How're We Doing With COVID, Canada?

"Canada's initial lack of a robust border policy or mandated supervised quarantine program for both incoming travellers and contacts of documented cases has impaired our ability to contain the epidemic here."
Peter Phillips, clinical professor of medicine, infectious diseases division, University of British Columbia

"In retrospect we could have closed the USA border earlier, and restricted all incoming flights to Canada to a handful of airports earlier, descending upon those airports with overwhelming public health powers [including mandatory testing and quarantining of all travellers from China and Europe."
Raywat Deonandan, global health epidemiologist, University of Ottawa

"It wasn't until we saw the kind of carnage evolving in Italy that the actual threat became clear."
"What COVID has taught us that we already knew is that we had a population that was particularly vulnerable to the ravages of this disease."
"Even if you have an app, it's not going to do all the work. You need feet on the ground, good old-fashioned shoe leather epidemiology and contact tracing."
Dr.Ross Upshur, head, division of clinical public health, Dalla Lana School of Public Health

"When a fire is flaming everywhere, you aim the hose everywhere."
"Toward the end you aim it where you think there are still hot embers. That's what we need to do."
"We need to be prepared to walk back as we walk forward, because nobody can say with any certainty how this is going to play out."
Dr.Alan Burnstein, president, CEO CIFAR, global charitable organization, Canada

Experts invited to speak before the Parliamentary House of Commons health committee studying Canada's response to the pandemic, among them infectious disease, epidemiology, family medicine, public health law, nursing, emergency medicine, and critical care specialists, all without exception spoke of the government's failings in meeting the challenge of the emergence and spread of SARS-CoV-2 in Canada.

Canada, they all agree without exception, was quite simply too tardy in recognizing the sweep of the threat posed by the novel coronavirus. Health officials went on to stress the low risk to Canadians well into the second week of March, despite that many scientists were stating the opposite while watching COVID-19 spread with sinister haste and destructive effect through the population in Italy as the health care system collapsed in on itself, and health-care workers were falling victim in huge numbers.

Testing to search for the genetic footprint of the virus in cells swabbed from patients never achieved the numbers required to help gain a level of control in Canada. The imposition of travel restrictions arrived too late to be effective. Backlogs in testing, amid critical shortages of swabs and key ingredients bedevilled the medical community. Hospital emergency rooms had been neglected for far too long to enable a sudden preparation for the anticipated surge capacity to handle a dreaded influx of COVID-19 patients.

It took until January 15 for Canada to finally activate its emergency operations centre. Dr.Theresa Tam, Canada's chief public health official informed Members of Parliament on the health committee that it was simply not all that likely asymptomatic people could spread the virus; it would be "rare, and very unlikely" they might be key drivers of an outbreak or epidemic. And then on February 1, the World Health Organization stated an awareness of the possibility the virus was being spread by people before they were themselves aware of having contracted the disease.

By mid-March, Canada finally closed its borders to non-essential travel, the U.S. border included. By the end of March, 14-day quarantines were finally being enforced for anyone entering Canada by air, sea or land connections, with or without symptoms of COVID. Dr.Tam indicated on April 2 that studies demonstrate after all that pre-symptomatic virus spread was occurring, more frequently than previously thought possible.

Camilla Care Community, 59 COVID deaths. Peter J Thompson/National Post

Mandatory testing and quarantining of travellers from China and Europe should long before then have been taking place. Cautioning, and taking steps to prevent Canadians from travelling out of the country for March break was an opportunity missed. Thousands of scheduled surgeries were set aside by end of March in the rush to ensure sufficient ICU units and ventilator capacity could be prepared. No one seemed to give much thought to the vulnerability of long-term care and retirement home residents.

A frenzy ensued to locate sufficient supplies of personal protective equipment for frontline health-care workers. Canadian cargo planes dispatched to China for that purpose returned to Canada empty. And then China provided Canada with a million masks that turned out to be contaminated, and swabs that were defective, leading a Toronto hospital to launch a public appeal for unused and unexpired PPE, while in some hospitals staff were urged to continue wearing the initial surgical mask "until grossly soiled or wet".

Clearly, the government of Canada failed the test of good governance  under stress of imminent public health threat. Doctors complained of incomplete communication from all levels of government leading to confusion on who to test, when to test, who to admit, who to return home. "It really seemed to many of us on the ground that we were on our own", commented Dr.Alan Drummond of the Canadian Association of Emergency Physicians.

After informing Canadians preparing for Easter Sunday: "This long weekend, we all have to stay home", Prime Minister Justin Trudeau himself took the opportunity to leave Ottawa for Quebec over Easter to visit with his family at the official country residence at Harrington Lake, in Gatineau Park, and posted a photograph with his wife and their children in an Instagram selfie. As of this week, Canada posted over 73,000 confirmed cases of COVID, though many are convinced the real number could be ten times greater.