The Bridge with Peter Mansbridge - Are We Still In A Pandemic, Or Are We Using An Overabundance of Caution?

Episode Date: February 7, 2022

A lot of reasonable people are getting frustrated and are beginning to ask "Are we still in a pandemic?"  So that is among the big picture questions on our regular Monday edition of The Bridge this week with Dr. Isaac Bogoch of the University Health Network in Toronto.

And hello there, Peter Mansbridge here. You are just moments away from the latest episode of The Bridge. Here's a reasonable question, or is it reasonable? Is the pandemic over? We're about to And hello there, Peter Mansbridge in Stratford, Ontario, with this week's opening edition of The Bridge. With that question, that gnawing question that we've all been asking for the last couple of years, when will it be over? To the point now where here we are two years later saying actually is the pandemic over i don't know about you but when i'm not talking about trucking protests and the kind of things we've witnessed going on not just in ottawa but in pretty well every

capital city in the country over these last few days. When I'm talking about that stuff, I'm asking that question because I think a lot of reasonable people are asking that question. You know, we've all done our thing on vaccines, around 90% on first vaccines. We're in the 80s on first and second vaccines, dragging a little bit behind on boosters.

But we've done our part there. We've socially distanced. We wear masks. We do all that stuff, the vast majority of us. And we're saying, okay, we've done what you've asked us to do, and you're telling us that if we do all those things, we probably shouldn't end up in hospital, and certainly we shouldn't end up losing our lives. So at what point is it over? Are the restrictions that are put in place these days,

are they an abundance of caution or an overabundance of caution? These are big picture questions and, you know, we turn at times like this to the people we trust and value in terms of their answers. And that's certainly what we do on Mondays here at The Bridge. As you know, we've made sure that Mondays have been pretty well isolated to talking to the experts and getting their thoughts. Epidemiologists from different parts of the country. Today is no exception. We're going to talk big picture with Dr. Isaac Bogoch, University Health Network Toronto,

on the science tables, dealing with advice and suggestions for public officials and government officials. Dr. Bogoch has been great with us over these last couple of years, as he has been with many different media organizations that value our time talking with him. And today is very specific in terms of these kind of big picture questions. So let's get at it. He's, in fact, should know that as well as spending these last couple of years with almost absolutely no time off, just as many of his fellow colleagues have done.

He's also kept his commitment that is long-standing to work overseas from time to time, a couple of times a year. And he's just got back from Sierra Leone, where he was for the last week or 10 days. But he's up to speed. He's got the big picture. And he's going to share it with us right now.

Here we go. Okay, I want to start big picture and stay with me here. I'm not trying to be cute. But are we still in a pandemic? Yes, very much so. We're in a pandemic yes very much so we're in a pandemic for a couple of reasons one is by definition a pandemic is global and even though arrows are pointing in the right direction in canada you can't forget the rest of the world you cannot treat this as a regional issue you have to treat this as a global issue. You have to treat this as a global issue.

Like how many times do we have to rinse, wash and repeat? We had you know, we were doing OK in Canada a year and change ago. And then we're coming off of our second wave. And then the alpha variant came out of the UK and just pummeled us in the third wave. Then, you know, there was a bit of a lull globally and delta emerged from from uh india and that was a very very uh challenging wave in many parts of the world then we're coming off of a delta wave omicron emerges from southern africa like you see a trend here so you know you can't just assume that this is the last wave and that all is well after this because there's going to be more variants and there are going to be more waves yes of course canada is way better prepared than most to deal with this given our high vaccine rates and and our health coverage but

no this is this isn't over this will peter out slowly or can peter out a little more quickly if we start to really get vaccines in arms in parts of the world that don't have the same degree of uptake. That will speed things up tremendously. If we don't do that, it'll still peter out. It'll just take a bit more time. Well, as I said, I wasn't trying to be cute there. I mean, it just seems to me that more and more officials in Canada as well seem to be trying desperately not to use that P word. As if we are, you know, past the worst of it. And we're, you know, we're going to move from a pandemic to an endemic, which somehow sounds worse for some reason the choice of that

but um but they they seem desperately trying to move away from the pandemic word yeah i mean i think there's how you communicate to the public uh and then what's actually happening on planet earth and sometimes those venn diagrams don't overlap. In all fairness, like you can't ignore that we are doing much better week after week in recent weeks. Like we are. I mean, this was a pretty significant wave in Canada. We had lots of hospitalizations, sadly, lots of deaths, you know, and this was a challenging wave by by any metric. And also by any metric, this wave is getting better. Cases are dropping. Hospitalizations are going down.

ICU stays are going down. All the models of the community burden of COVID are going down. Great. Great. Like, there's no other way to slice it. That's fantastic news. The issue, of course, is that, you know, there will be more waves. There absolutely will be. I don't know when they're going to be.

I don't know with what variant they're going to be, but there will be more waves. And, you know, I think we have to start thinking about what the long game looks like. You know, how do you bolster your hospital capacity so that you don't have to start canceling surgeries because you need all hands on deck you know how do you ensure that the community burden can be lessened by also not um you know having significant economic ramifications by shutting down businesses because you've got you know your hospitals that are shut down so you know obviously you have to start thinking about what what the long game looks like here it's not over but we are certainly in a much better place now than we were in the past. Well, you know, all this is happening at the same time as more and more people,

and I'm talking about, you know, reasonable people, not the, you know, not the wackos, but reasonable people are getting more and more frustrated and want to have this behind them. And this is happening at the same time as restrictions are starting to come down in different parts of the country, some faster than others, but they're all starting to come down. And it leads me to this question about where the line is between an abundance of caution and an overabundance of caution. Is there a line and are we anywhere near it? Yeah, I mean, I think that's a very arbitrary line. For starters, I don't think you'll find anyone in Canada who would wake up in the morning and say,

you know what? I love putting on my mask or, you know what? I can't wait to scan my QR code to get into this business. Like nobody likes this and nobody wants this. And depending on which officials you're listening to, most people have very clearly telegraphed that they don't intend to keep these longer than they have to. Great. Like fantastic. There will be aed that they don't intend to keep these longer than they have to. Great. Like, fantastic. There will be a time where we don't have to live with many of these public health measures. And that's that'll be very welcome, obviously, to most people, myself included. The real issue here is when is the right time? And you got to obviously be careful in declaring premature victory. We've seen this happen time and time again by different provinces, different states, different countries, only to reinstate additional public health measures. I think it's important to communicate uncertainty while also recognizing things are getting better right now.

But, you know, like anything else in the COVID era, it's very challenging to make predictions that are, you know, four, five, six weeks beyond in the future. It's hard to know. Like, it's really hard to know. It's pretty clear, though, that things are getting better now and that's wonderful and we should celebrate them. And of course, the policy has to match the threat on the ground. You can't have over burdensome policy that's overly restrictive if the threat of the ground is not that dire. So I think it's very reasonable to start either lifting some measures or telegraphing that measures are going to be lifted in the very near future. And, you know, you don't think of it like a dichotomous, there's restrictions or they're not. Maybe we can think of it more like a dimmer

switch. And, you know, but that takes very skilled communication to get public buy-in if you have to you know ask people to put masks back on again because there's out of control covid19 transmission like you know obviously we all want this to be behind us and um you know maybe the worst is behind us barring any unforeseen variant from popping up. But it's I think obviously the next few months are going to be turbulent because some people want to move at a faster pace. And there's I think there's still a lot of people that are very uncomfortable in moving forward by lifting up some public health measures. And we're certainly hearing very vocal voices on many sides of the spectrum saying too slow and others saying too fast. And I think it'll be very tricky to walk that tightrope to really get it right.

Who's doing things right right now? When you, I mean, when you look around the world, you're in close contact with, you know, a lot of your colleagues from different parts of the world. You read a lot, you travel a lot. You've just been on the other side of the world in the last week who's doing things right out there right now i honestly don't know the answer i truly don't know one of my colleagues had a good line um we can really judge this when it when it's in the rearview mirror uh you know policies like that look brilliant now

might ultimately be foolish policies that we sort of scoffed at aren't might not be so so bad uh i think that uh we've got to give this time and a lot you know contrary to popular belief i think we're still figuring a lot of this out as we go but that's also not entirely accurate because we do know a lot especially two years in um but i think i'm very hesitant with that you know you say look in country x and then country x falls apart or we make oversimplified country to country comparisons because, you know, they've had different policies or different vaccines or vaccine uptakes or different demographics. Like it's, I think these are very hard to do. So I'm not sure who's, who's getting it right. I think it's way easier to say who's getting it wrong and who we shouldn't be

emulating. I mean, you look at some parts, not everywhere, but some parts of the United States, I think poor vaccine uptake, tremendous morbidity, tremendous mortality, like that's no good in a high income country. Some parts of the UK, not all of the UK, but some parts of the UK, same thing, like very high rates of COVID-19 high morbidity, high mortality. Like we got to avoid that if you're in a resource extravagant setting. So some places are doing better than others, but I'm not sure if anyone's

knocked it out of the park you know one of the phrases that we've become so familiar with over these two years is you know follow the science listen to the science what's the science telling us now not to get cocky and to stay humble uh the virus will change with time our policies have to align with emerging science it's pretty clear though that you know we know how to control this we do which is that these are choices of whether or not we want to do this right we know that if you've been vaccinated with two doses especially with three doses you're probably not going to get that sick you know you still might get infected but you're probably not going to die you're probably not going to get that sick. You know, you still might get infected, but you're probably not going to die. You're probably not going to end up in an ICU.

You're probably not going to end up in a hospital. It might happen, but your risks are remarkably less. Science is pretty clear. Let me rephrase that. The science is exquisitely clear that the vaccines are really, really good. And remember, this vaccine was created with the original strain, for lack of a better word, of COVID that emerged from Wuhan, China. The virus has changed so much

since then, and still, these vaccines hold up. That's a no-brainer. For anyone listening who hasn't been vaccinated, and I don't know what to say at this point, these are really, really effective vaccines. They do a great job keeping people alive. That's pretty clear. It's also pretty clear how COVID is transmitted. We have a good understanding

that, you know, your biggest risk is an indoor venue, usually in close proximity, but it doesn't have to be in close proximity with other people, usually without masks. But of course, it doesn't have to be without masks. So we have the tools to keep this in check. Now, I think there's a lot of political wrangling to figure out what measures we're going to have, what measures we're not going to have, and how are we going to sort of wriggle our way through the next couple of months as we're either rapidly or gradually lifting some of these public health measures as we're emerging from this pretty significant wave. How frustrating is it for people like you who help advise governments or at least offer them your sense of where we are in the situation?

So, you know, you're in a room or you're in a conversation or you're on a Zoom call with people who have to make the, you know, political decision, and you're a part of that group or on the kind of the science side the medical side the doctor's side how how difficult is that that conversation you know it it's not that challenging right uh i don't envy senior decision makers one bit that's the hard part is ultimately making a firm decision um and i think that's i certainly don't envy them i you can talk we can talk science we can talk public health we can talk uncertainty but at the end of the day there's a political leader be it at a federal level a provincial level or municipal level that has to say, OK, this is the plan forward.

And, you know, science and public health obviously should help inform that decision. But by no means is that the sole decisive factor. You know, there's it's I think it's an important piece, but there's still a much larger puzzle. You have to figure out what is the will of the people you're governing? What are the economic ramifications? What are the social ramifications? What is the trust and buy-in? These are all things that I'm pretty sure are going through their minds. Obviously, you want to help as many people as possible, stating the obvious. So that's tough.

I mean, my standpoint is pretty straightforward. I can talk about the science and the public health, but they're pulling the trigger. And that's, I mean, that's tough. Can you imagine people going into government just before the pandemic started? Like, no one wants to make these decisions. No one wants to say, okay, sorry, we're cutting your business to 50%. Oh, sorry, you got to close your doors. Like, no one wants to do this.

No one wants to be the bad guy here. But I can't imagine how challenging that must be. And all the pressures seem to be the ones you just listed a moment ago that are on the, you know, the decision makers in terms of what restrictions or lack of restrictions are going to be placed upon the public. All those pressure points are there right now more than they've been in the last two years. And you hear increasing talk, not just from the politicians, but also some of the medical people as well, about we have to learn to live with COVID. Now, what does that mean? What does that mean in the big picture in terms of how we're going to be living as we come out of this, either quickly or slowly over these next few months? It's so funny funny i like how you mentioned that there's certain phrases that have kind of been weaponized over the last couple of

years that's that's one of them right we have been learning to live with we've been living with covid for two years not well at some points better at other points um but i think it's an appreciation that you know number one it's not going anywhere It's going to be around for a long, long time. Number two, we have to figure out ways where this has not zero impact, but a minimal impact on our society. We can't shut things. You know, we can't just constantly open and shut society because of, because of this virus. And we've got to take steps to really be able to decrease the morbidity and mortality associated with this. And of course the economic destruction that, that this brings. But I think, you know,

the quote unquote learning to live with the virus clearly means different things to different people. There's some people where they say learning to live with a virus that that means, okay, we're done with the pandemic. We're going back to, you know, pre-COVID times, and that's the way it's going to be. To other people, it says, it means, listen, this virus isn't going anywhere. How can we create safer environments so that this virus just doesn't have any, or doesn't have as many negative impacts on our society?

So, you know, it's a bit of a loaded phrase. And that's unfortunate because quite frankly, you know, it's just a phrase we are learning to live with it. We are when we have been for two years. So the way I think about it is obviously I don't want people to die. I don't want people to get hurt from this, you know, and, and you know are there some simple light touch solutions that we can have to meaningfully create safer indoor environments where we're not impacting people's lives or livelihoods significantly um and um i don't know we'll see how that goes i think it's going to be a learning process, though. And, you know, I don't think anyone's got it figured out.

What can you, you're a young parent. What can you say about the impact this has all had on kids? lost generation because you know they've been at home or they're learning remotely or even in class it's so different than um than the way it was before or the way they thought it was going to be when they got to school what is the the the impact the long-term impact on this generation of of young people um and not just you know like the five six-year-olds but you know anywhere in that kind of 10-year gap between 5, 15, 18? Yeah I mean I think anyone between age 0 and 120 isn't coming out of this pandemic unscathed, right? We're all going to have bruises and scars from this for a long time. People have lost family members. People have lost jobs. People have been home from school.

People haven't had the appropriate socialization. People are living under a roof with others who might have exacerbations of mental health issues or substance use issues like no one's coming out of this just fine i think that's pretty clear some people might be better off than others but we're all going to be impacted by this psychologically and emotionally i think that's that's abundantly clear now know, I'm not going to pretend to be a mental health expert, nor am I going to pretend to be a child health expert. But, you know, I think it's tough. You see some of these stats where you have, you know, an increase in referrals to

eating disorder clinics for kids, you have increase referrals for child mental health issues. One interesting thing, and I'm not going to pretend to understand this, is suicides have not gone up. And this is documented by experts in suicide, which is obviously a very specialized area. Obviously, that's good news. But just because suicides haven't increased, and in fact, they might have even decreased,

that doesn't mean there aren't mental health issues that are circulating that are significant. I don't know what the long term repercussion is. Obviously, it's a tightrope. It's a tough, tough area to move forward, right? You want to have kids doing very important physical exercise and extracurricular activities and have as close to a normal childhood and upbringing as possible. On the other hand, you can't have kids amplifying this virus at schools or wherever they are and bringing it home and killing grandma and grandpa. That's also unacceptable so i think we're at a state though where we have such high rates of vaccination where vaccination is eligible for for kids where we know how to create safer indoor environments and where we're coming out of a nasty way but we are coming out of it and you know i think things are scaling up and you are starting to see hockey get back and other extracurricular activities get back. And, you know, those are very welcome positive signs. You know, obviously this isn't a normal time,

nor should we pretend that it's a normal time, but the more that we can do to ensure kids have physical activity, social and emotional connections with other kids and adults i think i think that'll go a long long way i appreciate you taking that one let me close with just uh one last question and that's about basically is about how you and your colleagues are holding up through this you guys yeah some better than others uh you know what's really interesting here's what i wonder and again i'm not going to pretend to have the answer to this but right over the last couple of years

everyone's entitled to their opinion right and and you know like anything else there's no one right path forward some people in medicine or science or public health have taken rather extreme opinions and rather extreme opinions and rather extreme beliefs or dug their heels in or bought into, you know, some flaky science or some flaky ideology. And again, like you're in everyone's entitled to a bad day. Everyone's entitled to a bad take. Everyone's entitled to make a mistake. Everyone's entitled to have a bad week, maybe even a bad month.

Some people have had a bad pandemic, like, you know, consistently either swept things under the rug or when you really should, when things were pretty dire or consistently claim that the sky is falling. What I'm really wondering, and again, I don't know, I'm very curious to see what unfolds over the next year and two years ahead. How do those individuals reintegrate into a medical community, a scientific community, a public health community, when people have had some very public inflammatory opinions or very public and very wrong opinions on and on again and again like i think in general you know not just the medical and scientific community but like people in general are pretty forgiving like if you just say oh i screwed up sorry that one's wrong messed up that one better like next time that's fine but you know there you see like you know i'm not i'm not going

to pretend to do a psychology 101 on any of these individuals but you know so some people just consistently have been very inflammatory or or consistently said you know what this isn't an issue and i'm consistently underplayed things as well which is quite frankly dangerous um and i'm just very curious to see how that how that unfolds you know in the we like to think we're you know, in the, we'd like to think we're open-minded in the medical and scientific world, but we're not, we're actually rather petty. I think so.

It'd be curious to see what happens. I think there's still like any other field though, at least in the medical community, and I'm not going to pretend to speak on behalf of the entire community, but you know, it's, it's, it's obviously been a very challenging, uh, couple of years and, um, you know it's it's obviously been a very challenging uh couple of years and um you know burnout is very real uh and we've been asked to do a lot uh especially during this wave when you've got a lot of absences because of covid either direct infection or or exposures uh high patient volumes not a lot of staff to see. Everyone's already given their all for two years, and now you're asked to give more and sign up for more.

COVID wards reopened and more COVID teams reopened and you've got a staff. People can use a break. And it's obviously the next few weeks, while these numbers numbers decline are welcomed by everyone but i think many in the healthcare profession are really breathing a sigh of relief taking their masks off when they go home and just are going to have a good long sit maybe a nap or maybe a stiff drink as well well as well as all the pressures you just mentioned there's also the whole issue of the harassment that many healthcare workers. Oh, yeah. This is crazy.

It is. Can you believe that? Like, honest to God, I get it. You can be upset at policymakers or decision makers, but the healthcare providers, the nurses, physiotherapists, respiratory therapists, occupational therapists, doctors, everyone in those buildings. Like they're really there just to help.

If you get sick, where do you think you're going? This is what we do. It's not really the kind of place you want to be yelling and screaming outside of. We're the ones who are going to bail you out when you're having the worst day of your life. It's not like we need pots and pans and thank yous. But on the other hand, maybe protest somewhere else. Yeah, I've just found that whole aspect of it mind-boggling. I don't get it.

I don't understand why they are attacking healthcare workers in that way of harassing them the way they've been doing. It's just, it's mind-boggling. Dr. Bogoch has always, you knowar has always been another busy weekend for you, traveling around the world as well as having to worry about what's going on at the hospital as well. So thank you for taking the time. I appreciate the talk we've had today. I know it's been mainly big picture, but I think we could all use that big picture talk right now.

There's so much other stuff that's been going on around our society across the country in this last week or so. Trying to get a handle on just where we are in the big picture, I think, is important. So thank you again. Always happy to chat. And just one last point. I think we're heading the right direction like it's we're clearly in a much better spot this week than we were last and big picture it does appear that no things are truly truly improving and we are coming out of this and i think there are much brighter days ahead so that's it is good news well it's a nice

way to leave it take care have a good one. Dr. Isaac Bogoch from Toronto University Health Network is at the University of Toronto. And as I said earlier, he sits on the Ontario science table. So he's helping advising various groups, including bureaucrats and government officials on how to handle the situation that's before them. You know, starts on a, well, hardly an optimistic note by saying we're still very much in the pandemic and for the reasons why we're still very much in the pandemic. But ending on an optimistic note that he thinks, you know, we're heading towards better times. And boy, we all hope that those who feel that way are right.

Enough is enough. And we've increasingly had enough. And the frustrations have come forward through different ways and through different groups of people, especially over this last while. I'm not going to go into the whole trucker thing in Ottawa and elsewhere today. Anyway, we shot our bolt on that one last Friday on the Good Talk. And a lot of reaction from many of you who are feeling the same kind of frustrations, but at the same time are trying to find what is the way out of this. And if you've got to use the hammer, how do you use the hammer in a fashion that's not going to cause you more problems

than you've already got? So officials in Ottawa and elsewhere have been trying to do that. And we'll see where that leads. But the point I was trying to make in this big picture discussion is a lot of reasonable people who aren't out in the streets doing their thing, but are asking these same kind of questions about how do you know when you've reached the end in terms of the pandemic. How do you draw that distinction about an abundance of caution versus an overabundance of caution? These are good questions and they're, you know, it's interesting to listen to somebody obviously who has some serious thoughts based on where he is in terms of this story

on the answers to those questions. All right. It's about time we took our pause, our break for the day, and that's what we're going to do. And then we'll come back with a COVID-related story from Greece. That's right after this. And welcome back. I'm Peter Mansbridge in Stratford, Ontario.

You're listening to The Bridge on Sirius XM Canada, channel 167, Canada Talks, or on your favorite podcast platform. And we just came out of a week where we had the biggest numbers we've ever had on podcast downloads. It's been terrific. and it's great to know that the word about the bridge seems to have exploded over these last few weeks. It's been on a straight line up, actually ever since the election last fall. But the numbers last week were, well, they were big.

They were significant. And they're, you know, as we like to say, they're worldwide. Getting a lot of comments from different people. And as a result of that, we're going to throw in a story here about Greece. Because it kind of fits with the pattern here today. We're talking about, in Canada, a number of restrictions are starting to come down. It started over the weekend, will continue today in different parts of the country, and hints that they're going to get much a bigger decrease in restrictions in other parts

of Alberta. Jason Kenney suggesting over the weekend that they would cut most restrictions in that province. Saskatchewan did last week. Ontario drops a bunch of things this week. Some tough sledding going on in Atlantic Canada in the last couple of days, which is probably going to restrict the restriction dropping, if there's such a phrase in Atlanta, Canada. Wish you luck with that. And we'll keep our eye on it,

maybe talk to Dr. Lisa Barrett in Halifax at some point in the next little while. All right, I wanted to tell you a story about Greece because this goes against the trend about moving away on restrictions. Greece is issuing fines to anyone age 60 and older who is not vaccinated against COVID-19.

This is kind of like that tax thing that Quebec was toying with and then dropped. But it's not a tax. It's a fine. It's like a parking ticket. 100 euros. That's not peanuts. What is that, about 150 bucks Canadian?

So let me read this from ap greece is issuing fines to anyone age 60 and older who was not vaccinated against covet 19 it's a way to boost lagging inoculation levels and reduce pressure on the nation's health care services prime minister mitzotakis has told seniors that the simplest way to avoid the levy is to just get vaccinated. Take the step, he urged them. Yes, the fines will be imposed, but that should be the least of their concerns, he said. Protect your life, the lives of those you love, and understand that the vaccine is safe, he implored. Greek authorities say the non-vaccinated elderly remain at high risk for hospitalization from the coronavirus. Some 9 in 10 COVID-related deaths in Greece

have been among people 60 and above, and while 7 in 10 of those hospitalized from the virus are over 60, and of those, 80%, 8-0, 80% are unvaccinated. Before the compulsory shots were announced in November, some 520,000 seniors in Greece hadn't been vaccinated according to health ministry data. Since then, about 220,000 more have rolled up their sleeves. But the remaining 300,000 individuals, some will be eligible to apply for exemptions for medical reasons. There you go. Fines for being unvaccinated. Don't know how long that'll last.

But it's been in play here for a little while in Greece now. Okay, that's it for this day for the bridge, the opening up yet another week. I haven't decided what we're going to do tomorrow. It may have something to do with the convoy in Ottawa. I'm not sure. Wednesday, Smoke Mirrors and the Truth. Bruce will be by.

See how we ranch this week. Thursday, opportunity for your thoughts. The Mansbridge Podcast at gmail.com. The Mansbridge Podcast at gmail.com. And Friday, of course, Good Talk with Chantelle Hebert and Bruce. I'm Peter Mansbridge. Thanks so much for listening. Talk to you again in 24 hours. Thank you.