Pub­lic Heath of­fi­cials opt for soft soap over sci­ence

Vancouver Sun - - PAN­DEMIC - JOHN IVISON Com­ment Na­tional Post jivi­son@post­

Nor­mal­ity will not come back as be­fore un­til a COVID vac­cine has been de­vel­oped, the prime min­is­ter has ad­mit­ted.

With no cure on the im­me­di­ate hori­zon, the news was as bleak as the April flur­ries that pro­vided a back­drop to Justin Trudeau’s grim up­date on Thurs­day.

Sta­tis­tics Canada re­ported that its March sur­vey in­di­cated one mil­lion jobs were lost, tak­ing the un­em­ploy­ment rate to 7.8 per cent for the month. Even this un­der­played the sever­ity of the sit­u­a­tion, given 5.47 mil­lion Cana­di­ans have ap­plied for emer­gency as­sis­tance since March 15. The April jobs re­port will not be for the faint-hearted.

The Par­lia­men­tary Bud­get Of­fi­cer added his harsh tid­ings, say­ing the fed­eral deficit is set to reach $184 bil­lion this year — 8.5 per cent of GDP — thanks, in part, to the $2,000-a-month emer­gency re­sponse ben­e­fit, which he es­ti­mated will cost $22.3 bil­lion.

These were som­bre num­bers but were at least de­liv­ered in straight-up fash­ion, with­out am­bi­gu­ity.

That was not the case with the fed­eral gov­ern­ment’s best guess on how the virus is likely to play out on the health front.

Pub­lic health mod­el­ling, like pub­lic opin­ion polling, should be used as a drunk uses a lamp­post — for sup­port, rather than il­lu­mi­na­tion.

Sci­en­tists hate mod­els, for the ob­vi­ous rea­son that they have the po­ten­tial to make them look like id­iots in hind­sight.

Ho­ra­cio Ar­ruda, Que­bec’s pub­lic health direc­tor, said mod­els pre­dict­ing the course of COVID-19 would have as much sci­en­tific ve­rac­ity as a horo­scope — the day be­fore re­leas­ing his de­part­ment’s pro­jec­tion model at the be­hest of his premier.

Theresa Tam, Canada’s chief pub­lic health of­fi­cer, clearly takes a sim­i­larly dim view of the astrol­ogy of virus pre­dic­tion.

As she re­leased her agency’s data Thurs­day, she warned the model is “im­per­fect” and “not a crys­tal ball.”

That re­luc­tance was re­flected in a re­port that was, at best, con­fus­ing, and at worst, mis­lead­ing for any­one fol­low­ing along.

The Pub­lic Health Agency was bold enough to of­fer a straight-up pre­dic­tion on how things might go in the next week — namely an in­crease in cases to around 27,215 from the cur­rent in­fec­tion rate of 18,447, and a rise in the death count to be­tween 500-700 from 401 on Wed­nes­day.

Af­ter that, things got hazy. The agency of­fered a range of even­tu­al­i­ties — sug­gest­ing a death toll of 11,000, if 2.5 per cent of the pop­u­la­tion is in­fected, or 22,000 if five per cent of Cana­di­ans be­come ill. These were cited as the best-case sce­nar­ios.

If “weak con­trols” are put in place — namely lax so­cial dis­tanc­ing and a low per­cent­age of cases and their con­tacts traced and iso­lated — the per­cent­age in­fected could rise to 50 per cent and lead to an es­ti­mated 250,000 deaths over the course of the pan­demic.

If no con­trols at all are put in place, the model sug­gested the in­fec­tion rate could reach 80 per cent and re­sult in up to 400,000 deaths.

I asked Tam where Canada is, or is likely to be, on that con­tin­uum. She was frank: “We don’t know.”

But the im­pli­ca­tion from the pre­sen­ta­tion deck was that, if we achieve the epi­demic con­trol sce­nario through iso­la­tion, travel bans and hand-wash­ing, only a rel­a­tively small num­ber of peo­ple will get sick and die. To put 11,000 deaths into con­text, in 2018, 8,511 Cana­di­ans died of in­fluenza and pneu­mo­nia.

But that is not how the sci­ence works, as Tam and her col­leagues know well. Iso­la­tion is work­ing be­cause peo­ple with­out im­mu­nity have not been ex­posed to the virus.

As Amir At­taran, pro­fes­sor in the fac­ulty of law and school of epi­demi­ol­ogy and pub­lic health at the Univer­sity of Ot­tawa, pointed out, when so­cial-dis­tanc­ing rules are re­laxed, “as one day they must be,” vi­ral trans­mis­sion will re­sume.

The slide in the Pub­lic Health Agency deck that sug­gested strong in­ter­ven­tions would keep in­fec­tions to five per cent of the pop­u­la­tion was, in At­taran’s view “garbage.”

“They would not, un­less (in­ter­ven­tions) con­tin­ued in­def­i­nitely un­til a vac­cine is avail­able, which no one ex­pects in 2020,” he said.

The al­ter­na­tive to a vac­cine is the de­vel­op­ment of herd im­mu­nity, which would kick in once be­tween 40-70 per cent of the pop­u­la­tion have been in­fected. (The re­pro­duc­tive mode of the virus at that stage would fall to the point where each per­son in­fects fewer than one other per­son, and the epi­demic dies out).

But for that to hap­pen, some­where close to half the pop­u­la­tion of this coun­try has to catch COVID-19.

Ex­trap­o­lat­ing the Pub­lic Health Agency’s own fig­ures, that would see 1.4 mil­lion peo­ple hos­pi­tal­ized, 460,000 pa­tients en­ter­ing in­ten­sive care units and nearly a quar­ter of a mil­lion Cana­di­ans dy­ing.

The pre­cise num­bers may be as ac­cu­rate as astrol­ogy but the epi­demi­ol­ogy is not pseudo-sci­ence.

Which brings us back to the prime min­is­ter’s mo­ment of un­com­mon frank­ness, when he sug­gested nor­mal ser­vice will not be re­sumed un­til we have a vac­cine.

“So­cial dis­tanc­ing and iso­la­tion buys us time be­fore reach­ing that des­ti­na­tion but it is in­ca­pable of chang­ing the des­ti­na­tion,” said At­taran.

The Pub­lic Health Agency did not tell that story, pre­fer­ring soft-soap to sci­ence and the straight goods.


From right: Deputy Prime Min­is­ter Chrys­tia Free­land, Min­is­ter of Health Patty Hajdu and Chief Pub­lic Health Of­fi­cer Dr. Theresa Tam at a COVID -19 news con­fer­ence in Ot­tawa Thurs­day. There were a lot of som­bre num­bers com­ing out of Ot­tawa on Thurs­day, John Ivison writes.

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