Leading B.C. through COVID-19 pandemic fears

Although we've come a long way since the start of the pandemic, there are many issues in the near future that we still have to face

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      Imagine, for a moment, what the COVID-19 pandemic would have been like had the most common coronavirus symptoms been visible. Imagine what it would have been like if we had seen people—in person, on the street, in news articles, on social media—with physical signs of infection such as being covered in skin lesions, oozing bodily fluids, bleeding, or other visual symptoms.

      Would there have been as many conspiracy theories or accusations of hoaxes? Would there have been as much resistance to health measures such as closures, mask-wearing, and vaccinations? Would there have been as many young people disregarding the impact of the virus?
      Although there will always be conspiracy theories and doubts, it’s far more challenging to argue with visual evidence.

      Accordingly, with a disease that’s difficult to represent visually—with symptoms similar to other respiratory diseases and with many mild cases (particularly among younger people)—the pandemic has often remained a conceptual one for many people, including those who weren’t infected themselves or haven’t been around others who were. Consequently, we’ve relied heavily upon health officials and numbers to provide indications of where we are on the roller-coaster ride that’s been running for almost two years now.

      How seriously each person reacted to the pandemic depended upon numerous factors, including how each person perceived the threat level, which has varied greatly. On one end are people who still contend that the virus isn’t worse than the flu or isn’t as serious as authorities claim, that restrictions are part of government control schemes or that contracting the novel coronavirus isn’t as much of a concern as being unable to live “freely”. At the other end are those afraid that more needs to be done to prevent transmission, including border closures, mandatory masks and vaccinations, and enforcement of stricter, more protective measures. In between are the majority, with varying degrees of conscientiousness in following health guidelines.

      A common thread through all of this is how people react to and manage anxiety and anger. In the search for security and stability in an uncertain time, a focal point for much of that nervous energy and frustration has been health officials across the province and nation, including Canada’s chief public health officer, Dr. Theresa Tam; provincial health officer, Dr. Bonnie Henry; and Health Minister Adrian Dix.

      Take, for instance, the responses to an October 1 news conference when Henry, along with Education Minister Jennifer Whiteside, announced an expansion of the mask mandate for students from kindergarten to Grade 3. Social media lit up with criticism of Henry, ranging from those deeming mandatory masks to be child abuse to others who perceived the move to be inadequate to disagreement with and condemnation of a statement she made comparing the flu to COVID-19 (“We know that influenza, unlike COVID, can cause very serious illness, more commonly in children,” she stated). Henry has previously explained that she gets attacked from both ends of the spectrum, and her oft-spoken phrase of finding the right balance applies to figuring out how to manage the often conflicting demands of health and well-being, the economy, social needs, education, and more. And there's been no shortage of backseat drivers, armchair critics, and amateur researchers who purport to know more than the experts. 

      While questioning is necessary, it can also be taken to extremes. What has been most troubling is when forceful criticisms have veered off into disturbing territory. In the most extreme examples, the once-lionized Henry has faced threats of harm or death, which she mentioned in September 2020 and February of this year—with both Dix and Premier John Horgan condemning these attacks—and in her book, Be Kind, Be Calm, Be Safe: Four Weeks That Shaped a Pandemic, in which she described how she needed a security detail at her home.

      But there have been numerous other targets, too. There was the wave of anti-Asian vandalism and assaults that arose early on in the pandemic, despite victims not having any connection to the pandemic’s cause; tantrums, physical disputes, and verbal abuse of or assaults upon staff at stores and on ferries over mask-wearing; and protests held at hospitals and restaurants that have put lives at risk or targeted healthcare workers and service staff.

      Yet the situation continues to demand that we all figure out how to constructively focus on solutions if we’re intent on surviving and emerging from this pandemic or if we will remain impeded by confusion and conflict.

      More protests against emergency health measures in B.C. could arise in response to a number of imminent developments this autumn, including vaccines for children and third, or booster, doses.

      Navigating through darkness

      In the allegory of the cave by Greek philosopher Plato, a group of people imprisoned in a cave their entire lives develop misunderstandings about and misperceptions of the world because they had never experienced anything else. One escapes, emerges into the sunshine, and discovers what life is like beyond the cave, and is thereby obliged to share this enlightenment with the other prisoners.

      Even though not everyone may see it this way, health officials and scientists have been endeavouring to help us emerge from the cave of the pandemic, from the darkness of uncertainty toward living with COVID-19. Consider, for example, how far we’ve come since the early days of the pandemic, when very little was known about the virus. Remember when people washed all vegetables and grocery purchases with soap as a precautionary measure? Or products arose to help people open doors or press buttons without touching them? Or some people even resorted to burning down 5G towers due to beliefs that they contributed to the spread of the disease?

      But as with Plato’s parable about education—like how the cave dwellers mistook the shadows cast on the cave walls for reality—one of the biggest difficulties has been confusion about what to believe and who to listen to. Acquiring knowledge about the pandemic has been a work in progress, so health officials haven’t been faultless in their delivery of information. Although one of Henry’s strengths has been her ability to convey complex scientific information in a digestible way for the average person, not all of her logic has, despite repeated explanations, appeared to completely align.

      For instance, her stances on masks, particularly her reluctance to make them mandatory, have been perplexing at times. Although she has been consistent in maintaining that they aren’t the most reliable form of protection, she had argued in the past that masks can be counterproductive, particularly among children, because of people touching them and infecting themselves. Although she has since capitulated to public pressure to make them mandatory, what remains foggy is why wearing a mask—in reducing, at the very least, some transmission—wasn’t considered better than wearing nothing at all. (The Georgia Straight submitted requests for an interview with Henry but did not obtain one.) In addition, though both she and the B.C. Centre for Disease Control (BCCDC) have stated that surface transmission has been limited, hand-washing and the sanitization of surfaces is still recommended. The BCCDC states that “even though COVID-19 can survive for hours or days on different surfaces, infection from contact with contaminated surfaces appears to be rare”, but it still advises hand-washing, not touching faces, and cleaning and disinfection of all high-contact surfaces.

      Yet while there’s always room for improvement, we have only needed to look east or south throughout the pandemic to see how B.C. could be faring far worse.

      What lies ahead

      As we head into our second “respiratory season” during this pandemic, vaccinations mean we’re in a different position than this time last year—but we’re also operating with fewer broad restrictions in this go-round. What could impact our progress is if a variant develops that’s even far more vaccine-resistant; Henry has stated a few times at briefings that every transmission of the virus is an opportunity for it to mutate. Needless to say, one of the major concerns is how the healthcare system will hold up under additional strains, including any potential increases in healthcare-worker burnout as the pandemic drags on.

      There’s also the question of when or if a booster dose is necessary. That may depend upon when data confirms that COVID-19 antibodies disappear from the vaccinated—news reports on October 4 stated that a study of the Pfizer vaccine suggests that antibodies may last only seven months. In September, B.C. began administering third doses for the most vulnerable individuals, including the severely immunocompromised and long-term-care residents. Of the latter group, Henry has explained that older individuals sometimes don’t mount immune-system responses as strong as younger people, which explains why numerous outbreaks and deaths have continued in healthcare facilities despite all residents being fully vaccinated. As of October 4, the B.C. Health Ministry stated that there were 20 active outbreaks in healthcare facilities in the province.

      Then there are the potential conflicts. Third (and possibly other future doses) may also mean that the B.C. Vaccine Card program could be extended, which could also prolong resistance. Another imminent point of contention could arise when vaccinations are approved for children from ages 5 to 11. CBC News reported on October 4 that Pfizer and BioNTech are expected to formally file a submission for authorization of their vaccine for children later this month.

      Also, will there be a fifth wave? A sixth? Henry has often clarified that modelling data and graphs are “not a crystal ball”—they provide an idea of possible outcomes and probabilities—but she has also said that unexpected developments can mean “all bets are off”. Illustrating how things can change, several regions or countries that have been regarded as success stories in keeping case numbers low throughout the pandemic—Australia, New Zealand, Singapore, Taiwan, Vietnam—have been experiencing their largest surges, hitting hundreds and thousands in weekly case counts over recent months.

      The only certainties are that we know much more now than we did in the past, and we all are still forced to work together, whether we like it or not. The pandemic has highlighted numerous issues—social inequalities, violent resistance, the spread of misinformation—that will need to be addressed once the more immediate health concerns subside.

      Zooming out to the bigger picture, something else to consider is that as the human population continues along its exponential curve of growth while being beset by numerous challenges—from the climate crisis and collapsing ecosystems to resource depletion and ongoing territorial conflicts—this pandemic may be a precusor to other global crises that could rise in the future. We may have to consider the possibility that we may have seen nothing yet.

      You can follow Craig Takeuchi on Twitter at @cinecraig or on Facebook.