Time for a change in B.C.'s pandemic strategy? Former SARS doctor urges grassroots pivot
A respected emergency doctor credited with a pivotal role in B.C.’s avoidance of the SARS epidemic is speaking up, urging health officials to adopt a grassroots approach to health care as the province struggles in the fourth wave of the COVID-19 pandemic.
Dr. Lyne Filiatrault spent decades at Vancouver General Hospital, where she was working that fateful night in 2003 when a man arrived at the hospital struggling to breathe and turning blue. He’d recently returned from a trip to Hong Kong and it would be three days before the virus that afflicted him had a name: SARS.
“We were concerned and we didn’t know if it was the avian flu so we decided not to take any chance and wheeled this patient into a single isolation room with airborne precaution,” she said. “It wasn’t me — it was the entire team and it took the concern of not wanting to have this unknown virus spread. That set up the success of all our virus response in B.C.”
Given that experience and the “nip it in the bud” approach that saw the province avoid the kind of death toll Ontario saw, Filiatrault is disappointed and alarmed that the health leaders of today have not learned the lessons of early, decisive intervention and a proactive approach. She is now retired and feels free to speak her mind.
“We’re trying to use a simple solution for a complex problem — we thought vaccine was going to be it,” she said. “We’re relying on government to act quickly and I don’t think they have the resources and they certainly don’t have line of sight, so we need community engagement and there’s certainly no way we’re going to get out of this without community engagement.”
PUBLIC HEALTH’S TOP-DOWN STRUCTURE QUESTIONED
Filitrault is part of Protect our Province BC, an advocacy group of health-care professionals, scientists and others advocating for a multi-disciplinary approach to combatting the virus, including accepting the role of airborne transmission in spread of the disease.
In recent months, Northern B.C. doctors have described regional attitudes and mindsets that’ve contributed to vaccination and infection rates, while community leaders have felt they’ve been left in the dark about decisions and support from their local health authorities who do not respond to questions and concerns via phone or email.
“The only way we’re going to be successful is through a collective effort,” insisted Filiatraul. “Embracing all of the science, not just medicine but aerosol science, building engineers, sociology, behaviour sciences and the lived knowledge on the ground.”
PRECEDENTS FOR CHANGE
At her weekly COVID-19 briefing on Tuesday, Dr. Bonnie Henry urged British Columbians to look at public health measures like vaccine passports as necessary responses to a shifting threat.
"This virus has changed and so we need to adapt our measures and the things we’re doing to keep each other protected to make sure we can get through this fall and winter,” she said.
But Henry has been criticized before for being slow to adopt strategies that work in other jurisdictions, with several observers and public health experts describing her approach as reactive.
She backtracked on the controversial decision to end notifications of COVID-19 exposures in schools and reversed her decision to make masks optional for students in kindergarten to Grade 3, but it took intense pressure from teacher and parent groups, as well as local mandates by school districts before that happened. Similarly, regional public health measures in Whistler, the Okanagan and Northern B.C. came only after local cases skyrocketed and threatened or outright overwhelmed local healthcare facilities.
“I think we have to thank Bonnie Henry and thank Adrian Dix and other people in public health because this has been really a difficult situation that’s gone on for a long time,” said Filiatrault. “However, I think there needs to be a bit of reflection that if what we’re doing is not working, we need to change.”