There is a proverb that speaks to looking at the past to understanding the future. It is proving to be very prescient during the COVID-19 pandemic.
We don’t have to look too far back or too far away to know what is in store for us in Saskatchewan if our political leaders don’t take swift, decisive action to blunt the surge that is overwhelming our health care system and putting Saskatchewan citizens at risk.
The government’s Nov. 6 policy on localized mandatory masking was sound policy. However, it is not enough. The COVID-19 virus is showing that it doesn’t go down without a fight. It is resilient, stealthy, and patient. To beat it we have to be at our best. Doing the right thing too late is better than nothing, but it is not our best. Health organizations are united in making our call for more stringent measures to safeguard the public and curtail the spread of COVID-19 in the community.
The pandemic has taught some hard lessons. The virus is highly but variably contagious. Some people are more likely to spread it than others; some are more likely to get it. It is more deadly among older people but there are significant numbers of younger “long haulers” with long- lasting debilitating symptoms. Most infected people become symptomatic but significant numbers don’t, especially in the early contagious phase. A jurisdiction can go months with relatively low numbers and then get hit by a new wave. It appeared to be eradicated in New Zealand, and then it wasn’t. Singapore was lauded for its performance; then its numbers rose.
As doctors, nurses and pharmacists, our first duty is to keep people safe. But we know that pain comes in many forms beyond the direct effect of COVID-19: lost income, anxiety, depression, a sense that the world has been yanked out of its orbit. People are wondering whether we will ever see the end of restrictions on education, commerce, movement, and social interaction. It is discouraging to see new outbreaks when the end seemed in sight. We all need normal.
We believe three measures are essential to drive the numbers down again and allow the fullest possible resumption of normal activities. Importantly, they are all essential – think of them as the three pillars that support the entire containment structure.
One is partially in place: mandatory masks in indoor public spaces. This needs to be extended throughout Saskatchewan.
The other two are equally important.
First, some environments are much more likely to seed outbreaks than others. The recent outbreaks in Saskatoon started in bars and clubs, as have many others around the world. These venues are very COVID-friendly. People go there to congregate; physical distancing is hard. Alcohol is a disinhibitor. Loud music makes people raise their voices to be heard, which releases more virus-containing droplets.
We believe targeted closing of bars and nightclubs until the surge is blunted is the most effective strategy we have. The risks are too high and the consequences are too serious.
Second, we have to redouble efforts to test and trace. One reason why pandemics get out of control is the time lag between getting a test and getting the results. Another is that tests aren’t readily available to asymptomatic people who may be at risk. Testing technology is improving; there are now test strips that can produce results within 15 minutes. Intensive testing with instant results is the only way to detect emerging clusters before they grow too big to contain. Similarly, once the numbers of new cases gets to a certain level, effective contact tracing becomes too labour-intensive to be practical.
This is a Canadian, not a specific Saskatchewan issue. Slovakia tested half of its population of 5.5 million in one day at the beginning of November. About 1% tested positive and moved to quarantine. If we want to put the pandemic behind us sooner than later, we have to be more like Slovakia.
The time to act is now; even short delays can cause massive increases in cases. We do not propose these measures lightly. But if the province does not pursue them, things will get worse – possibly a lot worse. Keeping bars open makes more outbreaks likely. As cases mount, there will have to be a more widespread lockdown, and the economic domino effect that ensues. Wearing a mask not only prevents a lot of infections, it is also a visible reminder that the threat is real, and we need to be vigilant at all times.
Eight months of pandemic have taught us some hard lessons. Perhaps the most important is to recognize when reasonable, well-intentioned strategies fall short, and change course quickly. Dithering is the pandemic’s best friend. Decisive and swift action based on new evidence gives the pandemic as little chance as possible to keep rearing its head.
Sincerely,
Dr. Barb Konstantynowicz President, SMA
On behalf of College of Physicians and Surgeons of Saskatchewan; College of Family Physicians of Canada, Saskatchewan Chapter; Saskatchewan Registered Nurses Association;Saskatchewan Union of Nurses; Pharmacy Association of Saskatchewan; and Saskatchewan College of Pharmacy Professionals.
