Geography, leadership and sheer luck: Why B.C. and N.B. flattened the curve so quickly
TORONTO -- As more restrictions are loosened in provinces across the country, Canadians are beginning to feel some respite from the COVID-19 pandemic.
Yet while some of the worst-hit provinces, including Ontario and Quebec, continue efforts to flatten the curve, others seem to have emerged on the other side of the outbreak faster and better equipped to handle the second wave many experts expect to hit in the fall.
British Columbia, the province whose initial community-spread outbreak was considered the first in the country, lifted lockdown restrictions three weeks ago.
Hair salons, gyms and even schools are back in session thanks to a steady decrease in cases, a success experts say is linked to aggressive testing and tracking of early cases.
Meanwhile, officials in New Brunswick have cited the province’s small size, spread-out rural population, and widespread public compliance as reasons for its relative good fortune amid the pandemic.
But experts say while sheer luck may have something to do with it, both provinces are shining examples of how quick decision making and strong leadership is needed for effective public health response in times of crisis.
“B.C. and New Brunswick got lucky in some ways, but what we can learn from them is a consistent, central, competent public health voice; clear, consistent, modern public health dataflow; and, early competent and hard public health measures put in place,” Dr. Raywat Deonandan, an epidemiologist at the University of Ottawa, told CTVNews.ca by phone Friday.
“It was a kind of ragged, inconsistent, and grudging way in Ontario and Quebec, whereas B.C. showed strong leadership early on and they are reaping the dividends now.”
‘STRONG, COMPETENT PUBLIC HEALTH VOICE’
B.C., in particular, has a secret weapon: Dr. Bonnie Henry.
The province’s health officer, lauded by the New York Times as “The Top Doctor Who Aced the Coronavirus Test,” has been praised internationally for her response to the outbreak.
“B.C. had one strong, competent public health voice, Dr. Bonnie Henry, and she as a figurehead has been quite strong in all this, and everyone goes to her for leadership in this matter,” Deonandan explained.
“In Ontario, we've had a variety of voices. We have multiple press conferences, sometimes giving conflicting information.”
Under Henry’s direction, B.C. implemented a testing strategy and enforced social distancing orders faster than other provinces, allowing them to get ahead of the curve.
Officials also quickly cracked down on health-care workers travelling between different long-term care homes in B.C., quelling the severity of the outbreaks that have plague homes in Ontario and Quebec.
The province has also demonstrated better data transparency in reporting the number of COVID-19 cases, whereas the data pipelines in Ontario “are a little clogged, for lack of a better word,” Deonandan said.
But Henry’s leadership and genuine care about the safety of residents, demonstrated in her tear-filled remarks, also instilled a sense of trust that may have helped with public co-operation.
“She has earned the vocal trust of physicians and other health officials and the province at large,” Tom Koch, professor with the University of British Columbia's Department of Geography, told CTVNews.ca by email.
“She showed a superb ability to communicate the facts about the infection and its dangers, and what people should do to combat it, in a way that was generally understood and accepted.”
New Brunswick also had a leg up geographically.
“New Brunswick got lucky in that many older, vulnerable population was more rural,” explained Deonandan, a luck factor that health officials themselves pointed to as a reason for their success.
Less international traffic through the province’s airports may have also played a role, Deonandan added.
WILL THESE LESSONS BE PUT TO PRACTICE IN THE EVENT OF A SECOND WAVE?
Despite B.C. and New Brunswick’s fast, effective approach to the first wave of COVID-19, experts have mixed feelings about whether or not this will bring about change, especially in Ontario -- a province that failed to learn from previous outbreaks.
“We experienced SARS in Ontario 17 years ago, heard many of the same lessons, and did not act. A good example of this is modernizing the data collection system or surveillance system,” said Deonandan.
“Back in the SARS days, we were using fax machines to send case information from public health units to the central offices. And guess what? We still are. That was identified as something a need to modernize, and steps were taken early on but were abandoned.”
Though he remains skeptical that issues of data transparency will be resolved before the next potential wave of COVID-19, Deonandan says the easiest fix for health officials nationwide is to concentrate on effective, consistent communication.
But this isn’t just a Canadian issue. Referring to the coronavirus pandemic as a “crisis in clear public health communications,” Deonandan notes that even the World Health Organization (WHO) has come under fire for poor communication regarding the virus, even walking back statements made by officials during press conferences.
Most importantly, experts agree that Canada should invest heavily in disease surveillance at federal and provincial levels to be better prepared for future outbreaks.
“Once an epidemic becomes entrenched the time it takes to not simply ‘flatten the curve’ but outlive the microbes’ lives,” explained Koch. “Depriving them of new hosts takes time.”