No ambulances available: Code blacks now a daily occurrence in Thunder Bay

The chair of the union local representing Thunder Bay, Ont., paramedics says code blacks – periods during which no ambulances are available in the city – are becoming longer and more frequent, and Rob Moquin says somebody could die as a result.

Moquin, the chair of Unifor 3911, publicly posted an article to his Facebook page on Thursday about a Quebec family that is suing their province after a 24-year-old man died from cardiac arrest after waiting 20 minutes for an ambulance. 

"This is a real possibility in the city of Thunder Bay," Moquin wrote.

Speaking to CBC on Friday morning, he said there had been eight code blacks since 2 p.m. the previous day. 

"We had a very dangerous situation, it was about two or three weekends ago, where we had no ambulances available in the city of Thunder Bay from 7 p.m. until 1 a.m.," he said. "Anytime a car cleared up, we were sent right back out to do another call."

The chief of Superior North Emergency Medical Services backed up Moquin's concerns.

"Code black [a] couple years ago, it was probably occurring, you know, maybe once or twice a week," Wayne Gates said. "But now we're at a point where …  it's becoming a daily occurrence."

Thunder Bay EMS performance standards call for it to arrive at top-priority calls within eight minutes 70 per cent of the time and at calls regarding sudden cardiac arrest – which is frequently fatal if not attended to immediately – within 6 minutes 60 per cent of the time. 

So far, EMS has maintained those performance standards, Gates said, and when it misses the six or eight-minute standard, it's frequently only by seconds.

However, both Gates and Moquin said the COVID-19 pandemic has added to the challenges facing the service. 

"We have paramedics that are off due to COVID exposure or close contact with people at work," said Moquin.

"It has happened several times where we've been down two or three ambulances at night for a night shift."

Gates said the staff shortages caused by the Omicron variant of COVID-19 are starting to subside in the ambulance service now. But paramedics are still being held up due to delays at the hospital. 

"They're also having staffing challenges, much like we were having in the paramedic service. And all that is the Omicron causing that kind of chaos in our system right now." 

Paramedics are also dealing with a growing number of calls related to accidental overdoses as a result of the growing opioid crisis, Moquin said.

The service receives about three calls a day related to overdoses, Gates said, and it sees overdose deaths two to three times a week. 

Both Gates and Moquin agree that the main challenge facing EMS is not a lack of physical ambulances but staff shortages due to illness and struggles to attract and retain paramedics.

"Human resources are very challenging now, very much like the healthcare sector for nurses," Gates said. "The service demands on paramedic services has increased substantially over the years. And with those increases on service demands, we are increasing our staffing level. And so there's less of a pool to draw from."

There are also systemic challenges, Moquin said.

For example, he said, the ambulance dispatch system across the province does a poor job of differentiating between true, life-threatening emergencies and situations in which a person could wait for service.

More funding needed for social programs

Paramedics sometimes race to people's homes only to discover there's no pressing emergency, he said.

Offload times at the Thunder Bay Regional Health Sciences Centre also continue to be a problem, Gates said, meaning paramedics are often held up waiting to transfer a patient into the hospital's care. 

He hopes to implement a new program there in the next week or two that will allow paramedics to leave patients who are medically stable in the waiting room. 

Both Gates and Moquin believe increased funding to social services could also help reduce the burden on paramedics.

There is a need for more detox beds and more services for people struggling with addictions and mental health issues, Moquin said. 

"We keep adding money to the system, and we're not solving the problem," Gates said. "Let's add money to the system and solve the problem, so we don't have to keep adding money to the system."