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Opinion: Recommendations, yes, apologies, no, in wake of heat dome tragedy

A report from the provincial coroner’s “death review panel” makes it impossible to single out a clear culprit for the deaths of 619 victims in last June’s heat dome
Emergency ambulance - chung chow
Most of the 619 victims of last June’s heat dome who could even get an ambulance didn’t make it to the hospital.

For almost all of the 619 victims of last June’s heat dome, the blazing temperature outdoors didn’t kill them. 

Solitude indoors did. 

Their immobility contributed.

Their age, their poverty, their frayed underlying health abetted. 

They perished because their living quarters became ovens.

Because most didn’t have fans, much less air conditioners.

Because many lacked the physical or cognitive means to escape peril. 

Because many reached out to say they were unwell and weren’t helped.

Because less than half of them were even checked upon for wellness.

Because most who could even get an ambulance didn’t make it to the hospital.

Because a doubly-busy 911 gave some a busy signal.

Because even bearing multiple chronic diseases, not even the medical professionals that most had seen in the last month thought to call on them. 

Nor, for that matter, did any of us who knew them.

The report in recent days from the provincial coroner’s “death review panel” spreads enough blame for the heat-related fatalities to make it impossible to single out a clear culprit. It was systemic fault.

The findings are an enervating 33 pages of advice and 23 pages of appendices. It constantly prodded me to wonder why we hadn’t thought of doing all of this self-evident support earlier and worry that perhaps we had but just didn’t bother.

The province’s chief coroner tapped pretty much all the expert fields that somehow couldn’t cope then but claim to have learned enough to be ready if, probably when, there is a next time: emergency management, medicine, public health, First Nations health, seniors, city and municipal planning, health administration, poverty reduction, patient safety, policy, research, housing, police, fire and ambulance services. 

Before we get to the prescriptive windshield, let’s cast our eyes on the diagnostic rear-view mirror and at one piece of that well-travelled road. 

Most stunning for me was that these victims were on the one hand well-known to authorities but on the other hand poorly designated as priorities for emergency help.

Some 91 per cent were on at least one health ministry chronic disease registry, more than 80 per cent of them were on three or more, more than one-third on six to nine of them. More than two-thirds had such conditions as heart failure, osteoarthritis or Parkinson’s disease. Nearly two-thirds had mood or anxiety disorders, dementia or schizophrenia.

Yet the report revealed that these registries don’t include clinical diagnoses. Each registry defines its own criteria for inclusion from the tabulated administrative data. Damned little good that seems to have done.

One other terrible set of statistics reflects those days of chaos.

Of the 619 deaths, there had been 447 calls for an ambulance; the other 172 were later discovered.

Of those 447 calls, 332 ambulances were dispatched; the other 115 had earlier died.

Of those 332 ambulances dispatched, 277 were pronounced dead upon arrival or died at the scene.

Of the remaining 55, they made it to hospital, only to die later.

Another well-chronicled matter bears reminding: the federal Environment and Climate Change department had issued a heat warning, and the province and communities were simply lead-footed in responding soon enough.

The report concluded there are three key needs: a co-ordinated heat alert system, the identification and support of vulnerable populations during extreme heat events and prevention and risk-mitigation strategies. 

There are 14 priority actions out of these recommendations, many of them quickies before the next expected bout of hot weather in late July, like a better heat alert system and stronger co-ordination, and some longer-term advice, like improved codes for construction of cooler buildings and plans for canopy in cities.

One recommendation that rings smart is for cooling devices as medical equipment for the most vulnerable, something done elsewhere that could easily be implemented but instead will be studied. 

To some credit, the John Horgan government outlined next steps one day before the report was issued: it’s moving ahead on a better warning system, making a commitment to more ambulance services and planning to move more people to cooler places when temperatures rise dangerously.

But, true to form for most governments, nowhere in the last year or even in the last week has been basic contrition: an admission of administrative failure to contend even with a relatively slow-moving disaster like a days-long descent into hellish temperatures.

While the provincial statement on the debacle included bromides of “our hearts go out” and “it was clear we needed to work together to be prepared,” there was no “we are sorry we weren’t ready” or “we bear responsibility for losses of life,” much less a “we are resigning out of shame for what happened.”

The BC Liberals, not so long ago in charge of that same system, nevertheless noted the premier’s verbal blunders of last June: his ill-considered off-script quip that “fatalities are a part of life” (a gaffe he tried to walk back) and that amid the systemic dysfunction there was “an element of personal responsibility” to blame.

True, that. None of us deserves absolution. We can all be deemed complicit, because we had systematically, indifferently made those victims invisible to live out their lives, having failed to build viably their conditions of safety. 

But no political leader can have it both ways. Administration of public safety confers all-in responsibility for it. You can’t choose when to sheepishly pass the buck and bray that the buck stops with you – even when the covenant with the public sees it pay so others can look after what we cannot, do not or will not.

None of us had insight into where those vulnerable citizens were, how seriously they were threatened, and what might have been done to bring them to safety. 

That, I am afraid to say today, is what a publicly administered health system is supposed to be underwritten by us to record, monitor, and keep safe. 

And it didn’t. And its political overlords just won’t say sorry. •

Kirk LaPointe is publisher and editor-in-chief of BIV and vice-president, editorial, of Glacier Media.