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Analysis
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Health
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Politics
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Coronavirus

Canada’s Crazy Pandemic Response

As the third wave has built and now may drown us, our leaders keep blathering about ‘balance.’

Andrew Nikiforuk 17 Apr 2021 | TheTyee.ca

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

If you want to know how crazy the COVID-19 crisis has become in Canada, just listen for a moment to Quebec Premier François Legault.

“We’ve had no choice but to lock down, reopen, lock down, reopen,” protested the premier last week as he acknowledged how fed up people are with Canada’s disastrous yo-yo approach to COVID-19.

“The idea is to try to find a balance,” added Legault.  “When we lock down, it’s to protect people’s physical health; when we reopen, it’s to help their mental health.”

“Some people think there are too many restrictions, others say they aren’t enough,” added Legault who talks like the political riddle he is. “I would like to please everyone, but that’s not possible.”

With leaders like Legault, who needs government?

Legault, who seems divorced from reality, has pleased no one because his ineffective COVID-19 rollercoaster has achieved nothing except drag his province into a public health and economic hell with no clear exit.

For example, when you rely on your hospitals rather than public health measures for pandemic control, you should not be surprised that 84,000 health-care workers have had infections or that half of those infections have occurred in Quebec.

Widespread political malpractice

What kind of leader cultivates such repeated failures? Answer: the delusional premiers of Canada’s most populous provinces.

Legault’s pitiful comments typify a broadening crisis in this nation: a total abdication of responsibility in the face of a clear and evolving emergency. We need decisive and just leadership, and six premiers have not measured up to the task.

Canada just had its worst week ever for new COVID-19 infections. Yet everything about the third wave was foretold and preventable.

“A disaster, freely and KNOWINGLY chosen by an elected government, is not someone else's emergency,” tartly noted public health and legal expert Amir Attaran.

This chosen “catastrophe” starts at the top with Prime Minister Justin Trudeau. Remarkably, he still does not consider the pandemic an emergency requiring national standards, national goals, national direction or a co-ordinated response. Right. That would require leadership and hard decisions.

Last February, Green MP Elizabeth May requested an emergency debate on Canada’s response to the pandemic and the new threat posed by the rise of the variants. The Speaker of the House denied it. Instead the nation’s elected representatives debated the Keystone XL pipeline which to date hasn’t killed a single person let alone overrun a hospital.

But Legault’s remarks on choice and balance really strike to the heart of the matter. They highlight what’s so wrong with the pandemic response in Quebec, Ontario, Manitoba, Saskatchewan, Alberta and B.C. They expose the rot in Canada’s democratic apple.

First of all, Legault did have a choice, and he chose badly without ever laying out the options to ordinary people.

When COVID-19 arrived last year governments had three distinct but broad choices: mitigate, eliminate or do nothing.

Mitigation is all about limiting the spread of the virus with the major goal of preventing the health-care system from being flooded with COVID-19 patients.

It’s a hospital-centric policy and an entirely reactive one. Every time the hospitals go into crisis mode with patients plugging the ICUs, the government imposes restrictions.

As soon as hospitals exit the crisis mode, the government reopens again and the virus predictably resurges. The cycle repeats itself because COVID-19 is airborne and mostly driven by 20 per cent of the population, who are superspreaders. Many are asymptomatic.

So mitigation becomes all about waiting for a vaccine, because there is no Plan B. But with vaccines now here, we see they cannot race against the exponential growth of variants — and the fact that coronaviruses are likely to evolve into more potent variants was long known.

Nor can vaccines end this pandemic on their own.   

The effective approach is elimination

Vastly different from mitigation is elimination, a strategy widely applied by East Asian nations, Australia, New Zealand and Atlantic Canada last year. It uses tried and true public health interventions (masks, distancing, contact tracing, border controls and one hard lockdown with financial support for essential workers) but with a different goal: the stomping out of the virus in the community altogether.

Elimination fights a viral fire with focus and determination. When battling a wildfire, you don’t stop spraying water on it when it dies down a bit. You don’t stop fighting it at the second storey of a building in the name of balance or libertarianism unless you want to fail. You don’t walk away from a fire half extinguished.

Elimination is not about lazily getting by, it is about getting the job done and protecting the vulnerable with financial support. It seeks to maximize the benefits of restrictions to end the threat so that the population doesn’t become ensnarled in a virus-gripped world that only Franz Kafka could have imagined.    

Elimination also recognizes another critical truth. Travel spreads COVID-19. The virus needs us to move and replicate. Stop that movement, and the outbreak dies.

The evidence from Taiwan, Australia and New Zealand shows that success in this pandemic is not so such about locking down as it is about locking out the virus. Without tight border controls (international or provincial), elimination will not work. Atlantic Canada and the North quickly learned that lesson; the rest of Canada and most of Europe ignored it.

So Legault and the premiers of Canada’s most populous provinces did have a clear choice. And they have repeatedly chosen to inflame the pandemic instead of extinguishing it. Their performance is unconscionable because the rich can survive fires (they have more than one home) that last for months, but the rest of us cannot.

Moreover, when it became clear last summer that that mitigation wasn’t going to control the virus and that Atlantic Canada modelled the solution, our leaders embraced failure again and again with even greater vigour. How crazy is that?

Yaneer Bar-Yam and Nassim Nicholas Taleb, two brilliant experts on risk and complexity, have noted that governments really only have one true job: to uphold the collective safety of their citizens against systemic risk.

“Failing that mandate of prudence by gambling with the lives of citizens is a professional wrongdoing that extends beyond academic mistake; it is a violation of the ethics of governing,” noted the experts last year in the Guardian.

But Canada’s premiers are now repeat violators. They dismissed elimination as an impossible option and did not even consider the subject worthy of debate in a democracy. Premier Horgan, for example, proclaimed that B.C. could not be like New Zealand where elimination drove out the virus. But he never explained why. Where is the transparency in decision-making in this country?

Elimination is not easy and requires more work than muddling along. Of course there is also the risk of failure. But it’s becoming clear that six Canadian premiers didn’t want to lead and make hard choices at a time when the majority of Canadians clearly favoured hard lockdowns to eliminate the virus.

Reject the futile fallacy of ‘balance’

Legault, of course, talks about “balance” in his decisions. Balance is a favourite word of Canadian politicians these days. Faced with a destabilizing change, biodiversity loss or tyrannical technologies, decision-makers always pull out the word balance. Our approach must be balanced. You know you live in an upside-down world when immense threats demand bold action, but politicians can only talk about balance, balance, balance.

And so, during a pandemic we must also balance public health and the economy like a tiny dog on top of a ball. Doug Ford called it a “happy balance.” Ontarians do not seem to be feeling happily balanced right about now.

There is no such thing as balance in response to a pandemic. Emergencies flip societies or ecosystems into a state of crisis and chronic imbalance. What’s alarming about this truth is that Legault and his fellow premiers can’t grasp it.

Jason Kenney and Doug Ford, for example, have prattled on and on about lives and livelihoods as though you could have one without the other. They played chicken with a virus and failed to protect their citizens. Kenney swore that “Zero COVID” was not in the cards for Alberta. Now his province’s case rate towers over that of most U.S. states. Remember, this was the same incompetent premier who dismissed COVID-19 as an “influenza” because the average age of the dead at the time was 82 and life expectancy in Alberta is 83.

Let’s be blunt about what the “balanced” yo-yo response of Canada’s six provinces has cost this country so far: suicides, failed businesses, lost educations, lost years, failed marriages, damaged health-care systems, burned out doctors and nurses, delayed surgeries, dead elders, an epidemic of Long COVID, lost trust, fatter billionaires and punishing inequalities for poor and immigrant communities.

The problem with mitigation is that it postpones hard choices and exacerbates inequalities. It’s like the debate about the abolition slavery in the 19th century. Some called for “gradual abolition.” One economist replied to the idea as a grand joke. It reminded him of “the man, who in order to cut off his dog’s tail without hurting him, cut off a little piece of it every day.”

Every day, in the name of balance, COVID-19 mitigation as practiced by six of Canada's premiers has cut off a little bit of Canada’s tail. The pandemic is worse, and the dog is now furious. What could possibly go wrong next?

Media failed to zero in

In my 40 years as a reporter, I have never seen such a shameless display of incompetence and unaccountability among elected leaders. Or such a dangerous one. And yet the media has rarely questioned the insane political arguments for balancing health and economy during a runaway pandemic.

Do firefighters arrive at a fire only to have a raucous debate about a balanced approach about saving lives or property?

No, they fight the fire. They end the emergency. And then, with the flames quenched, the inhabitants of the structure can go about rebuilding and living their lives, with the maximum number of neighbours spared immolation.

You will rarely read this in Canada’s press that has given so little space to the case for imposing a sharp, serious lockdown followed by relentless testing to drive down virus infections. But the economic evidence from nations that pursued elimination is shocking and unequivocal.

The Paris-based Molinari Economic Institute recently compared the performance of G10 countries that chose mitigation like France versus those that chose elimination such as New Zealand and Atlantic Canada.

It should have made front page news everywhere in Canada, but it didn’t. On every count, the Zero COVID and elimination nations won. The nations that chose elimination suffered much smaller declines in mobility. Their GDP shrunk less than the mitigators. And by huge margins. Nor did their citizens experience endless openings and closings either.

The success of Zero COVID is easy to explain. Confidence drives any economy; a pandemic destroys that. When you eliminate the circulation of the virus, life returns to normal because governments have restored confidence and certainty for all. The good health of ordinary people opens economies.

Meanwhile, the craziness of balance and bad choices persists throughout much of Canada like some kind of intractable political affliction.

One day the Ford government says it will keep schools open (it has always denied their role in airborne transmission), and the next day it changes its mind. Then Ford’s government makes strange decisions about how to parcel out vaccines, focusing not on hot zones but skewed to political ridings that voted for Ford. As an entirely preventable wave engulfs hospitals and communities, construction sites remain open and long-term care homes are now receiving the sick hospitals can’t accommodate. Oh, happy balance.

The police measures Ford has now imposed represent a total failure of leadership. A weak and flailing premier still doesn’t get the message. If you want to defeat this coronavirus, says infectious disease expert Andrew Morris, the recipe isn’t complicated: close and pay all essential businesses. Provide paid sick leave for the infected. Provide places for the infected with symptoms to quarantine. Use regional travel restrictions to create green zones (areas with no COVID-19). And then lead with honest and daily communication.

In Alberta, the premier talks daily about cases rising to 2,000 one minute, and then promises citizens the best summer ever. Kenney’s mixed messages have fostered rebellion in his own ranks. Over a quarter of governing party MLAs demand he lift his most recent restrictions. This is what happens when a leader fails to embrace and explain science and avoids hard decisions from the outset. Left to fester, doubt flourishes like a virus.

In fact, five other premiers and the prime minister have similarly failed at leadership 101. It’s pretty basic stuff. When faced with an emergency, it is better to act quickly and decisively. Delay magnifies the pain when battling exponential growth. Wishful thinking is not a strategy. Balance is not an option against an existential threat. A good leader does not put on the brakes after he or she has slammed into a brick wall. And so on.

A year of bad decisions have not only brought us to a third wave but to other hazards. New variants are rising around the world and that promises more uncertainty given our porous borders. Vaccines will not achieve herd immunity because of these variants and anti-vaxxers. That means mitigation has never been a sustainable strategy.

And so an urgent question faces most of Canada: “What strategies might work combining mass vaccination, mass testing, mass high quality masking and stay at home restrictions, to achieve local elimination?” asks pandemic expert Bar-Yam.

Don’t expect Trudeau, Legault, Kenney, Ford, Horgan or many other of our politicians to ask this question, let alone answer it. They prefer leading us into COVID-19 Crazy Time. And that’s why most Canadians live there now.  [Tyee]

Read more: Health, Politics, Coronavirus

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