Why York Region’s top doctor is following a different COVID-19 pandemic path than Toronto, Peel

Theglobeandmail.com
March 3, 2021
Jeff Gray

Just days after York Region broke ranks with neighbouring Toronto and Peel and convinced the province to ease the region’s COVID-19 restrictions, shoppers almost on cue clogged the checkout lineups at a suburban HomeSense.

The reason this home-furnishings outlet in Vaughan, Ont., could open at all was largely because of York Region’s Medical Officer of Health, Karim Kurji. He had urged the Ontario government to move his area to a lower level of restrictions last month -- even as his counterparts in Toronto and Peel Region

Critics seized on a viral Global News video of the crowds at HomeSense as proof Dr. Kurji’s rush to reopen was leading to disaster. While he did send out an inspector, Dr. Kurji said the store was following the new 25-per-cent capacity limit and has since tweaked the way it handles lineups to ensure better physical distancing. While saying people should still stay at home as much as possible, he isn’t overly concerned about shoppers from Toronto or Peel crossing into York Region, because all three areas have similar infection rates.

And the real risks while standing in line briefly at a store, he said, are low: “We aren’t particularly bothered, because most of our businesses are following the rules.”

The soft-spoken Dr. Kurji is also not bothered about being a public-health outlier in the Greater Toronto Area -- a role he has played almost since the pandemic’s beginning. He resisted being put into full lockdown in December as cases were rising, and alarms sounded from Toronto and elsewhere. And he has called for York Region to remain in the province’s looser “red control” zone for now, even with Simcoe Muskoka to the north, as of Monday, added to the list of regions locked down over fears of new, more contagious variants.

The province, Dr. Kurji says, is on track to avoid a feared third wave of infections, despite the warnings of other public-health experts who point to threatening mathematical modelling and the experiences of several European countries, which saw cases rise quickly as the new variants took hold.

But the speed at which those variants are spreading in York Region is actually slowing, he says. Once the variants replace the current breed of COVID-19 completely, in a month or two, he said, there may be an increase in cases, but he doesn’t expect “explosive growth.” If he’s wrong, he says, he won’t hesitate to call for stricter measures.

“I don’t think there will be a third wave,” Dr. Kurji told The Globe and Mail in a wide-ranging interview. “I honestly don’t think so.”

He also points to new quarantine measures at airports and borders to keep new cases from entering from the U.S. and elsewhere, and the ramping up of vaccinations, as mitigating factors. (York Region started taking appointments for people 80 and over on Monday, two weeks before Ontario’s provincewide system for that age group is to launch, but ran out of slots in just hours.)

Dr. Kurji is skeptical of the impact of Ontario’s recent lockdowns, although he acknowledges they were necessary when the pandemic began. The recent stay-at-home order did help suppress cases, he said. But the December lockdowns came with a natural decline in infections after the winter holidays, as gatherings and events decreased.

Dr. Kurji’s more hands-off approach is popular with businesses and local politicians, although he denies they have influenced what he says are his data-driven decisions.

His moves have not won over some on the front lines of York Region’s health care system. In early December, with cases rising, three York Region hospital CEOs publicly warned they were at a tipping point, in the face of Dr. Kurji’s calls to keep the region out of lockdown. On Monday, while new COVID-19 hospitalizations were down, the area’s intensive-care units remained jammed with patients.

“One of my major concerns was that he kept making reference to business,” said Steve Flindall, an emergency room physician in York Region who has treated hundreds of COVID-19 patients. “In my opinion, that’s not the concern of the medical officer of health. That’s the concern of business leaders and politicians.”

Dr. Kurji, 66, has spent his entire career in public health. He grew up on a speck in the Indian Ocean: Mafia Island, off Tanzania. But he was sent alone at the age of 14 to secondary school in London. He said his parents -- his father ran a garage, his mother was a dressmaker -- were driven to ensure he got a good education. Acing his studies, he entered medical school at University College Hospital in London at 18, surrounded by graduates of Oxford and Cambridge.

In his first year, his parents were killed in a car crash in Tanzania. An uncle who had looked after him in London also died the same year. Dr. Kurji vowed to continue his studies as his parents had wished. And he found himself attracted to what was then called community medicine in Britain, because it seemed to allow him to do the most good, and prevent the most deaths: He pursued his studies at the prestigious London School of Hygiene and Tropical Medicine.

After moving to Calgary to be closer to a sister, and working as a public-health official in Edmonton, Dr. Kurji spent time teaching at Dalhousie University before spending a decade as Associate Medical Officer of Health in York Region, until 1999. He then took a job in public health with the province of Ontario, becoming Associate Chief Medical Officer of Health as the Severe Acute Respiratory Syndrome (SARS) outbreak hit in 2003. (He returned to York Region’s public-health unit in 2005.)

His boss during SARS, then-chief medical officer of health Colin D’Cunha -- also a York Region resident -- said in an interview that Dr. Kurji was a steady hand at his side during the crisis and also a key part of the rollout of free flu shots across the province.

“I always considered him to be a knowledgeable colleague, who is guided by the evidence, the science,” Dr. D’Cunha said. “And he makes decisions very thoughtfully. He’s someone who doesn’t go for the limelight.”

Dr. Kurji says he follows an “old school” approach to public health that focuses not on lockdowns, but on all-out efforts to trace and isolate the contacts of confirmed cases, something York Region tightened even as other districts’ operations were overwhelmed. And he is unapologetic about his belief that public-health decisions must consider the well-being of society at large.

“You know, there was a saying at medical school: As you do your surgery, make sure that the patient doesn’t die whilst you are operating,” Dr. Kurji said. “You could actually just, as it were, strangle the life out of the whole community, just because you are focused so heavily on preventing COVID-19.”