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Friday, December 09, 2022

Canadian public health leaders navigate choppy waters as pandemic

Montreal –

The sudden departure of Quebec’s public health director last week was further evidence of the country’s chief medical officials navigating a rocky road as the Omicron wave moves the pandemic battle toward a third year.

Quebec’s Dr. Horacio Aruda, who had been public health director since 2012, cited criticism over the government’s handling of the latest wave as he abruptly resigned on Monday after 22 months overseeing the province’s pandemic response.

“The recent comments about the credibility of our opinion and our scientific rigor are undoubtedly causing a certain erosion of public support,” Aruda wrote in a letter offering his resignation.

This was far from March 2020, when Aruda was among a group of top provincial health officials on the job when the pandemic hit. Aruda and others, including Dr. Bonnie Henry of BC, Dr. Dina Hinshaw of Alberta and Dr. Robert Strang of Nova Scotia, rose to prominence almost overnight, offering reassuring voices 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 useful role, as he intended it – to be the public face of the government and explain that. What’s happening,” said Patrick Fafford, a professor of public and international affairs at the University of Ottawa who is studying the role of the country’s medical authorities.

“There has been a decline in their position in the context of the media or in public opinion – some of it is inevitable, but it is also due to tensions and contradictions in the role.”

Dr Deena Hinshaw 1 5639352 1635282293416Dr. Dina Hinshaw, Alberta’s chief medical officer of health, provides an update on COVID-19 and the school’s behind-the-scenes guidance in Edmonton, Friday, August 13, 2021. Canadian Press/Jason Franson

Dr. Dina Hinshaw, Alberta’s chief medical officer of health, provides an update on COVID-19 and the school’s behind-the-scenes guidance in Edmonton, Friday, August 13, 2021. Canadian Press/Jason Franson

Fafford said medical officers play an advisory role, but each province approaches the role differently. In an expanding pandemic, when scientific evidence is rapidly evolving, they have had to reconcile divergent views and governments that do not make decisions based on science alone. They are often left to interpret policies, even though the decisions ultimately lie with the politicians.

Most of those employed in 2020 remain in place, except for Aruda and Ontario’s Dr David Williams, who was subject to criticism before retiring last year.

In British Columbia, Henry is known for his signature, “Be Kind, Keep Calm, Be Safe,” which has been featured on posters, T-shirts, masks and even “Dr. Henry Shue” designed in his honor. ” has also been embellished. Acclaimed as an effective communicator for his encouraging tone during briefings, Henry has also faced criticism for strongly defending his stance against the widespread use of rapid tests.

Dr Bonnie Henry 1 5367597 1627495833909Dr. Bonnie Henry delivers his daily media briefing about COVID-19 for the Province of British Columbia in Victoria, BC, Monday, December 7, 2020. Canadian Press/Jonathan Hayward

Dr. Bonnie Henry delivers his daily media briefing about COVID-19 for the Province of British Columbia in Victoria, BC, Monday, December 7, 2020. Canadian Press/Jonathan Hayward

In Alberta, Hinshaw has gone from being known as the Lion to harsh criticism. In early 2020, her face was engraved on clothing and designer prints as she became the face of a prudent provincial government enforcing health restrictions to protect Albertans and their health system.

But in subsequent waves, as Premier Jason Kenney’s government delayed the implementation of new restrictions and threatened to break down the health system, Hinshaw became caught in the whipsaw between Albertans who wanted more restrictions and those who wanted less. The nadir came in a fourth wave last summer, when thousands of surgeries were canceled and the armed forces were called in for help.

Kenny and Hinshaw acknowledged that they helped set the stage by eliminating health restrictions too early in June, despite the rise of the Delta version. Kenny claimed responsibility for the mistake but also said that he would have taken action if Hinshaw had recommended it.

“Sometimes politicians aren’t helping, because they refer to the advice they get from their public health officials,” said Daniel Beland, a professor of political science at McGill University. “Finally, it is important to understand that the responsibility for these decisions rests with elected officials, not civil servants.”

The distinction is not always understood by the public, and amid strict measures in Quebec, Prince Edward Island, Saskatchewan and Nova Scotia, medical officials there have seen protests in front of their homes. Some have even received death threats.

“They are scientists, they are civil servants, they are experts, but they are surrounded by politics,” said Beland, director of the McGill Institute for the Study of Canada. “It’s a very difficult situation when you’re really under pressure, you get death threats, you get humiliated on a regular basis. It’s tough.”

In Quebec, some commentators felt that Aruda, who had played his role as an assistant deputy minister, was closely associated with the government of Premier François Legault. Opposition parties as well as the Quebec College of Physicians have called for more freedom to be given to the next director.

Fafford said after the pandemic, it would be wise to revisit the role in jurisdictions as part of a larger post-mortem. But it is important not to focus on who is making the decision.

“The bottom line is that we have to hold our governments accountable, not these people,” Fafford said. “Let’s focus on the politicians we choose to elect, not the unelected public servants.”

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

“I don’t know if the public is getting tired of hearing from me,” Strang told a briefing last week. “My commitment is to stay here and help Nova Scotia get through this pandemic as safely as possible.”

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

–With files from Keith Doucett in Halifax, Dean Bennett in Edmonton and Camille Bains in Vancouver.

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