An Edmonton doctor returned from a trip to the United States late last month, saw patients in early March, and had elective surgery at a hospital just days before testing positive for COVID-19.

But although Alberta Health disclosed on March 11 that a patient at the Misericordia Hospital in west-end Edmonton had tested positive, it did not disclose the "man in his 30s" was a rheumatologist, and that he had seen patients.

Alberta Health also did not inform the patients seen by the doctor after he returned from the U.S. that he was infected.

In an interview with CBC News Thursday, Dr. Deena Hinshaw, Alberta's chief medical officer of health, said the patients were not notified because the doctor had no symptoms when he saw them.



"If we contacted everyone that people were involved with, before they even had symptoms, that would be a huge use of our resources in public health and we would alarm people unnecessarily if they're not at risk," Hinshaw said. "And it also diverts resources away from the important task of contacting those who are at risk of exposure."

Hinshaw stressed that Alberta follows national guidelines, based on the best collective evidence, that define who is deemed to be at risk, when the risk of exposure begins, and what the risks of transmission and exposure are.

In this case, Hinshaw took the extra precaution of calling in an infectious diseases specialist to review their decision not to notify the doctor's patients and the specialist agreed with that decision.

None of the doctor's patients have so far tested positive. Hinshaw did not know how many patients the doctor saw.

In a statement to CBC News before the interview with Hinshaw, Alberta Health stressed the infected doctor "did nothing wrong.



"They followed all directions in effect at the time, cooperated fully, and put no one at undue risk based on the knowledge at the time. This situation has evolved rapidly and there is now protocol in place to ensure that all Albertans, including physicians, self-isolate for 14 days after returning to Alberta. This has been in place since March 12," the statement said.

Doctor returned from Seattle

CBC News has confirmed the doctor returned from a trip to Seattle, one of the epicentres of the COVID-19 outbreak in the United States, and then saw patients at a clinic on Thursday, March 5.



CBC News has agreed not to name the clinic. The identity of the doctor is not known.



On March 6, the doctor had elective orthopedic surgery at the hospital and was released the following day. On Monday, March 9 the doctor tested positive. He is now self-isolated at home.

In an internal email obtained by CBC News, Covenant Health, the publicly funded Catholic health authority that operates the Misericordia Hospital, said it had identified the staff and physicians who were in direct contact with the patient, and they were sent home for self-isolation.

Dr. Deena Hinshaw, Alberta's chief medical officer of health, told a news conference March 11 that a man in his 30s in the Edmonton zone had COVID-19. (John Shypitka/CBC)

"Each staff member who is self-isolating will be contacted and monitored by [occupational health and safety] and will be cleared before they return to work," the internal email states.



"We are continuing to assess this situation and are determining the impact to service delivery at our site and putting plans in place to ensure continued service to our patients and community."

Hinshaw said the doctor began to show symptoms on the same day he had surgery in the Misericordia "but he was not symptomatic while he was practising as a physician."



As soon as the doctor's COVID-19 test was confirmed, health officials took immediate action to trace all the people with whom he had contact while at the hospital and after he was released. So far, there has been no further spread.

Second case in Canada of infected doctor

The ministry statement said that in every case only patients at risk are contacted.

"This is an important part of protecting patient confidentiality and avoiding alarming Albertans who aren't at risk," the statement said. "We have completed all appropriate contact tracing from this case and we know of no further spread."

Alberta Health said that as the COVID-19 pandemic continues to impact Alberta, there will likely be more cases involving every profession, including health care providers.

"This is exactly the approach we will take with every case," the ministry statement said.

"It would be inappropriate for us to disclose these details in every case; we are doing it here simply to ensure accurate reporting and to avoid undue public concern."

This is the second known case in Canada in which a doctor has tested positive for COVID-19. A week ago, a radiation oncologist in Hamilton tested positive after returning from a trip to Hawaii.

In that case, health authorities also did not alert the public but did confirm to CBC News a doctor in her 30s had been infected and that she had seen patients before being tested. Health authorities there contacted all 14 patients the doctor had seen.

Both the doctor, and her husband, a surgeon, self isolated.

The province has declared a state of public health emergency. Daycares, schools, colleges and universities and most other public facilities are closed, and public gatherings have been limited to no more than 50 people — all in an effort to limit community transmission of the virus.

Although Premier Jason Kenney recently said the outbreak is expected to peak in four or five weeks, Alberta Health said there is no way definitively know when this might happen.

If you have information about this story, or information for another story, please contact us in confidence at cbcinvestigates@cbc.ca

@charlesrusnell