GRADUAL STEPS
B.C. charts course for reopening
B.C. is about to join the list of provinces that have announced plans to ease physical-distancing restrictions. As the economic toll of COVID -19 mounts, the province has been in no hurry to do so.
B.C. leaders have steered the province through one of the most effective emergency responses in Canada, but have cautiously said that restrictions may only begin to be lifted slowly in a couple of weeks. Details are expected soon.
B.C. Premier John Horgan has said he doesn’t want to give people false hope.
When restrictions are finally eased, what will that look like? And what are the risks?
Public health experts and epidemiologists warn that if extraordinary measures that have shut down schools, universities, and businesses from pubs to hair salons are lifted too soon or too liberally, there is every chance there will be a rebound of the virus.
The measures are meant to ensure hospitals are not overwhelmed by critical cases and to reduce deaths. The measures include social distancing, where people limit close contact with other people by, for example, working from home and staying two metres away from those not in their household.
In B.C., 112 people have died as of May 1. But as much as British Columbians want to get back to some semblance of normality — and the more than 130,000 who have lost jobs because of the pandemic want to get back to work — nobody wants a resurgence of the coronavirus. That would almost certainly require slamming restrictions back into place.
Daniel Coombs, a University of B.C. epidemiologist, says the percentage of people who have contracted the virus in B.C. is probably low, which means the population continues to be susceptible to the coronavirus.
If you think about it as if it were a wildfire, he says, that means there is still a lot of timber left for fuel.
“That is why we have to be, in my opinion, very, very cautious, gradually opening back up,” said Coombs.
There are lessons to be learned from around the world.
South Korea, Taiwan, Singapore and Hong Kong are among the jurisdictions that used aggressive testing and contact tracing to identify and isolate people infected with the virus who enter hospitals and their contacts, who are quarantined for at least 14 days.
Some of these countries have used technology to track and trace people and their contacts, including a voluntary cellphone app in Singapore and the use of credit card information and cellphone location-tracking data in South Korea. Laws were changed in South Korea after the MERS outbreak — a high mortality respiratory illness that hit the country in 2015 — to allow some invasion of privacy during a national health emergency.
Whether technological measures that invade privacy will be palatable in western liberal democracies remains to be seen.
Notwithstanding some privacy concerns, Norway has launched a voluntary virus-tracking application.
South Korea’s approach, which has been praised globally for its effectiveness, has resulted in less restrictive distancing measures there. Bars and restaurants have remained open.
South Korea has among the world’s lowest COVID-19 mortality rates per million people, at less than five.
As of April 30, Canada’s stands at 84, the U.S. at 187 and Italy at 463. British Columbia is at 21.
B.C. is stepping up its capacity for contact tracing, which it will need to put to good use if the province wants to lift some restrictions, B.C.’S provincial health officer, Dr. Bonnie Henry, has said.
Dr. Dale Fisher, an infectious disease expert at National University Hospital in Singapore, says no one should be patting themselves on the back because virus transmissions have dropped under a lockdown. That’s what is supposed to happen when human interactions are reduced.
The key, when lifting restrictions, is to make sure one has a robust system for testing, tracing contacts and, in particular, isolating infected people and their contacts, says Fisher, who chairs the Global Outbreak Alert and Response Network hosted by the World Health Organization.
“You attack the virus, instead of the whole population,” said Fisher, who participates in a weekly call with other global infectious disease leaders to discuss strategy with the WHO general director, Dr. Tedros Adhanom Ghebreyesus.
‘IT’S GOING TO BE A NEW NORMAL’
Business and labour leaders and experts Postmedia spoke with said that schools, at minimum at the elementary level, would need to be reopened if parents are to return to work. B.C.’S premier said this week not to expect a regular return to classes until September.
Transit, which has reduced service in Metro Vancouver and faces impending layoffs of 1,500 because of a huge drop in ridership, will also need to be rebooted.
The president of the B.C. Federation of Labour, Laird Cronk, noted that thousands of workers use transit to get to their jobs.
And until it’s safe for children to be in school, he said, reopening the economy is going to difficult.
“In the absence of child care, workers are going to be at home looking after the children,” said Cronk, who is a member of the B.C. government-appointed economic recovery task force.
Any reopening of the economy is likely to mean less travel, more digital meetings, some people continuing to work from home and possibly staggered shifts.
The CEO of the Surrey Board of Trade, Anita Huberman, says reopening the economy requires a science-based approach until a vaccine is found.
Experts have said that will take 18 months at minimum, if a vaccine can even be created, and some type of restrictions could be in place for up to two years.
When restrictions are lifted, businesses will face a slew of decisions, including how to deal with elevators, said Huberman.
Guidance — perhaps a template — from government would be helpful, said Huberman, who is also on the province’s economic recovery task force.
The B.C. provincial health officer has already provided guidance for grocery stores and industrial work camps.
“It’s not going to be normal,” said Huberman.
“It’s going to be a new normal. And there’s going to have to be a risk management type of approach.”
In B.C., as in other jurisdictions, businesses deemed essential have remained open, including grocery stores, pharmacies and hardware stores.
While manufacturers such as sawmills, for example, have also remained open, many have curtailed production. Large projects such as the $40-billion Canada LNG project have scaled back, reducing workers by 65 per cent.
Hardest hit has been the service sector — restaurants, which can supply only delivery or takeout food, and pubs, which have been closed unless they have a liquor licence that allows deliveries. Also closed are hair salons, barbers, workout gyms and physiotherapists.
Horgan said a plan for a slow, methodical reopening approach will be announced next week. Ontario, Quebec, Saskatchewan and Manitoba have already unveiled details of phased reopenings.
In Manitoba, the first businesses to open, on May 4, include hair salons and restaurant patios.
Restaurant dine-in services will open in that province’s second phase.
The Donnelly Group shut down its chain of pubs in mid-march, including 14 in Vancouver. The shutdown put nearly 600 people out of work, both here and in Toronto, where Donnelly owns bars. A handful of those workers have been hired back as the Donnelly Group, like other pubs and restaurants, has started a delivery service for food and liquor.
Donnelly’s vice-president of brand, Harrison Stoker, said it’s difficult to peer into the future when you are a business that is so deeply affected by COVID-19.
“There’s a balancing act we need to execute and that is trying to ensure we bring as many businesses back as possible, as well as bringing as many employees back,” said Stoker.
He said the company expects to be deeply involved with talking to health officials on what a reopening transition looks like. Stoker noted that challenges include what happens in kitchens because of the close quarters.
The B.C. Restaurant and Foodservices Association has said a reopening strategy could include less seating, more space between tables, reduced menu choices and an emphasis on patios and outdoor eating areas.
The worst thing is to open it, and then it backfires. It will be much harder to get society to follow isolation once we reopen.
TAKING STOCK OF HOW BUSINESS IS DONE
B.C.’S technology sector has not been hit as hard, but a survey by the B.C. Tech Association still found revenues are down for 80 per cent of its companies. Half have seen a 30 per cent drop in revenues and 50 per cent have implemented a hiring freeze.
Burnaby-based Traction on Demand, one of North America’s largest sales force consulting and application development firms, has been able to hold on to its 920 employees.
Similar to moves made by other tech companies, Traction on Demand implemented a voluntary wage-reduction program and has pivoted to providing applications in the health sector to offset a loss of business in hospitality and retail.
Among its health sector projects is a supply and service online hub for the COVID-19 response created for the B.C. government and a joint project with another B.c.based tech firm, Thrive, to develop an application to enable hospitals and health-care authorities to track and distribute medical staff and resources to better respond to the pandemic.
Traction on Demand’s founder and CEO, Greg Malpass, says he isn’t worried about the profitability of these new projects right now, counting on the longer term opportunity to diversify and grow business. He also wants to do the right thing by helping where possible during the pandemic.
“Over all the years, in terms of building this company, it’s always been: If we take care of our people, they take care of our customers, then our profits will always work out,” he said.
Malpass, who like all of his employees is working from home, said as a result of its work in B.C. on creating applications to manage resources and medical staff, the state of California asked his company to set up something similar for all its COVID-19 testing.
Malpass said the pandemic may be the right time to take stock of how business is done.
A simple example is the discovery that working from home appears to be more productive, he said. What that means is a bit unclear, acknowledged Malpass, as people may not want to work from home all the time. Perhaps that means the office can be smaller and become more of a gathering place, he said.
But the things that concern Malpass as B.C. examines how to reopen the economy are issues beyond his own business, including ensuring that all students get access to online learning, as well as social distancing ’s effect on mental health.
“The psychological war that people have gone through — all those effects will be there,” he said.
CAUTIONARY TALES
Cronk, the Federation of Labour president, says that the pandemic offers society an unprecedented chance to examine what kind of economy it wants and the values that drive that economy, particularly how workers are treated.
For example, the importance of workers in grocery stores and in long-term care homes has become clear and some of them are being paid higher wages because of the pandemic, he said.
“I don’t want to see rollbacks of the respect that we are now seeing for workers who are largely undervalued and they weren’t even, in some respect, noticed,” said Cronk.
Andrey Pavlov, a professor in Simon Fraser University’s Beedie School of Business, said society needs to keep the longer-term perspective in mind when considering how to reopen the economy.
That means that B.C., he said, needs to position itself to take advantage of the eventual rebound in the economy.
The hard reality is that some businesses are not going to survive. A recent survey commissioned by B.C. business groups, including the Greater Vancouver Board of Trade, found 38 per cent of businesses that are temporarily closed because of the pandemic doubt they will be able to reopen. Another eight per cent have closed for good among the 1,938 surveyed March 26 to April 1.
There may be opportunities for businesses, perhaps in the technology field, to help people or companies better work remotely and to increase children’s or students’ ability to learn or play while practising social distancing, said Pavlov.
He noted, as an example, madein-b.c. arts company 4cats.com, which pairs art supply kits for children with online classes.
“As a society and government, we need to empower those people, make it real easy for them to start new businesses, reduce red tape and regulation, so we are right at the forefront of those new industries that are going to occur,” he said.
Pavlov, like others, agrees that as restrictions are lifted and the economy is opened up, caution is needed. “We can’t open too early, I think everybody understands that. The worst thing is to open it, and then it backfires,” he said. “It will be much harder to get society to follow isolation once we reopen.”
The experiences of other countries and jurisdictions as they lift restrictions include cautionary tales. Singapore, which initially had a handle on the epidemic, had a huge surge in cases in the first half of April in dormitories that house tens of thousands of migrant workers. Its use of testing, contract tracing and isolation had allowed businesses to remain open.
But when its cases started doubling — now at more than 16,000, most of those in the worker dormitories — the government closed schools and required its citizens to wear masks. It also quarantined the dormitories.
By the third week of April, Singapore Prime Minister Lee Hsien Loong implored everyone in the country to download the contact-tracing app.
“It’s obvious you cannot control this disease without some sort of social restriction … which are the dials you can crank up to be quite severe and you can ease off if everything is working,” said Fisher, the infectious disease expert at National University Hospital in Singapore.
Coombs, the UBC epidemiologist, and his colleagues at UBC, Simon Fraser University and the B.C. Centre for Disease Control, have produced a study, not yet peer reviewed, that examines the effectiveness of social distancing.
Their modelling estimated that physical distancing measures in place now remove nearly 80 per cent of potentially infectious contacts compared to life without restrictions. The study estimated that the critical percentage to prevent resurgence in cases is a continued 45 per cent reduction in contacts.
Coombs said it indicates that there is a safety margin between the current level of restrictions and the critical level needed.
“It also tells us that if things get bad again, then we can go back to how we are now,” he said.