After Wallace inquires as to why, MacDonald writes to Adamo and Kline, saying the Star wants a reason.
“I would say nothing at all or a scheduling conflict,” Adamo replies.
Adamo also instructs the Ontario Health communications team to cancel the remainder of Anderson’s media interviews following a segment on CBC’s “Metro Morning.” No explanation was included in the emails.
That day, Moore also spoke to The Canadian Press, Postmedia and the Globe and Mail.
The emails show that Adamo asks to view the names of the media outlets and reporters to be approached. As well, Adamo tells the communications teams for Ontario Health and the chief medical officer that “We’d also like to see key messages for both Matt and Dr. Moore in advance.”
The three-page document outlining Moore’s speaking points includes messages on the importance of getting a flu shot and COVID booster, staying home if sick, good hand hygiene, wearing a mask in indoor public spaces and creating a mask-friendly environment if you are hosting guests.
The health system was stressed at the time — hit hard by a “triple threat” of COVID, RSV and flu cases, with strains on the pediatric care system and in emergency rooms. Calls for a return to masking had resurfaced the month earlier and Moore himself had urged residents to wear masks in indoor public settings.
Western University’s Smith says some degree of communications co-ordination between the offices of the chief medical officer of health and the minister is to be expected to “avoid unnecessary mixed messaging.”
“However, the line between co-ordination and control can become blurred or easily crossed, the result of which being that public health communications are mediated by political considerations and objectives,” he says. “This can in turn undermine the public’s trust in public health interventions and communications insofar as they’re no longer perceived as being independent from political influence, and hence no longer strictly in the interest of the public’s health.”
Lori Stoltz, a lawyer with expertise in public health law, says the emails raise questions about the independence of the chief medical officer.
“And the reason that’s an important question is that the CMOH under the Ontario legislation holds very important operational powers that are there to be engaged in times of public health emergency,” she says.
“In the context of a public health emergency, it is absolutely essential that the population have confidence that the chief MOH is going to advise the public and advise the minister and exercise those powers or choose not to exercise those powers really free from bureaucratic or political pressure of any kind … It’s not just the actual independence but the perception of independence.”
Josh Greenberg, director of Carleton University’s School of Journalism and Communication, says when bureaucrats engage in the kind of message control highlighted by the emails, it risks shifting the focus from public health to politics.
Greenberg notes there was an observable shift in Moore’s approach to public health advocacy and communication after he moved from his role as the chief medical officer for Kingston, Frontenac, Lennox and Addington to Ontario’s chief medical officer of health in 2021.
At the regional job, he was “widely lauded for his openness,” Greenberg says, but as a provincial chief medical officer “his style became very clearly more controlled.”
“This may well reflect the different responsibilities and priorities that these jobs entail.”
Fafard says the chief medical officer’s competing roles can cause confusion, even among public health experts, many of whom believe the chief medical officer’s priority is to advocate for the population’s health.
Recent academic papers by Fafard, including one in which the authors interview former medical officers of health, call on governments to clarify the role.
“Coming out of the pandemic, we need to ask questions about what we learned, and what changes we want to make,” Fafard says. “Because we do want the (CMOH) to be understood by the public as autonomous and independent, but there may be better ways of doing that.”