Bruce Arthur: ‘A punch in the stomach’: Doug Ford wants to extend Dr. David Williams, and epidemiologists are not happy

On Monday the province announced its . And the most polite possible response was, him? That guy?

“Well he’s brought us all the way through this, along with (associate chief medical officer of health) Dr. (Barbara) Yaffe and their whole team,” said Ontario Premier Doug Ford, on the day the province proposed extending the chief medical officer of health’s contract through next September, despite everything. “I just do not ever believe in changing a dance partner in the middle of a dance, especially when he’s an incredible dancer, like Dr. Williams.”

An incredible dancer?

“Now more than ever, we need experienced, stable leadership,” said Minister of Health Christine Elliott in a statement. “We need someone who fully understands the pandemic and the province’s public health system as we continue to work collectively to stop the spread of , and continue the work preparing for the deployment of vaccines. There is no one better suited for the job than Dr. Williams.”

No one better suited for the job?

If you think this government could do better, moving Dr. Williams’s retirement date from February to September of 2021 was deeply dispiriting. And a lot of the medical and epidemiological community was truly disheartened, quietly or otherwise.

“I don’t think he’s useless,” said one highly respected member of the medical community, who requested anonymity because of connections to the provincial response. “He’s dangerous. He’s dangerous because he can’t communicate, and he doesn’t advocate for sound public health measures. If you flipped a coin you’d get it right more often than David.”

That’s the core of this. It’s not personal. It’s not even political. Many people in the medical community say Dr. Williams is a good man, and some whisper he is a more canny bureaucrat than he appears.

But as one doctor who has worked with Williams on the provincial response put it, “He’s a lovely guy, but … part of the story nobody is talking about is they were cutting public health. They chose (to retain and support) someone on purpose who wasn’t a great communicator. It wouldn’t have been advantageous having a strong health leader for what was being planned.” As one accomplished ex-colleague of Williams recalls, they would be sitting in meetings with him and the ex-colleague would think, what is he talking about?

The worse part is he is such a poor communicator that you can’t always discern how bad his ideas are. In March, Williams denied community transmission was ongoing, while ER doctors were telling you it was everywhere. He only acknowledged asymptomatic transmission in mid-April, long after it was clear that asymptomatic transmission was not just occurring but was significant. He didn’t ban shared staff between long-term-care homes until mid-April, three weeks after British Columbia did so. Ontario’s LTC death rates were four times those in B.C.

“This is one of those moments of the pandemic that’s like a punch in the stomach,” said the highly respected member of the medical community. “One of those moments that we know, this is going to hurt us.”

And more recently, something happened that might explain this decision better than anything. Sources indicate there was a search for a replacement; names like Dr. Eileen de Villa and Dr. Vera Etches were seen as strong potential CMOH’s, though de Villa has clashed with the province.

But three weeks ago, Williams endorsed — or created, depending on which day the premier was speaking — the framework and that it was changed it within two weeks.

That was the moment. Williams had gone along with the province by letting asymptomatic migrant workers keep working; he had publicly endorsed every decision the government has made, even as the second wave built without meaningful interventions, while keeping his own advice confidential.

.

“It’s hard to imagine that Dr. Williams both understands the issues, and is honestly saying keep things as they are,” said Dr. Andrew Morris, a professor of infectious diseases at the University of Toronto, and the medical director of the Antimicrobial Stewardship Program at Sinai-University Health Network, a couple weeks ago, when Williams defended the province’s restrictions framework. “I just find those two things impossible to reconcile. He either doesn’t believe the advice he’s giving, or he doesn’t understand the situation that we’re in.”

The framework was the moment that someone in this government grabbed the steering wheel and tried to yank Ontario into the wild Reform-style conservatism that has led Alberta, Manitoba and Saskatchewan to the worst second-wave spikes in the country, as their doctors plead for restrictions that either come too late or don’t come at all. And when Ontario tried it, Dr. David Williams was still on board.

“(He signalled) they can continue to direct the pandemic response as they see fit,” said one medical source familiar with Ontario’s response.

The counter-argument, as delivered by Ford more than once, is that it could be worse. Look at the numbers soaring in Manitoba, Alberta, Saskatchewan, B.C. Look at the untrammelled plague in the United States. Ontario’s not so bad. And comparatively, that’s true.

“This is nothing to brag about, because we’re in a serious situation,” said Ford. “But when I compare this spread that’s going on across our country and to the exclusion of the small Maritime provinces, we have the lowest cases. Then I look at the United States. Again, outside of a few small states, we have lower cases per hundred thousand than any other jurisdiction.”

But good Lord, pick a lower bar. Ontario has a vastly disparate population, an unequalled Canadian medical infrastructure in Toronto, and has succeeded only relatively, despite everything. To credit Williams for Ontario not being the Prairie wildfires, or the American disaster, is to not understand how wrong he’s been, how important public health and hospitals have been, and how much better it could be. It’s to fail to understand how , invested sooner, and could still be taking care of the vulnerable, and the working poor. But we’re not.

Replacing David Williams might mean doing this better, and it might mean a change. We could have tried but we didn’t, instead.

Clarification — Nov. 23, 2020: This article has been updated to make clear that a doctor who has worked with Dr. David Williams was not saying the current government appointed Williams as chief medical officer of health. He was appointed by the Liberal government.

Bruce Arthur is a Toronto-based columnist for the Star. Follow him on Twitter: