Lloydminster Mayor Gerald Aalbers leads a unique city in Canada, divided between two provinces and two distinct philosophies on reporting COVID-19 cases.
The border city straddles Saskatchewan and Alberta, which have taken starkly different approaches to identifying the location of positive cases during the pandemic.
An interactive map on the Alberta government website breaks down cases in the province’s 19 cities, including Lloydminster, and in dozens of counties and municipal districts. For each population centre, the map displays total cases, active cases, recoveries and deaths.
Saskatchewan reports cases and deaths based on six sprawling regions, ranging in population from the far north with 40,703 to Saskatoon with 380,653.
“Alberta Health Services chose a different model and I appreciate the model they chose,” Aalbers said in an interview on Monday. “They’ve broken it down by the municipality.”
On the Saskatchewan side, Lloydminster is located in the north region, which stretches across the province and includes other cities located far apart like North Battleford, Prince Albert, Meadow Lake and Melfort.
The charter that governs Lloydminster dictates that the Saskatchewan public health act applies across the entire city of about 32,000, Aalbers said, even though most residents are located on the Alberta side.
Aalbers said tests of residents on either side of the border are recorded by the Saskatchewan Health Authority (SHA). The interactive Alberta map shows just one case in Lloydminster, despite an April outbreak at the SHA hospital that involved at least 13 cases.|”The zone is quite large,” he said of the north region. “Neither system is perfect, I’ll tell you that.”
But residents of Cold Lake, a northern Alberta city of about 15,000 located near the Saskatchewan border, can find out online that four residents have been diagnosed with COVID-19 and all four recovered.
Given the number of urban and rural municipalities in Saskatchewan, Aalbers said he understands why the province has adopted its current approach. Saskatchewan has 466 urban municipalities, but only 15 cities with populations of more than 5,000, and 296 rural municipalities.
The SHA approach is based on combining the 12 former health regions that were dissolved in 2017, plus the far north Athabasca Health Authority, into six large regions. The north region, for example, includes Prince Albert Parkland, Prairie North and Kelsey Trail, with a population of 210,100.
Considering geography and population, it could be argued that Saskatchewan residents are receiving among the least specific information about the location of COVID-19 cases in Canada.
Most provinces break down cases based on health care regions or districts, but Saskatchewan’s size and lack of a major population centre result in less specific information than most other provinces.
Manitoba and British Columbia each release case information based on five regions, but more than half of the population of each province is concentrated in one urban area: Winnipeg and the Lower Mainland, respectively.
The Lower Mainland, which includes Vancouver, is divided between two health authorities, while one regional health authority covers Winnipeg.
Saskatchewan’s largest reporting region, Saskatoon, includes three other cities — Warman, Martensville and Humboldt — making it difficult to determine the location of cases in the region.
The central region is split up on opposite sides of Saskatchewan, divided by the Saskatoon and Regina regions. The sparsely populated far north region covers the top half of the province.
Ontario is reporting cases based on 35 health units covering the province with the second largest territory. An interactive map shows the cases per health unit, the infection rate and the population of each unit. The province also posts data that breaks down cases by municipality and even postal code.
Last week, the City of Toronto, Canada’s largest by population, started posting a map breaking down cases among its dozens of neighbourhoods.
Quebec, the largest province by territory, reports cases based on 18 regions, but these are further divided. The Laval region, for example, is divided into six sectors.
Canada’s Maritime provinces also break down cases based on health districts or zones. New Brunswick, which covers a fraction of the territory of Saskatchewan, features seven zones.
Similarly, Nova Scotia is divided into four health zones.
Newfoundland and Labrador, with about 62 per cent as much territory as Saskatchewan, is divided into 24 primary health care areas.
Throughout the pandemic, Saskatchewan residents have heard from the province’s chief medical health officer, Dr. Saqib Shahab, that privacy and the potential for complacency in communities with low case numbers have driven the lack of specificity.
Shahab’s counterpart in B.C., Dr. Bonnie Henry, has delivered a similar message, although Shahab said last week that Saskatchewan is working on a new map with “a bit more detail.”
Aalbers said he would welcome a more specific approach.
Gordon Barnhart, president of Municipalities of Saskatchewan, said there has been discussion with member communities about getting more information about case locations. However, Barnhart said the organization, which represents urban municipalities, is following the SHA’s guidance.
Saskatchewan privacy commissioner Ronald Kruzeniski said the different approaches taken by governments and health authorities across the country do not reflect vastly different legislation.
Kruzeniski said in an interview last week that different approaches represent decision makers choosing to apply “pretty similar” privacy legislation in different ways.
Two basic principles underpin all provincial privacy legislation, Kruzeniski said: that governments should provide as much information as possible, but that no individual’s privacy should be violated.
This means decision makers must strike a balance, he said.
“One death in Regina (population 244,661) doesn’t identify anybody; one death in Ituna (population 923) might,” Kruzeniski said. He noted that deceased people have privacy rights, too.
Saskatchewan has identified the province’s 11 deaths linked to COVID-19 by the region in which the person lived and by age range. Ontario, by comparison, releases the gender, age range, suspected transmission cause, date and status for every diagnosed case in each health unit.
The family of Alice Grove, a 75-year-old woman, identified her in March as one of Saskatchewan’s first two deaths related to COVID-19.
Grove’s family called for more transparency on the location of cases after Grove, who lived on a farm by herself, opted to make multiple trips into nearby North Battleford. Specific information on locations of cases may have deterred her from venturing into the city, her family said.
The location of some outbreaks, such as the one in the northern village of La Loche and the hospital outbreak in Lloydminster, have been identified. However, Shahab refused to reveal the Saskatoon neighbourhoods where large family gatherings linked to COVID-19 cases took place.
Shahab said identifying the neighbourhoods served no public purpose since the outbreak was contained.
Kruzeniski said the small size and large number of municipalities in Saskatchewan may make reporting based on smaller population centres difficult in terms of breaching privacy.
“Yes, geography is a problem,” he said.
However, Kruzeniski said he has tried to deliver the same consistent message throughout the pandemic — information builds faith in residents.
“More information tends to create trust in the decision makers providing the information and making the decisions,” he said.
“Take it as far as you can, except to the point where if you give out information it would identify the particular citizen.”
