'They've failed Ontarians': Doctors highlight mistakes and missteps of Ontario's COVID-19 response

'They've failed Ontarians': Doctors highlight mistakes and missteps of Ontario's COVID-19 response

For months, doctors in Ontario have been calling on the province to listen to public health officials, to heed the advice of epidemiologists and to lean on the advice of their science advisory table, but some physicians feel it is falling on deaf ears. The failure of Ontario’s government COVID-19 response, which has been documented as being skewed toward businesses, is causing frustration in the medical community and doctors are speaking out.

“I think they've failed Ontarians,” said Dr. Amit Arya, a palliative care physician in Mississauga, Ont.

More than ten months into the pandemic, Dr. Arya is quick to the point and unafraid of pulling punches, but he’s not the only one. Dr. Nili Kaplan-Myrth, a family doctor in Ottawa, has been using her social-media to call out the shortcomings of Ontario’s COVID-19 policies for months.

“The COVID-19 response has been one of waiting for things to get worse before acting. A lot of what’s happened has been preventable,” said Dr. Kaplan-Myrth.

“There's a lack of transparency, there's a lack of honesty about what is happening behind the scenes, what's happening on the ground and nothing is changing,” she said.

Dr. Kaplan-Myrth has been patiently waiting for Minister of Health Christine Elliott to include the death totals in her updates on social media, but it still hasn’t happened. Instead, when the minister posts, her colleagues Dr. Vivian Stamatopoulos or Dr. Jennifer Kwan have made it their business to remind Elliott that people are dying everyday.

Dr. Jennifer Kwan responds to Ontario Minister of Health Christine Elliott on Twitter to include the death total that the Minister leaves out of her daily update on social media.
Dr. Jennifer Kwan responds to Ontario Minister of Health Christine Elliott on Twitter to include the death total that the Minister leaves out of her daily update on social media.

Officials travelling despite Ontario restrictions

Then there is the case of the premier knowingly allowing his Minister of Finance, Rod Phillips to travel abroad while urging Ontarians to stay-at-home over the course of the winter break. Phillip’s trip seemingly did not come out of the blue as his team organized videos and posts to make it seem as though he was still in the province.

It doesn’t stop there, as a member of the province’s COVID-19 task-force resigned after it was discovered she had travelled outside the country, and a member of the Ontario’s Science Advisory Table resigned after traveling to the Dominican during the holidays. Not to mention the premier himself going to check on his cabin, while telling Ontarians not to travel within the province, and his daughters came to visit him violating the restrictions his own government had put in place.

“There's a lack of transparency, there's a lack of honesty about what is happening behind the scenes, what's happening on the ground and nothing is changing,” she said.

While the public relations aspect of the government have been shoddy at best, Dr. Kaplan-Myrth points to the accumulating death toll, in particular at places like Roberta Place, a long-term care facility in Barrie, Ont. where almost one-third of residents have died. The scathing report of Roberta Place, a for-profit care facility, indicates that their residents could’ve been inoculated with the COVID-19 vaccine weeks ago, but weren’t until the outbreak began.

“How can you even begin to evaluate a government that will let seniors, migrant workers, labour workers die,” said Dr. Kaplan-Myrth.

With the failures in Roberta Place and the tone-deaf public relations 10 months into the pandemic, Dr. Kaplan-Myrth admits she has become less trusting of the government and its ability to make the right decisions.

“Fundamentally, there's no trust. We haven't been given any reason to trust, they have not tried to build a relationship that allows for trust,” she said.

Dr. Nili Kaplan-Myrth is a family doctor in Ottawa, Ont.
Dr. Nili Kaplan-Myrth is a family doctor in Ottawa, Ont.

She’s not the only one feeling the lack of trust, as Dr. Arya noted that the government has consistently pointed the finger at other factors for the rise in cases and deaths while trying to clear its name or take responsibility. In the case of Pfizer, when the major COVID-19 vaccine producer announced it was experiencing delays in production, the premier lashed out at the company, but focused little on Ontario’s lagging rollout plan.

“Throughout the pandemic there's all this gas lighting, it’s blaming someone else, its pointing fingers, it’s just not leadership,” he said.

The lack of effective communication was cited in the Ontario Auditor General’s report after writing that Ontario was “less coordinated” and inconsistent when it came to messaging than other provinces. In her practice, Dr. Kaplan-Myrth has been trying to navigate hundreds of patients, feeling like she’s been fed public relations stunts and false realities of safety from a government that may be shying away from the mess it has created.

“People don’t talk about the field hospitals or ICUs being full, they see the premier smiling and making a cheesecake, that is the public image of COVID-19 — and it’s wrong,” she said.

Who is the Ontario government taking advice from?

On Monday, Jan. 11, associate chief medical officer of health, Barbara Yaffe said that “urgent action,” was required, but that a curfew was off the table. During the press conference Dr. Arya felt that the government would announce a larger-scale lockdown, seeing as the one implemented on Boxing Day was not enough in reducing the spread. But, despite modelling showing just how bad things could end up, Ontario’s COVID-19 stay-at-home order was messy with little discernible change to policy. The modelling data was so stark, it indicated that by early-to-mid February, the intensive care units would be overwhelmed and at capacity.

“The government recognized that COVID-19 is a critical issue, but they need to listen to experts at the table and the modelling data. They failed to take action based on recommendations and data,” said Dr. Arya.

There aren’t just concerns about the government not listening to it’s medical teams, but in the Auditor-General’s report, Bonnie Lysyk outlined that U.S. based consulting firm, McKinsey and Company were driving the province’s response to the pandemic which was allowing business to take precedence over science.

“This pandemic is an illustration about how medical expertise and scientific data should be free from political interference,” said Dr. Arya.

As she watched the daily case count in Ontario rapidly move from the hundreds to the thousands, Dr. Kaplan-Myrth was only reminded of how the premier who talks about doing everything in his power, was described as having shown poor leadership and not providing adequate resources and funding to public health in the Auditor General’s report.

“There is exhaustion from family doctors to infectious disease specialists, epidemiologists, public health officials and virologists and at this point the emperor has no clothes,” she said.

Long-term care facilities in Ontario facing worst of COVID-19 crisis

Seniors and people with disabilities living in long-term care facilities have been left out die, according to Dr. Arya. He thinks inaction by the government to secure proper living conditions and improve staffing in the homes has resulted in calamity in the long-term care sector.

“I really feel that seniors and other vulnerable citizens who live in long-term care (LTC) homes have been abandoned, and they've been left to die,” said Dr. Arya.

Whenever Ontarians see an outbreak in a home, they see a death toll, often eclipsing a couple dozen, but Dr. Arya is quick to remind people they’re not just numbers, and were often avoidable deaths.

“It's horrific because these are people's lives on the line. These are people's parents, brothers, sisters and grandparents, real human beings who are dying,” he said.

Dr. Amit Arya is a palliative care physician working on the frontline during the COVID-19 pandemic in Ontario.
Dr. Amit Arya is a palliative care physician working on the frontline during the COVID-19 pandemic in Ontario.

Canada received 168,000 vaccine doses in late December, but most were sent to hardest hit regions and frontline workers. The strategy was criticized as doctors voiced their opinions about the slow rollout. At Roberta Place, the outbreak happened rapidly, and residents were immunized a week later, but by that time over 120 residents were already infected and over 75 staff. At least 45 residents from Roberta Place have died from COVID-19.

“These are completely preventable situations, and this is a human rights violation,” said Dr. Arya.

These problems afflicting long-term care homes were outlined in detail by the military and by doctors last year, but there was slow action from the province. As part of their COVID-19 announcement on Sept. 30, the province announced they would be investing $540 million towards the long-term care sector. Part of the money, nearly $52.5 million was allocated to recruiting and keeping 3,700 more frontline health care workers and caregivers, but over 200 long-term care workers have yet to receive their $3 pay increase. The problem was none of these measures were introduced until the second wave was already underway and didn’t address the structural issues of for-profit homes.

“Homes are still for-profit, they’re crowded and these for-profit long-term care facilities are older, they’ve not been renovated and there are critical issues of staffing,” said Dr. Arya.

Change can take time, but during a pandemic, when there is a will there's a way, points our Dr. Arya. He noted that Quebec, which had a disastrous start to the pandemic in terms of deaths in long-term care facilities, made a move to train and hire 10,000 personal support workers, and while they fell short of that goal by about 3,000, they're still planning to hit their target. Across the country, B.C. which had initial outbreaks in care homes went a different route by nationalizing their long-term care sector, which allowed the provincial NDP government to hire long-term care workers, ensuring staff were limited to working in one home, received a pay bump and benefits such as sick leave.

“Even though British Columbia has half of our long-term care sector, they only had 1/10 of the deaths. They proactively put in the money to prevent crises from happening,” he said.

Did Ontario not prepare for the second wave?

Experts told Yahoo News in April that the second wave was about to hit harder, faster and the government should begin preparing to lessen the impact. Whether it was flip-flopping on how to reopen schools, allowing for businesses to run and operate as normal during summer, or not introduce mandatory masks until fall, the process wasn’t smooth.

“What we’ve seen is that the government really delayed taking some measures to control community spread such as lockdown that would protect everyone,” said Dr. Arya.

Even during the outbreaks at the start of the second wave, there was trepidation and fear growing amongst doctors, but Dr. Arya feels the province tried to keep businesses and workplaces open while also trying to prevent community spread.

“In September when we knew there was going to be a second wave, there were outbreaks in Ottawa, and our premier did not listen to the advice of scientists or health workers. There was a false dichotomy between businesses and saving lives,” he said.

Leading into the second wave, doctors across the province and the official opposition, the NDP called for paid sick days to be added before schools started, but the debate still rages on. The premier says there is “no reason” for the province to offer sick days, despite a swell of health experts thinking otherwise.

“We cannot get something as basic as sick days, so when people have symptoms they’re forced to work, and they shouldn’t be in that position,” said Dr. Kaplan-Myrth.

Ontario’s vaccine rollout plan was flawed from the start, doctors say

Dr. Arya and Dr. Kaplan-Myrth believe the strategy to inoculate residents was flawed from the beginning. Year after year if Ontarians wanted to get a flu shot, they could turn to myriad options to get vaccinated. Despite having that infrastructure readily available, the province chose to use hospitals as the main vaccination site.

“We already had the systems in place, through public health, through family doctors, nurses, nurse practitioners and pharmacists who regularly participate in mass vaccination campaigns and do it very successfully,” he said.

Hospitals were equipped with deep-freezers that could cool the Pfizer vaccine to it’s required -72 C, but as Dr. Arya points out, the vaccine could have been sent to LTCs instead to be refrigerated.

“We had really a very sluggish anemic roll out, jurisdictions that kept the vaccine in the hospitals, because of the special freezers, but there is data showing that it can be refrigerated for up to five days,” he said.

To this day, Dr. Kaplan-Myrth struggles to understand why family doctors, who are seeing patients daily have not received funding for personal protective equipment or been allowed to be a part of the public health strategy.

“Family doctors in the community are the ones who keep our patients out of hospital, and we're the ones who communicate with our patients. We have been systematically excluded from all COVID-19 strategies in this province and from all support in this province,” she said.

In fact, multiple doctors voiced their concerns about the province scaling down vaccination efforts over the winter break, which they didn’t understand at the time, or now. In Toronto there has been a vaccine centre setup, and while it’s not operating right now due to shortage of supply, the centre was never set up to be accessible at any time of the day.

“We should have had a vaccine operation that was 24/7, we still don’t have that, even when people’s lives are on the line,” said Dr. Arya.

While the province is sticking to its message that it can still inoculate 8.5 million Ontarians by June, those in the trenches looking at the data and slow rollouts don’t think that’s a reality.

“Everybody keeps seeing these official statements that we’re going to reach our targets, but in the health community we know it's La La land — there is no plan,” said Dr. Kaplan-Myrth.

When she assesses how the vaccine rollout is unfolding paired with the spread in the community and a government too slow to make tough decisions, Dr. Kaplan-Myrth thinks we could be living with the virus in a lockdown state for a while.

“I would say next Christmas, we're gonna be faced with the same thing,” she said.

Despite the lack of trust, Dr. Kaplan-Myrth and thousands of health workers continue to put their uniform on and show up to work.

“We haven't given up because we are accountable to the people that we promise to take care of,” she said.