COVID-19 Pandemic Reflections and The Next Pandemic

Well the pandemic is over, at least according to most governments, science and medicine not so much. So now it is time to look back, and to look forward.

Perhaps my biggest reflection is that governments, at least in Canada, did not receive the rational criticism for their failures that they should have. The media was intent on concentrating on the irrational response of the anti-science, anti-public health, anti-vaxer crew who were co-opted by the far right white supremacist convoy types in Canada. The left, on the other hand, felt so strongly the need to defend the principle of governments acting to protect Canadians from this deadly pandemic that they failed to properly criticize governments failures in doing so. Not that there was no rational criticism, but what there was was overwhelmed by the Freedumb Convoy Shitshow.

The biggest failure was in not being prepared, even though scientists and public health officials had predicted that pandemics would be commonplace in the future, along with not following the precautionary principle and treating it as airborne until that could be completely ruled out.

But the most egregious, and I would say unforgivable decision, was to not utilize the front line of our health care system, but rather shutting down the vast majority of family physicians’ offices pushing an even greater workload onto the overwhelmed hospital system. This was either complete negligence on the part of the health care system or a clear indication we don’t actually have a health care system but just a bunch of disconnected parts.

As far as messaging goes, we had the use of the language “social distancing” rather than “physical distancing” at a time when maintaining social connections was critical to people’s mental health. Along with that error in messaging was the message to stay inside, rather than stay away from other people, at a time when getting outdoors (with appropriate precautions) could be critical people’s mental health.

However, in the long run, if only coincidental, there is some truth to the arguments for “no more lockdowns” and “we have to learn to live with the pandemic”.

If and when pandemics become a normal part of our reality we will indeed have to learn to live with them and it will not be sustainable to completely shut down our economy and society everytime they occur. Shutdowns or lockdowns, whatever you want to call them, will have to only occur rarely and for short periods when necessary to get an initial grasp of what is happening. And they will of necessity have to be political decisions.

But living with pandemics does not mean ignoring them. It means taking necessary precautions, such as physical distancing, masking with high quality masks, extensive vaccination programs, and, at times, restricting the highest risk activities such as large indoor gatherings of people packed closely together for long periods, methods that have been proven to work and reduce the incidence and seriousness of the outbreaks and most of all save lives.

But most importantly it means being prepared beforehand.

The first step in being prepared is having a primary care system where everyone has access to a primary care physician. In Ontario everyone does not have access to a primary care physician so we urgently need to drain more family doctors, fast track the approval of foreign trained doctors to work in Ontario and increase immigration and training of doctors from abroad, along with increasing the number of nurse practitioners available. And, of course, not shutting the primary care system down during a public health emergency.

We also need to have a hospital system that is not running at over 100% of capacity during the best of times. How do we build in excess capacity without it being inefficient. By using that excess capacity. As it is now so-called elective surgery is ridiculously backlogged. But this elective surgery is not elective at all. What we call elective surgery is surgery for non-life threatening conditions. Knee and hip replacements, eye surgery and many other so called elective surgeries may not be life saving but they certainly can be life changing for many patients for whom they make life worth living again. We can then, in the case of a public health emergency, divert that capacity to save more lives during a future pandemic. Purpose built publicly funded and operated specialty clinics can be part of that solution, and can be used to treat pandemic patients separate from hospitals, reducing the risk of infecting patients in the general hospital population.

And, though it need not be said, when the problem is the lack of doctors and nurses adding profit into the system is not going to solve the problem, only add unnecessary costs.

It also should not have to be said that the lives of vulnerable elderly persons should not be routinely sacrificed to ensure the profit margins of private long-term care facilities, creating a situation where those needless deaths increase exponentially during a pandemic. Being prepared for future pandemics requires that all health care should be publicly funded and operated. Private profit has no place in health care because that profit always has to come at the expense of patient care.

The other need for preparedness is economic. During the COVID pandemic the government scrambled to implement makeshift assistance programs for those economically impacted by the pandemic, and though it helped many it was a very messy solution. What we need is a permanent solution that will not only deal with public health emergencies but also with the economic disruptions of a transition from a fossil fuels based economy to a sustainable energy based economy. What we need is a guaranteed basic income along with a fair progressive taxation system.

There is no justification for not being prepared for the next pandemic.

Intuitive Lessons from The Pandemic – A Fantasy

This post is not based on comprehensive research or particular expertise on my part. Rather it is more what we would have called “common sense” before Mike Harris completely destroyed the meaning of the phrase.

We start off with the most obvious. We need a public health care system that is not overloaded to begin with. We can solve two problems here, provide pandemic readiness and provide timely life enhancing health care. We currently provide timely care for life threatening situations like cancer, heart surgery and emergency trauma but have created an artificial class of so called “elective surgery” we consider to be of lesser importance. This includes things like hip and knee surgery and replacements and many other types of health care that are necessary to allow people to live fulfilling lives. Health care is much more than preventing premature deaths. If we provided the necessary resources to provide all necessary health care without unreasonable wait times we would have the capacity to deal with a pandemic without putting peoples lives at risk.

Equally obvious is the need to bring long term care into the public health care system. Before the pandemic the horror stories of private long term care were well known even if the body counts were not as inexcusable as they became with the pandemic meeting the profit motive.

And still looking at the health care system, why did doctors offices shut down or become virtual during the pandemic when they should have been part of the response to it. Family physicians provide the first source of diagnosis for many serious illnesses like heart disease and cancer where early detection can be a matter of life and death. The system may respond quickly when these diseases are diagnosed but it does not respond at all when they are not detected. And why was the network of family physicians not used for pandemic testing and vaccinations.

And what of government policies. The big thing we got right was vaccines. In comparison to some jurisdictions to the south of us, all jurisdictions understand the importance and effectiveness of vaccines. The federal government did an admirable job of making vaccines available to the provinces and the provinces did a decent job in administering them. The main things Ontario could have done better was utilizing doctors offices and the school system to more efficiently get vaccines to the public.

As to the timely and appropriate response to the threat that is where we could have done better. We knew it was coming but we didn’t know what it would be like so it was a learning process. There is lots to criticize in hindsight but more importantly is learning going forward.

The biggest lesson was that internationally jurisdictions that put public health first and took strong, even drastic, measures quickly were able to get out of it faster than those that took half measures being more concerned with protecting the so-called economy than the public’s health. Having a provincial leader that considered himself a “businessman first” and by implication a Premier second did not help. We are still stumbling through in Ontario.

What is saving us is our sense of community. This works on two levels. On the personal level, it means in our personal behaviour, such as distancing, mask wearing and getting vaccinated, we base our decisions not just on what will keep us safe but also on what will keep our neighbours safe. This has made the big difference on how Canada has fared, compared to the United States, who arguably had better resources available to fight the pandemic.

The other level is the collective level, our collective actions taken together through our governments.

Here we are talking about three levels of government, federal, provincial and local, sometimes with differing philosophies and priorities. We really need to find a way to make federalism work better in these sorts of, not just national but international emergencies, climate change being another example.

If the pandemic has shown us anything is that individual action cannot replace collective action, and some things are just done better by acting collectively rather than acting individually. This is where we need to do better, particularly by strengthening our health care system and providing social supports. We are not financially prepared for the next pandemic because the political parties in power have chosen to go down the populist road of under-taxation thinking that would buy them votes. This is perhaps the most disastrous public policy position of the last half century.

Fortunately, because of that trend, there is substantial room to increase taxes to fill the void, particularly on that portion of the population that are excessively wealthy and under-taxed. This is a group in society that actually stands to gain more from collective spending by government than they can from individual spending by themselves. There is only so much you can spend on a wealthy lifestyle and the benefits of a better society far outweigh the benefits of people who have everything buying more everything for themselves.

We can be better prepared next time, and there will be a next time, but only if we choose to.

And the fantasy part – the belief that those in power will actually choose to learn these lessons and implement the necessary measures.

Climate Change, The Pandemic and Multi-Use Pathways (MUPs)

The greatest long term threat to humankind is undoubtedly climate change. While the planet can no doubt survive anything short of a collision with a planet sized meteorite or asteroid, climate change has the potential to be be disastrous to human habitat.

In the short term the greatest threat to humankind is the COVID-19 pandemic.

While both of these threats are said to be non-discriminatory and many claim “we are all in this together”, that clearly is not true because while the threats may not discriminate, our societies and dominant economic system certainly do. Both climate change and the pandemic have a greater impact on the developing world than the developed world, and within the developed world a greater impact on poor and marginalized communities.

But what does this all have to do with multi-use pathways (MUPs).

Climate change has created multiple freeze-thaw cycles every year, rather than one each spring, causing excessive damage to cycling infrastructure, in particular MUPs. At the same time the pandemic has created an increase in outdoor activity and in particular much greater demand for bicycles putting much greater demands on cycling infrastructure including MUPs.

This is is the impact on a typical Ottawa MUP in Kanata.

Bridlewood Small Hydro Corridor Multi-Use Pathway (MUP)

We need to improve our multi-use pathway standards so that they do not completely deteriorate after one winter and connect the MUPs together to create a city wide system for recreational and utilitarian use, commuting, shopping, etc.

While considering this we need to keep these important facts in mind. Improving cycling infrastructure increases the number of people using bicycles for utilitarian purposes like commuting and shopping, which reduces the strain on roads and automobile infrastructure and reduces road traffic congestion. At the same time improving cycling infrastructures costs considerably less improving automobile infrastructure. Leaving the only reasonable conclusion that the most cost efficient way to reduce road traffic congestion is to improve cycling infrastructure.

The Pensioner and the Pandemic

This is the post I was going to write before I was rudely interrupted and told to lock myself in my room.

I may indeed be the least affected person on the planet by this pandemic, and the only one that it seems to be not such a big deal, simply because it simply has not had a huge impact on my daily life.

Health-wise, although technically in a higher risk group by age, I am in the lowest risk group by perhaps the most important metric, economic status. I am not living in a long term care facility or living with a pre-existing condition that puts me at greater risk and I am relatively healthy with a strong immune system. As long as I follow the recommended precautions regarding mask wearing, physical distancing and avoiding crowded indoor gatherings I feel completely safe.

As a retired pensioner I do not have to worry about either being out of work and out of income or conversely having to work in an environment that may expose me to the virus. This is a huge issue for many people, especially those in lower income occupations, many of whom are in the highly praised but underpaid “front line” occupations we hear so much about now and who will no doubt go back to being ignored when this is all over.

Most importantly my daily lifestyle has been impacted very little. The biggest inconvenience has been having to wear a mask when grocery shopping. My daily routine of outdoor exercise, primarily cycling with some hiking, has had little impact other than having to be somewhat more aware of keeping as much distance as possible when passing people.

Yes, we have not been able to eat out at restaurants but we only did that once every two or three months anyway, and that is a luxury many live their wholes lives without being able to afford.

We have not been able to travel outside the country for the past year, but then most people are not in a position to undertake foreign travel on an annual basis, and we have not done any recreational travel within the province for the last year, again something that many do not have the economic means to do regularly.

We saw investments in equities fall significantly (but they have now recovered) but our concerns about economic effects should be saved for those living from paycheck to pay check rather than for those that can afford to invest in the stock market.

I really have no reason to feel hard done by due to the pandemic.

Lessons We Must Learn From COVID-19 to Build a Better Society

Community is the key to the future. Those societies that are fairing best in responding to COVID 19 are those with a strong sense of community. America's dismal response is not just because of Trump, but also due to the country's overemphasis on individualism over community.

Our public health care system, part of our collective sense of community, was key to our response. It made our ability to control the outbreak possible. But it is still flawed and could not respond was well as it should have because it is underfunded and incomplete. We saw that particularly in the for profit long term care sector, measured in body counts. We must complete the system by extending it to prescription drugs, vision and dental care and most importantly long term care of the elderly and home care. We must eliminate profit from the provision of health care so that patient care and profits are never competing for funds. Most importantly we must realize that health is the most important priority for everyone and under-funding health care in order to promise lower taxes is in nobody's best interest.

Our economic safety net was the next most important factor in our successful response. Unfortunately we did not have a proper system in place to respond and the government had to respond with a series of patchwork measures put together quickly which, while it managed to avoid the worst of our southern neighbours problems, it still left the most disadvantaged, well still disadvantaged. That series of measures, as necessary as they were, increased both the deficit and national debt because the government, that has been under-taxing the wealthy for decades, did not have the financial capability it should have.

What we needed and what we need is a basic guaranteed annual income, and not just one to keep people barely above the poverty line but one designed to provide a decent quality of life for everyone.

We say 'we are all in this together" but we clearly are not equally in this together and never will be as long as we live in a society of massive economic inequality.

We talk about groups such as seniors being more at risk but in reality the biggest risk factor with COVID 19 is economic status. Those placed at highest risk, our so-called front-line heroes, those responsible for producing and providing our food and goods, are working in cramped and unsafe conditions, along with those working in high risk long term care facilities, are the biggest group of COVID 19 victims. And these are the people most susceptible to the economic consequence of COVID 19, often living from paycheck to paycheck. A few extra dollars per hour for a few weeks is not the solution.

We must deal with the economic inequality in our society by raising incomes at the bottom and reducing them at the extreme top end. CEOs of corporations who make their profits and fortunes from minimum wage earners simply do not earn the millions of dollars per year they are paid. They are paid that because of an unequal economic and political system. We must reform our tax system so that those that can afford to pay more do and those at the bottom pay less at the same time as we reduce the gap between the bottom and the top.

We need to raise minimum wages to a level that provides a decent quality of live and use the tax system to redistribute the wealth of the excessively overpaid. We cannot build the type of community and society we need on a basis of extreme inequality.

We also cannot build the society we need without concern for the environment it lives within and without addressing the challenge of climate change.

We need to build a new society, based on community rather than individualism, if we want to meet the challenges of the future and this includes a move from more individual spending to more collective spending. Fundamental change is required if we are to survive the challenges of the future and thrive within it.

Also of Interest:

THE FIFTH COLUMN: Towards a Green Social Democratic Economy

THE FIFTH COLUMN: On Inequality, Democracy and Taxing the Rich – A Modest Proposal

THE FIFTH COLUMN: On Democracy