The heat killed dozens of Quebecs

Over the past five years, half of those who have died from heat waves have had mental or drug problems, according to an analysis from Coroner’s reports.

^{Annabelle Place and Charles Matthew, Office of Inquiry}

• read more: 166 stories of Quebecs affected by heat and dying

• read more: Although healthy, the heat killed him

Although a deadly heat wave in the west of the country last week claimed many lives, our intelligence unit focused on people at high risk during heat waves.

Across Quebec, between 2015 and 2020, we analyzed 166 coroner’s investigation reports.

The over-representation of people with mental disabilities is very significant. Of all the heat deaths analyzed, 52% were people with problems such as schizophrenia, anxiety disorders, depression, bipolar disorder, or deficiency or addiction to drugs, medications, or alcohol.

Among those who died between the ages of 30 and 59, the rate was even 70%.

In its inquiry into the 2018 heat wave, the Directional Regional de Sante Public de Montreal (DRSP) acknowledged that there is still work to be done to prevent deaths in this population.

Medications to look out for

There are different reasons why this is so high risk. The DRSP investigation and several coroner reports indicate that medications such as antipsychotics or antidepressants can worsen dehydration and heat stroke.

They disrupt the body’s thermoregulation and affect the ability to sweat or change the sensation of heat.

The survey found that people with severe disabilities were less likely to adopt “heat-adaptive behaviors” such as hydrating, wearing light clothing or adapting to their activities.

“Another factor is the social isolation that comes with the most severe mental disorders,” the doctor explains.^r David Kaiser, of Montreal Public Health. There is also a correlation with housing and living conditions. “

Many of them live in room houses. This is why, after the deadly heat wave of 2018, the DRSP did a job of identifying these places.

“In the heat waves, we go from house to house, and we prioritize these places,” explains Dr. Kaiser. He is also working on a program of registering vulnerable individuals for emergency services.

“It allows us to get to know them and visit them to make sure they are well when there is a heat wave,” he adds.

Regions are also affected

Another observation is that heat does not only kill in Montreal. About 45% of the deaths occurred off the island.

For example, two died in the Abyssinia, one in Pass-Saint-Laurent and five in Capitol-National. Last year, the number of remaining deaths in Quebec was slightly higher than in Montreal (11 against 10).

The south of the province is still vulnerable: to the metropolitan area (with Laval, Longwell and Crown), which accounts for almost 70% of all deaths.

Highlights of 2015 and 2020

• Of the 166 heat-related deaths, 75 occurred outside Montreal.
• Three-quarters (125) of the deaths occurred in the summer of 2018, including 117 related to the July heat wave. On July 4 and 5, 2018 alone, 44 people died.
• The 2019 and 2020 heat waves meanwhile killed 17 and 21 people, respectively.
• People with schizophrenia account for 11% of deaths during heat waves, and 0.4% of people in the Quebec community are affected. The average age of death from schizophrenia is 59 years.
• 70% of people aged 30 to 59 who died from heat waves had mental problems.
• Men are the most affected, they represent 66% of deaths.
• The average age of the deceased was 66 years. The most affected age group is 60 to 69 years old, or about 32% of deaths.
• There are 3 deaths in people aged 30-39. All three had mental health issues.
• The victim was 3 years old.

^{* Source: Analysis of Coroner’s reports from 2015 to 2020}

75 days of intense heat if left untreated

If nothing is done to reduce our greenhouse gases in the next few years, the number of extreme hot days will increase. Natural resources are plentiful in Montreal, according to a recent report from Canada.

^{Elizabeth Maynard and Annabelle Place, QMI Agency and Bureau of Investigation}

In the metropolitan area, if global warming increases to 4 ° C, extreme temperatures can be counted at 62 in Toronto, 45 in Calgary or 20 in Vancouver for 75 days.

Heat deaths and the number of hospitalizations will also increase. For example, the six-day 2018 heat wave caused more than 117 deaths (125 for the entire summer).

“Heat is one of the most deadly, underestimated and worst weather events,” said Environment Canada meteorologist Steve Boyle.

The vicious circle

Air conditioning may be part of the solution, but it causes other problems. In recent years, air conditioning has increased global energy demand.

“If they don’t use renewable energy sources, they contribute to climate change, which causes more and more heat waves, so this is a vicious circle,” said Daniel Cognon of the Montreal Heart Institute.

Subsequent research focuses on physiological responses to thermal stress.

He has been studying many cooling techniques such as using a fan, soaking feet in cold water, or drinking water.

“These are suggestions or things we ask for, but there is a lack of science behind saying: yes, whether it’s really effective or not, it does not change anything,” he explains.

Thus, the fan can operate up to 38 C. Up to this temperature, it will accelerate the evaporation of sweat.

Fight against the hot islands

However, cooling strategies to protect the most vulnerable and all public health emergencies have their limitations. The solution will inevitably pass the fight against global warming.

“People should be less in the hot islands […] Do what we can to reduce climate change, ”said David Kaiser, a doctor at the Montreal Public Health Service.

Dropped in heat waves

A man struggling with mental health issues was left to fend for himself and was found in a heat wave a week after he died. A play that can be avoided according to his sister.

^{Nicola Lachans, Office of Inquiry}

Manon Charette is still angry following the tragic death of his brother in July 2018 as a huge heat wave spread through much of the Montreal area.

“This death, for me, is a tragedy,” the woman lamented, her voice trembling, three years after her brother’s death, still haunted by the tragedy of living with him.

Mudisuda concluded that he died of complications after being exposed to excessive heat.

He notes that some of the drugs prescribed for Sylvain Charette disrupt body temperature regulation. These people are more likely to be affected by heat waves and die from it.

A few weeks before his death, the 62-year-old Mr. Charett was hospitalized with a mental disorder.

The psychiatrists who treat him refer to chronic harassment, suicidal thoughts invading with loneliness and anxiety.

In June, he was released from the hospital. His condition improved with the recommendation of one antidepressant and two antipsychotics.

A social psychiatrist resulted a few times about his condition, but on June 29 Mr. Charette announced that he did not want the next meeting.

“He lived alone, he was irregular, without air conditioning and with new drugs,” Mr recalled.^Me Cart.

Lay dead

On July 12, for eight days without his brother’s message, Mr.^Me Charett panicked at the Argentine community in Laval.

Two respondents go to the man, but the answer is not available.

They decide to alert the Laval Police Department to enter the apartment. Sylvain Charette is lying on the back of his bed. His death was several days earlier.

However, during the heat wave, Manon Charette asked his brother for help.

“The heat was too hard for me. I have health issues and I was working. I followed up on the phone, “he explains.

The last contact with his brother was before July 4, 2018. Following this call, he worries because his brother is suffering from heat waves.

Help requested

After consulting with Laval’s Social Emergency Unit, he contacted the psychiatrist who was following him. A worker followed the same day. But Mr. Charette never responded.

“She decides to stay with a friend he has already told her about and leaves the place. No other resumption has been made until the day Mr. Charrett’s body was found on July 12,” the death sentence writes.

On July 12, Manon Charette made several repeated calls to various sources for someone to come. “I contacted the social emergency. Faced with my grief, they sent people. But it was too late. “

– In collaboration with Pascal Ducas-Borden and Annabelle Place

► Mudisuda suggested in his statement that in the event of severe heat, the mental resource should write its response plan.