Now is the time for the provinces to sit down together with the federal government and draw up a detailed implementation plan for re-opening the Canadian economy. Every province should be in a position to re-open some of its social distancing closures by the end of May.
It is essential, however, that our governments be clear that the process of re-opening the economy poses two separate questions.
One question is short-term and relates to how we sequence the re-opening of different sectors of the economy in different regions of the country. In other words, some sectors are going to be re-opened before others and some provinces are going to be in a position to re-open before other provinces. And in the first weeks – if not months – social distancing protocols like those in place in supermarkets and pharmacies need to be in place in the re-opened operations.
The second question is a bigger and longer-term question: what kind of economy do we want to emerge from the crisis?
Before discussing the two questions, let’s take a brief look at the current state of the COVID – 19 pandemic in Canada and explore why a phased re-opening starting in May would be both good for the economy and good for the health of Canadians.
Why it is not too early to begin planning for re-opening the economy
First, to say that it is time for developing a detailed plan for beginning the re-opening of the Canadian economy in May is not to say we should relax all social distancing requirements in all provinces in May. That would be reckless – even dangerous. Bars, concerts, sporting events and other large-scale events will likely have to wait until June or later to re-open – especially in hard-hit Ontario and Quebec.
And opening up schools involves a whole set of difficult issues that will have to be worked through province by province and be agreed upon by both school boards and the teachers’ unions.
But the fact is that all provinces are either passed (or at) their peak of new, confirmed COVID-19 cases. New cases will begin to come down in all provinces over the next few weeks and all provinces should be in a position to begin opening up some sectors of their economies by the end of May without in anyway undermining the fight against COVID – 19.
For example, British Columbia is now well past the peak of daily new infections; at time of writing, there were just 115 COVID-19 patients in hospital and 54 in intensive care in the entire province. Alberta, with far fewer infections than first predicted, is also approaching its peak, and is sending personal protective equipment and ventilators to neighbouring provinces. Ontario and Quebec, the worst-hit provinces, are either at their peak or should reach their peak within days. And this follows recent trends in countries such as Italy, Spain, Germany, Switzerland and Austria, where cases and deaths from COVID-19 have reached their peaks and are slowing. Even the New York City area is seeing a significant decline in new cases.
Secondly, almost all of Canada’s health systems, notwithstanding shortages of personal protective equipment (PPE) in some jurisdictions, remain entirely capable of supporting hospitalized COVID-19 patients. Ontario currently has 197 COVID-19 patients on ventilators; Ontario is the hardest hit province other than Quebec but still roughly 80 per cent of the province’s 2,811 ventilator-equipped critical-care beds are unoccupied and ready for use by new patients.
Remember, the single biggest reason for the massive economic lockdown that is causing millions of Canadians to lose their jobs, was the fear that our hospitals would be overwhelmed by a flood of COVID-19 cases. From the numbers cited above, it is clear that this is simply not happening – even in relatively hard-hit Ontario.
Moreover, nearly half of all COVID -19 deaths in Canada (over 60% in Ontario) have occurred in long-term care homes – a crisis that is largely separate from the COVID -19 crisis in the community. The average age of those who have died in long-term care facilities is 85 and in Ontario more generally, the average age of those who have died from the virus is 80.
At-risk communities and individuals (e.g. the elderly and frail) will remain especially vulnerable to COVID – 19 but the vast majority of people in institutional settings who have been infected (or are vulnerable to future infection), were not infected while at work, in a store, or walking the sidewalks of their communities. In other words, the broader economic lockdown did not protect institutionalized residents and carefully lifting the lockdown will not put them at greater risk.
To be clear, particularly in Ontario and Quebec, provincial governments have failed to protect residents of long-term care homes, homeless shelters and those in correctional facilities. This is a tragedy and massive resources need to be allocated to halt the spread of the virus in these institutional settings. But the measures that should have been taken by provincial governments in the first weeks of the epidemic (and need to be taken now) to protect these vulnerable Canadians (i.e. blanket and repeated testing of all residents and staff and then isolating those confirmed positive), are pretty much unrelated to the broader economic lockdown.
In other words, particularly in Ontario and Quebec, we have two COVID – 19 pandemics – one in the community at large and a separate one in institutional settings. The economic lockdown was a response to the community pandemic and the measures taken have been largely successful. That success has laid the foundation for the gradual and careful re-opening of the economy starting in May.
What is happening in our nursing homes, shelters and correctional institutions is a heart-breaking tragedy that points to a massive failure on the part of at least some of our provincial governments to protect our most vulnerable.
That said, continuing the current economic lockdown into the summer will do little to protect residents of long-term homes and other institutions.
Where should we start to re-open?
A good place to start would be to thoughtfully reopen parts of the health system, including elective surgery and cancer care.
Early on, as the epidemic loomed, many hospitals took the common-sense step of halting elective surgery. Knee replacements, face lifts and most hernias could wait. So could checkups and routine mammograms.
But some conditions fall into a gray zone of medical risk. While they may not be emergencies, many of these illnesses could become life threatening, or if not quickly treated, leave the patient with permanent disability. Doctors and patients alike are confronted with a worrisome future: How long is too long to postpone medical care or treatment?
Delaying treatment is especially disturbing for people with cancer, in no small part because it seems to contradict years of public health messages urging everyone to find the disease early and treat it as soon as possible. Doctors say they are trying to provide only the most urgently needed cancer care in clinics or hospitals, not just to conserve resources but also to protect cancer patients, who have high odds of becoming severely ill if they contract the coronavirus.
Outside of health, the list of “essential services” can be carefully and incrementally expanded to include more businesses and allow for a gradual reopening of the economy.
B.C. may be providing a model for re-opening the economy.
For example, British Columbia’s public-health officer is challenging the province’s embattled restaurant industry, largely closed as a result of the COVID-19 outbreak, to come up with innovative options to allow for in-restaurant dining when B.C. eventually eases its pandemic restrictions.
In her daily briefing last Monday, Dr. Bonnie Henry said the challenge is to figure out how to proceed without assembling large groups of people where there can be a risk of spreading the coronavirus among customers and causing a risk to staff.
“I think there are lots of innovative ways that we can have in-restaurant dining that protects both the staff, as well as people who are coming in. And I am looking to industry to come up with those ideas of how this could work,” she said.
She said there is no likelihood of a short-term return to all the norms of the past, but added, “This is not forever. This is for the foreseeable months, certainly this summer.”
Provincial orders in B.C. currently ban gatherings of 50 people or more.
Ian Tostenson, president and chief executive officer of the B.C. Restaurant and Foodservices Association, said his organization assembled a group of at least 15 industry members last week to consider the future operation of restaurants, and Dr. Henry’s comments gives them some context for their work.
The industry group will try to figure out how the industry can restart in a profitable and safe manner, Mr. Tostenson said. “I think that we’ll find some innovation here. I really do. Restaurants are designed to be full at all times, but we’re going to have to rethink that and see how we can make it work given the initial restrictions we have of 50 people.”
He said the goal ahead is to come up with a master plan in fewer than 10 days, and then stress-test it through industry experts to fine tune a plan that could be a model for even operators outside British Columbia.
Mr. Tostenson said the B.C. restaurant industry, which has about 15,000 operations, is facing an unprecedented challenge, with about 175,000 of its 190,000 workers temporarily out of work. Some operators are offering takeout and delivery, but that’s not a sustainable business model unless it’s part of their core model.
The B.C. plan to re-open in-restaurant dining could very well be a model for the other provinces as well.
What kind of economy do we want long-term?
But over and above the mechanics of sequencing the re-opening of different sectors of the economy in different provinces, there is the larger question of what kind of economy Canadians want long-term.
Many of the essential workers during this crisis are performing jobs that have been historically undervalued in our society; they are truckers, warehouse workers, delivery workers, police officers, firefighters, utility maintenance workers, bank tellers, sanitation workers, supermarket cashiers, stock clerks, nurse assistants, hospital orderlies and home care providers.
These workers lack the luxury of working from the safety of their homes and holding meetings on Zoom. They, along with the doctors and nurses caring for the afflicted in hospitals, are the ones who are putting their health at risk so the rest of us can seek refuge from contagion. Beyond symbolically thanking them for their service, we now have the opportunity to begin the hard work of re-configuring our economy to accord such workers the compensation and recognition that reflects the true value of their contributions — not only in a short-term emergency such as the one we are currently experiencing, but long-term in our everyday lives.
To take an obvious example: do we want to come out of the pandemic with the same underfunded, understaffed, under-regulated, long-term care sector where personal support workers average $18 – $21/hr., rarely have full time jobs, and as a consequence are forced to work at two or three facilities every week to make ends meet? It is precisely these conditions that led to the catastrophic institutional COVID -19 outbreaks that have resulted in more than half the virus-related deaths happening in these institutions.
Or to take another example, should we consider making some variation on the new Canada Emergency Wage Subsidy permanent to ensure that workers can maintain their employment in situations of mass layoffs and earn enough to support thriving families, neighborhoods and communities? Should we bolster the dignity of work by shifting the burden of taxation from payroll taxes to taxes on financial transactions and wealth? Should we reconsider our current policy of taxing income from labor at a higher rate than capital gains? Should we strengthen our labour legislation so that it is possible to form unions that will improve wages and working conditions for the kind of non-unionized, front line workers that are doing the heavy lifting in the fight against COVID – 19?
Even when they recede, pandemics and other great crises seldom leave social and economic arrangements as they were. It is now up to Canadians to decide what the legacy of the COVID-19 will be.
While the short-term question may be when things open, perhaps the more important long-term question will be what: What kind of economy will emerge from the crisis? Will it be one that honors the dignity of work, rewards contributions to the real economy, gives workers a meaningful voice and shares the risks of ill health and hard times?
Or will it be an economy like the present one that worships at the altar of “maximizing shareholder value”?
We need to ask whether reopening the economy means going back to a system that, over the past four decades, pulled us apart, or whether we can emerge from this crisis with an economy that enables us to say, and to really believe, that we are all in this together.
The logic that ordinary people need security is as true in normal times as it is under crisis. If something like the Canada Emergency Wage Subsidy is fiscally feasible under the current conditions, then it is absolutely possible when growth is high and unemployment is low.
Are we all really in this together? The next few months will tell.