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Paramedics and firefighters place a man in an ambulance after responding to an SRO in the Downtown Eastside during a heat wave in Vancouver, on June 29, 2021.DARRYL DYCK/The Globe and Mail

British Columbia’s emergency response system was plagued by understaffing and slow response times months before last summer’s deadly heat wave pushed the 911 system into crisis, internal documents show.

The records were released to the BC Liberals following an access-to-information request to E-Comm, the province’s 911 emergency dispatcher service. They show that in early June, a data analyst for the agency warned that for a year, calls for an ambulance had been going up and the response time by the ambulance service had been declining.

Three weeks later, B.C. shattered dozens of historic heat records, including a national high of 49.6C in Lytton. The BC Coroners Service and the province reported 569 “heat-related deaths” in the province from June 20 to July 29. Most of the fatalities were people 70 years and older.

Premier John Horgan has said there was no way for the province to prepare for a “once in a 1,000-year event.” But the documents show a series of factors that were known before temperatures started to rise contributed to a perfect storm and touched off a desperate scramble by E-Comm to find more staff to respond to calls. Some callers got a busy signal; others who got through were told it would take more than 10 hours for help to arrive.

“The volume for May 2021 is already higher than peak summer (July and August) volumes in 2020,” Suzanne Halliday, the executive director of data, analytics and decision support for EComm911.ca, wrote in a June 3 e-mail to colleagues.

“The trend is consistent and is alarming in that we are not yet into peak summer 2021 … and we are already struggling with answer delays that threaten to overwhelm our service delivery.”

After presenting a chart with the data, Ms. Halliday went on to write that the BC Ambulance Service “is compromising public safety overall by negatively impacting 911 answerability.”

The documents show the heat wave corresponded with the Canada Day long weekend – long weekends frequently see higher call volumes, but especially this year when British Columbians were eager to celebrate the lifting of COVID-19 restrictions. At the same time, the already-stretched-thin service had several staff on vacation.

As calls flooded in, 911 operators had a duty to stay on the telephone with the person seeking help until either fire or ambulance paramedics could respond. But staff in those services were themselves backlogged, waiting for patients to be seen in emergency rooms. As a result, some operators were on calls for hours with increasingly desperate people and were unable to pick up other calls coming in.

The documents show there was a scramble to recruit more call-takers by buying out breaks, requesting overtime and tapping recently retired staff.

“The demand for BCEHS [BC Emergency Health Services, the agency responsible for out-of-hospital and inter-hospital health services across the province] remains very high,” Stephen Thatcher, vice-president operations for E-Comm, wrote June 29.

“The picture is a complicated one, and, even if helpful over a short duration or for special events, simply adding more call takers to E-Comm’s emergency communications centres is neither a practical or sustainable answer.”

In the legislature, Liberal MLA Karin Kirkpatrick noted that on the same day E-Comm officials were grappling with an overwhelmed system, Mr. Horgan said publicly that “fatalities are a part of life” and that people had a “level of personal responsibility” to look after each other.

“We know that by June 3, E-Comm was convinced that the problems at BCEHS were compromising public safety, yet nothing was done to fix the problems and the system collapsed during the heat wave,” Ms. Kirkpatrick said during Question Period.

Health Minister Adrian Dix said his government has significantly increased resources to the ambulance service in each of the last four years.

“This dramatic increase – other than Mental Health and Addictions – is the largest increase of any area of health care since I became Minister of Health,” he said, referring to his time in the portfolio since 2017.

Mr. Dix went on to say the annual funding increases are a recognition of “both a structural need for reform, and that’s been happening, and of urgent services that are provided to support communities.”

The documents show E-Comm was acutely aware of public frustration and anger as the inability of emergency services to respond to the mounting disaster was featured in media reports. Officials complained that E-Comm had been placed at the centre of controversy as BCEHS refused to comment.

Troy Clifford, president of the Ambulance Paramedics of BC union, said his organization has been sounding alarm over recruitment challenges for almost a year.

“It’s well documented that we’ve had staffing issues well before the heat, and well documented that we’ve been short staffed for a long time, and we’d have delays,” he said in an interview on Tuesday. “That’s what really led up to what the heat dome exposed for us.”

Mr. Clifford said the province’s move to to bolster ambulance operations by hiring more paramedics and dispatchers has not been enough.

“But we’re still working on more, and we’re still seeing those delays.”

BC Emergency Health Services said Tuesday evening that hundreds of new paramedic positions, 30 new dispatchers and 22 new ambulances are expected to be filled between October and December 2021.

On June 28, Jasmine Bradley, E-Comm’s director of corporate communications, wrote an e-mail to E-Comm’s executive leadership team in which she shared a Reddit post that she surmised was written by someone on E-Comm’s staff. The post was vividly critical of the inability of 911 staff to help, and described how 911 logjams then bleed into calls for police to respond to crimes and firefighters to respond to blazes.

The post concludes the crisis “is impacting paramedics, EHS call takers, EHS dispatchers, 911 call takers at E-Comm, police call takers and dispatchers throughout B.C. ... It is impacting B.C. residents, it is impacting you, your family, your friends.”

Ms. Bradley notes in the e-mail that the post contains “nothing that’s untrue – but it does make me nervous to think about more and more people potentially speaking out publicly. Although perhaps that will just add to the pressure the provincial government is feeling.”

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