BC Isn’t Ready for the Next Heat Wave, Doctors Say

Over the past two weeks British Columbians have revisited the deadly heat wave that smothered the province and most of western North American in 2021.

The question now, as a “super El Nino” weather pattern develops in the Pacific Ocean, boding a hotter and drier late summer than usual in the region, is whether we are ready for similar extreme temperatures.

The answer is no, according to doctors, nurses and paramedics who warn the provincial government is putting people at risk of death or injury in extreme heat.

Members of the Canadian Association of Physicians for the Environment and Canadian Association of Nurses for the Environment marked the five-year anniversary of the 2021 heat dome on June 29, reflecting on how the province remains at high risk for heat-related injuries and deaths.

Not enough has been done to protect the province’s most vulnerable, and at the same time B.C. is continuing to use and produce fossil fuels, which worsens climate change and future extreme heat events, health experts warned.

All levels of government were critiqued for not divesting from fossil fuels, including the City of Vancouver, which recently decided to renew its choice to allow new homes to be built with gas-powered heating.

“We know that increased emissions means increased temperatures and we know increased temperatures means increased death,” Tim Takaro, a member of CAPE and professor emeritus of health sciences at Simon Fraser University, said at the event.

As the experts issued their warnings, the extreme weather unfolding in other temperate regions offers British Columbians a stark reminder of what’s at stake.

This week France faced its third heat wave of the year. The second, starting in mid-June and reaching unprecedented temperatures, caused at least 1,000 excess deaths. In 2003 a heat wave in France caused at least 15,000 excess deaths.

France and B.C. are comparable because they both have lower-income populations who can’t afford to cool their homes and governments that continue to encourage the emission of climate-changing gases, Takaro said.

Looking at this summer in France, B.C. needs to do more to make sure it’s prepared for the next extreme heat event, Takoro added.

“Some progress” has been made on beefing up the provincial heat alert response system, identifying at-risk people and creating cooling centres, but these responses are limited to people who can physically access them, said Dr. Melissa Lem, a family physician in Vancouver and past president of CAPE.

“If you’re isolated, elderly, or have mobility issues, there’s actually no real provincewide mechanism in place to get people to those cooling centres,” Lem said.

Dr. Jay Slater, a family physician and home-based care provider to frail elders, added that hospitals are now better prepared for extreme heat and the public knows more about the signs of heat injury.

But that won’t help the populations who are most vulnerable to extreme heat, such as people living in Vancouver’s Downtown Eastside.

He worries people in that neighbourhood will be “well represented” in future casualties because of the concentration of highly vulnerable people, who are often also dealing with substance use and mental illness, live in poor-quality housing that traps heat or on the street and have limited access to shady green space.

A 2024 study from the BC Centre for Disease Control found that poverty and chronic diseases, such as schizophrenia, chronic obstructive pulmonary disease, heart failure, and substance use disorder significantly increased a person’s risk of injury or death during heat events.

During the 2021 heat dome Slater said he did a house call in the DTES to a single-room occupancy building. Luckily the patient was able to be revived with a rehydration drink and survived.

“I can’t ever forget the smell and the stifling heat of the place,” he said. “It was an awful situation.”

Slater was limited to helping with cooling procedures and helping people rehydrate, but wasn’t able to transport patients to hospital in his car or start an IV in their home.

“As a health-care provider, it’s really hard not to be able to do anything,” he said.

Paramedics felt similarly overwhelmed and helpless during the 2021 heat dome.

David Hollingworth, paramedic and Ambulance Paramedics of BC director of environment and climate change, said he saw many cardiac arrest deaths during the heat dome when elderly people were living alone in hot, small apartments.

When a patient is no longer viable for resuscitation, paramedics are supposed to call the police, who take over the call, he said.

But during the heat dome there was such a high volume of emergency calls it could take police hours to arrive, further tying up paramedics, he said.

“These were hours that we were not available for emergency calls, and this was just one way in which we saw our system collapse during this emergency,” he said, adding that some paramedics in the hottest parts of the province attended 11 or more cardiac arrest deaths in a single shift.

To better protect the most vulnerable in society the province needs to make sure people’s homes stay cool.

Health is shaped by the conditions people live in, including how isolated they are, what supports they have access to and how cool and safe their housing is, said Emily Wang, a University of British Columbia medical student and CAPE representative.

If someone is living with mental illness, cognitive impairment or social isolation it can be much harder to recognize the danger of extreme heat, seek help and get to a cool place, she added.

“Our response cannot rely on telling individuals to be more prepared, because preparedness depends on whether someone has money, mobility, access to a car, different living spaces, or someone checking in on them,” Wang said.

She added that all levels of government need to ensure that people have access to safe indoor temperatures and practical cooling supports and are connected to proactive outreach before emergencies happen and people are in crisis.

New Westminster is the only municipality in the province that has introduced updated bylaws requiring landlords to keep at least one room below 26 C.

The BC Building Code requires all new homes to be built to that standard, but this excludes older buildings.

The New Westminster bylaw applies to building owners and landlords, not tenants, and is non-prescriptive, which means cooling can happen through shade, air conditioning or heat pumps.

“This directly fills the need that we saw in that it’s older rental stock that gets deadly hot, and where we know people die during heat events, which we know are inevitable,” said Nadine Nakagawa, New Westminster city councillor and advocate for the heat maximum bylaw.

Nakagawa said 33 people died in her city during the heat dome.

Most of those fatalities were in the Brow of the Hill neighbourhood, which has the lowest percentage of tree cover, lowest income and highest number of seniors and people with disabilities, she said.

Adding to that tragedy was how many people were following COVID-19 safety protocols and isolating at home or avoiding cooling centres, she said.

Vancouver city councillors Pete Fry and Sean Orr attended the event.

Vancouver could be a leader in climate-change readiness but instead it is lagging behind, which is embarrassing, Orr told The Tyee.

The ABC majority city council also cancelled $8 million in climate retrofit grants; voted against funding for cooling kits for people in the Downtown Eastside; got rid of its climate justice chart; and scrapped the West End waterpark, he said.

ABC’s recent austerity budget also means it’s not clear if there’s enough money to restore the tree canopy and create green space in neighbourhoods like the Downtown Eastside, which could help with cooling during the next extreme heat event.

On the upside, Orr said ABC’s councillors Lisa Dominato and Peter Meiszner have asked the province for the power to establish maximum indoor temperatures; Orr and Coun. Lucy Maloney introduced a fine for landlords who prohibit air conditioning; and the city approved a grant to improve cooling in SROs.

Extreme heat becomes deadly in Vancouver because of inequality, Orr said.

Between 2023 and 2025 the number of unhoused Vancouverites rose 12 per cent, to 2,715 people.

Vancouver can’t say it’s prepared for extreme heat with numbers like that, Orr said.