Wake-Up Call: Why We Need Powerful New Emergency Protocols

social_isolation

Canada was battered with several serious rogue weather events that jeopardized lives and property this year. The insurance industry is reeling from hundreds of millions of dollars of claims: floods in Alberta and Toronto, ice storms that decimated the urban forest and left families freezing in the dark at Christmas.

But far more serious than the material cost is the threat to fragile human lives. It has become obvious that we are in no way prepared for emergencies that leave the sick, the elderly and the isolated high and dry.

How many communities – cities, villages, apartment buildings – have protocols to ensure the survival and well-being of those who are vulnerable and alone? This story provides just one example of the problem: a cancer patient toughing out the ice storm cold in his freezing basement.

Toronto’s Cathy Crowe, a long-time street nurse and tireless advocate as well as Ted Rogers School of Management Professor Alison Kemper co-authored an article calling on Mayor Ford to acknowledge that the ice storm was an emergency saying:

“The emergency in Toronto is not about the speed at which hydro workers have accomplished their tasks (they are truly heroic), it is the unknown distress of hundreds of thousands of Torontonians whose homes could no longer provide warmth, whose elevators weren’t working, whose kitchens could no longer provide food, whose telephones could no longer connect them to the outside world and whose medical conditions could no longer be managed.

What happened to the thousands of Torontonians who weren’t able to book a hotel, go to their in-laws’, eat in restaurants or leave town? How are they doing? We have no idea. We have been told that emergency calls have been five times their normal level, and we hear sirens screaming down our roads constantly.

For days, Toronto has not assigned anyone to find out how people are, to tell them in person that there are warming centres and to offer them transportation to one, or to bring them food and water, to ensure that their oxygen tanks are full, to make sure they have their medications. No one has been assigned to check on their safety — how were they staying warm, did they understand the dangers of hypothermia, of using BBQ devices, gas stoves or generators to stay warm? We have entrusted the safety of tens of thousands to Twitter, to silent radios to websites that won’t stay up because of the demand.

What will we find in a week — in our rooming houses, in our high rises, in the little wartime bungalows that are scattered across our city? Will we have escaped without increased deaths? Or will we regret our lack of action this week?”

The Mayor of Toronto’s decision not to declare a state of emergency has caused great controversy, which continues. Crowe and Kemper also draw some very powerful parallels between the murderous 1995 Chicago heat wave and the ice storm.  When it comes down to a emergency or a disasters – seniors – particularly socially isolated ones are perhaps the most vulnerable among us:

“In the summer of 1995, Chicago saw an oppressive heat wave. Large numbers of seniors in highrise apartments without air conditioning died. Morgues were overflowing. The normal death rate was exceeded by more than 700 deaths in the few days of the heat wave.

When researchers later looked at the data, they found that seniors who had had active social lives — drinking coffee with friends, attending religious services, going to cafes where they were known — were far less likely to have died. Seniors who were more isolated were significantly more likely to have died. It wasn’t just a force of nature, or even a problem of bad architecture and power brown outs. The difference between people who made it and those who didn’t was their social ties.

Chicago learned from its mistakes. In 1999, they declared an emergency during a similar heat wave, got the media to help and bussed people to cooling centres. City employees and police went door to door to check on people. The result? Only 110 excess deaths, far fewer than in 1995.”

Some very important questions are asked – will we find out how many seniors perished or were hospitalized because of freeze? How? And if we don’t, how are we to learn from this emergency? All we know is that by far the highest number of freezing deaths tend to occur among seniors.  Postdoctoral fellow and University of Western Ontario NiCHE project coordinator Josh MacFayden provides some very helpful data and insights here via www.activehistory.ca:

Most Canadians are familiar with famous cases of hypothermia such as the victims of the Franklin Expedition, the Scott Expedition, the Titanic (whose passengers technically succumbed to “cold shock” not hypothermia), or perhaps even the Saskatoon freezing deaths, but probably none of us personally knows of anyone who has frozen to death. There are several reasons for this.

First, the Canadian Vital Statistics, Death Database shows that an exceedingly small proportion of Canadians die by “Exposure to Forces of Nature.” This is one reason why it seems so shocking to hear of someone who was lost in a blizzard or frozen to death, often within a stone’s throw of safety. Yet in northern climates it is still a very real concern. Of all the accidental deaths since 2000 the overwhelming majority (78 percent) died from “Exposure to Excessive Natural Cold.” Most freezing deaths are men, but some particularly disturbing recent cases have included abused women and children.

However, roughly the same number of victims perish from the cold each year as those who die by drowning, and yet we are much more aware of deaths by drowning. (Oddly, drownings are not included in the “forces of nature” category.) Most of us are willing to risk a swim in the ocean, but not many try sleeping outside in January.

The second reason you’ve probably never personally heard of someone who has died in this way is because of the demography of cold weather victims. A breakdown of the data shows that the largest group of drowning victims are teens and twenty-somethings, but victims of cold weather are older. Most are over the age of 50. And whereas drownings happen at the resorts and beaches of the middle class, cold weather deaths are probably more likely to occur in alleys, abandoned buildings, and other residences of the poor and homeless.

Accidental-Deaths-by-Drowning-and-Freezing-CVS-Death-Database

Toronto Mayor Rob Ford noticed similar demographics at the city’s warming stations during the outage. “For some reason or another it seems like it’s seniors are the ones that don’t want to go. They just want to tough it out.”

It’s possible that some older residents were made of tougher mettle, but it’s more likely that they are less mobile and less able to “sleep over” at places like warming centres. For those without family the challenges can be threatening. One 76-year old Cancer patient opted to stay put in his freezing basement over the holidays, because his diagnosis (not to mention a fallen electrical wire in his driveway) made leaving riskier than staying. Still, this Austrian survivor of the Second World War claims it was only “the fourth or fifth worst Christmas of my life.” He had a small stove and his son brought some firewood from Waterloo, but still the basement hovered around 10 degrees.

(From “Cold Comfort: Firewood, Ice Storms  and Hypothermia in Canada)

We have to do much, much better. Let’s resolve in 2014 to ensure that every single community in the country has a protocol to check on the vulnerable and the isolated. This means knowing who is actually going to check on each person, and who is responsible for getting help where it is needed. There is no excuse for Canadians to freeze to death all alone or on their stoop because the hospital failed to ensure that they received safe passage.  None.

Related