Background

1. In the mid ‘50s the functions of the then Department of Health and Welfare’s support of civil defence measures included the creation and maintenance of a National Emergency Strategic Stockpile Program with large quantities of essential health and social services supplies strategically located across Canada so as to be available as quickly as possible in the aftermath of a nuclear attack. This program combined with education and training programs including the publication of special manuals and pamphlets and the existence staff with the appropriate expertise to provide advice and assistance to provincial health and social service officials was part of a network of arrangements and agreements with the provinces. This approach was necessary because provinces have always had the primary responsibility for such services.

Components of the National Stockpile

2. As of the late ‘80s /early ‘90s approximately 35% of the stockpile was pre-positioned in the Provinces. The remainder was held in seven Department of National Defence facilities and three commercial depots across Canada. The stockpile consisted of the following units:

UNIT	PRE-POSITIONED	FEDERAL RESERVE
200 Bed Emergency Hospitals	92	104
Advanced Treatment Centres	154	389
Casualty Collection Units	383	211
Hospital Disaster Supplies	3,318	25
Blood Shadow Depots	4	26
Blood Donor Packs	278	300
Airport Disaster Kits	122	7
Airport Disaster Units	37	6
Public Health Laboratories	20	16
Mobile Feeding Units	83	40
Reception Centre Kits	251	26

3, The three main medical units in the National Stockpile were the Emergency Hospitals, the Advanced Treatment Centres and the Casualty Collecting Units.

• Casualty Collecting Units – These were designed to provide first aid treatment for 500 casualties at the rescue site and to facilitate casualty evacuation to the supporting Advanced Treatments Centre.

• Advanced Treatment Centres – These were designed to provide early life-saving care to the seriously injured and prioritize for evacuation to available treatment facilities.

• 200 Bed Emergency Hospitals –

These hospitals were designed to provide life-saving surgical and post- operative care. The units were intended to supplement and expand capacities of existing hospitals in times of extreme demand. Over the last few decades many of these packaged hospitals have been ‘lent’ to various nations suffering disasters and in need of such help. Deployed on their own, they would have required being housed in a large building such as an arena or school and would have had to have appropriately skilled medical staff assigned to them. Two tractor-trailer trucks, one railroad car or one Hercules aircraft would be required to move one of these hospitals. All needed equipment was carefully packed in protective, numbered and labled wooden boxes. The Diefenbunker Museum has a small display of the contents of one of these boxes that was created by Algonquin College Museum studies students about 2007.

4. Social Services units are exemplified by the following:

• Reception Centre Kits – These kits were designed to establish reception areas for persons having been evacuated out of primary danger zones. The equipment included the materiel needed to set-up reception centres, registration of evacuees and response to inquiries about missing family members, and to identify personal needs such as food, lodging, clothing and counseling.

• Mobile Feeding Units – These units were designed for food preparation for workers and evacuees. They consist of stoves, kitchen utensils and related equipment. They required only food, fuel and staff to become operational.

Current Status (as of 2003)*

5. Some of the units (particularly the emergency hospitals/medical supplies) described above remain in existence today and have at times, been used in response to major disasters. They are packaged for long-term storage and for this reason it is believed that no dated items (i.e. pharmaceuticals) are contained in the actual units. As far as is known dated items, such as pharmaceuticals and other perishables are held in Health Canada’s Emergency Services Ottawa Depot or would be obtained through other government departments or commercial sources as needed.

*Authors Note: There is a very complete description of the NESS on the Public Health Agencies website. I question whether the capability still exists. My information indicates that as of 2018-19 all of the emergency hospitals and ancillary equipment and supplies stored in depots across the country have been or are in the process of being disposed off. In my opinion this attempt at federal government cost-cutting is ‘penny-wise, pound-foolish’ as it removes a resource that could save many lives in the event of certain types of disaster (major earthquake, pandemic, nuclear terror attack, etc,). This disposal has, as is usual in such matters been done covertly and with out the media being aware of its happening.

For an article on what the US equivalent to the NESS hospitals looked like check out this link: US CD Hospitals (“Civil Defense Emergency Hospitals, later renamed Civil Defense Packaged Disaster Hospitals, were 200 bed mobile hospitals based on the military mobile hospitals. The CD hospitals were equipped with supplies for 30 days of operations….”)

What is the “National Emergency Strategic Stockpile (NESS)” ?

The following information is abstracted from the Public Health Agency of Canada’s website entry on the NESS:

Canada’s National Emergency Strategic Stockpile (NESS) contains supplies that provinces and territories can request in emergencies, such as infectious disease outbreaks, natural disasters and other public health events, when their own resources are not enough.

These supplies include a variety of items such as:

• medical equipment and supplies
• pharmaceuticals
• social service supplies, such as beds and blankets

The National Emergency Strategic Stockpile

The Public Health Agency of Canada (PHAC) maintains the NESS. PHAC continuously assesses the composition of the stockpile and refurbishes supplies that are distributed.
NESS facilities consist of:

• a central depot in the National Capital Region
• warehouses strategically located across Canada

Supplies can be deployed anywhere in the country, usually within 24 hours of a request from a province or a territory.

Origins of the NESS

On January 11, 1952, Cabinet gave authority to the Minister of National Health and Welfare to stockpile essential health supplies. This Cabinet decision was part of a civil defence plan responding to the threats of the Cold War.

On June 7, 1965, a Cabinet decision gave the authority for provinces and territories to use these supplies during peacetime. Memoranda of Understanding were developed with provinces and territories to facilitate the maintenance of Crown assets for use in a national emergency. They outline the respective roles and responsibilities of the federal government and the provinces and territories.

Over time, the threat of a nuclear attack decreased and the scope of the stockpile program expanded to include the capacity to respond to natural disasters and other emergencies.

NESS Capabilities

Since 1952 the NESS has evolved to enable the federal government to respond to the ever-changing risks to public health in our society. These include:

• emerging and re-emerging diseases
• the increasing severity and magnitude of natural disasters
• health threats due to exposure to harmful chemical, biological, radiological or nuclear agents

The NESS now includes:

• medical equipment and supplies, such as:
  • ventilators
  • stretchers
  • x-ray machines
  • mini-clinics for triage and minor treatment
  • personal protective equipment including masks, gloves and disposable gowns
• pharmaceuticals, such as:
  • antibiotics and antivirals
  • analgesics
  • anesthetics
  • medical countermeasures against chemical, biological and radio-nuclear events
• social service supplies, such as:
  • beds
  • towels
  • blankets
  • generators

The mini-clinic is a core component of the NESS. It is a collection of medical equipment and medical supplies that offers primary care for patients. It is scalable and flexible to adapt to various circumstances. This reduces demands on existing medical care services during health emergency situations.

Over the past ten years, NESS assets have assisted provinces and territories in response to the:

• Canadian H1N1 outbreak (2009)
• Alberta Floods (2013)
• Operation Syrian Refugees (2015)
• Fort McMurray wildfires (2016)
• Salluit Tuberculosis outbreak (2018)

In coordination with federal, provincial and territorial partners NESS supplies were also pre-positioned to ensure emergency readiness during events such as the:

• 2010 Olympics in Vancouver
• 2010 G8-G20 Summits in Ontario
• 2015 Pan American Games in Toronto
• 2018 G7 Summit in Quebec

Evaluation of the National Emergency Stockpile System (NESS) – Background