Thursday, 26 March 2020

TIME FOR A REAL WAR ON COVID-19


The Chief of Defense Staff – aka Commander of the Canadian Army - should be involved in fighting the war on COVID-19; the Prime Minister and the Premiers should step back, at least a little, as coordination to combat the spread of the virus seems both late and fragmented.  

After three weeks, we only have the dulcet tones of the Prime Minister and the Premiers. They are doing a good job of staying in touch with Canadians, but as to a coherent plan that will save lives and get the public back to work, there is none. In particular, knowing that one person can infect dozens, no regime exists to stop people from engaging in irresponsible behaviour.  

Canada spends billions of dollars on the Armed Forces. It is a group ostensibly more practised in the art of maintaining domestic order in minor crises than exploding bombs; but their logistical expertise on an international level should not be discounted. That we have not heard from the Commander, or of the expertise he can offer in planning and logistics, is peculiar. We don’t even know if the Forces have spent five minutes considering the prospect of a pandemic. Don’t kid yourselves, politicians write cheques and are good at social engagement. But that’s not enough. 

This global pandemic threatens to engulf a large segment of the population and, in the process, overwhelm healthcare systems everywhere. Healthcare professionals have been very effective in preaching this message. But should the politicians have handed them responsibility for fighting the whole war? Should moral suasion be the singular tool in their tool-kit? 

Chief of Defense Staff Jonathan Vance
Take a look at this province. The lateness with which seniors’ homes were closed to visitors invokes concern not just of poor planning but of afterthought. We should rightly be concerned about the things that distinguish our state of health — an elderly population and generally poor health indicators.  In addition, the readiness and depth of our health care system, already constantly taxed, causes enormous concern. If we can’t deal with wait-times and scheduling of surgeries in “normal” times, from where will the human resource capability — or the physical capacity — come to deal with a high-volume health care emergencies?  Who has considered our geography or the fact that hospitals with capacity for ICU services are located mostly in St. John's? Has anyone thought that, in Central or Western NL, a temporary ICU should be under construction now? 

If every available ICU bed is filled, then what? Is there a Plan B? Do we charter a 737 to medevac patients to Halifax or Toronto?  Will they take the patients if they survive the trip? 

As it stands, we are at an especially heightened risk of quickly overloading our hospital resources. Already a number of healthcare workers are in isolation and unavailable for at least 14 days. This number will grow and further weaken the capability of the health care system. The rapid growth in the number of our presumed positive cases is an ominous harbinger of things to come.  

It is easy to carp, but while there is still time for frankness, we have witnessed Dwight Ball and his officials wait and wait and play copycat after observing actions taken in other provinces. Sadly, the flat-footedness is consistent with this government's performance since they came to power in late 2015. 

The necessity for a “Commander” or a “Command Group” — seasoned and with a single  focus — is the best antidote to this clearly under-resourced crisis. 

Physicians and other healthcare providers are ill-equipped to do much outside their hospitals anyway. Their role ought to be — apart from sharing the science with the Commander about the insidious nature of the invader — to help save the wounded. Even the best epidemiologists and other professionals are not equipped to devise the civil defenses — operational strategy and tactics — required in a real war. And this should be a real war.  

The politicians are well-intentioned, to be sure; but the effect of the soft-pedaling politician-commander is pusillanimity. They have engaged the public in the fight by permitting them to go madly off in all directions. This may not have been their plan, but did they really even have one? 

Some members of the public have neither been hearing nor heeding the message of COVID-19’s ability to explode. A failure to self-isolate may be deadly for those with whom someone infected comes in contact. There have been many such reports. This failure exposes two disconnects.  

First, traditional war witnesses bombs raining down; people and property are blown to smithereens. For most people, today, such an event happens all the time — in video games or in war movies on TV. Even thousands of deaths in China, Italy and Spain may not have the impact of the death of a loved one or the next-door neighbour. This war has not hit home just yet; hence, for many, it’s not real.   

Second, a war requires a set of actions by the State that confirms the presence of a threat. Undoubtedly, shutting down the economy is real. But permitting us to go online to apply for EI, as important as it is, or threatening the removal of our driver’s licences — if we are being dumb — does not qualify as a machinations of war! 

COVID-19 is existential; the threat was mishandled at the outset. Islands, like PEI and Newfoundland, have limited entry points. Where better to invoke rigid controls — having commandeered University residences or hotel rooms, many of which are empty anyway — to enforce quarantine for returnees from Canada and globally? Would those so isolated be allowed to engage in “frat” parties? Not if the civil or armed forces were engaged to help people protect themselves, if necessary at the point of a gun.  

In short, we’re involved in a war we’re barely even fighting. In this Province, the political leadership can’t even set up a good website on COVID-19, let alone a command post from which battle plans are drawn up and orders are given.  

Apart from health care providers trying to deal with the small number of “wounded” and, otherwise, counselling “social distancing”, there's little taking place to control the “walking” viruses that can’t use their heads and can’t self-quarantine.  

Most returnees have already arrived home; some news stories suggest that the new casualties will be “community-based” rather than “travel-related”. Having failed to deal with the recognizable first invasion, a completely dispersed second one will be far harder to identify. Hence, the war will be more difficult to win.   

I suggest that we let the physicians heal people. Otherwise, let the Commanders, in concert with the politicians — as in any war — propose the physical defenses necessary to screen and isolate those who are still in transit, and to ensure that those who test positive do, indeed, self-isolate. An Australian study shows how important social distancing actually is: at least 8 in 10 must stay home; 7 in 10 will not flatten the curve. The study even makes a case for shutting down mining and offshore operations as well as the construction industry. Similar conclusions flow from comparisons based on a recent study prepared by researchers at the University of Oxford on Lodi and Bergama, in northern Italy. The study references evidence of "flattening the curve" in the province of Lodi where harsh movement restrictions were enacted quickly (Feb 23rd) vs two weeks later in Bergamo (March 8th).

Big, harsh decisions escape the grasp of most politicians, however. Besides, an able Commander is needed to plan and help organize the testing strategy that will ultimately defeat the virus’ spread.  Able members of the public — the equivalent of civil defense — can be included in this process. But, first, let’s see a plan. 

Unless we see more evidence of professional people with expertise devising tactics and strategies to outwit an enemy, we could be in for a hard time.  

Otherwise, my advice is: look out for yourself. Be disciplined — no matter how inconvenient, and even if it hurts. By all means, listen to the politicians too. 

But, even if self-preservation is not important to you, don’t count on them to guarantee you a funeral.