“It was mind-boggling. I’m still in shock”: Andrew Morris, a member of the Science Advisory Table, on why the government ignored their recommendations

“It was mind-boggling. I’m still in shock”: Andrew Morris, a member of the Science Advisory Table, on why the government ignored their recommendations

Courtesy of Mount Sinai

Among the chorus of voices speaking out in anger and frustration in response to Doug Ford’s announcement on Friday, Andrew Morris’s was one of the loudest. He’s an infectious diseases specialist at UHN and a member of the Ontario Covid-19 Science Advisory Table, and he called the Ontario government “morally bankrupt,” and deemed the lack of support for essential workers “criminal.” Here, he speaks to Toronto Life about his emotional reaction, the Science Advisory Table’s science-based recommendations for curbing the spread (spoiler: they don’t include closing playgrounds or carding citizens), and why he suspects the government went in the opposite direction. 

You’re a member of the Science Advisory Table. What does that mean?
The Science Advisory Table gathers the best scientific evidence on a variety of topics that we believe need to be addressed. We provide that information to the Ontario government, as well as to the public. There are various working groups within the Science Advisory Table. I co-chair a group with Dr. Menaka Pai, in which we assess, in a very prompt manner, new knowledge around the best available Covid treatments. We release our recommendations to the public so that doctors and other health care providers know the best ways to treat Covid patients with a variety of different therapies.

What kinds of recommendations has the Science Advisory Table made in the past, and how often does the government follow those recommendations?
There have been many instances where the government hasn’t used our advice in the manner that the Science Advisory Table recommended. Of course, we don’t expect the government to take up 100 per cent of our suggestions. But there’s some advice you’d think they’d take more seriously, especially when it’s going to make a huge difference. For example, we provided a brief on Israel’s vaccine rollout, which has been immensely successful. That approach has not been adopted by our government. There was also strong advice weeks ago not to loosen up any public health restrictions, yet the government chose to do the opposite. The rejection of that advice has led to some really unfortunate outcomes, as we saw this past weekend.

What advice did the Table give the government in advance of Friday’s announcement? What were you and your colleagues hoping to see?
Our recommendations included limiting mobility to truly necessary trips, asking people to avoid close contact with anyone outside of their households, targeting high-risk communities with vaccines and providing immediate support for essential workers in high-risk communities. Knowing what our numbers were like and the modelling data we provided, it was hard to imagine that they could respond in any way other than by taking a sensible, evidence-based approach.

When the new restrictions were announced on Friday, you tweeted that the Ontario government has demonstrated its total unwillingness to do what is needed, that it’s morally bankrupt and that its lack of support for essential workers is criminal. Can you elaborate?
Our provincial government did everything other than implement restrictions and offer support that would help curb the spread. So they essentially did nothing useful. They rejected all of our recommendations, like implementing support for essential workers. They actually came up with ideas that I hadn’t even heard of—nobody has even contemplated closing playgrounds or carding citizens to see if they are following public health measures. I haven’t the faintest idea where those recommendations came from. On the other hand, the government did nothing for essential workers, their families and communities that have been hit hard by the virus.

They had a cabinet meeting on Thursday night and met again on Friday morning, and I just can’t figure out how they came to those conclusions after giving the issues all that thought. It almost makes me think they were busy talking about what’s on Netflix.

So I guess it’s safe to say you were surprised by the announcement.
It was totally mind-boggling. I’m still in shock. In the days leading up to Friday, many of my colleagues and I were saying, “You know, maybe they finally get it. Maybe they realize how bad things are right now, and they’re going to act in the manner that is needed.” Part of that is blind faith. But then you listen to the press conference and discover that, in fact, they have failed to recognize the severity of the situation. They haven’t learned anything over the past six to 12 months. I don’t understand it. It’s just so disappointing.

Can you explain why these new restrictions are so misguided?
Our whole approach should be about preventing as many people as possible from being indoors with people who aren’t members of their households. We know from the data on cases and postal codes that there’s a much higher concentration of cases in postal codes where there are more essential workers. Now, that doesn’t mean that transmission is only happening in the workplace. There’s also community-based spread. The postal codes with greater numbers of essential workers also tend to have more multi-generational households, which increases the likelihood not only of household transmission, but of transmission to more vulnerable members within the household. If you’re an older person living in a multi-generational home, you’re adopting the risk that your son or daughter is taking by going to work.

If people need to be indoors with people from other households, then we need to do everything we can to protect them—give them PPE, proper ventilation, vaccination. On top of that, we should try to get them outdoors as much as possible, because—and we’ve known this for well over 100 years—fresh air is good for people. In this situation in particular, it’s good for people because the risk of transmission is so much lower than it is indoors.

What kinds of restrictions would help curb the spread of the virus in Ontario?
It’s not all about restrictions. The truth is we’ve had a lot of restrictions and those alone aren’t going to work. One of the things we’ve recommended is reconsidering what essential businesses are. If you look at the businesses the government has deemed essential—other than maybe nail salons and barbershops—it seems like everything falls under that designation. There’s no reason for law offices and accounting firms to have that designation. It’s 2021: those businesses can function remotely.

Another thing, if we’re talking about restrictions, is regional travel. The government is trying to close the borders with checkpoints between Ontario and Manitoba and Ontario and Quebec. But the reality is that we shouldn’t be fearful of Manitoba and Quebec—they should be fearful of us. The Table has shown repeatedly that a regional approach like the colour-coded system that Ontario has used results in a dramatic movement of people from one region to another. If you look at how the new variants spread, they essentially travelled up Highway 11, all the way up north, in a pretty linear manner.

Do you think we’re going to see any changes in our case numbers in Ontario with these new restrictions?
It’s hard to know, because there’s a lot of dynamic change with this virus. The government introduced some changes just over a week ago, and some of those new measures, like the stay-at-home order, should make a difference. We’re starting to see some degree of reduction in cases in the past few days. I just don’t know if it’s going to be enough.

I’m also very concerned that the announcement on Friday will just make the public tune out the government. The public isn’t stupid. When people see government policies like those we saw on Friday, the thinking citizen is going to say, “This seems really arbitrary. Why should I follow anything the government says?” That makes the situation even worse.

And it’s further worsened by the government’s backtracking as well.
Absolutely. It’s hard to know what to do as a citizen.

What do you think of Ontario’s vaccine distribution? What should we be doing differently to curb the spread?
We need to prioritize hot spots. The Table used data to identify high-risk communities. As far as I know, the area codes that the government identified as hot spots were not provided by the Scientific Advisory Table. We need vaccines in hot spots like Peel—as opposed to distributing vaccines to health units based on population—to prevent further disease transmission. I’ll offer the analogy about firefighters and forest fires. You don’t have all your firefighters battling a tiny little fire at a campsite. You send them to the raging forest fire. It’s the same with vaccines. You need to send the vaccines to where the pandemic is raging hardest. It’s just common sense.

If we are to trust the government numbers that have been supplied to us, we have roughly 1 million vaccine doses in freezers. We’re pumping out just under 100,000 doses per day at the moment. At that rate, we have about a 10-day supply of vaccine. Just imagine what we could do with one million doses in some of our hot spots. Many of these communities have populations substantially below 100,000. If we could get even 50,000 doses to some of them, it would do wonders for disease transmission over the next few weeks. I’m at a loss for why that isn’t happening.

Yesterday, the government made yet another announcement, lowering the minimum age for the AstraZeneca vaccine from 55 to 40. Your take?
I think it’s the right move. It would be great if this allows the rollout to focus more on hot spots.