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Why is Isra Levi and Ottawa Public Health…

…running the real risk of freaking people to the point of bringing on a negative health outcome out over such a low, low health risk? I just don’t get it.

Key statement in this article:

However, the chances that someone could have been infected with hepatitis B is less than one in a million. In the case of hepatitis C, those odds drop to less than one in 50 million and are less than one in three billion for HIV, according to OPH.

Other things that are about one in a million:

Less than 1 in 50 millionish:

And one in 3 billion???

Get the drift?

With odds this long, wouldn’t it be better to just shut up about it? Why call a presser and go off the deep end over what will almost certainly be a non-issue??? Surely more harm than good will come of this due to increased stress? Out of the 7,000 or so people who will receive letters telling them that there is an infinitesimal chance that they may have contracted something bad at the endoscopy clinic, I would estimate that more than a few of these folks will experience a negative health impact just because of the letter!!!

Am I so off-base on this??? I’m not the only one who thinks this way.

Dr. Michael Gardam, director of infection prevention and control for Toronto’s University Health Network, told CBC News that in cases like this where the risk is so low, not informing the patients at all might be the better choice.

“When you get to less than one-in-a-million, we often times give advice not to tell anybody because the risk is so small, that you’re actually creating more harm by worrying people,” said Gardam.

In fact, one in 100,000 is what I have been told is the threshold for the act/don’t act decision.

Yet the question – “wouldn’t you want to be informed if you had been treated at the clinic” question rightly comes up. Of course, but is the ancillary risk to the greater population worth knowing?

Interesting question.


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  1. Oh man, I thought I was the only one who was thinking this! Seriously … was it necessary to freak out the entire Ottawa area?? I think it would make more sense to contact the patients directly and skip the media frenzy. At the very least, the media should have at least been underscoring how low the actual risk was.

    1. trashee says:

      Ya know, I do “get” the whole idea about a patient’s right to be informed if something is amiss – but this could have been handled WAY better without causing unneeded worry for thousands of folks.
      And you’re right – the media has done diddly-squat to spell out what 3 BILLION in one odds represent!

  2. Technically, your odds on the super 7 were 3x better than you list. A single play got you 3 sets of numbers that could win.

  3. Dave says:

    Sorry I have to disagree with you on this one. Information is the most important thing we can have to try and manage our health care. Even with a tiny probability the patient deserves the right to know and then decide how to progress. It is too easy to go down the path of not telling at 10,000 to one then at 5000 to one then not unless you think you’ll get caught. Better to have the knowledge no matter how distasteful that is and have the opportunity to do something about the information. The vagueness of the PR move however was needless.

    1. trashee says:

      Gee. Don’t be sorry. I’m not like Harper who feels the need to crush all dissent 🙂 I like dissent! Well, not by my staff… I veel crush dem!!!


      After speaking to a friend whose wife is a physician, I think it can come down the Hippocratic Oath which states that a physician shall do no harm. And in this case, I think that this is being violated as the chance if harm being done is greater through the disclosure than the odds of any of the former patients having one of the conditions.

      But agree or not, this is certainly not straightforward and a good mental exercise.

  4. John Shipley says:

    It’s all about CYA! They are damned if they keep quiet and damned for being too open.

    1. trashee says:

      Yuppers! They’re damned either way!

  5. Conrad says:

    I don’t know, Trashman. I think it’s always better to be informed than not to be informed. The freak-out part, I think, comes from yesterday’s vague announcement that didn’t name the clinic or the risk of infection. It would just take one person — who’d contracted HIV at this clinic to later discover that Public Health had kept him in the dark, denying him the chance to get tested and treated early — for all hell to break loose. A much bigger hell than is breaking loose now even.

    1. trashee says:

      Hmmm… why did I have to approve this? You using a new email addy?

      See what I said to Dave. I agree that in most circumstances, full disclosure (without the press conf histrionics) is the right way to go… but in this case I think that there is a greater chance of harm by disclosing than by not disclosing. And Doctors are bound to do no harm.

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