Herd Immunity: Reporters Force Health Agencies to Release Infection Rates

Here’s how journalism should work.

The Canadian Broadcasting Corporation (CBC) wanted to find out about health-care-associated infections in the country’s hospitals. It started asking the two health agencies that oversee hospitals in the New Brunswick province for their statistics.

Both the Horizon Health Network and Vitalité Health Network refused.

The CBC invoked the country’s Right to Information and Protection of Privacy Act.

That did not impress the health authorities.

This dragged on for three months. So the CBC’s Daniel McHardie wrote about the refusal:

The Horizon Health Network and Vitalité Health Network have both refused to publicly disclose how many cases of C. difficile and MRSA were discovered in their facilities. CBC News requested the information under the Right to Information and Protection of Privacy Act in January, but both health authorities sent formal rejection notices in the last week. The decisions of the two health authorities have been appealed to the Office of the Access to Information and Privacy Commissioner.

McHardie had good reason to want the statistics. In December, the CBC reported that Dr. Georges-L-Dumont University Hospital Centre in Moncton had been hit with an increase in C. difficile cases and, as a result, had barred visitors from the hospital while it disinfected room after room. The CBC reported at the time:

The Dr. Georges-L.-Dumont University Hospital Centre had closed parts of the emergency room last month for cleaning after the rate of infection for the dangerous and highly contagious bacteria had tripled.

"The primary focus was obviously the emergency department because of the fact it is a high transit area where you have the possibility of having more acute cases," said Luc Foulem, a hospital spokesperson.

The rates had tripled? But from what to what? From 30 cases for every 1,000 patients to 90? From 3 per 1,000 to 9?

The CBC wanted to know, and it did the right thing in asking for all the hospitals’ information so it could make comparisons. But the health authorities seemed to forget that health statistics are a vital piece of public information.

At least until two weeks ago when Horizon Health took a different course from Vitalité and released its infection stats to the CBC. McHardie wrote:

Dr. Eilish Cleary, the province’s chief medical officer of health, said in an interview on Thursday the two regional health authorities would be disclosing C. difficile data in April. She said the authorities would disclose other infections, such as MRSA, at a later date. Horizon’s pre-empted the provincial move on Friday by disclosing the statistics requested by CBC News.

The New Brunswick Health Council sets the benchmark rate for C. difficile at 0.6 cases per thousand patient days. According to Horizon Health, there were 171 cases in 2011-12 making the rate 0.33 per thousand patient days. So far in 2012-13, there have been 123 cases of C. difficile, giving it a rate of 0.32 per thousand days.

One can almost hear the strategy session that happened before the decision to go public with the stats. Horizon must have felt that the fact its numbers were below the provincial bench mark would mean that they’d come out looking better than expected. The hospital that had the highest rates – Saint John Regional – still had rates below the provincial standard. I added Saint John to the Herd Immunity Map.

It’s now up to the public to decide how big a factor the infection rates should play into their decision of where to seek care. And they can push for improvements in infection control measures, too.

While they’re at it, they should call their local CBC station and say, “Thank you.”

Have an addition to the Herd Immunity Map? Send it to askantidote@gmail.com or to me via Twitter @wheisel.

Image by Kris Krug via Flickr