Jillian Horton is a physician and the author of the national bestseller We Are All Perfectly Fine: A Memoir of Love, Medicine and Healing.
Ten days after all public health measures were dropped in my province, I found myself seeing red – lines, that is, and two of them, on a rapid test, to be specific.
First, my husband tested positive for COVID-19, and over the next three days, along with two of our kids, so did I. Since then, between fevers and chills, I’ve found myself asking a question that just two years ago I would have found unthinkable: Can we still trust our chief medical officers of health?
Here in Manitoba, amidst what sure seems like COVID-19’s sixth wave, the provincial government is trying out the brand-new strategy of simply putting the best logic of public health on mute. The province has decommissioned its COVID-19 dashboard. Wastewater surveillance data, useful for inferring the virus’s presence in a community, is sampled twice weekly and sent to the province, but they have refused to disclose it (even though the federal government publishes it once a month). The definition of a COVID-19 death has been narrowed. There are no more regular press conferences, and critical questions – for instance, how Manitobans can assess their COVID-19 risk when there are now fewer tools – have gone unanswered. If you have a sense that COVID-19 is spiking in your community, well, you’ll just have to crowdsource that data on your own.
Yet Brent Roussin, Manitoba’s Chief Public Health Officer, declared in a March 14 government news release that citizens were now “empowered” to make their own decisions about what is right for them and their families. Empowered! In the current context, that statement is genuinely tough to differentiate from propaganda.
The real cost of this so-called “empowerment” is not hard to uncover. This weekend, I got a message from a friend who happens to be a prominent COVID-19 researcher. He wanted to let me know that his mother, who was immunosuppressed but otherwise healthy and triple-vaccinated, had contracted COVID-19. It had been a week since the last public health measures were abandoned – when people in Manitoba, along with many other jurisdictions in the country, did away with basic protections like masking in public spaces. Like my family, his mother had managed for two years without a positive test. But he told me that she had just died.
This hardly sounds like she was empowered. It sounded, to both of us, like she was sacrificed.
My colleague and I are both in health care, and of course neither of us thinks that being a chief medical officer of health during a pandemic is an easy job. Our CMOHs have endured harassment, threats and relentless pressure. Like many other public health staff, they have delivered heroic performances, both in front of cameras and behind the scenes. Early in the pandemic, the majority of them earned accolades, and rightly so.
But over time, many of those same voices, including the once-celebrated CMOH of Ontario, Kieran Moore, have begun to sound more like mouthpieces for their political bosses eager for a return to “normal”, not the experts who led us to a per capita death rate less than half of that of the United States.
It’s hard to avoid comparing the seeming acquiescence of our CMOHs with the steady hand of the Ontario Science Table. The OST has made consistently accurate predictions, full of appropriate caveats and humility, and has been a source of well-communicated information since the early days of the pandemic. Their performance is a testament to what happens when highly skilled experts are allowed to provide counsel, free of political interference and considerations. Recently, the head of the OST plainly stated that wastewater data suggest Ontario is “in the middle” of a sixth wave, one that has arrived because “we just got a little bit too much ahead of ourselves.” One hopes that the April 4 transfer of the OST’s operations and oversight to Public Health Ontario, an arm’s-length government agency, will not affect the integrity of the group’s work.
The Ontario government has not always taken the OST’s advice; indeed, all restrictions are expected to lift in the province by the end of April. But the group’s work still stands as a fact-based counterpoint to ideologically driven, politically convenient narratives, and will surely do so at the innumerable inquiries and inquests to come.
The OST has also demonstrated the critical difference between the counsel provided by public health experts in an academic setting versus those who are structurally enmeshed with governments. There is an inherent impossibility in the CMOH role as it exists; as researchers with the Global Strategy Lab at York University and the University of Ottawa wrote in the Globe and Mail last year, “the same person cannot advise the minister in the morning and publicly criticize the government in the afternoon.” The dilemma for the public is unavoidable: the counsel of the CMOH is presented as unbiased medical advice, but it is almost inevitably tainted by politics.
That has always been the case over the course of this years-long pandemic. But as another wave catches us, this time with our masks down, it feels like a new line – or two – has now been crossed. My second red line will eventually fade. But so much else can never be undone.
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