A former chief medical officer of health for Alberta says the provincial government should be embarrassed by the role Alberta has played in Canada’s measles outbreaks and loss of the country’s measles elimination status.
The Public Health Agency of Canada announced on Monday that the Pan American Health Organization had notified it that Canada has lost the designation, which it achieved in 1998.
“My gut reaction is sadness,” said Dr. James Talbot, a former chief medical officer of health for Alberta.
“A lot of people worked for a long time to achieve that measles elimination status, and to lose it in one year because of a failure of government action … for a disease that’s totally preventable, it just makes me sad.”
Pointing to the 1,956 cases Alberta has reported since its outbreaks began in March, Talbot said Alberta bears a significant amount of responsibility for Canada losing its elimination status.
He’s one of a number of doctors and scientists who have been highly critical of the provincial government’s response to the measles outbreaks, saying messaging on the importance of immunization and the dangers of measles was not strong enough to rein in the outbreaks early on.
“I think they should be embarrassed. … I think they owe an apology to Albertans, to admit that we fumbled. We have the worst record in North America,” said Talbot.
The latest federal data shows Alberta accounts for 38 per cent of Canada’s cases. In July, Alberta passed a grim milestone, reporting more cases than the entire United States.
“We had a year to fix this,” said Talbot, also an adjunct professor at the school of public health at the University of Alberta.
“Now that Canada has lost its immunization status, I think along with the province of Alberta, they owe it to the rest of Canada to say what they’re going to do differently to ensure that this doesn’t happen again.”
‘Wake-up call’
While transmission has been slowing in Alberta in recent weeks, the province isn’t in the clear yet. There are currently two Albertans in hospital due to the illness.
“This is a wake-up call,” said Dr. Karina Top, a pediatric infectious diseases specialist at the Stollery Children’s Hospital in Edmonton.
“To me, it’s a collective failure at many levels of government, public health, the health-care system to address what we saw as declining rates of vaccination over many years that got much worse since the COVID-19 pandemic and really set the stage for measles to spread like this in our country.”
Alberta has had the highest per population rates of measles in North America, according to Top.
The Alberta Medical Association said it, too, is disappointed by the news.
“It didn’t have to be this way,” the organization said in a statement on social media.
“Too many people are being targeted with false claims, leading to vaccine hesitancy and dangerously low immunization rates. This event also reinforces the critical need for strong, proactive public heath leadership in the province.”
More than 25 years after eradicating the disease, Canada has lost its measles elimination status. <br>It didn’t have to be this way. <br>Full statement from Alberta Medical Association: <a href=”https://t.co/GVDODTQWyH”>pic.twitter.com/GVDODTQWyH</a>
—Albertadoctors
Dr. Sam Wong, president of the association’s section of pediatrics, said the Alberta government “didn’t put enough resources into pushing the vaccinations early on and really doing a better job of public health.”
“I think the government didn’t really see the seriousness of it.”
In October, Alberta reported its first measles death since the outbreaks began in the spring: a premature baby who died due to congenital measles.
Wong continues to worry that Albertans don’t understand the dangers of a measles infection.
“I think if we had gotten on top of it a bit sooner, maybe we could have stopped the spread or reduced the spread [and] maybe we wouldn’t have lost the status. It’s hard to say for sure,” said Wong.
A total of 154 Albertans have been hospitalized since the outbreaks began, including 15 people who ended up in intensive care.
Province defends vaccination approach
In a statement, the Alberta government said there has been a sharp drop in measles cases.
“We continue to promote vaccination and we’re hopeful that numbers will continue to fall and remain low, allowing us to declare the outbreak officially over, though there is always a risk of new introductions,” said Maddison McKee, press secretary for the Minister of Primary and Preventative Health Services Adriana LaGrange.
“Public health officials implemented targeted vaccination campaigns, expanded clinic hours, and launched provincewide outreach to increase uptake and limit spread.”
According to the ministry, more than 137,000 measles vaccines have been administered across Alberta since the outbreaks began in March, which translates into a 50-per-cent increase compared to the same period last year.
It said uptake in the south and north zones, which have historically had lower rates, rose 83 per cent and 73 per cent respectively.
Measles has spread in smaller communities with low vaccination rates, the statement said, but there has been no “significant spread” through the rest of the province, including cities.
“Public health continues to take proactive steps to limit further spread and ensure Albertans have timely, clear information to protect themselves and their families,” said McKee.
‘It’s not rocket science’
Top believes while it will likely take a couple of years, it is possible for Canada to regain its elimination status.
“Vaccines could be easier and more convenient for people to access. And I think we need to help make people more aware when they or their children are due for vaccines,” she said.
Top would like the province to offer vaccines in more places where Albertans access health care, such as hospital clinics. Pharmacies could also offer more vaccines, and public health clinics could further expand their hours or provide drop-in spaces, she said.
Top would also like to see more efforts to engage vaccine hesitant communities and build trust.
Talbot said Alberta, along with the rest of the country, should commit to increasing immunization rates for all childhood diseases to over 90 per cent by the age of five, within five years, and to provide the resources to make that happen.
“That’s all it requires. It’s not rocket science. It’s not difficult to do. We’ve done it before,” he said.
Public health needs to be strengthened as well, he said, so when cases arrive in Canada, surveillance, contact tracing and case management teams can act quickly to rein in the outbreaks.
According to the Public Health Agency of Canada, the country can regain its measles elimination status once transmission of the measles strain currently circulating has stopped for at least 12 months.
