What if the real scandal of Ontario’s science table is exhaustion?

OPINION: Amid the controversy of epidemiologist David Fisman’s resignation from the table, one thing is clear: our best and brightest are burning out
By Matt Gurney - Published on Aug 24, 2021
David Fisman is a professor of epidemiology at the University of Toronto’s Dalla Lana School of Public Health. (@DFisman/Twitter)

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This isn’t a column about the resignation of epidemiologist David Fisman from the Ontario COVID-19 Science Advisory Table, a volunteer group of experts who’ve been advising the government throughout the pandemic. But his resignation makes a good place to start the column.

Fisman has been an outspoken critic of the government and has been right on many occasions. As noted here in my own columns, the Doug Ford government has a lot to answer for, both in terms of smart things it didn’t do and unwise things it did. When Fisman suggested the table might be sitting on “important modelling work“ showing a grim fall ahead for Ontario and, in response to a tweet, left open the possibility that political considerations might be at play, that seemed entirely plausible. I’ve been watching our ICU occupancy level for weeks, as it is now our most useful, meaningful metric for understanding the pandemic. And it is moving in the wrong direction. It’s not high enough yet to pose any danger. But that’s been true of the metrics at every stage in the pandemic before a disaster: the numbers rise for a while before they get too high, and we haven’t been willing to act quickly and ruthlessly enough to head off the disaster until it has begun. So what Fisman said made sense to me.

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But ... it wasn’t what I’d been told. 

I’m in an awkward spot here, as most of my chats about this have been off the record or on background, so forgive me for speaking only in the most general terms. But I can say that those individuals “in the know” I’ve spoken to this summer are worried about the fall but that, to the very best of my knowledge, there was no official model yet, because it simply wasn’t (and isn’t) ready. Everyone agrees it would be good to have it, but the science table, as I’ve heard it, has been operating at a slower pace this summer because everyone is exhausted, they’re all volunteers, and they had simply reached their limit and needed a break. I’ll add further that Bruce Arthur’s column in Tuesday’s Toronto Star, which includes some on-the-record quotes, reflects an understanding that basically perfectly aligns with my private understanding of the situation. I’d encourage you all to read it. I repeat: read Bruce’s column.

In the meantime, though, you can summarize my private grasp of the situation and Bruce’s public reporting with basically the same snappy one-liner: the members of the science table have concerns about the fall and are working on a model and wish it were ready, but it isn’t, because the people doing the work needed a break after working crushing volunteer hours on top of their essential day jobs for basically 18 months straight. So it’s not clear to anyone what Fisman was talking about when he said there was modelling work that was not being released (the science table publicly denied that claim). 

But, as I said above, this isn’t a column about Fisman. The Fisman stuff is just the preamble to the key point here: exhaustion. Fisman’s resignation is ultimately a personal decision, but the discussion around his resignation is forcing an issue into public view: some of our best and brightest are exhausted and simply cannot continue on like this.

It’s not a new issue. In a July interview, the Ontario Hospital Association’s Anthony Dale flagged for me accumulated exhaustion among health-care workers as a major issue that Ontario must contend with. Our staff is fried, but there’s no relief in sight — even if we largely avoid a punishing fourth (and further) waves, there are still the routine care needs of 15 million people, plus the accumulated backlog in testing and care caused by the pandemic. Furthermore, a big part of me suspects exhaustion, to the point of near collapse, was largely responsible for the absolute chaos in Ontario’s government at the start of the third wave. 

Dear reader, I implore you to actually think back that far, to when the police were being given massive new powers and playgrounds were ordered closed. I ask you to remember Ford’s emotional press conference from the backyard of his late mother’s home. Set aside your normal partisan preferences or whatever your personal feelings on Ford are. Shunt them off to the side of your brain just for a moment. Think back to those days, and tell me sincerely that you don’t think exhaustion played at least some role in the chaos.

It’s not just the politicians and the doctors and the nurses. We’re all tired. All of humanity, probably. (And remember, Ontario hasn’t been that badly hit compared to some other places.) There is no cure for exhaustion and probably no avoiding it, not during an emergency like this. But if and when we are ever able to properly review the time of COVID-19 and assess where our weaknesses were, we should give at least some attention to the psychology of decision-makers and essential personnel — not because they have failed us but because we cannot rest our plans for future emergencies on theoretical notions of human beings who never get tired, never burn out, and never make bad, impulsive decisions because their brains simply cannot process any more information and output good conclusions. 

We’ll have to think long and hard about our systems and our institutions and how to make them stronger. But human beings are at the centre of all of this. We have limits. We are pushing them.

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