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<h1 class="entry-title post-title">Human error, miscommunication and lack of training behind false alarm at Pickering nuclear station</h1>
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<a href="https://www.durhamradionews.com/archives/124716" title="Human error, miscommunication and lack of training behind false alarm at Pickering nuclear station" rel="bookmark"><time class="timestamp updated" datetime="12:00 pm">February 27, 2020 | 12:00 pm</time></a>
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<p>Ontario&#8217;s solicitor general says human error led to <a href="https://www.durhamradionews.com/archives/123830">thousands of people receiving a false alert about a supposed &#8220;nuclear incident&#8221; at the Pickering generating station</a>.</p>
<p>More than six weeks after phones, radios and TVs lit up with the warning, <a href="https://www.durhamradionews.com/archives/123845">Sylvia Jones&#8217; report into the events of January 12 describes a chaotic scene of confusion, miscommunication and a number of &#8220;procedural gaps&#8221; which only exacerbated the situation</a>.</p>
<p>The alert was sent out from the Provincial Emergency Operations Centre (PEOC) at 7:23 a.m., just minutes after a shift change at 7 a.m.</p>
<p>The report says employees are required to test two systems after each shift change&#8211; the training-only version of the alert system and the real, live alert system.</p>
<p>An employee mistakenly thought they had logged into the training system and sent out what they believed would be a test alert.</p>
<p>The report says the training program is &#8220;nearly identical&#8221; to the real one and both programs share the same login credentials.</p>
<p>Instead of a harmless test, the pre-scripted message went public, sparking &#8220;significant concern and confusion.&#8221;</p>
<p>The report says there was a string of phone calls, emails and other communications between various employees, supervisors and agencies.</p>
<p>&#8220;Through a series of consultations with supervisors at different levels, no clear instructions were provided to [the employees on site at the PEOC] in the immediate aftermath of the first alert,&#8221; reads the report. &#8220;[Those employees] did not know how to take corrective action and immediately sought direction from supervisors.&#8221;</p>
<p>However, according to the report, &#8220;the supervisors were [also] uncertain about whether or how to issue a second broadcast intrusive alert.&#8221;</p>
<p>Some of the people and agencies involved were against sending out a second public alert to notify people that there was no emergency.</p>
<p>During this time, &#8220;unrelated information about Pickering Nuclear Generating Station circulated and added confusion to senior Ontario Public Safety executives&#8217; understanding of the situation,&#8221; the report claims.</p>
<p>It says there was a &#8220;momentary loss of power&#8221; at the station around 1:21 a.m. and some employees had suggested this was the reason for the alert.</p>
<p>That wasn&#8217;t true and later discussions confirmed the power outage had nothing to do with the message sent out six hours later.</p>
<p>As a result of the uncertainty and hesitation, a second public alert advising that the original message was false wasn&#8217;t sent out until 9:11 a.m.</p>
<p>Perhaps most troubling, the report says some of the employees who were on duty that morning, including the person who sent out the false alarm, were not properly trained.</p>
<p>According to the report, they only attended a shortened training session and weren&#8217;t always following proper shift change procedures.</p>
<p>&#8220;Most Emergency Management Ontario supervisors did not have access to or training on the Alert Ready system,&#8221; the report continues. The supervisors&#8217; communications with government agencies were also &#8220;reactive&#8221; and &#8220;inconsistent.&#8221;</p>
<p>The report suggests a number of changes, including making the training and live alert programs much more distinct and including some type of &#8216;test&#8217; label to all messages sent through the test system.</p>
<p>It also says that both programs can be open at once on the same station and that only one employee is needed to send out an alert, which can cause problems because of a lack of oversight.</p>
<p><a href="https://www.mcscs.jus.gov.on.ca/english/Publications/InvestigationemergencyalertssentJanuary122020.html">You can read the full report by clicking here</a>.</p>
<p>Pickering Mayor Dave Ryan has responded to the report, you can read his full statement below:</p>
<blockquote><p><em>&#8220;</em><em>As you are all aware, a false nuclear alert was issued province-wide on January 12, 2020. This significant error created a great deal of angst in our community and beyond. Consequently, the Solicitor General, Sylvia Jones, and our MPP, Peter Bethlenfalvy committed to having a full investigation conducted on the matter.</em></p>
<p><em>The Solicitor General has personally followed up with me and provided my office with a comprehensive 20-page investigative report on what had occurred on January 12th. The findings revealed procedural gaps, lack of training, lack of familiarity with the Alert Ready system, and communication failures. These findings can provide context to the error and the length of time – 108 minutes – that elapsed between the alert issued in error and the second clarifying alert.</em></p>
<p><em>We were also provided with a 15-point Action Plan which outlines corrective actions taken and planned to help prevent future errors in emergency notifications and to strengthen Ontario’s public alerting system.</em></p>
<p><em>On behalf of the Members of Council and residents of the City of Pickering, we would like to thank the Ministry of the Solicitor General and Province of Ontario for taking this matter very seriously, by ensuring that a robust investigation was conducted, which has led to meaningful corrective actions being implemented.</em></p>
<p><em>If there is a silver lining from this unfortunate situation, it is that we have renewed confidence in the province’s public alerting system, and that the whole community has become engaged in a broader discussion on emergency preparedness.&#8221;</em></p></blockquote>
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2 comments on &ldquo;<span>Human error, miscommunication and lack of training behind false alarm at Pickering nuclear station</span>&rdquo; </h6>
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<cite class="fn">TB</cite> <span class="says">says:</span> </div>
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<a href="https://www.durhamradionews.com/archives/124716#comment-45695">February 27, 2020 at 2:02 pm</a> </div>
<p>Keep hiring contact and you will see much more of this. Perhaps worse. Good for you OPG.</p>
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<cite class="fn">Sumwun</cite> <span class="says">says:</span> </div>
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<a href="https://www.durhamradionews.com/archives/124716#comment-45712">February 28, 2020 at 3:49 am</a> </div>
<p>@TB , First of all, OPG had nothing to do with the alert being sent out it was the PEOC’s error. Secondly, where in the article did it state that it was a contract employee?</p>
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<button class="djacc__btn djacc__btn--invert-colors" title="Invert colors">
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<li class="djacc__item djacc__item--contrast">
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<span class="djacc_btn-label">Dark contrast</span>
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<span class="djacc_btn-label">Light contrast</span>
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<li class="djacc__item djacc__item--contrast">
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<span class="djacc_btn-label">Low saturation</span>
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<span class="djacc_btn-label">High saturation</span>
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<li class="djacc__item">
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<span class="djacc__size">100<span class="djacc__percent">%</span></span>
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<span class="djacc__bar"></span>
<span class="djacc__size">100<span class="djacc__percent">%</span></span>
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