More than two months later, the new coronavirus remains an urgent crisis, having sickened nearly 31,000 people in the province and causing nearly 2,500 deaths.
But while Ford continues to invoke “expert advice” to explain its government’s U-turns on things like test protocols and the provincial reopening strategy, there has been little disclosure of who provides it. , and just what they say.
This makes it difficult for health professionals and lay people to understand why Ontario is making the choices it is making and where science could lead us, critics say.
” I do not think so [Ford] has an abbreviated dialing expert, “said Colin Furness, infection control epidemiologist and assistant professor at the University of Toronto’s Faculty of Information. Decision-making tells me it’s not a question of expertise. ”
Mystery of the control table
The Prime Minister often says that he trusts the advice he receives from Dr. David Williams, the province’s Chief Medical Officer of Health, and from COVID-19 Command Table, the government’s main advisory body on the disease, who reports directly to Christine Elliott, the Minister of Health.
Dr. Williams has a joint master’s degree in epidemiology and community health among his four degrees from the University of Toronto. However, it looks like he may be the only person sitting around the table with specialized training in infectious diseases and epidemics.
The co-chairs of the command group, Matt Anderson, President and CEO of Health Ontario, and Helen Angus, Deputy Minister of Health, both have extensive experience in health care administration, but no scientific credentials. . Anderson studied English at the University of New Brunswick, then obtained a master’s degree in health administration, before starting his career in information technology. Angus holds a Master of Science in Planning from the University of T.
The CBC asked the Minister of Health and Minister Elliott’s office for the names of the other members of the command table. They have not been provided, but the government says representatives from several “affected” departments such as long-term care, seniors and accessibility, and the Solicitor General are also participating in the discussions.
A flowchart for Ontario’s COVID-19 response, released in early March, suggests that these are primarily deputy ministers. If so, the Command Table also has bureaucrats with a history in public relations and a former Toronto high-ranking police officer among its members.
A ministry spokesperson told the CBC that the control table also used “outside experts who each serve voluntarily”, but declined to identify them.
Aside from some colleagues who participated in the early modeling of the disease, Furness said he did not know anyone who had been asked to advise the government. He finds this situation curious, given that so much expertise is concentrated in hospitals and educational institutions in downtown Toronto, a stone’s throw from Queen’s Park. “You don’t even need a bus ticket,” he notes.
As the crisis continues, he has been mystified by the Ontario government’s reluctance to adopt random sentinel tests to try to get ahead of the disease, and its inability to collect important data from road signs, such as race and the income of those who have already fallen. bad.
And he said that certain aspects of the first phase of reopening – such as allowing housekeepers and staff to return to work – made no sense.
“I mean who’s sitting around the table saying we have to let the butlers get back to work?” Furness asks.
Curious decisions with few explanations
Dr. Dominik Mertz, Medical Director of Infection Control for Hamilton Health Sciences and Associate Professor at McMaster University, says he knows some people who have consulted COVID locally, but doesn’t know what’s going on at ‘provincial level. .
“I would love to know who advises them and what that advice was. And what are the underlying assumptions, ”says Mertz. “I feel like sometimes the left hand doesn’t know what the right hand is doing. ”
He cites choices like allowing adults to play golf and tennis, but keeping playgrounds closed to children. And in particular, he questions the often cited provincial benchmark of less than 200 new cases per day for further relaxation of the lockout rules. This measure suddenly appears to have been dropped as Ontario moves toward a regional approach to reopening.
WATCH | Premier Ford announces a regional approach for the second phase of the reopening of Ontario:
The Hamilton area has been experiencing a “mild burn” for weeks, says Mertz, with an average of less than 10 new cases per day. However, it is clustered in areas like Toronto and Peel, which have much higher case rates, and has refused permission to proceed to step 2 of the province’s reopening plan.
“I don’t know what the rationale is,” says Mertz. “I doubt things will get better locally in a few weeks, if not a few months. ”
Mertz said a more scientific approach to reopening could look at things like local health care and intensive care capacity, or infection rates per capita, rather than just the raw numbers of cases.
The province employs its own epidemiologists and infectious disease experts, particularly within Public Health Ontario (OPH), which is responsible for providing scientific and technical advice to the entire health sector.
The government’s COVID response flowchart suggests that PHO is playing a leading role in developing a strategy on things like screening, monitoring, care and treatment. But these plans have never been released to the public.
Infectious Disease Specialist Dr. Andrew Morris at Toronto’s Sinai Health and University Health Network says the superstructure Ontario created to fight the coronavirus in early March amid fears of a supply shortage and overwhelmed hospitals, no longer seems appropriate. It is far too opaque and bureaucratic, he says, to deal with the stubborn reality of a disease that will only be brought under control through comprehensive screening and testing and continued social distancing.
“This is not the right structure because it certainly does not take into account the blind spots that we have already identified,” says Morris. “We know there have been challenges regarding behavior change and communication with the public. ”
“We are asking a lot of the public,” he adds. “They deserve to have as much access to information as possible. “
In response to questions from the RSC on where the Prime Minister and the COVID command table obtain their expert technical advice, the Department of Health provided one, outside of the name – Steini Brown, Dean of Dalla Lana School of Public Health at the University of Toronto. He chairs a pair of scientific tables on modeling and synthesizing evidence.
Brown declined a request for an interview, but responded to a series of questions sent to him by email, describing his role as largely administrative, removing the barriers for unnamed scientists doing “the hard work.”
Brown says the tables he oversees have provided “numerical estimates and syntheses of evidence”, which have affected Ontario government policy, but they do not make specific recommendations. The referral for reopening 200 new cases a day, for example, did not come from its experts, he said.
Asked how the Ford government could improve its response to the COVID-19 crisis, Brown suggested more openness.
“There is so much misinformation on COVID-19 that the more transparency we have on scientific advice and the progress of the pandemic, the more solid foundations we will have to engage the public in the fight,” he wrote.