Quebec faces calls for transparency, greater scientific rigour after public health director's resignation

In early December, researchers across the globe were still scrambling to learn more about the transmissibility and severity of the Omicron variant.

But in Quebec, on Dec. 7, Premier François Legault and then-public health director Horacio Arruda, announced a plan to open the province up further, bolstered by optimistic hospital projections from the province's public health-care institute, the INESSS.

Despite uncertainty regarding Omicron, the Legault government said up to 20 vaccinated people could congregate for family dinners over the holidays.

"Maybe two weeks ago I wouldn't have done the same, but today I feel reassured," Arruda said at the time of the plans to re-open.

For Quebec, it would mark the beginning of one of the worst stretches of the pandemic — culminating with soaring hospitalization rates, Arruda's resignation and calls for greater transparency in government decision-making.

By Dec. 16, Legault urged people to scale back holiday gatherings to 10 people. Six days later, he acknowledged the province faced a "steep, exponential increase" in cases and further restrictions would be necessary (the toughest weren't put into place until after Christmas).

Now, the province's hospitals are overwhelmed with COVID-19 patients, with the highest hospitalization rates per capita in Canada, and surgeries have once again been delayed to free up staff and space.

Late Monday, Arruda submitted his resignation, citing an "erosion" in public trust. Legault thanked Arruda for his service and said in the interim, he will be replaced by INESSS head Luc Boileau.

Legault also floated the possibility of a tax on unvaccinated residents, which helped shift the focus away from a difficult stretch for the premier and his government.

But experts say the political muddling ahead of the holiday period in the face of a new, highly contagious variant is indicative of the provincial government's inability to react quickly to emerging science.

Arruda drew criticism in particular for his continued insistence that N95 masks weren't better than surgical masks, his changing position on boosters as well as rapid tests and for the curfew imposed on Dec. 31, once again without clear evidence such a measure is effective.

At times, though, it's been difficult to separate the public health findings from the politics.

In the wake of his resignation, health experts and stakeholders — including Quebec's College of Physicians — have called for the government to ensure Arruda's successor has independence from political decision makers.

Dr. Donald Vinh, an infectious diseases specialist at Montreal's McGill University Health Centre, said such a change will be crucial in the months ahead. He noted that Arruda was, in addition to the director of public health, an assistant deputy minister of the Health Ministry.