COVID patients have a right to know if they were infected with variant of concern, medical ethicists say

·4 min read
After testing positive for the coronavirus, Hobson Lin wanted to know if he'd caught a more transmissible variant because he had been serving customers at a Starbucks on the morning his symptoms began. But Vancouver Coastal Health says it doesn't give that information to patients. (Ben Nelms/CBC - image credit)
After testing positive for the coronavirus, Hobson Lin wanted to know if he'd caught a more transmissible variant because he had been serving customers at a Starbucks on the morning his symptoms began. But Vancouver Coastal Health says it doesn't give that information to patients. (Ben Nelms/CBC - image credit)

Medical ethicists in Canada say people who test positive for COVID-19 have a right to know if their tests reveal variant strains of coronavirus, but that's not happening in the Vancouver Coastal Health region, where variant infections have been surging.

B.C. has the majority of Canada's cases of P1, the variant first identified in Brazil that is 2.5 times more transmissible than the original coronavirus strain that causes COVID-19. The spread of the P1 variant in Whistler, part of the VCH area, forced the closure of the ski resort there.

Fears about both the short-term and long-term effects of becoming infected by P1 — as well as the B117 strain that is even more prevalent in B.C. — have led some people who developed COVID-19 to seek more information about the strain they caught.

But VCH says it doesn't release that information.

Kerry Bowman, a bioethicist at the University of Toronto, says patients have the right to know the results of any tests that form part of their diagnosis.

He said people have a right to be as informed as possible about their own health and any doctor who withholds information from a patient could be in breach of professional standards.

"There should never be secrets from patients," said Bowman.

Provincial Health Officer Dr. Bonnie Henry said last week that variants of concern have become so prevalent in B.C. that whole-genome sequencing testing to identify them would no longer be routinely done.

But the B.C. Centre for Disease Control said in an email to CBC News that the majority of positive samples are still being tested for variant strains.

Epidemiologists say treatment is the same for all strains of COVID-19.

Hobson Lin, who works at a busy Starbucks in the Yaletown area of Vancouver, wanted to know if he was infected with a variant of concern after he tested positive for the coronavirus in early March.

Hobson Lin says he tested positive for the coronavirus on March 3 after his shift at a Yaletown Starbucks.
Hobson Lin says he tested positive for the coronavirus on March 3 after his shift at a Yaletown Starbucks.(Hobson Lin)

Lin, 27, left work to get tested the morning of March 3 after developing a fever and aches, and received his results that night.

He wanted to know if he was infected with a variant because he'd served dozens of customers the day he tested positive. He says he'd been very careful, but recalled that some unmasked customers had peeked around his Plexiglas barrier.

He also worried about the long-term health effects of the variants.

But Lin hit a dead-end trying to get further information from VCH.

"What's frustrating is that … I don't know what strain I have and they are not disclosing that," said Lin.

In an emailed statement, Vancouver Coastal Health said patients are only told whether they are positive or negative — not which strain of COVID is involved in the infection.

A laboratory technologist at the B.C. Centre for Disease Control holds a genome cartridge while conducting genomic sequencing of the coronavirus.
A laboratory technologist at the B.C. Centre for Disease Control holds a genome cartridge while conducting genomic sequencing of the coronavirus.(Ben Nelms/CBC)

Bowman and other medical ethicists say that is not acceptable.

"If they are testing people for the variants and as part of that testing they uncover the information that you are infected with the variant ... You are entitled to know that health information because it's about you," said Lorian Hardcastle, who works at the University of Calgary's department of community health sciences.

Hardcastle said knowing where variants are showing up could help keep people safer by encouraging them to be even more careful with public health rules and guidelines.

She used the example of the Albertan traveller who returned from B.C. in March with the P1 variant and ended up infecting 35 people, one of whom died.

"One wonders if that person had been informed they had the variant if they might have been more careful," said Hardcastle. "… I really don't think there's anything to be lost by telling them."

Provinces like Alberta and Ontario are screening aggressively for variants of concern and sharing that information with doctors. .

The B.C. Ministry of Health was asked whether other health authorities besides Vancouver Coastal inform British Columbians infected with a variant.

"If an individual asks a contact tracer whether their case is a variant of concern and the results are available, the contact tracer is able to provide this to them," it said in a statement.

The Whistler Blackcomb ski resort was closed due to an outbreak of the P1 variant of the coronavirus that causes COVID-19.
The Whistler Blackcomb ski resort was closed due to an outbreak of the P1 variant of the coronavirus that causes COVID-19.(Tina Lovgreen/CBC)