British Columbia revises COVID-19 directive that prevents firefighters from attending to most overdose calls

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British Columbia has revised a recent directive by the provincial health officer that prevented firefighters from attending most overdose calls during the COVID-19 pandemic.

The amendment, effective immediately, takes place after B.C. mayors and fire departments pushed back on the March 31 order by Provincial Health Officer Bonnie Henry, which significantly limited the number of medical calls that firefighters could attend, saying it would put citizens at serious risk.

In a joint internal memo distributed on Tuesday and obtained by The Globe and Mail, the Provincial Health Services Authority, BC Emergency Health Services (BCEHS), the Office of the Fire Commissioner and the Fire Chiefs’ Association of BC said the agencies had discussions with the Ministry of Health since the directive was implemented. “An opportunity for improvement was identified,” the agencies said.

The Globe reported on April 2 that Dr. Henry had issued a directive restricting firefighters to only the most immediately life-threatening medical calls, such as cardiac arrest – events that are colour-coded as purple.

That meant no longer attending red events, the tier below purple, which include drowning, choking, chest pains – and most overdoses. Firefighters were dispatched only if technical assistance was required, or if paramedics expected to be delayed by more than 20 minutes.

“Patient care and outcomes could be improved by expanding notification to fire first responders for red overdose calls,” the memo said. “BCEHS will revert notifications of fire first responders of red-coded overdose calls to prepandemic protocols.”

The March directive is intended to reserve the province’s supply of personal protective equipment and limit first responders’ potential exposure to COVID-19.

However, there was immediate pushback back by fire departments and B.C. mayors, who said that while the safety precaution is well intentioned, its unintended consequences could put citizens at risk.

In Vancouver, which has been particularly hard hit by the continuing overdose crisis, acting fire chief and general manager Kiran Marohn noted that there had been an increase in overdose deaths in the two weeks leading up to the change at the end of March.

“This is not the time to reduce responses to these events," she wrote in an April 6 letter to Mayor Kennedy Stewart.

On April 3, 14 B.C. mayors wrote to deputy Health Minister Stephen Brown outlining their concerns.

“We are very fortunate to have such strong leadership as Dr. Henry’s during these unprecedented times,” read the letter, printed on the letterhead of Delta Mayor George Harvie.

“However, we are concerned that Dr. Henry may not be fully apprised about the serious unintended consequences of this decision to limit our firefighters to only attend purple events and to only be ‘considered’ for red events if [BC Ambulance Service] is delayed more than 20 minutes. This delay or non-response puts our citizens at serious risk.”

Mr. Harvie did not respond to multiple requests for comment.

The memo announcing this week’s amendment said that firefighter dispatching should meet certain criteria, including limiting the number of people responding, and that they wear appropriate personal protective equipment. There is no change to non-overdose red calls.

Vancouver Fire Rescue Services Captain Jonathan Gormick said he was pleased to learn of the change.

“Everyone in health care has been trying to strike a balance between protecting staff and continuing to care for the communities we serve,” he said.

“We’re pleased that the unique circumstances in Vancouver have been addressed and we’re now allowed to work side by side with BC Ambulance Service, providing critical care for the community’s most vulnerable.”

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