The B.C. Ministry of Health waited three days to notify the public about B.C.’s first monkeypox case last year.
Email released under freedom of information, after more than a year-long delay, included a message at 5:23 p.m. on June 3, 2022 from deputy provincial health officer Dr. Réka Gustafson to provincial health officer Dr. Bonnie Henry and Vancouver Coastal Health chief medical officer Dr. Patricia Daly.
“Please find attached a draft information bulletin that we thought we would send out on Monday,” Gustafson wrote.
The headline said “first monkeypox case detected in B.C.”
The previous day, June 2, 2022, a medical microbiologist at the B.C. Centre for Disease Control (BCCDC) forwarded an email from a doctor titled “monkeypox suspected case.”
Dr. Victor Leung said the patient’s symptoms included fever, chills, tinnitus, dizziness, night sweats and a sore throat. The 54-year-old Vancouverite, who had visited Montreal, had been notified at 2 a.m. by one of his sexual contacts that he had tested positive.
The email said the patient was isolating at home after Leung, two registered nurses and one phlebotomist had seen him. Leung reported that they took various nasal, oral, urine and blood samples from the man while following strict contact/droplet/airborne personal protective equipment protocol.
BCCDC epidemiologist Dr. Danuta Skowronski was concerned that the patient’s personal information may have been compromised because of email shared with the Ministry of Health. “I suggest everyone now delete the messages containing this information, unless required,” Skowronski wrote.
“The .gov email addresses are indeed behind the firewall now so that is no longer an issue,” Henry responded. “But of course a reminder to treat confidential information carefully is always good.”
Catherine Hogan, a medical microbiologist with the BCCDC, provided an update before 6 p.m., with a caution that BCCDC testing was “unvalidated and preliminary given have not previously had positive cases.”
Then, just over a half-hour later, she called the initial results “compelling.”
“Seven of the eight tested samples are positive for monkeypox. Interestingly, we also received notice that the patient has in the meantime developed vesicular lesions (or fluid-filled blisters),” Hogan wrote.
On the morning of June 3, 2022, Ministry of Health communications director Clay Suddaby asked Henry if she had been advised of the confirmed case and told her that the Provincial Health Services Authority was working on an information note. Henry confirmed she had been in touch with Minister Adrian Dix about the situation.
“Not yet officially confirmed as that requires testing at [the national microbiology laboratory],” Henry said. "But yes I know the details and am happy to talk to it if needed. I expect we won't get confirmation until next week. I have updated the Minister as well.”
“If it's not yet fully confirmed then I don't think we need to make a statement or do media unless approached,” Suddaby wrote.
The approach happened June 6 at 7:14 a.m., when a CBC reporter emailed government communications asking about the first case. That unleashed a flurry of activity involving multiple officials from BCCDC, the Ministry and Government Communications and Public Engagement before they issued the news release that Gustafson had drafted three days earlier.
Confirmation was still pending from the national microbiology lab, but the key messages list said the risk to the public was very low and the disease was spread “through contact with sores and items with the virus on them. It can also spread through respiratory droplets during prolonged close contact.”
According to the BCCDC website, there have been 199 confirmed cases of monkeypox in B.C., 159 of them in the Vancouver Coastal Health region. The 2022 outbreak was declared over Jan. 9, 2023 and most cases stemmed from close, intimate contact during sex. A vaccine, called Imvamune, is available to close contacts and those at highest risk.
It is not the first time that the Ministry of Health has delayed telling the public about a spreading disease. On Christmas Day in 2021, the BCCDC lab confirmed the U.K. variant of COVID-19 had been detected in B.C., but the announcement was not made until the day after Boxing Day.
In the 2007 final report of Ontario’s SARS Commission, Judge Archie Campbell recommended public health officials adopt the precautionary principle, to prevent potentially fatal delays.
“The importance of the precautionary principle that reasonable efforts to reduce risk need not await scientific proof was demonstrated over and over during SARS,” said the report.
B.C.’s Freedom of Information and Protection of Privacy Act contains a public interest override clause, that requires a public body to disclose to the public information, without delay, about the risk of significant harm to the health or safety of the public.
A reporter paid the $10 application fee on June 7, 2022, seeking documents about the spread of monkeypox to B.C. The file was finally disclosed last week, after a complaint to the Office of the Information and Privacy Commissioner. The FOI law contains no penalty for a public body that disobeys disclosure deadlines.
In the most-recent thee-year report card on timeliness of FOI disclosures, Information and Privacy Commissioner Michael McEvoy reported in September 2020 that the Ministry of Health was one of the worst performers. Its on-time score fell from 74 to 55 since 2017 and average processing times increased from 51 business days to 65. The Ministry of Health boasts the government’s biggest budget at $28.67 billion this year.
