“Those who fail to learn from history are destined to repeat it.”
Let’s get the lessons straight, well documented, and get prepared for the next one, as Bill Gates said prophetically in 2016! Despite the fact that outbreaks seem to come as a big surprise to the population and health officials, they are cyclical! This is the reality of modern times.
After months of media clips showing China dealing with this virus, the World Health Organization declared a pandemic on March 11, 2020, this announcement being based on very early experience and forecasts employing statistical models done by experts. This was after major US media outlets had down-played the seriousness and the U.S. administration was admonished for curtailing air traffic from China.
Within the health and public policy community, there was very little knowledge of the virus and its characteristics.
There somewhere was a body of knowledge available from previous outbreaks, particularly SARS in 2004. Based on the very limited understanding of SARSCovid-19 the world was cast into turmoil with economies largely shutting down overnight and a whole new language of mitigation: stay home, close down, don’t go to church, the theatre, or anywhere else for that matter, don’t socialize, maintain social distance, don’t touch or breathe on anyone. The world was sent into panic based on theory but few facts.
Forecasts of spread and potential deaths were enormous leaving people terrified. And why not? What else has ever caused the deaths of over 2 million Americans or 200,000 Canadians? And Dr. Deborah Birx, about 6 weeks into the pandemic, acknowledged that the statistical models used by the World Health Organization were off by factors of 10; in all probability there will not be anything like 2 million deaths in the US or 200,000 in Canada.
And who will forget the network images of crisis and temporary hospital facilities in New York City that, in the end, were hardly used.
The media seemed fixed on “cure” and “vaccine” as if it were even possible to develop cures and vaccines for a virus just introduced to the world a month earlier. In the early stages of any contagious element, until its characteristics are well documented and treatments recognized, the key is treatment and preserving life. It all has provided much theatre while leaving many in the public terrified and confused.
Some recognized pathologists in various countries reported that most patients who succumb had underlying chronic health issues that would claim their lives at some point. Another new term introduced was: “death from Covid vs with Covid”. Those who deal regularly with senior care understand that eventually COPD or Congestive Heart Failure or Alzheimer’s Disease or Parkinson’s Disease will claim the person’s life; that is simply the cycle of life. Some at 65, some at 72, some at 95 years of age or more. Flu-like disease in other years accelerates that process.
One serious matter not discussed at all is that of perspective. For generations our population has had the common cold and the flu as winter time, contagious diseases that tend to result in the deaths of many people. In New Brunswick, for instance, during the pandemic, as sick as it makes people, there have been six deaths compared to 13 during the same time frame from the common flu. On a national scale, to date there have been some 9,942 deaths from Covid but the Canadian Institute for Patient Safety projects 28,000 deaths annually from Medical Errors! And while the media has expressed shock about 200,000 Covid deaths in the US, mortality from Medical Errors, Suicide, and auto accidents far outstrips pandemic numbers. Many of the leading causes of death are preventable, not just Covid.
Should we, as citizens, be concerned? Absolutely. Should we be in a state of panic while shutting businesses and schools down. No. In any given year, there is huge school and workplace absenteeism during these months attributable to the common cold and the flu. As a father and grandfather, I have watched for decades the way that these illnesses rage through schools, one student to another, one employee to another.
Panic tends to drive irrational behavior and irrational behavior is often devastating with lasting results. Many in the public have noticed, and been angered by, the inconsistencies seen in regulations.
The lessons for New Brunswick are several. First, leaders acted quickly and decisively. The Premier, along with political leader colleagues, rallied around the best advice from the Chief Medical Officer, Dr. Russell, and they did everything the WHO directions suggested. Stay home; masks; shut down much activity; creation of zones. Quick action and probably other factors contributed to New Brunswick experiencing a very few deaths.
The SARS outbreak of 2004 was deadly serious, although with limited impact in New Brunswick. The large outbreaks in Quebec and Ontario caused some sober analysis. I recall vividly that the struggle to coordinate public health with hospitals, care facilities and other sectors was profound and that was one of the key lessons taken forward.
This time in New Brunswick there were serious struggles in the flow of information, clear direction, availability of essential resources between public health, department of social development, long term care facilities.
Directives were dutifully created by very intelligent people, transferred through several levels of public service, then finally received by the over 460 Special Care Home facilities, many of whom were overwhelmed already with the basics of obtaining gloves, toilet paper, gowns and protective gear, disinfectant. Many operators would not have the time to sit and study bulletins, often written in “legalese”.
For long term care, the simple act of restricting or eliminating visiting has been difficult with tragic consequences. Visiting regulations have been devastating for frail seniors and their families and must be revisited before such cruel measures are implemented again. On visiting one resident, when rules were loosened, it was acknowledged that “it’s like being in jail!”. If those same seniors happened to live in a senior’s apartment building, they would enjoy a much more liberal level of social contact, albeit still not normal.
Long before the Pandemic, the collaboration and sharing of information between the long-term care system and the government departments that regulate them was not great. The pandemic has accentuated that in many ways.
Long term care facilities continue to grow bank overdrafts or strain on lines of credit and cash as the exorbitant costs imposed on them by the pandemic go unrecognized to date. In PEI, government awarded a Covid-19 bonus to the per diem rate when the pandemic was declared which relieved for them much of the distress currently being felt in New Brunswick.
The lack of recognition of some of the key people who, for minimum wage, went to work every day has been a huge problem. They could have remained at home with CERB or WHSCC but continued at work while watching other employees in other sectors doing roughly the same work earning 40-50% more money! These are good people who care for seniors because they love the work!
Bill Gates also emphasized in 2016 that governments should engage in planning and pandemic drills similar to fire and disaster drills. Had that been part of our programming in NB, someone would have seen the problems imposed on a complex system in handling a crisis with no plan. Training and knowledge gaps have existed and led to much distress at many levels.
To their credit, staff in Health and Social Development Departments have responded and for them it has been like re-designing the car while driving!
Ken McGeorge,BS,DHA,CHE is a retired career health care CEO, part time consultant, and columnist with Brunswick News; he is the author of Health Care Reform in New Brunswick and may be reached at firstname.lastname@example.org or www.kenmcgeorge.com
Ken McGeorge, BS,DHA,CHE is a career health care executive based in Fredericton, NB, Canada.