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Ford’s declaration of COVID defeat isn’t justified by lack of beds: Shawn Whatley in the Toronto Sun

January 4, 2021
in Columns, COVID-19, Domestic Policy Program, Health, In the Media, Latest News, Shawn Whatley
Reading Time: 4 mins read
A A

The hospital crisis is not new. COVID adds a new twist. Real solutions require more than lockdowns and emergency measures. Yet here we are again. After ten months of preparation, calling for lockdown seems an admission of failure, writes Shawn Whatley in the Toronto Sun. 

By Shawn Whatley, January 4, 2021

COVID-19 has tested the Ford government, and Premier Doug Ford has mostly risen to the challenge. Live daily updates, plans, programs, and spending: It has been the main (only) policy issue for ten months. Ford’s COVID-19 response will define his legacy.

Ontario now has 2,250 new acute care beds, which include 1,492 new ICU beds with ventilators. Spring shortages have disappeared. PPE abounds. If the mood strikes, you could bathe in alcohol hand sanitizer, and no one worries about running out of toilet paper. A massive vaccination program has just launched, and untold hundreds of millions of dollars have distracted voter anxieties.

Yet after all this success, and more, Ford is declaring defeat, issuing another complete lockdown this week.

What evidence informs his decision? Are Ontario’s 3,504 critical care beds all full? Have COVID patients flooded Ontario’s roughly 24,000 acute-care hospital beds?

In the spring, the province shut down to flatten the curve and protect the health-care system. We needed time to build capacity, spread out demand. The first wave was sharp and short. At the peak, roughly 1,000 admitted COVID patients per day populated a curve that looked much like other epidemics. Most hospital beds remained empty and ICU beds unused.

Now, ten months later, we have hit 1,000 COVID patients in hospital again. Almost 270 of those patients are in ICU, approximately 180 on ventilators. But unlike the spring, we have 2,250 new hospital beds. If the beds were one giant COVID hospital, it would be less than half full of COVID patients today, and over 80% of the ICU would lie empty. My own almost-500-bed hospital on the outskirts of Toronto has only 20 COVID cases on the ward, five in ICU. We could care for over 80 ICU patients if necessary.

So why is the entire province facing a brutal provincewide lockdown over the ordinarily festive Christmas season?

Politicians are vote maximizing machines, so we cannot blame them for following votes. Given all the media concern about case counts, who would vote against lockdown? Salaried hospitals workers love lockdowns. It makes life so much easier and less risky for the same amount of effort. White-collar workers love them too. Why commute when you can telecommute for half the cost and none of the risk? Civil servants love lockdowns secure in their jobs, programming on hold.

To this, point, these groups have swayed politicians, winning the media debate over concerns about the economic devastation, the plight of customer-driven small businesses, isolated people suffering without family, and those who would emphasize a more sensible risk-benefit analysis that preserves individual freedoms to conduct business and personal affairs safely.

Part of the premier’s previously successful pandemic strategy was to accept that the pandemic situation varies greatly across this massive province. Colour-codes were assigned. Areas such as Ottawa and Eastern Ontario had lighter restrictions based on their manageable level of spread.

Without question, some regions suffer more, and in parts of the GTA stricter controls might be required. But a crude, provincewide lockdown has been applied everywhere. Once again, the premier declares defeat in the face of victory.

Over 95% of COVID deaths occurred in patients over the age of 60. More than 80% of deaths occurred in LTC patients. COVID kills the elderly. Will a provincewide lockdown protect them? Will it keep LTC patients safe? Or do we need more drastic measures for LTC but less drastic for everyone else? Maybe we need to quarantine and isolate LTC staff in two-week shifts, creating COVID-free bubbles like professional sports teams.

Disasters require leaders trained in disaster response. Politicizing a disaster guarantees a politicized response. Politicians and public health doctors have designed new disaster plans with each wave, with comments from critical-care docs for good measure. If COVID-19 is a true disaster, then we should have a broad-based, multidisciplinary disaster response team to weigh all the risks, without trying to mitigate only one.

Even before COVID, some hospitals were in a state of emergency due to overcrowding. This is not new. Going into COVID, Ontario had only 2.4 hospital beds per 1,000 residents, eighth lowest among 42 OECD countries. Japan has 13.1 beds per 1,000, South Korea 12.3, Russia 8.1, and Germany 8.0.

We need more beds, but more lock downs will not deliver them. If hospitals have too few beds or staff, then hospitals must cancel surgery and delay treatment. This is harsh, but nowhere near as harsh as a provincewide lockdown.

The hospital crisis is not new. COVID adds a new twist. Real solutions require more than lockdowns and emergency measures. Yet here we are again. After ten months of preparation, calling for lockdown seems an admission of failure.

Shawn Whatley is a physician, past president of the Ontario Medical Association, and a Munk senior fellow at MLI. He is author of the book titled When Politics Comes Before Patients—Why and How Canadian Medicare is Failing.

Tags: COVIDHealthHealth PolicyhealthcareShawn Whatley
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