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Snap Out of Your Pandemic Passivity, Canada

The rise of variants demands action. Here’s why we should join the ‘get-to-zero’ movement.

Andrew Nikiforuk 19 Feb

Tyee contributing editor Andrew Nikiforuk is an award-winning journalist whose books and articles focus on epidemics, the energy industry, nature and more.

The COVID-19 pandemic has gained an insidious advantage. The old Wuhan strain is receding. Below the surface, the more infectious variants are rising.

Yet Canada’s response remains locked in a listless, “poor me” passivity.

But it is not too late to choose a life without the virus.

The choices are stark: We can carry on our witless way and drift on the COVID sea, or change our strategy and go for zero.

To understand what that means, listen to Yaneer Bar-Yam. He’s the brilliant U.S. physicist who specializes in complexity and fighting pandemics. He’s been early and right about masks, travel bans and the role of breathed aerosols in spreading the virus.

And he has spent the last couple of months trying to build a global movement that embraces going to zero.

We have featured him in The Tyee because he has grasped realities our political leaders haven’t.

“Success in a pandemic is not waiting for a vaccine,” says Bar-Yam. “It’s about using an arsenal of tools, including vaccines, to defeat the virus while we have the chance.”

Going to zero therefore means a serious five to seven-week lockdown that brings numbers down exponentially.

It means financially supporting struggling small businesses and their workers during that lockdown.

It means changing our testing programs from passive systems that wait for symptomatic citizens to show up, to an active approach that brings tests to the most at-risk communities and workplaces.

It means more testing and contract tracing.

It means quarantine hotels.

It means designating small areas that have achieved virus-free status “green zones" — and enacting travel restrictions to keep the virus out of green zones.

It means, as critical care physician Brooks Fallis recently wrote in the Globe and Mail, “being decisive in tackling the virus from all angles.”

A failure to commit

Summoning the public to understand and accept such measures requires a grown-up discussion among our politicians and citizenry.

But the status quo doesn’t want to change or even entertain a national conversation.

Even as one variant disrupts a Newfoundland election and other variants silently gather force across the country (expect a national eruption in late March), most provinces are merrily reopening businesses and schools.

This strategy has been tried twice. And it has failed Canadians twice.

What was Einstein’s masterful definition of insanity? Oh, yes. Doing the same thing over and over again and expecting different results.

Canada’s major premiers, of course, have consistently defended their indecisive and inconsistent measures by claiming they are preserving livelihoods and the economy.

But what did the very conservative McKinsey and Company, a pillar of capitalist thinking, warn back in May?

“Countries on the near-zero-virus path radically reduced viral spread, minimizing the chances of transmission and making it easier to control flare-ups as they occur. Leaders of those countries have built public confidence, and the public has responded by resuming economic activity.”

There is only one way to banish uncertainty and open up economies. And that way to is to crush the virus, and go to zero.

And yet, when it comes to the complexity of a pandemic, Canada’s political elites still don’t get it. They believe that they can still play a “balancing act.”

Are they at all clear on what they are balancing? When they enable rising infections, do they acknowledge that about 10 per cent of the infected (and that’s millions of people) are now suffering from long-term COVID-19 with a host of debilitating symptoms?

Do they place on one side of the fulcrum the news that in the U.K. tens of thousands of children are suffering from long-term COVID-19 effects, as Deepti Gurdasani, a cracker jack British epidemiologist, says new English data suggests?

The kids’ symptoms include chest pains, exhaustion, gut symptoms and heart palpitations.

The virus exploits inaction

Meanwhile Canada’s elites have embraced a very convenient defeatism. “Oh, what can we do? It’s a pandemic.”

But citizens and their governments are not innocent bystanders in a pandemic; we are all evolutionary players.

Viruses evolve in tandem with their hosts, and every virus is looking for optimum conditions. Killing off too many hosts is a dead end, and something every virus seeks to avoid.

COVID-19 quickly found a sweet spot: contagious as hell, but not too deadly to affect the speed of its conquest.

The evolutionary biologist Paul Ewald long has argued that the behaviour of human populations can and does influence the virulence of pathogens.

During the 1918 pandemic a modest influenza virus, probably carried by an imported workforce of Chinese labourers, suddenly heated up in the trenches of the First World War.

That environment offered ideal conditions for selecting a nastier strain. When the virus jumped into soldiers with gassed lungs in jam-packed trenches and teeming hospitals, it quickly mutated and became a royal killer. A new victim just lay a few breaths away. Crowding can sharpen virulence, because it makes it easier for a virus to kill, and still succeed as a virus, argued Ewald.

In other words, collective human behaviour can heat up or cool down pandemics. The critical variables for COVID-19 have been well identified: the reproduction number (the rate at which one person infects others) and long-distance travel.

Regions that made efforts to control both of these variables (a long list of places, including Atlantic Canada, Laos, Vietnam and New Zealand) have wrestled COVID to the ground. Collective action works and works powerfully. Global behaviours probably explain why global cases are now dropping.

But in the absence of political will, closed borders, community engagement or adequate resources, bad things are guaranteed to happen. In jurisdictions where politicians have willfully let the virus run amok (England, Brazil, the United States and South Africa), evolution has taken over with variants that are more transmissible and possibly more lethal.

It is instructive that none of these variants have emerged in nations with a COVID-zero policy. They have proven that the more we actively put a lid on the coronavirus’s spread with get-to-zero strategies and then vaccines, the faster we will be able to drive its evolution toward a benign state — or just another cold.

Right now, it’s almost as if Canadian politicians are rooting for rapid viral evolution.

With no effective national travel restrictions until last month, our leaders let in the variants. (What’s the single most important factor for eliminating COVID-19, asks a Swiss study? Early border controls that remain firm.)

Our same leaders now are relaxing restrictions with no other strategic goal other than hoping the vaccines will get into people’s arms by maybe September.

The growing ‘get-to-zero’ movement

Since The Tyee first called for a national debate on this issue, the clamour for decisive action has been growing in both Canada and Europe.

The Edmonton Independent Hospitality Community, which represents independent restaurants, has issued a call for the Alberta government “to adopt a COVID Zero plan.” The group notes that “the lack of meaningful government intervention to curb the spread of COVID-19 including appropriate support to help businesses remain closed has prolonged the crisis and destroyed many lives and livelihoods.”

Physician Fallis, in his Globe article, warns the country now stands at a critical crossroad: “There is one path forward that will save lives, minimize medical disability and allow our economy to reopen once and for all: COVID-19 Suppression.”

But a strategic shift “requires non-partisan leadership and a transition from acceptance to complete intolerance of the virus. An ethically grounded goal-directed COVID-19 strategy led with conviction is something most Canadians can support.”

(Disturbingly, the Ontario government relieved Fallis of his duties as interim medical director of critical care at William Osler Health System after he criticized the government’s response to the pandemic in mid-January.)

In Quebec, a group called COVID-Stop, composed of frontline physicians, has led the fight to get the Quebec government to respect what the research says about aerosol transmission and masks.

COVID-Stop also supports the Canadian Shield plan to get to zero.

“The decisive issue at stake today is the choice between the yo-yo status quo strategy vs. the COVID-zero strategy,” recently stated epidemiologist Michel Camus, a member of COVID-Stop.

The Registered Nurses' Association of Ontario continues their “call for an aggressive and all-encompassing lockdown, followed by an effective and concerted strategy to snuff out the virus — a ‘COVID-Zero’ strategy.”

In Europe, a group of prominent researchers have signed a manifesto calling for a continental elimination strategy based on three pillars: “Vaccination, green zones, and test, trace and isolate strategies.”

A green zone is any geographical jurisdiction where schools and businesses can open freely because the virus has been all but chased beyond its borders.

The European manifesto notes that a zone can go green “once the origin of every transmission is known, such that test, trace and isolate strategies can prevent further uncontrolled spreading of the remaining few infections.”

Any reappearance of the virus is subject to hard and fast containment. (New Zealand and Australia can now stamp out any viral outbreak in five days because they understand the meaning of freedom.)

Is becoming a green zone worth the effort, asks the European manifesto?

“Yes. Economically and socially, almost any short-term cost is outweighed by the benefits of exiting from the paralysis of the pandemic. Public health and economic prosperity are not competing but complementary objectives. In addition, the perspective of a secure return to normal will counter growing fatigue in the population, and provide motivation and empowerment in local communities.”

Put out the fire

A pandemic (and COVID is mild one) is viral fire that burns down households, and communities.

In a real fire, citizens expect firefighters to do their job. While battling a blaze, they don’t suddenly roll up the hoses and tell homeowners they’d better learn how to live with this fire for now. Nor do they sit down and have a Monty Python-like debate about the role of government in fighting fires or how fire trucks curtail the freedom of citizens to park on any street they like.

Operating on the reality principle, firefighters get the job done and save what they can. They stamp out every smoldering ember so there is no more exponential growth. They end the threat.

And that’s what we must do with COVID. The example of Australia and New Zealand says we can do that in five to seven weeks.

The choice should belong to Canadians, and not their politicians. Their passivity has failed us.  [Tyee]

Read more: Coronavirus

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