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Rights + Justice

Frank Talk about COVID-19 Risk with Former Health Minister Jane Philpott

A Salt Spring Forum video conversation between two doctors suggests the worst may be yet to come.

Serena Renner 20 May 2020 |

Serena Renner is a journalist and editor who writes about social justice, the environment, and creative change-makers and their big ideas. She is completing a practicum with The Tyee.

The Salt Spring Forum’s COVID-19 series just went full circle as its first guest, Dr. Kevin Patterson, took the interviewer’s chair to question Canada’s former health minister Jane Philpott, who also served as Treasury Board president in the Trudeau cabinet before resigning in protest over the SNC-Lavalin scandal, then running for her MP seat unsuccessfully as an Independent.

The discussion is a reality check, reminding us of the ongoing risks and vulnerabilities that will be with us for at least the next few years. If not forever.

Both Philpott and Patterson — the latter has been working in intensive care during the pandemic — know the vulnerabilities all too well. Ahead of her new role as dean of the faculty of health sciences at Queen’s University, Philpott has been lending a hand at Participation House, a group home for young and older adults with disabilities in Markham, Ont., which experienced a devastating COVID-19 outbreak in early April.

That put Philpott on the frontlines of Canada’s fight against the virus, at a group care home where 40 out of 42 residents have caught the virus, and six had died as of May 1 (according to this moving National Post interview).

“It was a really difficult situation, so I stepped in to help there on Easter weekend and have been there most of the time since,” Philpott says. “Things are thankfully starting to get better.”

While many countries are facing similar challenges with senior care, Canada’s death toll speaks for itself, Philpott says. In some provinces, 70 to 80 per cent of COVID-19 deaths have had some association with long-term care.

Reasons range from home designs that force people to live in close quarters, to retention rates, to weak regulations that in some provinces only require one nurse no matter the size of the centre. And then there’s the new evidence from Ontario that shows higher death rates in for-profit long-term care homes versus their non-profit or public counterparts.

“If we can’t take care of the elderly, of our grandparents, of the people who built this country and laid the foundation that we’re enjoying now, then it would be pretty shameful for us,” Philpott says, adding that senior care isn’t all that expensive when compared with everything else the country is spending on. “Providing good quality care is surely something that is worth all of us bearing the cost of in order to care for the people who cared for us.”

Although we know “an ounce of prevention” is “worth a pound of cure,” the annual budget for the Public Health Agency of Canada is only $675 million — modest for a federal department, according to Philpott. The budget, combined with the collection and sharing of data between provinces, needs attention in the years to come.

“Hopefully now, one of the good things that will come out of this is that we have to figure out how to strengthen those institutions of public health at every order of government in the country,” she says.

In addition to seniors, many questions from Patterson and the Salt Spring community focused on the vulnerability of other groups, particularly Indigenous communities that have so far been spared from COVID-19, whether due to geography, smart decision-making, or strong health departments. Philpott says protecting such communities needs to be a collective focus for the next two to three years, or until a vaccine is found.

“What is going to happen when you suddenly get five, 10, 20 sick people and there’s only a little nursing station?” Philpott asks. “That’s where there are going to be big challenges.”

A serious concern is the risk of co-morbidity — the presence of two diseases simultaneously — if COVID hits a community already struggling with a disease like tuberculosis. Inuit people in Nunangat, for example, have a tuberculosis rate that’s 300 times higher than the Canadian-born non-Indigenous population, according to Philpott, so an outbreak of COVID-19 in Nunavut would be “highly lethal.”

“Let’s just hope it doesn’t happen in the near future,” she says. “I hope that officials will be very very cautious about reopening travel into the territories and into the North.”

NGOs like the Canadian Red Cross have already been working with communities to prepare for possible field hospitals in remote areas that don’t have adequate health services, she adds. Médecins Sans Frontières,' better known as Doctors Without Borders, recently sent teams to Navajo communities in northwest New Mexico, giving us a sneak peek for what might be in store for Canada, Patterson adds.

“Hopefully that can be done in a way that’s highly respectful of the rights of Indigenous peoples, who need to be in the driver’s seat,” Philpott says.

Questions from the community unsurprisingly start with testing, and the fact that Canada is still well behind many developed nations, as a recent Globe and Mail article by André Picard demonstrates. Philpott agrees with Picard: “Getting a hold over the pandemic and the outbreaks will not happen without huge availability of testing.”

A followup question inquires about long-term health impacts or treatment side effects for people who’ve contracted COVID-19 and recovered. Philpott acknowledges that “we’re still learning a lot about this virus,” but a variety of inflammatory conditions have emerged in recovered patients, including children developing a vascular disease like Kawasaki syndrome — one of the leading causes of heart disease in kids.

Unfortunately, the bad news doesn’t stop there. Philpott echoes the predictions of other health experts who speculate that the virus is here to stay, even if we do manage to develop a vaccine. “The worst of this pandemic is still to come,” she says, particularly in areas of the global south that might only have one respiratory doctor for a population of 80 million people. “I wish that were not the case, but I think that’s a fairly safe prediction,” she says.

More than anything, this pandemic has exposed the social determinants of health and vulnerability, Philpott says. It’s a lesson for health education at institutions such as Queen’s University, where she’ll take her new post as dean of health sciences in July.

“It’s not all biomedicine that health professionals need to know,” she says. “They need to understand the social sciences. They need to understand that when people don’t have housing or live in crowded housing conditions that they are more likely to have a bad outcome from a virus like this. I think this is also, hopefully, going to really help us do better at teaching both public health and population health.”

But first, people need to grieve, including Philpott who isn’t immune to the tragedies at Participation House. “People have kind of set aside that emotional pain that they have to work through, but you can’t set it aside forever,” she says. “There will be a tremendous amount of post-traumatic stress related to what people have gone through. It’s going to take a long time to rebuild ourselves and our mental wellness.”

The Tyee is partnering with Salt Spring Forum on this video interview and others, including with physician and author Kevin Patterson, China historian Timothy Brook, climate change author and activist Bill McKibben, and Canada’s Amnesty International secretary Alex Neve.  [Tyee]

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