Senior executives with the largest 911 dispatch service in B.C. warned its board members that paramedic staffing was dangerously inadequate weeks before the heat wave this summer killed dozens in the province, internal documents show.
The string of emails, first published by CTV News and later obtained by CBC News, show frustrated executives with E-Comm discussing how significant staffing shortages at B.C. Emergency Health Services (BCEHS), which manages the British Columbia Ambulance Service (BCAS), were leading to delays across the entire emergency response system during one of its busiest seasons.
"BCAS is compromising public safety overall by negatively impacting 911 call answer ability, due to delays with BCAS call answer," read a June 3 email from Suzanne Halliday, E-Comm's executive director of data, analytics and decision support.
The documents were revealed as health-care advocates, first responders and opposition politicians try to determine what kind of action — or inaction — might have contributed to the number of people who died during the heat wave, which saw unrelenting temperatures in excess of 40 C in late June and early July.
'Significant risk' to public safety
E-Comm has previously said delays in emergency response were "directly related" to problems at BCEHS.
Across most of B.C., calls to 911 are first answered by an E-Comm dispatcher who determines whether the caller needs police, fire or ambulance. If the caller asks for ambulance, the dispatcher must transfer the call to BCEHS and stay on the line until one of its call-takers picks up.
Staffing shortages at BCEHS mean it's taking longer to answer those transfers from E-Comm, according to the latter agency. Since E-Comm dispatchers are required to stay with the caller until the transfer goes through, they're stranded by the delay and cannot take other incoming 911 calls — which creates backlogs across the entire E-Comm system.
Concerns expressed within E-Comm ramped up after the heat dome descended on the province later in June.
"The significant risk to public safety posed by call-answer delays in transferring 911 calls for the ambulance service to BCEHS, has significantly worsened," read an email from CEO and president Oliver Grüter-Andrew on June 29, the third day of extreme temperatures.
"At the very busiest moments of the day, BCEHS' ability to accept our calls is being fully exhausted … Last night we had to wait almost 30 minutes in one case to hand off a call."
In another email chain discussing more possible solutions, Halliday's exasperation spilled over.
"What the heck is BCEHS doing to come up with other creative solutions," she wrote in an email on June 30, after days under the incessant heat.
In June, BCEHS said it was "continuously monitoring staffing levels and making daily adjustments as needed."
"As well, our managers and supervisors are out in the field supporting our crews and providing much-needed hydration, food and assistance in helping paramedics clear the hospital emergency departments more quickly and efficiently as they work in this challenging weather," she said in an email to CBC.
In an interview on Friday, CEO Grüter-Andrew said he wrote his email because the issue had reached a clear breaking point.
"The system has been under strain for some time ... I worry a lot about our staff at E-Comm. I worry about staff at other emergency communication centre, police, fire and ambulance," he said.
"The right thing to do is look at the system of emergency communication in British Columbia end-to-end ... and redesign and resource the system appropriately to deal with that for the sake of public safety."
Health minister responds
The documents were uncovered through a freedom of information (FOI) request filed by the B.C. Liberals, whose leader raised the issue in the Legislature on Tuesday.
Health Minister Adrian Dix responded by reiterating steps the province has taken to alleviate strain while the ambulance system faces "extraordinary challenges" in the face of two concurrent public health emergencies.
"We're responding with more resources, more ambulance paramedics, more ambulances, more air ambulances and more dispatchers," said Dix, who added the province has been adding resources to the ambulance service since 2018.
Nearly 600 people died unexpectedly during the heat wave, the majority of whom were older and living alone. Some waited hours for an ambulance, with one paramedic saying there was a time when first responders had more than 200 calls pending.
The Liberals have called for an independent review of the province's response to the disaster. Premier John Horgan in July said municipalities had fair warning and were prepared to respond, but that no one could have anticipated how catastrophic the heat wave would be.