“I hope I'm not the first one who dies.”
      One Grand Manan resident voiced what may be on the minds of more than a few islanders with the failure of New Brunswick's government to renew Atlantic Charters' medevac contract through Ambulance New Brunswick (ANB). New Transport Canada aviation regulations for pilot duty and rest times came into effect on December 12. While the changes have been in the works since 2018, small air charter services are still scrambling to meet the requirements. There is a pilot shortage, and many companies must offer much higher salaries to attract them, even in areas with more amenities than Grand Manan. The prescribed duty, rest and advance-notice periods mean charter operators that also run medevacs have to hire more pilots. The increased cost of "staffing up" was a factor in the negotiations between Atlantic Charters and ANB, and time ran out on December 12.
      Islanders have counted on the local service for 40 years, especially in weather conditions where taking off is possible but landing is not, and Atlantic Charters is ready to go in about 40 minutes. ANB has declined comment on the details and states that its service is "available to all New Brunswickers, including Grand Manan residents" and that it is "committed to the health and safety of all New Brunswickers." ANB has one plane for the entire province.

First crisis already arises
      The first crisis arose on Wednesday night, December 14. A 30% chance of freezing rain in the forecast led to both ANB and Nova Scotia's EHS helicopter being unable to make a medevac transfer. Atlantic Charters was called but would not have been in compliance with the new regulations and had to decline. Eventually a Coast Guard Cormorant helicopter from the Joint Rescue Coordination Centre (JRCC) in Halifax made the flight, and the patient arrived safely. From pickup on Grand Manan to drop-off at the regional hospital took an hour and four minutes, according to JRCC's Public Affairs Officer LCDR Len Hickey.
      Hickey says their helicopter has de-icing capability while ANB and EHS do not, and it was already out on a training flight when they got the call. "Medevacs happen, but it is relatively rare," he says, adding that while a cost for the flight wasn't available, JRCC doesn't charge the province for them. Medevacs affect their operations "to a degree" because it would cut into search-and-rescue availability. He says it's a service they could provide again.

Islanders share medevac stories
      Atlantic Charters president Melanie Sonnenberg clarifies why the company is no longer able to do medevac flights. She says the new regulations "impact our operation, which have been outlined numerous times to the responsible parties. Under the new regulations we are unable to accept medevacs without the necessary support and need to add additional crew to be in be compliance with the new regulations. We are saddened by the position we have all been put in and look for a resolution with the province that benefits our community."
      Residents took to social media to express their anxiety and frustration at the loss of the local service. Within about 24 hours on one discussion thread, over 40 people posted stories of their own or family members' medevacs -- some on multiple occasions and for all manner of ailments from broken bones to labour to heart attacks -- where without Atlantic Charters' service they "wouldn't be here."
      The contingency plan with ANB, NS-EHS and JRCC isn't ideal, because as Mayor Bonnie Morse has pointed out, they have to go down the list and see if the aircraft are available ? all of which takes time that may be critical in an emergency.
      On December 15, six members of the village council went to Fredericton to meet with Premier Blaine Higgs, Health Minister Bruce Fitch, MLA Andrea Anderson-Mason and others from the health department and premier's office. Morse says the previous night's medevac was a good example that allowed them to air their concerns about the impact on Grand Manan residents.
      "Grand Manan is isolated and doesn't fit into the same model as the rest of New Brunswick," Morse points out. "It's different to access care here" than on the mainland, and the province needs to consider this. They have asked provincial officials to seek clarification of the Transport Canada regulations and determine whether Grand Manan can be classed as an isolated area and whether an exemption to the regulations could apply. If so, negotiations between ANB and Atlantic Charters would still have to be completed.
      "Everybody recognizes the urgency, which we appreciate," Morse says. "We need to do something sooner rather than later." She is reassured that JRCC answered the call, but "that's not a long-term solution." She also commends the Grand Manan hospital staff. While they could find themselves in need of air transport like anyone else, they have the additional stress of actually dealing with medevac patients and transfer timelines.
      To concerned residents, Morse says, "I understand and share that worry myself. I think everyone has that worry." She thinks the federal government will be given a good understanding of the situation and hopes for a timely resolution so the island doesn't end up "back where we were 10 years ago" when a previous Atlantic Charters contract expired and a woman died waiting for an ANB plane.
      As of December 20 the village was still awaiting word from the province.