Prominent Wesleyan Pastor John Symonds and his wife, Willo Ann, created a song that is making the rounds on Facebook expressing the spirit of the proper response of the public to this pandemic: “Cough if you want to, sneeze if you will but I came here to stay…………it’s a battlefield, brother, not a recreation room, it’s a fight and not a game…..cough if you want to, sneeze if you will but I came here to stay”, sung by the piano in their living room! This folksy little song expresses the spirit of what officials are trying to get us to understand as the key method of preventing the spread of this disease. Just stay home!
But it is not entirely that simple for sick people need to be cared for, essential services provided, policing to be done, groceries to be on the shelves and secured, electricity needs to be generated and distributed, elders in homes and care facilities need to be cared for, fed, clothed, bathed and entertained.
Premier Blaine Higgs and Dr. Jennifer Russell have been the calm, factual, steady face of the battle against this awful virus in New Brunswick and thankfully it has not gotten to the level that it could have at this stage were it not for rapid response.
In his explanation of the rationale, Minister Ted Flemming said that the task force is being given military-like powers with Dr. Nicole LeBlanc using the term “we are at war”. And indeed we are as a province and as a continent. By now every New Brunswicker of average intelligence should understand the deadly nature of this virus; for younger people, it will make you very sick; for older people, very sick, for elders with co-morbid conditions, lethal.
If there were lawless gangs roaming the streets doing destruction, the community would be on lock-down, the police would be out in full force with all of its armor and training and, probably, augmented by additional resources until the crime criminals are in custody. Similarly with Covid-19. It is a deadly virus, an invisible killer.
Why a Task Force with military-like powers? Government systems in normal times are ponderous. Consider the contents of several of my previous commentaries which have pointed out the months and years required to get recognition within normal government systems of what seems, to people on the ground, as obvious. How often do we hear, in normal times, “well that is just the way it works”? That normal pace of accomplishing the obvious just is not adequate when you are at war….and we are, make no mistake.
That “normal pace” does not even serve the public well in times when there is no pandemic!
For decades now we have tried to get telehealth and electronic communication embedded in routine health care practice at both the primary care and specialist levels. Now all of a sudden, virtual doctor visits and virtual consultations are reality! Why? Because someone recognized that there are more efficient ways to do business without face to face contact with the high risk of infectious disease spread at this time.
In war time, as well, the leaders must give clear, concise direction in terms that the average citizen can understand and easily follow. A previous column recommended “written at a grade 5 level of understanding”.
Since frail elders are the very high risk population, special attention must be given to this sector that includes Home Care, Special Care and Adult Residential Facilities, and Nursing Homes. These sectors, in normal times, are highly reliant on directions from the Fire Marshall’s office, Regional and Provincial offices of the Department of Social Development, Health Authorities, the Department of Health, the RCMP, Local Police departments, family doctors, Extramural Hospital, Ambulance New Brunswick, and more.
Consider, for a moment, the challenge faced by organizations at local level getting what often are conflicting directions from that many organizations. In normal times, that makes the work of caring for elders very, very frustrating and some days people understandably go home at the end of the day saying “if I did not love my residents so much I would find a new way to earn a living!”
Now suddenly inserted into that work environment is a crisis caused by an unseen entity about which there is little knowledge of transmission, cure, and prevention. The long term care system does not enjoy the same rich resources as other components of the public service with Administrative Support, significant management teams and support staff; the system operates very lean! So the people who have titles of Executive Director, Care Director, or Accountant are still pretty close to the residents and in times of distress often have to take extra shifts providing direct care to people.
There are no Infection Control Nurses or other resources and they do not have the time to read long documents. Special Care Homes, working on very tight budgets, usually do not have large stocks of supplies that can be used in pandemic such as isolation gowns, masks and gloves which you would normally find in hospitals and, to some extent, in nursing homes.
In true war time, everything changes for the duration of the war; suddenly red tape is dissolved, decision-making about essential goods and services is crisp, clear, and efficient. This, of course, runs counter to the conventional governmental way of operating and eliminates, typically, many steps in conventional approval processes.
What is a bit mystifying is the extent to which the system seems to have been caught flat-footed by this outbreak. Signals were being raised in late 2019 internationally but with conflicting assessments of urgency. When the outbreak was confirmed in North America it still took, and is taking, the system precious time to respond.
Canada has had many serious outbreaks in 20 years commencing with SARS in 2004 and at either 2 or 4 year intervals since then. The SARS outbreak was thought to be incredibly serious and the country made many adjustments at that time. There were many important lessons learned which seem to have been all but forgotten in the corporate memory of the health and long term care system. So we find ourselves re-learning what we learned in 2004! Like going back to school for some! Like starting school for others!
Lessons from SARS included carefully monitoring outbreaks of infectious disease around the world, storage and management of pandemic supplies, early education and information to all in the health and long term care field, compensation and recognition of key personnel, ability to respond quickly with temporary measures, command and control, communication systems between public health and the rest.
Basically it was a huge lesson in Emergency Preparedness from which Pandemic Planning and Pandemic Exercises should have become the norm for the system. In the absence of an actionable plan, the entire system ends up, as is happening even now, incurring large expenditures that more foresight might have avoided.
But instead we got lulled back into business as usual, serving people, making money, squabbling about power and influence, creating structures, in-fighting, turf protection, and all the things that impede real meaningful progress.
So now we start again and the Task Force has a golden opportunity to lead us through this mess and to set the stage for a new day in Pandemic Planning and Preparedness. When this is “over” the one thing we know is that there will be another, not if but when.
Ken McGeorge is a retired CEO in major teaching hospitals and long-term-care facilities. He was co-chair of the New Brunswick Council on Aging and is a columnist with Brunswick News. His email address is firstname.lastname@example.org
Ken McGeorge, BS,DHA,CHE is a career health care executive based in Fredericton, NB, Canada.