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Championing Inclusive Healthcare, Q&A with Dr. Isaac Bogoch

Dr. Isaac Bogoch has become a familiar face during the COVID-19 pandemic. In an interview with WeRPN, he reflects on what the pandemic has taught us about public health in Ontario –and how RPNs play a role in strategies moving forward.

WeRPN: In the early days of vaccination, you were on the committee that drove Covid immunization, and when you realized there were no nurses in the group, you took it upon yourself to meet every Monday with the four main nursing organizations, including WeRPN. Why was it so important to you to make sure they had access to that committee? 

Dr. Bogoch: When we’re thinking about immunizing the province, it is extremely important to have all the relevant stakeholders at the table. This is truly a team effort. Nurses bring so much to the table in terms of healthcare delivery, health care policy ideas as to how health care can be equitably rolled out to communities. I thought it was extremely important to get input and advice from the nursing organizations in Ontario, and that would help drive some of the decisions and policies that we would ultimately make at the level of the task force. 

In a perfect world, nursing representatives would have a seat at the table. In the absence of that, I worked very closely with nursing leadership in the province to at least get input into how we could best roll out vaccines in a data-driven and equitable manner. And their input was invaluable. I really learned a lot from our regular meetings, where information would flow in both directions. It was a lot of work, but I think it went a long way in shaping the vaccine roll out in the province. 

 

What have been your biggest learnings from this pandemic? Recognizing, of course, that it’s not over. 

No it’s not. There really are a lot of lessons learned in terms of how to work closely. At the end of the day, health care is delivered at a very individual level and that’s done locally. That involves good local partners and good local leadership with public health. This is a massive province with close to15 million people. You can’t sit in the Ivory tower and make decisions for 15 million people. I think you really have to get good input from the communities. You have to communicate and work with local communities. You have to have very strong local community leadership and interaction with community leadership as well.

If you really want to have public buy-in and public trust, you have to get everyone involved, keep everybody informed, and have very broad engagement in terms of creating valuable solutions as to how vaccines are going to be rolled out or how health care is going to be delivered.

 

In the early days of the pandemic health care professionals, including yourself and nurses, saw huge support from the general public banging pots and pans every night at 7 p.m. Sadly, it turned and the perception changed with some groups – they saw healthcare professionals as the bad guys. Did that surprise you?

For many people in healthcare, we’re very proud of what we do and we take a lot of pride in our work. Obviously there was some fright and anxiety-provoking times very early on in the pandemic when we just weren’t sure what we were dealing with. How deadly was this? How do you catch this infection? How do you protect yourself? We worked a year in the pre-vaccine era putting ourselves at risk, caring for patients on the wards, and certainly there was some strong appreciation of that, and there still is strong appreciation of that. I think there was a lot of attention paid to some protests and people who weren’t as impressed. But honestly, I think that’s a small percentage of a very vocal minority of individuals. Obviously you don’t want to see that, but I think at the end of the day, most healthcare workers just roll up their sleeves and get to work.

 

How prepared do you think we are for the next pandemic?

Poorly prepared. It’s really unfortunate. We can say all the right things, but we haven’t actually done that at a global level. At a global level, we really need to focus very much on early detection systems, and that means bolstering laboratory capacity in many parts of the world. We need better and faster data sharing so that if we do see an emerging pathogen, we can rapidly respond to it. We need to really bolster the public health capacity in many low income countries around the planet as well. So sadly, there’s been a lot of talk but not a lot of action. There are some moves in the right direction in terms of we now have technology where we can rapidly create pretty impressive vaccinations in a short period of time. And we’ve seen some moves to get that technology in lower income countries and for example, in African settings, production plans for vaccination. So there are steps that will help out. But I think we’re a long way away, unfortunately. 

 

What would you say to RPNs and practical nursing students who are working or starting to begin working in year 2.5 of the pandemic?

Thank you. I mean, it’s such a noble profession and such a wonderful job. And we know that it hasn’t been easy over the last two and a half years of the pandemic. But the whole healthcare team, that’s not just doctors and it’s not just nurses. Everybody working in healthcare has really done a remarkable job rolling up their sleeves and really taking care of the Canadian population.

All the pots and pans are nice, the accolades are nice, but that’s not why we do it. It’s a wonderful job, and you can truly transform people’s lives for the better. You can help provide the health care that Canadians deserve. There’s a bright future in healthcare, and it’s an absolutely wonderful profession. So I only have the strongest words of encouragement for anyone going into the field.

 

When you think about the changes in the healthcare system and how we as a society changed in the past two years, what gives you hope?

During the pandemic, we had not just the public appreciation of infections and epidemiology, but also equity. It’s not every day you see on every major media outlet the cry to push for greater vaccines in racialized neighbourhoods or low income neighbourhoods or among essential workers who couldn’t stay at home when everyone else was staying at home. 

It was wonderful to see that momentum, that push for better health care to those who would be considered more on the marginalized end of the spectrum. And again, the cries to really improve health care for seniors and in our long term care sector, I don’t want to lose that momentum. 

I think by shining a light on that, many people became aware of it. They were able to look outside of their bubble and look at the challenges that others face. And this is not somewhere overseas. This is right here in our backyard.

We had a lot of momentum this time last year, and I think we need to keep that momentum up because we’re obviously caring for 38 million Canadians, not just a select few. That means providing exceptional health care for everybody.