Bloomburg – Virus Fight Behind North America’s Lowest Death Rate: A Doctor Who Fought Ebola

By Natalie Obiko PearsonMay 16, 2020, 4:00 AM PDT

The outbreak came early to British Columbia, in January, and public health officials braced for the worst. Now the Canadian province has one of the lowest death rates in North America.

“I thought we were going to be dealing with something unprecedented in that region specifically, but then it didn’t happen,” said Jason Kindrachuk, a virologist at the University of Manitoba.

British Columbia’s success story shows how tried-and-true methods — when paired with strong public health agencies — can have sweeping impact, according to Kindrachuk and other scientists. Many governments embraced technology, with the U.K. using drones to help police enforce lockdowns and South Korea tapping location data from mobile carriers and credit-card transactions to track infections.

B.C. stuck to old-fashioned basics, alerting primary care doctors by fax about how to be on the lookout for the novel pathogen and tracing potential transmissions through interviews. Data compiled on May 13 show the province’s Covid-19 death rate was 3 per 100,000 residents, better than almost anywhere in North America and much of Europe.

It’s Doing Something Right

British Columbia’s Covid-19 death rate is among the lowest.

Sources: John Hopkins Coronavirus Research Center, Public Health Agency of Canada, U.S. Census Bureau, Eurostat, Statistics Canada

*Covid-19 deaths as of May 13. Population estimates for 2019. Select regions with more than 5 million people.

Local officials would be the first to say that luck surely played a role. But British Columbia also had stockpiles of equipment along with the benefit of a public-health system making communication and coordination smoother than in U.S. states. And it had a provincial health officer, Dr. Bonnie Henry, with the power to order doctors and hospitals to take certain steps, such as canceling elective surgeries, which she did early on to free up beds.More FromPrognosisU.S. Cases Up 1.8%; Italy Speeds End of Lockdown: Virus UpdateItaly’s Conte Says Taking Calculated Risk in Easing LockdownExperts Doubt Mexican Government’s Claims on Falling CurveCuomo Reports Sixth Day of Deaths Below 200; Racetracks OpeningREAD MORE FROM PROGNOSIS 

Henry’s soft-spoken authority — she’s on TV every day, often repeating her mantra, “Be kind, be calm, be safe” — won over British Columbians. When her favorite local shoe designer offered a limited edition Dr. Bonnie Henry Mary Jane heel ($240 a pair with all profits going to food banks), the website crashed.

“She was able to galvanize the public across British Columbia to understand that this was something new and very different,” Kindrachuk said.

Bonnie Henry GETTY sub
Bonnie HenryPhotographer: Don Mackinnon/AFP via Getty Images

Like other countries, Canada has an uneven history with infectious diseases. In 2003, the country’s first SARS cases appeared at hospitals in Vancouver and Toronto on the same day. Vancouver quickly contained transmission, while Toronto would suffer the worst outbreak outside Asia.

An independent commission later noted that Vancouver’s public health system had swiftly put emergency rooms and physicians on the lookout for unexplained fevers and immediately scaled up protective gear for health workers.

In Toronto, Henry, then that city’s associate medical officer of health, tried to issue warning of the emerging SARS epidemic in Hong Kong, but her office’s email-distribution list wasn’t extensive enough and many doctors missed the alerts.

In British Columbia, she became the top health official in 2018 and has been in charge of the province’s rapid mobilization to contain the virus. Within days of Chinese researchers releasing the genetic sequence of the virus on on Jan. 10, the province became one of the first in the world to develop a test. A week later, before Case One in B.C. emerged on Jan. 26, it had the chemical reagents necessary to carry tests out, said Reka Gustafson, deputy provincial health officer.

Early testing helped the province pounce on transmissions before they spiraled, crucially at long-term care facilities. Canada has the highest share of Covid-19 deaths in care homes, according to an international study of 13 countries published on May 3, a disturbing distinction fueled by facilities in Ontario and Quebec that have been ravaged by the virus.Michael Schwandt@MichaelSchwandt

If anyone tells you that massive and deadly #COVID19 outbreaks in #LongTermCare are “inevitable,” please tell them otherwise. We’ve managed 17 LTC outbreaks in Vancouver Coastal Health and have developed some useful measures, which we think are life-saving. 1/

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British Columbia commandeered nursing homes at the first sign of infection, barring visitors. Employees were forbidden from working at more than one facility, a move other Ontario and Quebec didn’t make until later in the crisis.

The ability to manage nursing-home outbreaks played a key role in limiting deaths in B.C., said Patricia Daly, chief medical health officer for Vancouver Coast Health, one of the regional public-health authorities. “We could get in and get in front of it.”

Some steps defied the prevailing wisdom at the time. The province didn’t attempt the mass testing South Korea did and, unlike the government in Wuhan, China, didn’t aggressively hospitalize those confirmed positive, sending 80% of cases home to recover.

Henry has become the public face of the crisis. A former military doctor who helped track down Ebola infections in Uganda earlier in her career, she also personally handled the contact tracing of Patient Zero’s family in Toronto’s SARS outbreak.

“She’s really been trained for this,” says Perry Kendall, her predecessor. “She’s not scared of giving orders.”

British Columbia’s top politician, Premier John Horgan, has taken a back seat in the public eye; it’s Henry who presides over daily briefings.

That has been key, said Peter Berman, a public-health expert at the University of British Columbia. “The same scientist who was empowered to lead this effort also has the authority to issue instructions.”

Henry is the first to caution against complacency. “We don’t know what is going to happen with this virus,” she said at a recent briefing, where she underscored how the province could quickly lose all the gains it’d made by easing restrictions too far. “We need to hold the line.”

Isolation

We’re all in this boat together. Like it or not!

During this coronavirus I have been pretty much contributing very little or better said, nothing, to the blogosphere about the pandemic, and how it is affecting my life, or for that matter, how it affecting anybody or anything.

It’s not that I don’t have anything to contribute to the conversation. It is that this thing is a really, really big deal, and I don’t want to diminish its importance to anyone by failing to reflect just how important it really is, to me, and to the world around me.

To those out there who believe that the government is overstating the dangers of Covid 19, and they can cheerfully go on about their business without changing anything, well, thanks for less than nothing, since your ignorance may already be having a serious effect on the lives and well being of thousands of people, some right in your own neighbourhoods, some physically a long ways away. Like maybe even in other countries or even continents.

Like it or not, failing to self isolate yourself is reckless endangerment, and potentially, mass suicide/murder.

Canada’s Healthy Minister Patty Hajdu

You see, normally I’m a skeptic when it comes to government health warnings, and generally dismiss most as merely propaganda to serve the interests of an overbearing nanny state.. Not this time, not now and not ever. This virus kills people, lots of people, including people like me, with immune deficits that mean infection will mean a ferocious battle for my very life.

If I’m really lucky, most people in my own area, Vancouver, British Columbia and Metro Vancouver will have been helping the Provincial and Federal governments by isolating themselves at home as much as is humanly possible, and help slow the disease so that by the time I get it, there will still be hospital resources available, and I’ll get whatever it is I need from medical treatment whether it includes Intensive Care, Respirators or other devices. Hopefully there won’t be so many of us sick at one time that the system simply collapses after being overwhelming by the demand created by our citizens being unwilling to do what it takes to flatten the curves, or plank it.

Because isolating ourselves doesn’t necessarily mean that people like me who are vulnerable in the extreme won’t get it. It might, if I get incredibly lucky, and it passes me by. But most scientists believe that eventually this virus will infect somewhere between 50 and 70% of people in the world. The only real question is whether or not society can slow down the spread to give medical professionals and researchers the time to effect solutions that will reduce the numbers of us that are going to die as a direct result of the Covid 19 pandemic.

Even if everybody does everything right, and socially isolate themselves, a lot of people are going to die from this disease. No matter what we do this is true. All ordinary people can do is take whatever precautions are available to allow treatment by skilled professionals to those of us who catch this damn thing, under circumstances that increase the odds of finding an effective treatment and a vaccine that stops it dead in its tracks.

Neither of these is guaranteed, but we have a hell of a lot better chance if we all follow the best advice. Stay at home and socially isolate yourselves. Help our front line defensive workers, like nurses, doctors, researchers survive and get their work done for all of us.

Don’t be stupid. Wake up. Sometimes you just have to listen, and do whatever the hell somebody who knows a lot more than do you, tell you. Now.

Certainties

There are only two certainties in life. Death. And, Oh Ya, that other thing, whatever it is. I think maybe it’s called extreme anxiety.

For a lot of us right now, one of the biggest anxieties is about whether or not you or someone you love is going to get the coronavirus and die a horrible painful death. Can you imagine if you carried that level of anxiety about your health with you every day of your life?

This is precisely how I and many other people with serious chronic illness or pain live every day.

Waking up to a good day, when I’m not in so much pain, or simply in less pain, would be a good reason to celebrate. Or so you would think, but it isn’t necessarily so. If I’m not in serious pain right now, I’m probably super anxious about when it will start up again, since it’s seldom very long until the next session. Can you imagine being so fearful of your next bout of pain that you can’t ever be rid of the sense of dread that hangs over you.

And people who come in contact with me try to cheer me up by saying something like, “Don’t worry it, it can’t last forever, can it?” “Just get over it, you’re too obsessed with it.” As if I, someone with serious chronic pain wouldn’t part with anything I have to make it go away. And, well, yes, it can bloody well last forever, well, at least until I die from it, or some other condition that doesn’t happen to hurt, right now.

If I seem focused on feeling sorry for myself, just leave me alone. If you just can’t provide some comfort to me, exactly as I need it right now, then please get out of my face. I hardly need you to tell me to cheer up. And if you can’t handle it to see me suffering in pain, then just don’t. Leave. Piss off.

For me, and a lot of people with chronic pain, the coronavirus is just more thing to worry about, and make me more anxious about everything I have to do, everybody I have to see, and also more fearful about being able to obtain the bare necessities of life.

As if there isn’t enough to stress out about already, without the Damned Tsunami Pandemic, sweeping over the whole world.

To someone with a serious disease and chronic pain, death isn’t the scariest thing, it’s just the most certain.