Thursday, 4 June 2020

Ontario’s Slightly Firmer Swedish Squirrel Approach to COVID-19


After over two months of “lockdown” in Ontario, our progress with respect to COVID-19 appears to have reached what can only be termed a plateau.  We have avoided worst case scenarios like Spain and Italy and not overwhelmed our hospitals but we are not seeing our numbers of new cases consistently go down as in some other provinces across the country such as Manitoba or B.C.  To be fair, Ontario does have some of the most densely populated parts of the country – namely the GTA – and the combination of dense populations and an international airport are factors which made the COVID-19 situation worse.  Ontario is not PEI or Manitoba. 

At the same time, our response to the onset of COVID-19 could have been quicker – here Ontario was not alone given the federal response – and the resulting “lockdown” was not really a lockdown in the sense of some of the European countries such as Italy or Spain.  While those countries were hit harder, they were at the front end of the pandemic and responded more firmly with their lockdowns.  In Italy, the “lockdown” was a complete shutdown where you could not go out unless it was to the grocery store or pharmacy and if stopped while out you needed to justify where you were going to police.  As a result, despite a more severe outbreak and having four times Ontario’s population, Italy is now registering fewer daily new cases than Ontario.

Ontario’s approach to COVID-19 in the end is a sort of Swedish approach with a fuller shutdown, less public compliance and a bigger economic cost in terms of shutdown.  Sweden’s population at just over 10 million people is close to Ontario’s 14 million.  Its approach in the end has been less successful in that it currently has a total of about 41,000 cases and 4,542 deaths compared to Ontario’s 29,047 cases and 2,312 deaths.  The Swedish approach has been less damaging to its economy - even schools and restaurants remained open – but its daily case numbers have not gone down settling into an equilibrium between 500 and 1000 new cases a day. The problem with the Swedish approach is not only the higher death rate but of course the greater risk of the pandemic re-igniting given the larger number of embers.

Ontario’s approach in the end has parallels to the family of five squirrels nesting in my rear yard’s pine tree.  Obviously, they are sensitive to COVID-19 given that they are sticking to gatherings of five.  However, they are a bit of a nuisance.   Despite my obvious attempts to discourage them, they do pretty much as they please as they gallivant from tree to tree.  However, they are very skittish and if I play hawk calls from my phone, they scamper away and lay low.  That seems to be the case in Ontario where despite a pandemic emergency and rules on social gatherings, people still pretty much go about their daily business including gathering in public parks and even participating in demonstrations in large densely populated cities.  And, the relaxed approach and lack of attention to details is even in some of those institutions that we were all most afraid of being overwhelmed – our hospitals. And then, as soon as something goes wrong, we act. Its not a consistent strategy.

This story on Thunder Bay’s CBC web site regarding a commuting physician with COVID-19 symptoms working at Thunder Bay Regional for days is an unfortunate case in point.  While I am certain that this is a complex story with many dimensions, the essence to me is that the hospital was not consistently following its own protocols – whatever they happen to be – and once a problem emerged, the response was the squirrel thing – a rapid shutdown again of all its “non-essential” surgical and outpatient procedures.  I suspect that in the end, the mortality rate is going to rise in the coming year in Ontario but more of the rise will be attributable to delayed diagnostics and medical procedures than from COVID-19 itself. 

In the case of Thunder Bay Regional, the interesting part of the story is that there will now be an investigation but that “the full report may be kept under wraps.”  Really? Are we implementing Chinese Communist Party management principles in Ontario health care?  I would be interested in knowing why during a pandemic an incoming commuting physician was not tested for COVID-19 as a matter of course especially given that the physician was exhibiting symptoms. True, they could be seasonal allergies, but given the difficulty of separating COVID symptoms from allergies, should not the medical staff worker have been tested as a precaution?  Is there not a supervisor this physician reports to who could have compelled testing on first mention of “allergy symptoms” to remove doubt? As an aside, was this physician flying back and forth to their other abode or driving?  

 

In the end, what do I really know?  I am a simple country economist observing the world from my home – be it presidents and prime ministers trying to make decisions affecting the welfare of their populations, hospital administrations and public health units dealing with health care, or squirrels foraging about their daily business.  To date, the motivation and behaviour of the squirrels has been the easiest to understand.