Healthcare Response in the Fort McMurray Wildfires:

Managing the Beast

David Matear

Senior Operating Director

Northern Lights Regional Health Centre/Area 10

Quality Forum 2017, March 1-3, 2017

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Agenda

• Alberta, Area 10 North Zone, and Fort McMurray

• Fort McMurray Pre-Evacuation

• City and Hospital Evacuation

• Suncor Firebag

• Fort McMurray emergency support

• Recovery

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AHS Zones

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Area 10 TOTAL PERMANENT (USUAL) POPULATION 81,948

Urban Service Area (Fort McMurray) 78,382

Nine Rural Communities 3,566

TOTAL SHADOW POPULATION 43,084

Urban Service Area (Fort McMurray) 4,342

Nine Rural Communities 478

123 Project Accommodations 38,264

TOTAL POPULATION 125,032 (Regional Municipality of Wood Buffalo Municipality Census Report 2015)

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Fort McMurray

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Northern Lights Regional Health Centre

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Hospital/NLRHC Overview

• Numbers of acute beds: 105

• Number of LTC beds: 31

• Clinical Services

– Acute Care: Ambulatory and Respiratory Care, Critical Care, Maternal Child and Pediatrics, Medicine, Psychiatry, Surgical Services

– Cancer Care, Renal Dialysis,

– Diagnostic Imaging, Clinical Laboratory

– Allied Health: OT, PT, SLP, Recreation Therapy, Audiology, Social Work

– Seniors Health

• Community-based services

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Wildfire Facts – The Beast

• On average 2.3 million hectares across Canada burn each year

• In 2014, more than 51,000 forest fires burned over 4.5 million hectares

• In 2015, nearly 4 million hectares burned around 6,700 fires by early September

“The Beast”

• Fort McMurray evacuation is largest wildfire evacuation in Canada on record, and the third-largest environmental disaster evacuation

• Covered 600,000 hectares (1.5 million acres)

• Destroyed over 2,400 homes

• Began on May 1, 2016; declared under control on July 5, 2016

• Defied wildfire laws in movement and spread

• Created its own microclimate

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How The Beast Grew

Fort McMurray Pre-Evacuation

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The Days Before – May 1, 2016

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The Days Before – Sunday May 1

• Fires in and around Fort McMurray

• Emerging Issue Report generated for May 1, 2016 (00:25 May 2)

Sit Rep #1 May 01, 2016 20:53

• Recovery Centre in Fort McMurray was evacuated due to fire getting closer to the building

• Code Green was activated and patients were evacuated and positioned in the parking lot

• No injuries reported

• Decision was made to send some patients to their families in Forth McMurray and house the remainder in a hotel downtown Fort McMurray

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NLRHC and Gregoire

5km

Recovery Centre

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The Days Before – May 2, 2016

City and Hospital Evacuation

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E Day – May 3, 2016 • Sunny clear day

• Normal business including arranging birthday cake event for 1400

Meeting May 3, 2016 1100–1130

• Review Incident Action Plan

• 3/19 fires out of control in North Zone – Fort McMurray, High Level

• Forecast “Dynamic Fire Conditions, high temperatures until after May long

weekend

• Fort McMurray Fires (2) – EDM

– South

• Centennial park still mandatory evacuation

– North

• Wood Buffalo – Fire growing, winds favorable, smoke is main concern

• REOC

– Site crew to Wood Buffalo

– Severe fire conditions

– Evacuation order lifted in Prairie Creek

– MacDonald Island Reception Centre – Only 3 spent night between May 2 and 3

• PPIH

– MacDonald Island Reception Centre – AHS Strike Teams there only 12 spent

at the site

– REOC stated no longer needed AHS

• AMH – Programs delivered from hotels

• Logistics – Hotel Booking for May 3 night

• Next steps – REOC evacuation plans to NLRHC

– Anzac Reception Centre

– REOC at Fire Hall #5

– Leadership may change if event continues

• Next meeting - Touch base at 1600

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E Day – May 3, 2016 • HIM email 1400 – Staff asking to leave early

and for direction.

Emergency Incident Meeting 1415-1445 (Invite sent at 1403)

• All Managers invited

• Mandatory evacuation – Abasand

– Beacon Hill

– Dickensfield

– Grayling Terrace

– Gregoire

– Waterways

– Wood Buffalo (including Golf course)

– AMH patient evacuation

– No access for medications and pets

• Voluntary evacuation – Thickwood*

– AHS • Thickwood Medical Centre

• Home Care

• Thickwood Public Health (some staff deployed to MacDonald Island)

• YMCA – Adult Day Program

– 30 minute standby for evacuation

• Register at MacDonald Island evacuation centre

– Prepare to up to 25,000 evacuees

• NZEOC formally established

• ICP to be formally established in NLRHC

• NLRHC began evacuation planning and action – Closed Ambulatory Care Clinics

– All staff memo drafted (before 1600)*

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Evacuation Areas

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AHS Facilities Thickwood

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E Day – May 3, 2016 Incident Command Post Meeting 1600-1630

• Patient count: Acute 73, LTC 32, Visitors 22

• ICP formally established

– Immediate coordination of patient movement

• Status

– Highway 63 closed south

– Lower downtown evacuated, except MacDonald Island

– Evacuate Fort McMurray residents north to Norelta lodge (40 kms)

NLRHC evacuation options

• Transport

– 1 medevac

– 6 ambulances

– 17 buses (8 transit/city buses and 9 highway buses)

• North

– Airport location

– Suncor/Syncrude sites being explored

– Suncor Medical Centre

• Priorities vent and stretcher patients

– Ambulances deployed for evacuation

• Priority for Patients and Staff

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Oil Sands Sites

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E Day

HWY 63 Closed

Medevac 1

Getting out

Airport Time Lapse

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E Day – May 3, 2016 Incident Command Post Meeting 1745-1815

• Fort McMurray mandatory evacuation

– Abasand, Beacon Hill, Dickinsfield, Draper, Grayling Terrace, Gregoire, Saline Creek, Thickwood, Waterways, Wood Buffalo.

• Confirmed evacuation of all patients and staff

– Evacuation site confirmed as Suncor Firebag and ultimately to AHS sites

– Requesting air ambulances

– Ordered 737 Westjet to Suncor Firebag

– Ultimate destination Edmonton

– Evacuation site on MacDonald Island under evacuation order

• Notes:

– Patient movement had started prior to 1700

– 1727 ICP confirmed NLRHC shortly to evacuate with Communications

– 1730 staff memo with updated evacuation information

– RCMP to aid with final sweep of NLRHC

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NLRHC North West

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Evacuation Route

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Patient Transport

Suncor Firebag

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Firebag First 12 hours

The Largest Emergency Airlift in Canadian History

• 33 aircraft

• 40 Flights

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Fire Map – May 4, 2016 1300

• Fire covering 10,000

hectares (25,000 acres)

• 1,600 homes destroyed

• Evacuation of patients and

majority of staff from Firebag

completed at 1230

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Reorganization of Hangar

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Oil Sands Community Evacuation - May 5-6, 2016

Gog

Shughie

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May 7, 2016

• Fire 156,000 hectares (390,000 acres)

• Fort McKay voluntary evacuation begins

• Air quality 10+

• Fort Chip LTC evacuated

• Oil sands camps on evacuation notice

• AHS supporting CANTF2 medical operations

• Reduced activity at Firebag

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Last Out, First Back

Fort McMurray Emergency Support

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Keyano Location

AHS Medical Clinic

Can TF2

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AHS Medical Clinic – Gregoire

Fort McMurray Recovery

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The Damage

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Access

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The Site

• Fort McMurray Urgent Care

Centre (May 12 – June 7,

2016)

• Syncrude Sports and

Wellness Centre

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Portable Isolation Containment System (PICS)

First Full Deployment

• Edmonton Zone

• Calgary Zone

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UCC Initial Plan (with OR)

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Fort MASH

Initial Setup

UCC Complete

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UCC Support

Registration

Supplies

Staffing

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Panoramic Green Area

Stretchers/Yellow Area

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Patient Services

Inpatient Beds Isolation Beds

Resuscitation & Pharmacy Operating Room

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Diagnostics

Diagnostic

Imaging

Mobile Whole

Body CT Scanner

Laboratory

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Air Quality

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Incident Command

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Incident Command Post

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FMMUCC – SSWC

Incident Command DI

Lab WHS

Medical

Affairs

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Fire Map – May 16, 2016

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Health Services and NLRHC Phased Opening

• Phase 1

– Resumption Date: June 1, 2016 of : ED, Lab, DI, temporary Pharmacy, HIM, Food Services

• Phase 2

– Anticipated reactivation date: June 15, 2016:

– Actual Reactivation date: June 11, 2016

– Fully Operational ED, ICU (3 beds), Surgical OR (2 theatres for life or limb), Ambulatory Care, Ortho Clinic, CWS, RT, Mat/Child(6 beds) NST Clinic, Surgery opening (10 beds), Pediatrics (3 inpatient beds), MH Crisis Supports, Allied Health, Social work, OT/PT, Educators (4 for BLS certifications and front line work requirements), PCC coverage.

– Subbasement - support services: CPSM, MDC, MDR, Laundry/linen

– Basement: Admin, Volunteer Resources, Medical Affairs, IT/Computer services, Nutrition/Food Services/Cafeteria

• Phase 3:

– Anticipated Reactivation Date: June 20, 2016

– Actual Reactivation Date: June 13, 2016

– Floors 3 and 5: Medicine Unit, Inpatient Psychiatry, Pharmacy, Renal Dialysis, Allied Health

• Phase 4:

– Anticipated Reactivation Date: July 25, 2016

– Actual reactivation Date: July 14, 2016

– Floor 4: Long Term care

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RMWB Rentry Plan

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SSWC Community Services

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Task Force Transition – June 4, 2016

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NLRHC Task Force

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UCC Activity DATE PTS CTAS 1 CTAS 2 CTAS 3 CTAS 4 CTAS 5 CTAS 9 MEDIVAC AG

May 12 9 4 5

May 13 13 1 10 2 1

May 14 19 1 13 2 3 1

May 22 37 7 26 4 3

May 23 24 1 8 14 1 7

May 24 22 2 2 13 4 1 1

June 4 40 1 12 18 6 3 1

June 5 36 13 13 9 1

June 6 30 1 6 12 11

TOTAL 698 13 153 363 132 37 8 42

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Timeline Conclusion

June 27

• ZEOC North and Task Forces closure

July 26

• Debriefs at NLRHC start

July 27

• Debriefs at NLRHC continue

July 28

• Debriefs at NLRHC finalize

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NLRHC Remediations

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ED Opening – June 1, 2016

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NLRHC ED Activity DATE PATIENTS CTAS 1 CTAS 2 CTAS 3 CTAS 4 CTAS 5 CTAS 9 MEDIVAC AG

May 31

June 1 23 2 9 8 2 2 1 7

June 2 43 2 14 23 3 1 6

June 3 85 8 23 43 11 1 1?

June 4 69 2 13 48 6 2 5

June 5 77 4 22 44 7 1 1 4

June 6 106 1 6 29 59 11 1

TOTAL 406 1 24 111 228 40 4 6 68

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NLRHC Bed Opening Plan NLRHC BED OPENING SCHEDULE

JUN-20 JUN-27 JUL-04 JUL-11 JUL-18 JUL-25

MEDICINE 20/43 26/43 36/43 43/43 43/43 43/43

ICU 3/6 3/6 3/6 6/6 6/6 6/6

SURGERY 10/27 25/27 25/27 25/27 25/27 25/27

PEDS 3/8 8/8 8/8 8/8 8/8 8/8

PSYCHIATRY 9/10 10/10 10/10 10/10 10/10 10/10

MAT/CHILD 6/11 11/11 11/11 11/11 11/11 11/11

LTC 5/31 (JUNE 24) 13/31 (JUNE 30) 21/31 (JULY 7) 31/31 (JULY 14) 31/31 31/31

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Celebrations

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Happy Ending

Back in Phoenix,

enjoying Halloween!

Gog

Shughie

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Discussion and Questions