Access to Information Orders
Decision Information
During the spring and summer of 2003, the City of Toronto (the City) experienced a serious health crisis when severe acute respiratory syndrome (SARS) was detected in a number of area residents. The City describes the crisis as follows: [SARS] was first recognized in Toronto in a woman who had returned from Hong Kong in late February 2003. Transmission to others resulted subsequently in an outbreak among 257 people in several Greater Toronto Area hospitals. On March 12, 2003, the World Health Organization issued a global alert regarding the mystery illness soon to be known as SARS. During [the period of March 8 to March 18, 2003], public health officials began to suspect the connection between the disease in Guangdong province, Hong Kong and Toronto. Physicians began to discover that standard protection would not prevent the spread of the disease and a number of SARS clusters developed as the disease was transmitted from patient to patient or patient to caregiver. March 13, 2003, Health Canada received notification of the Toronto clusters and began daily teleconferencing with provincial and local health officials. After implementation of province-wide public health measures, including strict infection control practices, the number of recognized cases of SARS declined substantially, and no cases were detected after April 20 th . On April 30, 2003, the World Health Organization lifted a travel advisory issued on April 22, 2003 that had recommended limiting travel to Toronto. A second wave of SARS cases among patients, visitors, and health care workers occurred at a Toronto hospital 4 weeks after SARS transmission was thought to have been interrupted. From February 23, 2003, to June 7, 2003, the Ontario Ministry of Health and Long-term Care received reports of 361 SARS cases (suspect 136 [38%]; probable 225 [62%]; as of June 7, 2003, a total of 33 people (9%) had died. (Health Canada)). The economic impact of the SARS was severe and is still being felt by the City.
Decision Content
BACKGROUND
During the spring and summer of 2003, the City of Toronto (the City) experienced a serious health crisis when severe acute respiratory syndrome (SARS) was detected in a number of area residents.
The City describes the crisis as follows:
[SARS] was first recognized in Toronto in a woman who had returned from Hong Kong in late February 2003. Transmission to others resulted subsequently in an outbreak among 257 people in several Greater Toronto Area hospitals.
On March 12, 2003, the World Health Organization issued a global alert regarding the mystery illness soon to be known as SARS. During [the period of March 8 to March 18, 2003], public health officials began to suspect the connection between the disease in Guangdong province, Hong Kong and Toronto. Physicians began to discover that standard protection would not prevent the spread of the disease and a number of SARS clusters developed as the disease was transmitted from patient to patient or patient to caregiver.
March 13, 2003, Health Canada received notification of the Toronto clusters and began daily teleconferencing with provincial and local health officials.
After implementation of province-wide public health measures, including strict infection control practices, the number of recognized cases of SARS declined substantially, and no cases were detected after April 20th.
On April 30, 2003, the World Health Organization lifted a travel advisory issued on April 22, 2003 that had recommended limiting travel to Toronto.
A second wave of SARS cases among patients, visitors, and health care workers occurred at a Toronto hospital 4 weeks after SARS transmission was thought to have been interrupted.
From February 23, 2003, to June 7, 2003, the Ontario Ministry of Health and Long-term Care received reports of 361 SARS cases (suspect 136 [38%]; probable 225 [62%]; as of June 7, 2003, a total of 33 people (9%) had died. (Health Canada)).
The economic impact of the SARS was severe and is still being felt by the City.
NATURE OF THE APPEAL:
The City received a request under the Municipal Freedom of Information and Protection of Privacy Act (the Act) from a journalist, for all documents related to the SARS outbreak between Saturday, March 8, 2003 and Tuesday, March 18, 2003.
The requester identified log reports, emails, briefing reports and status reports as potential responsive records, as well as any individual records and specific reports created or kept by several individuals named in his request. The requester made it clear that he did not want any information that would identify SARS patients, including their names and birthdates, and asked that this type of information be severed from the records prior to disclosure.
The request included the following details:
Toronto Public Health has told me they keep a record of a developing situation (such as SARS) but I do not know the name of the record(s). I am therefore describing the record and also requesting individual records kept by [five named public health officials]. [I will refer to these individuals as officials #1, #2, #3, #4 and #5 throughout this order.]
The first report, which will be noted in a log or other report, was a notification of a possible [tuberculosis] outbreak. This came from Scarborough Grace Hospital on or about Sunday March 9, 2003. The report was made to, either [official #5] at Toronto Public Health or [official #4] at Toronto Public Health. In either case, both became involved and would have log, email, or diary records that should provide the records pursuant to my request.
By Thursday, March 13, 2003, [official #3] of Toronto Public Health became involved. I request any log entries, emails or other [records] made by her.
At the same time, reports were also being made in writing to [officials #1 and #2], both senior [Toronto Public Health] officials.
I am asking for this information so that I may scrutinize the effectiveness of [Toronto Public Health]. There is a public interest in scrutinizing the management of the outbreak.
The City identified 197 pages of responsive records and granted partial access to some of them. The City relied on the invasion of privacy exemption in section 14 of the Act as the basis for denying access to all remaining information, and also identified sections 7 (advice or recommendations) and 9 (relations with other governments) as exemptions applicable to certain identified records.
The requester, now the appellant, appealed the City’s decision.
During mediation, the appellant took the position that more responsive records should exist. He also claimed that the public interest override in section 16 of the Act should apply in the circumstances of this appeal. These two issues were added to the scope of the appeal.
Also during mediation, the City changed its position regarding pages 47, 101, 119, 123, 126 and 128 and provided copies of these records to the appellant.
Further mediation was not successful and the appeal was transferred to the adjudication stage of the appeal process.
I began my inquiry by sending a Notice of Inquiry to the City, setting out the facts and issues in the appeal and inviting written representations. These representations were shared with the appellant, and he in turn provided representations on the various issues raised in the Notice. I then invited the City to reply to the appellant’s representations, which it did.
In the course of preparing its reply representations, the City located 38 additional pages of responsive records, all of which are notes made by official #3 during the time period of the appellant’s request. The City issued a supplementary decision letter to the appellant, claiming that all of these new records qualify for exemption under section 14 of the Act. The appellant asked that the new records be added to the scope of the appeal, so I sent the City a Supplementary Notice of Inquiry and received representations relating to these records. The appellant in turn was invited to respond, which he did, and the City provided a final set of reply representations in response to the issues raised by the appellant.
RECORDS:
The records that remain at issue are described as follows:
Pages 1-17 A “Summary of First Reported Cases of SARS to Toronto Public Health”, dated May 2003. It is described as “a transcript of [a named Senior Public Health Inspector’s (official #6)] handwritten notes for the period March 13 to April 4, 2003”. Only the portions dealing with the timeframe of the appellant’s request are included. This summary is a day-by-day narrative description of various cases and actions taken by various staff of the City’s Public Health Department. Much of the information on these pages has been disclosed to the appellant. The names and other identifying information of patients has been severed and withheld under section 14, along with details regarding clinical treatment and other information about these patients and their family members gathered during the March 8-18 time period.
Page 18 A 1-page “note to file” made by official #5 (a Manager, Communicable Diseases) regarding her actions and activities on March 9, and her interaction with others involved in the SARS crisis. Some portions of this page have been disclosed. The undisclosed parts contain names, other identifying information and clinic treatment details of patients, as well as portions of one sentence containing information about a doctor. All withheld information is denied on the basis of section 14.
Pages 19-25 A series of charts dated March 13, some with handwritten notations, prepared by a Program Manager, Communicable Diseases (official #7), reflecting clinical assessments, treatment details and other information about patients gathered during the SARS investigation. These pages are withheld in full under section 14.