We Must Move from Simply Reacting to COVID-19 to Actively Controlling It
With COVID-19 cases increasing at an alarming rate, our leaders face a difficult balancing act. The challenge for us all is to chart a path forward that protects Canadians’ health – on COVID, mental health and other aspects – as well as their economic well-being.
Between now and the time when the pandemic is brought fully under control it will be important for Canada to manage the disease by controlling its spread and severity, while allowing Canadians to regain more of their ordinary lives. Public health must be the highest priority, and a well-designed strategy to manage COVID-19 will save lives and reduce the pandemic’s social and economic damage. However, to achieve these results, we must move from simply reacting to the disease to actively controlling it.
A plan to replace Canada’s current patchwork approach of reacting to daily numbers is overdue. It is neither socially nor economically sustainable to rely heavily on rotating lockdowns while we wait for an effective vaccine to be widely administered in the coming year.
Let the government know we need a plan to manage COVID-19.
A coherent national strategy must include all three levels of government working together as partners, collaboratively addressing these six key components:
Data-driven, science-based policies to limit the spread of the virus
In the first wave of the pandemic, information about the impacts of the disease, how it spreads, who is most vulnerable, how it can be avoided and how best to treat it was minimal. In addition, Canadians were forced to deal with a severe shortage of personal protective equipment and medical supplies, such as ventilators. As a result, governments had no choice but to resort to blunt instruments like generalised lockdowns to prevent the disease from overwhelming our medical system.
Fortunately, as we navigate the second wave, advances in knowledge, in equipment and in therapeutics provide tools to control the disease much more effectively without having to rely on crude measures like lockdowns except in the most severe cases where time is needed for other measures to take effect. Medical authorities caution that lockdowns can serve as a “circuit breaker,” but cannot be the primary tool to prevent the spread of the disease. Indeed, we have seen that lockdowns create serious economic, mental and social problems for Canadians.
Governments must make a priority of generating and sharing timely data about how and where the disease is spreading and must design their policies based on that data. Their actions must be timely, targeted and effective, avoiding either waiting to act before an outbreak becomes uncontrolled or imposing measures that unduly restrict activities that are not significant contributors to spread.
Canadians have a right to expect that measures taken to protect them will be based on information that is both solid and openly shared. Unfortunately, today, the information being used to justify policy decisions is often fragmentary, outdated, and inconsistent. As a result, the policies are frequently ineffective and unfair, and undermine public confidence.
In contemplating measures to reduce the number of infections, governments should be able to accurately predict the number of cases they expect to reduce through their policies prior to their implementation. This transparent data-driven analysis, including numerical projections, will help ensure measures taken, including targeting specific sectors of the economy for closure, will achieve the desired infection reduction. It will help ensure policies are perceived as fair and are supported. It will provide a clear measure to judge the success of the policies and to guide how future policies can be made most effective.
Data that illuminate where the virus is spreading allow responses to be finely targeted. They will make it easier for safe activities to continue and for Canadians to live their normal lives to the greatest extent possible. At present, most jurisdictions in Canada are either not collecting or not releasing data on where people are actually coming into contact with the disease. It is therefore impossible to predict if our collective efforts to reduce virus numbers will be effective; this must urgently change.
When decisions are made, they must be based on fact and data. They cannot be based on – or perceive to be based on – intuition, symbolism, or partisan politics
Significant, widespread rapid testing and contact tracing
The first step in any program to successfully get ahead of the virus must be to understand accurately and in real-time who has the virus and with whom they have been in contact. Learning this information days or weeks after the fact or not at all has severely limited the ability to control the spread of the disease.
Among other locations, rapid testing should be urgently deployed in:
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Schools, daycares, and other childcare settings
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Airports, public transit hubs, and other transportation centres
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Places of worship
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Every heath care facility and clinic
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Indigenous communities
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Any geographic location tied to a recent outbreak
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Any situation where a person has a contact tracing alert.
Our country has been desperately slow in the deployment of this critical technology. Rapid test kits have proven effective in countries around the world. Canada must urgently catch up.
As rapid testing is deployed, it will enable our contact tracing system to be rebuilt and reactivated. By knowing who has been recently exposed to the virus, in many cases even when people are infected but asymptomatic, we can contain its spread through accurately targeted responses. This approach will limit the need for blanket response measures like lockdowns, which cause serious collateral damage.
Enhancing testing in a layered approach will also support a safe restart of critical business travel to support companies that cannot undertake their activities in a virtual format.
Finally, successful widespread deployment of rapid testing and tracing will help our governments develop their ability to effectively manage the rollout of vaccines. A global vaccine rollout of this scale has never been attempted before, so we must take full advantage of every opportunity to learn and to apply the knowledge gained.
Open, transparent communications and consistent messaging
During the first wave of COVID-19, Canadians demonstrated that they are willing to do their part when they feel properly informed and understand how they can make a difference.
Today, however, the information Canadians receive is often incomplete, contradictory and confusing. The messaging from governments has often contributed to citizens feeling that they are simply victims of the disease and that their individual actions count for little. A successful COVID management strategy will require informing Canadians fully and helping them understand that, if we all do our part, we can control the virus and regain our lives more quickly.
The goal must be to educate and empower Canadians. While there is no silver bullet that will quickly return life to normal, we now have a wide variety of tools, including testing and tracing, the use of personal protective equipment and physical distancing, mobile apps, wastewater testing, improved therapeutics, data-driven responses, new medical techniques and medicines, including what appear to be several highly-effective vaccines. Taken together, these tools provide a way to control the spread of the disease and may in time allow us to eliminate it altogether. However, success depends on each of us – governments, businesses and other institutions and individuals alike – doing what is needed. Every one of us can – and must – make a difference.
While regional variations in infection rates may require different responses, public health officials should strive to be as consistent as possible in the advice they give. To date, this consistency has been lacking.
Officials should also provide as much detail as possible. Canadians are much more likely to comply with public health guidance when they understand the basis for those decisions. The more information that can be shared on a consistent basis about the cause, nature and location of outbreaks, the better. The successful use of rapid testing and contact tracing will both lead to better decisions by public officials and lend credibility to the information being provided to Canadians.
Unfortunately, despite many months of travel restrictions, the enforcement of measures at points of entry remains inconsistent. This inconsistency has been disruptive for companies trying to navigate travel regulations.
Governments should not impose restrictions on low-risk business activity if evidence suggests that community spread is driven by non-compliance with social-gathering guidelines. Since the goal is to reduce the spread of COVID-19, communications and resources must focus on where the virus is actually spreading. We trust our businesses to design, build, and maintain critical products; we trust entrepreneurs with critical health and safety guidelines every day. So, too, must we empower them with the tools and trust to serve their clients safely and responsibly now. In the small minority of cases where businesses fail to act responsibly, governments should apply enforcement measures directly on the organizations involved, as opposed to penalizing all businesses.
Canadians are fair-minded and they expect rules they are required to follow to be rational and fair. When restrictions are necessary, they should be applied with care to ensure a fair and level playing field. Focusing undue enforcement or lockdown rules on safe activities and on those who are following the rules undermines public confidence in our fight against COVID-19, including disproportionately penalizing small businesses in communities across the country.
Finally, governments and businesses should share best practices. We will be living with COVID-19 for many months to come and we must strive constantly to improve our management of the pandemic. Governments and public health must share best practices and seize every opportunity to harmonize and learn from other communities and jurisdictions, both in Canada and around the world.
Supporting the hardest hit economically
Employees and business owners should not suffer financially when they are denied the ability to work because of pandemic restrictions like stay-at-home orders and Indigenous community access closures. While the federal and provincial governments have created several helpful business relief programs and more are in development, they are not ready and proportionate to the size of the challenge we are facing during the second wave of COVID-19.
Looking ahead, particularly for those businesses operating in sectors at the bottom of a K-shaped recovery, we must think longer-term and provide more-focused supports. Given that our economy will not recover until at least 2022 – the most optimistic scenario assuming widespread vaccine deployment in the coming year – the reality is we are in this for the long haul, and we need to start thinking longer-term.
With finite public resources available, we need to look carefully at the return on investment of public money. The time for one-size-fits-all programs has passed. Some policies will contribute more to economic growth and so our governments’ spending now must be focused on quality over quantity, and on those sectors that need support the most.
We must also consider which Canadians need support the most. For example: the downturn in food services and accommodation has disproportionately impacted women and cultural minorities. Additionally, Indigenous businesses have had difficulty navigating and accessing programs and infrastructure resources. Our Canadian economy will not be able to recover until all Canadians, including those who have been hardest-hit, are able to recover. Consequently, we recommend that the Government of Canada support an Indigenous organization to provide a navigator function to support Indigenous businesses to access Federal programs and infrastructure resources.
Vaccine administration
As vaccines start to arrive in Canada, the need for a thoroughly choreographed plan to administer them becomes increasingly apparent. Communicating this plan to Canadians in advance of the vaccines’ widespread distribution also becomes increasingly urgent. In particular, combatting disinformation about the safety and efficacy of vaccines must not wait until they are widely available. Because bringing the disease fully under control will require the vaccination of a significant majority of Canadians, an effective education campaign will be critical to saving lives and restoring our economic health.
As mentioned previously, the rollout and use of rapid testing can provide a learning opportunity on how our governments can best distribute vaccines. Data that have been collected and released based on contact tracing, hotspots, and at-risk populations can also be used to inform distribution priorities. It is critical to success that the plan be evidence-based and clearly communicated.
As the plan to administer millions of vaccines to Canadians is developed, several key considerations must be addressed. Work to prepare these pillars should be underway now. These include: refrigeration capacity at the national, regional, and local levels; transportation methods; communications plans for various audiences, including health care professionals, those administering the vaccines, and the public (Who gets the vaccine? When? Where? What happens if a person declines?), and any necessary security precautions.
The transparent release of data will be vital as vaccines are deployed, including tracking on the number of people vaccinated, the expected impact on case numbers over time (as distribution will likely occur over many months), and information on unexpected results.
The arrival of vaccines in Canada is very positive news, however this does not alleviate the need for an overall strategic plan to control the virus in the coming year. As vaccine administration begins presently, we must remember that achieving widespread immunity will take considerable time, likely well into the summer of 2021. We must continue to utilize other programs and tools to control the virus in concert with vaccine rollout over the coming year.
A holistic approach
We have, in large measure, lost sight of the real harm being done to Canadians by anything not named COVID. This unidimensional consideration of the factors affecting Canadians needs to stop. In its place, we must consider much more information, so decisions being made are more holistic, with the goal of reducing the most overall harm.
Lockdowns and other blanket measures may have a positive effect on short-term COVID numbers. However, they also have many other negative outcomes associated with them. Those non-COVID factors must also be evaluated and minimized.
To achieve this goal, we must consider a broader definition of what constitutes COVID data. Public health units should engage with medical experts, sociologists, labour market experts, and emergency services to determine the other key indicators affected by COVID measures and provide regular updates on them as well. Indicators to consider could include mental health crises, family violence, drug addiction, the number of hospital and/or medical appointments cancelled or delayed, and the associated negative health outcomes.
By considering the full picture and understanding that COVID and anti-COVID measures do not exist in a vacuum, we will be able to better protect the overall health and well-being of Canadians.
