLink are a good point of contact if you see someone sleeping rough and are concerned for their safety.
Streetlink will connect the vulnerable person with local support services that can help to end their homelessness.
You can contact StreeLink on 0300 500 0914.
Visit the Streelink website here to sign up and send alerts when you see someone who is at risk.