Alberta's top doctor should be given green light to speak publicly on measles, health experts say

As the spread of measles shows no sign of slowing in Alberta, some health experts are calling for stronger public health messaging and are questioning why the province's top doctor isn't front and centre.

Alberta's chief medical officer of health, Dr. Mark Joffe, has been largely absent from the public eye since the province's outbreaks — spanning all five health zones — began.

Three more cases were reported on Friday, pushing Alberta's measles case count to 27 since the surge started.

While the government is updating its measles webpage with confirmed cases on weekdays, and Alberta Health Services continues to issue exposure location alerts, there have been no press conferences regarding the spread of the highly contagious and potentially deadly illness.

"I would love to see the chief medical health officer actually come out and speak," said Dr. Sam Wong, president of the section of pediatrics with the Alberta Medical Association.

"I think there is a post-pandemic fear — or maybe I wouldn't say muzzling — but there's a certain fear of speaking out without permission of the government. I just wonder if that's part of the reason why."

Wong is worried measles will continue to spread and could hit populations with extremely low vaccination rates. 

And he's calling for more definitive messaging on the disease itself and the importance of immunization.

"It seems like they have to be prodded to say something about it."

CBC News has submitted a number of requests for interviews with Joffe since Alberta's outbreaks began. On multiple occasions, CBC has been told he's unavailable and, in some cases, we did not receive a response from Alberta Health.

Role of top doctor

"If you've been hired and told you're not going to be talking publicly, then I guess you're doing your job. But that's not the role of a medical officer of health," said Dr. Louis Francescutti, an ER physician and professor in the school of public health at the University of Alberta.

"A properly trained medical officer of health … is a very effective communicator; one that conveys trust, one that conveys credibility, one that conveys a sense of direction, one that doesn't panic the public but that directs the public to know what to do in terms of vaccination."

According to the Alberta government website, the office of the Chief Medical Officer of Health [CMOH] "provides public health expertise to support health surveillance, population health and disease control initiatives on issues of public health importance."

The CMOH is responsible for the health of four million Albertans, according to Francescutti.

"Albertans should say: 'Where's my doc? Where's the doc that's taking care of the population?'" he said.

"From my perspective, as someone who trains these physicians, things don't seem to be going quite the way they should be going."

The role is one of the most important in the province, according to Francescutti, because it involves providing key, evidence-based information to politicians and policymakers as well as communicating effectively with the public.

"It's crucially important that that trust be built when you're not in the middle of a crisis or outbreak."

Province responds

In response to questions from CBC News about why the chief medical officer of health is not being made available for interviews and has not appeared publicly since the outbreaks began, the province said the CMOH plays an important role in managing public health issues and is leading the response to the measles outbreaks across the province.

"Dr. Joffe and public health officials have been working closely with Alberta Health Services and their public health team to manage the outbreak response. He has been monitoring the situation closely and providing guidance and advice to medical officers of health," an Alberta Health spokesperson said in an email.

"The current situation, while concerning, continues to be at a localized level, in part due to excellent work by front-line public health staff, and Dr. Joffe's leadership. Our response is appropriate to the current circumstances. Should the situation escalate, and a provincewide outbreak is declared, we anticipate Dr. Joffe speaking more broadly to Albertans."

The spokesperson said the Alberta government continues to take the measles situation seriously.

"The reality is if you Google any other province, you see their MOHs out there talking about stuff, and for some reason ours are super quiet," said Francescutti.

In B.C., where five travel-related measles cases have been reported, provincial health officer Dr. Bonnie Henry has spoken publicly about the measles threat.

Health officials in Saskatchewan, which has six reported cases, have also appeared publicly.

And medical officers of health in Ontario, which is experiencing the largest Canadian outbreak with case counts over 600, have also conducted media interviews.

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Dr. Lynora Saxinger, University of Alberta infectious diseases specialist, describes the province's messaging around measles as "restrained."

"The actual overall visibility has been a lot lower than I might have expected compared to past similar events. And that's a bit of a concern because I think it's possible that people might have no idea that any of this is going on," she said.

"Based on his past approach in various roles, I would expect that the CMOH would be quite keen to be able to give an update if given a green light to do so." 

While Joffe has not appeared publicly during this year's measles surge, he was quoted in a government news release on March 14, after news of Alberta's first outbreak was initially reported.

"Measles is not just a mild childhood illness — it is a serious, highly infectious disease that can have devastating consequences. Thankfully, we have a highly effective vaccine with a long-proven track record of safety," Joffe's mid-March statement said.

Window closing

Craig Jenne, a professor in the department of microbiology, immunology and infectious diseases at the University of Calgary, is worried time is running out to ensure Albertans are in the know about the dangers of measles and the need for immunization.

"We have that small window right now to try and ensure [measles] does not achieve this broad community foothold, and I think that window is closing," he said.

Measles vaccination rates in parts of Alberta are far below the 95 per cent threshold needed to prevent community spread.

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"The potential risks are widespread community-level transmission. And this isn't a hypothetical. We've got this right now in Canada, in eastern provinces. We have this in the southwestern U.S."

Meanwhile, Francescutti said doctors on the front lines are getting solid guidance on what to look out for, how to test and how to report measles.

And he called Joffe a "very knowledgeable" physician.

Trained as an infectious diseases specialist, Joffe was appointed to the role by the health minister in November of 2022. 

"Unfortunately, for a lot of provinces, these positions have become political targets and have put a damper on what a good chief medical officer of health should be doing," said Francescutti.