B.C. firefighters push back on order restricting their medical calls after overdoses spike in Vancouver

Fire departments in British Columbia have asked Provincial Health Officer Bonnie Henry to reconsider her recent order restricting firefighters to only the most life-threatening calls, saying the unintended consequences put citizens at serious risk.

The new protocol, which came into effect this month, means that firefighters are not responding to most overdose calls during the COVID-19 pandemic because they are not classified as requiring the most urgent response.

Overdose deaths have spiked in Vancouver recently. City data obtained by The Globe and Mail list eight suspected overdose deaths in each of the past two weeks – the most in a week since last summer. The figures have not been confirmed by the BC Coroners Service.

The Globe reported on April 2 that B.C. firefighters were ordered to respond only to the most immediately life-threatening calls, such as cardiac arrest – events that are colour-coded as purple. This means no longer attending red events, the tier below purple, which include drowning, choking, chest pains – and most overdoses. Firefighters are dispatched only if technical assistance is required, or if paramedics expect to be delayed by more than 20 minutes.

The order is aimed at limiting first responders’ exposure to the new coronavirus and the amount of personal protective equipment needed.

On April 3, the mayors of 14 municipalities sent a joint letter to Deputy Health Minister Stephen Brown outlining their concerns.

“We are very fortunate to have such strong leadership as Dr. Henry’s during these unprecedented times,” read the letter, printed on the letterhead of Delta Mayor George Harvie.

“However, we are concerned that Dr. Henry may not be fully apprised about the serious unintended consequences of this decision to limit our firefighters to only attend purple events and to only be ‘considered’ for red events if [BC Ambulance Service] is delayed more than 20 minutes. This delay or non-response puts our citizens at serious risk.”

The letter says it is “alarming” to see the types of red-coded events fire departments will no longer be attending, and requests that Dr. Henry reconsider the order or, at a minimum, refer the discussion to BC Emergency Health Services and the BC Fire Chiefs COVID-19 Task Force to provide alternative solutions.

How many coronavirus cases are there in Canada, by province, and worldwide? The latest maps and charts

What are the coronavirus rules in my province? A quick guide to what’s allowed and open, or closed and banned

Coronavirus guide: Updates and essential resources about the COVID-19 pandemic

The 14 signatories are the mayors of Delta, New Westminster, Port Coquitlam, Port Moody, Belcarra, Richmond, West Vancouver, Pitt Meadows, Burnaby, Anmore, Langley, White Rock, and the city and district of North Vancouver.

On April 6, Vancouver Fire Rescue Services (VFRS) acting fire chief and general manager Kiran Marohn wrote to Mayor Kennedy Stewart and council outlining the department’s concerns, focusing on overdose deaths.

“Since the emergence of the opioid crisis in the City of Vancouver, VFRS has been on the front lines providing critical care, saving lives and reversing the outcomes of potential overdoses,” she wrote. “In the two weeks leading to these changes, we have seen a higher number of overdose deaths than usual. This is not the time to reduce responses to these events.”

Statistics included in the letter showed that from March 2 to 5, prior to the change, VFRS was dispatched to a total of 44 suspected overdose events. From April 2 to 5, it was dispatched to 15.

Acting Fire Chief Marohn added that “we still believe we are better positioned to provide timely service to our communities than the BC Ambulance Service,” and that firefighters are equipped with all necessary personal protective equipment.

Asked about the unintended consequences of the directive on Saturday, Dr. Henry said it came out of discussions with the emergency operations centre and that “fire services were not wanting to respond to health calls” because of COVID-19 risks.

VFRS Fire Chief Darrell Reid said in a post to Twitter shortly after that the service did not ask for major reductions in dispatches to medical calls and was not expecting the announcement.

Asked again about the change on Tuesday, Dr. Henry said it was initiated in consultation with “some of the fire services, but primarily with BC Emergency Health Services,” to reduce the use of personal protective equipment and the number of first responders who could potentially be exposed to COVID-19.

Dr. Henry said the protocol “unfortunately was misunderstood by some when it first came out” and “was not a reflection, as it seemed to have been interpreted, of the value of fire services and other non-paramedic first responders.”

Richmond Mayor Malcolm Brodie said Tuesday that the city was concerned with the new protocol and had not heard any updates since the letter was sent.

Sign up for the Coronavirus Update newsletter to read the day’s essential coronavirus news, features and explainers written by Globe reporters.