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Paramedics stand by their ambulances at Toronto Western Hospital on Oct. 27, 2020.Frank Gunn/The Canadian Press

Paramedics across Canada are struggling to answer emergency calls and provide care because of staff shortages and overcrowded hospitals, with people who are calling 911 in many regions of Canada facing lengthy delays, sometimes hours long, for ambulances – and further delays once they arrive at hospitals.

Pierre Poirier, chief of the Ottawa Paramedic Service, said “level zero” events – times when no paramedics are available to answer calls – have increased at an alarming rate in recent months. So far this year there have been more than 750 level zero events in the city, compared with about 400 in 2019.

The length of level zero events has also been increasing, he said, with the longest reaching nearly 10 consecutive hours.

While dispatchers are triaging calls, giving priority to the most serious medical emergencies, the pressure on paramedic services is having effects throughout Canada. In Montreal earlier this month, a 91-year-old woman who injured her leg died during a seven-hour wait for an ambulance. Also this month, in Ottawa, a 75-year-old woman who fractured her hip had to wait for six hours in intense pain before an ambulance arrived.

Health experts say these problems are not new and that they have been calling attention to the overstretched system for years. But the COVID-19 pandemic has brought additional challenges that are pushing many parts of the system beyond the breaking point.

Part of the problem is that many emergency departments in Canada are being forced to close their doors for hours or days at a time because of staff shortages. These are often a result of doctors and nurses catching COVID-19 and needing to isolate at home, but the shortages are exacerbated by holidays and job-related burnout.

The lack of medical staff has left paramedics needing to drive longer distances to health facilities that are frequently overwhelmed with patients. As a result, paramedics must wait for hours with patients until they can be safely offloaded, or transferred, to the care of a nurse or doctor.

“The offload delays are extraordinary,” said Darryl Wilton, president of the Ontario Paramedic Association. “I’ve never seen anything like this and I’ve been doing this for 25 years.”

Mr. Wilton said some paramedics are spending entire shifts waiting to offload patients, only to be relieved by new teams, who must remain until hospital staff members are free to take over.

“It’s not unlike mass casualty events, where there’s not enough resources on hand to treat everybody,” he said.

The situation is similar in Nova Scotia. There, according to Kevin MacMullin, business manager of the Nova Scotia Paramedics International Union of Operating Engineers Local 727, offload delays are 30 per cent longer compared with before the pandemic, and paramedics are struggling to answer calls because of the gridlock.

“It’s kind of devastating to be tied up at the hospital knowing there’s calls going on out there that they’re not able to answer,” Mr. MacMullin said.

Steven Skoworodko, president of the Paramedic Services Chiefs of Saskatchewan, said the number of calls being fielded by paramedics has risen significantly this year and is contributing to burnout among paramedics and hospital staff.

“It’s a difficult time for everyone,” he said, adding that the level of emergency calls is unprecedented in his 27-year career. “We’ve never seen the type of pressure on the health care system that we’re seeing right now.”

Ryan Woiden, president of Winnipeg’s MGEU Local 911 paramedic union, agreed. He said the intensity of paramedics’ shifts is driving away newer hires, who are desperately needed.

“I think something that’s important here is not just a high volume of calls, but the types of calls, and the inability for a paramedic or a dispatcher to decompress from those,” he said.

He praised new initiatives in Manitoba that use what are known as “community paramedics” to relieve pressure on paramedics and help people avoid trips to the hospital. Community paramedics are people with paramedic training who can respond to house calls in regular vehicles when an emergency room visit is not required.

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