Toronto officials don’t know why B.C.’s deadly fentanyl crisis has not yet spread to the city, but they’re aiming to ensure it never does.

On Monday, Dr. Barbara Yaffe, Toronto’s acting medical officer of health, will chair the first in a series of monthly gatherings in a joint effort to prevent any spike in overdoses involving fentanyl and other illicit opioid drugs.

Mayor John Tory, city manager Peter Wallace, paramedics, police, harm-reduction advocates and others in the “Toronto overdose surveillance & alert partnership” will focus at home while warily looking west to the shocking toll fentanyl, a highly potent anesthetic commonly used for surgery, has taken on Vancouver.

Last month the B.C. coroner’s office issued an urgent warning after at least 11 people in the province died on one day, six in Vancouver’s Downtown Eastside. In B.C. there were 374 overdose deaths involving fentanyl detected between January and October 2016 — up 194 per cent over the previous year.

Fentanyl, often mixed by traffickers with heroin or cocaine, is up to 100 times more toxic than morphine. B.C. victims include addicts with jobs, families and children as well as those in Vancouver’s infamous “shooting gallery.”

“I don’t think anyone truly has the answer to the question why they are seeing so many deaths in Vancouver and we’re not yet seeing that situation here,” said Shaun Hopkins, manager of the Toronto Public Health’s “The Works” harm-reduction program, in an interview Thursday.

“By putting preventative measures in place and looking at this issue in a comprehensive way, hopefully we will not experience the kinds of deaths and situations they are seeing in Vancouver.”

There are signs in Toronto of increased fentanyl use, including a “bootleg” version — but nothing like the explosion seen out west.

Toronto paramedics used overdose-reversing drug naloxone 161 times last year, up from 110 in 2015. They caution that naloxone is also used for overdoses involving other drugs and at least part of that jump could be attributed to the fact that all paramedics now carry the antidote.

That figure may also underestimate fentanyl use because family members of addicts can get and administer naloxone themselves, averting overdoses that would not necessarily get recorded by emergency services.

Toronto police seized about three kilograms of fentanyl last year — up from 350 grams in 2015, but still a tiny fraction of all drug seizures.

“We’ve seen a change from primarily patches in 2015, with some pills primarily disguised as oxy(contin), but now we’re seeing more fentanyl powder in the last year,” said police Acting Insp. Steve Watts.

Toronto police track overdoses, and have recorded one involving fentanyl since starting to specifically look for that drug late last year, Watts said. However, police figures don’t capture overdoses when someone is privately transported to hospital.

While acknowledging patient confidentiality concerns, he said “it could be helpful, in terms of oversight of the problem, that we do more (information) sharing between public health, hospitals and the police.”

As well as real-time tracking of fentanyl and other narcotic deaths, the joint effort being launched Monday could prompt, or call for, wider public access to naloxone, new outreach efforts to drug users and improved treatment options.

One major step already in the works — three supervised injection sites approved by council — is in limbo awaiting federal approval, provincial funding of $1.8 million in annual operating costs and $350,000 in one-time renovation costs.

Ontario’s health ministry is “currently working with the city to review their (safe-injection) proposal,” Shae Greenfield, a spokesman for Health Minister Eric Hoskins, told the Star on Thursday.

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Tory, meanwhile, said, “I think we’ve done everything we need to do.

“I just hope (the province) takes a look at this and says ‘This is a very small amount to invest to save lives and to address a problem that is increasing in prevalence in our cities.’ When it comes to saving lives, what’s more important than that?”

The mayor got personally involved in the fentanyl response after reaching out to Vancouver Mayor Gregor Robertson to ask how Toronto could help with the crisis. Tory was told Canada’s biggest city should prepare for its own onslaught.

“I piggybacked on top of, and expanded, the group that was coming together to try to make sure we get, under the direction of Dr. Yaffe and Councillor (Joe) Cressy, questions and answers in advance of any type of dramatic fentanyl increase,” Tory said. “It will also help me be a much louder advocate on this.”

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