THE RACE IS ON BETWEEN THE VACCINE AND THE VIRUS — AND IN THE EARLY RUNNING, THE VIRUS IS WINNING. IN THE ABSENCE OF AN ABRUPT SHIFT IN PUBLIC POLICY, A THIRD WAVE IN SPRING LOOKS INEVITABLE.
The race is on between the vaccine and the virus — and in the early running, the virus is winning.
A new, more virulent strain of COVID is infiltrating the country in the middle of winter, when social distancing is hardest.
We are seeing explosive growth in the number of people infected – in the week to December 29, the number of new daily cases across Canada was nearly four times the 1,770 reported in the worst week of the first wave in March.
In the absence of an abrupt shift in public policy, a third wave in early spring looks inevitable.
I have supported the mitigation strategies of provincial governments in Ontario and Quebec to this point. But they are clearly not working – there are too many holes in the Swiss cheese through which the virus can insinuate itself.
A more impenetrable approach is required – a hard lockdown strategy similar to the one adopted in Melbourne, Australia, that was only lifted when new cases all but disappeared.
The purpose of the first wave lockdown was to save health systems from being swamped. But the latest infection rates in Ontario and Quebec are grim, hinting at darker days to come, once the toll from the festive period becomes clear.
Ontario reported 3,270 new cases on Monday, with 29 new deaths.
Hospitalizations were up nearly 200 from Sunday at 1,190, with 333 people in intensive care.
Quebec's news was equally grim – 2,546 fresh cases, with another 32 deaths, an exploding hospitalization rate, with 1,294 new admissions and 188 in ICUS.
The provincial government funded health institution, INESSS, reported that hospitals in the greater Montreal area are in danger of exceeding dedicated capacity, which will likely see the cancellation of surgeries for other conditions. As one intensive care doctor put it, a continued increase in positive diagnoses will stretch capacity to its limits. The system has never run out of beds before, Francois Marquis told Radio Canada.
Meanwhile, only 0.3 per cent of the Canadian population has been vaccinated – a number one bio-statistician called “embarrassingly low.”
We have entered a new phase of the pandemic, one in which the UK variant of the virus means COVID is likely to become more transmissible (early research suggests every person with positive test results infects an extra 0.36 to 0.68 persons compared to earlier). When success depends on reducing the reproductive number below one, so that every infected person infects less than one other person, a more transmissible virus is the worst news possible.
The only solution in the eyes of the COVID Strategies Choices Group – a taskforce of epidemiologists, economists and business people – is to adopt the strategy that proved successful in Melbourne.
At the beginning of August, Melbourne instituted the world's tightest restrictions. Residents were not allowed to leave their homes, except for essential travel or one hour of exercise. The city introduced a 9 p.m. — 5 a.m. curfew, closed schools and daycares and required residents to stay within 5km of their homes. The stay-at-home order was lifted in October because the action worked – by the end of November, the city had not seen an active case for four weeks. The good news for brave politicians is that Victoria premier Daniel Andrews — “Dictator Dan” to his detractors — saw his approval ratings soar.
The COVID Strategic Choices Group says the present mitigation strategy has failed to save lives or keep economies open and should be replaced by a sustained lockdown that is only lifted when
COVID cases are low enough that testing, tracing and isolation can work effectively. The yardstick of success, in the view of the taskforce, would be a steady decline in new COVID cases of 17-25 per cent a week.
“Success will allow Canadians within a few weeks to take back collective control of their lives, their hospitals, their businesses and their communities,” the report's authors say.
Christopher Cotton, a professor of economics at Queen's University, estimates in the report that an intense lockdown could be less costly to the economy than less intensive, shorter duration lockdowns spread over a longer period.
The authors point out that Atlantic Canada saw its seven-day average fall by 25 per cent in the month to the end of December.
“This is not a minor change in tactics, this is an explicit change of strategy,” the authors say.
Modelling by Caroline Colijn of Simon Fraser University suggests that without a strategy shift, Canada will likely experience a third wave this spring, with a potential of over 9,000 cases a day, provoking a third round of lockdowns in late March/early April.
The group's “Canadian shield” strategy mirrors Melbourne's hard lockdown.
Provinces would focus on persistent suppression by setting a clear goal of 75 per cent case reduction before coming out of lockdown. They could do that by considering “stay-in-place” orders to minimize unnecessary interactions, restricting non-essential movement within and between provinces and clamping down on international travel – a suggestion that might face obstruction from some of our wayfaring elected officials.
None of this is desirable.
The role of the state should be to reconcile the differences of its citizens, not boss people about.
But governments are also obliged to protect civil society in extremis. Make no mistake, the circumstances are extreme.