David Olive: As we reopen our economy, we must think ahead to COVID-19’s second wave

The COVID-19 pandemic isn’t over, not even close, though popular sentiment of late has shifted to the idea that maybe it is.

In fact, the pandemic threatens to claim even more Canadian lives, and to sabotage our plans for reopening the economy.

The dreaded “second wave” of COVID-19 that was expected to strike us in the fall is already hitting European and Pacific Rim countries that thought they had COVID-19 beat.

COVID-19 is a virus that remains largely a mystery. It kills and harms people in varied ways in different places.

The one thing in common among jurisdictions suffering relapses of COVID-19 is that they have all reopened their economies, as Canada has begun to do.

Indeed, many jurisdictions reopening their economies have yet to emerge from COVID-19’s first wave. They include the U.S., Britain, Brazil, Russia, Ontario and Quebec.

Dr. Theresa Tam, Canada’s chief public health officer, has warned that the second wave of COVID-19 could be more devastating than the first.

Tam has urged health and government officials to ramp up COVID-19 testing capacity; to increase the number of hospital beds for treatment of people suffering from the virus; and to bolster supplies of personal protective equipment (PPE).

That was a month ago, yet there has been little progress on those imperatives.

One example: As of June 18, Canada lagged most major economies in COVID-19 testing, a basic necessity in fighting the virus. With just over 59,000 tests per million population, Canada trails the U.S. (79,000), Britain (105,000) and Denmark (148,000), among others.

But if we act now, we can minimize the impact of a second wave that might strike sooner than the fall flu season.

Most health experts believe Canada is not prepared for a second wave.

Canada’s three levels of government still can’t or won’t promptly share crucial medical data, though doing so is essential in quickly containing future COVID-19 outbreaks. (To be fair, U.S. authorities are equally negligent.)

Hospitals and long-term-care facilities (LTC) are still scrambling for PPE. And a continued lack of reform of the LTC sector might be our biggest reason to fear a disastrous second wave.

These are some of the crisis measures required to minimize the harm from a second COVID-19 wave.

Emergency measures in LTC

Eighty-five per cent of the total 8,484 COVID-19 deaths in Canada are tied to long-term-care facilities. That’s the highest proportion of any major economy.

And that largely accounts for a Canadian pandemic fatality rate, of about 7 per cent, that is more than twice the global average (3.8 per cent).

There’s every reason to expect that the second COVID-19 wave, like the first, will do its greatest harm in the LTC sector.

There isn’t time for the total reinvention of LTC earlier discussed in this space.

But starting now, we can impose on all LTC facilities a standard, approved protocol for rapid, effective response to outbreaks.

As well, inspections of LTC facilities must be increased in frequency; no longer be conducted over the phone but done in person; and occur without prior warning to the LTC facility, as continues to be the practice in many provinces.

And we need to build temporary patient isolation units adjoining LTC facilities. We also need them near hospitals, so that acute-care facilities are not overwhelmed with COVID-19 patients in a second wave.

An army of infectious disease experts (IDE)

We must deploy communicable-disease experts in LTC facilities and in reopened schools, daycare facilities and industrial workplaces.

Their job is to prevent, identify and report outbreaks.

Some IDEs would be assigned full-time on-site positions at the bigger LTC facilities and at workplaces with large employee populations.

Other IDEs would be assigned to as many as four smaller locations.

Since travel among locations is implicated in disease spread, IDEs working multiple locations would be COVID-19 tested when they arrive and depart each facility, and would be provided adequate PPE and the training to use it properly.

Such skilled personnel are scarce, of course. With workplaces reopening, occupational health nurses have become a new front line against COVID-19. They will require the same IDE training that their fellow front-line health workers need.

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Rapid response

On average, countries that were late in imposing anti-COVID-19 measures have suffered eight times the number of fatalities of countries that acted at the first sign of trouble.

Those measures have included, of course, social distancing, stay-at-home orders, travel restrictions and workplace closures.

And they worked.

In detecting the initial signs of a second wave, we need an “emergency brake” on economic reopening, as Taiwan and South Korea have devised. We need a national protocol that can achieve a return to full or selected lockdown in a rapid but orderly way. And we need employers and individuals to know the protocol ahead of future outbreaks.

What you can do

Ontario, Alberta, Germany, Japan and several other jurisdictions have made contact-tracing apps available for voluntary downloading. The Ontario version, developed in Canada, is called COVID Alert.

The app warns users that they may be at risk of infection, due to contact with a person who has tested positive for COVID-19.

Quickly notifying such people is essential in containing outbreaks.

There has been some popular resistance in the GTA to the app, on privacy grounds.

But COVID Alert doesn’t store or share personal or medical data or even GPS location. It merely complements rigorous tracing efforts by public health authorities that are already in place.

So, download the app. It could save your life, and the lives of others.

And wear a mask, especially in crowded indoor spaces. The COVID-19-laced droplets an infected person expels remain airborne for as long as half an hour, primed to infect others.

Finally, evidence is mounting that a lot of people are getting careless of others in no longer following the safety measures by which millions of lives have been saved.

So far, most of the Canadian incidents have been isolated cases. Many of the breaches elsewhere appear to be persistent.

Every day brings new images of people amassed at the beach, travelling by the busload to tourist attractions, crowded into places of worship, or attending packed rallies and demonstration. Few participants wear a mask.

The images are followed by reports of as many as one-third of the participants testing positive for COVID-19.

The pandemic has not been called off. It remains a clear and present danger until we’ve all been vaccinated.

In the meantime, be well and stay safe. And enjoy the outdoors now before the arrival of flu season, or a second wave that could hit us well before that.

David Olive

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