Will we learn this time? - Keith Roulston editorial
Our governments are throwing a mind-boggling amount of money at the health and economic crises caused by the COVID-19 Coronavirus pandemic but when it’s finally all over, will we learn lessons from it all – and remember them?
Word has filtered out recently that the Ontario government did indeed learn from the 2003 SARS epidemic – it’s just that once the crisis passed, people who should have known better got busy with other things and ignored what was learned.
After Ontario (particularly Toronto) was whacked by SARS, killing 44 and leading to the quarantining of hundreds, Ontario held a Royal Commission to see what could be done in case of a similar, or worse, infectious disease outbreak in the future. Based on one of the recommendations, the province amassed a stockpile of 55 million N95 surgical masks – exactly the high-quality masks nurses and doctors are pleading for these days.
That stockpile should have been an answer to today’s needs, except that the masks have an expiry date. Rather than keeping on top of the situation and rotating those masks out for use in the province’s hospitals while they were still useful, then replacing them with new masks, whoever was in charge just let the expiry date go by. The masks were eventually discarded and not replaced. A precious resource that should be helping us now was wasted.
Many of the mistakes we made that are hampering the effort to fight the Coronavirus were examples of the advice of the mechanic in the old oil filter advertisement who advised viewers not to save a little now at a higher cost later: “You can pay me now, or pay me later.”
Provincial governments of various political stripes tried to drive health care costs down by rationing hospital rooms, including Intensive Care Unit (ICU) beds. It’s a theory of efficiency that you don’t provide resources you don’t need at the moment. As a result, it’s been estimated that Canadian hospitals have 10-12 ICU beds for every 100,000 residents, compared to 35 in the U.S. and 30 in Germany and Taiwan.
Maybe our governments’ parsimony kept our taxes a little lower back then, but today we face a dire shortage of ICU beds if COVID-19 surges as it has in other countries.
Similarly, faced with limited funds, our hospitals bought only enough ventilators to meet their day-to-day needs. Our governments didn’t create an emergency reserve supply as the U.S. government did. So when the number of Coronavirus cases grew which required extreme breathing assistance, we had no reserve supply. Governments are scrambling to find more.
The problem, of course, is that every other country in the world also needs every ventilator it can lay its hands on. A different sort of efficiency got in the way here.
The theory of free trade is that companies, even countries, should specialize in what they can do cheapest. We use economies of scale and low wages to provide products at the lowest price. In the case of medical supplies, that keeps the cost of health care down.
Most of Canada’s ventilators come from China. So do medical masks desperately needed by frontline healthcare workers. The problem arises when China has its own crisis. Naturally it wants all that equipment for its own needs – not to mention that other hard-hit countries also need all the medical supplies they can get. Because there were few Canadian sources of this essential equipment, Canada is scrambling to get manufacturers of other equipment to switch production to meet our medical needs.
The danger of cost-cutting in seniors care has been demonstrated in the tragedy of the Lynn Valley Centre near Vancouver where at least 11 patients have died and 46 residents and 24 staff were infected by the virus as of last weekend. Staff who were formerly unionized were replaced by workers from a subcontractor (often it’s the same people but at $2 an hour less and with fewer sick and vacation days).
To make up for their low wages, often the staff members take jobs at more than one seniors facility. If there is an infectious illness like COVID-19 in one home, the worker might spread it to a second home.
Here in Ontario many workers can’t get full-time work in one seniors facility so they work at different homes on different days, again increasing the chances that disease can spread from one home to another.
Right now we’re regretting many decisions authorities have made on our behalf over the past couple of decades. With our own health and the health of people we love at risk, the wisdom of “efficient” choices now seems questionable. Will we remember that, however, when the urgency passes and repaying the debts governments have incurred becomes a higher priority?