Canada's COVID 19 Performance: Oped

 

Canada’s COVID performance on key measures among worst in developed world

Livio Di Matteo 

Appeared in the Globe and Mail, May 26, 2021

There have been more than 167 million COVID-19 cases worldwide and 3.5 million deaths. Canada ranks 22nd in the world with more than 1.3 million cases and more than 25,000 deaths. Given the spread of new variants and varying vaccination rates around the world, the effects of the pandemic will be with us for some time to come.

But how does Canada compare to other advanced countries? For 2020, COVID cases per million ranged from a high of 87,000 (Czech Republic) to a low of 7 (Taiwan). Canada (approximately 19,000) ranked 24th out of 35 advanced countries. Deaths per million ranged from a high of almost 1,800 (Belgium) to 0.3 (Taiwan), with Canada in 22nd place (approximately 500 deaths per million).

However, on a crucial measure—the “case fatality rate” (total deaths from COVID-19 as a percentage of total COVID-19 cases), Canada in 2020 had the 7th highest rate (meaning 7th worst) in the developed world, due primarily to COVID’s impact on Canadians in long-term care. In 2020, 11 per cent of Canada’s COVID-19 cases, and more than 70 per cent of COVID-19 deaths, were in long-term care facilities. According to the Canadian Institute for Health Information, while Canada’s overall COVID-19 mortality rate was relatively low compared with rates in other OECD countries, we had the highest proportion of deaths in long-term care. If we’ve learned anything from COVID, it’s that we must do a much better job with long-term care here at home.

Unfortunately, lessons provided are not always lessons learned. Crucially, Canada failed to learn from the SARS outbreak.

Between 2002 and 2004, some 30 countries reported SARS cases, with only eight countries reporting more than 10 cases and only five (China, Hong Kong, Taiwan, Singapore and Canada) reporting more than 100 cases. Fast-forward to 2020, these five countries combined reported about 18,000 fewer COVID-19 cases (per million) compared to countries that did not experience SARS. Apparently, countries heavily hit by SARS learned something about how to prevent viral spread during a pandemic. Except Canada. While Hong Kong, Singapore, China and Taiwan in 2020 saw COVID-19 deaths (per million) range from 22 to 0.3, Canada reported nearly 500 deaths per million. In this key five-country group, Canada was an outlier.

Why? Post-SARS, governments in Canada studied and planned for future pandemics and increased spending on public health measures. Yet we were still unprepared for COVID-19. For example, in the years before the pandemic, the federal government seemingly (and quietly) deactivated its pandemic early warning system, failed to maintain stockpiles of personal protective equipment (e.g. masks), and once the pandemic began often moved slowly to deal with its impact. On the other hand, following its SARS epidemic, Taiwan established a National Command Centre in 2004, which helped coordinate and map out its current—and significantly more successful—pandemic response.

As for other lessons from around the world, high rates of testing remain an important factor, with each additional 100,000 tests (per million) associated with 21 fewer COVID-19 deaths per million. Last year Canada ranked 26th out of 35 advanced economies for COVID-19 tests per million.

Another important factor was the number of hospital beds per 1,000, with each additional bed associated with 31.5 fewer COVID-19 deaths per million. Among 35 advanced countries, Canada ranked 32nd for the number of hospital beds. What does that look like? Again, among advanced countries, hospital beds per 1,000 ranged from 13.1 (Japan) to 2.2 (Sweden), with Canada near the bottom at 2.5.

In summary, key deficiencies in Canada’s pre-pandemic preparation and response capability (even after the lessons of SARS), combined with low rates of testing, low numbers of hospital beds, and an inadequately prepared and protected long-term care sector, have produced relatively poor results, particularly on certain measures of mortality. As a result, Canada was forced to rely on lockdowns and other stringent measures, which—while effective during the first wave—were less effective as time wore on and Canadians grew tired and confused with the shifting rules. And it’s the restrictions imposed by government, not the pandemic’s death rates, which caused the economic disruption that will continue until a sufficient proportion of the population has been vaccinated and we reach some level of herd immunity.

In light of the suffering we’ve witnessed across the country, let’s hope we actually learn more this time around.

Ranking Canada's COVID-19 Performance: It is Not as Pretty as We Like to Think

 

The IMF has released the October 2020 edition of its fiscal monitor and economic indicator numbers for world economies and its World Economic Outlook report titled “A Long and Difficult Ascent”  paints a pretty gruesome picture of the carnage wrought by the COVID-19 pandemic.  While the global economic growth outlook has improved somewhat from its June 2020 report, it is still projected at -4.4 percent and is surrounded by a fair amount of risk. 

 

However, in the end, performance is relative and what is more interesting is how different advanced economies are expected to fare in 2020.   Moreover, what is also of interest is their performance economically and fiscally relative to their pandemic performance – which certainly should be of interest to Canadians.   Polling results have often indicated that Canadians have largely approved of the way that their governments have responded to COVID-19 and an international ranking places Canada near the top of countries whose public thinks their country has handled COVID-19 well.  How justified is this perception by Canadians?

 

In understanding how well Canada has done dealing with COVID-19, one has to start with how Canada ranks in terms of the severity of the disease which in itself can indicate how good a job Canada has done in limiting its spread.  Figures 1 and 2 plot the ranked total number of COVID-19 cases per 1 million population and the deaths from COVID-19 per 1 million people as of October 17th (as taken from Worldometer) for 35 advanced economies as defined by the IMF.  Cases per 1 million ranged from highs of 32,914 and 25,083 for Israel and the United States to lows of 490 and 376 for Korea and New Zealand respectively.  COVID deaths per million people ranged from highs of 893 and 722 for Belgium and Spain (with the USA third at 675) to lows of 5 for both New Zealand and Singapore.  

 

 

 

 

 

Canada ranks 21^st in total cases per million – putting it in the bottom half of incidence severity – but 10^th highest in deaths per million population putting it in the top third.  So, while Canada was not hit as hard by infections compared to many countries, it was among those seeing higher death rates – largely because of its poor handling of the long-term care sector where over 80 percent of the deaths occurred.  While Canada is not the United States or Spain or Belgium in terms of the incidence and mortality of COVID-19, it is not Australia or New Zealand or Korea either. One might argue being an island helps but it did not help Cyprus or Malta that much.

 

How about the economic impact?  Figures 3 to 6 are based on the IMF October 2020 World Economic Outlook Report.  Figure 3 ranks the 35 advanced economies in terms of their projected 2020 real GDP growth rates and here Canada ranks 24 out of 35.  While everyone is going to see their economy shrink, some are going to be hit worse than others. Canada is basically at the top of the bottom third with an anticipated drop in real GDP for 2020 of -7.1 percent.  Overall, it is sandwiched between highs of -1.8 and -1.9 percent for Lithuania and Korea and lows of -10.6 and -12.8 for Italy and Spain. Figure 4 ranks these same countries according to their estimated 2020 unemployment rate and here Canada is an honorary Mediterranean country where at 9.7 percent it is coming 4^th out of 35 countries – behind Greece, Spain and Italy.  And if one looks at the percentage point increase compared to 2019, Canada’s is a 4 percent point increase.  Based on Figure 5, we are the second worse increase of the 35 advanced countries, behind the Americans who are expected to see a 5.2 percent point rise in their unemployment rate. 

 

 

 

 

 

 

 

Of course, one might think that Canada’s somewhat mediocre performance relative to other advanced countries when it comes to the spread of COVID-19 and its mortality rate may simply be due to the fact that Canada has been a cheapskate in terms of its public spending compared to other countries.  And, by extension, perhaps our economic performance has been so much worse than other advanced economies because our federal and provincial governments have been captured by deficit scolds who have foisted restraint upon Canadians.  Well, put those notions to rest.  When the government deficit to GDP ratios for these advanced economies are ranked in Figure 6, it appears that Canada is finally number one in something – the size of its 2020 government deficit relative to GDP.  It is expected in 2020 to have the largest government deficit to GDP ratio of these 35 advanced economies registering at 19.7 percent. 

 

 

 

Once again, Canada has been spending a lot and seemingly getting relatively much less for its money.  True, we have not done as badly as some countries when it comes to the effects of COVID-19 on our population (unless you are a resident of a long-term care home) but our economy appears to have been fairly hard hit even with the many billions of support and assistance that have been funneled into it.  Why Canadians have to date been so charitable towards their federal and provincial governments when it comes to performance during the COVID-19 pandemic is a bit of a puzzle to me. Perhaps we just like to be nice.

Air Canada’s On Time Record Needs to Improve

I noted in a July post that Air Canada’s service from Toronto to Thunder Bay had been showing some rather erratic performance when it came to on-time arrival.  I monitored performance rather casually for a few weeks later and noticed there were still issues and finally decided to do a more formal monitoring and see what statistics I could come up with.  For the period August 25^th to September 7^th 2019, I noted the scheduled and actual arrival times for the three daily Toronto to Thunder Bay Air Canada flights.  If the flights actually arrived within 15 minutes of their scheduled time, they were deemed to be on time. Otherwise, they were late and the amount of time they were late was also noted. 

The 15-minute window is a pretty standard application of this type of this type of airline performance metric.  If you are looking for a benchmark, Forbes reported on a recent airline performance – the OAG 2019 Punctuality League statistics – and they also use this 15 minute window.  If you are looking for an international benchmark, in the top 20 airlines for on-time performance for all airlines in the report, the top airline was Copa Airlines with a 89.8 percent on time rate (that is arrived within plus or minus 15 minutes of the scheduled arrival nearly 90 percent of the time).  Rounding out the top 20 was Alitalia which was on-time 82.9 percent of the time.   If one only looked at mega airlines, the top 20 ranged from 85.6 percent for LATAM Airlines Group to 66.8 percent for – Air Canada – just below Air China at number 19 with 68.8 percent.  By the way, Westjet had a 76.3 percent on time rate.  Porter did not appear to be included in the report.

Without giving to much away early for the rest of the post, Air Canada’s Toronto to Thunder Bay on time performance during the August 25^th to September 7^th period was pretty abysmal as it did not even meet its low overall on-time performance.  Over this time period, the planes were late 57 percent of the time with an average late arrival of 29 minutes.  You might think that 29 minutes is not so bad – but the time differential ranged from a maximum of 201 minutes (that is 2 hours and 21 minutes late for AC 1512 on September 1^st) to 11 minutes early for AC 1512 the next day.   

 

The accompanying figure plots each flight during this period and at least 8 flights (that is about 20 percent of flights) were at least 50 minutes late.  The only good news is that during this period, there is a slight downward trend in minutes late but there is still a lot of room for improvement.  Keep in mind, aside from the last flight of the day which even if a couple of hours late is able to take off as the first flight the next morning on time – all the late flights coming mean a late flight the other way.  And, this poor performance is during a summer period where there is relatively good weather.  One can only imagine what this winter is going to be like.

So, there you have it.  Air Canada has work to do period but it would be nice if it could bring up its Thunder Bay run performance to at least its overall standard – which is not great by international standards.