On Monday, Dr. David Williams, Ontario’s chief medical officer, said the “high transmission” of COVID-19 in the four Ontario regions now under modified Stage 2 restrictions had prompted him to recommend against traditional Halloween night trick-or-treating. Ontario Premier Doug Ford strongly endorsed Dr. Williams’ position.
In Dr. Williams’ view, the current Covid situation has made it too dangerous for door-to-door trick or treating in Toronto, Peel, York and Ottawa.
The ban on trick and treating will break the hearts of Ontario’s young children and will be yet another Covid cancelled memory that families won’t be able to share with each other in future years.
And, according to most independent Ontario public health officials and infectious disease experts, the ban is completely unnecessary and serves no health or safety purpose whatsoever.
In the words of respected Globe and Mail health columnist Andre Picard:
Public health is about harm-reduction, about finding ways for people to live while minimizing their risks as much as possible. It’s not about depriving them of all pleasure.
Banning Halloween also plays into the hands of those who oppose any sort of restrictions. When you impose unrealistic and unjustified rules, you erode trust. If you can cram 30 kids into a classroom, how can you argue that they can’t walk around outside in small groups?
Ontarians have endured months of constant mixed messaging and ham-fisted, irrational regulations. There might not be much trust left to spare.
PC MPP’s push back against closures
The truth of the matter is that there is a growing sense amongst independent health experts, the general public and even Ontario PC Party insiders, that the Ford government’s ongoing handling of the Covid pandemic is a complete mess.
In a letter sent to Dr. Williams, on Saturday, two PC MPPs from Halton region, west of Toronto, say the government risks losing the confidence of the public by imposing further restrictions without clear guidelines.
“During the height of COVID-19, the majority of Ontarians accepted unprecedented restrictions in order to stop the spread and flatten the curve,” the letter said. “Now, nearly seven months later the public is demanding more than just the blanket statement of ‘on the advice of medical experts.’”
The letter, which is also copied to Premier Doug Ford and Health Minister Christine Elliott, is signed by Burlington PC MPP Jane McKenna, Milton PC MPP Parm Gill, Burlington and Milton’s mayors and the chair of Halton region.
The mayors of Oshawa and Pickering (communities east of Toronto) also said publicly over the weekend that moving their cities into a modified Stage 2 will negatively impact small businesses that are already trying to get by amid a second wave of Covid.
The Durham mayors also asked the Ford government for evidence that closing inside dining in restaurants and closing movie theatres will reduce the spread of the virus.
Ontario testing regime descends into chaos
Because of the optics of long line-ups at testing sites in September, testing was allowed to crash into a reset (the Ford government has completely reversed its months-long testing policy and Covid tests in Ontario are now restricted to only those showing symptoms and who have reserved an appointment in advance). This is causing chaos across the testing system and is especially damaging to hard hit lower-income, heavily racialized communities where residents (many of whom have English as a second language) have difficulty navigating the complex online reservation system. They are also having trouble getting to distant testing sites (where they finally found an open spot) that are often hours away by transit.
Not surprisingly, the number of daily tests in Ontario is actually dropping.
According to the province’s data, Ontario’s labs have the capacity to analyze more than 45,000 COVID-19 tests daily, just shy of the stated goal of around 50,000 daily by mid-October.
But since the recent move to the appointments only approach at the province’s assessment centres, the labs’ actual testing output has fallen significantly for the first time since late May. As of Tuesday, the seven-day average for lab output is about 36,000 tests daily, down from a peak of more than 43,000 as of Oct. 9; the 24,049 tests reported processed Monday were the fewest since early September.
Moreover, delays in the turnaround time between testing and getting results are unacceptably long, which not only undermines the testing and contact tracing system as a whole, but is also a mortal danger in long-term care homes where the residents are especially vulnerable to the rapid spread of the virus. In other words, delays in getting testing results of care residents can easily lead to many deaths in residences in a matter of days.
Many, many mistakes have been made in Ontario in the fight against Covid but the most unforgiveable mistake (after failing to prevent the Covid deaths of nearly 2000 elderly residents in Ontario’s care homes) was the failure to build an effective testing-and-tracing system over the summer when for several months, new Covid cases averaged in the 150 range compared to roughly 800 per day in the third week of October. The hard truth is that if Ontario’s testing-and-tracing systems had been bolstered substantially months ago, the new restrictions and closures imposed on Ontario’s “hot zones” would not have been necessary this Fall.
This point can’t be emphasized enough. For many months, public health officials and infectious disease experts have been urging Ontario health authorities to put in place an effective testing and contact tracing system to deal with a second Fall wave – largely to no avail. Toronto Public Health was quite open with the fact that they only called for the closure of inside dining and related restrictions in Toronto after it became evident that their testing, isolation and contact tracing system had lost control of the virus spread.
But, as indicated above, infection rates were manageable in the late summer and that begs the question as to why, seven months into the pandemic, effective testing, isolation and contact tracing systems were not in place in Ontario by the end of August when cases began to rise.
The real significance of Ford cancelling Halloween
Cancelling Halloween in the “hot zones”, a move considered unnecessary by almost all independent health experts, is indicative of the lack of a coherent Covid plan on the part of the Ford government and Ontario’s senior health authorities.
Put bluntly, it is increasingly looking like these latest restrictions are more about optics and politics than keeping Ontarians safe. For example, the imposition of “Stage 2” restrictions on the “hot spots” closed down inside dining, movie theatres, gyms and other inside venues in the effected communities. However, there is no evidence that even a single positive Covid case originated in an Ontario movie theatre. This suggests that the reasoning behind closing down movie houses in the “hot zones” was the same as cancelling Halloween. Essentially, the Ford government’s strategy is that if it sounds like people are having fun together, they are going to clamp down on it because hectoring Ontarians on their supposedly irresponsible behaviour is a simple message that plays well with many voters.
If you think about it, “blaming the victim” is a complete winner for the Ford government in that it focusses attention on individual Ontarians’ personal behaviour and deflects attention away from the Ford government’s catastrophic failure to protect long-term care residents, the mess they have made of Ontario’s testing and contact tracing systems, and their disastrous “non-plan” for re-opening K-12 schools.
Focusing on restrictions, closures and wayward behaviour also plays to Premier Ford’s communication strengths – he is very good at scolding Ontarians over their personal behaviour but not much good at communicating anything else related to the fight against Covid (e.g. the testing regime, school re-opening, etc.). It also plays to the inclinations of Chief Medical Officer of Health, Dr. David Williams, who seems to see everything related to the spread of Covid in terms of personal behaviour.
There is another pattern emerging – the people driving Ontario’s fight against Covid seem oblivious to the collateral damage caused by broad-based restrictions and closures. The new “hot spot” restrictions are going to wreck a lot of businesses and jobs. They are a brutal and painful approach to controlling the pandemic and will deal an especially cruel blow to parts of the service sector (like restaurants) that are barely hanging on.
But the people driving Ontario’s Covid strategy just don’t seem to care.
An ongoing effort to hide the facts
Another disturbing aspect of the Ontario Covid response is an ongoing effort to suppress the facts and to prevent accountability.
For example, until last spring, the well being of long-term care residents was supposed to be captured by care-plan assessments documented by residence staff and sent to the Canadian Institute for Health Information (CIHI), an independent not-for-profit funded by federal and provincial governments along with universities and research institutes.
Using these assessments, CIHI publishes quarterly “health indicator” data that show, among other things, a rise or fall in the incidence of worsened mood or depression, the ability to manage daily activities like dressing, bladder control, weight loss and pain.
Then, early last spring, as the virus hit residents and staff, the province passed an emergency measures act that let homes opt out of those assessments, “unless they involve changes of a significant nature.”
The Ontario government has repeatedly refused to explain why the requirement for assessments was dropped.
Then there is Bill 218, Supporting Ontario’s Recovery and Municipal Elections Act. A provision in the Act is designed to protect the owners of long-term care facilities (remember, over 75% of Ontario deaths from Covid occurred in such facilities) from lawsuits. It does this by setting extremely high bars for allowing class action suits against the owners of long-term care homes to proceed. One criteria is that you have to prove that the target of a lawsuit (the owner of the long-term care facility) did not act, or make a good-faith effort to act, in accordance with public health guidance. And beyond that, you can’t just prove negligence; you have to prove gross negligence.
Who is really calling the shots in Ontario’s fight against the Pandemic?
Banning trick-or-treating in the “hot zones”, the chaos that has accompanied recent optic-driven changes to Ontario’s testing regime, and the mess in re-opening schools, also raises the question as to who is really driving the Ontario response to Covid and who is responsible for its many failures.
More than anything, it is clear that the premier has been listening to the wrong people too often. Ford often cites Dr. David Williams, Ontario’s hapless chief medical officer of health, who seems oddly incapable of understanding why the public doesn’t follow his often-incomprehensible advice.
Williams denied community transmission when it was happening in March; he didn’t acknowledge asymptomatic transmission until mid-April, long after it was clear that up to 20 per cent of people with COVID-19 transmit the virus without experiencing symptoms. He allowed asymptomatic migrant workers to keep working after a positive test in June, and strongly backed the school reopening “non-plans” in September.
With each week of the pandemic, Williams looks more and more like a bureaucrat whose highest priority is to curry favour with his political superiors (i.e. Premier Ford and senior staffers in the Premier’s Office) and who is relatively uninterested in the advice flowing from the independent medical community. This is consistent with the fact that in 2019, when the Ford Government began cutting public health, it wouldn’t have been advantageous for the government to have a strong health leader who might fight the public health cutbacks. In other words, he has is job because he is weak and is loyal to the Premier.
Premier Ford has also repeatedly said his government relies on the advice of the COVID-19 Command Table, but won’t reveal who is on it except to say it’s led by Williams, Deputy Minister of Health Helen Angus and Ontario Health CEO Matt Anderson. The Ministry of Health (MOH) says the table also includes representation from a number of provincial ministries and “external experts”. However, it won’t name the “external experts” who each serve voluntarily.
How does the Command Table actually work? According to sources familiar with the table, deputy health minister Helen Angus or Matt Anderson of Ontario Health present ideas or plans, and they are debated. But when the health table disagrees, it doesn’t get resolved. Sources say it has never held a vote and that senior MOH bureaucrats who report to Deputy Minister Angus are the single most important drivers of Ontario Covid initiatives.
The province also looks to the Public Health Measures Table which includes Dr. Andrea Feller, an associate medical officer of health in Niagara. In addition, it consults the Incident Management System Long-Term Care Table which includes Dr. Tom Stewart, CEO of St. Joseph’s and Niagara Health, as well as his predecessor Kevin Smith who now heads Toronto’s University Health Network.
Dr. Dirk Huyer, Ontario’s Chief Coroner is also considered a key inside player by those in the know.
It may be a frightening thought, but it is possible that no one is really in charge of Ontario’s anti-Covid fight.
Even more frightening, it is also possible that not having anyone in charge was built into the Ontario Covid strategy from the beginning in order to avoid accountability.
More on the forces undermining the Ontario government’s anti-Covid efforts in Canada Fact Check’s next post.