Story by Jason Markusoff • CBC
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."
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."
Related video: Alberta health minister, CMOH address why they didn’t publicly comment until a week after outbreak (cbc.ca) Duration 3:51 View on Watch
cbc.caSevere cases of E.coli on the rise
2:03
The Canadian Press Health violations found after E. coli outbreak
2:14
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."
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."
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.
As of Tuesday, 25 children were at Alberta Children's Hospital due to the E. coli outbreak, and six were on dialysis to help their kidneys function. (Alberta Children's Hospital)© Alberta Children's Hospital
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.
Cockroaches, previous violations at kitchen used by Calgary daycares as E. coli outbreak toll climbs to 264
Story by Jade Markus • CBC
Alberta health inspectors have disclosed they found major health issues, including cockroach infestations and unsafe food handling, at a shared kitchen used by several daycares hit by a widespread E. coli outbreak.
This comes after an outbreak of the shiga toxin-producing E. coli, which can cause serious issues. The outbreak has sent children to hospital and some are on dialysis after developing hemolytic uremic syndrome, a disease which affects the kidneys.
At a press conference Tuesday, Dr. Mark Joffe, the province's chief medical officer of health, said the kitchen inspection came after a noticeable increase in young children coming to the emergency departments over the September long weekend.
"The emergency department physicians were very astute and quickly recognized that something unusual was happening and they reached out to the medical officer of health on call and to the team," Joffe said.
"From there it was quickly determined that the cases that they were seeing were linked to daycare centres and, in turn, those daycare centres were linked to one centralized kitchen."
Since then, there have been 264 lab-confirmed cases of E. coli connected to the outbreak. The cause of the outbreak has not yet been determined and remains under investigation.
In an environmental inspection report of the kitchen at KidsU Centennial - Fueling Minds Inc., AHS detailed "significant evidence of a pest infestation" at the food establishment on Sept. 5, the date of the inspection, which happened the day after the outbreak was declared.
"Two live adult cockroaches were observed on the sides of stainless steel equipment around the dishwashing area. The tin cat traps by the two separate two-compartment sinks had at least 20 cockroaches on the sticky pads each," the report read.
AHS said the inspection also found instances of food not being handled in a manner that makes it safe to eat, and a lack of appropriate equipment for keeping food cold during transportation.
In total, inspectors found three critical violations and two non-critical violations related to an odour and utensil storage.
The report shows other violations cited on a number of dates ahead of the September inspection.
Joffe said the kitchen is closed and will only reopen once AHS has determined that it is safe.
He added that Alberta Health Services conducts more than 40,000 inspections a year — and it is unusual to have a completely clean inspection.
Prior to the closure, he said, the facility had last been inspected in April. Two infractions were found at that time, and they were corrected. By the end of April, there were no violations in the kitchen, he said.
In a statement to CBC News late Tuesday afternoon, Kent Hehr, vice president of Fueling Brains, said their daycares source food from Fueling Minds, a catering company which also provides food to other daycare centres.
Hehr said that Fueling Minds' kitchen is supervised by a Red Seal chef. While Fueling Brains and Fueling Minds share "similar ownership," Hehr said they are independent entities.
"While the kitchen remains closed, all food will be sourced by external providers," the statement reads.
Hehr added that Fueling Brains took immediate action to shut down affected daycares and communicate with parents when they were notified of the outbreak by AHS on Sept. 4.
"Communicating with our families has been our priority and we have been sending out daily parent and staff messages to help keep our community informed and safe. Throughout this process, we have remained transparent, cooperative, and have taken immediate action wherever possible."
There are currently 25 patients receiving care in hospital, the province said in an emailed media release — 22 of whom are confirmed as having hemolytic uremic syndrome, which is a severe illness caused by E. coli infection.
Six patients are receiving peritoneal dialysis at Alberta Children's Hospital. The children with severe illness are all in stable condition and are receiving the care they need in hospital. Other children and families are receiving care and support at three outpatient clinics set up in Calgary hospitals.
When asked why he and Alberta's minister of health didn't comment on the outbreak sooner, Joffe said he had been following the daily communications from AHS closely.
"We didn't feel that there was urgency to do that up until this point," he said.
In an email sent after the press conference, Joffe issued a clarifying statement regarding that comment.
"This 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 priority was first and foremost getting people looked after and then to provide the public with a fulsome update on the situation."
Alberta Health Minister Adriana LaGrange said she has received daily updates on the situation, but didn't comment publicly as she's been monitoring AHS and "wanting to really make sure that AHS was focused on what they needed to do."
Katie McLean's daughter, who is almost two years old, attended Fueling Brains McKnight, one of the affected locations, and was recently released from Alberta Children's Hospital after being sick with E. coli. McLean said the report released by AHS was "disgusting" and "hard to imagine."
She said she understands that inspections happen and violations are corrected, but said the lack of appropriate equipment for keeping food cold during transportation was the most egregious part.
Dr. Mark Joffe, Alberta's chief medical officer of health, provides an update to the media about an outbreak of E. coli in Calgary daycares while Health Minister Adriana LaGrange, third from left, looks on. Alberta Health Services says the number of people affected has continued to climb to 264. (Colin Hall/CBC)© Provided by cbc.ca
"If your entire business is transporting food to children, their entire business is catering, why would you not have the safety pieces in place to make sure that that food is safely delivered?"
"It just makes me absolutely sick. I can hardly talk about it without crying. It's so hard to imagine my little girl eating at the daycare — so innocent and not knowing that she was at risk."
Eleven child-care facilities were closed as part of the outbreak investigation.
AHS has since rescinded the closure orders for four facilities — Little Oak Early Education, Almond Branch, Braineer Academy and Fueling Brains Bridgeland — as no one from those sites has tested positive, and public health inspectors have ensured that the sites have taken appropriate measures such as cleaning and disinfection.
The Canadian Food Inspection Agency said it is providing support as the source is investigated.
On Tuesday, the Alberta NDP called for a full inquiry into the outbreak.
"When we do discover the source of that outbreak, we need to move immediately to a full and public inquiry into how this food handling site was left uninspected for months," Alberta NDP Leader Rachel Notley said in a statement.
Story by Jade Markus • CBC
Alberta health inspectors have disclosed they found major health issues, including cockroach infestations and unsafe food handling, at a shared kitchen used by several daycares hit by a widespread E. coli outbreak.
This comes after an outbreak of the shiga toxin-producing E. coli, which can cause serious issues. The outbreak has sent children to hospital and some are on dialysis after developing hemolytic uremic syndrome, a disease which affects the kidneys.
At a press conference Tuesday, Dr. Mark Joffe, the province's chief medical officer of health, said the kitchen inspection came after a noticeable increase in young children coming to the emergency departments over the September long weekend.
"The emergency department physicians were very astute and quickly recognized that something unusual was happening and they reached out to the medical officer of health on call and to the team," Joffe said.
"From there it was quickly determined that the cases that they were seeing were linked to daycare centres and, in turn, those daycare centres were linked to one centralized kitchen."
Since then, there have been 264 lab-confirmed cases of E. coli connected to the outbreak. The cause of the outbreak has not yet been determined and remains under investigation.
In an environmental inspection report of the kitchen at KidsU Centennial - Fueling Minds Inc., AHS detailed "significant evidence of a pest infestation" at the food establishment on Sept. 5, the date of the inspection, which happened the day after the outbreak was declared.
"Two live adult cockroaches were observed on the sides of stainless steel equipment around the dishwashing area. The tin cat traps by the two separate two-compartment sinks had at least 20 cockroaches on the sticky pads each," the report read.
AHS said the inspection also found instances of food not being handled in a manner that makes it safe to eat, and a lack of appropriate equipment for keeping food cold during transportation.
In total, inspectors found three critical violations and two non-critical violations related to an odour and utensil storage.
The report shows other violations cited on a number of dates ahead of the September inspection.
Joffe said the kitchen is closed and will only reopen once AHS has determined that it is safe.
He added that Alberta Health Services conducts more than 40,000 inspections a year — and it is unusual to have a completely clean inspection.
Prior to the closure, he said, the facility had last been inspected in April. Two infractions were found at that time, and they were corrected. By the end of April, there were no violations in the kitchen, he said.
In a statement to CBC News late Tuesday afternoon, Kent Hehr, vice president of Fueling Brains, said their daycares source food from Fueling Minds, a catering company which also provides food to other daycare centres.
Hehr said that Fueling Minds' kitchen is supervised by a Red Seal chef. While Fueling Brains and Fueling Minds share "similar ownership," Hehr said they are independent entities.
"While the kitchen remains closed, all food will be sourced by external providers," the statement reads.
Hehr added that Fueling Brains took immediate action to shut down affected daycares and communicate with parents when they were notified of the outbreak by AHS on Sept. 4.
"Communicating with our families has been our priority and we have been sending out daily parent and staff messages to help keep our community informed and safe. Throughout this process, we have remained transparent, cooperative, and have taken immediate action wherever possible."
There are currently 25 patients receiving care in hospital, the province said in an emailed media release — 22 of whom are confirmed as having hemolytic uremic syndrome, which is a severe illness caused by E. coli infection.
Six patients are receiving peritoneal dialysis at Alberta Children's Hospital. The children with severe illness are all in stable condition and are receiving the care they need in hospital. Other children and families are receiving care and support at three outpatient clinics set up in Calgary hospitals.
When asked why he and Alberta's minister of health didn't comment on the outbreak sooner, Joffe said he had been following the daily communications from AHS closely.
"We didn't feel that there was urgency to do that up until this point," he said.
In an email sent after the press conference, Joffe issued a clarifying statement regarding that comment.
"This 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 priority was first and foremost getting people looked after and then to provide the public with a fulsome update on the situation."
Alberta Health Minister Adriana LaGrange said she has received daily updates on the situation, but didn't comment publicly as she's been monitoring AHS and "wanting to really make sure that AHS was focused on what they needed to do."
Katie McLean's daughter, who is almost two years old, attended Fueling Brains McKnight, one of the affected locations, and was recently released from Alberta Children's Hospital after being sick with E. coli. McLean said the report released by AHS was "disgusting" and "hard to imagine."
She said she understands that inspections happen and violations are corrected, but said the lack of appropriate equipment for keeping food cold during transportation was the most egregious part.
Dr. Mark Joffe, Alberta's chief medical officer of health, provides an update to the media about an outbreak of E. coli in Calgary daycares while Health Minister Adriana LaGrange, third from left, looks on. Alberta Health Services says the number of people affected has continued to climb to 264. (Colin Hall/CBC)© Provided by cbc.ca
"If your entire business is transporting food to children, their entire business is catering, why would you not have the safety pieces in place to make sure that that food is safely delivered?"
"It just makes me absolutely sick. I can hardly talk about it without crying. It's so hard to imagine my little girl eating at the daycare — so innocent and not knowing that she was at risk."
Eleven child-care facilities were closed as part of the outbreak investigation.
AHS has since rescinded the closure orders for four facilities — Little Oak Early Education, Almond Branch, Braineer Academy and Fueling Brains Bridgeland — as no one from those sites has tested positive, and public health inspectors have ensured that the sites have taken appropriate measures such as cleaning and disinfection.
The Canadian Food Inspection Agency said it is providing support as the source is investigated.
On Tuesday, the Alberta NDP called for a full inquiry into the outbreak.
"When we do discover the source of that outbreak, we need to move immediately to a full and public inquiry into how this food handling site was left uninspected for months," Alberta NDP Leader Rachel Notley said in a statement.
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