Ontario’s retiring chief medical officer of health defended his tenure during the COVID-19 pandemic in a wide-ranging exit interview with CBC’s The National, saying that the complexity of tough issues the government faced were not always clear to detractors and that the province’s third wave might have been quashed if not for early hiccups in the world’s vaccine rollout.
Dr. David Williams, speaking with host Andrew Chang, discussed how he saw his job, the goals set at the start of the pandemic, tough decisions the province had to make and criticism of his performance, including from fellow doctors on Ontario’s COVID-19 science advisory table.
“They’re free to say whatever they want and not all of them agreed with each other at the table,” he said. “That’s what a science table is. You get a bunch of doctors in the room. They hardly ever agree. That robust discussion is fair.”
Premier Doug Ford’s government and Williams were widely criticized when the third wave of the pandemic hit in March. Critics said they moved too quickly to reopen as the second wave receded.
Ultimately, the province was forced back into lockdown and closed schools in April as hospitals became overrun.
“These are not easy decisions. These are huge decisions that governments have not had to make in a long time,” Williams said.
Williams also defended the province’s response in the early days of the pandemic.
“I would say we responded with the evidence and information we had at the time. We consulted as widely [as] we could at the time, in a situation that was anything but mapped out, in a global situation that was evolving rapidly. I think we did a good job at the time. Are there things we could have done better? We welcome that input. We welcomed it then. We needed to hear from those experts at that time. And we did widely consult from the beginning.”
Williams points to vaccine rollout disruptions
Williams said a shortage of vaccines helped along the third wave. He said between the second and third wave, the vaccination rollout “pretty well came to a halt for three weeks” because supplies of Moderna, Pfizer-BioNTech and AstraZeneca-Oxford were disrupted for separate reasons.
The province could have “suppressed the third wave quite extensively” if that hadn’t happened, he said.
At the start of the pandemic, Williams said he and Dr. Barbara Yaffe, associate chief medical officer of health, sat down and mapped out “where are we going to end up” at the end of the pandemic.
According to what the data said then, 2.5 million to 3.5 million people in Ontario could have tested positive for the virus in the first year. Six per cent of those infected could have been admitted to hospital, a number that would have overwhelmed the hospital system. “We’re talking 150 to 200,000 people die,” he said.
They set three goals — decrease mortality, morbidity and social disruption, he said. Ontario’s death toll from COVID-19 is 9,093, as of Wednesday.
Williams said he listened to criticism from doctors on the science table, but he thinks it was not always apparent that a lot of complex issues were at play when decisions were made.
Successor well-positioned, Williams says
Williams, who was set to retire months ago but delayed the move because of the COVID-19 pandemic, said his successor, Dr. Kieran Moore, is well-positioned in his new role because of the provincial public health team that is in place.
Moore, who has served as the medical officer of health for Kingston, Frontenac and Lennox & Addington Public Health, is set to replace Williams on Saturday.
Williams urged local medical officers of health to support Moore fully. The province needs to be careful in the next year, because COVID-19 variants of concern can emerge at any time, Williams said.
He said lessons learned from the deadly SARS (Severe Acute Respiratory Syndrome) outbreak in 2003 will help to guide the province’s pandemic response as Ontario reopens. A total of 44 Canadians died in that outbreak.
“We have a very fabulous team at this time that’s going to be very important as we go into the recovery mode, because what we learned from SARS, if you turn off the switch too fast, you may regret that. And we’re dealing with a global pandemic, with many issues happening in many countries where variants can arise at any moment,” Williams said.
One key lesson is that the province will have to invest as much in recovery as it did in its pandemic response, he said.
Williams, who was in his post for more than five years, said “moral suasion” is an important quality to the job because it involves giving advice to Ford, Health Minister Christine Elliott and the rest of the Ontario cabinet, but having the backing of medical officers of health from 34 public health units.
“Having a strong central spokesperson who speaks on [the medical officers of health’s] behalf in the government is critical and important. And their job is to keep him as informed as possible as they can of any nuances or issues. And that’s this dynamic consultation process.”
Williams feeling ‘mixed emotions’ before retirement
Williams said he says he’s feeling “a lot of mixed emotions” about his job ending, but that he believes he is leaving the province in a good position because key indicators — case numbers, hospitalizations, occupancy of intensive care units and number of people on ventilators — are dropping.
Retirement will be a big adjustment and will be like “stepping off a treadmill” that he has been on for the past year-and-a-half without breaks, he said.
“I’m so busy all the time, connecting, co-ordinating, facilitating, advising. It’s just all day long into the evening,” he said.
Williams has been chief medical officer of health since Feb. 16, 2016. He had previously been interim chief medical officer of health for about half a year and was the medical officer of health for the Thunder Bay District Board of Health from October 2011 to June 2015 and from 1991 to 2005.
“The critical part is to enable those around you, enable those in leadership and enable the wider government ministry to step up and rise to the occasion,” he said of his leadership style.
Williams, who was criticized by some as too deferential to Ford, said the Ontario government sought his advice and did not muzzle him at news conferences. There were open discussions about his advice, and he and Ford have mutual respect for each other, he said.
“I felt I was privileged to be able to give that advice,” he said. “They took 95 per cent of what I advised and asked for more information on that. I was very pleased at how responsive and how receptive they were and actually procuring and wanting my advice on many situations, even ones where I hadn’t prepared a position and we had to prepare a position on that matter.”