Wednesday, April 08, 2020

How has BC avoided the COVID-19 problems of Ontario and Quebec?

British Columbia, Canada's third most populous province, was one of the first provinces to register COVID-19 cases. Located on the west coast, and having a huge transplanted Chinese population, you might have expected it to have the worst coronavirus problem. But, both in terms of hospitalizations and active cases, BC has managed to "flatten the curve" more successfully than Ontario and Quebec.
New cases in BC have been pretty much flat for about a week now, at between 30 and 60 a day, while Ontario's  and Quebec's statistics continue to rise inexorably, to the tune of several hundred a day, almost a thousand a day in Quebec's case. The total number of cases in BC stands at 1,291 as at April 6th, with 43 deaths. This compares pretty favourably with 4,726 cases and 153 deaths in Ontario, and 9,340 cases and 150 deaths in Quebec.
So, how has BC achieved this? According to Chief Medical Officer, Dr. Bonnie Henry (yes the same Bonnie Henry that so successfully led Toronto through the SARS epidemic in 2003), it has been a mixture of good preparation and luck. Unlike other provinces, BC had a few early cases in January and February to prepare it, and it has also managed to avoid having a single "super-spreader", more by luck than judgement. But also, BC has a better, more integrated and better-funded, health system and epidemiology service, a model for the rest of Canada, with clear lines of communication to enable it to quickly scale up a unified response early.
One way this was exemplified was BC's response to the March Break period. BC recommended against all non-essential travel at that time, while Doug Ford in Ontario was telling people to "go away" and "have fun". Many of those Ontarians, and particularly Quebeckers, came back from places with much greater COVID-19 transmission, and proceeded to spread it round within the local community. It may have helped that Quebec's March Break (2nd March) was two weeks earlier than BC's (16th March), and so BC could learn from that bad experience. But Ontario's March Break was also 16th March, and Ontario apparently did not learn from Quebec.
But credit must also go to Dr. Henry herself. She has been a consistent and reliable presence on BC television, calm and assured, but frank and occasionally emotional. She made several good decisions early, like the decision to stop health care workers from working at multiple care homes, she recommended against pulling people out of long-term care homes, and generally kept up a unified response and messaging from day one.
That said, BC only reduced allowed gatherings to 50 on March 16th, the same date as Ontario, and Ontario later reduced that to 5 people. BC has also had more than its fair share of problems with people ignoring social distancing recommendations on beaches and in parks, but they seem not to have any lasting repercussions (at least so far).
Also, I do wonder - and I have no proof either way on this - whether the sheer number of Asians living in the Vancouver area has made mask-wearing more socially acceptable than in some other provinces. However, the wearing of masks is no more mandatory or even recommended in BC than anywhere else in Canada.
So, as Dr. Henry says, good preparation, but also a whole lot of luck.

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