Coronavirus response in Canada is not good enough

In 1458, after the plague killed the chief judge and his wife in the quietest republic of Venice, the Senate of Venice established a strong health judge based on Cicero ’s precepts: al fish (Salus populi suprema lex esto) -People's health is the highest law.

At that time, the Venetians died of swarms of plague, a terrifying disease, and doctors mistakenly believed that it was transmitted by mi qi (bad air) rather than mice and fleas. Therefore, the magistrates did a lot of useless things-conducted many ceremonial purifications and religious demonstrations-but they were happy to pass effective measures.

The Venetian established the island where the boat was moored for 40 days- quaranta giorni Italian-we got the slogan of isolation here. They chose this period for religious reasons-Noah's 40 days and 40 nights-which happened to be longer than the incubation period of the plague.

"Therefore, inaccurate theory combined with biblical beliefs can produce effective public health procedures", Frank Snowden in his stern and fascinating book Epidemics and Society Wrote.

Although the plague started in the Ottoman Empire until the ships originated in the land of the Ottoman Empire, in Venice,

Venetian innovation spread first in northern Italy and then throughout Europe, which helped control this terrible The spread of the disease, although it took doctors for centuries to know, but under the full authorization of the state, health work has only a long time. why.

Read more: What it should look like when Canada ’s COVID-19 economic stimulus plan arrives

I think the same thing is happening now, although the most advanced society is no longer the northern Italian city state, and They are East Asian democracies, and they have shown their advantages more effectively than Western countries by responding to COVID-19. So, for example, although the clinical evidence of the value of wearing masks is weak, all of us are covering ourselves up. We do this for the same reason that other cities have followed Venice ’s isolation: they are doing so and achieving better results.

Today ’s public health officials in Venice are the heirs of the 15th-century magistrates and work in the same place. The old University of Padova acted more effectively than its colleagues from other poor people suffering in Italy and kept the mortality rate at The lower level because they imitated South Korea's success in reducing transmission by testing actors.

Every day on "Financial Times" Coronavirus country death map, we should obviously follow the example of South Korea. Its beautiful and low wavy light blue lines are far lower than any lines in Western countries.

South Korea has a population of 50 million, and only 217 people have died of coronavirus, a hundred people less than Canada. They are too close to China. They can even begin to ease social alienation now.

They realized the threat as soon as possible, established isolation centers in their airports, sought the assistance of private companies for testing, distributed masks through the workplace, and began conducting large-scale testing and contact tracking instead.

We Canadians The recognition of threats is slow and passive, cautious and slow.

For example, on January 24, the Chief Public Health Officer, the accomplished Theresa Tam, asked the House of Commons Health Standing Committee whether it is wise to invite travelers to Wuhan to isolate themselves for two weeks.

"As our Director of Public Health said, I want to say that realizing that global efforts to contain the virus require the absolute commitment and participation of affected communities." "Otherwise, they will be stigmatized. [19659002] It was a wrong call, which showed that the structure of Tan ’s office was realistic. Due to the reorganization of the Stephen Harper era, she would be postponed to the chairman of the agency, the civil servant. Therefore, the Public Health Bureau responded to the government instead Like the Venice Public Health Magistrate, responded to a special committee of doctors.

Therefore, the political principles that are essential to the Justin Trudeau government are avoidable praiseworthy wishes

from February The agenda for starting a teleconference with the provincial health minister has been released to the health committee, and the agenda shows that Tan should be expected to give a written speech, which seems to put more pressure on ethnic minorities than looming our health Threats.

Key points of the conversation reviewed by the Office of the Minister of Health Patty Hajdu. Tan on February 3 He commented: "WHO does not recommend any travel or trade restrictions based on existing information. Canada ’s actions have been consistent with these recommendations.

Given that China is putting pressure on WHO to take action. The ban on travel is prohibited, and we have every reason to doubt whether Tam is sufficiently independent, not only from the Canadian government, but also from international organizations. Hajdu often asks Tam Seeking advice to verify the government ’s decision is a long-term political tool to maintain legitimacy. We need to repay this debt.

We have every reason to hope that Canadians will continue to be confident in Dr. Tam ’s wise advice, Dr. Tam has many years of experience in dealing with the world ’s most urgent health emergencies. But it is also necessary to question the government, which apparently did not respond to this pandemic as effectively as the Korean government.

Why when it means acceptance With greater pain and death, why should we accept this failure?

By the way, this has nothing to do with Confucian obedience. The political culture of North Korea is at least as cruel as our own. It is related to effectiveness. They are much better than us in this respect.

They should not be like this We were warned. In 2003, a committee that reported the SARS epidemic killed 44 people in Toronto. The committee found a series of problems that continue to this day, including a lack of public health capacity, problems in jurisdictions, testing deficiencies and Bad protocol for data sharing.

Because we failed to learn from SARS, many Canadians died in hospital beds that could be alive.

Responsibility belongs to all levels of government, to a certain extent human nature. COVID-19 is A 100-year event. Humans cannot properly manage these diseases because no one remembers the last one.

As US Secretary of Health Michael Leavitt said in 2006: “Before the pandemic occurred, our Everything that is said is alarmist;

Still, it is hard to believe that we are doing better.

The federal government seems unable to organize to send Snowbirds appropriate public health warnings that the prime minister requires them to take a holiday, so that Montreal feels the need to enter the federal jurisdiction.

In Quebec, this is an early and aggressive approach that promotes physical alienation. Catastrophic failure to inspect long-term care facilities. Unlike British Columbia, officials in British Columbia can be more proactive , Probably because they did not face the same problem. Quebec has an earlier rest period in March, so Snowbirds spread disease more widely than elsewhere.

Or at least we think so. It is difficult to know what happened in Ontario because public health officials did not conduct enough tests and the rest in March was partially interrupted. David, an epidemiologist at the University of Toronto, said that Prime Minister Doug Ford was forced to intervene. This is a surprising and gratifying proof of his ability, which people might not have imagined.

However, it took too long and people were killed. Fisman. "Because of the poor test numbers, there is a lack of situational awareness, and you will see this situation manifested in hospital outbreaks, nursing home outbreaks, prison outbreaks. This does have its consequences, but they are also lack of leadership and I think the provincial public Signs of insufficient sanitation capacity. "

It is too late to restore public health capacity and order enough masks, but our politicians and businessmen have stepped up their efforts and we will soon have the ability to start being Koreans in January The ability to start doing things should mean that we can quickly start talking about ending this terrible blockade.

The way forward is unclear. We still do n’t know much about the virus, including whether the recovered person is still immune. This is what we must hope for.

But the first step is a large-scale test and a “large crowd, contact tracing,” said Dr. David Naylor who wrote the SARS report.

“When this wave breaks, things subside … this It will be a prank game, "he said in a recent podcast." Every outbreak must be resolved through real active testing and tracking, which will become part of our escape from the current limitations that plague our society.

"What are we doing to suggest that you can engage in dynamic social alienation." Said Dr. Fisman. "We know about socially estranged work." We know it will close the transmission. You do it long enough to empty your full ICU bed, or you do it long enough to enable you to build more ICU capacity, and then stop a little bit to allow economic development to recover and let people psychologically On rehabilitation, knowing that this will come back. "

Within a few months or years from now, before there is no vaccine, we are unlikely to have an open society again.

" There will be nowhere ", Dr. Fisman said." We Economy is intertwined with the United States. They will spread uncontrollably for a while. Our work is much better than what they did, but we live next to them and there is no fence. And it will be introduced repeatedly. So this is why you need excellent monitoring. "

At the same time, we can expect overconfident opinion advocates to insist that we overreact to the whole thing and the economy is stagnant than other options.

No one needs to vote to say this, but part of the Canadian comment usually will Echoing the point of view of the US industry ’s interest in resisting climate change, you can feel that they are struggling a bit, warming up wasting an epidemiological model and urging the working class to go back to work, while the commentator will of course stay in a safe place. [19659002] Their nonsense will distract the real problems in front of them because they peddle fantasies. We cannot reopen the economy in one breath.

Donald Trump was appointed as the Director of the Food and Drug Administration, Sri Lanka Scott Gottlieb recently explained in the National Review podcast why we ca n’t: “This does n’t infect everyone. Therefore, currently, 3-5% of the US population is exposed. See what happened. Look at all the deaths. See all hospitalizations. The health system in New York City has been overrun. It was consumed. New Orleans, Louisiana. The same is true of Detroit. The same is true in Miami.

If we just let the virus wreak havoc, Dr. Gottlieb said, we will have to accept three things.

  1. "The hospital will overrun. There will be no health care. Both are COVID. Therefore, you will not be able to get medical care for a period of time. Otherwise, you will not want to go to the hospital.
  2. "You must accept that the number of deaths due to COVID 19 will be much higher than it is currently.
  3. " "I think you must also accept a certain percentage of the population, not an insignificant percentage, and will not go anyway Go to work. "

Those of us who are capable will work from home.

"Not everyone goes to work to have this luxury," Dr. Gottlieb said. "This will be divided by socioeconomic boundaries. Wealthy people who can voluntarily isolate themselves and others who cannot isolate themselves. That is reality. You will not have a fully functioning society."

Recovered from COVID If the person still maintains immunity and can return to work, it will take a lot of effort. Dr. Fisman said that this is the "doorway."

"When testing, you now know who owns the antibody, and as time goes on, the number of people who have the antibody will increase, and those people will become your immunity, They may be able to work safely, safely participate in concerts or other events. There is a huge ethical problem about a two-tier society in which immunized people can go out to play, while people lacking antibodies are still locked in … … But we can only have a conversation if we have the data. ”

This raises a thorny privacy issue, and there is another potentially powerful tool: mobile phone tracking, which can keep public health officials in the dark Find someone who may be exposed to the virus and test it before infecting others.

If you, like the Venetian, believe that people ’s health is the highest law, then this seems to be an easy call. Follow us and reopen the economy. Let's go back to work, spend money, go out for dinner, play sports, and go to the cottage.

But the data collected from our mobile phones must be processed by a trusted third party (an institution independent of the government). Strictly speaking,

The power to use this extraordinary power should be independent. The response of a specially formulated physician committee, not a response to politicians, is an innovation of Venice in the 15th century, and we may eventually prepare to adopt it in Canada.

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