No Ottawa ambulances available for more than 15 straight hours at end of December
CBC obtained data on the strain on paramedics in December, January
Data released under freedom of information laws reveal just how stretched Ottawa's paramedic service became in the last week of December, when dispatchers had no City of Ottawa ambulances available to transport patients for between eight and 18 hours a day.
The longest single instance of so-called "level zero" lasted 15 hours and 31 minutes, from just before the lunch hour on Dec. 30, 2021 through to 3 a.m. the next day.
While some of the most acute calls still could have seen an ambulance crew in that time, the level zero didn't end while 911 calls remained in the queue.
It was during that period that a United Counties of Leeds and Grenville ambulance was called from Gananoque, Ont., two hours away, because it was the closest team to respond to central Ottawa.
At the time, the Omicron variant of COVID-19 was spreading quickly and the number of 911 calls had climbed. The hospitals to which paramedics transfer their patients were seeing severe staff shortages.
Those offload delays at hospitals are often cited as the single biggest factor for ambulance shortages.
Meanwhile, dozens of paramedics had contracted the virus after an annual holiday party held Dec. 15 in a ByWard Market restaurant when gathering limits still allowed it.
City said service impacts were 'minimal'
CBC News had asked the paramedic service for the number of incidents of level zero in early January, but had to obtain the list — including when each one began and when it ended — through access to information.
In total, Ottawa hit level zero 143 times in December and nearly 80 more times through mid-January. Mayor Jim Watson had approximated Ottawa reached 750 overall for 2021 in a letter to the province where he sought for help to solve delays offloading patients to hospitals.
On Dec. 21 and 22, two memos to city council from paramedic Chief Pierre Poirier about the holiday party indicated that had minimal impact on service levels.
The data show that between those two memos, Ottawa had actually gone through a period with no local transport ambulances that lasted 574 minutes straight, or nine and a half hours, from Dec. 21 into the early hours of Dec. 22.
By Dec. 28, Poirier followed up with another memo saying 61 paramedics had returned to work, and "contingencies are no longer required to mitigate service delivery impacts related to this incident."
The paramedic service had asked fire fighters to help, used ambulances from other jurisdictions and asked dispatch and paramedic staff to work overtime and during planned vacations.
And yet, the worst stretch was about to begin.
Ottawa had no ambulances on more than a dozen occasions on Dec. 29, totalling 17 hours and 36 minutes. Dec. 30 saw the worst and longest day at level zero, with Ottawa going without local ambulances for a total of 18 hours and 22 minutes over several incidents.
Community still served, chief says
In an interview Wednesday, the paramedic chief said he had never seen such a long level zero and called the 15-hour one an "aberration." He said the city reviews calls that are delayed and said it hasn't determined any one had died as a result of a delay.
"The timeline of those level zeros is a concern to us, but the important piece there is we were still able to provide the service to the community," Poirier said.
"I want the community to feel safe about the service we're providing them."
Poirier pointed to other methods to mitigate the impact, such as having a single paramedic in a vehicle go to a call, even if they can't transport patients.
The regional call centre also allows Ottawa to "seamlessly" enlist ambulances from nearby areas like Renfrew County, Cornwall and elsewhere.
Asked if a response from outside the city is an acceptable alternative to an ambulance arriving from within city limits, Poirier said, "I wouldn't say it's an acceptable alternative, but I would say it is an alternative that still provides the care to the community."
He also maintained that the measures the paramedic service took, such as having staff work overtime, were effective at dealing with its staffing issues.
"I would say, yes, there was a minimal impact to our community."
Since mid-January, Ottawa hasn't seen such continuous long periods of level zero, Poirier added.
It's trying new methods, such as having a single paramedic look after multiple patients at a hospital, or treating patients without taking them to hospital.
Buffer needed for surge periods
Ottawa has been struggling with the issue of ambulance shortages for years, if not a decade, but that period in late December and early January led paramedics and dispatchers to flood their union with emails.
CUPE 503 said the desperation in those messages led it to do a survey in January. Nearly 300 paramedics and dispatchers reported feeling very high workplace stress, little support from managers, and that the service was understaffed.
"It's unsettling," union treasurer Carrie Lynn Poole-Cotnam said of the December data, and the impact that had on staff trying to help families in the community.
She looks back now and says that exceptionally difficult time was followed by yet another unpredicted event: several weeks of convoy demonstrations in the downtown.
[There] doesn't seem to be much of a buffer about how we respond when things turn quite quickly.- Carrie Lynn Poole-Cotnam, CUPE 503
"It's very difficult to anticipate every single circumstance, but there also doesn't seem to be much of a buffer about how we respond when things turn quite quickly," she said.
To that point, she worries if Ontario's decision to lift all COVID-19 restrictions in late April will lead to another surge in 911 calls.
Rather than be in a "constant state of stretch," Poole-Cotnam said paramedic staff need to be given time off to rest and the city needs to assess its long-standing practice of hiring 14 new full-time positions a year given the city is both expanding outwards and its population is aging.
CUPE 503 also wants to see a "bigger review," but not one that comes from a "place of defensiveness." She refers to city politicians who see level zero as a hospital problem rather than a city one.
"The system is integrated and one part impacts another," Poole-Cotnam said.
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