Sask. doctor who led push for 4th wave measures frustrated after province 'rebuffed' science

The doctor who led recent lobbying efforts urging the Saskatchewan government to do more to battle the province's fourth wave of COVID-19 says he's frustrated with the government's response on Monday.

After medical health officers strongly cautioned a series of steps the province could take to blunt the wave's impact — including a return to enforced indoor masking, plus mandatory vaccinations for all health-care workers and people wanting to enter non-essential businesses — Premier Scott Moe merely announced that the province would support other groups in enacting so-called "vaccine passports" and that only some health-care workers would need to be immunized.   

"I'm certainly frustrated by that response, as I have been at many stages in previous waves as well," said Dr. Cory Neudorf, the interim senior medical health officer for the Saskatchewan Health Authority (SHA). "The main job of public health is to try to be future oriented and in future forecasting, we're in the business of preventing disease."

In a 17-point letter sent to the Ministry of Health last Thursday, Neudorf and other medical health officers said new and old measures are needed because the province's low vaccine uptake (only 57.6 per cent of Saskatchewan's entire population is fully vaccinated) and the more-transmissible Delta variant create greater risk for unvaccinated people, particularly children under the age of 12. In addition, the measures are needed to try and combat so-called "breakthrough" cases — people who get infected in spite of being fully vaccinated.

Doctors also called for:

• The reinstatement of the requirement for infected people and their close contacts to isolate.
• Mandatory vaccinations for teachers, caregivers, parents, students and school children aged 11 and under once they turn 12 and become eligible for vaccination. 
• Improvements to ventilation in schools and long-term care homes.
• Resumption of ticketing of people who break the rules. 

The letter emerged on social media shortly before Premier Moe held a COVID-19 news conference — his first in weeks — on Monday afternoon. 

Moe stressed, as he has for months, that further vaccinations are Saskatchewan's way out of the pandemic.

He said it would be "grossly unfair" to vaccinated people to return to broad restrictions.

Neudorf countered that he hasn't heard talk like that from vaccinated people.  

"The people who are immunized, fully immunized already, for the most part are the ones who want to see this come to an end," Neudorf said. "The idea of continuing to wear a mask for a few more weeks to a few more months is not that big a deal."

Heavy-handed measures like full lockdowns aren't necessarily needed at a time when vaccines are available, Neudorf said.  

Different measures needed

"There are a different suite of measures you can take to still blunt that fourth wave, which are the ones that we've recommended," he said. 

"So to see that science, if you will, rebuffed and to say: 'No, we're just putting this all back down on individual responsibility and calling on people to do the the right thing,' like: 'This time, please do it. Do it right.' We've been calling on people to do the right thing already. Unfortunately, with something like a pandemic, you can't go for 70 per cent following the advice. That still leads to something going out of control.

"You need more unambiguous messaging from the government, not just what you should please do. And often some teeth behind it, so that it's actually followed."

What led to the letter

The SHA is the operational arm of Saskatchewan's medical health system. It's distinct from the Ministry of Health, which enacts the types of public health orders that were in place in the province until the government rescinded them in early July, amid much lower COVID-19 case numbers.

Dr. Saqib Shahab is the province's chief medical health officer and works for the Ministry of Health. He can make recommendations to the government, but it's the government that decides whether to act on those suggestions. 

• OPINION: Medical health officers should be fully independent

Neudorf said medical health officers from the SHA meet regularly with Shahab to talk about Saskatchewan's COVID-19 response. 

"We have outlined the kinds of needs that there are, the responses we should likely be having with him on the line during that time," Neudorf said. "He has offered his suggestions. We've offered ours. So in that sense, the ideas certainly have been discussed with him. But because of the way the COVID response is set up in government, he can offer his advice as a provincial employee. It may or may not get to the minister. I don't know to what extent does he meet directly with the minister, does his advice just go up the chain.

"But the advice coming back from government wasn't reflecting the advice we have as medical health officers on how to manage this issue."

We've been calling on people to do the right thing already. Unfortunately, with something like a pandemic, you can't go for 70 per cent following the advice. That still leads to something going out of control.- Dr. Cory Neudorf, interim senior medical health officer, Saskatchewan Health Authority

The medical health officers (MHOs) decided as a group they needed to make their thoughts on the fourth wave official and crafted the letter together, Neudorf said. 

A draft of the letter urging stepped-up efforts was shared with Dr. Shahab, Neudorf said. 

"The need for masks, the need for a collective set of responses beyond vaccines, but not likely including full lockdown, is something that as a group of MHOs, including Dr. Shahab, we've discussed and said would be reasonable for some time now," Neudorf said.  

In an interview with CBC News last week, Shahab questioned the need for provincial mandates, including masks, citing the need for voluntary compliance. 

"Does there need to be more local measures in place," Shahab asked. "Do we require a stronger provincial mandate? I think this is something that needs to be discussed in an ongoing fashion." 

Neudorf said local medical health officers could, under the Public Health Act, require businesses or municipalities to mandate masks. But there's a catch.

"Any order like that has to be approved by the minister of health," he said. "So in the end, we can make that recommendation, but the minister would still have to sign off on it."