'Categorically not my boss': Niagara medical officer pushes back at Ontario's top doctor

In what is starting to look like a David vs. Goliath battle, Niagara’s top doctor asserted this week that he does not report to Ontario’s chief medical officer of health and will continue to reject the provincial doctor’s request to dial back COVID safety measures in schools. “The chief medical officer of health is quite categorically not my boss,” Dr. Mustafa Hirji, Niagara's acting medical officer of health, said during a regional council meeting that was covered by The Standard newspaper in the Niagara city of St. Catharines. “It is clear in the Health Protection and Promotion Act that a medical officer of health reports to, and is accountable to, the board of health, which is this regional council. Regional council is my boss.” The province’s chief medical officer of health, Dr. Kieran Moore, is a “close colleague that we want to work with at times,” added Dr. Hirji. “But, historically, when we take action that affects us locally, we generally have not consulted with the chief medical officer of health. That has never been an expectation.” Over the last two weeks, at least 29 people with COVID-19 have died in Niagara, which at last count had 153 COVID patients in hospital including 26 in intensive care. Read: Ontario hospital closing health centre in Niagara region due to staff shortage Dr. Hirji’s remarks in council on Jan. 20 marked the first time he spoke publicly about his disagreement with Dr. Moore, who sent a letter on Jan. 15 to Dr. Hirji to express his “concern with your approach to in-person school and childcare in Niagara.” The letter pointed out that Niagara is the only jurisdiction in Canada to keep students out of school for seven days if they test positive for COVID, two days longer than the provincial recommendation of five days. “I am concerned that these measures will lead to increased harms to children and youth in the Niagara Region and strongly urge you to reconsider your approach in alignment with provincial direction,” a Toronto Star article quoted from Dr. Moore’s letter. Dr. Moore also took issue with Niagara region requiring a verified doctor’s note from students asking for masking exemption, and with the provision of portable HEPA filters for poorly ventilated classrooms. Dr. Hirji needs to get approval from regional council before issuing these HEPA filters, wrote Dr. Moore. However, Dr. Hirji controls a budget set annually by regional council. Read: Shorter isolation allowed in Ontario if two rapid tests come back negative According to The Standard's article, Dr. Moore’s office took the unusual step of sending copies of the letter to Niagara region’s chair, the province’s deputy ministers of health and education, and to local school board leaders. Niagara’s anti-vaccine community—which has targeted Dr. Hirji in the past through actions such as shining a strobe light into his home and yelling vulgar remarks over a megaphone—also got hold of the letter and circulated it on social media. “This became very political very quickly, and I don’t know where the heck that came from,” Rob Foster, a councillor for the Niagara region town of Lincoln. “It’s apparent that the memo was leaked, and how it became a readily available public document is somewhat beyond me.” During the Jan. 20 meeting, Niagara’s regional councillors voiced their support for Dr. Hirji and pushed to remove the word "acting" in his job title. “When Dr. Hirji released the memo with additional measures about the school boards and CO2 monitoring and everything else, hundreds of parents across Niagara breathed a collective sigh of relief about the safety of schools and protecting Niagara’s children,” said St. Catharines councillor Laura Ip. “Let’s remember children are contracting COVID, they’re taking it home, and their parents are taking it into their workplaces and the rest of the community. “What I know for sure is that the vast majority of parents in Niagara do not want to spin the roulette wheel that is the Omicron when it comes to their children’s and their family’s safety.” Read: Saskatchewan schools take on contact tracing once done by healthcare workers Regional chief administrative officer Ron Tripp noted that Dr. Hirji is not dictating to schools, and that Niagara’s current safety measures for education were decided through discussions between public health and school officials. “We’ve worked collaboratively with the four school boards, and I think we came to an agreement that was informed by all the different inputs,” he said. Dr. Moore did not always stay within provincial guidelines when he was medical officer of health in 2020 for the eastern Ontario communities of Kingston, Frontenac, Lennox and Addington. In June of that year, Dr. Moore issued a sweeping masking order for indoor public venues in region–a measure the province did not adopt until October 2020. Read: Bringing surgeons to patients: Check out this Ontario hospital's surgeon of the week program

'Categorically not my boss': Niagara medical officer pushes back at Ontario's top doctor

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