In fourth wave, he’s a man boxed in
Sometimes the fog of war lifts, and what is left is a moment of clarity. Tuesday, with Omicron popping up and Delta already on the march, Dr. Kieran Moore was asked: Given the worrisome modelling from earlier in the day, and given the worry that the good doctor had shown on the subject, why isn’t Ontario … uh … doing anything?
“We’re working very closely with our (regional) health units that are experiencing high rates of illness,” said Moore, the province’s chief medical officer of health. “And quite appropriately, those health units are putting in public health measures. So because it’s so differential across Ontario, the impact on the health-care system, we’re working regionally and we’re working locally.” He mentioned recent public health measures in Algoma, Sudbury, Windsor, Kingston. (Chatham-Kent later followed suit.)
“So your health units at a local level are working full out to protect you. They have our full support when they have to put in any change in the Reopening Ontario Act or any orders under the Health Protection and Promotion Act, and we’re providing regular consultation, and I just can’t thank them enough for what they’re doing to protect their communities.”
In other words, Moore might be trying to help put out local fires, but at a higher level, the province is going to sit and watch the flames.
You can even argue it makes sense. Algoma is a mess; Toronto is a relative breeze; Kingston is transferring patients from its hospital to other parts of the province for what is believed to be the first time in the pandemic; Peel, where hospitals worried more than once about being overrun in the first three waves, is under control. Ontario is not experiencing the pandemic the same way, and never did.
There are only three problems with Moore’s logic. One is people move around, so the virus does, too. A second is that under the current protections he lauds, Ontario is in exponential growth as a whole, and even optimistic scenarios would push the hospital system right up against the bright red line of cancelling surgeries again. The big provincial move Tuesday was to continue to pause full capacity reopening in nightclubs, strip clubs, sex clubs and bathhouses. That’ll sort it.
And third, Omicron. There are early indications vaccines and even some post-infection immunity could hold up against the variant, which is so exceedingly transmissible even that could not be enough to avert a hellaciously fast wave. But even if it vanishes, surgeries are in danger again.
It was dispiriting. Sources familiar with Moore’s office have lauded some of his work: a more stringent level of case and contact management across the province, sending rapid tests home with kids over Christmas, a continuing support of vaccine passports under a government that would absolutely love to chuck the flawed, fraud-prone version they rushed out.
And Moore clearly gets it. The province’s independent volunteer science table released a new set of modelling earlier in the day, and it showed that even if the province vaccinates 50 per cent of children aged five to 11 by the end of December — the current level is about 22 per cent — without a corresponding change in individual behaviour, Ontario will hit 300 COVID patients in the ICU by mid-January. The province says 300 would be the approximate level at which elective
surgeries are cancelled again.
Moore said the modelling was disconcerting, which it is. He emphasized the health-care system: Last week, the science table laid out just how fragile the system was. It’s not beds; it’s staffing. We burned out a lot of people in the second and third waves.
And Moore noted that the vast majority of people in ICU with COVID are unvaccinated, which is also true: According to the science table’s daily dashboard, there are 2.9 fully vaccinated Ontarians per million in the ICU, versus 85.9 unvaccinated Ontarians per million. It is an overwhelming asymmetry. If everybody who is eligible were vaccinated, this pandemic wouldn’t be much of a pandemic, just now.
So why doesn’t Ontario do anything about it? Mandates and stronger passports and better education for vaccine holdouts, more aggressive measures to hold down case counts even on a regional basis, more rapid tests than the five that families will take home?
Well, watch carefully. Moore pointed out that he would recommend vaccine passports stay in place past the province’s farcical Jan. 17 review date, but he emphasized it was the province’s call. He mentioned, over and over, recommendations to government. On passports he said, “this is the government’s decision. It’s not my decision.”
It sure looked like he’s a man operating in a box drawn by a government that is quite content to wait, again, to see if the modelling ends up in the hospitals. Ontario has the third-highest proportion of unvaccinated citizens left in the country. Only six per cent of the province has a third dose. Even though the province finally opened up the door to those 50 and older, they can’t even register for another week. The science table modelling also notes a 15 per cent drop in contacts could flatten Ontario’s predictably exponential curve. Polite requests may not do it.
So even better comms would help here, but where is the campaign to convey the urgency of boosters? Where is the campaign to convey the urgency of anything? Probably in the same place the campaign for urgency in vaccination in general is, in a province that has eschewed mandates and undermined its own easily falsifiable vaccine passport. Which means more people who could end up in the hospitals that we all share.
No, Ontario seems content to wait. Moore had one line: He said, “You know, our fate is in our hands. We can wash them, we can use them to put a mask on, and we can find the nearest clinic where we can provide the safe and effective vaccines.”
In other words, make your own decisions, because that will work. We’ve tried that before, though. We’re trying it now. It won’t.
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I just can’t thank (local health units) enough for what they’re doing to protect their communities.
DR. KIERAN MOORE ONTARIO CHIEF MEDICAL OFFICER