Opinion: Quebecers have the right to seek 2nd opinion on public health's handling of pandemic
Published Tuesday, July 12, 2022 12:56PM EDT Last Updated Wednesday, July 13, 2022 6:32AM EDT
A key recommendation from Quebec coroner Géhane Kamel's recent scathing report on the deaths at the CHSLD Herron residence was that the government allow its public health director complete independence "without political constraints."
Coroner Kamel decried the lack of independence, which may have led to thousands of deaths in long-term care homes.
In early January 2022, the College of Physicians also demanded that public health be fully independent of government interference, adding that their "recommendations be based on science."
Has public health changed much since the beginning of 2022?
A complete evaluation is beyond the scope of this article, but fallacious, unsupported and inaccurate statements are still too frequent.
For example, in a carefully worded statement, Quebec's institute of health (INSPQ) claimed that the N95 mask is no better than a regular medical mask in the workplaces, such as schools, contradicting top expert advice and US Centers for Disease Control (CDC) findings.
As a result, Quebec denied -- sometimes forbade -- their use to (mostly female) health care workers, teachers and daycare workers.
There is the constant infantilization of the population by paternalistic messages, such as wearing the N95 is too difficult for the average person, contrasting the U.S. White House's decision to provide 500 million masks free of charge to all adults.
Why is Quebec so untrusting in its people's abilities?
Quebec public health officials told us that air purifiers in schools "can be dangerous" -- an outlandish claim -- and so Quebec refused to allow schools to install air purifiers in sharp contrast with other jurisdictions.
Ontario adopted a more proactive and judicious approach, investing at least $650 million to install air exchangers and air purifiers in every school setting.
The U.S. earmarked an astounding $500 billion to improve ventilation in schools and other public settings.
Other countries have also made ventilation in public places a top priority.
The burning question is: why does Quebec fail to keep up with the science?
Since January 2022, 3,800 COVID-19 related deaths have been reported in Quebec, 520 more than in 2021, a far higher proportion than in other Canadian provinces and many industrialized countries, affecting mostly the elderly and most vulnerable.
Sadly, many of these deaths could have been prevented with effective science-based risk management.
Public Health Director Dr. Luc Boileau's latest recommendation, based on a "calculated risk" to lift the mask mandate in public transit on June 18, may understandably be popular for many, weary from over two years of restrictions, but it literally threw the elderly and most vulnerable under the bus once again.
His advice that everyone "should manage their own risk" is totally disconnected from the daily reality that the most vulnerable face every day, especially those of low income who have no other means of transportation to go to work, who live in multigenerational families, who need to go to medical appointments, etc.
It is not acceptable that they are forced to live like hermits.
Why were options not made available to them, such as designated Metro cars with mandatory masking or special shopping hours in stores and free N95 masks?
One of the cornerstones of public health is the protection of the most vulnerable, to leave no one behind.
This latest one-size-fits-all recommendation discriminates blatantly against the elderly and vulnerable at a critical time when experts are sounding the alarm about an imminent resurgence worsened by a health care system on the verge of collapse.
Dr. Boileau states "the prospect for (COVID-19) growth was very weak." However, not everyone agrees with this statement.
Journalist Patrick Déry called it "obviously inaccurate," noting that as early as June 10, the rise was already well underway as shown by several indicators, including PCR testing up by 10 per cent and self-reported tests up 12 per cent in a week.
Moreover, the BA 2.12.1, B.4 and B.5 sub-variants jumped almost twelvefold, from less than six per cent on May 8 to 69.4 per cent on June 12.
On June 29, barely less than two weeks after the lifting of the mask mandate on public transit, in a stunning contradiction to Boileau's statement, his expert, infectious disease microbiologist Dr. Jean Longtin, conceded in a joint press conference with Boileau that a surge "was to be expected."
With the new subvariants so transmissible, the frantic urge to lift the mask mandate on Canadian Grand Prix weekend, with buses and the Metro crammed with passengers and tourists, defies understanding and violates the fundamental public health precautionary principle.
With the current surge posing a significant risk of infection, a clear, unequivocal message is essential: urge everyone to wear a mask in closed crowded spaces -- not because it is obligatory, but because it will protect you and is an act of solidarity and caring for others.
We are still not hearing this message from public health.
Public health cannot perform its role if it is driven by political influence instead of science.
Unfortunately, baseless claims, flawed recommendations and deafening silence when it should be using its privileged position to speak truth to power have undermined its credibility.
In public health, the population is the patient, and as in the clinical field, the patient has the right to seek a second opinion if the first is unsatisfactory.
Quebec needs an independent public health system, but the existing political structures do not allow it.
An effective solution is the creation of an independent scientific table composed of experts from various fields, free from government interference, similar to the Ontario COVID-19 Science Advisory Table.
The government and its public health doctors should be bound to listen and respond to its comments and recommendations.
In addition, the Quebec College of Physicians must assume a more proactive role and fulfil its responsibility to ensure quality public health, using every measure at its disposal.
Judging from Quebec's management of the COVID-19 pandemic, it is not ready for the next variant, nor the next airborne pandemic.
"Indifference and (mis)calculations kill," -- Volodymyr Zelenskyy, President of Ukraine.
- Michael Levy, MPH, Environmental Health Specialist and Epidemiologist
- Stéphane Bilodeau, Eng., Ph.D., Fellow of Engineers Canada, Independent Expert, Lecturer, Bioengineering Department, McGill University, and Coordinator, Indoor Air Quality Task Force, World Health Network
- Simon Smith, Ph.D. ARCS CChem FRSC(U.K.) Researcher respirator filter development (retired), past president of the International Society for Respiratory Protection
- Michel Camus, Ph.D., Epidemiologist and risk analyst expert
- Marie Jobin, Ph.D., Organizational Psychology
- Marie-Claude Letellier, M.D., M.Sc., Mcb.A. Microbiologist and medical specialist in public health and preventive medicine
- Dre. Joanne Liu, Professor at the School of Population and Global Health at McGill University
- David Juncker, Professor and Director, Dept. Biomedical Engineering, McGill University
- Nimâ Machouf, PhD, epidemiologist, infectious disease consultant and lecturer at the School of Public Health, Université de Montréal
- Jérôme Lavoué, Professor, School of Public Health, Université de Montréal
- Denis Bégin, Senior Research Advisor, ESPUM, Université de Montréal
- Richard Massicotte, M.Sc., Ph.D., Researcher specialized in healthcare disinfection
- Pierre Chevalier, Ph.D., Microbiologist, Institut de santé publique du Québec (retired)
- Louis L. Grenier Eng. M.Sc. Aerospace Vehicle Design, OIQ Member
- Marc-Andre Lavoie, M.Sc., ROH
- Luc Bhérer M.D., Occupational medicine specialist
- Annie-Danielle Grenier, Rare Disease Advocate • Patient partner
- Lyne Filiatrault, Physician (Retired)
- Maximilien Debia, Associate Professor, School of Public Health, Université de Montréal