Half-measures won’t slow pandemic spread
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Hey there, time traveller!
This article was published 18/12/2020 (899 days ago), so information in it may no longer be current.
BY October’s end, Manitoba’s COVID-19 death toll was 69. In November, Manitoba tragically lost 243 people. Most of these deaths were avoidable. Manitoba’s December COVID-19 fatalities will be worse; in just the first two weeks, the province lost 188 to COVID-19.
Some suggest this disaster started in October, when poor adherence to Code Orange public-health orders failed to slow case growth. Others have implied that the public’s bad behaviour is driving COVID-19 spread.
While everyone’s actions count, Manitoba’s second wave was predictable. COVID-19 came late to Manitoba, and officials here had ample opportunity to learn from other jurisdictions and plan accordingly.
Worldwide, there are only three successful pre-vaccine strategies for suppressing COVID-19. The first creates a geographic bubble so life inside can continue almost normally. Anyone entering the bubble must isolate for two weeks until confirmed healthy. New Zealand effectively eliminated COVID-19 using a bubble. In Canada, Prince Edward Island has relied on similar tactics.
The second strategy allows movement across borders, but strictly enforces social distancing under aggressive COVID-19 surveillance, including extensive asymptomatic testing, positive case isolation and contact tracing. Japan, Korea, Germany and British Columbia follow this strategy.
The final strategy is lockdown, confining all but essential workers to their homes. The more extreme the limitation, the more effective the COVID-19 suppression will be. This is a last resort, because lockdowns damage economies.
Manitoba’s first-wave response used all three approaches. Movement across borders and to northern Manitoba was reduced to essential travel. Public health implemented social distancing, testing and contact tracing. All in-person, non-essential business was closed, including schools. This combination drove Manitoba’s COVID-19 numbers to near-zero by July.
The serious errors came as the Pallister government hurried to reopen the economy. Manitobans were reminded to observe “fundamentals” of proper hygiene, but the province followed no single proven public-health strategy, adopting a hybrid hodgepodge rather than sustaining one model.
With the U.S. border closed, Manitoba’s leaders opened interprovincial borders to travellers without mandatory isolation. The Restart Manitoba campaign invited tourism. The bubble collapsed and re-seeded Manitoba with COVID-19. Strategy one: compromised.
Last summer, Manitoba could have built COVID-19 testing capacity, hired and trained contact tracers and staged field hospitals. Manitoba Health could have identified nurses ready to help and offered refresher courses in critical care. Instead, our leaders disbanded the pandemic response committee and seemingly went to the cottage.
Some planning and supply acquisition occurred. Dynacare was contracted to increase testing capacity. But when the second wave came, Manitoba Health scrambled. There weren’t enough nurses or contact tracers. Critical PPE shortages were widespread.
Even with Dynacare, Manitoba (population 1.35 million) has a daily testing capacity that is roughly half of Cornell University’s, which effectively serves 35,000 students and employees. Our officials say they can’t begin asymptomatic COVID-19 testing to contain community spread because they lack testing capacity and reagents. Strategy two: compromised.
With low summer case-counts, the government suspended the lockdown. People left home and gathered. Essential-business-only transitioned into something like business-as-usual. When COVID-19 cases increased, geographically targeted restrictions were imposed slowly.
With schools closed, an August lockdown in Brandon squelched an outbreak. This fall, lockdowns in Steinbach and Winnipeg with schools open haven’t produced similar results. Steinbach schools only closed when test positivity rates approached 40 per cent, while Winnipeg schools remain open with 13-14 per cent test positivity.
Chief provincial public health officer Dr. Brent Roussin claims there’s no evidence of widespread COVID-19 transmission in schools, but no one has tested Manitoba’s children to document the frequency of infected but asymptomatic students. Recent research from Australia suggests schoolchildren may be important virus reservoirs, which then allows infection to escape into the broader population. Most Manitoba schools remain open. Strategy three: compromised.
Premier Brian Pallister and Dr. Roussin repeat that the current infection rates and hospitalizations are unsustainable. We are berated for failing “Team Manitoba.” But, the players aren’t the problem; the fault lies with the coaches’ strategy. Despite the arrival this week of the Pfizer BioNTech vaccine, we may not have widespread COVID-19 vaccination until autumn 2021. Manitoba needs public-health strategies that will effectively control this virus now.
Manitoba’s leadership must be bold. Close the borders and keep them closed until 70 per cent of Manitobans are vaccinated. Half-measures don’t work. We need a full lockdown, closing most manufacturing, construction and schools. Manitobans must prepare for the lockdown to last. Victoria, Australia, needed 113 lockdown days to overcome its second wave.
To do this, the province must provide economic and social supports to protect vulnerable populations, small business owners and laid-off workers. Our education system must provide high-quality remote education, with face-to-face instruction only for essential workers’ children and those at high risk.
Build additional capacity required for testing, contact tracing, critical and long-term care, and vaccination. This all will be expensive, but the alternative is mass casualties due to systemic health-care collapse. The sooner we act, the better off Manitoba will be. The only thing worse than hundreds of premature deaths is thousands of them.
Jeffrey Marcus is a professor in the department of biological sciences at the University of Manitoba. Joanne Seiff is a Winnipeg-based freelance writer and the author of three books.