Comment
Faith and fact
I confess to losing my grasp on the COVID- 19 messaging of late. Part of it is surely fatigue. And part it is likely a reaction to the rising numbers and the prospect of a dark winter of isolation. But part of it is driven by the nagging feeling that we should have better information by now, with better tools to manage the virus in our own lives, in our own circumstances.
Most fair-minded Canadians agree our governments at all levels—federal, provincial and municipal—responded well to the outbreak of the coronavirus pandemic. Each moved quickly to lock down our lives to alleviate the risk of overwhelming our healthcare capacity and, in particular, the folks who deliver these services. Governments moved rapidly to put in place financial supports to ensure we had an economy to return to once the worst was past. And should we get a vaccine approved by the end of the year, this all may be a strange collection of memories by next summer. The messaging, however, has been a bit wobbly from the start. Some of it was contradictory. Some turned out to be wrong.
And even that is okay. We are battling an unseen and ferociously virulent enemy, and we had little experience in countering such a widespread pandemic. As our understanding changed, the message changed. Fair enough.
But eight months have slipped away. Shouldn’t we have better information about how this disease spreads by now? And a better idea of changes in our behaviour that will affect it? Better measures to assess risk?
To be clear, there is plenty of evidence—experiential and data—showing that masks and social distancing have helped to limit the spread. But beyond that, we are still operating mostly on faith in authorities to guide us the right way. I prefer evidence.
Ten folks have tested positive for the virus in Belleville over the past 14 days. Seven in Quinte West. That is a third of the cases between March and August in the entire Prince Edward Hastings Public Health (HPEPH) unit region counted in the past two weeks in these two communities. Of these, nine were identified as caused by close contact, six by local spread and two by travel. None have been hospitalized. But beyond these basic facts, we know little about this recent flare-up in Belleville. The information provided by the HPEPH COVID- 19 dashboard was great in April and May. But it hasn’t evolved.
I have no wish to intrude upon privacy concerns, but surely, we can know the neighbourhood in which most recent cases reside. Shouldn’t we know their intersections with public spaces like malls, schools, churches, seniors’ residences, restaurants and gyms? Or demographic information? How old are they? Gender? Pre-existing conditions? The HPEPH dashboard does provide basic age info, but it is on a cumulative basis since the pandemic began. Given the recent spike, it seems vital that we understand this new cluster better.
A fair question might be: What will we do with this information? On a purely personal level, it might guide our decision about where we will go—or not. It might nudge us to stay wide of those intersections—perhaps more effectively than another plea from a government official. It might also—and stay with me on this—ignite the hive mind, inasmuch as collectively we might find patterns that even the most brilliant, motivated and dedicated team of experts might overlook.
One example shows why this might be useful. A growing number of folks are urging more exploration of the clusters of infections. They suggest, in this overly simplistic description, that the primary vector (or patient zero in a cluster) may be a rather important way of understanding how the most lethal forms of this disease spread. They point to the Lombardy region in Italy, where 17,000 of Italy’s 36,600 COVID-19 deaths have occurred. The notion is that a simple test—even if less sensitive form— that we can take at home may help identify that vector patient more quickly and improve our overall response.
There may be nothing here. But the point is that we ought to be empowering folks, rather than herding them into submission with the hammer of another lockdown looming over their heads. It seems an awfully clumsy and unsophisticated tool this far into the pandemic
And for those preparing and delivering the messages— the test for transparency and evidence is only going to increase as we head into the winter months. When the premier decrees that restaurants can stay open, but only until 11 p.m., it feels random and paternalistic. There may be good evidence behind it. If so, push it out. Make it available to everyone. When the province cancels outdoor trick-or-treating, but permits indoor church services, it feels contrived. The contradictions and hypocrisies are likely to continue to pile up.
It is a tough job guiding a nervous herd through an unknown swamp—and I have no wish to undermine what has been earnest and good faith efforts by health unit officials and governments. The herd, however, will only stay together to the extent it believes authorities are acting on the best science and information. As time passes, our expectations for transparency and straight information necessarily rises. What was an act of faith in March requires a bit more of a factual foundation in October.
This means authorities will need to trust the average citizen with more information. More data. This may be challenging. It may seem a low priority.
Get over it. We need the herd to stay together.
Comments (0)