Tragic E. Coli outbreak in Calgary is a crucial reminder of public health's vital role

The recent E. coli outbreak in Calgary serves as a stark reminder of the critical role that public health plays in safeguarding the well-being of our communities. While the O’Brien Institute for Public Health is not directly involved in addressing this specific outbreak, we feel compelled to emphasize the broader implications and importance of public health in light of recent events.

Statement from Dr. Jon Meddings, MD, past dean, Cumming School of Medicine, and the O’Brien Institute for Public Health

On September 4, 2023, an E. coli outbreak was declared in 11 Calgary daycare sites, affecting over 300 individuals, primarily children. While no fatalities have occurred, many children are grappling with the serious consequences of this outbreak, including hemolytic uremic syndrome, a secondary illness associated with E. coli infection that affects the kidneys.

Our thoughts are with the affected families and we commend the efforts of healthcare professionals and public health officials working to address this crisis.

This outbreak serves as a painful reminder of the importance of investing in strong public health systems and underscores several fundamental principles of public health:

1. Prevention over reaction: Public health is primarily concerned with preventing health crises rather than reacting to them. As the saying goes, "an ounce of prevention is worth a pound of cure." Investing in public health infrastructure decreases the likelihood of disease outbreaks. Preventive measures are generally more cost-effective than dealing with a crisis after the fact, and can protect the health and wellbeing of our communities, especially the most vulnerable.
2. Transparency and communication: Timely and transparent communication with the public is essential during health emergencies. The delay in sharing information during this outbreak has highlighted the need for clear and rapid dissemination of information to maintain public trust and cooperation.
3. Accountability and governance: Effective public health systems rely on strong leadership and governance structures. This outbreak prompts us to reflect on the importance of accountable and responsive public health leadership at all levels of government.
4. Collaboration and research: Public health is a multidisciplinary field that relies on collaboration between academia, healthcare professionals, government agencies, and the community. It necessitates ongoing research to inform evidence-based policies and practices.

It is always challenging to define the worth of investments in public health, precisely because its main goal is to prevent negative health outcomes and emergencies. When public health functions effectively, then "nothing (bad) happens" in terms of large-scale health crises, epidemics, or disease outbreaks.  

A 2022 Canadian Public Health Association report emphasizes the need for cohesive provincial public health systems to improve overall health, prepare for future crises, and reduce the strain on medical systems. The report reveals a discrepancy between spending on treating illness and investing in preventative public health measures, which is inefficient for both public well-being and economics.

Recent dismissals and resignations have left a vacuum of public health expertise and experience in the team of Alberta's Chief Medical Officer of Health. Alberta Health should consider it a top priority to rebuild capacity in this critical office. Public health cannot fulfill its extremely important role without adequate government support.

The E. coli outbreak in Calgary is our “canary in the coal mine” moment, warning us that our public health system in Alberta is inadequate. While this is critically important for the current E. coli outbreak, another urgent issue will inevitably arise, sooner than we would like. Having a forward-planning and well-functioning public health system in Alberta will be critical to manage the next pandemic.

The Walkerton E. coli outbreak in 2000 damaged the lives of hundreds of people for decades. The Calgary outbreak will do the same and we are heartbroken that we have failed to remember the lessons of Walkerton. We must urgently take action to prevent this and other public health crises from happening again.