Western Canada: Vancouver aims to protect homeless, even though capacity for overdose response reduced

Good morning! Wendy Cox in Vancouver here.

Vancouver Mayor Kennedy Stewart has been frank about his fears for the city as the impact of COVID-19 continues to upend everyone’s lives: among other things, he’s especially worried about Vancouver’s homeless population. The challenges of physical distancing and of self-isolation are virtually impossible for someone without a safe home to retreat to.

To that end, the city has worked with the province to allow those addicted to drugs to get safe prescription alternatives, a radical step aimed at ensuring the black-market supply – now drying up because of closed borders – doesn’t prompt increasingly desperate people to do desperate things to get a fix.

On Friday, the city announced it would pay for two weeks of meal delivery to the 1,100 residents in single-room-occupancy hotels, as well as commercial cleaning in 21 of the privately owned SROs. The city has also contracted with an undisclosed hotel to provide rooms for homeless people who must self-isolate.

But amid such measures, the overdose crisis continues. Earlier this week, health officials said eight people died of suspected overdoses last week, the highest number since last August and in contrast to a decline in overdose deaths over the past year.

Against this sobering backdrop, B.C.'s public-health officer has issued an order to ensure firefighters are as protected as possible from exposure to COVID-19 and to preserve the amount of personal protective equipment needed. As Andrea Woo writes, the order, obtained by The Globe and Mail, requires firefighters to limit their response to emergency calls to only those deemed the most life-threatening, such as cardiac arrest, events that are colour-coded as purple, the most urgent category. It means firefighters will not routinely respond to most overdoses. Overdose calls are usually 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.

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

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.

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.

In a statement provided by spokeswoman Sarah Morris, BC Emergency Health Services said paramedic specialists monitor all calls and can upgrade events and recommend sending additional resources, such as firefighters. She noted there is an ambulance station in the Downtown Eastside that regularly responds to overdoses.

Jonathan Gormick, spokesman for VFRS, said he believes the change has the potential to delay the response to overdose calls.

“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.

This is the weekly Western Canada newsletter written by B.C. Editor Wendy Cox and Alberta Bureau Chief James Keller. If you’re reading this on the web, or it was forwarded to you from someone else, you can sign up for it and all Globe newsletters here. This is a new project and we’ll be experimenting as we go, so let us know what you think.

AROUND THE WEST:

FOREIGN STUDENTS: Federal and provincial governments have responded to the economic crisis triggered by COVID-19 with a flurry of relief programs and rescue packages, but international students are finding themselves stuck with no access to Canadian government relief because they are not citizens. Nor do they have access to relief measures that may be on offer from their home countries because they are away. Frances Bula and Xiao Xu spoke to several who find themselves with abruptly ended classes and closed borders, barring their return home. Job prospects are minimal and rent is almost impossible to pay.

TEMPORARY HOSPITALS: Three provinces rolled out plans this week to transform other sites into makeshift hospitals. In British Columbia, Vancouver’s waterfront Convention Centre will be equipped to house 270 patients. In Quebec, the government has earmarked 4,000 hotel rooms that could be pressed into service under its public-health-emergency laws. And in Ontario, the government is giving hospitals the go-ahead to temporarily lease space in other buildings, including hotels and retirement homes.

VIRUS MODELLING: The federal government is lagging some provinces and other countries as it continues to figure out the modelling that shows the best- and worst-case scenarios Canada faces in the COVID-19 pandemic.

VENTILATORS: Health ministries across Canada are unearthing unused ventilators from government stockpiles and rushing to buy some of the few still for sale as they work to put to rest doubts about whether Canada has enough intensive-care beds and ventilators to cope with the coronavirus pandemic.

NATHAN FONG: Nathan Fong wasn’t part of the Canadian food elite. “He was food royalty,” said Vancouver chef Quang Dang, a close friend. “He was respected by culinarians at every level all around the world.” Mr. Fong, an award-winning food stylist, media personality, chef for the British Columbia government and advocate for the gay community, died in Vancouver of a suspected heart attack on March 30. He was 61.

PAGING ALL CALGARY DOCTORS: Dr. Yael Moussadji, an emergency physician and chair of the physician work force pandemic plan, said Calgary’s hospitals are likely to need extra physicians with all kinds of backgrounds, including community doctors and pediatricians. Up to one-third of admitted COVID-19 patients may require a ventilator, and others will still require high levels of care, she said. At the same time, physicians must be available to treat patients without COVID, too. Dr. Moussadji and her colleagues are working with Calgary’s City-Wide Medicine Emergency Pandemic Operations Command and issued their call based on projection models that suggest the city does not have enough acute-care physicians to look after the many patients expected in the weeks ahead.

DOUBLE HOMICIDE: The RCMP have charged a man from a small town in Alberta with two counts of murder after two Métis men were fatally shot on a rural road last week. Anthony Bilodeau, 31, is charged in the deaths of Jacob Sansom and Maurice Cardinal, who were killed last Friday near Glendon, a town of about 500 people located 220 kilometres northeast of Edmonton. Police have not pinpointed a motive and said there is nothing to suggest race was a factor.

ALBERTA CARE HOMES: Alberta has confirmed cases of COVID-19 at nine of the province’s seniors facilities, with the most significant outbreak at Calgary’s McKenzie Towne Continuing Care Centre. Chief Medical Officer of Health Dr. Deena Hinshaw said the virus has been spread by workers who hold jobs at more than one seniors’ facility. On Thursday, she announced new, stricter requirements for alerting public-health officials of coronavirus at congregate-care facilities and set new parameters on staff members’ ability to work at more than one facility. As of Thursday there are 74 confirmed cases, among both residents and staff, in nine continuing-care facilities in Alberta. Sixty-five of those cases are at Calgary’s McKenzie Towne. At that centre, four residents have died.

OPINIONS

The Globe and Mail’s Editorial Board on why the rest of Canada should follow in Dr. Bonnie Henry and Adrian Dix’s lead: “In B.C. last Friday, Dr. Henry and Mr. Dix gave everyone in the province a clearer picture of the situation, while adding to the global store of knowledge. It’s exactly what’s needed as this country figures out the virus and hones its strategies to fight it.”

Sylvain Charlebois on B.C.’s decision to give itself the authority to take over the food supply chain: "Governments have taken steps to manage public-health risks the best they possibly can in these unprecedented times; for the most part, their work has been amazing. But supply chains are not something bureaucrats are qualified to fully understand, especially nowadays. When someone is not involved with the mechanics of supply chains daily, blind spots can be overwhelming for the uneducated eye.”

Adrienne Tanner on the small businesses of neighbourhoods: A friend in Toronto told me this week he worries how the feel of his city will change if help for the small shops he loves doesn’t come soon. I share his concern. Small businesses are the beating heart of any neighbourhood. If they fail, we all lose.