Lloydminster Hospital outbreak should have been made public sooner: Sask. Health Authority CEO

The Saskatchewan Health Authority says it should have notified the public sooner about an outbreak at the Lloydminster Hospital, which was not announced for days after it was declared internally.

"We are reviewing this situation and we will be coming forward with improvements to support our [medical health officers] and communications through the outbreak notification process," Scott Livingstone, the health authority's CEO, said in a statement Friday.

The outbreak of 13 cases was announced Wednesday afternoon, three days after it was declared internally, according to the medical health officer for Lloydminster. Premier Scott Moe said he was also notified Wednesday morning. The mayor of Lloydminster, Gerald Aalbers, was not told about the outbreak until it was released publicly on Wednesday afternoon. 

"This is not the way the SHA wants to work with our partners, like, communities, the mayor of Lloydminster, or councilmen, or anyone in the community," said Livingstone, who elaborated on his statement in a news conference Friday. 

"I do think we have, I wouldn't say broken our trust, but I think we have unknowingly raised the anxiety in that community and we will do our very, very best in the future for this not to happen again and certainly to rebuild those relationships locally in Lloyd."

Five health care workers and eight patients were infected through transmission at the hospital. Five more cases have been confirmed in Lloydminster since Wednesday, but it is not clear if they are linked to the hospital. 

Dr. Mandiangu Nsungu, the medical health officer for the Saskatchewan Health Authority's northern region, which includes Lloydminster, said in a news conference on Wednesday that the Ministry of Health was notified of the outbreak on Sunday. He said the outbreak was declared that day.

The SHA now says the Ministry of Health was notified on Monday. 

Livingstone said it is up to the local medical health officer, such as Dr. Nsungu, to notify the public "in co-operation with SHA." He emphasized that the communication issue was not the fault of Dr. Nsungu or other staff in Lloydminster.

"It is clear that as a health system we need stronger processes to support them in their decision-making around the public disclosure process."

On Thursday, Premier Moe deferred questions about why the outbreak was not announced earlier to Livingstone. Moe said there was a challenge in the "flow of information."

CBC requested an interview with Livingstone. He released his statement on Friday. 

SHA apologizes for information error

"To clarify the statement made by Dr. Nsungu at Wednesday's news conference, the official notification to Ministry of Health of an outbreak at Lloydminster Hospital occurred at 6 p.m. Monday," Livingstone said in the written statement. 

"We apologize for the error." 

He said that in the two days before the ministry was notified, Dr. Nsungu had meetings with local SHA leadership, along with the Northern Integrated Health Incident Command Centre leadership, about the cases at Lloydminster Hospital.

At that time, the public was still unaware of the outbreak. 

"Given the scale of the cluster and the number of staff already on isolation, initial efforts focused on the strategies to maintain adequate staffing levels and determine if service adjustments were required," said Livingstone. 

"While we do not believe there was any additional risk created for staff or public because of the delay in the public notification, we do recognize that it should have occurred sooner than the public health alert issued on Wednesday."

Livingstone said the SHA's outbreak notification process is built on the model designed to handle influenza outbreaks, but COVID-19 has different requirements and there is more public interest.

He said influenza outbreaks are not escalated to a provincial level and there are no public notices. 

Premier Moe said Thursday his government is working to ensure Health Minister Jim Reiter and the public have access to information in a timely manner.  

"I think there's a responsibility for … all of us, including the Saskatchewan Health Authority, to be as transparent as possible with the people of this province," Moe said at a news conference on Thursday.

"In particular now that we are beyond one and maybe two cases of COVID ... in many of these communities."

'Need to reflect on what we could improve'

The president of the Saskatchewan Union of Nurses, Tracy Zambory, said Thursday that more than 40 hospital staff are now self-isolating due to the outbreak. She said a call was issued for workers to backfill those who are off work. 

Livingstone thanked Dr. Nsungu and other health workers in the Lloydminster area for their work to contain the virus.  

"While we need to reflect on what we could improve in a situation like this, we need to recognize that these same leaders are under immense pressure as a result of the pandemic and need our support for the excellent health care they deliver every day," he said.

Another outbreak was declared at the Victoria Hospital in Prince Albert on Friday. A single case was confirmed on Thursday and announced to the public on Friday. 

While only one patient at the hospital has tested positive and there are no signs of transmission within the facility, an outbreak was declared because the patient was in the hospital for 10 days before testing positive.

A total of 39 cases of COVID-19 have been reported in Lloydminster, including two announced Friday.