TORONTO — Lessons must be learned out of Canada’s response to the COVID-19 pandemic, but the extreme economic and social lockdown the country is emerging from now was the right move, says an infectious disease expert.
The fact that Canada has only seen a fraction of the illnesses and deaths projected in early worst-case scenarios is testament to the success of preventative measures, says Zain Chagla, a physician at St. Joseph’s Hospital and Hamilton Health Sciences in Hamilton, Ont.
Federal modelling released in early April forecasted that, without restrictions put in place, up to 80 per cent of Canadians could contract the virus and up to 300,000 could die.
But with the strong lockdown measures instituted in March, Health Canada predicted the death range was likely to fall between 11,000 and 22,000 deaths. It then developed models based on between 2.5 per cent and 10 per cent of the population contracting the virus over the course of the pandemic.
As of Friday, the country’s cases topped 100,000, with a death toll of 8,300.
Canada’s lockdown measures minimized community spread of the virus and kept hospitalization numbers manageable, says Chagla.
More than 80 per cent of Canada’s deaths have come through long-term care homes, according to the Public Health Agency of Canada. That is leading to questions about whether Canada went too far in locking down much of its economy, enforcing physical distancing, and closing its borders. But Chagla says the overall success of the measures speak for themselves.
“We’re not remembering the catastrophic scenarios where hospitals couldn’t handle all the patients and people were dying outside hospitals,” Chagla said on CTV’s Your Morning Friday.
The toll of COVID-19 in Italy and New York City illustrate what happens when “profound spread” overwhelms hospitals, and deaths mount among health-care workers and the young, he says.
But there have been serious costs to the shutdown.
Canada’s unemployment rate is 13.7 per cent and relief measures have cost the federal government more than $100 billion so far. A University of Toronto study says the economic upheaval could add more than 2,100 suicides to the national average by the end of 2021.
And a study published in the British Journal of Surgery in May predicted nearly 400,000 elective surgeries would have been cancelled or delayed in Canada by mid-June. It’s expected the backlog could take more than a year to clear.
Delayed surgeries and health screenings and the burden of social isolation and economic lockdown have been severe, but Chagla believes the lockdown measures enacted in March in Canada were wise, nonetheless.
There are major lessons out of COVID-19, says Chagla, who is an assistant professor of medicine at McMaster University. The first is the need for better management of supply chains and emergency stockpiles, especially of personal protective equipment and the reagents and swabs needed for testing.
The country also needed to do a better job of early testing and contact tracing, and should have closed down the border to the United States earlier, he says.
The most drastic lesson comes in preventing and managing outbreaks in long-term care, says Chagla.
“Many of us didn’t realized the breadth and how profound this would be, in terms of hitting long-term care.”
Chagla says hospitals have the built-in infrastructure to deal with infection control that aren’t applied in long-term care, where sick people are housed together, staff often aren’t using PPE correctly, and staffing levels aren’t appropriate to the needed level of care, says Chagla.
“And that’s the perfect storm. If the disease gets in the door, and it did through multiple care homes and it is still getting in through multiple care homes, it sweeps like fire and multiple patients get infected at any given time.”