Admonished by Kieran Moore, Niagara medical officer stands by his increased safety measures in schools
Niagara's beleaguered medical officer of health says he is standing by his orders to enhance COVID-19 safety measures in schools despite being admonished for his efforts by Ontario's top public health official.
In a statement Thursday morning, Dr. Mustafa Hirji acknowledged a request from Dr. Kieran Moore to drop expanded masking, case management and air quality monitoring measures, but said his orders stand.
We appreciate the feedback of the Chief Medical Officer of Health regarding these measures and have discussed them with our school board partners," said Hirji's statement. (We) will be proceeding with these measures in order to give children, teachers, and other school staff additional protection as we successfully resume in-person schooling."
The statement comes after a pointedly critical Jan. 15 letter from Moore to Hirji circulated on social media - first by members of Niagara's anti-vaccine community Wednesday night and then Thursday morning by Ontario doctors.
We now have Ontario's cmoh dressing down highly competent local MOHs for following science to protect kids and communities," tweeted Dr. David Fisman, physician and professor of epidemiology at the University of Toronto.
In his letter, Moore said he was writing Hirji to express his concern with your approach to in-person school and childcare in Niagara."
The letter, which indicates Moore and Hirji had spoken about the issue previously, says the Niagara doctor has gone beyond provincial guidelines about schools and COVID-19, including requiring a verified doctor's note for a student to be exempt from wearing a mask, something the province is not recommending.
The letter also takes issue with Hirji's plan to have his department monitor CO2 levels in schools as an indication of the effectiveness of ventilation systems. Moore said there is no link between CO2 levels and COVID-19 infections. However, Fisman said in an interview, the monitoring is an indication of the quality of the ventilation system, not that the gas causes infections.
Where ventilation appears to need improvement, Niagara's public health department will provide portable HEPA filters, something Moore said Hirji should get regional council approval for.
However, as medical officer of health in Niagara, Hirji controls a budget that is set annually by regional council.
Moore also criticized Hirji's orders to increase the amount of time a cohort of students will be dismissed from schools following a positive COVID-19 test, to seven days from the provincial recommendation of five.
While very disruptive to parents and children when it happens, its benefits in health outweigh that disruption in our estimation," said a Jan 14 memo from Hirji to Niagara school boards.
Moore wrote that Niagara is the only jurisdiction in Canada to continue to have seven-day dismissals and that he is worried they will put students at risk.
I am concerned that these measures will lead to increased harms to children and youth in the Niagara Region and strongly urge you to reconsider your approach in alignment with provincial direction," wrote Moore.
The shorter isolation period recommended by the province is at odds with information provided Wednesday by Canada's chief medical officer of health, Dr. Teresa Tam, who noted a person can remain contagious for up to 10 days after infection.
The studies that we've managed to amass, including a recent one for Japan, suggest that the period of communicability is no shorter than the other variants, because the viral shedding and the viral load doesn't decrease really until Day 10 following symptom onset or specimen collection after the diagnosis," Tam told the House of Commons health committee.
Moore also criticized Hirji for placing measures in school but not the general community, saying only 25 per cent of infections happen in classrooms.
However, schools have been closed through much of the Omicron surge to date, and there is not yet clear data on how the variant will spread as schools reopen.
When asked about his letter during a Thursday press conference, Moore said he wants to ensure a consistent and persistent approach so that parents, school boards, families can expect the same level of protection and care," in Ontario.
The purpose of the communication was to seek clarity and seek to seek ongoing consultation and to be supportive of our local medical officers of health, which we try to co-ordinate regular meetings," Moore said.
However, Moore's letter did not ask for clarity, but urged the Niagara doctor to reverse course.
Hirji and Moore have not answered follow-up questions from Torstar.
While Ontario's top public health doctor criticized Hirji's decision to go beyond provincial guidelines, Moore took similar action when he was the medical officer of health for Kingston, Frontenac, Lennox and Addington in 2020.
That June, as COVID cases rose in the community, Moore instituted a sweeping masking order for indoor public venues in the region. The province did not institute such an order until October of that year.
Medical officers of health are empowered by the provincial Health Protection and Promotion Act to take steps to limit the spread of a communicable diseases, including placing orders on workplaces. Ontario Health Minister Christine Elliott has said on more than one occasion she expects medical officers of health to institute their own measures beyond provincial rules based on local contexts.
In Niagara, where at least 32 people with COVID-19 have died in the last 11 days, 158 patients are in hospital with the virus, including 26 in ICUs.
Less than 45 per cent of Niagara children five to 11 have received a single dose of a COVID vaccine.
It is not clear how Moore's letter came to be shared by the Niagara anti-vaccine community Wednesday evening. The letter was shared by Moore's office with Niagara Region Chair Jim Bradley and Ontario deputy ministers of health and education, along with the leadership of local school boards.
Hirji's home has been targeted by anti-vaccine protests, which featured people yelling vulgarities at him over a megaphone and shining a strobe light into the home's windows.
Hirji has also faced political criticism locally for past orders to fight the spread of COVID-19, including from the mayor of Niagara Falls, who falsely claimed health promotion act was not the law," and Hirji's orders were only recommendations. Niagara mayors have attacked Hirji for commenting about the spread of COVID-19 and the Niagara border with the United States.
Since Moore's letter was shared widely on social media, many showed support for Hirji. The hashtag #IstandwithDrHirji was used more than 680 times Thursday afternoon, and all three Niagara NDP MPPs - Jennie Stevens, Jeff Burch and Wayne Gates - published an open letter supporting Hirji.
Hirji should be lauded for his initiative, not attacked by Ontario's Chief Medical Officer," the NDP letter said. Dr. Moore's letter has Ford's fingerprints all over it. Dr. Hirji was right to take extra measures and Ford should not be trying to make schools in Niagara less safe."
Grant LaFleche is a St. Catharines-based investigative reporter with the Standard. Reach him via email: grant.lafleche@niagaradailies.com