How Canada fumbled COVID
Tags: Covid 19

A story about how to spoil a lead

(Disclosure: I’m not an MD, virologist, epidemiologist, public health expert, etc. I’m just someone who can read news and understands that time is linear.)

I thought Canada would do well in this pandemic. Canada already had SARS 1.0 in 2003, what could go wrong? Canada already had this muscle! Well, I was wrong.

Fumble #1: “It’s not happening here” rural snobbery

Canada is a very urban country, however people like to believe they’re spread out because a raccoon sometimes makes an appearance in their ex-burb. Canadians themselves love to feel distant from craziness that is happening, especially if the craziness is happening primarily in the United States. One supposes it’s mentally comforting to believe one is very far away from extreme episodes of gun violence and extremely partisan struggles occurring in the United States.

Of course, COVID doesn’t work this way, and I believed the wake-up call for people in definitely “rural” areas should have been British Columbia’s first presumptive case of COVID — https://www.summerlandreview.com/news/first-presumptive-case-of-coronavirus-identified-in-the-interior-health-region/

“She landed at the Vancouver International Airport before travelling in a private vehicle to her home in the Interior Health region, which includes Kamloops, the Okanagan, the Kootenays and Cariboo. She has self isolated herself in her home.”

It would seem that this person drove along many sparsely populated roads — no big deal, right? However the other side of the coin is that services offered along these roads are quite densely populated. British Columbians knew in February that a COVID case had more than likely visited the Tim Horton’s in their community and decided to go on pretending that what was important was their local numbers. Cases in British Columbia and Alberta were counted locally and acted upon locally, as if each town was a magical hermit kingdom. This did not work.

Not only did this not work, the attitudes of Canadians did not change even after a small community in Alberta managed to acquire one of the highest COVID-19 infection rates in the world.

Fumble #2: The Mask Snub

The question of what do to with PPE was a screwup from the start. But few jurisdictions outside of Canada has screwed it up as much as Canada has.

First, Canadian companies fortunately acted — April 22, Tim Hortons required employees to wear masks. On May 21, Costco Canada started asking customers to wear masks.

Then provinces started to do something — Quebec mandated masks in July and started arresting people for noncompliance.

And Washington State similarly moved — King County Mask Mandate was in effect on May 18, and Washington State passed July 7.

What did British Columbia do? Nothing at all until November. Bonnie Henry actually wrote an op-ed about how enforcement would be problematic from a social justice perspective — https://bc.ctvnews.ca/dr-bonnie-henry-op-ed-why-b-c-doesn-t-have-a-universal-mask-mandate-1.5191721 Ten days later, enforcement was introduced anyways.

Alberta was even more pathetic, passing mask enforcement measures only in December. Recall that during all this time, travelers were arriving in Alberta and BC from COVID hotspots in Canada *without any quarantine restrictions*. Municipalities knew this and became amateur epidemiologists — in late July, the Town of Cochrane, Alberta passed what might be the most complicated mask mandate in the world, with masks being required if more than 10 active cases were within their city limits (or was it new cases per day? I cannot recall). The mandate was to be automatically removed if there was 0 cases for 14 days.

The algorithmic complexity of bylaws was astounding as the Town of Cochrane, and presumably all municipalities across Canada, did not actually employ an epidemiologist. This job should have been on the provinces to manage, and provinces should have realized that a city-by-city approach to masking does not work.

Furthermore, mask requirements without the support of police put small businesses (and more tragically, young low wage employees) in the awful situation of needing to police a rule without the manpower necessary to actually make a patron comply.

Unfortunately, John Horgan did not want to piss off the part of the BC electorate that believes that 5G caused the rona and that masking interferes with their life energy. Similarly, Jason Kenney did not want to piss off conservative wexiteers that think the rona was made in a lab in order to elect Biden and love to ramble on about how one dewormer or another might be a cure-all for the virus.

Overall, pathetic slow footed leadership at the provincial level (that often imagined provinces to be entirely different than the state to its south) is responsible for screwing up mask mandates in Canada. Cowardly premiers relied on expendable mayors and city councils to make the unpopular tough decisions early on and all this did was let the infection fester.

Fumble #3: Tracing and school preparation failures

By many accounts, British Columbia and other provinces did a fine job of contact tracing at the individual level. The problem is that this effort did not adequately roll up into policy or public awareness. Many Canadians are under the impression that there are magical places — schools, massage therapy clinics, hockey rinks — that are not at all responsible for “the spread”.

Early in the pandemic, we knew that schools in Israel had outbreaks. We knew one of the worst superspreader events in the United States was a choir practice only an hour’s drive from Vancouver.

Given this information, it is quite shocking that a music teacher in Surrey, BC got covid in *NOVEMBER*.

As a music teacher, Lourenco was not assigned to a learning cohort. Instead, she taught nine classes per day — and estimates about 500 kids came through her class every week.

This result was entirely predictable. What is not clear is how anyone could have thought this activity was an acceptable risk to take.

Fumble #4: App failures

As with everything now, there’s an app for that!

Restating the boundaries of my knowledge, I am not an epidemiologist, but I do know a think or two about software, and how to build a good app.

If there was a list of rules on how to build a good app, these 3 rules would be on the list:

Provide value Don’t build two apps Put telemetry in the application and closely watch adoption rates

On every measure, Canada’s contact tracing apps have failed. The federal app, COVID Alert, is not used in BC and Alberta. BC insists it is a waste of time, while Alberta simply loves its own app, ABTraceTogether, for reasons I don’t even want to bother thinking about.

The United States is no better in this respect, as apps go by a state-by-state model that is also ineffective.

Ultimately Canada had a chance to get the federal app to be understandable and widely adopted, but this failed to materialize. Yet this failure is not completely on BC and Alberta’s inability to be team players — it’s not clear if any contact tracing apps in Canada would have the adoption necessary to be extremely useful. Diligent restrictions like Australia and New Zealand and Atlantic Canada have executed on would seemingly be started and completed long before any contact tracing app would have the population penetration necessary to matter very much. Instead of following Australia’s proven trajectory, Canada is content to just make contact tracing apps into a useful political football.

Fumble #5: Border failures

Very early in the pandemic, Canada closed the southern border. Only ‘essential’ travel was allowed. Despite qualifying as ‘essential’ for reasons of family reunification and repatriation, I decided to sit and swelter in Seattle all summer instead of chilling in Canada. After all, a mandatory 14 day quarantine takes weekend trips off the table.

As I masked-up and wore a hairshirt for the sin of existing in Seattle, people from Alberta and the Lower Mainland of British Columbia were seemingly invading the interior of British Columbia mask-free. The province of British Columbia sat idly by while the masked-up Washington community of Point Roberts was economically destroyed by a border control measure that most Canadians supported while not bothering to restrict travel from COVID hotspots within Canada. Living in Point Roberts and doing basic shopping in Canada was completely forbidden while those coming from Toronto (pronounced “Torona”) were able to immediately land, take off their Torona masks and start gobbling up margaritas in BC bars.

It is absurd that throughout this pandemic the 49th parallel has been a legal nightmare while health districts did not bother to build any internal restrictions. If paying the economic cost of closing the border with the United States, Canada should have taken the next logical step and instituted zone control like the Atlantic provinces have managed. If Canada provided equal weight to equal risks, Canada could have had hit zero cases nationwide. Instead, Canada took a figurative shit on US citizens and expatriates for no good reason. All USA-sourced travel was bad, while all Canada-sourced travel was good. This does not make sense from a public health perspective, but it makes sense if you understand Canada’s politics.

Now back to the personal story of the failure of this insane border policy — eventually the summer ended and lead to many more months of planning for post-border crossing quarantine. After being allowed to cross into Canada from the apparently disease-ravaged United States, anxiety about quarantine restrictions quickly became anxiety about the incompetence of the public health response. It was another Canadian application failure — the ArriveCAN app was accepted, but seemingly not promoted by border officials. The app itself asked the traveler to “voluntarily” report symptoms (the sentences in the app became a bit less relaxed as the situation rapidly deteriorated in November). In 2 weeks, the authorities called 3 times and only spoke to 1 member of a 2 person party. The ArriveCAN app makes no attempt to determine where a user is or whether they are compliant with location restrictions and does not even bother to ask for Location privileges in Android. While these measures may be a success for user privacy and citizen freedom, it is a complete failure of an actual public health measure. By many accounts, South Korea, Taiwan, and Hong Kong have deployed measures on incoming travelers that might actually work — Canada’s approach is a half-assed in comparison and relies on individual compliance. Individual compliance is sadly lacking given the amount of misinformation that people like Trump/Kenney acolytes have been spewing all year.

Canada has what it takes to follow Australia/New Zealand’s success — the Atlantic ‘bubble’ proves this. Unfortunately, lazy self-satisfied incompetence squandered the great luck Canada had early in 2020. Hopefully it’s not too late to get back on track.