Disability rights groups decry Ford government ‘secrecy’ about COVID-19 triage guidelines

A coalition of disability rights groups is calling on government to make public the directions they plan to give hospitals about how to decide who should be prioritized for life-saving treatment if intensive care units become overwhelmed with patients.

The call comes after the government’s initial COVID-19 triage protocol — which , but was never officially released — was rescinded after it was .

“We write about a life-and-death issue now facing Ontarians,” reads the , signed by more than 60 organizations and sent Thursday to Ford, Health Minister Christine Elliott and Raymond Cho, the minister responsible for seniors and accessibility.

The letter calls on the province to immediately release the latest recommendations from its Bioethics Table — the government-appointed group of physicians and bioethicists advising the ministry on a number of COVID-related issues — and ensure that any new triage guidelines “respect the constitutional and human rights of all patients, including patients with disabilities.”

The purpose of a triage protocol, which would be invoked only if critical care resources needed to be rationed, is to minimize overall mortality by prioritizing patients with the best chance of survival.

Among the concerns raised by disability advocates about the government’s initial protocol was its inclusion of the Clinical Frailty Scale, a nine-point grading tool they said was inherently discriminatory against people with disabilities and could lead to their exclusion from life-saving treatment.

In their letter, the organizations commend the government for rescinding the initial protocol, but the fact that nothing has taken its place also poses a danger.

“If critical care triage becomes necessary, decisions over who gets refused life-saving critical care would be wrongly left to individual hospitals and doctors without safeguards against the serious danger of arbitrary and discriminatory decisions made because of disability,” the letter reads.

Roberto Lattanzio, executive director of the ARCH Disability Law Centre, said the province needs to ensure that any new policy protects the rights of people with disabilities.

“The pandemic doesn’t give governments a pass on ensuring that human rights and constitutional rights are respected,” he said in an interview. “We’ve been advocating for a framework free of discrimination for eight months now and now we find ourselves in a very similar situation as we did from the outset.”

While the number of active COVID-19 cases in Ontario is nearly three times as high as during the peak of the first wave in the spring, hospitalizations and admissions to intensive care units (ICUs) are actually lower now than they were then. On Wednesday, . On May 1, by comparison, there were more than 1,000 COVID patients in hospital, including 225 in ICUs.

The province in April, increasing the number of ICU beds by nearly 1,500 to a total of 3,504. Roughly half of the province’s ICU beds were occupied as of Dec. 1, according to Critical Care Services Ontario’s daily report.

Last month, , Progressive Conservative MPP Robin Martin confirmed the government had rescinded its initial protocol, which she said was only a draft, and that a “revised framework may be shared … should pandemic conditions deteriorate significantly.”

But, Martin said: “We don’t anticipate getting anywhere near having to use such a protocol.”

David Lepofsky, chair of the Accessibility for Ontarians with Disabilities Act Alliance, said cases have steadily increased since Martin’s assurances, and the lack of action by the government is inexcusable.

“They can’t wait until the day where they need triage and then say, ‘By the way, here are the rules.’ ”

The health ministry ignored specific questions for this story and instead sent a 265-word statement, which says, in part, that the ministry asked the Bioethics Table to “ensure that concerns and perspectives of those representing Indigenous people, Black and racialized communities, persons with disabilities, and others who may be disproportionately affected by critical care triage due to systemic discrimination, are meaningfully considered and reflected in a revised protocol.”

A ministry spokesperson did not respond to a follow-up question asking whether the government intended to make the revised protocol public.

Lattanzio and Lepofsky both decried the government’s lack of transparency about the protocol, a criticism that has also been raised by and .

“What’s the secret?” Lepofsky said. “There is no plausible reason for them to keep secret whatever the Bioethics Table recommended. There’s nothing served in the public interest.”

Brendan Kennedy is a Toronto-based social justice reporter for the Star. Follow him on Twitter: