`Armchair experts' frustrate doctors
Social media makes fighting virus more difficult for health officials
In recent weeks, Eastern Ontario medical officer of health Dr. Paul Roumeliotis has heard from tearful business owners and politicians worried about what tougher pandemic restrictions might mean for their futures.
He has analyzed data and talked to front-line health workers and long-term care officials about what they have been seeing during the second wave of COVID-19 in the large, mainly rural, health region he oversees east and south of Ottawa.
He has even heard from antimaskers who are furious about any restrictions.
Listening, understanding and trying to find balance that protects the public is all part of his job as a local public health leader in the time of COVID.
What isn't part of his job, he says, is dodging criticism from “armchair experts” who have strong opinions about what he should do.
They have a right to criticize,
Roumeliotis says. But, he notes, they don't have the same perspective public health officials have when they make decisions.
“We are the ones who can give a real indication of what is happening on the ground.”
Being a medical officer of health in the time of COVID is not easy. But being a medical officer of health during the time of Twitter and other social media might be even tougher.
“I am just frustrated because I am hearing all of these experts — who are experts in infectious diseases or ICU (intensive care) or epidemiology, but they have never practised public health. We live this day in and day out. We are constantly on the ground.”
Roumeliotis, who heads the Ontario Council of Medical Officers of Health, said his colleagues across the province share his frustration about the second-guessing that is now part of the job.
“This is a lot more difficult with social media,” agreed Dr. Rob Cushman. He is currently Renfrew's acting medical officer of health and was Ottawa's chief medical officer during the first SARS crisis, in the days before social media.
Social media has been a key factor in the pandemic — with both positive and negative results.
It allowed some Chinese health professionals to tell the world about the novel coronavirus in Wuhan before much information was public. It has also helped raise awareness and understanding of public health measures to slow the virus's spread. Ottawa Public Health, for example, has been praised for its clever use of social media to get its messages out with humour.
In Ontario, social media, along with traditional media, has helped build public pressure to improve long-term care homes. But it has also enabled the spread of misinformation, helping to fuel resistance in some cases.
And it has put some public health officials under a dangerous spotlight. Some female public health leaders have received death threats.
For others, it has brought a chorus of criticism. In Roumeliotis's case, that has included “unkind and, at times, personally insulting emails and social media posts.”
Roumeliotis found himself under scrutiny this month when he made a decision to keep local bars, restaurants and other businesses open with tightened restrictions, rather than moving to the stricter lockdowns now in place in Ottawa, Toronto and Peel.
Cases shot up in Eastern Ontario beginning in September. There have been 249 new cases in Eastern Ontario in October and there were 111 in September. That is more than double all the cases during the rest of the pandemic.
Those numbers required some action and Roumeliotis said he began warning that the region might have to move back into the full restrictions of Stage 2, which would shut down restaurants, gyms and other businesses.
The pushback from businesses and politicians was immediate. He listened to those concerns and took a close look at how and where cases were spreading in the region before making a final decision.
A significant percentage of the cases were in one long-term care home, Prescott and Russell Residence, where five people have died and more than 100 have been infected.
The Canadian Red Cross and paramedics have gone in to assist staff at the Hawkesbury home, which is the site of the worst outbreak in Eastern Ontario.
Other recent cases have come from people living with others who have tested positive, he said.
Roumeliotis said he started to see trend lines stabilizing and going down and decided to wait before closing businesses again.
Beginning Monday, new restrictions took effect in the Eastern
It is a very difficult balancing act that we have to look at. Do you close everything? ... Do you wait and see?
Ontario health region that put 100-person limits on restaurants, bars and banquet halls, with no more than six people at a table. The regulations also limit fitness and dance classes to 10 people, and limit the numbers inside gyms and other indoor fitness centres to 50.
Roumeliotis said he will not hesitate to go further if it is warranted, despite the pushback from businesses and others.
Meanwhile, he began receiving emails and messages on social media criticizing him for not going far enough.
Roumeliotis says he made the right decision, not because he got pushback from the community, but because the numbers were starting to go down and did not reflect the kind of community-wide spread that would warrant a full lockdown — for now.
“It is a very difficult balancing act that we have to look at. Do you close everything? Do you put measures in place? Do you wait and see? These decisions are not made easily,” he said.