Heat Warning and Information Systems in Canada: Development, Implementation and Assessment

1. Heat Warning and Information Systems in Canada:Development, Implementation and Assessment NIHHIS Workshop: Developing Integrated Heat-Health Information for Long-term Resilience and Early Warning, for the El Paso-Juarez-Las Cruces Region Melissa MacDonald Program Meteorologist Health and Air Quality Forecast Services Environment and Climate Change Canada July 13, 2016

2. National Pre-harmonization picture • ECCC, federal government, provides public weather warnings → HEAT • Public health and safety are under provincial and municipal government jurisdiction • Health Canada, federal government, supports through local vulnerability assessments and development of Heat Alert and Response Systems (HARS) • Heat related mortalities in Europe (2003) and climate change projections of “hot” days increased Heat Awareness • Provincial or local implementation of “health” relevant threshold and messaging • Result is a patchwork of indices with different triggers/criteria Summer 2014

3. Ontario Heat Alert Harmonization Collaborative • Collaborative of multiple levels of government: • Environment Canada, Health Canada = Federal • Ministry of Health and Long-term Care, Public Health Ontario = Provincial • 36 Public Health Units = Municipal and Provincial • First Meeting in Summer 2012 • Mission: “…to develop an efficient, coordinated, evidence-based system comprised of standardized criteria for calling heat alerts and language easily understood by the public as well as the flexibility to address local vulnerabilities and needs.” • Secretariat function by a respected NGO • Development of Working Groups: • Initial: Governance, Communications, Science • Final: Evaluation, Alert Consistency, Communication/Media Release

4. Evidence Base for Warning Thresholds • Alert triggers protect human health when they are based on knowledge of community- and region-specific weather conditions • Warning thresholds have been established considering: • Meteorological and air pollution data. • Non-accidental death and cause-specific death (Cardio-vascular, respiratory, etc.) • Vulnerable populations (e.g. seniors, children, etc.) • A state-of-the-art approach to estimate the nonlinear and distributed-lag effects of ambient temperature for selected regions • Consultation with local health authorities Illustration of the non-linear relationship of mortality relative risk (RR) versus air temperature in Ontario over the period 1996-2010

5. Ontario Heat Warning and Information System • Heat Warning and Information System developed based on exposure to both intensity & duration of a heat event. • Early notification to enhance mobilization and reduce impact of those most vulnerable. • Three forecast regions were identified in consultation with Environment Canada and local health authorities in Ontario. • Region specific triggers took into consideration ECCC’s forecast uncertainty, temperature-mortality relationship and alert system fatigue. • Intervention to reduce heat health risk is either the local public health or municipal jurisdiction (depending on circumstance). • System piloted during Summer 2015 in coordination with Toronto PanAm/ParaPanAm Games. • Fully implemented with adjustments in Summer 2016.

6. Environment Canada New Warning Criteria for Summer 2016 • Provision of multi-tier service with new Heat Warning Criteria • Responsibilities balanced between OSPC and MSC Central Services (WPM) • Early notification (2-4 days in advance of heat event, updated every 24hrs) • Special Weather Statements (first event of the season with messaging) • Warnings and Warning De-escalation (significant change in conditions, -2C) • Extended Heat Warning at 3+ days, most municipal action and response

7. Evaluation Setting the Stage for 2016 • Evaluation protocol defined (indicators and outcomes) • Public Health Units • Feedback gathered between the Pan and ParaPan Am Games • Comprehensive survey completed at the end of season • Public Opinion Survey (post-event assessment) • Validation of the draft triggers using health outcome from summer 2015 (emergency department visits or telehealth data) • Analysis of historical morbidity to inform heat-health messaging on vulnerable populations (e.g. seniors, mental health) • Moving Forward • Addressed stakeholder and internal concerns raised in evaluation in new standard operating procedures • Communications products and plan approved

8. Alberta Heat Warnings Summer 2016 • Similar service and warning system as Ontario: • Early Notifications by WPM • Warnings by PASPC • No humidex, temperature thresholds only based on the averaged 95th percentile in a health “Zone” • AHS to provide early season reminder • AHS will issue a heat advisory for Extended Heat Warnings, 3+ day event

10. Challenges and Lessons Learned • Health protection (temp) vs. assumed risk (svr wx) • Compromise between heat-health related risk through epidemiological study and climatology & forecast accuracy • Forecaster assumptions and understanding of client needs • Language & terminology (extended/extreme, alert/warning) • Warning fatigue & health protection vs. action/response cost • Vulnerability groups and access to relief from heat • Regional differences within a National system • Communication from multiple levels of government (approval) • Education of partners on forecast operations and use • Key component and requirement = Evaluation

11. Thank you • For more information please contact either … • Melissa MacDonald – melissa.macdonald@canada.ca • Dave Henderson - dave.henderson@canada.ca • Sharon Jeffers - sharon.jeffers@canada.ca • Abderrahmane Yagouti - abderrahmane.yagouti@hc-sc.gc.ca