In 2018, 66 deaths were directly related to the heat, according to a new report by Montreal's public health authority. That works out to 6.4 deaths per day, per million inhabitants.
Better public awareness and improved institutional responsiveness meant there were far fewer deaths than the summer of 2010, when there were 9.3 deaths per day, per million inhabitants, but the 2018 deaths were nonetheless "avoidable," said public health officials.
"It is going to be difficult to have zero deaths from a heat wave, but there is room for improvement," said Dr. Mylène Drouin, the director of public health for the Montreal region, at a media event to release the report and the plan for 2019.
Montreal was smothered by the heat wave from June 30 to July 5 2018, with maximum temperatures reaching as high as 35.5 C — more than 40 C with the humidex — and minimums remaining above 20 C.
The report found that low income and social isolation were key factors in the deaths attributable to that heat wave. Of those who died, two out of three were 65 years old or older, and nearly three in four — 72 per cent — had a chronic condition.
A disproportionate number of deaths in 2018 occurred among people suffering from schizophrenia. Those victims made up 25 per cent of the total, even though they represent just 0.6 per cent of Montreal's population.
Part of the issue is that those suffering from schizophrenia can be less sensitive to heat because of their condition and the drugs they take to manage it, said Drouin. Their medications can interfere with the body's ability to eliminate heat.
"We need to refine the types of interventions and the frequency with which we visit them," she said.
The public health authority is working with various partners to build a registry of people in need and where to find them, and it plans to have it finished by the end of June, Drouin said.
They are using housing data, social and mapping data to show hot spots, in combination with the knowledge of various first responders and health workers with first-hand knowledge of vulnerable areas and individuals.
During 2018's heat wave, police and firefighters made 42,000 door-to-door visits, but Drouin said the intention is to make the on-the-ground efforts more targeted and more effective.
"We can improve the way we're reaching out," she said. "We want to ensure the people doing the interventions are people they trust."
Environment Canada says it's too early to issue a summer forecast, but meteorologist André Cantin says data so far suggests the summer of 2019 will be close to, or slightly above normal. Last summer was below normal during the month of June, but well above normal during July and August.
Coun. Laurence Lavigne-Lalonde, the city's executive member responsible for environmental sustainability, said greening projects — such as putting up temporary walls made of plants and erecting canopies to create more shade — would provide short-term relief to people living in or near urban heat islands.
Heat islands are areas in a city where the summer heat is trapped by expanses of concrete, brick and asphalt, exacerbated by a lack of green space and shade from trees.
"As a city, we have to make sure we're reducing greenhouse gases and creating an environment that is healthier, that we're not increasing these climate hazards," Lavigne-Lalonde said. "On the other hand, we have to be able to respond when these hazards emerge."
The total deaths from the 2018 heat wave differ from report to report, but this is because not all used the same methodology.
The Montreal public health authority's methodology considered all deaths over the heat wave period and used statistical criteria to identify deaths very likely related to heat, while the Quebec coroner's numbers are based upon evidence from autopsies.
"Evidently, both methodologies have their limits," Drouin said. "Not every death is going to be referred to the coroner."
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A man relaxes under a tree in a park in Montreal, Thursday, July 5, 2018. (THE CANADIAN PRESS/Graham Hughes)
MONTREAL — Health authorities in Montreal are adding 13 more people to the list of victims of last summers heat wave, and are urging the city to do more to diminish heat across the densely populated urban neighbourhoods that are home to the most vulnerable.
At least 66 people died as a result of extreme heat on the island of Montreal between June 30 and July 8, 2018, said Mylene Drouin, head of the citys public health authority, on Wednesday. Authorities last year thought the number was 53.
Drouin and medical researchers discovered 72 per cent of those who died suffered from a chronic illness and 66 per cent were over the age of 65.
The statistic that stands out, however, is how 25 per cent of heat wave victims had schizophrenia, a severe form of psychosis.
Drouin said people with schizophrenia need to be better looked after by the health care system but "collaboration is not always easy."
The health authority recommended Montreal do more to identify vulnerable people. Drouin said her office is currently building a registry of those deemed most in need of attention during heat waves.
The health authority also suggested some neighbourhoods immediately plant more trees and other greenery to combat the so-called heat island effect.
Urban heat islands are defined as the parts of a city made hotter by human activity, as compared to nearby rural areas. These neighbourhoods often have less vegetation as well as more buildings and other material that absorb heat.
The study indicated people living in heat islands were twice as likely to die from extreme heat than others in cooler parts of the city. Neighbourhoods in heat islands are also home to a higher percentage of people living in poverty.
Councillor Laurence Lavigne-Lalonde told reporters the city is planning to increase the number of temporary urban green spaces to try and cool down the temperature in heat islands.
Street corners could have temporary urban gardens equipped with shelters from the sun, she said. These spaces would encourage citizens to interact more outside.
"It has an impact on reducing heat and it has a social impact," Lavigne-Lalonde said, alongside Drouin. "People go outside more and talk to their neighbours. In emergency situations its important to know who your neighbours are."
Last summers heat wave officially occurred between June 30 and July 5, when daytime temperatures were recorded between 31.9 C and 35.5 C. Drouins office extended the period of analysis by three days because she said people suffered health effects related to the heat until then.
Researchers analyzed all 328 deaths reported to the coroner that occurred on the island of Montreal between June 30 and July 8, 2018.
They collected information from the medical records of the deceased as well as the circumstances of their death, such as the location, room temperature and the presence of air conditioning, to come up with results.
Kevin Benoit-Simard and Taylor Endicott take dog Buddy for a cool down swim in the Ottawa River across from Ottawa in Gatineau, Que. on Tuesday July 28, 2015. THE CANADIAN PRESS/Sean Kilpatrick