Bruce Arthur: With COVID-19, pushing to reopen too soon is a loser’s bargain
I hope Doug Ford misspoke. It happens, when you hold a daily press conference for seven months. Because otherwise, on Friday, the premier may have chosen a path.
“Based on the latest evidence, based on what I am seeing in the modelling, I have asked our public health experts to come back next with a plan to begin to ease restrictions in a way that will safely allow businesses to start opening back up after the 28-day period is over,” said Ford, on the hot spots of Toronto, Ottawa and Peel, which have been in Stage 2 restrictions since Oct. 9. “I want the health officials to come up with a plan that lets business operate safely, because we don’t know how long this virus will be with us, but my friends, what we do know is together, we’re going to get through this.”
The engine light blinked yellow on that statement, and maybe red. Of course we want to reopen safely. Everyone wants that.
But the definition of safely is the issue. On Wednesday Ford said “we see the curve going down, which is great news,” but Thursday the government’s public health presentation said the rate of case increases had merely slowed, and that Ontario would only exceed ICU capacity in one of three scenarios, having avoided the worst case.
How could that spur talk of reopening? Twice Friday, Ford was asked what about the data indicated reopening would be warranted; twice, he dodged the question. He kept comparing Ontario to the rest of the world, which when you are jammed between Quebec, Canada’s-worst pandemic, Manitoba’s emerging disaster, and the tragic grease fire of the United States, offers many low bars. Ford was asked, if his much-maligned science and public health advisers come back and say it’s a bad idea — and only Ottawa has shown a per-capita case drop in the last three weeks, and remains high — will he follow their advice?
“Well, anything’s possible,” said Ford. “Again, I’m going to rely on the data and the advice from the health team, but this can’t go on indefinitely. You know, again, one doesn’t work without the other. Without your health, you don’t have the economy. And if the economy goes south, then there’s a lot of people with health issues, mental health, depression, addiction. So there’s a happy balance. So we’ll find that happy balance with our health team.”
Except the pandemic isn’t a balance beam so much as it’s a sequence: public health, then the economy. Ford moved quickly enough on widespread restrictions in the spring, and that was laudable. He has been and to implement in the fall.
Saying we don’t know how long the virus will be with us, and that this can’t go on indefinitely — that points to a desire to open up and hope the hospitals can handle it, and with that is a loser’s bargain. Does Ford want to emulate Alberta, which has stuck with many voluntary restrictions as their cases rise, or Manitoba, which waited too long to act and is now in crisis? This sounds like the talk of a province that didn’t invest enough in public health or epidemic response — whose crashed, and where contact tracing has been half-abandoned in Toronto and Ottawa, among other places feeling the strain.
“He’s right; we don’t know how long it’ll be with us,” says Dr. Andrew Morris, a professor of infectious diseases at the University of Toronto, and the medical director of the Antimicrobial Stewardship Program at Sinai-University Health Network. “But this is why we need an open public discussion about strategy.
“It is possible to move on without controlling COVID? That has to be the first discussion. Is it possible? Is there an example anywhere in the world right now of any country that has been able to do this? Everyone’s talked about Sweden, and now it’s been totally disproven as an approach. So is there another country anywhere in the world where you can just live with this? And the answer is no.
“What’s our strategy? We don’t have a strategy.”
“I think if we’re doing magnificently in two weeks, then try it, see how it goes,” says Dr. David Fisman, an epidemiologist at the University of Toronto’s Dalla Lana School of Public Health. “If it’s a disaster, reverse it. (But) we know what direction that would go, and the downside risk there is you would shut the bars and restaurants after things exploded, as they did in the (United Kingdom) after their Dine Out campaign, and you would potentially also wreck the schools, and wreck the wider economy in the process. So I think it’s a pretty big gamble.”
Fisman noted the locally uninformed kerfuffle over data showing few bars and restaurants had been linked to outbreaks in Peel or Ottawa, but points out that 10 per cent of cases are outbreaks, 40 per cent of cases have a link to some other case, and 50 per cent have no known epidemiological link at all, and that last number is going up. He also notes that the Centers for Disease Control found that unlinked cases are three to four times more likely to have visited a bar, restaurant, or coffee house, or similar.
And finally, Fisman notes Ontario is not immune from what we know about how the virus is spread. Thursday the province’s own medical advisers said the danger of non-essential indoor spaces is well established. And Friday the Star reported an outbreak at Ford’s own constituency office, which he said was the result of visitors coming indoors.
“I was a huge believer in the hammer and the dance,” says Morris, referring to the now-famous description of a pattern of lockdowns and reopenings published earlier this year. “And it’s all bulls—. It’s total bulls—. Nobody’s been able to do it. They thought they could do it, but they can’t. Maybe the Danish, but in September and October they’ve increased restrictions to control things. But no country has the exquisite infrastructure to be able to dance, so instead, the only strategy that seems to work is you keep it as close to zero as possible.”
Ontario certainly lacks the tools to dance, and the footwork along with it. So I hope Doug Ford just got impatient, and was momentarily overcome by his heartfelt devotion to small businesses, about which he speaks more empathetically than about any other part of the pandemic. Because the way he spoke Friday sounded like someone who wanted to open up before the virus is under control. And the world has discovered the hard way that it’s not how it works.
Bruce Arthur is a Toronto-based columnist for the Star. Follow him on Twitter:
