The greatest tragedy in responding to disasters, and CDN healthcare is disaster, is the misuse of the chain of learning. We fail to learn or we do not implement what we learn. 

There is a need to do disaster contingency planning for healthcare. Especially primary care. Those in public health are aware but powerless to direct corrective actions.

How to prepare for various disasters. COVID was one such disaster. We better prepare for the next one. Disease X, as it is called. 

There is also a need in Canada to provide mass fatality guidance documents. As we prepare for the next pandemic. However, this could be applied today. We know that over 13,000 persons died on waiting lists last year. That checks all the boxes for mass fatality. 

One problem in mass fatality planning is the over emphasis on terrorism. We need to take calls from across Canada from real patients in need to develop a deep understanding of how the lack of access to urgently needed care is a cause of mass fatality. Lac Megantic, Quebec cost 47 lives. Not 13,000 lives.

After Lac Megantic, various branches of government did a deep dive into root causes. This involved hundreds of experts in the analysis of root causes and recommendations and government committed over $155M to this one community.

In response to the 13,000 patients who died on waiting lists last year, nothing that compares in emergency preparedness and disaster prevention happened to assist these various communities.

Emergency planning is built around scenarios. Canada has millions of scenarios. We just have to listen. 

Today, I got a call from an Atlantic province. The 48 year old carpenter had a cardiac event six weeks ago. The hospital ER he visited did not activate the appropriate cardiac protocols. He was discharged with no treatment and no followup. His walkin clinic doctor who replaced his retired GP, did nothing but attempt a referral to cardiology. 

A cardiac echo was booked for 5 months out. A cardiology referral had no date attached. He was at risk of dying of an untreated cardiac event. That is one of the thousands of scenarios that we hear about. We actually answer our phone and attempt to assist.  It is like boiling the ocean in terms of the response that is needed for these patients.

So mass fatality planning is very appropriate for our healthcare system at this very moment.