Emails obtained by QP Briefing suggest Ontario's chief medical officer of health doesn't always have the last word on his own statements before they're released to the public.

The emails, received through a freedom-of-information request, were sent between top staffers in Dr. Kieran Moore's office, the premier's office and the Ministry of Health, just before most of Ontario's mask mandates ended in early June 2022.

They largely discussed Moore's statement on the end of masking, which he issued on June 8.

That statement appears to have been drafted by communications staff in the Ministry of Health — not Moore or his own team.

The emails also suggest that Moore's statements — including this one — are edited and approved by Premier Doug Ford's office.

Moore is not only the province's top doctor; he is also an assistant deputy minister within the Ministry of Health. However, the Ford government has stressed that the province's top doctor operates independently.

"I do not direct Dr. Moore," Ford has said. "I just don't."

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"Hello OCMOH [office of the chief medical officer of health] friends," reads a June 6 email to Moore's top communications staffers from Neil Zacharjewicz, the Ministry of Health's acting manager of media planning and community outreach. "Attached is the draft CMOH statement for Wednesday for your office’s review. Asking for this back by no later than 10 a.m. tomorrow morning, but also flagging that MO is already asking to see it. Let us know if you have any edits, questions or concerns."

"MO" is usually an acronym for minister's office. It could refer here to staff for the health minister, who would still have been Christine Elliott at this time, since Sylvia Jones wasn't sworn in until June 24.

Gillian MacDonald, Moore's communications manager, sent it back for edits the next day. "Note this has not been reviewed by Dr. Moore. We would appreciate at least MO feedback on it before having him review so as to limit the number of versions that he sees."

Zacharjewicz replied, "...I presume Dr. Moore after PO [premier's office] review as well, correct? As per usual process."

"If possible after PO review as well that would be appreciated – I just know that is not always possible," MacDonald wrote back.

That afternoon, after "MO" edited the statement, Zacharjewicz told MacDonald that the premier's office edits may not come until the morning. MacDonald replied that she "will ensure that people are ready, including Dr. Moore, for a quick review once those edits/comments are received."

In an earlier exchange, Moore did confirm that he supported the end of masking. "Yes … just discussed with the team," he said when Deputy Health Minister Catherine Zahn asked if he was okay with the June 11 end date. "We will further review with stakeholders and issue a statement on Wednesday."

It's unclear, though, whether he saw that statement before it went public.

QP Briefing sent a list of detailed questions to the premier's office, Jones' office and the people in the emails — about whether Dr. Moore edited this statement or others, who writes his statements, who "MO" is, and more — but did not receive a response.

MacDonald also said Moore wanted to avoid a news conference on the end of masking.

"I know a presser was floated around at one point, and Dr. Moore has indicated that he would strongly prefer not to do a presser, although is amenable to media interviews if necessary," she wrote.

Public health experts and opposition MPPs have criticized Moore and the government for a lack of leadership during the pandemic and the current health-care crisis. Moore has held just one press conference this fall, on Nov. 14.

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Ontario is the only province where the chief medical officer is an employee of the Ministry of Health, NDP health critic France Gélinas noted. She said these emails demonstrate the need for her private member's bill, which would make the CMOH an independent officer of the legislature.

"This speaks for itself," she said. "It does not serve the people of Ontario well. And we have seen ... that the Ministry of Health treats our medical officer of health like an employee."

Trust is everything in public health, she said. "And once you erode that trust, then it makes any public health policies less effective."

Liberal health critic Adil Shamji said he was unnerved that the premier's office had such a big role in editing Moore's statements.

"When I think about my own clinical practice, I could not imagine a world where I wrote a prescription for one of my patients, and it was double-checked by the CEO of my hospital," he said.

In total, Moore's statement was viewed or edited by at least seven different parties: Ministry of Health communications staff, Moore's office, the premier's office, "MO," the Ministry of Long-Term Care, the Ministry of Seniors and Accessibility, and the Health System Emergency Management Branch.

The emails reveal disgruntlement about how long the editing process was taking. Parts of the government disagreed about whether to require or only recommend that masking continue in long-term care and retirement homes.

"There is a suggestion that there is delay again on our end … can we follow this up and ensure that it goes asap," Zahn told Moore and Health Ministry staffers the morning of June 8, the day the statement was scheduled to, and ultimately did come out.

Then-Associate Deputy Minister of Communications Kristen Routledge said her team was waiting on Moore's office for a response to questions from the premier's office about masking in congregate care.

Associate Deputy Health Minister Alison Blair asked for an update from Collen Kiel, Moore's director of strategy and planning.

Kiel said there was "confusion" and "some bewilderment" about masking moving "from a requirement to a recommendation" in long-term care and retirement homes.

Blair then sent a lengthy explanation to her Health Ministry colleagues, but not Kiel, about the disagreements between ministries on that topic.

The Ministry of Long-Term Care (MLTC) and the Ministry of Seniors and Accessibility (MSAA) "would like to have a continued requirement for masking" in LTC and retirement homes, she wrote.

"MLTC is ready with a Minister's directive to make it a requirement but MSAA," which oversees retirement homes, "doesn't have those powers," she wrote.

The government kept masking requirements in place for retirement and long-term care homes, but later lifted the requirement for visitors to wear them while in residents' rooms. Masks are only recommended it in other congregate settings, like shelters and group homes.

‘Not always possible’ for top doctor to have final say on his statements, documents reveal

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