Alberta communities ran out of ambulances 31 times last weekend, union warns

When Maulik Doshi's 18-month-old daughter came down with a fever and chills last month, he was worried but never thought it could turn into one of the longest waits of his life.

Unable to get a doctor's appointment in Calgary, he took young Ira to the hospital.

After a 4.5-hour wait at the hospital and still no doctor, he decided they could head home and wait things out. But by the wee hours of the morning, Ira's condition had worsened.

"She was shouting, crying, shouting, crying. She was knocked down and shivering. So I thought she had a seizure," Doshi told the Calgary Eyeopener this week.

Doshi called 911 at 5 a.m. and stayed on the phone with the dispatcher for nearly a half-hour but no ambulance came. He then hung up to look after his daughter. 

Forty minutes after his first call for help, the dispatcher called back to say they did not have an estimated arrival time for the ambulance due to larger than expected call volumes.

"Just imagine no ambulance in Canada for an hour and then say, we don't know when the ambulance really comes," Doshi said.

It sounds like a rare and terrifying story everyone would fear — but Doshi is not alone.

Last weekend, there were at least 31 "code reds" or "red alerts" in Alberta — 31 times that no ambulance was available to respond when someone called for help, according to the Health Sciences Association of Alberta (HSAA), the union that represents the province's paramedics.

And there were at least 39 times when 911 callers had to wait anywhere from 30 to 86 minutes — far longer than the target times set out by the province.

Ninety per cent of ambulances should respond within 12 minutes in urban centres and 15 minutes in smaller communities of 3,000 or more people, according to Alberta Health Services (AHS), which is responsible for dispatching ambulances in the province. 

In total, 68 communities had some form of rerouting, red alert, dropped ambulance or long response, stretching from the northwest to the southeast.

CBC News obtained the numbers from the HSAA after the union launched a sustained social media campaign meant to highlight the gaps in the system.

CBC News asked AHS to confirm the union's numbers but AHS has not responded directly to the question, nor has it released its own figures.

The union says 33 ambulances that were scheduled to serve the province that weekend sat inactive due to a lack of paramedics to staff them. 

This led, according to HSAA president Mike Parker, to the ensuing 31 red alerts, long responses and ambulances being rerouted out of their regular jurisdictions to respond to calls.

He noted that officials will sometimes say a code red lasted only 30 seconds.

"So, in that 30 seconds, what happened?

"One ambulance in the region cleared once," he said. "And that means we're not code red anymore for a population base of, I don't know, 1.4 or 1.5 million in the Calgary region and one [ambulance] unit cleared up. One unit does not make the province safe."

HSAA data tracking for the weekend shows 39 trips of 30 minutes or longer and excluded those still outside of the province's 90th percentile limit of 12 or 15 minute response times in urban centres and communities of 3,000 or more people, respectively.

In 55 cases, ambulances responded to calls in locations outside their jurisdictions. The most common of these was Airdrie ambulances responding to emergencies in Calgary, with a total of eight trips in one weekend. 

Calgary also figured prominently in the number of long responses as it drew from outlying communities, sometimes as far away as Banff, which the HSAA said was an 86-minute drive.

In one of the most egregious response times cited by Parker, in one weekend in Novembers an ambulance in Vauxhall responded to a call in Calgary, a 2½-hour drive away.

Doshi will never know how long he would have had to wait because he gave up after 40 minutes and rushed Ira to the hospital himself.

Amalgamation and pandemic effects

The issues with the ambulance dispatch are arising in large part because of a historic rise in 911 calls due to the COVID-19 pandemic and surge in opioid overdoses, AHS says. 

With over 30 per cent more emergencies since 2019, AHS said in a written statement it has managed to hire 232 new paramedics, an 8.73 per cent increase, and "has created and filled 30 full-time and 70 temporary part-time paramedic positions across the province."

AHS also officially took over municipally controlled operations in Calgary, Lethbridge, Red Deer and the Regional Municipality of Wood Buffalo in January, merging them with its three existing AHS centres.

The four city mayors criticized the move approved by the UCP government, saying it would not serve the public and would increase wait times. They ultimately filed a complaint with the province's ombudsperson.    

The province has also redeployed supervisors, deferred non-urgent transfers and used single paramedic units when possible to meet increased demands.

The vast majority of 911 calls are responded to "quickly and appropriately," the AHS statement reads.

Parker admits the ambulance redeployments are a reflection of a more efficient system that is using outside resources to meet demand. 

But he says this strategy amounts to the province running the health-care system at the brink, which is a recipe for burnout and a bigger disaster when a tragedy such as a bus crash or a tornado strikes.

"Let's not kid ourselves." Parker said. "[It's] an intense job and now they're driving 45 minutes to get to a call, and as they're heading there, they're being updated by dispatch saying, 'Where are you guys? It's getting worse!'"

CBC News requested further numbers to show on-time performance of ambulance responses but has not received a reply to those queries. However, the province does publish a quarterly dashboard of EMS performance.

The province's charts show that heading into 2020, response times have been on the rise.

The province's median response time targets are approximately eight minutes for urban centres and 10 minutes for smaller communities with more than 3,000 people, respectively. That means 50 per cent of response times should be greater than that number and 50 per cent lower. 

Into the first quarter of 2021, median response times have been below their target.

The province also lists the 90th percentile targets, when 90 per cent of response times should be below the target, which is 12 minutes for urban centres and 15 minutes for places of more than 3,000 people. Response times have been at or above target since 2019 for smaller communities and the same since mid-2020 for urban centres.

As a resident of an urban centre, Doshi thinks the province isn't getting what it deserves from its health-care system. He says if he were in a similar situation again, he doubts he'd call and wait for an ambulance or even go to the hospital.

"I would rather not go, to be honest with you, unless it's like a life-and-death situation."

With files from the Calgary Eyeopener