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Open Letter to Premier David Eby, Health Minister Adrian Dix, Provincial Health Officer Dr. Bonnie Henry, the Board of Vancouver Coastal Health

Protect our Province BC along with several other medical professionals, scientists, and academics are extremely concerned about misinformation spread by Dr. Patricia Daly, Chief Medical Officer of Health for Vancouver Coastal Health. We are calling on Premier David Eby, Health Minister Adrian Dix, Provincial Health Officer Dr. Bonnie Henry and the Board of Vancouver Coastal Health to immediately remove her from her role.

On May 5th Dr. Daly made multiple incorrect assertions about COVID-19 in an interview on CBC’s “BC Today” radio show (transcript here) None of her statements are supported by current science on the SARS-CoV-2 virus, and many of them contradict scientific findings from the Province of BC’s own health agencies. The misinformation that Daly spread could be grievously harmful to the health and safety of CBC’s listeners and to British Columbians in general.

Public Health leaders cannot broadcast unscientific misinformation that puts the public at risk. They must be held accountable for their actions and for their public communications.

Most of Dr. Daly’s incorrect statements about COVID-19, the most egregious of which are itemized below, amount to a contradiction of available data and a downplaying of the risks posed by this virus. Covid is not ‘like a cold.’ Saying this in 2023, when rates of death, hospitalization and Long Covid remain high and bear no resemblance to the impacts of the common cold, more closely resembles internet disinformation than science.

Dr. Daly’s statements vs. the science:

1. On COVID-19 being ‘like a cold’:

As journalist Crawford Kilian reported in The Tyee, "Dr. Patricia Daly, chief medical officer of health for Vancouver Coastal Health, was on CBC Radio on May 5, the day WHO declared the end of the emergency. She encouraged listeners to think of SARS-CoV-2 'like other respiratory viruses,' especially the coronaviruses that can cause common colds."

If COVID-19 is just a cold, why did 42 British Columbians die of the virus in the final week of April 2023? If COVID-19 is just a cold, why does the BC CDC feature on its website a long list of COVID-19 symptoms and long term consequences, but no equivalent page for the common cold?

There are multiple harms from COVID-19 that have not been clearly established with common cold viruses. For instance, a BC study indicates COVID-19 is associated with an increased risk of diabetes.

So far, this is “the twelfth study linking COVID infections to later diabetes diagnoses.”

Just because BC public health stops looking (and counting) COVID-19’s impact after 30 days, does not mean SARS-CoV-2’s harmful effects magically stop thereafter.

In an April 21, 2023 interview, the Provincial Health Officer finally “acknowledged that while the acute symptoms of a COVID-19 infection are typically brief, the longer-term impacts are increasingly evident.

“It's not just affecting the lungs,” said Henry. “We know it can lead to heart disease, we know that people who have post-Covid symptoms have things like neurological issues, they have fatigue and brain fog and some of the other things that we have seen are related to things like diabetes.”

2. On “Hybrid immunity”:

Dr. Daly stated that British Columbia has “such high population immunity against COVID-19” through a combination of vaccination and infection and “that strong hybrid immunity means that our population is now protected against severe illness and death.”

This claim is unsubstantiated. BC CDC’s own report, 2022/23 Respiratory Season Surveillance Report, Epidemiological weeks 35-17 (August 28, 2022- April 22, 2023) states:                                                                                                                   
Hospitalizations, critical care admissions, and deaths among individuals with a positive COVID-19 test stayed relatively stable but elevated throughout the season, with highest rates among 60+ year olds.                                                                

In the week of April 23 to 29 2023 alone, there were 42 COVID-19 deaths. Whether these deaths are from or with Covid misses the point. It’s like asking whether SARS-CoV-2 is the culprit or the accomplice that led to an early death.

42 COVID-19 deaths is an undercount. It does not include all the deaths from post-Covid conditions occurring 30 days or more after an acute infection. Again, the damage done by SARS-CoV-2 does not magically stop after 30 days.

As of February 4, 2023, BC is the province with the third highest number of all cause excess deaths since the pandemic started. These are deaths above expected historical levels, and they exclude deaths arising from the toxic drug supply and the 2021 heat dome. What is causing excess deaths in BC? To provide an answer, our public health leaders must first acknowledge these excess deaths even exist.

Focusing on COVID-19 deaths reported to the Public Health Agency of Canada, BC saw more Covid related deaths in 2022 than in 2020 and 2021. So far in 2023, BC reported 635 COVID-19 deaths within 30 days of infection. At the same rate, we can expect COVID-19 deaths in 2023 to surpass those of 2022. Where is that strong hybrid immunity Dr. Daly talks about?

Dr. Daly’s claim of “strong hybrid immunity” (infection plus 2 vaccine doses) also completely ignores the low vaccination rate of BC children. Only 42% of children 5 to 11 years of age have received two vaccine doses, while that number falls to 15% in children 6 months to 4 years of age. What about clinically extremely vulnerable children? Do they have “strong hybrid immunity”? BC’s very own study showed that even after three doses of vaccine and the arrival of Omicron, CEV adults had significantly more “breakthrough hospitalizations” compared with matched non-CEV adults.

In addition, Omicron infection is a poor booster of COVID-19 immunity and cannot be relied on to confer “strong hybrid immunity”. This helps explain why Omicron reinfections are so common.

Not only do Omicron infections not provide significant immune protection from COVID-19 going forward, they actually carry a risk of immune dysregulation rendering one susceptible to other viral, bacterial and fungal infections, and the reactivation of dormant infections such as Varicella-Zoster virus, Epstein Barr virus, CMV and more.

Also not mentioned by Dr. Daly, is that one in every ten Covid infections leads to Long Covid, as stated by the WHO.

3. On young people being at “low risk” from COVID-19:

Dr. Daly: “young people… are at very low risk by the way of COVID-19.”

COVID-19 has not been mild in kids over the past year, as BC CDC’s own situation reports showed. The number of BC children under 10 who were hospitalized from Jan 1 to November 26, 2022 was 3.6 times higher than the total admissions in 2020 and 2021 combined. The critical care admissions were 5.2 times greater over that same period compared with the total critical care admission in the first two years of the pandemic.

For the 10 to 19 year olds, admissions were 2.4 times higher during the same period while critical admissions were twice as high than the total at the start of 2022.

Let’s also remember that these numbers do not include Long Covid in BC children, nor new post-COVID-19 chronic medical conditions such as new onset diabetes in children.

4. On LTC residents being no more at risk from Covid than from the common cold:

Dr. Daly: “Among the people most at risk, for example people living in LTC, the level of risk is about the same as those common cold viruses. The risk of experiencing severe illness and death is probably about the same.”

Imagine being a CMOH and making this egregious comment. As BC CDC’s own data shows, even with Omicron’s arrival, seniors continue to die and make up the majority of acute Covid related deaths. Additionally, dementia is both a risk factor for getting infected with Covid and for dying from it. SARS-CoV-2 accelerates the dementia process, effectively robbing residents and their families of precious remaining quality of life.

In 2021-2022, COVID-19 was the third leading indication for hospital admissions in BC. In the 65 and over, it was the 5th leading cause of admissions.

In Canada, for 2020, the first year of the pandemic, the common cold viruses did not make the top 10 list of causes of deaths in 65-74 year olds. Even influenza and pneumonia ranked 9th behind COVID-19's 5th place as the leading cause of death in that age group.

5. On Long Covid and post-Covid conditions:

Dr. Daly: “I know some people may be concerned about long term implications of infection, that is no different than other viruses, that may have longer term implications to people who are infected.”

Is that so? Unlike the common cold viruses, SARS-CoV-2 is associated with a long list of serious post-Covid conditions including Long Covid, heart attacks, strokes, kidney and liver disease, blood clots and much more, as the BC CDC's own communication to primary care providers lays out.

If there were no significant long term health implications from COVID-19, why did the province start in April 2020 to develop a post Covid interdisciplinary clinical care network?

6. On the Cochrane review on the efficacy of masks:

Dr. Daly: “There was a really great Cochrane review, and this is an organization that looks at the evidence around a whole bunch of interventions in healthcare, that looked at population use of mask and they did not find they were a lot of benefit in Covid-19.”

This is a gross misrepresentation of the findings of the Cochrane review.  The Editor-in-Chief of the Cochrane Library, Karla Soares-Weiser, posted a response addressing similar misleading comments. “Many commentators have claimed that a recently-updated Cochrane Review shows that ‘masks don’t work’, which is an inaccurate and misleading interpretation.”

“It would be accurate to say that the review examined whether interventions to promote mask wearing help to slow the spread of respiratory viruses, and that the results were inconclusive. Given the limitations in the primary evidence, the review is not able to address the question of whether mask-wearing itself reduces people's risk of contracting or spreading respiratory viruses.”

A recently published article, Masks Work. Distorting Science to Dispute the Evidence Doesn’t, provides a good explanation of why randomized controlled trials are not useful, and could even be unethical, when it comes to proven engineered solutions. We would not use such trials to evaluate seatbelts or parachutes, nor should randomized controlled trials be used to evaluate masks.

This misleading statement made by Dr. Daly regarding mask use during the COVID-19 pandemic, is also particularly concerning given that she is not only Vancouver Coastal’s CMOH but also a Clinical Professor in the School of Population and Public Health in the UBC Faculty of Medicine. She is responsible for the education of future public health leaders.

7. On antiviral agents being made available to the public:

Dr. Daly: “...we also have antiviral agents that are available, that people can take if they're at high risk for severe disease. Those are excellent tools and we should continue to use those going forward.”

Paxlovid is less available in BC than in any other province or territory in Canada. How can we “continue” to use tools that are available to almost no one in BC, because of severely restrictive eligibility criteria?

In summary, Dr. Daly’s public statements are not based in science and they minimize the real risks of COVID-19 infections. We expect public health leaders not to negligently misrepresent the accumulating scientific evidence related to SARS-CoV-2. We expect these authorities to protect all British Columbians who still put their trust in provincial public health leaders, not put them at risk of harm.

The undersigned call for Dr. Daly’s immediate removal from her current role as Vancouver Coastal Health’s VP of Public Health and as Chief Medical Health Officer.

We also demand a public retraction and correction of Dr. Daly’s May 5th, 2023, comments on CBC radio to limit the harm her false claims could cause to British Columbians. Trust in public health must be restored.

"WHN is in agreement with the scientific statements in this letter that challenge the misinformation that has been provided to the public."

~ Yaneer Bar-Yam, Professor and President, New England Complex Systems Institute, Co-Founder World Health Network

Signed:

Protect our Province BC, including:

• Dr. Elisabeth Crisci, Medical Director
• Jaclyn Ferreira, Researcher & Disability Inclusion Advocate, Protect our Province BC
• Dr. Lyne Filiatrault, retired Emergency Physician, Protect our Province BC
• Jennifer Heighton BSc (Physics), BC Teacher, Safe Schools Coalition BC, Co-founder Protect our Province BC
• Dr. Susan Kuo, Family Physician, Clinical Associate Professor, UBC Faculty of Medicine, Protect our Province BC
• Dr. Karina Zeidler, Family Physician, Clinical instructor, UBC Faculty of Medicine, Co-founder of Protect our Province BC

Other Individual signatories:

• Dr. Satoshi Akima, BHB, MBChB, FRACP, consultant physician Nephrology and Internal Medicine, South Western Sydney Area Health Service, Australia
• Dr. Ric Arseneau, MD, FRCPC, MA(Ed), MBA, FACP, CGP, Clinical Professor, Division of General Internal Medicine, St. Paul's Hospital, University of British Columbia
• Yaneer Bar-Yam, Professor and President, New England Complex Systems Institute, Co-Founder World Health Network
• Dr. David Berger, BSC(Hons), MBBS(Hons), MRCP(UK), MRCGP, FRACGP
• Anne Bhéreur, MD, CCFP(PC), FCFP
• Astrid Brousselle, Ph.D. in Public Health, Professor, School of Public Administration University of Victoria
• Arijit Chakravarty, Ph.D., CEO, Fractal Therapeutics
• Damien Contandriopoulos, Professor, School of Nursing, University of Victoria
• Mauricio Drelichman, Ph.D.
• Dr. Lauralee Dukeshire, MD, CCFP, Family Physician 
• Dr. Genevieve Eastabrook, MD, FRCSC, Associate Professor of OBGYN and Maternal Fetal Medicine subspecialist
• Dr. David Fisman, Professor in the Division of Epidemiology, Dalla Lana School of Public Health 
• Colin Furness, Ph.D., MPH, Epidemiologist and Assistant Professor, Faculty of Information, University of Toronto
• Malgorzata Gasperowicz, Ph.D., Developmental Biologist
• José-Luis Jimenez, Distinguished Professor, Dept. of Chemistry & Biochemistry, CIRES Fellow, University of Colorado
• Gabrielle Peters, Disabled Writer, Policy Analyst
• Kimberly Prather, Atmospheric Chemist, Distinguished Chair in Atmospheric Chemistry, and a Distinguished Professor at the Scripps Institution of Oceanography and the Department of Chemistry and Biochemistry at UC San Diego
• Dr. Doreen M. Rabi, MD, MSc, FRCPC; Professor of Medicine, Cardiac Sciences and Community Health Sciences, Cumming School of Medicine, University of Calgary
• Laurence Svirchev, MA, BS, CIH, Svirchev OHS Management Systems, Vancouver, Canada
• Mark Ungrin, Interdisciplinary Biomedical Researcher, Associate Professor University of Calgary