Front Burner - Lessons learned, forgotten from the 1st wave

Episode Date: November 17, 2020

The second wave of the coronavirus is battering much of the country right now. Over the weekend, Alberta, Saskatchewan, Manitoba, Ontario and Quebec all had record-breaking new case numbers. As some familiar issues re-emerge, like deadly outbreaks at long-term care homes, we're talking to Globe and Mail health columnist Andre Picard about what Canadians learned from the first wave, and what lessons we've missed.

In the Dragon's Den, a simple pitch can lead to a life-changing connection. Watch new episodes of Dragon's Den free on CBC Gem. Brought to you in part by National Angel Capital Organization, empowering Canada's entrepreneurs through angel investment and industry connections. This is a CBC Podcast. Hello, I'm Jamie Poisson. The number of Albertans hospitalized with COVID-19 has hit a record high. Already in Saskatoon, officials say intensive care units are filled beyond capacity. Ontario sees its 10th straight day where daily case counts have reached four figures. So the coronavirus second wave is battering much of the country right now.

And there are aspects of it that remind me of the first wave, like that feeling that every day is bringing some grim new number. We can't sustain this number of cases in our health care system. We need to bring these numbers down and we need to work on that starting right now. And the slew of headlines about deadly outbreaks in long-term care homes that take me back to the darkest days of the spring all over again. In Ontario, where almost 1,800 residents died as of June 12th, some privately owned homes were especially hard hit.

Allegations of neglect and abuse by staff. Residents bed-bound for several weeks. I find myself asking, didn't we learn anything the first time around? Today, I'm putting that question to Globe and Mail columnist Andre Picard. He joins me to talk about the lessons that stuck and the ones that haven't. This is FrontBurner. Hi, Andre. Thank you so much for making the time to talk with me today. Yes, thank you.

So before we get rolling, the second wave has really been creeping up for some time now. Cases have been ticking up for months, but it feels like we're really in the thick of it now. Over the weekend, Ontario, Quebec, Manitoba, Saskatchewan, Alberta, all broke records for new cases. And can you give me a sense of where things are right now with regards to the pandemic across the country? Well, things are bad everywhere. So in the first wave, it was really concentrated Ontario and Quebec, and most of the rest of the country got off pretty lightly. This time, it's everywhere except in the Atlantic bubble. So actually the worst hit province right now is Manitoba. We're seeing double digits of death rates, hundreds of cases each day. We can't go on in this manner.

Followed by Alberta and BC is catching up so it's really hitting the west hard. This virus is in our communities and can spread very easily. We need to say no to social gatherings right now. I know this next while will be challenging but as we have seen with recent numbers and we'll see with today's it is critical that we all continue to do our part. I think the message we're getting is there's no escaping this virus if we are complacent. And is it fair for me to say that cases are way up? Like in April, we were seeing nearly 2,000 cases a day at its peak. But then just a few days ago on November 9th, the country saw more than 6,500 cases. Oh, yeah. Cases are up two, three times all over.

You know, Ontario and Quebec have been bad all along. They had a little dip, so they haven't seen these huge resurgences, but they also haven't seen their cases drop very much. So that's almost as alarming to not be able to get any control than to see these new surges in areas that weren't hit before. Okay, and I'm hoping we can get into that today, because I do want to talk to you about the lessons that we've learned since the virus hit here in Canada, or I guess the lessons that unfortunately it seems that we haven't.

And one of the big things, if we could start here, that has stood out to me over the last week or so is the latest horrifying headlines coming out of long-term care homes. The candlelight vigil flickers as an ambulance backs into Maple's care home in Winnipeg. Infections among workers have now left the home gravely understaffed, leaving residents inside dehydrated and dying. Things had started to escalate. Patients had started to deteriorate rapidly. There are 107 long-term care homes with outbreaks in Ontario alone right now. And it all just feels like the darkest parts of the spring all over again. And what mistakes are being repeated here? Yeah, so the numbers are really

troubling and it's really sad. I've just spent months writing a book about this, about what's wrong with long-term care. And I think the essential problem, the reason this is happening all over again, is nothing has fundamentally changed. So we know why we had this horror back in the spring. It's because of inadequate staffing, poor infrastructure, putting three, four people to a room. All these things are just a recipe for disaster.

Get them out. Don't leave them in there. Why do you say that? Shortage of staff, neglect, abuse. It's sad and difficult and terrifying to be in a position where all you can do is yell and scream and hope that somebody does something to correct it. And what's changed in the interim? Really nothing. We got a little bit of control of the virus in the community, so it didn't go into homes for a while. But once it's in the community, there's no escaping it in homes. These are the most vulnerable people in society. So sadly, I don't think this

should surprise us in any way, because if you don't, you know, there's a famous Einstein quote, right? If you do the same thing over and over again and expect different results, that's the definition of insanity. And that's exactly what we're doing in long-term care. Nothing has fundamentally changed. Why is it, Andre, that you think nothing has fundamentally changed? I feel so, like, incredulous about this because, you know, we know that 80% of deaths are in these long-term care homes. We have spent an unprecedented amount of money to try and fix or try and stem this pandemic. And yet we haven't made any progress on long-term care homes. It just, it defies logic to me. Well, it defies logic, but you have to remember the history. The history is these problems have existed for decades and they've never been dealt with and they're not going to be dealt with quickly.

If we want to change the system, a broken system that's been around for decades, we need money. The premier and his minister speaker cannot claim to be surprised by a crisis that they had a hand in creating. We've been talking about this for years and nobody's done a thing. We need tens of thousands of workers.

They're chronically understaffed. So we have lots of promises. Quebec has promised to hire 10,000 more workers in its public care homes, but it takes time to train them. These are not appealing jobs in any way. Even, you know, we've promised raises to people, but they're still not appealing jobs. It's really, really hard work, backbreaking work for very little pay. So that's not going to be solved overnight. Then there's the infrastructure problem. The infection control nightmare of three and four

person rooms. Dr. Stahl says move residents even into empty hotels or climate controlled tents. Where a number of the big explosive and deadly outbreaks have happened, they've occurred in these older homes that continue to have occupancy in three or four person rooms. We could solve that overnight. We could ban them, no more three people to a room, but we would lose thousands of places. Where would these people go? So what's happening is our history is catching up with us. 30, 40 years of neglecting this whole sector is now we've created the ideal, the perfect storm for a virus to hit and kill people. And that's, again, what's happening. So sadly, it's not going to be fixed quickly. There's no easy solution to this except

to change our philosophy long term to fix this sector really from the ground up. You know, another issue I'm seeing flagged over and over has to do with clear public health messaging from our officials. And how are you seeing leaders grapple with clear public health communication in this wave of rising cases? Yeah, I think the messaging has become more difficult. So I don't envy our public health officials. People are tired. The fatigue is setting in. In the spring, there was really this, you know, this solidarity.

We're going to listen to them and we're going to do what we're told. And it was a pretty simple message, stay home. Now we're trying to find more subtlety, more balance. We want the economy to be operating where it can. We want more regional lockdowns. So the message is infinitely more difficult to convey. Add on to that, that, you know, back in the spring, I think our politicians, most of them had the good sense to just step back and say, let's let public health run the show. So the message was clear, was coming from one voice,

or at least one voice in each province. And now the politicians have gotten their sticky little fingers in there. They really want to take control. And you literally get, you know, especially in places like Ontario, which has stood out for bad messaging. With Thanksgiving coming up, are you asking residents in Toronto, Peel or Ottawa not to visit family in outlying areas like Waterloo Region or Guelph and vice versa? Well, I'll pass this to the Minister of Health, but we've got to keep in mind people's mental health as well.

Do you know how many people live by themselves or maybe live with a roommate or something? You literally get people at the same press conference contradicting each other. Well, we are asking people to keep their social gatherings as small as possible as to immediate family. But as the Premier said, there are a number of people who do live alone. So you have to use precautions. We're seeing household.

We didn't get down to any tight definition. Right, right. I wonder if we could talk about Alberta as an example as well, which cracked 1,000 new cases in a day over the weekend. Some hospitals are now operating at overcapacity. And Premier Jason Kenney has been emphasizing the importance of personal responsibility. We are putting our faith in the good judgment of Albertans. No one wants to have a government tell us how many people we can have in our homes. But the alternative to voluntary action by Albertans is mandatory restrictions,

like in most other places, backed by fines. He recently implemented two-week restrictions in Calgary and Edmonton that will close bars earlier in the evening. There are limits on weddings and funerals to 50 attendees. But many other restrictions are voluntary. For example, the province is asking people to stop holding social gatherings at home. And so what kind of messaging do you think that this is sending to Albertans? Yeah, so I think first of all, it's important to say, yes, people should be doing the right thing. But the problem with Alberta's messaging is it's like, well, we just want you to do what's right.

But you have to tell people what's right. This is an unprecedented pandemic. People don't know exactly what they can do to help. So the problem I have with Mr. Kenny is I think what he's doing is a cop-out. He's just saying, oh, you know, be responsible, but you have to, if you're a leader, you have to tell them what responsibility is, and you have to model it. If people have clear messages, they will be responsible. The problem right now is that we have very mixed and confusing messages at a time where people in Canada have said, we are willing to do what is necessary. We are going to prioritize life, but you need to help us know what to do. And that is the help that they're not receiving right now. Right. And I think I see a lot of people talking about this on Twitter, you know,

friends and family have sent me lots of messages about this. You know, this idea that, you know, you can go to a wedding with 50 people outside of the home except for essential reasons, like going to work, school, getting groceries, or medical appointments. But this also seems so confusing to me that you tell people they can only do essential things, but lots of businesses that are open right now, they're not necessarily essential, right? Like retail shops. Estelle Wigg knows Toronto Public Health says she's really only supposed to go out for emergencies.

But then again, the stores are open. I did just return something in the mall, thinking that I want to make sure that it's done before I'm not able to. Yeah, so there's an example. What does essential mean? We have to make that clear for people because we're just trying to have it both ways. We're trying to have as many things open as possible and hope that people follow the rules, wishful thinking that maybe it won't spread even if we do have weddings because people will be unhappy or not vote for me if their wedding's cancelled. But I think the politicians have to come to grips with this, that you can't have it both ways. You have to have clear rules

and you're going to upset some people, and that goes with the territory. Why do you think eight months on, we're having so much trouble with this mixed messaging? And I think you alluded to some of this earlier. Yeah, I think it's this, who's in charge? Do we want this run by public health? Do we want it run by politicians who care predominantly about the economy? We have to make these decisions up front. You have to have a philosophy. I have much more time for politicians who are really open about what they want to do, even if I don't agree with it. You know, Quebec, for example, Quebec has been really clear saying our priority is keeping children in school.

Now, whether you agree with that or not doesn't matter. They're clear. This is the priority. Everything else is secondary. That's that's how you have to be. You have to pick your battles because this is a you know, this pandemic is there's no right or wrong way to do things overall. You have to make choices and they're very, very difficult choices, but make them clear and explain to the public why you're making that choice. In the Dragon's Den, a simple pitch can lead to a life-changing connection. Watch new episodes of Dragon's Den free on CBC Gem.

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50% of them do not know their own household income? That's not a typo, 50%. That's because money is confusing. In my new book and podcast, Money for Couples, I help you and your partner create a financial vision together. To listen to this podcast, just search for Money for Couples. All right, so we've gone through some examples of issues that we still haven't sorted out. But in the second wave, it does also feel like we have figured some things out. And I want to talk with you about that today as well.

You know, I have been relieved, of course, to not see runs on toilet paper in the last few months. But what do you see as examples of lessons that we generally have learned by now? Well, I think we've learned to live fairly well with it. You know, when all is said and done, life is going on. And that's remarkable in itself, I think, when all is said and done, life is going on. And that's remarkable in itself, I think that, yeah, we do have toilet paper, our stores are open, you know, I can't think of things that are in a shortage. So we've got that part down, the society's still going on. We've adopted masks to an amazing degree in most of the country. That was, I think,

unthinkable in March. Nobody would have imagined that, oh, we just walk out of the house, put on our mask, that's that. It's become this normality. I think schools is actually quite a success story. There's a lot of cases in schools, but overall, I think there's been much less harm than we expected. So we've figured that out to a certain degree. We've done a remarkable job of delivering medical care. We are delivering health digitally to 90% of patients now. You know, we probably made 10 years of progress in 10 weeks when it comes to digital health. So we have done some remarkable things. Picking up on the healthcare and healthcare systems, I want to talk to you a little bit more about that. It strikes me that even though we're seeing so many new cases of the coronavirus in so

many parts of the country, the death rate has slowed quite considerably. And why is that? What have we learned there? Well, I think there's a couple of reasons. One is we're better at treating the coronavirus. So we've learned a lot medically on how to treat people, when to treat them, what, you know, new treatments that have come along. Some have been overhyped, but we found stuff that works. So that's the medical side is really a success story. And the other part of it, a big part of it is the demographics. So the people who are getting infected now tend to be younger,

healthier, they don't have as many chronic illnesses. So, you know, we know that in the first wave, a lot of frail elders were really affected, especially in congregate care. They all have other chronic illnesses. So they were really, really a high-risk population, and a lot of them died. An obscene number of people died who were infected. And now we have different people who are going to get better, but we have this whole overhangingness. We have this notion of long COVID. We know that some people seem to just not get better for seven, eight months now, and we don't know if it'll last for years. So there are some concerns. So I think we have to be careful.

Mortality is an important measure, but it's not the only measure we have to pay attention to. Great. Those concerns seem incredibly valid. Aside for a moment, the fact that the death rate has slowed so considerably, might that be a reason to be less concerned about these climbing cases in the second wave? Well, I guess if we only care about death, and I think that, again, that would be a mistake. It really rankles me when I hear people say, well, if we only care about death, and I think that, again, that would be a mistake. You know, it really rankles me when I hear people say, well, it's only old people dying. It doesn't matter. They're going to die anyhow.

I hope we're not at that point in society where we just accept that, that older people are disposable, because that's what we're saying. Yes, they were going to die eventually, but that doesn't mean that they should suffer and die in this way. It's a horrible way to die, COVID. You know, you almost drowned lying in a bed. It's a nasty, nasty illness. So I think this obsession with just looking at mortality and saying, ah, not many people are dying, let's get back to work. I think that's very naive. It doesn't feel like we're alone here, obviously.

In the second wave, the U.S. is, of course, really struggling. It is just stunning. The summer surge was horrific, right? That was 77,000 new infections a day at its peak. 184,000 plus on Friday. The death trend starting to trickle up as well. As are many countries in Europe. If you could compare us, relatively speaking, you know, how is think we're kind of middle of the pack. So there are, you know, there are, of course, places we can always take comfort from looking, you know, we look at the US and we always take comfort. Oh, our health care is better than ours, our COVID rates are a fraction of theirs. So that's easy, right? But they don't really have

any public health measures. They don't have a public health system. They're obsessively individualistic. I talk about, you know, freedom at all costs. So I don't think they're a good comparator. When we compare ourselves to Europe, I think we're doing relatively well. But again, their epidemic started earlier. It was more severe. So the virus is just more seeded. It's more integrated into the society. So I think what we should take from that is not, hey, we're doing better. It's that, hey, we can't allow ourselves to go in that direction because it'll just get much worse. So when I look at the numbers every day, I'm like, well, we have 5,000 cases today. I hope it's not 10,000 next week because

I see what happened in France and Spain and just how quickly things can go out of control. The powerhouses of Europe, the economic powerhouses, France, Germany, the UK, Italy, all going into different levels of lockdown. Hospital in Naples, where the ICU is so full, patients are being treated with oxygen in their cars. Right. Do you think that we could easily reach 10,000? and their cars. Great. Do you think that we could easily reach 10,000? I think sadly, yes, it could happen in the blink of an eye if we just lay off and, you know, just give up. And I saw that, you know, I remember in France looking one day and they had 500 cases. They were pretty well under control. Canada had, you know, we were down to about 200 at that point. Three weeks later, France had 10,000 cases and Canada had 1,000. So we didn't quite go as fast, but we had the same problem.

We just sort of were complacent and you just do that for a little bit and the virus takes advantage. Are there examples of places in the world that have taken the lessons of the first wave and applied them with success or with more success than you think Canada has applied them? Well, I think there's definitely countries that have controlled it better, whether they learned from the first wave or they learned from looking at other countries, I'm not sure. But these days, we're talking a lot about Australia. Australia is a country very similar to Canada. And they've really, you know, in some

states like Victoria State, a large state where Melbourne is the capital, they've really got zero COVID. Melbourne, the city that was the epicentre of Australia's coronavirus outbreak, will move out of lockdown this week after recording no new cases for the first time since June. The ninth day in a row, New South Wales has recorded no new cases of locally acquired COVID-19 in the 24 hours to eight o'clock last night. So we're now having this discussion, can we have zero COVID in Canada or like Australia? So maybe, you know, if we learned lessons from them, there are places like Taiwan, China, you know, China is a massive country with no coronavirus anymore. It started there. So it's doable. But

you have to figure out, is it doable in our in a democracy? Is it doable in our geography? Is it doable in our political system, being a neighbor to the US? There's all kinds of caveats. Yes, we can learn from others, but I don't know if we can copy them exactly. I just want to pick up on this idea of a zero COVID strategy, which is something several experts and infectious disease experts and epidemiologists have been touting the last couple of days. You know, if we were going to try to implement that strategy here, you know, what do you think we would have to give up in order to do it? Well, I think the answer to that is what did Australia do? So Australia did 100 days of lockdown, and it was a real lockdown. It wasn't a Canadian-style

half lockdown. Sweeping new restrictions, including a nightly curfew from 8pm to 5am. Residents are allowed one hour of daily exercise, but that's within five kilometres of their homes. Also, grocery shopping is to be done by one person per household. It was no school, no church, no nothing. It was stay at home 23 hours a day minimum for everyone. So it's doable. But the question is, is it doable politically? So in Canada, it becomes a question

of maybe one jurisdiction can do it. You know, we've done it in the Atlantic pretty well with not that severe of restrictions. By the Atlantic bubble, a collective effort by Nova Scotia, New Brunswick, Prince Edward Island and Newfoundland and Labrador to monitor and restrict travel in and out of the region. But can we do it in Ontario and Quebec? Would people tolerate that? Politically, will it be palatable? And I'm not sure about that part. So zero COVID, I think fabulous idea on paper.

I don't know about in the real world if it's doable. All right. Andre Picard, thank you so much for this conversation. I really appreciate it. I hope we'll be talking again soon and there will be more positive news on the horizon. Great. Thanks, Jamie. All right, so some more COVID news before we go today. Starting tomorrow, Nunavut is entering a mandatory territory-wide partial shutdown.

All non-essential businesses and services will be required to close for two weeks. Nunavut has gone much of the pandemic with zero coronavirus cases. The first confirmed case only came in early November. As of Monday afternoon, the territory's total was 26. That's all for today. I'm Jamie Poisson. Thanks so much for listening to FrontBurner, and we'll talk to you tomorrow. For more CBC Podcasts, go to cbc.ca slash podcasts.