Cyberattack confirmed as cause of health-care disruptions in N.L.

The disruptions rocking the Newfoundland and Labrador health-care system are due to a cyberattack, Health Minister John Haggie confirmed Wednesday.

Haggie'sconfirmation comesfive days after the IT problems were discoveredSaturday morning, and after repeated government refusals to detail the situation that caused the cancellation ofthousands of medical procedures, ranging from chemotherapy to X-rays.

"We are not yet clear on the total extent of the failures. We know we have been subject to an attack," Haggie said.

Haggie would not comment on who may behind the attack, what communication there may have been with those behind it, or whattype of cybercrime it is.

Pat Hepditch,vice-president of the Newfoundland and Labrador Centre for Health Information which handles the province's health-care IT needs said their investigation revealed an "unauthorized third party" had compromised the system.

"We are working hard now to gain a full understanding of the attack, but there are still many unanswered questions," said Hepditch.

Revealing moremight jeopardize the investigation into what happened and the efforts to restore the IT systems needed to get the bulk of the province's health-care systems back online, Haggiesaid.

"Those involved in the attack may actually be monitoring what we are saying in media and on the floor ofthe House [of Assembly]," Haggie said.

"It's very important, therefore, we don't do or say anything that compromises the efforts underway to investigate and resolve this matter."

Authoritiesincluding the RCMP are investigating, Haggiesaid.They and other experts being consultedrecommendminimizing the information released to the public, he added.

"We are following their advice. They know this area. This is not health care; this is cybersecurity, and these people are world-class in their field," he said.

Possible ransomware attack

Sources have told CBC News it was a ransomware attack, a breach in whichdata or systems are encrypted until a ransom is paid. Ireland's health-care system fell victim to a ransomware attack in May, with government officials there refusing to pay theransom.

Haggie would not say if data has been lost in the attack. A price tag on repairing Newfoundland and Labrador's damage is also unknown.

"We want this fixed. We'll do whatever it takes, and we'll work out the price later," Haggiesaid.

COVID-19 test resultsunavailable

While the cyberattack has affected all four of the province's health authorities to varying degrees, Western Health was initially thought to be the least affected.However, upon further investigation, that situation changed as of Wednesday, Hepditch said, and "the safe thing to do" was to take that health authority offline as well.

The action has reduced much of that health authority to dealing with urgent procedures only, and it will remain that wayat least through to Friday, Haggie said.

Western Health now joins Central Health and Eastern Health in operating largely offline. It also means the cancellation of a swath of regular proceduresthat are reliant on the main IT system. These procedures range anywherefrom orthopedic intakes to pap smears.

COVID-19 test results are also unavailable. Haggie said positive cases will get a call from public health, but if 72 hours goes by without one, people can assume they tested negative.

Chemotherapy will go ahead at the hospitals in Stephenville and Port aux Basques on Wednesday, he said, while clients booked for Thursday and Friday will be contacted. Chemotherapy at the hospital in Corner Brook has been cancelled since Monday,as it relies on connecting to Eastern Health's system.

The cyberattack has laid clear thedigital inter-connectedness of the health authorities.Labrador-Grenfell Health has also been"seriously impacted," by the IT outages, said Hepditch.

"A number of their critical systems are connected to Eastern Health, so they were taken down through that connection," he said.

Eastern Health, the largest health authority, is now working on a largely paper-based system. CEO David Diamond said there's no official tally to the backlog of cancelled procedures, estimating it to be in the thousands.

One of the hurdles with working offline is contacting patients, he said. Urgent appointments going ahead will get a call, while everyone else should assumecancellation.

"We know there's lots of angst," said Diamond, who asked for patience.

Many people travel to the St. John's area from all corners of the province for specialist care, said Diamond, and if patients have arrived to find appointments cancelled, they should get in touch.

"Hopefully you have been in contact with us. If you have not, and you're in the city, we would like to hear from you and we would like to work with you to see if we can get you scheduled in at the earliest possible opportunity," he said.

'A lot of uncertainty'

Eastern Healthwill remain offline through to at least through to the end of Thursday.Diamond said restoring cancer treatments is one of the health authority'sbiggest priorities when it comes to patient care.

Amid the delays, Debbie Walsh, Eastern Health's vice-president of clinical services, said Wednesday morning that staff are working on a contingency plan for when the systems are back up and running.

Thanks to the experiences gleaned from the massive snowstorm of Jan.,2020,and COVID-19 lockdowns, she said staff will be able to reschedule the backlog of appointments "within days."

Butthere's no timeline yet to getting back up and running to deal with that backlog.

"There's a lot of uncertainty, and we need to proceed slowly and cautiously to ensure that what we bring back online is stable and secure and safe," said Hepditch.

What the restoration system entails is also not being made public out of caution, Haggie said.

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