Montreal expects more brutal heat waves, vows to improve response

Climate change will make heat waves in Montreal more frequent and more brutal, public health authorities and city officials say, and they want to better protect the city's most vulnerable residents.

In 2018, 66 deaths were directly related to the heat, according to a new report by Montreal's public health authority. That works out to6.4 deaths per day, per million inhabitants.

Betterpublic awareness and improved institutional responsiveness meant there were far fewer deaths than the summer of 2010, when there were 9.3 deaths per day, per million inhabitants,but the 2018 deaths werenonetheless "avoidable," said public health officials.

"It is going to be difficult to have zero deaths from a heat wave, but there is room for improvement," said Dr. Mylne Drouin, the director of public health for the Montreal region, at a media event to release the report and theplan for 2019.

Montreal was smothered by the heat wave from June 30 to July 5 2018, with maximum temperatures reaching as high as 35.5 C more than 40 C with the humidex and minimums remaining above 20 C.

Schizophrenics highly vulnerable

The report found that low income and social isolation were key factors in the deaths attributable to that heat wave. Of those who died, two out of three were 65 years old or older, and nearly three in four 72 per cent had a chronic condition.

A disproportionate number of deaths in 2018 occurred among people suffering from schizophrenia. Those victims made up 25 per cent of the total, even though theyrepresent just 0.6 per cent of Montreal's population.

Part of the issue is that those suffering from schizophrenia can be less sensitive to heat because of their condition and the drugs they take to manage it, said Drouin. Their medications caninterfere with the body's ability to eliminate heat.

"We need to refine the types of interventions and the frequency with which we visit them," she said.

The public health authority is working with various partners to builda registry of people in need and where to find them, and it plans to have it finished by the end of June, Drouin said.

They are using housing data, social and mappingdata to showhot spots, in combination with the knowledge of various first responders and health workers withfirst-hand knowledge of vulnerable areas and individuals.

During 2018's heat wave, police and firefighters made 42,000 door-to-door visits, but Drouin said the intention is to make the on-the-ground efforts more targeted and more effective.

"We can improve the way we're reaching out," she said. "We want to ensure the people doing the interventions are people they trust."

Greening projects

Environment Canada says it's too early to issue a summer forecast, but meteorologist Andr Cantin says data so far suggeststhe summer of 2019 will be close to, or slightly above normal. Last summer was below normal during the month of June, but well above normal during July and August.

Coun. Laurence Lavigne-Lalonde, the city's executive memberresponsible for environmental sustainability, said greening projects such as putting up temporarywalls made of plants and erecting canopies to create more shade would provide short-term relief to people living in or nearurban heat islands.

Heat islands are areas in a city where the summer heat is trapped by expanses ofconcrete, brick and asphalt, exacerbated by a lack of green space andshade from trees.

"As a city, we have to make sure we're reducing greenhouse gases and creating an environment that is healthier, that we're not increasing these climate hazards,"Lavigne-Lalondesaid. "On the other hand, we have to be able to respond when these hazards emerge."

Differing numbers

The total deaths from the 2018 heat wave differ from report to report, but this is because not all used the same methodology.

The Montreal public health authority'smethodology consideredall deaths over the heat wave period and usedstatistical criteria to identify deaths very likely related to heat, while the Quebec coroner's numbers are based upon evidence from autopsies.

"Evidently, both methodologies have their limits," Drouin said. "Not every death is going to be referred to the coroner."