White Coat, Black Art

To prepare for future heat waves, classify air conditioners as medical devices, UBC expert says

Advocates say the devastating heat dome in B.C. in June through early July should be a wake-up call for health authorities to develop new measures to better protect the elderly and other vulnerable populations from future extreme weather emergencies.

Many vulnerable people, including seniors, lacked ways to stay cool during B.C.'s recent heat wave

A B.C. Ambulance Service paramedic is pictured outside of St. Paul’s Hospital in Vancouver on June 30, 2021. Advocates warn that seniors and people with disabilities will be particularly vulnerable in future extreme heat waves. (Ben Nelms/CBC)

Barbara Reed did everything she could to help Ollie O'Rourke keep cool on a late June evening during the deadly heat wave in British Columbia. 

Reed, a tour bus driver in Richmond., B.C., could tell from her first aid training that O'Rourke, the mother of Reed's daughter-in-law, bore the signs of heat stroke: bright red skin, no perspiration, loss of consciousness.

She tried to keep O'Rourke cool with wet towels and a fan while waiting for an ambulance — it took more than six hours to arrive.

After she made it to the hospital, Reed said her condition "went downhill." O'Rourke died on July 5.

"I think it was needless suffering at the end of her life," Reed told White Coat, Black Art host Dr. Brian Goldman.

At the time of her death, O'Rourke was in poor health and living at home with her husband, who has dementia. She had Stage 4 cancer, was on oxygen and was waiting for a bed in a palliative care unit.

Reed believes heat was a factor in O'Rourke's death, but said the family hasn't been given an official cause yet.

A spokesperson for the B.C. Coroners Service told White Coat their office received 808 reported deaths between June 25 and July 1. That's an increase from 232 deaths during the same week in 2020.

Advocates say this should be a wake-up call for health authorities to develop new measures to better protect the elderly and other vulnerable populations from future heat emergencies.

Paramedics in B.C.'s Lower Mainland reported being stretched to their limits during the heat emergency. Dispatchers at times had more than 200 calls waiting for a response, and lower-priority calls were left unattended from four to up to 16 hours.

Ollie O'Rourke with her grandchild, left. O'Rourke died in July during a devastating heat wave emergency in B.C. Right: O'Rourke in her youth. (Submitted by Kendra Johnson)

Heat warnings not urgent enough: professor

Jennifer Baumbusch, an associate professor at UBC's school of nursing with expertise in care for older adults, said health authorities' warnings weren't urgent enough to convey just how dangerous the heat level was compared to previous heat waves. 

"The communications, at least that I saw, were more things like: 'Make sure you drink lots of water, make sure you try and stay cool.' But there was no way for citizens to anticipate what this would feel like," she said.

"I don't think we ever kind of got to that stage of messaging or understanding [on] who you could reach out to [in] an emergency. There was no one. You were on your own."

Jennifer Baumbusch is an associate professor at The University of British Columbia’s School of Nursing. She specializes in health-care delivery and nursing practice with older adults. (Submitted by Jennifer Baumbusch)

Air conditioning

Fewer than 40 per cent of households in B.C. have air conditioning, according to a B.C. Hydro study published last year.

Baumbusch said seniors and people with disabilities are more likely to live in housing that doesn't have air conditioning or other heat-mitigating factors like windows that can open for better airflow, if it's cooler in the evening.

Air conditioning units, she suggested, could be considered medical equipment during a heat wave, which would allow them to be distributed to people who need them through the province's disability support systems.

A spokesperson for B.C.'s ministry of health told White Coat that "quick action" was taken to address the heat wave, including public heat alerts across all of the province's regional health authorities on June 25.

"Despite these efforts, the impact of the heat wave was tragic, and we offer our deepest condolences to those who lost a loved one," the statement said.

Isobel Mackenzie, B.C.'s seniors advocate, said while many people were aware of the warnings, they likely had no idea they were facing down a heat dome of historic proportions.

"We're not talking one or two degrees higher, but eight and 10 degrees higher than what would be a heat wave in the past. And we simply went from 'this is uncomfortable' to 'this is dangerous,' and unfortunately, in some cases fatal," she told The Current's Mark Kelley earlier this month.

The need to prepare 

Last week, B.C. Health Minister Adrian Dix committed to hiring more paramedics and dispatchers as well as providing new ambulances.

And on Thursday, Vancouver passed a motion to plan for future heat waves, in response to a memo from the City Planning Commission calling for action to help residents cope with heat.

That memo's recommendations included ensuring accessible public spaces with shade and water fountains, as well as providing air conditioner units to low-income residents.

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Baumbusch called the memo's recommendations "outstanding" and hopes they will be taken up by other municipalities outside the Vancouver area.

"I am surprised that we aren't already mobilizing some of the resources that we can. So things like trying to get air conditioning units into supportive housing, that's something that can be done immediately," she said.

Baumbusch also had several suggestions for dealing with heat waves and potential heat emergencies, including:

  • Get your grocery and other shopping done early to minimize time spent outside.
  • Keep a daily log of how much water and fluids you're drinking.
  • Keep towels and cloths handy to douse in cool water to keep yourself cool.
  • Consider preparing meals in advance and freezing them, to minimize time spent in a hot kitchen.

'We have an ageist society'

Baumbausch said seniors who live alone are at particular risk and it's possible some people who died during the heat wave have yet to be discovered.

"We have an ageist society … that doesn't look at old people. And so when they disappear from view, nobody says anything for a while," she said.

"It's sad to think that we have a society in which people are so invisible that they wouldn't be missed for two, three weeks, a month before somebody says, 'Oh, I wonder what's happening there.'"

It's terrifying. And I don't think that this will be the last. I think this is just the start of unbearable summers.- Barbara Reed

In a statement, a representative from the B.C. Coroners Service told White Coat they are still investigating the extent to which that week's sudden deaths and, potentially, others were caused by the extreme weather.

It noted that a person's cause of death is "determined on an individual basis by coroners at the conclusion of their investigations."

"Once aggregate data is available for analysis, we'll be in a better position to determine the review that will be undertaken," it continued.

A sign posted on a Canadian Tire store in Vancouver states they are sold out of air-conditioner units and fans. Baumbusch advised people buy supplies like these as early as possible ahead of projected heat waves, before they're sold out or appear for resale at inflated prices. (Ben Nelms/CBC)

Baumbausch called the review "an important step," explaining that deaths may be categorized as either anticipated or unanticipated, and that a coroner typically doesn't investigate the former.

As coroners conduct a review of data, Ollie O'Rourke's husband is still in shock, according to Barbara Reed, despite receiving support from family members.

She worries about what future heat waves may bring.

"It's terrifying. And I don't think that this will be the last. I think this is just the start of unbearable summers."


Written by Jonathan Ore with files from CBC Vancouver. Produced by Rachel Sanders.

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