Canada’s public health leaders navigate choppy waters as pandemic drags on

MONTREAL — The abrupt departure of Quebec’s director of public health last week is further evidence of the rocky road taken by the country’s chief medical officers as the Omicron wave pushes the fight against the pandemic into a third year.

Quebec’s Dr Horacio Arruda, who has served as director of public health since 2012, criticized the government’s handling of the latest wave as he abruptly resigned on Monday after 22 months overseeing the province’s pandemic response.

“Recent comments about the credibility of our opinions and our scientific rigor are undoubtedly causing some erosion of public support,” Arruda wrote in a letter offering his resignation.

That was a far cry from March 2020, when Arruda was among the top group of provincial health workers on duty when the pandemic hit. Arruda and the others, including Dr. Bonnie Henry from British Columbia, Dr. Deena Hinshaw from Alberta and Dr. Robert Strang from Nova Scotia, rose to prominence almost overnight, offering voices reassuring in times of crisis.

“In the beginning, when we didn’t know what we didn’t know, and there was a lot of uncertainty, the chief medical officer played an incredibly helpful role, as they are supposed to – being the public face of government and explain what’s going on,” said Patrick Fafard, a professor of public and international affairs at the University of Ottawa, who has studied the role of military doctors in the country.

“Their status in terms of media or public opinion has declined – some of that is inevitable, but it’s also because of the tensions and contradictions in the role.”

Fafard said while medical officers of health play an advisory role, each province views the role differently. In a protracted pandemic, when scientific evidence is rapidly changing, they have had to reconcile differing viewpoints and governments that don’t make decisions based on science alone. They are often left to explain the policies, even though the decisions ultimately rest with the politicians.

Most of those who were in office in 2020 remain in place, except for Arruda and Ontario’s Dr David Williams, who faced criticism before retiring last year.

In British Columbia, Henry became known for her signature saying “Be Kind, Be Calm, Be Safe,” which has been affixed to posters, t-shirts, face masks, and even a “Dr. Henry shoe” designed in his honor. Hailed as an effective communicator for her encouraging tone during briefings, Henry has also been criticized for consistently defending her position against the widespread use of rapid tests.

In Alberta, Hinshaw went from being adored to harshly criticized. In early 2020, her face was etched into designer clothing and prints as she became the face of a cautious provincial government implementing health restrictions to protect Albertans and their healthcare system.

But in subsequent waves, as Premier Jason Kenney’s government delayed implementing new restrictions and the health care system threatened to collapse, Hinshaw found himself caught in the whirlwind between Albertans who wanted more restrictions and those who wanted less. The nadir came last summer during the fourth wave, when thousands of surgeries were canceled and the armed forces were called in for help.

Kenney and Hinshaw admitted they helped set the stage by ending health restrictions too soon in June, despite the Delta variant’s surge. Kenney took responsibility for the error, but also said he would have acted if Hinshaw had recommended him.

“Sometimes politicians don’t help because they refer to the advice they get from their public health officials,” said Daniel Béland, a professor of political science at McGill University. “At the end of the day, it’s important to understand that the responsibility for these decisions lies with elected officials, not public servants.”

The distinction is not always understood by the public, and despite stricter measures in Quebec, Prince Edward Island, Saskatchewan and Nova Scotia, military doctors have seen protests outside their homes . Some have even received death threats.

“They are scientists, they are public servants, they are experts, but they are surrounded by politics,” said Béland, director of the McGill Institute for the Study of Canada. “It’s a very, very difficult situation when you’re really under pressure, you receive death threats, you regularly receive insults. It’s hard.”

In Quebec, some commentators had felt that Arruda, who retained his role as assistant deputy minister, was too closely aligned with the government of Premier François Legault. The opposition parties as well as the College of Physicians of Quebec have demanded that the next director be more independent.

Fafard said post-pandemic it would be wise to review the role across jurisdictions as part of a broader post-mortem. But it is important not to lose sight of who ultimately makes the decisions.

“The bottom line is that we need to hold our governments … accountable, not these people,” Fafard said. “Let’s focus on the politicians we elect to make the choices, not the unelected officials.”

For his part, Strang said he heard criticism from some and was thanked by others.

“Whether the public is tired of hearing about me or not, I don’t know,” Strang said during a briefing last week. “My commitment is to be here and help Nova Scotia get through this pandemic as safely as possible.”

This report from The Canadian Press was first published on January 15, 2022.

— With files from Keith Doucette in Halifax, Dean Bennett in Edmonton and Camille Bains in Vancouver.

Sidhartha Banerjee, The Canadian Press

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