Fix Our Failed Health System Instead of Protecting It With Lockdowns

March 22, 2021 Updated: March 22, 2021

Commentary

New variants of SARS-CoV-2 hit England last fall. Over 70 percent of those infected in England’s second wave tested positive for the more-lethal B.1.1.7 variant. As the National Health Service struggled, the government responded with stay-at-home orders, school closures, and strict non-pharmacologic interventions.

New research on the variants hit the scientific press this month and are causing concern in Ontario. Increased risk of death and higher rates of transmission seem destined to overwhelm the health-care system.

Although Canada faced a lighter burden of disease, some regions have been hit hard. Caring for critically ill patients weighs on clinicians at any time. Trying to manage preventable suffering in crowded hospitals can lead to despair.

Alarm about the new variants is right, but often for the wrong reasons. And the wrong people are becoming alarmed.

Worry About the System, Not the Virus

Canadian health care has struggled every winter for decades. Medicare left over a million people on waitlists long before COVID. The pandemic made it worse. For the most part, COVID has not made people panic about the system—it has made them panic about catching the virus.

It has been a full year since the pandemic began, during which time the system could have been fixed, but leaders continue to employ lockdowns to protect a failed system. Politicians seem to manage the pandemic by handing over management of government to public-health officials. At some point, politicians will need to take back leadership and attend to the rest of their mandate.

At the peak of wave two, Ontario had 1,600 hospitalized patients with COVID. Premier Ford added 3,100 new beds in 2020. If we took all the new beds, built one giant COVID hospital and put all the COVID patients into it, the hospital would be just over half full.

But perhaps fresh research on the new variants warrants more lockdowns?

New Data, Finding Perspective

Scottish historian Thomas Carlyle called statistics “the dismal science.” Most people hate it for good reason. But we must dip our toe into the statistical pool to see past the headlines.

The British Medical Journal (BMJ) reported a 64 percent increased risk of death from the new variant B.1.1.7. Nature estimated close to the same: 61 percent.

A 64 percent increase in anything sounds significant, especially death. However, data points mean little by themselves. Even a 100 percent increase in a tiny number is still a tiny number. If we look more closely at each article, we find a big increase in a very small number, which remains “relatively” small.

On March 10, the BMJ noted that variants carry a 64 percent higher risk of death, but the risk was still “relatively low.”

“[T]he most probable hazard ratio estimate [is] 1.64, or a 64% increased risk of death. The absolute risk of death in this group of community-identified participants, however, remains relatively low, increasing from 2.5 to 4.1 deaths per 1,000 cases,” it stated.

On March 15, Nature reported that the new variants are more transmissible and make people sicker.

“[An] … absolute risk of death for a 55–69-year-old male increasing from 0.6 percent to 0.9 percent (95 percent CI 0.8–1.0 percent) within 28 days after a positive test in the community,” it stated. “[W]e estimate a 61 percent (42–82 percent) higher hazard of death associated with B.1.1.7.”

The males in the study had a 1 in 167 chance of dying from the old variants, and a 1 in 111 from the new. By comparison, males have a 1 in 5 lifetime risk of dying from cancer. The new variants are worse but cannot compare with other health risks.

What About Lockdowns?

In February, Dr. Ari Joffe, critical care doctor and member of the health ethics centre at the University of Alberta, publishedCOVID-19: Rethinking the Lockdown Groupthink.” He referenced 275 articles in his review.

Dr. Joffe suggests lockdowns rest on three false assumptions: that they work, that the benefit outweighs the risk, and that they are the only option. But data do not support these assumptions. Dr. Joffe shows that lockdowns offer marginal benefit, if any. They carry up to 10 times the risk, and far better options exist, such as focused protection based on core principles of emergency management. He suggests we focus on preventing the most harm to the whole society rather than focusing on preserving health-care capacity as the only goal. The ministry of health has many ways to build surge capacity; it should pursue these and prevent another shutdown.

Ontario now has the new variants, and numbers are climbing fast. Even small bumps in hospitalized patients threaten the system. Sunnybrook Hospital put up field hospitals, which seems appropriate. Will they prevent stay-at-home orders? Will public health advocate for anything less than a lockdown? Will politicians resume their role of watching everything else, instead of focusing only on COVID?

We shall see. But unless voters push back, we should prepare for wave three and more inevitable lockdowns.

Shawn Whatley is author of the new book, When Politics Comes Before Patients: Why and How Canadian Medicare is Failing. He is a physician and a senior fellow with the Macdonald-Laurier Institute.

Views expressed in this article are the opinions of the author and do not necessarily reflect the views of The Epoch Times.