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Experts: Governments must disaster-proof Canada's hospitals against climate change

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OTTAWA — When David Matear finally left the downtown Fort McMurray hospital, a wall of flames hit him after the last patient was taken from the building and onto a waiting bus. “You couldn't see the trees.

OTTAWA – A wall of flames awaited David Matear when he finally left the hospital in downtown Fort McMurray after the last patient was hastily escorted out of the building and onto a waiting bus.

“You couldn't see the trees. You just saw fire,” said Matear, who was then chief operating officer for the health system in northern Alberta.

“The fire was right on the doorstep… literally, probably about, I don't know, 200 yards away.”

The skies above the northern Alberta city glowed red and it looked eerily deserted as tens of thousands of people fled the spreading wildfires.

This happened eight years ago, during the largest medical evacuation in Canadian history.

Everyone was able to exit the building safely and, amazingly, the Northern Lights Regional Health Centre was still standing when the flames died down. However, the smoke caused considerable damage.

The 90,000 people who fled the region had to wait for hospitals and other essential services to reopen before they could return to their homes.

The ventilation system was thoroughly cleaned and every one of the 8,200 ceiling tiles in the facility had to be replaced.

Matear oversaw some of the work as incident commander. He later worked in British Columbia, which experienced horrific wildfire seasons, and helped hospitals in Manitoba and California weather COVID-19 surges.

He said Canada could do more to protect its hospitals, “on a much larger scale.”

That means preparing Canada's hospitals for a growing number of disasters, says Ryan Ness, director of adaptation research at the Canadian Climate Institute.

Disasters that send people to emergency rooms – such as fires, floods, heat waves and other extreme weather – often also affect hospitals themselves, Ness says.

And with climate-related emergencies expected to increase in the coming years, some parts of the country must rapidly shift to creating life-saving, disaster-resilient infrastructure.

“It is extremely urgent in the most vulnerable places,” he said.

“I think every health authority, every health ministry in every part of the country should think about this.”

Last month, the Canadian Medical Association warned that Canada's health facilities are among the oldest public infrastructure anywhere, with half of them built more than 50 years ago, making them particularly vulnerable to extreme climate events.

Several hospitals outside Fort McMurray also had to close due to the extreme weather conditions.

Regina General Hospital was closed for eight days in 2007 due to extreme heat and humidity, a hospital in New Brunswick flooded in 2012, and air quality alerts led to the temporary closure of 19 health facilities in 2017.

The threat varies across the country. According to one study, 10 percent of Canada's hospitals and large health facilities are located in a 100-year flood zone, Ness said.

Five percent were in a 20-year flood plain, meaning they have a five percent chance of being flooded each year.

“The results were quite surprising,” he said. “Even under the existing climate conditions, many facilities are located in flood zones.”

The solution could be to move the hospital's electrical systems out of the basement to prevent floodwater from entering and causing short circuits, and to upgrade the ventilation systems so they are not overloaded by smoke from nearby wildfires.

It might also be easy to install air conditioning to combat the extreme heat, as high temperatures are becoming more and more common.

None of these solutions are cheap, but Ness says the cost is preferable to the alternative.

“I guess the counter question is: Can we afford not to do anything about it?” he said.

“Can we afford not to ensure that these facilities are resilient, available, accessible and functional even in times of greatest need?”

Otherwise, Canada will face additional costs or even loss of life, he said.

A 2018 report for the government of British Columbia addressed a similar issue, using the example of Superstorm Sandy in 2012, which led to the closure of six hospitals in New York City.

When two emergency generators failed, hundreds of patients had to be evacuated from New York City Hospital, including 20 babies from the neonatal unit.

Hospitals suffered $800 million in damage and total reconstruction costs are estimated at $3.1 billion, according to the report prepared by Island Health.

The Spaulding Rehabilitation Hospital in Boston famously attempted to learn from this harrowing and costly experience by designing the building with disaster in mind. Emergency care is located above the 100-year flood plain projected for 2085 to accommodate expected sea level rise in the coming years.

This type of future-proofing was highlighted as a priority in a comprehensive 2022 Health Canada report titled “The Health of Canadians in a Changing Climate.”

“Adaptation actions that anticipate the increasing impacts of climate change on ecosystems, infrastructure, communities and health systems must go beyond incremental approaches and introduce transformative changes,” the report’s authors said.

The authors of this study cited a 2019 survey that found that only eight percent of Canadian health care organizations had considered climate change in their strategic plan or identified climate risks in specific policies.

The report should help federal and provincial governments be better prepared for the impacts of climate change on the health of Canadians.

For example, the new St. Paul's Hospital in Vancouver, scheduled to open in 2027, will be built five meters above the sea level rise predicted for 2100 so that it will not be shut down in the event of a major flood. The cooling system has also been designed to withstand temperatures predicted for 2080.

Of course, not every hospital needs to be prepared for every disaster, said Ness. You just need to know where the risks lie.

But these risks are increasing as emergencies become more frequent, Matear said.

People were shocked when a forest fire raged through Fort McMurray in 2016, he said, but fires have remained a threat every year since then.

People in Fort McMurray recently returned home after their community was hit by another wildfire and forced to evacuate.

“I think that’s why you have to be much better prepared than the provinces were before 2016,” Matear said.

This report by The Canadian Press was first published May 25, 2024.

Laura Osman, The Canadian Press