Right to know: Identifying quarantine hotels in five communities challenges Sask. health privacy laws

It's a list that no one wants to talk about.

According to Saskatchewan's Ministry of Social Services, 390 people isolated for 14-day stints in five hotels in Regina, Saskatoon, Prince Albert, North Battleford and La Ronge between April 7 and the end of September.

These people were required to isolate due a COVID-19 diagnosis, symptoms or exposure, but did not have the means to do so. They accessed an "assisted self-isolation hotel stay" through social services, the Saskatchewan Health Authority and the Canadian Red Cross.

Neither the government nor the Red Cross will identify the hotels. 

"To protect the privacy of the individuals being supported in the self-isolation hotels, we're not able to provide that information," said Chad Ryan, executive director of program support with the Ministry of Social Services.

Providing for the needs of people who don't have the means to self-isolate is testing the province's privacy laws when it comes to releasing health information. Should the general public know, for instance, that a specific hotel is actively quarantining people?

"There's specific legislation dealing with the disclosure of health-related information by the government and health trustees," said Saskatoon lawyer Andrew Mason.

"In that legislation there is a balance that must be struck between the right of individuals to have their health information protected and the obligation of government to protect public health."

Stepping up

Jim Bence, head of the Saskatchewan Hotel and Hospitality Association, said the province's hotel industry knew back in March that its members were going to play a role in managing the fallout from COVID-19.

They looked at Europe and saw how the virus had overwhelmed the health-care system in Italy.

"We took the position of supporting health care by way of creating an emergency preparedness plan," he said.

"We had lots of empty floors that we could section off. So we thought we had a pretty good plan in which we could free up bed space in hospitals prior to them perhaps reaching capacity."

The association began working with Saskatchewan Health and the Red Cross to develop protocols that would allow hotels to safely quarantine people. This involved changing how the hotels ran their day-to-day operations, covering everything from how bed sheets are changed daily to separating those isolating from other guests.

Pandemic protocols

Guidelines apply to all hotels and motels where people may be self-isolating. They recognize that the five hotels are not the only facilities where this might be happening.

For instance, someone coming from out-of-province may need a place to isolate.

The guidelines are as follows:

• Regular housekeeping services should not be provided to rooms where individuals are isolating. Advise staff to leave linens, toiletries, cleaning supplies (including garbage bags) and food/meals outside the door. Staff should not enter these rooms.
• Staff should wear disposable gloves and wash their hands with soap and water or an alcohol-based hand sanitizer approved by Health Canada after handling soiled items from rooms (e.g. linens, tableware and garbage bags).
• Clothing and fabric items should be washed and dried in mechanical laundry machines at the hottest settings possible.
• Steam cleaning can be used for areas that may be contaminated, but cannot be laundered (e.g. armchairs).
• In a commercial dishwasher, properly wash and sanitize any reusable glassware or dishes in rooms between guests. Or, consider providing disposable dishes and utensils in rooms.
• If possible, isolate guests in rooms with an independent HVAC unit.
• Guests who are in isolation must not enter common areas of the hotel.
•  After guests are done isolating in a room, staff should thoroughly clean and disinfect all surfaces that may be contaminated, including laundering all clothing and fabric items.
• Hotel management should share the latest travel advisories and isolation recommendations with staff and guests.

Balancing interests

The Red Cross fits into the equation because of its volunteer base.

"We have a large group of volunteers that have been working very hard since this started," said communications manager Roxanne Beaubien.

"They're providing registration services, doing daily wellness checks with those people who are isolating to make sure that they're doing OK, as well as providing basic needs such as food and personal hygiene products."

Andrew Mason said the degree to which the government shares personal health information may turn on the individual's circumstances.

The tipping point could be someone who has tested positive for COVID-19 yet continues to behave in a manner that threatens the health of others.

"So, for example, if you had a person who was contagious, had a very contagious disease and was known to the health authorities not taking adequate steps to prevent the spread of that contagion, they could publicize that person's health circumstances," he said. 

"With respect to the identification of hotels in which people who are who are unable to quarantine in their homes and are put up at public expense, that probably represents a small fraction of the total number of people who are self quarantining."