Ford’s PCs nothing if not consistent
If you wanted to discern what this government truly cares about you could make a short list, a year into the COVID-19 pandemic. The PC government cares about the economy, and their donors within it. Intertwined with that, they care about their image and getting re-elected, as every government does.
And beyond that animal self-interest, there appears to be one thing, and one thing only, that moves Doug Ford’s government to take real action in this yearlong pandemic. It’s not an early exponential rise in cases; cruelly, it’s not deaths in long-term care.
No, it’s the spectre of Lombardy, or New York, or anywhere hospitals became war hospitals. Since the fear of the first wave, that’s the only thing that’s ever moved them.
Well, Monday night the province’s independent volunteer science table that showed the variants which now dominate Ontario’s cases are fundamentally a different pandemic from classic COVID-19. They produce a 63 per cent higher chance you go to hospital, double the chance to reach the ICU, 56 per cent higher chance you die, within your age range and comorbidities.
Meanwhile, Ontario’s ICUs crept to within 10 patients of the second-wave high, with patient transfers at an all-time high to preserve space, as case counts increase exponentially. The seven-day average for new cases is now 2,207 per day.
At the current doubling rates, with the implied ICU rates, that would mean over 4,000 cases per day in 11 days or so; an ICU load of 600 within weeks may be likely under those conditions, on the way to 800, even if action is taken quickly. It takes 10-14 days after significant changes for the peak to arrive. A lot of this is grim, gasping, sorrowful, weeping, avoidable, life-or-death math. One person at a time.
In response to the brief, the government cited hospital capacity: a $125-million investment in extra ICU beds announced Jan. 18, which doesn’t include the specialized staff for those beds, and the field hospital outside Sunnybrook, which isn’t a true ICU.
“Part of the care that is knowing the details, the expertise of our respiratory therapists and nurses and physicians that tip things in a patient’s favour that allows them to get over this,” says Dr. Martin Betts, the head of critical care at Scarborough Health Network. “And my great fear is, at some point in the first wave someone suggested we put two patients on a ventilator, and you’d end up with two deaths, because the precision you need to manage these patients is so intense. With an unskilled nurse that isn’t familiar with this, or even an unskilled doctor, we will experience worse outcomes once we get beyond the limits.”
We cannot hospital-capacity our way out of this unless we are willing to swallow more horror than we’ve seen.
“If there is exponential growth, every hospital system cannot keep up with it,” said Dr. Peter Juni, the scientific director of the province’s independent volunteer science table. “It’s only a question of when; it’s not a question of if. You need to control exponential growth with efficient public health measures. And the later you do it, the more you have to do it.”
The variants are different. The head of the U.S. Centers for Disease Control and Prevention, Rochelle Walensky, was talking about reopening Monday, and got emotional. She said, “I’m going to lose the script, and I’m going to reflect on the recurring feeling I have of impending doom. We have so much to look forward to, so much promise and potential of where we are, and so much reason for hope.
“But right now I’m scared. I know what it’s like, as a physician, to stand in that patient room gowned, gloved, masked, shielded, and to be the last person to touch someone else’s loved ones, because their loved ones couldn’t be there.”
The United States has vaccinated approximately three times as many people per capita as Canada, and its weekly case count of 133 per 100,000 people per week has risen 12 per cent in the last seven days. The weekly case count in Ontario is 106 per 100,000 people per week, and has risen 38 per cent in the last week. At those respective rates of growth, Ontario will pass the American case count in about nine days, unless someone does something to stop it.
Tuesday, Ford pulled out the old grim face, saying he was concerned about the younger people getting infected and ICU capacity. It all felt very familiar, including the fact that it was already late.
“Everything’s on the table right now, so folks, be prepared,” said Ford. “I’m asking you don’t make plans for Easter. That’s what I can tell you, I won’t hesitate to to lock things down if we have to. I did it before, I’ll do it again. Nothing’s more important than our health. You know the economy, yes it’s important, but that can wait. Without people’s health, we don’t have an economy.”
Sometimes Ford says things that are admirably true, like needing public health to have a healthy economy, which is the most important and misunderstood point of this pandemic. Those things just doesn’t match his government’s actions. After failing to adequately prepare for a second wave, the wave built all the way to Christmas and beyond, because Ontario’s government decided on policies that combined degraded economic performance and an unwillingness to control the virus. We haven’t been in anything that resembles a real lockdown, but the stay-at-home order Jan. 6 bent the curve.
And then we abandoned it too soon, with tragically predictable results. Now the clock is ticking on the premier and his cabinet, a few days before Easter. It’s been two months since chief medical officer of health Dr. David Williams said Ontario would need to drop below 1,000 cases per day in order to reopen. Simpler times.
At least Ford is indicating action is possible, beyond the cardboard shoes of the province’s weakened colour-coded framework.
Schools should probably go virtual again, with all the stresses that entails; the economy will probably again need to grind to a halt. It’s all predictable as hell. It stinks.
And if the premier has to strike another compromise between here and there, the same COVID half-life will haunt this province into the spring and maybe even summer, even as the weather changes and as the vaccines arrive. We could have nailed the second wave. We could have blunted a third one. But this is Ontario, and this is how it’s done.