A No-End to COVID Scenario

This blog addresses three questions:

  1. Are we about to be disappointed about the ability or effectiveness of a vaccine to end COVID?
  2. Are we unlikely to rebound or recover from COVID for months or years?
  3. What changes in our health-care policies will improve the economy, our nation’s well-being, and emotional health?

Second Guessing Vaccines as Salvation

We’re all weary with the impacts of COVID on our lives.  We’re praying to be able to vaccinate everyone till the point that we have herd immunity and can return to the old normal. But what if COVID-19 persists even with a vaccine in circulation and, in mutated forms, continues to claim thousands of lives each year like the flu. In that scenario, Canadians can’t counteract it or rebound because we’ve mis-allocated resources, run up the deficit, and run out of money.

To date, our country’s infectious disease strategy laid out under serial, emergency-power edicts has been  predicated on curing or conquering the coronavirus. But what if global immunity does not end until late 2024 at the earliest. What if the ever-mutating virus never truly goes away? According to Albert Bourla, CEO of Pfizer, one of the people most responsible for immunizing the world to date, “we do not know yet, but it looks like COVID is here to stay”. The vaccine might be effective for only six months and need annual re-dosing.

In a globally interconnected world, more experts increasingly believe that the coronavirus is better understood as a chronic condition, not a conquerable illness. In all of known, recorded human history, we have treated infection, plague or leprosy by isolating only the sick. With coronavirus, however, we’ve implemented comprehensive, reactive workplace and school lockdowns that have punished and isolated the well and the sick together. 

A report recently published by the Economist Intelligence Unit, the research and analysis division of The Economist Group, explained that whereas the rollout of vaccines against coronavirus has started in developed countries, mass vaccination will take time. The unit predicts that the bulk of the adult population in advanced economies will have been vaccinated by mid-2022. Middle-income countries will take until late 2022 or early 2023. “For poorer economies, mass immunization will take until 2024, if it happens at all,” the report said. In the meantime, while not everyone is vaccinated, we will have the emergence of new variants, and it could mean going back to square one.”

Canada’s Poor Performance

Last week, the not-for-profit Sydney-based Lowy Institute think tank released a report on comparative, national pandemic fighting success of nearly 100 countries in fighting the pandemic. It comes as world coronavirus cases surpass 100 million with the death toll exceeding 2 million. Canada’s death toll is now 20,000. Canada, the U.S. and the U.K. respectively rated a poor 61, 94 and 66 out of 98 countries studied.

Source: University of Oxford and Global Change Data Lab, Our World in Data Series, as selected by Lowy Institute

Systemic factors like size, political regime and economic prosperity alone do not fully explain the national differences in global virus responses. In their analysis, the report’s authors conclude that citizen’s trust in their leaders seems to have a strong correlation with outcomes. Whether those leaders preside over a competent and effective recovery plan in particular has a strong correlation with successful COVID-fighting outcomes.

We are a country of law-abiding citizens, a peaceable kingdom, blessed with strong institutions and mutual dependencies. Canadians need a coherent policy that will re-establish trust and confidence. One that allows businesses to flourish and offer relief to a weary citizenry. We need to listen to scientists who recommend letting responsible, healthy citizens work, play and learn – not blanket us all with a stay-in-place order, yet undermine this with a myriad of inconsistent exemptions.

According to an October 2020 IMF report, pandemics reduce output and increase inequality, stoking social unrest which further lowers output and worsens inequality. The study was based on disease outbreaks in 133 countries from 2001 to 2018. In short, the idea of a certain post-COVID bounce-back bright future is questionable.

Our current on again-off again reactive pattern of partial lock-downs is increasingly being exposed as a blunt, economically ruinous, and insufficient attempt on the government’s part to deal with years and years of inadequate and mis-allocated spending compounded by poor, blind (data deficient), virus-cure policies. If not remedied, the legacy could be years of inter-generational and inter-regional demonstrations and unrest, compounded by enormous amounts of “moral damage” mental-health counselling for thousands of over-stressed and ill-used front line health care and other essential workers.

Alternatives to Doom and Gloom

All need not be doom and gloom. We need responsible and effective public policy that replaces  keeping everyone distanced and staying at home with intensely-focused tracing, tracking and saving lives among those most at risk. To do so requires implementing as rigorous a testing, tracking and contact tracing program as possible, backed up by strong quarantine protocols. Countries like South Korea and Taiwan that have used just such policies have a fraction of Canada’s per capita COVID death rates. South Korea has a fifteenth of our virus deaths, despite having a larger population, open stores and shops, and an economy with far less contraction or unemployment.

Some scientists have been saying for months that our country’s policies to address COVID have been one-dimensional, reactive, too narrow and ill-chosen. Our political leaders federally and provincially need to comprehensively address many other crucial health factors (such as mental health, the economy, social and economic determinants of health, a scandalously under-regulated nursing home industry, and the backlog of non-virus ICU bed surgeries).

Canadians would support improving our policies.  Our provincial and territorial governments have administered less than 3 per cent of the 14.5 million rapid virus tests purchased and supplied. The federal government has purchased enough vaccines for five times our population only to realize that depending on foreign vaccines is an anguishing  supply problem of our own making. 

It is reasonable to control the three C’s—close confined contact. However it is neither reasonable nor realistic in a democracy to either lock down everything or reduce harm for everyone. We don’t have the resources, nor the quality of political leadership, and not everyone is at equal risk. We need fresh policies that emphasize personal responsibility and empower us. We need to abandon a one-size-fits-all stay-at-home mentality for everyone. Instead, we should be focusing on identifying, alerting through warning, and quarantining those ​who are at greatest risk of being a spreader or infecting others, as well as those with co-morbidities in specific locations that have been or are putting them at great health risk.

If an end and positive rebound to COVID is not reasonable, we need to plan to make it so.

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David Nitkin
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