After a solitary Easter Sunday, Canadians entered another week in social isolation confronted by two contradictory facts.
The lockdowns that have transformed daily life across the country are working, slowing the spread of the virus and saving lives. The western provinces are seeing a significant decline in new cases from their peak, while the number of new cases has flattened in Ontario and Quebec.
But the lockdowns have brought commerce to a shuddering halt, forcing several million Canadians out of work and threatening to provoke a deep and long-lasting recession with unpredictable and profound consequences.
Those two realities cannot coexist indefinitely, yet there is no simple way to deal with the trade-offs involved in restarting the economy and possibly reigniting the spread of COVID-19. The return to a semblance of normalcy, experts say, will not happen overnight but in stages and at different speeds for different regions of the country.
As such, it is best to focus on the very short-term until the trade-offs are clearer. Here are four urgent things Canada can do now to begin the transition back to normalcy.
Planning needs to begin for a gradual workplace re-opening with strict social distancing protocols
In Spain, perhaps the hardest hit country by the COVID-19 virus, the Spanish government on Saturday set out guidelines for people returning to work under a loosening of lockdown restrictions, while the country reported its lowest one-day increase in deaths from the coronavirus since March 23.
As in Canada, most Spaniards have been confined to their homes since mid-March with only businesses in sectors deemed strategically important allowed to operate normally.
Starting Monday, some other Spanish industries such as construction and manufacturing will be allowed to restart, enabling thousands to return to work.
If hard hit Spain can begin thinking about opening up the economy, Canada, far less hard hit than Spain, can begin serious planning on selectively re-opening parts of the economy, too.
And this planning should not just include government and industry. Labour must be a full partner in developing back to work plans. Organized labour has historically been the driving force behind workplace health and safety measures in Canada and its expertise needs to be at the table as plans for re-opening the economy are developed.
Under guidelines issued by the Spanish prime minister’s office on Saturday, companies returning to work must provide appropriate protective equipment and ensure employees have space to be at least two metres apart.
Spanish security forces will distribute 10 million masks at public transport hubs in the coming days and their use was recommended but not compulsory.
Proposals being floated in Italy, also much harder hit than Canada, to allow for re-opening include the issuing of immunity certificates, which would require antibody blood tests, and allowing younger workers to return first, as they are less vulnerable to the virus.
Researchers at Sinai Health and the University of Toronto announced this week that a robotic laboratory platform at the Lunenfeld-Tanenbaum Research Institute (LTRI) has the potential to process 10,000 tests daily that can determine who has antibodies to COVID-19, and potentially some level of immune protection.
The tests are still being fine-tuned, but the ability to carry out antibody testing — also known as serology — on a massive scale is a necessary component for a re-opening strategy being contemplated in some European countries: “immunity passports.”
The idea is to identify people carrying antibodies to the novel coronavirus, evidence that their immune system already fought off COVID-19 and they have some level of protection from being reinfected. (These antibody blood tests are different from the typical tests to diagnose the illness, which search for viral genetic material in nose or throat swabs.)
If the anti-body tests are proven to be safe and effective, people with protective antibodies might safely return to work, restoring some parts of the labour force. This writer does not have the expertise to assess how close we are to having safe and effective anti-body testing, but it should be a top priority of governments and labs across the country as it is potentially a crucial tool in allowing people to return to work.
Get the Canadian Emergency Wage Subsidy out the door
On Friday, April 10, Statistics Canada reported that more than one million people in Canada lost their jobs in March reflecting the first wave of layoffs resulting from the COVID-19 pandemic.
Ontario experienced the largest job losses in raw numbers, with the number of employed people declining by about 403,000, followed by Quebec at 264,000 and British Columbia at 132,000.
And the April job loss numbers are expected to be much, much worse.
And remember, the job losses don’t stem from reduced demand because people are sick. Millions of Canadians are being thrown out of work because the government (probably correctly) closed down large parts of the economy to fight the pandemic.
On Saturday, April 11, Parliament passed the Canadian Emergency Wage Subsidy (CEWS). This program will pay 75% of wages up to an annual salary of $58,700.
It is retroactive to March 15, and employers can’t lay off employees if they want to qualify. The program, in effect, is an attempt to “freeze” the economy and stop business and job destruction.
The Canada Emergency Wage Subsidy takes a page out of Europe’s playbook and directly pays businesses to meet their payroll obligations and retain their employees.
This accomplishes several important goals. By reducing layoffs, it keeps workers employed by their companies, so that firms will have an easier time ramping up after the crisis passes. By reducing unemployment, it keeps workers from having to take it on themselves to wait for hours on the phone, or online, to secure jobless benefits. By at least attempting to freeze layoffs, it could reduce anxiety for millions of people who, at this moment, don’t know where their next job is, or when they should realistically think about applying for work.
Canada needs to stop the mass layoffs underway and the CEWS is an excellent way to do it. But the program has to get out the door now and in the first few weeks of applications, in particular, employers have to be given the benefit of the doubt that they have suffered the revenue losses required to be eligible for the program.
Protect our most vulnerable in our long-term care facilities
Residents sitting in their own urine and feces because their incontinence pads had not been changed in days. Others dehydrated, starving and disoriented, having not been fed or given their medications. Two patients on the verge of death.
That’s what public-health inspectors found when they visited Résidence Herron, a 134-bed private long-term care facility in Dorval, Que., on March 29.
On Saturday, Quebec Premier François Legault, visibly shaken, said there had been “gross negligence” at the home and he has asked police to determine if criminal charges are warranted.
The situation at Residence Herron is sadly not unique.
Hundreds of nursing homes and seniors’ residences across Canada have been hit by outbreaks of coronavirus, often with deadly consequences.
The most publicized case is Pinecrest Nursing Home in Bobcaygeon, Ont., where 29 people have died so far.
But there are many, many others.
At the Centre d’hébergement de LaSalle there have been 20 deaths, and 19 at the Ste-Dorothée long-term care centre; both are in the Montreal area.
And there have been 18 deaths at McKenzie Towne Long-Term Care Home in Calgary.
All told, half of the almost 750 COVID-19 deaths in Canada have been in institutional settings.
More than a month ago, a deadly outbreak occurred at Lynn Valley Care Centre in North Vancouver (where 18 have now died) and it should have sounded an alarm that all seniors’ residences were at serious risk from the new coronavirus.
Yet, in long-term care residences across the country, business continued more or less as usual, with homes restricting visitors and installing hand-sanitizer dispensers and isolating people only after they fell ill.
Essential safety measures such as routine coronavirus testing, measures banning staff from working at multiple sites, and the use of personal protective equipment have still not been fully implemented
What the horror stories tell us is that we should be testing every single person in institutional care, and isolating the infected aggressively.
Where routine testing has been done, the results are frightening; at the Ste-Dorothée long-term care centre, for example, 115 of the 174 residents have tested positive.
Both B.C. and Alberta have banned health-care staff from working at multiple institutions, a common practice that allows the coronavirus to spread quickly.
This should be a permanent policy in every province, not a temporary one in B.C. and Alberta only.
The problem is that many long-term care employers refuse to offer full-time work so they can avoid paying benefits. This forces staff, especially low-wage ones such as personal support workers, to juggle shifts at various locations.
COVID-19 has been a disaster in seniors’ residences. But, more than anything else, it has exposed a crisis that already existed – a crisis of neglect for our elders.
Terrible food, one bath a week, over-medication, inadequate personal care such as changing incontinence pads – all these complaints arise far too regularly in institutional care.
The challenge now is not just to get through the pandemic without much more carnage, but to deal with these issues permanently.
Massive ramping up of diagnostic testing
There also needs to be a massive ramp-up of diagnostic testing (again, which is different from anti-body testing discussed above) – especially in Ontario.
Since the start of the COVID-19 pandemic, Ontario has trailed the rest of the country when it comes to testing people for the virus.
It’s been a fatal gap in the province’s pandemic response, since a key method of stopping the outbreak involves figuring out who has the virus, and then isolating them and their contacts. Doing public health without adequate testing is like telling the fire department to rush to a nine-alarm blaze, and then not telling them where the fire is.
British Columbia has tested twice as many people, relative to its population. Alberta has tested at three times Ontario’s rate. Quebec, despite having barely more than half as many people, has administered tens of thousands more tests.
As of April 11, Ontario is the province with the largest number of deaths from COVID-19 (274), yet its public health officials, hospitals and nursing homes don’t have a handle on where the coronavirus is.
Ontario Premier Doug Ford says the province has the capacity to test 13,000 people a day – more than the number of tests performed on an average day in the other nine provinces combined. He says Ontario has the kits and laboratories to achieve those numbers. But this week, between Sunday and Saturday, the province averaged fewer than 4,000 tests a day. That means as of Saturday, Ontario was using only 25% of its testing capacity.
In data reported early Sunday, the province announced more than 6,800 patients were tested for COVID-19 the day prior, the largest single-day total since March 29.
But according to Hayley Chazan, spokesperson for Ontario Health Minister Christine Elliott, there is no plan for “widespread testing.” That, she said, would only cause a new round of lab test backlogs.
While it is good that Ontario has picked up the diagnostic testing pace (at least for one day), doing fewer than 4,000 tests per day when you could be doing 13,000 tests is a disgrace. And why can’t the lab processing of tests be expanded along with the testing capacity?
There is a clear reason why Ontario’s increased capacity has failed to translate into a corresponding increase in tests. Until Friday, April 10, guidelines issued by the Ontario Ministry of Health, encouraged local health authorities, assessment centres and doctors to discourage most Ontarians from getting tested and to self-isolate if they are showing symptoms. These frontline health personnel, who are used to testing kit shortages and who were told to be stingy with a scarce resource by the Ministry of Health, continued to stick to these outdated ministry guidelines even though Ontario increased the capacity to test at four times the rate it was testing as of Saturday.
Those guidelines were loosened up somewhat as of last Friday, but Ontario is very unlikely to catch up with the rest of the country in the near future.
That said, Ontario health officials have an obligation to do their best to match Alberta and massively increase testing and processing in the province. Opening up the Ontario economy is simply not possible until testing rates increase significantly.
Hard and very complex decisions need to be made about how best – and when – to restart the economy.
However, if in the next two weeks Canada can successfully deal with the four challenges outlined above, we will be in an excellent place to begin the hard work of re-starting the economy without endangering the lives of Canadians.