Former Alberta Chief Medical Officer of Health Dr. James Talbot talks to Alberta Primetime host Michael Higgins about Canada’s loss of measles elimination status, Alberta’s role in the outbreak, and the future of eradicated infectious diseases in Alberta. This interview has been edited for clarity and length. Michael Higgins: What does this loss designation represent to you as a health professional? Dr. James Talbot: Two things. One is that it’s an admission to the world that we have failed to control a very important and communicable disease, and the world needs to take precautions, either for their own citizens travelling to Canada or Canadians travelling to other countries. The second thing, is that we need to address the root causes of how we lost that control so we can regain that status in the future. MH: Alberta is second only to Ontario in the overall case count. What is to be made of our province’s role in this outcome? JT: We’ve been the major contributor if you take a look at the per capita number of cases. We’re responsible for about 40 per cent of the cases in Canada, with [almost] 2,000 cases in Alberta, most of them in children. And we only have 10 per cent of the population. We have more cases in Alberta than the U.S. has in total, and we have the worst rate in North America of any jurisdiction. Because measles was eradicated, the cases that we have this year are actually worse than the last 30 years in Alberta in total. That’s how bad our performance has been. MH: The province says more than 137,000 vaccines have been administered since March – a 50 per cent increase year over year. How would you rate Alberta’s progress in bringing the outbreak under control? JT: It’s been nowhere near enough. That’s why it’s taken so long and why our performance has been so bad compared to other places. They always talk about how many they’ve given, but they haven’t talked about how close they are to achieving important numbers like 90 per cent of kids under the age of five being immunized. When north central [Alberta] and south [Alberta] are at about 50 per cent of the immunization rate, and way away from the 90 per cent that we would aim for, 137,000 on a population of 5 million is just a drop in the bucket compared to what we need to regain that status. It’s a bit like if you had a losing hockey team and the score said you were losing, but the coach was telling you we’re getting more shots on goal. Fine. I’m glad that you’re getting more shots on goal, but we’re clearly still losing. MH: What does that say to you about the state of public health in Alberta? JT: There are two things that it says to me. One is that we need the courage and the leadership from the provincial government to commit to say, a five-year plan to get immunization rates for the kids under the age of five back to 90 per cent. We need that kind of commitment, and we need then the resources, and we need the government to commit to reporting on the yearly progress, to getting to the point where our kids are safe again. The second thing it tells me is there hasn’t been enough attention paid to how badly the public health system has been damaged by things like COVID and the constant restructuring and political interference that’s going on. I know a lot of people in public health who got burnt out or had to leave the system because COVID was such a stressor. They were on the front lines before there was a vaccine, and then after the vaccine it was a sprint to try to get people as protected as possible. There’s been no recognition by this government that we need to strengthen those systems, particularly if we’re going to regain that measles free status. So one, a commitment to get the immunization rates up, and two, the resources to be able to do that and to rapidly bring any new outbreaks under control. MH: The president of the Alberta Medical Association identifies vaccine hesitancy as one of the challenges here. What is the risk of a resurgence of other problem diseases? JT: It’s pretty significant. First of all, measles [vaccines] come as a package with mumps and rubella. Then there are other childhood immunizations that are very important, like diphtheria, pertussis, tetanus and polio. A lot of people think that because the rates have been low for so long -as they were for measles - that these diseases have gone away. They haven’t. The bacteria and viruses are still circulating in some cases within Canada, in some cases within the world. Because of that, we’re always at risk of these things coming back and killing kids or maiming kids or permanently damaging their hearing or their mental acuity. Diseases like diphtheria, you can end up with paralysis of the breathing muscles and kids suffocating. Or whooping cough, where kids sustain brain damage because they’re not getting enough oxygen because they’re coughing so hard. Or polio, for those of us who remember it, or have family members who are affected by it, which can cause people to be on ventilators lifelong, or be crippled because of the effects of the virus. These are not things that we want to wait until people understand the urgency because they’ve seen cases happen, and all of the rates for immunization for those diseases are way below where they should be in Alberta. There are parts of Alberta where the immunization rates are actually below what we’d see in the third world.
