We can’t say it’s a big surprise. On the front lines of the fight against COVID-19 for almost two years, Dr Horacio Arruda has tendered his resignation as National Director of Public Health.
The dazzling spread of the latest Omicron variant has certainly had something to do with it. Except that the criticisms against him, but also with regard to the management of the pandemic by the Legault government, had already begun to be more numerous and more insistent. Over the months, inconsistencies surfaced, many of which stemmed from the evolution of knowledge surrounding this coronavirus and its variants. Lately, with the explosion in the number of cases caused by Omicron and the rise in hospitalizations which are pushing the network to its limits, a feeling that the government was losing control has spread.
In his resignation letter, Dr Arruda recalled the “context of uncertainties and rapid progression of knowledge” which led to the various opinions of Public Health and its recommendations. “The recent comments on the credibility of our opinions and on our scientific rigor undoubtedly cause a certain erosion of the support of the population”, admitted the resigning.
He was criticized for having opposed wearing a mask at the start of the pandemic, when he argued that they gave a false sense of security and that people infected themselves by handling them. He was slow to recognize the aerosol spread of COVID-19. But it was only expressing the consensus of public health experts who believed the coronavirus to behave essentially like the flu virus. However, COVID-19 had some surprises in store for us.
Quebec has also been slow to embrace rapid testing. Again, it is a decision of Public Health, which considered it a priority to properly identify the infected people and thus systematically search for cases. This strategy worked well with the Delta variant: we can say that before the arrival of Omicron, the situation, both in terms of the number of cases and that of hospitalizations, was under control.
The apparent simplicity of Dr Arruda, his good nature, his colorful expressions served him wonderfully at the start of the pandemic. She contrasted with the cerebral coldness of some of her colleagues in Public Health. But these qualities had their faults, especially when it was necessary to defend a damaged credibility.
The dramatic emergence of the Omicron variant led to the return of restrictive health measures, including the curfew. The population had to revise their plans for the Holidays. Students are not yet guaranteed to return to class next Monday. Alongside François Legault, the Minister of Health and Social Services, Christian Dubé, said Tuesday that he was discussing with the unions to add 2,500 people in the very short term to the workforce in hospitals and CHSLDs. Horacio Arruda is not responsible for this situation. The storm is global, the Prime Minister said on Tuesday. But the weak capacity of our health system is typically Quebec.
This poor capacity is challenged by the unvaccinated. While they represent 10% of the adult population, they represent 50% of COVID-19 patients who are hospitalized. The Caquista government wants to crack down on them by imposing a special “health contribution”, which would be levied by the tax authorities, a bit like the drug insurance premium. Assume that only taxpayers who pay tax would be affected. Better than compulsory vaccination, very difficult to impose, this contribution is not at first sight a public health measure, but a vindictive charge against a selfish and brainless minority.
It would be wrong to throw stones at Horacio Arruda. What we can blame him for, and it is not really his doing, is his proximity, his symbiotic relationship with the government. “At the end of the day, it’s the government that decides,” said François Legault. Very good. But it would be necessary to know what Public Health, in complete independence, thinks.
Now is not the time to change structures; the priority is the fifth wave, said the Prime Minister. Hopefully, however, the new interim national public health director, Dr.r Luc Boileau, who was before his appointment President and CEO of the National Institute of Excellence in Health and Social Services (INESSS), will insist on maintaining a healthy distance. He may have already started: called to comment on this contribution imposed on the unvaccinated, he suggested that Public Health does not have to pronounce on all the decisions of the government.