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Mourners attend a makeshift memorial a day after a van struck multiple people along a major intersection in north Toronto, April 24, 2018.CARLO ALLEGRI/Reuters

From corporate offices to hospital hallways to police headquarters, a massive effort to counsel first responders and comfort the grieving is unfolding across Toronto as the city comes to grips with Monday’s deadly van rampage.

The attack that killed 10 people and injured 14 is unprecedented in Toronto for the sheer number of people it affected: Forty-six paramedics and command staff who responded to the scene; dozens of medical staff at three hospitals; and an untold number of bystanders who watched as the white rental van tore a lethal path across the Yonge Street sidewalk.

The counselling response is equally unprecedented.

At Capital One Canada, where about 600 employees work in two towers overlooking the attack scene, employees gathered in the cafeteria Wednesday to share their stories before heading to Mel Lastman Square to lay 400 roses to commemorate those who died or were injured.

The company has two human-resources staff who are also trained grief counsellors and had them set up in a conference room within an hour and a half of the attack to offer help. They also brought in an external grief counsellor within two hours.

In addition to an e-mail, employees received texts that allowed them to ask for help via a cellphone with the touch of a button, said Shane Holdaway, the president of Capital One Canada.

His employees use the stretch of sidewalk where the attack took place every day, walking between the two offices or heading out to lunch. By some miracle, none of his workers were hurt or killed. He did see some of his people giving CPR in the immediate aftermath.

“We could see right out our window, not to be graphic, a pretty horrific scene,” Mr. Holdaway said in an interview.

“Some of the images, like someone’s shoes that have been knocked off, that is never going to be erased from my memory.”

Toronto police have been urging witnesses such as the Capital One employees to seek help if they are reeling from what they have seen or experienced.

Chief Mark Saunders told reporters this week that anyone – including witnesses, families and friends of victims – can call the 24-hour non-profit Victim Services line to seek help.

“I don’t want anybody to feel like there is nowhere to go,” Chief Saunders said. “That hotline is there to provide a starting point for those people who will need that help.”

When someone calls the line, they will be connected with one of the 11 staff crisis counsellors or 200 trained volunteers with Victim Services Toronto, which is an independent non-profit that operates out of police headquarters.

Bonnie Levine, the service’s executive director, says her team usually provides counselling and other help, including financial assistance, to victims of all manner of crimes and takes about 50 to 60 calls a day. Since Monday, she said, they have taken hundreds of calls related to the Yonge Street attack – plus many more calls than they can count from people offering to help.

The delay in positively identifying the dead has been particularly difficult for the families, she said, describing them as “frantic” for information. Ontario’s Chief Coroner said Tuesday that the sheer number of victims means they need to use dental X-rays, fingerprints and possibly DNA before positively identifying any of the bodies, a process that could take a number of days.

At Sunnybrook Health Sciences Centre, the major trauma centre that cared for 10 of the victims, crisis-intervention specialists were on site Tuesday and Wednesday.

Counsellors held open-door sessions for health-care workers and visited the critical-care and emergency departments to offer “targeted sessions” to the nurses and doctors on the front lines of the response.

But Marilyn Reddick, Sunnybrook’s vice-president of human resources, organizational development and leadership, said staff are taking the most solace in debriefings with their own colleagues.

“Those [meetings] are the kind of situations that, I think, make them the most comfortable to share and talk among themselves,” Ms. Reddick said. “I find that staff are watching each other. If they see someone that just looks a bit weary, they will go over and give them a hug and talk to them. We find that’s far more effective than having external counsellors.”

Siobhan Carlin, an advanced care paramedic who responded to Monday’s attack, also underlined the importance of paramedics supporting one another.

She is part of the Toronto Paramedic Services’ peer resource team, which immediately dispatched members to the hospital ambulance bays on Monday to help paramedics cope.

“We all are in the trenches together. Sometimes it’s nice to be able to turn to a peer and just say, ‘Wow, that was really difficult,’” she said, adding that a staff psychologist has also been made available to paramedics who need further counselling.

The Toronto District School Board, whose head office is near the attack scene, offered principals and teachers resources to help students distressed about the attack, and access to counselling services.

Seneca College offered counselling for its staff and students. The school was doubly affected by the tragedy: The alleged van driver and one of the people killed in the attack both studied at the school.

As Toronto grieves, other cities that have experienced large, public tragedies have lessons to offer.

In Las Vegas, where 58 people were killed and hundreds injured when a gunman opened fire at an outdoor music festival last October, some witnesses and survivors have only now begun to recover emotionally.

Monique Cox, a Las Vegas therapist, said that when the shock was fresh, some of her clients could barely speak. Even people on the periphery of the tragedy – a hotel worker who was almost trampled by fleeing festival goers, a man who watched the carnage unfold from his car – sought help in the aftermath.

Flowers, candles, and messages of sympathy are appearing at the scene of Monday's deadly van attack along Yonge Street.

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