Description - Figure 9 - Graduated alert systems used to communicate risks

A figure is shown describing the Montreal HARS activation and deactivation decision flowchart. Activation of the prevention and protection plan occurs in the event of extreme heat. This is a "Seasonal watch" level which is in effect from May 15 to September 30, 2011. The DSP issues a press release to CSSSs to appear in weekly newspapers.

A Heat warning is issued and an "Active watch" level is reached when the temperature is greater than or equal to thirty degrees Celsius and humidex is greater than or equal to 40. The DS-EUS issues advisories to the public on how to prevent negative health effects. CSSSs implement increased surveillance and prevention measures for vulnerable patients.

A forecast of at least 3 consecutive days of maximum temperature greater than or equal to thirty-three degrees Celsius (weighted average) and minimum temperature of greater than or equal to twenty degrees Celsius (weighted average) or at least 2 consecutive nights with minimum temperature of greater than or equal to twenty-five degrees Celsius triggers an "Alert level. The DSP-EMO notifies partners of the situation to put them on alert. Partners include Joint, Environment Canada, DSP-Emergency Management Office, Health Agencies, the City of Montréal, and Emergency Health Services.

Monitoring of weather conditions and the health surveillance data occurs. The following questions are asked: did weather conditions meet the extreme heat criteria for at least two days, and is Environment Canada weather forecast maintained or is an increase in morbidity and mortality detected using health surveillance data? If the answers are no, then monitoring of weather conditions and the health surveillance data continues. If the answers are yes, then a teleconference is held with neighbouring DSPs the Agence and SCACs to share information on the weather, health and other aggravating factors. An "Intervention level" has been reached and activities set out in the Emergency Response Plan are carried out. Activities include: Management of overcrowding in emergency rooms, Impact management in health care institutions, Health watch, Measures put in place by the Montréal Civil Security Centre, Management of the increase in ambulance transport, Management of fatalities if there is an excess, Communication management, and a Door-to door campaign.

The following question is asked before a "Demobilization" level is reached; that is: Did weather conditions and anticipated levels in the health surveillance data return to normal? If yes Return to "Seasonal watch" or "Active watch" level and the "Demobilization" level. If the answer is no, activities set out in the emergency response plan continue to be carried out.