No Ottawa ambulances available for more than 15 straight hours at end of December

Datareleased under freedom of information laws revealjust how stretched Ottawa's paramedic service became inthe last week of December, when dispatchershad no City of Ottawaambulances 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 periodthat a United Counties of Leeds and Grenvilleambulance was called from Gananoque, Ont.,two hours away, because it was the closest team to respond to central Ottawa.

• Paramedics respond to call almost 2 hours away due to 'level zero' in 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 severestaff 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 annualholiday party held Dec. 15 in a ByWard Market restaurantwhen 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 thelist including when each one began and when it endedthrough access to information.

In total, Ottawa hit level zero143 times in December and nearly 80 more times through mid-January. Mayor Jim Watson had approximated Ottawa reached750 overall for 2021 ina letter to the province wherehe sought forhelp to solve delays offloading patients to hospitals.

On Dec. 21 and 22, two memos to city council from paramedic ChiefPierre 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 periodwith 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 askedfire fighters to help, used ambulances from other jurisdictionsandasked dispatch and paramedic staff to work overtime and duringplanned vacations.

And yet, the worst stretch was about to begin.

Ottawa had no ambulanceson more than a dozen occasions on Dec. 29, totalling17 hours and36 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 chiefsaid he had never seen such a long level zeroand called the 15-hour one an "aberration."He said the city reviews calls that aredelayed 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 providethe service to the community," Poirier said.

"I want the community to feel safe about the service we're providing them."

Poirierpointed to other methods to mitigate the impact, such as having a single paramedic in a vehicle goto a call, even if they can'ttransport 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 measuresthe 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."

• Ontario tells paramedics to consider 'batching' patients to reduce off-load delays

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, ortreating patients without taking them to hospital.

Buffer neededfor 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.

• Union survey finds paramedics facing high stress with little support

"It's unsettling," union treasurer Carrie Lynn Poole-Cotnamsaid of the December data, and the impact that had on staff trying to help families in the community.

Shelooks back nowand says that exceptionally difficult time wasfollowed 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 restrictionsin late April will lead to another surge in 911calls.

Rather than be in a "constant state of stretch," Poole-Cotnamsaid paramedic staff need to be given time off to restand the city needs to assess its long-standing practice of hiring 14 new full-time positions ayear 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 "placeof 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-Cotnamsaid.