Keep COVID Restrictions in Line With Experience
Posted June 5, 2020
Nova Scotians pay close attention to our Covid-19 statistics and the associated directions from Premier McNeil and Dr. Strang. It is important to look beyond our borders and learn from the experiences of other jurisdictions.
The United States leads the world in the number of cases, closing in on 2 million, and the number of deaths is now over 100,000. There is evidence that both are understated. Lockdowns to prevent spreading have led to a lot of pent-up frustration.
On May 25th, police in Minneapolis were videoed kneeling on the neck of a handcuffed George Floyd until he suffocated. The subsequent protests turned spread to more than 100 American cities and were sometimes violent.
This was no isolated incident. There have been multiple cases of police assaulting and killing black Americans and weak response by the justice system, bringing to life the Black Lives Matter movement.
Black Americans have suffered disproportionately from Covid-19, in both health outcomes and unemployment. They have reason to be the most frustrated.
A common result of the protests was the abandonment of masks and physical distancing protocols. This may set back efforts to contain the virus for months. The virus that contributed to the mayhem will be strengthened by it.
President Trump’s divisive leadership has made a bad situation worse by mismanaging needed supplies and subverting efforts by governors to promote social distancing and other measures to minimize transmission of the virus.
In Canada, governments are working well together. People generally accept the necessity of public health measures, but pent-up frustration is also a factor here.
In Montreal, it may have contributed to violence accompanying the protests triggered by the Minneapolis incident. Though not involving violence, it may also have been a factor in the wildly irresponsible decision by a doctor in New Brunswick to return from Quebec and immediately resume treating patients.
The outcome in New Brunswick is instructive. From a public health point of view having an infected doctor fail to quarantine, see patients—including those in a nursing home—and travel freely in the community is about as bad as it gets.
The province was able to gang-tackle the problem, deploying massive testing capacity in the area. As of Friday, the thousands of tests they have done yielded just over a dozen cases.
This, together with Nova Scotia’s success in suppressing three urban clusters in May, demonstrates that a province with very few active cases and strong testing capacity can be optimistic about its ability to contain an outbreak of infection.
When its outbreak was revealed, New Brunswick reintroduced restrictions, but only did so in the Campbellton region, which has less than 10% of New Brunswick’s population. The rest of the province continued to be in the “yellow” zone which is notably less restrictive than Nova Scotia’s current rules.
A note about severity. The outbreak at Northwood has taken 53 lives. For the families, it is especially difficult because they were unable to visit during sickness or be present at the end.
The infected patients were unlikely to be a source of community contagion.
Apart from care facilities, there were seven other Covid-19 deaths so far this year, about the same as the number of people killed in traffic accidents in an average month last year. The infection has galvanized our attention in part because it is unfamiliar, and especially because of its ability to quickly spread.
Public health measures have succeeded in containing the contagion. As of Friday, there are two cases, both from Northwood. Nova Scotia was slower than others to open up and still has one of the strictest protocols while having fewer cases than every other province from New Brunswick to British Columbia. The other provinces are comfortable differentiating protocols by region when the data points that way.
Nova Scotians have had more than their share of other tragedies this year, and the inability to properly mourn them. We also are experiencing pent-up frustration.
The public health measures have succeeded because people believe they are necessary and appropriate. There is a serious risk to them if people believe that the government’s actions are out of touch with the risk where they live. This may lead to a growing pattern of disregard and minor rebellions to the point that the government’s urgings no longer hold sway.
The emergence of occasional cases will not signal a failure of those prescriptions if the potential outbreak is successfully managed.
Since April 23rd, there have been only four cases outside of the Central Zone and none of them in the Western Zone. If there is a nascent outbreak in one of the zones, some restrictive measures will need to be reactivated but that should typically be only in the affected zone.
On Tuesday, Premier McNeil congratulated and supported the peaceful anti-racism protesters even though social distancing had been far from perfect.
Keeping Nova Scotians on board with the program will require that kind of pragmatism that adapts to emerging experience. Nova Scotians will be there for the long-haul if they feel that the government is making sensible choices indicated by the data.
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