Preparations underway for dangerous temperatures as B.C. officials hesitate to escalate weather warning level

Vancouver -

Despite discussions between multiple health agencies and weather experts about B.C.’s coming heatwave, health officials aren’t escalating their response from a standard heat warning to an “extreme heat alert” even though some of the criteria have been reached, CTV News has learned.

The extreme heat “Level 2” alert level has only been issued once before, as the heat dome swept over the province and saw 569 people die in record-shattering temperatures in late June; it carries more dire warnings of the risks of high heat, with dozens of fatalities expected in the region each day.

"We've been meeting as a health authority with several partners -- municipal partners as well as Environment and Climate Change Canada -- and right now it is sitting at a heat warning," explained Fraser Health public health officer, Dr. Arielle Zbar.

“We keep monitoring and if we need to adjust upwards, then we'll be working with Environment Canada.”

But internal documents on the B.C. Centre for Disease Control's heat alert response system obtained by CTV News show the criteria to move to an extreme heat alert is when the forecasted maximum at Vancouver International Airport is above 29 C for at least two days or above 34 C in Abbotsford for two days or longer.

The current forecast exceeds those temperatures in the Fraser Valley, but will only surpass 29 degrees at YVR for one day. 

"It's not anticipated to reach the same levels we recorded during the extreme heat late in June and early July, but we still need to prepare for this and to remind people the importance of taking care of themselves and looking out for others during these heat events," said provincial health officer, Dr. Bonnie Henry in defense of the decision to not escalate the warning. “

These anticipated temperatures (that) we're expected to see can cause negative health outcomes.”

DANGEROUS TEMPERATURES FOR CERTAIN MEDICATIONS, SENIORS

Medical terminology like “negative health outcomes” can dampen the seriousness of the consequences: high temperatures, especially when combined with high humidity, can make some people extremely sick, while others may die as a result.

Zbar points out that certain blood pressure medications, antidepressants, antipsychotic prescriptions and medications for Parkinson’s Disease can impact the body’s ability to respond to high heat and stay cool.

“When you start to see people and it’s really hot out and their temperature is increased but they're not sweating and they're very flushed and red with disorientation, that is a medical emergency -- that is signs of heat stroke and it's really important to call 911 right away and get that person cooled down and drinking water while they wait for help," Zbar said.

“We are historically used to a temperate climate, we're not accustomed to the same heat that in other parts of the country really wouldn't make much of a difference -- that's at a population level, and that's why we tell people to stay cool, drink lots of fluids." 

The ministry of health sent CTV News a seven-page email in response to an inquiry about what was being done differently for this heat wave compared to the heat dome in late June.

In the aftermath of that early summer heatwave, B.C. premier John Horgan admitted his government was “giddy” at the prospect of ending the pandemic state of emergency and the top doctor acknowledged a typical response to an atypical heat wave was “not sufficient.”

Expanded availability of cooling stations, clearer messaging about the risks of heat, providing air conditioning units to long-term care homes, increasing staffing and outreach for vulnerable populations, more closely monitoring heat-related emergency room visits, and increased staffing at Vancouver Coastal Health hospitals are included in the enhanced response. 

AMBULANCE PARAMEDICS NOTIFIED LATE TUESDAY

As preparations were underway and Lower Mainland municipalities worked closely with their health authorities to develop and enact plans for the forecasted heat, CTV News has learned paramedics were unaware of any plans of an augmented response until after 5pm on Tuesday.

Several frontline workers expressed concern that the service would once again be caught off-guard with a delayed response, similar to the June heatwave, which was largely blamed on managers described as skeptical of the forecast and slow to react as the death toll began to mount. 

In a recent internal memo, BC Emergency Health Services told staff their alert level had been escalated with the opening of their emergency operations centre and that additional managers and support staff would be on hand to facilitate patient transfers and ambulance turnovers to let paramedics grab a break and improve 911 responses. 

“In addition to the above actions already in place, BCEHS leadership in consultation with CUPE 873, will waive collective agreement language to improve the ability to increase staffing,” wrote ECC Director Lucas Hawkes-Frost, offering staff the chance to work whatever hours they wanted on overtime with the partner of their choice.

“Notify your partner, supervisor and dispatch if you are showing signs or symptoms of heat stress.”

TOP CORONER DISCUSSES HEAT DOME TRAGEDY

While B.C.’s top coroner expects to maker her formal report and recommendations to government on avoiding a future tragedy several months from now, she shared her thoughts about discoveries and knowledge gained in the meantime, starting with acknowledging she was among the vast majority of people who had no idea that the “Extreme Heat Alert” was unprecedented. 

“We’ve had some discussions with the provincial health officer’s office since this extreme heat event because we did not communicate as well as we should have, clearly – I don’t think anyone is going to dispute that,” said chief coroner, Lisa Lapointe.

“We should have been in better communication and not just with the coroner’s service and the provincial health office, but ambulance, police and fire.”

Lapointe revealed that while the BC Coroners Service has been involved in training exercises for mass casualty events like plane crashes, tsunamis and earthquakes, they had never imagined a scenario where there would be so many dead spread over such a huge geographic area; in Fraser Health alone, there were 166 deaths on June 29, whereas the year before there had only been 12 on that date.

“It’s data but every single one of those is a person with a family and a history and a family doctor we want to speak to, so it’s a very thoughtful, careful process,” she said, explaining that the coroners had to speak with each victim’s family as well as their doctor and whomever had last spoken with them to determine whether or not they died from heat or other causes.

The provincial government has not provided statistics on how many people were hospitalized or sought medical attention during the heat dome, but with 569 confirmed dead due to the heat, the number would be considerable. 

When asked whether Oregon and Washington states had different definitions or criteria for hyperthermia deaths, which could account for their far-smaller death tolls during the June heatwave, she said they use the same guidelines as B.C., which are used internationally, describing the discrepancy as “a really good question.”  

The settings where hyperthermia victims, or those still in distress, were found during the heat dome serves as a warning for subsequent heat waves, particularly for the elderly and those who live alone. 

“The coroner or police or ambulance would walk into the residence and it was extremely warm — either windows not open or just no air flow, no fans, no air conditioning,” said Lapointe.

“We heard warnings of the heat dome, we heard warnings of extreme heat, but I’ve been with the coroner’s service almost 30 year’s and we’ve never seen this tragic number of deaths related to environment.”