Ottawa paramedics have recorded a significant drop in so-called ‘level zero’ incidents during 2025 — the first sustained improvement in a metric that has long been a red flag for Canada’s ambulance system. ‘Level zero’ means no ambulance is available to respond to a call, forcing paramedics from other duties or requiring mutual aid from neighbouring services. According to data cited by local news reports, the decline marks a turnaround from previous years when Ottawa routinely logged record-high level-zero hours.

What ‘level zero’ means for Ottawa’s emergency response

When Ottawa’s paramedic service hits level zero, it is not merely a statistic—it represents real delays for patients in cardiac arrest, stroke, or traumatic injury. The metric directly measures system strain: ambulances stuck in hospital offload delays, crews waiting for beds, and a public health system that often has no spare capacity.. The 2025 drop, as reported by Ottawa paramedics, suggests that some of these bottlenecks may be easing, at least temporarily.

Paramedic chiefs have long warned that level-zero hours correlate with worse patient outcomes, including longer response times for life-threatening calls. The improvement, while welcome, comes after years of advocacy for more hospital capacity, better offload protocols, and increased staffing.

The 2025 decline: staffing gains and offload improvements

Several factors appear to be driving the drop, according to the same data. Ottawa paramedics have pointed to new hiring rounds that brought more frontline staff online, as well as pilot programs aimed at reducing the time ambulances spend waiting to transfer patients to emergency departments. The provincial government has also funded additional paramedic positions and invested in ‘treat-and-release’ models that let paramedics leave patients at home with follow-up care, avoiding hospital trips altogether.

Public health officials caution that the decline is still modest in absolute terms, and that level-zero hours remain above pre-pandemic baselines. The improvement is also uneven: some shifts continue to see prolonged periods without available ambulances.

What the 2025 figures don’t tell us about paramedic sustainability

The drop in level-zero incidents does not automatically mean Ottawa’s paramedic system is healthy. open questions remain about paramedic burnout rates, overtime hours, and whether the gains can be sustained without further investment. As the source report notes, the data reflects aggregate hours, not the severity of calls during level-zero periods. A single hour of level-zero during a multi-car crash is more dangerous than an hour during a quiet overnight shift.

It is also unclear how much of the improvement is due to one-time factors, such as mild weather reducing call volume, or temporary hospital surge funding. Without year-over-year data for the full 2025 calendar year, analysts warn that the decline could partly be the result of a low-comparison baseline from 2024, which saw record-level-zero hours due to a severe respiratory illness season.

Another unknown: whether Ottawa’s experience can be replicated in other Canadian cities. Toronto, Montreal, and Vancouver have all faced similar crises, but their hospital networks and municipal funding differ significantly.

The persistent challenge of hospital offload delays

Even with fewer level-zero incidents, Ottawa paramedics still report that offload delays—where crews wait for hours to hand over patients—remain a core driver of system strain. The 2025 improvement is partly attributed to new offload protocols that allow paramedics to transfer patients to hospital ‘hallway medicine’ areas more quickly, but emergency physicians warn that these areas are themselves crowded. The fundamental mismatch between hospital capacity and patient demand has not been resolved, according to the source report.

The drop in level-zero hours may therefore be a symptom of a shift in where the bottleneck occurs: from paramedic availability to emergency department crowding. the ultimate measure of success, medical directors argue, is not just fewer level-zero hours but faster response times for the most critical calls—and that data has not yet been released for 2025.