Could Ontario have saved lives, stress, and debt with more innovative problem-solving? Absolutely.
Covid 19 forced governments into a crisis beyond what anyone has experienced since the World Wars. Having lived in New Zealand, Australia and Canada, it was frustrating to contrast how each country defined the challenges it faced and then managed the process to solve them. I now live in Canada, based in Ontario. We failed to achieve results. Ontario’s Premier even looked like he was crying when he repealed an order for Police to stop people in lockdown to question if they are must be out. The issue is not that Police checks are wrong (they were used in NZ and AU), the issue is how poorly the Government tried to implement this policy. At a minimum, the Government should have met with Police Chiefs to discuss the implementation of the policy. In fact, Ontario was never in a true lockdown.
From a problem-solving perspective, Covid was not one challenge, it was two:
- The medical challenge to create interventions to help infected people survive – our top experts and billions of dollars were invested in Covid tests, masks, protective clothing, vaccine development, hospital expansions, and medical costs.
- The behavior change challenge to stop people from being infected – the non-medical interventions included communication strategies (advertising, social media, etc.), design of lockdowns, solutions for practical social distancing, tracking strategies, and solutions for staying safe while in schools, grocery stores, workplaces, and society.
I do not believe governments truly understood the need for innovative behavior change strategies. The expertise differs… designers, architects, marketers, planners, change experts, and more. An example…when my local Health Unit opened a vaccine centre, it made logistical mistakes that a conference planner would have seen as obvious. We tried to turn our medical experts into communication experts. It did not work well. Communication strategies seemed amateur.
Complicating our Covid strategies is that they are not apolitical. Provinces led by Conservative Governments were slow to act and indecisive. Covid strategies talked of “balancing business and health needs”. Currently, Alberta, Ontario and Manitoba continue to struggle. They did not learn enough in the second wave to prevent a third. When you look to New Zealand or the State of Victoria in Australia, you find Labour Governments which imposed harsh conditions on their citizens in order to eliminate Covid.
Today, Australians are enjoying theatre and sports; Kiwis are shopping, visiting, and going to live concerts. Some say it was easy Downunder. If people studied strategies created by New Zealand, they would see a well-planned attack to eliminate Covid19. The aims of its strategy are:
- To eliminate transmission chains – stop Covid19 from getting into the country
- To prevent the emergence of new transmission chains originating from cases that arrive from outside – stop community spread they used hard lockdowns with police roadblocks, police checks, and limits on travel.
It published an elimination national strategy in April 2020 that articulated a six-phase strategy:
- Plan For It(planning and preparedness),
- Keep It Out(border management),
- Stamp It Out(cluster control),
- Manage It(pandemic management),
- Manage It: Post-Peak(post-pandemic management), and
- Recover From It(recovery).
The plan allowed the government to shift through the phases as the virus spread through the population. A case study was written that I quote to provide insight:
“By mid-March, as clusters of COVID-19 cases began emerging, the team shifted from the Keep it Out strategy to the Stamp It Out strategy and began preparing for a move to the next phase: Manage It. That phase—similar to the herd immunity strategy—was modeled on 40% of the population becoming infected over the course of eight weeks and aimed to limit the impact of the pandemic. An influential Imperial College London paper published on March 16 …found that such a mitigation strategy in the United Kingdom would “likely result in hundreds of thousands of deaths and health systems being overwhelmed many times over.” Then New Zealand doubled down on the Stamp It Out approach.
This means it had to stop Covid from getting into the country. NZ closed borders with all returning citizens forced into isolation hotels for 14 days. At Christmas 6000 citizens were in isolation hotels. A three-month waiting list was in place for citizens to book a room before they could arrive. This means NZ citizens had to wait months to return and be welcomed with 14 days in isolation. AU and NZ continue to manage this challenge.
What happened in Ontario?
Results in Ontario were disastrous with over 8100 deaths. The daily death count would be considered a massacre in any other context. It is clear we failed. This is more than my opinion; three reports so far.
Health Communications during COVID-19
After the first wave, the University of British Columbia looked at “Democratic Health Communications during COVID-19: A RAPID Response” in nine countries plus Ontario and BC. Ontario was near the bottom of the list for communication effectiveness. The researchers put New Zealand at the top.
In late November, the Ontario Auditor General published a formal review of the Government’s actions during the first wave. In summary, Ontario was slow and late in responding. The full volumes are found on its website. Some findings:
- Ontario’s command structure evolved to become overly cumbersome, and it was not dominated by public health expertise.
- The Chief Medical Officer of Health did not fully exercise his powers under the Health Protection and Promotion Act to respond to COVID-19. He did not issue directives to local Medical Officers of Health to ensure public health units responded consistently to the COVID-19 pandemic, nor did he issue directives on their behalf.
- In May 2020, 34 local Medical Officers of Health jointly prepared and signed a document stating there needed to be more direction and regional consistency.
- The Ford Government delegated much of the responsibility to district health units. The reports commented: Variations in management and operations contributed to fragmentation and inconsistencies across Ontario.
Five months later, the Auditor General produced a second report on deaths of elderly in long-term care homes. Despite knowing of the potential for such tragedy, the Government’s inability or unwillingness to create the processes to stop infected employees from entering these homes and infecting the elderly cost 3700 lives and stressed thousands more who live isolated and lonely. The audit found that long-term-care homes were ill-prepared to prevent or minimize COVID-19 outbreaks due to chronic staffing shortages and inconsistent practices in infection prevention and control prior to COVID-19. To compare, 900 people died of Covid in Australia. Worse, several LTC homes recorded more deaths than New Zealand (26 deaths).
The Auditor General will write a third report on the failure of Ford Government leadership for the vaccination phase of covid. On one hand, it is remarkable that vaccines were created in months, not years. Governments knew that vaccines would come. Perhaps this explains the difference between government approaches:
- New Zealand began to research opinions on vaccine resistance in September 2020 to create a marketing campaign. See the article for details and link to the research.
- Ontario planned an online registration system for vaccines. This failed. District health units had to pick from the failure. They had to book venues at the last minute and design software or telephone systems for registration.
There are too many failures and inconsistencies to explore here. Perhaps the greatest failure was to harness its expertise to design vaccination strategies to target the different segments of society over time. Policies seem to change daily. Too little preparation was made for a third wave. There are a growing number of commentators writing on themes like this.
For all of the talk of innovation, I would be satisfied to see a consistent quality of professional problem solving and decision making. We are not seeing this. Vaccines are the last resort to stop the virus. It is sad that a wealthy first-world country could not innovate solutions to do so.
Links to other Covid19 articles written by Ed Bernacki