Does COVID-19 spread in a hospital mean there's an outbreak? Not anymore, says B.C. health ministry

Several B.C. hospitals and long term care facilities have seen a spike in COVID-19 cases recently according to the provincial health ministry, but these cases are not being named or reported publicly. 

In a response to questions from CBC about COVID-19 outbreak declarations at acute care and long-term care facilities, the B.C. ministry of health confirmed that in some cases an outbreak is no longer reported even when there is a spike in cases due to spread at the hospital or care home.

Instead, "enhanced measures" are put in place without alerting the public.

As of Sept. 11, the ministry said there are two acute care or long term care facilities on Vancouver Island and one in the Northern health region that have "enhanced measures" in place. In addition, the ministry said enhanced measures were ended for two sites on Vancouver Island on Sept. 11. They did not name the sites or locations.

These questions were raised after health-care workers at a Vancouver Island hospital sounded the alarm about over a dozen cases of the pandemic virus that were transmitted in hospital. 

An email from an Island Health medical director seen by CBC said they did not declare an outbreak at Saanich Peninsula Hospital — where the majority of patients are elderly and therefore more vulnerable to the virus — despite known spread due to "negative connotations to the public ... media attention, possible patient shunting to [other local hospital] beds, and closing of all admissions to the affected units."

According to the statement from the B.C. health ministry, "enhanced monitoring and infection prevention and control measures to prevent further transmission of COVID-19 are considered in some non-outbreak circumstances, such as when:

• Severity of illness amongst vaccinated patients/residents suggests circulation of a variant that causes more severe illness.
• A facility has low COVID-19 vaccination coverage among patients/residents.
• There is an increased number of COVID-19 cases on the unit."

The ministry also did not say whether they would publicly report which facilities have enhanced measures in place due to COVID-19 going forward. 

Even without including sites with enhanced measures, the BC Centre for Disease Control's latest report shows a spike in COVID-19 outbreaks at acute care facilities as of Aug. 27 compared to the summer, though numbers are much lower than August of last year.

There were 241 confirmed cases of people hospitalized with COVID-19 in B.C. as of Sept. 7 — nearly five times the number of cases in hospital at the start of August. Though testing is limited, BCCDC data shows the percentage of COVID-19 tests turning up positive is the highest it has been since April, at 17.9 per cent. COVID-19 hospitalizations are also on the rise across Canada.

Without a public outbreak declaration, health-care workers said, neither patients nor staff are fully aware of the situation.

"The measures to control the spread of [the virus] that should happen as a result of enhanced measures don't get instituted as fully as they would if the term 'outbreak' was used," said Dr. Jeff Unger, an emergency room physician at Saanich Peninsula Hospital, in an interview with CBC News last week. 

Fall vaccine campaign coming

The B.C. health ministry said they are working on updating viral respiratory illness outbreak guidance for this year, with help from public health, infection prevention and control, and workplace health experts. 

The province's health minister, Adrian Dix, told reporters on Tuesday that he and provincial health officer Dr. Bonnie Henry will be rolling out their fall vaccine campaign within the next 10 days, after Health Canada approved Moderna's latest vaccine — a monovalent mRNA shot that targets the Omicron XBB.1.5 subvariant that is currently circulating. 

People most vulnerable to COVID-19, like people with underlying medical conditions, those who live in congregate settings, seniors, and health-care workers, will be prioritized to get the shot first, Dix said.

"COVID-19 affects people in often profound and lasting ways, and we have to respond with a program of vaccination and encourage everyone to be involved," Dix said. 

WATCH | Masks make a comeback at federal COVID-19 briefing: 

Why federal health officials wore masks at their latest COVID-19 briefing

1 year ago

Duration 0:45

Several federal health officials wore masks at their Tuesday technical briefing on updated COVID-19 vaccines. Chief Public Health Officer Dr. Theresa Tam explains why they've brought them back.

Neither the health minister nor the ministry would comment on whether they plan to reinstate a mask mandate for health-care workers in response to rising hospitalizations. 

Several hospitals in Ontario have tightened their mask rules in response to rising COVID-19, as have some schools and hospitals in the U.S.

"We haven't seen a significant increase in COVID-19 hospitalizations, at least not yet," said Dr. Don Sin, a respirologist at St. Paul's Hospital in Vancouver. "If there is an uptick in transmissions at St. Paul's or other healthcare facilities, policies should reflect that and possibly the mandates need to come back."

The lack of a public mask mandate at the moment is the right call, according to Sin, who said staff at St. Paul's are largely still wearing masks and isolating COVID-19 patients in specific wards. 

"As we approach the fall and as we see some increase in COVID-19, I would strongly advise my patients and others with respiratory comorbidities to get their COVID shots, flu shots, and other vaccinations, and consider masking when going into a densely populated settings," Sin said. 

While announcing the Moderna vaccine approval on Tuesday, several federal health officials, including Chief Public Health Officer Dr. Theresa Tam, sported N95 masks. 

"I do think now is the time to get your masks ready, if you don't already have them," Tam said.

"In our own particular context ... in our area, there's been an uptick in some of the COVID-19 indicators. For me, personally, there have been cases around, even my work colleagues, so that's one of the reasons why we're wearing masks today."

Tam's office shared several recommendations to reduce the spread of respiratory viruses on X, formerly known as Twitter, including staying home when sick, wearing a mask in indoor public settings, and improving ventilation by opening a door or window. 

For their part, the B.C. health ministry said they would be sharing specific guidance for respiratory illness season in the coming weeks. 

"For example, we will be encouraging people to keep their hands clean and to stay away from others when they're sick," reads the statement.