Officials still opposed to naming infected team
Documents obtained by The Spectator confirm the name of the team behind an October outbreak, but do not make clear why public health is adamant the name not be released
It was last October, as the second wave of the COVID-19 pandemic began to roll through Hamilton, when an outbreak occurred at an elite local basketball academy.
Hamilton’s public health department made it public Oct. 23, but mysteriously refused to name the club, despite naming dozens of other businesses and organizations where outbreaks had occurred.
Internal emails acquired by The Spectator through a Freedom of Information (FOI) request show public officials debated the issue:
“Are we obligated legally to put up the team in the outbreak?” asked one employee.
“What if we name it L.P. Basketball? Would that help to reduce privacy concerns?” asked another.
“We also do not want to post something that will spark the media to ask a lot of questions,” wrote another.
After consulting with a city privacy officer, staff decided to call it “Hamilton-based basketball club.”
The emails do not show why public health was adamant the club’s name not be released, other than mention of “privacy concerns.” Public health also told media at the time it could not share information due to “privacy reasons.” The exact reasons were never specified.
Public health argues the name still should not be released.
“The information you have received — specifically, the name of the ‘Hamilton basketball club’ ... — is, in my view, confidential and protected information, which, when combined with other known information, could reveal personal health information about identifiable individuals,” said the city’s medical officer of health, Dr. Elizabeth Richardson, in a statement to The Spectator last week.
“While the City of Hamilton Public Health Services is committed to
transparency and accountability, and strives to ensure that the public has an understanding both of how COVID-19 is evolving and the associated risks are in the community, it also has an obligation to protect the privacy of individuals,” Richardson added. “That privacy protection includes permitting those infected with COVID-19 to remain anonymous unless they consent otherwise.”
Asked if the city clerk’s office, which processed The Spectator’s two FOI requests — one asking for the club’s name, the other asking for emails discussing the outbreak — erred in its decision to release the team’s name, city spokesperson Aisling Higgins said the city “is conducting a review of the disclosure” to “determine the factor(s) that led to the disclosure of this information.”
“The review will determine any additional steps to be taken,” Higgins said, noting public health has “taken steps to notify affected individuals that their information has been disclosed to an outside party.”
Public health and the city clerk’s office both follow provincial Freedom of Information laws. It’s unclear why one body could release the information but the other could not. Higgins noted public health considered its obligations under the Personal Health Information Protection Act as well as the Municipal Freedom of Information and Protection of Privacy Act (MFIPPA). The Spectator’s FOI requests, meanwhile, were “assessed largely in the context” of MFIPPA.
Over the past week, The Spectator has repeatedly asked public health to explain what privacy issues make the basketball outbreak different from other outbreaks with respect to potentially identifying individuals. Was it the online profiles of the players? Was it something else? The Spectator sought to understand what makes this outbreak so unique it could rightly be the rare exception to naming outbreaks. No clear answers have been provided.
Public health routinely makes public the names of hospital units, schools, businesses, long-term-care homes and other settings experiencing outbreaks. Hundreds of businesses and sites have been named. This case is a rare outlier.
What is the team’s name?
The club identified to be at the centre of the October outbreak is Lincoln Prep, an elite, private Hamilton-based basketball academy whose players are high schoolaged.
Asked by The Spectator last week for comment for this story, Lincoln Prep coach Zach Angelini said: “Due to privacy concerns I have no authority to discuss personal information about any of the participants in the Lincoln Prep program about COVID-19 or any other issue. As a matter of policy, Lincoln Prep supports and adheres to provincial safety guidelines with regards to all aspects of COVID-19.”
The team’s website appears to show 25 players. The Spectator is unable to ascertain how naming the club, whose six COVID-positive “patrons” — at least three of whom the emails confirmed to be players — could identify anyone.
If the concern is with the fact the 25 players’ names are public, it is unclear why privacy laws would not also prevent public health from naming settings such as a small daycare or congregate setting with a widespread outbreak.
For instance, St. Matthew’s House children’s centre in Hamilton has twice been publicly declared to be in outbreak, with three cases that include staff. A total of 16 staff photos and names are listed on the organization’s website. In the case of a horrific outbreak at Rosslyn Retirement Residence, public health revealed that all but two of 66 residents tested positive, which means the public was told almost everyone at the home had COVID.
The public’s need to know
Hamilton public health should have released the name from the beginning, Colin Furness, an infection control epidemiologist and assistant professor at the University of Toronto, said in an interview with The Spec last week.
Not doing so risked losing the public’s trust in how public health was managing outbreaks and COVID in general, he said.
“People really need to know what’s going on around them in terms of assessing their own safety,” Furness said. “People are afraid ... they (Hamilton public health) don’t seem to get that.”
Furness did not see how privacy could be an issue in this case, especially considering public health set a precedent by already naming businesses and groups in outbreaks. He added: “Privacy is an easy shield to hide behind” when there are other reasons agencies don’t want to be transparent.
Arthur Schafer, founding director of the Centre for Professional and Applied Ethics at the University of Manitoba, echoed Furness’ point, saying in an interview this week with The Spectator that public health needs to share information about outbreaks so the public can gain a better understanding of how COVID spreads and what is being done to address it.
Disclosure breeds trust, he said. “Public trust is a precious resource and is promoted by openness, honesty, transparency, disclosure to the
maximum extent possible and is undermined by secrecy and concealment,” Schafer said.
Sometimes, sharing information that is in the public interest comes at the expense of personal privacy, he said.
Schafer added that Hamilton public health seems to have a problem with consistency, as evidenced by this case. The health unit needs to decide if it wants to stick with its transparent practice of naming names, or start withholding them, he said.
A risk to the public?
While Hamilton public health repeatedly said in October there was no risk to the public, emails suggest otherwise.
The emails show the players worked out with a trainer at a gym, practised at a site that was also home to a daycare, some players were members of other teams and clubs and someone who appears to be affiliated with the team took a GO bus to Mississauga. The possible exposures listed in the emails took place in the days leading up to and on Oct. 16 — the listed date of earliest symptom onset.
Responding to The Spectator’s questions about the public risk, Higgins said public health “concluded that there was no direct risk to the broader public associated with this case and no unidentified ‘at risk’ contacts.”
“However, during a pandemic there is always some risk to the public when out in the community, which is why public health services consistently reiterates the public advice that all need to remain vigilant when it comes to public health measures, and ensure they are followed in order to reduce the risk of transmission as much as possible,” Higgins said.
Outbreaks in context
A factor in why The Spectator felt obliged to share more information about the basketball outbreak in October was because it came amid another outbreak: SpinCo.
Hamilton’s SpinCo outbreak, which infected upwards of 80 people, was ongoing at the same time as the basketball outbreak. SpinCo was raising worrying questions about whether existing public health guidance was sufficient at mitigating spread in athletics and fitness settings. Ontario’s public health officials were reviewing provincial policies in its wake. It still remains unclear exactly how the SpinCo outbreak got so bad. It also remains unclear how the Lincoln Prep outbreak occurred.
After the unnamed club was declared in outbreak, The Spectator continued to ask public health for information about the basketball outbreak, including the club’s name and if it was players who were sick.
Upon receiving no answers in the following week, The Spectator published an article on Oct. 30 that included criticism from an epidemiologist (Furness), an infectious disease physician and an ethicist who argued public health was hindering Hamiltonians’ ability to make informed decisions about risk assessment by withholding information.
Emails show the article was poorly received.
“(A)ll those arm-chair quarterbacks,” wrote Richardson, medical officer of health, in response to an email from a colleague about the article. “If anyone feels that we could disclose more, happy to have the advice and consider how we can adjust moving forward.”
Dr. Doug Sider, a Hamilton Public Health Services physician and former medical officer of health for Brant County, responded to Richardson and weighed in on what public health could have done differently.
“The key findings of great relevance to the community are why did this happen, what were the shortcomings in COVID preventive practices, those are the key takehomes ... not who the team was, as that can directly or indirectly lead to persons being identified ...,” Sider said. “And when we say no risk to the broader public, do we explain clearly what that means, i.e. that we’ve got a complete handle on
The emails show the players worked out with a trainer at a gym, practised at a site that was also home to a daycare, some players were members of other teams and clubs and someone who appears to be affiliated with the team took a GO bus to Mississauga.
cases and their contacts, there are no unidentified, at-risk individuals to the best of our knowledge?”
Else Khoury, a city privacy officer, suggested the public doesn’t understand well enough how contact tracing works.
“I actually think that part of the arm-chair epidemiology practice that we see might be that some people don’t really understand that there is a whole machine in the background doing contact tracing and assessing risk,” she wrote.
In the emails, Kevin McDonald, a director with the city’s healthy and safe communities department, called The Spectator’s print headline — “It’s a health scare shrouded in mystery” — “deliberately sensationalized.” He added: “The story includes the reporter’s go-to vocal disclosure critic — Colin Furness.”
In her statement to The Spectator last week, Richardson said she and her colleagues “regret” the comments.
“Our comments do not represent the level of professionalism that we strive to maintain on a daily basis nor the respect we have (for) the media, and other professionals,” she said.
“In reflection we are seeking to ensure we learn from this experience, and continue to maintain a high level of professionalism in correspondence.”
Furness, however, did not think the criticism — including criticism of him — was that bad.
“I kind of thought there might be more vitriol than that,” he said. “They’re under a lot of pressure. Let’s be clear, this is a really miserable time to be working in public health.”