The Canadian Press used Freedom of Information law to request copies of all written responses sent to Ford after he asked in October for input from health leaders on a potential mandatory vaccination policy for hospital workers.
Ford, citing concern over staffing pressures, ultimately stuck with a policy requiring all hospital workers who aren’t vaccinated to regularly get tested for the virus.
Many hospitals, however, chose to go beyond that minimum standard and made vaccinations a condition of employment.
Several hospital CEOs who wrote to Ford shared positive outcomes from those policies, including increased vaccine uptake and minimal staff losses.
Many of the letters also expressed support for the position of the Ontario Hospital Association, which called for a mandatory policy covering all hospitals that it said would make the facilities safer.
A hospital in Hearst, Ont., meanwhile, was the only facility that asked Ford not to mandate the shots provincewide.
Hopital Notre-Dame Hospital CEO Liza Fortier wrote on Oct. 19 that she feared having to cut services or pay high nursing agency fees to replace people if they refused to get vaccinated. That could leave some patients stuck driving up to three hours for care, she warned.
“We are torn on this decision as we completely understand the risks, however at this time our vaccination rate is still quite low,” she wrote.
“It is slowly rising up, but our staff are very well informed … and still choose not to be vaccinated. Therefore, based on (health human resources) restriction, I would have to say leave it to the individual hospital to decide.”
Fortier noted that the vaccination rate for her rural hospital in northern Ontario rose to 74 per cent, up from 60 per cent, after the province introduced rules requiring people show proof of vaccination to access restaurants, gyms and other activities.
In explaining the province’s decision, Ford and Health Minister Christine Elliott repeatedly pointed to the possible strain on rural and remote hospitals that might come from a vaccine mandate.
Some rural hospitals that wrote to Ford in support of a provincewide policy did express worries about strain from possible staff losses, but asked for a flexible timeline in implementing the policy to make things easier. Others noted that a province-led policy would alleviate concerns about workers leaving for other jobs with less strict vaccination rules.
Some also pointed out that COVID-19 shots were already being mandated for long-term care staff, which became a complicating factor for hospitals that also run long-term care homes.
“As the operator of Dundas Manor LTC home (100 per cent vaccinated before mandate), I question why hospitals would be treated any differently,” Cholly Boland, CEO of Winchester District Memorial Hospital, wrote. “In our case, both organizations have proceeded in lockstep to implement the highest precautions against COVID.”
Three unions were against the idea of mandatory vaccinations, stressing in their letters that the policy could worsen already dire staff shortages. They urged Ford to look for other solutions to staffing problems that predated the pandemic.
The chair of the Council of Ontario Medical Officers of Health, which represents top officials in the province’s 34 public health units, wrote in support of a mandatory policy, noting that outbreaks among staff would be more disruptive than losing unvaccinated workers.
But one top local public health official wrote to Ford individually to voice his opposition.
Dr. Matthew Strauss, acting medical officer of health for the Haldimand-Norfolk Health Unit, said he doubted a mandate would “be of much benefit,” and advised Ford to let hospitals make their own decisions because they are best informed on the “hyperlocal” effects of possible staff shortages.
A spokeswoman for Ford said Tuesday that the province reviewed input it received along with evidence from other jurisdictions that struggled to implement mandatory vaccination policies.
Ivana Yelich specifically pointed to British Columbia, which had to cancel some procedures due to staff shortages, and Quebec, which scrapped the idea altogether over concerns about workforce impacts.
“The government has maintained a flexible approach and has been consistent that hospitals are in the best position to make human resourcing decisions based on their own unique circumstances,” Yelich wrote, adding that one Ontario hospital recently paused the rollout of its vaccine mandate to respond to the Omicron variant.
Niagara Health said the pressures of the latest wave of infections were unexpected but it intends to finalize the mandate eventually.
“We remain committed to a fully vaccinated workforce at our hospital, and we will proceed with the implementation at a later time to be determined,” hospital CEO Lynn Guerriero wrote last month.
Ontario has so far only mandated COVID-19 vaccines for long-term care staff, citing the heightened risk for vulnerable residents. Workers in the sector had to have two shots by mid-December and now have until mid-March to get mandatory third doses.
Eighty-three per cent of Ontario residents aged five and older had two COVID-19 vaccine doses as of Tuesday and 45 per cent had received three shots.