COVID-19 shows Canada’s health system a slow learner

Opinion

Hey there, time traveller!
This article was published 11/03/2020 (1653 days ago), so information in it may no longer be current.

IT was hard to ignore the apocalyptic tone this week, with constant headlines about the coronavirus (COVID-19). People are stockpiling toilet paper and hand sanitizer, and Costco has stopped handing out food samples. Large-scale gatherings are being cancelled daily, including the St. Patrick’s Day celebrations in Ireland and SXSW festival in Austin, Texas, as the number of COVID-19 cases continues to rise.

The news became even more grim on Tuesday with the report of Canada’s first virus-related fatality, an elderly British Columbia man who died after becoming infected in a care home in North Vancouver. He was in his 80s.

While there is a lot of hype and exaggeration, the evolving COVID-19 situation will certainly reveal how vulnerable this country is as a result of cuts to health-care infrastructure and a lack of investment in our health-care system. No matter how many lessons public health officials learned after SARS, the investment in our front-line resources — hospitals, health-care professionals and long-term care homes — did not follow suit.

In 2003-04, SARS, or severe acute respiratory syndrome, killed 44 people in Toronto. In its aftermath, a national advisory committee was formed to understand what could be improved to better deal with future pandemics. In the wake of SARS, the committee identified weaknesses in Canada’s public health system, such as an inability for health-care facilities, including emergency rooms, to deal with a sudden influx of patients.

It also found that during the SARS crisis there were difficulties getting access to laboratory testing and results; there wasn’t enough sharing of information and resources between federal and provincial public health bodies, and weak linkages existed between personal and public health systems for sharing information.

In response to these concerns, the Canada Public Health Agency was created in 2004 to co-ordinate information and to act independently from government.

Fast-forward to 2020 and the COVID-19 outbreak, and officials say many of the lessons from SARS have been put into action. But this is a very different health-care crisis than SARS, which makes it much more difficult to respond. First, there are already more than 121,000 confirmed cases worldwide, in more than 110 countries, with the death toll at more than 4,300 and rising.

By comparison, from 2002 to 2004 SARS had slightly more than 8,000 confirmed cases and 774 deaths. COVID-19 is becoming such a public health issue that on Tuesday, Air Canada suspended flights to Italy, one of the hardest-hit nations with in excess of 10,000 confirmed cases and more than 600 deaths.

The federal public health agency has asked Canadians to avoid cruise ship travel. And because this outbreak is no longer limited to one region, it will be difficult to take precautions or quarantine based on geographic information. Indeed, in B.C., two new cases earlier this week involved individuals returning to Canada after visiting different regions — one from Italy, and another from Iran.

With SARS, screening passengers on flights that originated from Asia made it easier to track and quarantine. Another challenge is that COVID-19 can present with no apparent symptoms and yet still be contagious, infecting those who are most vulnerable.

Unlike SARS, cases of COVID-19 in Canada are not just limited to the Toronto region. Instead, cases have been diagnosed in B.C., Alberta, Ontario and Quebec, further underscoring the need for interprovincial responses and communication. B.C. and Ontario are bearing the brunt of the pandemic, with the largest caseloads in Canada — around 40 confirmed cases each.

The lack of communication between federal and provincial governments was the impetus behind the creation of the Canada Public Health Agency in 2004; now, that framework for interprovincial communication will be tested, and it must perform at a very high level.

Of paramount concern in this crisis is the ability for our health-care system to withstand more pressure than it’s already under — and there are reasons to doubt that it’s up to the challenge. Statistics from the Canadian Institute for Health Information released in November suggest wait times for emergency room visits remain high across provinces — patients in ERs waited an average of 3.9 hours in 2018-19, up 22 per cent over the previous year (in Manitoba, the average ER wait time decreased slightly, to 4.4 hours).

The national wait-time numbers continue to rise. If Canadian ERs and long-term care facilities are buckling under the weight of a typical annual flu outbreak, what will they do as COVID-19 continues to spread across the western world?

Because this is not your average flu.

The World Health Organization, which labelled it a pandemic on Wednesday morning, reported the fatality rate for COVID-19 is 3.4 per cent of those who are infected (by comparison, the flu is fatal for 0.1 per cent). In those who are over 70 years of age, the COVID-19 mortality rate rises to eight per cent; over 80 years of age, the fatality rate is 14 per cent.

The death toll from COVID-19 is the price Canadians will pay for politicians not heeding the lesson from SARS and properly investing in health care. Forget the toilet paper and hand sanitizer. Start hiring nurses.

Shannon Sampert is a retired political scientist who runs the communications consulting company Media Diva.