Zombies, Scapegoats and Crises, oh my!

Last night, the Alberta politics Twitterati entertained themselves with the idea that Premier Smith had accidentally appointed the wrong Dr. Joffe. The idea was so delicious that the Strategists apparently devoted an entire podcast to it. And I succumbed to peer pressure and drew a flowchart.

But there’s no way that happened. Because if you’re going to spend political capital to appoint an enthusiast of the Great Barrington Declaration as your chief public health officer, you’re not going to make it an interim appointment. Back to reality, guys!

Replacing the Zombie CMOH

The harsh reality is that for the past month, Alberta has had a Zombie CMOH. When Premier Smith casually announced at the press conference after her swearing in that Dr Hinshaw would be fired, she effectively ended her time as CMOH. But no formal actions were taken or announced until yesterday, so Dr Hinshaw remained in the role with no ability to act or speak publicly.

Which is a bit of a problem when the spread of infectious disease is filling pediatric emergency rooms with sick children, and pushing that part of the health system to the brink of collapse.

As Chief Medical Officers in other provinces have started to make public statements and even encourage members of the public to put their masks back on to help ward off disaster, the Zombie CMOH situation became intolerable.

Enter Dr Joffe, a seasoned AHS senior leader. And, I suspect, someone strongly inclined to do the right thing, even at some personal cost. Because he has just agreed to take on a highly visible role with responsibility for managing a rapidly worsening public health situation, knowing that most of the powers of the position cannot be exercised, and all for no extra pay.

(Somewhere in an office tower in downtown Edmonton, there’s a search consultant with a sick feeling in the pit of their stomach knowing that soon they’ll be writing a cheery document detailing the “opportunity” for a “progressive public health leader” to take on the important leadership role of Alberta’s next Chief Medical Officer of Health. And then phoning senior public health officials across the country asking if they’d like to move to Edmonton to enjoy the 9 hours of daylight in winter and the chance to be fired for doing their job. But I digress.)

Scapegoats: 2 and counting

For any ambitious health leaders thinking of making the move to the country’s northernmost provincial capital, a word of advice: pay careful attention to the terms of exit in your contract. Alberta’s developing a bit of a habit when it comes to public health officials.

Let’s not forget Dr Verna Yiu, who was removed from her role at the helm of Alberta Health Services last spring to appease the UCP party base, which had settled on the bizarre fiction that if AHS had ‘done its job’ then Alberta could have sailed through the pandemic without any of the pesky mask and vaccine mandates that the rest of the country adopted.

Happily, Dr Yiu quickly found a new role as interim Provost at the University of Alberta. (The role of Provost is notoriously challenging: you’re the ‘hand of the king [president]’ which means you do all the hard work while the President takes credit. Universities are sprawling complex places filled with very smart and extremely opinionated people who resent being managed. I suspect that Dr. Yui is the first person in the history of university leadership who would find the role of Provost more relaxing than her previous job. But I digress. Again.)

I find it difficult to muster up the same sympathy for Dr Hinshaw as I did for Dr Yiu. When the pandemic started, she was a heroic figure, bringing science to a frightening situation. Like many of you (and Dr Joffe apparently), I bought a t-shirt.

And there’s no question: Dr Hinshaw faced an incredibly challenging situation as she offered public health advice to a government disinclined to implement mandatory measures and struggling with its own internal divisions.

But in the summer of 2021, Dr Hinshaw allowed that government to claim that their decisions were, in fact, hers. And then allowed the government to release an op ed supporting the ‘best summer ever’ decision under her name. At that point, her credibility cratered, and never really recovered. (Figure below is a sneak peak of a chapter I wrote in the forthcoming Blue Storm edited volume - coming soon!). At about that point, I started wearing my Hinshaw t-shirt inside out.

Trust is essential for a Chief Medical Officer of Health. The challenge Dr Hinshaw faced was that, to maintain the trust of her bosses in government, she had to do things that would cause the medical community and the public to lose trust in her. And yesterday’s announcement was her ‘reward’ from that government.

This is the week that the Smith government is focusing on health care, so I’ll be watching to see if the scapegoat count goes up.

The Crisis We’re In

Yesterday’s announcement must have been both satisfying and frustrating to the people who supported Danielle Smith’s run for UCP leader. On the one hand, the author of the terrible “lockdowns” and “mandates” was gone. But in her place, Smith appointed an AHS doctor with impeccable credentials and a history of publicly encouraging vaccinations as a means of managing infectious disease.

Why did she do this? Because the bumpers are up on her bowling lane.

Ironically, Dr Joffe is probably better positioned than Dr Hinshaw was to be a voice of scientific and medical reason as Alberta copes with the current stage of the ongoing COVID crisis. He has not been tainted by the province’s handling of the pandemic up to this point. He was not a character in the musical comedy about the internal drama of Jason Kenney’s government. And as an interim appointee with a regular job at AHS, he doesn’t have as much to lose if he deviates from the government’s position.

And I’ll end this rather long newsletter with one comment about the government’s position, as articulated by the Premier yesterday. We live in a province where we value children. We value them so much that we don’t want to make them suffer by having to wear a mask to school. Even if the cost is that other children spend 12 hours sitting miserable and feverish in an ER waiting room staffed by nurses and doctors on the brink of collapse.

Best of luck, Dr Joffe.