Canada and Covid

Fred Lazar

Schulich School of Business

York University

Toronto

May 2, 2021

Introduction

At the beginning of this year, many Canadians and most of their political leaders, were prepared to do a victory lap, believing that the worst of the pandemic was behind us and the national, provincial and territorial governments had all performed beyond expectations. Developments since then have likely tempered our celebrations. But I intend to demonstrate that our political leaders, and I am being generous in referring to any of them as leaders, have failed us from the outset. I could make similar arguments for leaders of almost every other country in the world. Since I am a Canadian, I focus on our leadership.

The late Yogi Berra, who in my opinion was one of the greatest strategic minds of all time, once said: “You’ve got to be careful if you don’t know where you are going because you might not get there.”

What does this have to do with the arguments I intend to make? The political leadership might have been clear on where they wanted to go — re-election — but they were totally oblivious to where their policies would take the country. Unfortunately, they, along with the majority of Canadians, still do not see where we might be heading. Again, I could say the same about the leadership of most countries — consider the European Union where many countries are experiencing a W-shaped economic recovery (many countries are now on the second recession leg), the Covid-wave is not subsidizing, and increasing numbers are protesting the loss of basic freedoms.

I start with the following question: as we now enter month 15, actually closer to month 20, but the Government of Canada only acknowledges that the pandemic began in March 2020; how well has Canada done in dealing with Covid?

The answer depends on the metrics to be used to grade the performance of Canadian governments. Of course, should I use absolute or relative values for each of the metrics?

Since Canada likes to compare itself to the US, given our similarities, the long border that we share, and since most Canadians see themselves as the antithesis of Trump and his supporters, let me start with some comparative data. It appears from the data in Table 1 that Canadians should be proud that we have done better than the US. We have had approximately one-third the number of cases per capita as the US — 32,000 cases per million population vs. 100,000 per million for our neighbors to the South. The number of deaths per capita also seem to be about one-third of the levels in the US — 638 deaths per million vs. 1,774 deaths per million. However, the infection mortality rate in Canada continues to be higher than in the US — 1.98% vs. 1.78%. At least this gap is narrowing. By the end of last summer, the infection mortality rate was 6.1% in Canada, and 2.9% in the US. Thus far, in comparison to the US, Canada — stand up and take a bow.

Table 1: Coronavirus Cases and Deaths, Canada and the US, End of April 2021

 

Canada

US

Global

Total cases (000s)

1,224.0

33,116.7

152,639

Total cases per 1 million population

32,198

99,566

19,582

Tests per 1 million population

828,050

1,343,555

 

Total Covid deaths

24,255

590,215

3,201,764

Total deaths per 1 million population

638

1,774

411

Total deaths/Total cases (%)

1.98

1.78

2.10

 

Or should we?

While it seems as if we have done better than the US, at least in the pre-President Biden era, we do not seem to have done better than the world as a whole. In terms of cases per million population and deaths per million population, Canada has underperformed. Compared to the gold standard — Australia — our record is abysmal. Australia has had only 1,158 cases per million people and 35 deaths per million. But Australia’s infection mortality rate is higher — 3.05%.

While Australia, and its neighbor New Zealand, can be considered to represent the gold standard, it is far from clear that their leaders have an end-game in mind — Yogi is right. Perhaps, they never did. When will they be able to open up their economies? When everyone in their respective countries have been vaccinated? Not likely, since they will be reluctant to open up to all countries, and especially those that lag behind in vaccinating their citizens. So, will they have to wait till the entire world is vaccinated? This too does not make much sense since this might never happen. Thus, what is their end-game?

Nevertheless, we seem to have outperformed the US.

What about on the economic front — has our seemingly better performance on the health front come at a cost of inferior economic performance?

The data in Table 2 indicate that, thus far, Canada has performed slightly better than the US. For example, real GDP in Canada has recovered by the fourth quarter of 2020 to almost 97% of the level at the end of the fourth quarter in 2019. Real GDP in the US recovered by only 94%. In terms of employment, unemployment and unemployment rates, Canada appears to have recovered slightly more than the US.

Congratulations Canada!

Table 2: Select Economic Indicators, Canada and the US, Year-end 2019- March 2021

 

 

Canada

US

Real GDP ($millions)

Q4 2019

2,114.1

19,254.0

 

Q4 2020

2,045.9

18,194.4

 

Q4 2020/Q4 2019 (%)

96.8

94.5

Employed (000s)

December 2019

19,021.5

157,538

 

March 2021

18,500.8

150,493

 

March 2021/December 2019 (%)

0.973

0.956

Unemployed (000s)

December 2019

1,041.9

6,001

 

March 2021

1,631.7

9,905

 

March 2021/December 2019 (%)

156.6

1.651

Unemployment Rate (%)

December 2019

5.2

3.6

 

March 2021

8.1

6.0

 

March 2021/December 2019 (%)

1.558

1.667

 

It took hard work and very large checks from the Canadian Government to produce the V-shaped recovery. Canada’s COVID-19 Economic Response Plan during the fiscal year ending March 31, 2021 included the following:

  • $37 billion for emergency response benefits provided through the Employment Insurance program;
  • $53 billion for the Canadian Emergency Response Benefit and Canada Recovery Benefits;
  • $85 billion for the Canada Emergency Wage Subsidy; and,
  • $49 billion for transfer payments.

All told, the Canadian Government’s total program expenses increased $276 billion during the 2021 fiscal year, and the budget deficit increased from $39 billion (1.7% of Canada’s GDP) for the fiscal year ended March 31, 2020 to $354 billion (16.1% of GDP) in the 2021 fiscal year.

But is applause in order for our Prime Minister and his government? My unequivocal answer is NO!

The Prime Minister and his provincial and territorial counterparts across the country have done an abysmal job of dealing with the pandemic. They should be thrown out of office. As the Queen of Hearts said: “Off with their heads.” I quote figuratively, not literally.

The End-Game for Canadian Governments

Canadians were terrified, primarily by the media, and demanded foolish policies that our political leaders, who all being astute followers of public opinion polls, were more than happy to provide. Anthony Furey, writing in the Toronto Sun on September 26, 2020 asked an important question: “What’s Canada’s pandemic objective?” The same question could be asked of most governments. His conclusion, at least for Canada: “Our leaders don’t seem to have a clue.”

I disagree with his conclusion. Our leaders did have an objective. They knew where they wanted to go. They just had no idea where the policies might take the country as a whole — they ignored the wisdom of Yogi

In the remainder of this essay, I intend to demonstrate the total incompetence of most governments, and especially ours across Canada, using Covid-19 as a case study; to show that evidence-based policy-making is a myth; to show that short-sightedness and incompetence have long tails creating future crises; and to argue that we cannot afford a similar degree of global ineptitude the next time a new virus appears on the horizon. In an inter-related global community, mistakes made by some governments negatively impact many other countries. We must be very wary about hysteria and fear creating the foundation for totalitarianism. When people are terrified, they can be misdirected and captured by a strong and charismatic leader.

Always be careful of what you ask!

Decision-Making Process

Let me step back and start with my views on decision making. Every year I teach a new cohort of MBA students that decision making involves choosing a path (a strategy) to get from “here” — the present, to “there” — some place in the future. Decision making also requires choosing the time frame for moving from “here” to “there.”

All decisions are forward looking. Hence, they are based on guestimates of key variables. Consequently, mistakes are inevitable since the future is unpredictable — the known unknowns and the unknown unknowns. Thus, once a path has been chosen, the decision makers must continually collect new data and re-assess their original decisions. There must be contingencies in place to deal with possible mistakes — the original guestimates can turn out to be wrong. There is the selected path/strategy (plan A), and there also must be plans B, C and so on. Furthermore, as the decision makers and their organizations move over time closer to “there,” they need to engage in the next round — selecting the next “there,” path and time frame.

The starting point for all decisions is knowing what “there” is — the objectives.

This is a simple framework, but with much complexity and uncertainty. The essence of risk taking is preparing for and dealing with the inevitable uncertainties — the absence of complete and perfect data.

How does all of this apply to governments across Canada and their responses to Covid-19?

Keep in mind that Justin Trudeau, when he first became Prime Minister, proclaimed that his government would base policy on evidence. Since the beginning of 2020, he supposedly based his policies on “science.” The provincial and territorial leaders also proclaimed they were following the science — the data.

Government Objective(s)

The principal, and usually the only objective of all governments is to stay in power, and in democracies, this requires getting re-elected. For democracies, the time frame is determined by the election cycle. Unlike the US, the Party in power in Canada can orchestrate a defeat on a motion of confidence and/or call an election any time within five years of the last election. The Party forming the current government cannot go beyond five years between elections. Thus, there is no regular four-year election cycle in Canada. With the Prime Minister and his Liberal Party continuing to be ahead in the polls, it is quite likely that an election will be called within the next six months. I suspect that the Prime Minister is waiting for a massive inflow of vaccines so that he can claim success in getting a majority of Canadians vaccinated, at least with one dose.

Hence, the strategies, at both the national, provincial and territorial levels of government, for dealing with Covid-19 have been and continue to be doing what is necessary to increase the incumbent party’s standing in the polls. Politicians know where they want to go. But this does not mean they know where their policies will take the country.

Now that we know the objective, what does this mean for the strategies — the paths? This should have depended in part on what “here” looked like in March 2020 and beyond, and what might happen during the appropriate time frame — the time till the next election.

At the beginning of 2020, there were rumors about a new virus in China, but there was no great concern in Canada and most other countries at that time. By the second half of January, everything was beginning to change as China shut down Wuhan. The US was among the first countries to close its borders to China. Canada did not follow because our Prime Minister sold himself as the anti-Trump. Regardless of the data, being the anti-Trump was the right decision to generate favorable poll results. When the evidence/data do not support the political narrative, ignore the evidence and get new data. I guess this is what our Prime Minister really meant by evidence-based policy-making.

Outbreaks began occurring on cruise-ships at the beginning of February. The Diamond Princess became the poster child for the dangers of cruising. Stories and pictures started coming out of Italy of people dying and hospitals being overrun with critically ill patients. Modellers came out of the woodwork predicting enormous losses of life if nothing were done to combat the spread of this new virus. The media was off to the races — creating hysteria and fear to generate ratings. The word pandemic, and Hollywood movies that portray pandemics as apocalyptic events threatening the future of the world, made it easy for the media to succeed. The predictions of millions and possibly tens of millions of people dying from this virus drove the fear levels even higher. Every day, more and more people began to believe that we were all on the precipice of Armageddon.

This was the basis for “here” in late January and throughout February.

Governments felt compelled to do something — Covid-19 had become the most pressing crisis, at least for increasing numbers of people in every country. Canada was no exception. The polls indicated the people demanded immediate action — being the anti-Trump was no longer sufficient — and our Prime Minister had to come up with some strategy in order to be re-elected, and especially with a majority government. We have a parliamentary system of government, and if a Party can win a majority of the seats in the House of Commons, the Prime Minister and her/his inner group of advisors face few impediments to enacting whatever policies they might desire, as long as they do not infringe on provincial rights or upset Quebec.

Policy Options

What were the options in March 2020?

There were essentially four. At one extreme was the China-Wuhan option — complete lockdown of a region or even a country. At the other extreme was the original Putin/Bolsonaro option — do nothing and let everything continue as it did before anyone had heard of Covid-19. In between, there was the option combining making masks mandatory, at least indoors; mandating social distancing of at least six feet; restrictions on the number of people that could gather in indoor or outdoor spaces; and shutting down certain businesses and activities, including possibly schools. Finally, there was the Swedish option — a much lighter version of the preceding option, relying on volunteer compliance.

Which path should Canadian governments have chosen?

At this point it is useful to look at the data in Table 3.

        Table 3: Coronavirus Cases and Deaths, Brazil, Russia and Sweden, End of April 2021

 

Brazil

Russia

Sweden

Total cases (000s)

14,726.0

4,814.6

973.6

Total cases per 1 million population

68,874

32,979

95,908

Total Covid deaths

406,565

110,520

14,048

Total deaths per 1 million population

1,902

757

1,384

Total deaths/Total cases (%)

2.76

2.30

1.44

With hindsight, it might appear that the Brazil/Russia and Sweden options produced poorer outcomes, at least with respect to total number of cases and Covid-19 deaths. However, Russia’s experience to date has not been dissimilar to that of Canada, and the infection mortality rate in Sweden has been much lower than in Canada. But there is more to decision-making than these data.

Selecting the Path

Rational decision making would have required assessing what “here” looked like, and what might happen as government and the country moved along the path over time to reach “there” — the next election date.

The following data are critical — how easily does the virus spread, the value for R; the severity of the virus, that is, what proportion of the people who would be infected would need to be hospitalized; the mortality rate, that is, the probability of dying; possibly the level at which herd immunity might be achieved; and how long before an effective vaccine might be available. Unfortunately, in the first quarter of 2020, there were no reliable data, only guestimates.

But other data were needed as well to make a rational decision and choose the path forward. For each option, it was necessary to estimate the possible impacts on the healthcare system, healthcare costs, the number of lives saved, and the economic consequences and costs, including social and longer-term health costs. A cost-benefit analysis would have been helpful and should have been conducted. Good decision making requires collecting the best data available, analysing the data, and estimating the possible costs and benefits of various strategic options.

Traditionally, governments have relied on a range of experts — covering several different disciplines — to make policy decisions. Data are imperfect and incomplete. The science is not necessarily definitive or supported. Trade-offs are considered, of course, with the objective of improving the government’s chances for re-election.

But this did not happen at either the national level or the sub-national levels. The data were not available or were unreliable. The hysteria reached levels that turned the debate into one of lives versus money. How dare anyone put a price on anyone’s life, even if it is an 85-year-old in extremely poor health?

Yet all safety regulations do place a value of life. So too do military and law enforcement decisions. In Canada, doctors have been left to make decisions regarding whether or not to resuscitate certain patients. Provincial governments, since they are constitutionally responsible for healthcare in Canada, have made many decisions regarding the funding of life-saving drugs, and oftentimes, they have refused to pay for such drugs. No politician wants to discuss life and death issues publicly, unless they involve national security.

Consequently, given the objective for governments, the lack of good data, and the horrific projections for the possible number of deaths, most governments decided that empathy and a single-mindedness focus on limiting the potential damage that might be caused by the virus were the paths to follow in order to achieve their objective. Trying to minimize the economic and fiscal damage and costs did not get any traction in the decision-making process. Who would choose money over lives?

Flatten the curve became the motto. Governments in Canada, and elsewhere, started with the China-Wuhan option, but for a much more limited period of time. This option was followed by the mask, social distancing, limiting numbers and selective closures option. As the curve would be flattened and pushed downwards, the restrictions would be gradually lifted, and governments could declare victory and head for an election. To mask the economic consequences, political leaders would march out each day and throw around tens of millions and even billions of dollars in every direction imaginable. Alfred E. Neuman would have been proud: “What me worry?”

Free money and a government that cared. What could go wrong?

By choosing this path, governments stoked and even exacerbated the fears of their citizens. As the media reported each day the new body counts, people became even more frightened. In Canada, we were regularly inundated with the slogan, “we are all in this together.” Of course, the three Territorial Governments, the Atlantic provincial governments and the Government of Manitoba interpreted this to mean that only for those people who live in each of these respective regions were we in this together. If you lived elsewhere in Canada, we did not want you. Nimbyism spread across the country and the federal government made no effort to prevent these restrictions on cross-country travel. The polls likely indicated that to do so would diminish the chances of winning the next election. Travel freedoms and the economy were the wrong path, according to polls, which were in turn driven by the daily fear mongering of government and the media. I, for one, never imagined that in my lifetime I would not be able to travel freely across Canada.

When the government initially chose the path in March 2020, it did not want to mislead the people into believing the goal was to eradicate the virus entirely. Flatten the curve became the goal — to prevent the healthcare system from being overrun (no one wanted a repeat of the pictures from Italy and Spain where many infected with the virus were left to die in hospital hallways — a picture is worth a thousand words), and to limit the total number of infections and deaths until a vaccine became available. What governments did not point out was that a flatten the curve approach would not necessarily reduce the total number of infections and deaths versus the Putin/Bolsonaro option if it took 18 months or more for a vaccine to be available. I guess governments continue to believe that people can’t “handle the truth.”

The Science

From the beginning, governments across Canada emphasized that they were following the science, unlike the Neanderthal south of the border. The political leaders regularly trotted out their senior health advisors, and oftentimes hid behind them when they resorted to draconian lockdowns.

By following the “science,” did the governments succeed in flattening the curve? Was a flare-up, or worse yet, a second wave or third wave inevitable as restrictions were gradually lifted? If other countries encountered a second and third wave, what should Canadian leaders do to maintain their standings in the polls dive?

Canada eagerly agreed to travel restrictions between the US and Canada in the spring of 2020, and these restrictions continue in force. When the number of cases and deaths in the US spiralled in late 2020 and early 2021, the vast majority of Canadians applauded these restrictions and demanded even tighter controls. We had to show the Americans, and in particular the Trump supporters, that we were smarter in dealing with the pandemic.

More recently, our Prime Minister had a more difficult time in imposing a one-month travel ban on flights from India. As the virus seemed to spiral out of control in India, more and more Canadians demanded a travel ban. But the Indian vote is crucial for the Liberal Party in British Columbia and Ontario, and the Prime Minister found himself in a dilemma. Undoubtedly, days of polling convinced him that his party would win more seats than it might lose in the next election with a travel ban.

Science had nothing to do with the border restrictions in the two cases. Polls were all that mattered.

Remember, a critical part of decision making is to continually monitor new data and change the original decision when necessary. “Here” is not static. Science is rarely definitive.

Even though the media publish each day the number of new infections and deaths attributable to the virus, what do we really know?

The New York Times, which continues to pretend that it is an important part of the news media — indeed the people who run the NYT believe they are the most important part — updates each day its chart on new reported cases in the US. The chart begins on March 1. According to the NYT, the virus did not enter the US prior to this time. Similar charts for other countries, Canada among them, also have a March start date. The first red flag.

It is well known now, and it was known even at the beginning of 2020, that the virus originated in Wuhan and started circulating across China, and then the rest of the world, by mid-November 2019. Between mid-November and mid-January, about the time that President Trump imposed a travel ban to China, tens of millions of Chinese travelled around China and the world, and hundreds of millions of others travelled around the world. It is naïve, and just plain stupid to believe that the virus was not circulating around the world, including Canada, since December 2019. Thus, governments did not even know the start date for counting the number infected. There were no tests to identify a carrier of the virus until some time in January 2020.

How about post-March 2020? Once more, it is naïve and just plain stupid to believe that the numbers reported each day have been accurate. Unless everyone in a country is tested each and every day, and the tests produce very few false positives, the daily numbers reported tell us little, and especially about the shape and trend of the “curve.”

For example, on April 30, 2021 there were about 150,000 tests and 7,600 new cases reported in Canada. This translates into a positivity rate of 5.1%. If we accept that there were only 7,600 new cases, this implies that if the remaining 38 million Canadians also had been tested, none of them would have tested positive. The probability of this outcome is zero. In other words, if many more people had been tested, the number of new cases would have been commensurately higher.

What if we apply the positivity rate to the entire population? This implies that up to 1.9 million Canadians would have been counted among the new cases for April 30. The probability of this outcome also is zero. What can we conclude? The number of new cases must have been between 7,600 and 1.9 million — quite a range. This has been the case since Canadians started being tested. In other words, we do not really know what the daily number of new infections has been. All that we can say with some certainty is that the number of new cases each day has exceeded the numbers reported. And this is the case for all countries. So much for evidence-driven policy-making.

Governments have been making and continue to make decisions based on ignorance. But ignorance might be bliss as people are still overwhelmed with fear; and as long as the government seems to care about lives and doles out money, election prospects continue to look good.

Without a reliable estimate of the base — the number of infections — we do not know two other critical pieces of this puzzle: the mortality rate, not the meaningless infection case mortality rate (presented in Tables 1 and 3); and the severity of the virus

Is Covid a Crisis?

Did we really face a crisis? Was the fear overdone?

Governments were “spurred” to act by the rising hysteria and fear, and especially by the projections made by the modellers at the Imperial College in London. Apparently however, no government bothered to review the accuracy of past predictions made by these same modellers. A study by John Ioannidis (Stanford Prevention Research Center, Department of Medicine, and Departments of Epidemiology and Population Health, of Biomedical Data Science, and of Statistics, Stanford University, and Meta-Research Innovation Center at Stanford), Sally Cripps (School of Mathematics and Statistics, The University of Sydney and Data Analytics for Resources and Environments, Australian Research Council), and Martin Tanner (Department of Statistics, Northwestern University) pointed out the gross errors made in the past:

“Failure in epidemic forecasting is an old problem. In fact, it is surprising that epidemic forecasting has retained much credibility among decision-makers, given its dubious track record. Modeling for swine flu predicted 3,100-65,000 deaths in the UK. Eventually only 457 deaths occurred. The prediction for foot-and-mouth disease expected up to 150,000 deaths in the UK and led to slaughtering millions of animals. However, the lower bound of the prediction was as low as only 50 deaths, a figure close to the eventual fatalities. Despite these obvious failures, epidemic forecasting continued to thrive, perhaps because vastly erroneous predictions typically lacked serious consequences. Actually, erroneous predictions may have been even useful. A wrong, doomsday prediction may incentivize people towards better personal hygiene. Problems starts when public leaders take (wrong) predictions too seriously, considering them crystal balls without understanding their uncertainty and the assumptions made. Slaughtering millions of animals in 2001 aggravated a few animal business stakeholders, most citizens were not directly affected. However, with COVID-19, espoused wrong predictions can devastate billions of people in terms of the economy, health, and societal turmoil at-large.”

The Canadian Government could have used the resources and expertise of Statistics Canada to conduct monthly random sampling of the population to estimate the numbers infected, and the severity. Random sampling works for producing data on the labour market. Random sampling could have worked just as well with the virus. But for unknown reasons, Canada, and many other countries, chose not to do the obvious, probably for the same reasons they did not want to question the original dire predictions about the possible number of deaths.

In Table 1, the infection case mortality rate for Canada is just under 2%. Is this a reasonable estimate of the mortality risk? This would be a valuable piece of information to consider in trying to make a decision regarding how to deal with Covid-19.

A recent study by Arnold Barnett (“Covid-19 Risk Among Airline Passengers: Should the Middle Seat Stay Empty?”), a professor at the Sloan School of Business at MIT, used a mortality rate of 1%.

In mid-September, as the number of reported cases in the UK appeared to be rising again, Sir Patrick Vallance (the Chief Scientific Advisor to the UK Government) said:

“At the moment we think the epidemic is doubling roughly every seven days. If, and that's quite a big if, but if that continues unabated, and this grows, doubling every seven days... if that continued you would end up with something like 50,000 cases in the middle of October per day. Fifty-thousand cases per day would be expected to lead a month later, so the middle of November say, to 200-plus deaths per day.”

In other words, he was predicting a mortality rate of 0.4%.

Let’s apply the range of mortality rates between 0.4% and 1% to the Canadian estimates for the number of people who have died from Covid-19. We get a range for the possible actual number of Canadians infected to date between 2.4 and 6.1 million — well above the reported number of 1.2 million. For the US, we get a range between 59 and 148 million — compared to the reported 33 million.

There have been several studies indicating that the actual number of people infected with the Covid-19 virus might be six to 20 times the actual numbers reported.

What is the real number? No one yet knows, and definitely not governments.

The mortality rates might even be lower than 1% or even 0.4%, especially when we exclude the very old who die in nursing homes. For example, research by Oxford University found that around 29% of the people included in the coronavirus death tolls by the Office of National Statistics in the United Kingdom during the summer months had died primarily from other conditions. Most of these might have died even if the people had not become infected with the coronavirus. The research found that throughout the entire pandemic, about 8% of the people classed as Covid-19 victims did not have the disease as an underlying cause of death.

Dr. Jason Oke, part of the team from the Centre of Evidence-Based Medicine at Oxford that uncovered the data, said many people had been dying “with” coronavirus but not “from” it.

He added:

“The true death rate is an important thing to know because it gives us an idea of impact…The impact now seems to be lessening, and if that is true – which it certainly looks like at the moment, because there doesn’t seem to be the same fatality rate – then that will guide decisions in managing risk, so it's important to get this number right. In the lockdown, there may have been even more deaths that were not caused by Covid, but were caused by the actions of lockdown – and that is important to know.”

The CDC in the US reported last year that only 6% of all deaths attributed to Covid-19 were caused by the virus alone. In the other 94% of the cases, the virus was a contributing factor, and not always a critical factor. Thus, not only do we not know the number of total and daily new infections, we probably do not even know the number of deaths attributable primarily to the virus.

Remember that one of the objectives for flattening the curve was to prevent the healthcare system from being overwhelmed. What is the severity of the illness caused by the virus? That is, what proportion of all people infected by Covid-19 require hospitalization and intensive care?

As more data have become available, there are indications that 90% or more of people infected with the virus either are asymptomatic or suffer very mild symptoms. This would be consistent with the apparent low mortality rates. This virus might not be a more serious threat than the flu

Policy Making in Ignorance

In February and March of 2020, governments were shrouded in the “fog of war” — they did not have data to evaluate policy options. They chose the path of least resistance — the one that appeared to increase their popularity with the electorate, even though they created serious problems in the future, beyond the next election cycle. Data are still spotty and incomplete, but the economic damage is apparent, and the severity of the virus is increasingly questioned.

A good friend of mine, Irvin Studin, has created a global Commission to investigate the number of students who have dropped out of the education system entirely as more and more schools were shut down by governments; and to develop solutions to find these students, reintegrate them into the education system and motivate them to graduate and succeed. Thus far, he has estimated that between 200,000 and 300,000 students have disappeared from the education system in Canada alone. The global numbers run into the hundreds of millions.

Most of these students come from low-income households. If we lose 30% of these students permanently; that is, they never return or remain in school, this collateral damage alone from the policies implemented in many provinces in Canada will destroy the lives of at least 60,000 to 90,000 Canadians — a far greater loss than the 24,000 who have died to date from the virus. These young people are just part of the aggregate collateral damage. To this we can add the countless numbers of businesses created by immigrant families that have been destroyed; the longer-term physical and mental health consequences of lockdowns, isolation and fear; the hysteresis effects of longer-term unemployment; and the eventual burden on future generations to pay for the record government deficits. Were the costs less than the benefits? Did governments even try to estimate either?

So, what does all of this tell us?

First, that the numbers being tracked on a daily basis are meaningless. This, in turn, means that no one knows what the curve actually looks like to date — we don’t know the start date, and we don’t know if the actual number of cases is rising or falling.

If we exclude people 80 years of age and over, the mortality rates for everyone else might not be significantly greater than for the seasonal flu. Yet, people are not panicked about the flu, and governments do not resort to draconian measures to reduce the number of deaths during the annual flu season.

As more data have become available, governments do not seem to have changed their preoccupation with flattening the curve and limiting the number of deaths, even as the economic, social and health costs mount. Professor Mark Woolhouse, an expert in infectious disease at Edinburgh University, argues the government must carefully “balance the harms” of Covid with the consequences that come from trying to contain it. He says there is already growing evidence the “cure has been worse than the disease” because of the wider societal costs. While good decision making requires changes in strategies as more data become available and it becomes clear that the original assumptions were incorrect, rarely do we see any political leader admit that s/he made a mistake and is prepared to change paths.

Decision Making Failures

Did governments make the best decisions in March 2020? What about since that time? Consider the following five examples in Canada, and the so-called claims that decisions were following the science.

1. Shutting Schools

Most provincial premiers ordered schools to be shut and education to be moved online. These decisions did not realize that students in low-income families would be most negatively impacted. Their families could not afford laptops or tablets, or the costs of access to the Internet. What would happen to these young people? Irvin Studin has found out. Governments should have anticipated these outcomes.

Moreover, many new studies have shown that there are very low risks for infection among young people, and mortality risks for them are in line with those for the flu. Several studies also indicate that there are low risks of students spreading the virus to teachers. Yet, as new data have become available, and the science continues to evolve, our political leaders have not changed course. Schools continue to be shut down in many provinces. So much for evidence-based decision making.

2. Overwhelming Hospitals

Flattening the curve was the battle cry for lockdown decisions. Apparently, we are now in a third wave in Ontario, despite not knowing the real numbers. The number of hospitalizations and patients in ICUs do provide an indicator, and they appear to suggest that we are into a new wave. But our current experience highlights two major shortcomings with Canada’s healthcare system — one the result of current decisions, the other the result of past decisions (Yogi’s warning once more).

There are remedies to reduce the incidence of hospitalizations. But with the current system, when someone tests positive, s/he is ordered to go home and self-isolate. This person is not directed to a physician. New evidence shows that a physician could prescribe certain medications that would reduce the likelihood that the patient’s health would deteriorate so as to require hospitalization. But instead of going on medications, some peoples’ health deteriorates and then they must be hospitalized.

Then there is the question of a limited number of ICU beds. The real limitation is the number of healthcare workers, in particular nurses that are available. Canada’s healthcare system did not anticipate a pandemic, and provincial governments were unwilling to fund the costs of maintaining spare capacity. Imagine an electricity power system with no excess capacity to handle peak-load demands. Exacerbating the problem, which is strictly a budgetary problem, were policies to reduce the growth in healthcare costs by reducing the number of nurses, and de-listing more services. Canada’s single payor healthcare system has not been financially sustainable for many years, especially as the first wave of baby boomers started passing 60 years of age. The budgetary decisions to try to control spiralling healthcare costs were not based on “science.” They were driven by politics — a desire to avoid tax increases, and hide the erosion of the system.  

3. Restrictions on Air Travel

In March of this year, the Prime Minister introduced a three-day mandatory stay in an airport hotel for travellers returning to Canada, followed by a 14-day quarantine. The cost of the three-day imprisonment ranges between $1,500 and $3,000. There are tests that can provide results quickly. Even the standard test can produce results within 24 hours. And travellers who have been vaccinated are subject to the same rules. Thus, the three-day mandatory stays, or an alternative fine, were implemented solely to deter Canadians from travelling. Where is the science behind these requirements? There are the polls that show a majority of Canadians do not want other Canadians to travel, and the government being an astute follower of polls, responded.

Yet, a giant loophole has developed. Many Canadians have discovered that if they fly into US border cities, for example Buffalo, they can take a taxi to the nearest border entry point and walk across the border. They can then return home and abide by the 14-day quarantine requirement and not have to endure and pay for a three-day stay at a designated hotel. What is the science that permits this loophole to persist?

4. Vaccines

Canada lags far behind the US in acquiring vaccines. Even though we seem to have performed as well as the US last year, the economic paths likely will diverge as the US opens up and Canada lags behind. Our Prime Minister, being the anti-Trump, did not follow President Trump and lock up supplies from Pfizer and Moderna. Instead, he chose to partner with China, even though we were still in the middle of an ugly diplomatic dispute with China. This ended badly and Canada has had to scramble for supplies. Forget about the science, where was the logic?

In order to vaccinate as many Canadians as possible before the end of this summer — the desired time for an election, there is up to a four-month delay for Canadians receiving their second doses, even though the recommended time-limit between the first and second does is 21 to 28 days. There is no science to back the government’s decision, only raw politics. Canadians have become a science experiment so that the Prime Minister and his Liberal Party can claim that most Canadians have had the opportunity to receive at least one vaccine by the end of summer.

5. Vaccination Priority

The prioritization for receiving a vaccine makes no sense. Old people, anyone over the age of 65, should have been at the bottom of the priority list. If the objectives of the vaccines are to accelerate the opening up of the country and reducing the number of additional cases and deaths, all essential workers, including teachers and people working in transportation and warehousing, people who could not work from home, people living in multi-family residences or buildings, and people living in multi-person (more than three) households should have been at the top of the list, regardless of age. Old people could have continued to take precautions — masks, social distancing and minimal contact — in order to protect themselves. There was no science behind the government’s prioritization decision. Politics and polls have driven decisions to deal with the pandemic.

Conclusions

The lives versus money debate exemplified the hypocrisy of people and their inherent self-interest, a hypocrisy that hypocritical politicians were only too glad to exploit. If people really believe that one cannot put a price on the value of human life, then shouldn’t governments be banning driving, cigarettes, alcohol, other drugs, and every risky activity? We know how well prohibition worked out, and how criminalization of most drugs is working. In Ontario, Premier Ford has introduced a fine of up to $10,000 for anyone organizing and hosting an “illegal” gathering (10 people indoors, 25 people outdoors). Why aren’t there comparable fines for anyone caught speeding, regardless of how little over the posted limit a person might be driving?

If we really cared about lives, why aren’t we pressuring our governments to spend as much money tackling starvation, water-related diseases and deaths, malaria, and other communicable diseases around the world? Are we willing to pay significantly more in taxes to reduce preventable deaths in other parts of the world? What are we willing to do to stop conflicts? I don’t see the same concerns for these problems, all of which will continue long after our preoccupation with Covid-19 ends.

What are my conclusions therefore?

Governments, at least in democracies, will always be short-sighted. As a result, they will not be concerned with any problem(s) they might create when dealing with an issue they deem to be critical for the next election. They regularly kick a problem forward — Yogi Berra.

Governments do not make decisions that are in the best collective interests of the people. Every policy has winners and losers, and governments rarely consider compensating the losers at the expense of the winners. The losers are most likely to be people who do not support the incumbent government. Thus, when any politician claims to do what is in the public interest, try to contain your laughter and run away from this person.

Health crises cannot be separated from the economy. Lives versus money is a meaningless approach for dealing with any crisis. It is important to consider trade-offs and all costs and benefits, short-term and long-term. Whoever wins the next round of elections in each country will face the difficult task of dealing with the lingering fears of people.

But there are two other important lessons. Given global integration, no country, not even Sweden, Russia or Brazil can escape bad decisions made by other governments. The collapse of economies spreads from one country to another. We definitely are all in this together.

Fear is a necessary condition for tyranny to arise. People who are afraid demand “strong” leadership and are willing to sacrifice their freedoms.

I end with the following. Luke Kemp, a research associate at the Centre for the Study of Existential Risk at the University of Cambridge, argued in an article published on BBC.com on April 28, 2021:

“There is emerging evidence that emergency powers are usually used to benefit governments rather than save lives. The greatest danger is that these become a state of exception in which the government transcends the rule of law. The entire Third Reich occurred during a state of emergency that lasted 12 years. It began in 1933 after Hitler invoked Article 48 of the Weimar Republic, allowing for the use of emergency decrees without parliamentary approval…

Emergency powers tend to only go one way: top-down. During an emergency, the knee-jerk reaction is always to stomp-down, to reinforce those atop hierarchies in the state and significantly curtail the freedoms, voice and agency of citizens, often in a draconian fashion. I call this the “Stomp Reflex” …This Stomp Reflex is a power-grab: it is built on ideology, not evidence. Covid-19 is just one of many threats we will face over the coming century, from climate change to cyberwarfare and potentially bioengineered pandemics. In the coming decades, we face a choice between letting disaster steer the world towards control and corruption, or democracy and solidarity. If we continue with the Stomp Reflex, the true disaster would be that we move ever-closer towards a world in chains.”

Be careful of what you ask!

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