Overview

The Health System Emergency Management Branch (HSEMB) was created in 2003 to plan, organize and coordinate provincial responses to health emergencies. Since its creation, the branch has developed a variety of emergency management programs and plans designed to support Ontario’s health system to help individuals, organizations and communities prepare for, and respond to, unexpected disruptions and emergency events.

Ministry Emergency Response Plan

Under the Emergency Management Civil Protection Act, RSO 1990 (EMCPA), each minister of the Crown presiding over a ministry of the Government of Ontario must formulate an emergency plan with respect to the type of emergency assigned to it by the Lieutenant Governor in Council. The Ministry Emergency Response Plan (MERP) offers a general framework on how the Ministry of Health meets this responsibility by providing health system coordination and direction during emergencies of human health, disease and epidemics, and health services during an emergency.

In the plan, the term emergency refers to a situation or impending situation that constitutes a danger of major proportions that could result in serious harm to persons or substantial damage to property and is caused by:

  • the forces of nature
  • a disease or other health risk
  • an accident or an act whether intentional or otherwise

This includes declared emergencies under the EMCPA as well as undeclared emergencies. Components of the plan can also be used for emerging, critical health situations that may not meet this definition.

Download the Ministry of Health Emergency Response Plan (MERP)

Ontario Health Plan for an Influenza Pandemic

When an influenza pandemic occurs, it will likely spread rapidly to many communities and trigger the implementation of local, provincial, national, and international pandemic plans. As opposed to providing detailed planning guidance for provincial health system partners, the Ontario Health Plan for an Influenza Pandemic (OHPIP) outlines anticipated health sector response activities based on the severity of the pandemic virus. Response activities for the health care system at the time of the emergency is determined by, but not exclusive to:

  • the epidemiology of the virus
  • the age distribution
  • the severity of the illness
  • the efficiency of transmission from human to human
  • impacts on the provincial health system
  • behavioral responses of the public

Ensuring that all parts of the health care system have the systems and procedures in place allows Ontario to identify an influenza pandemic early, minimize its impact, reduce the extent of the outbreak, and reduce morbidity and mortality rates.

Download the Ontario Health Plan for an Influenza Pandemic (OHPIP)

Influenza pandemic planning resources

Seasonal Respiratory Pathogen Guide

Seasonal pathogens such as influenza and respiratory syncytial virus circulate in Ontario in highest numbers between November and April. The Seasonal Respiratory Pathogen Guide supports health system readiness to respond to respiratory pathogens outbreaks and surges by setting expectations and accountabilities of health system partners. In this plan, the term “system” refers to all the organizations, agencies, employers and providers (such as public health units, hospitals) that deliver health services in Ontario.

The Guide was developed to align with the Chief Medical Officer of Health’s 2022 Annual Report, Being Ready to build on key lessons from the COVID-19 pandemic, and to integrate a health equity lens into readiness activities.

Download the Seasonal Respiratory Pathogen Guide

High-risk pathogens

Any health sector organization that suspects they may have a case of a high-risk pathogen (HRP) should immediately notify the Ministry of Health through the Health Care Provider Hotline at 1-866-212-2272

It is critical to ensure early and immediate notification of a suspected case of an HRP so the ministry can initiate immediate coordination across provincial and federal health systems to respond to the situation.

A high-risk pathogen (HRP) includes:

  • Ebola virus
  • Marburg virus disease
  • Lassa fever
  • other viral hemorrhagic fevers with person-to-person transmission
  • other emerging pathogens with the following attributes:
    • highly infectious involving human-to-human transmission
    • have the potential to cause severe disease and/or high mortality
    • effective prevention and treatment measures may not be available

While outbreaks of HRPs have occurred in many parts of the world, there have been no confirmed cases in Ontario to date. Ontario continues to work collaboratively with federal and provincial health system partners to maintain collective readiness efforts to respond to potential cases of HRPs.

The Public Health Management of Viral Hemorrhagic Fevers – Interim Guidance is available to support preparedness and response to HRPs.

This document supports public health units by:

  • managing individuals with a history of travel from countries affected by viral hemorrhagic fevers who may develop symptoms in Ontario
  • outlining various public health unit actions in:
    • risk assessment
    • reporting and partner collaboration
    • follow-up activities to manage exposed, symptomatic and asymptomatic individuals, depending on level of risk and federal Quarantine Order requirements

Radiation Health Response Plan

The Provincial Nuclear Emergency Response Plan, Master Plan 2017 (PNERP) requires the Ministry of Health to develop and maintain a plan for the management of patients that have been exposed to radiation as a result of a radiological or nuclear incident of an accidental or deliberate nature.

The Radiation Health Response Plan (RHRP) aims to meet this goal by guiding health sector planning at provincial and local levels across Ontario on:

  • how the health system responds to a radiological and/or nuclear incident of an accidental or deliberate nature, and the conditions which precautionary and protective actions are implemented for the public and health system
  • a comprehensive province-wide approach to health planning and response, including information to guide local incident planning
  • roles and responsibilities, operational concepts and response principles for coordinating the response of health organizations

While the RHRP primarily supports the PNERP and shall be activated within the context of that plan, the RHRP can also be used when the PNERP is not activated. For example, components of this plan could be used as a guideline for an offshore nuclear incident which may or may not impact Ontario.

Download the Radiation Health Response Plan (RHRP)

Radiological and nuclear planning resources

Health services during a First Nations evacuation

When a First Nations community is evacuated due to an emergency, for example from flooding or forest fire smoke, community members arriving in a host community will need access to health services. The range of health needs may differ based on the population being evacuated and any injuries or traumas that may have been sustained in relation to the event.

The Provincial Emergency Operations Centre provides the overall coordination of provincial response activities and works in partnership with the community leadership, other provincial ministries and federal departments in response to the event, as outlined in the Provincial Emergency Response Plan (PERP). The Ministry of Health coordinates the health system’s response to the emergency with a focus on supporting the planning and provision of health services to meet the health needs of evacuees.

The Ministry of Health works with Ontario Health regions, Indigenous Services Canada, and relevant health system providers in the evacuated community and in the host community to support planning and response. This will typically include gathering and disseminating critical response information such as high-level needs assessments for evacuees among health response partners. Health system partners in host communities work to ensure health services are available for evacuees who may require access to health care providers to maintain continuity of care during the difficult and often stressful period while evacuees are away from home.

Non-Insured Health Benefit program

Health Canada provides eligible First Nations members not covered through private insurance or provincial health programs with a specified range of medically necessary health-related goods and services through the Non-Insured Health Benefit (NIHB) program. During an evacuation of a First Nations community, there may be an increased number of individuals requiring access to this program.

Health sector evacuation planning resources

Emergency Medical Assistance Team

Health emergencies that cause significant human injury or illness can sometimes overwhelm the health care resources of the community in which they occur. The Emergency Medical Assistance Team (EMAT) can provide the medical resources needed in any community that is unable to manage large number of patients resulting from a health emergency.

The team is a mobile medical field unit that can be quickly deployed by the Ministry of Health to support hospitals and communities across the province in a modular and scalable fashion. It is operated by Sunnybrook Health Sciences Centre on behalf of the Health System Emergency Management Branch of the Ministry of Health.

Capabilities

The capabilities of EMAT are wide-ranging but it is primarily adept at providing surge capacity to support a variety of incident types. Once the team arrives at the destination, it takes approximately 4 to 6 hours to become fully operational.

The team can be onsite within 24 hours anywhere in Ontario, including to fly-in communities. The team can set-up a multi-bed unit that provides a staging and triage base and has the capability to treat acute care and intermediate care patients. In addition, EMAT can provide:

  • patient isolation in the case of an infectious diseases outbreak
  • medical support and decontamination in the case of a chemical, biological or radiological incident
  • case management and triage of patients in a mass casualty situation

Staff and volunteer health care team

The system uses on-call health care professionals who volunteer to work on the team. The team members come from a variety of locations so that no single area is without vital health human resources, including:

  • acute care nurses
  • medical radiation technologists
  • physicians
  • critical and advanced care paramedics
  • social workers

The staff members are specially trained to respond to a variety of major health emergencies including natural disasters, infectious disease outbreaks and chemical, biological, radiological or nuclear incidents. They have the appropriate training and skills to function as a team in a health emergency environment involving:

  • infectious diseases outbreaks
  • natural disasters
  • chemical, biological, radiological or nuclear incidents

Once EMAT is dispatched and is on its way to the site of the emergency, its on-call staff is alerted and transported to the site.

Deployment

As a provincial medical assistance team, EMAT deploys to all communities, including into First Nations communities within Ontario, in response to health-related emergencies when local resources are overwhelmed, or to support the provision of primary care needs within a host community housing evacuees during the forest fire and flooding seasons.