Need for a co-ordinated heat alert response system

A panel of subject-matter experts has identified the need for a co-ordinated heat alert response system, identification and support of vulnerable populations, and implementation of prevention and longer-term risk mitigation strategies as key areas of focus to prevent loss of life in future extreme heat events in B.C.

The findings are contained in the report Extreme Heat and Human Mortality: A Review of Heat-Related Deaths in B.C. in Summer 2021 released by the BC Coroners Service.

“This report includes recommendations that the panel believes will help build resilience and greatly reduce the likelihood of death in future heat events,” said Michael Egilson, Chair, Death Review Panel. “It was important that we focus both on the immediate threat and on longer-term prevention strategies, and the final report includes measures that can be actioned now and changes to be made in the years to come.”

In late June 2021, British Columbia experienced an unprecedented extreme heat event, with record temperatures in many parts of the province lasting for several days. Temperatures began to rise on June 24 and continued increasing to a peak on June 28 and 29. At its peak, temperatures reached over 40 C in many parts of the province. Overnight temperatures also remained uncharacteristically high throughout this period.

During the week of the extreme heat event, the BC Coroners Service responded to a sudden and significant increase in reported deaths. More than 800 deaths were investigated between June 25 and July 1, with 619 deaths later identified as heat-related.

Findings from coroner investigations reviewed by the panel show:

* 98% of deaths occurred indoors;

* there was a lag between the heat alerts issued by Environment and Climate Change Canada and public agencies and the public response.;

* heat-related deaths were higher among people on specific chronic disease registries, including schizophrenia, substance-use disorder, epilepsy, chronic obstructive pulmonary disease, depression, asthma, mood and anxiety disorders, and diabetes, compared to the B.C. population;

* more than 60% of decedents had seen a medical professional within the month prior to their death;

* 67% of decedents were 70 or older;

* 56% of decedents lived alone;

* more decedents lived in socially or materially deprived neighbourhoods than the general population;

* most decedents were in homes without adequate cooling systems, such as air conditioners or fans;

* 74% of deaths occurred in Fraser and Vancouver Coastal health authorities;

* Fraser North, Fraser East and Vancouver had the highest rates of deaths by Health Services Delivery Area;

* 911 calls doubled during the peak of the heat dome; and

* paramedics attended 54% of deaths with a median time of 10 minutes and 25 seconds.
* In 50 instances, paramedics took 30 minutes or longer from the time of the call until they arrived at the scene;

* In 17 instances, 911 callers were placed on hold for an extended period.

* In six instances, callers were told that there was no ambulance available at the time of their call.

Following extensive review and discussion of the aggregated data, the panel provided advice to the chief coroner that included three recommendations to a number of ministries, agencies and authorities:

1. Implement a co-ordinated provincial heat alert and response system (HARS).

2. Identify and support populations most at risk of dying during extreme heat emergencies.

3. Implement extreme heat prevention and long-term risk mitigation strategies.

The recommendations reflected analysis of the mortality data and/or panel discussions. The chief coroner has forwarded the recommendations to the relevant ministries and organizations.

“I am very grateful to each of the panel members for their insights, collaboration and commitment to the health and safety of the people of B.C.” said Lisa Lapointe, Chief Coroner. “We know that weather-related emergencies caused by climate change will continue to challenge us as individuals and as a province. We must learn what we can from the tragic loss of life last summer to support future awareness and focused public health and safety strategies. I am encouraged by the work already underway across ministries and organizations, and believe that the panel’s recommendations will support improved outcomes for people in B.C., should similar heat events occur in the future.”

Learn More:

Extreme Heat and Human Mortality: A Review of Heat-Related Deaths in B.C. in Summer 2021:

Death Review Panel: