ICU covid

A medical team in the intensive care unit of Toronto's Humber River Hospital helps a patient with COVID-19. The risk of hospitalization among people who are unvaccinated has been found to be seven times greater than that of vaccinated and their intensive care attendance rate is nearly twice that. Most Canadians are fed up with this situation and favour consequences.

By Ian Pattison

This is an updated version of a column that first appeared in the print edition Jan. 15.

There! Did you feel it? A tectonic shift in public opinion occurred this week along a coronavirus fault line. A year ago we were still in the “we’re all in this together” stage. Now it seems it’s everyone for themselves.

You can’t get tested anymore unless you’re vulnerable. That’s because there aren’t enough tests for everyone who may or may not have the milder Omicron variant that may or may not land you in hospital where there may or may not be a bed for you. Unless you’re unvaccinated and really sick. Then you go to the front of the line ahead of someone else who may need cancer treatment or an arterial stent or a new hip.

As one Thunder Bay area pharmacist wrote this week, drug stores are still not permitted to sell rapid antigen test kits for home use. “I know, we think it makes sense that people could purchase and use these at home, too.”

So you’re left to wonder, “Is this Covid, flu or just a bad cold?”

As more people get vaccinated and boosted, Omicron’s surge has prompted a new round of confusing restrictions.

At the start of the month Ontario said school re-openings would be delayed to allow for distribution of masks and HEPA filter units. Then Premier Doug Ford said schools will re-open Monday prompting mixed reaction among those who say kids must be back in school for their mental health and those who say they should stay at home for their physical health. More than half of Ontario children aged 5 to 11 haven’t had their shots.

If schools do re-open on Monday parents won’t be told if there is sickness in the school until at least 30 per cent of students or staff are absent. Before that they won’t be told if coronavirus is present. This is public policy?

The Thunder Bay District Health Unit said at week’s end there were 356 active cases, including 80 new ones, with 17 in hospital including two in intensive care. The real case number is much higher because testing and tracing have been severely reduced.

Thunder Bay Regional hospital, which re-opened a dedicated Covid unit last week, is now at 98-per-cent overall occupancy while ICU is at 73 per cent. This brings to mind the recurring “gridlock” situation that has plagued the hospital multiple times in the years before we even had a pandemic.

Omicron is not expected to peak until later this month, at up to 300,000 cases daily throughout the country. On Friday there were 37,500 new cases, again underestimated. So it’s anyone’s guess how many people are infected.

Overall there remains a stubborn minority of Canadians – I can’t find an official estimate anywhere but it’s in the millions – who can’t or won’t get vaccinated. The ‘won’t’ group has hardened the hearts of most Canadians who resent them monopolizing scarce hospital space.

Nowhere is this more evident than in Quebec where Premier Francois Legault announced Tuesday that unvaxxed Quebecers will have to pay a "significant" financial penalty if they persist in not getting jabbed.

Quebec has already persuaded some holdouts by denying them entry to liquor and marijuana stores until they get vaccinated. Maybe someone should flip the concept and use positive reinforcement. If it were me I'd have a lot of loyalty to any store that offered me a gift certificate or discount when I presented my vaxx pass.

About 10 per cent of adult Quebecers aren’t vaccinated, but they represent about half of all patients in intensive care and are the most seriously ill.

“I think right now it’s a question of fairness for the 90 per cent of the population who made some sacrifices,” Legault said. “I think we owe them this kind of measure.”

Polling shows majority support for the idea in every province. So much for the old all-for-one-and-one-for-all mood.

Whether because of this proposal, or denying the unvaxxed entry to liquor and pot stores, or both, Health Minister Christian Dubé said that first-shot appointments grew threefold as of Friday.

Writing in La Presse, Francis Vailles explains the reasoning for the penalty:

‘... the risk of hospitalization of recalcitrant is 7.1 times greater than that of vaccinated and their intensive care attendance rate, 13.8 times greater. Taking these proportions … we can estimate that with their vaccination, there would have been approximately 237 fewer patients in intensive care for 28 days and 924 fewer in the ordinary unit (excluding intensive care). Knowing that a COVID stay costs $50,000 in intensive care and $15,000 otherwise, it can be estimated that the refusal of the unvaccinated to comply has cost the government $26 million over the past 28 days. In short, we are at nearly $1 million per day. That's a lot of dough!”

Tasha Kheiriddin defends the plan in the National Post:

“It’s like saying ‘wear your seatbelt, but if you don’t, that’s OK.’ Well guess what — it’s not. If you get in an accident, it will cost up to three times more to treat you in hospital than if you were buckled up. Sound familiar? The reality is that we restrict plenty of behaviours where we judge the harm to others, including economic harm, outweighs the limits to individual liberty.”

Outspoken Thunder Bay-Rainy River Liberal MP Marcus Powlowski, an ER doctor, agrees, and believes others in his party do, too.

"We already have taxes on tobacco. We have taxes on alcohol, which are there for similar reasons because people who consume those products are more likely to end up in the hospital," said Powlowski Saturday on CBC's The House. "And as a result, we're all going to have to pay for their hospitalization."

Again in the Post, John Ivison thinks it’s a bad idea, and maybe illegal:

“Targeting the vaccine hesitant with an additional taxation obligation is discriminatory and sure to be the subject of a future constitutional challenge. It is astonishing to think that this Liberal government is not only relaxed about the Canada Health Act being breached, and serene about blatant discrimination against a minority of the population, it is also indulgent of a regressive tax that does not make allowance for age or income.”

As usual, Prime Minister Justin Trudeau won’t say where he stands on a thorny Quebec issue while opposition Conservative Leader Erin O’Toole maintains that the unvaxed should be accommodated, not punished. Opposition for its own sake can sometimes be nonsensical.

“It’s his belief that you can’t coerce people into getting vaccinated; you need gentle persuasion,” writes Gary Mason in the Globe and Mail. “This, of course, is ridiculous and a tactic that continues to be futile.”

So, to sum up, you can’t tell anymore if you’ve got Covid without a test unless you’re sick enough to be admitted to the hospital which probably means you’re one of an unknown number of unvaccinated Canadians – including school children – living among us. Your province, other than Quebec, will continue to accommodate unvaccinated citizens while vainly trying to convince them to get a jab they’ve avoided for two years.

No wonder we feel less secure but more cavalier about the whole ruddy thing.

Ian Pattison is retired as editorial page editor of The Chronicle-Journal, but still shares his thoughts on current affairs.