I am in the midst of being the Campaign Chair (a silly title if there ever there was one) for the Peoples Party of Canada candidate in Victoria, John Randal Phipps. Which is my excuse for not blogging much.
The single issue in this campaign is the Vax Passport set to be introduced in BC tomorrow. This is a particularly obnoxious idea. Basically, it is a rule that people have to show proof of vaccination (and I use that term loosely) in order to access pubs, restaurants, sporting events, gyms and so on.
It has nothing whatsoever to do with health. Rather, it is a means to coerce and punish the unvaccinated. Which is nuts simply because the vaxxed are able to be infected and transmit the virus but are less likely to know they actually have the damn thing.
Here is the Israeli Ministry of Health on its version of the Vax Pass:
My own bet is that the BC Vax Passport, despite our superabundance of Karens, will fail in a matter of weeks. First off, of the 5 million or so British Columbians less than 1.5 million have applied for their vax passport. That leaves 3.5 million without papers. Second, while there may very well be enforcement at large venues, I can’t imagine a lot of very close to the edge pubs and restaurants showing a Gestapo like diligence in checking their potential patrons at the door. While the restaurants were packed tonight with people enjoying their “last suppers”, after about a week of 25% houses, the hospitality industry is going to get very slack. (And, amusingly, the BC Government has given fast food places and cafes an exemption for dining in without alcohol for 30 minutes or less. The MickyD’s exemption. They really are just making shit up.)
I have two bright kids, one a coder, one a designer, working away at my own, private Vax Pass App. It will look quite a bit like the BC Gov’t app – when that is available – and it will feature a QR code (see above, took three clicks) leading to a web page with something like.
I’m Good…Thanks
or,
Good Service gets great Tips
At a guess, in a couple of weeks, that will be more than enough to gain entry to most of the smaller venues – if those venues ask at all.
Never underestimate the power of human laziness when people are asked to do a silly thing which will cost them money.
British Columbia has a vax rate over 80% for first jabs with second jabs catching up fast. We also have exponential growth in “case” numbers and hospitalizations and admissions to the ICU are rising as well.
Our Health Minister and Public Health Officer have called a press conference tomorrow where, I expect, they will announce some restrictions – almost certainly travel restrictions, earlier bar closings and, perhaps, a return of the indoor mask mandate.
They will also probably have some unkind words for the unvaccinated although I would be very surprised if any form of vax passport was introduced.
While these measures will be pitched as public health responses to the 4th Delta wave they are, in fact, political responses to a fearful population a vocal portion of which is demanding “action”. The population is fearful because, it turns out that even a successful vaccination program, and BC has many shots in arms, does not actually stop COVID. While this may be blamed on the unvaccinated, the evidence from Israel and Gibraltar and Iceland suggests even high levels of vaccination, while helpful as to outcome, does not stop the Delta 4th wave.
I suspect Dr. Bonnie Henry already knew this. Minister Dix is a smart guy and likely knew this was coming. But the vax was oversold as immunizing when it isn’t. For the fearful, the vax was “the solution”. Now that it turns out to be pretty much a therapeutic rather than a sterilizing vaccine the fearful feel even more vulnerable. Which, in turn means they are advocating for restrictions, the harsher the better. Which is what, I suspect, Dix and Henry will be responding to tomorrow. (Remember, Henry did not impose BC’s first mask mandate, it was imposed by the government at the request of the BC Retail Council – public health had very little to do with it.)
Frightened people demand solutions, the more draconian the better. Politicians have to deal with those demands. The new school year is around the corner, the COVIDians – double vaxxed for safety and masking even without the mandate – are petrified that the Delta variant will kill them. They want the government to back up their fear with the traditional “strict measures”.
It will be interesting to see which way BC jumps. Will it continue along the path to more complete re-opening even at the risk of a rise in “cases” – as Alberta has done – or will it start the mask mandate/travel restriction regime again? Politically, this is a question of whether the government values fear over freedom. From a public health perspective there does not seem to be much that will stop the Delta 4th wave – at least anything which is open for public discussion.
I suspect fear is going to win tomorrow. I hope it doesn’t, but the fearful are a very motivated bunch. I hope that Dr. Henry stops short of re-imposing masks but, even more, I hope she takes a moment to remind people to take a walk in the sun, eat well, lose a bit of weight and rely on their vaccines, their natural immunity and the systems which support it.
The 4th Delta wave is upon us. I suspect the vast majority of us will be just fine.
UPDATE: I was wrong. Fear did not win this round. The only significant announcement was a vax requirement for people working in LTC facilities. While I doubt this will make much difference there is a logic driven rather than fear driven reason for such a mandate.
The government of Quebec is planning on introducing a vax passport. The government of Canada is looking at “mandating” COVID vaccination as a condition of employment for the federal government and corporations regulated by the feds. Dr. Bonnie Henry hinted today that she was fed up with healthcare workers who were not vaxed. If you want to enter a restaurant in New York City you have to prove at least one shot.
As I have said before, I am not at all an “anti-vaxer”, I am just not in any rush to get “the jabs” as I would like a lot more data on their long term effects. One mid term effect which is now emerging is that the efficacy of the jab in preventing serious illness appears to wane at about the 6 month mark. And, of course, the jab does not prevent infection or transmission of COVID, it appears to reduce the severity of COVID should you contract it. And all of this comes at the price of potential adverse consequences for a small number of those jabbed.
Against that people are arguing that there are good reasons to encourage people to get jabbed – principally their own health. Encouragement in the form of celebrity endorsements, free stuff, lotteries and the like seem like fair ball to me. But we go over the foul line when we impose consequences for not being jabbed.
I use the term “consequences” advisedly. Not being permitted to attend an event without vax proof is a consequence and, in my view, incompatible with a rights based view of humanity. It is a mild infringement to be sure, but it really is the top of a slippery slope and should be subject to strict scrutiny. Now, it can be argued that a venue or a rock band or a restaurant has a right to exclude whomever it wants so long as it does so without violating general anti-discrimination laws. However, this sort of exclusion regime will almost certainly be operated using government issued credentials.
The entire concept of a vaccine “passport” or “certificate” issued by the government – provincial, in the case of Canada – is acceptable right up until it is used to visit consequences, however well-intentioned, on those who lack that passport. This is not a loss of “priviledge”, it is the loss of the most basic right to be treated equally because you are person and a citizen.
Confronted with a disease which has a recovery rate of 99.9% for the non-elderly and relatively healthy the inner authoritarian in everyone from Premiers to pundits suddenly is put on parade.
“Just as we began to think the COVID pandemic was coming to an end, a fourth wave has arrived, due almost entirely to the unvaccinated. As a result, restrictions are coming back, masks are returning, and our short precious summer looks like it may become even shorter yet. Scott Gilmore, Macleans
(Interestingly Gilmore is so eager to administer “the stick” that he contradicts his claim about the nasty unvaccinated in the very next paragraph. “Even those of us who fully vaccinated are being forced to mask back up. This is because we have now learned that the new and deadly Delta variant can still be carried and transmitted by the immunized.” Which is it Scott? And, Scott, look up the word “immunized”.)
Once that inner authoritarian is in charge, the sky is the literal limit – no flights for the unvaxed, no restaurant dining and, at the extreme end, no job, no grocery shopping, no public transport. The rationales range from the alleged danger of the unvaxed spreading the disease to interesting theories about how the unvaxed will destroy “herd immunity” and act as human petri dishes for the incubation of ever nastier “variants”. That there is not a shred of evidence for any of these outcomes does not seem to deter the “papers please” crowd.
I suspect parts of Canada are in for a nasty, authoritarian, fall. Scott Gilmore is a reliable indicator of bien pensant thinking in Canada and he wants to beat the unvaxed with all manner of sticks. Can’t wait really. The government of Quebec, fresh off six months of curfews, seems to enjoy curtailing the rights of it citizens.
The BC government seems more modest in its medical authoritarianism – vax mandates for healthcare workers, maybe. But BC’s case numbers are going back up and with that rises a need to “do something”.
Here is the root problem: COVID19 is not going away. It will, eventually, but when is deeply uncertain. The “vaccines” don’t actually work quite as well as had been hoped. They do not immunize, rather they confer a degree of protection from serious illness. With flu season just around the corner, the public health establishment has pretty much run out of bullets. A fact tacitly conceded in Alberta where all restrictions have been cancelled as has non-symptomatic testing.
Vax mandates and passports are not going to change the COVID outcomes. They will let Scott Gilmore put a bit of stick about and Premier François Legault to coerce the long suffering people of Quebec a while longer but there is no reason to believe this is anything but an extension of the sanitary theatre we have had to put up with for the last 18 months.
The Gilmores and Legaults might be better advised to look at improving the general health of the population, actually building the backup facilities to prevent the healthcare system from being overwhelmed and to take a serious look at the treatment options for COVID. Not nearly as much good, clean, totalitarian fun; but ultimately more productive.
“In preparation for this change, CDC recommends clinical laboratories and testing sites that have been using the CDC 2019-nCoV RT-PCR assay select and begin their transition to another FDA-authorized COVID-19 test. CDC encourages laboratories to consider adoption of a multiplexed method that can facilitate detection and differentiation of SARS-CoV-2 and influenza viruses. Such assays can facilitate continued testing for both influenza and SARS-CoV-2 and can save both time and resources as we head into influenza season.” CDC: Lab Alert
The PCR test was used all over the world to detect “cases” of COVID. Implied in the CDC notice is that the test detected influenza as well. Which would explain why there was no “flu” this past flu season. If you tested positive on the PCR you were regarded as a case of COVID but you might well have had plain old flu.
[Update: My 20 year old bio-chemist, lawyer and reader, son, Sam, points out that the CDC is pulling one PCR test of 20 or so which are approved. PCR lives! (Still far more cycles than there should be, but he has a point.)]
From Israel, a heavily vaccinated country, we have the Prime Minister stating, “We do not know exactly to what degree the vaccine helps, but it is significantly less…the Delta mutation leaping forward around the world, including in vaccinated countries such as Britain, Israel and the US.”
In BC, having seen our numbers steadily drop heading into summer, our case count is rising again. Given the lifting of virtually all public health restrictions this is not surprising but it is a bit worrying.
The “vaccine will fix everything” strategy is examined by a professor in this Twitter thread. (h/t SDA)
On this beautiful summer day (though some mention the whole drought thing) it is worth thinking a little about what happens next with COVID. The good news on vaccines is that, so far, while they do not stop infection or transmission they do seem to reduce the severity of the symptoms for people who are infected. And, yes, it may well be that even without the jab those people would have had mild infections, but the hospitalization and death numbers seem to be encouraging. The jabs don’t seem to do as well against the variants but that is not yet a huge problem.
At the moment there is a fair bit of media enthusiasm for assorted coercive measures to be taken against the unvaxed. Vaccine passports are all the rage in the dimmer reaches of Ontario and Quebec and Manitoba seems to have implemented such a scheme. It is obvious nonsense from a direct public health perspective because the vaccinated an be infected and spread infection, but it seems to satisfy the more basic urge to “punish” the non-conforming.
The back and forth on testing, case rates, the need for non-pharmacological measures, the efficacy of vaccines and the safety of those vaccines, not to mention treatment and prevention options can make for interesting Twitter threads but there is a real flu season coming up shortly. To prepare for that season is something everyone, every family, can start doing right now.
If COVID and the flu continue to circulate, and there is no reason to believe they will not, jabs not withstanding, there will be non-medical consequences which may be more severe than the illnesses themselves.
Right at the moment, supply chains in BC and in Canada generally, are holding up quite well. However, they have been under considerable stress and the dislocations caused by gov’t reaction to increased case counts could be severe. It would be prudent for families to stock up on non-perishable essential goods. (Looking at the current crop conditions in Canada and much of the US it would be prudent for economic reasons as well.) Simple things like rice, flour, pasta, sugar, salt and beans are a starting point. Canned goods are good to have. A well stocked freezer – on sale ground beef, on sale frozen fruits and vegetables – may come in handy. And, why yes, toilet paper and paper towels are great to have. Cash – and while 100’s a lovely they can be hard to spend if things go sideways. 20’s are more practical.
Believe it or not, now is likely the time to buy PPE – mask, gloves, hand sanitizers. And, yes, indeed, I don’t think any of those items made a speck of difference in the first waves. However, right now they are practically being given away and it is not at all out of the question that the Phi variant or some such will be surface contact transmissable.
Stock up on your vitamins and supplements: Vit D & C, quercetin, zinc. Ivermectin if you can get it. There are plenty around at the moment, that could change.
Now, normally, this is the moment where people say, “And get the vax!” I am still waiting to see how well it performs and what side effects emerge. Your mileage may vary and you may not alreadly lead a largely self-issolated life. You do you.
My own scenarios for the Fall and Winter range from a nothingburger where, like the Great Influenza of 1918, COVID burns itself out and we see no substantial third wave, all the way to “the vaccine has compromised vaxers immunity and, like the ferrets, the vaccinated are all very sick and many of them die.” Being neither a virologist nor an epidemiologist, I have no idea what is going to happen come “seasonal upper respiratory virus” season. And I have no idea what the government/public health reaction is going to be. My only thought is to be prepared for the worst.
Being able to hunker down for a few weeks is never a bad thing. Depending on the severity of the Fall wave, you may want to close your door to the world for a month without the government telling you to.
Meanwhile, good long walks, trimming that last 5, well, 15 really, pounds, avoiding MSM are all useful things to do right now.
With luck, COVID will be a bad memory by Christmas. I hope so.
There has been a good deal of optimism generated by the growing number of people who have been vaccinated against COVID-19. Despite the fact that the vaccinated can still get COVID and spread COVID, vaccination has been seen as a way out of the COVID mess. Let’s hope so.
However, there seems to be a bit of a problem emerging in such high vax nations as England and the Netherlands are seeing cases, hospitalizations and deaths rise again. Israel, with an over 80% double jab rate, is seeing case numbers rise and attributing that to the “delta variant”.
There is now some talk of the need for a “booster” shot in the Fall.
Not being an epidemiologist I have nothing useful to say about these infection rates in the face of the vaccine. However, from a public policy perspective, it underlines something which has been a weakness from the earliest days of the COVID issue: non-pharmaceutical interventions (masks, social distance, lockdowns) and the arrival and distribution of the vaccine have been the go to public responses. Other responses have largely been ignored.
Were you to rely on the mainstream media and our public health people – not to mention the politicians, you could easily form the impression that there were no other alternatives.
I have banged on about how losing a few pounds, getting outside, taking Vitamin D were all things which, while they will not “prevent” COVID infection, will certainly make you more able to put up a good fight if you happen to catch COVID. (And we are seeing much more evidence that the people who are most at risk of dying with COVID are over 80, often suffering a number of co-morbidities, diabetic or very obese – people at much greater risk of death even before they caught COVID.) Simply encouraging people who can to improve their overall health could significantly reduce the overall risk COVID poses.
Frankly, Public Health officials should have been pushing exercise, weight loss, sun exposure and Vit D pretty much from the go. But there is no reason not to start now. (Especially if the vaccines are not super effective against the delta variant.)
The ivermectin and HCQ questions remain outstanding. It was not helpful that one of what looked like a positive study of ivermectin appears to be an out and out fraud. However, looking at countries and states in which one or both have been used suggests some efficacy. The argument is going to go on for a while but, again from a public policy perspective, it would seem sensible to set up and run proper trials for both substances.
I suspect there are other promising treatments out there which I am unaware of. The point being that we need to be developing alternatives to complete reliance on vaccines which seem to have varying efficacy and worrying side effects which are only now emerging. This is not at all an “anti-vax” position, rather it is a prudent position. If, for some reason, the vaccines’ effectiveness against emerging variants is reduced, having treatment options and a generally healthy population would be, as Martha Stewart used to say, “a good thing”.
Lauchie Reid: Hyacinths and Thistles. All images courtesy of the artist.
I got into a Twitter fight last night with a person – I think female but can’t tell for sure – who tweeted that she did not want to be in crowded indoor spaces with the unvaccinated and that they should stay outside like smokers.
I suspect we will hear a lot of this sort of thing over the next few months as COVID wanes and the vaccinated become a majority because it is not enough to be “protected”, the vaccinated seem to need to be isolated from the unvaccinated. Thus the call for vaccine passports and vaccinated only events.
The logic of this seems to rest on the idea that the “vaccine” is not 100% effective in preventing infection or transmission of COVID. What it does confer, apparently, is a reduction in the severity of the symptoms of COVID in the event that the vaccinated person is unlucky enough to catch the virus. You can see the problem, essentially a vaccinated person may be at the same risk for infection as an unvaccinated person and at the same risk of transmitting the bug as an unvaccinated person.
Now, frankly, I don’t think we have enough data one way or another on the vaccine’s efficacy in preventing infection or transmission – the early data seem pretty encouraging on the vaccine’s reducing the severity of the COVID symptoms and the mortality numbers are falling encouragingly. But separating the vaccinated from the unvaccinated is not at all obvious based on what we know so far.
My Twitter gal did not like that position at all and was eventually reduced to calling me “selfish” for not a) getting jabbed, b) for suggesting that there was no logic in separating people who could be infected and who could transmit the virus but who had the prospect of a better outcome if they did from people who could be infected and who could transmit the virus and only had a 99.9% chance of full recovery.
The COVID conversation usually comes down to people’s perception of the risk COVID presents. The vast majority of people who contract COVID feel badly for a few days and are done. Death from COVID is largely confined to people over 80 with one or more co-morbidities. At a clinical level doctors are becoming much, much better at treating the symptoms of COVID. This is not contested information. The daily statistics show much better outcomes for hospitalized patients. Even the “variants of concern” do not seem to have increased the lethality of COVID.
So a risk calculus with respect to the vaccine needs to begin with assessing an individual’s likelihood of a fatal outcome if he or she were to contract COVID. A 99.9 percent survival rate if you are under 80 and are not significantly compromised is a reassuring place to start. Does it make sense to take a new and untested vaccine to improve those odds? (And before we get into the weeds on testing, the vaccines all are being used based on an Emergency Use Approval which is not at all the same as the full testing which drugs typically undergo. That testing is ongoing and will be completed in late 2022 or early 2023.)
As I have consistently written about COVID, you have to manage your own situation which means being aware of and assessing what your life holds by way of risk. First off, do you live in an area with high rates of infection? Do you interact with strangers on a regular and continuous basis? What is your general health status? Do you get outdoor exercise? Individuals can assess these factors for themselves.
Against your personal risk profile when you are looking at “the jab” you would normally take the advice of the medical community which, in turn, would rely on the peer reviewed results of the drug testing the jab is undergoing. But those results are not yet available. Even the mid-term effects of mRNA based vaccines are more a matter of conjecture than evidence.
So the calculation is not so straightforward. As I happily say when asked, “Not yet, I’m in the control group.”
Which brings us back to “selfish”. I assess my personal risk of contracting – much less dying from – COVID as very close to zero which has meant I have been in no hurry to get jabbed. But my Twitter pal seems to think that is selfish. Somehow, my not being jabbed is going to…what? Make her jab less effective? Nope. Destroy herd immunity? No, at worse it may reduce herd immunity infinitesimally but there is very little evidence either way. Prevent her from feeling confident in enclosed crowded spaces? Maybe, but not at all my problem. Prevent the great re-opening? Possibly. The re-opening is a political decision and various politicians have come up with various metrics – case numbers, outbreaks, hospitalizations, first jab percentages, full jab percentages – to give the appearance of science to a purely political decision. Again, not my problem and not part of any rational, personal, risk calculation.
I suspect that the woman on Twitter was, in fact, driven by the very basic human tendency to want others to do what you are doing. When people are terrified, and COVID and the mass media have scared the Hell out of people, they want the security of the group. When the politicians, media and public health officers all say, “Everybody needs to get the jab,” it is much easier to go along with the crowd. Part of going along with the crowd is trying to herd dissenters into the ranks of the righteous. If they won’t be herded then, well, they’ll have to be ostracized.
The good news is that, as COVID fades, so will the zealous. As the threat recedes the urgency of the group think will diminish. As normal returns, attempts to separate the vaccinated sheep from the unvaccinated goats will lose their moral force.
My Twitter friend will have to find something else to be indignant about.
BC is re-opening in stages based upon the percentage of the population who have had first doses of the “vaccine” (I use quotes as it is not at all obvious that the mRNA injections are vaccines in the traditional sense of that term. This is not a knock, rather it is an indication that some caution is warrented.) Indoor dining started lasst night, the mandatory masks indoors in public order is expected to end July 1, travel restrictions are being eased are are rules about gatherings.
The COVID numbers are dropping with only 289 new “cases” (ie. positive test results) in the province yesterday. Only 6 on Vancouver Island where I live. Hospitalizations, cases in the ICU and deaths are all down.
These improvements are being credited to the vaccine despite the fact that only a tiny percentage of British Columbians (less than 5%) have had the required two doses. Arguably, a single dose strategy, while it does not confer 100% protection, is good enough to bend the infection curve. [The past month of warming, sunny, weather might have had something to do with this as it did last year when there were no vaccinations and COVID virtually disappeared.)
Predictably there are plenty of people on Twitter and in the MSM who are worried that this is too soon. There is an active claque who want COVID-Zero before even thinking of re-opening. Against that view are people looking at states in the US like Texas and Florida which are wide open and back in business.
Politically, and a good deal of the response to COVID is political, public acceptence of restrictions has been eroding quickly. The vaccinated can see no reason not to get on with their lives, the hesitant and outright rejectionists, are looking at falling case numbers and assessing their own risk more aggressively.
For restrictions to work there has to be public buy-in. Back in March 2020, when COVID was new and terrifying, restrictions simply structured the response of a public already staying at home and avoiding other people. As we understood the virus better, realized that it was far from lethal for a large part of the population and began to understand how it was transmitted, people were more willing to lead semi-normal lives. (This was particularily true for people who had been keeping up with the rapidly changing “science”. Knowing that outdoor transmission was extremely unlikely was useful, knowing that the virus was only very, very rarely transmitted by contact with inanimate objects was useful. Taking onboard the fact that the virus was airborne was both worrying and actionable.)
“The jab” simply accelerated the return to a more normal life. People who had even a single shot were less afraid. And the public was more than able to recognize that if the jab worked the need for restrictions and mask mandates faded. Otherwise, what was the point of the jab?
You do not have to presume a conspiracy to note that a great deal of the public COVID reaction was grounded in fear rather than fact. The public at large seemed to believe that the virus was deadlier than it is and more infectious than it has turned out to be. Terrified the public wanted lockdowns, masks, business closures and travel restrictions. Once that fear began to fade because of falling “case” numbers and rising jab rates the public support for restrictions began to slip.
The BC Government recognized that the fear was over. Re-opening was going to happen whether the government permitted it or not. The official “re-opening plan” is largely a recognition of this reality rather than a public health document.
A couple of detailed BC COVID reports leaked to the Vancouver Sun last week. They were interesting in themselves – I just moved from 0% positivity rate North Saanich to .1-1% positivity rate Oak Bay – but they bring up the question of how much information should be given to the public and how much, if any, withheld? And for what reasons?
My own view is that it all should be released as soon as it is compiled so I can make informed decisions as to my relative level of risk and my behaviour in the face of such risk. Against that view are a variety of arguments: granular data may compromise privacy, detailed demographic data could lead to racial discrimination, data on co-morbidities might give people a false confidence (“I’m not fat so COVID is not a problem for me.”)
However, underlying the decision not to fully disclose is the public health agenda of compliance. In BC, unlike Ontario and Quebec, we do not have mandatory stay at home orders. Our public health response has been to suggest limiting contacts, eliminating a lot of indoor activities, mandating masks and asking people to limit travel to essential purposes. Whether this has worked better than the more restrictive lockdowns in other provinces is an open question.
For the BC light handed approach to work there has to be a good deal of voluntary compliance with the various measures suggested. Generally there has been, but as the vaccination program gains traction and Spring brings a welcome decline in cases, hospitalizations and deaths, the logic of compliance is beginning to break down.
Having better, more granular, information would, I suspect, actually improve public health outcomes. We are going to open up in any event eventually; have good information will let each person assess his or her relative risk. Vaccinated in Oak Bay? You’re golden. In South Surrey? It would be wise to maintain precautions until a really significant percentage of the population is vaccinated.
In the early stages of the COVID problem there was a great deal of uncertainty. We were given advice in good faith which turned out to be wrong. COVID is almost never transmitted by surface contact so the sanitary theatre and gloves were largely a waste of time. However, COVID is airborne which means that ventilation is critical. Social distancing and masks have turned out to be of limited use in stopping the spread but may have some utility in “hot spots”. There are all sorts of pieces of information like this which are useful to individuals trying to reduce their own risk.
At the beginning the messaging was that “we are all in this together” and that messaging worked. But, in actual fact, we now know that some populations and demographics have much higher risks. Pinpointing those populations and demographics – the poor and the brown – means that vaccination doses can be targetted while shortages persist. (And, frankly, for those vunerable populations, the “two dose right on time” regime makes a lot of sense. Even at the expense of us Oak Baysians having to wait a bit longer.)
Most of all, giving complete information will tend to increase the public’s trust in the public health officials and the politicians who direct them. At this point, with the end of the crisis (but likely not COVID itself) in sight, that public trust is a critical factor in defeating the virus.
COVID cases in BC have shown an alarming upswing. There are reports of people refusing to abide by the guidelines about gatherings. There are indications that the nasty Brazilian variant is on the rise. And, as always, hospitals are under tremendous pressure. Add to that a shortage of vaccines and the provincial government felt it had to act.
It announced a “non-essential” travel ban. The details are sketchy but in the first instance the police would be empowered to conduct random checks to ensure that no one left their Health Authority for non-essential purposes. (This was walked back a bit, now police will set up roadblocks to check on motorists.) And BC Ferries is cancelling the reservations of RVs. Constitutional niceties be damned, this time we’re serious.
There is simply no way that this “order” will work. Begin with the fact that Health Authority boundaries are principally administrative and that the average citizen is entirely unaware of where Coastal ends and Fraser begins. Worse, in the Lower Mainland, there are literally thousands of people who commute to work across the Fraser Coastal HA divide. Then there is the question of what is essential travel. (Probably best defined negatively as “travel whose purpose is not primarily recreational – take that you RVers.)
The entire scheme reeks of panic. Not panic at the relentless course of the virus, rather panic at the inability of the government to “do something” to stop that virus. A ban on ill defined non-essential travel between bureaucratic fiefs pretty much defines “half measure.”
There is a happy battalion of lefties who want nothing less than “COVID Zero” and who want that by way of a very strict, Australian style lockdown. Mandatory stay at home orders with only the most limited exemptions for food shopping. These people tend to refer to Dr. Bonnie Henry as a “libertarian” which they don’t mean in a nice way. It is certainly an option.
Counter poised to the “COVID Zero” types are people who don’t think lockdowns, masks and the various other non-pharmaceutical interventions are worthwhile – either because they don’t work or don’t work well enough to justify their significant economic, social and medical cost.
The great difficulty the current provincial government faces is that for any of the potential measures to work there has to be a level of public trust and agreement. It is becoming clear that the Canadian Courts take a dim view of fines and orders which are in direct violation of the Charter of Rights. All the provincial governments know this and it explains why so very few cases have been taken to Court. The last thing a government wants is for a Court to rule that its orders are unconstitutional.
Just as the COVID Zero people point at Australia and New Zealand, the anti-lock down people point at Florida and Texas. The COVID Zero folks point at case rates, the no lockdowners are more interested in deaths and hospitalizations. Both sides seem to agree that vaccination offers the best hope of beating the virus although there is some skepticism about whether “beating the virus” means eradicating it or reducing it to manageable levels.
Where people fall in this argument is largely a matter of their view as to the effectiveness of the state itself. Which is precisely where the travel ban fell apart. The one thing left and right will agree on is that a half hearted, unenforceable, unconstitutional set of restrictions will not work. That these restrictions were proposed at all undermines people’s confidence that the state can be effective. “Do something” is not the basis for policy which will have widespread support.
Right now, the government of British Columbia is faced with a set of unpleasant options. My own sense is that a really hard lockdown for a set period might still be possible; but that window is rapidly closing absent some truly horrible COVID outcomes. Which means that the default option of piecemeal activity, masking, closed restaurants and the hope that the vaccine and warmer weather work their magic is our most likely outcome.
Dr. McCullough is a very smart, very eminent, doctor and he raises the question of why COVID patients are not offered treatment when they first test positive for the virus. He outlines some of the early treatment options but the real take away is that patients are routinely not offered any treatment or even information about treatment at all.
This has puzzled me from the outset of the pandemic. I realize that this time last year there were few clues as to what might make a difference. HCQ was touted but dismissed on the basis of some rather badly constructed single drug, later intervention, studies. Ivermectin was still over the horizon and some the steroids were being looked at but were not really options. But, a year later, you would think that early treatment would have advanced. But it hasn’t. Nor has there been much official conversation about the benefits of having strong Vitamin D levels and trying to bolster your immune system.
The entire arc of the COVID story has been social distance, masks, closures and lockdowns until vaccines can be delivered in bulk. The idea of a parallel track where doctors and researchers come up with a set of best practices to treat patients once they have tested positive seems to have simply never gained traction. At least not in the West.
Dr. McCullough points out that while all eyes were on the vaccine there was no comparable effort to develop treatment protocols. Why not? The good doctor points out that none of Trump’s COVID advisors had ever actually treated a COVID patient which might explain a bit. But Trump’s people were not the only people advising political leaders. Every country had its advisers.
My own ten cents worth is to look at it from a public policy perspective. From the go COVID has been seen as a public health emergency. Public health, by definition, looks at population scale solutions. Hospital capacity, rates of transmission, reduction of transmission by restriction on movement and activities. To public health officials, with the best will in the world, COVID is a mass phenomena which requires mass solutions. There are, however, other lenses to bring to COVID.
COVID could have been viewed as public emergency like an earthquake or an economic collapse. Through this lens, public health is one element of a government wide response. Through this lens, the public health interest in containing the spread of COVID would be matched by a medical response on a case by case basis. There is no reason we could not have done both. (Obviously, in the hospitals and the ICUs, case by case medicine is being practiced with somewhat encouraging clinical results.)
In a purely public health response, the idea of treating individual cases and developing protocols for early intervention can easily be lost in the drive to preserve the population until vaccines can be developed to save us all. And the logic of public health can justify all manner of non-pharmaceutical interventions to avoid overwhelming the hospitals and keep people from getting the virus. However, the public health response tends to see the virus as a binary: either you avoid it long enough to get vaccinated or you don’t and your risk of death rises. For a nastier virus than COVID has turned out to be, that might have been the correct reaction. But COVID is not ebola or even the Spanish flu, its nasty but most people will survive it.
The medical question, rather than the public health question, is what Dr. McCullough wants to talk about. It is a conversation which should have been had in the Spring and Summer of 2020 when the first wave had broken and the second wave had not yet arrived. Doctors now had clinical experience with severe COVID and were developing strategies to deal with it in hospital settings. But, apparently, there was very little work being done to figure out what to do in the critical week or two between a person testing positive and developing symptoms severe enough to require hospitalization.
Frankly, that amazes me. It shocks and amazes Dr. McCullough.
Right now I am going to organize the daily dog park tour and drink in the Spring sun. Like most upper respiratory infections, COVID should fade quickly as the weather warms. But, as it does, it would be a very good idea, even with the vaccines, to come up with standard of care treatment plans for people who come down with COVID as we wait for the vaccine.
Jay Currie 