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.
