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Saskatchewan physician Dr. Alexander Wong on the power of nuance on social media — really

Canada’s physicians are increasingly taking on public advocacy roles. Dr. Alexander Wong, a clinician-researcher in infectious diseases and addictions medicine in Regina, talks about becoming one of the few physicians on the Prairies speaking out on the pandemic – and navigating the politics of health policy.

 

Since becoming active on social media, you have gained more than 18,000 Twitter followers and made countless media appearances. What encouraged you to step into the public eye?

Honestly, when I started in March of 2021 I never imagined how this would evolve, and I had no real plan.

Our provincial Alpha wave was horrible. So many young and otherwise healthy people on the front lines of healthcare, and essential workers in other industries, were getting so sick, dying. So when I learned Regina was at the forefront of the Alpha surge in Canada, I felt as an infectious disease physician I had to sound the alarm, let everyone know we were in trouble. After that, it just progressed. We advocated for paid sick leave, supporting workplace interventions for first responders and essential workers. That was the original push, as well as trying to keep the public informed; that started it all.

 

How has your messaging changed since then?

At the start of the pandemic it was appropriate and “easier” in that there was generally political and scientific consensus. Everyone agreed vaccines were good, but it was confusing to navigate the landscape with all the changes, developments and such. Everyone mostly agreed that protecting the vulnerable and our health care system made sense and I tried to focus on explaining the evidence in simple and practical ways, especially as things were changing so quickly.

Then by last fall, during our crushing Delta wave, Saskatchewan was air transporting our sickest patients to Ontario because we didn’t have enough ICU capacity, despite innumerable warnings from our health care system leaders and public health officials that the situation was escalating. I continued to speak truth from the front lines, as there was so much anger, despair and burnout from my health care colleagues.

It became clear that advocating for patients and our health care system had to become advocating for policy measures and protections. This approach has continued with our Omicron surge. I try as hard as I can to not editorialize, but to focus on science and evidence. Trying to work and live in a pandemic is exhausting and navigating all the information being thrown from all directions was impossible for most people.

I committed to try and make it easier for the general public to make good decisions for themselves by simplifying the evidence and science at hand to inform their choices. There is a vocal group of persons who disagree with what I have to say, that is a given. No matter a person’s views, I try to treat everyone with respect and kindness. Fighting misinformation and disinformation has been so tiring, but also so important.

 

 

What is your strategy on social media?

I focus on reviewing and simplifying facts, evidence and data, and I’m comfortable stating when I don’t know something. A good indicator that you’re around intelligent people is when there is nuanced discussion about the uncertainty of a situation. The problem is that it’s hard to communicate nuance and uncertainty in 280 characters or less.

I’ve also tried very hard to stay away from any frank political affiliation. I give credit when credit is due, and I am critical when I feel it is deserved as well. Some people will naturally assume that if I’m being critical or complimentary of policy decisions that it is because of some political motivation. It’s not, but I can’t explain that explicitly every single time for every person.

 

How do you handle trolls?

I focus on being kind and giving everyone the benefit of the doubt — that is huge. When someone posts or emails something hateful or really vile, it would be easy to respond in ways that stem from anger and frustration. That might feel good in the moment, but it’s never productive or helpful. I’ve learned over the years that any kind of reflexive response is usually not a good idea, so I try never to do so, whether in real life or social media.

It’s our duty and responsibility as health care providers to look after everyone, regardless of political ideology, whether they are vaccinated, anything.

It’s our job as physicians to provide patients with the best care possible each day, regardless if we are tired or have differing beliefs and opinions.

Being open-minded and being kind, and never judging the person in front of me, whether in real life or on social media is my intention always.

 

Has your advocacy changed your work as a physician?

To be completely honest, making time and setting aside energy to be public facing has stretched me thin. I hope over time to move back my more boring and simple life where I can just be a clinician and researcher.

I never envisioned that all of this advocacy and media work would get to where it is right now, but for the most part, whenever I’ve spoken to the media it has just been an extension of my personal and professional self. I have just shared views around advocacy and public health that make up my core self when I enter the hospital every day as a physician.

I value the relationships I have formed with many hard-working journalists and members of the general public throughout all of this. I recognize that I have created a degree of mutual trust and respect with all of those individuals, and I work hard to honour that trust and respect every day.

In the end, the fundamental work I do as an infectious disease and addictions physician requires that I advocate for those who don’t have the voice or privilege or means to advocate for themselves. That’s why I chose the fields of medicine I did. I won’t ever stop advocating.

 

 

What are some of the challenges of the pandemic?

It has been so hard to absorb all the pain, suffering and unnecessary death. Not just from COVID, and there have been enough heart-breaking stories from COVID alone to last a lifetime, but also from our opioid crisis and countless overdoses. In our infectious diseases clinic in Regina we have had so many patients die from overdose, nearly all from fentanyl, and these are patients that we’ve been close with for many years.

It’s been really hard for our team, for myself. There have been so many tears, so much anger and frustration and sadness. But you realize that you have to keep pushing forward, because there are so many other people that need help, and the health care system is so fragile right now. So many strong providers and amazing leaders have left, moved on for the sake of their personal and professional health.

I think many infectious disease doctors choose the specialty because of some personal desire to advance social justice. I think for the majority of us, even with the challenges of the pandemic, that still holds true. We all have to find ways to manage, cope and move forward.

This interview has been edited and condensed for clarity.