Dr. Kieran Moore is placing vulnerable persons at increased risk of COVID19 Infection. He Must Resign.
My June 9 Letter to Premier Doug Ford
June 9, 2022
TO: Premier of Ontario, Hon. Doug Ford MPP
Deputy Minister of Health, Dr. Catherine Zahn MD FRCPC
RE: Dr. Moore is placing vulnerable persons at increased risk of COVID19 Infection
Dear Premier Ford and Dr. Zahn,
Like many physicians across Ontario, I am dumbfounded by the decision of Dr. Kieran Moore, Chief Medical Officer of Health to end mask mandates in hospitals, group homes, and on public transit.
Dr. Moore has made this decision:
1. Against the advice of the Ontario Hospital Association — Multiple hospitals across Ontario have chosen to disregard his direction and will enforce their own Mask Mandates including the University Health Network in Toronto, the London Health Sciences Centre, the Children’s Hospital of Eastern Ontario, and the Windsor Regional Hospital. I am sure the full list is quite lengthy. This is a vote of non-confidence.
2. Against the advice of The COVID19 Science Advisory Table, an independent group of largely Public and Community Health Physician Specialists, Infectious Disease Specialists, and affiliated Epidemiologists at the Dalla Lana School of Public Health, University of Toronto, who were recently brought into the Ontario Ministry of Health as an official recognition of this advisory group to your government.
3. With the knowledge that mortality rates among Canadians have been slow to decline since mask mandates were relaxed in March (charts attached).
4. Though vulnerable Individuals who live in group homes include those with severe developmental impairments such as Down’s Syndrome: COVID19 Mortality rates are 20 times higher among those with Down’s syndrome and other developmental disabilities.. Yet, mask mandates were lifted in Ontario group homes also. Simultaneously, Dr Moore has encouraged vulnerable persons continue to mask to protect themselves.
Group homes should be regulated so that ventilation requirements including HVAC systems are installed. Generous incentives and tax credits should be included. They should not be treated different than long term care homes or retirement homes. All include very vulnerable persons and multiple care providers or staff.
What do so many healthcare professionals and experts know that Dr. Moore does not? This should be a question that you ask yourself and your immediate advisors. Dr. Moore has refused to make himself available to the media to explain the rationale for his recent decision. This is problematic from a physician heading our provincial public health response to current and future pandemics.
COVID19 is an airborne pathogen. Vast improvements in HVAC systems across public buildings, hospitals and schools are needed. In the meantime, masking will save lives and prevent disability. Vulnerable persons frequent hospitals often and take public transit. Disabled Ontarians rely on public transit especially since most are low income to very low income. Buses have very poor ventilation systems. My partner is a school bus driver trainer, safety officer, and a mechanical engineer. He is knowledgeable on this aspect of bus transportation: Removing masks places the disabled and elderly at increased risk of infection — The very people at highest risk of poor outcomes from COVID19. This will be especially true in the fall when bus windows are closed once again.
I am a physician with a primary immunodeficiency and autoimmune disorder. Masking in public buildings provided me some ability and comfort to interact with the community. I no longer feel safe to do so. I have to monitor PCR sewage rates in my community and local hospital admissions for suspected COVID19 to gauge community transmission. This is not how an advanced medical health care system should monitor an infectious disease outbreak. This data is becoming increasingly difficult to monitor or to find. You have the means and funds to test individuals. You have the funds to provide RATs but have been reluctant to do so, except for private schools. You’ve released to them to area pharmacies though they have never had them in stock when I attempted to secure a kit. Someone like myself, especially if low income, should have had tests provided by this government without charge. I cannot believe this hasn’t happened yet. I have had to purchase my own. Immunodeficient individuals like myself develop frequent viral illnesses, low grade fevers etc. Every time that occurs, we must test to rule out COVID19. This government has given no consideration to those with disabilities during the pandemic, especially those with low incomes. That is a classic example of Ableism. Low income persons who are vulnerable to COVID19 should have N95 masks and test kits provided.
Unfortunately, the COVID19 pandemic continues whether we would like to believe it or not. Surgical waits are excessive. Illnesses of nurses, doctors, hospital and clinic staff have all caused lengthy waits for ER assessments, surgery, colonoscopy and even cardiac stress tests. The latter are booking with a 5 month delay in Windsor. Imagine having a patient with angina and having to wait 5 months to know if they need an urgent angiogram or should see a cardiothoracic surgeon!
Canada has done extremely well with the use of vaccines and public health measures, until recently. However the end of mask mandates in early March, has coincided with one unfortunate fact: The mortality rate has failed to decline in Canada compared to other OECD countries. This is occurring on the backdrop of falling COVID19 global mortality rates. Why?
To review, 1 in 330 Americans has died of COVID19 since the pandemic began. In Canada, about 1 in 919 people have succumbed to the pandemic, which is about half the rate of cancer death per year. COVID19 was never a ‘cold’.
Omicron variants, the SARS-CoV-2 variants circulating in the past year, have not been more mild as some have communicated. It is clear now that mortality rates among the unvaccinated are just as severe as earlier variants. And the vast majority of hospital admissions are occurring among the vaccinated in Ontario.
The charts below illustrate the slow decline of Canadian mortality rates compared to other OECD countries. Vaccination rates remain poor among children especially in my area of ESSEX. Dr. Moore’s suggestion that vaccination rates are high ignore the disparity among vaccination uptake in some Ontario regions. Immunity is waning and more could be done to ensure better vaccination uptake. Most mass vaccination sites have closed. There has been a lack of action to improve vaccination rates with novel approaches such as financial inducements to vaccinate children or adults; an approach successful in other regions. A push must be made to provide booster vaccinations to everyone over age 18.
Recently, Dr. Moore refused a request from the Medical Officers of Health in Windsor, Peterborough, and Niagara Regions, to enact provincial mask mandates because excessive transmission was occurring in those communities. Why did those Medical Officers of Health find it necessary to request permission when the Health Protection and Promotion Act clearly gives them the authority to do so? What special instructions were given by Dr. Moore? Why would he not respect the advice of his well-qualified colleagues? And why did they feel the need to publish the letter that was sent to Dr. Moore?
Finally, another infectious disease outbreak is upon us and Dr. Moore has not provided a single briefing in Ontario unless I’m mistaken? Monkeypox continues to spread in North America. We have the means to control and eradicate this outbreak quickly if there is a will to act.
Respectfully, I believe it is time this government requests Dr. Moore resign his post. He has lost the respect and trust of many Ontario physicians and indeed, Ontario hospitals. He is at odds with the Ontario COVID19 Advisor Task Force and has refused rather benign but important requests from three fellow Medical Officers of Health. This should matter to this government.
The comments I made are my own.
Christopher Leighton MD, FRCPC
Christopher Leighton MD, FRCPC
Adjunct Professor, Department of Oncology
Undergraduate Medical Educator
University of Windsor Program
Schulich School of Medicine & Dentistry
