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Canada has now entered into the delay phase of its pandemic response to COVID-19.
The country—and indeed a large swath of the globe—has been hampered in its planning by the reluctance of the World Health Organization and national agencies like the Public Health Agency of Canada in acknowledging what was readily apparent to anyone paying attention: that COVID-19 had morphed into a pandemic a week ago or longer.
The suspension of the NBA and the NHL and the report of actor Tom Hanks’ infection seem to have awakened policy makers to the severity of the situation.
It is of course pathetic that this was the spark required to kick things into gear.
In Canada, the tepid response has trickled down to provinces and regions.
And while some areas of the world have taken appropriately drastic measures—think China—the response has been ridiculous in others.
Take my province, Manitoba.
Inexplicably (it would be laughable if lives weren’t at stake, and—let’s make no mistake—they are) Manitoba’s education minister, Kelvin Goertzen, has declared that schools will be shuttered—but not until March 23. This downright bizarre tactic is somewhat inconceivable.
I guess we will give the kids a week to get infected and then lock them down in their homes with their families so that entire households get sick with COVID-19.
And due to the absolutely bungled response south of the border, there is almost certainly a smouldering brush fire that will spread across into Canada.
The epidemiological curve—the visual tool to map the progression of an outbreak—may be flattening, meaning that it will be less intense, but will also likely mean that the pandemic will be with us longer.
Knowledge about COVID-19 continues to evolve, but our understanding remains in its infancy. We are finding out some alarming features, such as the possibility that transmission might be able to occur between individuals who show no symptoms.
If that is in fact the case, this takes away a critical screening tool—identifying those with symptoms and separating them from the asymptomatic population.
The above screening protocol nevertheless continues to be used widely throughout our country.
That perhaps should not be surprising. Only days ago, health care workers were still taking travel histories from patients, identifying who had travelled to “hot spots” such as Iran, Italy, South Korea and China.
This was well after the fact that COVID-19 had gone global and that community transmission (as opposed to contracting the virus in another country) had occurred in many countries
Looking ahead, as we emerge from the current debacle we should take a hard look at what we got right and what we got wrong.
In the post-mortem evaluation—morbid pun intended—we need to take stock of the fact that professional sports leagues and rom-com actors shouldn’t be the agents leading public health policy.
Public health infrastructure and decision-making are relatively simple and economically-viable measures. It would be prudent to not neglect them.
In the wake of COVID-19, it should be apparent that this is the case.
Just take a look at free-falling stock markets around the world. COVID-19 is turning out to be very costly—both in terms of money and lives.
Comments
It's not only a matter of "preparedness" but also content of real-time communications.
Most concerning to me is that while Public Health nudges in the direction of taking emerging science into account, they are still pushing the same background messaging as before they had access to it, and sometimes the messaging is simply poorly constructed, and nowhere near as useful as it could be.
Examples? Lousey communication of useful handwashing technique. Lousey communication of how to not carry pathogens with you if you must use public toilets. No communication of the similarities to and differences from SARS-1 (this virus was first referred to as n-SARS-2 (n- meaning novel -- and I heard it pronounced as rhyming with Nobel, as in the Prize, obscuring the meaning).
There is evidence now that asymptomatic, pre-symptomatic and post-symptomatic infection can cause viral shedding for up to 5 weeks.
The applicable symptoms Public Health owns up to do not include gastro-intestinal symptoms, or the related fecal-oral route of transmission.
While on the one hand, they seem bent on saving profitable corporations and "investments" from loss, there seems to be less import given to a cautionary principle in terms of protecting people ... but that isn't exactly new to Health Canada.
There is also relatively new research indicating that the virus has undergone significant mutation ... still remaining pathogenic: nothing yet to indicate whether or not mutations observed to date point toward it "changing itself toward extinction," or simply toward ineffectiveness of the testing that we have to date.
While Public Health messaging seems geared to induce calmness more than anything, including discouraging "hoarding," nothing distinguishes, e.g., between stocking up on emergency supplies to prepare for the eventuality of flood, power outages or famine, and the current situation. Would it have been so difficult to make an applicable list, for heaven's sake?
But, you know, (and here, please read in free-flowing, not only dripping, sarcasm) ... we have to maintain "balance" between destroying what's left of nature including the organisms known as humans, and "supporting" uber-profitable corporations who do nothing for either nature or people whether as organisms or as taxpayers. By all means protect the portfolios of the wealthy: and damn the "useless eaters." And that's the end of the sarcasm bit.
Continuing to promote the story that transmission is solely by individuals with active illness, and solely by immediately being coughed upon or touching something that has been touched by hands contaminated by direct coughing does everyone a disservice who willingly engages in self- and community-protecting behaviours.
Yes, it makes things less scarey, and no one wants to tell kids they're not going to visit grandma's house for the foreseeable future. But there's a point at which completeness of information is better than "not scaring or disappointing" people ... much less maintaining an atmosphere conducive to maintaining corporate profits, come hell or high water.
I'd like to see research into COVID-19 include genetic and epigenetic profiles of people who remain asymptomatic or have light cases, compared to those who become very ill. Especially those without chronic disease, though overlap might be likely.
And, you don’t even mention the highly restrictive testing protocols that assure even more widespread contamination....self quarantine all you like and assume that everyone will be a responsible citizen, there will still be increasing rates of transmission. If everyone could be assumed to be a responsible citizen, looking out for the welfare of others, we would have no crime and no prisons...and I don’t believe for a second that all criminals are in prison!