BY IAN PATTISON
As the coronavirus creeps across Canada and fear seeps into people’s minds, governments are doubling down on their advice -- stay put to stay healthy. Not everyone can do that, especially the people we rely on most to keep us safe. Health-care workers have been sounding alarms from the moment this isolated infection grew out of China to pandemic proportions. Canada has let them down, and it needn’t have happened.
Right now supply chains are racing to make up for lost time. Contracts for personal protective equipment (PPE), ventilators and test kits are being doled out as fast as governments can find manufacturers who aren’t already committed to others’ orders. The bidding is fast and furious. The bills to come later will help crystalize the message that was long ignored. The Boy Scouts have known it all along: Be prepared.
The situation is plain at Thunder Bay Regional Health Sciences Centre where medical vice-president and COVID-19 incident manager Dr. Stewart Kennedy says that testing for the virus is still behind the curve. “We want to increase (test) swabs,” he said on March 31, “but we still have shortages and provincial directives lack clarity.”
By April 1 Kennedy was saying the hospital would have to ration PPE. It approached one, then two U.S. companies to try to buy in-house testing equipment as provincial test turnarounds stretched to nearly a week. Without accurate testing, authorities have no idea the extent of the virus in the community.
Two days later, admitting Thunder Bay and the Northwest are “lower priority” for getting PPE from senior government supplies, Kennedy announced more aggressive rationing, fully expecting “push-back from staff.” By now, patients were restricted to their rooms. Concern in the community was verging on fear.
“Fear is good,” said hospital chief of staff Dr. Zaki Ahmed on April 6, since it prompts people to stay home and follow the rules. “I worry about panic,” Ahmed said, apparently thinking about hospital staff “using things inappropriately, acting irrationally or worse, spreading panic and getting everyone else panicked.” He sought to boost their morale, likening them to military personnel. “It’s not just a profession, it’s a commitment.”
A local nurse was interviewed about her state of mind and she thought of a duck. Above the water it appears calm and unruffled, but underwater its little legs are pumping furiously to get it to where it needs to go. Staff are trying to portray a calm demeanor, she said, but inwardly there is a great deal of fear as PPE supplies dwindle and cases rise -- to 26 in the Thunder Bay area as of Saturday with nine more in the wider Northwest region -- leading to two hospital admissions and 29 presumptive cases waiting on tests that still take three days.
“We are in crisis mode,” said Rebecca Piironen, a personal support worker at a nursing home near Hamilton, where eight residents have died of COVID-19 and several dozen more are infected. “These people are dying, gasping for air.”
Doctors' and nurses' groups told the Commons health committee Monday that health-care professionals across Canada are alarmed by shortages of desperately needed PPE. The president of the Canadian Medical Association, Sandy Buchman, spoke for doctors. "They are scared. They are anxious," he said. "They feel betrayed. They don't know what supplies are available."
By Tuesday, Kennedy said arrival of in-house test kits locally won’t occur until late next week -- depending on availability. “If we had an endless supply of swabs and quicker turnaround time it would be nice because . . . there is prevalence (of coronavirus) as high as 20 to 30 per cent in the community.”
In his Thursday briefing Kennedy revealed the hospital has acquired two pieces of equipment to test swabs but still needs associated test kit materials. One kit awaits federal licensing and the other is in huge demand. The hospital could conduct 400 tests per day in-house if it had the kits and Kennedy is clearly frustrated at the delays.
The number of COVID-19 tests completed in Ontario each day has dwindled steadily over the past week, raising concerns that the province is missing cases and failing to capture the true spread. Ontario is testing a smaller portion of its population than anywhere else in Canada.
It’s bad enough that Thunder Bay’s hospital has to scramble on its own for test kits. But the overall shortfall in supplies was foreseen.
In 2006, reports The Globe and Mail, top health authorities from across Canada put together a playbook to prepare for a situation strikingly similar to this one. One of the co-authors was Theresa Tam, now Canada’s chief public health officer in charge of the fight against the novel coronavirus.
As the CBC’s Murray Brewster reported Tuesday, for years there have been quiet but persistent demands coming out of the defence and acquisition sectors for successive federal governments to develop a list of "strategic industries" that do not have to rely on foreign supply chains — as insurance against the kind of procurement panic in play right now. These calls were largely ignored.
"We've been totally negligent on that and it is something I have articulated over and over again," said Alan Williams, the former head of the procurement branch at the Department of National Defence. "It's absolutely critical and if this doesn't wake us to that reality, I don't know what would."
It all goes back to the mad rush to globalization. Spread manufacturing throughout the world to make the things we need at the cheapest possible price and everything would hum along nicely. Except it hasn’t.
Corporate greed and government self-interest -- U.S. President Donald Trump is increasingly using private sector friends to restrict supplies to politically supportive governors -- have borne out warnings from as early as 2000. That’s when a report for the Council of Canadians said our health care system was coming under increasing pressure from international trade deals like NAFTA. “These agreements, stripped of their complexities, are little more than charters of rights and freedoms for transnational corporations,” the report said.
One of their purposes is to speed up the privatization of health care and protect and encourage government measures that increase access to markets. For-profit health care grows while governments rely on marginal supply chains that come up short during a crisis like the one we are experiencing right now.
The planning is clear, the advice concise: Prepare for worst-case scenarios, and that includes the effects of climate change which is taking a worrisome back seat to the coronavirus even as the evidence of widespread harm and damage quietly escalates.
Ian Pattison is retired as editorial page editor of The Chronicle-Journal, but still shares his thoughts on current affairs.