■ Top doc grilled over LTC response,
Knowledge of how virus spread developed over time, Williams says
Ontario’s chief medical officer faced pointed questions about his handling of COVID-19 from a commission investigating the pandemic, including why he didn’t “stand up” and go public about concerns over Premier Doug Ford’s relaxed triggers for lockdowns last fall.
In a 266-page transcript released Thursday by an inquiry into COVID-19’s devastating impact on nursing homes, Dr. David Williams was asked about slow testing, perceived delays in protecting long-termcare residents and taking proactive steps in the absence of conclusive evidence.
Commission counsel John Callaghan raised the example of the rapid and sometimes deadly transmission of the virus between passengers on cruise ships last February and suggested it was a harbinger of things to come in congregate settings like nursing homes.
“You are aware that a big issue here is when you take precautionary principles because there is the possibility that there could be asymptomatic spread? You realize that is a big issue in this situation?” commission counsel said to Williams.
“If you have people coming in close contact with each other, it spreads, that’s correct,” Williams confirmed, adding he is well aware of the “precautionary principle” established after the SARS crisis two decades ago to err on the side of caution in the absence of conclusive evidence.
“Right. And the reason why we ask is because we are trying to figure out when people were thinking about long-term-care homes,” Callaghan replied.
The doctor maintained there was no evidence early in the pandemic that people could spread the virus while symptom-free — something that did not come until “later, in the summer” — and said he did not have the power to stop staff from working in more than one nursing home to reduce spread of the virus, only to encourage it with a directive in March.
“There was no evidence to me that employees working at one long-term-care home had carried it to an adjacent one and caused an outbreak,” Williams told the commission.
“You keep on waiting for evidence,” Callaghan said in retort.
Williams acknowledged test results were slow in getting back to nursing homes — in many cases by mail — but said infection protection and control (IPAC) measures should have been taken without delay on the assumption sick residents had COVID-19.
Pushing back at Callaghan, he said “to say that you are doing the testing, you then decide if you are going to do IPAC, I can’t agree with that.”
But Williams did acknowledge he knew results were arriving slowly by mail and that infection prevention and control in nursing homes was weak.
However, he didn’t issue any orders to improve nursing home computer systems to receive results faster.
“We were dealing with the outbreaks, not with the technology.”
Caregiver advocate Vivian Stamatopoulos said she was appalled by that response.
“They knew there was a problem in communicating results and they didn’t fix it.”
Williams said he did not go public with internal concerns about the level of cases that would trigger tougher public health restrictions on businesses and gatherings in the fall because his advice to cabinet is confidential, and because scientists getting into a public debate could leave citizens “confused.”
Another public health doctor, Shelley Deeks, did go public in a story in the Star and the triggers were strengthened.
The interview with Williams and the three-member commission, which hears submissions behind closed doors in private, was conducted Monday and the transcript released Thursday.
Williams told a news conference Thursday afternoon that his actions were based on input from advisers at Public Health Ontario, the government’s science advisory table and he understands the commission is looking to make recommendations for improvement.
“Some things we have done well. Some things I think we could do better. That’s always the case.”
For the commission, Callaghan also expressed frustration with 217,000 documents it recently received following a long-standing requests for information from the Ministry of Health and a tight deadline of producing a final report in April, with the government refusing requests for an extension.
Reading and digesting them is “a gargantuan task, almost impossible,” Callaghan said as the interview with Williams began behind closed doors Monday. The commission conducts its interviews in private and releases transcripts later.
He also pointed to 2,000 pages of notes requested from Williams, many of which had portions redacted, forcing the commission to go to an arbitrator to have some segments restored.
“It is a little vexing for us to get these so late,” he replied when a government lawyer objected to questions about the process of submitting his notes, claiming solicitor-client privilege.
New Democrat Leader Andrea Horwath charged “the government is trying to cover up what went wrong in longterm care.”