Canada’s first death from a coronavirus infection was confirmed Monday as news broke that some provinces are running short of medical supplies. As of Tuesday evening, there were 86 officially confirmed coronavirus infections across four of the country’s ten provinces and three territories: 32 in British Columbia, fourteen in Alberta, 36 in Ontario, and four in Quebec. However, Chief federal medical officer Dr. Theresa Tam has warned that these figures likely lag behind the reality on the ground in each province.
Canada’s first COVID-19 casualty was a man in his 80s who died at the Lynn Valley Care Centre in North Vancouver, British Columbia on Monday. He had a number of underlying conditions. The virus was first contracted by a worker at the care home in the local community and has since spread to another nursing home resident. B.C.’s chief medical officer, Bonnie Henry, described the spread of COVID-19 at the care home as an “outbreak.”
In a separate development, 228 Canadians who had been holidaying on the Grand Princess cruise ship off the California coast were repatriated to Canada yesterday. Foreign Minister Francois-Philippe Champagne said that “a handful” of Canadian crew members tested positive for COVID-19 and were left in the United States for treatment. Six cases out of Canada’s total resulted when passengers on an earlier leg of the Grand Princess’ voyage were infected. Officials have advised against any travel on cruise ships due to the ease with which the disease can spread among passengers.
Federal Health Minister Patty Hajdu conceded Monday that provinces are already running out of basic medical supplies to treat patients, including face masks, eye shields, gowns, gloves, and ventilators. “We are very alive to the fact that some provinces are indicating that they have deficits,” said Hajdu, “and we are gathering that information and we have said all along that we will be there as a federal government to support them with the resources they need, whether those are financial resources or practical resources.” Deputy Prime Minister Chrystia Freeland addressed a letter to Canada’s premiers urging them to provide updates to the federal government on medical supply shortages prior to a meeting of federal and provincial government first ministers scheduled for Friday.
The news that some provinces are already running out of critical medical supplies despite the relatively low number of confirmed infections to date illustrates how ill-prepared Canada’s healthcare system is to deal with the looming epidemic. Successive governments at the federal and provincial levels have implemented austerity budgets for healthcare and other critical social services for years, including the current Trudeau Liberal government. Health transfers from the federal government to the provinces have risen by a miserly 3 percent per year over the past four years. This “increase” barely keeps pace with the inflation rate, never mind population increases and the growing demands on the healthcare system produced by an aging population.
According to epidemiologist David Fisman, coronavirus will infect between 35 and 70 percent of the Canadian population, depending on the extent of public health measures taken to combat the disease. Even at the lower end of this spectrum, this would mean some 12 million people would be infected. Fisman bluntly warned in an email to the National Post, “That’s still a huge number of people ill, and critically ill people are a large fraction in this disease. I’m not going to share more specific numbers because I think they will scare people to no particular end.”
In Alberta, doctors are already criticizing a lack of emergency planning, while nurses in B.C. say they are already working short-staffed prior to a large-scale outbreak.
“We have scenarios where there are more people requiring ICU beds than there are acute care (hospital) beds in Ontario at peak,” added Fisman. Paul-Emile Cloutier, president of HealthCareCAN, an advocacy group for hospitals and other medical facilities, noted that many hospitals are already operating well beyond capacity, with some running at 120 percent, prior to a large-scale coronavirus epidemic.
In Ontario, for example, recent research by CBC found that hospital gridlock, normally associated with patient surges during flu season, has become the “new normal.” Five hospitals in the Greater Toronto Area, as well as the main hospitals in Hamilton, Peterborough, Sudbury, and Niagara Falls ran over capacity for more than 160 days during the first 181 days of 2019, according to the research, which was based on data obtained in a freedom-of-information request.
In an interview with the Toronto Star, Cloutier criticized claims by federal politicians that the healthcare system has everything under control. “We know as experts and as people who work in the system, it’s not all under control,” he said. Another HealthCareCAN official remarked that a vast amount of work is required to scale up levels of coronavirus testing, both for patients and healthcare professionals.
Inevitably, those most at risk are the poorest sections of the population. Most of Canada’s largest cities, including Toronto, Montreal, and Vancouver, have homeless populations running into the thousands. Most homeless people lack access to soap and water so they cannot regularly wash their hands, as the entire population is being advised to do to mitigate the spread of the virus. Nor will they be able to follow the two-week self-isolation guideline if they come into contact with the virus. The same is true for millions of workers across the country who lack sick leave benefits or cannot afford to take time off work for fear of losing their job.
Dozens of Native reserves across Canada are under boil water notices at any given time, and many more lack even the most rudimentary healthcare services.
The federal and provincial governments are now seeking to reassure the public with hollow pledges that they will procure the medical equipment needed to overcome the shortfalls their years of austerity policies have produced. Such pledges only serve to underscore that they have been criminally negligent, failing to take advantage of the two-month window China’s efforts to block the spread of the virus afforded them
This negligence is all the more damning given that it takes place in a country that was roiled by the 2003 Severe Acute Respiratory Syndrome (SARS).
Outside of the Asia-Pacific, Toronto was the city worst impacted by SARS, with at least 32 in the Toronto region succumbing to the SARS virus. Even before the outbreak was over, information emerged that showed the spread of SARS was directly attributable to the devastating healthcare-spending and hospital-staffing cuts that had been implemented by the federal Liberal and Ontario Conservative governments (see: “SARS outbreak exposes public health decay in Toronto”)
In an indication of the utter lack of planning and preparation for another epidemic, Ontario health officials confirmed to Reuters Monday that 55 million N95 masks stockpiled by the province to protect healthcare workers in a crisis have passed their expiration date. As early as December 2017, a report by the province’s auditor general revealed that 80 percent of the stockpiled masks had passed their expiration date. Yet nothing was done to replace them. Asked directly by Reuters whether any masks remain on hand, Ontario’s Health Ministry avoided providing a definite answer.
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[6 March 2020]