'It's upsetting': Finger-pointing, obfuscation as Vancouver Coastal Health fights hospital outbreak disclosure

Battle over hospital outbreak information B.C.'s two largest health authorities have actively fought disclosure around COVID-19 outbreaks in hospitals.

A year-long tug-of-war that included two freedom of information requests and a review from B.C.’s privacy watchdog has resulted in Vancouver Coastal Health producing some of the COVID-19 outbreak reports it repeatedly insisted did not exist.

Dozens of emails and recent conversations with bureaucrats involved resulted in finger-pointing suggesting internal confusion, obfuscation and a “need to know” attitude that has even health authority personnel confused and contradicting each other as to who’s responsible for what information gathered during a pandemic – if it’s even documented at all.

Staff at Vancouver Coastal Health’s privacy office claim that after repeated and extensive internal discussions and searches that didn’t result in any hospital outbreak documents, they were surprised that subsequent searches and prompting from CTV News produced material titled “COVID-19 Outbreak Reports” at Health Emergency Management BC, a government health agency that typically handles coordination for medical services during disasters.

“Is the health authority just phoning it in?” asked Freedom of Information and Privacy Association Executive Director, Jason Woywada. “They don't want to create the record so they're calling it in to HEMBC so they create the record and you're left making a request and being handed back and forth between the two because both are able to say they don't control the information.”

CTV News made multiple attempts to speak with a senior VCH medical health officer about how hospital outbreaks are handled and who holds the information, but the health authority stopped replying to emails and didn’t send a written statement either.

Hundreds of British Columbians have died and many more have fallen ill from COVID-19 infections likely acquired from hospitals, and though they’re no longer announced, outbreaks and transmission continue in the province’s acute care facilities where staff absentee rates remain high.

HEADACHES AND CONFUSION IN RESPONSE TO SIMPLE QUESTIONS

On May 28, 2021, CTV News asked Vancouver Coastal Health for outbreak reports in their acute care facilities to analyze the strategies public health was using to try and curb hospital-acquired infections and get insight into whether recurring mistakes or new issues were driving infections.

The health authority’s communications department ignored the initial request and a follow-up, prompting a request under the Freedom of Information and Privacy Act to produce the documents. A privacy staffer responded in mid-July that “we have not been able to find any records that are responsive to your request.”

In response to an identical request, Fraser Health’s FOI office took several months to respond, but ultimately provided some heavily-redacted outbreak reports for hospitals in October.

VCH continued to insist they had no “after action” reports of their own. The Office of the Information and Privacy commissioner looked into the matter and after extensive interviews determined there were no report. However, the OIPC suggested that there may be documents not titled “reports.”

When CTV News filed a fresh FOI request for all documentation and record-keeping including spreadsheets, standardized forms, memos, minutes and notes for Vancouver Coastal Health and Providence Health Care authorities, the privacy office responded that there were now too many records to search and we would need to be more specific.

WHO HAS THE REPORTS?

When VCH finally provided a massive PDF file of more than 500 pages on May 27, the very first page was on Vancouver Coastal Health letterhead and titled “COVID-19 Outbreak Report.” While they did not address all the Vancouver Coastal and none of the Providence Health outbreaks, it was something.

Staff at the VCH privacy office insisted that they had been unaware of the documents until CTV News suggested they consult HEMBC. They described a situation where the emergency management agency created and stored documents created for Vancouver Coastal Health, which did not have custody of them.

However, in a discussion with HEMBC on Tuesday, an official insisted the agency performed a secretariat role during the pandemic by documenting daily meetings and the records belonged to VCH as they were distributed to relevant personnel who could access them at any time; that was news to the privacy office.

“It’s pretty concerning, this whole dynamic of the shell game, the whole ‘who has what information, where?’ and failing to meet a duty to assist because they’re not even informing you someone else might have that record and be in control of it,” said Woywada.

“It's disappointing and it's upsetting because we expect public bodies are being transparent and we'll be able to understand the decisions they're reaching because they've been transparent with the information.”

Some B.C. hospitals were described as “near collapse” in the months that CTV News awaited the information about what was being done to keep patients and staff from getting sick.

THE FURTHER EROSION OF PUBLIC TRUST

When Fraser Health sanitized its outbreak reports by redacting nearly three-quarters of the pages, the details spread like wildfire and garnered widespread criticism that outstripped the few legible details it contained.

With the incomplete VCH outbreak reports, there are no conclusions about where or how the virus spread in hospitals but there are other relevant details. Infection Prevention and Control Teams swabbed multiple surfaces and found cause for concern in the earliest documents dealing with what would be a deadly outbreak at Lions Gate Hospital in North Vancouver.

But no other outbreaks appear to include swabbing and officials relied heavily on disinfecting surfaces and decluttering work and off-duty areas of hospitals through late 2021. There is no mention of investigating or mitigating airborne transmission of aerosolized COVID-19 particles. Mass testing of patients and staff happened only sometimes. In one case, officials declared an outbreak two days after the first case, but in others it took a week or longer before they did so and shut down transfers of other patients and restricted staff movements.

While that’s nothing particularly explosive, the year-long fight to withhold that information may have done more damage to the relationship between health authorities and the public than any concerns about further spooking prospective patients by discussing COVID-19 transmission in hospitals.

“You can't build trust without being transparent and without being accountable and on both these counts this government has actually really undermined trust,” said Green Party Leader, Sonia Furstenau, who has championed openness about COVID-19 data for nearly two years.

“The (internal government) culture has become very secretive with the lack of transparency, lack of accountability and it's up to Adrian Dix, the minister of health, to give the direction and to say 'we are resetting this culture, we are orienting ourselves to transparency, openness and a recognition that the public has a right to information related to healthcare in this province.”