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A firefighter (left) and a paramedic (right) speak outside the Lynn Valley Care Centre, a seniors care home which housed a man who was the first in Canada to die after contracting novel coronavirus, is seen in North Vancouver, British Columbia, Canada March 9, 2020.

JENNIFER GAUTHIER/Reuters

B.C. firefighters have been ordered to stop responding to all but the most dire medical emergency calls during the COVID-19 pandemic, a directive that means they will no longer attend most overdoses.

The order, a copy of which was obtained by The Globe and Mail, was issued by B.C. Provincial Health Officer Bonnie Henry and is aimed at limiting first responders’ exposure to the new coronavirus and the amount of personal protective equipment needed. The directive states firefighters must go only to the most immediately life-threatening calls, such as cardiac arrest, events that are colour-coded as purple.

But in Vancouver, which recorded eight overdose deaths last week, most overdose calls are classified as red – life-threatening or time-critical, but less urgent than purple. Data provided by the fire service show firefighters usually arrive at such calls first.

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That is in part because one fire hall is in the heart of the city’s Downtown Eastside, which has a large population of drug users.

Firefighters Brandon Davies, left, Ian Hawksbee, middle, and Tyler MacLeod, right, attend a call to an overdose victim in Vancouver's Downtown Eastside, Tuesday, September 27, 2016.

Rafal Gerszak

A computer-automated dispatch system usually sends both paramedics and fire fighters to purple and red calls. Under the order, effective immediately, only paramedics will be dispatched to most medical calls.

Firefighters can be considered for select red events only if paramedics expect to be delayed by more than 20 minutes, or if technical assistance is required, such as in car accidents.

The classification is determined by what callers report – whether a patient is breathing, for example. However, the information can be unreliable and the person’s condition can change quickly.

In a statement provided by spokeswoman Sarah Morris, BC Emergency Health Services (BCEHS) said the order will protect firefighters from potential exposure to COVID-19 and limit the spread of the disease within communities.

As well, “the changes are being made to maintain a reliable supply of personal protective equipment for health-care workers, which includes paramedics,” the statement says.

During the pandemic, first responders have attended calls wearing protective equipment such as N95 face masks.

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“To be clear, this order does not change the way BCEHS operates or responds to medical emergencies. Our aim, as always, is to send the closest ambulance to patients as quickly as possible.”

Firefighters attend a call to an overdose victim in Vancouver's Downtown Eastside on Sept. 27, 2016.

RAFAL GERSZAK/The Globe and Mail

From March 26 to April 1, a period that captures the week when income assistance cheques are distributed and when overdose calls are historically higher, Vancouver Fire Rescue Services (VFRS) responded to 89 overdose calls, according to the fire services data. Of those, 31 were classified as purple and 58 red or lower.

From Feb. 14 to Feb 20, VFRS responded to 138 overdose calls; 31 were purple, and 107 red.

In March, of all medical calls, VFRS were first on scene 63.4 per cent of the time.

Jonathan Gormick, spokesman for Vancouver Fire Rescue Services, said he believes the change “of course” has the potential to delay the response to overdose calls.

“Even if the person making the call is right, and they assess that breathing is present, maybe the person is unconscious, the very nature of opiates is to suppress the respiratory system,” he said. “So if that person is breathing now, chances are, if it’s an opiate overdose, they’re not going to be breathing in a few more minutes.”

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If an ambulance is diverted, it could be additional 15 or 20 minutes before fire is dispatched, Capt. Gormick said – adding minutes to a call with few to spare.

“With a call where it can escalate from not super high priority to very high priority very quickly, by the nature of the poisoning, I think it’s hard to imagine there wouldn’t be an impact on patient care," he said.

In an e-mail, Ms. Morris said paramedic specialists monitor all calls and can upgrade events and recommend sending additional resources, such as firefighters.

“However, we have an ambulance station in the Downtown Eastside, which is fully staffed and regularly responding to overdoses,” she wrote.

The eight overdose deaths in Vancouver, which occurred between March 23 and 29, were the most in a single week since last August and are in contrast with the decline in overdose deaths in the past year.

The COVID-19 pandemic has forced community spaces and social service providers to close, while some overdose prevention services are shuttered, and others are operating at half-capacity.

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