The premier’s ‘happy balance’ could cost lives
Doug Ford was explaining how the system works. You need a system, in this economy. The question was whether two more regions, Halton and Durham, would be returned to the public health restrictions of Stage 2. Friday, the premier said both were under consideration. Monday, neither one was moved.
So how did that work, exactly? What are the thresholds for this incredibly important public health measure, and who makes that call?
“I had a phone call with Mayor (Rob) Burton from Oakville, we have a great relationship,” said Ford Monday. “He said, ‘Hey, I don’t think we’re at that point,’ and in Halton, this is unique, because we have none of the mayors agreeing, we have the regional chair not agreeing, we have our MPPs not agreeing, so I suggested to write a letter. Write a letter, let your local chief medical officer of health be aware of how you feel and how other mayors feel and how our MPPs feel. I spoke to one of my great MPPs, Jane McKenna, saying I encourage you to write a letter.”
Uh, what? So the premier encouraged a letter arguing against further restrictions in Halton from two Ontario Progressive Conservative MPPs, McKenna of Burlington and Parm Gill of Milton? That was his strategy?
As it turned out, Ford misspoke on Friday about Halton being under consideration at all, because, while the region’s numbers had been rising, their COVID case numbers had also started to flatten. Nobody seemed to communicate to the premier that he had made a mistake. And the whole dumbshow unfolded, which gave ammunition to Ontario’s goofy herd immunity anti-lockdown crowd, who reacted to something, to be clear, that wasn’t actually being proposed at all.
A hasty caucus meeting was called Monday night to discuss it, and it’s all definitely how you want a government to be handling the epidemic response to the second wave of a pandemic. Good stuff.
It was revelatory, if repetitively so, because Durham wasn’t Halton. In the past three weeks, Durham’s cases per 100,000 people per week have gone from 16.3 to 26.8 to 37.3, and now sit at an even 40, per the Star’s invaluable Ed Tubb. Their contact tracing seems to be in great shape, and hospital capacity too, though waiting for your hospitals to fill up is one of the losing strategies of this pandemic. On cases alone, Durham is roughly where York was a week before it hit Stage 2, or Toronto two weeks before, or Ottawa and Peel three weeks before. Positivity rates had been increasing in both Durham and Halton.
“It very much looks reactive, and not proactive,” says Dr. Gerald Evans, the chair of the division of infectious diseases at Queen’s University, and a volunteer member of the province’s science table. “If you look around the world, you can very nicely see groups where, that was the time you should have started it, not the time they did do it. So some of us are saying, be proactive, do something, don’t wait!”
The province doesn’t get ahead of the virus, ever. It’s clear the bar for the province actually imposing restrictions is quite high. How high? They won’t tell us, which means the anti- and pro-lockdown factions are both left to guess. When Dr. Eileen de Villa and the Toronto Board of Health asked Ford to place Toronto into a modified Stage 2 on Oct. 2, it took a solid week — not just of waiting, but of acrimony and negotiation — before the province acceded, and put Ottawa and Peel in as well. They waited until Toronto was at 69.9 cases per 100,000 residents per week, and 3.1 per cent positivity. Two weeks later the city’s test positivity is 4.4. Which is a bad number.
“Three per cent is kind of interesting, right around 3 or 4 per cent,” says Dr. Evans. “If you look around the planet, right around 3 or 4 per cent test positivity rates in many larger cities and jurisdictions, that’s the inflection point. After that point it begins to rise exponentially.”
That number will wrestle with restrictions now, and it all should have happened sooner. Ottawa has seen a hopeful dip in reported cases; Peel, Toronto and York, unfortunately, have not. And other jurisdictions may yet meet the same problems, because listen to the premier. When he lists who he calls before making these decisions, Ford says he calls local politicians first, then local businesses.
“I always say I gotta listen to the docs, I always will, and the science, but in saying that, I have to listen to the small business owners,” said Ford.
Never mind that public health officials and infectious disease specialists and epidemiologists will tell you that you control the virus first, and that is the best way to preserve the economy. Never mind that this pandemic is a marshmallow test, and the strongest measures to slow spread are the early aggressive ones. Ford compromises, you see. There is a balance.
“Can I justify if a region is hitting super-high numbers, be it Peel or Toronto?” said Ford. “No, I can’t justify. Can I fight all day long for Halton and other regions and cheering them on and really pushing back at the health table? I do it all the time. I do it all the time. But we have to have a balance there.
“We have caucus members, cabinet members on both sides. We have some cabinet and caucus members who think, don’t worry, everything’s fine. We have other ones that may feel, OK, shut everything down. But we’re going right down the middle of the road. We have to have a happy balance.”
Ford does sometimes listen to certain scientific advice. He doesn’t say how or why, or make their advice public, but he does.
Still, it’s clearer and clearer that this province doesn’t understand or believe in truly preventative public health measures, much less powerful enough epidemic response, to preserve the economy. And the result is we have case counts and hospitalizations and longterm care outbreaks rising in a data-poor system with bad public health communication and a gaffe-prone premier, and we’ll see where that goes. Everyone wants to save the economy; the smart people say, deal with your public health first. Because sometimes the middle of the road is where you get run over.