The Ontario Physicians and Surgeons Discipline Tribunal has revoked the medical licence of a Toronto doctor who allegedly profited from writing more than 1,000 COVID-19 exemption letters “without adhering to medical standards and guidelines.”
In a decision released last month, the tribunal found that over a three-month period from August to October 2021, Dr. Celeste Jean Thirlwell wrote 1,425 exemption letters for COVID-19 related vaccination, masking and testing requirements.
“She did so for profit and without adhering to medical standards and guidelines,” the tribunal wrote in the Feb. 11 decision.
According to the tribunal, 999 were for vaccinations, 230 were for masking, and 196 were for testing. First-time patients were charged $300 for their first exemption letter, according to the decision, and the doctor charged patients directly without billing the Ontario Health Insurance Plan (OHIP).
The tribunal alleges that her services were advertised “through word of mouth” and patients were sent an email “setting out the process for obtaining exemption letters and the associated costs.”
“Patients were asked to complete a request for medical consultation in which they were asked to describe the medical concern they had relating to either masking, a nasal swab or vaccines,” the decision read. “They were given examples of what to describe.”
Patients offered discounts for family members
Some of the examples, according to the tribunal, were severe anxiety, inflammation, autoimmune condition, blood clotting or other blood-related disorder, a heart condition, difficulty breathing, fear of anaphylactic (allergic) reaction to vaccines, or a family member who received a vaccine recently had a severe allergic reaction.
“The information sent to patients set out the costs for the letters and included discount pricing for multiple letters and multiple family members,” the tribunal wrote.
According to the decision, patients were assessed over the phone and Thirlwell saw dozens of patients in a single day, including 107 patient encounters on October 28, 2021, and 116 patient encounters on October 30, 2021.
“Dr. Thirlwell did not obtain any information from her patients’ primary care physicians and did not provide any of the information she collected to the patients’ primary care physicians,” the decision noted.
“She also did not copy the patients’ primary care physicians on her exemption letters.”
The tribunal noted that she received her registration in 2013 with a specialty certification in psychiatry.
“At the relevant time, she practised primarily in sleep medicine working at sleep clinics in Ontario,” the decision read. “She has no specific training in immunology, public health or infectious diseases.”
The tribunal also stated that Thirlwell did not properly store patient information and had “loud patient telephone conversations in a public space.”
According to the decision, Thirlwell was on board a VIA Rail train between Ottawa and Kingston on Sept. 9, 2021, when a fellow passenger overheard her talking on the phone about exemptions.
“Dr. Thirlwell took a series of phone calls and spoke loudly in approximately six to 10 telephone conversations over the course of approximately two hours. She identified herself by her full name and said that she was a registered psychiatrist with the College,” the tribunal wrote.
At the time, the Ministry of Health provided guidance for medical exemptions to COVID-19 vaccination, which the tribunal noted was “essentially limited to an allergist/immunologist-confirmed severe allergy or anaphylactic reaction to a previous dose of a COVID-19 vaccine or to any of its components and a diagnosed episode of myocarditis/pericarditis after receipt of an mRNA vaccine.”
‘Lack of knowledge, skill, and judgment’
Physicians were also told about the importance of working to manage patient anxiety relating to vaccination and “not enable avoidant behaviour.”
The tribunal stated that Thirlwell’s “lack of knowledge, skill, and judgment” is such that her practice should be restricted “at the very least.”
The tribunal noted that they were forced to proceed with the hearing without Thirlwell’s participation after she failed to respond to correspondence from the disciplinary body.
“Dr. Thirlwell, through her then-counsel, initially participated in the case management conferences held in this matter in 2024. A hearing was scheduled for September 24, 2024, but adjourned for medical reasons, at Dr. Thirlwell’s request,” the decision read.
In July, 2025, the tribunal said she was advised that they would no longer allow further delay based on the medical information they had received so far.
“Dr. Thirlwell was directed to provide more detailed information regarding her health condition and how it restricted her ability to participate in a hearing,” the tribunal wrote.
“A hearing was subsequently scheduled for September 18, 2025, but again adjourned once Dr. Thirlwell’s counsel advised that he was no longer representing her.”
Following that, the doctor “failed to respond” to the tribunal and College counsel and did not attend a case management conference in September 2025, the decision read.
At that conference, the tribunal learned that Thirlwell had not filed her annual renewal and her certificate of registration had expired.
The Wilson Avenue sleep clinic where Thirlwell was previously employed confirmed to CP24.com that she no longer works there and was unable to provide contact information for her.
“Relying on deemed admissions pursuant to a request to admit, we concluded that Dr. Thirlwell failed to maintain the standard of practice of the profession, failed to respond appropriately or within a reasonable time to a written inquiry from the College and engaged in conduct that is disgraceful, dishonourable or unprofessional,” the decision read.
“We have decided to revoke Dr. Thirlwell’s certificate of registration based on the seriousness of the misconduct, the finding that she is incompetent and the absence of any evidence that she would engage in meaningful remediation.”
The tribunal also ordered her to pay a penalty of $10,370.
