August 31, 2020

The progress of the world wide pandemic has revealed serious flaws in the way most countries planned for such an event.   We had been warned about the possibility of such an event through our experiences with SARS in 2003 and H1N1 in 2009.  It was the highly contagious nature of COVID-19 (combined with the extreme mobility of individuals today) that caused it to spread rapidly.   As a result, we have experienced rapidly growing rates of infection and death as well as serious economic disruption.  The stresses to our health care systems are severe, as many jurisdictions run short of critically needed intensive care units and necessary personal protective equipment.   

RESPONSES TO COVID-19

CHINA

China had designed an excellent infectious disease reporting system, whereby hospitals could input patient details into a computer which would automatically notify health officials in Beijing.  Action could then be taken to smother any outbreak.  When doctors in Wuhan, China (where COVID-19 originated) began treating clusters of patients having a mysterious pneumonia last December, reporting should have been automatic.  Unfortunately, local health officials (fearful of upsetting Beijing) prevented that reporting from taking place.  When individual doctors tried to sound the alarm, they were arrested by the police and one of them has disappeared.

For forty days, China concealed, destroyed and falsified information about the rapid spread of COVID-19.   China waited several days to alert the World Health Organization about the initial cluster of cases and waited more than a week to release the virus’ genome.  These delays gave COVID-19 additional time to spread both within China and to other countries. At the same time, China instituted a covert program of importing huge quantities of personal protective equipment.   If China had been candid and honest about the outbreak, other countries would have been better prepared and would not have allowed the export of needed health equipment.  More recently, the Chinese government has been engaged in a disinformation campaign that promoted anti-American conspiracy theories related to the pandemic.

UNITED STATES

In the United States, President Donald Trump minimized the problems associated with COVID-19 when it first became established.  He ignored numerous warnings (as being alarmist) and said that it would go away quickly.  During the month of February, little action was taken by the Federal government to deal with the pandemic.  After that, he seemed to be under the illusion that he was the `Chief Medical Officer“ of the United States.  He had to be continually corrected by the medical professionals, as he made one misstatement after another.  In his more recent briefings, he spent much time criticizing reporters and anyone else who did not share his views or failed to praise him.  

President Trump continued to set a bad example.  He had refused to wear a mask (which the Center for Disease Control recommends) and talked about the need for less testing. Finally, on July 8 he publicly wore a mask while visiting a hospital.  He has promoted campaign rallies and other meetings where large numbers of people are present without social distancing or the requirement to wear masks.  While the cases and deaths from the pandemic rise sharply (in part due to his actions), his response has been to engage in divisive rhetoric and to sign an executive order protecting monuments.  One of his last efforts has been to threaten aggressive measures (including the withholding of funds) to force educational institutions to fully open regardless of health issues.  As an apparent diversionary tactic, he has sent Federal agents (against the wishes of local governments) to deal most aggressively with demonstrators.

Mike Pence, vice-president, who was supposed to be in charge of the pandemic program, finally agreed (after long delay) that it is a good idea to wear a mask.  He also said that the pandemic conditions were getting better.   This statement is in direct contradiction to the reality that cases in the United States are rapidly rising and some States are close to running out of critical care hospital beds.  As a result, many States are imposing tighter rules after having opened too early.  Mike Pence falsely attributed the rise in cases to more testing.  All of the health professionals (with whom he is supposed to be in close contact) attribute the increase to alarmingly high infection rates in many States.

Fortunately, the media, health professionals and some State governors have done an excellent job of giving proper advice, getting the facts out, and dealing with the crisis.  Their work has been hampered by poor leadership at the Federal level evidenced by inconsistent or absent messaging.  In a recent Tweet, Trump praised people who were demonstrating against the Covid-19 health standards which his Administration had approved.  His concern now seems to be more about “opening” the economy, while ignoring the health risks.   While downplaying the value of testing, Trump has made sure that those in his inner circle are tested very frequently with quick results.   For many others (except sports stars), getting tested involves long wait times and lengthy delays in getting results.  The consequence of the inconsistent Federal government response has been that the United States now has one of the highest rates of COVID-19 cases and deaths in the world. President Trump organized his acceptance of the presidential nomination to take place on the White house lawn with a large crowd not socially distanced or generally wearing masks.  His lack of adherence to official health advice and his poor example has certainly cost lives.

CANADA

In Canada, the Federal and Provincial governments have communicated to Canadians about COVID-19 in a consistent manner.  However, the early intelligence was deficient and contributed to a delayed response.   Based on previous experience with China, we should have known that “intelligence” means much more than relying upon official statements from China.  Our restrictions on travel, the closure of non-essential businesses, and the “social distancing” requirements have been well communicated and amplified by the media.  Government officials and in particular our Prime Minister (Justin Trudeau) have also set good personal examples of “social distancing.”   All of these elements are important in making Canadians want to follow all of the recommendations.

One major problem area has been a very high rate of infections and deaths at nursing homes which are under provincial jurisdiction.  Such deaths have accounted for a shocking 81% of all Covid-19 deaths which is much worse than other countries.  Serious issues have been raised regarding the apparent abysmal levels of care at many such institutions.  Government agencies are now involved in addressing this problem and the army has been called in to help.   A full investigation of all of the contributing factors contributing tro this disaster is needed.  As is the case in the United States, meat processing plants have had extremely high infection rates.  Plant shutdowns have been needed causing related disruption to the agricultural sector.  To minimize the spread of Covid-19, many changes to operating procedures have been made. 

Canada has done a much better job of testing than the United States.  However, we are well short of the exemplary standard (highest in the world) achieved by Iceland.  On a per capita basis, Canada has had less than half the cases but more than half the deaths when compared to the US.  The present trend of cases in Canada is also much more favourable.  In July, Canada’s new cases (per million of population) were only 10% of the US level.  Both Canada and the US have had a significant shortage of masks, ventilators, test kits and related personal protective equipment.  Justin Trudeau has accepted personal responsibility for solving this problem. 

The Federal Government has been aggressively purchasing such items and is aiding Canadian companies who are able to manufacture these products.  Contracts have already been signed with five companies and more are expected.  The Federal and Ontario governments have made a deal with 3M enabling it to increase the production capacity of N95 masks by up to 100 million per year at a facility in Brockville, Ontario.  Each level of government is committing $23.3 million to this effort.

Most recently, we have seen a unity of purpose and a tangible spirit of goodwill develop between the Prime Minister and all of the provincial Premiers.  They are working together on national standards (with flexibility as to timing) on re-opening the economy. Finally, individual Canadians (in a spirit of support for our health care workers) have begun making masks and face shields.

LESSONS FOR THE FUTURE

This pandemic has heightened our awareness of both the risk and the cost of future pandemics.  COVID-19 showed us that in a crisis situation, each country has to rely mainly on its own resources.  When other crisis situations affected only one or two countries, aid has often been available.  With COVID-19, every country in the world is affected.  As a result, each country has been husbanding the critical resources to take care of its own needs first. 

Historically, we have often sourced critically needed products from the cheapest supplier.  While we can continue to do that in part, such supplies should be purchased to build up a rotating inventory for emergency use.  Government involvement will likely be needed as this is not an economic proposition for the private sector.  At the same time, we will need to maintain a standby production capability with the government purchasing such items on a negotiated basis.  By taking such actions, the government will be purchasing insurance against the next pandemic.

In the United States, Mr. Rubio (a conservative Florida Republican) has introduced a Bill that aims to cut off China’s chokehold on the global pharmaceutical supply chain.  This Bill has bipartisan support which includes progressives such as Elizabeth Warren, Democrat of Massachusetts.  The pandemic has helped spur this important action.  If such a bill is passed, Canada should co-operate with the United States in this effort. 

Our experience with the pandemic should make Canadians think about our other strategic vulnerabilities as European countries are doing.  EU Trade Commissioner Phil Hogan recently said that there’s a need for a discussion “on what it means to be strategically autonomous.”  EU Trade Commissioners also agreed recently on the importance of diversifying to “reduce the reliance on individual countries of supply.”

For example, China dominates the mining and processing of rare earths which are of critical importance in the manufacturing of various electronic items.   At the same time, China has shown a willingness to use this dominance to bully other countries.  Co-operative action with other countries may be needed to find alternatives or to subsidize the production of rare earths.   Subsidies would be required as the Chinese keep these prices very low for strategic reasons.   Research is needed (hopefully in conjunction with other countries who share our values) to determine other products critical to our economy and our health care.   With such products, we should resist the temptation to purchase only from the lowest priced foreign producer.    We should try and build up reserve stocks, look for alternatives and support local producers where feasible.

CONCLUSION

As we have all been told, our strength will be in all Canadians working together and following the necessary rules.  Being more self- sufficient in essential health and other strategic products is also very important.  As we live through this crisis, we are learning lessons that will make us more resilient in the future.

Elliot Rodin
Bachelor of Commerce      -University of Manitoba
MBA                                      -Harvard Business School