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Heat dome timeline: delays led to hundreds of deaths

Emails obtained through freedom of information request offer internal look at how the province handled and responded to heat wave warnings last summer
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A B.C. Coroners Service death review panel blamed delayed reaction to heat alerts for the deaths of 619 people between June 25 and July 1, 2021.

As spring turned to summer in 2021, “weather Twitter” was abuzz.

Social-media-savvy meteorologists throughout the Pacific Northwest were awestruck with forecasts for the first full weekend of summer.

“Several of the global models are predicting an extraordinarily unusual heat wave this weekend in the Pacific Northwest,” blogged University of Washington atmospheric sciences professor Cliff Mass. “A heat wave so extreme that many locations might experience their warmest temperature on record.”

What happened in British Columbia was the biggest natural disaster in Canadian history.

Officials were late to warn the public. Dispatchers, paramedics and emergency room doctors and nurses struggled with the deluge of patients. Coroners had hundreds of heat-related deaths to investigate.

What went wrong? What follows is a timeline constructed via freedom of information-obtained email from Health Emergency Management B.C. (HEMBC) executive director John Lavery and Provincial Health Officer Dr. Bonnie Henry.

 

JUNE 23

7:23 a.m.

HEMBC acting director Jamie Galt receives a reminder that the Climate Action Secretariat’s (CAS) climate change accountability report on managing climate change risks and reducing departmental greenhouse gas emissions is due July 2. “CAS recognizes that [the Ministry of Health] has not previously participated in this reporting.”

 

4:00 p.m.

Environment Canada issues a heat warning for most of British Columbia: “a dangerous, long duration heat wave” coming June 25-29. Highs of 34-38 degrees Celsius and lows of 18-20 degrees Celsius from June 25-27 were forecast for Abbotsford — considered the bellwether for Southwestern B.C. heat warnings.

 

JUNE 24

8:30 a.m.

BC Emergency Health Services (BCEHS) board hears from Neil Lilley, senior provincial director of patient care, communications and planning. Lilley describes how injuries and illnesses are assigned a colour code that determines whether an ambulance is dispatched or a patient is diverted to the 8-1-1 nurse hotline.

“They could be somebody who stubbed their toe or has some severe sunburn, which probably is going to happen quite a bit this weekend,” Lilley laughed. “8-1-1 might be busy, but hopefully not.”

Later in the June 24 meeting, chair Tim Manning asks about call volume trends more than a year into the pandemic.

“This extreme weather that you’re going to see this weekend is going to have a further boom, so it’s very challenging at the moment,” Lilley said.

 

1:22 p.m.

Galt, under the subject “Heat Impacts - Provincial Materials,” shares links with colleagues to background documents about the high heat hazard.

 

4:00 p.m.

Environment Canada forecast temperatures for Abbotsford updated. High of 32 C, low of 20 C beginning June 25, hitting 38 degrees by June 27.

 

6:00 p.m.

Lavery says if there isn’t an Environment Canada and BC Centre for Disease Control (BCCDC) heat warning tomorrow, then it would be Saturday: “I've sent an email to our contact at Environment Canada to see if they can give me the prediction for humidity for the next week.”

 

JUNE 25

8:00 a.m.

In Abbotsford, it’s 24.7 C, but the humidex is already 30 degrees.

 

9:21 a.m.

“WEATHER ALERT: Heat Warning” sent on behalf of Fraser Health environmental medical health officer Dr. Emily Newhouse and HEMBC Lower Mainland director Mark Phillips:

“We are set for very hot temperatures in the coming weeks. These high temperatures may result in an increase in heat-related illnesses, require closer monitoring of patient/resident care environments, and require consideration for at-risk populations.”

It included forecast highs of up to 39 C and overnight lows of 18 C, but the humidex could reach the low 40s.

 

11 a.m.

In Abbotsford, 30.4 C, but the humidex is at 35 C.

 

11:13 a.m.

Dr. Mark Lysyshyn, deputy chief medical health officer at Vancouver Coastal Health, broadcast an email that reads: “We will meet our rare Extreme Heat Alert level. According to the BCCDC historical data, the Extreme Heat Alert criteria is linked to at least a 20% increase in mortality.”

Lysyshyn recalls the 2009 heat wave’s increase in mortality and warns that people who live alone, are confined to bed or suffering a chronic physical or mental illness, are at highest risk.

 

11:49 a.m.

Leaders' Bulletin from Lavery warns of heat-related illness or death and wildfires.

“Although many of us are looking [forward] to ushering in summer, all PHSA [Provincial Health Services Authority] leaders and staff are asked to be advised about a dangerous, long-duration heat wave that will affect B.C. beginning on Saturday (June 26) and lasting until Wednesday (June 30).”

 

12:11 p.m.

Lexie Flatt, Provincial Health Services Authority’s (PHSA) head of pandemic response and data, says she doesn’t have a distribution list for the heat warning email. Someone in the communications department would know how to reach executives and senior managers.

 

12:58 p.m.

Deputy Provincial Health Officer Dr. Reka Gustafson tells the BCCDC’s environmental health heads Dr. Sarah Henderson and Dr. Tom Kosatsky that peak temperatures are coming before the expected lifting of B.C.’s indoor mask mandate. “Is this something we need to address before the weekend — public messages, reinforcement that masks are not recommended outside?” Gustafson asks.

 

1 p.m.

In Abbotsford, 32.7 C. Humidex reaches 38 degrees.

 

1 p.m.

Lavery to Madeline Maley at B.C. Wildfire Service: “We are running into an issue in the Interior with the extreme heat and some (censored).

 

1:07 p.m.

Henderson tells Gustafson sweat-saturated masks are ineffective and even harder to breathe through. People “oppressed and suffocated in this heat” should take them off. “Masks in hot indoor environments (restaurant kitchens) are of particular concern.”

 

2:08 p.m.

BCCDC environmental health scientist Kathleen McLean says the emergency 2:15 p.m. meeting is triggered by the average of today’s measured and tomorrow’s forecast readings at Vancouver (26.4 C) and Abbotsford (34.4 C) airports.

 

2:42 p.m.

Henderson to Gustafson and Henry: The Heat Emergency Alert is on.

"While the threshold has been met a few times since implemented in 2012, the region has previously decided to de-escalate based on the weather forecast. This time is different.”

Extreme hot weather is now a bigger health risk than COVID-19 infection and nobody should be denied access to a cooling space.

 

2:54 p.m.-3:14 p.m.

Caeli Murray of PHSA communications asks Lavery about the procedure for issuing his internal warning.

 

3:16 p.m.

PHSA communications sends Lavery’s leader’s bulletin email, same as the 11:49 a.m. message.

 

4:34 p.m.

Dr. Bonnie Henry is in Kelowna, meeting area health officials. The province was enjoying a downward trend in COVID-19 infections, a rolling seven-day average of 74. It had been a week since it reported more than 100 new infections in a day.

Ministry of Health communications director Aileen Machell sends the draft of the Vancouver Coastal Health and Fraser Health extreme heat alert to Henry for her approval.

 

4:43 p.m.

Machell sends Henry an attachment with tracked edits.

 

5:33 PM

Three hours after the urgent teleconference, Vancouver Coastal Health sends the Extreme Heat Alert to media.

“As heat continues to build in the Lower Mainland, the Heat Warning issued by Environment Canada has now been escalated to an Extreme Heat Alert… Humidex values during this period will reach the high 30s to possibly the low 40s. High temperatures are historically associated with an increase in deaths among Lower Mainland residents.”

 

As the weekend progressed and the unrelenting heat intensified, the public became worried.

At 8:31 p.m. on June 26, someone wrote to Henry and New Westminster NDP MLA Jennifer Whiteside, worried their elderly, wheelchair-confined mother in the second floor of the Kiwanis Care Centre would die in the extreme heat in a building without central air conditioning.

“Please take immediate steps to ensure all the seniors in Kiwanis are kept comfortable in the

heat,” reads the email. "If that means they all have to stay on the main floor over the next few days then so be it. Someone needs to take it seriously and figure it out. Now.”

Several vaccine clinics across the region closed June 27 or temporarily relocated due to lack of air conditioning or malfunctions in cooling systems.

Henry and Health Minister Adrian Dix appeared at an afternoon news conference on June 28 in the Legislative press theatre. Their script remained heavy on mass-vaccination messaging, despite the internal advice that the heat wave get temporary precedence over the pandemic.

Dix did acknowledge June 25 and 26 were consecutive record days for ambulance call volumes, 1,833 and 1,850, respectively. Henry called the challenges to keep some vaccine clinics open a “dynamic situation.”

The heat and rapid snowmelt prompted Pemberton to open its emergency operations centre.

An air quality advisory was issued for the Sunshine Coast, a flood warning for the Upper Fraser River, high streamflow advisory on the Quesnel River and strong winds with lightning and thunderstorms in Prince George and north of Peace River.

Contractor Helijet told PHSA officials on June 29 that it was so hot that its choppers were unable to land on Vancouver General, Royal Columbian and Children’s and Women’s hospital helipads. Ian Lightbody, the BCEHS manager of aviation operations, explained the heat made for a double-whammy: “Not as much lift from the wing/rotor blade and not as much power from your engine.”

“Never thought I would see 29 C being a problem here.”

At least 100 deaths were blamed on the heat so far. At a news conference about dropping pandemic restrictions, Premier John Horgan famously says: “I’ll await the coroner’s determination. As Dr. Henry said, fatalities are part of life.”

Coroner Lisa Lapointe says at least 233 deaths were reported; a normal four-day period would be around 130.

At 5:38 p.m., someone wrote to ask Henry for advice. “What are you recommending we do about sleeping in an apartment that has a temp over 30 C? I personally am afraid to go to my place right now and I am not the only one.”

Nearly a year later, on June 7, 2022, the B.C. Coroners Service death review panel blamed delayed reaction for the deaths of 619 people between June 25 and July 1, 2021.

“Ninety-eight percent of deaths occurred indoors,” the report stated. “There was a lag between the heat alerts issued by Environment and Climate Change Canada (ECCC) and public agencies and the public response.”

Most of the victims lacked access to cooler buildings or air-conditioned spaces, many had chronic health conditions and more than two-thirds were 70 or older. More than half lived in poorer neighbourhoods with no access to air conditioning or fans.

BCEHS did not activate its dedicated emergency operations centre until June 29.

“Paramedics attended 54% (332) of deaths with a median time of 10 minutes and 25 seconds;

in 50 instances, paramedics took 30 minutes or longer from time of call to scene attendance; and in 17 instances, 9-1-1 callers were placed on hold for an extended period of time; and

in six instances, callers were told that there was no ambulance available at the time of call,” the report said.