This opinion piece is by Steven Lewis, who is a health policy consultant formerly based in Saskatchewan. He now lives in Australia.
Congratulations. You are enrolled in a massive scientific and political experiment, no informed consent necessary. The laboratory is the planet and the study population is everyone. It’s mad-scientist stuff: unleash a novel pathogen, contagious but with ingenuity containable, lethal for some and barely symptomatic in many, difficult to treat but potentially vanquished by a vaccine.
Without a vaccine or a wonder drug, there is only containment.
Successful containment is built on five pillars: a) knowing what works; b) policies to implement what works; c) consistent and committed execution of the policies; d) clear rules for what people can and cannot do; and e) widespread public adherence to and enforcement of the rules.
Governments are responsible for pandemic control.
It is an inexact science, not least because the playbook has to be updated for new viruses like COVID-19 because they spread and harm people differently. It’s unfair to expect governments to get everything right with absolute precision, every restriction perfectly targeted, every risk perfectly quantified. But it’s fair to criticize them when they ignore very good evidence and put people in harm’s way.
Sask. has ignored good evidence
Saskatchewan Premier Scott Moe frames pandemic control as a choice between reducing risks and saving the economy. This explains the reluctance to close high-risk environments known to be contagion hotbeds. The key word in the sentence is “known.” When do you know enough to act decisively?
If you require perfect, irrefutable evidence of effectiveness before acting, you will do nothing. There is only one piece of definitive evidence about COVID-19: Doing nothing is guaranteed to spread it rapidly throughout the population.
You could get to a million cases in Saskatchewan in a few weeks by pretending it is 2019. People with symptoms would tough it out and continue to go to work, visit their elderly relatives, and congregate in bingo halls and bars. The virus would spread faster than a Taylor Swift video.
But there is no definitive evidence about how to contain it. By definitive I mean clear cause and effect: not just, we did A and B happened, but A caused B, and without A, there would be no B.
To illustrate with the example of the state of Victoria in Australia, population 6.5 million:
- In early July there were 150 cases a day in the state — equivalent to about 30 in Saskatchewan.
- The government closed non-essential businesses, made masks mandatory indoors and outside, and on July 7 severely limited time outside the home and social interactions.
- The daily case rate continued to rise, peaking at 687 on Aug. 4.
- The government locked down even harder the same week, with an 8 p.m. curfew.
- The daily numbers dropped to 100 within a month, the teens in another month, and zero by the end of October.
- The state has had no new cases for four weeks as of Nov. 27.
- Since March the police have issued 25,000 fines totalling $30 million for violating COVID-related rules.
Would the numbers have gone higher without the July measures? Would the drop-off have been as steep without the August lockdown boost? Did the prospect of a stiff fine deter young people from gathering in high-risk situations? Is the state well and truly virus-free, or are the current restrictions — limited seating in bars and restaurants, distancing in stores, masks mandatory in indoor public places — still necessary?
We don’t — and probably won’t ever — know for certain.
What we will eventually learn is how different governments viewed and used the evidence available.
Time to get ahead before it is too late
Saskatchewan implicitly has equated even quite strong evidence with no evidence, and given itself a licence to go with its hunches. Other governments have been humbler about their own wisdom, subordinating their own speculations to the best available, albeit imperfect evidence. They acknowledge that to ignore what is partly known concedes easy victories to a pandemic that exploits every weakness in the response.
Saskatchewan has ignored good evidence and, as a result, there will be more cases that extend the pandemic’s duration and dash the premier’s hopes for an early return to a full-throttle economy.
For far too long the premier chose to act on the “evidence” that some people didn’t want to wear masks indoors instead of the evidence that they work. Continuing to leave high-risk venues open flies in the face of a great deal of international experience, at best a little short-term gain for massive long-term pain.
Saskatchewan is reacting to the pandemic as if it can be finessed and outsmarted with a half-measure here, a belated response there, and opportunistic concessions to interest groups. It’s time to get ahead of it before it is too late.
Already the next few months look bleak. Continue to dither and ignore the evidence, and bleak will become catastrophic.
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