Health experts are expressing unprecedented frustration and issuing extraordinary warnings in response to Ontario's COVID-19 situation.
That includes the Registered Nurses' Association of Ontario (RNAO) sounding the alarm that what it sees as the province's insufficient response will make a fourth wave "likely" and medical officers of health in three regions co-signing a letter making the case for a stay-at-home order, stating that the government's response falls short of what's necessary and that online or hybrid learning should be adopted where necessary.
Doris Grinspun, the president of the RNAO, told QP Briefing that intensive care units are spiralling out of control and that four ICU nurses at one hospital walked off the job due to mental health stress.
"They don't have a government that gives a damn about what's going on in ICUs," she charged, calling on the government to issue a stay-at-home order, accelerate vaccination for essential workers, implement paid sick days, and allow workers leave to go get their shots.
Grinspun, who has been critical of the government's pandemic response dating back to the summer and warned about second and third waves at the time, expressed the feeling among members that the government has given up on supporting them. "He's destroying the morale," she said of the premier's choices. "We are feeling desperate, angry, exhausted about the lack of action," she added.
Grinspun called the premier at midnight the other day — a time at which she says she has never called before — to leave a message outlining the grave concerns, including ICU nurses leaving the job. She said she has not heard back from him yet.
Congrat @HomerTien PLEASE move this week
1) #vaccines to workers in warehouses & food plants! On-site vac using thousands of primarycare #nurses who are already in the payroll eager to help!2) Homebound seniors + person with disabilities by homecare
https://t.co/qF7mVpuSOv— Doris Grinspun RN, PhD LLD(hon),Dr(hc), FAAN,O.ONT (@DorisGrinspun) April 5, 2021
She described horror stories in the ICU, including a previously healthy teacher being put on a ventilator and health professionals breaking down in tears at what they see. "I'm fed up," the frustrated Grinspun responded, adding that she is hopeful that Homer Tien, who was picked to lead Ontario's vaccination efforts, can make a difference on that front.
In addition to Grinspun, the medical officers of health from Toronto, Peel and Ottawa sent a letter to Chief Medical Officer of Health Dr. David Williams urging a stronger response than the province's "emergency brake" which it refers to as a "shutdown."
"A stay-at-home order issued by the province through an emergency order is necessary to prevent and mitigate large-scale morbidity and mortality and irreparable strain on the health-care system," the health authorities wrote on Monday. "Stricter lockdowns have been shown to be effective in other countries to control transmission while vaccine campaigns progressed to achieve sufficient population coverage to suppress transmission."
I am asking the Province to implement further restrictions, including a province-wide Stay at Home order.
My team is in the process of reviewing the COVID data in schools to advise on an approach to take for schools in Ottawa. (4/5)
— Dr. Vera Etches (@VeraEtches) April 5, 2021
Peel announced school closures for the next two weeks in the region on Monday, a response to persistently high case numbers in the area outside Toronto.
Ontario saw cases decline under a stay-at-home order and school closures in January. But the government has so far resisted returning to those measures and in the two weeks prior to last Thursday announced loosened restrictions despite rising cases. When he took part in a modelling briefing last week, which projected COVID-19 ICU pressure to double even with a stay-at-home order in place, Williams rejected the assertion that the choices made by the government represented a policy failure.
The Ontario Medical Association (OMA), which is often more cautious in its messaging than other major health stakeholders, also sounded the alarm, saying that a "pandemic wake-up call" is needed.
@Ontariosdoctors say pandemic wake up call needed. https://t.co/H9Y7jOAefs#Onhealth #COVID19 pic.twitter.com/n1fn1MYak1
— Ontario Medical Association (@OntariosDoctors) April 5, 2021
"We are in a dangerous moment right now with case numbers rising at an alarming pace. A new stay-at-home order, vaccines for essential workers, and paid sick days are all sensible policies that will help get infections under control and support the tireless efforts of our public health doctors as they lead us out of this pandemic," OMA CEO Allan O'Dette stated.
The OMA also called for every Ontarian to get the first vaccine they are offered and the closure of all non-essential businesses, except for curbside pickup.
The criticism of the government was not limited to institutions, with a variety of health leaders expressing unprecedented frustration over the long weekend and on Monday.
Dr. Kali Barrett, a widely-respected University Health Network critical care physician who has carefully considered her words throughout the pandemic, shared her strong concern in a message posted on Twitter last week.
My twitter feed has changed.
The gloves are off. People are speaking up and demanding better.@fordnation admit you made a mistake, apologise, listen to the experts and change course. It's not too late to save those currently destined to die over the coming weeks.
— Kali Barrett (@DrKaliBarrett) April 3, 2021
Her call for a stronger response and concern for the consequences if it goes unheeded was echoed by other health leaders.
"Many of us feel that the measures that were taken aren't going to amount to significant change in the province," said Dr. Isaac Bogoch, speaking to QP Briefing from the COVID-19 ward on the 14th floor of Toronto General Hospital. "Things are very likely to get worse because the areas that we're seeing significant cases are going to continue to see significant cases and case growth because nothing really changed in those areas."
He also expressed some hope that the increasingly vocal approach made by health experts can help to nudge political leaders and the public towards supporting the health measures seen as necessary. "You see some people on social media, you see some things in the mainstream media, some people are advocating and speaking directly with senior policy-makers as well. And you know, it all probably helps."
Dr. Naheed Dosani, a palliative care physician who is part of the University of Toronto faculty of medicine, criticized the status quo as insufficient. "What's been put together isn't the kind of public health intervention we need to curb the pandemic," he told QPB. He said that health-care workers are frustrated and demoralized, and are trying all sorts of arguments on social media — appeals to moral imperatives and the cost-effectiveness of preventive care — in order to try to move the needle.
"What you're seeing across the board is health workers really producing a rallying cry to better support the people we are caring for," he explained. Those stakes are very high, he added.
"We are witnessing people who are sick and dying who shouldn't be sick and dying," he said, referring to the younger profile of people in ICU wards due to the variants of concern. "Our government is not listening to the science, they are not listening to the evidence."
He said that despite the extraordinary efforts by health-care workers to respond to the substantial suffering experienced by patients in hospitals, the Ontario government hasn't risen to the occasion. "We're not seeing the government step up and meet the moment in the same way."
-With files from Jessica Smith Cross
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