Observations From Just Outside the Pandemic #13

As it appears as if we are entering a period when people and companies will slowly start to re-engage with their environment, we are going to be inundated with all kinds of experts telling us what our governments did wrong and why we should be angry about it. Some of this has already occurred with various groups/individuals suggesting that the Canadian government erred in its lack of planning, in not having enough medical supplies, in not testing enough, or doing it sooner and in not shutting down our borders fast enough.

There will also be an almost equal number of comments suggesting that the government did too much. That there was no need to close almost every conceivable service or if we had just exercised reasonable precautions, life could have gone on - in almost a normal fashion.

The problem with the above comments is that they are all, at least partially, right. It just depends upon what information the "experts" use to come to their conclusions. There would appear to be almost no consistency about how various countries measured the extent of the virus in its general population.

For example - Dr. Tam, Canada's chief public health officer on a daily bases reports the number of people who have been diagnosed with the virus. People can and do compare that number with other countries and rank whether Canada is doing better or worse in managing the crisis than other countries. The number of people sick or even in a hospital is a useless piece of data unless one knows the percentage of people who have been tested and who they are. If a country is only primarily testing people in health care, people who have been potentially been exposed to the virus,  the proportion of people infected may be significantly different than in a country where the testing limits are less restrictive in terms of occupation. Without knowing who was tested, we are comparing apples and oranges. Never a useful exercise.

As of today, 2800 people have died from complications of being infected with the COVID-19 virus. As of last week, almost half of the deaths in Canada have occurred in nursing homes. If we are going to discuss the number of deaths, we need to separate the number of seniors and their caregivers in long term care who have died from the general statistics. It is not that those deaths, or in fact those individuals are insignificant but rather that the reasons for their deaths have far more to do with the quality of care (or the lack thereof) than the federal government's failure to plan for a pandemic. It might be very useful to compare data about such deaths with what happened in other countries. If Sweden or Japan have had fewer deaths from the virus, what was the percentage of seniors who died and where did they live? According to the Independent (1), a respected British newspaper, Japan, while it has a higher percentage of senior citizens than many countries, it has fewer long term beds. Japan supports the elderly without incarcerating them in institutions.

If we are going to have a conversation about how many died and why - we need to understand all of the data. Depending on what data is used will change the conversation about whether or not Canada was successful in managing this health crisis.

(1) https://www.independent.co.uk/voices/japan-elderly-social-care-system-uk-nhs-health-old-people-a8377631.html

Observations From Just Outside the Pandemic #12

I sometimes (actually most of the time) get irritated at various politicians who put their party's or their personal needs ahead of Canada's. I should know better than to take it personally. Being self-centred is, I suppose, part of a politician's job description. But there are times when I see something that is so outrageous that I fume about it all day.

Yesterday morning I saw a bit of Andrew Sheer's press conference where he was denying any responsibility for what one of his party's members (and someone who is running for the leadership of the Conservative party) had said about Dr. Theresa Tam. Sheer who lost the last federal election and then resigned as the leader has continued to act as the leader until a new one can be elected. Sloan, an MP from Ontario has stated on Twitter " “Dr. Tam must go! Canada must remain sovereign over decisions. The UN, the WHO, and Chinese Communist propaganda must never again have a say over Canada’s public health!”  While it is entirely appropriate that at some point when all of the information is available and if one is qualified to understand the data, that all officials need to reflect and discuss their decisions, this may not be the time.

Sheer, in his role as an interim leader, has refused to comment on Sloan's statement. He has absolved himself of responsibility for what a member by suggesting that it is not his role to discuss what any leadership candidate says. By refusing to condemn the comments it appears as if he is supporting them. Hiding behind someone else's comments is, at best, cowardly. At worst it is a national leader demonstrating his bigotry, his ignorance and his determination to find fault with anyone and everyone who does share his political values.

Quite frankly, Mr. Sheer needs to develop some male body parts, and have either the courage to come out and support the words and attitude of Mr. Sloan or to stand up and condemn them. There cannot be a middle path.

Dr. Tam may not have given the best advice all of the time. She and her team may have, in hindsight, needed to recommend more aggressive action earlier. Or it may be that Dr. Tam should have recommended that we follow the example of Sweden and Norway and therefore not mandated an almost total closure of the country. Perhaps the federal government should have taken control of all extended care facilities for seniors so that the death rate in those places would have been significantly reduced. Maybe we should have done more sooner or maybe we should have done a lot less. Hindsight is a wonderful tool to learn from our past mistakes, but using it in the middle of a crisis may not be wise. People who are not accountable to anyone such as Mr. Sheer or Mr. Sloan, people who believe it is their right to take "pot shots" at those who are doing their best, people who have no accountability should sit down until they have some useful suggestions.

I would hope that in the next few years a number of the possible scenarios will be investigated. Clearly we, and the rest of the world need to know how to manage these sorts of crises. While we will never know, many people including myself, would have been resistive if the Government of Canada had locked down the borders immediately. There was not the time to have a national debate as to how to deal with a medical crisis, someone needed to make a decision. Someone needed to decide on how to make that decision.

The Canadian public decided that that person would not be Mr. Sheer

Addendum:

It is interesting to note that Sweden has had a relatively low COVID-10 death rate and it traditionally has one of the lowest rates of senior institutionalization in the world (1).

(1) Age and Ageing 1997; 26-S2: 3-12

Nursing homes in 10 nations:

a comparison between countries

and settings

MIELW. RIBBE, GUNNAR LJUNGGREN1, KNIGHT STEEL2, EVA TOPINKOVA3, CATHERINE HAWES4,

NAOKI IKEGAMI5, JEAN-CLAUDE HENRARD6, PALMI V. JONNSON7

The Pain and Loss in Portapique, N.S

 I feel an overwhelming need to scream in anger and frustration. I want to raise my fist and rail against a world that allows one person to end the lives of 20 people and to disrupt the lives of so many more. I want there to be a way that we can eradicate from our memories this individual's name, his history, his being. I want there to be some way to celebrate the lives of those who have passed, without remembering the cause. The perpetrator of these events has lost any right to be remembered at all. We will give him no false fame - no annual remembering of the deeds.

I, along with millions of Canadians are sadder today than we were yesterday. Not only have people been senselessly murdered and countless others impacted, not only have whole communities been shattered but there has been an impossible-to-imagine number of opportunities lost. But, almost as important, we as a nation have lost just a little bit more of our innocence We so desperately want to, need to believe that we are better than this. That our culture and our way of life prevents these irrational and unfathomable obscenities from happening. Perhaps we need to hang on to those beliefs. Perhaps we need to work just a little bit harder to make the country the place we think it is.

There is nothing to say, no words to express my sadness, no deed that I can do that would make the world even the tiniest bit better for those who live in the relatively narrow stretch of land between the village of Portapique and Halifax, nearly a 100 kilometres away. There is no memorial that I could create that would adequately memorialize those who have died.

There is nothing anyone can do except to try harder to make our Canada a place where this cannot happen again.

Observations From Just Outside the Pandemic #11

I am, I must confess, just a little bit nervous when I hear or read about the possibility that some of the COVID-19 restrictions/limitations will be reduced or even done away with. I understand that for some, these limitations have been almost impossible to live with, that individuals and families have suffered real hardships during the month or so of reduced social contact. For families that have mortgages, car payments and student loans to pay off, the anxiety as to how they could financially survive must have been almost all-consuming. I am not at all sure if a sudden reduction of limitations will do much to ease their worries. It will help but it might take months before the economy will get back to anything like normal.

It is much easier for people like me to argue that the restrictions around personal contact and travel should be maintained for a bit longer. I have lost very little in the last few weeks. I go out a lot less than normal, I miss my 7-8 hours a week of volunteer time and I would much prefer to go shopping every 4-5 days rather than once every two weeks. But I have talked to my neighbours more than I ever have, I have spoken on the phone more than normal and I have seen my son more frequently than in other months. My pension cheque comes in like clockwork; I have not bothered to look at my few investments - there seems no point. Other than not buying a new bicycle, I have not lacked for anything. The one area that has impacted me the most - the closure of farmers' markets for craftspeople, is a concern in terms of income and in finding other ways of dealing with my being a bit of a work alcoholic. But that too is quite manageable.  

Yesterday, a neighbour argued that on Vancouver Island - all of the restrictions are unnecessary as there are only (relatively) a small number of people who have developed the disease. He was right, there have been only 94 confirmed cases (58 recovered), three deaths and as of the last report - no new cases this weekend. It sounds very positive and on the surface of it - life should get back to normal as soon as possible. But.....

It has been suggested by public health officials and others with expertise in community disease management, that if places like BC have managed to "flatten" the curve avoiding hospital over-crowding and the depletion of resources, it is because we have been successful at limiting the spread of the virus. There is no cure, there is nothing that we can do to stop it spreading except to not inhale/ingest the contaminated breath of other people. It is true that the risk of becoming infected on Vancouver Island during the course of daily events is extremely unlikely. It is even less likely for those of us who live north of the Malahat.  However, for those of us who have compromised lungs or hearts - we need to remain vigilant. Sounding rather selfish - as much as I want people working and investing in their lives, as much as I want my grandchildren to be able to play with their friends and get back to school - I do not want to get sick because we all relaxed too soon.

I would be far more comfortable with restrictions being reduced if someone could guarantee that no one would visit the island or that no one from the island would visit anywhere else and then comeback.

Stop the ferries and close the airports. Vancouver Island could be COVID-19 free in a few weeks. But we can't do that, nor can we assume that people will be careful, that all people will continue to limit contact, wash hands and to monitor their health perhaps more closely than normal.

I can trust myself to be careful - but as much as it saddens me to say so - I am not sure if I can trust someone else, someone who I have never met, someone who may not look or feel sick, but someone who might be spreading, inadvertently, the virus to me or those I care about.