Alberta Health
Alberta Health Services

COVID-19 in Continuing
Care Facilities
1

Report of the Auditor General
February 2023

Summary of Comments on COVID-19 in Continuing Care
Facilities Performance Audit
Page: F1
Number: 1

Author: daviddickson

Subject: Highlight Date: 2023-02-25 3:20:28 PM

Already setting up both for further restrictions with “future pandemics” and ongoing damaging protocols
for any “outbreak” using incorrect data for a vaccination push. Once in the care system, these poor souls
will be effectively imprisoned until they die in a program called “focused protection”.
NOTE: This report focuses ONLY on 2020. There are significant and ongoing problems related to COVID
protocols still in evidence in LTC. Most of the protocols which caused inordinate damage ARE STILL IN
EFFECT.

1
Mark Smith, MLA

Chair
Standing Committee on Legislative Offices
I am honoured to transmit my report, COVID-19 in Continuing Care Facilities, to the Members of theLegislative Assembly of Alberta, under Section 20 of the Auditor General Act.

W. Doug Wylie FCPA, FCMA, ICD.D
Auditor General
Edmonton, Alberta
February 2023

Page: F2
Number: 1
Author: daviddickson
Subject: Highlight Date: 2023-02-26 10:16:00 PM
MLA Mark Smith was in receipt of information contained in these comments before this report was written, including a letter to the Premier. He
is our MLA and has NEVER responded to any communication.

See:
https://dksdata.com/MLA
https://dksdata.com/Court/ToAlbertaPremierJanuary292023.pdf

Contents

Summary _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1
Context _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 5
COVID-19 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 5
COVID-19 and Continuing Care _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 6
Background on Alberta’s Waves One and Two Continuing Care Experience _ _ _ _ _ _ _ _ _ _ _ _ _ 6
Key participants involved in the COVID-19 response _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 7
Timeline of Alberta’s response to COVID-19 in continuing care facilities _ _ _ _ _ _ _ _ _ _ _ _ 8
The goals of the COVID-19 response _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 9
Key facts and ﬁgures on Alberta’s continuing care experience in COVID-19 _ _ _ _ _ _ _ _ _ _ 9
How COVID-19 got into facilities and the implications of community spread _ _ _ _ _ _ _ _ 10
About This Audit _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 11
Objective and Scope _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 11
Criteria _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 11
What We Examined _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 12
Conclusion _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 13
Why This Matters to Albertans _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 13
Detailed Findings and Recommendations _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 15
PLAN: Pre-COVID Planning and Preparedness for a Pandemic _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 15
Context _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 15
Criteria _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 17
Our ﬁndings _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 17
COMMUNICATE: Providing Guidance and Communications to Continuing Care Facilities _ _ _ 21
Context _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 21
Criteria _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 22
Our ﬁndings _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 22
EXECUTE: Assessing Resource Needs to Support Outbreak Prevention and Management _ _ _ 27
Context _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 27
Criteria _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 28
Our ﬁndings _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 28

MONITOR AND ENFORCE: Monitoring Performance and Enforcing Compliance at Facilities _ 44
Context _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 44
Criteria _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 45
Our ﬁndings _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 45
Appendix A: Summary of Pandemic and Communicable Disease Plan Goals _ _ _ _ _ _ _ _ _ _ _ _ _ _ 53
Appendix B: Timeline of COVID-19 in Continuing Care Response in 2020 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 55
Appendix C: Key Facts and Figures on COVID-19 in Continuing Care Facilities _ _ _ _ _ _ _ _ _ _ _ _ _ 59
Appendix D: Continuing Care Facility COVID-19 Compliance Inspections_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 67
Appendix E: Recommendations from AHS Internal Reviews _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 69
Appendix F: Major Events and Developments After the End of Our Scope _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 77
Appendix G: Audit Responsibilities and Quality Control Statement _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 79

Related Reports•

Seniors Care and Programs (May 2005)•

Seniors Care in Long-term Care Facilities Followup (October 2014)•

Seniors Care in Long-term Care Facilities AOI (February 2023)

Appointed under Alberta’s Auditor General Act, theAuditor General is the legislated auditor of every
provincial ministry, department, and most provincial
agencies, boards, commissions, and regulated funds.
The audits conducted by the Office of the Auditor
General report on how government is managing its
responsibilities and the province’s resources. Throughour audit reports, we provide independent assurance
to the 87 Members of the Legislative Assembly of
Alberta, and the people of Alberta, that public money
is properly accounted for and provides value.

Summary

1

COVID-19 was a global pandemic causedby the SARS-CoV-2 virus. The COVID-19
disease presented the greatest risk ofsevere illness and death to older people andthose with underlying health conditions.
It spread efficiently between people inenclosed spaces via respiratory droplets and5aerosols, as well as contact.

In this audit we looked at the public health response by
the Department of Health (Alberta Health) and Alberta
Health Services (AHS) to COVID-19 in Alberta’s 355
2 auditedpublicly funded continuing care facilities. We
what Alberta Health and AHS did to prepare for andrespond to COVID-19 in these facilities during waves
pandemic—the period of
one and two of the COVID-19 pandemic—
3
March to December 2020. In that time, 379 outbreaks
started in continuing care facilities, accounting for more
4
than 8,300
COVID-19 cases and 1,000 deaths.

The reality of the risk posed by the COVID-19 pandemic
to continuing care facilities1 and the residents they carefor quickly became apparent across the world in early
2020, sometimes with terrible severity. Continuing carefacilities across Canada came under severe pressure
from COVID-19 as it began to spread across the country,
resulting in large outbreaks and signiﬁcant illness anddeath among both residents and staff. Governments andhealth authorities across the country were challenged torespond quickly to a disease for whichh there was limited
initial understanding. COVID-19 was a threat unlike
system—indeed the entire
anything the continuing care system—
health system—had faced.

Our work is grouped into four crucial activities for
success: planning, communicating, executing, and6monitoring and enforcing
compliance.

Alberta Health identiﬁed the ﬁrst COVID-19 outbreak in
a continuing care facility on March 14, 2020, startinga years-long effort to protect facilities and to keep
residents, and the staff who care for them, safe.

1

In the ﬁrst section of our report, we discuss
pre-COVID-19 pandemic planning and preparedness.
We found planning and preparedness was in place but
was not sufficient to respond to COVID-19. Facility-levelplans quickly began showing limitations in the face ofthe scale and severity of COVID-19 outbreaks. Many
facilities struggled to meet regulated standards for
infection prevention and control aand staff training evenprior to COVID-19. Alberta Health and AHS found their
existing provincial-level plans insufficient aand quickly
adapted away from them, resulting in initial confusion
during the ﬁrst wave of COVID-19. Wewith role clarity dalso noted that while emergency preparedness exercises
speciﬁc to a pandemic had happened just a year before
COVID-19 began, these exercises were siloed and did notpractise scenarios and coordination across the many key
participants—Alberta Health, AHS, facility operators, andothers—which make up the continuing care sector.

What are commonly called “nursing homes” and congregate care facilities for people who are elderly or inﬁrm are referred to as “continuingcare facilities” in Alberta. We adopt this naming convention for the remainder of this report.
Report of the Auditor General—February 2023 1

Page: 1
Number: 1
Was?

Author: daviddickson

Subject: Highlight Date: 2023-02-24 2:16:24 PM

Number: 2
Author: daviddickson
Subject: Highlight Date: 2023-02-24 2:29:04 PM
What was audited? Who provided the data? Was the original source data analyzed? It is clear from this report that the real data and information
was not reviewed.
Number: 3
Author: daviddickson
Subject: Highlight Date: 2023-02-25 3:23:02 PM
Most of these 'outbreaks' were based on staff voluntarily testing asymptomatically.
Outbreaks in Alberta were primarily caused by the voluntary testing of asymptomatic staff. Despite constant testing daily (or more), CC
Dickinsfield, as an example, had almost no COVID positive residents in 2020. In addition, due to the inaccuracy of testing and assumption of
COVID (over other potential ILI's), many other illnesses were misdiagnosed, improperly treated (or not treated at all in the case of COVID).
In CC Dickinsfield, they had significantly less ILI deaths in 2020 than normal but an overall higher mortality due to the COVID restrictions.

Where is the detail on what types of outbreaks, number of symptomatic cases etc.? What about other deaths, co- morbidities, age etc.?
Location of death (care home or hospital, ventilated or not)? So many questions and just a superficial assumption to further the propaganda.
Number: 4
Author: daviddickson
Subject: Highlight Date: 2023-02-25 5:54:26 PM
https://dksdata.com/AlbertaDead#APL
From 'when is a negative test a positive?' to 'how many days back for a case?'

These numbers are based on manipulated statistics related to when a person was coded as a COVID case, not when they died. In some cases
these Covid cases 'survived' for over two years. Did they really die of COVID?
The criteria for a COVID death was death up to 6 months after a COVID diagnosis (with or without a death certificate to support). COVID deaths
were identified by nurses in the COVID statistical department reviewing NetCare and Connect Care (and sometimes death certificates). In
August of 2022, that criteria changed to 60 days instead of 6 months. However, there are instances where the 6 months and the 60 days was
ignored.
http://dksdata.com/AlbertaDead
COVID cases were known to be unreliable and, as such, COVID hospitalizations and deaths were built on flawed foundations. Fruit of the
poisonous tree from the start. For an Auditor to not even look at this is beyond negligent and further reinforces the need for a police forensic
investigation of all relevant data and facts.
The obsession with testing WAS THE PROBLEM.
See https://rumble.com/v1ddohu-counting-cars.-how-covid-19-is-being-reported..html
https://rumble.com/v28lhpw-who-cares-about-false-positives-every-single-case-was-used-to-terorrise.html
KENNEY SAYS WHO CARES ABOUT FALSE POSITIVES! From Kenney's own Q&A::
00:00"Alright Donna Stratton Stratton Tip says I've read about the maker of the PCR test has stated it's about 50% wrong and wasn't designed forwhat we're using it for. Is that true?" And then this.
00:13"I actually asked for this to come up because I know there's a lot of folks often when I check out the Facebook comments, there's a lot of thisstuff about PCR, so PCR is the standard test for COVID-19 in Canada and Alberta and around the world."
00:30"It's it's true that based on how many cycles the PCR test is does on the sample that that it can generate in many cases does generate a false
positive…"
01:01"So there are, I'll call them covid skeptics, who are claiming that all of the restrictive policies are being wrongly informed by exaggerated Covid
case counts because of false positives through PCR testing."
01:53"In a sense, I mean, who really cares about the false positives?"
WHO CARES?? WHO INDEED!! Let me tell you WHO CARES, KENNEY!! How about the people isolated for two weeks, losing their business,closed care homes, closed schools, cancelled surgeries, suicides, poverty....
It takes a single 'case' to shut down the lives of hundreds of care home residents and all connected to them and our then Premier had the
audacity, to say "..who really cares about the false positives?"

Number: 5
Author: daviddickson
Subject: Highlight Date: 2023-02-24 2:17:55 PM
This made masks and faceshields completely redundant as was outlined in the SAG report of 2022. see: https://dksdata.com/MASKS#AHSSAG
Number: 6

Author: daviddickson

Subject: Highlight Date: 2023-02-25 3:31:48 PM

Comments from page 1 continued on next pageSummary

COVID-19 was a global pandemic causedby the SARS-CoV-2 virus. The COVID-19
disease presented the greatest risk ofsevere illness and death to older people andthose with underlying health conditions.
It spread efficiently between people inenclosed spaces via respiratory droplets andaerosols, as well as contact.

In this audit we looked at the public health response by
the Department of Health (Alberta Health) and Alberta
Health Services (AHS) to COVID-19 in Alberta’s 355
publicly funded continuing care facilities. We audited
what Alberta Health and AHS did to prepare for andrespond to COVID-19 in these facilities during waves
pandemic—the period of
one and two of the COVID-19 pandemic—
March to December 2020. In that time, 379 outbreaks
started in continuing care facilities, accounting for morethan 8,300 COVID-19 cases and 1,000 deaths.

The reality of the risk posed by the COVID-19 pandemic
to continuing care facilities1 and the residents they carefor quickly became apparent across the world in early
2020, sometimes with terrible severity. Continuing carefacilities across Canada came under severe pressure
from COVID-19 as it began to spread across the country,
8
resulting in 9large outbreaks and signiﬁcant illness
anddeath among both residents and staff. Governments andhealth authorities across the country were challenged torespond quickly to a disease for which
there was limited
h11
12
initial understanding. COVID-19 was a threat unlike
system—indeed the entire
anything the continuing care system—
health system—had faced.

Our work is grouped into four crucial activities for
success: planning, communicating, executing, andmonitoring and enforcing compliance.

16
Health identiﬁed the ﬁrst COVID-19 outbreak inAlbertaa continuing care facility on March 14, 2020, startinga years-long effort to protect facilities and to keep
residents, and the staff who care for them, safe.

1

7
In the ﬁrst section of our report, we discuss

pre-COVID-19 pandemic planning and preparedness.
We found planning and preparedness was in place but
was not sufficient to respond to COVID-19. Facility-levelplans quickly began showing limitations in the face of10
the scaleand severity of COVID-19 outbreaks. Many
facilities struggled to meet regulated standards for
13
infection prevention and control aand staff training evenprior to COVID-19. Alberta Health and AHS found their
14
existing provincial-level plans insufficient aand quickly
15
adapted away from them, resulting in initialconfusion
17
during the ﬁrst wave of COVID-19. Wewith role clarity dalso noted that while emergency preparedness exercises
speciﬁc to a pandemic had happened just a year before
COVID-19 began, these exercises were siloed and did notpractise scenarios and coordination across the many key
participants—Alberta Health, AHS, facility operators, andothers—which make up the continuing care sector.

What are commonly called “nursing homes” and congregate care facilities for people who are elderly or inﬁrm are referred to as “continuingcare facilities” in Alberta. We adopt this naming convention for the remainder of this report.
Report of the Auditor General—February 2023 1

'Enforcing compliance' - This is what this was really about. And this led to all the unnecessary deaths and suffering.
Number: 7
Author: daviddickson
Subject: Highlight Date: 2023-02-25 3:38:09 PM
The planning for a potential ILI pandemic was in place but was thrown out at the start. The responses were not those of a pandemic, but they
were a government plan implemented in a wash and repeat format with no more thought than people panic buying toilet paper. It was a caseof 'they did it , so should we'. https://dksdata.com/COVArticles
There was never an indication of a pandemic from the start. The response was never justified based on the data and real world impacts.
However, the response (flawed testing, lock-downs, isolation, masking, fear and panic) created the crisis to justify itself. This was a crisis that was
MADE by the response and all the data is there to demonstrate this. How the auditor can have missed this is nothing less than willful
negligence and criminal at worst.
https://dksdata.com/CourtUpdate
Number: 8
Author: daviddickson
Subject: Highlight Date: 2023-02-25 3:39:06 PM
What staff deaths? Where are the staff deaths listed? None were announced! That information would have been front page news.
Number: 9
Author: daviddickson
Subject: Highlight Date: 2023-02-24 2:22:38 PM
Outbreaks in Alberta were primarily asymptomatic caused by the voluntary testing of asymptomatic staff. Despite constant testing daily (ormore), CC Dickinsfield had almost no positive residents in 2020. In addition, due to the inaccuracy of testing and assumption of COVID (overother potential ILI's), many other illnesses were misdiagnosed and improperly treated (or not treated at all in the case of COVID).
In CC Dickinsfield, they had significantly less ILI deaths in 2020 than normal but an overall higher mortality due to the COVID restrictions.
Number: 10
Author: daviddickson
Subject: Highlight Date: 2023-02-25 3:40:27 PM
Scale was manufactured by asymptomatic testing. Severity was created by the response/lack of response in care. In many cases, the severity was
actually overstated.
Number: 11
Author: daviddickson
Subject: Highlight Date: 2023-02-24 2:24:34 PM
This disease was well understood with well known treatment protocols from the start. This is nothing less than propaganda!
Number: 12
Author: daviddickson
Subject: Highlight Date: 2023-02-24 2:30:00 PM
The inflammatory statement here is unsupported and primarily based on propaganda. It is not supported by the facts. The response created athreat, not the disease. The major damage was caused BY THE RESPONSE not the disease.
Number: 13
Author: daviddickson
Subject: Highlight Date: 2023-02-25 3:41:49 PM
There were tried and tested protocols for this before COVID, all thrown out from the start. This made a mockery of IPC that continues to thisday. Staff come back sick, hiding behind a mask while healthy visitors and DSP's are denied access because they are unable to wear a mask. See
https://dksdata.com/MASKS#AHSSAG
Number: 14
Author: daviddickson
Subject: Highlight Date: 2023-02-25 3:42:49 PM
They did not use existing plans. The inappropriate response created a self fulfilling prophecy through faulty testing, improper diagnosis,
onerous PPE protocols, limited staff access, and the removal of family and support access. Although negligence and incompetence could beassumed initially, it is clear now that this was a manufactured crisis from the start.
Number: 15
Author: daviddickson
Subject: Highlight Date: 2023-02-24 2:55:44 PM
This was clearly by design to ensure no one saw that the response was inappropriate in every way, from continuous masking/testing of the
population to ventilators for an ILI to 'go home/no treatment for weeks, isolation without care and more. All on the basis of almost no provable
cases.
Number: 16
Author: daviddickson
Subject: Highlight Date: 2023-02-24 2:30:30 PM
They kept no one safe and caused nothing but unmitigated suffering, death and destruction based on a web of lies that is further pushed in thisreport.
Number: 17
Author: daviddickson
Subject: Highlight Date: 2023-02-24 5:34:52 PM
None of the responses followed the documented AEMA response plan (See Lt Col;. David Redman). However, there was never a crisis to
respond to until it was artificially created. There had been a significant wave of low mortality ILI's from late 2019 to spring 2020 which was used
as a spring board for the fear factor. The legislative response (M.O.608 2020) was legally flawed and had no supporting evidence. see https://
dksdata.com/CourtUpdate
https://dksdata.com/DS/Shandro1.jpg

1
The second section of our report discusses guidanceand communication between provincial authorities andcontinuing care facilities. We found that the processes
to develop guidance and ensure efficient two-way
communication with facilities were effective. 5We
W notedthat the Orders of the Chief Medical Officer of Healthspeciﬁc to continuing care facilities initially causedThis
confusion and frustration at facilities in wave one. T
happened because of their novelty, the pace at which
6
they were issued in the ﬁrst
three months, and theirlength and complexity. Alberta Health continuously
reﬁned its process for creating and communicating these
Orders across the ﬁrst two waves.
8
The third section of our report looks at the processes

to provide key resources and supports to facilities to
We foundprevent and respond to COVID-19 outbreaks. W
9that facilities
struggled to ensure they had enough ofThis wasthe right staff to provide safe resident care. T
10especially true during an outbreak, which could cause
20 to 50 per cent of already stretched facility staff to
12 usebe off due to illness or isolation requirements. The
of shared rooms, as well as large and dated buildings
were common in the most severe COVID-19 outbreaks.
13
Facilities also struggled to manage outbreaks due todelays in receiving COVID-19 test results for theirstaff—sometimes waiting a week orresidents and staff—
more at the same time as Albertans in the public werereceiving their own test results within days. Decisions toprovide $250 million of funding and personal protective
equipment (PPE) to facilities were key to relieving somestrain and came as facilities were reaching a breaking
point in these areas.
The last section of our report considers the systems
to monitor the response to COVID-19 in continuingcare facilities. We found that Alberta Health and AHS
developed and used several systems to monitor facilities,
particularly during COVID-19 outbreaks. Alberta Healthand AHS both quickly established in-person facility
inspection programs. While they initially struggledwith coordination, consistency, and siloed information,
there can be no doubt that facility inspections improved
resident safety. Other monitoring processes—such as

2 Report of the Auditor General—February 2023

2
epidemiologicalinvestigations of large outbreaks and3
in-depth internal
reviews of the system-level response—4
took place, butthese critical monitoring efforts ceased
after wave one.

Our report notes many ﬁndings in areas relating topreparedness, the impacts of conditions at the startof the pandemic, and other structural challenges on
the COVID-19 response. However, our report also
consistently notes the effort of people—individuals andgroups—at all levels of the continuing care system torespond to COVID-19 and protect residents despite,
and often directly in the face of, these sorts of structural
7 consistently saw examples of people
challenges. We
adapting, ﬁnding workarounds and temporary solutions
to structural problems, and a genuine effort to criticallyevaluate what was working and what was not, so thatthey could continuously improve the response over time.
Overall, we concluded that Alberta Health and AHS had
processes to respond to COVID-19 in continuing care
11 that improvements can be made.
facilities, but
We make eight recommendations in our report. Four
recommendations deal with preparedness and structural
factors that challenged the COVID-19 response.
These recommendations include updating and better
coordinating pandemic plans and preparedness, as well
as taking steps to increase the resilience of the facility
staffing system and resolving infrastructure limitations
encountered during COVID-19. Four recommendations
deal with ensuring that adaptations, learnings, and otherprocesses that were developed or reinforced to resolve
problems during COVID-19 are not lost.
We cannot overstate the dedication, focus, care, andindefatigable spirit shown by people across the system in
responding to COVID-19.

Page: 2
Number: 1
Author: daviddickson
Subject: Highlight Date: 2023-02-25 3:45:18 PM
This was a top down Order based response with no feedback loop on what was actually happening in the Care Homes. As such, the responses
were inappropriate and the cause of the ensuing crisis, harms and death. This was known by all in government and health care management
though. We told them over and over in written communications, all on the record. They did not care. Why?
Number: 2
Author: daviddickson
Subject: Highlight Date: 2023-02-24 4:00:06 PM
This could not have happened as MOST OUTBREAKS WERE LIMITED TO ASYMPTOMATIC STAFF as a trigger.
Where is this data in the report?
Number: 3
Author: daviddickson
Subject: Highlight Date: 2023-02-24 4:00:36 PM
Where are the PUBLIC REVIEWS? Where are the independent forensic reviews? WHERE ARE THE CRIMINAL INVESTIGATIONS?
Number: 4
WHY?

Author: daviddickson

Subject: Highlight Date: 2023-02-24 4:01:02 PM

Number: 5
Author: daviddickson
Subject: Highlight Date: 2023-02-24 3:03:27 PM
Care Homes just went into a blanket lock-down for the first three months with subsequent rolling lock-downs SUPERVISED BY AHS Zone
Medical Officers for the rest of 2020. The rapidly changing Orders created chaos which furthered the manufactured crisis. It is clear this can only
have been by design when reviewing the information available.
Number: 6
Author: daviddickson
Subject: Highlight Date: 2023-02-25 3:56:12 PM
For the first three months, Care Homes were on TOTAL LOCKDOWN. This government mandated response meant countless residents died notnecessarily from COVID but from failure to thrive (with osteomyelitis and other such impacts). This was a direct result of isolation and neglectand despite (in most instances) the best efforts of care staff. Without the ability for family and friends to oversee their loved ones' care, many
vulnerable souls died unnecessarily. Lies by the government were apparent from the start and continue to this day.
Number: 7
Author: daviddickson
Subject: Highlight Date: 2023-02-24 4:02:48 PM
All unnecessary as the CRISIS was created by the response, not the other way around. The documents, data and communications within AHS
show this clearly.
Number: 8
Author: daviddickson
Subject: Highlight Date: 2023-02-25 3:57:26 PM
They removed the most essential support structure throughout this manufactured crisis. - family and friends. Without these critical supports, theresidents declined and there was no one to help them other than over-stressed, overworked, faceless, masked strangers. This continues to thisday to one extent or another.
Number: 9
Author: daviddickson
Subject: Highlight Date: 2023-02-25 4:01:27 PM
This again was manufactured by forced sick leave, the consequence of flawed asymptomatic testing, 'close contact isolation', coupled with theinability to move between care centres (even though these very HCP's were all shopping at the same grocery stores unmasked! Then in 2021,
Alberta Health fired approximately 25% of temporary workers due to vaccine mandates making the situation even worse - and ongoing. Addthat to the 30% lost through site movement and it is a wonder the system has continued to function at all.
This is clearly a contributory part of the huge increase in overall All Cause Mortality in the province that cannot be accounted for by the highly
suspect COVID cases.
See: dksdata.com/AlbertaDead (all cause mortality in Alberta).
Number: 10
Author: daviddickson
See above comment.

Subject: Highlight Date: 2023-02-24 3:14:41 PM

Number: 11
Author: daviddickson
Subject: Highlight Date: 2023-02-24 5:37:54 PM
The response taken SHOULD NEVER BE REPEATED. IT CAUSED MOST OF THE AVOIDABLE DEATHS - BY DESIGN.
Number: 12

Author: daviddickson

Subject: Highlight Date: 2023-02-25 4:02:19 PM

This report FAILS TO MENTION the written AHS protocols for the specific transfer of COVID POSITIVE/Symptomatic (with any illness that may
have been listed as COVID) into SHARED ROOMS with a NON COVID/ NON SYMPTOMATIC resident. This forced these otherwise healthy
residents into CLOSE CONTACT and forced isolation with a new sick resident.
WHY DID THE REPORT MISS THIS?
How many deaths were caused by this deliberate cross infection (from who knows what ILI')?
https://thenationaltelegraph.com/regional/exclusive-alberta-government-transferring-covid-positive-patients-into-care-homes
https://thenationaltelegraph.com/regional/the-alberta-government-has-turned-care-homes-into-outbreak-centres
https://rumble.com/v2au726-january-30th-2021-karen-alberta-legislature-speech.html
Number: 13
Author: daviddickson
Subject: Highlight Date: 2023-02-25 5:54:37 PM
This is not correct. Testing for Care Homes was specifically prioritized for turn around in 4 days or less (and in most cases in 48 hours or less
BEFORE the prioritization announcement). Testing was done daily on almost all residents (symptomatic or not and even with no 'close contact'),

Comments from page 2 continued on next page

The second section of our report discusses guidanceand communication between provincial authorities andcontinuing care facilities. We found that the processes
to develop guidance and ensure efficient two-way
communication with facilities were effective. We
W notedthat the Orders of the Chief Medical Officer of Healthspeciﬁc to continuing care facilities initially causedThis
confusion and frustration at facilities in wave one. T
happened because of their novelty, the pace at which
they were issued in the ﬁrst three months, and theirlength and complexity. Alberta Health continuously
reﬁned its process for creating and communicating these
Orders across the ﬁrst two waves.
The third section of our report looks at the processes
to provide key resources and supports to facilities to
We foundprevent and respond to COVID-19 outbreaks. W
that facilities struggled to ensure they had enough ofThis wasthe right staff to provide safe resident care. T
especially true during an outbreak, which could cause
20 to 50 per cent of already stretched facility staff tobe off due to illness or isolation requirements. The useof shared rooms, as well as large and dated buildings
were common in the most severe COVID-19 outbreaks.
Facilities also struggled to manage outbreaks due todelays in receiving COVID-19 test results for theirstaff—sometimes waiting a week orresidents and staff—
more at the same time as Albertans in the public were14
receiving their own test results within days. Decisions
toprovide $250 million of funding and personal protective
equipment (PPE) to facilities were key to relieving somestrain and came as facilities were reaching a breaking
point in these areas.
The last section of our report considers the systems
to monitor the response to COVID-19 in continuingcare facilities. We found that Alberta Health and AHS
developed and used several systems to monitor facilities,
particularly during COVID-19 outbreaks. Alberta Healthand AHS both quickly established in-person facility
inspection programs. While they initially struggledwith coordination, consistency, and siloed information,
there can be no doubt that facility inspections improved
resident safety. Other monitoring processes—such as

2 Report of the Auditor General—February 2023

epidemiological investigations of large outbreaks andin-depth internal reviews of the system-level response—
took place, but these critical monitoring efforts ceased
after wave one.
Our report notes many ﬁndings in areas relating topreparedness, the impacts of conditions at the startof the pandemic, and other structural challenges on
the COVID-19 response. However, our report also
consistently notes the effort of people—individuals andgroups—at all levels of the continuing care system torespond to COVID-19 and protect residents despite,
and often directly in the face of, these sorts of structural
challenges. We consistently saw examples of people
adapting, ﬁnding workarounds and temporary solutions
to structural problems, and a genuine effort to criticallyevaluate what was working and what was not, so thatthey could continuously improve the response over time.
Overall, we concluded that Alberta Health and AHS had
processes to respond to COVID-19 in continuing carefacilities, but that improvements can be made.
We make eight recommendations in our report. Four
recommendations deal with preparedness and structural
factors that challenged the COVID-19 response.
These recommendations include updating and better
coordinating pandemic plans and preparedness, as well
as taking steps to increase the resilience of the facility
staffing system and resolving infrastructure limitations
encountered during COVID-19. Four recommendations
deal with ensuring that adaptations, learnings, and otherprocesses that were developed or reinforced to resolve
problems during COVID-19 are not lost.
We cannot overstate the dedication, focus, care, andindefatigable spirit shown by people across the system in
responding to COVID-19.

which created an artificial crisis of resources from test kits to staff. This never slowed the testing down though and there were no instances of alab result changing the timing of an 'Outbreak' which was defined as TWO WEEKS (28 days with Delta) AFTER the last positive test/probablecase (symptoms). People were assumed positive until tested and Outbreaks were not dependent on test delays (that did not exist).
1 probable or confirmed case made a center 'Under Investigation'. A second Probable or Confirmed Case put them on Outbreak for 2 weeks (or28 days). Any subsequent 'cases' extended the outbreak by 1 - 2 weeks. Testing delays were not the problem. TESTING too much with a known
faulty test WAS THE PROBLEM. "Who cares about false positives" said Premier Kenney - EVERYONE SHOULD!
https://rumble.com/v28lhpw-who-cares-about-false-positives-every-single-case-was-used-to-terorrise.html
KENNEY SAYS WHO CARES ABOUT FALSE POSITIVES! From Kenney's own Q&A::
00:00"Alright Donna Stratton Stratton Tip says I've read about the maker of the PCR test has stated it's about 50% wrong and wasn't designed forwhat we're using it for. Is that true?" And then this.
00:13"I actually asked for this to come up because I know there's a lot of folks often when I check out the Facebook comments, there's a lot of thisstuff about PCR, so PCR is the standard test for COVID-19 in Canada and Alberta and around the world."
00:30"It's it's true that based on how many cycles the PCR test is does on the sample that that it can generate in many cases does generate a false
positive…"
01:01"So there are, I'll call them covid skeptics, who are claiming that all of the restrictive policies are being wrongly informed by exaggerated Covid
case counts because of false positives through PCR testing."
01:53"In a sense, I mean, who really cares about the false positives?"
WHO CARES?? WHO INDEED!! Let me tell you WHO CARES, KENNEY!! How about the people isolated for two weeks, losing their business,closed care homes, closed schools, cancelled surgeries, suicides, poverty....
It takes a single 'case' to shut down the lives of hundreds of care home residents and all connected to them and our then Premier had the
audacity, to say "..who really cares about the false positives?"
APL and its implication in testing and fraudulent cases.
https://dksdata.com/AlbertaDead#APL
From 'when is a negative test a positive?' to 'how many days back for a case?'
These numbers are based on manipulated statistics related to when a person was coded as a COVID case, not when they died. In someinstances, these Covid cases 'survived' for over two years. Did they really die of COVID?
The criteria for a COVID death was death up to 6 months after a COVID diagnosis (with or without a death certificate to support). COVID
deaths were identified by Nurses in the COVID statistical department reviewing NetCare and Connect Care (and sometimes death certificates).
In August of 2022, that criteria changed to 60 days instead of 6 months. However, there are instances where the 6 months and the 60 days was
ignored.
http://dksdata.com/AlbertaDead
COVID cases were known to be unreliable and as such, COVID hospitalizations and deaths were built on flawed foundations. Fruit of the
poisonous tree from the start. For an Auditor to not even look at this is beyond negligent and further reinforces the need for a police forensic
investigation of all relevant data and facts.

Number: 14
Author: daviddickson
Subject: Highlight Date: 2023-02-25 4:12:49 PM
Excessive (and inappropriate by design and use) PPE was the cause of many of the issues from masks causing health issues to face shields
causing glare from the sun (a huge safety risk). The loss of communication as a result of these face coverings further impacted (and continues
to impact) the care of residents. Increased staffing and delays in 'screening', donning and doffing, and improper use all contributed to make
Care Homes (and Hospitals) one of the most dangerous and unhealthy places to be (this continues to this day).
The negative impacts to Staff, Residents, Visitors and DPS's is incalculable.
This was confirmed in the July 2022 SAG report where the authors even acknowledge that the optics of mask wearing, that is to assuage andvirtue signal to the public, is a factor in the decision to persist with the continuous masking policy. (see https://dksdata.com/MASKS)

Audit objective:
To determine whether the Department of Health and Alberta Health Services effectively actioned a pandemic andoutbreak response to COVID-19 in publicly funded continuing care facilities.
Key ﬁndings:•

Criterion 1:
Alberta Health and AHS
should have strategies,
plans, and protocols readyto guide the facilities’
pandemic and outbreak
response.

••

Continuing care facilities were 1not well-prepared for communicable disease
COVID-19—
outbreaks the magnitude of COVID-19—facility
pandemic plans were notsufficient and many facilities did not meet all requirements around infection
prevention and control and staff training prior to COVID-19.
2
Provincial
pandemic emergency plans were in place, but role clarity between
major participants was an issue in the ﬁrst wave of the COVID-19 response.

Pre-COVID pandemic and emergency preparedness exercises did not practise
coordination across the continuing care sector and lacked operational staff
involvement.

Recommendations:
3••

Recommendation 1: Update and expand a pandemic plan common to entire
continuing care sector
Recommendation 2: Exercise and simulate updated plan regularly, with allpartiesKey ﬁndings:•

Criterion 2:
Alberta Health and AHS
should communicate all
relevant plans, updates,
guidance, and emerging
information to facilities.

••

4of the novelty of the process and the urgency of the task, A
Because
Alberta
Health did not fully work through the implications of the ﬁrst few iterations of
5
Orders on facilities—as a result, the Orders caused confusionand frustration at
the front lines.
6
AHS
guidance for continuing care facilities was robust, consistent, and madewidely available.
7
Alberta
Health and AHS quickly established two-way communication channels
with facility operators.

Recommendations:
Alberta Health resolved noted issues during the course of our audit.
8 made no recommendations related to communication.
We

Report of the Auditor General—February 2023 3

Page: 3
Number: 1
Author: daviddickson
Subject: Highlight Date: 2023-02-25 4:16:12 PM
They were well prepared. For decades past, this vulnerable care sector managed effectively through every ILI season and many GI and otheroutbreaks throughout the year. However, no organization, however well prepared and experienced, could have navigated the manufactured
crisis that may have looked incompetent at best but can only be explained by willful negligence/criminal behavior. The terrorization of a
population for political purposes (increased power base) is classified in the Canadian Criminal Code as Terrorism. Nothing more, NOTHING
LESS.
Number: 2
Author: daviddickson
Subject: Highlight Date: 2023-02-25 4:16:43 PM
The Provincial AEMA plans were not implemented AT ALL. If they had been, the fraud in this crisis would have been identified at the start.
People would have received proper early treatment and avoidable deaths and suffering would have been prevented. (See Lt. Col. David
Redman).
Number: 3
Author: daviddickson
Subject: Highlight Date: 2023-02-25 4:17:36 PM
No one who is party to this report or the response taken should be any where near a pandemic response plan. The first thing to be assessed inany plan has to be... DO WE HAVE A CRISIS TO RESPOND TO? Secondly - DO NOT CREATE A CRISIS FROM THE RESPONSE.
Number: 4
Author: daviddickson
Subject: Highlight Date: 2023-02-25 4:18:12 PM
The 'urgency' was manufactured by the response, not the other way around.
Why did this report not look back on the history of Alberta Health and AHS in 'preparing' for this 'Pandemic' in August 2019 (bulk purchase ofventilators and refurbishment of ventilators that were supposed to be replaced) and December of 2019 (bulk purchase of PPE beyond any
reasonable ability to be used based on talks with AHS and contacts in Wuhan China)?
Number: 5
Author: daviddickson
Subject: Highlight Date: 2023-02-24 4:19:25 PM
This was clearly by design if the Orders are reviewed. Also, where is the evidence to back up these Orders?

“I, Dr. Deena Hinshaw, Chief Medical Officer of Health (CMOH) have initiated an investigation into the existence of
COVID-19 within the Province of Alberta.
This investigation has confirmed that COVID-19 is present in Alberta and constitutes a public health emergency as a novelor highly infectious agent that poses a significant risk to public health.”
Or“Whereas I, Dr. Deena Hinshaw, Chief Medical Officer of Health (CMOH) have initiated an investigation into the existenceof COVID-19 within the Province of Alberta.
Whereas the investigation has confirmed that COVID-19 is present in Alberta and constitutes a public health emergency asa novel or highly infectious agent that poses a significant risk to public health.” etc.
FULL DISCLOSURE IS REQUIRED
Number: 6
Author: daviddickson
Under what criteria?

Subject: Highlight Date: 2023-02-24 4:19:45 PM

Number: 7
Author: daviddickson
Subject: Highlight Date: 2023-02-24 4:20:11 PM
Clearly not. The communication was ONE WAY. AHS Mandated - DO AS YOU ARE TOLD.
Number: 8

Author: daviddickson

Subject: Highlight Date: 2023-02-24 5:38:33 PM

From care managers to frontline staff working with residents on the floor, there was complete chaos andconfusion as Orders changed sometimes daily. The requirements for PPE shifted constantly for staff andresidents. The same can be said for PPE requirements for visitors (for example, goggles own/provided,
required/not required. Isolation protocols, duration of isolation (dependent on vax status), testing – ALL inconstant flux.

Key ﬁndings:
1
•
2
•
3
•

Criterion 3:
Alberta Health and AHS
should assess whether
facilities have resources
to implement plans,
protocols, and guidance.

••

Having enough staff to provide safe care during an outbreak was a persistent,systemic problem.
Facilities experienced major delays in getting the results of COVID-19 tests forresidents and staff.
Shared rooms and aspects of facility infrastructure featured prominently in themost severe COVID-19 outbreaks.
4
Alberta
Health and AHS provided over $250 million in incremental funding tofacilities in 2020.
5
PPE
and supplies were a critical constraint for the ﬁrst month, but rectiﬁed after
mid-April 2020.

Recommendations:•

Recommendation 3: Develop a continuing care staffing strategy to increasestaffing system resilience•

Recommendation 4: Formalize centre of expertise for outbreak management•

Recommendation 5: Formalize operational improvements in outbreak testing•

Recommendation 6: Evaluate all existing infrastructure and set a strategy for
improving facility infrastructure

Key ﬁndings:•

A complete suite of in-person facility inspections began within weeks of the ﬁrst
outbreak and continuously improved.

•

Operational outbreak monitoring from AHS zone leadership was effective.

Criterion 4:•

Alberta Health and AHS
should monitor whether
facilities are complying
with the plans, protocols,
and guidance, and enforce
action as needed.

Detailed epidemiological investigations of outbreaks were critical tools to learn
from COVID-19 outbreaks in facilities and make operational improvements, butceased after wave one.

•

System-level monitoring of the response of Alberta Health and AHS to COVID-19
in continuing care facilities was robust, but ceased after wave one.

Recommendations:•

Recommendation 7: Track resident illness and staff absences duringcommunicable disease outbreaks in facilities•

Recommendation 8: Implement recommendations from Alberta Health Services
internal reports

4 Report of the Auditor General—February 2023

Page: 4
Number: 1

Author: daviddickson

Subject: Highlight Date: 2023-02-24 5:38:56 PM

Staffing – requirement for isolation for “symptoms” 10 days (post vaccine - 14 days in 2020), thenreduced to 5 after system went into freefall. Most of initial outbreaks were the result of staff infections.
The system functions with “part time” staff moving from site to site because they are a cheap anddisposable commodity for the system (reduced health benefits/no overtime pay etc.)
Staff went off repeatedly for so much as a sniffle (either genuinely concerned or in some cases taking
advantage of the protocols). Contact tracing meant even if a staff’s family member “tested positive” thestaff member was required to stay home and isolate. Most staff took time off as their physical and mental
health deteriorated in the face of unmanageable protocols making work demands untenable. The entire
system was bound to collapse leaving residents to suffer and die - BY DESIGN.
Add into that equation, centers shut down for 2 asymptomatic cases with family denied entry. AGAIN,ISOLATION AND NEGLECT were the greatest threat to this vulnerable population.
Number: 2
Author: daviddickson
Subject: Highlight Date: 2023-02-24 4:41:00 PM
False. Even if it was true it could not have impacted the Outbreak protocols as they were time based in 2020 to a minimum of 2 weeks from 2
probable cases (even asymptomatic or 'close contacts').
This is a red herring in the report. The real issue was faulty and excessive indiscriminate testing, improper diagnosis and treatment of any and allconditions.
Number: 3

Author: daviddickson

Subject: Highlight Date: 2023-02-24 7:34:01 PM

This report FAILS TO MENTION the written AHS protocols for the specific transfer of COVID POSITIVE/Symptomatic (with any illness that may
have been listed as COVID) into SHARED ROOMS with a NON COVID/ NON SYMPTOMATIC resident. This forced these otherwise healthy
residents into CLOSE CONTACT and forced isolation with a new sick resident.
WHY DID THE REPORT MISS THIS?
How many deaths were caused by this deliberate cross infection (from who knows what ILI's)?
https://thenationaltelegraph.com/regional/exclusive-alberta-government-transferring-covid-positive-patients-into-care-homes
https://thenationaltelegraph.com/regional/the-alberta-government-has-turned-care-homes-into-outbreak-centres
https://rumble.com/v2au726-january-30th-2021-karen-alberta-legislature-speech.html

Number: 4
Author: daviddickson
Subject: Highlight Date: 2023-02-24 4:55:23 PM
Excessive (and inappropriate by design and use) PPE was the cause of many of the issues from masks causing health issues to face shields
causing glare from the sun (a huge safety risk). The loss of communication as a result of these face covering further impacted the care ofresidents. Increased staffing and delays in 'screening', donning and doffing, improper use all contributed to make Care Homes (and Hospitals)
one of the most dangerous and unhealthy places to be (and still are).
The negative impacts to Staff, Residents, Visitors and DPS's is incalculable.
This was confirmed in the July 2022 SAG report (see https://dksdata.com/MASKS)
Number: 5
Author: daviddickson
Subject: Highlight Date: 2023-02-24 5:02:20 PM
PPE was bulk purchased in December of 2019 FOR THE EXPECTED PANDEMIC. WHAT WAS THE ISSUE WITH AVAILABILITY?
https://edmontonjournal.com/opinion/columnists/david-staples-masterminds-behind-albertas-medical-supplies-surge-to-meet-covid-19-crisis/"Jitendra “J.P.” Prasad, who runs the AHS supply procurement system, is always on the lookout for terrible diseases that might impact supply
and demand. He and his team heard disturbing news about a “strange flu” in Wuhan, China, in early December, Prasad said. “We have contacts
from China and a lot of the conversation from them was, ‘Hey, J.P., we think something is happening that may impact us.'”""It stockpiled all incoming supplies in one city, Edmonton, at two huge warehouses, one for daily operational supplies, the second for
emergencies.""In mid-December, Prasad’s team looked at how to increase stock. If they were placing an order for five days’ supply of masks, gloves andgowns, they now doubled the order, increasing their emergency stockpile."
Jason Kenney"Thanks to the great work Jitendra Prasad and his team at @AHS_media procurement, we have 9 warehouses like this 150,000 sq.ft. one, filledwith PPE & medical equipment for our front-line workers.
Alberta will be prepared with enough equipment to fight #COVID19AB."

Comments from page 4 continued on next pageKey ﬁndings:

Criterion 3:
Alberta Health and AHS
should assess whether
facilities have resources
to implement plans,
protocols, and guidance.

•

Having enough staff to provide safe care during an outbreak was a persistent,systemic problem.

•

Facilities experienced major delays in getting the results of COVID-19 tests forresidents and staff.

•

Shared rooms and aspects of facility infrastructure featured prominently in themost severe COVID-19 outbreaks.

•

Alberta Health and AHS provided over $250 million in incremental funding tofacilities in 2020.

•

PPE and supplies were a critical constraint for the ﬁrst month, but rectiﬁed after
mid-April 2020.

Recommendations:•

6
Recommendation
3: Develop a continuing care staffing strategy to increasestaffing system resilience•

7
Recommendation
4: Formalize centre of expertise for outbreak management•

8
Recommendation
5: Formalize operational improvements in outbreak testing•

9
Recommendation
6: Evaluate all existing infrastructure and set a strategy for
improving facility infrastructure

Key ﬁndings:••

Criterion 4:•

Alberta Health and AHS
should monitor whether
facilities are complying
with the plans, protocols,
and guidance, and enforce
action as needed.

•

10complete suite of in-person facility inspections began within weeks of the ﬁrst
Aoutbreak and continuously improved.
11
Operational
outbreak monitoring from AHS zone leadership was effective.
12
Detailedepidemiological investigations of outbreaks were critical tools to learn
from COVID-19 outbreaks in facilities and make operational improvements, butceased after wave one.
13
System-levelmonitoring of the response of Alberta Health and AHS to COVID-19
in continuing care facilities was robust, but ceased after wave one.

Recommendations:••

14
Recommendation
7: Track resident illness and staff absences duringcommunicable disease outbreaks in facilities
15
Recommendation
8: Implement recommendations from Alberta Health Services
internal reports

4 Report of the Auditor General—February 2023

https://twitter.com/jkenney/status/1249104560330649600?s=20
Number: 6
Author: daviddickson
Subject: Highlight Date: 2023-02-24 5:02:56 PM
Maybe don't create unworkable environments and don't fire 25% of the staff!
Number: 7
Author: daviddickson
Subject: Highlight Date: 2023-02-24 5:03:32 PM
AEMA already fits this role ands always did! IT IS THE REASON THAT ORGANIZATION EXISTS.
Number: 8
Author: daviddickson
Subject: Highlight Date: 2023-02-24 5:03:54 PM
TO MUCH FAULTY TESTING WAS THE PROBLEM (See above)
Number: 9
Author: daviddickson
Subject: Highlight Date: 2023-02-25 4:22:12 PM
This has always been an issue, but it was not the issue for COVID. THE PROTOCOLS WERE!
Number: 10
Author: daviddickson
Subject: Highlight Date: 2023-02-24 5:06:25 PM
Failed every time to identify there was no issue other than that CAUSED BY THE IMPROPER PROTOCOLS.
Number: 11
Author: daviddickson
Subject: Highlight Date: 2023-02-24 5:19:37 PM
Having communicated DIRECTLY with the multiple Edmonton Zone Medical Officers, this could not be further from the truth. Communications
were shared with ALL MLA's, MP's and the current Premier of Alberta - Danielle Smith (and more).
THEY DID NOTHING.
https://dksdata.com/DS/03%20-%20Danielle%20Smith%20-%20NEVER%20RESPONDED%20TO%20THE%20THE%20LAST%20EMAILS%20-%
20WHY%20-%20And%20just%20sent%2060K%20to%20the%20JCCF_Redacted.pdf

https://dksdata.com/DS/04%20-%20Danielle%20Smith%20-%20Elderly%20Albertan%20denied%20access%20to%20ambulance_Redacted.pdf
https://dksdata.com/DS/05%20-%20JCCF%20response%20to%20Jerry%20Dunham%20as%20shared%20with%20Danielle%
20Smith_Redacted.pdf
Number: 12
Author: daviddickson
Subject: Highlight Date: 2023-02-24 5:20:06 PM
This could not have happened as MOST OUTBREAKS WERE LIMITED TO ASYMPTOMATIC STAFF as a trigger.
Where is this data in the report?
Number: 13
Author: daviddickson
Subject: Highlight Date: 2023-02-24 5:20:21 PM
This could not have happened as MOST OUTBREAKS WERE LIMITED TO ASYMPTOMATIC STAFF as a trigger.
Where is this data in the report?
Number: 14
Author: daviddickson
Subject: Highlight Date: 2023-02-25 4:23:22 PM
They did this. It was reported from Capital Care to all family members. throughout 2020. Ironically, this communication recently STOPPED. The
information is in stark contrast to what this report alleges (as does the Alberta Health published data).
Number: 15
What reports?

Author: daviddickson

Subject: Highlight Date: 2023-02-24 5:20:37 PM

Context
COVID-19
1
COVID-19 is a respiratory disease caused by the

SARS-CoV-2 virus. SARS-CoV-2 is a coronavirus in thefamily of viruses that caused the SARS epidemic in 2003.2
4
Most
people infected with COVID-19 experience mild tomoderate illness and recover without special treatment.
Older people and those with underlying medical
conditions are more likely to develop serious illness ordie from COVID-19.

COVID-19 was ﬁrst identiﬁed in Wuhan, China in
December 2019. By January 30, 2020, the World HealthOrganization (WHO) declared COVID-19 a public healthemergency of international concern. After signiﬁcantinternational spread, the WHO upgraded COVID-19 toa pandemic on March 11, 2020.3

Ontario identiﬁed the ﬁrst probable COVID-19 case in
Canada on January 25, 2020. The national laboratory
conﬁrmed the case two days later. On March 6, 2020,
Alberta conﬁrmed the ﬁrst case of COVID-19 in the
2 11 days, cases grew from one to more thanprovince. In
3100. OnO March 17, 2020, Alberta declared a state of
public health emergency.
The characteristics of the disease and the sheer
magnitude of COVID-19 caused the greatest challenge
The entire
ever faced by Alberta’s health care system. T
health system needed to act quickly, make decisions
with limited and changing information, and continuously
reﬁne its approaches to respond to COVID-19.

Alberta COVID-19 Cases, Deaths and Case Fatality
March 2020–December 2020
Age in years

0-9

10-19

20-29

30-39

40-49

50-59

60-69

70-79

80+

Cases

7,935

11,70019,50319,80016,43912,285

7,670

3,768

4,143

Deaths

-

-

4

7

16

48

163

309

983

Case fatality4

-%

-%

0.02%

0.04%

0.10%

0.39%

2.13%

8.20%

23.73%

2

For more information see “Learning from SARS: Renewal of public health in Canada – Report of the National Advisory Committee on SARS and
Public Health.” https://www.canada.ca/en/public-health/services/reports-publications/learning-sars-renewal-public-health-canada.html

3

See World Health Organization’s timeline of their COVID-19 response: https://www.who.int/emergencies/diseases/novelcoronavirus-2019/interactive-timeline#!

4

A case fatality rate is a common measure of disease severity which asks: “Of those who caught the disease, how many died?”
Report of the Auditor General—February 2023 5

Page: 5
Number: 1
Author: daviddickson
Subject: Highlight Date: 2023-02-25 4:25:11 PM
SARS (and MERS) had much higher mortality and R0 (infectious replication in the community). However, they were prevented by NOT
responding in the way Alberta did for SARS-CoV-2 (COVID-19). Early treatments REFUSED in 2020 and beyond proved highly effective in SARS
and MERS. Alberta canceled the trials (HOPE) of these treatments under very suspicious circumstances. And where did those millions of
donated doses of HCQ disappear to?
See https://dksdata.com/Articles/COVArticles/Article5.html (including references)
Alberta HOPE Trial
https://dksdata.com/covidimages/NoHopeCases.pdf

Novartis (130 Million doses), Mylan (50 million doses), Teva (16 million doses), Amneal (20 million doses), Bayer (3 million doses)
https://www.fiercepharma.com/pharma/new-commitments-mylan-and-teva-move-to-supply-tens-millions-hydroxychloroquine-tablets-to"
130 million doses from Novartis
https://www.novartis.com/news/media-releases/novartis-commits-donate-130-million-doses-hydroxychloroquine-support-global-covid-19pandemic-response
100 Million Doses from Sanofi
https://www.reuters.com/article/us-healt-coronavirus-sanofi-hydroxychlor/sanofi-will-donate-100-million-doses-of-hydroxychloroquine-to-50countries-idUSKCN21S0JK
HHS Accepts 30 Million DONATED doses for COVID patients.
https://public3.pagefreezer.com/browse/HHS%20%E2%80%93%C2%A0About%20News/20-01-2021T12:29/https://www.hhs.gov/about/news/2020/03/29/hhs-accepts-donations-of-medicine-to-strategic-national-stockpile-as-possible-treatments-for-covid-19-patients.html
Jamp Pharma Donating one million of doses
https://www.newswire.ca/news-releases/canadian-jamp-pharma-group-gets-involved-donating-one-million-doses-of-hydroxychloroquine-tohospitals-to-help-combat-covid-19-897524025.html
Apotex donating two million doses
https://www.newswire.ca/news-releases/canada-s-apotex-donates-two-million-dosages-of-hydroxychloroquine-to-the-public-health-agencyof-canada-843392095.html
Apotex donating doses for trials
https://everythinggp.com/2020/04/13/hydroxychloroquine-will-be-studied-in-alberta-as-a-possible-covid-19-treatment/
Amneal Pharmaceuticals donates 4.3 million doses
https://timesofindia.indiatimes.com/business/international-business/indian-americans-us-pharma-firm-donates-3-4-millionhydroxychloroquine-sulphate-tablets/articleshow/75039058.cms
Number: 2
Author: daviddickson
Subject: Highlight Date: 2023-02-25 4:26:57 PM
This escalation was minimal for the end of ILI season and also was based on very suspect criteria for a 'CASE'. How many cases were
CONFIRMED at the time? The Alberta Data has TEN (10) ACTIVE CASES on March 17th, 2020. Official reports had 19 'cases' by March 16th, but
the actual data published by Alberta Health does not support that.
In addition, there were 91 RECOVERED cases in the data from Alberta Health (many 'probable'). As it takes a minimum of 2 weeks (after
symptoms) to be considered 'Recovered', the 11 cases to over 100 in 11 days is nothing less than a lie.
This is deliberately misleading.
The World Health Organization states that there are over 1 billion cases of Influenza each year, but we don't report 1 billion ACTIVE CASES!
see https://dksdata.com/Articles/COVArticles/Article7.html"Besides future pandemics, the seasonal flu currently infects 1 billion people every year, including 3-5 million severe cases, and causes 290 000
to 650 000 respiratory deaths."
http://www.emro.who.int/pandemic-epidemic-diseases/news/the-next-flu-pandemic-a-matter-of-when-not-if.html
Number: 3
Author: daviddickson
Subject: Highlight Date: 2023-02-24 5:52:11 PM
Why did Alberta trigger an 'Influenza Pandemic' in March of 2019 on the advice of the Health Minster Tyler Shandro - Without the legislative
authority to do so?
https://dksdata.com/DS/Shandro1.jpg
Number: 4
Author: daviddickson
Subject: Highlight Date: 2023-02-25 4:29:21 PM
In almost all instances, if treated early, people recovered. No one being appropriately treated early FOR COVID died OF COVID. In fact, as
COVID 19 was circulating the world from late 2019 without any restrictions or mass casualties, it was clear from the start that the response wasdeadlier than the disease.
See https://dksdata.com/COVArticles

Comments from page 5 continued on next page

Context
COVID-19
COVID-19 is a respiratory disease caused by the
SARS-CoV-2 virus. SARS-CoV-2 is a coronavirus in thefamily of viruses that caused the SARS epidemic in 2003.2

Ontario identiﬁed the ﬁrst probable COVID-19 case in
Canada on January 25, 2020. The national laboratory
conﬁrmed the case two days later. On March 6, 2020,
Alberta conﬁrmed the ﬁrst case of COVID-19 in theprovince. In 11 days, cases grew from one to more than100. OnO March 17, 2020, Alberta declared a state of
public health emergency.
5
The characteristics of the disease and the sheer

Most people infected with COVID-19 experience mild tomoderate illness and recover without special treatment.
6
Olderpeople and those with underlying medical
conditions are more likely to develop serious illness ordie from COVID-19.
7
COVID-19
was ﬁrst identiﬁed in Wuhan, China in
December 2019. By January 30, 2020, the World HealthOrganization (WHO) declared COVID-19 a public health8
emergency of international concern. Aftersigniﬁcantinternational spread, the WHO upgraded COVID-19 toa pandemic on March 11, 2020.3

magnitude of COVID-19 caused the greatest challenge
The entire
ever faced by Alberta’s health care system. T
health system needed to act quickly, make decisions
with limited and changing information, and continuously
reﬁne its approaches to respond to COVID-19.

Alberta COVID-19 Cases, Deaths and Case Fatality
March 2020–December 2020
9
Age in years

0-9

10-19

20-29

30-39

40-49

50-59

60-69

70-79

80+

Cases

7,935

11,70019,50319,80016,43912,285

7,670

3,768

4,143

Deaths

-

-

4

7

16

48

163

309

983

Case fatality4

-%

-%

0.02%

0.04%

0.10%

0.39%

2.13%

8.20%

23.73%

2

For more information see “Learning from SARS: Renewal of public health in Canada – Report of the National Advisory Committee on SARS and
Public Health.” https://www.canada.ca/en/public-health/services/reports-publications/learning-sars-renewal-public-health-canada.html

3

See World Health Organization’s timeline of their COVID-19 response: https://www.who.int/emergencies/diseases/novelcoronavirus-2019/interactive-timeline#!

4

A case fatality rate is a common measure of disease severity which asks: “Of those who caught the disease, how many died?”
Report of the Auditor General—February 2023 5

Number: 5
Author: daviddickson
Subject: Highlight Date: 2023-02-24 5:59:23 PM
This is nothing less than fear mongering based on fraudulent data and propaganda. There is no evidence, with a properly executed thoroughaudit to support these statements. The publicly available data alone, shows the complete opposite and that the crisis was manufactured by the
response. This is also demonstrated by the UK ONS data, Health Canada, Alberta Health and more.
see: https://dksdata.com/COVID19
https://dksdata.com/ONSDATA
https://threadreaderapp.com/thread/1628981616143114241.html
https://dksdata.com/AlbertaDead
https://dksdata.com/MASKS
https://dksdata.com/CourtUpdate
https://dksdata.com/DavidDicksonAHRC
Number: 6
Author: daviddickson
Subject: Highlight Date: 2023-02-25 4:30:33 PM
Older people DID NOT RECEIVE EARLY TREATMENT. THEY WERE LOCKED IN THEIR ROOMS, AS PER THE AHS PROTOCOLS.
This caused untold avoidable deaths, not just with a COVID diagnosis.
Number: 7
Author: daviddickson
How did Alberta get to be so connected?

Subject: Highlight Date: 2023-02-24 5:40:19 PM

PPE was bulk purchased in December of 2019 FOR THE EXPECTED PANDEMIC. WHAT WAS THE ISSUE WITH AVAILABILITY?
https://edmontonjournal.com/opinion/columnists/david-staples-masterminds-behind-albertas-medical-supplies-surge-to-meet-covid-19-crisis/"Jitendra “J.P.” Prasad, who runs the AHS supply procurement system, is always on the lookout for terrible diseases that might impact supply
and demand. He and his team heard disturbing news about a “strange flu” in Wuhan, China, in early December, Prasad said. “We have contacts
from China and a lot of the conversation from them was, ‘Hey, J.P., we think something is happening that may impact us.'”""It stockpiled all incoming supplies in one city, Edmonton, at two huge warehouses, one for daily operational supplies, the second for
emergencies.""In mid-December, Prasad’s team looked at how to increase stock. If they were placing an order for five days’ supply of masks, gloves andgowns, they now doubled the order, increasing their emergency stockpile."
Jason Kenney"Thanks to the great work Jitendra Prasad and his team at @AHS_media procurement, we have 9 warehouses like this 150,000 sq.ft. one, filledwith PPE & medical equipment for our front-line workers.
Alberta will be prepared with enough equipment to fight #COVID19AB."
https://twitter.com/jkenney/status/1249104560330649600?s=20
Number: 8
Author: daviddickson
Subject: Highlight Date: 2023-02-24 5:34:35 PM
Why did Alberta trigger an 'Influenza Pandemic' in March of 2019 on the advice of the Health Minster Tyler Shandro - Without the legislative
authority to do so?
https://dksdata.com/DS/Shandro1.jpg
Number: 9
Author: daviddickson
Subject: Highlight Date: 2023-02-25 4:31:36 PM
This data is the very definition of Lies, Damned Lies and Statistics.
https://dksdata.com/AlbertaDead#Byyear
https://dksdata.com/AlbertaDead#AGCOVID

In 2021/2022, Alberta Health/AHS moved almost 500 reported COVID deaths into 2020 in what can only be seen as an apparent attempt tofalsify the perceived risk of death in one specific group.
How did they do this?
By reclassifying deaths from the year they died to the year they were put into the system with an initial COVID diagnosis. In some cases, thetime from that diagnosis to a reported death was up to 768 days for someone in the over 80's category. Alberta has COVID deaths reported ashigh as 105 years and even 107 years old, so the 80+ category is quite large.

COVID-19 and Continuing Care
1
COVID-19 presents signiﬁcant risk to continuing carefacilities5 and their residents. The disease spreads
efficiently in small and crowded spaces, and it canspread before people know they are ill. It presents themost risk of severe illness or death to older people
and those with complex medical conditions. This
describes most continuing care residents. Residents live
communally in these facilities. While many live in privaterooms, in early 2020 it was not uncommon to see
3
residents sharing a room. Oncethe disease gets into a
facility, it can spread quickly and cause signiﬁcant illness
and death among its residents.

Background on Alberta’s Wave
One and Two Continuing Care
Experience2
In this report we focus on the response of Alberta Healthand AHS to outbreaks in continuing care facilities in the
period of March to December 2020 during the ﬁrst andsecond waves of COVID-19.

4
Across the world, the risk presented by COVID-19 tonursing homes and other congregate care facilities
quickly became obvious, sometimes with terrible severity.
5 late May 2020, Canada had
Canada was no exception. In
the highest proportion of COVID-19 deaths attributable tolong-term care across the OECD,6 at 81 per cent.7

5

As we deﬁne later in the “About This Audit” section, we focus this report on continuing care facilities that receive public health funding toprovide designated supportive living (DSL) and long-term care (LTC) services to residents. In this report, we will refer to “continuing carefacilities,” “facilities,” or “continuing care” to refer only to these facilities in the scope of our audit.

6

The Organization for Economic Co-operation and Development (OECD) is an organization representing 38 developed countries. The OECD
countries are a common benchmark for comparing experiences, outcomes, and policy responses between comparable countries.

7

Canadian Institute for Health Information (CIHI). “Pandemic Experience in the Long-Term Care Sector: How Does Canada Compare with OtherCountries?”

6 Report of the Auditor General—February 2023

Page: 6
Number: 1
Author: daviddickson
Subject: Highlight Date: 2023-02-25 4:32:38 PM
Except the case count in Care Homes demonstrates that they did not get sick. They were the most tested population in Alberta yet they account(by this report's own data) for one of the smallest groups for 'cases'. What really happened is clear. They died primarily as a result of the COVID
response (as has been reported elsewhere in the world). Some may have had COVID and some may have died 'WITH' COVID, but very few died
OF COVID. And MANY died as a result of the response.
The All Cause statistics for the care homes demonstrate this. Why are those details not here for comparison? And this situation got a lot worse
starting the end of 2020 and beyond - and continues.
See https://dksdata.com/AlbertaDead
https://threadreaderapp.com/thread/1628981616143114241.html
Number: 2

Author: daviddickson

Subject: Highlight Date: 2023-02-24 7:34:16 PM

The most vulnerable in LTC have ALWAYS been at most risk for ANY outbreak. Protocols in the past were
extremely effective in managing and indeed mitigating spread. What we saw put in place for COVID19
CAUSED suffering and death from isolation and neglect. AND IT CONTINUES TO THIS DAY.
If this was such a deadly pandemic, why were COVID positive patients transferred into shared rooms as
per AHS’ own policy throughout the last three years? Either COVID19 was deadly and the policy was
designed to infect residents (not COVID positive) in shared rooms… or it wasn’t. Which was it, AHS?? You
don’t get to bat for both sides in this game of deceit!
This report FAILS TO MENTION the written AHS protocols for the specific transfer of COVID POSITIVE/Symptomatic (with any illness that may
have been listed as COVID) into SHARED ROOMS with a NON COVID/ NON SYMPTOMATIC resident. This forced these otherwise healthy
residents into CLOSE CONTACT and forced isolation with a new sick resident.
WHY DID THE REPORT MISS THIS?
How many deaths were caused by this deliberate cross infection (from who knows what ILI's)?
https://thenationaltelegraph.com/regional/exclusive-alberta-government-transferring-covid-positive-patients-into-care-homes
https://thenationaltelegraph.com/regional/the-alberta-government-has-turned-care-homes-into-outbreak-centres
https://rumble.com/v2au726-january-30th-2021-karen-alberta-legislature-speech.html

Number: 3
Author: daviddickson
Subject: Highlight Date: 2023-02-25 4:33:42 PM
This was not the case in 2020. Other than a few care homes with known high mortality rates (due to the type of residents and history of the
facility), the majority of 'Outbreaks' were primarily asymptomatic in the residents. Even the public reporting shows this let alone the information
the Auditor General's office should have access to.
Number: 4
Author: daviddickson
Subject: Highlight Date: 2023-02-24 6:11:50 PM
Report after report from Quebec, Ontario, New York and the UK has shown that the response to COVID was the greatest cause of death in Care
Homes. For this report to ignore that fact is criminal.
Number: 5
Author: daviddickson
Subject: Highlight Date: 2023-02-24 6:21:14 PM
As with the Alberta Data, this is manipulated data and is not reflective of the actual records. Just changing a sort date does not make a statistic
true. Statistics are the worst and easiest way to portray a lie. The comments in this report outline how that is the case here.

Key participants involved in the continuing care COVID-19 response
The response to COVID-19 in continuing care facilities was complicated. It required action from all major participantsin the continuing care sector, as well as entities outside the health sector. The continuing care system exists within,and has many key relationships with and dependencies on, the broader provincial health system. The diagram below
outlines the main participants that this report focuses on at the highest possible level.

Oversight

Alberta Health

Alberta Health Services
ReportingContinuingcarebranchOfficeof the
CMOH

Inspectors(PCCAT,
EPH, IPC)

Compliance&monitoring
branchHealtheconomics
branchReport on staffing

Provincial
continuing
care

Information& feedback

Operator
associations

Publichealth& CDC
Covid test
results

Inspect
facilities

Guidance

Public HealthOrdersCommunication

Zone
operations

Outbreakreporting

All continuing care facilities
Contracted operators

AHS owned & operated

Facilities operated by
not-for-proﬁtorganizations

AHS-operated facilities

Alberta
Precision
Labs
Swabs

CapitalCare & Carewest
facilities

Facilities operated byfor-proﬁt organizations

Information& feedback

Report of the Auditor General—February 2023 7

Timeline of Alberta’s response to
COVID-19 in continuing care facilities

From this point, Alberta’s continuing care sector—
residents, their families, staff, operators, AHS, andAlberta Health—began a years-long effort to keep
residents safe from COVID-19.

1
On March 9, 2020, the Chief Medical Officer of Healthtold family members to avoid continuing care facilities
if they were feeling unwell. A
AHS sent the ﬁrst guidance
to continuing care facilities and operators on March 11.
3
On that same day, the ﬁrst COVID-19 case linked to an
Alberta continuing care facility was suspected. The ﬁrst
outbreak was conﬁrmed on March 14, 2020.

2 provide a consolidated timeline of Alberta’s responseWe
to COVID-19 in continuing care facilities in 2020 inAppendix B.

Alberta Continuing Care Facilities
Daily Cases, Deaths, and Active Outbreaks
March–December 2020
180
160
140
120
100
80
60
40
20
0
3-1-2020

4-1-2020

5-1-2020

6-1-2020

7-1-2020

Active Facility Outbreaks

8 Report of the Auditor General—February 2023

8-1-2020

9-1-2020 10-1-2020 11-1-2020 12-1-2020

Daily Cases

Daily Deaths

Page: 8
Number: 1

Author: daviddickson

Subject: Highlight Date: 2023-02-25 4:37:49 PM“On March 9th, 2020, the Chief Medical Officer of Health told family members to avoid continuing carefacilities if they were feeling unwell.” To put this into actual context – DESIGNATED SUPPORT PERSONSWERE ACIVELY REFUSED ENTRY TO PROVIDE ESSENTIAL CARE FOR THEIR LOVED ONES – A SITUATIONTHAT LASTED FOR ALMOST THREE MONTHS. THIS RESULTED IN SUFFERING AND DEATH BEYOND ANYRISK POSED BY COVID19. To use the word "avoid" is disingenuous and disinformation at its finest.
Essential supports were actively barred from access to their loved ones.
Despite the removal of critical care supports, outbreaks continued unabated, propelled for the most partby staff infections and in spite of all protocols including PPE put in place to supposedly mitigate spread.
Number: 2
Author: daviddickson
Subject: Highlight Date: 2023-02-24 6:26:01 PM
The timeline is not 100% accurate. However, as the Orders were reviewed, I assume the information behind them was also. Where is theevidence to back up these Orders?
“I, Dr. Deena Hinshaw, Chief Medical Officer of Health (CMOH) have initiated an investigation into the existence of COVID-19 within the Provinceof Alberta.

This investigation has confirmed that COVID-19 is present in Alberta and constitutes a public health emergency as a novel or highly infectious
agent that poses a significant risk to public health.”
Or“Whereas I, Dr. Deena Hinshaw, Chief Medical Officer of Health (CMOH) have initiated an investigation into the existence of COVID-19 within theProvince of Alberta.
Whereas the investigation has confirmed that COVID-19 is present in Alberta and constitutes a public health emergency as a novel or highly
infectious agent that poses a significant risk to public health.” etc.
FULL DISCLOSURE IS REQUIRED
Number: 3
Author: daviddickson
Subject: Highlight Date: 2023-02-25 4:40:15 PM
See notes and links in this commentary as to how this data has been deliberatively manipulated to support a narrative, one that resulted in the
avoidable deaths of so many people in Alberta (not just Care Home residents).

This data is the very definition of Lies, Damned Lies and Statistics.
https://dksdata.com/AlbertaDead#Byyear
https://dksdata.com/AlbertaDead#AGCOVID
In 2021/2022, Alberta Health/AHS moved almost 500 reported COVID deaths into 2020 in what can only be seen as an apparent attempt tofalsify the perceived risk of death in one specific group.
How did they do this?
By reclassifying deaths from the year they died to the year they were put into the system with an initial COVID diagnosis. In some cases, thetime from that diagnosis to a reported death was up to 768 days for someone in the over 80's category. Alberta has COVID deaths reported ashigh as 105 years and even 107 years old, so the 80+ category is quite large.

The goals of the COVID-19 response
In the ﬁrst section of our report, we describe the manyplans that were in place prior to COVID-19 to guide allparts of the health system’s response to a pandemic.
Each plan describes goals for a pandemic response
which guides action. Each plan focuses on certain
levels, from system-wide and strategic to increasingly
operational. We summarize these goals in Appendix A.
In September 2020, Alberta Health, AHS, andrepresentatives of facility operators developed an
additional plan which lays out ﬁve goals for the
COVID-19 response in continuing care facilities. These
goals reﬂect many of the themes in the existing plans,
as well as what was learned from the ﬁrst wave of
COVID-19. They provide a direct and clear idea of what
everyone wanted to achieve. They are:1
1.

prevent the introduction of COVID-19 into[continuing care] sites

2. contain and reduce the spread of virus once at a site

Key facts and ﬁgures on Alberta’s
continuing care experience in COVID-19
Our audit focuses on the activities of Alberta Healthand AHS in responding to COVID-19 in continuing carefacilities. Their actions took place within the broader
context of what happened at individual facilities andacross the sector in the ﬁrst two waves of COVID-19.

COVID-19 Cases and Deaths
Continuing Care vs. Rest of Alberta
March–December 2020
100%
80%
60%
40%
20%
0%
COVID-19 Cases

3. meet residents’ health needs (care plans met, qualityof care)4. resident mental health, quality of life, social
connections, and family caregiver involvement
5. ensure staff are well-trained, prepared and havegood quality of work life and mental healthContinuing Care Facilities

COVID-19 Deaths
Rest of Alberta

2
In 2020 4,529 residents and 3,785 facility staff got

COVID-19 in connection with an Alberta continuing carefacility outbreak. A total of 1,042 people connected tocontinuing care facilities—overwhelmingly residents—
lost their lives to COVID-19. While continuing carefacilities accounted for eight per cent of COVID-19 casesin the province, they accounted for 65 per cent ofdeaths.
In Appendix C, we provide analysis of data and key facts
about COVID-19 in Alberta’s continuing care facilities
between March and December 2020.

Report of the Auditor General—February 2023 9

Page: 9
Number: 1
Author: daviddickson
Subject: Highlight Date: 2023-02-25 4:43:20 PM
Everything about the response failed on all levels. To pretend that an airborne virus can be contained with staff meeting off-site atsupermarkets etc. and with PPE that was never designed to prevent such spread was one of the most egregious lies. It is even admitted in theAlberta SAG report of July 2022.

Further, the physical and mental health of residents and staff was destroyed by the protocols that isolated the most vulnerable in their rooms
for 18 hours a day, leaving staff with no time to assist in basic care, mandated PPE which hindered and never helped, and removed the basic
support system of family and friends - all for no good reason. This cannot be excused as incompetence or negligence. The level that this went
to and continues to this day is nothing less than criminal and should be investigated as such.
https://dksdata.com/AlbertaDead
https://dksdata.com/MASKS
https://dksdata.com/COVID19
https://dksdata.com/ONSDATA
https://dksdata.com/CourtUpdate
Number: 2
Author: daviddickson
Subject: Highlight Date: 2023-02-25 4:45:35 PM
I make no apology for the repeated comments. They are critical for a full understanding of what has transpired.

See the analysis and links in this commentary as to how this data has been deliberatively manipulated to support a narrative, one that resulted
in the avoidable deaths of so many people in Alberta (not just Care Home residents).
This data is the very definition of Lies, Damned Lies and Statistics.
https://dksdata.com/AlbertaDead#Byyear
https://dksdata.com/AlbertaDead#AGCOVID
In 2021/2022, Alberta Health/AHS moved almost 500 reported COVID deaths into 2020 in what can only be seen as an apparent attempt tofalsify the perceived risk of death in one specific group.
How did they do this?
By reclassifying deaths from the year they died to the year they were put into the system with an initial COVID diagnosis. In some cases, thetime from that diagnosis to a reported death was up to 768 days for someone in the over 80's category. Alberta has COVID deaths reported ashigh as 105 years and even 107 years old, so the 80+ category is quite large.

How COVID-19 got into facilities andthe implications of community spread
2
Facility staff, contractors, designated visitors, andresidents all come and go between the facility and theoutside community. Each of these people presented an
opportunity for COVID-19 to enter a facility. In larger
facilities this can be hundreds of people every day.

1
Epidemiologists
from Alberta Health and AHS showedthat there was a direct relationship between the amountof COVID-19 transmitting in the broader communityand cases in continuing care facilities. When community
cases began to increase, continuing care cases followed
shortly after. It is a relationship that our analysis of thedata also demonstrates.

Alberta Daily New COVID-19 Cases
Community vs. Continuing Care
Wave Two (September–December 2020)

2000

250

Community New Cases

1600

200

1400
1200

150

1000
800

100

600
400

50

200
0
9/1/2020

0
10/1/2020

10/31/2020

Daily Community Cases

10 Report of the Auditor General—February 2023

11/30/2020
Daily Continuing Care Cases

12/30/2020

Continuing Care New Cases

1800

Page: 10
Number: 1
Author: daviddickson
Subject: Highlight Date: 2023-02-25 5:55:42 PM
Where is the data to prove this? Not a single model used by experts in the last three years has proven to be anything but criminally flawed. This
information is based on flawed data, flawed cases and a narrative that was clearly politically driven. Government lied and people died.

This data is the very definition of Lies, Damned Lies and Statistics.
https://dksdata.com/AlbertaDead#Byyear
https://dksdata.com/AlbertaDead#AGCOVID
In 2021/2022, Alberta Health/AHS moved almost 500 reported COVID deaths into 2020 in what can only be seen as an apparent attempt tofalsify the perceived risk of death in one specific group.
How did they do this?
By reclassifying deaths from the year they died to the year they were put into the system with an initial COVID diagnosis. In some cases, thetime from that diagnosis to a reported death was up to 768 days for someone in the over 80's category. Alberta has COVID deaths reported ashigh as 105 years and even 107 years old, so the 80+ category is quite large.
https://rumble.com/v28lhpw-who-cares-about-false-positives-every-single-case-was-used-to-terorrise.html
KENNEY SAYS WHO CARES ABOUT FALSE POSITIVES! From Kenney's own Q&A::
00:00"Alright Donna Stratton Stratton Tip says I've read about the maker of the PCR test has stated it's about 50% wrong and wasn't designed forwhat we're using it for. Is that true?" And then this.
00:13"I actually asked for this to come up because I know there's a lot of folks often when I check out the Facebook comments, there's a lot of thisstuff about PCR, so PCR is the standard test for COVID-19 in Canada and Alberta and around the world."
00:30"It's it's true that based on how many cycles the PCR test is does on the sample that that it can generate in many cases does generate a false
positive…"
01:01"So there are, I'll call them covid skeptics, who are claiming that all of the restrictive policies are being wrongly informed by exaggerated Covid
case counts because of false positives through PCR testing."
01:53"In a sense, I mean, who really cares about the false positives?"
WHO CARES?? WHO INDEED!! Let me tell you WHO CARES, KENNEY!! How about the people isolated for two weeks, losing their business,closed care homes, closed schools, cancelled surgeries, suicides, poverty....
It takes a single 'case' to shut down the lives of hundreds of care home residents and all connected to them and our then Premier had the
audacity, to say "..who really cares about the false positives?"
APL and its implication in testing and fraudulent cases.
https://dksdata.com/AlbertaDead#APL
From 'when is a negative test a positive?' to 'how many days back for a case?'
These numbers are based on manipulated statistics related to when a person was coded as a COVID case, not when they died. In someinstances, these Covid cases 'survived' for over two years. Did they really die of COVID?
The criteria for a COVID death was death up to 6 months after a COVID diagnosis (with or without a death certificate to support). COVID
deaths were identified by Nurses in the COVID statistical department reviewing NetCare and Connect Care (and sometimes death certificates).
In August of 2022, that criteria changed to 60 days instead of 6 months. However, there are instances where the 6 months and the 60 days was
ignored.
http://dksdata.com/AlbertaDead
COVID Cases were known to be unreliable and as such, COVID hospitalizations and deaths were built on flawed foundations. Fruit of the
poisonous tree from the start. For an Auditor to not even look at this is beyond negligent and further reinforces the need for a police forensic
investigation of all relevant data and facts.

Number: 2
Author: daviddickson
Subject: Highlight Date: 2023-02-25 4:52:21 PM
For the first three months visitors were banned from facilities, yet cases continued.

Everything about the response failed on all levels. To pretend that an airborne virus can be contained with staff meeting off-site atsupermarkets etc. and with PPE that was never designed to prevent such spread was one of the most egregious lies. It is even admitted in theAlberta SAG report of July 2022.

Comments from page 10 continued on next pageHow COVID-19 got into facilities andthe implications of community spread
Facility staff, contractors, designated visitors, andresidents all come and go between the facility and theoutside community. Each of these people presented an
opportunity for COVID-19 to enter a facility. In larger
facilities this can be hundreds of people every day.

Epidemiologists from Alberta Health and AHS showedthat there was a direct relationship between the amountof COVID-19 transmitting in the broader communityand cases in continuing care facilities. When community
cases began to increase, continuing care cases followed
shortly after. It is a relationship that our analysis of thedata also demonstrates.

Alberta Daily New COVID-19 Cases
Community vs. Continuing Care
Wave Two (September–December 2020)

2000

250

Community New Cases

1600

200

1400
1200

150

1000
800

100

600
400

50

200
0
9/1/2020

0
10/1/2020

10/31/2020

Daily Community Cases

10 Report of the Auditor General—February 2023

11/30/2020
Daily Continuing Care Cases

12/30/2020

Continuing Care New Cases

1800

Further the physical and mental health of the residents and staff was destroyed by protocols that isolated residents in rooms for 18 hours a day,left staff with no time to assist in basic care, mandated PPE which hindered and never helped and removed the basic support system of family
and friends - for no good reason. This cannot be excused as incompetence or negligence. The level that this went to and which continues forthe most part to this day is nothing less than criminal It MUST be investigated as such.
https://dksdata.com/AlbertaDead
https://dksdata.com/MASKS
https://dksdata.com/COVID19
https://dksdata.com/ONSDATA
https://dksdata.com/CourtUpdate

About This Audit

Objective and Scope1
The objective of this audit was to determine whether

1. Plan: Have strategies, plans, and protocols readyto guide the facilities’ pandemic and outbreak
response.

the Department of Health (Alberta Health) and Alberta
Health Services (AHS) effectively actioned a pandemic
and outbreak response to COVID-19 in publicly funded
continuing care facilities.

2. Communicate: Communicate all relevant plans,
updates, guidance, and emerging information tofacilities.

We did this audit to identify areas for improvement sothat Alberta Health, AHS, and the entire continuing caresector are better prepared for future pandemics andcan incorporate learnings from COVID-19 to other morecommon communicable disease outbreaks, such as
seasonal inﬂuenza.

3. Execute: Assess whether facilities have resources toimplement plans, protocols, and guidance.
4. Monitor and enforce: Monitor whether facilities
are complying with the plans, protocols, andguidance, and enforce action as needed.

Our audit looked at the activities related to the publichealth response by Alberta Health and AHS to COVID-19
in AHS-owned and operated, as well as contracted
long-term care and designated supportive living facilities.8
At March 31, 2020, there were 355 facilities receiving
public health funding to provide these services.

Plan

Not included in the scope of our audit were:•licensed supportive living, seniors lodges and othertypes of facilities that AHS does not contract or fundto provide health care services to residents•

home care•other residential care and treatment facilities for adults(such as residential addictions treatment facilities)

Monitor & enforce

Communicate

ExecuteWe focused our audit on the activities to prepare for andrespond to the ﬁrst two waves of COVID-19 during theperiod of March to December 2020.

Criteria
Our audit criteria include four related elements relevantto the roles and responsibilities of Alberta Health andAHS. Alberta Health and AHS should:

8

We received management’s acknowledgment of thesuitability of our audit criteria:•

from Alberta Health on December 9, 2020, and•from AHS on February 11, 2021.

We presented our audit plan and criteria to the audit
and risk committee of the AHS board of directors on
February 19, 2021.

In this report, we will refer to “continuing care facilities,” “facilities,” or “continuing care” to refer only to these facilities in the scope of ouraudit.
Report of the Auditor General—February 2023 11

Page: 11
Number: 1
Author: daviddickson
Subject: Highlight Date: 2023-02-25 4:53:35 PM
Like many pages here, this is just typical fluff to fill out a report to make it worth the time and money. When the facts are taken into
consideration, this is all moot.

The whole response (and this report) was and is based on flawed and manipulated data and false statements. This is why this matter MUST be
handed over for a complete forensic investigation by people with the power to execute warrants, make arrests, interview under caution,
perform detailed technical forensic audits and press charges. Anything less is an insult to and fails the Alberta public.

What We Examined•

1
The COVID-19 response was complex, novel, urgent,and dynamic. Our criteria framed our audit by focusing
on what Alberta Health and AHS did to prepare,communicate, support, and monitor COVID-19
in individual continuing care facilities, and in thecontinuing care system overall.

•

conducted multiple interviews and discussions withindustry organizations representing contracted
operators, as well as CapitalCare and Carewest
leadership, to get the perspectives of the facility
operators10
2interviewed
the Health Quality Council of Alberta,
leading academics and other subject matter experts•

obtained data and analytical support from the
Canadian Institute for Health Information
reviewed relevant reports published by academics,
think tanks, other legislative auditors and special
investigative bodies, and continuing care facility
operators, among others

To complete our audit, we:•interviewed staff and management from all involved
functional areas of both Alberta Health and AHS
to understand their roles, actions taken, andperspectives on the response••interviewed staff and management from Alberta
Precision Laboratories9 to understand the processes
to swab and test continuing care residents and staff
for COVID-19

We conducted our ﬁeldwork from February 15, 2021
to February 18, 2022.

•

interviewed senior officials from Alberta Health andzone medical leadership from AHS•

examined all relevant documentation of plans,
protocols, processes, guidance, and other direction
provided to facilities•

performed detailed reviews of in-scope Orders of the
Chief Medical Officer of Health•performed detailed examinations of all internalreporting on investigations and other detailed
reviews of major continuing care facility outbreaks•

obtained data relevant to continuing care facilities
and the COVID-19 response, and performed awide variety of analytic work on data sets ranging
from outbreak and case data to compliance andinspection reporting data•

sampled and evaluated information and reportingfrom or about activities at individual continuing carefacilities

9

Alberta Precision Laboratories is a wholly-owned subsidiary of Alberta Health Services. It provides laboratory medicine services—including
lab-based COVID-19 testing—to the provincial health system and Albertans.

10

In our report, we refer to information coming from our interviews with industry organizations and CapitalCare and Carewest collectively as“continuing care facility operator representatives” or “facility operator representatives.” It is important to understand that while the industry
organizations we interviewed represent many of the organizations that run contracted continuing care facilities, they do not represent allcontracted operators.

12 Report of the Auditor General—February 2023

Page: 12
Number: 1
Author: daviddickson
Subject: Highlight Date: 2023-02-25 4:54:46 PM
You don't interview the Fox as a 'witness' when trying to work out who killed all the hens!
Yet the facts are all there in the public domain which the Auditor has clearly ignored.

The whole response (and this report) was and is based on flawed and manipulated data and false statements. This is why this matter MUST be
handed over for a complete forensic investigation by people with the power to execute warrants, make arrests, interview under caution,
perform detailed technical forensic audits and press charges. Anything less is an insult to and fails the Alberta public.
Number: 2

Author: daviddickson

Subject: Highlight Date: 2023-02-25 4:56:11 PM

Where, in the array of interviewees consulted to compile this report was the input of those directly
impacted – namely the residents and their loved ones?? HQCA paid lip service to resident and family
concerns. Zoom meetings by care centre senior management with families quickly became limited to
select questions and family were excluded from Resident/Family council meetings.
Page 15/16 – Understand that restrictions for care homes masquerading under the guise of “focusedprotection” now cover EVERY respiratory illness even the common cold.
“AHS designed the plan to cover any emergency presented by a disease that can spread from human tohuman.”THIS LIE EFFECTIVELY ALLOWS PEOPLE TO BE LOCKED UP TO DIE.

Conclusion1
Based on our audit criteria, we conclude that Alberta

Health and AHS were able to action a response to
COVID-19 in publicly funded continuing care facilities,
but not all processes were effective and improvements
can be made.

Why ThisT
Matters toAlbertans
Continuing care facilities serve some of the mostvulnerable of our society. These are our parents,
grandparents, friends—the people who built thisprovince.
During our audit we encountered people acrossthe continuing care system working incredibly
hard, rapidly adapting to changing circumstances,transparently identifying problems, and making
timely ﬁxes and improvements where possible
to try to improve the response continuously andto keep residents safe. We believe that with thesame dedication, focus, care, and indefatigablespirit shown by people across the entire system in
responding to COVID-19, the system can be better
prepared next time. And valuable lessons about
preparedness and outbreak management can beapplied to other communicable diseases—suchas seasonal inﬂuenza—which affect Alberta’s
continuing care facilities every year.

Report of the Auditor General—February 2023 13

Page: 13
Number: 1
Author: daviddickson
Subject: Highlight Date: 2023-02-25 4:57:47 PM
A conclusion based on flawed information, manipulated data and false statements. This is more than negligent. It is a contributory factor incrimes that have taken place in its attempt to rewrite history. Authors and all supporting this document are equally complicit.

Detailed Findings andRecommendations

PLAN: Pre-COVID Planningand Preparedness for a
Pandemic
Context
Provincial health system preparedness
and planning1
In March 2014, the government published Alberta’s

Pandemic Inﬂuenza Plan (APIP). APIP is a strategic plan,developed and owned jointly by Alberta Health, AHS, and
the Alberta Emergency Management Agency. It details
roles and responsibilities in responding to a pandemic
at a province-wide level. It directs both the main ownersof the plan, as well as partner organizations within andoutside of the Government of Alberta, such as othergovernment ministries, local governments, and AHScontracted service providers.

The Alberta Outbreak Response Protocol (AORP) was
jointly developed by Alberta Health, AHS, Alberta
Precision Laboratories, and Indigenous Services Canada
in December 2018. The AORP guides and coordinates
common processes to identify and respond to unusualoutbreaks12 of communicable diseases in Alberta.
The Alberta Emergency Management Agency hosts
simulation exercises for emergency and disaster
scenarios every year. The simulated disasters range
from natural events like ﬁres, ﬂoods, and pandemics—
to man-made disasters—like terrorism. The aim is topractise Alberta’s emergency response plans.
Alberta Health participates in these province-widesimulations every year and uses these exercises as anopportunity to conduct internal exercises of its speciﬁc
emergency plans.

The government created the APIP after the H1N1
inﬂuenza pandemic of 2009. By its very name, it focuseson pandemic inﬂuenza. No other pandemic plan at
the provincial level deals with the broader sweep ofpossible pandemic-causing diseases. These include
diseases caused by coronaviruses, paramyxoviruses,
pneumoviruses, picornaviruses, and adenoviruses.111112These are all examples of families of viruses that have the potential to cause pandemics. Examples of human diseases of each include:•2
coronaviruses—COVID-19, Severe Acute Respiratory Syndrome (SARS), Middle East Respiratory Syndrome (MERS)•

paramyxoviruses—measles, mumps, and human parainﬂuenza viruses (HPIV)•

pneumoviruses—cause cold-like respiratory infections•

picornaviruses—common cold, poliomyelitis (polio), meningitis, and hepatitis•

adenoviruses—cause a wide-range of mild to severe respiratory diseases

The AORP deﬁnes several factors that would classify as an "unusual outbreak," including several that are relevant to COVID-19 in continuingcare facilities such as: a novel or emerging pathogen, severe illness or mortality among identiﬁed cases, a rapidly expanding outbreak, and an
over-represented vulnerable population among cases.
Report of the Auditor General—February 2023 15

Page: 15
Number: 1
Author: daviddickson
Subject: Highlight Date: 2023-02-24 6:58:51 PM
THE AEMA PLAN WAS NOT FOLLOWED. See Lt. Col. David Redman. However, had AEMA taken control the lies would have been impossible tohide and the whole approach would have failed at the start. From the illegal State of Emergency to the improper PPE, isolation and more.

However, there was never a crisis to respond to until it was artificially created. There had been a significant wave of low mortality ILI's from late2019 to spring 2020 which was used as a spring board for the fear factor. The legislative response (M.O.608 2020) was legally flawed and had
no supporting evidence.
Why did Alberta trigger an 'Influenza Pandemic' in March of 2019 on the advice of the Health Minster Tyler Shandro - Without the legislative
authority to do so?
See https://dksdata.com/CourtUpdate
https://dksdata.com/DS/Shandro1.jpg
Number: 2
Author: daviddickson
Subject: Highlight Date: 2023-02-25 4:59:18 PM
SARS (and MERS) had much higher mortality and R0 (infectious replication in the community). However, they were prevented by NOT
responding in the way Alberta did for SARS-CoV-2 (COVID-19). Early treatments REFUSED in 2020 and beyond proved highly effective in SARS
and MERS. Alberta canceled the trials (HOPE) of these treatments under very suspicious circumstances. And where did those millions of
donated doses of HCQ disappear to?
See https://dksdata.com/Articles/COVArticles/Article5.html (including references)
Alberta HOPE Trial
https://dksdata.com/covidimages/NoHopeCases.pdf

Novartis (130 Million doses), Mylan (50 million doses), Teva (16 million doses), Amneal (20 million doses), Bayer (3 million doses)
https://www.fiercepharma.com/pharma/new-commitments-mylan-and-teva-move-to-supply-tens-millions-hydroxychloroquine-tablets-to"
130 million doses from Novartis
https://www.novartis.com/news/media-releases/novartis-commits-donate-130-million-doses-hydroxychloroquine-support-global-covid-19pandemic-response
100 Million Doses from Sanofi
https://www.reuters.com/article/us-healt-coronavirus-sanofi-hydroxychlor/sanofi-will-donate-100-million-doses-of-hydroxychloroquine-to-50countries-idUSKCN21S0JK
HHS Accepts 30 Million DONATED doses for COVID patients.
https://public3.pagefreezer.com/browse/HHS%20%E2%80%93%C2%A0About%20News/20-01-2021T12:29/https://www.hhs.gov/about/news/2020/03/29/hhs-accepts-donations-of-medicine-to-strategic-national-stockpile-as-possible-treatments-for-covid-19-patients.html
Jamp Pharma Donating one million of doses
https://www.newswire.ca/news-releases/canadian-jamp-pharma-group-gets-involved-donating-one-million-doses-of-hydroxychloroquine-tohospitals-to-help-combat-covid-19-897524025.html
Apotex donating two million doses
https://www.newswire.ca/news-releases/canada-s-apotex-donates-two-million-dosages-of-hydroxychloroquine-to-the-public-health-agencyof-canada-843392095.html
Apotex donating doses for trials
https://everythinggp.com/2020/04/13/hydroxychloroquine-will-be-studied-in-alberta-as-a-possible-covid-19-treatment/
Amneal Pharmaceuticals donates 4.3 million doses
https://timesofindia.indiatimes.com/business/international-business/indian-americans-us-pharma-firm-donates-3-4-millionhydroxychloroquine-sulphate-tablets/articleshow/75039058.cms

System-wide preparedness andplanning at AHS

The CDERP is not speciﬁc to any one pathogen, disease,or situation. AHS designed the plan to cover any
emergency presented by a disease that can spread fromhuman to human.

1
AHS ﬁrst organized its existing plans into theCommunicable Disease Emergency Response Plan
(CDERP) in November 2016. The CDERP is a broadand comprehensive plan—several thousand pages inlength. The purpose of the plan is to deﬁne roles andresponsibilities, and to coordinate response strategies
and actions of all AHS departments.

Understanding the Intended Relationships
Among Pre-COVID Pandemic Plans
Plan includes roles & responsibilities for:

Alberta Health

AHS-owned& operated
facilities

AHS

Contracted
facilities

Alberta Health

AORP
Plan owner:

APIP

AHS

Alignedwith

CDERP Base Plan

Chapter of

CDERP Continuing Care chapter
CCPOG
Aligned with

Individual
facilities

16 Report of the Auditor General—February 2023

Facility-level plans

Annex ofPage: 16
Number: 1
Author: daviddickson
Subject: Highlight Date: 2023-02-25 5:02:01 PM
Like many pages here, this is just typical fluff to fill out a report to make it worth the time and money. When the facts are taken into
consideration, this is all moot.

The whole response (and this report) was and is based on flawed and manipulated data and false statements. This is why this matter MUST be
handed over for a complete forensic investigation by people with the power to execute warrants, make arrests, interview under caution,
perform detailed technical forensic audits and press charges. Anything less is an insult to and fails the Alberta public.

Continuing care preparedness andplanning at AHS
1
The continuing care chapter of the CDERP covers the fullsweep of continuing care services—from home care to
supportive living to long-term care. It provides guidance
and resources for management and staff to respondto a communicable disease emergency. AHS wrote thecontinuing care chapter of the CDERP for AHS-owned
and operated continuing care services, but it notes that
contracted service providers are key stakeholders inmeeting the objectives of the plan.
A resource provided within the CDERP continuing carechapter is the Continuing Care Pandemic Operational
Guide (CCPOG). This guide provides a ﬁnal level of detailfrom AHS and is distinct from the CDERP continuingcare chapter because AHS wrote it for all continuing carefacilities in Alberta, including contracted service providers.
The plan provides detailed guidance and resources tofacilities to help them respond to pandemic situations.

Preparedness and planning at
continuing care facilities
Regulated Continuing Care Health Service Standards require
all continuing care facilities to have facility-speciﬁcplans to respond to emergencies, including explicit
requirements to plan for pandemics. For contracted
facility operators, the contract with AHS includes further
requirements for facilities to have sufficient plans. It also
requires that contracted operators align their plans with
AHS plans and policy. These standards and contracts
require that facilities educate their staff on the plans andpractise the plans every year.
The Continuing Care Health Service Standards set
out minimum requirements pursuant to legislative
authority13 for operators of publicly funded continuingcare facilities in the province.14 There are 19 healthservice standards. Each standard is made up of moredetailed sub-requirements. The standards focus on thehealth care services facilities provide to their residents.
They include things like staff training, infection
prevention and control, and continuity of health care—all of which would help a facility be prepared to respondto a pandemic. All continuing care facilities are audited
to the health service standards at least once every three
years.

Criteria
Alberta Health and AHS should have strategies, plansand protocols ready to guide the facilities’ pandemic andoutbreak response.

Our ﬁndings
Key ﬁndings:•

Continuing care facilities were not well-preparedfor communicable disease outbreaks themagnitude of COVID-19—facility pandemic plans
were not sufficient and many facilities did notmeet all requirements around infection prevention
and control and staff training prior to COVID-19.

•

Provincial pandemic emergency plans were inplace, but role clarity between major participants
was an issue in the ﬁrst wave of the COVID-19
response.

•

Pre-COVID pandemic and emergency
preparedness exercises did not practise
coordination across the continuing care sector andlacked operational staff involvement.

Facilities were not well-prepared for an
event of the magnitude of COVID-19
Initial assumptions about continuing carefacility readiness proved inaccurate
From discussions with senior health officials at Alberta
Health, we found that in the weeks before COVID-19 enteredAlberta they assumed continuing care facilities would bebetter positioned than other areas of the health system todeal with a communicable disease outbreak. They thought
this because continuing care facilities regularly prepare forand respond to outbreaks of communicable diseases likeseasonal inﬂuenza. With hindsight, the sheer magnitude andcharacteristics of COVID-19 proved this assumption wrong.
Provincial continuing care leadership at AHS identiﬁed
the potential risks posed by COVID-19 to continuing carefacilities and began developing guidance and updating
their continuing care pandemic plans in late February
and early March 2020.

13

Pursuant to the Nursing Homes General Regulation under the Nursing Homes Act, the Co-ordinated Home Care Program Regulation, under the
Public Health Act, and a Ministerial Directive under the Regional Health Authorities Act.

14

Alberta Health also maintains standards focused on the quality and safety of continuing care and other types of supportive living
accommodations in the Long-Term Care Accommodation Standards and Supportive Living Accommodation Standards. Alberta Health inspectors
also monitor facilities against these standards. For the purposes of our audit, we focused on the health service standards as they speak more
directly to resident health and care.
Report of the Auditor General—February 2023 17

Page: 17
Number: 1
Author: daviddickson
Subject: Highlight Date: 2023-02-25 5:01:53 PM
Like many pages here, this is just typical fluff to fill out a report to make it worth the time and money. When the facts are taken into
consideration. this is all moot.

The whole response (and this report) was and is based on flawed and manipulated data and false statements. This is why this matter MUST be
handed over for a complete forensic investigation by people with the power to execute warrants, make arrests, interview under caution,
perform detailed technical forensic audits and press charges. Anything less is an insult to and fails the Alberta public.

Facility plans were not sufficient1
We analyzed pre-COVID compliance audit data from

AHS and found that in the two years before COVID-19,
82 per cent of facilities met health service standards
requiring them to have a pandemic plan.15 16 However,
we found the plans that were in place were insufficient
to respond to the scale of COVID-19 outbreaks. In
reviewing detailed investigations of major COVID-19
outbreaks prepared by AHS, we found that theyfrequently noted facility plans were unrealistic andlacked details on key things like infection prevention andcontrol. Facilities were also unable to activate the plans
as quickly as needed to respond to a COVID-19 outbreak.
When we evaluated a sample of facility plans we also noted:•

pandemic-speciﬁc content varied widely, but
generally was brief and lacked speciﬁcity•

half of the plans we sampled did not show evidenceof a recent review or update•

contracted facility plans were not aligned with AHS
plans and policy, as required under the contract•

only 50 per cent of the plans discussed any
relationship with AHS or provincial pandemic plans,
and of those that did, we noted two facility plans
where the full extent of the pandemic plan was areference along the lines of “See AHS plans.”•

30 per cent of the plans were general, corporatelevel plans for the organizations that run facilities,
and were not speciﬁc to the individual facility wesampled, as required in standards“Pandemic outbreak plans for staffing are
critical. Sites need to have plans in place that
include redundancy given issues being seen inother outbreaks with plans not being able to be
actualized. All steps need to be taken to ensure thatthe plan can be activated and implemented within
24 hours’ notice as COVID outbreaks can rapidly
impact staffing particularly when asymptomatic
staff and residents are identiﬁed through testing.
Supplemental staffing needs to be recruited,trained and readily available.”

The only guidance or expectations for what these plans
should include is in the standards and the AHS contract.
Neither are speciﬁc or detailed. When we reviewed
pre-COVID compliance audit processes we found thatcompliance audits and other monitoring by Alberta
Health and AHS prior to COVID-19 did not examine
the contents of plans, only whether the facility could
produce a plan when requested.

Many facilities did not meet staff training andinfection prevention and control standards
before COVID
We analyzed compliance audit data from the two years
leading up to COVID-19. When we looked at the complianceof sub-requirements under the health service standard
for staff training, we found that more than 90 per cent offacilities had training for topics like infection prevention
and control, and pandemic preparedness. However,compliance inspectors found that only 67 per cent offacilities met requirements to provide this training to staff
within six months of hiring and every two years after hiring.
Overall, inspectors found 20 per cent of facilities met all
sub-requirements for the staff training health service
standard.17
Looking at the health service standard compliance for
infection prevention and control, we found that morethan 80 per cent of facilities met sub-requirements
related to hand hygiene, personal protective equipmentuse, and outbreak prevention. However, only 20 per centmet sub-requirements related to managing the resident
care environment—things like cleaning of spaces andnon-medical devices. Overall, 25 per cent of facilities
met all sub-requirements for the infection prevention
and control health service standard.17– AHS outbreak investigation report

15

There is an analogous standard in the accommodation standards—Standard 16(1).

16When AHS identiﬁes non-compliance with any standard, they require the facility to ﬁx the problem and follow-up to ensure the facility does so.

17

The way that the health service standards are structured is such that in order to be considered compliant with a standard, a facility would
have to meet every sub-requirement within that particular standard. For example, Standard 9—Staff Training includes 24 sub-requirementsthat cascade up to the overall standard. If a facility is deﬁcient in any one of these sub-requirements it is considered non-compliant with thestandard overall. For this reason, we provide more detailed compliance rates on certain sub-requirements most relevant to our audit.

18 Report of the Auditor General—February 2023

Page: 18
Number: 1
Author: daviddickson
Subject: Highlight Date: 2023-02-25 5:01:07 PM
Like many pages here, this is just typical fluff to fill out a report to make it worth the time and money. When the facts are taken into
consideration, this is all moot.

The whole response (and this report) was and is based on flawed and manipulated data and false statements. This is why this matter MUST be
handed over for a complete forensic investigation by people with the power to execute warrants, make arrests, interview under caution,
perform detailed technical forensic audits and press charges. Anything less is an insult to and fails the Alberta public.

Existing provincial plans were notutilized to their full intent
1

Early assumptions about plan suitability led toadaptation away from existing plans
Earlier we describe the many plans that were in place
before March 2020. The authors of these plans based
them on past experience with pandemics and epidemics.
We reviewed the Alberta Pandemic Inﬂuenza Plan
(APIP) in detail, spoke with subject matter experts andfound that, with the beneﬁt of hindsight, the planningassumptions contained in the plan provide a good
approximation of COVID-19. The assumptions foresee
things like the possibility of asymptomatic illness andtransmission, airborne transmission, multiple waves
with particular severity in fall and winter, and heightenedrisk for a number of speciﬁc groups of people, including
residents of continuing care facilities.
We found these existing plans were underutilized due
to a lack of awareness, particularly among operational
management and staff. Our interviews revealed thatunless we were speaking to someone in an emergency
preparedness role, awareness of these plans and theircontents was minimal—even well into the COVID-19
response.

Roles and responsibilities were an initialchallenge
The APIP and other pre-existing pandemic plans deﬁneroles and responsibilities for the health system response.
However, we found that Alberta Health and AHS still
had to establish who needed to do what and how tocoordinate between themselves, especially in the earlydays of the response to COVID-19 in continuing carefacilities. Alberta Health and AHS continuously worked toestablish and clarify roles and responsibilities in the ﬁrst
months of the response.
Through evidence gathered from facility operator
representatives we found confusion stemming from alack of clarity between Alberta Health and AHS. Facilities
were not sure who to turn to for what and were getting
mixed messages depending upon whom they asked.
In September 2020, Alberta Health, AHS, and facility
operator associations jointly developed the “Fall Action
Plan.” The plan sets out clear roles and responsibilities
for the COVID-19 response among Alberta Health, AHS,
and continuing care facilities.

Report of the Auditor General—February 2023 19

Page: 19
Number: 1
Author: daviddickson
Subject: Highlight Date: 2023-02-25 5:01:37 PM
Like many pages here, this is just typical fluff to fill out a report to make it worth the time and money. When the facts are taken into
consideration, this is all moot.

The whole response (and this report) was and is based on flawed and manipulated data and false statements. This is why this matter MUST be
handed over for a complete forensic investigation by people with the power to execute warrants, make arrests, interview under caution,
perform detailed technical forensic audits and press charges. Anything less is an insult to and fails the Alberta public.

Pandemic and emergency exercises
happen in isolation and lack operational
staff involvement
Pandemic exercises did not include all
stakeholders
1
We interviewed emergency management specialists

Alberta Health identiﬁed several learnings and potential
revisions to the APIP from these exercises, including:•the need for more guidance on how to prepare for apandemic situation that started in another country•

the need for increased participation from AHS in
Alberta Health disaster exercises

from Alberta Health and AHS and reviewed
documentation of emergency preparedness exercises
Weand simulations in the 10 years before COVID-19. W
found that each organization—Alberta Health, AHS,
and facility operators—had practised aspects of theiremergency and pandemic response plans in some way,
but these exercises were siloed within each organization.

Alberta Health’s business continuity team received
approval to begin updating the APIP in January 2020, but
stopped due to COVID-19.

We could not identify any evidence of facility operators
ever being involved in pandemic exercises with Alberta
Health or AHS. Since the creation of the APIP in 2014,
there had never been a full-scale pandemic exercise
including all key stakeholders and partners with roles
and responsibilities in the plan.

We recommend that the Department of Health ensure
the development of an up-to-date, comprehensive,
continuing care-focused pandemic plan relevant to all
key stakeholders—Department of Health, Alberta HealthServices and facility operators.

We found that when Alberta Health or AHS tested
their pandemic plans, representatives from the otherorganization would be invited to participate. However,
the individuals who attended were limited to the otherorganization’s emergency preparedness team and did
not include management and staff from operational
units—such as the continuing care management groups.

Pandemic scenario was the focus of a 2019provincial emergency simulation exercise
In the winter of 2019, the Alberta Emergency
Management Agency ran a provincial disaster exercise
based on a pandemic scenario. Alberta Health co-led
this exercise. An objective of the exercise was to increaseawareness of the APIP across the government and toprompt government departments to test and evaluate
their own plans for long-term staffing disruptions from apandemic.
Alberta Health conducted its own internal exercise basedon this scenario. We reviewed documentation for thisexercise and found that 53 per cent of the staff that
Alberta Health identiﬁed to participate in the exercise
attended. Two staff from the continuing care branch
were at this exercise, but neither was still in their role byearly 2020.

20 Report of the Auditor General—February 2023

RECOMMENDATION:
Update and expand a pandemic plan common to entire
continuing care sector

The Department of Health should ensure such a plan forfacility-based continuing care:•sets measurable goals and targets, is aligned withother related plans, and is regularly communicatedto operational management and front-line staff
across the continuing care sector, including at the
Department of Health and AHS•

reﬂects learnings from the COVID-19 response•

is disease-agnostic and is scalable•

integrates compliance monitoring and otherinspection activities•

includes clearly deﬁned escalation pathways, basedon established measures or triggers, for outbreakmanagement and resolution•

clearly deﬁnes roles, responsibilities,
accountabilities, and decision-making structures forall stakeholders

Consequences of not taking action
Precious time and effort may be diverted to preparationand organization in the critical early stages of apandemic response if appropriate planning is not inplace.

Page: 20
Number: 1
Author: daviddickson
Subject: Highlight Date: 2023-02-24 7:10:24 PM
HOW ABOUT THE AUTHOR OF THE AEMA PLAN? LT. COL DAVID REDMAM OFFERED HIS ASSISTANCE AND IT WAS REFUSED OVER AND OVER.
I KNOW, I WAS PART OF THE OFFER!

Alberta, It's Time: to join us in demanding the Alberta Government listen to the experts!
When: Monday, April 12th (2021), at noon
Where: Alberta Legislature, Edmonton, 10800 97 Avenue NW
Alberta, It's time for a real and honest debate over the current government's COVID restrictions. The Alberta Government has refused to betransparent about their actions throughout this crisis. It is, in fact, long past time for a real discussion of ALL data that has been compiled andthe various strategies the government has used over the last year, today, and may use in the future.
An Alberta Medical and Emergency Management Team is ready to debate and are demanding Premier Kenney, Health Minister Shandro, and
CMOH Hinshaw commit to this democratic principal. The current government has not been granted a mandate from the people of Alberta for
their handling of this crisis and no opposing view has been seriously debated in the Legislature. For our democratic institutions to survive anycrisis, rigorous debate and consultation must exist. This is especially true when government policy has such vast and long lasting effects.
This diverse team of leading experts in their corresponding fields is made up of:
Lt.-CoL. (retired) David Redman, CD1, BEng, MSEE
Dr. Dennis Modry, BSc, MD, MSc, FRSC, FACCP, FACS
Dr. Roger Hodkinson, MA, MB, FRCPC, FCAP
Retired police officer David Dickson“For over a year, the Government of Alberta has used a blanket population-wide approach with arbitrary and constantly changing measuresthat have resulted in unnecessary death of our seniors and collateral damage to our society’s mental health, societal health, children’s educationand development, Albertans with other severe illnesses, and our economy,”“In the interest of over 4.3 million Albertans, we want to provide all of them with a transparent discussion of data, facts, and alternatives so we
can all make an informed, collective decision on how best to move forward with the interests of every demographic in mind.”

RECOMMENDATION:
Exercise and simulate updated plan regularly, with allparties1
We recommend that the Department of Health lead

periodic pandemic response exercises for Alberta’s
facility-based continuing care sector across all levels of
the system, and involve operational and front-line staff.

Consequences of not taking action
In an emergency situation the facility-based continuingcare system must respond seamlessly across multiple
organizations. Without periodic exercises including
all parts of the system, this cross-organizational
preparedness cannot be critically evaluated andcontinuously strengthened.

COMMUNICATE:
Providing Guidance andCommunications toContinuing Care Facilities
Context
The importance of clear, consistentcommunication in a crisis
Fast-moving, risky situations like a pandemic require
clear, consistent information sharing across andbetween all levels of a system. Decisions need to becommunicated to front-line staff, who put them into
operation. Situational information from the front
lines needs to get back to decision makers. Militaryorganizations see this as a key competitive advantage
and have it down to a science: observe, orient, decide,act.18 The faster and more accurately this process
happens, the better.
Responding to COVID-19 in continuing care facilities
was no exception to this rule, particularly in the ﬁrst
wave of the pandemic. Several hundred individuallyunique facilities, run by 31,000 staff, caring for 25,000
residents, had to get the information they needed tohelp them prepare and respond immediately. Those
facilities, staff, and residents needed to get informationback to decision makers on what was working, what wasnot, and what they needed.
In the ﬁrst months of the response, understanding of
COVID-19 as a disease, its implications on different
groups of people, and how best to prevent infection andspread changed quickly. New evidence and changing
information and guidance came rapidly from national
and international public health bodies, requiring
frequent updates to guidance.

Guiding and communicating with
continuing care facilities
Alberta Health and AHS spent considerable time in theﬁrst two waves of COVID-19 developing and distributing
written guidance for facilities. This guidance took two
main forms—Orders of the Chief Medical Officer of
Health, and guidance from AHS.

18

The “OODA loop” (Observe, Orient, Decide, Act) is one of the more famous of such models developed by Colonel John R. Boyd and used
extensively in military aviation. Other militaries and branches use similar decision models premised on the same fundamental principles.
Report of the Auditor General—February 2023 21

Page: 21
Number: 1
Author: daviddickson
Subject: Highlight Date: 2023-02-25 5:03:17 PM
And again, the Fox is in charge of the hen house. As this report is so flawed, any recommendations are moot.

The whole response (and this report) was and is based on flawed and manipulated data and false statements. This is why this matter MUST be
handed over for a complete forensic investigation by people with the power to execute warrants, make arrests, interview under caution,
perform detailed technical forensic audits and press charges. Anything less is an insult to and fails the Alberta public.

Chief Medical Officer of Health Orders
1
Under the authority of the Public Health Act, Alberta

Health developed public health Orders from the Chief
Medical Officer of Health (Orders) to continuing carefacilities and other facilities like seniors lodges andlicensed supportive living facilities. These Orders were
enforceable under the law.

AHS operational guidance
AHS is normally responsible for providing clinical andoperational guidance to continuing care facilities. This
responsibility is also consistent in a pandemic underprovincial pandemic plans.
AHS publishes guidance materials both centrally
and from each of the ﬁve AHS zones. AHS guidance
also comes from AHS organizational units outside ofcontinuing care—such as infection prevention andcontrol, communicable disease control, and publichealth—as well as from Alberta Precision Laboratories.

Criteria
Alberta Health and AHS should communicate all relevantplans, updates, guidance, and emerging information tofacilities.

Our ﬁndings
Key ﬁndings•

Because of the novelty of the process and theurgency of the task, Alberta Health did not fully
work through the implications of the ﬁrst few
iterations of Orders on facilities—as a result, theOrders caused confusion and frustration at thefront lines.

•

AHS guidance for continuing care facilities wasrobust, consistent, and made widely available.

•

Alberta Health and AHS quickly established
two-way communication channels with facility
operators.

22 Report of the Auditor General—February 2023

First few iterations of Orders caused
signiﬁcant confusion and frustration
Initial Orders came without notice, causing
confusion and strain
There were two main series of Orders with direct
relevance to continuing care facilities: the outbreakmanagement series and the visitor policy series.
Outbreak management dealt with speciﬁc, incremental
direction to facilities to prepare for, prevent, and respondto a COVID-19 outbreak. Alberta Health issued six
iterations of the outbreak management Orders in 2020.
The visitor policy series provided facilities with rules
governing visits to residents. Alberta Health issued four
iterations of the visitor policy series in 2020.
On April 10, 2020, the Chief Medical Officer of Healthannounced Order 10-2020. The Order contained whatcame to be called the “single-site staffing order”—rulesthat required continuing care staff to work at only one
continuing care facility.
2
We examined the processes to develop andcommunicate the Orders. Due to the urgency of thesituation, we found Alberta Health developed the early
iterations of the Orders with minimal, if any, direct input
from operators. For the ﬁrst few iterations, facilities ﬁrst
heard about these rules when they were announced atpress conferences. These early Orders were also in effectthe same day as the Chief Medical Officer of Healthannounced them.
As a result, facility operators learned about new rules
the same way as all Albertans—while watching a press
conference. They needed to quickly but carefully go
through pages of information to ﬁgure out what theyneeded to do. Finally, the operators needed to explain
the new requirements to facility staff, which could
involve hundreds of staff across multiple shifts.
Our interviews with facility operator representatives
revealed that this situation was a predicament for theoutbreak management series but became a real problem
for the visitor policy series. It fell to facilities to enforce
these Orders—managing confused and angry families,
visitors, and residents as rules changed.

Page: 22
Number: 1
Author: daviddickson
Subject: Highlight Date: 2023-02-25 5:03:51 PM
And again, the Fox is in charge of the hen house. As this report is so flawed, any recommendations are moot.

Why did Alberta trigger an 'Influenza Pandemic' in March of 2019 on the advice of the Health Minster Tyler Shandro - Without the legislative
authority to do so?
https://dksdata.com/DS/Shandro1.jpg
These Orders really had no l;egal authority as they were based on the Fruit of the poisonous tree
This was clearly by design if the Orders are reviewed. Also, where is the evidence to back up these Orders?
“I, Dr. Deena Hinshaw, Chief Medical Officer of Health (CMOH) have initiated an investigation into the existence of COVID-19 within the Provinceof Alberta.
This investigation has confirmed that COVID-19 is present in Alberta and constitutes a public health emergency as a novel or highly infectious
agent that poses a significant risk to public health.”
Or“Whereas I, Dr. Deena Hinshaw, Chief Medical Officer of Health (CMOH) have initiated an investigation into the existence of COVID-19 within theProvince of Alberta.
Whereas the investigation has confirmed that COVID-19 is present in Alberta and constitutes a public health emergency as a novel or highly
infectious agent that poses a significant risk to public health.” etc.
FULL DISCLOSURE IS REQUIREDThe whole response (and this report) was and is based on flawed and manipulated data and false statements. This is why this matter MUST be
handed over for a complete forensic investigation by people with the power to execute warrants, make arrests, interview under caution,
perform detailed technical forensic audits and press charges. Anything less is an insult to and fails the Alberta public.
Number: 2
Author: daviddickson
Subject: Highlight Date: 2023-02-24 7:13:47 PM
This was clearly by design if the Orders are reviewed. Also, where is the evidence to back up these Orders?
“I, Dr. Deena Hinshaw, Chief Medical Officer of Health (CMOH) have initiated an investigation into the existence of COVID-19 within the Provinceof Alberta.

This investigation has confirmed that COVID-19 is present in Alberta and constitutes a public health emergency as a novel or highly infectious
agent that poses a significant risk to public health.”
Or“Whereas I, Dr. Deena Hinshaw, Chief Medical Officer of Health (CMOH) have initiated an investigation into the existence of COVID-19 within theProvince of Alberta.
Whereas the investigation has confirmed that COVID-19 is present in Alberta and constitutes a public health emergency as a novel or highly
infectious agent that poses a significant risk to public health.” etc.
FULL DISCLOSURE IS REQUIRED

Chief Medical Officer of Health Orders Relevant toContinuing Care Facilities in 2020
2020

Outbreakmanagement
seriesVisitor policy
series

March

April

Order
06-2020Order
10-2020

Order
08-2020

Order
03-2020

May

June

July

AugustOrder
23-2020

September

Order32-2020Order
12-2020

Order
09-2020

Order
29-2020

Order
14-2020
1
We found that Alberta Health changed and updated theOrders frequently as understanding and information needs
rapidly changed in the ﬁrst two months of the COVID-19
response. Between March 20 and the end of April 2020
there were seven new and updated Orders directly applicable
to continuing care facilities—more than one a week.
When we examined the process to develop Orders, we foundthat Alberta Health made improvements to the way it did
this. Processes to consult with operators, as well as giving
facilities notice of upcoming changes, improved over time.

Orders were increasingly lengthy, detailed, andcomplex for facilities
As Alberta Health revised and updated Orders, they
became lengthier, more detailed, and complex.
When we interviewed facility operator representatives,
we learned that facilities struggled with the length andcomplexity of the Orders. They also noted that someof the language in the Orders caused differences inpractice and disputes with compliance inspectors overinterpretation.

Length of Relevant Chief Medical Officer of HealthOrders in 2020

Outbreakmanagement
seriesVisitor policy
series06-2020
March 25
10 pages

08-2020
April 212 pages

10-2020
April 1023 pages

12-2020
April 28
19 pages

23-2020
May 2540 pages

03-2020
March 20
2 pages

09-2020
April 7
6 pages

14-2020
April 28
7 pages

29-2020
July 1621 pages

32-2020
September 3
53 pages

Report of the Auditor General—February 2023 23

Page: 23
Number: 1
Author: daviddickson
Subject: Highlight Date: 2023-02-24 7:17:02 PM
Where is the evidence to back up these Orders?
“I, Dr. Deena Hinshaw, Chief Medical Officer of Health (CMOH) have initiated an investigation into the existence of COVID-19 within the Provinceof Alberta.

This investigation has confirmed that COVID-19 is present in Alberta and constitutes a public health emergency as a novel or highly infectious
agent that poses a significant risk to public health.”
Or“Whereas I, Dr. Deena Hinshaw, Chief Medical Officer of Health (CMOH) have initiated an investigation into the existence of COVID-19 within theProvince of Alberta.
Whereas the investigation has confirmed that COVID-19 is present in Alberta and constitutes a public health emergency as a novel or highly
infectious agent that poses a significant risk to public health.” etc.
FULL DISCLOSURE IS REQUIRED
Why did Alberta trigger an 'Influenza Pandemic' in March of 2019 on the advice of the Health Minster Tyler Shandro - Without the legislative
authority to do so?
https://dksdata.com/DS/Shandro1.jpg
These Orders really had no l;egal authority as they were based on the Fruit of the poisonous tree

1
We reviewed each Order in detail. We found that thelength and the complexity of the Orders increased
substantially over time. It was not just the page length
but also the additional materials referenced in each
Order that built length and complexity to the task ofunderstanding and complying with them. For example,
Order 12-2020 is 19 pages and contains 19 unique
hyperlinks referencing other materials and guidance.
Together, these additional references total 159 pages,
which themselves reference 69 unique hyperlinks out
to further sources of guidance. Our analysis suggested
that the task of fully understanding an Order could easily
balloon into many hundreds of pages.
When we analyzed the language of the relevant Orders
declared in 2020 in detail, we found that 42 per cent of
the language used was suggestive ("may" and "should")
rather than obligatory ("must" and "will"). This canfurther confuse interpretation and application.

Operational implications not fully worked
through for initial Orders
The Orders required signiﬁcant changes in how facilities
conducted their normal business. For example, thecontinuous wearing of masks became mandatory andfacilities needed to screen everyone coming into facilities
for COVID-19. In March and April 2020 continuing care
operator associations sent letters to explain implications
and outline what incremental support and resources—ﬁnancial, staffing, and supplies—facilities needed tomeet the requirements of the Orders.
The need to develop the type of Orders necessitatedby COVID-19 had never been seen before. As a result,
Alberta Health management responsible for developing
the Orders did not have a pre-established process tofollow. They needed to work quickly and with limited
information to develop and update the ﬁrst iterationsof the Orders. Their most important goal with the ﬁrst
few Orders was to keep residents safe from COVID-19,
period. For the ﬁrst few Orders, we found Alberta Healthwas not able to fully work through the implications ofOrders on facilities’ ability to implement them withexisting resources and capabilities.

Single-site order was complicated and not fully
implemented by all facilities
The Chief Medical Officer of Health announced Order
10-2020 on April 10, 2020. It contained what came tobe known as the “single-site staffing order” requiring allcontinuing care staff to work at only one continuing carefacility. Facilities were supposed to implement the Order
by April 23, 2020. On that day, the Chief Medical Officer
of Health announced that facilities needed more time to
implement the single-site order.
From this point, it is unclear when or whether all
facilities fully implemented the Order.19 Responsibility
for enforcing the Order ultimately fell to AHS zone
continuing care management, but they told us they
were never clear who was accountable for facilities
implementing the Order. AHS reported that 95 per centof the facilities it directly operates were compliant with
the Order by May 11. All zones had asked facilities tomeet the requirements of the Order by the end of
May 2020.
Reporting out of AHS later suggested the ﬁrst date offull implementation of the Order was October 16. But
after we completed a detailed review of staffing data
maintained by Alberta Health, we found that at the endof December 2020 at least 523 people were working
at more than one continuing care facility.20 While it ispossible that some of these 523 identiﬁed workers were
granted an exemption to the Order by the Chief Medical
Officer of Health, Alberta Health did not have enoughdetail or a process to cross-reference exemption tracking
data with the single-site staffing data.

19

Here we take the common, dictionary deﬁnition of the verb “to implement”: to give practical effect to and ensure the actual fulﬁllment byconcrete measures. In this case, the actual fulﬁllment would be the direction of the single-site order being complied with: that all staff incontinuing care facilities work only at one site, unless granted an exemption by the Chief Medical Officer of Health.

20

We use the words “at least 523” because the reporting and data that supported this information was only about three-quarters complete. We
discuss this matter in greater detail in the section of the report discussing facility staffing, below.

24 Report of the Auditor General—February 2023

Page: 24
Number: 1
Author: daviddickson
Subject: Highlight Date: 2023-02-24 7:19:23 PM
Where is the evidence to back up these Orders?
“I, Dr. Deena Hinshaw, Chief Medical Officer of Health (CMOH) have initiated an investigation into the existence of COVID-19 within the Provinceof Alberta.

This investigation has confirmed that COVID-19 is present in Alberta and constitutes a public health emergency as a novel or highly infectious
agent that poses a significant risk to public health.”
Or“Whereas I, Dr. Deena Hinshaw, Chief Medical Officer of Health (CMOH) have initiated an investigation into the existence of COVID-19 within theProvince of Alberta.
Whereas the investigation has confirmed that COVID-19 is present in Alberta and constitutes a public health emergency as a novel or highly
infectious agent that poses a significant risk to public health.” etc.
FULL DISCLOSURE IS REQUIRED
Why did Alberta trigger an 'Influenza Pandemic' in March of 2019 on the advice of the Health Minster Tyler Shandro - Without the legislative
authority to do so?
https://dksdata.com/DS/Shandro1.jpg
These Orders really had no l;egal authority as they were based on the Fruit of the poisonous tree.
This report (without that information and knowledge of the flawed and manipulated data is more than negligent, it is complicit to the crimes
that have taken place in its attempt to rewrite history.

1

April 2Chief Medical Officer of Healthsays restricting workers createsrisk to care at press conference

April 10Single-site order announced;
M.O. 22/2020 amends labour
laws

April 17

M.O. 625/2020 requires
reporting of employee data

April 23

Single-site order
implementation delayed

April 24

M.O. 026/2020 further
amends labour laws

May 11

AHS says 95% of staff at its
facilities working at single site

May 31All AHS Zones expect facility
compliance

June 13First exemption grantedby Chief Medical Officer of
HealthOctober 16

AHS asserts single site
is fully implemented

End ofDecember

Alberta Health identiﬁes atleast 523 multisite workers

AHS g
guidance was robust, consistent,
and made widely available
We obtained and conducted extensive reviews of AHS
guidance documentation. We found that AHS publishedits ﬁrst COVID-speciﬁc guidance for continuing carefacilities on March 11, 2020. On March 24, 2020 AHS
also published an updated version of its Continuing
Care Pandemic Operational Guidelines, with updates
speciﬁc to COVID-19. From that point, it published over
100 guidance and explanatory documents relevant tocontinuing care facilities on topics ranging from outbreakmanagement and swabbing residents for COVID-19 to
how facilities needed to handle resident laundry andassist residents with showering during COVID-19. AHS
also published numerous tools, signage, and checklists
to aid in operational matters like COVID-19 screening.
AHS normally publishes some guidance that is available
only to its facilities, as well as to physicians and clinicalstaff. However, we found that AHS ensured that all
COVID-19 guidance was available to everyone by moving
as much content as possible onto its public-facing
website and opening access to its “Continuing Care
Connections” website to anyone who requested it.
We compared AHS guidance to other available guidancefrom AHS, Orders, and other information from the sametime. Across hundreds of documents and thousandsof pages we found only one instance of contradictory
guidance. This inconsistency was corrected within twodays with an update to the corresponding Order.
In our analysis, we also noted the care with which AHS
published its guidance—adapting it, where necessary,to different audiences in the sector. For example, tocommunicate one particularly complicated piece of
guidance, it prepared three different documents, one forfacility operators, one for facility managers, and one forfacility staff with speciﬁc clarity on aspects most relevant
to each audience’s role and focus.

Report of the Auditor General—February 2023 25

Page: 25
Number: 1
Author: daviddickson
Subject: Highlight Date: 2023-02-24 7:22:31 PM
Just some thoughts on this statement.
Beds
https://thenationaltelegraph.com/regional/ahs-ceo-caught-spreading-misinformation-about-icu-bed-capacity
Deathshttp://dksdata.com/AlbertaDead
Vaccinations
https://thenationaltelegraph.com/regional/ahs-achieves-92-percent-vaccination-rate-by-removing-26255-staff-members
Masks
http://dksdata.com/MASKS
And more.
https://thenationaltelegraph.com/regional/albertas-public-health-restrictions-are-based-on-flawed-and-frequently-altered-ahs-data
Lying about the beds caused panic and helped feed the push for mandates that killed.
https://thenationaltelegraph.com/regional/ahs-retroactively-edits-icu-data-alberta-hospitals-were-not-being-overwhelmedOver and over the data was manipulated for political purposes. People died (and are dying) as a result.
https://thenationaltelegraph.com/regional/albertas-public-health-restrictions-are-based-on-flawed-and-frequently-altered-ahs-data

1Channels were developed
p for regulargtwo-wayy communication with seniordecision makers
Regular touchpoints provided formal andinformal guidance to facilities
Continuing care management groups from each
AHS zone played a critical role in communication
between facilities and the broader health system.
Zone management is the main relationship holder
with facilities in their zone—both AHS facilities andcontracted facilities. We found zone management
involvement with facilities was comprehensive andsupport for facilities was near daily. Zone management
was a critical conduit of information and also provided
their own resources to help facilities.21 Across our audit,
the many groups we interviewed were consistent inrecognizing the efforts of zone management, particularlyin the area of communication.
When a facility had an active outbreak they were involved
in daily status calls with AHS zone management, zone
medical leadership, and public health. In more serious
outbreaks AHS sent management, administrative, andsometimes clinical staff to support the facilities. There
were also four discrete groups from both Alberta Healthand AHS conducting in-person inspections at facilities.22
All these touchpoints provided opportunities for
management and staff from the facilities to ask speciﬁcquestions of representatives of Alberta Health and AHS.

Weekly meetings with operator representatives
The Assistant Deputy Minister responsible for continuingcare at Alberta Health started holding regular meetings
with operator representatives on April 15, 2020. We foundthat for a time these meetings happened as regularly as
daily and consistently happened at least weekly throughthe end of 2020. Senior management from Alberta
Health, AHS, and the operator associations attended thesemeetings. The purpose of the meetings was to facilitate
two-way communication, giving the operators a conduit
to identify issues and ask questions directly with decision
makers at Alberta Health and AHS.23

Town halls with the Chief Medical Officer of
HealthThe Chief Medical Officer of Health hosted two sets oftown hall meetings24 with continuing care operators,
residents, and their families starting in June 2020.
These meetings provided a unique opportunity in the
COVID-19 response for senior officials and senior
management of Alberta Health and AHS to hear directlyfrom residents and their families.

Why we are not making recommendations
regarding guidance and communications:
There were some initial problems with providing
guidance to facilities, particularly around issuing
Chief Medical Officer of Health Orders. We
have determined it is not necessary to make a
recommendation to Alberta Health in this area
because the issues we identiﬁed in the processes
to develop and communicate early iterationsof the Orders were resolved by Alberta Health.
Our audit work, including conversations withstakeholders and AHS, corroborated this fact.

21

The provision of AHS staff to facilities is discussed in greater detail on page 33.

22

Explained further in the section on facility monitoring.

23

We found there were countless other meetings that took place between March and December 2020. The meetings established by theAssistant Deputy Minister stood out to us because, compared to other meetings, these were formal, happened regularly, and took placeconsistently across the time period covered by our audit.

24

Each set of town halls was comprised of multiple meetings. A further two sets of town hall meetings were hosted in 2021, outside the time
scope of our audit.

26 Report of the Auditor General—February 2023

Page: 26
Number: 1

Author: daviddickson

Subject: Highlight Date: 2023-02-25 5:04:44 PM

Zone Medical Officers – didn’t understand the Orders, were laregly unaware what was actually happening
in the care homes and fully supportive of excluding all family and any other visitors from the care homes
indefinitely, CONTRARY TO THE ORDERS (as per our personal experience on multiple occasions with theseofficials).

EXECUTE: Assessing
Resource Needs to Support
Outbreak Prevention andManagement
Context

Staff
Estimates of facility staffing at the beginning of 2020
were that 31,600 people worked in continuing carefacilities—of those, 85 per cent worked part-time or
fewer hours. Many of these staff worked at two or more
facilities in a week.
Having enough trained staff to provide care toresidents was an existing challenge for facilities before
COVID-19.25

Resources needed to prevent andrespond to COVID-19
Continuing care facilities needed additional resources
to prevent COVID-19 from getting into facilities, andto respond to outbreaks when they started. The needfor more resources came from the loss of facility staff
to illness and isolation during outbreaks, the additional
requirements of Orders and AHS guidance, and thesustained pressure of lengthy and complex outbreaks.
We identiﬁed ﬁve main classes of resources that directly
affected a facility’s ability to respond. We focused our
audit work on what Alberta Health and AHS did tounderstand and support facilities in these areas.
Contracted continuing care facilities and those run
by AHS subsidiaries—CapitalCare and Carewest—
receive set health care funding for the care services
they provide. They also receive revenue from monthly,
regulated accommodation charges paid by residents.
These facilities are responsible for procuring theirown resources and are expected to maintain outbreak
response supplies.

1

COVID-19 testing
Laboratory testing is a common and essential process
to manage a disease outbreak. For COVID-19—which
infects and spreads before symptoms present in aperson—knowing who has the disease is critical to
stopping outbreaks. The faster that this information is in
the hands of the facilities, the better they can respondand interrupt further spread. There is a signiﬁcant bodyof academic literature proving what is intuitively clear:delays in getting test results leads to more disease
spread.
2
Alberta Precision Laboratories (APL) did all COVID-19

testing for continuing care facility residents and staff byusing polymerase chain reaction (PCR))26 swab testing. At
this same time, APL was also completing substantially all
COVID-19 testing in the province—from outbreak testingfor health care and other settings, to symptomatic andasymptomatic testing of the public. This amounted to
between 10 and 20 times their normal daily volumes
and coincided with global shortages of testing supplies.

Five Types of Resources Impacting Facility Response

Funding

Staff

PPE & criticalsupplies

COVID-19
testing

Facility
infrastructure

25This issue has been a central focus of evaluations of facility-based continuing care stretching back more than 20 years; and was a focus of ourpast work on long-term care in 2005 and 2014. See Report of the Auditor General of Alberta—May 2005 and Report of the Auditor General ofAlberta—October 2014.

26

Polymerase chain reaction (PCR) allows a laboratory to copy a genetic sequence it is interested in examining and use that copy to create
enough of that genetic material to allow it to be analyzed. In the case of COVID-19 testing, the goal would be to analyze whether a sample
taken from a person, generally via a swab, contained genetic material from the SARS-CoV-2 virus that causes COVID-19—indicating that
person was infected with the virus and so considered COVID-19 positive.
Report of the Auditor General—February 2023 27

Page: 27
Number: 1

Author: daviddickson

Subject: Highlight Date: 2023-02-25 5:05:13 PM

PCR tests were turned around in rapid time to ensure the continued isolation of residents. Testing wasrelentless at our mother's care home and turnaround in record time. Also, symptoms and/or positive
result required isolations.
Number: 2
Author: daviddickson
Subject: Highlight Date: 2023-02-25 5:56:00 PM
APL and its implication in testing and fraudulent cases.

https://dksdata.com/AlbertaDead#APL
From 'when is a negative test a positive?' to 'how many days back for a case?'
These numbers are based on manipulated statistics related to when a person was coded as a COVID case, not when they died. In some cases
these Covid cases 'survived' for over two years. Did they really die of COVID?
The criteria for a COVID death was death up to 6 months after a COVID diagnosis (with or without a death certificate to support). COVID
deaths were identified by nurses in the COVID statistical department reviewing NetCare and Connect Care (and sometimes death certificates). In
August of 2022, that criteria changed to 60 days instead of 6 months. However, there are instances where the 6 months and the 60 days was
ignored.
http://dksdata.com/AlbertaDead
COVID cases were known to be unreliable and as such, COVID hospitalizations and deaths were built on flawed foundations. Fruit of the
poisonous tree from the start. For an Auditor to not even look at this is beyond negligent and further reinforces the need for a police forensic
investigation of all relevant data and facts.

Facility infrastructure
1
At March 31, 2020, there were 355 individual

continuing care facilities which received public healthfunding to provide continuing care services to residents.
The physical buildings in which continuing care facilities
operate had major impacts on the COVID-19 response.
Facility layout, use of shared rooms, and insufficient
HVAC systems27 became some of the most common
issues in COVID-19 outbreaks and by far the hardest to
resolve quickly or without considerable cost.

27

Heating, Ventilation, and Air Conditioning.

28 Report of the Auditor General—February 2023

Criteria
Alberta Health and AHS should assess whether facilities
have resources to implement plans, protocols andguidance.

Our ﬁndings
Key ﬁndings:•

Having enough staff to provide safe care during an
outbreak was a persistent, systemic problem.

•

Facilities experienced major delays in getting theresults of COVID-19 tests for residents and staff.

•

Shared rooms and aspects of facility infrastructurefeatured prominently in the most severe COVID-19
outbreaks.

•

Alberta Health and AHS provided over $250
million in incremental funding to facilities in 2020.

•

PPE and supplies were a critical constraint for theﬁrst month, but rectiﬁed after mid-April 2020.

Page: 28
Number: 1

Author: daviddickson

Subject: Highlight Date: 2023-02-25 5:07:06 PM

This report FAILS TO MENTION the written AHS protocols for the specific transfer of COVID POSITIVE/Symptomatic (with any illness that may
have been listed as COVID) into SHARED ROOMS with a NON COVID/ NON SYMPTOMATIC resident. This forced these otherwise healthy
residents into CLOSE CONTACT and forced isolation with a new sick resident.
WHY DID THE REPORT MISS THIS?
How many deaths were caused by this deliberate cross infection (from who knows what ILI')?
https://thenationaltelegraph.com/regional/exclusive-alberta-government-transferring-covid-positive-patients-into-care-homes
https://thenationaltelegraph.com/regional/the-alberta-government-has-turned-care-homes-into-outbreak-centres
https://rumble.com/v2au726-january-30th-2021-karen-alberta-legislature-speech.html

1

Havingg enoughg staff to p
provide care
was a persistent, systemic weakness

Pre-COVID understanding of staffing was
limited

The importance of having enough staff, particularly
during an outbreak, is hard to overstate. Facilities musthave enough staff to provide, at a minimum, essential
safe care for residents during an outbreak.

Alberta Health and AHS did not have a complete
understanding of staffing at facilities prior to COVID-19.
AHS derived estimates of the number and types of staff
at facilities in April 2020 from ﬁnancial reporting. This
information was obtained from facilities for the ﬁscal
year ended March 31, 2019.

We analyzed outbreak investigation reporting preparedby AHS, as well as the results of facility complianceinspections. Facilities not having enough staff was, byfar, the most common issue identiﬁed.

Understanding Continuing Care Facility Staffing

Full-time worker(15% of total)

Food services(9%)

Part-time orcasual worker(85% of total)

Laundry &cleaning (5%)

AHS estimated 31,600
staff in continuing carefacilities at the beginningof 2020

Health Care Aides (59%)

Nurses &therapists(25%)

Management& other (2%)

Report of the Auditor General—February 2023 29

Page: 29
Number: 1

Author: daviddickson

Subject: Highlight Date: 2023-02-24 7:35:40 PM

Single site order – the apparent reduction of spread was achieved NOT by the single site order but by the
manipulation of testing.
Again, as per the report’s own admission, the single site order “was estimated to have reduced the total
pool of continuing care staff by about one third.”
WHAT DID THIS MEAN FOR RESIDENTS? UNNECESSARY SUFFERING AND DEATHS.
Add into that the tens of thousands they subsequently lost for vaccine mandates.

Single-site order created signiﬁcant operational
challenges
The requirement of the Chief Medical Officer of HealthOrder 10-2020 that staff work at only one facility
was universally viewed as a necessary measure, but
presented an administrative and operational challenge to
all levels of the continuing care sector.
1
Before the single-site order, Alberta Health and AHS

suspected that staff regularly working at more than
one site allowed COVID-19 to move between facilities.
We analyzed how COVID-19 outbreaks clusteredgeographically before and after the single-site order.28
We found that the degree of clustering decreased
noticeably after the single-site order—suggesting that
the Order had the desired effect of reducing spread
between facilities.
The biggest impact of the single-site order on facility
staffing was that it was estimated29 to have reduced thetotal pool of continuing care staffing by about one-third.
Requiring one individual to work at only one facility
eliminated the pool of part-time and casual staff who
normally ﬁlled shifts at more than one facility.
“Operators faced difficulties in responding
immediately to staffing shortages which weresigniﬁcantly exacerbated by the CMOH singlesite restriction staffing order. As a result of therestriction of staff to single sites there was a limited
pool of casual or agency staff available to address
shortages. This led to CMOH order exemptions
for certain sites to ensure adequate staffing wasavailable for outbreak sites.”

Single-site order monitoring system wasquickly deployed but not all facilities reported
data
We found that Alberta Health quickly purchased an
information system that allowed it to monitor whether
facilities were following the single-site order. The systemcost about $670,000 to build and maintain, and Alberta
Health was able get the system working within aboutfour weeks. The system required every employer30
to report staff information for anyone working at acontinuing care facility on a secure website each pay
period. The system worked by comparing unique
staff information and ﬂagging anyone who had hours
recorded at more than one site. Alberta Health would
then investigate as many of these instances as it could.
The system was the only certain way Alberta Health had
to ensure facilities were following the single-site order,
but its usefulness suffered because not all facilities
uploaded their data as required. Between March andDecember 2020, at most 76 per cent of facilities
uploaded their data—meaning at least 7,500 facility
staff31 were not in the system.
Even with incomplete data, Alberta Health still
consistently identiﬁed many workers who had hours
at multiple sites in a pay period. While the number
continued to decline over time, in the last pay periodof December 2020 Alberta Health still identiﬁed 523‘multi-site workers.’– AHS outbreak investigation report282
We used the geographic area of the City of Calgary and the North Zone as test areas for our analysis. We used geographic information to plot
the locations of outbreaks over the ﬁrst six weeks of both wave one (before the single-site order) and wave two (after the single-site order).
We compared the degree of spacial clustering of new COVID-19 outbreaks between both.

29

No systematic study of this effect had been completed by any party we spoke to during our audit. The estimate of about 30 per centreduction in the staffing pool was common among facility operator representatives, subject matter experts, and our discussions with anddocumentation from Alberta Health and AHS.

30

During COVID-19 outbreaks, this included facility operators, but also a considerable number of staffing agencies who provided theiremployees to facilities.

31

Because the data is incomplete and the pre-COVID understanding on staffing numbers were estimates based on payroll data, and so did
not take into account contractors, agency staff, and others in facilities during COVID-19, this exact number cannot be known with certainty.
7,500 is the minimum based on the estimate of 31,600 continuing care staff developed by AHS based on ﬁnancial data from March 31,
2019. However, this data does not include other sources of personnel in facilities such as agency staff. Other ways of estimating this number
based on the single-site staffing database and comparing the number of workers reported in the single-site worker database to the response
rate give estimates as high as 14,000 people working in facilities that were unaccounted for.

30 Report of the Auditor General—February 2023

Page: 30
Number: 1
Author: daviddickson
Subject: Highlight Date: 2023-02-24 7:36:12 PMSingle site order – the apparent reduction of spread was achieved NOT by the single site order but by the manipulation of testing.
Again, as per the report’s own admission, the single site order “was estimated to have reduced the total pool of continuing care staff by about
one third.”
WHAT DID THIS MEAN FOR RESIDENTS? UNNECESSARY SUFFERING AND DEATHS.
Add into that the tens of thousands they subsequently lost for vaccine mandates.
Number: 2

Author: daviddickson

Subject: Highlight Date: 2023-02-24 7:35:54 PM

Footnote 28 – completely limited, focused, incomplete analysis used to come to the conclusion that single
site order was effective. Dropped when staffing levels became unsupportable due to this policy.
Footnote 29 – NO systematic study performed on effect of third reduction in staffing.

1
Facility
staff had more to do with fewer people
to do it, especially in outbreaks

The COVID-19 response meant facility staff had much
more work to do than normal. We found that even
without an outbreak, the workload for staff increased
because the resident family members, volunteers,and students that they relied on to help with resident
care were restricted from facilities. The Orders andAHS guidance required staff to do extra cleaning andinfection prevention and control work, as well as conduct
screening of residents, other staff, and visitors manytimes a day. Existing staffing was already strained by the
impacts of the single-site order, increased resignations,and a general staff absenteeism problem that facility
operators estimated at more than 20 per cent at times.32

2
We found that when an outbreak started, the situation

faced by facility staff went from bad to worse. Theirworkload grew much more. In addition to all theincremental outbreak prevention work, staff now
needed to safely care for ill residents, meet additional
outbreak rules, do their own contact tracing, swab
residents for COVID-19 testing, respond to concernedfamily members, facilitate inspections, and provide
daily reporting to Alberta Health and AHS. At the sametime, an outbreak would cause 20 to 50 per cent of theremaining facility staff to be off due to illness, isolation
requirements, or absenteeism due to fear of contracting
COVID-19.
3
When we analyzed outbreak investigation reporting

prepared by AHS, we found that issues related to staffing
shortages were the most common identiﬁed, occurringin every major outbreak studied.

Impacts of COVID-19 on Resident Care Providers*
Pre-COVID

Facility
staff

COVID No Outbreak

Resident
familyFacility
staff

Resident

Students

COVID Outbreak

Resident
familyFacility
staff

Resident

Volunteers

Students

Resident
familyResident

Volunteers

Students

Volunteers* Note that over time rules around caregivers evolved to allow a designated resident family member to visit,
under additional safety protocols, even during COVID-19 outbreaks later in 2020.

32

While no systematic study of this situation was available, we identiﬁed this fact consistently across our audit, both in review of
documentation from Alberta Health and AHS, as well as in discussions with facility operator representatives. The reasons for this were healthand safety concerns, stress and burnout, but also the implications of the federal income support program CERB, which did not represent asigniﬁcant drop in income for workers making little more than the minimum wage.
Report of the Auditor General—February 2023 31

Page: 31
Number: 1

Author: daviddickson

Subject: Highlight Date: 2023-02-25 5:08:49 PM

PROTOCOLS CAUSED system failure, inordinate stress on staff and suffering and death of residents.
Exclusion of DSP’s increased workload exponentially for staff.
Staff duties (on an already depleted workforce) increased to include extra cleaning, “infection prevention
and control work, screening of residents, other staff, and visitors, many times a day”. Who were left tobear the brunt of this? RESIDENTS!
What impact did this have on a workforce already pushed beyond the brink? “…increased resignations,general staff absenteeism… estimated at more than 20% at times.” Why would staff continue in thisoppressive environment with concerns about “their health and safety” (not all related to the risk ofcontracting/transmitting COVID19, I might add) but related to the protocols in place, “stress and burnout”
and the CERB incentive paying them marginally less than they were getting for going to work.
Number: 2
Author: daviddickson
Subject: Highlight Date: 2023-02-25 5:56:17 PM
https://rumble.com/v28lhpw-who-cares-about-false-positives-every-single-case-was-used-to-terorrise.html
KENNEY SAYS WHO CARES ABOUT FALSE POSITIVES! From Kenney's own Q&A::
00:00"Alright Donna Stratton Stratton Tip says I've read about the maker of the PCR test has stated it's about 50% wrong and wasn't designed forwhat we're using it for. Is that true?" And then this.
00:13"I actually asked for this to come up because I know there's a lot of folks often when I check out the Facebook comments, there's a lot of thisstuff about PCR, so PCR is the standard test for COVID-19 in Canada and Alberta and around the world."
00:30"It's it's true that based on how many cycles the PCR test is does on the sample that that it can generate in many cases does generate a false
positive…"
01:01"So there are, I'll call them covid skeptics, who are claiming that all of the restrictive policies are being wrongly informed by exaggerated Covid
case counts because of false positives through PCR testing."
01:53"In a sense, I mean, who really cares about the false positives?"

WHO CARES?? WHO INDEED!! Let me tell you WHO CARES, KENNEY!! How about the people isolated for two weeks, losing their business,closed care homes, closed schools, cancelled surgeries, suicides, poverty....
It takes a single 'case' to shut down the lives of hundreds of care home residents and all connected to them and our then Premier had the
audacity, to say "..who really cares about the false positives?"
APL and its implication in testing and fraudulent cases.
https://dksdata.com/AlbertaDead#APL
From 'when is a negative test a positive?' to 'how many days back for a case?'
These numbers are based on manipulated statistics related to when a person was coded as a COVID case, not when they died. In some cases
these Covid cases 'survived' for over two years. Did they really die of COVID?
The criteria for a COVID death was death up to 6 months after a COVID diagnosis (with or without a death certificate to support). COVID
deaths were identified by nurses in the COVID statistical department reviewing NetCare and Connect Care (and sometimes death certificates). In
August of 2022, that criteria changed to 60 days instead of 6 months. However, there are instances where the 6 months and the 60 days was
ignored.
http://dksdata.com/AlbertaDead
COVID cases were known to be unreliable and as such, COVID hospitalizations and deaths were built on flawed foundations. Fruit of the
poisonous tree from the start. For an Auditor to not even look at this is beyond negligent and further reinforces the need for a police forensic
investigation of all relevant data and facts.

Number: 3
Author: daviddickson
Subject: Highlight Date: 2023-02-25 5:56:38 PM
Did the outbreak report mention how many 'Cases' were asymptomatic? Most were in 2020.
So many clear indicators of fraud in the classification of 'cases' and Deaths ignored by this report as it attempts to reinvent history.

https://rumble.com/v28lhpw-who-cares-about-false-positives-every-single-case-was-used-to-terorrise.html
KENNEY SAYS WHO CARES ABOUT FALSE POSITIVES! From Kenney's own Q&A::
00:00

Comments from page 31 continued on next pageFacility staff had more to do with fewer people
to do it, especially in outbreaks
The COVID-19 response meant facility staff had much
more work to do than normal. We found that even
without an outbreak, the workload for staff increased
because the resident family members, volunteers,and students that they relied on to help with resident
care were restricted from facilities. The Orders andAHS guidance required staff to do extra cleaning andinfection prevention and control work, as well as conduct
screening of residents, other staff, and visitors manytimes a day. Existing staffing was already strained by the
impacts of the single-site order, increased resignations,and a general staff absenteeism problem that facility
operators estimated at more than 20 per cent at times.32

We found that when an outbreak started, the situation
faced by facility staff went from bad to worse. Theirworkload grew much more. In addition to all theincremental outbreak prevention work, staff now
needed to safely care for ill residents, meet additional
outbreak rules, do their own contact tracing, swab
residents for COVID-19 testing, respond to concernedfamily members, facilitate inspections, and provide
daily reporting to Alberta Health and AHS. At the sametime, an outbreak would cause 20 to 50 per cent of theremaining facility staff to be off due to illness, isolation
requirements, or absenteeism due to fear of contracting
COVID-19.
When we analyzed outbreak investigation reporting
prepared by AHS, we found that issues related to staffing
shortages were the most common identiﬁed, occurringin every major outbreak studied.

Impacts of COVID-19 on Resident Care Providers*
Pre-COVID

Facility
staff

COVID No Outbreak

Resident
familyFacility
staff

Resident

Students

COVID Outbreak

Resident
familyFacility
staff

Resident

Volunteers

Students

Resident
familyResident

Volunteers

Students

Volunteers

4* Notethat over time rules around caregivers evolved to allow a designated resident family member to visit,
under additional safety protocols, even during COVID-19 outbreaks later in 2020.

32

While no systematic study of this situation was available, we identiﬁed this fact consistently across our audit, both in review of
documentation from Alberta Health and AHS, as well as in discussions with facility operator representatives. The reasons for this were healthand safety concerns, stress and burnout, but also the implications of the federal income support program CERB, which did not represent asigniﬁcant drop in income for workers making little more than the minimum wage.
Report of the Auditor General—February 2023 31

"Alright Donna Stratton Stratton Tip says I've read about the maker of the PCR test has stated it's about 50% wrong and wasn't designed forwhat we're using it for. Is that true?" And then this.
00:13"I actually asked for this to come up because I know there's a lot of folks often when I check out the Facebook comments, there's a lot of thisstuff about PCR, so PCR is the standard test for COVID-19 in Canada and Alberta and around the world."
00:30"It's it's true that based on how many cycles the PCR test is does on the sample that that it can generate in many cases does generate a false
positive…"
01:01"So there are, I'll call them covid skeptics, who are claiming that all of the restrictive policies are being wrongly informed by exaggerated Covid
case counts because of false positives through PCR testing."
01:53"In a sense, I mean, who really cares about the false positives?"
WHO CARES?? WHO INDEED!! Let me tell you WHO CARES, KENNEY!! How about the people isolated for two weeks, losing their business,closed care homes, closed schools, cancelled surgeries, suicides, poverty....
It takes a single 'case' to shut down the lives of hundreds of care home residents and all connected to them and our then Premier had the
audacity, to say "..who really cares about the false positives?"
APL and its implication in testing and fraudulent cases.
https://dksdata.com/AlbertaDead#APL
From 'when is a negative test a positive?' to 'how many days back for a case?'
These numbers are based on manipulated statistics related to when a person was coded as a COVID case, not when they died. In some cases
these Covid cases 'survived' for over two years. Did they really die of COVID?
The criteria for a COVID death was death up to 6 months after a COVID diagnosis (with or without a death certificate to support). COVID
deaths were identified by nurses in the COVID statistical department reviewing NetCare and Connect Care (and sometimes death certificates). In
August of 2022, that criteria changed to 60 days instead of 6 months. However, there are instances where the 6 months and the 60 days was
ignored.
http://dksdata.com/AlbertaDead
COVID Cases were known to be unreliable and as such, COVID hospitalizations and deaths were built on flawed foundations. Fruit of the
poisonous tree from the start. For an Auditor to not even look at this is beyond negligent and further reinforces the need for a police forensic
investigation of all relevant data and facts
Number: 4
Author: daviddickson
Subject: Highlight Date: 2023-02-24 7:42:27 PM
Some DSP's have never been allowed to visit due to an inability (medical exemption) to wear a mask. Yet sick staff are allowed in as long as theywear a mask.
'Allow' - THIS WAS A BASIC HUMAN RIGHT THAT WAS DENIED!
dksdata.com/MASKS@AHSSAGStaffing agencies were an imperfect stopgap
Facility emergency plans rely on the use of staffing
agencies to stopgap critical staffing shortages during
emergencies. COVID-19 proved the assumptions
underlying this as a pandemic contingency plan wrong.
First was the assumption that agencies would provide
staff at all. When we analyzed outbreak investigation
reporting we found instances where agencies refused
to send their staff. When agencies were willing, someagency staff would not report for duty, or fail to comeback after a day or two.
2
Second was the assumption that agency staff weresuited to the work required. While some agencies could
offer staff with relevant skills and training—including
nurses and health care aides—many agency staff did
not have these skills. Outbreak investigation reporting
we analyzed notes repeated incidents of agency staff notunderstanding or following basic infection prevention
and control protocols or not understanding cleaning
techniques required for a healthcare facility. Where
agency staff had relevant medical training, their lack offamiliarity with the residents could cause them to missthe development of symptoms.
Finally, there was the assumption that critical staffing
shortages would be rare and isolated occurrences. The
plans did not anticipate a situation where the demand
for agency staff would be coming from multiple facilities
in a geographic area simultaneously.

Provincial responses to staffing shortages met
targets
The main staffing initiative from Alberta Health was
the health care aide funding initiative. This included a
two dollar per hour wage top-up for health care aides,
increased funding to allow facilities to hire more aides,
and paid practicums for health care aide students. The
initiative aimed to increase staffing by a total of 2,000
health care aides working in the system.

33

We found the initiative met its goal—adding just under
its target of 2,000 aides. These additional workers
represented about 11 per cent of the health care aides inthe system at the beginning of 2020.33
1

AHS holds ultimate accountability for safe
resident care
Any operator of a health facility—whether that operator
is AHS, an AHS-subsidiary, or a contracted service
provider—has an obligation to provide safe care in theirfacilities and to meet any applicable legal requirements.
AHS is ultimately accountable for safe care in theprovince. And, as we and others have pointed out in pastreports on the continuing care system, safe and effective
care starts and ends with facilities having enough of theright staff providing care.
We found that none of the AHS pandemic plans
directly considered a scenario in which they would
need to regularly send their own staff to support theirsubsidiaries and contracted facility operators withoutbreaks. After eight months of navigating the situation
case-by-case, AHS developed a plan for when and how
it can provide AHS staff to support continuing careoutbreaks.
The plan formalized AHS’ position that it would redeploy
its staff to other facilities when facilities had exhausted
all other options. The position reﬂects the fact thatfacilities hold the primary obligation under their contract
with AHS to have sufficient staff to provide safe resident
care, and that they have plans to ensure sufficient
staffing in emergencies. In evaluating the AHS plan, we
found there were three main barriers that would hinder
AHS staff freely working in other facilities—the singlesite order, the need of AHS to staff its own facilities
and the entire provincial health system, and collective
agreements.

Recognizing the need for more staff in facilities, AHS began planning for another method of providing additional staffing to facilities in
November 2020. As we note in Appendix F, on December 30, 2020, AHS contracted a major staffing agency to recruit and deploy 1,600
personnel to ﬁll non-clinical support positions called “Comfort Care Aides.” These staff began rolling out to facilities in 2021.

32 Report of the Auditor General—February 2023

Page: 32
Number: 1
Author: daviddickson
Subject: Highlight Date: 2023-02-25 5:13:09 PM
AHS and the Government lied and people died.
And AHS is governed by and is ultimately accountable to the Health Minister (by law). He could have interjected at any time... but that was not
his intent.
Care Homes also stated (as this report does) that they HAD TO FOLLOW DEENA HINSHAW'S ORDERS.

However...
Where is the evidence to back up these Orders?
“I, Dr. Deena Hinshaw, Chief Medical Officer of Health (CMOH) have initiated an investigation into the existence of COVID-19 within the Provinceof Alberta.
This investigation has confirmed that COVID-19 is present in Alberta and constitutes a public health emergency as a novel or highly infectious
agent that poses a significant risk to public health.”
Or“Whereas I, Dr. Deena Hinshaw, Chief Medical Officer of Health (CMOH) have initiated an investigation into the existence of COVID-19 within theProvince of Alberta.
Whereas the investigation has confirmed that COVID-19 is present in Alberta and constitutes a public health emergency as a novel or highly
infectious agent that poses a significant risk to public health.” etc.
FULL DISCLOSURE IS REQUIRED
Why did Alberta trigger an 'Influenza Pandemic' in March of 2019 on the advice of the Health Minster Tyler Shandro - Without the legislative
authority to do so?
https://dksdata.com/DS/Shandro1.jpg
These Orders really had no legal authority as they were based on the fruit of the poisonous tree
In the end, everyone involved is accountable and needs to be treated as such.
The whole response (and this report) was and is based on flawed and manipulated data and false statements. This is why this matter MUST be
handed over for a complete forensic investigation by people with the power to execute warrants, make arrests, interview under caution,
perform detailed technical forensic audits and press charges. Anything less is an insult to and fails the Alberta public.
Number: 2

Author: daviddickson

Subject: Highlight Date: 2023-02-25 5:13:40 PM

I have it on good authority from countless frontline staff that agencies were NOT called when there werestaffing shortages because of budget restraints/concerns.

1Barriers to Sending AHS Staff into Other Facilities

Whole health system
responsibility:••

Numerous other criticalpatient care areas AHS
is responsible for—acutecare, public health,
COVID-19 assessment
centres, among others
Largest staffing need
was for health care aides,
which AHS has fewer of inits operations

Single-site order:

Collective agreements:•

Cannot send staff alreadyworking in an AHS
continuing care facility•

Agreements with unions
do not allow sending staff
to other employers•

Acute care staff are not
restricted by the Order but
were in low supply andhigh demand, particularly
in wave two•

Each instance would need
to be agreed with unions•

Risk of labour grievancesand complaints

We found that where AHS provided other facilities
with its staff, it varied in type and intensity dependingon the severity of the outbreaks and the needs at thefacility. It ranged from coordinating and administrativeroles, consultative services to facility management,
assessment and support with speciﬁc non-care tasks,
all the way to resident care providers—like nurses
and health care aides. We saw frequent evidence inmajor outbreaks of AHS zone management providing
administrative and management support,34 but fewer
instances of staff who directly provide resident care.35

34

These non-clinical staffing resources were more freely available because they were typically management or exempted staff who were notsubject to collective agreements.

35

This excepts the two situations where AHS took over operations of facilities from operators.
Report of the Auditor General—February 2023 33

Page: 33
Number: 1
Author: daviddickson
See previous comments.

Subject: Highlight Date: 2023-02-24 7:46:53 PM

AHS began work early to clear a path for staff
re-deployment with major unions
AHS expended signiﬁcant effort in the ﬁrst twomonths of COVID-19 to clear a legal path with thethree main unions who represent its employees. AHS
wanted ﬂexibility to redeploy staff to other facilities
when needed. On April 24, 2020, AHS formalized
an agreement to permit redeployment, but only
until June 29. After that time, when AHS needed toredeploy staff, it could only do so if a staff member
volunteered and it notiﬁed the union.36
We found this effort to sort out labour relations asevidence of AHS trying to ﬁnd solutions, but also
as another example in the COVID-19 response offoundational matters not being anticipated or in placeprior to a pandemic.

Every facility operator representative we interviewed
detailed problems getting timely results of swabs fortheir residents and staff. Most gave us some estimateof the delays ranging from ﬁve to more than seven days
for resident results from the time they sent the swabs
back to APL.37 For staff results, the wait was even longer.
This happened at a time when an Albertan, even without
symptoms, could go get a swab from an AHS site andgenerally receive their results within a day or two.
“Large outbreaks Alberta sites experienced todate have reinforced the importance of […] early
identiﬁcation and isolation of symptomatic persons
and those with known exposure to COVID-19 [and]swift access to testing and results …”– Chief Medical Officer of Health Order 32-2020;
September 3, 2020.

1

Delaysy in COVID-19 testingg results
for facilities hampered outbreakmanagement
Facilities experienced major delays in getting
the results of swabs taken at facilities
We reviewed guidance from AHS, Alberta Precision
Laboratories (APL), and Orders to ﬁnd concrete
expectations for how long it should take for a facility to
get COVID-19 test results from swabs of its residents
and staff. The clearest articulation we identiﬁed was
one piece of AHS guidance to facilities on COVID-19
testing suggesting facilities would have swab results
within 96 hours (four days) of the site notifying AHS
of a possible outbreak.

One of the reasons for delay was a system-wide backlog
driven by increasing numbers of swabs from acrossthe health system and from asymptomatic swabs forthe public. This reached a peak on September 7, 2020,
when the time for APL to get swab results reached 234
hours—almost 10 days.38 39 This backlog affected theentire system.

36

Even when a union member volunteered and AHS notiﬁed the union, AHS was still technically offside of its authority under the collective
agreements. We did not identify evidence of the unions objecting when this happened in 2020.

37

As we discuss below, it generally took two or three days for facilities to receive swabbing supplies, and then a further one to two days tocomplete the swabbing of residents and ship swabs back to APL for testing. Meaning it would be at least three days from the point an
outbreak was suspected to send swabs to APL for testing.

38

This ﬁgure is reported at the "80th percentile." What this means is that, in this particular case, if you had 10 swabs, eight of them would take234 hours or less, two of them would take more than 234 hours.

39

While not the focus of this audit, we noted that APL introduced process improvements and brought the time it took to process swabs down towithin its target of 24 hours quickly after this peak.

34 Report of the Auditor General—February 2023

Page: 34
Number: 1
Author: daviddickson
Subject: Highlight Date: 2023-02-25 5:57:02 PM
This is not correct. Testing for Care Homes was specifically prioritized for turn around in 4 days or less (and in most cases in 48 hours or less
BEFORE the prioritization announcement). Testing was done daily on almost all residents (symptomatic or not and even with no 'close contact'),
which created an artificial crisis of resources from test kits to staff. This never slowed the testing down though and there were no instances of alab result changing the timing of an 'Outbreak' which was defined as TWO WEEKS (28 days with Delta) AFTER the last positive test/probablecase (symptoms). People were assumed positive until tested and Outbreaks were not dependent on test delays (that did not exist).
1 probable or confirmed case made a center 'Under Investigation'. A second Probable or Confirmed Case put them on Outbreak for 2 weeks (or28 days). Any subsequent 'cases' extended the outbreak by 1 - 2 weeks. Testing delays were not the problem, TESTING too much with a known
faulty test WAS THE PROBLEM. "Who cares about false positives" said Premier Kenney - EVERYONE SHOULD!

https://rumble.com/v28lhpw-who-cares-about-false-positives-every-single-case-was-used-to-terorrise.html
KENNEY SAYS WHO CARES ABOUT FALSE POSITIVES! From Kenney's own Q&A::
00:00"Alright Donna Stratton Stratton Tip says I've read about the maker of the PCR test has stated it's about 50% wrong and wasn't designed forwhat we're using it for. Is that true?" And then this.
00:13"I actually asked for this to come up because I know there's a lot of folks often when I check out the Facebook comments, there's a lot of thisstuff about PCR, so PCR is the standard test for COVID-19 in Canada and Alberta and around the world."
00:30"It's it's true that based on how many cycles the PCR test is does on the sample that that it can generate in many cases does generate a false
positive…"
01:01"So there are, I'll call them covid skeptics, who are claiming that all of the restrictive policies are being wrongly informed by exaggerated Covid
case counts because of false positives through PCR testing."
01:53"In a sense, I mean, who really cares about the false positives?"
WHO CARES?? WHO INDEED!! Let me tell you WHO CARES, KENNEY!! How about the people isolated for two weeks, losing their business,closed care homes, closed schools, cancelled surgeries, suicides, poverty....
It takes a single 'case' to shut down the lives of hundreds of care home residents and all connected to them and our then Premier had the
audacity, to say "..who really cares about the false positives?"
APL and its implication in testing and fraudulent cases.
https://dksdata.com/AlbertaDead#APL
From 'when is a negative test a positive?' to 'how many days back for a Case?'
These numbers are based on manipulated statistics related to when a person was coded as a COVID case, not when they died. In some cases
these Covid cases 'survived' for over two years. Did they really die of COVID?
The criteria for a COVID death was death up to 6 months after a COVID diagnosis (with or without a death certificate to support). COVID
deaths were identified by Nurses in the COVID statistical department reviewing NetCare and Connect Care (and sometimes death certificates).
In August of 2022, that criteria changed to 60 days instead of 6 months. However, there are instances where the 6 months and the 60 days was
ignored.
http://dksdata.com/AlbertaDead
COVID Cases were known to be unreliable and as such, COVID hospitalizations and deaths were built on flawed foundations. Fruit of the
poisonous tree from the start. For an Auditor to not even look at this is beyond negligent and further reinforces the need for a Police Forensic
investigation of all relevant data and facts.
The obsession with testing WAS THE PROBLEM.
See https://rumble.com/v1ddohu-counting-cars.-how-covid-19-is-being-reported..html

1

COVID-19 Testing Timelines for Continuing Care Facilities

Facilitysuspects an
outbreak

Facility has
results

Expected
timelines
4
Days

Time in days

1

2

3

4

2-3
Days

5
1-2
Days

6

7

8

9

1-2
Days

10

11

12

13

14

15

16

17

7-10
Days

Actualtimelines*
Swab kitreceived

Residents
swabbedResults at
APL

Facility has
results* Actual timelines are based on our documentation review, data analysis, and supplemented by discussions with APL
management.

We found APL has robust administrative data on
testing volumes and the time it took to test a swab.
However, because APL’s administrative data does nottrack outbreaks, no one had complete testing data on
continuing care facility outbreaks. No one could say withcertainty how long it took for APL to generate results forcontinuing care outbreaks.

APL’s data and administrative measures stop at the point
they have the result—positive or negative—for the swab
in their lab information system, which normally thenpushes the results to other information systems at AHS
and Alberta Health. There was no tracking of how long it
took to get the results of COVID-19 swabs into the handsof facilities so they could start acting on them.

Report of the Auditor General—February 2023 35

Page: 35
Number: 1
Author: daviddickson
Subject: Highlight Date: 2023-02-25 5:18:49 PM
An outbreak exceeded the timeline for swabs being returned. If residents were symptomatic, the Orders made testing irrelevant.

See comment above about testing, false positives and APL

1Delays in getting results to facilities stemmed
from weak process and errors in requisitions
2
We compiled process descriptions based on what eachof three main parties—AHS, APL, and facilities—had
to do to get a facility’s residents and staff tested andthe results back to the facility from the point when afacility suspected it had a COVID-19 case. Our analysis
found that the process encompassed over 50 discrete
steps and sub-steps, crossing the three separateorganizations. It involved ﬁve different functional areas
within AHS itself. Each organization and functional
area had complicated steps, and many steps had key
dependencies on previous steps being done right.
We found that the biggest driver of delays in results
was due to errors in completing the swabbing process
at facilities. Despite the process for taking samples andsending to the lab for testing being almost identical topre-COVID lab testing processes, APL regularly foundswabs from facilities had problems with labelling anddocumentation. Forms and labelling were incomplete,missed key identifying information like full legal name,personal health number, or date of birth, and did notnote an ordering physician.40
This meant that before APL could send the results backto each facility, they needed to ﬁnd this information foreach of the hundreds of swabs and then spend hours
cleaning up the data to ensure swab results were linked
to the correct individual. We found that, for a time,
the backlog caused by these errors and the process toresolve them manually became so problematic that APL
needed to pull medical microbiologists away from testingswabs to aid in clerical data-cleaning tasks. Without this,APL’s information system could not transmit COVID-19
test results to the other key information systems used to
notify AHS, Alberta Health, and get test results to facility
management.
APL management told us that these issues with
continuing care swabs created a situation where thelab would have results for the swab within two days ofreceiving the sample, but they estimated it would takebetween seven and 10 additional days to get the results
properly identiﬁed, the lab information system data
cleaned, and test results sent out.

40

As APL saw this issue worsening, they took steps
to correct the problem. We found they worked with
AHS and facilities to develop manual workarounds toget facilities results as soon as possible. They hired
additional clerical staff to help with data entry andcleaning. We also saw evidence in late fall and winter of2020 of APL staff spending signiﬁcant efforts to educate
facilities on proper labelling and documentation forswabs.
The issue with testing result delays was known to Alberta
Health and AHS as early as May and June 2020. Issues
with testing and getting results feature prominently inan AHS outbreak investigation from an outbreak thatran from April until June 2020. We also found email
correspondence from Alberta Health to facility operator
representatives on June 23 responding to questions fromfacility operators on COVID-19 test result delays. The
email notes the importance of accurate and complete
labelling and documentation.
3

Until mid-October 2020, facilities had to
wait for swabbing supplies when an outbreakstarted
We found that when a facility suspected a COVID-19
outbreak they would need to order swabbing supply kitsfrom APL. The order and shipping process normally took
between two and three days, even for facilities in majorurban centres.
Once facilities received the supplies, they began theprocess of swabbing residents and shipping completed
swab samples back to APL labs in Edmonton or Calgary.
From our review of outbreak reporting prepared by AHS,
swabbing residents and shipping the swabs back to APL
could take several days.
Together, this meant that from the date facilities
suspected a COVID-19 case it would normally take atleast four days before swabs could enter APL’s testing
queue.
4
We found that in mid-October, APL worked with

Edmonton and Calgary zone continuing caremanagement from AHS to develop a solution that saw
APL provide facilities with swabbing kits large enoughfor facilities to complete two full swabbing sweeps
of all residents and staff before they would need toorder further supplies. This solution cut days out of the
COVID-19 testing process.

Knowing who, exactly, a swab actually was taken from is intuitively important, but it is also a legal requirement under Alberta’s healthinformation legislation.

36 Report of the Auditor General—February 2023

Page: 36
Number: 1
Author: daviddickson
Subject: Highlight Date: 2023-02-24 7:51:47 PM
The weakness was in the level of testing itself that caused more harm due to known issues. See comments above on testing, fraudulent cases
and APL.
Number: 2

Author: daviddickson

Subject: Highlight Date: 2023-02-25 5:21:04 PM

Without accurate testing under what authority were they locking down centres? This entire fiasco points
to a catalogue of mismanagement, whether willfully or through neglect, that directly resulted in
unnecessary suffering and death.
The obsession with testing WAS THE PROBLEM.
See https://rumble.com/v1ddohu-counting-cars.-how-covid-19-is-being-reported..html
See comments above on testing, fraudulent cases and APL.
Most of these 'outbreaks' were based on staff voluntarily testing asymptomatically.
Outbreaks in Alberta were primarily caused by the voluntary testing of asymptomatic staff. Despite constant testing daily (or more), CC
Dickinsfield, for example, had almost no COVID positive residents in 2020. In addition, due to the inaccuracy of testing and assumption of
COVID (over other potential ILI's), many other illnesses were misdiagnosed, improperly treated (or not treated at all in the case of COVID).
In CC Dickinsfield, they had significantly less ILI deaths in 2020 than normal but an overall higher mortality due to the COVID restrictions.
Where is the detail on what types of outbreaks, number of symptomatic cases etc. ? What about other deaths, co morbidities, age etc.? Locationof death (care home or hospital, ventilated or not)? So many questions and just a superficial assumption to further the propaganda.

Number: 3
Author: daviddickson
Subject: Highlight Date: 2023-02-25 5:24:03 PM
By October, most facilities had been on outbreak multiple times; each time was CAUSED by staff testing asymptomatically off site. The swabs
getting back to the centers promptly was irrelevant as they went onto outbreak merely by the presence of residents with symptoms. What wasstressful for staff and particularly residents)was testing - DAILY and more!

The obsession with testing WAS THE PROBLEM.
See https://rumble.com/v1ddohu-counting-cars.-how-covid-19-is-being-reported..html
See comments above on testing, fraudulent cases and APL.
Number: 4
Author: daviddickson
Subject: Highlight Date: 2023-02-25 5:57:29 PM
The obsession with testing WAS THE PROBLEM.
See https://rumble.com/v1ddohu-counting-cars.-how-covid-19-is-being-reported..html

APL and its implication in testing and fraudulent cases.
https://dksdata.com/AlbertaDead#APL
From 'when is a negative test a positive?' to 'how many days back for a case?'
These numbers are based on manipulated statistics related to when a person was coded as a COVID case, not when they died. In someinstances, these Covid cases 'survived' for over two years. Did they really die of COVID?
The criteria for a COVID death was death up to 6 months after a COVID diagnosis (with or without a death certificate to support). COVID
deaths were identified by nurses in the COVID statistical department reviewing NetCare and Connect Care (and sometimes death certificates). In
August of 2022, that criteria changed to 60 days instead of 6 months. However, there are instances where the 6 months and the 60 days was
ignored.
http://dksdata.com/AlbertaDead
https://rumble.com/v28lhpw-who-cares-about-false-positives-every-single-case-was-used-to-terorrise.html
KENNEY SAYS WHO CARES ABOUT FALSE POSITIVES! From Kenney's own Q&A::
00:00"Alright Donna Stratton Stratton Tip says I've read about the maker of the PCR test has stated it's about 50% wrong and wasn't designed forwhat we're using it for. Is that true?" And then this.
00:13"I actually asked for this to come up because I know there's a lot of folks often when I check out the Facebook comments, there's a lot of thisstuff about PCR, so PCR is the standard test for COVID-19 in Canada and Alberta and around the world."
00:30"It's it's true that based on how many cycles the PCR test is does on the sample that that it can generate in many cases does generate a false
positive…"

Comments from page 36 continued on next pageDelays in getting results to facilities stemmed
from weak process and errors in requisitions
We compiled process descriptions based on what eachof three main parties—AHS, APL, and facilities—had
to do to get a facility’s residents and staff tested andthe results back to the facility from the point when afacility suspected it had a COVID-19 case. Our analysis
found that the process encompassed over 50 discrete
steps and sub-steps, crossing the three separateorganizations. It involved ﬁve different functional areas
within AHS itself. Each organization and functional
area had complicated steps, and many steps had key
dependencies on previous steps being done right.
We found that the biggest driver of delays in results
was due to errors in completing the swabbing process
at facilities. Despite the process for taking samples andsending to the lab for testing being almost identical topre-COVID lab testing processes, APL regularly foundswabs from facilities had problems with labelling anddocumentation. Forms and labelling were incomplete,missed key identifying information like full legal name,personal health number, or date of birth, and did notnote an ordering physician.40
This meant that before APL could send the results backto each facility, they needed to ﬁnd this information foreach of the hundreds of swabs and then spend hours
cleaning up the data to ensure swab results were linked
to the correct individual. We found that, for a time,
the backlog caused by these errors and the process toresolve them manually became so problematic that APL
needed to pull medical microbiologists away from testingswabs to aid in clerical data-cleaning tasks. Without this,APL’s information system could not transmit COVID-19
test results to the other key information systems used to
notify AHS, Alberta Health, and get test results to facility
management.
APL management told us that these issues with
continuing care swabs created a situation where thelab would have results for the swab within two days ofreceiving the sample, but they estimated it would takebetween seven and 10 additional days to get the results
properly identiﬁed, the lab information system data
cleaned, and test results sent out.

40

As APL saw this issue worsening, they took steps
to correct the problem. We found they worked with
AHS and facilities to develop manual workarounds toget facilities results as soon as possible. They hired
additional clerical staff to help with data entry andcleaning. We also saw evidence in late fall and winter of2020 of APL staff spending signiﬁcant efforts to educate
facilities on proper labelling and documentation forswabs.
The issue with testing result delays was known to Alberta
Health and AHS as early as May and June 2020. Issues
with testing and getting results feature prominently inan AHS outbreak investigation from an outbreak thatran from April until June 2020. We also found email
correspondence from Alberta Health to facility operator
representatives on June 23 responding to questions fromfacility operators on COVID-19 test result delays. The
email notes the importance of accurate and complete
labelling and documentation.

Until mid-October 2020, facilities had to
wait for swabbing supplies when an outbreakstarted
We found that when a facility suspected a COVID-19
outbreak they would need to order swabbing supply kitsfrom APL. The order and shipping process normally took
between two and three days, even for facilities in majorurban centres.
Once facilities received the supplies, they began theprocess of swabbing residents and shipping completed
swab samples back to APL labs in Edmonton or Calgary.
From our review of outbreak reporting prepared by AHS,
swabbing residents and shipping the swabs back to APL
could take several days.
Together, this meant that from the date facilities
suspected a COVID-19 case it would normally take atleast four days before swabs could enter APL’s testing
queue.
We found that in mid-October, APL worked with
Edmonton and Calgary zone continuing caremanagement from AHS to develop a solution that saw
APL provide facilities with swabbing kits large enoughfor facilities to complete two full swabbing sweeps
of all residents and staff before they would need toorder further supplies. This solution cut days out of the
COVID-19 testing process.

Knowing who, exactly, a swab actually was taken from is intuitively important, but it is also a legal requirement under Alberta’s healthinformation legislation.

36 Report of the Auditor General—February 2023

01:01"So there are, I'll call them covid skeptics, who are claiming that all of the restrictive policies are being wrongly informed by exaggerated Covid
case counts because of false positives through PCR testing."
01:53"In a sense, I mean, who really cares about the false positives?"
WHO CARES?? WHO INDEED!! Let me tell you WHO CARES, KENNEY!! How about the people isolated for two weeks, losing their business,closed care homes, closed schools, cancelled surgeries, suicides, poverty....
It takes a single 'case' to shut down the lives of hundreds of care home residents and all connected to them and our then Premier had the
audacity, to say "..who really cares about the false positives?"
COVID cases were known to be unreliable and as such, COVID hospitalizations and deaths were built on flawed foundations. Fruit of the
poisonous tree from the start. For an Auditor to not even look at this is beyond negligent and further reinforces the need for a police forensic
investigation of all relevant data and facts.

Continuing care facility swabs were notspeciﬁcally prioritized for testing
We found that between March and December 2020,swabs from continuing care facilities were not prioritized
differently than other settings with outbreaks—suchas other healthcare settings like hospitals, as well as
outbreaks at private businesses or events.
2
In August, as the large amounts of asymptomatic

public swabs continued to put pressure on the system,
APL began taking steps to prioritize swabs from someindividuals and settings, including COVID-19 outbreak
investigations and healthcare workers.

Testing was optional for facility staff and had
structural barriers to getting timely results
When a facility suspected it had a COVID-19 case,facilities were required under Chief Medical Officer
of Health Orders to “recommend” staff be tested for
COVID-19. But even in the context of an outbreak staff
could refuse to be tested.41 If a facility suspected aresident had COVID-19, and that resident did not consent
to swabbing, the facility could still take steps to reduce therisk of transmission. It was much more difficult to isolate
an ill staff member who refused to be tested if they did
not show symptoms, were not caught by screening, orwere not known to be exposed to COVID-19.
Until Order 32-2020 was announced on September 3, 2020,
Orders barred facilities from swabbing their staff on site,even if staff were willing to do so. This requirement meantthat facilities had to depend entirely on each individual staff
member to complete their own testing, outside of work andon their own time. This separate testing process for staff
often caused individual staff COVID-19 test results to not
be linked to a facility outbreak—sometimes taking days or
weeks for AHS public health or the facility management tomanually link.

1

Shared rooms and aspects
pof facilityyinfrastructure consistent in the most
severe COVID-19 outbreaks
Pre-COVID understanding of facility
infrastructure was limited
Before COVID-19, Alberta Health and AHS had a limited
understanding of the buildings that continuing carefacilities operate in Alberta. Alberta Health funds andsets the policy and mandatory guidelines governingfacility construction, and AHS deals with the contractingof new facility capacity. Both can also set additional
speciﬁc requirements for new facility construction.42
We found that neither had a complete understanding ofexisting facility design or condition across the province.
In 2018, AHS compiled the most complete listing ofcontinuing care facility infrastructure in the province. AHS
based this list on its understanding of the infrastructure
it owned, as well as results from a survey of all contracted
operators. AHS did not intend to gather a complete
architectural assessment of all facilities. The information
was limited to details such as the date the facility wasbuilt, number of beds and rooms, number of sharedrooms, and which building code the facility was built to.
Neither Alberta Health nor AHS had a complete
understanding of other aspects of facility infrastructurethat proved important, such as room size, ability tocontrol movement to and from the building, HVAC,
states of disrepair, ability to isolate or quarantine rooms
or sections of a building, and use of common dining andrecreation areas.

During our interviews with facility operator
representatives, we found that it could take weeks tohear back about staff results—either from AHS publichealth or from the staff themselves.

41

The concept of patient consent for any medical procedure is a foundation of modern health care. A patient can refuse any treatment orprocedure, no matter how strongly a medical professional feels about it. This principle does not extend to employer-employee relationships
for health care workers.

42

The distinction as to whether Alberta Health or AHS set any additional requirements depends upon whether grant funding for capital isrequired or not.
Report of the Auditor General—February 2023 37

Page: 37
Number: 1

Author: daviddickson

Subject: Highlight Date: 2023-02-24 8:00:41 PM

This report FAILS TO MENTION the written AHS protocols for the specific transfer of COVID POSITIVE/Symptomatic (with any illness that may
have been listed as COVID) into SHARED ROOMS with a NON COVID/ NON SYMPTOMATIC resident. This forced these otherwise healthy
residents into CLOSE CONTACT and forced isolation with a new sick resident.
WHY DID THE REPORT MISS THIS?
How many deaths were caused by this deliberate cross infection (from who knows what ILI's)?
https://thenationaltelegraph.com/regional/exclusive-alberta-government-transferring-covid-positive-patients-into-care-homes
https://thenationaltelegraph.com/regional/the-alberta-government-has-turned-care-homes-into-outbreak-centres
https://rumble.com/v2au726-january-30th-2021-karen-alberta-legislature-speech.html
Number: 2
Author: daviddickson
Subject: Highlight Date: 2023-02-24 8:01:17 PM
The obsession with testing WAS THE PROBLEM.
See https://rumble.com/v1ddohu-counting-cars.-how-covid-19-is-being-reported..html

1Facility infrastructure was a common problem
in major outbreaks
In our analysis, we found AHS regularly noted problems
stemming from facility layout, condition, and use ofshared rooms in major outbreak investigation reportingand compliance inspections. Common features included:•

large facility size (200 or more beds)•

use of shared rooms and shared bathrooms•

small, congested communal areas used by all
residents43•

old HVAC systems—poor air circulation and no air
conditioning•

old buildings and maintenance issues•

building layouts preventing cohorting COVID-19
positive residents44•

number of facility entrances made screening staff
and visitors challenging“[Analysis found] statistically signiﬁcant higher
rates of outbreaks:•

for sites with higher percentage of sharedaccommodations and bathrooms.

•

at older facilities. Attributes that may have
impacted this include shared accommodation,
narrow hallways, older HVAC, lack of air
conditioning and higher use of fans.”

We reviewed analysis prepared by AHS on wave one
outbreaks and completed our own further analysis
combining outbreak data from both waves with facility
data from the 2018 AHS listing. What we found wasconsistent with analysis of wave one outbreaks by AHS:
facilities with outbreaks were typically older and had alarger number of rooms with more than one resident.
This effect was even more pronounced in facilities withoutbreaks larger than 40 cases.

One-third of facilities do not meet current
requirements
Alberta Health sets the minimum building requirements
for continuing care facilities in its Continuing Care Facility
Design Guidelines. These requirements are made up ofbuilding code classiﬁcation requirements, and somecontent adapted from the AHS Infection Prevention andControl Facility Design Recommendations.45
Continuing care facilities operating in Alberta were built
to one of three building code classiﬁcations: Group B2,
B3, or C.46

– AHS outbreak investigation report

43

For example: one dining room for the whole facility.

44

Cohorting refers to the placing of individuals exposed to or infected with the same disease in the same space, separate from those notexposed or infected. Cohorting is an important outbreak control tactic, but can be challenging if facility design is not conducive to it. It isparticularly important in facilities where residents with more advanced cognitive decline sometimes tend to wander—potentially moving fromor into rooms or parts of the facility with COVID positive residents.

45

AHS infection prevention and control specialists publish and regularly update this guidance on how to design and build health facilities toprevent and manage infections. We found that this guidance has slowly lost authority in the years leading up to COVID-19.

46

National Building Code (Alberta Edition) Group B, Division 2—Treatment Occupancy; Group B, Division 3—Care Occupancy;and Group C—Residential Occupancy.

38 Report of the Auditor General—February 2023

Page: 38
Number: 1
Author: daviddickson
Subject: Highlight Date: 2023-02-24 8:02:12 PM
See above. The response was the issue, not the facility.

1

There were no requirements to upgrade
existing facilities to current standards

Building Code Classiﬁcation ofAlberta Continuing Care Facilities

Building codeclassiﬁcation

Group B
Division 2(B2)Group B
Division 3(B3)Group C(C)

Application tocontinuingcare facilities

Minimum
standard
until 2018

Minimum
standard
from 2018
to present

LegacyIntendedoccupancy

Medicaltreatment for
occupants

Care
services foroccupants

Occupants
not receiving
medical careor treatment

Examplebuilding uses

Hospitals

Continuing
Apartment
care facilities buildings, hotels

Continuing care facilities were originally built to thestandards in place, including the building code, at theirtime of construction. However, we found one-quarter ofthe buildings, representing about 33 per cent of all beds,
in operation at the time of the 2018 AHS survey are
more than 40 years old.
We found that there are no requirements for older facilities
to renovate or make improvements to meet current design
requirements or building code classiﬁcations.

Current building code requirements do notalign with expectations of facilities underpandemic plans
In March 2018, the Minister of Health approved theadoption of building code classiﬁcation Group B3 as the newminimum building code requirement for continuing carefacilities, replacing the previous requirement of Group B2.

We found that 119 facilities, more than 30 per cent offacilities in the province, were Group C—a classiﬁcation
not approved for medical treatment or care occupancy.47

One of the key directions to continuing care facilities inexisting pandemic plans is for them to “care and treat
in place.” If facilities are being built to provide care,but not medical treatment,48 then these foundational
expectations of continuing care facilities in pandemics
may need to be re-evaluated.

There is no data on the extent to which existing
continuing care facilities meet the current required
infection prevention and control design requirements.

Alberta Continuing Care Facilities
By Building Code Classiﬁcation
As of 2018

119

0%

10%

217

20%

30%

40%

50%

60%

16

70%

80%

90%

16

100%

Continuing care facilities
Group C - Residential

Group B2 - Treatment

Mix of B2 and C

Unknown

47

The deﬁnition of Group C in the National Building Code (Alberta Edition) is: “the occupancy or use of a building or part thereof by persons forwhom sleeping accommodation is provided but who are not harboured or detained to receive medical care or treatment or are not involuntarily
detained.” [emphasis added]

48

The National Building Code (Alberta Edition) deﬁnes treatment as: “The provision of medical or other health-related interventions to persons,
where the administration or lack of administration of these interventions may render them incapable of evacuating to a safe location without
the assistance of another person.”
Report of the Auditor General—February 2023 39

Page: 39
Number: 1
Author: daviddickson
Subject: Highlight Date: 2023-02-24 8:02:38 PM
See above. The response was the issue, not the facility.

1

Signiﬁcantgincremental fundingg
provided starting six weeks after ﬁrst
poutbreak
The need for additional funding quickly became
apparent. Following discussions in late February andMarch, we found that facility operator associations
began formally lobbying for funding to cover growing
expenses from incremental supply and staffing
requirements and lost revenues.
In response, Alberta Health and AHS developed anddeployed three main funding envelopes, totalling$251 million.
We found that the funding started to ﬂow six weeks
after the ﬁrst outbreaks started, and at a point whensome operators were reaching dire cashﬂow shortages.
The initial funding support of $24.5 million from AHS
represented the quickest solution possible under its
authority while Alberta Health developed other, larger
funding solutions.

40 Report of the Auditor General—February 2023

March 11First facility outbreak starts;
ﬁrst guidance from AHS

March 24

Letter from operator
association
to AHS and Alberta Health

March 25

Order 06-2020 announced

April 2

Order 08-2020 announced

April 10

Order 10-2020 announced

April 15

AHS begins supplying PPE
at no cost

April 20

$24.5M and Health Care Aide
funding announced

April 24$24.5M paid; 2nd letter fromoperator association

May 8

1st Health Care Aide funding
installment paid

May 19

Incremental funding initiative
announced

June 8

1st incremental funding
initiative installment paid

Page: 40
Number: 1
Author: daviddickson
Subject: Highlight Date: 2023-02-25 5:28:18 PM
Money is a distraction in this report. Money would not have been an issue had they responded appropriately as with SARS, MERS and H1N1
(2009). This was an engineered crisis from the start; once that became clear, there was no option but to continue the insanity. Government liedand people died. Prosecution not a pension is the only way forward for those responsible when the truth comes out.

1

Incremental COVID-19 Funding for Continuing Care Facilities
March–December 2020
Funding envelope

Developed byAmountDateannounced

Date ﬁrst paid Funding type

March 2021 monthly
funding advanceAHS$24.5 million

April 20, 2020

April 24, 2020

One-time
advance

Health Care Aide
Initiative

Alberta Health$91.0 million

April 20, 2020

May 8, 2020

Monthly
installments

COVID-19 Incremental
Funding Initiative

Alberta Health$135.6 million†

May 19, 2020

June 8, 2020††

Monthly
installments

Total:$251.1 million†

Note that the COVID-19 Incremental Funding Initiative is often quoted at $170 million. This is accurate, but imprecise to the scope of ouraudit as it includes about $34 million contributed by the Ministry of Seniors and Housing and paid to licensed supportive living and seniors
lodges, which are not part of our audit scope.

††

The COVID-19 Incremental Funding Initiative payments were made retroactive to March 15, 2020.

2

PPE and supplies
pp
were a criticalconstraint for the ﬁrst month
In the early days of the COVID-19 response, the guidanceon the use of PPE and masks was frequently changing.
We found that Alberta Health and AHS followed theguidance of the Public Health Agency of Canada, whichaligned with the US Centers for Disease Control andPrevention, and the World Health Organization.
AHS told us that facilities should have maintained astockpile of PPE. Other than as an example of bestpractice, we could not identify any direct requirement
for facilities to do so. Because there was no requirement
for this, neither Alberta Health nor AHS inspected for orotherwise had understanding of facility PPE and supply
stockpiles prior to March 2020.

49“Early in the pandemic, the plan to supply
contracted operators with PPE from AHS was not inplace and continuing care operators encounteredan insufficient stock of PPE, hand sanitizer andcleaning supplies.”– AHS outbreak investigation report
Until April 15, 2020, contracted facilities needed to
procure their own PPE and supplies. At this time, global
demand spiked the average costs of PPE by an averageof 4.2 times pre-2020 costs49 and facilities struggled
to source PPE. Incremental requirements for more andmore masking, PPE use, and cleaning across late Marchand early April exacerbated this problem—culminatingon April 10 with the continuous masking requirement inOrder 10-2020.

UK National Audit Office, "The supply of personal protective equipment (PPE) during the Covid-19 pandemic." 25 November 2020.
Report of the Auditor General—February 2023 41

Page: 41
Number: 1
Author: daviddickson
Subject: Highlight Date: 2023-02-25 5:30:02 PM
Money is a distraction in this report. Money would not have been an issue had they responded appropriately as with SARS, MERS and H1N1
(2009). This was an engineered crisis from the start; once that became clear there was no option but to continue the insanity. Government liedand people died. Prosecution not a pension is the only way forward for those responsible when the truth comes out.
Number: 2
Author: daviddickson
Subject: Highlight Date: 2023-02-24 8:05:21 PM
PPE was bulk purchased in December of 2019 FOR THE EXPECTED PANDEMIC. WHAT WAS THE ISSUE WITH AVAILABILITY?
https://edmontonjournal.com/opinion/columnists/david-staples-masterminds-behind-albertas-medical-supplies-surge-to-meet-covid-19-crisis/"Jitendra “J.P.” Prasad, who runs the AHS supply procurement system, is always on the lookout for terrible diseases that might impact supply
and demand. He and his team heard disturbing news about a “strange flu” in Wuhan, China, in early December, Prasad said. “We have contacts
from China and a lot of the conversation from them was, ‘Hey, J.P., we think something is happening that may impact us.'”""It stockpiled all incoming supplies in one city, Edmonton, at two huge warehouses, one for daily operational supplies, the second for
emergencies.""In mid-December, Prasad’s team looked at how to increase stock. If they were placing an order for five days’ supply of masks, gloves andgowns, they now doubled the order, increasing their emergency stockpile."
Jason Kenney"Thanks to the great work Jitendra Prasad and his team at @AHS_media procurement, we have 9 warehouses like this 150,000 sq.ft. one, filledwith PPE & medical equipment for our front-line workers.
Alberta will be prepared with enough equipment to fight #COVID19AB."
https://twitter.com/jkenney/status/1249104560330649600?s=20

1
Several facilities experienced critical supply shortages

which AHS outbreak investigations note contributed
to the severity of some early outbreaks. However, we
did not see evidence of any complete depletions of key
supplies being reported.
As early as March 19, 2020, AHS conﬁrmed it was
prepared to supply contracted facilities with PPE. On
April 11, 2020, AHS was instructed to begin shipping
PPE and ventilators to other Canadian provinces.
Approval from Alberta Health to supply facilities cameon April 15, 2020, and we found that AHS immediatelybegan supplying continuing care facilities with PPE andcritical supplies at no cost—resolving the PPE and supply
constraints to facilities through the remaining scope of
our audit.

March 11First guidance from AHS

March 19

AHS conﬁrms it can supply
contracted providers

RECOMMENDATION:
Develop a continuing care staffing strategy to increasestaffing system resilience
We recommend that the Department of Health work with
Alberta Health Services and facility operators to develop andimplement a staffing strategy for facility-based continuingcare.
This strategy should build on efforts already underway
focused on staffing hours and staff mix from theresponse to the Facility-based Continuing Care review
recommendations, and consider other factors that
contributed to staff vulnerability during COVID-19 such as:•

the costs and beneﬁts of maintaining a largely
single-site staffing model•

appropriateness of primarily part-time and casualstaffing model use in the care of vulnerable elderly
residents•

mandatory beneﬁts—particularly paid sick leave•

minimum staff training•

staff quality of work and life•

staff mental health, wellness, and post-traumatic
supportMarch 24

Letter from operator
association to AHS and Alberta
HealthMarch 25

Order 06-2020 announced

April 2

Order 08-2020 announced

April 10

Order 10-2020 announced;
continuous masking

Consequences of not taking action

April 11

AHS told to ship PPE andventilators to other provinces

Insufficient resources to care for residents during COVID-19
reinforced the importance of continuing care facility
staff to safe resident care, outbreak response, and facility
operations.

April 15

AHS approved to supply PPE
at no cost to continuing caresector

A staffing strategy should determine what the
Department of Health wants to achieve in these areas,and determine what it can accomplish with existing andpotential future resources.

RECOMMENDATION:
Formalize centre of expertise capacity for outbreakmanagement
We recommend that Alberta Health Services formalize
multi-disciplinary outbreak response and support
systems tasked with providing centre of expertise
services, monitoring and tracking, and post-outbreakdebrieﬁng and reporting for communicable disease
outbreaks at continuing care facilities.

42 Report of the Auditor General—February 2023

Page: 42
Number: 1
Author: daviddickson
Subject: Highlight Date: 2023-02-24 8:05:31 PM
PPE was bulk purchased in December of 2019 FOR THE EXPECTED PANDEMIC. WHAT WAS THE ISSUE WITH AVAILABILITY?
https://edmontonjournal.com/opinion/columnists/david-staples-masterminds-behind-albertas-medical-supplies-surge-to-meet-covid-19-crisis/"Jitendra “J.P.” Prasad, who runs the AHS supply procurement system, is always on the lookout for terrible diseases that might impact supply
and demand. He and his team heard disturbing news about a “strange flu” in Wuhan, China, in early December, Prasad said. “We have contacts
from China and a lot of the conversation from them was, ‘Hey, J.P., we think something is happening that may impact us.'”""It stockpiled all incoming supplies in one city, Edmonton, at two huge warehouses, one for daily operational supplies, the second for
emergencies.""In mid-December, Prasad’s team looked at how to increase stock. If they were placing an order for five days’ supply of masks, gloves andgowns, they now doubled the order, increasing their emergency stockpile."
Jason Kenney"Thanks to the great work Jitendra Prasad and his team at @AHS_media procurement, we have 9 warehouses like this 150,000 sq.ft. one, filledwith PPE & medical equipment for our front-line workers.
Alberta will be prepared with enough equipment to fight #COVID19AB."
https://twitter.com/jkenney/status/1249104560330649600?s=20

1

Consequences of not taking action
Without established teams of specialists prepared tosupport outbreak response and debrief them, outbreak
response can be hampered and valuable lessons indisease-speciﬁc and general outbreak management may
be lost.
RECOMMENDATION:
Formalize operational improvements in outbreak testing
We recommend that Alberta Health Services workwith Alberta Precision Labs to review, identify, andformalize process improvements and streamlining during
COVID-19.
Considerations should include other process
improvements that could prevent human errors,
facilitate linking samples to outbreaks, build redundancy
and resiliency into the critical outbreak testing processes,
and ensure timely delivery of results to continuing carefacilities.

Consequences of not taking action
Alberta Precision Labs, along with AHS zone andprovincial management, worked tirelessly to ﬁnd thebest solution possible to every challenge they faced. If
APL and AHS do not capture and formalize these process
improvements, the invaluable testing system will not
be able to optimally support continuing care facility
outbreak management.

RECOMMENDATION:
Evaluate all existing infrastructure and set a strategy
for improving facility infrastructure
We recommend that the Department of Health develop apriority list and strategy for improving existing buildings,
where necessary.
This priority list and strategy should be based on acomprehensive assessment of all continuing carefacilities in the province to be completed by Alberta
Health Services for:•whether the building meets the mandatory
requirements of current facility design guidelines,
and its capacity for upgrading to current minimums
if necessary•

the adequacy of their HVAC and ﬁltration systems•

the size of resident rooms and extent of sharedaccommodations•

the capacity of the building to permit adequate
isolation practices•

the extent of building entrances and exits and theirability to be secured

An infrastructure strategy should determine what the
Department of Health wants to achieve and determine
what it can accomplish with existing and potential future
resources.

Consequences of not taking action
Without a strategy for making informed, priority-based
decisions to improve facility infrastructure where
necessary, some of Alberta's continuing care facility
infrastructure will continue to challenge the best
responses to communicable disease outbreaks.

Report of the Auditor General—February 2023 43

Page: 43
Number: 1
Author: daviddickson
Subject: Highlight Date: 2023-02-25 5:31:52 PM
This is and always was the responsibility of AEMA. Why was that process not followed? Becasue the fraud would have fallen at the first hurdle.
There was no crisis and there was no legal authority to do what they did.

AHS and the Government lied and people died.
And AHS is governed by and is ultimately accountable to the Health Minister (by law). He could have interjected at any time... but that was not
his intent.
Care Homes also stated (as this report does) that they HAD TO FOLLOW DEENA HINSHAW'S ORDERS.
However...
Where is the evidence to back up these Orders?
“I, Dr. Deena Hinshaw, Chief Medical Officer of Health (CMOH) have initiated an investigation into the existence of COVID-19 within the Provinceof Alberta.
This investigation has confirmed that COVID-19 is present in Alberta and constitutes a public health emergency as a novel or highly infectious
agent that poses a significant risk to public health.”
Or“Whereas I, Dr. Deena Hinshaw, Chief Medical Officer of Health (CMOH) have initiated an investigation into the existence of COVID-19 within theProvince of Alberta.
Whereas the investigation has confirmed that COVID-19 is present in Alberta and constitutes a public health emergency as a novel or highly
infectious agent that poses a significant risk to public health.” etc.
FULL DISCLOSURE IS REQUIRED
Why did Alberta trigger an 'Influenza Pandemic' in March of 2019 on the advice of the Health Minster Tyler Shandro - Without the legislative
authority to do so?
https://dksdata.com/DS/Shandro1.jpg
These Orders really had no legal authority as they were based on the fruit of the poisonous tree
In the end, everyone involved is accountable and needs to be treated as such.
The whole response (and this report) was and is based on flawed and manipulated data and false statements. This is why this matter MUST be
handed over for a complete forensic investigation by people with the power to execute warrants, make arrests, interview under caution,
perform detailed technical forensic audits and press charges. Anything less is an insult to the Alberta public.

1

MONITOR and ENFORCE:
Monitoringg Performanceand Enforcing Compliance at
Facilities
Context
Compliance monitoring via in-person
inspections
Periodic, in-person facility inspections are important
to ensure that facilities are meeting their obligations.
Where they are not, this needs to be ﬂagged for thefacility management and for AHS and Alberta Health,
who have accountability and oversight responsibilities.
When inspectors ﬁnd problems, they need to follow up
to ensure facilities resolve them quickly.

Public health and outbreak
investigations
The general processes for outbreak response andmonitoring for Alberta Health and AHS are outlinedin the Alberta Outbreak Response Protocol (AORP)
An important part of this process is ensuring thatepidemiologists and public health experts in Alberta
Health and AHS have up-to-date data on who is ill andhow the disease is progressing during an outbreak.

50

To facilitate understanding of outbreaks, AHS
public health specialists can prepare highly detailed
epidemiological investigations. These investigations lookat all aspects of an outbreak—pre-outbreak conditions,
how the disease got in, how it spread, the results ofinspections before and during the outbreak, and how
structural and operational factors affected the facility’s
response. These investigations can provide critical andconstructive evaluations of complex outbreaks.

Escalating and acting on risk toresidents
2
AHS is ultimately accountable for resident care, andAlberta Health oversees the continuing care system.
When the reasonable expectations of safety come into
question in any facility, Alberta Health and AHS needto get information, increase their involvement, andact quickly. This requires that both Alberta Health and
AHS have systems to escalate concerns and get key
information to senior decision makers and to escalate
their involvement as outbreaks evolve and as riskincreases.
In extreme cases the Minister can revoke a facility
operator’s contract and place AHS in charge of the
facility.

Monitoring system-level performance
System-level performance monitoring is different
from monitoring compliance and activity at individual
facilities. It involves Alberta Health and AHS monitoring
and critically evaluating their own performance, as partof the broader continuing care system. System-level
performance monitoring for the whole continuing caresystem means measuring performance against set goals
and targets.50

This is related to a concept our Office has spoken to in many audits over the past decades. We refer to such a system, generally, as a “results
management system.” See page 24 of our July 2014 public report for a reference guide on results management. See Report of the Auditor
General of Alberta—July 2014.

44 Report of the Auditor General—February 2023

Page: 44
Number: 1
Author: daviddickson
Subject: Highlight Date: 2023-02-24 8:08:25 PM
More distractions from the actual root cause of the problem that this report not only fails to address but is complicit in covering up.
Number: 2

Author: daviddickson

Subject: Highlight Date: 2023-02-25 5:32:24 PM

AHS and the government lied and people died.
And AHS is governed by and is ultimately accountable to the Health Minister (by law). He could have interjected at ANY TIME... but that was
not his intent.
Why did Alberta trigger an 'Influenza Pandemic' in March of 2019 on the advice of the Health Minster Tyler Shandro - Without the legislative
authority to do so?
https://dksdata.com/DS/Shandro1.jpg
Care Homes also stated (as this report does) that they HAD TO FOLLOW DEENA HINSHAW'S ORDERS

Criteria
Alberta Health and AHS should monitor whether
facilities are complying with the plans, protocols andguidance, and enforce action as needed.

Our ﬁndings
Key ﬁndings:•

A complete suite of in-person facility inspections
began within weeks of the ﬁrst outbreak andcontinuously improved.

•

Operational outbreak monitoring from AHS zone
leadership was effective.

•

Detailed epidemiological investigations of outbreaks
were critical tools to learn from COVID-19 outbreaks
in facilities and make operational improvements,
but ceased after wave one.

1

A completepsuite of in-personpfacilityyinspectionspbegan within weeks of theﬁrst outbreak
COVID-speciﬁc, in-person facility inspection
programs were rapidly developed and deployed
Alberta Health and AHS each had compliance audit andinspection programs that evaluated facilities against
health service and accommodation standards prior to
COVID-19. We found that both quickly appreciated that
COVID-19 presented unique risks to residents and thatcompliance needs changed as Orders began placing
additional legally enforceable requirements on facilities.
We found that both Alberta Health and AHS rapidly
halted their pre-COVID-19 compliance programs anddeveloped inspection51 programs speciﬁc to COVID-19.
Each quickly trained and redeployed their facility
inspection resources to start conducting in-person
COVID-19 compliance inspections.

•

System-level monitoring of the response of Alberta
Health and AHS to COVID-19 in continuing carefacilities was robust, but ceased after wave one.

51

We note that neither Alberta Health nor AHS used the word “inspection” or described their compliance teams who went to facilities as“inspectors.” We use this term because we believe it is simple, generalizable, and understandable in reﬂecting what these groups did atfacilities—all of these teams observed facility operations closely and critically, and undertook their work in an official capacity.
Report of the Auditor General—February 2023 45

Page: 45
Number: 1
Author: daviddickson
More repetition. See above.

Subject: Highlight Date: 2023-02-24 8:10:24 PM

1
As the Chief Medical Officer of Health announced new

March 11First facility outbreak starts

March 15

AHS halts all routine
compliance audits

March 25

1st Order on outbreakmanagement

March 31

1st AHS Quality Monitoring
Visit inspection

April 1

1st AHS Environmental Public
Health inspections

April 8M.O. 621 gives Alberta Healthinspectors powers

April 14

1st Alberta Health executive
officer inspection

May 15

1st AHS Site Preparedness
Assessment inspection

July 24

Alberta Health inspection
results in direction to AHS

July 30

AHS completes at least one
inspection at each facility

Orders, the inspectors needed to update their inspection
checklists and tools. We found that they normallymanaged to do this within a week, and were able to keep
pace with changing guidance.
By March 31, 2020, AHS had inspectors in facilities
across the province. Alberta Health inspectors began
their inspections on April 14, after putting in place thelegal requirements to give their inspectors additional
enforcement powers under the Public Health Act.52
By the end of July 2020, AHS had completed at least
one inspection at every continuing care facility in theprovince. Between March and December 2020, we
counted more than 1,400 inspections or follow-up visitsfrom Alberta Health and AHS inspectors at continuingcare facilities in the scope of our audit—an average offour for every facility in Alberta.53

Inspections improved safety2
Our analysis of inspection data, documentation andinterviews with inspectors found that they regularly
ﬂagged signiﬁcant problems with resident safety andcare during outbreaks. In some of the most severe
outbreaks, facility inspectors found::54•

Resident care concerns—including dangerous levelsof dehydration, insufficient meal services, inadequate
resident pain management, residents not receiving
hygiene services, and resident rooms which had notbeen cleaned for days.

•

Facility staffing problems—including a few instancesof staffing shortages in excess of 50 per cent, staff
working 16 hours a day or more, and facility staff insevere emotional and psychological distress.

•

Issues stemming from facility infrastructure—including inability to physically distance residents,
and dangerously high interior temperatures due tolack of air conditioning and poor air exchange.

•

Deﬁcient PPE and infection prevention practices—
including incorrect and insufficient PPE use, deﬁcientcleaning practices, and limited familiarity with
infection prevention and control best practices.

52

On April 8, 2021, Ministerial Order 621/2020 granted Alberta Health’s compliance and monitoring inspectors who focused on continuingcare facilities executive officer powers. “Executive officer powers” gives inspectors power under the Public Health Act to issue legally
enforceable orders for compliance.

53

Both Alberta Health and AHS conducted many additional inspections at facilities such as licensed supportive living, lodges and residential
facilities for adults living with disabilities, among others.

54

The Health Quality Council of Alberta's "COVID-19 Continuing Care Study" includes another view on resident experiences during the ﬁrst
wave of COVID-19 and is based on resident and family surveys. See: https://hqca.ca/reports/covid-19-continuing-care-study/

46 Report of the Auditor General—February 2023

Page: 46
Number: 1
Author: daviddickson
Subject: Highlight Date: 2023-02-24 8:10:49 PM
More errors, repetition and a failure to report the root cause.
Number: 2
Author: daviddickson
Subject: Highlight Date: 2023-02-25 5:33:45 PM
These were all the result of the response to COVID. With a mother in a care facility for nearly a decade when COVID hit, it was clear thatsomething changed for the worse and it has never got any better. Residents are still dying as a result of this continuing insanity in Care Homes
controlled and directed by the Alberta government and AHS.

1
All of these problems create risk to resident wellbeing

and safety. Facility inspections brought needed attention
to these problems in facilities during outbreaks—bothat facilities, and equally at Alberta Health and AHS. By
ﬂagging and ensuring the resolution of these problems,
inspectors improved resident safety.

No speciﬁc pre-existing pandemic plansconsidered facility compliance monitoring
The task of rapidly deploying a facility inspection
program for COVID-19 was complicated. Pre-existing
pandemic plans did not consider the role complianceinspections should play in a pandemic response.
Both Alberta Health and AHS needed to develop theirprograms at a time when the COVID-19 situation was
evolving rapidly.

Coordination of compliance inspection efforts
was initially challenging
In total, we found ﬁve distinct in-person, COVID-19
speciﬁc inspections.55 AHS developed four distinct typesof inspections across three functional areas. Alberta
Health’s compliance and monitoring branch developed
the ﬁfth type of inspection. All ﬁve of these inspection
types worked with continuing care functional areas inboth Alberta Health and AHS.
We found that until the fall of 2020, the suite ofinspections was being done with limited coordination
between inspection groups. When we analyzed facility
inspection data from across the different inspection
activities, we found several hundred instances wherevisits from different inspection functions happened
within three days of each other. We found 74 instanceswhere different inspectors visited facilities on the same
day56—including one instance where two different
inspection teams from AHS and the Alberta Healthinspectors all visited the same facility on the same day.
When we asked for evidence that a sample of thesesame-day visits were coordinated in advance, less thanhalf could show evidence of pre-visit coordination.
The different compliance functions recognized thisproblem and continuously worked to improve theircoordination.

In the fall of 2020, AHS brought together its functionalgroups involved in facility inspections, and the provincial
continuing care management of AHS to formalize
its current COVID-19 compliance practices into asingle guiding document. The document covered key
topics such as roles and responsibilities, common risk
assessment tools, inspection triggers, timelines forinspections, and how the different inspections relate toand coordinate with each other under what AHS calls thecontinuing care “Quality Monitoring Program.”

Inspections had overlapping responsibilities
and focuses, gave different interpretations
Each inspection program had slightly different mandates
and triggers for when to conduct an inspection, but wefound there were signiﬁcant overlaps between what
each looked at. Of the ﬁve different inspections, wefound three looked at compliance with the Chief Medical
Officer of Health Orders.
Facility operator representatives often received inconsistentinterpretations of requirements from inspectors, particularly
with the requirements in the Orders. Facility operators
found the inspections were important but put a further
strain on already stretched facility resources—particularly
as inspectors tried to be on the ground in the ﬁrst few
days of an outbreak. Inspections became problematic forfacilities when they experienced duplication, had more than
one inspector looking at the same things on the same day,and especially when they received mixed messages fromdifferent inspectors.

Only one type of inspection was regularly
unannounced
Only Alberta Health’s executive officer inspection teamregularly conducted unannounced inspections.
We found that in one major outbreak, Alberta Healthinspectors conducted an unannounced visit shortly after
several other types of inspectors had been in the facility.
They found many resident safety risks, PPE issues,
and major staffing concerns that were not identiﬁed
during announced inspections just days earlier. While allinspections improved safety, unannounced visits gave
the most accurate picture of what was happening dayto-day at facilities.

55

See Appendix D for an overview of the AHS and Alberta Health COVID-19 continuing care inspection programs. We also note the Ministry ofLabour and Immigration's Occupational Health and Safety inspectors conducted a sixth type of in-person inspection at facilities during 2020.

56

This count does not include same-day inspections from AHS Infection Prevention and Control and AHS Environmental Public Health“COVID-19 Controls Inspections” because these inspections were designed to be conducted simultaneously, when resources allowed.
Report of the Auditor General—February 2023 47

Page: 47
Number: 1

Author: daviddickson

Subject: Highlight Date: 2023-02-24 8:12:58 PM

When Inspectors finally went into facilities, the report notes that they “regularly flagged significant
problems with resident safety and care during outbreaks.”
Resident care concerns – including dangerous levels of dehydration, insufficient meal service, inadequate
resident pain management, residents not receiving hygiene service, and resident rooms that had not beencleaned for days.
… staffing shortages in excess of 50%, staff working 16 hours a day or more, and facility staff in severe
emotional and psychological distress”.
THESE ISSUES are still ongoing. In addition, we have med errors, the result of communication challenges
caused by continuous masking, along with other safety risks to both staff and residents caused bycontinuous masking. Isolation protocols for residents are still in effect and causing undue andunnecessary distress to residents and burdens for staff. Masking and vaccination policies are STILL at thediscretion of facilities in effect resulting in the denial of essential access for DSP’s.

1

Inspection results, data, and information ﬂows
were siloed

Daily outbreak monitoring provided criticalinformation

We found that each inspection had developed its own
distinct tools and data systems. There was not a process
to accumulate and consolidate the detailed results fromall inspections. This required signiﬁcant manual effort
to bring together results across inspection types, andlimited the ability of Alberta Health and AHS to efficiently
analyze data for broader trends in compliance.

AHS zone continuing care management would become
closely involved in monitoring and supporting every
facility in an outbreak. Facilities sent a daily email to AHS
zone management summarizing their current COVID-19
status and cases and how these were changing. Eachfacility would also attend daily outbreak meetings withzone management, zone medical leadership, and other
AHS public health specialists.

AHS partially remedied this by introducing a common
risk-scoring tool for all its inspectors to use and share.
We also found that inspection information only ﬂowed
in one direction: from AHS to Alberta Health. Two-way
sharing of the ﬁndings and results of inspections would
allow for better coordination of effort and situationalawareness—particularly for AHS which has responsibility
for ensuring safe care in facilities.

Operational outbreak monitoring from
AHS zone leadership was effective
Common system to notify AHS and get
direction was established quickly
In the ﬁrst month of COVID-19, operators would use
different processes to notify AHS of suspected outbreaks
depending on the zone they operated in. On April 2, 2020,
AHS launched the COVID-19 Coordinated Response Linefor all congregate living setting operators—including
continuing care facilities. The response line allowedfacilities to make a single call to notify AHS of a suspected
outbreak and get essential, consistent guidance on theimmediate next steps they needed to take.

These monitoring activities were critically important andanother example of the effort of AHS zone management.

Detailed epidemiological outbreak
investigations virtually ceased after
wave one
We found that detailed epidemiological outbreak
investigations happened regularly for continuing careoutbreaks in wave one, but functionally stopped in wave
two. There are no direct requirements for completingthese types of detailed epidemiological studies—it is at thediscretion of public health and zone medical leadership.
In evaluating what happened with these investigations, wefound that, at ﬁrst, AHS decided that it would do a detailed
investigation of any “large” outbreak. They deﬁned this as
20 cases or more. Over time, they expanded this deﬁnition
to 40 cases or more. As the enormity of wave two became
understood, they removed any notion of case number
thresholds and relied on the judgment of zone medical
officers of health to decide whether or not to complete adetailed outbreak investigation report.

Alberta Continuing Care Outbreaks
Epidemiological Investigations on Large Outbreaks (>40, and >20 Cases)
Wave One vs Wave Two
Wave one

Wave two0

10
Outbreaks > 20 Cases

20

30
Outbreaks > 40 Cases

48 Report of the Auditor General—February 2023

40

50

Detailed Reports Finished

60

70

80

Detailed Reports Started

Page: 48
Number: 1
Author: daviddickson
Subject: Highlight Date: 2023-02-25 5:34:57 PM
Data is flawed, deliberately - this report is clearly complicit in this to reinvent history.

In the end, everyone involved is accountable and needs to be treated as such.
The whole response (and this report) was and is based on flawed and manipulated data and false statements. This is why this matter MUST be
handed over for a complete forensic investigation by people with the power to execute warrants, make arrests, interview under caution,
perform detailed technical forensic audits and press charges. Anything less is an insult to and fails the Alberta public.

1
In total, we found that AHS started 12 detailed

investigations on continuing care outbreaks. Nine
were completed for wave one outbreaks. Only threewere started from wave two outbreaks. At the time wecompleted our audit in early 2022, none were ﬁnished.
AHS told us that the decision to do fewer of these reports
in wave two was because the wave one studies told
them much of what they needed to know. We found that
continuing care management teams across AHS usedthe details in the nine reports from wave one outbreaks
to great effect in studying, analyzing across outbreaks,
and making suggestions for changes from wave one
outbreaks. These reports provided details beyond what
could be captured by compliance inspectors alone, they
helped understand how COVID-19 was getting into
facilities, how it spread, and the impacts that key factors
like facility infrastructure and staff had on outbreak
response. The absence of these detailed reports for wave
two was a missed opportunity to continuously learn fromwave two outbreaks.

System-level monitoring of Alberta
Health and AHS response was robust,
but ceased after wave one
Decisions to take over facilities were basedon operator responsiveness and compliancehistory
We found that Alberta Health and AHS both havedeﬁned pathways to escalate situations where resident
safety is in question, or where they identify other majorrisks at continuing care facilities. Pathways involve
increasing levels of each organization's leadership—fromcontinuing care management, up to executive leadershipand organization heads. They involve cross-consultation
with functions like legal counsel and risk management.

From our review of documentation and our interviews
with Alberta Health and AHS management, the ultimate
decision came down to the judgment of Alberta Healthand AHS. We found there were common criteria that
distinguished facilities that were taken over by AHS fromthose that were not, namely:•

whether the leadership of facility operators were
responding quickly and completely to resident safetyconcerns•

the recent history of compliance and responsivenessto other resident safety issues and complianceconcerns

AHS outbreak analysis and reporting from wave
one was robust
AHS completed three detailed reports analyzing
system-level performance in evaluating the response
to COVID-19 in continuing care facilities between April
and September 2020. We found these reports were good
examples of analysis and reporting to inform systemlevel monitoring.
The ﬁrst was dated late April 2020. It focused on the ﬁrst
few outbreaks and the main actions taken by AHS to that
date. It made 33 recommendations and considerations57
to AHS in improving its response at that time.
The second report was originally ﬁnished in August but
was subject to further editing and modiﬁcation after AHS
provided the report to Alberta Health. This report focusedon one major outbreak from wave one. It goes into
considerable detail and analysis, and fully debriefs theoutbreak. The report contains 26 “lessons learned” andmakes 41 strategic and operational recommendations.

There were two well-publicized instances where
escalation of resident safety concerns during COVID-19
2
outbreaks ultimately resulted in the Ministerof Healthterminating contracts with operators and placing AHS incharge of facilities: Manoir du Lac in the North Zone andMillrise Place in Calgary Zone. We found that there wereseveral other large outbreaks where escalation pathways
raised COVID-19 outbreaks up to similar levels ofdecision making, but where the decision was made not
to terminate contracts because other solutions—suchas staffing support from AHS or securing agency staff—
were possible.
57

The report does not deﬁne what a “consideration” is or how it is distinct from a recommendation.
Report of the Auditor General—February 2023 49

Page: 49
Number: 1
Author: daviddickson
Subject: Highlight Date: 2023-02-25 5:35:13 PM
The fox counting dead chickens in the hen house.

The whole response (and this report) was and is based on flawed and manipulated data and false statements. This is why this matter MUST be
handed over for a complete forensic investigation by people with the power to execute warrants, make arrests, interview under caution,
perform detailed technical forensic audits and press charges. Anything less is an insult to and fails the Alberta public.
Number: 2
Author: daviddickson
Subject: Highlight Date: 2023-02-25 5:35:41 PM
The fox counting dead chickens in the hen house.

The whole response (and this report) was and is based on flawed and manipulated data and false statements. This is why this matter MUST be
handed over for a complete forensic investigation by people with the power to execute warrants, make arrests, interview under caution,
perform detailed technical forensic audits and press charges. Anything less is an insult to and fails the Alberta public.
Why did Alberta trigger an 'Influenza Pandemic' in March of 2019 on the advice of the Health Minster Tyler Shandro - Without the legislative
authority to do so?
https://dksdata.com/DS/Shandro1.jpg

1
The third report was written in September. The

report provides a comprehensive study of ninelarge outbreaks58 from March through July 2020. It
integrates data, detailed outbreak investigations, theresults of inspections and other monitoring, and otherinformation to analyze and determine commonalities
and differences in these outbreaks. The report makes
25 recommendations which it further breaks down into
short-, medium-, and long-term focus, as well as who
within AHS and Alberta Health is responsible for each.
We have organized and summarized theserecommendations in Appendix E.

No evaluation of system-level response against
goals and plans
The Fall Action Plan developed jointly among Alberta
Health, AHS, and facility operator representatives in
September 2020 contained ﬁve goals59 and detailed
numerous speciﬁc actions for each of Alberta Health,
AHS, and facility operators.
We found that in February 2021, Alberta Healthcompleted a brief update report on the Fall Action Plan.
The report detailed several speciﬁc actions and steps
taken since September 2020. However, we found thereport did not:When we spoke to Alberta Health and AHS about this,they indicated that they viewed the goals in the plan as
aspirational and as a framework under which they couldorganize the actions. As of the completion of our audit,
we were not aware of any further evaluation against
goals articulated in the Fall Action Plan or other existing
pandemic plans.

Evaluation of outcomes by operator type
We found that both Alberta Health and AHS had
performed some analysis of COVID-19 outcomesamong different continuing care operator types. Their
analyses identiﬁed that contracted for-proﬁt operators
experienced proportionally more outbreaks, morecases, and more deaths compared to facilities run bycontracted non-proﬁt operators and AHS. Based on
its analysis from wave one outbreaks, AHS included
for-proﬁt operators as a possible risk factor for large
outbreaks.
A larger proportion of facilities run by contracted
operators exist in the two large urban zones ofEdmonton and Calgary, and this is where most
COVID-19 cases in the community were happening
during waves one and two—this fact can skew analysis
at a provincial level. We analyzed this effect focusing only
on Edmonton and Calgary zone facilities in Appendix C.

•

include a complete evaluation of whether all planned
actions described in the plan were done by each
party

•

consider or evaluate whether the actions that were
undertaken were successful•

evaluate performance or progress against the ﬁve
goals

58

The report deﬁnes a major outbreak as having ﬁve deaths, more than 20 resident cases, and more than 30 combined cases in residents andstaff.

59

As described in the context section of this report, the goals were to:
1. Prevent COVID-19 getting into facilities
2. Contain and reduce the spread, once at a facility
3. Meet resident health needs
4. See to resident mental health, quality of life, social connections, and family involvement
5. Ensure staff are well-trained, prepared, and have a good quality of work life and mental health

50 Report of the Auditor General—February 2023

Page: 50
Number: 1
Author: daviddickson
Subject: Highlight Date: 2023-02-25 5:36:05 PM
The fox counting dead chickens in the hen house.

The whole response (and this report) was and is based on flawed and manipulated data and false statements. This is why this matter MUST be
handed over for a complete forensic investigation by people with the power to execute warrants, make arrests, interview under caution,
perform detailed technical forensic audits and press charges. Anything less is an insult to and fails the Alberta public.
Why did Alberta trigger an 'Influenza Pandemic' in March of 2019 on the advice of the Health Minster Tyler Shandro - Without the legislative
authority to do so?
https://dksdata.com/DS/Shandro1.jpg

1Signiﬁcant statistical and qualitative analysis, beyond thescope of this audit, would be required to fully evaluate
this question. Such analysis, led by Alberta Health, may
help better understand COVID-19's impact on different
operating models and help better prepare the system for
future pandemics.
RECOMMENDATION:
Track resident illness and staff absences duringcommunicable disease outbreaks in facilities
We recommend that Alberta Health Services develop or
adapt a surveillance system to track all resident casesand deaths, as well as information on staff absences,during any communicable disease or outbreak infacilities.

Consequences of not taking action
Without regular, complete tracking of both resident andstaff impacts from communicable disease outbreaks,
AHS may miss these important indicators of resident
care, staff well-being, and overall facility risk.

RECOMMENDATION:
Implement recommendations from Alberta HealthServices internal reports
We recommend that Alberta Health Services accumulate,evaluate and action recommendations, lessons learned,
and other required actions identiﬁed in its own internalsummary reports on continuing care outbreaks. Any
recommendations not adopted should be rationalized.
We have organized and summarized theserecommendations in Appendix E.

Consequences of not taking action
Through considerable analysis and effort, AHS identiﬁed
many important recommendations and suggestions
for how it, Alberta Health, and facilities can make
improvements. If not actioned, the system may not bebetter prepared for future pandemics, and other smaller
communicable disease outbreaks such as seasonal
inﬂuenza.

Report of the Auditor General—February 2023 51

Page: 51
Number: 1
Author: daviddickson
Subject: Highlight Date: 2023-02-25 5:36:15 PM
Basic math seems outside the scope of this report.

The whole response (and this report) was and is based on flawed and manipulated data and false statements. This is why this matter MUST be
handed over for a complete forensic investigation by people with the power to execute warrants, make arrests, interview under caution,
perform detailed technical forensic audits and press charges. Anything less is an insult to and fails the Alberta public.

1

Appendixpp
A: Summaryy of Pandemic
and Communicable Disease Plan Goals

Plan

Owner(s)Levelof focus

Goals

Alberta’s
Pandemic
Inﬂuenza Plan
(APIP)

AEMA, Alberta
Health, AHS

Strategic/
provincial

The objective of pandemic planning is to provide
guidance and direction for activities aimed at:Communicable
AHS
disease emergency
response plan
(CDERP)—base
plan

CDERP—
continuing carechapter

AHS

Strategic/
system-wide•

controlling the spread of inﬂuenza disease andreducing illness (morbidity) and death (mortality)
by providing access to appropriate prevention
measures, care, and treatment•

mitigating societal disruption in Alberta throughensuring the continuity and recovery of criticalservices•

minimizing adverse economic impact•

supporting an efficient and effective use ofresources during response and recovery

The goals of the CDERP are to minimize:•

serious illness and overall deaths throughappropriate management of Alberta’s healthsystem resources•

societal disruption in Alberta as a result of acommunicable disease incident or emergency

Whole
The Continuing Care CDERP objectives are to:continuing care
• care and treat in placesystem• manage surge capacity•

prioritize services•

facilitate decanting from Acute care (if necessary)•prioritize admissions•

apply Infection prevention and control practices
within Continuing Care•manage Continuing Care Human Resources•

provide Alternate Care Centers (ACC)

Report of the Auditor General—February 2023 53

Page: 53
Number: 1
Author: daviddickson
Subject: Highlight Date: 2023-02-24 8:18:31 PM
These pages are moot considering the reality. More fluff copied from government documents to fill out a report.

Plan

Owner(s)Levelof focus

Goals

Continuing
Care Pandemic
Inﬂuenza
Operational Guide(CCPOG)

AHS

Operational
Requirements
for Continuing
Care

The goal of pandemic planning is to provide guidanceand direction for issues such as:

CCPOG—COVID-19
updateAHS[Published March24, 2020]

Operational
Requirements
for Continuing
Care•controlling the spread of disease and reducing
illness (morbidity) and death (mortality) byproviding access to appropriate prevention
measures, care, and treatment•

mitigating societal disruption in Alberta throughensuring the continuity and recovery of criticalservices•

minimizing adverse economic impact•

supporting an efficient and effective use ofresources during response and recovery

The Strategic Preparedness and Response Plan for
COVID-19 aims to:•

slow and stop transmission, prevent outbreaks anddelay spread•

provide optimized care for all patients, especiallythe seriously ill•

minimize the impact of the epidemic on healthsystems, social services and economic activity

The goal of pandemic planning is to provide guidanceand direction for issues such as (same as above):

54 Report of the Auditor General—February 2023•

controlling the spread of disease and reducing
illness (morbidity) and death (mortality) byproviding access to appropriate prevention
measures, care, and treatment•

mitigating societal disruption in Alberta throughensuring the continuity and recovery of criticalservices•

minimizing adverse economic impact•

supporting an efficient and effective use ofresources during response and recovery

1

Appendixpp
B: Timeline of COVID-19
in Continuing Care Response in 2020

Continuing Care Active
Outbreaks, Total Cases
and Deaths

Date

Event

January 25

Health Canada reports ﬁrst probable case of
COVID-19 in Canada

January 29

AHS activates provincial Emergency Coordination
CentreJanuary 30

World Health Organization declares COVID-19 a
public health emergency of international concern

March 5First conﬁrmed COVID-19 case in Alberta

March 9CMOH advises families to avoid facilities if they feelunwellMarch 10Government of Alberta activates Emergency
Operations Centre

March 11First facility outbreak starts; ﬁrst guidance from
AHS

March 11

World Health Organization deﬁnes COVID-19 a
global pandemic

March 17

Alberta declares state of public health emergency
due to COVID-19

March 20

CMOH Order 03-2020: implements strict visitation
restrictions to health care facilities

March 24

Letter from operator associations to AHS and AH
requesting resources; AHS updates CCPOG

Report of the Auditor General—February 2023 55

Page: 55
Number: 1
Author: daviddickson
Subject: Highlight Date: 2023-02-25 5:36:53 PM
Flawed based on all the information raised in the comments here. If you have reached this point you will know where to look.

Continuing Care Active
Outbreaks, Total Cases
and Deaths

At March 31
Outbreaks: 11
Cases: 86
Deaths: 5

At April 30
Outbreaks: 39
Cases: 624
Deaths: 72

56 Report of the Auditor General—February 2023

Date

Event

March 25

CMOH Order 06-2020: additional facility outbreakmanagement practices

March 31First in-person COVID inspection from AHS

April 2

CMOH Order 08-2020; AHS launches COVID-19
Coordinated Response Line

April 7

CMOH Order 09-2020: Further visitation rules

April 10

CMOH Order 10-2020: Single-site order;
continuous masking for facility staff

April 11

Ministerial order 624/2020: protects staff who areabsent due to single-site order

April 15

Health Assistant Deputy Minister begins weekly
operator and AHS meetings

April 15,

AHS begins supplying contracted facilities with PPE
and supplies at no cost

April 20

$24.5M monthly advance and $91M Health Care
Aide Initiative funding announced

April 22

AH sends letter to operators to delay implementing
SSO until further direction

April 24

AHS formalizes agreement with unions to permit
staff redeployment to other facilities

April 24

CMOH Order 14-2020: eases some visitation
restrictions

April 28

CMOH Order 12-2020: additional COVID
symptoms, testing, and IPC requirements

May 1

CMOH acknowledges lack of consultation/
notiﬁcation to operators for visitor changes

May 19

AH announces $170M COVID-19 Incremental
Funding Initiative

May 20

Ministerial order 22/2020: Delays annual
accommodation charge increase

May 25

CMOH Order 23-2020: recreational activities for
non-isolating residents permitted

Continuing Care Active
Outbreaks, Total Cases
and Deaths
At May 31
Outbreaks: 19
Cases: 792
Deaths: 110

Date

May 29All Albertans eligible for asymptomatic COVID-19
testingJune 5

CMOH states that isolating seniors is negatively
impacting their healthJune 13

AH grants ﬁrst SSO exemption

June 23-24
June 29

At June 30
Outbreaks: 21
Cases: 854
Deaths: 118

At July 31
Outbreaks: 23
Cases: 1,036
Deaths: 145

At August 31
Outbreaks: 28
Cases: 1,169
Deaths: 159
At September 30
Outbreaks: 40
Cases: 1,331
Deaths: 168

At October 31
Outbreaks: 68
Cases: 2,066
Deaths: 205

Event

Alberta Health Town Halls: CMOH discusses visitor
policy with operators, residents and families
AHS agreement with staff unions expires

July 2

CMOH acknowledges the single-site order has
negatively impacted some staff livelihoods

July 16

CMOH Order 29-2020: further eases visitation
restrictions

July 30

AHS has conducted at least one inspection at all
publicly funded continuing care facilities

August 17

AHS completes a major outbreak report, includes
41 recommendations

September 3

CMOH Order 32-2020: Eases various continuingcare restrictions

September 30

Fall Action Report developed outlining ﬁve desired
outcomes

October 10

Alberta Precision Labs begins prospectively
providing swabbing kits to urban continuing caresites

October 13

CMOH states limiting community cases one of best
ways to prevent facility outbreaks

October 20

Asymptomatic testing no longer available forAlbertans with no known COVID exposure

October 29

CMOH recommends Calgary zone operators to only
permit designated visitors

Report of the Auditor General—February 2023 57

Continuing Care Active
Outbreaks, Total Cases
and Deaths

At November 30
Outbreaks: 120
Cases: 3,834
Deaths: 383

At December 31
Outbreaks: 124
Cases: 7,955
Deaths: 798

Date

Event

November 12

CMOH acknowledges there are continuing carestaffing shortages

November 16

CMOH states most common point of entry of
COVID into continuing care is through staff

November 20

CMOH states SSO exemptions granted for sites
with signiﬁcant staff shortages

December 3

CMOH states staffing levels are very challenging at
outbreak continuing care sites

December 8

CMOH Order 41-2020: mandatory indoor masking

December 14

Alberta receives ﬁrst shipment of Pﬁzer vaccine

December 18

Rapid COVID testing pilot project expanded tocontinuing care facilities

December 29

Alberta receives ﬁrst shipment of Moderna vaccine

December 30

AHS to recruit 1,600 Comfort Care Aides forfacilities; 1st resident receives Moderna vaccine

58 Report of the Auditor General—February 2023

Appendix C: Key Facts and Figures
on COVID-19 in Continuing Care
Facilities
Caution on using data from our report to compare COVID-19 outcomes between jurisdictions
The organization of facility-based continuing care varies signiﬁcantly across the country. There are different
legislative frameworks, delivery models, and ways of deﬁning continuing care service levels. There are also crucial
differences in how jurisdictions deﬁne simple but important terms like “outbreak” or “COVID-19 death.”
For readers interested in comparative information, the Canadian Institute for Health Information (CIHI) published acomparative report titled "The Impact of COVID-19 on Long-Term Care in Canada, Focus on the First 6 Months," as wellas other selected comparative information about long-term care on its website. The reader should understand that
long-term care reﬂects only about half of the facilities considered in our report.
1

Illness and Death
Alberta’s continuing care facilities accounted for 8,314 COVID-19 cases and 1,042 deaths in outbreaks that started
between March and December 2020. Cases were almost evenly split between residents and facility staff. Residents
accounted for the large majority of deaths from COVID-19.

COVID-19 Cases and Deaths
Continuing Care Residents and Staff
March–December 2020
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%

5

3,785

1,037

4,529

Cases

DeathsResident

Staff

COVID-19 was the most severe in the large urban zones of Calgary and Edmonton. Together these zones accounted
for more than 90 per cent of continuing care cases and 91 per cent of deaths. This trend reﬂects the proportion of all
COVID-19 cases in the community—Calgary and Edmonton accounted for 82 per cent of all COVID-19 cases in thesame period.

Report of the Auditor General—February 2023 59

Page: 59
Number: 1

Author: daviddickson

Subject: Highlight Date: 2023-02-25 5:38:17 PM

Except the case count in Care Homes demonstrates that they did not get sick. They were the most tested population in Alberta yet they account(by this report's own data) for one of the smallest groups for 'cases'. What really happened is clear. They died primarily as a result of the COVID
response (as has been reported elsewhere in the world). Some may have had COVID and some may have died 'WITH' COVID, but very few died
OF COVID. And MANY died as a result of the response.
The All Cause statistics for the care homes demonstrate this. Why are those details not here for comparison? And this situation got a lot worse
starting the end of 2020 and beyond - and continues.
See https://dksdata.com/AlbertaDead
https://threadreaderapp.com/thread/1628981616143114241.html
This is nothing less than fear mongering based on fraudulent data and propaganda. There is no evidence, with a properly executed thoroughaudit. to support these statements. The publicly available data alone shows the complete opposite and that the crisis was manufactured by the
response. This is also demonstrated by the UK ONS data, Health Canada, Alberta Health and more.
see: https://dksdata.com/COVID19
https://dksdata.com/ONSDATA
https://dksdata.com/AlbertaDead
https://dksdata.com/MASKS
https://dksdata.com/CourtUpdate
https://dksdata.com/DavidDicksonAHRCThe obsession with testing WAS THE PROBLEM.
See https://rumble.com/v1ddohu-counting-cars.-how-covid-19-is-being-reported..html
https://dksdata.com/AlbertaDead#APL
From 'when is a negative test a positive?' to 'how many days back for a case?'
Author: daviddickson

Subject: Sticky Note

Date: 2023-02-24 8:19:51 PM

COVID-19 Continuing Care Cases and Deaths
Proportion of Totals by AHS Zone, with Comparative Information
March–December 2020
1
100%

90%
80%
70%
60%

Proportion of total

50%
40%
30%
20%
10%
0%
Continuing
Care Cases

Continuing
Care Deaths

2
Publicly
FundedContinuing Care Beds

COVID-19
Community Cases

North

5%

5%

8%

7%

Central

3%

2%

15%

7%

South

2%

2%

11%

5%

Calgary

36%

35%

33%

38%

Edmonton

54%

56%

33%

43%

While rural and remote continuing care facilities experienced fewer COVID-19 cases and deaths, outbreaks in thesesmaller communities and facilities presented signiﬁcant challenges. Many facilities in rural zones do not have accessto the depth of resources that larger operators in larger areas do.

60 Report of the Auditor General—February 2023

Page: 60
Number: 1

Author: daviddickson

Subject: Highlight Date: 2023-02-25 5:39:47 PM

Except the case count in Care Homes demonstrates that they did not get sick. They were the most tested population in Alberta yet they account(by this report's own data) for one of the smallest groups for 'cases'. What really happened is clear. They died primarily as a result of the COVID
response (as has been reported elsewhere in the world). Some may have had COVID and some may have died 'WITH' COVID, but very few died
OF COVID. And MANY died as a result of the response.
The All Cause statistics for the care homes demonstrate this. Why are those details not here for comparison? And this situation got a lot worse
starting the end of 2020 and beyond - and continues.
See https://dksdata.com/AlbertaDead
https://threadreaderapp.com/thread/1628981616143114241.html
This is nothing less than fear mongering based on fraudulent data and propaganda. There is no evidence, with a properly executed thoroughaudit, to support these statements. The publicly available data alone shows the complete opposite and that the crisis was manufactured by the
response. This is also demonstrated by the UK ONS data, Health Canada, Alberta Health and more.
see: https://dksdata.com/COVID19
https://dksdata.com/ONSDATA
https://dksdata.com/AlbertaDead
https://dksdata.com/MASKS
https://dksdata.com/CourtUpdate
https://dksdata.com/DavidDicksonAHRCThe obsession with testing WAS THE PROBLEM.
See https://rumble.com/v1ddohu-counting-cars.-how-covid-19-is-being-reported..html
https://dksdata.com/AlbertaDead#APL
From 'when is a negative test a positive?' to 'how many days back for a case?'

Number: 2
Author: daviddickson
Subject: Highlight Date: 2023-02-24 8:23:27 PM
Just some thoughts on this statement.
Beds
https://thenationaltelegraph.com/regional/ahs-ceo-caught-spreading-misinformation-about-icu-bed-capacity
Deathshttp://dksdata.com/AlbertaDead
Vaccinations
https://thenationaltelegraph.com/regional/ahs-achieves-92-percent-vaccination-rate-by-removing-26255-staff-members
Masks
http://dksdata.com/MASKS
And more.
https://thenationaltelegraph.com/regional/albertas-public-health-restrictions-are-based-on-flawed-and-frequently-altered-ahs-data
Lying about the beds caused panic and helped feed the push for mandates that killed.
https://thenationaltelegraph.com/regional/ahs-retroactively-edits-icu-data-alberta-hospitals-were-not-being-overwhelmedOver and over the data was manipulated for political purposes. People died (and are dying) as a result.
https://thenationaltelegraph.com/regional/albertas-public-health-restrictions-are-based-on-flawed-and-frequently-altered-ahs-data

The analyses of COVID-19 outcomes by operator type prepared by Alberta Health and AHS noted several relevant
factors which complicate any simple of analysis of results by operator type. They note facility size, age, and design ascomplicating factors, as well as the important relationships between community spread and facility operator type.
We analyzed this data looking just at the Edmonton and Calgary zones.
1

COVID-19 Continuing Care Cases and Deaths60
Proportion of Total Facilities and Beds to Proportion of Total COVID-19 Cases andDeaths, by Operator Type
Edmonton and Calgary Zone Only
March–December 2020
AHS Operated

Contracted - For-Proﬁt

Contracted - Non-Proﬁt

Capital Care & CareWest
0%

10%

20%

30%

40%

50%

60%

Proportion of total
Resident Cases

60

Staff Cases

DeathsFacilities

Publicly Funded Beds

In this graph, we provide information on COVID-19 outcomes along with the number of facilities and publicly funded beds as a comparator togive the reader a sense of proportionality. We note that some contracted facilities have additional spaces within their facilities beyond just the
publicly funded ones reported in this data, which may skew an understanding of proportionality on this basis.
Report of the Auditor General—February 2023 61

Page: 61
Number: 1
Author: daviddickson
Subject: Highlight Date: 2023-02-25 5:42:14 PM
Just some thoughts on this statement.
Beds
https://thenationaltelegraph.com/regional/ahs-ceo-caught-spreading-misinformation-about-icu-bed-capacity
Deathshttp://dksdata.com/AlbertaDead
Vaccinations
https://thenationaltelegraph.com/regional/ahs-achieves-92-percent-vaccination-rate-by-removing-26255-staff-members
Masks
http://dksdata.com/MASKS
And more.
https://thenationaltelegraph.com/regional/albertas-public-health-restrictions-are-based-on-flawed-and-frequently-altered-ahs-data
Lying about the beds caused panic and helped feed the push for mandates that killed.
https://thenationaltelegraph.com/regional/ahs-retroactively-edits-icu-data-alberta-hospitals-were-not-being-overwhelmedOver and over the data was manipulated for political purposes. People died (and are dying) as a result.
https://thenationaltelegraph.com/regional/albertas-public-health-restrictions-are-based-on-flawed-and-frequently-altered-ahs-data

Except the case count in Care Homes demonstrates that they did not get sick. They were the most tested population in Alberta yet they account(by this report's own data) for one of the smallest groups for 'cases'. What really happened is clear. They died primarily as a result of the COVID
response (as has been reported elsewhere in the world). Some may have had COVID and some may have died 'WITH' COVID, but very few died
OF COVID. And MANY died as a result of the response.
The All Cause statistics for the care homes demonstrate this. Why are those details not here for comparison? And this situation got a lot worse
starting the end of 2020 and beyond - and continues.
See https://dksdata.com/AlbertaDead
https://threadreaderapp.com/thread/1628981616143114241.html
This is nothing less than fear mongering based on fraudulent data and propaganda. There is no evidence, with a properly executed thoroughaudit, to support these statements. The publicly available data alone shows the complete opposite and that the crisis was manufactured by the
response. This is also demonstrated by the UK ONS data, Health Canada, Alberta Health and more.
see: https://dksdata.com/COVID19
https://dksdata.com/ONSDATA
https://dksdata.com/AlbertaDead
https://dksdata.com/MASKS
https://dksdata.com/CourtUpdate
https://dksdata.com/DavidDicksonAHRCThe obsession with testing WAS THE PROBLEM.
See https://rumble.com/v1ddohu-counting-cars.-how-covid-19-is-being-reported..html
https://dksdata.com/AlbertaDead#APL
From 'when is a negative test a positive?' to 'how many days back for a Case?'

1
A case fatality rate is a common measure of how severe a disease is by asking: “Of those who caught the disease,

how many died?” We compared case-fatality rates between continuing care residents and different proportions of
the broader population in Alberta for the period of March to December 2020.
Alberta COVID-19 Cases, Deaths and Case Fatality
March–December 2020
Continuing Care vs. All of Alberta
Continuingcare residents

All of Alberta
80 and over61

70 and over61

Under 70

All ages

Cases

4,529

4,143

7,911

95,332103,243

Deaths

1,037

983

1,292

238

1,530

Case fatality

22.90%

23.73%

16.33%

0.25%

1.48%

Looking at what is called “excess mortality” is another common measure of the impacts of a pandemic on a deﬁned
population. It compares all deaths in a period to an average or a range from previous, normal periods. As we expected, inAlberta we saw that during waves one and two there were more deaths than in the prior three-year range. However, when we
adjusted the total deaths to remove known COVID-19 deaths we found that, after the ﬁrst two months of COVID-19, deaths
not directly caused by COVID-19 in facilities were often below the prior three-year range.
2

All Continuing Care Resident Deaths in Facilities
2020 vs. Prior Three-Year Range
700

Resident deaths

650
600
550
500
450
400
350
300

Prior Three-Year Range

61

2020 (All Resident Deaths)

De
ce
m
be
r

N
ov
em
be
r

Oc
to
be
r

Se
pt
em
be
r

Au
gu
st

Ju
ly

Ju
ne

M
ay

Ap
ril

M
ar
ch

Fe
br
ua
ry

Ja
nu
ar
y

250

2020 (Resident Deaths not from COVID-19)

We include the sub-populations of “80 and over” and “70 and over” from the overall Alberta population as comparators. We include 80
and over because approximately half of continuing care residents in Alberta were 80 years of age or older in 2020. We include 70 and overbecause nearly 90 per cent of continuing residents in Alberta were 70 years of age or older in 2020. The reader should understand thatthese comparative sub-populations include continuing care resident illness and death within them. It is important to remember that residents incontinuing care facilities need to be cared for in facilities in the ﬁrst place because they have cognitive impairment, are too frail, or are otherwise
unable to safely care for themselves or be cared for in the community. These factors increase their risk of COVID-19 causing mortality.

62 Report of the Auditor General—February 2023

Page: 62
Number: 1
Author: daviddickson
Subject: Highlight Date: 2023-02-25 5:57:59 PM
Except the case count in Care Homes demonstrates that they did not get sick. They were the most tested population in Alberta yet they account(by this reports own data) for one of the smallest groups for 'cases'. What really happened is clear. They died primarily as a result of the COVID
response (as has been reported elsewhere in the world). Some may have had COVID and some may have died 'WITH' COVID, but very few died
OF COVID. And MANY died as a result of the response.
The All Cause statistics for the care homes demonstrate this. Why are those details not here for comparison. And this situation got a lot worse
starting the end of 2020 and beyond and continues.
See https://dksdata.com/AlbertaDead
https://threadreaderapp.com/thread/1628981616143114241.html

This is nothing less than fear mongering based on fraudulent data and propaganda. There is no evidence, with a properly executed thoroughaudit to support these statements. The publicly available data alone, shows the complete opposite and that the crisis was manufactured by the
response. This is also demonstrated by the UK ONS data, Health Canada, Alberta Health and more.
see: https://dksdata.com/COVID19
https://dksdata.com/ONSDATA
https://dksdata.com/AlbertaDead
https://dksdata.com/MASKS
https://dksdata.com/CourtUpdate
https://dksdata.com/DavidDicksonAHRCThe obsession with testing WAS THE PROBLEM.
See https://rumble.com/v1ddohu-counting-cars.-how-covid-19-is-being-reported..html
https://dksdata.com/AlbertaDead#APL
From 'when is a negative test a positive?' to 'how many days back for a case?'
Number: 2
Author: daviddickson
Subject: Highlight Date: 2023-02-25 5:58:15 PM
Except the case count in Care Homes demonstrates that they did not get sick. They were the most tested population in Alberta yet they account(by this reports own data) for one of the smallest groups for 'cases'. What really happened is clear. They died primarily as a result of the COVID
response (as has been reported elsewhere in the world). Some may have had COVID and some may have died 'WITH' COVID, but very few died
OF COVID. And MANY died as a result of the response.
The All Cause statistics for the care homes demonstrate this. Why are those details not here for comparison. And this situation got a lot worse
starting the end of 2020 and beyond and continues.
See https://dksdata.com/AlbertaDead
https://threadreaderapp.com/thread/1628981616143114241.html

This is nothing less than fear mongering based on fraudulent data and propaganda. There is no evidence, with a properly executed thoroughaudit to support these statements. The publicly available data alone, shows the complete opposite and that the crisis was manufactured by the
response. This is also demonstrated by the UK ONS data, Health Canada, Alberta Health and more.
see: https://dksdata.com/COVID19
https://dksdata.com/ONSDATA
https://dksdata.com/AlbertaDead
https://dksdata.com/MASKS
https://dksdata.com/CourtUpdate
https://dksdata.com/DavidDicksonAHRCThe obsession with testing WAS THE PROBLEM.
See https://rumble.com/v1ddohu-counting-cars.-how-covid-19-is-being-reported..html
https://dksdata.com/AlbertaDead#APL
From 'when is a negative test a positive?' to 'how many days back for a case?'
All Cause ONS doing the same thing as Alberta
https://threadreaderapp.com/thread/1628981616143114241.htmlc

1Facility outbreaks
Alberta Health began publicly reporting COVID-19 outbreaks in Alberta on April 21, 2020. The public-facing
reporting deﬁned an outbreak as two or more COVID-19 cases linked to a location. Internally, Alberta Health deﬁned
a COVID-19 outbreak for continuing care as any one case linked to a facility. For our report we used Alberta Health’sinternal deﬁnition and data reﬂecting an outbreak as one or more cases linked to a facility.
379 continuing care facility outbreaks started between March and December 2020. For a 44-day period between
October 22 and December 4, 2020 there was at least one new continuing care outbreak starting each day.

COVID-19 Outbreaks in Continuing Care Facilities

100

250

80

200

60

150

40

100

20

50

0

0

Cumulative outbreaks

300

914
-2
02
0
10
-1
420
20
11
-1
420
20
12
-1
420
20

120

814
-2
02
0

350

614
-2
02
0
714
-2
02
0

140

514
-2
02
0

400

414
-2
02
0

160

314
-2
02
0

Count of active & new outbreaks

March–December 2020

Because Alberta Health deﬁned even one case to be an outbreak, many of the 379 outbreaks were relatively small
scale—nearly half impacted a few facility staff and did not involve residents.

COVID-19 Outbreaks in Continuing Care Facilities
Outbreaks by Staff vs. Resident Involvement and Scale
Outbreaks Starting March–December 2020

113

0%

10%

55

20%

30%

40%

117

50%

60%

31

70%

80%

63

90%

Staff-only, Single Staff Case

Resident-involved, Between 20 & 40 Cases

Staff-only, More than One Staff Case

Resident involved, Over 40 Cases

100%

Resident-involved, Less than 20 Cases

Report of the Auditor General—February 2023 63

Page: 63
Number: 1
Author: daviddickson
Subject: Highlight Date: 2023-02-25 6:01:45 PM
By October, most facilities had been on outbreak multiple times; each time was CAUSED by staff testing asymptomatically off site. The swabs
getting back to the centers promptly was irrelevant as they went onto outbreak merely by the presence of residents with symptoms. What wasstressful for staff and particularly residents)was testing - DAILY and more!

The obsession with testing WAS THE PROBLEM.
See https://rumble.com/v1ddohu-counting-cars.-how-covid-19-is-being-reported..html
See comments above on testing, fraudulent cases and APL.

A small number of large outbreaks were responsible for most of the COVID-19 cases in continuing care facilities.
The 25 largest outbreaks caused half of all cases and 54 per cent of all deaths.
1

COVID-19 Outbreaks in Continuing Care Facilities
Impact of Large Outbreaks on Total Cases and Deaths
Outbreaks Starting March–December 2020

90%

300

80%

Cases & deaths

250

70%
60%

200

50%
150

40%

100

30%
20%

50

10%
0%

0
Largest outbreak

Smallest outbreakCases- Total

Deaths- Total

Cumulative % of Total Cases

Cumulative % of Total Deaths

Of the 355 continuing care facilities operating at March 31, 2020, 209 experienced at least one outbreak between
March and December 2020. Just over half of these 209 facilities experienced only one outbreak. 22 facilities
experienced four or more separate outbreaks. Two facilities experienced seven unique outbreaks in the 10 months
between March and December 2020.
2

COVID-19 Outbreaks in Continuing Care Facilities
Facilities with Outbreaks by Number of Unique Outbreaks Experienced

Number of unique outbreaks

March–December 2020
1

118

2

48

3

21

4

14

5

4

6

2

7

2

64 Report of the Auditor General—February 2023

Cumulative % of total cases & deaths

100%

350

Page: 64
Number: 1
Author: daviddickson
Subject: Highlight Date: 2023-02-25 6:01:59 PM
By October, most facilities had been on outbreak multiple times; each time was CAUSED by staff testing asymptomatically off site. The swabs
getting back to the centers promptly was irrelevant as they went onto outbreak merely by the presence of residents with symptoms. What wasstressful for staff and particularly residents)was testing - DAILY and more!

The obsession with testing WAS THE PROBLEM.
See https://rumble.com/v1ddohu-counting-cars.-how-covid-19-is-being-reported..html
See comments above on testing, fraudulent cases and APL.
Number: 2
Author: daviddickson
Subject: Highlight Date: 2023-02-25 6:02:13 PM
By October, most facilities had been on outbreak multiple times; each time was CAUSED by staff testing asymptomatically off site. The swabs
getting back to the centers promptly was irrelevant as they went onto outbreak merely by the presence of residents with symptoms. What wasstressful for staff and particularly residents)was testing - DAILY and more!

The obsession with testing WAS THE PROBLEM.
See https://rumble.com/v1ddohu-counting-cars.-how-covid-19-is-being-reported..html
See comments above on testing, fraudulent cases and APL.

Alberta Health considered an outbreak to be active until 28 days after the last person diagnosed with COVID
developed symptoms.62 Half of the outbreaks lasted 36 days or less. Four out of ﬁve outbreaks lasted less than
94 days. The longest COVID-19 outbreak lasted 300 days.
1

COVID-19 Outbreaks in Continuing Care Facilities
Outbreak Durations
Outbreaks Starting March–December 2020
300

250

Days in outbreak

200

150

100

50

0
Longest outbreakDays in Outbreak

Shortest outbreak

80th Percentile

Median20th Percentile

Between March 14 and December 31, 2020, Alberta continuing care facilities spent a total of 13,863 days onoutbreak status. If all of these outbreak days occurred at a single facility, the outbreak would have lasted 38 years.

62

In situations where the outbreak comprised a single staff member, the outbreak could be declared over as early as 14 days after they lastworked at the facility.
Report of the Auditor General—February 2023 65

Page: 65
Number: 1
Author: daviddickson
Subject: Highlight Date: 2023-02-25 6:02:27 PM
By October, most facilities had been on outbreak multiple times; each time was CAUSED by staff testing asymptomatically off site. The swabs
getting back to the centers promptly was irrelevant as they went onto outbreak merely by the presence of residents with symptoms. What wasstressful for staff and particularly residents)was testing - DAILY and more!

The obsession with testing WAS THE PROBLEM.
See https://rumble.com/v1ddohu-counting-cars.-how-covid-19-is-being-reported..html
See comments above on testing, fraudulent cases and APL.

1Appendixpp
D: Continuingg Care Facility
COVID-19 Compliance Inspections

AHS and Alberta Health COVID-19 Facility Inspections
Organization

AHS

AHS

AHS

AHS

Alberta HealthInspection
program

Site
Preparedness
Assessments(SPA)

Quality
Monitoring Visits(QMV)

COVID-19
Controls
Inspections

Infection
Prevention andControl (IPC)
Immediate
Response

Executive Officer
Inspections (EO)

Umbrella
program

AHS Continuing Care Quality Monitoring Program

N/A

Environmental
Public Health

Provincial
Infection
Prevention andControl

Complianceand Monitoring
BranchPublic healthinspectors

Infection
prevention andcontrol clinicalspecialists

Clinical auditors
and inspectors

Custom checklist
on preparedness
for COVID-19
outbreakSelect healthservicestandards,
CMOH Orderrequirements,
and IPCrequirements

CMOH Orders

IPC guidelines
and best
practices

CMOH Orders

Focus areas

Preparedness,
resident care

CMOH Order
compliance,
resident care,outbreakmanagement

CMOH Order
compliance

IPC practices
and outbreakmanagement

CMOH Order
compliance

Inspection
trigger63

Facility notcovered by otherinspection, lower
risk

Elevated risk
score, may or
may not be inoutbreak

COVID-19
outbreak

COVID-19
outbreakHigher risk,
COVID-19
outbreak

Functional area Environmental
responsible
Public Health

Provincial
Continuing Care
Audit Team

Personnel
specialty

Public healthinspectors

Continuing carehealth service
standards

Evaluates
complianceagainst63

We note there are many possible risk-based triggers for inspections, and this row represents the most common or distinct trigger. AHS zone
management was critical in funneling information to inspection groups to identify potential risk and triggers.
Report of the Auditor General—February 2023 67

Page: 67
Number: 1
Author: daviddickson
Subject: Highlight Date: 2023-02-24 8:29:29 PM
The fox inspecting the hen house again. More distractions from the root cause of the issue. The CRISIS WAS MANUFACTURED.

Why did Alberta trigger an 'Influenza Pandemic' in March of 2019 on the advice of the Health Minster Tyler Shandro - Without the legislative
authority to do so?
https://dksdata.com/DS/Shandro1.jpg

1

AHS and Alberta Health COVID-19 Facility Inspections
Inspection
announced inadvance?

Yes

Formal followup on ﬁndings

No, feeds intorisk scoring andYesother inspections

Yes

68 Report of the Auditor General—February 2023

Yes

Yes

No

Yes

No, followup possible if
determined
necessaryYesPage: 68
Number: 1
Author: daviddickson
Subject: Highlight Date: 2023-02-24 8:29:40 PM
The fox inspecting the hen house again. More distractions from the root cause of the issue. The CRISIS WAS MANUFACTURED.

Why did Alberta trigger an 'Influenza Pandemic' in March of 2019 on the advice of the Health Minster Tyler Shandro - Without the legislative
authority to do so?
https://dksdata.com/DS/Shandro1.jpg

1Appendixpp
E: Recommendations fromAHS Internal Reviews
Below we provide all recommendations made in the three 2020 outbreak analysis reports completed by AHS.
Wording is verbatim unless we needed to abridge for length. Abridged recommendations are denoted with anasterisk (*).

April 2020 reportAugust 2020 report

September 2020 report

R1. Pandemic staffing plans should
include redundancy and containstrategies to respond to several
outbreak scenarios and varying levelsof staffing requirements including
staffing above baseline.

P1. Provincially, identify all required
foundational elements of a site
preparation plan for COVID-19. Site
plans to be assessed against theseelements to ensure that appropriate
preparations are made in case of an
outbreak at a site.

Theme: Pandemic Plans
R1. Apply the COVID-19 Congregate
Settings Report ﬁndings,
recommendations, high priority
considerations and additional
considerations to the operational
processes of how AHS supports andresponds to all preparedness andoutbreak activities within congregate
sites.

R2. Pandemic plans should be
modiﬁed to more clearly address the
key risks related to COVID. *P2. Each zone to create a step-bystep plan for outbreak management
for sites in their zone that identiﬁes
tasks, roles and responsibilities
based on the standardized
foundational elements as per
Edmonton Zone example.

C3. Implement a standard COVID-19
R3. Assurance that pandemic
preparedness checklist including
staffing plans can be activated on
information for families. *short notice and that staffing levels
are monitored closely at the site
C20. Consideration should be given
prior to and throughout any outbreak
to developing and implementing
is required.
IP2. A standing policy should be
a COVID-19 EMS Assess Treat andestablished that AHS always stock
Refer (ATR) Response for all sitesthat phone 911. *sufficient PPE to supply contracted
operators and that we rapidly
C21. Additional considerations
resupply these operators when theyfor inclusion in the COVID-19
have supply issues.
care pathway such as increased
safety checks for residents
IP3. Implement increased high touchtaking potentially harmful drugs,
cleaning requirements for all sites or
identifying resident care equipment,
units with dementia residents and/maintaining same staff, etc. *or semiprivate spaces.
C28. Further to Consideration
21, there is a need to understandand recognize the health impacts
on families and loved ones as it
relates to COVID-19 CMOH Orders,
including impacts of social isolationand visitation restrictions.

Report of the Auditor General—February 2023 69

Page: 69
Number: 1
Author: daviddickson
Subject: Highlight Date: 2023-02-24 8:31:12 PM
Recommendations based on flawed and manipulated data and assumptions are moot. See above (if you got this far you should be able toanswer this on your own by now).

This is all to bring in Focused Protection' as the 'New Normal' which is what led to most of the deaths.

April 2020 reportAugust 2020 report

September 2020 report

R10. Improve the availability andtransparency of data including
comparator data with otherprovinces. Where possible, utilize
AHS analytic resources to improve
the accuracy, timeliness and analysisof data related to the current stateand modelling.

R4. Proactively hire and train
comfort care aides. *IP1. Increase Infection Control
Professional resources toenhance IPC practices, provide
PPE mentoring, and participate
in monitoring reviews, (including
contracted and partner sites).

C11. Consider the impact of thesuspended programs on subsequent
phases and plan for expansionof replacement activities (virtualsocialization, groups with reduced
numbers, volunteer phone calls) thatsome sites are already providing.

R6. Implementing a staffing
model with consistent resident
assignments prior to an outbreakis essential. This will enable staff toidentify subtle changes in resident
condition and streamlines thecontact tracing process.

C14. Consider restricting access tofacility immediately on notiﬁcationof COVID-19 presence in community
i.e. disease screening, one visitor
policy, suppliers deliver to outside
docks only, etc. *R7. Develop a proactive residentcentered plan to reduce medication
administration burden in the eventof decreased staffing levels due to
COVID. *Theme: Pandemic Plans
C29. Consider the sustainabilityof the dedicated operator liaison
through all phases of the pandemic.
C30. In the ‘post wave 1 strategy’
consider changes to the existinghome care and social supportmodels to enable a sustained andquality response through all waves ofthe pandemic and into the future (asper recommendation 2).
R31. Create a task force dedicated toaddressing ﬁnancial impacts for allparties (Government, AHS, Providers,and Residents) to inform thedevelopment of recommendations
for AHS and government supporting,response, recovery and sustainability.
Theme: Proactive planning

R5. Cohorting all staff as much as
possible in advance of an outbreakassists with reducing transmission
and includes care, dietary andhousekeeping staff.

C15. Reconsider the visitor
restrictions in light of continuous
masking and future impacts. Ethics
involvement should be considered.

70 Report of the Auditor General—February 2023

IP4. AHS should maintain pandemic
stock (e.g., PPE, hygiene, cleaning
supplies) at all times.

April 2020 reportAugust 2020 report

September 2020 report

Theme: Proactive planning
C22. Remodel the COVID -19
wave speciﬁc to congregate careenvironments – Examine what the
new probable reality may be andpivot thinking to meet the needs ofclients/residents during a potential“slow burn” scenario. Following this,develop a ‘post wave 1 strategy’ witha focus on seniors and vulnerable
populations. Additionally, consider
changes to the existing home careand social support models to enablea sustained and quality response
through all waves of the pandemic
and into the future. *R8. Visual Care Plans should be
developed and available in the eventof an outbreak to assist staff who
may or may not be familiar withresidents provide safe, quality care.
R9. Resident Goals of Care
Designations should be reviewed for
all residents at a site to ensure they
are current and resident wishes are
known should an outbreak occur.

C23. Need to re-assess if limiting
home care is the right approach now
that the projection models show a“slow burn” vs a “high peak” for AB.
This may have longer term negative
consequences post wave 1.
C24. Develop Restorative/Respite/
Recovery Community Support Space
operational/staffing/logistics plansas part of Surge Capacity strategy. *Theme: Testing1
C8. Consider pro-active testing for

all residents entering the facility
as more information becomes
available on the utility of swabbing
asymptomatic individuals.
C9 Consider putting a proactive planin place for point of care testing if/
when technology becomes available.

2
R10.
Providing on-site asymptomatic
staff testing during outbreaks atregular intervals increases theaccessibility for staff, ensures more
timely access to testing results andan overall increase in the number ofstaff who are tested.

R11. Obtaining consent forasymptomatic resident testingshould be completed once, ensuring
the consent is for the entire lengthof the pandemic.
R12. Additional staff resources may
be required to assist with resident
and staff testing to manage thesigniﬁcant workload and increase thetimeliness of testing.

M3. Implement routine swabbingof asymptomatic staff, students,
physicians and residents in an
outbreak. Frequency TBD based onrisk assessment.
M4. Continue 14 day additional
precautions/isolation andasymptomatic testing of newresidents as per CMOH Orders
M6. Expedite and fully resource
testing and contact tracing forseniors care environments.
M7. Provide on-site asymptomatic
staff testing during outbreaks toincrease accessibility for staff andan overall increase in the number ofstaff who are tested.

Report of the Auditor General—February 2023 71

Page: 71
Number: 1

Author: daviddickson

Subject: Highlight Date: 2023-02-24 8:31:51 PM

The obsession with testing WAS THE PROBLEM.
See https://rumble.com/v1ddohu-counting-cars.-how-covid-19-is-being-reported..html
See comments above on testing, fraudulent cases and APL.
Number: 2
Author: daviddickson
Subject: Highlight Date: 2023-02-25 5:58:43 PM
Most outbreaks were caused by asymptomatic testing. That is also what overloaded the system (by this reports own conclusions)!

So many clear indicators of fraud in the classification of 'cases' and Deaths ignored by this report as it attempts to reinvent history.
https://rumble.com/v28lhpw-who-cares-about-false-positives-every-single-case-was-used-to-terorrise.html
KENNEY SAYS WHO CARES ABOUT FALSE POSITIVES! From Kenney's own Q&A::
00:00"Alright Donna Stratton Stratton Tip says I've read about the maker of the PCR test has stated it's about 50% wrong and wasn't designed forwhat we're using it for. Is that true?" And then this.
00:13"I actually asked for this to come up because I know there's a lot of folks often when I check out the Facebook comments, there's a lot of thisstuff about PCR, so PCR is the standard test for COVID-19 in Canada and Alberta and around the world."
00:30"It's it's true that based on how many cycles the PCR test is does on the sample that that it can generate in many cases does generate a false
positive…"
01:01"So there are, I'll call them covid skeptics, who are claiming that all of the restrictive policies are being wrongly informed by exaggerated Covid
case counts because of false positives through PCR testing."
01:53"In a sense, I mean, who really cares about the false positives?"
WHO CARES?? WHO INDEED!! Let me tell you WHO CARES, KENNEY!! How about the people isolated for two weeks, losing their business,closed care homes, closed schools, cancelled surgeries, suicides, poverty....
It takes a single 'case' to shut down the lives of hundreds of care home residents and all connected to them and our then Premier had the
audacity, to say "..who really cares about the false positives?"
The obsession with testing WAS THE PROBLEM.
See https://rumble.com/v1ddohu-counting-cars.-how-covid-19-is-being-reported..html
APL and its implication in testing and fraudulent cases.
https://dksdata.com/AlbertaDead#APL
From 'when is a negative test a positive?' to 'how many days back for a case?'
These numbers are based on manipulated statistics related to when a person was coded as a COVID case, not when they died. In some cases
these Covid cases 'survived' for over two years. Did they really die of COVID?
The criteria for a COVID death was death up to 6 months after a COVID diagnosis (with or without a death certificate to support). COVID
deaths were identified by nurses in the COVID statistical department reviewing NetCare and Connect Care (and sometimes death certificates). In
August of 2022, that criteria changed to 60 days instead of 6 months. However, there are instances where the 6 months and the 60 days was
ignored.
http://dksdata.com/AlbertaDead
COVID cases were known to be unreliable and as such, COVID hospitalizations and deaths were built on flawed foundations. Fruit of the
poisonous tree from the start. For an Auditor to not even look at this is beyond negligent and further reinforces the need for a police forensic
investigation of all relevant data and facts.

April 2020 reportAugust 2020 report

September 2020 report

Theme: Testing1
R26. As the incubation period forthe elderly is not well understood,
there may be value in includingtime intervals (i.e. every 1-10days) for asymptomatic screening
during COVID-19 outbreaks wherecases continue to be detected in
the outbreak guidelines for future
outbreaks.
Theme: Compliance monitoring
R13. Communication between
operators, AHS, and Alberta Healthneeds to be streamlined to ensure
higher risk sites are identiﬁed. *R27. All stakeholders need tounderstand the triggers for
escalation of concerns, an approachto respond to concerns on a timely
basis and to report on sites ofconcern and actions required.
R28. Audits, inspections, and followup visits need to be completed on atimely basis. *R29. Audits, inspections and onsite
supports at outbreak sites need to berevisited when there is a signiﬁcant
increase in positive residents andstaff. *R30. Alberta Health and AHS need
to work closely together to ensurethat the two organizations areexchanging and jointly reviewing
audit, inspection and monitoring
information (outbreak status andresponse) in a timely and consistentmanner.

72 Report of the Auditor General—February 2023

M1. Analyze ﬁrst round of SPA/QMV assessments, make needed
modiﬁcations to the assessment
forms, conduct consecutive roundsof assessments, including staffing
timesheet audits.

Page: 72
Number: 1

Author: daviddickson

Subject: Highlight Date: 2023-02-24 8:33:39 PM

The obsession with testing WAS THE PROBLEM.
See https://rumble.com/v1ddohu-counting-cars.-how-covid-19-is-being-reported..html
See comments above on testing, fraudulent cases and APL.

April 2020 reportAugust 2020 report

September 2020 report

R14. Continuing care operators
must inform AHS operations
proactively of staffing issues that are
anticipated, and immediately whenunanticipated staffing challenges areexperienced.

S1. Operators to develop pandemic
staffing plans prior to an outbreakbased on the phase of pandemic/outbreak response to manage
resident care and ensure sufficient
staff are available to provide safe,
quality care. This will include
a requirement for an outbreak
supplemental staffing plan including
redundancy that is ready to
implement if staffing is suddenly
impacted.

Theme: Staffing
C12. Consider the impact andcosts of new staffing models andinterventions in long-term carefacilities. Engage IPC to lead andcoordinate efforts to safely introduce
additional supports including
volunteers and non- healthcare staff
to support the response.
C19. Ensure plans have adequate
staffing strategies that may include
review and documentation of
unexplained absences, assigning
COVID-19 suspected or conﬁrmed
staff to non-people contact, andrestricting AGMP to one locationin facility only and fewest staff aspossible. *C25. Use of volunteer resourcesin facility guidelines should be
developed, currently signiﬁcantlimits of essential visitors has
resulted in volunteer resources
restrictions

R15. Enhanced housekeeping
staffing is recommended
to complete the additional
environmental cleaning that isrequired during a pandemic. *1
R16.
Active physician involvement
on site is required to effectively
support resident care during theoutbreak. *R17. Enhance education andcommunication to staff about
asymptomatic testing and minor
symptoms. *2
R31.
Alberta Health should remind
all service providers/operatorsthat staffing shortages affecting
continuation of service delivery/caremust be reported to Alberta Healthand AHS.

S2. Zones to review and ensurethat site pandemic staffing plans
are reasonable, actionable and will
support needs should a site have an
outbreak.
S3. Review staffing issues andmodels, especially position types,
compensation, education, etc for
HCAs.

S4. Work with contracted providers
using a multi-skilled worker staffing
model to ensure site is providing
sufficient staffing levels for bothcare and accommodation (e.g.,housekeeping, laundry, and dietary
R32. AHS needs to develop zoneactivities). Ensure support functions
based plans for staffing supports thatare resourced appropriately outside
can be readily mobilized.
of care funding.
3
R33. Consideration should be given
to Alberta Health and Alberta Labour
having discussions with unions tocreate agreements for 12 hour shifts
during outbreaks.

Report of the Auditor General—February 2023 73

Page: 73
Number: 1

Author: daviddickson

Subject: Highlight Date: 2023-02-24 8:35:36 PM

Physicians for LTC actively discouraged/denied access to residents during outbreaks resulting in
unnecessary suffering and death.
Number: 2
Author: daviddickson
Subject: Highlight Date: 2023-02-24 8:34:53 PM
Staffing shortages were engineered between refusal to bring in contract staff, forced asymptomatic exclusion from the site and firing tens of
thousands of healthy workers because of vaccine mandates!
Number: 3

Author: daviddickson

Subject: Highlight Date: 2023-02-24 8:35:55 PM

Staff working double shifts and denied breaks (even in one case an HCP who was diabetic refused when
she asked to remove her mask to eat and drink when she could not take a break (short staffed).

April 2020 reportAugust 2020 report

September 2020 report

Theme: Infrastructure1
R18. Facilities with a highpercentage of semiprivate rooms
that do not allow for safe physicaldistancing should have reduced
occupancy. Alternatively, an
external location to relocate the ﬁrst
positive case immediately may be
advantageous. *R19. Consider designating privateroom(s) at each site as a temporary
quarantine location for new
admissions.
R35. Eliminate shared occupancy
beginning immediately with 3-4 bed
ward rooms followed by a risk based
approach to all double occupancy.

IS1. Eliminate fan use at outbreaksites.
IS2. Eliminate shared occupancy forrooms of 3+ residents, followed by arisk-based approach to eliminating
all double occupancy. Review optionof capacity RFEOI with an initial
focus on reducing shared occupancy
rooms on secure (dementia) units
where more active residents may
pose challenges for IPC.
IS3. Proactively eliminate fan use at
all sites.

Theme: Outbreak management
2R2. Focusing central leadershipand improving coordination of allquality-of-care activities (multiple
government and AHS teams)
occurring to ensure sites aresupported effectively and resident
risks related to poor health outcomes(not just COVID-19 speciﬁc) are
identiﬁed with integrated strategies
implemented to reduce/prevent
harm. *
3
C4. Consider the impact of this newpolicy (Continuous Masking) on theprevious visitor restrictions. With
this in place consideration should
be given to understand if visitor
restrictions be reduced further, andcould volunteers be re-introduced
into the sites to help reduce social
isolation and assist care staff asappropriate.
C13. Consider additional guidance
related to transitions andmovements including ensuring
a COVID appropriate evacuation
process is in place, restricting
movement to essential diagnostic
therapeutic only, etc. *R20. Reinforcement of Enhanced
Cleaning Processes as standardpractice as mandated by CMOH
Order 23-2020.
R21. Those sites with higher
percentage of semi-privates andthe high-risk populations describedabove should have high touchcleaning standards increased to aminimum of 6 times per day and thisshould be in place at all times, notonly when the site is on outbreak.
4
R22.
Those sites with higher
percentage of semi-privates andthe high-risk populations describedabove should have considerationof resident screening proactively
completed twice daily.

R23. Ensure that all staff on all
shifts, including care and support
staff (housekeeping, laundry, dietary,etc.) receive ongoing education
regarding IPC and PPE required
practices.

74 Report of the Auditor General—February 2023

P3. Implement single occupancy
temporary isolation rooms for new
admissions.
P5. Reassess visitation within theparameters of CMOH Orders andidentiﬁed site speciﬁc risk.
IP5. Reinforce Enhanced Cleaning
Processes as standard practice as
mandated by CMOH Orders.
Need to assess the ability withincurrent resources to ensure thisoccurs.
M2. Increase AH and AHS caremonitoring, and AHS leadershipand response oversight/support asneeded to identiﬁed at risk sites,
whether ongoing or during outbreaks
to follow-up on various audit results(e.g. AH, CCHSS Audits, SPA visits,
Quality Monitoring Visits, IPC Audits)
and increase support for outbreakmanagement in all continuing caresettings.

Page: 74
Number: 1

Author: daviddickson

Subject: Highlight Date: 2023-02-24 8:36:22 PM

Number: 2

Author: daviddickson

Subject: Highlight Date: 2023-02-24 8:36:38 PM

Number: 3

Author: daviddickson

Subject: Highlight Date: 2023-02-24 8:37:23 PM

Number: 4

Author: daviddickson

Subject: Highlight Date: 2023-02-25 5:59:00 PM

AHS had an active process to transfer COVID positive patients into shared rooms!!

R.2 Limited contact in terms of access to visitors, recreation etc. caused and continues to cause untold
damage to resident quality and quantity of life over and above any risk of infections.

MANDATORY CONTINUOUS MASKING NEEDS TO BE ENDED, EFFECTIVE IMMEDIATELY.
See Alberta July 2022 SAG reporthttps://dksdata.com/MASKS#AHSSAGINVASIVE, REPEATED TWICE DAILY AND PROVEN INEFFECTIVE TESTING SHOULD END IMMEDIATELY.
So many clear indicators of fraud in the classification of 'cases' and Deaths ignored by this report as it attempts to reinvent history.
https://rumble.com/v28lhpw-who-cares-about-false-positives-every-single-case-was-used-to-terorrise.html
KENNEY SAYS WHO CARES ABOUT FALSE POSITIVES!
00:00
Alright Donna Stratton Stratton Tip says I've read about the maker of the PCR test has stated it's about 50% wrong and wasn't designed forwhat we're using it for. Is that true? And then this.
00:13
I actually asked for this to come up because I know there's a lot of folks often when I check out the Facebook comments, there's a lot of thisstuff about PCR, so PCR is the standard test for COVID-19 in Canada and Alberta and around the world.
00:30
It's it's true that based on how many cycles the PCR test is does on the sample that that it can generate in many cases does generate a false
positive…
01:01
So there are, I'll call them covid skeptics, who are claiming that all of the restrictive policies are being wrongly informed by exaggerated Covid
case counts because of false positives through PCR testing.
01:53
In a sense, I mean, who really cares about the false positives?
WHO CARES?? WHO INDEED!! Let me tell you WHO CARES, KENNEY!! How about the people isolated for two weeks, losing their business,closed care homes, closed schools, cancelled surgeries, suicides, poverty....
It takes a single 'case' to shut down the lives of hundreds of care home residents and all connected to them and he says "who really cares about
the false positives?"
The obsession with testing WAS THE PROBLEM.
See https://rumble.com/v1ddohu-counting-cars.-how-covid-19-is-being-reported..html
APL and its implication in testing and fraudulent cases.
https://dksdata.com/AlbertaDead#APL
From 'when is a negative test a positive?' to 'how many days back for a case?'
These numbers are based on manipulated statistics related to when a person was coded as a COVID case, not when they died. In some cases
these Covid cases 'survived' for over two years. Did they really die of COVID?
The criteria for a COVID death was death up to 6 months after a COVID diagnosis (with or without a death certificate to support). COVID
deaths were identified by Nurses in the COVID statistical department reviewing NetCare and Connect Care (and sometimes death certificates).
In August of 2022, that criteria changed to 60 days instead of 6 months. However, there are instances where the 6 months and the 60 days was
ignored.
http://dksdata.com/AlbertaDead
COVID cases were known to be unreliable and as such, COVID hospitalizations and deaths were built on flawed foundations. Fruit of the
poisonous tree from the start. For an Auditor to not even look at this is beyond negligent and further reinforces the need for a police forensic
investigation of all relevant data and facts.

April 2020 reportAugust 2020 report

September 2020 report

Theme: Outbreak management
1
C17. During an outbreak or potential

R24. Consider the use of cloth
outbreak, and if not already in place, reusable gowns to reduce PPE
demand and waste.
treat all residents as COVID-19
positive until swabs prove otherwise.
R37. Communicate to operators
R18. Ensure capacity of newabout the funding decisions
outbreak response site team crossregarding outbreak costs toall geographies in the province toencourage them to make proactive
support multiple sites at one time.
decisions to be ready for an
Expand scope and reach of teams
outbreak. *with virtual technology and phone
R38. Each zone develops andwhen possible.
implements a collaborative plan foroutbreak management.
R39. Continuing care contact tracing
must be fully and appropriately
resourced.
Theme: Speciﬁc considerations for residents with cognitive impairment
2
C26. Establish a system of calls/

skype etc. to isolated seniors fromfamily and friends or “pen pals”.
C32. AHS to encourage all seniors
85+ and vulnerable populations who
do not have an AHS case manager(CM) to contact AHS continuing carecoordination offices. Consider AHS
to take these people on as homecare clients, so that they have directaccess to a CM in case they havesymptoms or they need help. This
would include disabled adults who
may be dependent on a caregiver
who could become ill. *R25. Develop a comprehensive,
pragmatic strategy for managementof residents with dementia once
an outbreak has been declared.
This will require signiﬁcant input
from operations and likely require
additional resources to implement.

M5. Develop detailed guidance forcognitively impaired residents withappropriate mitigation of infection
risk including at the site and unit
level for this population.

Theme: Staff supports
3
C27. An increase in distress, feelingsof loss, grief, guilt, and depressedmood will be felt by healthcare
professionals, especially in sites
where there is a higher numberof residents/staff who acquire
COVID-19 and die. Enhanced
supports and safety measures should
be considered to be developed andimplemented.

R34. A plan is required for supports
for staff to help deal with anxiety/fear, and physical and emotional
toll of caring for residents during an
outbreak to keep staff well and able
to work. *Report of the Auditor General—February 2023 75

Page: 75
Number: 1

Author: daviddickson

Subject: Highlight Date: 2023-02-24 8:41:21 PM

Positive until proven negative. Locked down in their entirety until “proven” otherwise.
This is 'Focused Protection' that led to all the issues raised in this report. (See page 46 of this report)
Also see All Cause Mortality
https://dksdata.com/AlbertaDead
All Cause ONS doing the same thing as Alberta
https://threadreaderapp.com/thread/1628981616143114241.html
Number: 2

Author: daviddickson

Subject: Highlight Date: 2023-02-24 8:42:41 PM

NOT SURE HOW MY MOTHER (WITH GLOBAL APHASIA, HARD OF HEARING, SIGHT IMPAIRMENT AND
UNABLE TO READ) WOULD BENEFIT FROM “CALLS, SKYPE AND PENPALS”. These people require in IN
PERSON” contact for their physical and emotional wellbeing. That includes issues caused by their DSP’s
and staff forced into continuous masking.
People will be held accountable for this!
See https://rumble.com/v21co6k-the-are-the-unforgotten-they-deserved-better..html
Number: 3

Author: daviddickson

Subject: Highlight Date: 2023-02-24 8:43:17 PM

A glaring omission of the fact that many HCP’s are very aware now that the policies in place, not infection
risk, are resulting in suffering and death to residents and negatively impacting their own physical andemotional wellbeing. Where is even the acknowledgment (let alone the support in place) for this?

April 2020 reportAugust 2020 report

September 2020 report

R36. Timely sharing of information
amongst operators, AH, AHS needs
to be reinforced.

P6. Share timely and detailed
information amongst operators, AH,
AHS.

Theme: Communication
C6. Ongoing communication aroundthe Continuing Care connection
website, single email and the single
point of contact for operators.
C7. Consideration be given that every
congregate site be risk assessed andthat higher risk sites be appointed
an AHS contact that works daily withscreening—Opportunity to reduce
call volumes to the 1844 line.
R16. Optimize the operations of the
1-844 line and promote a culture ofpatient safety and transparency.
Theme: Leadership and risk management
C5. Implement ongoing monitoringof the impact of this policy (Single
Site) on the overall workforce andensure the outcomes continue toreduce overall risk inclusive of thecare risks due to availability of staff. *R40. The unique risks related to
COVID in the continuing care sector
along with potential risk mitigation
strategies should be shared amongst
operators, Alberta Health and AHS
to enhance the ability of all sites to
respond to an outbreak.
R41. Consider options for
management of issues that arisein the absence of a declared Public
Health Emergency and strategies
required to put necessary supports
in place.

Theme: Other
C33. Ensure a comprehensive
approach is in place for protecting
correctional facilities and work
camps.

76 Report of the Auditor General—February 2023

1
P4.
Conduct in-depth
epidemiological studies to measure
the risk of illness or death in an
exposed population compared tothat risk in a matched, unexposed
population.

Reﬁnement/revision of prospective
risk assessment tool based on thisretrospective analysis of outbreakdata.

Page: 76
Number: 1
Author: daviddickson
Subject: Highlight Date: 2023-02-25 5:48:34 PM
The governments answer to everything... a publicly funded study wasting tax dollars.
COVID cases were known to be unreliable and, as such, COVID hospitalizations and deaths were built on flawed foundations. Fruit of the
poisonous tree from the start. For an Auditor to not even look at this is beyond negligent and further reinforces the need for a police forensic
investigation of all relevant data and facts, not a government cover up.

Appendix F: Major Events andDevelopments After the End of
Our Scope

December 14, 2020

Alberta receives the ﬁrst shipment of Pﬁzer Vaccine

December 17, 2020

Rapid testing expanded to LTC facilities, rural hospitals, and homeless shelters

December 30, 2020

AHS contracts Manpower Staffing Services to recruit and deploy 1,600"Comfort Care Aides" to facilities

December 30, 2020

First COVID-19 vaccine administered to LTC resident

January 4, 2021

Government of Alberta opens Facility Based Continuing Care review (FBCC)
surveyJanuary 18, 2021

First COVID-19 vaccine dose provided to all publicly funded LTC/DSL residents

February 9, 2021

Rapid testing expanded to asymptomatic LTC staff

February 19, 2021

Second COVID-19 vaccine dose provided to all publicly funded LTC/DSL
residents

February 24, 2021

Active COVID cases in LTC drop 92% compared to December

March 3, 2021

GoA Budget 2021 includes $154M budgeted for new Continuing Care Capital
program – aimed to increase continuing care capacity

March 3, 2021

GoA Budget 2021 increases Continuing Care budget by $200M

March 15, 2021

HQCA releases “COVID-19 in Continuing Care” study. It reports resident/
family LTC/DSL experience during March – July 2020

March 30, 2021

AH provides AHS $20M grant to modernize select AHS and AHS subsidiary
continuing care facilities

April 8 & 9, 2021

Town hall with CMOH, DSL/LTC staff, residents, families to discuss easing
COVID-19 restrictions in Continuing Care

April 22, 2021

May 10, 2021

1
GoA introduces COVID-19 Related Measures Actt (shields operators/AHS fromCOVID-19 related lawsuits)
Continuing care COVID-19 restrictions relaxed: indoor social visits permitted,
outdoor social visits expanded
Report of the Auditor General—February 2023 77

Page: 77
Number: 1

Author: daviddickson

Subject: Highlight Date: 2023-02-24 8:46:24 PM

GoA introduces COVID-19 Related Measures Act (shields operators/AHS from COVID-19 related lawsuits).
Note: This does not cover them from gross negligence or criminal related activity though.

May 31, 2021

GoA contracted ﬁrm MNP releases the Facility Based Continuing Care (FBCC)
review report, 42 recommendations issued

June 17, 2021

COVID-19 Related Measures Act receives royal assent

June 29 & 30, 2021

Town hall with CMOH, DSL/LTC staff, residents, families to discuss lifting
continuing care COVID-19 restrictions

July 1, 2021

Almost all COVID-19 restrictions lifted per GoA Open for Summer Plan

July 1, 2021

Alberta Health halts admissions to continuing care rooms where there are
already two residents

July 13, 2021

Additional continuing care COVID restrictions lifted (visitors, dining, recreation,screening)

August 21, 2021

Alberta Health reports only ﬁve multi-resident rooms remain in publicly
funded continuing care sites

August 30, 2021

Third vaccine dose begins for continuing care residents

August 31, 2021

AHS requires all employees to be fully vaccinated by October 31

1
October 19, 2021

Masking for continuing care facility visitors re-implemented

October 22, 2021

AHS extends employee vaccination deadline to November 30

November 24, 2021

Continuing care experiences fourth COVID-19 wave: more than 1,400 cases
report but lower mortality

December 9, 2021

Alberta Health releases phased plan to end single-site order by February 16

December 20, 2021

AHS increases restrictions for visitors/support persons at continuing carefacilities

December 23, 2021

CMOH reports omicron variant cases doubling every 2 – 3 days

January 10, 2022

Due to limited testing capacity, eligibility criteria for PCR testing made stricter
to only permit speciﬁc groups for testing

January 14, 2022

Continuing care experiences ﬁfth COVID-19 wave: highest active cases todate; but milder sickness & lower mortality

February 8, 2022

GoA removes Restriction Exemptions Program and other restrictions as part ofstaged plan to remove all COVID-19 measures

February 16, 2022

Alberta Health lifts the single-site order. Staff are now permitted to work
across multiple LTC or DSL facilities

78 Report of the Auditor General—February 2023

Page: 78
Number: 1

Author: daviddickson

Subject: Highlight Date: 2023-02-24 8:46:45 PM

Masking RE-IMPLEMENTED for visitors?? It was never dropped!

Appendix G: Audit
Responsibilities and Quality
Control Statement
Management of Alberta Health and Alberta HealthServices is responsible for the health system response
to COVID-19 in continuing care facilities.

Our responsibility is toexpress an independentconclusion on whether
Alberta Health and Alberta
Health Services has done so.
All work in this audit was performed to a reasonable levelof assurance in accordance with the Canadian Standard
on Assurance Engagements (CSAE) 3001—Direct
Engagements, set out in the CPA Canada Handbook—
Assurance. The Office of the Auditor General applies
Canadian Standard on Quality Management 1, which
requires the Office to design, implement and operatea system of quality management, including policies
and procedures regarding compliance with ethicalrequirements, professional standards and applicablelegal and regulatory requirements. The office complies
with the independence and other ethical requirementsof the Chartered Professional Accountants of Alberta
Rules of Professional Conduct, which are foundedon fundamental principles of integrity and due care,objectivity, professional competence, conﬁdentiality,and professional behaviour.

Report of the Auditor General—February 2023 79

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