Dr. Jennifer Russell has resigned
Russell confirmed she will be leaving her position 'later this fall'
She was unavailable for an interview, but confirmed she will be leaving her position "later this fall."
"I look forward to sharing more details about my plans in the near future," she said in an emailed statement.
She also confirmed her candidacy for the position of president-elect of the Canadian Medical Association.
"It has been an honour and privilege to lead the Office of the Chief Medical Officer of Health in New Brunswick, particularly during the pandemic," Russell said.
"I am proud of the work and positive outcomes that employees, staff, stakeholders and New Brunswickers achieved together."
Face of the pandemic response
Health Minister Bruce Fitch wished Russell "all the best in [her] future endeavours," in a post on social media Friday.
"Thank you Dr. Russell for all your service to the people of NB," he wrote.
Russell became the face of the province's response to the COVID-19 pandemic, providing daily televised briefings, and received the Order of New Brunswick in 2021 "for her steadfast and outstanding leadership and commitment, and for the compassion she showed while working to protect the health and safety of New Brunswickers."
But she later faced allegations of possible political interference, which she has denied.
Russell has been repeatedly unavailable for interviews in recent months.
No timeline for successor
Asked about the province's plans to find a successor, Department of Health spokesperson Sean Hatchard said the recruitment process hasn't started yet.
"We are not able to provide a timeline for when it will be completed," he said in an emailed statement.
Russell has served as the province's chief medical officer of health for about eight years.
She joined Public Health in 2014 as the deputy chief medical officer of health and later served as acting chief medical officer of health following Dr. Eilish Cleary's dismissal in November 2015, before being appointed chief.
"It has been a pleasure to serve my province, utilizing my clinical experience as a family physician, as a hospitalist and addictions and mental health experience, combined with my passion for upstream prevention and improving population health," said Russell.
"Throughout the pandemic, I asked the public to be kind, to be compassionate, and to support one another. I remain thankful to so many New Brunswickers who continue to show me that same kindness, support and encouragement every day."
Group identified as 'COVID core' in 3rd spot, Paul Martin's audit of the province's pandemic response shows
Bobbi-Jean MacKinnon · CBC News · Posted: Sep 07, 2023 11:07 AM ADT
N.B.'s top doctor at bottom of COVID-19 decision-making hierarchy, auditor general finds
Group identified as 'COVID core' in 3rd spot, Paul Martin's audit of the province's pandemic response shows
He described the COVID core as "the group of senior officials who supported the cabinet committee on COVID-19."
Tory MLA Trevor Holder said he didn't recall any such group and questioned what its purpose was.
Martin said, "a process was created whereby the Department of Health would bring forward advice to COVID core who would then review, challenge and provide strategic thought around the information."
Department of Health advice would then proceed to the cabinet committee on COVID-19 and on to cabinet, he said. The minister of Justice and Public Safety would then issue mandatory orders under the Emergency Measures Act "informed by advice from the Department of Health."
Tory
MLA Trevor Holder stressed the importance of proper record-keeping to
avoid a situation where things that get acted upon don't actually
reflect the decision of cabinet and elected officials. (Legislative Assembly of New Brunswick)
Overall, the government reacted quickly to the COVID-19 pandemic with unprecedented measures aimed at saving lives, including the province's first state of emergency, he said.
But he criticized the government's level of preparedness. For example, New Brunswick did not have an updated pandemic plan, based on lessons learned from the H1N1 flu experience, he said.
He also found problems with the government's decision-making process, record keeping and communications.
"We found six instances out of 14 sampled restrictions in mandatory orders where public health measures were supported by verbal updates only," the report says.
One mandatory order from June 2020, that everyone who enters any building open to the general public must wear a face mask covering their mouth and nose, was revised the next day, "after decision-makers asserted that it did not reflect the intended decision."
Holder said this "pointed out a significant gap."
"That wasn't leaving out a comma or a colon somewhere. That was a pretty significant oversight that changes what cabinet actually decided. That's a pretty big breakdown."
'Face' of COVID response missing from report
Tory MLA Andrea Anderson-Mason questioned the lack of reference to "what one would arguably say was the face of COVID [response] for us," Dr. Jennifer Russell, the province's chief medical officer of health.
"From my own recollection, she was very involved in the decision-making process and the advice that came from her department," Anderson-Mason said, adding she was surprised to see Russell's office at the bottom of the organizational chart.
Martin said the chief medical officer of health, assistant deputy minister of public health and deputy minister of health were among those with authority to attend cabinet committee on COVID-19. "So these people were in the room at these cabinet committee meetings," he said.
Tory MLA Andrea Anderson-Mason said she found the lack of information
about the 'elusive' COVID core 'quite concerning.' (Legislative Assembly
of New Brunswick)
Like Holder, Anderson-Mason zeroed in on the COVID core. "Even though I was a member of cabinet at the beginning of the pandemic, this is the first that I have ever heard of COVID core."
She consulted with a few of her colleagues, she said, and they're "in a very similar situation."
"And yet we have a whole chapter dedicated to this elusive cabinet core. How do you actually know that it exists?"
Martin said he got his information from the Department of Health.
Anderson-Mason said she found some of the information in his report "quite concerning," citing as examples the lack of terms of reference and lack of records, such as meeting minutes, agendas, discussion notes or actions.
She also found it "bizarre" that Martin's report describes the COVID core as a subcommittee of the security and emergency committee, yet it's listed above that committee in the organizational chart.
Martin acknowledged she has a "great question there for the executive council office when they come in."
5 recommendations
Overall, the structures and processes established by the province for the COVID-19 response "set a framework for effective oversight," but there are opportunities to improve oversight to be better prepared for a future pandemic, Martin said.
Among other steps, he recommended the province:
- Prepare and keep emergency response plans up to date for all hazards, including pandemics.
- Test and update plans on a regular basis according to a pre-defined schedule.
In addition, he said, the executive council office should ensure the roles, responsibilities and expectations of all executive committees involved in provincial emergency response are clearly defined and documented; records are maintained for all committee meetings during an emergency response; and that recommendations and decision support be documented for any similar future emergencies, "as emergency situations become more stable with the passage of time."
The executive council office, in collaboration with New Brunswick Emergency Measures Organization, should undertake a post-operation review and incorporate communication lessons learned into an updated New Brunswick Emergency Public Information Plan, said Martin.
The executive council office should also ensure the Department of Justice and Public Safety, in collaboration the Department of Health:
- Undertake an after action review to evaluate the provincial response to the COVID-19 pandemic.
- Incorporate lessons learned into an updated provincial pandemic emergency plan.
- Create and implement a schedule to regularly test and update the provincial pandemic emergency plan.
The government agreed with all five recommendations, according to the report.
The legislature unanimously requested the performance audit on March 31, 2022.
Another volume is expected in December.
N.B.'s former top doc decries 'official politicalization of public health'
Dr. Wayne MacDonald calls shift of pandemic powers to health minister in law amendments a 'dangerous step'
Dr. Wayne MacDonald describes the amendments as "the official politicalization of public health."
MacDonald, who served as the chief medical officer from 1998 to 2008, has voiced concerns over the past year about what he calls "blurred lines" between the "political element" and Public Health, both in the control of notifiable diseases and accountability.
"What this really does is put [it] into legislation … and it becomes the rule of law," he argued.
It's "absolutely perplexing" and "flies in the face of everything we learned," said MacDonald, referring to the recommendations of a commission's review of the SARS (severe acute respiratory syndrome) crisis in Ontario in the early- to mid-2000s, including the need for independent medical officers and clear lines of accountability.
Those recommendations were meant to serve as a "template" for the next major threat to the health of the public, through a communicable disease, he said.
"Now you've got the minister of health really having more extensive powers to control notifiable disease than the chief medical health officer, who's really the person hired to do that job," along with their team, including epidemiologists, who have knowledge in communicable diseases and immunization.
"It's a dangerous step, in my opinion."
Public health association seeks 'closer scrutiny'
The board of the Public Health Association of New Brunswick and P.E.I. also recently wrote an open letter to express "questions and concerns" about the amendments, which were introduced as Bill 104 on May 10 and received royal assent on June 10.
"The rapid timing of the readings of this bill didn't allow for much opportunity to influence change before it was passed," the board said in an emailed statement, "so the hope is that drawing attention to its limitations will either result in closer scrutiny and questioning when the powers are exercised and/or potential amendments in the future."
Dr.
Wayne MacDonald, who is retired and based in Fredericton, contends a
politician now has more extensive powers than the province's chief
medical officer of health to deal with infectious diseases, which 'makes
no sense.' (Submitted by Dr. Wayne MacDonald)
Like MacDonald, the independent, volunteer-run organization of public health and population health professionals, agrees with the intent of the legislation, which is to avoid the issuing of sweeping mandatory orders under the Emergency Measures Act, like the ones that were in place from March 2020 to July 2021 and again from September 2021 to March 2022.
"Although the changes are positive in providing appropriate powers under the Public Health Act (and hence avoiding the need for prolonged use of the Emergency Measures Act) there was little focus on who was granted these powers which is significant and diminishes the role" of the medical officers of health and chief medical officer of health in provincial emergencies, the board said.
When the COVID-19 pandemic hit, the province relied on the Emergency Measures Act to declare a state of emergency, a blunt instrument that gave the public safety minister broad powers to issue emergency orders.
The Higgs government used the order to do things it would not otherwise be able to do legally, such as close provincial borders to most travel, ban landlords from evicting tenants for non-payment of rent, and order striking hospital employees back to work, even though their labour dispute wasn't directly related to the pandemic.
More targeted power, but limited
Under the changes to the Public Health Act, the chief medical officer of health now has more power to issue targeted public health orders. Instead of locking down a zone, for example, they could zero in on a particular apartment building where an infectious disease is spreading and issue an isolation order to the owner.
But the amendments also limit the medical officer's role by confining any decisions to a region instead of the province, said MacDonald.
In addition, if there are any sporting or cultural events that should be cancelled or limited in some other way, the medical officer must contact the organizer of the individual event. So if there's another wave of the COVID-19 pandemic, for example, they wouldn't be able to order a temporary stop of all tournaments, according to MacDonald.
The minister of health, meanwhile, "a politician," has more "broad-scoped" powers to issue orders to groups or province-wide, he said. They could, for example, direct the closure of a public place, restrict public gatherings, or restrict travel to and from health regions.
Who's more accountable?
Health Minister Dorothy Shephard has said when such sweeping measures are required, elected officials are more appropriate and constitutionally accountable to the public for restrictions which may violate Charter rights.
"We challenge this view," the Public Health Association's board said in its letter.
"This type of action is clearly within the scope of practice of public health and preventive medicine specialty trained physicians. … It requires specialized training and expertise."
Public Health physicians are trained in the determinants of health, including personal, social, economic and environmental factors, as well as in ethical principles, such as least restrictive means, proportionality, reciprocity, and equity, the board noted.
Under
the changes, Dr. Jennifer Russell, the province's chief medical officer
of health, can issue an order to an individual in charge of a building,
for example, while the minister of health can issue an order to a class
of persons and/or businesses. (Ed Hunter/CBC)
"It is this combination of a deep understanding of human health and illness, with advanced problem analysis and solving abilities, blended with public health knowledge and skills, that enables [them] to integrate multiple sources of information and make and be accountable for the necessary decisions to promote and protect the public."
MacDonald said he doesn't "buy" Shephard's argument either.
He contends chief medical officers of health are just as accountable for every decision they make. They're accountable to the government, as an employee. They're accountable to the College of Physicians and Surgeons of New Brunswick, which licenses them to practise, along with the ethical obligations that go with that. And they're accountable to the public, he said.
No guarantee of consult
The board is particularly concerned that the chief medical officer of health is not explicitly named as someone who needs to be consulted when the minister issues an order.
The amendments state that "the minister may make an order if the minister has reasonable grounds" and the order "may provide for any action that the minister considers necessary to prevent, decrease or eliminate the risk to health."
MacDonald agrees. "Let's take the current players out of it," he said, envisioning five years from now if the province has a different minister of health who's "more aggressive" in their approach to controlling a disease.
"We could find ourselves in a bit of a problem."
New Brunswick saw a "great gap" between the former deputy chief medical officer of health's "strong" recommendation on Aug. 26, 2021 that people resume masking in indoor public spaces and Premier Blaine Higgs's masking message the next day, during an interview with CBC's Information Morning Fredericton, MacDonald noted.
"If you feel better wearing a mask, certainly do that," Higgs had said. "There's no harm in that."
Less than a month later, the state of emergency was reinstated and masks were mandatory again. "If they had sort of taken that advice … we may not have been in the situation that we ended up being in," MacDonald suggested.
Health
Minister Dorothy Shephard has said the government followed the model of
Saskatchewan, as most other provinces only extend powers to either the
minister or the chief medical officer of health, not both. (Ed Hunter/CBC)
Chief Medical Officer of Health Dr. Jennifer Russell had little to say about the amendments.
"Our policy folks and what have you would have, you know, researched what was in existence and what needed to be added. I don't really have any other comments to make," she said.
When pressed on whether she thinks the powers should rest with the chief medical officer of health or politicians, she replied, "Well, I think there's a balance between all of the ways that government works. And I don't think [there's] anything different really, other than what has been put forth, that I can speak to in terms of commenting."
The Department of Health did not provide a comment from Shephard in response to the criticisms, directing inquiries instead to government recordings of comments she made in the legislature about the bill.
"As in other provinces, the minister's decision to invoke such powers would be based on the advice of Department of Health officials, including the chief medical officer of health and the Public Health team," department spokesperson Michelle Guenard said in an emailed statement.
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