It’s time to plan the next step

Screen Shot 2020-04-21 at 06.13.53Following on from yesterday, I see an opinion piece in the Globe and Mail by Dr Eric Hoskins, a physician and the former Health Minister of Ontario, who says that “Here’s the COVID-19-related question I am asked most: “When will life get back to normal?” There is no definitive answer, unfortunately. But there are important, objective signs that things are improving … [because] …The epidemiological evidence shows that by the end of April, Canada should be through the worst of the pandemic … [I thinkshould” is an important word ~ this pandemic could still have nasty surprises for us, and] … The most reliable modelling I have reviewed suggests that, at that point, Canada will have in the order of 50,000 to 75,000 confirmed cases, depending on testing rates; sadly, approximately 3,000 people will have lost their lives … [and] … After this, and depending on our actions, some degree of spread will continue until herd immunity is reached or a vaccine is proven effective. But overall, Canada will be in a much better place by May – which means that our actions are having a decisive impact.

Screen Shot 2020-04-02 at 08.31.32In other words, Ontario’s Premier Doug Ford was right, six weeks ago, to have declared a state of emergency and to have told us to stay home in order to help prevent the spread of this virus. When he did so he led Canada and, indeed, North America, and he did so when many leaders, including Prime Minister Justin Trudeau and President Donald Trump, were still soft-peddling the crisis. Premier Ford deserves our thanks.

But, Dr Hoskins says, “That is not to say we should relax. Nearly half of all COVID-19 deaths in Canada have occurred in long-term care homes – a crisis within a crisis. At-risk communities and individuals who have difficulty accessing health care will remain especially vulnerable … [but] … British Columbia is now past the peak of daily new infections; at time of writing, there were just 115 COVID-19 patients in hospital and 54 in intensive care in the entire province. Alberta, with far fewer infections than first predicted, is also approaching its peak, and is sending personal protective equipment and ventilators to neighbouring provinces. Ontario and Quebec, the worst-hit provinces, should reach their peaks within days. And this follows recent trends in countries such as Italy, Spain, Germany, Switzerland and Austria, where cases and deaths from COVID-19 have reached their peaks and are slowing … [and] … Most health systems, notwithstanding shortages of PPE in many jurisdictions, remain entirely capable of supporting hospitalized COVID-19 patients. Ontario currently has 197 COVID-19 patients on ventilators; roughly 80 per cent of the province’s 2,811 ventilator-equipped critical-care beds are unoccupied and ready for use by new patients.

interim_chief_medical_officerIn other words, we can see that the best scientific advice ~ many thanks to Dr David Williams, ⇐ Ontario’s Chief Medical Officer of Health and to the thousands of scientists and physicians who sounded the warnings, world-wide ~ and the modelling worked. We did “flatten the curve” which means that our health care system did not collapse under the weight of hundreds of thousands of sick people, all needing intensive care all at once.

Eric Hoskins asks: “What lies ahead?” His answer is that” Recent University of Toronto and Harvard University studies suggest that a dynamic (open-close-open) approach to isolation and physical distancing will likely be highly effective in reducing and containing a second viral spread. If cases surge, restrictions and controls would be tightened until levels drop again. And this must be done in conjunction with widespread, easy-to-access testing, isolation measures and rigorous contact tracing. With such measures in place, the threat of future waves of the virus can be blunted … [and, fortunately for us] … Canada can also look to others ahead of us in this struggle. Italy, Germany and Switzerland are about to reopen certain small businesses. Spain’s manufacturing and construction industries are starting to come back online. The United States is adopting a three-phased approach to reopening, focused on maintaining physical distancing and protecting the vulnerable. We need to closely monitor these experiments and take lessons that can guide our decision-making …[and, he suggests] … A good place to start for Canada would be to thoughtfully reopen parts of the health system, including elective surgery and cancer care. The list of “essential services” can be carefully expanded to include more businesses and allow for a gradual reopening of the economy.

77888060-quebec_bridge_stop-_wc015-wAlthough Dr Hoskins favours a nationally coordinated strategy for reopening, I suspect it will have to be province-by-province. Geography, alone means that British Columbia’s situation differs from those in Québec and Nova Scotia. Politics and the Constitution mean that some provinces can impose inter-provincial border controls. The national government, led (if that’s the right word) by Justin Trudeau, is, largely, irrelevant (except for fiscal measures) in this crisis.

Eric Hoskins suggests that the data says that Ontario, at least, can start to reopen in May. Some, he says, will disagree with his assessment but, “the data is telling us that what we have done so far – while imperfect and challenging – has worked … [and, while] … Tragically, many lives have already been lost, and we will still see more deaths. But we have already made a difference, and by doing so, we’ve saved thousands, perhaps tens of thousands, of lives. This success can continue, even as we begin to test the waters and restart our communities.

It is time to be planning to reopen Canada. I trust premiers Horgan, Kenney, Ford and Higgs and all the others …

Screen Shot 2020-04-21 at 06.47.24

… to do so in a sensible, safe manner, coordinating with their neighbouring provinces, too. It’s what Premier Ford is already planning.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s