If public health is not there to protect the vulnerable, then why bother?

When did neglect and ignorance become the prevailing sentiment of government?

Recently, Barrie, Ont., considered a bylaw that would have made it an offence to provide water and food to homeless people on city property. Though overwhelming opposition was successful in quashing the proposal, how did it even get to that point?

I was immediately brought back to my review of the Ontario COVID-19 public health policy in 2022.

Last October, I was so shocked by the withdrawal of COVID-19 public health measures amid a sea of infection that I made my first Freedom of Information (FOI) request. I asked for all the scientific evidence the Chief Medical Officer of Health (CMOH) relied upon to shorten the mandatory five-day isolation requirement then recommended by the Public Health Agency of Canada and the U.S. Centres for Disease and Control and Prevention. I also requested all the scientific evidence that CMOH Kieran Moore relied upon that demonstrated one-way masking (primarily by highly vulnerable persons) was a safe approach, despite the fact that it exposed highly vulnerable persons to infectious persons wearing a mask of any quality (assuming strong mask compliance).

If the withdrawal of public health measures increased the risks to persons vulnerable to severe COVID-19 illness, then the CMOH at least had a duty to inform those at increased risk and explain how they could best protect themselves.

After being granted two 60-day extensions to respond to my request, I received 29 PDF documents and one Excel explanatory document on March 27, 2023. I have since prepared a detailed analysis of these documents in a public brief shared with opposition MPPs and the Chief Ontario Human Rights Commissioner.

The findings should worry all Ontarians.

The Ford government has offered little in the way of proof it considered the detailed, evidence-based analyses prepared and presented by senior experts at Public Health Ontario (PHO), Ontario COVID-19 Advisory Science Table Members and even a Senior Ministry of Health Branch Director. During a time of increasing contagiousness and immune evasion of the circulating Omicron variants, and when less than 37 per cent of children had completed a primary series of vaccinations, the Ontario government ignored calls to strengthen public health measures.

Instead, it gradually withdrew them in overt opposition to expert guidance. While the CMOH strongly encouraged masking by the public, Moore introduced no measures of compliance monitoring and was himself soon observed at a highly public and televised function without a mask.

In a March 4, 2022, communication to the CMOH and Associate CMOHs, Jessica Hopkins, Chief Health Protection and Preparedness Officer, Public Health Ontario (PHO), shared a technical briefing on the removal of mask mandates: “Public health ethics as well as potential stigmatization are relevant considerations for recommendations about mask use for only certain groups. Considerations may include best protection of people most susceptible to severe COVID-19 disease through both source control and personal protection (i.e., older adults, immunocompromised individuals, under-vaccinated populations and those ineligible for vaccination), considering ethical dimensions such as equity, reciprocity, individual liberty, proportionality and solidarity.

The risks could not have been stated more clearly, yet the Ford government ignored that evidence briefing and removed nearly all mask mandates.

“Mask mandates are associated with reductions in population-level SARS-CoV-2 transmission. The benefits of masking likely remain in the Ontario risk context which includes possible early resurgence, introduction of Omicron sub-variant BA.2, low uptake of booster doses among eligible populations, low vaccine effectiveness of three vaccines doses against Omicron infection, low levels of immunity among children under 12, negligible immunity among children under five, and large numbers of immunocompromised individuals. Mask mandates are less restrictive than other measures used during the pandemic.”’

The risks could not have been stated more clearly, yet just a few weeks later, the Ford government ignored seemingly every aspect of that evidence briefing and removed nearly all mask mandates.

The government withdrew measures without regard to the potential risks and harms to vulnerable populations, including those hit especially hard by the pandemic: seniors, persons with disabilities, pregnant persons, visible minorities and those living in high-density housing. It was a violation of the precautionary principle so lauded by Justice Archie Campbell of the SARS Commission.

Most notably, Anne Hayes, the Ministry of Health Director of Research, Analysis and Evaluation, Strategic Management and Policy Evaluation Branch, shared an evidence brief with the CMOH and the Science Table Members on Jan. 17, 2022. Her division had recommended respirators (N95/KN95 masks) for use in community settings “whenever possible” as providing the best protection against contracting COVID-19. The CMOH and the vice-president of PHO expressed concerns about the messaging (i.e., it was a more stringent recommendation than prior messaging by the government). “Staying on message” appeared to supersede new evidence. Her recommendations didn’t reach Ontario’s most COVID-19 vulnerable, even after they were supported again and again by PHO leadership through 2022.

Respirators were never endorsed for use by this government. Why? The airborne nature of transmission was well described in briefs prepared by PHO. Yet, as the summer came to a close, there was more focus on droplet transmission, i.e., “source control.” It beggared belief. Had politics usurped the role of the CMOH?

In July 2022, Emily Karas, Deputy Chief, Health Protection, PHO, described that re-implementing public health measures such as wearing high-quality N95/KN95 masks or the equivalent, improving ventilation and updating vaccination boosters were likely to make a significant impact by dampening community transmission, especially in schools and on public transit. She was explicit in her language: “The evidence that SARS-CoV-2 can cause immune dysregulation is increasing. Reducing the risk of SARS-CoV-2 infection and reinfection could reduce the overall burden of death and disease in Ontario during the pandemic and longer-term.”

Her worries about immune dysregulation were soon realized in Ontario when pediatric critical care centres were overwhelmed with children with severe RSV, influenza and COVID-19 infections. It posed the greatest pediatric critical care crisis since the polio pandemic. Immune dysregulation is accepted by many experts as a cause of this phenomenon. Had public health measures remained in place, this impact could have been greatly diminished.

FOI documents confirmed the Ministry of Health Schools Working Group had recommended high-quality masks for students who could not afford them in the fall 2022 semester. Discussions about a personal protective equipment (PPE) tender occurred at the highest level of the Office of the CMOH (OCMOH). Nothing materialized.

The CMOH and Ryan Dyck, Ministry of Health Manager, Healthy Populations, did not respond to my letters about the status of this proposed PPE tender. Instead, I received an unsigned letter from the OCMOH that failed to address the questions raised in my individual letters. Why did the OCMOH interfere with my personal correspondence?

The changes in isolation requirements issued on Aug. 31, 2022, were not based on experience or science. Gross assumptions were made from the pre-Omicron era and careless liberties were taken, such as not requiring respirators for the infectious and in the community. It was a reckless approach.

It’s unclear whether equity measures were ever seriously considered for the tens of thousands of highly vulnerable Ontarians. Many could not afford high-quality masks, and others were at increased risk of infection because of socioeconomic factors (low income, living in high-density housing, visible minorities, etc.). This inaction was apparently contrary to public health ethics, equity, the precautionary principle and the Ontario Human Rights Code policy on COVID-19 recovery planning. Use of public transit, for example, requires close contact amid a poorly ventilated location. Without the ability to purchase an N95 mask, vulnerable persons were and are at higher risks of infection/re-infection.

The Ford government failed to demonstrate a duty of care. It was obliged to at least notify those groups at greatest risk of infection, identify the environments they should avoid and provide free N95/KN95 masks if they could not afford them. That’s what responsible government does. This is the reason I have called for a public inquiry by the OHRC, per Ontario Human Rights Code R.S.O. 1990 c.H.19, Section 31, into the withdrawal of public health measures in 2022, to review the impact on code-protected Ontarians who were highly vulnerable to COVID-19.

It’s time to minimize the risks of COVID-19, and Long COVID, and prepare for the next pandemic. We have the tools. We need willing leadership.

The comments section is closed.

  • Alex says:

    The reality is, ethics & integrity clauses should apply for all regulated professions, even when not practicing the profession, and explicitly in public service. This is what lawyers have, and would create some measure of independence in the CMOH until it’s there in actuality.
    It is absurd that the CMOH was not practicing medicine in his position when his license was required for the position and he has blatantly harmed people through his in/actions.

  • Rob Murray says:

    Medicine is self-regulating but that only works when everyone is behaving altruistically. Self-regulation is a privilege, not a right. Dr. Theresa Tam was asked by the press early on in the pandemic if mask wearing would be a good idea. She downplayed the idea and her response was that public health is a ‘team event’. We in the Lyme community can confirm that PHAC prioritizes consistent messaging while patient website prioritize science. See: Patient Lyme disease websites prioritize science; public health websites prioritize consistent messaging—Comment on ‘Lyme disease prevention: A content analysis of Canadian patient group and government websites’, Lloyd V, Cox M, Bailey J, Roy C, Zoonoses and Pub Health 2021-03-21: https://doi.org/10.1111/zph.12794

    Medicine is also supposed to be based on science but that is forgotten when the science becomes inconvenient as in the hidden ignored epidemic of Lyme and tick-borne diseases [TBDs]. Ticks are responsible for 90%-95% of vector-borne illnesses in Canada [82% are Lyme] but mosquito-borne illnesses get all the press.

    PHAC should be directed by a public health doctor. The Lyme disease community was making progress with the 2016 Conference to Develop a Federal Framework on Lyme Disease when it was headed by CPHO, Dr. Greg Taylor. The Act that caused the Conference called for a made-in-Canada set of Lyme disease guidelines.

    The Summary Report should have been the basis of the Framework but Dr. Taylor was moved aside or retired to be replaced by 2 infectious disease doctors with close ties to industry and who take their direction and owe their loyalty to the 13,000 member private Infectious Disease Society of America [IDSA]. Industry has found that it can control medicine if it can control the guidelines. The Act that caused the Conference called for a made-in-Canada set of Lyme disease guidelines. Guidelines are meant to help patients and assist physicians. The IDSA Lyme guidelines have but one purpose, to punish physicians that don’t follow them.

    The resulting Framework was a status quo document designed to convince politicians that they were in good hands. The Framework is not in compliance with the act, no new made-in Canada Lyme guidelines were produced and they handed the problem and the money back to those that are the cause. The $4 million arising from the Conference was given to a single group, the Canadian Lyme Disease Research Network [CLyDRN] by CIHR without competition. CLyDRN was led by Dr. Kieran Moore while other key members belong to the private Association of Medical Microbiologists and Infectious Diseases [AMMI] Canada who owe their allegiance and take their direction from the IDSA. In addition CLyDRN includes PHAC employees, public health officials and status quo researchers. CLyDRN’s goal is to maintain the status quo although they did do some tick surveillance. There was no meaningful engagement with patient groups.

    The goal of research is generally to discover new things. CLyDRN under the direction of Dr. Kieran Moore clings to the flawed IDSA ideology. The PHAC evaluation report released on 30 May 2022 recommends that federal public health authorities attempt to manage stakeholder expectations “setting clearly defined roles and expectations for stakeholder groups”. This report also reiterates the false dichotomy between “science groups” [i.e. only IDSA ideologues] and “patient stakeholders. This dichotomy implies [falsely] that patient stakeholders are not operating based on credible scientific evidence. This is belittling and reflects PHAC’s one-sided support for the IDSA “acute Lyme only” perspective, instead of a more balanced science-based approach.

    The cause of all this is the long-term disability insurance industry that doesn’t want to underwrite the costs of treating complex disseminated [chronic] Lyme disease. This situation is a travesty with patients in danger of losing their jobs, homes and lives from a treatable disease. You can multiply whatever figures by ten and still be underestimating the true incidence. Similar to COVID and other infections 14%-30% of patients will remain ill with very debilitating symptoms. The scientific evidence for chronic Lyme from autopsies and animal studies is overwhelming but ignored by CDC types in favour of dogma.

    Dogma promoted by the CDC/ IDSA/ AMMI [Canada] and believed by 90%-95% of medical practitioners: “Lyme disease is difficult to acquire, easy to diagnose, readily cured with a short course of antibiotics. If a patient has symptoms following treatment either initial diagnosis was wrong or they have Post Treatment Lyme Disease Syndrome [PTLDS] since there is no such thing as chronic Lyme disease.” Dr. Ken Liegner

    The reason we can’t get anywhere is the same reason why Canada doesn’t have a pharmacare program. The lobbyists don’t want it. In this case the chief lobbyist is an infectious disease doctor with likely close ties to AMMI, IDSA, the CDC and WHO. The kingpin in this operation is the Deputy Chief Public Health Officer, Dr. Howard Njoo who said health is a provincial matter and provinces can do as they choose while he maintains control over research dollars and the direction of that research. As well he will remain gate keeper with the testing at the National Microbiological Laboratory which misses at least a third of those that truly do have the disease.

    It might be time to consider some civilian oversight of medicine in Canada. Unfortunately our elected representatives have been trained to look in the other direction and continue to ignore the problem. They have been told that all the questions have been answered and problems solved. In truth we are 35 years behind in basic research. “In medicine nothing is absolute, the science is never settled and patient care needs to be as individualized as the individual.” -L. Marcum


    Dr. Rob Murray [DDS retired]
    Lunenburg, NS


Christopher Leighton


Dr. Christopher Leighton is a retired Radiation Oncologist and Adjunct Professor in the Department of Oncology, Schulich School of Medicine and Dentistry, Western University. He has advocated for the rights of disabled persons throughout the pandemic including the prioritization of initial vaccinations, improved ventilation in schools, priority access to booster vaccinations, and evidence-based public health measures.

Republish this article

Republish this article on your website under the creative commons licence.

Learn more