One-on-one: Dr. Eileen de Villa takes stock of the year that was

Toronto's Medical Officer of Health, Dr. Eileen de Villa, takes stock of the year that was, how Toronto fared and shares her experience as the city's top doctor in year two of the pandemic with Dilshad Burman.

She is the face of Toronto Public Health and has been the bearer of news, both good and bad for the city, throughout the pandemic.

The city’s top doctor, Eileen de Villa took a look back with CityNews at the year that was, how Toronto fared as a people and a city and what 2022 might have in store, in a one-on-one interview.

Dilshad Burman: If you were to give us a grade, how do you think the city of Toronto did and how did Toronto Public Health fare in 2021?

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Dr. Eileen de Villa: I think those are great questions and ones that I expect I’m not just going to reflect on and give an opinion on now, but I may reflect on it for quite some time yet to come because it was a very, very, very active year.

But when I look at it overall, I am absolutely amazed at how well Torontonians did, how they stepped up into the largest vaccination campaign in this city’s history, how they participated actively, how they took care of each other, how they heeded advice and really followed rules as best they could, and they were challenging at times, no question.

I’m also extremely, extremely proud of my team at Toronto Public Health. It was at a tough year for sure. We had already been through quite a bit in 2020, and we were hoping that 2021 might see a little reprieve — certainly we saw spots of brightness but they have just continued to inspire.

Every single challenge that’s come along the way, no matter how tired they are from the last two years, they have just stepped up to every challenge and not just met it, but in fact, surpassed any expectations that I think anybody could reasonably have.

DB: Hindsight is 2020. Looking back on things, were there lessons learned or was there something that Toronto Public Health could have done differently or better?

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EDV: I think that when we look back at things that were always things that could be done better, but of course it’s easier in hindsight, right? You don’t know necessarily what’s coming down the pipe as it’s coming at you.

I would say that I’m really proud of the way that Team Toronto came together. It was a lot of people, from the health sector, to pharmacies, to our community agencies and members, to divisions all throughout the city and private sector partners. I’m just amazed at how people did come together. These are sectors that haven’t traditionally worked with each other before. So there’s always a little bit of working out, some bumps along the road and figuring each other out and trying to find ways to work well with each other.

So of course, knowing that now has made all the subsequent decisions and all the subsequent interactions and collaborations that much easier. So we’ve had lots of opportunity to learn the lessons from earlier in the year, refine them and now put them into good use.

We have to work out bumps along the road as we approach new issues, but with different relationships and a history of working well together, I find that each one of those problems, each one of the obstacles that we encounter along the way gets easier and easier to resolve because we know each other better.

DB: What has the working relationship been like with the province and do you think there are things that should have been done differently?

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EDV: I think they have different areas of responsibility and therefore they come at things in a slightly different way. But I think that this is one of those areas where when you have a diversity of approach and you have a diversity of perspective, that can be leveraged for strength.

We didn’t always agree with the province — that, by definition, is going to happen. You’re different parties. You come at an issue from a different perspective.

But the one thing that I think we all agreed upon was our desire to make sure that we were doing the best we could to protect health. I’m really pleased to say that in every conversation I had with provincial counterparts, there was this shared perspective that we are really trying to do the best we can to promote the health of the residents that we serve.

They were thinking about all of Ontario. For me, of course, and my colleagues at the city, our primary focus is on Toronto. Obviously we recognize that what happens in Toronto, being the largest city in the province, has clear impact on the rest of the province as well. So to my mind having that shared perspective and that shared desire to really focus on what we thought from each of our respective seats made the best sense to improve health and to deliver the best outcome was one of the things that I’m most proud of.

DB: Was there anything you can recall particularly where the city and the province were at loggerheads or just did not agree on how this was going to play out?

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EDV: I think that there was always conversation in and around how things should be distributed, for example, particularly when there were supply challenges around vaccine.

But again, I was always willing to a listen to our provincial partners because they see things and they have inroads and insights from other parts of the province that frankly aren’t front and center, from my perspective, given that I’m responsible for Toronto. So we always found a way to find a path forward so that we could discharge our responsibilities, one way or another, to our respective populations.

DB: What would you say is the number one gift or move from the provincial government that would help Toronto Public Health in 2022?

EDV: To my mind, the number one gift that the provincial government can give all of us — Toronto Public Health, the citizens of Toronto, is to remain committed to following the science when it comes to responding to COVID 19 and frankly, when it comes to responding to other public health issues — whether they’re emergency in nature or more chronic in nature.

The more we are able to rely on the science, the more evidence-informed our approach, then frankly, I think the more effective we can be in terms of actually addressing whatever challenge there is in front of us that has a potential to threaten public health or, on the other side, may actually have the opportunity to promote health.

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I’m looking for — what are the kinds of things that we can do effectively with policy leaders to actually raise health overall. And it’s not just about infectious diseases, it’s about the fulsome experience of overall physical, mental, social, spiritual wellbeing.

There’s good evidence that exists out there. We just need to use it as best as possible,

Over and above, making sure that we get through COVID-19 … we certainly have seen that there have been significant challenges in Toronto and beyond, with respect to mental health conditions, with respect to substance use. So certainly taking a very evidence-informed policy approach to drugs and drug use and to mental health and all the challenges associated with it would be near the top of my list.

As we also start to move beyond the pandemic and start to get to a period where we are looking at the pandemic in the rear-view mirror, thinking about how best we ensure a good recovery for people — we’re looking at  economic recovery — but I’d like to see that be a real person and community-focused recovery, thinking about reducing inequities across our system, as we know that that makes a huge difference for overall community health.

DB: Let’s get a little personal — you have been the public face of Toronto Public Health throughout this pandemic. For a while we saw you every single day. What has that experience been like for you personally?

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EDV: It’s had lots of blessings associated with it. If I can speak on a very personal level, as you know, I’m just returning from a medical leave myself, and the amount of support that I received from all corners of the city was overwhelming. And I think that’s one of the most wonderful aspects on a very, very personal level around the pandemic.

I do take my relationship with Torontonians very seriously. I do take the responsibility of being the people’s doctor, Toronto’s doctor, very, very much to heart. So having this opportunity to form this relationship with Torontonians over the last two years has certainly been a real privilege for me in my career and will always hold a special place in my heart.

I felt the relationship that we had developed over this last two years through all the support that I received from Torontonians.

Also on a very personal level, it is much harder to be out and about in the city now in my role. I was a little more anonymous about two years ago. So it makes moving around the city a little bit more interesting for me now.

Overall, it’s a real privilege for me to serve the residents of Toronto. It’s an obligation and responsibility that I take very seriously. But it’s one that I love and it allows me to do what I’ve trained to do for a city that I love.

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DB: On a lighter note, I’m not sure if you’re aware that there is a Twitter account dedicated to just your scarves. What do you think about that?

EDV: I am familiar with that account and it was established in the spring, if I remember correctly, of 2020.

For me, that’s one of those moments of resilience and strength that we see in our city. The fact that in the midst of this major public health emergency, the most significant public health crisis of the last 100 years, we are still able to find something to smile about. To have that sense of humor, I think is a real testament to the kind of city that we are, the residents that we have and how we still manage to find glimmers of hope, glimmers of humor, things to smile and laugh about. That’s the sign of a really good city. So to me, that’s one of the many little bright spots that I’ve encountered over the last two years of this pandemic.

DB: There’s been a lot of hope and a  lot of despair over the past two years. Have there been times when you have lost hope and where do you find the strength to stay the course and then lead the city through this crisis?

EDV: There have been darker moments for sure. But in public health, you just don’t lose hope. For me personally, I am truly, truly fortunate to be surrounded by so many supportive, skilled, passionate, caring colleagues.

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What’s been remarkable for me about this whole experience is that … fortunately we don’t all go through those darker moments at exactly the same time. So in our team at Toronto Public Health, when one of us has been feeling down about the stark numbers or how significant the situation is, others rally around and pull us up out of that. We’ve managed to find our way through and we stay very focused on what it is that we’re seeking to achieve, how important the job is, and focusing on the science to get the job done so that we do the best we can for the residents of the city.

I think the saying goes that many hands make for lighter work. There’s no question when it comes to pandemic response, that’s absolutely true.

We’ve been very, very fortunate that even in those moments where it has seemed almost too heavy to lift, somehow we rally and we’re able to make that lift. That for me again, another bright spot in the pandemic.

DB: People are feeling the pandemic fatigue even more acutely now because of the rise of Omicron. What can you say to people to stay the course just a little longer to continue following those public health measures?

EDV: You might remember from the early days of the pandemic, I had a refrain where I talked about staying safe and taking care of each other. And I think never more than now is this notion of taking care of each other so important. I think that’s one thing that we can all do — keep that at top of mind. The more we are able to take care of each other, even if you identify just one person, perhaps it’s somebody who’s living alone or a family that’s struggling, to the extent that you can adopt that person and take care of them, do so, and really show them that compassion.

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Neighbourliness — I think that will see us all through.

We know that it’ll be better for the person that you’re caring for and frankly, from a science perspective, we know that it’s actually good for your health to help others, to give to others. It’s remarkably fulfilling, which is good for your mental health and good for your physical health overall.

So I think at this point, the more we’re able to just take the time to stop and take care of each other, the better off we’ll be and the more resilient and healthier we’ll be as we try to make our way through the rest of this pandemic.

DB: What do you expect in 2022 in terms of the pandemic and the direction the city is going in?

EDV: I think that we’re all hoping, not just for Toronto, but for the rest of the province and the country, that we are seeking to get us past this very difficult wave of Omicron, which is a spreading very, very quickly, very transmissible form of the virus.

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But I have been so, so impressed — we’ve got Torontonians stepping up to get their booster doses to protect themselves and those around them. And of course, all the Team Toronto partners from all around the city, stepping up to deliver vaccines as quickly as is humanly possible. This was already the largest vaccination campaign in the history of our city, but now we’re adding even more to it to make sure that we’re able to get these booster doses into arms as quickly as possible.

It’s my sincere hope that with that effort, and of course the need to make sure that other parts of the world are also getting appropriate vaccine and using public health measures, that we’ll soon start to see ourselves getting to the other side of this pandemic, where COVID-19 becomes something more of a background infectious disease, something that’s more endemic, something perhaps that is more akin to influenza. so that we can start to restore some of the more regular aspects of our lives as they were before there was such a thing as COVID-19.

So just a little more from all of Toronto, a little more by way of continuing to practice self protection measures, getting booster doses for those who need boosters, getting first and second doses for those who need that first, and then hopefully, over time, we’ll see ourselves in a position where we’re starting to see the pandemic more in the rear view mirror.

DB: Do you have a message for Toronto as we wrap up this year?

EDV: First and foremost, given that I’m just coming back from my medical leave, I wanted to say thank you to everybody — residents of Toronto, to the colleagues around me, Team Toronto and beyond, for all your support. Thank you very, very much.

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I also wanted to say a huge, thank you to all of our partners and the people of Toronto for everything they have done this year in terms of making the COVID-19 response as successful as it has been, for stepping up to get vaccinated for following public health measures and practicing self-protective measures.

This has been really a very, very challenging year, but I continue to be impressed at how many Torontonians have stepped up to the plate over and over again, when we’ve asked them — this is really, really appreciated — I just can’t say that enough.

I have to say thank you also to my team at Toronto Public Health and my colleagues throughout the city, no matter what challenge or obstacle has been thrown in our path, and there have been many — this virus has been quite the formidable foe, if I can describe it that way — but no matter what sort of challenge has presented itself, no matter the obstacles that have emerged in our path, I have seen this incredible professionalism, this incredible skill and real caring and passion for what it is that we do.

That is what has sustained us and it’s certainly what has sustained me over the last two years. I know it will serve us well in the future.