Achi news desk-
David Matear was met by a wall of flames when he finally stepped outside the downtown Fort McMurray hospital, after the last patient had been rushed out of the building and into a waiting bus.
“You couldn’t see the trees. You just saw a fire,” said Matear, the health system’s senior director of operations in northern Alberta at the time.
“The fire was right on the doorstep … literally, about, I don’t know, 200 meters away.”
The sky glowed red over the northern Alberta town, which felt eerily abandoned as tens of thousands of people fled the spreading wildfires.
That was eight years ago, during the largest medical evacuation in Canadian history.
Everyone got out safely and, amazingly, the Northern Lights Regional Health Center was still standing when the flames died down. But the smoke did significant damage.
The 90,000 people who fled the region had to wait until the hospital and other essential services were running again before they could return home.
The ventilation system was scrubbed clean and all 8,200 ceiling tiles in the facility had to be replaced.
Matear oversaw some of the work as event manager. He later went on to work in British Columbia, which suffered terrible wildfire seasons, and help hospitals in Manitoba and California weather waves of COVID-19.
He said there is more Canada can do to protect its hospitals, and “it needs to be on a much larger scale.”
That means bracing Canada’s hospitals against an increasing number of disasters, said Ryan Ness, director of adaptation research at the Canadian Climate Institute.
Disasters that bring people to the emergency room — such as fires, floods, heat waves and other extreme weather — often also hit the hospitals themselves, Ness said.
And with the number of climate-related emergencies expected to worsen in the coming years, some parts of the country will need to move quickly to life-saving, disaster-preventing infrastructure.
“In the most vulnerable locations, it is very urgent,” he said.
“I believe that every health authority, every health ministry in every part of the country should be thinking about this.”
Last month, the Canadian Medical Association warned that Canada’s health care facilities are among the oldest public infrastructure in use. Half of them were built more than 50 years ago, making them particularly vulnerable to extreme climate events.
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Several hospitals outside of Fort McMurray have also been forced to close due to extreme weather.
Regina General Hospital was closed for eight days in 2007 due to high heat and humidity; a New Brunswick hospital was flooded in 2012; and air quality alerts in 2017 led to the temporary closure of 19 healthcare facilities.
The threat varies across the country. One study found that 10 percent of Canada’s major hospitals and health care facilities are located within a 100-year flood zone, Ness said.
Five per cent were in a 20 year floodplain, which means they have a five per cent chance of being flooded in any given year.
“The results were quite a surprise,” he said. “Even under the current climate, there are plenty of facilities in high risk flood zones.”
The repair could involve moving the hospital’s electrical plants out of the basement to prevent floodwater from seeping in and cutting them off, or upgrading the ventilation systems so they are not overpowered by smoke drifting in from wildfires nearby.
It could also be as simple as installing air conditioning to combat extreme heat, as high temperatures become more and more common.
None of those solutions are cheap, but Ness said the cost is better than the alternative.
“I guess the opposing question is, can we afford not to do something about this?” he said.
“Can we afford not to make sure that these facilities are resilient and available, accessible and operating in times of greatest need?”
Otherwise, Canada could pay in the form of additional costs or even lost lives, he said.
A report prepared for the BC government in 2018 made a similar case using the example of Superstorm Sandy in 2012, which forced the closure of six hospitals in New York City.
When two backup generators failed, hundreds of patients, including 20 babies from the neonatal unit, had to be evacuated from New York City Hospital.
The US hospitals suffered $800 million in damage and total recovery costs were estimated at $3.1 billion, according to the report prepared by Island Health.
Spaulding Rehabilitation Hospital in Boston tried to learn from that harrowing and costly experience by designing the building with disasters in mind. Emergency services are provided above the predicted 100 year floodplain in 2085, accounting for the expected rise in sea level in the coming years.
That kind of future-proofing was highlighted as a priority in a huge report published by Health Canada in 2022, called Health of Canadians in a Changing Climate.
“Adaptation measures that get ahead of the curve of increasing climate impacts on ecosystems, infrastructure, communities and health systems will need to move beyond incremental approaches to adopt transformative changes,” said the report’s authors.
The authors of that study pointed to a 2019 survey, which found that only eight percent of Canadian healthcare facilities recognized climate change in their strategic plan or identified climate risks in specific policies.
The report was intended to help federal and provincial governments be better prepared for the effects that climate change will have on the health of Canadians.
For example, the new St Paul’s Hospital in Vancouver, which is expected to open in 2027, is being built five meters above the predicted sea level rise by the year 2100, so it is not shut down if there will be a great flood. The cooling system has also been designed to withstand the temperatures predicted by the year 2080.
Of course, not every hospital will have to be fortified against every disaster, Ness said. They need to know where the risks are.
But those risks are increasing, says Matear, as emergency incidents become more and more common.
People were shocked when the wildfires tore through Fort McMurray in 2016, he said, but fires have remained a threat every year since.
People in Fort McMurray recently returned home after another wildfire encroached on their community and forced evacuations.
“I think, as a result of that, you need to be much more prepared than … states were before 2016,” Mtear said.
