Thursday, November 11, 2021

"Reactionism" is no way to solve the pandemic crisis

FOR months, after a brief jump in reported cases of COVID-19 in August, the Canadian province of Ontario has seen a slow, but steady, decline, with hospitalizations and severe cases remaining extremely low. Much of that was attributable to our vaccination coverage, which is north of 80% and now nearing 85%, which allowed the province to loosen almost all restrictions by the end of October, albeit with a "vaccine passport" requirement needed in places the province deemed "high risk".

However, as October turned to November, the reported case count began to creep up a little. As what usually happens in these cases, there were howls for the province to "do something" even though there was no evidence that anything needed to be done- the booster program is underway, vaccine coverage will be expanded to children and, more importantly, hospitalizations were still very low.

On November 9th, Ontario Health Minister Christine Elliott said that "Ontario was staying the course" in its reopening plan, reassuring nervous Ontarians that when Ontario mapped out its reopening, it took into account this rise in cases.

Should be "case closed", right?

Well, on November 10th, Ontario announced that the next step in its reopening plan- removing capacity restrictions at nightclubs, strip clubs, bathhouses and sex clubs- will not happen as planned on November 15, with the earliest it can happen being December 8. The province said this was "data driven" but then provided no data to support this conclusion.

Worse, the flip-flopping from "we're staying the course" to actually changing course is no way to reassure the public that the province's administrators have a clue that they know what they're doing.

What it really is, though, is yet another example of the old staple of politics- "reactionism"- and that's no way to solve a crisis. A year and a half into the pandemic, we ought to be better than this.

Personally, I find the move by the Ontario government disappointing but not at all surprising. This move reeks of the province trying to say it "did something" because, let's be honest with ourselves, nothing, realistically, will change.

The province effectively removed all of its remaining capacity limits on October 25, when restaurants and bars became able to operate at full capacity (with the vaccine passport). Nightlife venues these days are more multi-purpose establishments than strictly being a "nightclub" or a "bar" or a "restaurant" (a pre-pandemic development), so many of the places that are, in essence, "nightclubs", qualify as "venues" or "concert halls" or "event spaces" or "bars" or what-have-you so I can only see a few venues (if any) that are still subject to restrictions in Ontario.

Not that this quibble matters. With a vaccine passport, there's no reason to have capacity restrictions in any setting, because if the vaccines work as they should- and they do- then very few attending these venues are going to get sick.

Which is what matters. We've been told, time and again, that controlling the pandemic is really about controlling hospitalizations, and the vax passport is supposed to ensure that gathering in "high risk" settings doesn't lead to an unmanageable amount of hospitalizations.

Furthermore, the vax passport was supposed to entice people to get vaccinated, and I can't imagine people are going to be enticed to get vaccinated if they're still going to be restricted in what they're able to do.

Our healthcare administrators have said many times, "the vaccines will set you free". Well, time to deliver on that.

I could continue on with that rant but then I'd get away from the point I want to make.

Which is not having a plan- or a goal- has been the pandemic response's undoing ever since the beginning and threatens to unravel the response at the worst possible time.

Yeah, I'll grant that perhaps a lot of the situation around SARS-CoV2 (the virus that causes COVID-19) is probably beyond what can be reduced to "layman's terms", but considering the hold it has on all of our lives (in more ways than one), it's the job of those tasked to deal with it to communicate the best way we, the public, can deal with it while it's around.

In other words, it's the job of our healthcare administrators to say "this is what we want to achieve with COVID-19" and tailor the response towards that strategy.

This keeps things simple. Having a collective goal makes it easy for the collective to do what is asked of them. Further, seeing our leaders do their part in achieving that goal makes it easier for the collective to support their initiative, because the collective doesn't feel like they're "doing all the work".

How does this get to where we are now? In a number of ways.

Without getting into the play-by-play of the pandemic, last year we saw many governments promote the idea in their messaging of eliminating COVID-19 but very few of them actually commit to doing so. Many "re-opened" after lockdown before COVID-19 was eliminated, with those same governments waiting to reimpose restrictions despite weeks of rising cases.

Worse, the public had no idea what metrics were used to inform them that "now is the time to shut down" or "now is the time to open up". The decisions felt arbitrary.

This all boiled down to a failure in strategy. Last year, I maintained that there were only two viable strategies for dealing with SARS-CoV2- eliminating it or working around it.

Which means you either shut down the economy completely until it's gone or leave the economy entirely open while working with businesses and people so they can operate and manage the virus as best they can.

Which means SARS-CoV2 is either manageable or it isn't. There's no other way around it. Yeah I know there are nuances at work and that strategies may fail- but if a strategy fails, you change strategies. You don't flip flop between them.

Now that same narrative is playing out with the vaccines. We- still- don't know if all we want to do is manage SARS-CoV2 or eliminate it completely.

I have my own opinions on that but I think it's prudent that we, at least in Ontario if not the rest of the world, begin to understand what we want.

It's either we eliminate SARS-CoV2 from our shores, which means worrying about case counts, or we learn to live with it, which means we don't worry about the case counts and worry more about hospitalizations and severe outcomes.

There's no two ways about it. There's no "we're not worried about the rise in case counts" one day and then flip-flopping by implementing restrictions the next day simply on the basis of those counts.

That's not leadership. That's reactionism. Which is never fine regardless of the issue, but when it comes to the COVID-19 pandemic and the effect it has on all of our lives, it's simply not good enough.

Yeah, I'm sure Ontario officials are saying "things are evolving" and "this is science" but the decision made today isn't either. Either the metric of case counts matters or it doesn't, and dithering makes Ontarian officials look like they have no idea what they're doing.

They may think the worst this "uncertainty" will bring is just some angry people on Twitter but this has greater implications. Uncertainty will cost lives- directly or indirectly- and the longer our public health officials come up with more excuses than answers, the less the public will trust them and respect their authority.

So if our politicians and our health care officials want to keep their jobs, they better come up with solutions that allows the rest of us to keep ours.

Or we'll turn to someone else who will.

-Daniel Arnold

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