Wednesday, July 20, 2022

From The Bottom Up

COVID is back for the seventh time. Doctors are warning that our health system could collapse -- because we don't have enough people to staff it. Kwame McKenzie writes:

Early in the pandemic, we were told we were at war with COVID-19. Our initial plans to combat the virus made sense. We deployed an emergency response because we were not sure what we were dealing with, and we needed to contain a potentially catastrophic situation. Testing, tracing, isolation, distancing, mask mandates, lockdowns and vaccination were used to halt the spread the pandemic and ensure that it did not get out of control. Because of this, and the remarkable efforts of the Canadian people, we saved tens of thousands of lives.

But now our strategy makes less sense.

We have ditched the precautionary principle and are not deploying our most effective countermeasures, despite the fact that we are still unsure what the virus is going to do next — and despite mounting evidence that the situation is now catastrophic. There will be 20,000 to 30,000 COVID-19 deaths in Canada this year. Extrapolating from a U.K. study, we can estimate hundreds of thousands of Canadians will contract long COVID.

COVID-19 hugely increases the risk of diabetes, heart disease, dementia, mental health problems and other chronic diseases. Herd immunity will not happen. You can be reinfected. Vaccination may protect you from severe impacts, but has not prevented virus spread. And, perhaps most worrying, the risk of negative health impacts may increase each time we are infected. So, the current rates of death, hospitalization, long COVID and chronic health problems could rise significantly over time. We also do not know the long-term impact of reinfection on children.

Ramping up our emergency response in the face of the next wave will save lives and protect hospitals, while leaving us vulnerable to all the others impacts of COVID-19.

Recent polls indicate that Canadians don't want to go back to mask mandates. What's to be done?

One way of decreasing divisions is by increasing people’s inclusion in decision-making. Including the public in policy discussions could help us develop a more rational pandemic strategy. People are more likely to support collective action once they have had their say and feel they have been heard.

Questions for a public discussion could include: Are we happy to be reactive, or do we want to try to take more control? Should we focus on the here and now, or should we take precautions to decrease the likely long-term impacts of sequential infection? Should the focus be on severe impacts, or should we also consider long COVID? Are we happy to focus on protecting hospitals and business, or do we want to add schools and the way the virus is damaging our primary care and social sector? The aim would be to have a transparent democratic discussion about decisions which may have a profound impact on our future.

We are currently being asked to be part of a “living with COVID-19” strategy — a plan which cannot beat the virus, will lead to significant casualties and may blight our future. We may want to consider a more forward-thinking strategy. We should be given the opportunity to help decide to what extent we should fight back.

A top-down strategy worked the first time around. Now we'll have to work from the bottom up.

Image: The Toronto Star


Gordie said...

Part of the problem is communications. Sure, we hear about Covid on the news almost daily. But a year and a half or so ago we were told to get vaccinated. Once 70% of the population was vaccinated, Covid would go away. Then we were told we needed two doses. Covid still was rampaging! Next we needed a booster. Now we need another booster for Omicron. Now we are hearing that we'll have to just live with Covid. The vaccines only help reduce the severity of the infection, not the transmissibility of the vaccine. It's no wonder people have given up on eradicating the virus. No wonder people don't pay attention to the health officials anymore!

Owen Gray said...

Viruses evolve, Gordie. But officials made absolute statements that didn't note that our knowledge of the disease was evolving with the virus. You're right. We have a communication problem.

Toby said...

Agreed about the communication, Owen. A scientist acquaintance who worked as a scientist for the government presented the problem like this. He is a scientist. He can collect samples, analyze data and make reports. He is not a politician, not an enforcer. It is not up to him to design policy or enforce regulations. He's not a cop.

I don't blame the scientists for doing what they are good at. I blame our politicians for making such a mess.

Owen Gray said...

The problem, Toby, is that the politicians have politicized the science.

Anonymous said...

Policy from the bottom up is whatever the stupidest people will accept. It would look like what we have now. We had a small number of deluded fascists take over Ottawa and a few border crossings for three weeks. After that, governments of all stripes decided that Covid had magically disappeared and we could drop all precautions.

We've already tried policy from the bottom up and it's killing people and destroying our healthcare system. Time to learn from the countries that successfully contained Covid.


Owen Gray said...

A remarkable number of us are just plain stupid, Cap. And our politicians are letting them lead the march to the rear.