Alberta’s chief medical officer of health said though the E. coli outbreak linked to several Calgary daycares remains serious, there is a decrease in patients requiring care in hospital.
The government also announced a one-time payment to affected families of $2,000 per child. Alberta Premier Danielle Smith said information on how to apply for this funding will be available soon
“While Alberta’s government is providing this financial support, we expect that these child care facilities recognize the hardship that has been caused and reimburse families the fees for the days that children have spent out of care,” Smith said.
At a news conference Friday, chief medical officer of health Dr. Mark Joffe said there are now 337 confirmed cases of E. coli, with 12 patients receiving care in hospital, a decrease of eight in the last two days.
Ten patients have been diagnosed with hemolytic uremic syndrome (HUS), a kidney- and blood-related severe complication, and six are receiving dialysis at the Alberta Children’s Hospital in Calgary, Joffe said.
There have been 26 cases of secondary transmission, all within households connected to the daycares.
Joffe said there has been one case of Shiga toxin-producing E. coli (STEC) in a child in Calgary who did not attend one of the daycares linked to the shared kitchen identified as the likely source of the outbreak.
However, he explained that a small amount of children get infected with E. coli every week and this case could be unrelated, but it is still being investigated.
Alberta Health Services said it is in contact with that child’s family to determine if there’s a link to the outbreak.
The provincial health authority said Calgary JCC Child Care has been informed of the case of STEC in its daycare and the ensuing investigation of that facility.
That daycare has been closed out of caution and has been provided with guidance on monitoring symptoms and seeking clinical care, and children with symptoms will be tested for the E. coli bacteria.
The kitchen related to the outbreak is remaining closed indefinitely, Joffe said.
The press conference comes 11 days after an E. coli outbreak was declared in Calgary daycares and a day after parents and families affected by the outbreak sent an open letter to Premier Danielle Smith asking, “What are you going to do to protect our most vulnerable citizens and support their families?”
Alberta Health Services declared an outbreak on Sept. 4, closing the 11 original daycares and central kitchen.
AHS soon set up an E. coli outbreak webpage.
'Needle amongst a field of haystacks’
Joffe said 45 food samples have been collected from the daycares and kitchen, and 19 results have come back from labs, all negative for E. coli.
“Additional results for the samples that are remaining are expected within the next few days,” he said.
The testing of foods, childrens’ stool, interviews with kids, parents and healthcare workers, and an analysis of the epidemiologic data is part of the “extremely complex investigation.”
“Identifying the exact source and how things unfolded is like trying to find that needle amongst a field of haystacks,” the CMOH said.
Dr. Stephen Freedman, a professor of pediatric emergency medicine at the University of Calgary and a leading researcher in pediatric E. coli infections, said there may have been too much time between when the food was served out of the kitchen and when inspectors collected food samples.
“There was quite a delay of about five days – if not six, probably – between potential time of exposure and time of looking for the food source,” Freedman told Rob Breakenridge on QR Calgary.
“It’s possible the food source may no longer be present. So maybe it was all consumed, maybe it was discarded. And so it can be challenging to find it if it’s not available,” Freedman said. “Actually, that’s the problem, potentially the biggest concern, at this point in time.”
AHS officials previously said the food samples included samples from the kitchen and leftovers stored at the daycares.
Dr. David Swann, a former medical officer of health in southern Alberta, said the pre-outbreak history of inspections of the central kitchen raised red flags for him.
“My question as a medical officer is: why wasn’t it shut down earlier? Was there pressure above on the inspector or on the public health inspection office to not go hard on a particular kitchen or on a particular activity?” Swann said.
Swann is also the former leader of the Alberta Liberal Party and former leader of the Opposition.
Read the fine print
A Calgary-based personal injury lawyer is warning parents to mind the fine print when applying for the compassionate payment.
“I think the parents need to read the information provided to them very, very carefully and be sure that there is no mentioning of waiving of any right to sue or seek any other form of compensation,” Nainesh Kotak, founder of Kotak Law, told Global News.
“If they’re satisfied and it’s a simple application – there’s no such wording – they could well go forward and accept this.
Kotak said there’s lots of precedence of compassionate compensation following mass casualty events. He said this is a signal that the government cares about what happened to the children involved.
“It would be quite unfair if you’re just going to take the $2,000 or whatever is being offered and then be barred from suing, particularly when we don’t know the long term effect on the other children,” he said.
‘Fair criticism’
The press conference comes 11 days after an E. coli outbreak was declared in Calgary daycares and a day after parents and families affected by the outbreak sent an open letter to Premier Danielle Smith asking, “What are you going to do to protect our most vulnerable citizens and support their families?”
Smith said she initially wanted to let the provincial health authority investigate without political interference, a lesson from early in the COVID-19 pandemic, and wanted to come to the public with “answers” from the investigation.
“Politicians cannot be directing these investigations. Politicians cannot be interfering in health orders,” Smith said. “If politicians interfere in health orders, they can be rendered illegal. So we have to make sure that we’re deferring to the medical officer of health.”
Smith had previously expressed her “thoughts and prayers” for families affected by the outbreak, and asked for an “assessment” of the outbreak from Health Minister Adriana LaGrange and Minister of Child and Family Services Searle Turton to prevent a repeat.
In their open letter earlier this week, the parents said they wanted to know why the premier has not commented publicly. They also expressed disappointment about a prior update from the health minister, minister of child and family services, and health officials.
“The recent press conference revealed nothing to regain our trust in the government’s ability to respond adequately to this situation,” the letter read.
“It’s a fair criticism,” Smith said Friday. “And I’ll accept that for next time.”
She also cited anecdotes of politicians being met with disdain when they showed up at disaster scenes.
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“I suppose if we had come out early, we might have people saying, ‘Why are you interfering with the investigation?’” Smith said. “You can look back with 20-20 hindsight and say ‘we understand that people expected more of a response from our government earlier and we’ll do better next time.’”
Smith did express an understanding that the apparent violation of food safety standards was “undoubtedly a violation of parents’ faith in the system.”
“When people entrust their child to someone else, they expect their child will receive the best possible care.”
'Deficiency' in Public Health Act
Aleasha Loblaw, a parent of two kids who attended a Fueling Brains Academy location, said much of what the parents were asking for in their open letter was addressed.
“I think this was something that we probably would have hoped for in the first press conference,” she said.
“I hope that as they move forward, there’s a lot of transparency, that we’re able to see what they’re doing, how they’re doing it, how they’re interacting with the daycare.”
Loblaw said she wants to see rapid changes to the Public Health Act around repeated health inspection violations.
“That would need to be the first thing that needs to change — that if there’s infractions, particularly repeated infractions, that there are some consequences and that our government has some ability to follow through and take action,” Loblaw said.
Smith said Turton is leading that review of standards that are in place for catering kitchens that serve childcare facilities.
Smith characterized it as a “deficiency in our Public Health Act.”
Turton indicated that work had only just started and Smith said changes to the Act could come in the spring 2024 sitting of Legislature.
In a statement, Diana Batten, Opposition critic for child care and child and family services, said she felt disheartened and frustrated by the province’s response to what appear to by systemic issues.
“Rather than defending their actions, the UCP government and Danielle Smith herself, must recognize her government fell short in protecting the health of children and offer an unreserved apology to the families,” the Calgary-Acadia MLA said.
“While the government has offered some compensation, it likely falls short of what families are asking for in order to compensate for all associated costs and does not take into account costs related to potential long-term health effects.
“Once the source of the outbreak is discovered, we need to move immediately to a full and public inquiry into how this food-handling site, a site responsible for feeding kids, was left uninspected for months.”
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