Ontario’s chief medical officer of health and his associates “did not lead” the province’s response to the COVID-19 pandemic and were slow to respond, the auditor general wrote in a scathing report, prompting Premier Doug Ford to come out swinging in defence of his top doc.

Bonnie Lysyk said Dr. David Williams and his team did not “fully exercise his powers” under provincial law to marshal resources and enact measures to protect the public during the early months of the pandemic, nor did he embrace the “precautionary principle,” where any precaution thought necessary should be enacted as fast as possible, even when the science of the matter is not certain.

"Such delays included alerting Ontarians to avoiding unnecessary travel, acknowledging community transmission and requiring long-term care homes to take precautionary actions," Lysyk said Wednesday.

The auditors also found that Williams and his staff were largely aloof when it came to directing the 34 local public health units in the province.

“(Williams) did not issue directives to local medical officers of health to ensure public health units responded consistently to the COVID-19 pandemic, nor did he issue directives on their behalf,” auditors wrote.

She found that local medical officers of health were so frustrated in May they sent Williams a joint letter “stating there needed to be more direction and regional consistency” in the COVID-19 response.

The report drew rare, pointed ire from Ford, telling the independent officer of the legislature she should “stick with the number crunching.”

“I have some serious, serious issues with this report. To say that Dr. Williams wasn’t leading this response, it’s just isn’t right, it’s actually wrong. I can’t stand for this and I won’t stand for this,” he said.

“To sit in the office and throw hand grenades at Dr. Williams and his team and the Minister of Health is totally unacceptable, totally unacceptable. Stick with looking for value for money, stick with the job that we hired you for,” Ford said. “Don't start pretending you're a doctor or health professional, because I can tell you, you aren't. Stick with the numbers, stick with the number crunching.”

Williams

Lysyk even said Williams was not actually technically in charge of the sprawling “command table” set up by Ontario to deal with the pandemic, nor was the table actually able to command anything or make any decisions without a later sign-off by the Ford cabinet.

She later found that the membership in the Command Table was nearly 500 people, making it bloated and unwieldly.

They also found that Williams and his team were denying the possibility of community transmission of the virus as late as March 25, even though hospitals were reporting that as early as March 14 and Public Health Ontario was on March 15.

This denial fundamentally hampered early testing efforts, as only people with a foreign travel history or known contact with a previously identified case could be tested during this time.

Earlier this week, the Ford government announced Williams intended to delay his retirement until Sept. 2021.

Speaking in response to the report on Wednesday, Health Minister Christine Elliott said her government has full confidence in Williams.

“I have complete confidence in Dr. Williams, he has over 30 years of experience in public health, not only as chief medical officer of health but as local medical officer of health in Thunder Bay for a number of years – he has the knowledge and experience to lead us in this pandemic.”

Lysyk’s findings show that time after time during the early months, orders and directives came far too late or contradicted prevailing directives in other jurisdictions.

-          On March 18, an associate chief medical officer of health from a local public health unit asked Williams and his team about use of masks by workers in long-term care homes. A directive requiring all long-term care workers to wear masks during shifts was not issued until April 8. Nearly 90 long-term care residents had died of the virus by that point.

-          On March 12, Ontario said it was still safe to leave for March Break, while medical officers in B.C. and Alberta said it was largely unsafe to do so.

-          Despite detecting the first outbreak of COVID-19 on a farm in late April, there was no provincial order or memo to protect migrant agricultural workers until late June.

-          Ontario did not have a universal recommendation on masking in indoor public spaces until October. By then, many local medical officers of health had gone ahead and done so on their own.

“Overall, we found that Ontario’s response to COVID-19 in the winter and the spring of 2020 was slower and more reactive relative to other jurisdictions,” auditors wrote.

Elliott said the government had issues with Lysyk’s report, calling it “a disappointment and in many respects a mischaracterization.”

She said there were a number of issues she tried to get Lysyk to amend before publishing the report, but Lysyk declined.

The issues included the suggestion that the command table is not led by Williams and medical experts, comparing the province’s response to that of British Columbia’s, and the fundamental accusation that Dr. Williams “did not lead” Ontario’s early response to the pandemic.

Lysyk later told reporters that all items included in her report were "vetted for factual accuracy."

Liberal leader Steven Del Duca said the report showed the Ford government did not always listen to public health advice when navigating the pandemic.

“(The report) was a complete indictment of Doug Ford’s incompetence in terms of completely dropping the ball with respect to Ontario’s COVID-19 response,” he told CTV News Channel.

He said the faults cited in the report fell on Ford, not on Dr. Williams.

Meanwhile the NDP suggested the Ford government wanted Dr. Williams to stay on because he was pliable.

“Doug Ford says Dr. David Williams is a perfect dance partner – but only because Ford always gets to lead,” NDP deputy leader John Vanthof said in a statement.

Green Party Leader Mike Schreiner said the structure of the Command Table needs to change immediately based on what the auditor general has found.

“(Williams is) three levels down the ladder in the command structure, his authority is being hijacked, the status quo cannot continue, it needs to change.”

Province repeatedly ignored, changed Public Health Ontario’s advice

Lysyk and her team obtained documents from Public Health Ontario, an agency specifically developed to combat pandemics after the 2003 SARS crisis, that appear to definitively confirm the Ford government ignored its own public health advice when developing the latest five-tiered, colour coded COVID-19 response framework.

Lysyk says that in September, Public Health Ontario submitted a framework to the Ministry of Health with five tiers, and its acceptable thresholds for test positivity, number of cases per 100,000 per week and number of cases successfully reached by contact tracers within one day.

Lysyk says the Ford government took those thresholds and raised virtually all of them in every one of the five categories.

Framework

She said Public Health Ontario was not warned the thresholds were increasing and only found out once they were made public on Nov. 5.

Media first reported on the changes to thresholds on Nov. 12.