People & Places

The face of the fight: how Dr. Vera Etches gained her will of steel

The fight of Ottawa’s Central Command against the pandemic takes place in a child’s bedroom in Lowertown with pale yellow walls and a bunk bed. Physical distancing measures have forced the city’s chief medical officer, Dr. Vera Etches, to lead the city’s charge against COVID-19 from her home. She doesn’t have access to the stand-up desk she uses at her office in the Ottawa Public Health headquarters on Constellation Drive, but for now a laptop computer on top of her son’s dresser will do.

Etches, who became the city’s top doctor two years ago after nine years with Ottawa Public Health, typically starts her workday at 7:30 a.m. She’ll spend the day in conference calls with the mayor, councillors, city managers, and hospital leaders, all seeking her guidance on how to reopen the local economy safely.

One of her first calls of the day is with Councillor Keith Egli, chair of the city’s Board of Health. It always begins the same way, with a recap of what happened overnight: how many new cases were recorded and the grim acknowledgement of how many people died.

“There’s a real sense of empathy. She’s not just rattling off statistics,” says Elgi. “You get a real sense that she’s going through this as well.”

Mayor Jim Watson calls her “an incredible professional and an incredible human being” and says she’s the perfect person to be the face of public health at this time.

Ottawa has managed to plank the curve and prevent cases from overwhelming hospitals as was seen in New York City and northern Italy. After nearly two months of lockdown, May was ushered in with a stretch of days when the number of people recovering from the virus outpaced the number of new infections.

For Etches, this is progress but not success. “I can’t say we’re satisfied when we continue to see death. We have to be improving continuously by working with our hospitals and working with our partners,” she says.

Dr. Ken Farion, part of the city’s COVID-19 assessment team, talks to Councillor Keith Egli, chief medical officer Dr. Vera Etches, and Mayor Jim Watson at the Brewer Park assessment centre. Photo supplied

That cautious attitude has kept Ottawa ahead of the pandemic curve. Etches was one of the first health officials to warn of community spread. During a news conference on Sunday, March 15, Etches boldly stated that it was likely there were hundreds, even a thousand, undiagnosed cases in the city, even though there were only 10 confirmed cases at the time. She called for a ramping up of the city’s containment efforts and urged people to stay home and to take their children out of daycare. Two days after she sounded the alarm, the province declared a state of emergency.

Looking back, Etches says, if Ottawa hadn’t listened to her warning, the situation would have spiralled out of control. “If the people of Ottawa had not understood that we could get into dangerous territory in terms of overwhelming our system, the track we were on in early March with the spread of the infection would have taken us to thousands of deaths and ten thousand hospital admissions. That’s the curve, it’s not made up.”

During this pandemic, Etches has been working long days. Her back-to-back calls would be untenable if she didn’t have her husband around. When her two boys, aged four and six, get restless, she counts on Edward to take them out of the house for long bike rides. When she can, she’ll duck out of the house for a run. Her workday usually ends around suppertime. After putting the children to bed, her husband urges her to unwind with a Netflix comedy. Instead, she often finds herself responding to emails late into the night.

The 44-year-old chief medical officer isn’t afraid to show her vulnerability on social media. On Twitter, Etches has posted about dumping over her bowl of soup, breaking a glass, and feeling stressed. On Mother’s Day, she wrote about yearning to hug her mom.

She’s also taking medical fashion mainstream. In early May, she posted a selfie of herself wearing a mask with purple orchids: “Glorious day to be outside and wear a mask if maintaining physical distancing might be challenging. Anyone else wearing a homemade mask today and willing to share your look?” Ottawa Health linked to websites that sell face coverings, and the trend caught on. The public and politicians responded with mask selfies in a riot of colours and patterns,
demonstrating it’s stylish to protect yourself and others from transmission.

“She is very much the doctor for the city, and she feels each and every one of us is her patient. She’s polite and amiable, but she has an inner core that is made of steel,” says Egli, who has been impressed with how Etches leads by example. Egli points out that Ottawa Public Health immediately went beyond the province’s containment orders to protect the city.

Etches’ team translated vital COVID-19 information into 30 different languages and started collecting race data weeks before Ontario Public Health deemed it necessary to find out how the virus was affecting different ethnic groups. At press time, the chief medical officer was preparing a new contact tracing app while also expanding testing.

Left: Vera at the age of five with her brother, David. Right: Catching trout in a lake near Hazelton, B.C. Photos supplied

Vera etches was born in New Zealand in 1975; her parents, graduates of medical school at the University of British Columbia, were completing their medical residencies. In the middle of the night, 10 weeks early, she was delivered by a midwife. Only one and a half pounds at birth, she wasn’t expected to survive. Her father, Duncan, tried to resuscitate his newborn but inadvertently inserted the breathing tube into her stomach instead of her lungs. That’s when mom, Nora, still on the delivery bed and in stirrups, took matters into her own hands, leaning over to intubate her tiny child.

“I was very focused on what needed to be done,” says Nora, laughing as she recounts the story. “I had more experience [than Duncan] because I had just completed a neonatal rotation.”

When Etches was two years old, her parents returned to Canada and settled in the small village of Hazelton, in northern British Columbia. They worked at a hospital run by the United Church of Canada and raised four children, weaving themselves into the fabric of the community. “Health is more than medicine and surgery,” says Duncan.

They modelled that mantra by going beyond treating patients. Duncan built hiking trails in the area, while Nora helped organize a co-operative daycare and successfully lobbied to bring French immersion to her children’s school. The Etches children went to school on the Wet’suwet’en First Nation and learned the basics of Gitxsan, the language of the “people of the river of mist.”

A young Vera stands in the front row of this photo taken at John Field Elementary School in Hazelton, B.C.

In the early 1980s, the family’s church sponsored a family of Vietnamese boat people. Nora often took her children to read with the refugees. That Vietnamese couple would eventually give birth to a daughter who grew up to become Olympic gold medal wrestler Carol Huynh.

Vera Etches’ emergency-response skills were first tested in high school. While her parents were away on a trip, a heat lamp fell on some hay in the sheep barn. Upon seeing the smoke, Etches sprang into action, mobilizing her three younger siblings to corral the sheep to safety while she called the neighbours to help douse the flames.

As a child, her parents say, Etches was more interested in art than in science, but they note two events that might have focused their daughter’s attention on medicine as a career. In high school, Etches helped her father deliver a lamb. Around the same time, she accompanied her father on a house call and watched as Duncan delivered a friend’s baby.

Duncan says his daughter most likely got her gentle bedside manner from her mother, who was loved by the Indigenous patients she treated on nearby reserves. Nora says Etches got her “brains and thoughtfulness” from her dad. “She looks beyond what’s right in front of her and thinks about the implications,” says Nora.

Left: Vera Etches on the day of her graduation from Simon Fraser University. Right: Duncan, Vera, and Nora Etches

Etches’ 73-year-old parents say their daughter doesn’t need their advice, but Duncan sympathizes with her struggle. “Do you keep the ‘stay at home’ thing or start opening up? It’s a hugely difficult decision because if you get it wrong, there will be a lot of flak.” While Duncan worries about political ramifications, Nora worries about the personal cost to their daughter. “Vera’s not getting enough sleep.” 

While attending medical school at the University of British Columbia, Etches charmed fellow students with fresh-baked cookies and developed an interest in public health that took her to Malawi, where she studied the effect of vitamin A supplements on the vision of newborns. She wasn’t able to get enough mothers to participate in the study because too many were dying from the HIV epidemic ravaging the country. Instead, she saw ingenuity in the community nurses as they overcame immense obstacles to treat patients. It taught her that politics can either help or harm health outcomes.

“The biggest lesson for me was that politics affects the health of a population more than if you have a hospital or health clinic.” It was true in Malawi, and it’s true in Canada, says Etches. “Our housing policy matters to health — probably more than the public health services we run. So it’s always about trying to find ways to work with others to influence those policies.”

Prior to joining Ottawa’s public health team, Etches worked in Sudbury as an associate medical health officer. She was hired in part because of her interest in Indigenous health. In the four years Etches was there, she developed a reputation as a fighter for the underdog. She also helped develop Sudbury’s response to the H1N1 pandemic, which became the foundation for that city’s current COVID-19 strategy. 

Dr. Penny Sutcliffe, Sudbury’s chief medical officer, hired Etches. Sutcliffe says Etches never used her authority to push forward directives but proceeded with “humility” and a desire to understand other perspectives. “Vera has integrity, and her character aligns with her values,” Sutcliffe says. “She walks the talk. She’s a strong environmentalist and a strong advocate for social justice.”

Now that Sutcliffe’s protege has become her peer, she and Etches talk almost daily on a province-wide call of local chief medical officers. Different regions have different challenges, but Sutcliffe says Etches is always thinking about the overall system and searching for ways Ontarians can work together.
“She’s constructive and solution-oriented. She doesn’t complain or look for blame. She always looks for a solution.”

Sutcliffe’s comments shed light on how Etches has tackled the crisis in long-term care homes. While Ottawa has been successful in preventing a surge of COVID-19 in hospitals, the capital, like other Canadian cities, has been unable to stop the surge in nursing homes. As of June 22, there were 2,061 confirmed cases and 261 deaths in Ottawa. More than half of the cases are linked to exposure in a long-term care home or similar institution.

Left: Prime Minister Justin Trudeau visits the Ottawa Public Health office on Constellation Drive. Right: Dr. Andre Willmore of the Ottawa Hospital and Mayor Jim Watson look on as Etches explains procedures and takes questions at the Brewer Park assessment centre

Ottawa Public Health is coordinating help, but Etches says nursing homes, with their close quarters and shared spaces, are “challenging environments.” She refrains from criticizing and focuses on solving the problems. “Long-term care homes always care about their residents and patients. There’s no lack of care and concern. People are trying to do the right thing.”

The closest Etches has come to showing public disagreement was in late April, when the city’s director of long-term care facilities banned window visits at city-run homes, spurring public outcry.

“Looking through a window is not a threat. It can be an important source of reassurance for family members on both sides of the glass. Ottawa Public Health wasn’t consulted or advised before the city decided to issue this directive,” she said in an interview with CTV Ottawa Morning Live.

Now the focus is shifting again. Ottawans have been in lockdown for over three months. With the arrival of summer, the desire for more freedom is heating up, and Etches needs to recalibrate.

“Getting people back to employment and getting an income is so important to health. We’re doing harm to health right now with the damage to the economy, so I want to see that start up again in a safe way. But it’s a challenge because most of our population is not immune and I know we are at risk of a large spike of infections again if we’re not careful.”

Each day brings new research about COVID-19, new statistics on the economic toll, and new concerns. Amid the avalanche of information, Etches finds comfort in twice-weekly video chats with her parents. She gets to brag about her sons’ exploits and hear about their adventures — how they bang pots and pans from their Vancouver porch to cheer frontline workers. How they’re dropping off masks at their neighbours and teaching other seniors to use Zoom. The pandemic isn’t ending anytime soon, and hearing her parents’ stories rejuvenates her.

“So many people are caring for others. This is what is inspiring and gives me hope about making it through the pandemic together.”