'Never seen it this bad': Ambulance unavailability levels hit 4-year high in December

There were over seven hours in December when there were zero ambulances available in the City of Winnipeg to respond to emergencies — the longest monthly total in four years, according to data obtained by CBC.

"I have never seen it this bad," said Ryan Woiden, an advanced care paramedic who has worked in the city for 20 years. 

"We've sat around, we've discussed it and we just we can't believe that the calls are coming in as quickly as they are."

Data obtained from City of Winnipeg through access to information laws indicate 2019 was the busiest year for ambulance-based paramedics in the last four years. 

On average, there were over three hours each month when there were no ambulances available to respond to calls in 2019, with December being the worst month.

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December is the only month to ever reach a zero ambulance average of seven hours in the four years of data analyzed by CBC.

"That's just over 13 minutes a day, approaching 14 minutes a day, where if the call comes in, our communication operators are really searching for a vehicle to send, an ambulance to send," said Christian Schmidt, deputy chief of operations with the Winnipeg Fire Paramedic Service. 

"It's not a good feeling."

Calls increased by 32 per cent this year

Data from the Fire Paramedic Service show the number of medical incidents ambulance paramedics respond to has risen by 32 per cent since 2015. They responded to over 89,000 medical incidents in 2019, compared to 67,600 calls five years ago.

An aging population, an increase in 911 emergency calls related to methamphetamine and population increases have all led to an increase in calls, Schmidt said.

They have also seen a jump related to patients between the ages of 25 and 35 — which he suspects is mostly due to drugs and alcohol.

With 28 ambulances currently in service, figures for December show that nearly 50 per cent of the time that month the ambulances were in degraded mode — meaning there were six or fewer ambulances available for service.

Six is the base number the service uses to determine whether they can meet target response times. As the number of ambulances available decreases, so does their ability to meet those targets, said Schmidt.

"So the bigger area that the ambulance needs to cover, the longer you're waiting for the ambulance to arrive," said Schmidt.

'You hope you don't get a 911 call'

Woiden, who is also the president of MGEU local 911, says it has just become commonplace to hear that there are no ambulances available or that they are in "degraded mode."

He says six may sound like a lot of ambulances, but it only takes one major accident to tie up the ambulances.

"So we can quickly deplete those six ambulances down to zero, which at that point, you sit there and you hope you don't get a 911 call that was going to require an ambulance because we don't have any," Woiden said.

All the while, the number of ambulances in use during this time frame has remained the same for almost a decade. Since 2011, there have been 28 ambulances responding to calls — 17 that run 24/7 and 11 during 12-hour "peak" times.

"We haven't seen an investment like that since 2011. And we're starting to feel that pressure now," said Schmidt about the last time they received new ambulances. 

Schmidt said paramedics are now taking upward of 13 minutes to reach a patient — five minutes longer than national standards.

To maintain those standards, the service needs anywhere from six to 11 more ambulances — which will cost over $20 million. 

Adding more ambulances isn't the only solution: paramedic

Woiden doesn't think more ambulances is the only solution. He says the entire system needs to be evaluated to see if there are ways to better utilize advanced care paramedics.

One idea he supports is having single response units — meaning highly trained advanced care paramedics who ride in a separate vehicle and can treat patients on site. 

"And if we can leave that person in their home or treat them and leave them in their home, then that's what we would like to do," he said. "It could double the amount of work we could do."

That's simply not acceptable. People need to eat. And we're not even able to accommodate that at the current state we're in.- Deputy fire-paramedic chief, Christian Schmidt 

Meanwhile, paramedics are exhausted and working tirelessly to ensure patients aren't affected by this volume increase — a point made by both Schimdt and Woiden.  

"We have folks that are not getting their lunch breaks until 10 and 11 hours into a 12-hour shift," Schimdt said. 

"That's simply not acceptable. People need to eat. And we're not even able to accommodate that at the current state we're in."

Shared Health doesn't respond to call for more ambulances

Winnipeg also has trained paramedics on every fire truck that can respond to calls, but the main difference is the options available if the patient needs to be transported, explained Woiden. 

"If you need to go to the hospital, an ambulance needs to take you there," he said.

Shared Health, a newly created provincial health organization, is responsible for emergency services in Manitoba.

While 65 new ambulances were promised for rural health by the Pallister government, no new ambulances have been added to Winnipeg's current complement.

In a written response, Shared Health gave no indication they plan to fund more ambulances for the city.  

"It is important to note that ambulance availability data provides a snapshot of information," wrote a Shared Health spokesperson.

"Shared Health continues to work closely with government and our service partners, including WFPS, to improve emergency medical care."