An estimated 70 deaths have been connected to the scorching temperatures and humidity that rolled over Canada's Quebec province last week, and officials say the number may rise as hospital and nursing home records are reviewed.
Most of the people who died as the region reached temperatures up to 95 degrees are elderly men and women living alone in apartments with no air conditioning, and many had chronic health conditions.
David Kaiser, a physician manager at the Montreal Regional Department of Public Health, confirmed to NPR that 34 of the deaths occurred in the city from June 29 through July 7. With few exceptions, he said, the people were over the age of 50, many between 65 to 85. About 60 percent were men and most had an underlying medical or mental health condition, Kaiser added.
He explained the death toll has continued to rise despite a return to more normal seasonal temperatures, as the public health department continues to collect data from a variety of sources. Officials plan to issue an updated report next week.
And now that the immediate crisis is over, the department will soon embark on an even deeper dive into the records of every person who died during the eight-day window, including coroner reports and medical charts, a Montreal public health spokesman told NPR.
"We do this because it's always possible that we may have missed someone who maybe didn't die of heatstroke but died due to heat-related complications ... those can be hard to tell sometimes," Kaiser said.
It is a practice that was implemented after Montreal's 2010 heat wave that left 106 people dead. In that case, authorities discovered a handful heat-related hospital deaths that had previously gone unreported, Kaiser recalled.
Paul Brunet, president of the Council for the Protection of the Sick, a patient advocacy group, called for an independent investigation into the abrupt deaths of all people who recently died in a hospital, public nursing home or a public long-term care residential facility known as a CHSLD.
"Some figures that we have had in recent years do not always correspond to reality," Paul Brunet explained in an interview with LCN on Saturday.
In a statement issued on Monday, Brunet said he plans to file a class-action lawsuit against the publicly run CHSLD network over "the marked deterioration in the care and services that are offered in these facilities" — specifically the absence of air conditioning units in individual rooms.
A spokesman for Montreal's public health department told NPR none of the victims had died in public health care institutions.
Annick Lavoie, Executive Director of the Association of Private Convention Institutions, called Brunet's suggestion that patients are receiving inadequate care "horrific."
"The heat wave we knew hit the entire population hard. Why does Mr. Brunet really want to create the scandal where there is none?" she wrote in a statement, calling the allegations "dangerous."
"He sows suspicion with the public rather than emphasizing the hard work done by staff and volunteers," the statement said.
CTV News channel reported patients in some Montreal hospitals were in rooms without air conditioning, upsetting their families.
Kaiser told NPR that public policy changed after the 2010 heat wave. During periods of extreme heat, government-run health care facilities are required to provide an air-conditioned common area that is kept cool 24 hours a day.
Brunet argued that is not enough. Especially not while nursing home administrators work in air-conditioned offices, The Montreal Gazette reported.
"Don't tell me you don't have the money to put air conditioners in patients' rooms. These are facilities where people live, and these should be decent living conditions," Brunet said.