The Cult of Saint Janice

A year of political COVID management and old social and political attitudes

Friday, February 12, 2021.

In the afternoon briefing, CBC’s Peter Cowan asked Dr. Janice Fitzgerald about Alert Levels.  He prefaced the question by noting that  earlier in the week Dr. Fitzgerald had said she was moving away from Alert Levels.  Instead, Dr. Fitzgerald said, she would deal with the situation in front of her.

The question was important because in the face of a massive outbreak – she’d announced 100 new cases the day before and another 50 in that briefing – everyone was wondering when Dr. Fitzgerald would close everything down.

Dr. Fitzgerald told Cowan on Friday that in 2020, the Alert Level system was merely something she made up “to sort of help us open things back up.”

Flip ahead a few hours. Dr. Fitzgerald appeared at a hastily-called second news conference. She announced the province would be at Alert Level 5 right away.  Test results showed that some of the cases were a new variant of COVID that spread faster than the original.

When asked by a reporter what Alert Level 5 entailed, Dr. Fitzgerald said she did not know.  Someone else was writing up the special measures orders.

Dr. Fitzgerald’s comments last week confirmed that the government’s COVID management is about politics and personal beliefs, not public health based on evidence. Regular readers recognize this idea from a post last May that noted the Alert Level system “isn’t a plan to manage the disease.”  It arbitrarily adjusts restrictions based on time periods of 14 or 28 days that actually have nothing to do with the risk of disease. International expert advice specifically rejected that approach because it is meaningless.

Dr. Fitzgerald calls them “incubation periods,” incidentally, but that’s just a name.  She claims it has something to do with counting off the maximum known incubation period for COVID.  It has never been the date from the last case plus 14 days.  It is just 14 days  - or one time she went double that - from whenever she announces that she will change restrictions.

I returned to this point in a December post that contrasted the alert system in Newfoundland and Labrador with the one used in New Zealand.  When you compare where Newfoundland and Labrador was before this recent outbreak to the New Zealand scheme, you find we were at one of the highest levels of restriction in the New Zealand system.  By any reasonable view of where the disease was in Newfoundland and Labrador at the time, we should have been at New Zealand’s lowest level of restrictions.

Not convinced? 

Look at the briefings from that week before February 12. Look at the number of times Dr. Fitzgerald got visibly very upset at the repeated questions about what was going on with the election.  Look at her attitude when she talked about a hundred new cases and then half as many again the next day.

Compare that to the way she clamped down in Harbour Breton and moved in an extra team of testers to ram extra-long cotton swabs up noses of people who had no chance whatever of having come in touch with COVID. Or, for that matter, look at her reaction last year when COVID broke out. 

There’s a disconnect that doesn’t get explained by just saying Dr. Fitzgerald has learned new things.  You don’t over-react in Harbour Breton and then toss off 150 cases in metro St. John’s during an election as nothing to sweat about.

No.

The telling part of that week in February is the extensive argument Andrew Furey and Dr. Janice Fitzgerald waged against the obvious, even if you only used Alert Levels as some kind of prop.  Dr. Fitzgerald insisted she didn’t have the power to do anything.  Not her job.  Not her place.

Then Friday night she found her bracelets and Golden Lasso?

Don’t be so foolish.

Whatever happened between the afternoon briefing and the nighttime one was enough to shift the political scene.  Either finding those UK variants gave Dr. Fitzgerald the trump card she needed in the internal struggle about the election or the people who tried to keep the election going genuinely got the shit scared out of them that this thing could go wildly out of control.

Whatever the explanation, the whole episode confirmed we were talking about politics, not evidence-based decision-making in a coherent alert system.

Interestingly enough, what worked last year and again this time was the basic public health measures of containment and contact tracing. People think something else has kept us safe, and we’ll get back to that in a bit. For now, let’s just stick with this point that the provincial government’s COVID management is more about politics than anything else.

Look at the evidence.

The media briefings, for example, contain very little in the way of detailed technical information about the disease, trends in testing, or outbreaks.  Dr. Fitzgerald reports the same stats she did at the beginning, like the total number of cases, even though that is a useless statistic.  Oddly enough, she stopped talking about key indicators - hospitalization and ICU cases – that international experts advise she should be using to assess the impact an outbreak is having..

So why stop talking about them?

Well, remember that the briefings are highly controlled events designed to maximize the political benefit to the politicians who take part in them. They are not really about conveying factual information to help everyone understand what is going on. Take it from someone who has run a few and planned more than his fair share of emergency response briefings. Operational briefings on the health aspects of COVID emergency response don’t need politicians. You’d have the chief medical officer and whatever other government officials like the people running regional health authorities you need to answer technical questions.

If the briefings were about what the government was doing generally, then you’d have politicians but also a lot more technical folks.  And you would take questions about everything government is doing.  After all, COVID is about more than the chief medical officer.  As we learned last week, one set of orders in February tossed 15,000 people out of work in Newfoundland and Labrador.  You’d expect to see questions - and answers – about support for businesses, education, and raft of other things.   

Instead, you have sessions where the bit of useful information comes from Dr. Fitzgerald.  The politicians spout platitudes, delivery cute lines about licking shopping cart handles, or refuse to answer simple questions.

To drive home the point that these sessions are not about informing people, remember that there is a pretty firm and entirely arbitrary cap on the number and type of questions reporters can ask.  There’s even a Minder to cut people off if they dare to break the strict rules. If you were trying to inform people, it is hard to imagine a more bureaucratic, anal retentive, utterly useless exercise than limiting a reporter’s ability to ask questions at a question-and-answer session.

And if none of that convinces you, recall that these dog and pony shows are so far removed from real information sessions that the Premier uses a teleprompter to help him recite his prepared opening texts, complete with all the smarmy, meaningless platitudes his staffers can jam into them.

Another piece of evidence for the politics of these dog and pony shows is the way Dr. Fitzgerald limits what she explains. She seldom explains how cases are linked or how she concludes that cases are “community transmission.”   That’s another part of this exercise that has more to do with personal beliefs rather than a coherent, evidence-based strategy.

In that week in February,  Dr. Fitzgerald insisted there was “widespread” community transmission.   Now for those who do not know, “community transmission” is one of Dr. Fitzgerald’s bugbears.  It’s the thing that lurks under her bed and keeps her awake at night.  

Community transmission is an internationally recognized stage of infectious disease transmission when cases become so frequent and widely spread they either overwhelm contact tracing or can never be traced back to an external source.  The disease is in the community.

The picture is the provincial government’s own statistics  updated on Sunday.   There is no category for community transmission cases.  They just show the CT of unknown origin, which contains the eight cases that are actually just failures of contact tracing.

Officials haven’t put the recent outbreak’s cases in a new category that distinguishes them as community transmission versus “local” transmission.  The new cases are all piled under another category that also contains all the people from the Caul’s cluster or people who got the disease because they live in the same house with a traveler who got sick.  

This isn’t just laziness or not being able to keep up with the flood of information.  The categories on the government website reflect the way officials think about COVID.  These are the most basic types of information, like the number of people in hospital.  If officials have lumped these cases in with the crowd from Caul’s, then odds are high that once the officials got their tracing done, they tied the cases back to travel.

But they are not community transmission, even if that’s what it looked like in the middle of February.

If you are still doubting that government isn’t responding to evidence, consider the way Dr. Fitzgerald treats the fact there have no cases reported for very long periods of time.  This is actually evidence, but she dismisses it.  The absence of cases means there are no cases.

Sounds nuttily obvious when you put it like that.

But think about the way Dr. Fitzgerald speaks about COVID.  It’s always there, lurking.

Dr. Fitzgerald resisted lessening restrictions last year, and truth be told she didn’t. Her alert system controlled more and more aspects of our daily lives even though there were only, at the worst, the odd case and couple of people related to that case.

This time around, the belief in phantom cases is turning up another way.  Not only is Dr. Fitzgerald refusing to lower restrictions based on the actual evidence of disease, last week, health official started testing so-called “asymptomatic” cases.  These are people who aren’t sick and who haven’t been in contact with anyone who might be infected.

The results:  they didn’t find any new cases.

What this means is blindingly obvious.  There are no secret cases.  Same as last year. Yet, we remain heavily restricted and will be for weeks to come.

This approach to COVID comes at a price.  Think about those 15,000 lost jobs last month.  Think also about the 20-odd thousand operations and treatment, including heart surgeries that last spring’s lockdown caused. People have gotten sicker as a result.  People have died. 

A vaccine may not change the restrictions on our lives.  Until now, officials talked about a vaccine as the end of the line for Alert Levels, even if Dr. Fitzgerald does not use them.  Now that we have a vaccine and a sort-of plan to deliver it across the province, government officials are musing about a world in which COVID restrictions continue.

Last week, Dr. Fitzgerald said that the presence of new variants puts “us in a very different place than we were when these levels were developed last summer.”  Never mind that the week before,  Dr. Fitzgerald admitted she didn’t use alert levels to mean anything like a lessening of restrictions.  She wants people to work from home at least until “a sufficient proportion” of the population is vaccinated.  She never defined “sufficient.”

In a year of government’s COVID management, nothing in Newfoundland and Labrador has changed.

It’s still politics, which is about power.

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Another thing that hasn’t changed in Newfoundland and Labrador is the attitude people have to those with power.

This is a traditional society that treats people differently by virtue of the work they do.  Doctors and lawyers go to the top of the pile just because they are doctors and lawyers.  That social status transfers easily to politics or government jobs, which themselves come with an elevated social standing.

Sometimes the reverence or deference to authority turns into a kind of status that can only be described as a personality cult.  Joe Smallwood and Danny Williams were at the heart of a personality cult. Now Janice Fitzgerald is treated with the status of a secular saint.

She can do nothing wrong.  Kids dress up as her during the ordinary day. In the middle of February, when reporters kept asking Dr. Fitzgerald about the election, ordinary citizens criticised reporters not merely for persistently questioning Fitzgerald but for asking questions in the first place.

Laura Howells is a journalist originally from Newfoundland and Labrador.  In February, she took to Twitter in defence of her professional colleagues in her home province.

“I’m seeing so much anti-media rhetoric toward reporters who asked NL election questions at briefing, which is troubling,”  Howells wrote on February 13. “Voting is a public health matter during an outbreak and determines who will lead the response to 2nd wave. To not ask would have been irresponsible.”

She got 42 replies.

Some of them were striking for the attitude they revealed:

“Asking a question or two is one thing but getting on the way they were was uncalled for. The CMOH has said she cannot comment on the election, and an emergency briefing about a highly contagious variant should not have turned into badgering them [sic] about the election.”

When Howells pointed out that the election was hours away, this person made it absolutely clear she thought reporters were wrong:

“Like I said above, a question or two would have been fine. But after the reporters were told repeatedly that the question should be directed to Bruce Chaulk, it should have been put to rest. To defend the way the CMOH was spoken to is ridiculous.” [Emphasis added]

That last sentence was aimed squarely at Howells but also at reporters who did nothing except refuse to defer to Fitzgerald’s pronouncement.

Another:  “Some of the media asked relevant, necessary questions in a respectful way. Some were all but combative, with an obvious agenda that had little to do with public health and safety, and it showed. That's who we are disappointed in.”  [Emphasis added]

This writer added a couple of further sentiments, including this one:  “And it wasn't just asking questions. It was nitpicking and in general being an arse when told that the people he was asking were not in a position to provide the answers over and over.”

Another replied to Howells that a “lot of us were frustrated with the election q's simply because Dr. Fitzgerald's briefings are neither the time nor the place [for them].”

Another person suggested that while she could understand reporters being frustrated,  that  doesn’t “mean they should have taken it out on @CMOH_NL  but if this is their opportunity to speak directly to those in gov that influence decisions ( to inform the public on the issue) it makes sense to use platform to push for a better gov response. Doesn't excuse the attitude.”

Another even rejected medical questions for Fitzgerald: “But why do they keep asking election questions when they have to know by now that only Chaulk can answer them? And why ask things like, ‘How likely is it that the other variant will come here?’ Dr. Fitzgerald isn't Karnac. How can she know the answer to that?!?” That was part of a sub-thread in which one person argued it was legitimate to question reporters’ competence and motives.”

“To ask the same question over ad nauseum looking for a different answer,” another offered, “is badgering not journalism or reporting.” In a similar vein, another person said that “I don’t like to see the antimedia sentiment, and the election is an important issue. But to keep badgering about use of language and then end with a snotty remark about needing someone else to answer your question(like 1 reporter) was also totally uncalled for.”

To be sure, not everyone who replied to Howells felt this way.  What is noticeable, though is that the ones who did criticize reporters focused on the attitude supposedly revealed by the act of persistently asking questions. This is a kind of tone policing that turns up frequently in political discussions in Newfoundland and Labrador.  It’s passive aggressive, to be sure, and as these examples show,  tone-policing is a tactic deployed equally by men and women against other men and women who they feel are acting outside proper social bounds.

In this instance,  some of the people quoted above also included the Premier with Dr. Fitzgerald. Howells’ respondents felt that once reporters got the official answer – which was don’t ask us  - then there was no reason to persist.

The tone police also exaggerate the supposed offence. Measure the notion that one person asked “489” questions” or that one reporter had another agenda and therefore is solely to blame against the reality that even in the Friday night briefing reporters could only ask a limited number of questions in each round.

In itself, these comments might not reveal anything more than a fairly common public attitude against reporters.  Consider, though, that reporters themselves have expressed thanks publicly to Dr. Fitzgerald for her work, have asked about her popularity,  raised the question about naming the university science building after her, and otherwise indicated that they are both aware of and supportive of the chief medical officer’s popularity.

All of those things suggest something else is at work here.  That’s the personality cult of the sort seen with Williams and Smallwood.  Personality cults typically promote a paternalistic relationship between leader and follow such that the leader operates, always, like a benevolent father figure.  They are motivated only in the best interests of society.  Personality cults typically turn up in societies, like Newfoundland and Labrador, with traditions of paternalism and authoritarianism.  Don’t forget, the classic definition of paternalism includes restricting subordinates’ freedom and responsibilities  in the subordinates' supposed best interest.  That’s literally what people believe Dr. Fitzgerald is doing.

What makes this personality cult different is that ordinary people generated this one.  It isn’t an official construction.  Dr. Fitzgerald, to her credit, has actually rejected many of the efforts to raise her to some god-like status.  She is genuinely flattered by the attention and has responded graciously to the compliments, but she is by no means encouraging the behaviour.

The attitude some people take to Dr. Fitzgerald is very much in keeping with a more traditionally paternalistic attitude about doctors in many societies, including Newfoundland and Labrador. Normally, this comes up as an issue in the relationship between doctors and individual patients.  Doctors have to be aware of the danger of paternalism in their own attitudes toward patients.  But there is also a strong tendency for patients in some situations to look on doctors in a way that robs of patients of their individual right and power to make decisions for themselves.  That’s what we see here:  people voluntarily giving up their agency to an authority figure and, at the same time, insisting others do the same. 

Personality cults are unhealthy. That reluctance among people  to question government officials, including Dr. Fitzgerald, means that society is not holding those officials to account for their actions.  When reporters display the same attitudes, then we really get into a problem.  It means that, despite the example of Muskrat Falls,  people are not asking important questions that could prevent officials from making a mistake. People are misinformed as well,  frequently believing things that are not true.

While Dr. Fitzgerald herself hasn’t been encouraging this personality cult, that doesn’t mean there aren’t people who have encouraged it.  Both Dwight Ball and now Andrew Furey appeared at media briefings with Dr. Fitzgerald to bask in some of her reflected glow.  They wanted a personal political benefit from being part of the cult.   From his very earliest days in office, Furey signaled his worship of the Janice cult.  He continues to signal his membership, if not leadership of the cult, by persistently raising the idea of naming a public building after her. Promoting the Janice cult serves Furey’s personal agenda, not the public interest.

The cult isn’t healthy.

Janice Fitzgerald would likely be the first person to agree.