Health department staff members enter the Andrews County Health Department measles clinic carrying doses of the measles, mumps and rubella vaccine, on April 8, in Andrews, Tex.Annie Rice/The Canadian Press
Every Thursday, Public Health Ontario posts an “enhanced epidemiological summary” revealing the cumulative number of measles cases in the province. Alberta does the same, without the fancy descriptor, opting for a straightforward “Measles cases in Alberta” report.
Ontario’s total reached 1,020 measles cases last week, almost 100 more than the previous week. Alberta reported 137 cases, up from 105. That seems to be the sum total of the public-health response: counting new cases.
These are deeply disturbing numbers. They warrant action.
Canada is in the midst of its worst outbreak of a preventable childhood illness in three decades. There are more measles cases in Ontario than in all of the United States, which has reported 884 cases. There have been 11 outbreaks in the U.S. this year, the worst of them in Texas. Public health should be pulling out all the stops, not sitting on its hands.
Yet Dr. Kieran Moore, Ontario’s Chief Medical Officer of Health, has been largely silent, save for a handful of media appearances. During those interviews, he has played down the threat more than he has conveyed its severity. The CMOH has noted the spread is largely in Mennonite communities, suggesting it’s not a big threat to the general public.
Dr. Moore has also defended his own low profile, saying local public-health units are doing a good job. Well, the ever-growing number of measles cases tells a different story, and we know most public-health units are shoestring operations that struggle at the best of times.
Dr. Moore has also defended the province’s law that allows any parent with a “religious or philosophical” objection to opt out of vaccinating their school-aged children.
The opt-out law is indefensible. Allowing unvaccinated children in classrooms is a recipe for disaster.
Adults are free to do what they want with their own bodies – including refusal of vaccinations. But rules that prevent harm to others, such as requiring vaccination in some circumstances, are appropriate. And doubly so when applied to children.
Ontario’s top doctor needs to show leadership on this crucial issue. The CMOH isn’t paid $464,148 to waffle.
Meanwhile, in Alberta, the silence on measles is even more deafening. The government of Danielle Smith is openly hostile to public health. Earlier this month, it let the contract of its Chief Medical Officer of Health expire. Dr. Mark Joffe had been serving on an interim basis since 2022.
One of the first things he did after losing his job was write a searing piece in the Calgary Herald about the danger of the continuing measles outbreak in the province. The timing suggests he couldn’t do so when his job was (presumably) to tackle the outbreak. The new interim CMOH, Dr. Sunil Sookram, has not spoken publicly.
There are costs to officialdom’s indifference and inaction, the least of which is not hundreds, and perhaps soon thousands, of sick children.
There is also the financial cost. Measles is a reportable disease, and contacts of infected people need to be tracked down. The U.S. Centers for Disease Control and Prevention has found that, between contact tracing and treatment, each measles case costs between US$30,000 and US$50,000. That money could be better spent on prevention.
So, what more should public health be doing to slow the spread of measles?
Dr. Shelley Duggan, president of the Alberta Medical Association, says the province needs to offer weekly public briefings, dramatically expand public messaging, and set up booster clinics in areas with low vaccination rates.
Dr. Duggan also warned that, with the current laissez-faire approach, Alberta will surpass 1,000 measles cases within a few weeks, which would be a disaster.
It’s the same message out of Ontario, where Liberal public-health critic Adil Shamji (himself an ER doctor) called on the province to adopt a five-point strategy: a province-wide catch-up vaccination program (which is already happening in some health regions); millions of dollars in new funding for beleaguered public-health units; putting public health, and a measles response in particular, on the legislative agenda; regular briefings on measles from top public-health officials and politicians; and launching a province-wide vaccine-education campaign.
It’s sad that we’re at the point where politicians and professional organizations are doing a better job of public-health messaging than public-health officials.
In the U.S., as the COVID contrarians seek revenge, we’re seeing deliberate and sustained attacks designed to destroy the public-health infrastructure. In Canada, public health seems to be its own worst enemy, losing sight of its overarching role to protect the health of the population as a whole, not the purported rights of some individuals to harm others.
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Editor’s note: This article has been updated to correct the name of Public Health Ontario and the description of its weekly enhanced epidemiological summary.