Doctors in Vancouver and Toronto, the two Canadian cities hosting FIFA World Cup matches this summer, are worried.

Some are sharing growing concerns that the health-care system could collapse if there’s a major emergency during the more than one dozen combined games on both sides of the country.

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Dr. Catherine Varner, an emergency medicine physician in Toronto, recently wrote an editorial in the Canadian Medical Association Journal describing vulnerabilities facing the system she says would surface quickly as hundreds of thousands of people descend on both cities.

“We would be pressed in that situation to be able to accommodate the emergency needs of patients if they needed hospital-based care,” said Varner.

She points out that the health-care system in this country is already facing incredible pressure, especially on emergency rooms, urgent care centres, hospitals and burnt-out paramedics.

Varner says the matches begin at a time when Vancouver and Toronto will already be hosting several annual events and summertime festivals. She points to last April’s tragic Lapu-Lapu Day Festival attack in Vancouver that left almost a dozen people dead, including a child, and dozens of others injured.

“Preparing for a mass casualty event is front of mind. Mass casualty simulations involving multiple levels of emergency response providers and acute care hospitals are taking place, and these tabletop exercises and in situ simulations identify pressure points on the health-care systems,” she adds.

Varner stresses that patient care may be compromised if emergency rooms can’t keep up with demand.

“We do not function normally when we’re pushing 120 or 130 per cent capacity — patients suffer. And we know that based on research studies that show when hospitals are over 100 per cent capacity, patients are having prolonged stays in the emergency department, which, particularly for patients needing admission, can actually increase their risk of death.”

She understands the money within the federal budget is tight, but is imploring Ottawa to spend more on health care.

“Canada is increasingly vulnerable to events that may result in a surge in health care utilization, including climate emergencies, mass gathering events, infectious disease outbreaks, and global defence escalations. A coherent, feasible, actionable, and national plan is urgently needed to increase hospital beds and train the required personnel such that quality of care can be maintained.”

“Being in a constant state of surge capacity is actually the norm.”

Varner adds that major events lead to acute care for things like trauma, and alcohol and substance-abuse-related ER visits.

“And hospital admissions during peak event times, particularly during sporting events, as well as a surge in overall emergency department volumes afterward, suggesting that people may defer health-care utilization until after the event is over. Health-care providers in Canada are accustomed to flexing and triaging acute care and public health resources. Being in a constant state of surge capacity is actually the norm.”

Toronto emergency physician Dr. Raghu Venugopal says even on a “boring” Friday afternoon, they don’t have enough beds for an 84-year-old patient with RSV who is left on a hospital gurney in the hallway.

“So, why would we have the capacity at a global event?”

Dr. Brian Conway, medical director of the Vancouver Infectious Diseases Centre, says his concern is measles. There was an outbreak of more than 80 cases after Vancouver hosted the 2010 Winter Olympics, when two new strains were introduced into the local system.

B.C. spent much of 2025 dealing with a significant spike as Conway raised alarm bells of waning vaccine rates against the virus.

“My concern might be that someone has paid thousands of dollars for tickets, for a hotel room and so on, and gets told by a public health official here in British Columbia that they need to isolate in their hotel room for a week or 10 days. And they would… potentially look for a reason not to do that,” Conway explained.

Both Vancouver and Toronto have wastewater surveillance systems set up to detect any infectious disease outbreaks during and after the World Cup.

—With files from The Canadian Press