Communities across British Columbia needs to prepare for a climate-related health crisis like the deadly 2021 heat dome every year, according to the lead contributor to a report on health risks associated with climate change.

Dr. Michael Schwandt, a medical health officer with Vancouver Coastal Health, said the region needs to increase its resilience to extreme heat events, and risks “colossal harms” if it doesn’t.

“I think that while events like the 2021 heat dome aren’t expected to happen in a given summer, we need to be prepared for something like that every single summer going forward,” he said on Tuesday, referring to the weather phenomenon that shattered temperature records and was linked to more than 600 deaths in B.C.

“So that’s something that I would say our public health program spends a lot of time thinking about and working with partners to be more prepared for.”

The report on protecting health in a climate emergency, released by Vancouver Coastal Health’s Chief Medical Health Officer Dr. Patricia Daly, makes 17 recommendations about responding to health risks linked to extreme heat, wildfire smoke, flooding and droughts.

The report recommends updating municipal and provincial building codes, bylaws and rental standards to require cooling features such as air conditioning in new buildings and enable modifications to existing homes.

It says features such as shades, green spaces and heat pumps should be promoted, and also calls for improvements to indoor air quality to mitigate wildfire smoke.

Schwandt said inaction on risks associated with climate change puts people at risk.

“We have seen that the impacts of a changing climate in extreme heat in particular, can be massive, and can be very rapid. So we think that mitigating climate change and adapting to it does have the opportunity to protect lives,” he said.

“And I think that the evidence that we have shows us that the failure to do that could lead to colossal harms.”

A survey in Vancouver found temperatures of more than 31 degrees Celsius inside some homes in the summers of 2021, 2022 and 2023, the study said. Temperatures that high are considered dangerous, particularly for people who are already susceptible to high heat.

“So we think that this really does show a concern that overall, our housing in our region is not really prepared for the changing climate that we’re seeing,” Schwandt said.

Daly said every community within the Vancouver Coastal Health region, which covers 1.25 million people, is at risk of harm because of the changing climate but that the risks differ for each community, depending on its geography and demographics.

The report calls for more investment in protecting drinking water systems, with a focus on smaller systems that are more at risk.

It points to examples such as rapid snow melt in Whistler, B.C., in 2021 that led to cloudiness in the water and a boil-water advisory for people with compromised immune systems. Extreme rainfall in the Sunshine Coast later that year led to landslides and another boil-water advisory.

The report says communities should be provided with air quality monitors to offer real-time local data if they are not covered by existing government monitors.

Daly’s report said there needs to be better support for older adults and people with disabilities during extreme heat events and more work needs to be done with Indigenous populations to understand the specific risks they face and increase their resilience.

She said many of the recommendations are already being worked on by government and NGOs and she thinks they will be taken seriously.

She said her office will be holding workshops with local governments and community groups to discuss her recommendations as well as meeting with provincial ministries.