Evacuate or shelter-in-place? Applying a risk-informed decision support tool for long-term care facilities threatened by wildfire.

The summer of 2023 was Canada's most destructive wildfire season in recorded history. The southern region of the province of British Columbia (BC) is prone to wildfires and flooding, placing infrastructure, communities and human lives at risk. Residents of long-term care (LTC) facilities are especially vulnerable to these events. Healthcare leaders face the challenge of deciding when and under what circumstances to evacuate an LTC facility. This requires careful evaluation of the dangers posed by the event and the risks associated with the sudden displacement of frail residents. This risk assessment leads to two decision points: is it safer for residents to shelter-in-place or to evacuate to an alternative care facility? Given the increasing frequency and severity of climate-related disasters and their impact on the health and well-being of LTC residents, health emergency incident managers identified the need to develop a standardised approach for evacuation decision making. This paper analyses how the Interior Health (IH) Authority collaborated with Health Emergency Management BC (HEMBC) to develop an Evacuation Risk Decision-Support Tool. This tool informed LTC facility evacuations during the 2023 McDougall Creek wildfire in West Kelowna, BC.