Crisis forces Alberta public health leader out from shadows, even if he doubts 'urgency'

It took 10 months for the Danielle Smith government's replacement for Dr. Deena Hinshaw to speak publicly for the first time. Nearly a year on the job, and nine days into an E. coli outbreak that's sickened dozens of daycare-going children.

Tuesday was chief medical officer of health Dr. Mark Joffe's crisis-time debut, and what moment might Albertans remember from it? How the public health leader said there was no urgency to talk to them up to this point — not the sort of line you'll find in the crisis communications textbook.

This isn't the COVID public health emergency, and for so many reasons Joffe isn't Hinshaw, fired by Smith shortly after she became premier. But Albertans had come to expect a certain level of timeliness, thorough information-sharing and trust-building when it came time for public health leadership.

It's hard to make arguments that the public appetite for answers and context was satisfied in this first effort. 

Joffe and Health Minister Adriana LaGrange had spent a week leaving all communications to those at Alberta Health Services closer to the front lines of the rapidly growing emergency. The outbreak at several daycares which share a common kitchen has infected 264 people (mostly children), hospitalized more than two dozen and required six to go on dialysis, the treatment for kidney failure.

Finally taking to a news conference podium Tuesday, Joffe insisted he'd been engaged up until now getting daily updates from AHS, and had new information to share — a kitchen safety inspection report that found several critical violations, including cockroaches and improper sanitizing.

"At this point we felt it was prudent and appropriate for us to appear here and to speak to Albertans and to answer your questions," said the new CMOH (if he still counts as new after 10 quiet months).

"But we didn't feel there was urgency to do that up until this point."

Urgency?

LaGrange quickly took Joffe's place at the microphone after he said this. 

"Extremely serious case, I'm a mother myself, grandmother," she said. "Anyone who's had to sit at the bedside of a really sick child knows how devastating this is."

Then, she attempted to further blot out Joffe's words.

"I believe what Dr. Joffe meant was that it was urgent from the very very beginning, and it continues to be urgent until every single one of those children are home and safe with their families and progressing well."

Hours later, Alberta Health communicators sent reporters a clarification statement in Joffe's name: "The issue has been addressed with urgency from the very start. As the chief medical officer of health, my priority has been on the health and well-being of the children impacted, and the progress of the investigation."

The clarification concluded: "The priority was first and foremost getting people looked after and then to provide the public with a fulsome update on the situation."

WATCH | Dr. Mark Joffe, chief medical officer of health, speaks to reporters

Alberta health minister, CMOH address why they didn’t publicly comment until a week after outbreak

1 year ago

Duration 3:51

There was a media conference on the E. coli outbreak in Calgary Tuesday.

It's not clear what "fulsome update" has been provided, with health officials still unable to pinpoint what the source of E. coli bacteria was (investigations into kitchen items and daycare leftovers are ongoing).

It appears the new information Joffe and LaGrange had to share was AHS' problematic food safety report from Sept. 5. The doctor himself stressed that while it's a "flag" for potential problems at the kitchen, it may offer no direct links to whatever sickened the many little lunchers and snackers it served.

Another new input arrived Monday — criticism from André Picard, the veteran health columnist for the Globe and Mail. "Despite the magnitude of this problem, we have yet to hear a peep from Alberta's chief medical officer of health, who is (checks notes) Dr. Mark Joffe," Picard wrote.

"We didn't really need another brutal reminder of the eviscerated state of public health in this country, and politicians' indifference to it, but here we have it."

One day later, Joffe and the politicians emerged. When speaking about the outbreak, Children's Services Minister Searle Turton mispronounced it "E. co-lee" rather than "coal-eye."

Public health, public communication

We learned plenty about a CMOH's role during the coronavirus pandemic, and so much of it involves regular communication with the public, sharing helpful safety information, and constant monitoring and understanding of emerging problems.

On that last point, Joffe's debut had another bump. In one of his news conference answers about the Fueling Minds kitchen inspection he shared incorrect information. "What I have been advised is that the violations that were found typically were different from one inspection to the next," he said. "And that there were no critical violations during the earlier investigations or inspections, and that only the most recent inspection has had critical violations that were flagged."

A public health official who was more abreast of the situation may have done as reporters were doing in real time — looked at those inspection reports. In the last seven AHS investigations going back to February 2022, Fueling Minds had critical violations. It had been flagged for repeat violations on equipment sanitation, and this April, inspectors found problems with the same ammonia sanitizer as they did after closure this month.

Joffe could have also shared the publicly available information about new inspections at the Fueling Brains daycares at the centre of this situation. Two of its locations were flagged for not taking the temperature of cold food items, and a third was found to be improperly sanitizing common surface areas (a vital thing to do at the petri dishes known as child-care facilities).

While he has a medical background in infectious diseases, Joffe is not trained in the communications-intensive field of public health specifically.

The Smith government plucked him from AHS's executive ranks in November to fill Hinshaw's role, rather than hiring any of the hospital superagency's many public health officers.

And it's not clear what expertise is supporting him at Alberta Health. Hinshaw's two deputy chiefs both resigned in the wake of her firing, and no replacements have been found despite repeated job postings, the most recent one last Wednesday.

One suspects this will not be the last time Albertans hear from Joffe and LaGrange on this front, despite the clarifications needed after this outing. The number of infected children hasn't stopped rising, Alberta Children's Hospital still has 25 patients sick with daycare-borne E. coli, and AHS investigators are still trying to pinpoint which food item the kids were fed caused the severe illness.

And other issues may warrant the top public health official's attention, and public communication. It's unclear if COVID's new variant will surge this fall, and neighbouring British Columbia began treating its opioid and toxic drug crisis as a public health emergency seven years ago, well before the overdose and death rate reached the level of urgency it's now at in Alberta.

There's that word again. Joffe will likely be careful how he wields it in future public appearances, but he might now have a better understanding of how the term figures into his role.