The Importance of Region-Specific Triggers

The Manitoba Health, Seniors and Active Living’s (MHSAL) Office of Disaster Management established a Heat Alert and Response System Advisory Committee in 2009 to guide the development of a new Heat Alert and Response System that would improve Winnipeg’s preparedness to deal with increasingly dangerous extreme heat events. MHSAL initially collaborated with the City of Winnipeg and Health Canada to conduct city-wide heat-health vulnerability assessments. The assessments revealed that the general population in Winnipeg was vulnerable to extreme heat, especially as climate change continues to bring warmer summers. A Heat Science Group was created to develop a four-level heat alert protocol in Winnipeg. The group engaged with stakeholders from various backgrounds to develop appropriate response actions for each level that would protect the vulnerable groups identified in the initial heat-health vulnerability assessment. These measures were developed based on four factors: the nature of both the risk and vulnerability, capacity to engage the community, availability of resources, and the efficacy of the measures available. As part of the implemented Heat Alert and Response System, several communication techniques such as website, tweets, and other bulletins notify people in Winnipeg of heat events when they occur. Protective actions are included in these communications, as well as signs and symptoms of heat illness and where people can go to get more information. The City of Winnipeg’s Emergency Preparedness and Coordination Committee works to meet the emerging needs of citizens during extreme heat. The city may, for example, extend pool hours, arrange cooling areas, or extend the hours of air-conditioned municipal services to protect vulnerable populations during events of extreme heat. Officials in MHSAL have been dedicated to employing a continuous quality improvement approach to the Heat Alert and Response System, using ongoing input from stakeholders to make improvements to the response protocols.

Understanding and Assessing Impacts

Since they were implemented in the 1980s, Heat Alert and Response Systems have contributed to the reduction of illness and fatalities from heat events in Canadian and American communities. Public health officials with Manitoba Health, Seniors and Active Living (MHSAL) and City of Winnipeg officials recognized the growing risks to health associated with extreme heat events. In recent decades, severe heat waves in Europe and the United States killed thousands of people. The changing climate in Canada meant more extreme heat events were expected to occur in the future, prompting health officials with the MHSAL Office of Disaster Management to increase preparedness of individuals in the City of Winnipeg and the province more broadly. The first step of developing an adequate response system to extreme heat events was to assess the vulnerabilities of the population. MHSAL and the City of Winnipeg partnered with Health Canada to conduct a Winnipeg-based heat-health vulnerability assessment. This assessment evaluated the public’s baseline exposure and sensitivity to heat, and the ability to adapt to extreme heat events. The findings of the study revealed that Winnipeg’s population was vulnerable to increasing extreme heat events, with certain groups facing higher risks due to age, illness, socio-economic conditions, and occupation. The comprehensive assessment also identified opportunities to take actions that would protect health while adapting to the changing climate. Recognizing that this was an issue for Winnipeg and understanding which populations were most vulnerable to extreme heat allowed the City of Winnipeg to develop specific objectives for a Heat Alert and Response System.

For additional climate information, look at the Resources section of this example (below).

Identifying Actions

In 2009, a Heat Alert and Response Advisory Committee (HARSAC) was established by MHSAL’s Office of Disaster Management to engage with new stakeholders and government departments. This was the first step in the City’s approach to identifying specific measures to incorporate in the new Heat Alert and Response System. The committee identified the need for a Heat Science Group (HSG) to generate a scientifically-driven protocol for classifying and responding to heat events by their level of risk. The HSG developed a four-level heat alert protocol which would guide the City’s development of response measures for different levels of extreme heat events. Engaging stakeholders from various backgrounds allowed the HARSAC to access a broad range of expertise before implementing the new Heat Alert and Response System. In Winnipeg, existing resources were identified that could be employed in response to extreme heat events. These resources included volunteer organizations and response activities already in place for other issues. The results from the heat-health vulnerability assessment conducted with Health Canada were critical in identifying vulnerable groups that would be the focus of Winnipeg’s response measures. The nature of the risk and vulnerability, capacity to engage the community, availability of resources, and the efficacy of the measures available were the four primary factors guiding the development of adaptation measures. Although the Heat Alert and Response System has already been introduced in Winnipeg, the phase of identifying actions is not ever. The Office of Disaster Management employs a continuous quality improvement approach to the Heat Alert and Response System, meaning they continue to gather ongoing input from a diverse range of stakeholders to make further improvements to the City’s response to extreme heat events.

Implementation

After assessing vulnerabilities and identifying desirable actions and outcomes, the City of Winnipeg implemented the new Heat Alert and Response System. Depending on the level of the heat alert, specific messaging to individuals and stakeholders occurs. In extreme heat events, the Chief Provincial Public Health Officer issues a bulletin in the form of a Heat Advisory, which is sent to media outlets through a news release. Communication with the public was a fundamental component of the Heat Alert and Response System upon implementation. During extreme heat events, the public is not only informed of the situation, but also of signs and symptoms of heat illness, actions they should take to protect themselves, and resources for further information. The City also targets specific vulnerable stakeholders in their communication of extreme heat events, including health care professionals, public sector workers, and social service providers. Community partners such as the Red Cross and Salvation Army were included in the Response System so they could engage their own networks to reach out to at-risk populations depending on the situation. Other implemented measures included protocols such as additional seating and water supply in cooling areas and the extension of hours in pools and air-conditioned City of Winnipeg facilities. The City’s Emergency and Preparedness and Coordination Committee was given the responsibility of identifying and meeting the emerging needs of citizens during extreme heat. While there are specific response measures triggered by different levels of heat alerts, an important component in the implementation of the Heat Alert and Response System was the flexibility to introduce measures that help vulnerable populations as needed.

Outcomes and Monitoring Progress

With the Heat Alert and Response System implemented, MHSAL and stakeholders worked together to identify and collect data on heat-related health impacts. For example, Emergency Medical Services calls during extreme heat events were monitored to evaluate the effectiveness of the Heat Alert and Response System and identify areas for improvement. Another monitoring technique included having service providers review usage of resources, such as cooling locations and bottled water. Collected data and a post-season review of heat events is discussed with members of the Heat Alert and Response System Advisory Committee at the end of each heat season and continues to aid in refinement of adaptation strategies to aid vulnerable Winnipeg residents in events of extreme heat. Collecting tangible data on services used allows the City to effectively evaluate the response system and implement data-driven refinements to the plan. Randy Hull, Emergency Preparedness Coordinator for the City of Winnipeg, indicated that the biggest internal challenge in the development of the Heat Alert and Response System program was determining what services can be alerted or extended to provide comfort and relief to citizens. A major learning outcome of the program was the importance of cooperation with various stakeholders and organizations such as MHSAL. Mr. Hull added, “While the City of Winnipeg Heat Plan is limited to actions at the local level, support is provided from the MHSAL’s Office of Disaster Management and other sources. This helps to transmit reliable information that guides the City of Winnipeg’s response.” While continuous improvements are being made, the introduction of a new Heat Alert and Response System in Winnipeg has considerably improved the community’s preparedness for extreme heat events, lowering the risk of illness and injury in the face of an issue made more pressing by climate change.

Next Steps

The Office of Disaster Management and Public Health officials in MHSAL employed a continuous quality improvement approach. This means that the next steps for this project involve a continuous evaluation of the Heat Alert and Response System to identify needed changes to the system that improve preparedness for extreme heat events. The Heat Alert and Response System Advisory Committee will continue to host meetings and use input from stakeholders, public health, and disaster management officials to inform revisions to the program. Collecting data for each heat season will also significantly aid in the future refinement in adaptation strategies. The City of Winnipeg is committed to improving their Heat Alert and Response System to protect vulnerable populations in the face of increasing extreme heat events in the future.

Resources

Link to Full Case Study

Additional Climate Information:

Using climate change projections enables better adaptation decisions. To learn how to choose, access, and understand climate data, visit ClimateData.ca’s Learning Zone.

To further understand how climate information can be applied in health-related work, explore Health sector content on ClimateData.ca.