Sask.'s COVID-19 plan is 'stupid' and will not contain pandemic, says health policy analyst
Saskatchewan health policy consultant Steven Lewis has watched from the relative safety of Melbourne, Australia, as COVID-19 infections, hospitalizations and deaths have spiked back in his home province.
The southern Australian city of five million people, where Lewis is currently living, is now COVID-free and in the process of lifting restrictions.
Lewis, who has advised governments in several provinces and countries, agreed to share his thoughts on Saskatchewan's rapidly deteriorating COVID-19 situation — which saw nearly 3,000 active cases and more than 100 people in hospital as of Monday.
On Monday, the province announced four more people with the virus had died and that Premier Scott Moe is in isolation after a recent potential exposure in the Prince Albert area.
Lewis said the three-month lockdown in Australia was difficult, but that residents generally agreed it was necessary. Those tempted to flout the rules were slapped with large fines.
Lewis said he isn't recommending an Australia-style lockdown, but that one thing is clear: the Saskatchewan government's "half-assed" approach will simply prolong the pandemic's devastating effects on people's health and the economy.
The following comments by Lewis have been condensed and edited.
On 'high-risk venues'
Lewis: It's crazy to allow bars and restaurants and gyms to stay open. They are known worldwide to be three sites where infections take off. Alcohol is a disinhibitor. Loud music makes people lean in and talk louder to be heard over it, expelling more droplets. People exercising strenuously breathe more heavily, sweat, expel.
On gatherings
All mass gatherings, including church services, weddings, funerals, should be locked down, and [there should be] very strong prohibition of socializing at home with non-family members.
On mandatory masks
At least [Saskatchewan] has mandatory mask wearing indoors in public spaces. But responding too late can't be undone. It may be useful prospectively but the numbers got bigger than they had to.
On enforcing the rules
I don't have strong enough evidence to suggest cause and effect, but enforcement appears to matter.
Here in Victoria [Australia], population 6.5 million, since March the police have issued about 25,000 tickets for COVID non-adherence violations, at an average of about $1,200, which is pretty steep. I do think this, combined with the 8 p.m. curfew that was in place for weeks, was a deterrent for young people.
What we've learned is that even if messaging is well-done and broadly effective, a small number of non-adherers can spark a new cluster that quickly expands. When 95 per cent adherence isn't good enough, you cannot rely on moral suasion or appeals to civility.
On contact tracing
Once numbers get beyond double-digits per day, contact tracing becomes virtually useless. It's just too labour-intensive, people may not have good recall, and there is still stigma and suspicion of authority, so people may not disclose their contacts.
On testing
Canada is still terrible at testing.
Slovakia tested just about the entire adult population in a weekend and then repeated a weekend later. They found about a 1 per cent positive rate the first weekend and directed the infected to isolate. The positive rate the second weekend was a lot lower, no doubt because the first one removed the positives and kept them out of the population.
My understanding is that it is still hard for asymptomatic people (in Canada) to get a publicly provided test and the results take days rather than hours.
On the Saskatchewan government's 'slowdown' plan
[Health professionals] have I think justifiably hammered the government for it's half-assed and complicated approach.
It is increasingly clear that you can't slow-walk the pandemic with a fine-tuned balancing act that keeps the economy humming while keeping daily case rates at a predictable and low level. It's too volatile, there are too many asymptomatic transmissions, and there's too big a time-lag between when you are infected and when you know you are.
So you have to come down hard and fast and universally to flatten the curve quickly. If you have to stop and start and stop and start, it's just as disruptive for businesses and the pain is prolonged.
Bottom line: Saskatchewan has been tested by the second wave and largely failed. It was stupid to differentiate between urban and rural Saskatchewan [on mandatory masks] and it's really stupid to keep known high-risk venues open. The virus doesn't care if you're going to a bar or to church. It's going to bite people in both places if you keep them open.
