'I feel we are worlds apart': Internal emails at N.B. health department show moments of leadership and anxiety first week of the pandemic

“It’s so crazy here,” wrote one New Brunswick civil servant to another on March 11, 2020. The World Health Organization had just declared COVID-19 as a global pandemic, and New Brunswick was moments away from getting lab results back, confirming the province’s first case.

The week of March 8 to 15 saw decisions made on the daily, sometimes hourly — and many times, they were scrapped altogether after new information was realized.

Internal emails obtained by CTV Atlantic through a Right to Information Request, submitted to the Department of Health 13 months ago, show just how many people stepped up, answering emails from 4 a.m. to midnight, sharing slideshow presentations with updated COVID-19 information, and trying to find the right words to explain the situation to the public.

But there was also disarray.

“Yesterday, Bathurst ER was already submerged,” said one email sent to Dr. Cristin Muecke, acting chief medical officer of health at the time, from Dr. Mariane Pâquet, medical health officer for the northern region, on March 12, 2020. “If they are at 100 per cent capacity now, what will it be when they receive more patients. Staff needs to be ready.”

And one physician wrote how frustrated they were about the chain of command when it came to testing, in those early days.

“We receive as much calls as you do. It is overwhelming the number of calls we get,” they wrote to Horizon and Department officials on March 14. “You organize them having their swabs and send us all the information at the lab. Do not send them at emergency as is being done now.”

It’s a glimpse at what the sector was dealing with during that first week.

Monday, March 9

New Brunswickers were looking for more direction on what to do if they had symptoms, or had just returned from international travel.

New Brunswick Education Minister Dominic Cardy had announced all students who had been travelling were to remain home from school for 14 days.

“These students were not asked to go into quarantine by the Canadian government and were not asked any health questions when they came back into Canada. So, why are there two different messages? It's confusing to me, how and why, the minister of education can overstep the guidance from health officials in our province,” writes one parent in response to the decision.

Many more emails were sent to the department asking for clarification on the move.

And others, like a funeral home director, asked for guidance should people die with the virus.

The system also saw heightened concern from New Brunswickers in general.

“Please find attached the updated 811 messaging. We have seen a 15 per cent bump in volumes since Friday, so the sooner we have it approved and translated, the better. You will see a highlighted area on monitor vs isolation, would appreciate input as it is now one of our frequent questions,” one email says, written to department of health officials.

Also that Monday, the department was already moving away from singling out travellers from most-affected countries.

“All travelers returning to Canada from outside the country will be screened by Canadian Border Services Agency for symptoms and then provided direction regarding self-monitoring for symptoms for 14 days,” writes Dr. Muecke in a memo to public health system partners.

Tuesday, March 10

The department was starting to see more “CD Urgent Notifications,” outlining suspected cases, coming in from health-care workers across the province.

“At home...developed a fever with body aches, chills, and unproductive cough. On presentation to ER…was afebrile, but had labored breathing and strider…was admitted to a private room in the ER and with consultation with the MOH, COVID-19 testing was completed,” said one such notification. The person had recently travelled on a Caribbean cruise.

And more questions were coming in from health-care workers:

“We have started to receive a handful of calls from doctors and employers. PCPs advising the public that they should be wearing masks, employers telling asymptomatic employees to go home since they have recently travelled internationally. We also had an incident where a clinic who we have referred the caller to sent them back to us because they were not comfortable to see them,” writes a staffer fielding calls.

Wednesday, March 11

With a global pandemic declared, Dr. Jennifer Russell, the province's chief medical officer of health, sent out a memo to long-term care facilities, advising them not to allow anyone who travelled internationally to enter the facility for 14 days after they had returned from travel.

And at 4:29 p.m., a civil servant sends that day’s lab results to Dr. Muecke.

“There is one positive result in GDL… I assume you know, this is an fyi,” they wrote.

There was a flurry of emails — some are redacted.

“We have a 1st positive that travelled here from (redacted). Was in Moncton, came to Fredericton, and back to Moncton. Trying to contact this person now,” says one email.

A news conference was planned within the hour. Dr. Russell said the woman had been in France, and was feeling okay overall. At the time, arrangements were made for people to go to a local hospital to get tested, in an isolation room.

Thursday, March 12

The question of banning mass gatherings began — with all chief health officers from across Canada weighing in through an email exchange.

“I am also going to go ahead with MG cancellations later today. I have been a bit hesitant to act because it could be perceived as 'caving in' to public pressure rather than following scientific process and have been saying risk assessment,” wrote Dr. Bonnie Henry, the provincial health officer for British Columbia.

“But at this point, I think it’s timing more than anything. I don’t want to do anything too soon, but the higher risk is doing it too late. Particularly in light of what the U.S. has done in the last 24-hours and frankly, the fact that our biggest risk is from the U.S.”

Dr. Muecke was advising staff that anyone with flu-like symptoms should enter a ‘voluntary self-isolation’ — and government employees no longer needed a doctor’s note.

Regional Medical Officer for the East Region, Dr. Yves Leger, was identifying some gaps in communication.

“I feel we are worlds apart and it won’t help with delegation of this task and having a coherent approach based on clear objectives for guiding testing,” he wrote to the other regional officers.

The costs of COVID-19 were also starting to be tracked.

Financial services wrote to all department services heads: “We will report these costs as a separate line for quarterly reporting… Costs can include salaries and wages, materials and supplies, and services.”

Friday, March 13

By early afternoon, public health was recommending schools close for two weeks.

And there was an email chain on complaints coming into the department from hospitals.

“Hospitals on the Task Force call right now saying that they waited up to three hours for a call back from MOHs to discuss potential screening of COVID-19. Where are we at with having back-up MOH to assist with all of these?” writes Dr. Kim Barker, the medical officer of health for the south region.

“I have answered every call I got for testing… I have many emails and calls around questions or some community group looking for guidance that I’ve not had the chance to follow up with has 90-95 per cent of my day is focused on COVID testing,” wrote Dr. Leger.

The COVID cabinet committee met for the first time that evening — and agreed with public health’s recommendations to close schools for two weeks.

“Our collective goal is to minimize the spread of COVID-19,” Blaine Higgs said to reporters at the legislature that Friday evening. “The directive continues to be that all individuals who have travelled internationally, on or after March 9, still applies.”